Worrying About Treatment May Lower IVF Success The Beginnings of Obesity Acne Drug Warning Smoking During Pregnancy Increases the Risk of Testicular Cancer in Offspring Weight Only One Diabetes Risk Factor Chlamydia May Cause Infertility in Men

Worrying About Treatment May Lower IVF Success
According to a recent study conducted by researchers at the University of California San Diego, women who worry about their assisted reproductive technology treatment are likely to produce fewer eggs and have less of a chance of conceiving than women who don’t fret about their cases.

The prospective study tracked responses from 151 women who completed questionnaires at their initial clinic visit and at the time of their IVF or GIFT procedure. The questions focused on concerns specific to IVF and GIFT patients, including side effects, surgery, anesthesia, pain recovery, and missing work.

Women who worried about the medical aspects of the procedure had 20 percent fewer eggs retrieved and 19 percent fewer eggs fertilized than did women who were less anxious about the treatment. Those who were very concerned about missing work had 30 percent fewer eggs fertilized.

The results were adjusted for different variables that also may contribute to ART success, including age, race, smoking, the reason for infertility, the number of previous attempts to conceive, and the number of children already delivered by the patient.

These findings support previous research linking increased levels of stress to decreased levels of assisted reproductive technology (ART) success. The article was published in the April 2004 issue of Fertility and Sterility.

Helping couples cope with the stress and uncertainty of infertility is an integral part of the DVIF&G treatment program. Directed by Debra Ettinger, Ph.D., the Medical and Behavioral Therapy program helps couples expand their capacity to cope with life stressors and to reduce levels of depression and anxiety.

“On a very practical level, we also work to make the treatment process more workable in terms of helping patients overcome some common impediments to successful treatment, such as difficulty in keeping regular appointments, discomfort from sometimes painful shots, difficulties in specimen delivery, and in helping patients keep up with their recommended nutrition program,” says Dr. Ettinger.

For more information on the DVIF&G Medical and Behavioral Therapy program, please call (856) 988-0072.  

The Beginnings of Obesity
A recent study of nearly 8,500 women found that children born to obese mothers are more than twice as likely to be overweight by age 4 than are children born to women of average weight. The findings were published in the July 2004 issue of the journal Pediatrics.

Funded by the Department of Agriculture, the study was conducted to help determine ways to prevent childhood obesity. While obesity is known to run in families, this study is the first to track children from birth to preschool to see how early the problem develops.

The researchers found that by age 4, 24 percent of youngsters were obese if their mothers had been obese during the first trimester of pregnancy, compared with 9 percent of children whose mothers had been of normal weight during pregnancy.

Although the research was not designed to determine why the risk of obesity increases when the mother is obese, likely factors include genetics, changes in the mother’s uterus throughout the pregnancy term, and eating habits and physical activity at home.

DVIF&G has a special program called the Stork’s Nutrition Program® to help women achieve a healthier weight and to improve metabolic control before conception and throughout the pregnancy cycle. The program is directed by Melissa Bennett, RD, CDE. For more information, please call (856) 988-0072.

Acne Drug Warning
The U.S. Food and Drug Administration (FDA) recently issued important health guidelines regarding the use of the acne drug Accutane® or its generic form called isotretinoin. Because the drug has been found to cause birth defects, the FDA is taking steps to prevent pregnancy among women using the acne medication.

According to the FDA, patients given the drug must be enrolled in a national registry before receiving their supply of the medication. Women who are pregnant or trying to conceive should not take Accutane® or isotretinoin.

If a woman becomes pregnant while taking the medication, her baby can develop brain and heart defects, mental retardation, and other problems even if the mother took only a small dose for a short period of time.

The FDA advises women to wait 30 days after they stop using Accutane or isotretinoin before trying to conceive.

Smoking During Pregnancy Increases
the Risk of Testicular Cancer in Offspring
According to analyses of data from cancer registries and European survey data conducted by epidemiologists in Sweden and Italy, women who smoke while pregnant can increase their male offspring’s risk of developing testicular cancer. Their findings were published in the May 10, 2004 edition of the International Journal of Cancer.

The researchers believe that smoking can lower the levels of pregnancy hormones, reduce placental blood flow, and slow fetal growth. The carcinogens in tobacco also cross the placenta.

“If the testicular development is disturbed or delayed, this may result in neoplastic transformation, as well as fertility problems and malformations of the male urogenital tract,” the researchers explained to the Reuters Health Information network. 

Acrylamide, naturally formed when some starchy foods are fried, baked, or roasted, may be carcinogenic. The FDA found that fried snacks, including potato chips, pretzels, and popcorn, have the highest levels. The substance also is found in olives, prune juice, teething biscuits, fried chicken, peanut butter, and fast-food chicken nuggets.

According to the FDA acrylamide at high doses is known to cause cancer and reproductive problems in animals and may be toxic to the brain in humans. Until more tests can be conducted on acrylamides in food, women who are pregnant or trying to conceive should avoid the following foods:
• potato chips
• pretzels
• popcorn
• prune juice
• black olives
• sweet potatoes
• fried chicken
• fast-food chicken nuggets
• peanut butter
• bottled prune juice

Weight Only One Diabetes Risk Factor
A World Health Organization (WHO) Panel Report published in the Lancet urged physicians to be aware of differing risk factors for developing diabetes based on different ethnic populations.

Body mass index (BMI) is used to identify the risk for an individual to develop type 2 diabetes, but the report states that Asian Americans are 60 percent more likely to develop type 2 diabetes than Caucasian Americans even though their weight falls well within acceptable BMI cut-off points for developing the disease.

Armed with this data the researchers suggest that physicians routinely test their Asian American patients for insulin resistance, especially if they suffer from polycystic ovarian syndrome (PCOS) or another ovulatory condition.

Chlamydia May Cause Infertility in Men
Long linked to infertility in women, the sexually transmitted disease known as chlamydia may cause infertility in men.

According to a Swedish study published in the May 2004 issue of the journal Human Reproduction, the likelihood of a couple conceiving dropped by one third if the male partner tested positive for the infection. If a man has lgG antibodies, it means that he has previous or persistent chlamydia infection.

Since only half of men and nearly 90 percent of women with the infection experience symptoms, the researchers believe that couples should be tested for lgG as part of the standard infertility work-up.

Chlamydia is easily treated and cured with antibiotics, but early detection is key. If left untreated in men, the infection can lead to nongonococcal urethritis, inflammation of the urethra.

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