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MISCARRIAGE

NICE supports vaginal progesterone to prevent threatened pregnancy loss

The UK agency has updated its guidance on the management of miscarriage to recommend micronised progesterone for women with a previous miscarriage who bleed in a new early pregnancy - but only after ultrasound confirmation of the intrauterine location of the pregnancy.

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OCCUPATIONAL CHEMICALS

Maternal occupational exposure to endocrine-disrupting chemicals linked to urogenital anomalies in offspring

A large-scale case control study has shown an association between exposure during pregnancy to certain endocrine-disrupting chemicals in the workplace and a greater risk of urogenital anomalies – though not hypospadias – in offspring. Employers ‘need to be aware’ of this risk.

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SUGARED DRINKS

Young men’s consumption of soft drinks has marked effect on sperm parameters

The largest study to date on sweetened drinks and testicular function finds a link between consumption and sperm counts, although the authors are reluctant to extrapolate the link to male fertility.

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REGISTRY RESULTS AUSTRALIA

Multiple birth rate in latest Australia/New Zealand registry data falls to all-time low

Annual multiple birth rate fell to 2.9% in 2019, with an elective single embryo transfer rate of almost 92%. The results, when seen alongside a continuing increase in LBR in fresh and frozen cycles, were described as ‘unprecedented’.

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MENOPAUSAL AGE

Age at menopause: number of births has only limited effect from interrupted ovulation

A large population study has found that having three childbirths is associated with an older age at menopause – and none with a lower age – but there were no further effects beyond three. The results question the assumption that interrupted ovulation during pregnancy delays menopause.

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MOSAICISM

The definition of mosaic embryos and their management after PGT-A

Another day, another controversy in PGT-A, as leading groups appear in dispute over the definition of ‘mosaic’ based on a chromosomal copy number threshold, the idea that mosaic embryos might ‘self-correct’, and how the degree of mosaicism is related to clinical outcome.

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AIR POLLUTION

Ambient air pollution implicated in millions of underweight and premature births

An update of the ‘burden of global disease’ studies has for the first time shown to what extent air pollution affects several key indicators of pregnancy, including birth weight and preterm delivery.

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PCOS

Polycystic ovaries still a matter of contention in the diagnosis of PCOS

Substituting the ultrasound assessment of ovarian morphology with serum AMH measurement to diagnose PCOS according to the three Rotterdam criteria changed the number of women classified as having or not having PCOS – and ‘further blurs the diagnostic margins’.

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OBESITY

Cohort study finds a ‘causal effect’ of high (and low) BMI on subfertility

A large population study using two analytical approaches finds a consistent association between BMI measurements and subfertility; a predicted BMI of 23 in women and 25 kg/m2 in men was linked to the lowest subfertility risk.

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CAMPUS: GENETICS OF MALE INFERTILITY

The greater role of genetics in the cause and diagnosis of male infertility

A wide-ranging ESHRE Campus workshop organised by the SIGs Andrology and Reproductive Genetics looked at current and emerging approaches for the characterisation of various causes of male infertility, including tests in the genetics of idiopathic conditions, chromosomal anomalies – notably Klinefelter syndrome – and new molecular methods for investigation.

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