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Double board-certified obstetrician-gynecologist and reproductive endocrinology and infertility specialist Erica Bove discusses her article, “Why do high-quality IVF embryos fail.” Erica explores the heartbreaking reality of recurrent implantation failure, challenging the assumption …
The moon was full, the stars shone bright
I thought I’d settle down for the night
Upon my soft pillow my head got caught
Until a phone call stirred me from my foolish thought
On Friday night of weekend call
One patient had refused it all
When Pit was offered, she said, “No way!”
Internals too were brushed away.
We waited calmly, full of grace
For natural labor to take its place
And sure enough, on Sunday’s eve
After a day …
As a Menopause Society Certified Practitioner (MSCP), I strongly support the recent FDA decision to remove the boxed warnings from FDA-approved estrogen therapies. For decades, these warnings created unnecessary fear and confusion for women and clinicians alike. They were based on early interpretations of the Women’s Health Initiative (WHI) that we now understand were overstated, misapplied, and widely misinterpreted.
The new FDA stance aligns with The Menopause Society guidelines and what …
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Fertility specialist Oluyemisi (Yemi) Famuyiwa discusses her article, “How timing affects chemical exposure risks.” Yemi introduces her fascinating concept of “chrono-exposomics,” explaining how the time of day you are exposed to environmental …
Infertility affects one in six people of reproductive age worldwide, yet it remains one of the most overlooked public health challenges of our time. For decades, millions of individuals and couples have navigated this journey in silence, carrying grief, stigma, financial strain, and deep uncertainty about their reproductive futures. Despite its prevalence, infertility has rarely been treated as a global health priority.
That changed this year when the World Health Organization …
My mother’s life was defined by silence. She was born in India. In a world where a woman’s worth was measured in duty: how well she cared for others, how quietly she endured. She was obedient. Her dreams were practical, her voice gentle. Never shared an opinion.
I used to think that by becoming a doctor (a woman with a career, a passport, a voice) I had escaped that silence for …
My fourth year of OB/GYN residency there was an essay contest about what it meant to be an advocate for women’s health while preserving your sense of self. I sent a screenshot of the contest to my then-boyfriend, now-husband. He replied, “You want to add something else to your to-do list?” He was joking, but he wasn’t wrong. Just a few days prior, I was hyperventilating from all the things …
For the longest time, I believed that if I gave myself fully, 24/7, to work, to my son, to my marriage, to my friends, then eventually, everything would fall into place. That maybe, just maybe, I would finally be able to answer every message, refill every prescription, kiss every scraped knee, and fix all the things.
But what I’ve come to understand is that we, especially women, though not exclusively, often …
It’s no secret, is it? Health care organizations and institutions are struggling, some more than others. However, all are faced with seemingly insurmountable challenges. Demand outstripping resources, failing cultures and disengaged staff, and everywhere blockages and lack of flow are but a few of the common themes.
Big money, large initiatives, and great minds have all been thrown at the problem. The result? Well, if there was an answer we would …
Carrier screening has outgrown the language we still use to explain it. The rapid expansion of genetic testing has uncovered new layers of complexity in how conditions present, how results should be interpreted, and how patients experience and act on genetic information. To practice responsibly in this era of Genetic Carrier Screening 3.0, clinicians must understand not only what we are testing for, but how and why the results look …
Carrier screening has outgrown the language we still use to explain it.
For years, clinicians told patients they were either “a carrier” or “not a carrier.” But as the science has evolved, this binary approach is not only outdated; it is increasingly misleading.
Genetic carrier screening has entered a new era, and our counseling must evolve alongside it.
For decades, carrier screening was offered selectively based on ethnicity. Ashkenazi Jewish individuals were screened …
As I sit breastfeeding a newborn and hastily switch to pump while the newborn (my fourth child) dozes, I have some thoughts that I think are particularly timely given concerns that are facing millions of families of young children in our country. Maternal and infant mortality continue to be worryingly high in the U.S., especially for women and children of color and in socially vulnerable areas of our country. The …
As physicians, we’re used to thinking about dose (how much medication, how often, and for how long). But there’s another dimension that’s often overlooked: time. For decades, we’ve known that the body processes medicines differently depending on the time of day. A blood pressure pill or chemotherapy drug can have markedly different effects depending on when it’s taken. This field, known as chronopharmacology, has transformed how we think about drug …
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An excerpt from Understanding High-Risk Pregnancy: A Patient’s Guide to Prenatal Complications.
If you are 35 or older and either pregnant or thinking about having a baby, you are not alone. The average age for women having babies in this country and around the developed world has increased significantly over the past two decades, and the percentage of women having children after age 35 has increased as well. The teenage …
As a fertility specialist, recurrent implantation failure is one of the most difficult and heartbreaking problems we face. Over the last forty years, we’ve made tremendous improvements in both IVF protocols and lab techniques. A high-quality embryo may have up to a 70 percent chance of yielding a live birth. However, how do we approach the patient when high quality embryos are not taking? And what does the evidence really …
A young woman in her late twenties came to me after surgery for extensive endometriosis. The procedure had given her relief; her pain was gone. Her follow-up testing looked reassuring: her fallopian tubes were open on hysterosalpingogram (HSG), and her anti-Müllerian hormone (AMH) level was above 4 ng/mL, which is considered normal. Her question was straightforward: “If my AMH is good and my tubes are open, doesn’t that mean everything …
An excerpt from Understanding High-Risk Pregnancy: A Patient’s Guide to Prenatal Complications.
What is a high-risk pregnancy?
You may find it strange that there is no single accepted definition of what constitutes a high-risk pregnancy. Probably more than half of women will have at least one risk factor that could be an issue, but for most of these women it will minimally affect their pregnancy care or the outcome. For other …
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Maternal-fetal medicine fellow Frank I. Jackson discusses his article “Affordable postpartum hemorrhage solutions every OB/GYN should know.” Frank explains how postpartum hemorrhage remains a leading cause of maternal mortality, especially in low-resource …
Since the fall of Roe v. Wade in 2022, the United States has been navigating a reproductive health crisis unlike anything in modern history. Now, in mid-2025, the picture is even more stark, and more urgent.
In the wake of the Dobbs decision, nearly 1 in 5 patients seeking abortion care, including care for miscarriage, have been forced to travel out of state. That is more than double the number from …
Historical, cultural, social, and political factors contribute to the disparities in reproductive health, making it a multifaceted and deeply rooted issue in the fabric of the United States. Historically, the legacy of slavery and the American eugenics movements established race-based medicine, systems, and stereotypes that continue to influence provider bias and patient mistrust, contributing to the ongoing inequities in reproductive health. Culturally, persistent stereotypes, particularly toward Black women, have led …
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