The Leadership Report: The Best Ob/Gyn Research From 2012

From ASRM’s removal of the ‘experimental’ label from the procedure of oocyte cryopreservation, to discoveries into the complex genetic processes involved in ovarian cancer, 2012 was another important year in ob/gyn research. Here, the leaders of seven major ob/gyn societies reflect on the most exciting research of the last year.

(Want more? Check out their picks for the most hotly anticipated research of 2013 here.)

“The preliminary results of the KEEPS trial were very important because the study involved healthy women who were close to menopause-women who are most likely to want to use hormone therapy for their symptoms. The early results of the study indicated that there was no significant finding of cardiac harm or cardiac benefit in this younger, healthy group of symptomatic menopausal women.
    A major breakthrough in the last few years has been the national Microbiome project. This huge project has been studying which bacteria are normal in various parts of our body. With regard to menopause, we can finally say that the microbial population varies in the vagina from pre-puberty, through the reproductive years, and into menopause, but that it can all be considered normal for the function at that phase of life.”

Margery Gass, MD, Executive Director, The North American Menopause Society (NAMS)

“A preliminary report on the findings of a randomized clinical trial of aneuploidy screening of human blastocysts from women of advanced age undergoing IVF was presented at ASRM 2012. The groups of Schoolcraft and Scott showed that the live birth rate was dramatically improved in women older than 35 years by screening out embryos shown to have aneuploidy by comprehensive chromosome screening using SNP microarray technology.
    Another significant event was the removal of the ‘experimental’ label from the procedure of oocyte cryopreservation by the ASRM. The Practice Committee believed that the technology has advanced sufficiently that egg freezing can be offered routinely to women undergoing gonadotoxic chemotherapy for cancer. ASRM does not feel it is appropriate, however, for egg freezing to be offered for the purpose of delaying childbearing in healthy young women.”

Andrew La Barbera, PhD, Scientific Director,

“In the past year, studies conducted by the The Cancer Genome Atlas have demonstrated the complex genetic processes involved in ovarian cancer and how ovarian cancer from a molecular standpoint appears similar to high-risk breast cancer and endometrial cancer.”

Ronald D. Alvarez, MD, President, Society of Gynecologic Oncology (SGO)


 

“The standout research from 2012 was a study related to the sensitivity and specificity of NonInvasive Prenatal Testing (NIPT) for fetal aneuploidies, which was presented at the “Late Breaking” session of the SMFM Annual meeting and published in Obstetrics and Gynecology. The study confirmed the efficacy of massively parallel sequencing of maternal plasma DNA to detect fetal aneuploidy for multiple chromosomes across the genome. Also concluded, in the study authors’ words, was that the high sensitivity and specificity for the detection of trisomies 21, 18, 13, and monosomy X suggest that massively parallel sequencing can be incorporated into existing aneuploidy screening algorithms to reduce unnecessary invasive procedures.”

Kate Menard, MD, President, Society for Maternal-Fetal Medicine (SMFM)

“There were a number of studies evaluating the efficacy and safety of Botox injections in the bladder for the treatment of urgency urinary incontinence, including a randomized trial comparing Botox to anticholinergic medication. In January of this year (2013), the FDA approved Botox for use in the treatment of urinary incontinence associated with overactive bladder even when the cause of the leakage was not associated with a neurological disease. Botox therapy is approved for patients who did not have an adequate response to or who could not tolerate anticholinergic medication. The takeaway: Botox and oral medication reduce urge-related urinary leakage. Women receiving Botox are twice as likely to be completely cured with less dry mouth but have a higher chance of urinary tract infection and incomplete bladder emptying that may require temporary bladder drainage.”

Anthony Visco, MD, President, American Urogynecologic Society (AUGS)

“Because of the importance of contraceptive access to women not only in the United States but globally, I believe the most important research published in 2012 was the Peipert study. We at ACOG have been actively promoting the essential importance of universal and free contraceptive access for the health of women, children, families, our country, and civilization. Right now, we seem to be in a time when ideology trumps science and, as our politicians increasingly attempt to legislate the practice of medicine and the doctor-patient relationship, our advocacy efforts become even more important.”

James T. Breeden, MD, President, American Congress of Obstetricians and Gynecologists (ACOG)

“The most important piece of research published by the RCOG in 2012 was ‘Tomorrow’s Specialist.’ This report called for a radical rethink in the training and future role of specialist doctors. It sought the views of a wide range of stakeholders including women, patient groups, health service managers, and health care professionals.
    Recommendations include having more flexibility in the medical workplace, ensuring that personal professional development occurs throughout the consultant’s working life, and the provision of women’s services in community settings. There is also the need to ensure that women have access to qualified doctors at all times of the day on the National Health Service where appropriate.”

Tony Falconer, MD, President, Royal College of Obstetricians and Gynaecologists (RCOG)