Page 8 - Focus on REPRODUCTION SEP 2015

2015 HONORARY MEMBERSHIPS
outcomes in 5375 women with endometriosis with those of 8280 women without endometriosis who were pregnant at the same time. After adjustments for age and previous pregnancy, results showed that women with endometriosis had a significantly higher risk of early pregnancy complications than the controls. This risk was 76% higher for miscarriage (OR 1.76) and nearly three-times higher for ectopic pregnancy (OR 2.7). In women with a previous diagnosis of endometriosis the risks of adverse pregnancy outcomes, including ante- and postpartum haemorrhage and preterm birth, were also significantly increased. Principal investigator Lucky Saraswat from Aberdeen Royal Infirmary advised that women with a diagnosis of endometriosis should be counselled about the higher risks of miscarriage and ectopic pregnancy in the first trimester, ‘which warrants increased monitoring by ultrasound scans, and greater vigilance to identify potential complications such as bleeding and preterm delivery’.
An even bigger analysis of 21 cohort studies which included almost 2 million women found that a dilatation and curettage (D&C) procedure performed in cases of miscarriage or induced abortion increases the chance of preterm birth (under 37 weeks) in a subsequent pregnancy by 29%, and of very preterm birth (under 32 weeks) by 69%. Presenting the results, Pim Ankum from the Academic Medical Centre of the University of Amsterdam called for a more ‘restrained
Honorary
membership of
ESHRE was awarded
to Paul Devroey,
pictured left
receiving his award
from incoming
ESHRE Chairman Kersti Lundin, and to Steve Hillier,
who, above, received his award from outgoing Chairman Juha Tapanainen. Devroey himself was Chairman of ESHRE from 2005 to 2007, having developed ICSI more than a decade earlier with his Brussels colleague André Van Steirteghem. Hillier was Editor-in- Chief of Molecular Human Reproduction from 2007 to 2013.
use’ of D&C. Indeed, this decline in use appears already to have begun, reflected in the increased popularity of misoprostol either as an alternative to D&C or for cervical priming prior to curettage.
Another large cohort study reported in Lisbon - from the Netherlands Cancer Institute - found that after a median follow-up of 16 years in an ART group (the OMEGA project) of almost 30,000 women having treatment between 1983 and 2001, no significantly increased cancer risk was observed in any of the offspring conceived by ART. The results, said Mandy Spaan, confirm another linkage study reported at ESHRE two years ago in which no increased cancer risk was observed in 106,000 ART-conceived children in the UK. Similarly, results from the Cancer Registry of Norway presented in Lisbon by Marte Reigstad, which included more than 25,000 children conceived by ART, showed no overall increased risk of cancer but a small increased risk of leukaemia and Hodgkin’s lymphoma. These findings, said Reigstad, were in line with other studies.
Although the risk of ovarian damage following
treatment for childhood cancers depends on its
dose and
8 Focus on Reproduction // SEPTEMBER 2015