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Fertility

Review of Glow: A Reproductive Health App

25 Aug, 15 | by shaworth

Glow is a reproductive health app for Android and iOS, developed and released this year. It forms part of a triad of apps including Glow Nurture, which allows logging of pregnancy data, and Ruby (currently only available for iOS) which logs and advises on contraceptive use.

The purpose of Glow is to centralise fertility awareness measures for either optimisation of fertility, or for use as part of family planning through fertility awareness methods. Users can log their cycle length, body temperature and cervical mucus consistency to determine ovulation periods. After logging data, the app generates “insights” based on the data supplied i.e. short snippets of advice for improving fertility, or managing symptoms. In addition, Glow collects data on weight, stress levels, alcohol intake and exercise. Users are advised to enter a daily health log, and set reminders about user dependent contraceptive methods and pre-natal supplementation.

For all the data entry that is required, Glow is remarkably streamlined. It took very little time to enter a daily log, largely because the user interface to do so is excellent. Once the data is logged, the app returns to its home screen where the day of the cycle is demonstrated, alternating with the risk of conception (unless you’re using LARC, where it does not show this and is a nice touch). From here, it’s possible to navigate to all other areas of the app.

Glow’s user interface is exceptionally well designed, and using it feels intuitive. There are no flashy trimmings: the interface is streamlined, which is is probably why it comes in at around 24MB on your device. It can also synch with some fitness accounts with other providers.

Glow is free to download and use, and during my short time using it, I did not notice the presence of intrusive ads; although Glow’s ToCs do stipulate that advertised content is provided. Glow’s privacy statement says that personally identifiably data is not shared with third parties; although aggregate data is, which might explain where some of the profit comes from.

The main drawback to using Glow is that it is US-centric, and as such, its advice is based on US healthcare advice and guidelines. This said, the app can be used by people in other countries without feeling disconnected from the user’s personal experience.

Overall verdict: a powerful tool which can give women the tools to optimise fertility without taking up valuable baby-making time.

Sexual Function In Childhood Cancer Survivors

12 Aug, 14 | by shaworth

Journal readers may be interested to know about a recent study published in the Journal of Clinical Oncology, a cohort study of over two thousand women who had suffered from childhood cancer compared with their female siblings, which demonstrated an excess of psychosexual morbidity in those who had suffered cancer as children.

It is known that the treatment of cancer can affect sexual functioning in a variety of ways, from premature menopause to the direct effects on the genital tract; however in these women, it would appear that the effects of the cancer, and treatment, persisted into adulthood. Compared with their sisters, they reported having less sex, less desire for sexual and less satisfaction with sexual intercourse. Speaking to Reuters Health, the study lead Jennifer Ford, expressed her surprised at the persistence of these effects.

About ten percent of women in the study experienced premature menopause, and only half of these were taking some form of hormone replacement; although this did not seem to improve the outcomes measured.

The study did not measure similar outcomes in men, so it is not clear if their experience is similar; however, the study does suggest that sexual function should be addressed in adolescents who have suffered cancer, and opened up for discussion with those who are facing cancer treatment.

Coming Over Here: UK and Overseas Sperm Donors

29 Jun, 14 | by shaworth

 

Sperm donor anonymity was revoked in the UK in 2005, meaning that children born from donor sperm can now trace the identity of their genetic father at the age of eighteen. The same is true of egg donors. The reverse was not true at the time of the change, with gamete donors being unable to request information about any children they may have assisted in the production of; however cases have since been presented to court from sperm donors who are known to the recipient couple seeking access to the children they have produced.

This week there have been articles in the press about the perceived fall in UK sperm donors since the 2005 legislation was introduced; although few are able to prove this allegation, despite the data being available. All fertility clinics in the UK are regulated by the HFEA, who require registration data on all donors whose samples can be used to artificial reproduction techniques (thus excluding those whose samples are donated to research). In 2011, around 2,000 women received donor insemination and over the last few years, the number of embryos produced from donor procedures has remained steady; although this does not, for some reason, include ICSI procedures where sperm is directly injected into an egg, cultured and reimplanted, which somewhat muddies the waters.

In fact, contrary to the media reports, the number of new UK donor registrations with the HFEA has been rising steadily since 2005. New sperm donor registrations were actually lower in the year preceding the anonymity revoking than any other year since 1992. When the figures are broken down by UK and overseas donors, there has actually been a steady increase year-on-year since 2005. Yes, in 2005 1:10 new donors were from overseas, and in 2010 it’s 1:4, but over the same time period the UK new donor registrations have increased by a third, and overseas donors have increased four-fold, rather than a drop in UK donors and overseas donors making up a shortfall.

Of course, the data available to the public goes up to 2011, and it’s now 2014, so it’s possible that data has been selectively leaked to people who are not your humble blogger, and perhaps ICSI requests have risen stratospherically so that we can’t keep up with demand; although that wouldn’t explain why everyone is so quick to blame legislation that’s nine years old on a three year old phenomenon. Perhaps, the story here is not about a looming sperm-famine, but that you can make some good headlines out of unresearched articles produced with a mere flick of the wrist.

ESC – 13thCongress and call for applications for project funding

16 Sep, 13 | by shellraine, e-Media Editor

Mark your calendar:

28 till 31 May 2014
Lisbon, Portugal

First announcement

Check out the first announcement including:

  • programme overview: 8 workshops, 21 congress sessions, 2 debates…
  • abstract submission instructions (deadline 1 December 2013)
  • registration form

Register now

Please find here an overview of the registration fees.
You can now register through the online registration form

General information / Programme overviewCall for abstracts (deadline = 1st December 2013)/ Registration

ESC newsletter

Call for project or course applications

The ESC provides funding to support a project within Europe

The available budget for applications received between 1 August and 31 December 2013 is 30,000 euro. Applications should meet the following minimal conditions:

  • The applicant must be a paid-up ESC member
  • The grant may be used to support an individual, group, institute or organisation with a project related to the aims of the ESC.
  • Examples of projects include: research, audit, review, needs assessment

Deadline for the application period:  31 December 2013

Application Form

 

 

World Contraception Day – 26 September 2013

16 Sep, 13 | by shellraine, e-Media Editor

WCD will be using an umbrella theme for this and future years: ‘Its your life; its your future’. This theme has been chosen as it is forward-looking, positive and empowering.

There are 3 sub-themes:

Your options: where young people can learn about all the contraceptive options available, using a reliable, unbiased source of information.

Your future:  understanding how unplanned pregnancies can happen and how the body changes during puberty

Your partner: learning to talk to your partner about contraception and how to build a trusting relationship based on reliable information

Organisations may choose whether to concentrate on one theme per year or cover all or some of the subjects this year.

A selection of materials are available in the form of a modular toolbox addressing each theme with background information and info graphics. Social media will be used more widely this year and suggested topics for Twitter and Facebook will be made available. There is also a countdown clock.

Campaign materials are available here: http://bit.ly/WCD2013

 

 

 

 

July Journal published as Impact Factor soars to 2.1!

20 Jun, 13 | by shellraine, e-Media Editor

The July edition of the Journal is now available online and includes:

Venous thromboembolism and COCs: an ongoing saga

This ongoing controversy recently resulted in the decision of the French authorities to withdraw the combined oral contraceptive (COC) containing ethinylestradiol (EE) and cyproterone acetate (i.e. Diane 35®) from the market. This consensus statement from 26 international experts in contraception concludes that “Both epidemiological data and clinical trials must be taken into account when best practice is defined. Regulatory restrictions of previously registered methods should only be made after careful assessment of all the available evidence”. See page 156

Serum CA125 for ovarian cancer screening

This timely commentary raises questions about the widespread use of screening women with non-specific symptoms by measuring serum CA125 levels, following the publication of the NICE guideline on ovarian cancer in 2012. The authors acknowledge that there are barriers that prevent women with symptoms associated with ovarian cancer from presenting to their general practitioner. However, the authors also point out that this will lead to increased use of CA125 in general practice and raise concerns about how women with raised CA125 in the absence of evidence of any disease should be managed. See page 160

Ovarian cancer symptom awareness and help-seeking behaviour

Ovarian cancer symptom awareness is low in the UK, and varies widely between symptoms. In this study, Low et al. identify variables that may be implicated in a longer time to help-seeking for possible ovarian cancer symptoms, and highlights the need for more in-depth research into the factors related to time to help-seeking in real-world situations. See page 163

Fertility preservation decisions faced by women with breast cancer

This article presents a contemporary summary of fertility preservation techniques available to women of reproductive age with breast cancer. It offers unique insights into the difficult treatment decisions coupled with the difficult fertility preservation treatment decisions that these women face. The article highlights a number of themes that influence the decision-making process for these women. Egg and embryo banking appear to be the fertility preservation treatment of choice. Finally, this work may assist health care commissioners when deciding funding priorities within a health economy such as the NHS in the UK. See page 172

Correlates of unprotected sex in drug-injecting women

This study demonstrates that despite the high risk for HIV acquisition or transmission and unintended pregnancy, condom use among women who inject illicit drugs or who have sexual partners who inject drugs in St Petersburg in Russia is low. Programmes to investigate and improve contraceptive use, including condoms, among this vulnerable group of women are needed and might benefit from addressing alcohol misuse. See page 179

Contraception in a university environment

This is a very simple real-life observational study of a cohort of young, nulliparous women in a university-based general practice choosing and continuing with long-acting reversible contraceptive methods (LARCs) as their first line method of contraception. This article urges the health professional reader to consider offering this ‘fit and forget’ method of contraceptive to our younger population as a matter of routine. See page 186

Impact of UKMEC on CHC prescribing

Briggs et al. have assessed the effect of the UKMEC on prescribing of combined hormonal contraceptives (CHCs). Sadly, although there has been a small decrease in the proportion of higher-risk women being prescribed CHCs, their results suggest that in 2010 7.3% of CHC users had UKMEC Category 3 or 4 risk factors, particularly BMI ≥35 kg/m2. The authors point out that it is likely many of these women were being placed at an unnecessarily high risk of cardiovascular events, given the availability of lower-risk alternatives. See page 190

Financial cost to patients of a suspected ectopic pregnancy

In this article, Unger and colleagues in Edinburgh report on their assessment of an area of patient experience that is not often considered when assessing medical interventions. The financial impact on patients’ lives of the need to seek medical attention can be considerable and may become more significant as economic hardship increases. This article describes a well-conducted questionnaire study on the costs that patients themselves incurred in attending their general practitioners and a hospital clinic with a suspected ectopic pregnancy. The authors argue that such costs need to be factored into decisions regarding the cost-effectiveness of medical procedures. See page 197

Emergency contraception algorithm based on risk assessment

Introduction of a standardised protocol for the provision of emergency contraception (EC) has significantly increased the proportion of women offered an intrauterine device (IUD) as postcoital contraception, particularly in women at high risk of conception. Introduction of ulipristal acetate as an alternative method of EC has resulted in a reduction in the uptake of the emergency IUD. McKay and Gilbert state that this is cause for concern, and further investigation into the reasons behind this decrease in IUD uptake is needed. See page 201

No need for water torture

Cameron and colleagues set out to answer a simple question, namely does a full bladder assist insertion of intrauterine contraception? In the world of assisted conception a full bladder had been shown to aid intrauterine catheter insertion for embryo transfer, but could this knowledge be transferred usefully to the world of contraception? This simple question was answered in a simple and elegant way with a properly constructed and conducted randomised trial, which showed that we needn’t ask our clients requesting IUD/IUS insertion to arrive bursting – a fact for which both they and clinic staff will be duly grateful. See page 207

New monophasic natural estradiol COC

Lee Shulman reviews a new monophasic natural estradiol COC, Zoely®. This COC benefits from the progestogen nomegestrol acetate (NOMAC), which appears to result in good cycle control, with a 24/4 regimen. Since it is monophasic, it also has potential for extended cycle use. The great hope is that natural estradiol COCs will have a lower risk of venous thromboembolism (VTE) than EE-containing pills, but it should be stressed that there is currently no actual evidence for this. Studies are ongoing, but at present these COCs should be treated just like any other from the point of view of VTE. See page 211

Brook/FPA UK Sexual Health Awards 2013

The Journal’s Consumer Correspondent writes about the recently awarded Brook/FPA UK Sexual Health Awards, and opines that awards of this type are a good thing for the SRH profession generally and so rightly should be regarded as a highlight of the sexual health year. See page 219

Plus

An obituary for Dr Alison Bigrigg by Dr Audrey Brown; an organisational factfile on Tommys; a conference report from the FSRH Annual Scientific Meeting at University of Warwick;

And last, but by no means least, the Journal Impact Factor has risen, once again, to 2.1. Many congratulations to Anne Szarewski and her team.

 

Copenhagen Impressions

3 Jun, 13 | by shellraine, e-Media Editor

European Society of Contraception and Reproductive Health
First Global Conference

Global

Highlights of the Congress included:

Crown Princess Mary opening the Congress followed by the amazing Copenhagen drummers                          drummers

 

 

 

Green contraception – estrogen in water an issue, rating methods for their ‘greenness’: hormones, packaging etc.

Lidegaard / Shulman / Dinger – continuing debate on VTE, interpreting research, epidemiology and practical applications.

Emergency Contraception – confirmation that pills have no impact globally on unintended pregnancy rates only IUDs do.

Meeting friends, old and new, from wider across the globe than usual, especially from the Baltic states, Africa and the Far East.

In addition the Board voted to set up a working group to investigate and promote multidisciplinary working across Europe.

bella sky

The startling Bella Sky hotel & conference centre

– especially the, trompe l’oeil, walkway between the 2 towers on the 23rd floor. It goes uphill from Tower 1 to 2 but from a distance appears to go the other way.

 

 

oresund  The Oresund Bridge

– the 5 mile rail and road link between Copenhagen and Malmo

 

 

 

bikesBicycles, bicycles and more bicycles

and particularly proper, separate, dedicated cycle lanes – at times quite scary and felt like being in the middle of the Tour de France peloton without the lycra and wrap-around shades!,

Great open sandwiches (smorrebrod) but hardly any danish pastries.

Herrrings, steak & frites. Not brilliant for veggies.

Good beer but not wine – used by next years hosts in Lisbon as an enticement to go there.

Lisbon

 

 

DH Consultation on publication of abortion statistics

1 May, 13 | by shellraine, e-Media Editor

The Department of Health (DH) is proposing changes to the way it publishes abortion statistics for England and Wales, and is seeking the views of commissioners, clinicians, academics and other government departments and special interest groups. The consultation is open until 10 June 2013.

The aim of the consultation is to ensure that the abortion statistics remain relevant and useful to users. It covers:

  • the usefulness of the annual report
  • the engagement of users to derive maximum value from the statistics
  • the relevance of the statistics to devolved governments
  • whether to present detailed tables by primary care trust, clinical commissioning group or local authority

The responses and outcomes from the consultation will influence how the department presents the statistics for 2012. The 2011 annual abortion statistics report may be useful for comparing potential changes to the 2012 publication.

April Journal – 20th Anniversary of the FSRH

9 Apr, 13 | by shellraine, e-Media Editor

Hightlights from this edition include:

The FSRH’s 20th anniversary

It is 20 years since the establishment of the Faculty of Sexual and Reproductive Healthcare (FSRH). In celebrating its anniversary there is much to be proud of, and indeed Community Sexual and Reproductive Health is now a specialty in its own right. Readers should find the story of the birth and rise of the specialty interesting and some will be reminded of ‘old times’, while looking ahead to a bright future. See page 78

Does HRT cause breast cancer? Part 5

Shapiro and colleagues conclude the interesting and enlightening series of articles looking at the evidence around hormone replacement therapy (HRT) and breast cancer risk (page 80). The final part examines the evidence for there being a declining trend in breast cancer incidence as HRT use reduced. Although the two are widely held to be related, they conclude that it is not possible to say either way. In the accompanying
Commentary (page 72), Nick Panay reviews the whole series of five articles and reminds us that optimising the lives of millions of women going through the menopause should be our priority. See pages 72 and 80

COCs and the risk of VTE, ATE and cardiovascular death

Syd Shapiro provides another of his incisive reviews of the latest database study of the combined pill and venous (VTE) and arterial (ATE) thromboembolism risk. Unsurprisingly, he finds many of the same problems as in the other studies, and asks the question why do these studies keep being done badly when the methodological flaws have been so well established? See page 89

“Anything for the weekend – and beyond, madam?” Community pharmacies increase OC uptake

Parsons et al.‘s evaluation of a community pharmacy delivered oral contraceptive (OC) service in South-East London is of particular interest, as it demonstrates the value of providing OCs via this service outlet, especially for women who would not otherwise access long-term contraception. Specially trained pharmacists provided OCs under a patient group direction (PGD), and subsequent evaluation showed that these pharmacists were clinically competent to provide OCs according to a PGD, and that the service was successful in attracting the population identified as most in need.  See page 97

There’s a tale in this sting – The policing of abortion services in England

What was the background to last year’s Care Quality Commission inspections of all English abortion services? Why were medical and nursing colleagues reported to their regulatory Councils and why is a Metropolitan Police investigation still ongoing? Sam Rowlands’ commentary provides a fascinating and detailed account of the regulatory framework of abortion services in England and the unexpected consequences of a national newspaper’s ‘sting’ operation on certain clinics in February 2012. It suggests that the regulation of abortion goes further than the Law requires and that this is now out of step with progress in abortion practice, leading to unnecessary restriction for women with unwanted pregnancies in accessing the support they need. See page 121

Role of ambulatory hysteroscopy in reproduction

The relatively recent introduction of outpatient operative hysteroscopy enables investigation and treatment previously carried out in the operating theatre to be performed in the clinic setting without the need for general anaesthesia. A ‘see and treat’ style of management is being adopted, which is changing how we configure our gynaecological services. This review aims to summarise the role for ambulatory hysteroscopy in the diagnosis of conditions contributing to reproductive failure and in sterilisation. See page 127

LAM: why ignore this useful option?

In this interesting personal view article, the authors explore and elaborate on the reasons why health care providers and the public are hesitant in recommending/adopting the lactational amenorrhoea method (LAM), a valuable short-term postnatal contraceptive option. These include ignorance about the LAM criteria for correct use, mistrust of the method’s effectiveness despite a strong evidence base, inconsistencies in the advice given to breastfeeding women in the UK by health practitioners and public bodies (e.g. the National Health Service, Royal College of Obstetricians and Gynaecologists), and lack of awareness about potential benefits. See page 136

Internet: good or bad?

2013 marks the 30th anniversary of the Internet. Our Consumer Correspondent looks at whether this technological miracle is a ‘good idea’ for the health profession. See page 139

New subcutaneous DMPA injection

Sharon Cameron discusses the new subcutaneous injection of depo-medroxyprogesterone acetate (DMPA), Sayana® Press, which is soon to be released onto the market in the UK. It seems to be very similar to the intramuscular DMPA, but can be self-administered. Unfortunately, this advantage is not being utilised, as this contraceptive method is not yet licensed for self-administration in the UK. See page 75

Psychosocial factors affect semen quality

Semen quality appears to be declining and this cross-sectional study in China casts light upon some factors that may be associated with that decline. See page 102

The ‘Woman’s Condom’ – will the Chinese go for it?

The need for products that simultaneously protect against unwanted pregnancy and STIs, including HIV, has prompted interest in the development of multipurpose prevention technologies, including new variants of the female condom. In this issue, Coffey and colleagues describe their survey of initial reactions to the ‘Woman’s Condom’ (which obtained marketing approval in China in 2010) by potential user groups in Shanghai. See page 111

21 Feb, 13 | by shellraine, e-Media Editor

JFPRHC is looking for a dynamic reader to take on the role of social media editor

The Journal already has a strong readership and offers online features such as a blog, podcasts, Facebook and Twitter.  This new post has been created to assist the editorial team in improving the journal’s interactivity and web presence via these and other social media, by promoting the journal’s content as well as helping its core readership to stay up to date with news and developments in the field.

You should be educated to degree level with knowledge of the journal’s subject area. Some experience of science communication and/or web content management systems such as Twitter, Facebook andWordPress would be preferred, but the main criteria for the successful applicant will be enthusiasm for the subject area, creativity, and an interest in using new technologies to disseminate scientific research.

The role would be ideally suited to a junior researcher or practising clinician. The full advert, and how to apply, is available at: http://jfprhc.bmj.com/site/misc/JFPRHC%20Social%20Media%20Editor%20advert%20Feb%202013.pdf

Sexual Health Commissioning

the Local Government Association and Public Health England have produced a document of FAQs. They address a number of transitional issues relating to the transfer of responsibility for commissioning sexual health services to local government.  In addition to these FAQs the Department of Health will shortly publish guidance on local government’s mandatory responsibilities for sexual health.

Reminder to register as stakeholder for NICE Patient group directions Good Practice Guidance

Management of PGDs will change from the 1st April when commissioning of services changes. All those involved in development or use of PGDs can contribute at the  consultation stage by registering as a stakeholder now. Individuals can contribute as service providers.

To register your organisation as a stakeholder send registration details (name of contact, name of organisation, email address) to pgd@nice.org.uk using the subject heading Patient group directions GPG stakeholder registration 2012/13

National Infertility Awareness Campaign Welcomes updated NICE Guideline on Treating Infertility

The National Infertility Awareness Campaign (NIAC) has welcomed the new clinical guideline on the assessment and treatment of couples with fertility problems, published by NICE yesterday but fears remain over its implementation.

People experiencing fertility problems will be able to seek NHS help sooner and get the medical treatment they might require earlier. The updated guideline also includes other specific groups of people for the first time; these include same sex couples, those who carry an infectious disease, such as Hepatitis B or HIV and those who are unable to have intercourse (for example, if they have a physical disability). It also includes updated recommendations for people who are preparing for cancer treatment who may wish to preserve their fertility. However, as NICE clinical guidelines are not mandatory, fears still remain over local implementation as patients may continue to face a ‘postcode lottery’ approach to funding. This coincides with the release of the

Latest UK fertility treatment data and figures: 2010-2011

Published this week by the HFEA – ‘Fertility Treatment in 2011: Trends and Figures’

Education about abortion in the UK is failing young people

A report published by Brook and Education For Choice (EFC) finds that education about abortion in the UK is failing young people.  Some schools are addressing the topic as part of comprehensive sex and relationships education (SRE), but there is evidence of widespread bad practice including medical misinformation being provided by teachers and visitors to schools.  The report pulls together findings from surveys with schools and young people, and an audit of teaching materials used. Young people describe negative experiences of the education they received, and report that some schools are using inappropriate teaching materials including graphic images and distressing, inaccurate video material.

 

 

Latest from JFPRHC

Latest from JFPRHC