Prospective cohort study. MATERIALS AND METHODS: We followed 93,775 women participating in the Nurses' Health Study II between 1991 and 2013 who had no prior history of cardiovascular disease, cancer, or diabetes and who reported the usual length and regularity of their menstrual cycles at ages of 14-17, 18-22, and 28-48 years. We obtained hazard ratios (HR) and 95% confidence intervals (CI) for the relationships between menstrual cycle characteristics and mortality from Cox proportional hazards models adjusted for relevant confounders including body mass index, race/ethnicity, and physical activity, and lifestyle factors.RESULTS: We documented 1679 deaths, including 828 from cancer, and 166 from cardiovascular disease, during 1,729,410 person-years of followup. After adjustment for various covariates, women reported that their menstrual cycles were always irregular between the ages of 14-17 and 18-22 were 21% [HR¼1.21 (95% CI: 1.04, 1.40)] and 34% [HR¼1.34 (95% CI: 1.08, 1.66)], respectively, more likely to die from any causes during follow-up than women reporting very regular menstrual cycles in the same age range. A similar relation was observed with irregular menstrual cycles between the ages of 28-48 years. Likewise, women reporting a current usual cycle length of 32-39 days or of R40 days were more likely to die from any causes during follow-up than women whose current usual cycle length was 26-31 days [HRs ¼1.23 (95% CI: 1.04, 1.45), and 1.28 (95% CI: 1.05, 1.55), respectively]. Elevated HR for cardiovascular and cancer mortality was also associated with longer menstrual cycle lengths (>32 days) between the ages of 28-48 years.CONCLUSIONS: Irregular and long menstrual cycles are associated with an increased risk of mortality.
and elected to undergo single thawed mosaic embryo transfer (STMET) after genetic counseling. When more than one mosaic embryo was available, embryo selection occurred following discussion between the patient, physician, and genetic counselor.RESULTS: A total of 587 frozen single embryo transfer cycles after IVF with NGS occurred during the selection period. STEET occurred in 569 cycles (mean age 35.8). Fifteen patients without euploid embryos elected to pursue STMET following genetic counseling (mean age 37.7). Nineteen mosaic embryos were thawed and transferred in 18 STMET cycles; one embryo did not survive thawing. Nine of 18 mosaic embryos (50.0%) implanted, as evidenced by the presence of a gestational sac, compared to 408/569 euploid embryos (71.7%; p¼0.06). The ongoing pregnancy/live birth rate for mosaic embryos was 4/18 (22.2%), which was significantly less than that for euploid embryos (358/569 or 62.9%; p¼0.001). The spontaneous abortion rate for mosaic embryos was 5/9 (55.6%), significantly higher than for euploid embryos (50/408 or 12.3%; p¼0.006). Of interest, all four embryos that resulted in ongoing pregnancies were identified as mosaic for segmental aneuploidies, while the remaining 12 embryos showed mosaicism for monosomies, trisomies, or segmental aneuploidies.
RR 4.9, 95% CI 2.2-17.6, p¼0.002) (Table). History of infertility prior to cancer was associated with lower rates of pregnancy by 12 months (RR 4.8, 95% CI 2.3-9.9, p<0.001). Prior smoking, race, medical comorbidity, history of miscarriage, and number of prior pregnancies were not associated with clinical infertility.. CONCLUSIONS: The majority of cancer survivors who conceived became pregnant within 12 months, with a similar distribution of time to pregnancy to the general population. History of infertility prior to cancer and BMT exposure were associated with clinical infertility in female AYA cancer survivors. The lack of significant association with alkylators and radiation is likely due to a smaller effect that could not be detected by this sample size.
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