Polycystic Ovary Syndrome Might Start in the Brain, Not the Ovaries


Finally, some answers.

A new study has found evidence that the common and debilitating reproductive condition, polycystic ovary syndrome, could start in the brain, not the ovaries, as researchers have long assumed.

If verified, the research could change the way we think about the painful and severely misunderstood condition, which affects at least one in 10 women worldwide.

Anyone who has polycystic ovary syndrome (PCOS) – or knows someone with the condition – will be aware of how incredibly frustrating it can be.

Thanks to the variety of symptoms it can cause – from weight gain, large ovarian cysts, difficulty ovulating, acne, facial hair, depression, and agonising and heavy periods – it can take women years to get diagnosed.

Even then, there’s very little in the way of treatment options. Most women are simply told to go on the pill or take other hormonal medications to manage their individual symptoms, but not the underlying cause.

In the long-term, PCOS can lead to metabolic disorders, such as type 2 diabetes, cardiovascular disease, and hormonal dysfunction, including infertility. In fact, PCOS is the cause of more than 75 percent of anovulatory infertility, which is infertility caused by a woman not ovulating.

And yet, despite the severity of the condition, researchers still don’t understand how PCOS arises and how we can treat it.

Now, researchers led by the University of New South Wales in Australia have shown that mice without receptors for androgens – a group of steroid hormones commonly associated with males, such as testosterone – in their brains can’t develop PCOS. But if the androgen receptors in the ovaries are removed, the condition can still arise

 Seeing as mouse and human reproductive systems share many similarities, it’s compelling early evidence that doctors and scientists might have been focussing on the wrong piece of the puzzle all along.

“For the first time we have a new direction of where we should be looking to try and develop treatments that will treat the cause of PCOS, the androgen excess in the ovary but also in the brain,” said lead researcher Kirsty Walters in an emailed press release.

Before this, researchers knew that an increase in androgens, known as hyperandrogenism, was linked to the onset of PCOS. But exactly how and where these androgens act in the body was poorly understood.

“Hyperandrogenism is the most consistent PCOS characteristic; however, it is unclear whether androgen excess, which is treatable, is a cause or a consequence of PCOS,” the researchers write in their paper.

To get a better idea, the researchers took four groups of mice:

  • a control group of normal mice
  • a group of mice genetically engineered to have no androgen receptors (ARs) anywhere in their bodies
  • a group that had been engineered to have no ARs in just their brains
  • a final group that only had ARs missing from their ovaries.

The team then used a high dose of androgen to attempt to trigger PCOS in all four groups of mice.

While the control group developed PCOS as they expected, the mice missing ARs entirely, or just missing them from their brains, didn’t get the condition.

Interestingly, the mice that were only missing ARs from their ovaries still went on to develop PCOS, although at a lower rate than the control group. That means androgens acting on the ovaries can’t be the sole cause of PCOS.

The result suggests two important things: researchers were right about an excess of androgens triggering the condition; and the action of androgens on the brain is important to the development of PCOS.

That means if we can find a way to stop those excess androgens in the brain, it could signal a new way to treat PCOS.

“These data highlight the previously overlooked importance of extraovarian [outside the ovary] neuroendocrine androgen action in the origins of PCOS,” the researchers explain.

To be clear, this study has only looked at mice so far, and the results need to be replicated in humans before we can get an idea of whether the same thing is happening in our own reproductive systems.

But this is a big deal because, until now, the focus when looking for effective treatments and preventions has been on the ovaries – and we haven’t had much luck.

The new study, though it’s still early days, gives researchers a new target to look into, and it could hopefully lead to new, more effective treatments for people with the condition.

Source:http://www.sciencealert.com

Why Young Women All Over the World Are Still Dying in Childbirth


Why Young Women All Over the World Are Still Dying in Childbirth

Almost 800 women die every day while giving birth, and the curse of maternal mortality stretches from Sierra Leone to Myanmar.

By the time the pregnant 17 year old arrives at a hospital in Sierra Leone, it is already too late. Her baby has died—maybe the day before, maybe even longer. She has been left in labor for far too long—approximately 36 hours—waiting for a caesarean section that has been delayed due to an electricity cut. When power resumes, there is no doctor to help her. Now the race is on to save this teenage mother from death as well. Her womb is infected; the tissue falling apart. The doctors try their best to repair it, but her severe infection worsens overnight. The next morning is her last.

“Too much, too late,” writes a Médecins Sans Frontières obstetrics/gynecology registrar, Benjamin Black, on his MSF blog. This girl’s tragedy is shared by thousands more. In 2013, an estimated 289,000 women died during pregnancy or while giving birth. That’s almost 800 women every day. 99 percent of these deaths occur in the developing world.

Nearly all of these deaths and serious injuries are preventable and needless. Very few of them would happen in the west. Reading the statistics, we don’t need the World Health Organization (WHO) to tell us that maternal mortality is “unacceptably high” and that these deaths are a tragedy. The numbers speak for themselves: 800 maternal deaths every day are 800 too many. And yet, despite a 45 percent drop in maternal mortality since 1990, family planning organization Marie Stopes International still reports that the lifetime risk of dying from such complications is one in 22 in sub-Saharan Africa. In some African countries, the rate is as high as one in eight.

The United Nations Population Fund (UNFPA), whose work involves improving reproductive health, states on its website that the world has made “significant strides, but not enough.” While some developing countries have seen maternal deaths fall significantly in recent years, sub-Saharan Africa and southern Asia are still struggling.

A doctor with a baby Maasai patient in Kenya.

In Europe and North America, it is too easy to assume that death during childbirth is a thing of the past. A sensational plot development on an Edwardian costume drama—Downton Abbey, perhaps—or a Victorian tragedy in a Charles Dickens novel. You may be surprised to find that the five main causes of maternal death are, according to Marie Stopes: Hemorrhage, infection, unsafe abortion, eclampsia (a condition where convulsions occur in a pregnant woman with high blood pressure) and obstructed labor. Surprised—and horrified. Preventable, treatable, and avoidable; yet happening here and now in 2015.

 It’s worth underlining that there has been a significant and steady drop in numbers over the last 25 years. In addition, during the 2010 Millennium Development Goals Summit at the UN, secretary-general Ban Ki-moon unveiled a ‘global strategy for women’s and children’s health’ that aimed to save 16 million women and children over a four-year period. I asked Luc de Bernis, the UNFPA’s senior maternal health advisor in Geneva, if we are doing enough.

“Certainly not, but this is encouraging,” he said. “The challenge now is to maintain this gain in lives saved, and to accelerate the progress towards the goal and targets for 2030. Women’s health, maternal and adolescent health are not receiving enough attention, even if it has been demonstrated that the major part of the maternal and newborn mortality is preventable, even in poor settings.”

A woman had turned up to a hospital clearly needing a caesarean section. But there was no people to work the generator, no electricity, and no light.

“Unfortunately the answer isn’t simple and it’s not a purely medical answer,” said Black, the oby-gyn whose work with Médecins Sans Frontières has taken him to the Central African Republic and Sierra Leone. When it comes to maternal health, there is no “silver bullet,” as he puts it, to remedy this complex issue. “You’ve got to look at the social, political, economic dimensions to the problem,” he explained.

Benjamin talked about “the three delays”: A trio of barriers that too often prevent women from receiving the timely and effective medical attention they need. Delay one: The delay in recognising that something isn’t right. “If you’re a woman in sub-Saharan Africa who is in labor in your local village with your local birth attendant, they may not realize at first signs that there’s a problem. It may take more than a day,” he explained.

The second delay lies in actually getting to a place where you can even receive care. Benjamin recalled working in Sierra Leone, where it can take patients more than a day to reach a hospital because of poor roads, or because patients have no access to transport nor the money to pay for a taxi. Then there’s the third delay: The delay in receiving care once you’re there. Benjamin recalls the time “a woman had turned up to a hospital clearly needing a caesarean section. But there was no people to work the generator, no electricity, and no light.”

I was ‘a child giving birth to a child’ because I was only 14.

There’s another twist in this narrative: Teenagers are most at risk. Marie Stopes International, which provides sexual and reproductive healthcare to women around the world, reported on the case of 16-year-old Mi Aye, who lives in Myanmar. Married at 13 and pregnant at 14, Mi Aye told the organization: “Nobody told me about how you have children or how I could avoid getting pregnant, so of course, I got pregnant. I was ‘a child giving birth to a child’ because I was only 14. And afterwards I was really frightened about getting pregnant again but I didn’t know what to do to stop it.”

 Women aged between 15 and 19 are twice as likely to die during pregnancy or childbirth as women over 20; girls under the age of 15 are five times more likely to perish. Bethan Cobley, senior manager of policy and partnerships at Marie Stopes International explained why teens are most at risk. “Sometimes their bodies are not mature enough for pregnancy and childbirth, but more often it’s because young people are less likely to have access to quality health services, particularly in the developing world.”

Benjamin Black referred to this as an issue of ‘vulnerability.’ “Your vulnerability increases according to the wider socio-economic situation that you’re in,” he said. “For example, if you’re a 15-year-old girl from a poor [and] rural family, your vulnerability to each of those delays is much higher than, for example, a professional woman who’s working in a capital city, even in the same country.”

According to the UNFPA, access to trained midwives could help avert two-thirds of maternal and newborn deaths. According to de Bernis, “midwives can implement more than 85 percent of the recommended essential evidence-based RMNH (Reproductive, Maternal and Newborn Health) interventions”—yet there is so much more than mere medical intervention to tackling these horrifying mortality numbers.

Dr Azhar Abid Raza, a health and immunization specialist with UNICEF in New York, agreed that a holistic approach is “essential” and “is working.” Antenatal care and maternal vaccinations have improved. UNICEF also has programmes targeting child marriage. “In addition, UNICEF, WHO and UNFPA are collaborating to improve the nutritional status of mothers, and in promoting the concept of early initiation and exclusive breastfeeding,” he said.

Access to family planning is equally vital—as is ensuring abortions are a safe option for all women. As it stands, there are 222 million women in the world who would like to use contraception but aren’t able to access it. “An estimated 22 million unsafe abortions are performed each year, resulting in 47,000 deaths and leaving 8 million women with medical complications,” Bethan Cobley of Marie Stopes International told me. “It may sound obvious, but when women have access to contraception, the number of unplanned pregnancies falls dramatically.”

 It’s about the choices girls should be able to make—freely and safely—about their own bodies, without feeling stigmatized or judged.

Family planning and termination of pregnancy is still taboo in many developing countries. As a result, abortion becomes a secret and often deadly operation that can involve ingesting poisonous herbs or using sharp instruments. Perhaps unsurprisingly, these methods often lead to medical complications, infertility, and in the worst cases, death.

So what’s the bottom line? It’s about the choices girls should be able to make—freely and safely—about their own bodies, without feeling stigmatized or judged. When the political will, support and funding is there, women’s lives are saved.

“Where governments have made the decision to fund family planning services and remove policy restrictions, we have seen maternal mortality dramatically fall in a relatively short period of time,” Cobley said. “For example, the Ethiopian government has invested in family planning and as a result maternal mortality in the country has more than halved, falling from 990 deaths in 100,000 live births in 2000 to 440 in 2013.”

Pregnancy shouldn’t be an imposed death sentence for any woman, wherever she lives or whatever her financial circumstance. In 2015, it doesn’t have to be.

Over-the-Counter Birth Control Safe for Teens, Research Finds.


Days could be coming when birth control is harder to get, with no-copay contraception potentially dropping off the map. Even though costs could increase, researchers say there’s no reason oral contraception should remain restricted by prescriptions. While some have been recommending over-the-counter birth control pills for years, some have worried about safety. But new research shows birth control pills are very safe and effective — especially for teens.

NPR reports that a review of birth control pill research published in the Journal of Adolescent Health makes the most comprehensive case yet for allowing over-the-counter birth control for teens. In fact, the research found birth control pills might be safer for young people, because your risk for negative side effects such as blood clots is greater if you’re older.

“There is a growing body of evidence that the safety risks are low and benefits are large,” Krishna Upadhya, an assistant professor of pediatrics at the Johns Hopkins University School of Medicine and the lead author of the review, told NPR.

And when you’re young, Upadhya added, research shows you are less likely to experience some of the negative side effects of the Pill. While pills containing estrogen and progestin increase risk of a certain type of blood clot, Krishna said teens are less likely to develop that side effect and others, meaning the pill is “potentially safer the younger you are.”

 Research shows that good things happen when we reduce barriers to birth control. According to a 2016 research report from Urban Institute, about 63 percent of women reported that birth control reduces stress in their lives, about 54 percent said it had provided them health benefits, about 49 percent said it had helped them get their education, and about 49 percent reported more stable romantic relationships. On top of that, The American College of Obstetricians and Gynecologists backs access to over-the-counter birth control, as do many doctors.

With this new research, Upadhya told NPR, everyone, regardless of age, should be able to get the Pill from her local pharmacy, no prescription needed.

“These pills are safe and effective and we should reduce barriers to using them,” she said. “And teens should benefit just as adult women do.”

Source:http://www.teenvogue.com

10 Worst Toys Your Kids Should Stay Away From


Worst Toys for Kids

Story at-a-glance

  • Many top toy are hazardous and present strangulation, choking, and other risks to children
  • Toys often contain toxic chemicals that have been linked to cancer, reproductive problems, thyroid disruption, brain damage, and more
  • Many leading toys stores and top toy brands are among those offering dangerous products to kids

The US toy industry generates $22 billion in sales a year, with 65 percent of those sales taking place during the holiday season.1, 2 Unfortunately, many toys meant to bring children joy can end up injuring them instead, sometimes seriously.

According to Consumer Product Safety Commission (CPSC) data, there were 265,000 toy-related injuries and 11 deaths in 2012 alone.3 Many parents assume the toys they purchase from well-known retailers and toy brands, or which feature characters from popular movies and television shows, are heavily regulated and safe.

A new report from the World Against Toys Causing Harm, or W.A.T.C.H., reveals significant hazards abound. According to W.A.T.C.H.:

“Some toys that are in compliance with current industry or regulatory standards have proven to be hazardous, proving the inadequacy of existing standards.”

W.A.T.C.H., which recently revealed this season’s 10 worst toys, has been compiling hazardous toy lists for more than three decades, notes that many of the same hazards continue to appear year after year, showing manufacturers’ reluctance to make toys safer. Some of the top hazards could be easily changed, while others have no business being “toys” at all:

  • Dangerous projectiles
  • Strings that can cause strangulation
  • Small detachable parts that present choking hazards
  • Misleading or confusing warning labels, packaging, or instructions
  • Toy “weapons” designed to look real

The Top 10 Worst Toys List

While holiday shopping this year, be on the lookout for potentially hazardous toys such as the 10 that follow. These toys are meant to be examples of the types of hazards that exist widely in the toy industry, and are certainly not the only dangerous toys on the market.

Some of these are common sense… if you give a child a slingshot or bow-and-arrow to play with, there are obvious risks involved. Still, the way these toys are marketed draws in children and parents alike, often giving an illusion of safety when none actually exists.

What the list did not cover, unfortunately, are the dangerous chemicals lurking in many toys (see below for more information). Still, the list is an important reference for anyone who is planning to shop for toys this season or any time of year. W.A.T.C.H. stated:

“We are warning parents not to assume the toys they buy are safe. Many consumers are under the impression that heightened public attention to toy safety, increased government regulations and screening by big name manufacturers and retailers have eliminated hazards from toy store shelves—but this is not the case.

The key message today is to let caregivers know that while there are dangerous toys being sold in retail stores, awareness this holiday season and year-round truly can save lives.”

1. Air Storm Firetek Bow

This light-up bow-and-arrow set designed for kids 8 and up poses a potential for eye injuries. The arrows fly up to 145 feet and the toy (which is designed with illuminated arrows for “night or day” use) warns children not to pull back the arrows “more than half strength” or play with the toy “in complete darkness.”

 2. Radio Flyer Ziggle

This tricycle-like toy encourages children to “swerve & spin” and “race around the block,” but its low profile makes it a hazard for cars. It also poses a risk of forehead and other impact injuries. And while the warning states to “always wear” a helmet and other safety gear, the packaging shows riders using the device without protective gear.

3. Cat-a-Pencil

This toy is part pencil, part slingshot, which poses a risk of eye injuries. There are no warnings or age recommendations on the packaging, which encourages using the toy for “target practice from your desktop.”

4. Alphabet Zoo Rock & Stack Pull Toy

This pull toy has a pull cord measuring about 20 inches long, which poses a strangulation hazard and could cause entanglement injuries. Strangulation warnings are printed on the toy’s packaging but not on the toy itself. While strings on playpen and crib toys must be less than 12 inches long, pull toys have no such restrictions.

5. Swat Electric Machine Gun

This toy gun boasts “lights and realistic combat sound” and a warning that this “toy is a replica of a real weapon” that “may be mistaken for an actual firearm by law enforcement officers and others.” According to W.A.T.C.H.:4

In today’s world, there is no excuse for outfitting children with realistic toy weapons designed to produce potentially dangerous and unnecessary thrills.

Existing regulations addressing the hazards associated with such ‘toys’ are inadequate. Detailed replicas have resulted in a number of deaths through the years and should never be sold as toys.”

6. Wooden Instruments

One brand of wooden instruments distributed at Walmart stores is sold for babies as young as 12 months old, yet contains a slender, rigid 4.5-inch long drumstick, which could be ingested and cause choking. The toy contains no warnings.

7. Bottle Rocket Party

This bottle rocket kit, intended for children aged 8 and over, contains projectiles that could cause eye, face, or other impact injuries. It does include warnings that “this kit must only be used under strict supervision of adults,” but it makes shooting off bottle rockets sound like a party event. Also, though they advise safety goggles be used, they are not supplied.

8. Lil Cutesies Best Friends Doll

These dolls are marketed to children as young as 2, yet contain a decorative bow that could be detached and pose a risk of choking if ingested.

9. True Legends Orcs Battle Hammer

This hard plastic “battle hammer” is almost two feet long and poses the potential for blunt impact injuries. There are no warnings or cautions included.

10. Colored Hedgehog

This stuffed hedgehog, distributed by Toys R Us, is marketed to infants (ages 0+), but it has long, fiber-like hair that is “not adequately rooted and is easily removable.” It poses a potential for ingestion and aspiration injuries, a risk that is not referenced anywhere on the product or tag.

Chemicals: The Even More Insidious Toy Hazard

Just like many household products, toys are commonly made from materials that contain endocrine-disrupting chemicals (like bisphenol-A or BPA), carcinogens, and even toxic metals like lead. These chemicals are found in many toys at leading toy retailers, like Toys R Us. You might be familiar with some of the recommendations to avoid such toxins, such as choosing toys made from natural materials like fabric and wood, instead of plastic, but in some cases you may need to avoid a type of toy entirely.

One such example is make-up designed to be kid-friendly and “safe” for kids. One Toys R Us private label brand, TM! products, was recently outed by Andrea Donsky, the founder and editor-in-chief of NaturallySavvy.com.5 Some of the chemicals found in these children’s cosmetics (nail polish, hair and body gel, blushes, eye shadows, and lip glosses) include:

Propylene glycol, a solvent that produces a carcinogenic byproduct called 1,4 Dioxane Imidazolidinyl urea, a formaldehyde-releasing preservative that is carcinogenic and may cause allergic skin reactions
Fragrance, which may contain hundreds of synthetic toxic chemicals that are undisclosed on the label Parabens, which are carcinogens and endocrine disrupters that are used as preservatives
Synthetic dyes, which are often derived from coal tar and may be carcinogenic BHT, a preservative linked to tumor development in animals as well as developmental effects and thyroid changes, which suggests it may be an endocrine disrupter

Other brands, such as Disney and Barbie, didn’t fare any better. According to Donsky, of the children’s cosmetics sold at Toys R Us that she reviewed: They all contain parabens, phthalates and/or synthetic dyes. One of them even contains an artificial sweetener!”

Aside from children’s makeup, other top offenders included temporary tattoos, face painting sticks, glitter nail art, and body art. All contained chemicals on par with the toxins commonly found in adult cosmetics, and in some cases even worse. The Toy Industry Association (TIA) and the American Chemistry Council have successfully defeated numerous bills and policies that would have helped to keep hazardous chemicals like bisphenol-A (BPA), phthalates, formaldehyde, and others out of children’s toys.6

Last year, for instance, both groups opposed a now-defeated bill that would have required toy manufacturers to disclose the presence of 19 “high priority chemicals of concern for children’s health” – and remove the chemicals within five years.7 Many of these chemicals have been linked to cancer, fertility issues, thyroid disruption, and developmental problems, including brain damage and lower IQ, in children.

Steer Clear of Food-Based Toys…

The Easy Bake Oven is one of the most nostalgic family toys, but according to Donsky, the baking kits included with this brand are filled with toxic ingredients you and your children shouldn’t be eating. The same goes for the other food-based toys that Donsky encountered at her local Toys R Us – items like Cake Pops, a Blizzard Maker, and Slurpee Kits. Hydrogenated oils, artificial flavors and colors, genetically modified soybean oil, high fructose corn syrup, and preservatives are par for the course. If it makes you upset that kids are quite literally being deceived into destroying their health potential by junk food companies seeking revenue, then you will be equally dismayed to know that these junk foods are allowed to blatantly masquerade as children’s toys.

As you exit most Toys R Us stores, you’ll also pass by row upon row of candy, sodas and other snacks that represent the epitome of junk food, and which have been overwhelmingly implicated in rising obesity and chronic disease rates—especially among kids. Junk-food marketers know kids love toys, and what better place to capture their attention than in a toy store? Toys R Us, however, has the power to force its suppliers to at least remove the chemicals that we know are harmful, especially since their target market is children. If you’d like to get involved, please sign the petition below asking Toys R Us to stop selling products with toxic chemicals.Donate Today!

How to Choose Safe Toys: What to Look For

As W.A.T.C.H. stated, toys are designed and marketed for sales over safety. It’s very much a “buyer-beware” market when it comes to children’s toys, not only in regard to safety features but also in regard to the quality of materials and toxic compounds therein. So in addition to regularly monitoring toys in your home for broken parts, sharp surfaces, or dangerous wear-and-tear, you’ll want to pay attention to the quality of the materials from which your children’s toys are made.

There are many “green” and organic toy manufacturers that produce truly toxin-free toys for kids. If in doubt, contact the manufacturer directly and ask them what materials are used, and which are excluded, directly. Read toy labels and ask questions about where and how the toy is made. Additional tips to finding safe, pure toys include:

  • Purchase natural fabric or wooden toys instead of plastic ones, and if you’re going to purchase teethers and pacifiers, looks for those that are BPA- and phthalate-free (a frozen washcloth makes a great “natural” teether)
  • Avoid toys made from PVC plastic (soft vinyl plastic), which often contains lead and phthalates
  • Avoid children’s “play” jewelry and cosmetics, as well as food-based toys
  • Repurpose items around your home as toys (stainless steel bowls, measuring cups, cardboard boxes… get creative using items around your home as toys for kids)
  • Purchase simple high-quality toys that encourage imaginative play (wooden blocks, materials for building forts, construction paper, books, etc.)

Low levels of ‘anti-anxiety’ hormone linked to postpartum depression: Effect measured in women already diagnosed with mood disorders.


Effect measured in women already diagnosed with mood disorders

Summary:
In a small-scale study of women with previously diagnosed mood disorders, researchers report that lower levels of the hormone allopregnanolone in the second trimester of pregnancy were associated with an increased chance of developing postpartum depression in women already known to be at risk for the disorder.

In a small-scale study of women with previously diagnosed mood disorders, Johns Hopkins researchers report that lower levels of the hormone allopregnanolone in the second trimester of pregnancy were associated with an increased chance of developing postpartum depression in women already known to be at risk for the disorder.

In a report on the study, published online on March 7 in Psychoneuroendocrinology, the researchers say the findings could lead to diagnostic markers and preventive strategies for the condition, which strikes an estimated 15 to 20 percent of American women who give birth.

The researchers caution that theirs was an observational study in women already diagnosed with a mood disorder and/or taking antidepressants or mood stabilizers, and does not establish cause and effect between the progesterone metabolite and postpartum depression. But it does, they say, add to evidence that hormonal disruptions during pregnancy point to opportunities for intervention.

Postpartum depression affects early bonding between the mother and child. Untreated, it has potentially devastating and even lethal consequences for both. Infants of women with the disorder may be neglected and have trouble eating, sleeping and developing normally, and an estimated 20 percent of postpartum maternal deaths are thought to be due to suicide, according to the National Institute of Mental Health.

“Many earlier studies haven’t shown postpartum depression to be tied to actual levels of pregnancy hormones, but rather to an individual’s vulnerability to fluctuations in these hormones, and they didn’t identify any concrete way to tell whether a woman would develop postpartum depression,” says Lauren M. Osborne, M.D., assistant director of the Johns Hopkins Women’s Mood Disorders Center and assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “For our study, we looked at a high-risk population of women already diagnosed with mood disorders and asked what might be making them more susceptible.”

For the study, 60 pregnant women between the ages of 18 and 45 were recruited by investigators at study sites at The Johns Hopkins University and the University of North Carolina at Chapel Hill. About 70 percent were white and 21.5 percent were African-American. All women had been previously diagnosed with a mood disorder, such as major depression or bipolar disorder. Almost a third had been previously hospitalized due to complications from their mood disorder, and 73 percent had more than one mental illness.

During the study, 76 percent of the participants used psychiatric medications, including antidepressants or mood stabilizers, and about 75 percent of the participants were depressed at some point during the investigation, either during the pregnancy or shortly thereafter.

During the second trimester (about 20 weeks pregnant) and the third trimester (about 34 weeks pregnant), each participant took a mood test and gave 40 milliliters of blood. Forty participants participated in the second-trimester data collection, and 19 of these women, or 47.5 percent, developed postpartum depression at one or three months postpartum. The participants were assessed and diagnosed by a clinician using criteria from the Diagnostic and Statistical Manual of Mental Disorders, version IV for a major depressive episode.

Of the 58 women who participated in the third-trimester data collection, 25 of those women, or 43.1 percent, developed postpartum depression. Thirty-eight women participated in both trimester data collections.

Using the blood samples, the researchers measured the blood levels of progesterone and allopregnanolone, a byproduct made from the breakdown of progesterone and known for its calming, anti-anxiety effects.

The researchers found no relationship between progesterone levels in the second or third trimesters and the likelihood of developing postpartum depression. They also found no link between the third-trimester levels of allopregnanolone and postpartum depression. However, they did notice a link between postpartum depression and diminished levels of allopregnanolone levels in the second trimester.

For example, according to the study data, a woman with an allopregnanolone level of 7.5 nanograms per milliliter had a 1.5 percent chance of developing postpartum depression. At half that level of hormone (about 3.75 nanograms per milliliter), a mother had a 33 percent likelihood of developing the disorder. For every additional nanogram per milliliter increase in allopregnanolone, the risk of developing postpartum depression dropped by 63 percent.

“Every woman has high levels of certain hormones, including allopregnanolone, at the end of pregnancy, so we decided to look earlier in the pregnancy to see if we could tease apart small differences in hormone levels that might more accurately predict postpartum depression later,” says Osborne. She says that many earlier studies on postpartum depression focused on a less ill population, often excluding women whose symptoms were serious enough to warrant psychiatric medication — making it difficult to detect trends in those women most at risk.

Because the study data suggest that higher levels of allopregnanolone in the second trimester seem to protect against postpartum depression, Osborne says in the future, her group hopes to study whether allopregnanolone can be used in women at risk to prevent postpartum depression. She says Johns Hopkins is one of several institutions currently participating in a clinical trial led by Sage Therapeutics that is looking at allopregnanolone as a treatment for postpartum depression.

She also cautions that additional and larger studies are needed to determine whether women without mood disorders show the same patterns of allopregnanolone levels linked to postpartum depression risk.

If those future studies confirm a similar impact, Osborne says, then tests for low levels of allopregnanolone in the second trimester could be used as a biomarker to predict those mothers who are at risk of developing postpartum depression.

Osborne and her colleagues previously showed and replicated in Neuropsychopharmacology in 2016 that epigenetic modifications to two genes could be used as biomarkers to predict postpartum depression; these modifications target genes that work with estrogen receptors and are sensitive to hormones. These biomarkers were already about 80 percent effective at predicting postpartum depression, and Osborne hopes to examine whether combining allopregnanolone levels with the epigenetic biomarkers may improve the effectiveness of the tests to predict postpartum depression.

Of note and seemingly contradictory, she says, many of the participants in the study developed postpartum depression while on antidepressants or mood stabilizers. The researchers say that the medication dosages weren’t prescribed by the study group and were monitored by the participant’s primary care physician, psychiatrist or obstetrician instead. “We believe that many, if not most, women who become pregnant are undertreated for their depression because many physicians believe that smaller doses of antidepressants are safer for the baby, but we don’t have any evidence that this is true,” says Osborne. “If the medication dose is too low and the mother relapses into depression during pregnancy or the postpartum period, then the baby will be exposed to both the drugs and the mother’s illness.”

Osborne and her team are currently analyzing the medication doses used by women in this study to determine whether those given adequate doses of antidepressants were less likely to develop symptoms in pregnancy or in postpartum.

Only 15 percent of women with postpartum depression are estimated to ever receive professional treatment, according to the U.S. Centers for Disease Control and Prevention. Many physicians don’t screen for it, and there is a stigma for mothers. A mother who asks for help may be seen as incapable of handling her situation as a mother, or may be criticized by friends or family for taking a medication during or shortly after pregnancy.

Journal Reference:

  1. Lauren M. Osborne, Fiona Gispen, Abanti Sanyal, Gayane Yenokyan, Samantha Meilman, Jennifer L. Payne. Lower allopregnanolone during pregnancy predicts postpartum depression: An exploratory study. Psychoneuroendocrinology, 2017; 79: 116 DOI: 10.1016/j.psyneuen.2017.02.012

Source: Sciencedaily.com

Hospitals Giving Out Apple Watch to Aid Cancer Treatment


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When I first heard about the Apple Watch, I wasn’t sold. Now, after a massive commercial rollout and major word-of-mouth hype, I’m still skeptical. Even if the price (upwards of $349) weren’t an issue, you wouldn’t see me with the awkward-looking watch-phone hybrid around my wrist.

But the beauty of the market is that it makes room for consumers’ varying tastes and needs. For some, the Apple Watch is a stylish status symbol, and for others, it could even be an essential piece of medical equipment. King’s College Hospital in London has begun a pilot program that provides the watches to chemotherapy patients. A British medical company, Medopad, has been building apps designed to help cancer patients keep track of their medication usage.

“Patients forget to take the drugs or lose them. There are also many unnecessary visits to [emergency medical services] because doctors don’t have access to that information,” said the CEO of Medopad, Dr. Rich Khatib.

For patients, the design of the Apple Watch provides advantages over the typical smartphone. With the ability to wear the device on their wrist at all times, patients would be less likely to forget about using the apps provided. Additionally, patients dealing with illness, or loss of energy and strength, would benefit from the ease of access.

Not only are the Apple Watches convenient for patients and doctors, but also they could cut costs tremendously.

“After the treatment is over, another patient can use the Apple Watch so it could work out at £50 per patient. When you compare that to chemotherapy treatments and the fact that one pill could cost £1,000 per day, it’s worth it,” said Dan Vàhdat of Medopad.

It remains to be seen whether the pilot program will be effective, but the mere ideas behind the effort should get doctors, patients, and technology geeks excited. Smartphones, tablets, and other cutting-edge devices are often thought of as toys, providing mindless entertainment that replaces genuine human interaction. But these pieces of technology aren’t just for playing Candy Crush during math class; they increase our standard of living, facilitate improved communication, and can even save lives.

Read more at HIT Consultant, and watch our interview with James Currier on information management in health care.

 

Faulty gene is a major cause of repeated miscarriages, say experts


Up to half of couples who suffer repeated miscarriages may be carrying a faulty gene, doctors have discovered

At least four in ten couples who suffer repeated miscarriages may be carrying a faulty gene, research has found, which can be successfully treated with drugs.

Doctors have found that a faulty gene can trigger miscarriages

Doctors have found that a faulty gene can trigger miscarriages

Fertility doctors have found that a faulty gene that can be carried by either parent can trigger miscarriages.

It is the first time it has been discovered that a gene carried by the father can cause miscarriage in the mother.

The fault causes improper blood clotting and can be treated with blood thinners such as aspirin and heparin.

One in four pregnancies ends in miscarriage but it is thought that recurrent miscarriages may be a bigger problem than infertility and may affect hundreds of thousands of couples.

Doctors at Care Fertility, the biggest private provider of IVF treatment, found the faulty gene, known as C4M2, in 44 per cent of their patients compared with just 15 per cent of the general population.

Prof Simon Fishel, managing director, said the gene could be a major cause of recurrent miscarriage.

With proper treatment the number of couples having healthy babies increased to 38 per cent, a similar proportion to other infertility patients of the same age.

The findings were published in the journal Reproductive Biomedicine Online.

The fault means the embryo is unlikely to implant in the womb and if it does it may do so insufficiently, causing late miscarriage or growth problems in the baby.

If the women is the carrier of the faulty gene she is also at risk of complications such as blood clots.

Prof Fishel, lead author on the publication, said “Very recently a new genetic marker has been found that predisposes couples to the risk of miscarriage, which we call the C4/M2 variant.

“In addition to the risk of implantation failure and miscarriage, it is linked to blood clotting disorders, pre-eclampsia and low birth weight babies.

“What I do find remarkable, is that in the population of patients studied, the man has the same chance as the woman to pass on this variant to the developing embryo and disturb successful implantation. Where the genetic variant exists, the chance of delivering a baby is reduced to one in four that of fertile couples.”

Care Fertility now intend to screen selected patients for the faulty gene so they can be treated appropriately.

Prof Fishel said: “Whilst this test is available for all patients undergoing IVF, we are focused on patients who have had recurrent miscarriage or failed implantation. The risk is the same whether the male or female carries the gene variant – so both partners need to be tested. We hope to increase the chance of pregnancy and live birth, decrease the risk of miscarriage and reduce the incidence of obstetric complications arising from this genetic mutation.”

The research found that couples with the gene who had IVF treatment without blood thinners, none had successful pregnancies. However of those with the gene who were treated, 38 per cent had successful pregnancies.

A spokesman for the Miscarriage Association said: “This adds to the growing evidence of the links between infertility and miscarriage, especially at the level of implantation.

“The study seems to show a clear difference between the affected parents who were treated and those who weren’t.

“We always welcome new research into factors that can increase the risk of miscarriage, so we’ll be looking closely at these findings with the help of our research expert advisors.”

Stress doubles risk of infertility in women


Women with the highest levels of stress hormone in their saliva were far more likely to fail to get pregnant within 12 months of trying .

Women who were stressed found it far more difficult to get pregnant

Women who were stressed found it far more difficult to get pregnant

Stress doubles the risk of infertility in women, scientists have found, and have recommended yoga and mediation for those hoping to become pregnant.

Researchers discovered that women with the highest levels of stress hormones in their saliva were far more likely to fail to get pregnant within 12 months of trying.

Clinical infertility is defined by being unable to conceive within a year despite regular unprotected sex.

It may explain why women who have struggled to get pregnant manage to conceive often after they give up and the anxiety of trying has been removed.

Study leader Dr Courtney Denning-Johnson Lynch, from Ohio State University in the US, said: “We have demonstrated that women with high levels stress biomarkers have a lower probability of becoming pregnant, compared to women with low levels of this biomarker.

“For the first time, we’ve shown that this effect is potentially clinically meaningful, as it’s associated with a greater than two-fold increased risk of infertility among these women.”

Dr Lynch urged women having difficulty getting pregnant to consider stress-managing techniques, such as yoga and meditation.

However she pointed out that stress is not the only factor involved in fertility problems and may only play a minor role.

Co-author Dr Germaine Buck Louis, from the Eunice Kennedy Shriver National Institute of Child Health and HumanDevelopment in Rockville, US, said: “Eliminating stressors before trying to become pregnant might shorten the time couples need to become pregnant in comparison to ignoring stress.

“The good news is that women most likely will know which stress reduction strategy works best for them, since a one-size-fits-all solution is not likely.”

Previous research had already highlighted an association between high stress levels and a reduced probability of pregnancy.

The new findings, linking stress to infertility, are published in the latest online edition of the journal Human Reproduction.

Scientists measured levels of alpha-amylase, an enzyme in saliva that provides a biological indicator of stress.

The team tracked 373 American women aged 18 to 40 who were free from known fertility problems and had just started trying to conceive.

Their progress was followed over a period of 12 months, or until they became pregnant.

Women with high levels of the biomarker were 29 per cent less likely to get pregnant each month than those with low levels, the researchers found.

They were also more than twice as likely to be declared infertile.

The findings were published in the journal Human Reproduction.

What it’s like to freeze your eggs


After a break-up, one woman decided to put her dreams of children on ice – literally – at a cost of £14,000. She describes life as one of Britain’s very few ‘freezers’ .

It’s 7pm on a Wednesday night, and I’m sitting at my kitchen table, holding a hypodermic needle in one hand. With the other, I’m rubbing the small red puncture mark in my stomach, hoping it will stop bleeding so I don’t have to change the cream silk shirt I’ve picked out for my date tonight. I’m not diabetic nor a drug addict, and, although I’ve just injected the same hormones that women trying to conceive commonly use, I’m not doing IVF either. I’m single, I’m 36 and I’m freezing my eggs.

I’ll be honest: this wasn’t how I saw my life panning out. I was never one of those women who was desperate to get married and have children. I even went through periods of thinking I didn’t want them at all. But then in July 2012 I split up with the man I thought was going to father my children. This wasn’t just wishful thinking: while we weren’t actively trying to conceive, we had stopped using contraception. In my head, I was going to be pregnant by Christmas.

Instead, I was single, but convinced he would see that he’d made a horrible mistake and that we’d get back together. We didn’t. And when I really thought about why this upset me so much, I realised it wasn’t just the idea of him not being in my life, it was that I had considered him my best chance of getting pregnant.

This sort of thinking really isn’t conducive to dating. Forget men being able to smell desperation – I could see the cloud hanging over me. I didn’t want to be someone who saw every first date as an interview with the potential father of her children, but I couldn’t help it. And I really didn’t want to attempt to procreate from a one-night stand, so when a friend suggested I freeze my eggs, it didn’t seem the worst idea in the world.

At that point I knew a little about egg freezing. Essentially, it’s the first part of IVF: you take a load of hormones to encourage your ovaries to produce lots of eggs rather than just one, then the doctors take the eggs out. But rather than fertilising them and sticking them back in, they put them on ice until you want to use them.

I also knew that the success rates were pathetically low: up to December 2012, according to the Human Fertilisation and Embryology Authority, only 20 babies had been born in Britain from frozen eggs. And I knew that, as the quality and quantity of eggs decline with age, you’re far better off doing it in your twenties rather than your mid-thirties. Fine if you have the foresight and disposable income then, but I didn’t. Nor did my parents offer me egg-freezing as a university graduation gift, which is what some fertility experts in America are now suggesting wealthy mommies and daddies do for their daughters.


Egg freezing costs an average of £4,000 a cycle (HANK MORGAN/SCIENCE PHOTO LIBRARY)

So I’d dismissed it, thinking it sounded like all the worst parts of IVF – but on your own and without any hope of a baby. And it’s not cheap. While it’s offered in more than 40 clinics across Britain and some NHS trusts will cover it for medical reasons (if you’re a young woman who has to have chemotherapy that will make you sterile, for example), it’s not covered by private health insurance. So the average £4,000 cost of a cycle, which can produce anything from three to 15 eggs, comes out of your own pocket. And when you find out that most clinics recommend three cycles, you’re talking quite serious money.

But when I started looking into it properly late last year, I found that things had changed. A new method called vitrification, in which the eggs are frozen roughly 600 times faster than the old one, means they are more likely to thaw intact. Some research published in 2012 by the American Society for Reproductive Medicine suggested that the likelihood of pregnancy from IVF using eggs frozen in this way was equal to that of using fresh.


‘I had more in common with my friends than they’ll ever know’ (BSIP/GETTY)

Maybe I was just focusing on the positive stories because that was what I wanted to hear, but freezing my eggs suddenly seemed like a proactive step – the only way I could attempt to take charge of my life, to begin to bridge the widening chasm between me and my peers, who, with their marriages, babies and bumps, seem several rungs up the life ladder from me.

Loath as I am to wallow in self-pity, being 36, single and childless somehow feels like failure. Whether the edicts come from Kirstie Allsopp, the Pope or my grandma, it’s still assumed that a woman’s job is to procreate. That would be annoying enough if it wasn’t what I wanted, but as it is, it’s hard not to feel that, despite having a successful career, a home of my own and lots of friends, somewhere I’ve done something wrong. Or that there’s something wrong with me. It makes me feel like less of a person, as if my opinion doesn’t count as much – to politicians, certainly, I’m not in one of those “hard-working families”.

At parties, whether with my friends or meeting new people, I’m in the minority, and the talk is invariably of children. I’d always thought that was a cliché, but it’s not. I cringe when I hear myself joining in the only way I can – with anecdotes about my nephew’s latest milestones, or how my sister-in-law dealt with mastitis/nursery politics/school catchment areas.

The irony of course is that at several points in the past six months I have had far more in common with them than they’ll ever know, because, while these eggs that I’m freezing may never become children, in some ways I might as well have been pregnant. During the three two-week freezing cycles I shared the same hormone-swollen breasts and belly, and the accompanying emotional turmoil.


Kim Kardashian didn’t need the eggs she froze in 2012 to conceive baby North (GETTY)

I was even off alcohol, giving my liver a rest from processing G&Ts so it could more efficiently metabolise hormones. Then there are the friends lamenting that the advent of children has put paid to the annual skiing holiday. I can sympathise: I had to cancel this year’s trip because it coincided with an egg-freezing cycle. No bump, no baby, and I’m already making parental sacrifices.

I’ve told hardly any of them this. Only a handful of people know what I’m doing – even my parents don’t know. I’m not ashamed of it. It’s just that it’s not really anyone else’s business but mine. And I don’t want to be the subject of gossip, pity, speculation, admiration or anything else. I don’t want to be special. But I am. Because while many people now know about egg freezing, there aren’t, relatively speaking, that many of us actually doing it.

When I Googled to see if it was normal to get a nettle-sting-type rash after injecting one of the hormones, I found nothing for freezers, just chatrooms full of IVFers talking about how supportive their darling hubbies were being. In the heightened emotional state induced by hormone overload, even anodyne comments such as these had the power to reduce me to tears. And the clinics are no better, because most people there are doing IVF. That’s how it’s all set up. The form that the doctor filled in is headed “IVF Protocol” and the note printed after the final day says, “We wish you luck for your pregnancy test in two weeks.” It’s like putting a recurrent miscarriage unit next door to the maternity ward: a constant reminder that you’re not like everyone else, that it’s different for you.

Of course, the dream is still that I’m going to meet someone, conceive naturally – or use my frozen eggs, if necessary – and live happily ever after. But, if that doesn’t happen, I’ve not ruled out using a sperm donor to fertilise my frozen eggs and go it alone. Using donor sperm is surprisingly easy. While there aren’t a wealth of donors in Britain, you can import American or Scandinavian sperm to your clinic via websites that allow you to search by ethnicity, height, education, hair colour – it’s like internet dating, but they can’t turn you down. For about £500, their DNA is yours.


The actress Sofia Vergara revealed in 2013 that she had frozen her eggs (REX)

I struggle to get my head round the fact that these are things I’m even considering. And practicalities aside, I don’t know if it’s the right thing to do. Once, at a friend’s daughter’s first birthday, surrounded by children with both their parents, I considered whether creating a single-parent family, entirely through choice rather than circumstance, would always feel like the second best option for me and my child.

That might explain why, despite the fact I was embarking on an emotionally fraught path and was pumped full of hormones that heighten your emotions even further, I decided to schedule four first dates in the week I was doing my first ever freezing cycle. I can only assume my subconscious was trying to help. Obviously I wasn’t going to tell my dates the truth – I’m not quite sure when you do tell someone that sort of thing, but I’m guessing it’s not on the first date.

It being January, it was easy to pretend I was doing the whole dry January thing. A couple of them tried to press me to “just have one”, but mostly they accepted it. I rather admired the one who said, “Well, I’m afraid I’m not going to hold back,” and ordered a carafe of red wine. I even kissed one of them. But then I went home and cried because he wasn’t my ex. And then cried some more because I hated myself for being so pathetic.

None of those men are going to be the father of my child, but that’s OK. Freezing my eggs has undoubtedly helped to dissipate that cloud of desperation. It’s not gone entirely, but knowing those eggs are on ice has given me breathing space. And now, two months after my last cycle, I’ve realised that it’s let me be me again in a way I hadn’t anticipated. Not just the me I was before I started pumping my body full of hormones, but the me I was before I was heartbroken. I feel lighter, happier and more optimistic than I have in a long time. I don’t think I’ll ever feel oblivious to the baby factor in the way that I might have done when I was meeting men in my early thirties, but I don’t feel anything like as panicked as I did a year ago.

I’m not deluding myself. I know that this is, fundamentally, experimental medicine. The rhetoric around egg freezing paints us as the generation who are too busy having careers to get pregnant, the women who think science is going to let them finally have it all in the way that feminism promised. But none of that’s true. It oversimplifies the situations of thousands of women who are what you might call “emotionally infertile”: childless not because of biological problems, but because they’re not in a relationship that’s ready for children. It’s not as if I buried myself in my work and emerged, aged 35, hunting for someone to father my children. I had two long-term relationships, one in my twenties and one in my thirties, both of which I thought would result in marriage and children. For me, and many women like me, freezing eggs isn’t a magic bullet, it just feels like the least worst option.

I know that egg freezing comes with no guarantees, that there’s every possibility that even if I do find the man of my dreams, those 14 vitrified eggs may never become the child that I want. But even knowing that, knowing how much I’ve spent, the nights out and holidays I’ve given up, the bloating, the emotional upheaval, the lies I’ve had to tell, I’m still glad I’ve done it. I may never know if the £14,000 I’ve spent has bought me time, and I can’t pretend it’s entirely bought me peace of mind, but it bought me hope, which, at that moment in my life, I really needed. Because at a time when I couldn’t have felt more negative, it gave me the opportunity to take a positive step – and I’ll never regret that.

 

Why fertility is far from finished at 40


As the rising abortion rate among women over 35 is blamed on their mistaken belief that they are ‘past it’, we find out the truth about later-life pregnancy .

Ellen Arnison had two sons aged seven and five, and thought her family was complete. But shortly after her 40th birthday, Arnison, from Renfrewshire, changed her mind. “A couple of months after I married for the second time, my dad died. That led to a carpe diem conversation, when my husband and I decided we’d try for another baby,” she says.

Ellen Arnison - pictured with her sons Altair, 14, and Cormac, four - fell pregnant in her forties

Ellen Arnison – pictured with her sons Altair, 14, and Cormac, four – fell pregnant in her forties

“I’d read so much about it being impossible for ‘older’ women to have children, I was sure nothing would happen. I kind of forgot about it. But a couple of months later I was pregnant.”

Surprised but delighted, Arnison is by no means alone. For years, the media has been full of apocalyptic stories about women leaving motherhood too late. “Britain is facing an infertility time bomb” and “The female fertility clock starts ticking at 27” are just some recent examples. Author Helen Fielding summed up the pressures in Bridget Jones’s Diary, in which the advice for her quintessential singleton heroine was: “You career girls. Can’t put it off forever. Tick-tock.”

But last week, this thinking was turned on its head. The latest Department of Health figures showed that abortion rates among women aged 35-plus had risen by 15 per cent since 2001. According to the British Pregnancy Advisory Service (BPAS), this rise in terminations was the result of women stopping using contraception after the age of 35, due to “scaremongering” that had led them to believe that they were infertile.

According to BPAS’s research on 156,751 women having abortions between 2011 and 2013, 42 per cent of women in their forties hadn’t used contraception, compared with 36 per cent in their early thirties and 34 per cent in their late twenties. The organisation, Britain’s largest abortion provider, pointed out that more abortions were carried out for women over 40 than among teenagers.

“Over the past few years, we have seen much scaremongering about older women’s fertility,” says Ann Furedi, chief executive of BPAS. “From career women leaving it too late to older women banking on IVF to conceive, these stories lead many women to dramatically underestimate their own fertility later in life.

“Fertility does decline as you get older. But the drop is not as great as we are sometimes led to believe. For women who don’t want to fall pregnant, the message is simple: use contraception until you have passed your menopause.”

Cherie Blair was astonished to discover, at 45, that he was carrying her fourth child. “I thought: ‘I can’t be, I’m too old. It must be menopause,’ ” she said. Actress Halle Berry last year revealed she was pregnant aged 46. “This has been the biggest surprise of my life, to tell you the truth. I thought I was kind of past the point where this could be a reality for me.”

TV and radio presenter Gaby Roslin was similarly stunned, aged 41, to learn she was having a second child. “It was a surprise. I said to my obstetrician: ‘But I’m so old!’ He told me I was talking nonsense and that he had women of 46 on his books – and he’s right. He said it’s not an age thing, it’s down to how healthy you are.”

Before the introduction of reliable contraception, older mothers were common, with women giving birth to their last child when they were grandmothers. In the Twenties, the average age a woman had her last child was 42.

Today, forty-something mothers are more likely to be first-timers, and their numbers are rising once again. Office for National Statistics figures show that pregnancy rates for over-40s have more than doubled in the past 24 years, with 14 conceptions per 1,000 women aged 40-plus compared with six per 1,000 in 1990.

Today, many twenty-something women are saddled with student debt. The average age to buy a first property is now 35, the age when women’s fertility supposedly “goes over a cliff”. One in three British men and one in five women aged between 20 and 34 still lives with their parents. No wonder the average age for a British woman to have her first child is 30, and 35 for university-educated women.

Among my own middle-class peer group, none of my close friends had her first child before 30. The vast majority were older than 35 and several were in their forties. I became pregnant at 35 and 37, with no problems and no regrets that I’d spent my carefree twenties focusing on friends and career. Being labelled an “elderly primigravida” in my birth notes only made me laugh.

But panic among young women has been increasing. The tipping point came in 2002, when US academic Sylvia Ann Hewlett published Baby Hunger, containing the unnerving statistic (that was misleading, since it only covered a tiny sample) that 42 per cent of career women had no children at the age of 40, and most deeply regretted it.

I frequently meet women in their mid-thirties who fret about their fertility. “My boyfriend’s 10 years younger than me and doesn’t like me pressuring him to marry me, but I’m 36”; “I left my husband because he was unfaithful – I should have done it sooner but I didn’t dare because I wanted to be a mum”; and “I’m not sure I’m really in love with him, but I’m 34 so I’d better marry him than risk never being a mother,” are just three stories I’ve heard in recent months.

“I was consumed by anxiety that my age meant doom,” wrote the US academic Jean Twenge, whose recent article on fertility scaremongering in the Atlantic magazine went viral. “I was not alone. Women on internet message boards write of scaling back their careers, or having fewer children than they’d like to, because they can’t bear the thought of trying to get pregnant after 35.” Twenge had three children, all born after her 35th birthday.

The fertility expert Zita West says that she constantly sees clients “panicking unnecessarily”. “Modern life puts up so many hurdles for women in their twenties that it’s not easy for them to have babies at the ‘ideal’ time, and then there’s so much anxiety and impatience from clients in their thirties.

“Couples put huge pressure on one another during ovulation and it’s increasingly common in my consultations to see men who have performance anxiety around sex and ovulation. They say: ‘Oh, my God, it’s never going to happen’ when they’ve only been trying for three months, or they live in different countries and only have sex once a month. Often they rush into having IVF when they don’t need it.”

In fact, the true statistics about female fertility are far less terrifying than is widely believed. Women do lose 90 per cent of their eggs by 30, but that still leaves them with 10,000, when only one is needed to make a baby.

Then there’s the statistic that one in three women aged between 35 and 39 will not be pregnant after a year of trying, taken from a 2004 article in the journal Human Reproduction. These figures do not come from large, scientifically conducted studies of contemporary women, but from French birth records from 1670 to 1830, covering women with no access to modern health care or nutrition.

In contrast, the few studies of women born in the 20th century and trying to conceive are markedly more positive. One 2004 study of 770 European women found that 82 per cent of 35- to 39-year-olds would conceive within a year if they had sex once a week, compared with a very similar 86 per cent of 27- to 34-year-olds.

Consultant gynaecologist Tina Cotzias agrees that “older” women shouldn’t be daunted. “Yes, chances of pregnancy decline with age but this doesn’t mean it will never happen to you as an individual. And, of course, there are many reasons why it might not be right for a woman to have babies in her twenties, not least that she may not have met the right man. What’s important is not to scare single women, but to communicate to a 28-year-old who is with the man she wants to spend the rest of her life with that she might be better off trying for a baby now than delaying it 10 years.”

Cotzias warns that statistics are gloomier for IVF patients, with only 4 per cent of IVF cycles ending in a live birth in women aged 42 and older. Miscarriage rates soar in the over-40s, from an average 7 per cent to 18 per cent, and the risk of stillbirth doubles.

On the plus side, research indicates that “older” mothers usually have more solid marriages, command higher salaries and live longer than women who have their children in their twenties. When interviewed, these women almost invariably report that choosing to delay motherhood was the best choice they’ve made.

Ellie Stoneley, from Cambridge, author of the blog “Mush-Brained Ramblings”, was 47 when she conceived her daughter – Hope, now two – after IVF. “I had a straightforward pregnancy, and the medical staff could not have been more supportive. I get tired from time to time, but so do all new parents and I know if I’d had Hope younger, I’d have been trying to go out more in the evenings and would have found it much harder to get up in the night. Now all my energy’s focused on my daughter. I wish I’d had a child younger as I’d have loved lots, but I do feel incredibly blessed.”

Ellen Arnison went on, aged 42, to give birth to a healthy son, now four.

“Being pregnant in my forties was tougher than in my thirties,” says Arnison, author of another blog, “In A Bun Dance”. “But motherhood was easier. I was much more relaxed, because I was more confident.

“I could be paranoid, but I do sometimes feel there is a sexist agenda in telling women they must have babies at what’s also a crucial time in their careers,” she continues. “The truth is there’s no ‘best’ time for a baby – you take what life brings you.”

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