Providing Contraception Care for Women with Complex Medical Needs

woman speaking to provider

For women with complex medical needs, contraception throughout childbearing years may be essential for managing their underlying medical conditions and setting the stage for a healthy pregnancy when desired. To provide the needed expertise, the High Risk Contraception Clinic at Brigham and Women’s Hospital works with patients, often in collaboration with disease sub-specialists, to provide individualized contraceptive care within the framework of the underlying condition.

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Estrogen Therapy: Effects Differ by Age Among Women Who Have Had Ovaries Removed

In the first randomized trial analysis of estrogen therapy after bilateral oophorectomy, women who underwent surgical menopause followed by estrogen therapy in their 50s showed a nearly one-third reduced risk of mortality over 18 years compared to women who received a placebo instead of estrogen. Older women (particularly age 70 and over) showed no such benefit and experienced a negative net effect from hormone therapy.
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Patients Taking PARP Inhibitor Survive Ovarian Cancer Longer with Fewer Complications

dna strand

Ovarian cancer is one of the deadliest forms of women’s cancer, with a five-year survival rate of 47.4 percent. The standard of care for first-line treatment is platinum- and taxane-based chemotherapy, which results in high initial response rates.

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Genetic Association with Recurrent Miscarriage May Guide Further Treatment

diagram of chromosomal rearrangments
Left: Circos plot showing a complex chromosomal rearrangement involving four chromosomes (color lines) detected by low-pass genome sequencing. Right: Karyotype showing a chromosomal rearrangement involving the interchange of fragments of different chromosomes.
Dong et al., Genome Sequencing Explores Complexity of Chromosomal Abnormalities in Recurrent Miscarriage, The American Journal of Human Genetics (2019)

For couples with recurrent miscarriage (RM), the condition remains unexplained in about 40 to 60 percent, even after costly testing. Chromosomal abnormalities—rearrangements of large chunks of DNA—in the genomes of one or both individuals trying to conceive are thought to be among the major genetic causes of RM. But routine chromosome analysis (karyotyping) can currently detect these abnormalities in only about 1 in 50 couples.

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Preserving Fertility with Minimally Invasive Myomectomy

3D illustration of surgical robot on white background

Uterine fibroids are highly prevalent in women over 35. As more women delay childbearing, techniques to remove uterine fibroids (leiomyomas) while also preserving fertility are of increasing importance.

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Artificial Intelligence to Automate Drug Infusions for Safer C-Sections

Vesela Kovacheva, MD, PhD, was not thinking about her work as an obstetric anesthesiologist when she opened an article about artificial intelligence (AI) in 2017, expecting to learn about self-driving cars and the algorithms behind online shopping.
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Postpartum Transition Clinic for Hypertensive Pregnancies

Strong evidence that now connects preeclampsia with long-term maternal cardiovascular risks raises new questions for obstetricians (OBs):  What is the best way to care for women after preeclampsia? And, what postpartum care and support might help women minimize immediate and long-term risks?
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Inventing a “Better Way”: Developing Devices to Improve Minimally Invasive Gynecologic Surgery

Jon I. Einarsson, MD, MPH
Jon I. Einarsson, MD, MPH, didn’t set out to be an inventor. Chief of the Division of Minimally Invasive Gynecologic Surgery at Brigham and Women’s Hospital, Einarsson is a champion of minimally invasive approaches for their benefits to patients. But as a teacher and mentor, he knows that some techniques that benefit patients are slightly more challenging technically for trainees and others to master.
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Restoration of Infertility Using Patient-Specific Stem Cells

For women who want their own biological children, a diagnosis of infertility due to a lack of viable eggs can be devastating. Ovarian failure in women can have many causes, including aging, autoimmune disease and exposure to radiation therapy and certain chemotherapy drugs.
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Reducing Long-Term CV Risks after Preeclampsia through Online Intervention and Communication

An online intervention program for women who recently had preeclampsia has produced insight into how to reduce their future risks of cardiovascular disease.

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