1.3 % of women in the general population will develop ovarian cancer sometime during their lives. 39 % of women who inherit a harmful BRCA-1 mutation and 11-17 % of women who inherit a harmful BRCA-2 mutation will develop ovarian cancer by age 70. There are other risk factors for ovarian cancer which include a family history of breast, ovarian, and possibly, other cancers; the specific mutation(s) she has inherited; and reproductive history. However, none of these other factors are as strong of a risk factor as the harmful BRCA-1 or BRCA-2 mutation. BRCA-1mutations may also increase a woman’s risk of developing fallopian tube cancer and peritoneal cancer. The Ashkenazi Jewish population have a higher prevalence of harmful BRCA-1 and BRCA-2 mutations than people in the general U.S. population. Other ethnic and geographic populations around the world, such as the Norwegian, Dutch, and Icelandic peoples, also have a higher prevalence of specific harmful BRCA-1 and BRCA-2 mutations.
DNA (from a blood or saliva sample) is needed for mutation testing. The sample is sent to a laboratory for analysis. It usually takes about a month to get the test results. When an individual has a family history that is suggestive of the presence of a BRCA1 or BRCA2 mutation, it may be most informative to first test a family member who has cancer if that person is still alive and willing to be tested. If that person is found to have a harmful BRCA1 or BRCA2 mutation, then other family members may want to consider genetic counseling to learn more about their potential risks and whether genetic testing for mutations in BRCA1 and BRCA2might be appropriate for them.
Several options are available for managing cancer risk in individuals who have a known harmful BRCA-1 or BRCA-2 mutation. These include enhanced screening, prophylactic (risk-reducing) surgery, chemoprevention, and In Vitro Fertilization with Preimplantation Genetic Diagnosis. Screening includes clinical breast examinations beginning at age 25 to 35 years and a mammogram every year, beginning at age 25 to 35 years. No effective ovarian cancer screening methods currently exist. Some groups recommend transvaginal ultrasound, blood tests for the antigen CA-125, and clinical examinations for ovarian cancer screening in women with harmful BRCA1 or BRCA2 mutations, but none of these methods appear to detect ovarian tumors at an early enough stage to reduce the risk of dying from ovarian cancer.
Prophylactic surgery involves removing as much of the “at-risk” tissue as possible. Women may choose to have both breasts removed (bilateral prophylactic mastectomy) to reduce their risk of breast cancer. Surgery to remove a woman’s ovaries and fallopian tubes (bilateral prophylactic salpingo-oophorectomy) can help reduce her risk of ovarian cancer. Removing the ovaries also reduces the risk of breast cancer in premenopausal women by eliminating a source of hormones that can fuel the growth of some types of breast cancer.
Moreover, women of reproductive age desiring future fertility, can chose to freeze their eggs prior to prophylactic removal of their ovaries in order to preserve their fertility. For women with a partner, desiring pregnancy, they can chose the option of In Vitro Fertilization with Preimplantation Genetic Diagnosis where we can test the embryos for the harmful BRCA gene in the embryo so that we can prevent this gene from being passed on to their offspring. Such amazing technology has helped many women have healthy children without the BRCA gene allowing their children to have a reduced risk of both ovarian and breast cancer.
Dr. Christine Mullin, M.D.
Dr. Christine Mullin joined the Northwell Health Fertility team after completing her subspecialty training in Reproductive Endocrinology and Infertility at the NYU Fertility Center of the New York University School of Medicine. She is the Director of the IVF Program and Director of the PGD/PGS Program at Northwell Health Fertility.
“About one-third of men in the United States are obese,” said Dr. Avner Hershlag, chief of Northwell Health Fertility in Manhasset, N.Y.
America is getting fatter and fatter, despite the proliferation of new diets and exercise routines. And about one-sixth of children and adolescents are already obese, Hershlag noted.
“Along with the growing obesity trend, there has been a steady decline in sperm quality,” Hershlag said. “The findings in this study, while not specifically related to infertility, represent a trend towards a decline that is worrisome.”
Read the full article here.
The answer to that question and more is what researchers are currently aiming to find out over the course of a 12-week trial.
While an estimated one in six of all couples are unable to conceive on their own, half of these cases are attributed to sperm quality. For this reason, this study and studies like it are important to reproductive health. (read more…)
The first uterine transplant in the US has just been announced. We are excited about this new option for women who do not have a uterus to carry their own pregnancy. This procedure, already performed several times in Europe, awaits long-term validation regarding safety and ethical issues involved.
Below is a statement from the American Society for Reproductive Medicine, published today. (read more…)
A diet that is rich in soy could be helpful in protecting women that undergo certain infertility treatments against many of the effects of Bisphenol A (BPA), believed by some to be harmful. The chemical is used in many food containers and packaging, and for most, is unavoidable. But, findings from a new study suggest that soy may help counteract some of the health concerns associated with the chemical– particularly in regards to reproductive health. (read more…)
Researchers from the University of California Irvine recently discovered that excess consumption of green tea may have an adverse impact on reproduction and development in fruit flies. (read more…)
Dr. Howard Jones, the pioneer of IVF in the U.S. , passed at the age of 104. How befitting was it that “Dr. Howard,” as anyone who has had contact with him liked to call him, was given a gift of longevity. Rather than mourn his passing, we should celebrate his life, his legacy. Rarely does one person matter to the lives of so many people. Dr. Howard’s life is a story of a doctor who kept reinventing himself. The young surgeon who operated on over 300 Allied soldiers during WW II, chronicled every single surgery on a separate card, yet not a day went by when he didn’t write a love letter to Georgeana, his life and professional partner.
Upon his return, Dr. Howard led the Ob/Gyn Department at Johns Hopkins and developed a surgical expertise in gynecology that made him the prime surgeon in the country. He would get referrals of many complicated cases in the country and many from abroad. It was in that capacity that he met young Bob Edwards and gave him human eggs to fertilize – experiments that led to the birth of the first IVF baby in England, Louise Brown, in 1978. When Dr. Howard and Georgeana “retired” at the age of 65 from Johns Hopkins, they reinvented themselves by pioneering IVF in the US in Norfolk, Virginia, which led to the birth of Elizabeth Carr, the first US IVF baby, in 1981.
Dr Howard continued to lead the Jones Institute at Norfolk and inspire the viral spread of IVF in the country and worldwide. Millions of babies, children and adults owe their being to a person they’ve never met who, with humility, wisdom, perseverance and awareness of calling pursued what only 4 decades ago was considered science fiction.
Dr. Howard, you have been a huge inspiration to us fertility doctors. We have climbed on your shoulders to see the infinite terrain that is yet to be conquered. Your legacy will go on forever. And it is encumbered upon us to carry your torch!