IVF data shows risk

Early ovarian ageing: are a low number of oocytes harvested in young women associated with an earlier and increased risk of age-related diseases?

https://tinyurl.com/y3xd2cxa

    

     IVF is big business in Australia; one in twenty of all live births are following IVF therapy. There were more than 84,000 IVF cycles in 2018. These cycles are providing data, which is available for other purposes.

         This study looked at the number of eggs harvested during an IVF cycle and determined that a low number (less than 5) was an indicator of early ovary ageing (EOA) and a warning of early menopause.

         Ovarian cancer is mostly a disease of menopausal women; why this is so is unknown. The authors suggest that women who shows signs of EOA should be counseled about increased risk of menopause related disease.

Insomnia changes ovarian cancer risk

Sleep characteristics and risk of ovarian cancer among postmenopausal women

https://tinyurl.com/yx977xa7

 

         This study of almost 110,000 women as part of the Women’s Health Initiative (WHI) looks at sleep patterns and the effect on ovarian cancer incidence. The WHI began in 1991 with a total enrollment of 160,000 women looking at health issues for post-menopausal women mainly cancer, cardiovascular disease, and osteoporosis.

         The findings from the review are that the overall risk of ovarian cancer is unaffected by sleep disturbance. However, the grade of cancer differs between those who describe their sleep as restful or very restful and those who don’t.

         Women with insomnia have a higher incidence of invasive or high-grade serous ovarian cancer. Good sleepers are more likely to have low invasive borderline or low-grade serous ovarian cancer.

WHI

CA-125 survival predictor

Nadir CA-125 level as prognosis indicator of high-grade serous ovarian cancer

https://tinyurl.com/y3c8hxdr

 

         Some patients with High Grade Serous Ovarian Cancer (HGSOC) do better than others. This study looked at whether the serum level of Cancer Antigen 125 (CA-125) post surgery could be a predictor of length of survival.

         CA-125 has been used since 1980 to monitor the progress of patients after initial treatment for ovarian cancer. The lowest measure of CA-125 (Nadir) was recorded for 876 patients and outcomes reviewed, this was a retrospective survey.

         In Australia a serum level of less than 45 units/milliliter (U/ml) is normal. Those patients with lowest serum levels of less than 10 U/ml. after initial surgery had significantly better progress free and overall survivals. This was only true for the initial treatment and did not hold for repeat surgery.

BRCA1/2 MBS & MSAC, alphabet soup

 

Public Summary Document MSAC consideration Application No. 1554

https://tinyurl.com/y6qxtgcn

         Universal health care in Australia is unique; it acts as a funder not a provider with partial rebate of the fee for medical services through the Medical Benefits Schedule (MBS). The funding is always a compromise between what is desirable and what is affordable.

         The eligibility is determined by advice from the Medical Services Advisory Committee (MSAC). There is constant pressure for new funding of advances in technology or therapeutics. Application 1554 relates to genetic testing of ovarian cancer patients. 

         Currently there is funding only for testing of germ line or inherited mutations of the BRCA1/2 gene for patients who have recurrent ovarian cancer. The application sought expansion of testing to include somatic or acquired mutations at the time of initial diagnosis.

         The recommendation is that somatic and germ line testing be combined in one cheaper and quicker new test at the time of diagnosis. This means there is a need to increase funding for PARP inhibitor therapy with more patients being eligible sooner.