Since its inception in the mid-1980s, ‘post-abortion syndrome’ has become an invaluable arrow in the pro-life quiver, allowing arguments against abortion to be presented from the standpoint of protecting women’s health. Post-abortion syndrome lacks a specific definition, but does not lack for pseudoscientific arguments.

A new paper in Bioethics examines the career of David Reardon, an engineer who — according to news sources — earned his PhD in bioethics from an unaccredited online correspondence school. Reardon has generated more than two dozen articles claiming links between abortion and, among other things, psychiatric admissions, breast cancer and drug use during subsequent pregnancies. Reardon’s work isn’t exactly inconsequential: the US Supreme Court cited his work in its 2007 decision in the case of Gonzales v Carhart, which upheld a ban on partial-birth abortion in the US. Alberto Gonzales, US attorney general at the time, had submitted five of Reardon’s studies as evidence.

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In America, contraceptive marketing is the peppier cousin of antidepressant advertising (in this case, limber actresses doing yoga are substituted for the actresses strolling contemplatively through wheat fields). Birth control isn’t just about pregnancy prevention anymore; it’s become hormone therapy to treat everything from acne to mood swings. The prevention of birth defects has been added to that list, and cancer-clearing properties might soon follow.

Currently, the accepted treatment for endometrial cancers (which affect the lining of the uterus) is a complete hysterectomy. But a report in the Annals of Oncology describes how intrauterine devices (IUDs) that release estrogen might be used to treat endometrial cancer. In the 13-year study, 34 women with early-stage endometrial cancer had an IUD that released levonorgestrel inserted for one year, combined with six months of gonadotropin-releasing hormone (GnRH) shots. All were alive at the end of the study without evidence of disease, and nine were able to get pregnant after the IUD was removed.

This kind of hormone-releasing IUD is already on the market — there’s one called Mirena. The hormones are supposed to help with heavy periods, endometriosis and anemia.

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Women mount the highest steps of the ivory tower in greater numbers each year&mdash a growth pattern resembling that of a kudzu vine more than that of the proverbial ivy.

In the US, women have been earning solid majorities of the bachelor’s and master’s degrees for more than a decade. And in the past few years, women have overtaken men at the doctoral level as well. A report from the Council of Graduate Schools released this week shows a small lead, with women just clearing the mark at 50.4% of doctorate-level degrees conferred in 2008-2009. But another set of statistics, released by the US Department of Education in May, show a greater lead even earlier, with women taking 51% of all doctoral degrees awarded in 2007-2008.

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Hoping to prevent something along the lines of the birth of octoplets from happening in Georgia, state legislators proposed a bill that would cap the number of embryos created for any given round of in-vitro fertilization. The new rules would limit this to two embryos per cycle for a woman 39 years old or younger and three embryos for a woman above that age. In a press release, the president of Georgia Right to Life said the bill’s purpose is to “help reduce the attendant harm that could come to the mother and her children through the creation and implantation of more embryos than is medically recommended.”

In addition to limiting the number of embryos fertilized per cycle, an article in Slate.com explained how the bill, if passed, would give embryos legal rights, thus blocking certain types of stem cell research in the state. The Georgia legislation will probably not be voted on this year, but lawmakers there will likely reconsider the issue next year.

The proposed legislation does not take past IVF failures into account, unlike the joint guidelines previously issued by the Society for Assisted Reproductive Medicine and the American Society for Reproductive Medicine. So in addition to limiting biomedical research, the legislation would also promote an oversimplified approach to reproductive medicine that would likely harm more women than it would help. What do you think about the proposed bill?

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New research suggests that mammography, the low dose x-ray procedure that helps doctors diagnose small tumors in the breast, might frequently pick up tumors that will go away on their own. Scientists in Norway tracked two populations of over 100,000 women between the ages of 50 and 64. One group received mammograms every two years while those in the other group had a single mammogram at the end of the six-year study. The incidence of invasive breast cancer (the type of cancer that has spread beyond the milk ducts and into the surrounding tissue) was 22% higher in the frequent screening group. This finding led researchers to speculate that mammograms had detected cancers that would have regressed if the women had received no treatment. Otherwise they would expect the two groups, which had parallel risk factors, to have similar breast cancer incidence.

Without further research, it is unclear how often mammograms detect cancers that spontaneously regress. But if it happens as often as this study suggests, then doctors will have to spend more time thinking about how one can distinguish between a cancer that is likely to regress on its own and one that could progress and threaten a woman’s life. Should women endure surgeries, radiation and chemotherapy for cancers that could potentially disappear with no treatment at all?

If some 20% of cancers picked up in mammograms actually do regress within six years, it seems risky to assume they would disappear forever. Perhaps, in a decade or two, some of these tumors could return more aggressive than ever. Or if these cancers do vanish indefinitely, understanding what prevents them from mustering a full-fledged assault on the body might help scientists develop new treatment strategies.

Undoubtedly, this article raises a host of interesting research questions. But where does the scientist begin? I think we need longer term studies comparing groups of women receiving frequent and infrequent mammograms in order to determine if the incidence rates remain disparate beyond six years. What do you think should be on the agenda for future studies?

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A study presented at this month’s conference of the European Research Organization on Genital Infection and Neoplasia provided evidence that a widely-marketed cervical cancer vaccine might also stave off genital warts in young men. Gardasil, which immunizes women against the cancer-causing human papillomavirus (HPV), is also 90% effective in shielding young men from developing genital lesions caused by the four HPV strains it targets, scientists reported. The study was funded by the vaccine’s maker, Merck.

Health agencies in Australia and other countries have already approved Gardasil use for both males and females, but the US government has only cleared the vaccine for use in females. Merck is now seeking US Food and Drug Administration (FDA) approval for Gardasil’s use in preventing genital lesions among males ages 9 to 26.

Thwarting genital warts is an obvious boon—and there are other compelling arguments for extending Gardasil’s use to young men. HPV plays a role in oral, neck and other types of cancers affecting males. Furthermore, vaccinating boys might potentially curb the spread of the virus to young women, thereby reducing the burden of cervical cancer—the fifth deadliest cancer among women worldwide. And isn’t it only fair to vaccinate men and women for a disease both are responsible for spreading?

The idea may sound appealing, but concerns remain about Gardasil’s value—even for girls. And some reports have suggested that the vaccine might, in very rare circumstances, trigger serious illness among certain people. Additionally, exactly how long the immunity conferred by the vaccine lasts is unknown. Experts point out that the average follow-up time for patients in Gardasil’s clinical trials was about 15 months. There is also the argument that the vaccine, which costs about $375, may not be cost-effective for all of its target age groups.

Given the unresolved questions about Gardasil use in women, I think we should think twice about broadening its application to men at this time. What do you think?

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When will I hit menopause? How many more years will I be able to get pregnant? Many women ask themselves these questions, especially if they are planning to combine a family life with a professional career.

Scientists are trying to help women find answers. MaryFran Sowers and her colleagues from the University of Michigan in Ann Arbor are using a range of variables, including age and hormone levels, to predict the time window in which a woman is likely to hit menopause. The method they have developed has been published but is far from being packaged into a commercial test. Meanwhile, at least one European company is already selling a mail-order fertility kit: the PlanAhead Fertility Test, which according to the company can estimate the number of eggs remaining in the ovaries based on hormone concentrations.

This idea of precisely predicting menopause is appealing, but a one-size-fits-all test may not work for every woman, cautions Sowers. Factors such as obesity, diabetes and smoking might affect a woman’s fertility and the age she reaches menopause. Sowers is now beginning to study these special subpopulations.

There are clear benefits to knowing when menopause is coming. A woman who knows she is likely to soon lose the cardiovascular and bone benefits of reproductive hormones might be motivated to cut saturated fats and cholesterol from her diet, for example. But there may be instances in which knowing the future could lead to risky decisions. Suppose a woman takes a menopause predictor test and learns that she isn’t likely to reach menopause until age 55. She may delay childbearing until age 40, when her chances of developing gestational diabetes and placental problems are significantly higher. Research also shows that women over 40 are about 40% more likely than younger women to deliver early, and premature babies face a higher risk of developing chronic lung disease and other health problems. Will menopause tests lead to more high risk pregnancies?

For more of the latest news on fertility and reproduction, please see Nature Medicine’s November special on reproductive medicine.

Photo by Morten Liebach

This week fertility experts have descended on Barcelona for the annual meeting of the European Society for Human Reproduction & Embryology. Thirty years after scientists created the first ‘test tube’ baby Louise Brown, the discussion among these experts is not just about the ability to achieve pregnancy through in vitro fertilization (IVF) but also access to such treatment.

Many women in parts of Africa have inadequate access to cheap fertility treatments, including IVF, according to Willem Ombelet, head of an ESHRE task force at the focused on infertility in developing countries. Crucially, infertility can carry a huge stigma in Africa, causing women to lose inheritance rights and suffer accusations of witchcraft, for example.

One solution to the problem suggested at the conference was the development of low-cost clinics that substitute traditional IVF incubators with a water bath for the cells. This revised procedure could, if supported by the right infrastructure, potentially reduce the cost of IVF to around $200, claim its developers.

But women living in certain developed countries also suffer from a lack of access to fertility care, according to Guido Pennings, who recently published an ESHRE task force paper on cross-border reproductive care. One might also call this ‘reproductive tourism’, though Pennings voiced his dislike for this phrase. Essentially he and the other members of the task forced reached a conclusion that when a woman cannot receive the fertility treatment she wants in her country – for example because the waiting list is too long or the type of treatment she needs is forbidden by law – her physician has a “moral obligation” inform her about the option of seeking fertility care abroad.

The recommendation seems relatively harmless, until one considers that given the current demands of health care systems it’s unlikely that physicians have the time to closely track the success of uncertified foreign clinics. Pennings notes that ESHRE can certify clinics as meeting certain standards; but it will take years for such certifications to be widely adopted. For now, many women and doctors must rely on word-of-mouth and internet searches to choose the right fertility clinic abroad.

In my view, these recommendations supporting cross-border reproductive care come too soon. In fact, with the current lack of monitoring, increased reproductive tourism could create an environment where local women are exploited in egg donation and surrogacy. Pennings, meanwhile, maintains that it’s best for physicians to advise their patients on reproductive care abroad since these women will likely seek it anyway. Do you think the recommendations are premature?

Photo by Morten Liebach via Flickr

Breast pumping. Does the word make you queasy? I’m a nursing mom and I feel a bit weird about it.

That’s a problem. Too many women are denied the opportunity to breast pump at work –and at conferences –when they are away from their baby. This is not some scary hairy-legged feminine beast- roar. Given the numerous benefits of breast milk, it’s a real public health issue.

I’m happy to report, though, that the folks at the American Society for Cell Biology have a clue!! I brought my baby to the poster session (she loved it—the colors!). So I was drawn to a room that said “Baby changing room.” It was serviceable as a changing room, although the bathroom was better since it had a sink. But what the room was really good for was breast pumping. It had electrical outlets and discreet curtains all set up. Some moms were in there, making milk for their babies.

I applaud the organizers for keeping moms in mind. I must admit though I wish they had made it clear that the room was also good for pumping. If the organizers were going to bother using a euphemism, something like “Milk Lounge” might be appropriate.

The American Academy of Pediatrics advises women to breast feed for one year—the World Health Organization advises two. Nursing women away from their babies need to express milk to keep up their milk supply and to avoid pain.

But not everyone has gotten the message. Even in work environments that should be enlightened, I’ve seen women relegated to bathroom stalls, for some reason, when perfectly good utility closets were available. Another friend had four days of breast milk confiscated at the airport when flying back from a conference. She watched in horror as the agent spilled her milk into a garbage can.

How many moms out there have had such a room at conferences they have gone to? Would you like to see them more often? Has anyone stopped nursing because traveling or working was too hard to do without good facilities for pumping?