Publisher Health

Pursuing fair artificial intelligence (AI) for healthcare requires collaboration between experts across disciplines, says a global team of scientists led by Duke-NUS Medical School in a new perspective published in npj Digital Medicine.
While AI has demonstrated potential for healthcare insights, concerns around bias remain. “A fair model is expected to perform equally well across subgroups like age, gender and race. However, differences in performance may have underlying clinical reasons and may not necessarily indicate unfairness,” explained first author Ms Liu Mingxuan, a PhD candidate in the Quantitative Biology and Medicine (Biostatistics & Health Data Science) Programme and Centre for Quantitative Medicine (CQM) at Duke-NUS.
“Focusing on equity — that is, recognising factors like race, gender, etc., and adjusting the AI algorithm or its application to make sure more vulnerable groups get the care they need — rather than complete equality, is likely a more reasonable approach for clinical AI,” said Dr Ning Yilin, Research Fellow with CQM and a co-first-author of the paper. “Patient preferences and prognosis are also crucial considerations, as equal treatment does not always mean fair treatment. An example of this is age, which frequently factors into treatment decisions and outcomes.”
The paper highlights key misalignments between AI fairness research and clinical needs. “Various metrics exist to measure model fairness, but choosing suitable ones for healthcare is difficult as they can conflict. Trade-offs are often inevitable,” commented Associate Professor Liu Nan also from Duke-NUS’ CQM, senior and corresponding author of the paper.
He added, “Differences detected between groups are frequently treated as biases to be mitigated in AI research. However, in the medical context, we must discern between meaningful differences and true biases requiring correction.”
The authors emphasise the need to evaluate which attributes are considered ‘sensitive’ for each application. They say that actively engaging clinicians is vital for developing useful and fair AI models.
“Variables like race and ethnicity need careful handling as they may represent systemic biases or biological differences,” said Assoc Prof Liu. “Clinicians can provide context, determine if differences are justified, and guide models towards equitable decisions.”
Overall, the authors argue that pursuing fair AI for healthcare requires collaboration between experts in AI, medicine, ethics and beyond.

A collaborative research team, including members of LKS Faculty of Medicine of the University of Hong Kong (HKUMed), as well as The Family Planning Association of Hong Kong (FPAHK) and Sweden’s Karolinska Institutet, recently published its findings on adding an anti-inflammatory painkiller used for arthritis pain to an oral emergency contraceptive pill (also known as the morning-after pill) to increase the effectiveness of pregnancy prevention. The study was published in a recent issue of The Lancet.
Background
Emergency contraception is a contraceptive method that can be used to prevent an unintended pregnancy when a regular contraceptive method fails or is not used. It can be in the form of an oral emergency contraceptive pill or the insertion of a copper intrauterine contraceptive device (Cu-IUD). The oral levonorgestrel emergency contraceptive pill is one of the most popular choices of emergency contraception and is widely used in most countries. It was pioneered by a clinical trial in Hong Kong led by HKUMed’s Professor Ho Pak-chung, published in 1993. However, all contraceptive methods have a failure rate. Hence, the research team is continuing its efforts to explore more effective options.
Prostaglandins are substances produced by most body tissues in humans and mediate a number of biological processes, including inflammatory responses. In the reproductive system, prostaglandin is an important mediator of processes like ovulation, fertilisation and embryo implantation. The research team postulated that adding a medication that blocks prostaglandin synthesis may have an additional complementary effect in achieving contraception.
Research methods and findings
The research team conducted the first randomised, placebo-controlled trial in the world on the use of piroxicam, a long-acting nonsteroidal anti-inflammatory drug (NSAID) used to treat arthritis pain, which blocks prostaglandin production in the body, in combination with the levonorgestrel emergency contraceptive pill. The findings revealed that with the new combination regimen, only one out of 418 women became pregnant, while seven out of another 418 women receiving levonorgestrel and a placebo became pregnant. The results showed that the percentage of pregnancies prevented by piroxicam-levonorgestrel co-treatment (94.7%) was significantly higher than that of the levonorgestrel emergency contraceptive pill alone (63.4%). There was no significant difference in the occurrence of adverse effects, including changes to the menstrual bleeding pattern and stomach ache following intake of the two regimens.
Significance of the study
Chief-investigator Dr Raymond Li Hang-wun, from HKUMed, said, ‘Our study is the first to find that piroxicam, a readily available medication, taken at the same time as the levonorgestrel pill can prevent more pregnancies than levonorgestrel alone. We hope these findings will lead to further research and ultimately changes in clinical guidelines to enable women around the world to access more effective emergency contraception.’

Philadelphia is again the focus of a national campaign to open — or restrict — sites where people use drugs under medical supervision.Quetcy M. Lozada, a first-term Philadelphia City Council member, stood on a September evening near an elementary school just off Kensington Avenue, the epicenter of a sprawling fentanyl market in a city that saw a record 1,413 drug overdose deaths last year.Just a block away, the street and sidewalks were dotted with used syringes and their discarded orange caps.“Kids have to go through this every day,” Ms. Lozada said, her voice rising. Children “are so impacted that they don’t want to come to school.”Public health experts have long endorsed a controversial strategy to blunt the opioid epidemic that has been sweeping cities like Philadelphia: supervised drug consumption sites, in which people are allowed to take illicit drugs under professional supervision.The sites employ medical and social workers who guard against overdoses by supplying oxygen and naloxone, the overdose-reversing drug, and by distributing clean needles and other resources to opioid users. New York City has two sites, the only ones operating openly in the nation.Safe drug consumption facilities have reversed thousands of overdoses in the United States and abroad, helping people who use potent synthetic opioids like fentanyl avoid the worst consequences of a volatile drug supply.In the United States, the sites represent a novel form of “harm reduction,” which aims not to make drug users sober or abstinent but to prevent disease, overdose and death. President Biden is the first president to endorse the idea.But critics argue that the sites encourage a culture of permissiveness around illegal drugs, formally sanctioning opioid use in neighborhoods already struggling with high overdose rates. And they say that the groups working to open the sites, however well intentioned, should not encroach on communities that might be hostile to the strategy.Quetcy Lozada, a first-term Philadelphia City Council member, opposed having any drug consumption site in her district.Hannah Yoon for The New York TimesHours earlier, Ms. Lozada had shepherded a measure through City Council that restricted where drug consumption sites could operate in the city. The legislation, which passed 13-1, survived a veto from Mayor Jim Kenney, who supports opening the facilities.Ms. Lozada and her allies have cast their effort not as a rejection of drug consumption sites per se, but as a way for Philadelphia residents to choose whether one may operate in their neighborhoods. Kensington Avenue, which sits in Ms. Lozada’s district, is seen as one of the most obvious locations for such a facility.Ms. Lozada said that her constituents did not want to accept living around open drug use, that it discouraged the use of local libraries and parks and drove away local businesses. “People in the political world just became afraid of: What do we do? How do we do it? Let’s not do anything,” she said of the state of her neighborhood.Ms. Lozada has another idea: She supports involuntary roundups of opioid users, using the courts to route them to treatment facilities, a strategy that some public health experts have said is punitive and unproductive.As much as any city, Philadelphia showcases the seesawing tensions and legal battles around supervised drug use. The city encapsulates a broader struggle among state and federal health officials searching for new methods to curtail the roughly 110,000 annual fatal drug overdoses in the United States.The sites operate in a legal gray area. A federal law passed in 1986 prohibits people from keeping property where controlled substances are ingested, a measure that defenders called the “crack house statute.”Some cities and states have moved to open the facilities despite the risk of federal reprisals, as research has shown that supervised consumption sites in Canada, Australia and European countries have saved lives and led people to treatment.Yet even liberal elected officials and communities, like those in Philadelphia, continue to question what they consider more lenient approaches to opioid use.In May, Pennsylvania state senators passed legislation banning the sites. San Francisco is on track for a record number of overdose deaths this year, yet the city’s lone facility closed last December. Gov. Gavin Newsom of California, a prominent Democrat, has vetoed legislation that would have allowed some cities in the state to open them.Drug paraphernalia left behind on Kensington Avenue in Philadelphia.Hilary Swift for The New York TimesThis summer the top federal prosecutor in Manhattan threatened the group operating the New York sites, saying they were running afoul of the law.And in Washington, the Biden administration has taken steps to limit their use even after key officials signaled openness to the strategy. The Justice Department asked a judge in Philadelphia this summer to dismiss a lawsuit brought by Safehouse, a nonprofit group working to open a supervised drug use site in the city.The Trump administration sued the organization in 2019, halting its plans. The Biden administration and Safehouse have yet to agree on a settlement. Ronda Goldfein, the group’s vice president, said a decision from a federal judge could come any day.For groups with licenses to open sites, progress has been slow. After lawmakers in Rhode Island legalized drug consumption sites in 2021, the first state to do so, lease negotiations, construction delays and supply chain problems stalled the opening.“There’s layers of bureaucracy,” said Colleen Daley Ndoye, executive director of Project Weber/RENEW, a group working to open the facility.Fears have not been born out by research: Supervised consumption sites have not led to upticks in neighborhood crime or community drug use, studies have found. And they can save lives.In New York, the group operating the two sites said in August that workers had reversed 1,000 overdoses since opening. In San Francisco, medical workers reversed over 300 overdoses in nearly a year at a drug consumption site in the city’s Tenderloin neighborhood.Minnesota, the second state to legalize the sites after Rhode Island, plans to spend around $26 million on harm reduction services in the coming years, with some of the funds potentially going toward supervised consumption sites.Kendra Brooks, a Philadelphia City Council member, voted against a measure restricting the location of drug consumption sites.Hannah Yoon for The New York TimesThe state’s human services department is putting together potential plans to open the facilities, Jeremy Drucker, Minnesota’s director of addiction and recovery, said.“People can’t recover if they’re dead,” he said.In Philadelphia, the issue has captivated the city, pitting elected officials, residents and public health advocates against one another and exposing divisions in their approaches to the raging epidemic.The same has been true of state and congressional leaders. Gov. Josh Shapiro of Pennsylvania, a rising Democratic star, has long opposed the drug consumption sites, while Senator John Fetterman, a popular Democrat, has supported them.But at the recent City Council meeting, there was just one vote against legislation restricting where the sites might be opened. “I know that this is a fight that I’m not going to win,” Kendra Brooks, a council member at large, said in an interview before the meeting.“It can’t be a radical idea — providing folks who are in a medical crisis with the support they need to live,” she added.Michael Driscoll, a City Council member who opposes the sites, said that even if drug consumption facility were to offer people temporary protection against overdosing, “as they drift to other parts of their lives and stay dependent on these bad drugs, we’re going to lose that life as a productive citizen.”Mr. Kenney, the Philadelphia mayor, watched the vote from his office below the Council chambers in City Hall. “I was a little depressed,” he said in an interview after the meeting concluded.“It’s not just the people on Kensington Avenue. It’s people in every neighborhood, their sons and daughters in the basement or in the bathroom. If they’re by themselves, how do you get them better?”Philadelphia’s mayor, Jim Kenney, supports opening supervised injection sites.Hannah Yoon for The New York TimesMr. Kenney said that a site in Kensington would draw people from the street who have nowhere else to go, reducing drug-related litter and offering services far beyond the supervision of drug use.He criticized City Council members for deferring to constituents who balked at the idea.“If we put that standard on every public issue, our schools would still be segregated because people in the community, back in the day when we were desegregating schools, said no, and a court had to tell them to do it,” he said.Treatment alone is not always the answer, some public health experts say. Some substance users are unwilling to take medication, or cycle in and out of treatment programs.“If people aren’t ready, they aren’t ready,” said Susan Sherman, a drug policy expert at the Johns Hopkins Bloomberg School of Public Health who has studied supervised drug consumption.There are also major obstacles for anyone seeking treatment, including the resources available. One effective opioid addiction medication, methadone, is heavily regulated and often difficult to obtain. Another effective treatment, buprenorphine, is underprescribed.The area around Kensington Avenue in Philadelphia is often littered with used syringes. The city saw a record 1,413 drug overdose deaths last year.Hilary Swift for The New York TimesA site in Philadelphia would likely offer services far beyond medical supervision of drug use. Workers could distribute fentanyl test strips and clean needles, direct drug users to treatment once they are willing, and help them find housing or food. And staff could provide wound care, a vital service in a city besieged by xylazine, an addictive animal tranquilizer that causes horrific lesions.“We walk around all day looking at folks who are in the street, who need services, who are overdosing, who are losing their kids,” Moses Santana, a supporter of supervised consumption sites, told Council members at City Hall.“We have to look at these folks as if we’re looking at ourselves.”

A 2000-year-old practice by Chinese herbalists — examining the human tongue for signs of disease — is now being embraced by computer scientists using machine learning and artificial intelligence.
Tongue diagnostic systems are fast gaining traction due to an increase in remote health monitoring worldwide, and a study by Iraqi and Australian researchers provides more evidence of the increasing accuracy of this technology to detect disease.
Engineers from Middle Technical University (MTU) in Baghdad and the University of South Australia (UniSA) used a USB web camera and computer to capture tongue images from 50 patients with diabetes, renal failure and anaemia, comparing colours with a data base of 9000 tongue images.
Using image processing techniques, they correctly diagnosed the diseases in 94 per cent of cases, compared to laboratory results. A voicemail specifying the tongue colour and disease was also sent via a text message to the patient or nominated health provider.
MTU and UniSA Adjunct Associate Professor Ali Al-Naji and his colleagues have reviewed the worldwide advances in computer-aided disease diagnosis, based on tongue colour, in a new paper in AIP Conference Proceedings.
“Thousands of years ago, Chinese medicine pioneered the practice of examining the tongue to detect illness,” Assoc Prof Al-Naji says.
“Conventional medicine has long endorsed this method, demonstrating that the colour, shape, and thickness of the tongue can reveal signs of diabetes, liver issues, circulatory and digestive problems, as well as blood and heart diseases.

Researchers from North Carolina State University have pinpointed a particular peptide’s role in activating atopic dermatitis, or eczema. The work could lead to more effective treatments for the condition.
Atopic dermatitis (AD) is a skin condition characterized by itching, irritated and thickened skin at the site of the irritation. The brain natriuretic peptide (BNP) is a peptide, or short chain of amino acids, that is elevated in patients with AD.
“BNP is expressed in sensory neurons, the neurons responsible for conveying sensation to the brain via the spinal cord,” says Santosh Mishra, associate professor of molecular biomedical sciences at NC State and corresponding author of the work. “We know from previous work that BNP helps translate the sensation of itch from the skin to the brain. In this work we wanted to see if BNP was involved in activating AD.”
In a chemically induced mouse model of AD, the researchers saw that mice without BNP did not exhibit the thickened or irritated skin commonly associated with AD, and their itching was reduced compared with control mice who did have BNP.
“The results show that BNP likely plays a role in itch activation,” Mishra says. “We next looked at BNP’s relationship to periostin, to see if we could determine how that activation takes place.”
Periostin is a protein that can interact with sensory neurons in skin to activate itch response. It is produced in skin cells called keratinocytes and fibroblasts. Keratinocytes in turn, have receptors for BNP, which are called NPR1 receptors. When the BNP receptors are activated, periostin is produced and itch can be turned on.
“But the interesting thing here is that the sensory neurons are the activator,” Mishra says. The neuron releases BNP, which activates keratinocytes with the NPR1 receptor, which then release the periostin.
“This work shows that peripheral neurons, not just central neurons, are playing a role in AD — it begins in the sensory neurons, and cascades from there,” Mishra adds. “It also points to some potential therapeutic strategies, such as blocking BNP’s ability to bind to NPR1 receptors in the skin.”
The research appears as a letter to the editor in the Oct. 11 issue of the Journal of Investigative Dermatology. The work was supported by the National Institutes of Health under grant number 1R56AR077692-01. NC State undergraduate student Junho Yu, former NC State undergraduate student Nidha Williams, and NC State postdoctoral research scholar Joshua Wheeler, also contributed to the work.

Postpartum depression (PPD), a common subtype of major depressive disorder, is more heritable than other psychiatric conditions, yet the genetics of PPD are understudied compared to these other psychiatric conditions., such as anxiety and bipolar disorder.
To remedy that, UNC School of Medicine researchers led an international team of researchers to conduct the largest-ever meta-analyses of genome-wide association studies (GWAS) to investigate the genetic architecture of PPD.
Published in the American Journal of Psychiatry, their research shows that approximately 14 percent of the variation seen in PPD cases can be attributed to common genetic factors. A patient’s PPD is often not merely the result of environmental factors, such as past trauma. Instead PPD susceptibility carries a significant genetic component.
The researchers, led by first author Jerry Guintivano, PhD, assistant professor of psychiatry at the UNC School of Medicine, also revealed the genetic architecture of PPD, which they report significantly correlates with the genetic architecture of major depression, bipolar disorder, anxiety disorders, posttraumatic stress disorder, insomnia, and polycystic ovary syndrome. This means PPD symptoms likely occur as a result of the interplay between the same genes involved in these other psychiatric and hormone-related conditions.
“We studied about 1.1 million regions of the human genome,” Guintivano said, “and we can see that PPD has a similar genetic signature to these other psychiatric conditions. The genetic risk factors for PPD appear to be shared by other disorders, such as major depression, bipolar disorder, and anxiety.”
The researchers also discovered that genetic regions involving GABAergic neurons is associated with PPD, particularly in the thalamus and hypothalamus. GABAergic neurons control the release of the neurotransmitter GABA.
Brexanolone, the only FDA-approved PPD treatment, is known to circulate throughout the body and brain. UNC researchers had discovered earlier this year that the drug worked through GABAergic neurons to treat PPD symptoms so effectively. But now, this new research suggests brexanolone likely acts on GABAergic neurons in two particular brain regions.

In an unusual trial, Stanford Medicine researchers found that a patient’s belief that they had received ketamine, even if they didn’t, could improve their depression.
In study after study, the psychoactive drug ketamine has given profound and fast relief to many people suffering from severe depression. But these studies have a critical shortcoming: Participants usually can tell whether they have been given ketamine or a placebo. Even in blinded trials in which participants are not told which they received, ketamine’s oftentimes trippy effects are a dead giveaway.
In a new study, Stanford Medicine researchers devised a clever workaround to hide the psychedelic — or dissociative — properties of the anesthetic first developed in 1962. They recruited 40 participants with moderate to severe depression who were also scheduled for routine surgery, then administered a dose of ketamine or placebo when the participants were in surgery and under general anesthesia.
All researchers and clinicians involved in the trial also were blinded to which treatment patients received. The treatments were revealed two weeks later.
The researchers were amazed to find that both groups experienced the large improvement in depression symptoms usually seen with ketamine.
“I was very surprised to see this result, especially having talked to some of those patients who said ‘My life is changed, I’ve never felt this way before,’ but they were in the placebo group,” said Boris Heifets, MD, PhD, assistant professor of anesthesiology, perioperative and pain medicine, and senior author of the study published Oct. 19 in Nature Mental Health.
Just one day after treatment, both the ketamine and placebo groups’ scores on the Montgomery-Asberg depression rating scale — a standard measure of depression severity often referred to as the MADRS — dropped, on average, by half. Their scores stayed roughly the same throughout the two-week follow-up.

Around the globe, it is generally accepted that individuals with larger families have more resources and support to draw on as they age. Less discussed is that having many children can produce economic, social, emotional and biological burdens that impact health — even at older ages. However, a first-of-its kind-study by researchers at the University of Rhode Island; the SGH Warsaw School of Economics; the University of Maryland, Baltimore County; and the University of Padua examines the association between number of children and several key health indicators among older adults across multiple global regions.
“Our main motivation for this study is really population aging globally. There are multiple studies that look at the connection between children and an aspect of health or life expectancy. While various aspects of health have been studied, there are few studies that look at this relationship across various nations and we are aware of none that compare multiple dimensions of health across multiple countries — so this is unique,” said Nekehia Quashie, URI assistant professor of health studies and one of the paper’s authors.
The study, recently published in The Journals of Gerontology — Series B: Psychological Sciences and Social Sciences, draws on cross-national harmonized data from the global family of the Health and Retirement Study (HRS) surveys provided by the Gateway to Global Ageing repository. Researchers analyzed data for adults aged 50 and up across five health dimensions — specifically self-rated health; activities of daily living/limitations (eating, bathing, dressing independently); instrumental activities of daily living/limitations; depression and chronic conditions — in 24 middle- and high-income countries spanning North America, Latin America, Asia and Europe.
“What we found,” said Quashie, “is that in the majority of countries we analyzed more children are associated with poorer health outcomes later in life — especially for chronic conditions and depression.”
In fact, they found that in half of the 24 countries analyzed, those with more children had a greater probability of depression, and close to half (11 of 24 countries) showed a similar pattern for chronic conditions. However, a universal global or regional pattern could not be identified.
Interestingly, when it came to self-rated health, there were six nations in which adults aged 50 and up with fewer children were more likely to report poor self-rated health: China, Estonia, France, Israel, the Netherlands, and Switzerland. This suggests that having more children may impact overall self-assessment of an individual’s health in these nations. The variation in country contexts may reflect differences in the cultural value on children, having a more limited formal infrastructure by which to support older adults, or other localized conditions.
Quashie also identified other interesting findings — including that in the United States the link between fertility and older adults’ health appears very weak, hence, any potential health benefits/disadvantages of higher or lower number of children are likely moderated by other factors, such as sociocultural differences. While in Greece, Portugal, Spain, Italy, Czechia, and Mexico she noted those with higher numbers of children (four or more children) appeared to exhibit clear health risks for at least three health measures. In Israel, all substantial associations were related to disadvantages of lower number of children.
According to Quashie, reliance on children for support — whether it is financial, instrumental or emotional — differs depending on country context based on the availability of social welfare supports. For instance, in those countries where there is a higher availability of formal supports, people may be more open to relying on those supports or other social networks such as friends as opposed to children.
“Children can be great and having larger numbers of children can increase your potential supply of support for when you may be in need as you age — and that might be common across the board,” said Quashie. “But children do also present strains across the life course as well.”
While having larger families does appear to be more connected with health risk, the findings were far from universal and, thus far, cannot be interpreted as causal, said Quashie. Further research is needed, she adds, to delve deeper into the role of individual and contextual mechanisms that can help to provide a clearer picture of the connection between family size and health later in life and the conditions which shape it.

A Conservative has made “probably the most personal speech I will ever give as an MP” as she recalled her traumatic experience giving birth to her daughter. Theo Clarke broke down as she described being rushed into emergency surgery, terrified that she was going to die. She called on the government to do more to help women who go through birth trauma. Former cabinet minister Andrea Leadsom intervened to praise her for being “immensely brave” in speaking out.

In vitro fertilization (IVF) is a time-intensive and often stress-inducing fertility procedure. Yet how does that stress impact its success? Investigators at Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, assessed the effects of anxiety and depression in men on fertility and IVF outcomes. Their findings reveal no correlation between anxiety, regardless of antidepressant use, on IVF outcomes or live birth rate. Results are published in Human Reproduction.
“Our findings indicate that despite past concerns over antidepressant medication’s impact on fertility, treatment should not be withheld from men experiencing anxiety or depression, ” said Zachary Walker, MD, a reproductive endocrinology and infertility fellow in the Center for Infertility and Reproductive Surgery at the Brigham.
Investigators conducted a voluntary, survey-based study, collecting responses from 222 men undergoing IVF at a hospital-affiliated fertility center between September 2018 and December 2022, using the Hospital Anxiety and Depression Scale (HADS) questionnaire. Participants scoring eight or higher on the survey’s sub-sections were considered to have anxiety or depression, respectively. The study evaluated the correlation between these mental health conditions and IVF outcomes and live birth rates, as well as various semen parameters, while also examining the prevalence of erectile dysfunction and low libido among the cohort.
Results indicated that 22.5% of respondents experienced anxiety and 6.5% experienced depression, according to HADS scores. There was no notable difference in live birth rates between those with and without anxiety, though men with anxiety had, on average, lower total motile sperm counts during egg retrieval. Walker and the team found that IVF outcomes and live birth rates were unaffected by antidepressant use. Additionally, there were no statistically significant findings regarding erectile dysfunction or low libido between groups.
“There’s debate among fertility specialists about prescribing antidepressants during IVF due to potential fertility impacts. However, stress itself can alter hormones, sometimes leading to a condition called hypogonadotropic hypogonadism, where the brain tells our reproductive organs to shut down because we are too stressed to conceive,” explained Walker. “So, while anxiety medication can hinder fertility, so can stress. Given that IVF is notoriously stressful, our findings underscore the importance of prioritizing patient mental health during fertility treatment.”
The study’s limitations included an inability to assess sperm morphology at time of egg retrieval and to evaluate the full impact of depression scores on fertility due to the small portion of participants with high depression scores. Researchers also could not fully assess all patients’ hormone levels — something they aim to investigate with future studies. Roughly 80 percent of the cohort was Caucasian, which Walker explains may be indicative of access barriers, such as cost and insurance coverage, that many medically underserved racial and ethnic groups face when seeking fertility care.
Going forward, Walker and his team aim to evaluate patient hormone levels throughout the duration of fertility treatment to better understand how stress affects IVF and birth outcomes. He emphasizes the importance of screening patients for mental health issues prior to beginning IVF.
“These findings add to the growing body of literature examining general medical health and male fertility outcomes. Based on this study, I would encourage my patients to pursue and continue appropriate therapies for anxiety and depression without concern that they will adversely impact their IVF outcomes,” said senior author Martin Kathrins, MD, a urologist in the Department of Urology at the Brigham.