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Evidence Challenges Effectiveness Of Embryo Screening For Older Women
There is growing evidence that a procedure for identifying chromosomal abnormalities in embryos prior to in vitro fertilization is ineffective at helping older women become pregnant, the Wall Street Journal reports. The procedure -- known as pre-implantation genetic screening, or PGS -- is performed in dozen of U.S. fertility clinics and sometimes marketed to older women as a way to increase the odds of a healthy live birth. PGS involves extracting a single cell from a six-cell embryo and inspecting it for chromosomal abnormalities known as aneuploidies; unaffected embryos can then be implanted through IVF. Women older than age 35 have a higher risk of aneuploidies, in which embryos have fewer or more than the usual number of 23 pairs of chromosomes. Aneuploidies can trigger early miscarriage or certain genetics conditions, such as Down syndrome. Most medical experts agree that embryo screening is capable of significantly reducing the risk of Down syndrome and other serious chromosome-related illnesses. However, evidence from several studies increasingly suggests that the procedure does not increase older women"s chances of healthy live births. The American Society for Reproductive Medicine released an initial opinion about PGS in 2007, saying that available evidence does not support the use of embryo screening to increase live birth rates in older women. Andrew La Barbera, scientific director of the society, said, "Since that time, there have been several more trials that have reached the same conclusion." Another shortcoming is that most clinics can only test for fewer than half of the 23 chromosomes, meaning that many defects can go undetected. However, medical experts say that the use of PGS has increased in the two years since ASRM issued its recommendations. According to the Journal, PGS can add more than $2,000 to the roughly $10,000 cost of one IVF cycle. Very few health insurers cover PGS, though some pay for IVF. Some experts contend that studies showing a lack of clinical benefit from PGS do not use more efficient biopsy techniques that can prevent damage to the embryo. Santiago Munne, scientific director for Reprogenetics, said that the treatment is "effective." In a 2007 study, Munne and colleagues used PGS to reduce the rate at which patients miscarried. However, the chances of a woman getting pregnant largely were unchanged, which the authors said could be attributed to the small number of study participants (Naik, Wall Street Journal, 6/1).
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Human Cells Evolved To Reduce Cancer Risk
The cells of humans and other animals have likely evolved to reduce the chance of triggering cancers and other diseases, according to research published in the journal Science.
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A New Take On Growth Factor Signaling In Tamoxifen Resistance
Differences in growth factor (GF) signaling may cause the poor prognosis in some breast cancer cases. A new study, published in the open access journal BMC Medical Genomics, suggests that some estrogen receptor-positive breast cancers respond poorly to tamoxifen because of increased GF signaling.
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Some Patients Taking Statins May Suffer Muscle Damage

Structural muscle damage may be present in patients who have statin-associated muscle complaints, found a new study in CMAJ (Canadian Medical Association Journal). Statins are one of the most widely prescribed medications in the world, given their importance in reducing the risk of cardiovascular disease. Many patients on statins develop muscle weakness and pain. In some cases, muscle biopsies show underlying structural injury, even in patients without elevated levels of circulating creatine phosphokinase. The study, by researchers from the University of Bern, Switzerland and the Tufts-New England Medical Center in Boston, Massachusetts, looked at muscle biopsies from 83 patients, 20 of whom had never taken statins. They found significant muscle injury in patients who had taken statins, including several who had discontinued medication before the biopsy. "Although in clinical practice, the majority of patients with muscle symptoms improve rapidly after cessation of therapy, our findings support that a subgroup of patients appears to be more susceptible to statin-associated myotoxicity, suffering persistent structural injury," write Dr. Annette Draeger from the University of Bern and coauthors. They note there is a need to evaluate alternative treatment strategies for patients with significant muscle symptoms. Kim Barnhardt Canadian Medical Association Journal


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