Three visionaries for HRT

When a woman consults a doctor about Hormone Replacement Therapy (HRT), the first concern is that there is an increased risk of breast cancer with HRT. And this sole reason might be the reason for refusing the offer of HRT. However, this practice has minimal basis and evidence to support it. Although HRT is an umbrella term, women who have no uterus receive oestrogen-only HRT or Estrogen Replacement therapy (ERT). No valid study has linked ERT with an increased risk of breast cancer [1,2]

Ultrasound Reference Chart Based on IVF Dates to Estimate Gestational Age at 6–9 weeks’ Gestation

Accurate determination of gestational age underpins good obstetric care. We assessed the performance of six existing ultrasound reference charts to determine gestational age in 1268 singleton IVF pregnancies, where "true" gestational age could be precisely calculated from date of fertilisation. All charts generated dates significantly different to IVF dates (P < 0.0001 all comparisons). Thus we generated a new reference chart, The Monash Chart, based on a line of best fit describing crown-rump length across 6 + 1 to 9 + 0 weeks of gestation (true gestational age) in the IVF singleton cohort. The Monash Chart, but none of the existing charts, accurately determined gestational age among an independent IVF twin cohort (185 twin pairs). When applied to 3052 naturally-conceived singletons scans, The Monash Chart generated estimated due dates that were different to all existing charts (P ≤ 0.004 all comparisons). We conclude that commonly used ultrasound reference charts have inaccuracies. We have generated a CRL reference chart based on true gestational age in an IVF cohort that can accurately determine gestational age at 6-9 weeks of gestation

Plasma MIC-1, PAPP-A and hCG concentrations.

<p>(A) Mean MIC-1 levels across gestation. (B) Box and Whisker plots of MoM MIC1 levels in the ongoing pregnancy (n=428) and miscarriage cohorts (n=34) (C) Mean PAPP-A levels across gestation (D) Box and Whisker plots MoM PAPP-A levels in the ongoing pregnancy (n=312) and miscarriage cohort (n=11) (E) Mean hCG levels across gestation (F) Box and Whisker plots of MoM hCG levels in the ongoing pregnancy (n=428) and miscarriage (n=34) cohorts. *P=0.036, **P=0.0025, *** P=0.0008. For <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0072437#pone-0072437-g001" target="_blank">Figure 1A,C,E</a>, the numbers for each gestation were: 5 weeks n=19; 6 weeks n=132; 7 weeks n=95; 8 weeks n=65; 9 weeks n=54; 10 weeks n=35; 11 weeks n=21; 12 weeks n=6. For <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0072437#pone-0072437-g001" target="_blank">Figure 1A,C,E</a> error bars are standard error of the mean.</p