#Singapore infertility clinic

[gynaespecialist]

Common Tests and Procedures Used in Infertility Evaluation

Infertility affects millions of couples worldwide, posing significant emotional and psychological challenges. For those struggling to conceive, understanding the various tests and procedures involved in infertility evaluation is crucial. This article provides a comprehensive overview of the common tests and procedures used by gynaecologists to assess infertility.

Singapore that offers antenatal and gynaecological procedures like ultrasound scan, antenatal risk assessment and care, natural childbirth, instrumental vaginal delivery, caesarean delivery and management of fertility problems.

For more info, you may call 6733 8810 or visit the website: https://www.gynaemd.com.sg/infertility.html

[motivationalhealthtips]

Unlocking the Secrets of Infertility: What You Need to Know

Embarking on the path to parenthood can be a daunting journey, especially for couples facing the complexities of infertility. To fully comprehend this issue, it's essential to explore the key factors that can hinder the dream of starting a family.

The Intricate Dance of Conception

To understand infertility, one must first grasp the intricate process of conception. Natural conception involves a series of finely choreographed steps: Ovulation, Fertilization, Transportation, and Implantation.

It all begins with the production of a high-quality egg during ovulation. Simultaneously, during intercourse, the male releases sperm, embarking on a journey to meet the egg in the fallopian tube for fertilization. The fertilized egg then travels to the uterus, where it seeks to implant itself, marking the initiation of pregnancy. Any disruption in these delicate stages can lead to infertility.

Female Infertility: Unravelling the Causes

Female infertility can stem from various causes, as explained by Dr. Christopher Ng, a renowned gynaecologist and fertility specialist at GynaeMD Women’s & Rejuvenation Clinic in Singapore:

Ovulation Problems: Approximately 25% of infertility cases are attributed to ovulation issues, often linked to conditions such as polycystic ovarian syndrome (PCOS), hormonal imbalances, or stress.

Endometriosis: This condition occurs when uterine tissue grows outside the uterus, potentially causing scarring and blocking fallopian tubes.

Blocked Fallopian Tubes: Obstructions in the fallopian tubes can hinder sperm-egg interaction.

Uterine Fibroids: Although not a primary cause of infertility, large fibroids can affect sperm movement and embryo implantation.

Premature Ovarian Failure: Also known as early menopause, this condition halts egg production prematurely.

Age: As women age, fertility diminishes due to decreasing egg quality and quantity.

Male Infertility: Unveiling the Challenges

On the male front, infertility can be attributed to several factors:

Abnormal Sperm Production: Genetic factors, lifestyle choices, and medical conditions can result in low sperm count, poor sperm motility, and other issues.

Varicocele: Enlarged veins in the scrotum can lead to elevated testicular temperatures, negatively impacting sperm production.

Poor Sperm Delivery: Blockages, injuries, or conditions such as cystic fibrosis in the male reproductive system can hinder sperm transport, even if the sperm is healthy.

Hypogonadism: Inadequate testosterone production can lead to low or zero sperm production.

Environmental Factors: Exposure to heat, toxins from cigarette smoke and alcoholic drinks, and certain medications can affect sperm production. Certain treatments like radiotherapy and chemotherapy can also affect sperm production.

Age: Similar to women, male fertility can also decline with age.

Pathways to Hope: Fertility Treatments

The choice of infertility treatment depends on the specific diagnosis. Treatment options range from simple lifestyle adjustments to medication. Hormonal therapy is often the initial approach, especially for issues related to ovulation and enhancing testicular function. Surgery may be required in specific situations to address concerns such as uterine fibroids, endometriosis, or obstructions in the fallopian tubes or testicles.

For cases where conventional methods prove ineffective, couples can explore Assisted Reproductive Technology (ART). ART offers a multidisciplinary approach to help couples achieve conception when natural methods fall short. Some notable ART techniques include:

In Vitro Fertilization (IVF): This involves retrieving mature eggs from stimulated ovaries, followed by fertilization in a laboratory dish outside the body. Once fertilized, the embryo is implanted into the uterus.

Intrauterine Insemination (IUI): Sperm is directly injected into the uterus to expedite the fertilization process.

Intracytoplasmic Sperm Injection (ICSI): A single sperm is directly injected into a mature egg for fertilization.

Zygote Intrafallopian Transfer (ZIFT): In this procedure, the fertilized egg (zygote) is carefully placed in the fallopian tube.

Gamete Intrafallopian Transfer (GIFT): Both eggs and sperm are directly deposited into the fallopian tube for fertilization.

Additional ART techniques may include assisted hatching and the use of donor eggs and sperm. However, the success of these treatments largely depends on the couple’s overall health. Improving general health and addressing any underlying health issues, such as diabetes and obesity, can significantly enhance the chances of success.

Empowering Couples on the Path to Parenthood

Understanding the intricate web of factors contributing to infertility empowers couples to make informed decisions on their journey to parenthood. While infertility may pose challenges, advances in medical science provide renewed hope for couples striving to start a family. 

[healthcare-domain]

Infertility Treatment Market Scope of Current and Future, Key Players Analysis by 2026

According to the new market research report "Infertility Treatment Market by Product (Equipment, Media, Accessories), Procedure (ART (IVF,ICSI, Surrogate), Insemination, Laparoscopy, Hysteroscopy, Patient Type (Female, Male), End User (Fertility Clinics, Hospitals, Research) - Global Forecast to 2026", published by MarketsandMarkets™, the global Infertility Treatment Market size is projected to reach USD 2.2 billion by 2026 from USD 1.5 billion in 2021, at a CAGR of 8.1% during the forecast period.

Browse in-depth TOC on "Infertility Treatment Market"

215 – Tables 40 – Figures 255 – Pages

Download PDF Brochure: https://www.marketsandmarkets.com/pdfdownloadNew.asp?id=43497112

The decline in the fertility rate, increase awareness about the availability of infertility treatment procedures, rising number of fertility clinics, increasing public & private investments and growing technological advancements are expected to drive market growth in the coming years

The infertility treatment market include major Tier I and II suppliers of infertility treatment equipment, media & consumables are The Cooper Companies Inc. (US), Cook Group (US), Vitrolife (Sweden), Thermo Fisher Scientific, Inc. (US), Esco Micro Pte. Ltd. (Singapore), Genea Biomedx (Australia), IVFtech ApS (Denmark), FUJIFILM Irvine Scientific (US), The Baker Company, Inc. (US), Kitazato Corporation (Japan), Rocket Medical plc (UK), IHMedical A/S (Denmark), Hamilton Thorne Ltd. (US), ZEISS Group (Germany), MedGyn Products, Inc. (US), DxNow, Inc. (US), Nidacon International AB (Sweden), Gynotec B.V. (Netherlands), SAR Healthline Pvt. Ltd. (India), and InVitroCare Inc. (US). These suppliers have their manufacturing facilities spread across regions such as North America, Europe, Asia Pacific.

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COVID-19 has impacted their businesses as well. Logistical issues, managing patients with the disease, prioritizing patients with comorbidities and pre-existing conditions, and protecting public & hospital frontline workers from exposure to the COVID-19 infection are the major challenges faced by healthcare systems across the globe. One in six reproductive-aged couples experiences infertility, and many turn to treatments such as intrauterine insemination (IUI) and in vitro fertilization (IVF), which require in-person appointments to complete.

The fertility rate worldwide is declining steadily owing to various factors, such as the growing trend of late marriages and increasing age-related infertility. Global fertility rates are projected to decline to 2.4 children per woman by 2030 and 2.2 children per woman by 2050. This declining fertility rate has led to a significant increase in the demand for infertility treatment products that determine the fertility window in males and females.

The rise in number of fertility clinics to support the market growth during the forecast period.

Significant rise in number of fertility clinics, coupled with the decline in the fertility rate across the globe. Along with this growing focus of players and government towards the launching and acquiring new fertility centers across the globe is likely to contribute towards the growth of the segment. The expansion of fertility clinics equipped with advanced technology is anticipated to increase the accessibility of infertility treatment devices among infertile couples.

Speak to Analyst: https://www.marketsandmarkets.com/speaktoanalystNew.asp?id=43497112

Asia Pacific likely to emerge as the fastest-growing infertility treatment market, globally

Geographically, the emerging Asian countries, such as China, India, Japan and Singapore, are offering high-growth opportunities for market players. The Asia Pacific point of care market is projected to grow at the highest CAGR of 9.1% from 2021 to 2026. Expansion of healthcare infrastructure and increase in disposable personal income, rising medical tourism in Asian countries, increasing healthcare expenditure, and growing awareness among people about infertility are supporting the growth of the infertility treatment market in the region.

Prominent players in this market are The Cooper Companies Inc. (US), Cook Group (US), Vitrolife (Sweden), Thermo Fisher Scientific, Inc. (US), FUJIFILM Irvine Scientific (US), Kitazato Corporation (Japan), and Hamilton Thorne Ltd. (US), among others

[bhavanameti]

Asia-Pacific Plasma Therapy Market Expected to Reach $214 Million by 2030

Meticulous Research®, a leading global market research company, published a research report titled, ‘Asia-Pacific Plasma Therapy Market, By Type (Pure Platelet-rich Plasma, Platelet-rich Fibrin), Application (Orthopedics, Dermatology, Cosmetology, Rheumatology, Ophthalmology, Stomatology), End User (Hospitals & Clinics, Research Institutes) - Forecast to 2030’.

In the latest Meticulous Research® report, the Asia-Pacific Plasma Therapy Market is forecasted to reach $214 million by 2030, with a notable CAGR of 13.4% from 2023 to 2030. This growth is propelled by increased healthcare spending, a growing elderly population, and a notable rise in accidents across the region. Additionally, advocacy through conferences for Platelet-Rich Plasma (PRP) adoption and ongoing research activities drive market expansion. Despite stringent regulations posing challenges, the increasing adoption of PRP treatments and advancements in healthcare infrastructure offer promising growth prospects.

Key Players:

Leading players in the Asia-Pacific plasma therapy market include Arthrex, Inc., DePuy Synthes, Inc., Global Stem Cells Group, Inc., Terumo Corporation, Regen Lab SA, Stryker Corporation, Zimmer Biomet Holdings, Inc., Exactech Inc., Beijing Manson Technology Co., Ltd., Alocuro, Takeda Pharmaceutical Company Limited, Grifols, S.A., Octapharma AG, and CSL Limited.

Future Outlook:

Segmented by type, application, end-user, and country, the market is expected to be dominated by Pure PRP in 2023 due to its efficacy as a point-of-care therapy. The dermatology & cosmetology segment is projected to witness the highest CAGR, driven by increasing incidences of skin and hair-related conditions. Hospitals & clinics are likely to hold the largest market share in 2023, leveraging PRP therapy for pain management, regenerative medicine, and cosmetic enhancements.

Geographic Review:

Covering major countries such as China, Japan, India, South Korea, Australia, Singapore, and the Rest of Asia-Pacific, Japan is anticipated to lead the market in 2023. This is attributed to growing awareness of PRP therapy and increasing infertility issues, with physicians employing PRP in fertility treatments to aid market growth."

Download Sample Report Here @ https://www.meticulousresearch.com/download-sample-report/cp_id=5556

Key Questions Answered in the Report:

Which market segments exhibit high growth potential?

What are the historical and forecasted market trends?

What are the major drivers, restraints, challenges, and opportunities?

Who are the key players in the market?

Contact Us: Meticulous Research® Email- sales@meticulousresearch.com Contact Sales- +1-646-781-8004 Connect with us on LinkedIn- https://www.linkedin.com/company/meticulous-research

[meghanester]

Fertility Test Market 2023-2035 CAGR, SWOT Analysis, Factors Driving the Market Growth.

Research Nester released a report titled “Fertility Test Market: Global Demand Analysis & Opportunity Outlook 2035” which delivers detailed overview of the global fertility test market in terms of market segmentation by product, mode of purchase, end-user and region.

Further, for the in-depth analysis, the report encompasses the industry growth indicators, restraints, supply and demand risk, along with detailed discussion on current and future market trends that are associated with the growth of the market.

The global fertility test market is estimated to grow with a moderate CAGR during the forecast period, i.e., 2023-2035. Market growth can be attributed to the increase in the average age of first-time pregnancies across the globe owing to the decrease in first births among teenage women and the rise of first births among women aged over 30 years. OECD Family Database stated that the mean age of first-time pregnancy has increased from 29 to 30 globally by 2019. The declining fertility rate in women and men, along with the rise in the prevalence of disorders, such as, PCOS and obesity, are estimated to promote the market growth. Growing fertility education and the easy availability of fertility monitors through e-commerce websites, pharmacies, and retail shops and drugstores also contribute to the market growth.

Download Sample of This Strategic Report: https://www.researchnester.com/sample-request-3231

The global fertility test market is segmented by product into ovulation prediction kits and fertility monitors. The ovulation prediction kits segment is estimated to hold the highest share owing to advantages, such as, low cost, rising use of ovulation prediction kits, easy availability, and higher accuracy. On the basis end-users, the fertility test market has been segmented into home care settings, hospitals, and fertility clinics. Among these, the home care segment is projected to hold the highest share in the market. The growth of this segment can be attributed to the inclination of patients toward self-monitoring of healthcare conditions, easy accessibility of fertility and ovulation monitors on e-commerce websites, rise availability of easy-to-handle devices, and the growing preference for the confidentiality of test results.

On the basis of region, the market is segmented into North America, Europe, Asia Pacific, Latin America, and the Middle East & Africa. The market in the Asia Pacific is predicted to grow at the highest CAGR over the forecast period owing to the large population, especially the large young population which falls under the fertility age bracket. Moreover, increasing investment in healthcare infrastructure by government and non-government organization, along with rising awareness regarding sexual health and fertility are estimated to further boost the market growth. Moreover, less competition among players and friendly regulatory policies in developing markets have encouraged companies to focus on emerging countries.

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Declining Fertility Rate among Men and Women to Drive Market Growth

According to the CDC data from 2020, US births have been down since 2007, and total fertility rates have similarly declined. Total fertility rates and general fertility rates have both dropped by 4% during 2019, reaching record lows.

Rise in lifestyle disorders among men and women leads to rise in the occurrences of couples opting for IVF or surrogacy which are the major factors growing the fertility testing market. In Japan South Korea, and Singapore, due to low birth rate governments are offering subsidizes in the cost of infertility treatments. However, low precision of test results of fertility test kit and high cost of kit to restrain market growth in the near future.

Access Our Report at: https://www.researchnester.com/reports/fertility-test-market/3231

This report also provides the existing competitive scenario of some of the key players of the global fertility test market which includes company profiling of Swiss Precision Diagnostics, Legacy, Inc., Dadi Inc., Everlywell, Inc., Fertility Focus, ExSeed Health, Geratherm Medical, VirtualExpo, AdvaCare Pharma, and Valley Electronics AG. The profiling enfolds key information of the companies which encompasses business overview, products and services, key financials and recent news and developments. On the whole, the report depicts detailed overview of the global fertility test market that will help industry consultants, equipment manufacturers, existing players searching for expansion opportunities, new players searching possibilities and other stakeholders to align their market centric strategies according to the ongoing and expected trends in the future.

About Us

Research Nester is a one-stop service provider with a client base in more than 50 countries, leading in strategic market research and consulting with an unbiased and unparalleled approach towards helping global industrial players, conglomerates and executives for their future investment while avoiding forthcoming uncertainties. With an out-of-the-box mindset to produce statistical and analytical market research reports, we provide strategic consulting so that our clients can make wise business decisions with clarity while strategizing and planning for their forthcoming needs and succeed in achieving their future endeavors. We believe every business can expand to its new horizon, provided a right guidance at a right time is available through strategic minds.

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[prnlive]

Gary Null’s Show Notes 04 25 23

If you listen to Gary’s show, you know that he begins with the latest findings in natural approaches to health and nutrition. Starting this week, we will make some of those findings available each weekday to subscribers to the Gary Null Newsletter.

Exposure to chemicals found in everyday products is linked to significantly reduced fertility, says study

Leafy greens may boost gut immunity: Study

Can positive thinking prolong your life? Science says yes

Exposure to chemicals found in everyday products is linked to significantly reduced fertility, says study

Mount Sinai Hospital, March 20, 2023

Exposure to chemicals commonly found in drinking water and everyday household products may result in reduced fertility in women of as much as 40%, according to a study by Mount Sinai researchers. In a paper published in Science of the Total Environment, the team reported that higher blood concentrations of perfluoroalkyl substances, known as PFAS, were associated with a significant reduction in the likelihood of pregnancy and live birth among a reproductive-age cohort of women in Singapore who were trying to conceive.

"Our study strongly implies that women who are planning pregnancy should be aware of the harmful effects of PFAS and take precautions to avoid exposure to this class of chemicals, especially when they are trying to conceive," says lead author Nathan Cohen, Ph.D., at the Icahn School of Medicine at Mount Sinai. "Our findings are important because they add to the growing body of knowledge implicating PFAS in the development of adverse health conditions, with children being especially vulnerable."

PFAS are water- and grease-resistant chemicals found in drinking water as well as in a wide range of consumer products such as nonstick cookware, waterproof clothing, food packaging, stain-resistant coatings on carpets and upholstery, paints, and personal care products. Numerous studies have found that virtually every American has PFAS in their blood. While other studies have demonstrated that PFAS impair reproductive functioning in female mice, the Mount Sinai investigation is one of the first to show its impact in humans.

The team found 30% to 40% lower odds of attaining a clinical pregnancy within one year of follow-up and delivering a live birth when the combined effects of seven PFAS as a mixture were considered. The biggest contributor to the PFAS mixture was perfluorodecanoic acid, which was individually linked to reduced fertility. Associations with infertility outcomes were also observed for perfluorooctanesulfonic acid, perfluorooctanoic acid, and perfluoroheptanoic acid.

"PFAS can disrupt our reproductive hormones and have been linked with delayed puberty onset and increased risks for endometriosis and polycystic ovary syndromein few previous studies. What our study adds is that PFAS may also decrease fertility in women who are generally healthy and are naturally trying to conceive," notes senior author Damaskini Valvi,

"We also know that PFAS exposure begins in utero and transfers from the mother to the fetus, as many PFAS have been detected in cord blood, the placenta, and breast milk. Preventing exposure to PFAS is therefore essential to protect women's health as well as the health of their children.

Leafy greens may boost gut immunity: Study

Walter and Eliza Hall Institute, Australia, March 15, 2023

The new study finds that dietary factors, and in particular consumption of cruciferous leafy greens, control the activity of vital immune cells through the activation of a particular gene known as T-bet.

These immune cells, known as innate lymphoid cells (ILCs), play a vital role in protecting the body from infection by 'bad' pathogenic bacteria in our gut - and have also been suggested to play an important role in controlling food allergies, inflammatory diseases, obesity, and even bowel cancers, say the researchers writing Nature Immunology.

"In this study, we discovered that T-bet is the key gene that instructs precursor cells to develop into ILCs, which it does in response to signals in the food we eat and to bacteria in the gut," Dr Gabrielle Belz from the Walter and Eliza Hall Institute, Australia.  ILCs are essential for immune surveillance of the digestive system and this is the first time that we have identified a gene responsible for the production of ILCs."

Belz said that the proteins in cruciferous vegetables are known to interact with a cell surface receptor that switches on T-bet – and might therefore play a role in producing these critical immune cells.

"Proteins in these leafy greens could be part of the same signalling pathway that is used by T-bet to produce ILCs," she said.

Belz and her team noted that ILCs are essential for maintaining the delicate balance between tolerance, immunity and inflammation – by producing a hormone called interleukin-22 (IL-22), which can protect the body from invading bacteria.

"Our research shows that, without the gene T-bet, the body is more susceptible to bacterial infections that enter through the digestive system,” Belz added. “This suggests that boosting ILCs in the gut may aid in the treatment of these bacterial infections.”

Can positive thinking prolong your life? Science says yes

Studies show that staying optimistic about aging can be as beneficial to your health as exercising or eating well.

National Geographic, March 14, 2023

After my father died, my mother joined a community center with a pool and started swimming laps several times a week. Dorothy was nearly 80. She met people, learned about local programs and services for older folks, and discovered a senior center that remains her hangout 18 years later. It serves hot lunch for a dollar. A dee jay comes in and she dances. She has made friends, including a group of women who meet for lunch every Saturday in a restaurant that serves huge portions and free coffee refills. I often say, only half-jokingly, she has a better social life than I do.

Scientists have known for quite a while that people with strong ties to friends and family tend to live long. A team from Brigham Young University looked at results from 148 studies dating back to 1900 that investigated whether solid relationships are a lifesaver. All told, the studies included 308,849 participants and followed subjects for an average 7.5 years. At the end of that time, people with strong social connections were 50 percent more likely to be alive than those who were isolated and lonely.

According to the analysis, a satisfying social life was as beneficial for long-term survival as quitting smoking (something my mother did after a four-decade habit) and may be even more crucial than exercise and overcoming obesity.

Social connections may influence health through what the researchers call “stress buffering.” Support from others helps us adapt emotionally to illness, the death of a loved one, or other challenges that often pile up as we get older. Better coping, in turn, eases the flow of stress-induced hormones that weaken our immune system and increase susceptibility to deadly infections, heart disease, and stroke. Strong relationships also encourage us to take better care of ourselves, and can provide a sense of purpose—another factor associated with longer life.

In research like this, of course, it’s difficult to tease out cause and effect. Does social engagement keep older people healthy—or does robust health give them the zest and desire to spend time with friends? Either way, an editors’ note accompanying the Brigham Young analysis said doctors and other health professionals “should take social relationships as seriously as other risk factors that affect mortality.”

The power of beliefs

Becca Levy, a professor of epidemiology and psychology at Yale University, points to another influence on healthy longevity: our beliefs about aging. She has published scores of studies demonstrating that whether we think of old age as a time to enjoy or something to dread has a powerful influence on how well, or how badly, we do as we inch closer to that stage.

Levy became curious about the health effects of aging beliefs—and how cultural stereotypes and values about the elderly shape our personal attitudes—as a graduate student visiting Japan. That country has one of the world’s highest life expectancies. For a long time, scientists chalked it up to genes and diet, but Levy wondered if something less obvious was at play.

Her ideas about aging beliefs jelled when a national holiday, Keiro No Hi, which translates as Respect for the Aged Day, rolled around in September. Seniors packed parks and dined at restaurants for free. Schoolchildren delivered meals to shut-ins. In Japan, she observed, older people commanded respect, even reverence. They were not shunted aside or ridiculed as “geezers” or “over the hill.”

“What I actually noticed was how differently the culture seemed to treat the oldest members of the Japanese society, as opposed to some more of the ageism that I was used to seeing in the United States,” Levy recalls.

Levy has found that adults in their 30s and 40s who had positive notions about old age—they equated it with wisdom, for example, instead of decrepitude—were more likely to be in good health decades later. In another study, she showed that people 50 and older who had optimistic views of aging were much better able to perform everyday tasks over their next 18 years—activities like shoveling snow and walking a half-mile—than peers who regarded old age bleakly. Older people who had positive age beliefs at the start of one of Levy’s studies were also much more likely to fully regain function after a new disabling injury.

Levy’s research also suggests that rose-colored perceptions of aging offer protection against cognitive decline, even in adults who are genetically susceptible. Levy and her colleagues studied people who carried the APOE ε4 gene, which increases the risk of Alzheimer’s. At the start of the project, all her subjects were dementia-free. Those who had upbeat views of old age were 47 percent less likely to develop dementia than the APOE ε4 carriers who had grim notions of aging.

In another study, Levy found that relatively young, healthy, cognitively fit people who saw nothing promising about growing old were much more likely to eventually develop plaques and tangles in the brain, the pathological hallmarks of Alzheimer’s. And their hippocampi, the curved brain structures essential for memory, shrank three times as fast.

Perhaps most striking, Levy discovered that people with the brightest view of aging lived an average seven and a half years longer than those with the gloomiest.

Positive mindsets support bodies

How do beliefs exert such power? For one thing, Levy says, people with a positive mindset about aging tend to have better self-efficacy and self-mastery, the ability to take control of their lives and regulate their impulses. They also tend to eat well, exercise, and take prescribed medications. And they have lower levels of the hormone cortisol and other biomarkers of stress.

“What’s important about age beliefs is they’re malleable,” she says.

Writing is one way to shift how we think about aging. In a study, Levy asked groups of adults to imagine a day in the life of a hypothetical older person who is physically and mentally healthy, and briefly write about it once a week. After just four weeks, negative perceptions of aging declined significantly.

She also has had study subjects keep a journal of portrayals of elders on TV. It opened people’s eyes to the condescending and ugly stereotypes that bombard us and twist our perceptions and assumptions about aging. “The idea is to make people more aware of both their own age beliefs, and the age-belief messaging they encounter in everyday life,” Levy says.

I asked Levy if our collective view of aging has improved as the elder population has ballooned and more of us hit and surpass 65. In fact, she told me, ageist biases have gotten worse.

She and her colleagues developed a computerized linguistic program and analyzed a database of more than 400 million words from books, newspapers, magazines, and academic journals going back 200 years. The team looked at adjectives that appeared most frequently with “elderly” and similar words, and at synonyms for “old people.” The language was generally positive until the late 1800s, when life expectancy for white people in America was 41 years. (Researchers at that time did not track life expectancy for other populations.) Since then, old-age-related verbiage has steadily become meaner and more dismissive. For example, the word geezer, which first appeared in 1900, became 11 times more frequent through the twentieth century.

Old people may be the last group our society feels free to mock, Levy says. She points to news reports about cruel jokes early in the COVID pandemic, when people over age 65 were dying at exceptionally high rates and the term “boomer remover” became a widely shared meme on Twitter.

Reading research by scientists trying to unravel the mysteries of aging can make it hard to feel good about growing older. The idea of “curing” aging casts it as pathology. Published studies start, relentlessly, with bad news. “Aging is a degenerative process that leads to tissue dysfunction and death,” begins a typical paper.

“I think by labeling aging as a disease, it ignores the many strengths of aging and the many ways that there can be growth in later life,” Levy says.The future of medicine

The more I learned about the science of longevity, the more excited I felt about the prospects for discoveries that will benefit all of us as we grow older. But as I approached 68, I couldn’t shake off nagging images of the tissue dysfunction and cell death occurring inside me.

Steve Horvath, developer of epigenetic clocks to measure biological age, offered to run one on me—a test with the anxiety-producing name of GrimAge. I sent him two tiny vials of my blood. A few months later I received the results: My biological age was 3.3 years lower than my chronological age.

The report offered a cheerful “congrats” and said, “You are already beating the clock!” Still, I felt let down. I certainly wasn’t in league with some of the longevity scientists I met, like David Sinclair, who exercise religiously, fast, take supplements or off-label drugs, and seem to buck the tempest of time.

Then I thought about my mother, still enjoying life in her late 90s. Becca Levy’s research convinced me that my mom’s outlook at least partly explains her vitality. I’ve never heard her grumble about her birthday or say she can’t do something because she’s too old, a complaint I’m starting to hear from friends my age.

“No,” she says, when I point this out. “I’m not too old. I might do it slower, and I might do less of it. But I’m not too old to dance or walk or do anything I like to do.”

She pauses. “Well, I wouldn’t swim anymore.”

“Because you haven’t done it in a long time?”

“Because I don’t like the way I look in a bathing suit.

About Gary Null

An internationally renowned expert in the field of health and nutrition, Gary Null, Ph.D is the author of over 70 best-selling books on healthy living and the director of over 100 critically acclaimed full-feature documentary films on natural health, self-empowerment and the environment. He is the host of ‘The Progressive Commentary Hour” and “The Gary Null Show”, the country’s longest running nationally syndicated health radio talk show which can be heard daily on here on the Progressive Radio Network.

Throughout his career, Gary Null has made hundreds of radio and television broadcasts throughout the country as an environmentalist, consumer advocate, investigative reporter and nutrition educator. More than 28 different Gary Null television specials have appeared on PBS stations throughout the nation, inspiring and motivating millions of viewers. He originated and completed more than one hundred major investigations on health issues resulting in the use of material by 20/20 and 60 Minutes. Dr. Null started this network to provide his followers with a media outlet for health and advocacy. For more of Dr. Null’s Work visit the Gary Null’s Work Section or Blog.GaryNull.com In addition to the Progressive Radio Network, Dr. Null has a full line of all-natural home and healthcare products that can be purchased at his Online Store.

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[genderneutralendo]

Endometriosis and irritable bowel syndrome: A systemic review and meta-analyses

Michelle Y. Nabi, Samal Nauhria, [...], and Prakash V. A. K. Ramdass

Abstract

Objective

To estimate the pooled odds ratio of endometriosis and irritable bowel syndrome, and to estimate the pooled prevalence of irritable bowel syndrome in patients with endometriosis.

Data sources

Using Cochrane Library, MEDLINE, Science Direct, ClinicalTrials.gov, Web of Science, and CINAHL, we conducted a systematic literature search through October 2021, using the key terms “endometriosis” and “irritable bowel syndrome.” Articles had to be published in English or Spanish. No restriction on geographical location was applied.

Methods of study selection

The following eligibility criteria were applied: full-text original articles; human studies; studies that investigated the association between endometriosis and irritable bowel syndrome. Two investigators screened and reviewed the studies. A total of 1,776 studies were identified in 6 separate databases. After screening and applying the eligibility criteria, a total of 17 studies were included for analyses. The meta-analysis of association between endometriosis and irritable bowel syndrome included 11 studies, and the meta-analysis on the prevalence of irritable bowel syndrome in endometriosis included 6 studies.

Tabulation, integration, and results

Overall 96,119 subjects were included in the main meta-analysis (11 studies) for endometriosis and irritable bowel syndrome, with 18,887 endometriosis patients and 77,171 controls. The odds of irritable bowel syndrome were approximately 3 times higher among patients with endometriosis compared with healthy controls (odds ratio 2.97; 95% confidence interval, 2.17 – 4.06). Similar results were obtained after subgroup analyses by endometriosis diagnosis, irritable bowel syndrome diagnostic criteria, and Newcastle-Ottawa Scale scores. Six studies reported prevalence rates of irritable bowel syndrome in people with endometriosis, ranging from 10.6 to 52%. The pooled prevalence of irritable bowel syndrome in people with endometriosis was 23.4% (95% confidence interval, 9.7 – 37.2).

Conclusion

Patients with endometriosis have an approximately threefold increased risk of developing irritable bowel syndrome. Development and recent update of Rome criteria has evolved the diagnosis of IBS, potential bias should still be considered as there are no specific tests available for diagnosis.

Systemic Review Registration

Keywords: irritable bowel syndrome, endometriosis, systematic review, meta-analyses, functional gastrointestinal disorders

Introduction

Endometriosis and irritable bowel syndrome (IBS) are two common medical conditions that markedly affect a substantial proportion of adults and teenagers, and even some menopausal adults (1, 2). Even though they are two distinct conditions with different etiologies, a significant percentage of people experience both concurrently (3). Endometriosis, with an estimated worldwide prevalence ranging from 0.7 to 8.6%, (4) is characterized by the existence of endometrial-like tissue that has been disseminated beyond the uterine cavity. Patients with endometriosis commonly experience menstrual disturbance, infertility, abdominal and pelvic pain, and irregularities with bowel movements (5, 6).

Irritable bowel syndrome, which shares many clinical features with endometriosis, is a gastrointestinal disorder that primarily affects the large intestine, and is characterized by an array of symptoms such as alteration in bowel movements, abdominal discomfort, pain, and cramping (7). The prevalence of irritable bowel syndrome ranges from 0.4 (in India and Ghana) to 20.9% (in Singapore), with a pooled global prevalence of 5.9% (8). Moreover, approximately 61% of adults and teenagers who were assigned female at birth are affected by irritable bowel syndrome (9).

Irritable bowel syndrome and endometriosis have a significant overlap in symptom presentation due to chronic inflammation thus leading to chronic pelvic pain (10). Endometriosis may even masquerade as irritable bowel syndrome in some patients (11). However, despite these similarities in clinical presentation, a recent nationwide study in the U.S. has shown that endometriosis increases the risk of irritable bowel syndrome approximately threefold (3). Possible explanations for this increased risk include chronic low grade inflammation resulting from mast cell activation, neuronal inflammation, leaky gut, and dysbiosis (12).

It is unclear if endometriosis is an independent risk factor for irritable bowel syndrome. The main purpose of this study was to quantify the association between endometriosis and irritable bowel syndrome, and to estimate the prevalence of irritable bowel syndrome in patients with endometriosis through pooled analysis.

Materials and methods

Sources

This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and protocols (PRISMA-P) statement (13). The study protocol was registered in the PROSPERO database (University of York, United Kingdom).1 A systematic search of the following electronic databases was conducted to identify peer-reviewed literature from inception until October 2021: MEDLINE, Science Direct, ClinicalTrials.gov, Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL, and Web of Science. Key words or MeSH terms used were “irritable bowel syndrome” AND “endometriosis.”

Study selection

Citation files from the searched databases were imported into Endnote reference management software and duplicates were removed. Using the eligibility criteria, two investigators independently screened titles and abstracts of the studies for relevance. The potential full texts articles were further assessed to be included in the review. Any disagreements between the authors were resolved with a discussion. Inclusion criteria were any observational or experimental studies that investigated both endometriosis and irritable bowel syndrome. Studies were included if irritable bowel syndrome was diagnosed by pre established criteria. Endometriosis had to be confirmed surgically, by clinical inspection, or reported as the International Classification of Diseases code for endometriosis. Meta-analyses, reviews, conference summaries, abstracts, case reports, opinions, letters, and animal studies were excluded. There was no search restriction for year of publication or the age group of patients. Articles were restricted to English and Spanish.

Data extraction and quality assessment

Data were extracted into a standardized data-collection sheet using the following headings: first author name, date of publication, study site, study design, irritable bowel syndrome diagnosis criteria, endometriosis diagnostic criteria, sample size, event rate, and quality assessment score. Two investigators (MN and PR) assessed the quality of all included studies using the Newcastle-Ottawa Scale (NOS), and the overall scores were recorded (14). NOS scale is widely used for assessing quality of each included study in meta-analyses and is based on ranking studies on according to the selection criteria, group comparability and ascertainment of exposure.

Data synthesis and analysis

Forest plots were generated with Review Manager version 5.4 (Nordic Cochrane Centre, Cochrane Collaboration, Denmark) and funnel plots were created with JASP statistical software. The primary outcome of the association of irritable bowel syndrome and endometriosis in this meta-analysis was performed using the random effects model to produce odds ratios (OR) with 95% confidence interval (CI). We conducted subgroup analyses based on diagnosis of endometriosis (surgical versus ICD-9-CM 617.x codes), method of diagnosis of irritable bowel syndrome, NOS scores (>6 vs. <6), and a combination of all criteria (endometriosis diagnosis; irritable bowel syndrome criteria; NOS score; and study design). In the subgroup analysis based on all criteria, studies were grouped as having met all criteria (surgical diagnosis of endometriosis, irritable bowel syndrome diagnosed with Rome criteria (15–17), NOS score > 6, and longitudinal studies), or not. This allowed for strong epidemiological evidence for the association between endometriosis and irritable bowel syndrome.

According to Rome III criteria, IBS patients can be classified into four subtypes and can be useful for treating specific symptoms of the patient. The subtypes include: IBS with diarrhea (IBS-D), IBS with constipation (IBS-C), IBS with mixed features (IBS-M) or IBS, unsubtyped. Whereas Rome IV criteria defined IBS as a functional bowel disorder in which recurrent abdominal pain is associated with defecation or a change in bowel habits.

A separate forest plot was generated for the prevalence of irritable bowel syndrome in patients with endometriosis, for studies that provided only prevalence data. The random effects model account for between-study heterogeneity by weighting studies similarly. Heterogeneity was assessed using the I2 statistic. Values of I2 > 50% were considered as indicative of large heterogeneity (18). We used the Begg’s and Egger’s funnel plot, which is a subjective visual method, to estimate risk of publication bias. A funnel plot that appears asymmetrical suggests publication bias. A p-value of <0.05 for all analyses was considered statistically significant. Although p-values are poor predictors of outcome, all quantitative studies included in our analyses mention p-values in accordance to the AM Stat recommendation.

Results

Search results and study inclusion

A total of 1,776 studies were identified in 6 separate databases. After removal of 168 duplicates, there were 1,608 eligible studies (titles/abstracts) which were independently screened by two reviewers. Of the 1,608 screened studies, 1,573 did not meet inclusion criteria and 35 full-text articles were reviewed. A total of 17 studies met criteria to be included in the systematic review. Eighteen studies were excluded for the following reasons: did not meet criteria; conference abstracts; reviews; letters; case series; and registered trials. The meta-analysis of the association of endometriosis and irritable bowel syndrome included 11 studies, and the meta-analysis on the prevalence of irritable bowel syndrome in endometriosis included 6 studies (see flow chart in Figure 1).

Study characteristics

Overall 96,119 subjects were included in the main meta-analysis (11 studies) for endometriosis and irritable bowel syndrome association, with 18,887 endometriosis patients and 77,171 controls (patients without symptoms). The participants in the study by Ballard et al. (19) were already reported in the study by Seaman et al. (2), thus they were not added to the main meta-analysis twice. The meta-analysis on the prevalence of irritable bowel syndrome in endometriosis included 6,395 subjects. Almost all articles were published during the last decade, with two exceptions, which were published in 2005 and 2008. Of the 17 studies in this review, the majority were conducted in the United States, the United Kingdom, and Sweden. Table 1 describes the key characteristics of the included studies. Most studies used either Rome II (15), Rome III (16), Rome IV (17), or the visual analog scale for irritable bowel syndrome (VAS-IBS) (20) questionnaires to diagnose irritable bowel syndrome. Endometriosis diagnosis was confirmed either by laparoscopy or laparotomy. Each study had a quality assessment score between 5 and 10 on the Newcastle-Ottawa Scale (14), with most studies having a score of 7 or greater.

Meta-analysis of studies

Of the 11 studies in the main meta-analysis (1–3, 10, 21–27), most were cohort and case control. Studies were conducted from 2005 to 2020, and sample sizes ranged from 80 to 36,456. In this meta-analysis the pooled odds ratio of endometriosis and irritable bowel syndrome was 2.97 (95% CI = 2.17 – 4.06), based on all selected criteria (see details in Figure 2). Odds ratio for the individual studies ranged from 1.69 (26) to 5.65 (10). There was a large heterogeneity in this study (I2 = 91%, [P < 0.00001]). In our subgroup analyses, the odds ratio for each subgroup was approximately 3, regarding endometriosis diagnosis (see Figure 3), criteria used for irritable bowel syndrome (see Figure 4), and NOS score (see Figure 5). Visual inspection of the funnel plot appears asymmetrical, suggesting the presence of publication bias (see Figure 7).

Endometriosis diagnosis

There were 9 studies (28,888 patients) in the meta-analysis that confirmed endometriosis surgically, and 2 studies (67,161 patients) that used the ICD-9-CM 617.x codes to diagnosis endometriosis. The random effects model showed a significant association between endometriosis and irritable bowel syndrome with a pooled odds ratio of 3.0 (95% CI = 2.18, 4.11) (see Figure 3).

Irritable bowel syndrome diagnostic criteria

Four studies (67,699 patients) did not state what criteria were used to diagnose irritable bowel syndrome, three studies (667 patients) used the Rome III criteria, and one study each used the following as their criteria: history (26,779 patients); VAS-IBS (289 patients); Rome II (362 patients), and Rome IV (323 patients). The random effects model shows a significant association between endometriosis and irritable bowel syndrome, with a combined odds ratio of 2.96 (95% CI = 2.16, 4.06) (see Figure 4).

Pooled prevalence of irritable bowel syndrome

There were six studies (6, 19, 28–31) that estimated the prevalence of irritable bowel syndrome in people with endometriosis. These studies ranged in sample size from 101 to 5,540. The prevalence of irritable bowel syndrome in patients with endometriosis ranged from 10.6 to 52%, with a pooled estimate of 23.4% (95% CI = 9.7%, 37.2%) (see Figure 6).

Discussion

This systematic review and meta-analysis was designed to estimate the association of endometriosis and irritable bowel syndrome. Our literature search included all available original studies investigating irritable bowel syndrome and endometriosis, thereby allowing us to include a large number of subjects (17 studies; n = 96,974).

The most significant finding of our study is that the pooled analysis showed endometriosis was associated with an almost three-fold increase in risk of irritable bowel syndrome, and that more than 1 in 5 people with endometriosis have irritable bowel syndrome. Of particular significance, all 11 studies in the main meta-analysis showed a positive association of irritable bowel syndrome and endometriosis. Moreover, almost all subjects in this analysis were followed longitudinally, either retrospectively or prospectively, thus allowing for inference on temporality vis-à-vis risk factor and disease. In addition, five studies (n = 68,129) included in this meta-analysis showed a positive association of endometriosis and irritable bowel syndrome, even after adjustments were made for potential confounding variables (3, 10, 21, 25, 26). Furthermore, there were significant findings in our subgroup analyses based on diagnostic method for endometriosis, diagnostic criteria for irritable bowel syndrome, and NOS scores. More importantly, after the studies in the main meta-analysis were categorized based on the following criteria: longitudinal study design; surgical confirmation of endometriosis; Rome diagnostic criteria for irritable bowel syndrome; and NOS scores > 6, the pooled odds ratio was 2.77 (95% CI = 1.37, 5.60). Thus, this provides strong epidemiological evidence for the increased association of endometriosis and irritable bowel syndrome.

Endometriosis is characterized as a chronic, estrogen-dependent inflammatory disorder with the presence of endometrial tissue outside the uterine cavity (3). Affected areas encompass the pelvic peritoneum, ovaries, rectovaginal septum, the abdominal cavity, and the gastrointestinal tract.

Histologically, endometriosis can be characterized into superficial endometriosis, ovarian endometrioma (OE) and deep infiltrating endometriosis (DIE). DIE can present with severe symptoms as the lesions penetrate deeper into the peritoneum and thus produce more pain as compared to the superficial. DIE also tends to involve the uterine ligaments, pouch of Douglas, rectum, or vagina. OE on the other hand, is the most common type of endometriosis and located in the pelvic areas or along the intestines. Multifocality of such a variably distributed lesion thus, predisposes to a variable clinical presentation the patients.

The relationship between endometriosis and irritable bowel syndrome has not yet been fully elucidated, and multiple theories have been proposed. One such theory is the immunological linkage through increased mast cell activation seen in both conditions (32). The major hallmarks postulated in this immunological linkage are the abnormal levels of inflammatory cytokines and immune cell activation in the peritoneal cavity (33). Retrograde menstruation has been a plausible explanation, which causes the dissemination of menstrual blood containing endometrial cells into the pelvic cavity, thus triggering symptoms of irritable bowel syndrome (34). Specifically, in endometriosis, the activated mast cells have been activated near nerve endings within the pelvic and abdominal regions, and in irritable bowel syndrome they have been shown to be activated near the bowel mucosa (35). Moreover, Remorgida et al. (22) have found that the severity of gastrointestinal symptoms was directly related to the extent of infiltration of endometriotic foci in the bowel, and reversal of symptoms occurred after removal of those lesions. However, they did not find any conclusive evidence regarding endometriosis and predisposition to a specific subtype of irritable bowel syndrome.

Another theory for the increased association between these two disorders is through a hormonal linkage. This hormonal connection involves the presence of gonadotropin releasing hormone-containing neurons (36) and receptors for luteinizing hormone within the pelvic organs (37) and the enteric nervous system (38). It is hypothesized that the pain experienced in some people with irritable bowel syndrome could be as a result of the sex hormones found in afab people, as reports have shown a fluctuating exacerbation of symptoms of irritable bowel syndrome during menstruation (39). Likewise, it was observed that patients with endometriosis had worsening of gastrointestinal symptoms during the time of menstruation (30). It is posited that patients with endometriosis and irritable bowel syndrome both experience visceral hypersensitivity, which is likely to contribute to the severity of gastrointestinal symptoms (24). A large population-based study reported that the highest prevalence rate for endometriosis was for the 40–44-year age group (40), and Oka et al. reported that afab people between the ages of 30–39 years were more likely to have irritable bowel syndrome when compared to those less than 30 years old (8). Thus, the prevalence for both conditions peak at approximately the same age range, just around the beginning of the menopausal period. Moreover, postmenopausal patients with irritable bowel syndrome experience symptoms more severely than premenopausal patients with irritable bowel syndrome, most likely due to modulation in the brain-gut axis as a result of hormonal changes (41). Our study was not analyzed according the age of the patient.

Furthermore, a meta-analysis on the sex differences of irritable bowel syndrome reveals that afab people are more likely to experience abdominal pain when compared to amab people, and this may be because of sex hormonal differences (42).

Other important factors to consider when examining the relationship between endometriosis and irritable bowel syndrome are race/ethnicity and geographical region. In their study, Bougie et al. showed that Black people were less likely than White people to have endometriosis, and that Asian people were more likely than White people to have endometriosis (43). Similarly, Wigington et al. reported that Black people were less likely than White people to have irritable bowel syndrome (44). Thus, White people were more likely to have both endometriosis and irritable bowel syndrome when compared to Black people. Interestingly, of the 11 studies in our meta-analysis, only two studies stated the race of the participants (10, 27), and of these, the study by Schink investigated only Caucasian people (27).

As discussed previously, endometriosis is a chronic and multifactorial (genes, hormones, immune and environmental) and multi risk factor (family history, long menstrual cycle, low parity, and poor physical activity) associated disease (45, 46). An association between endometriosis and heavy metal sensitivity has been discussed in research that can potentially play a role in producing produce an IBS-like syndrome. Specifically, heavy metal nickel has been shown to interfere with estrogen and its receptors and thus plays a role in the pathogenesis of IBS. Researchers have even demonstrated a higher nickel level in endometriosis tissue (46, 47).

Recent global studies showed that the prevalence of irritable bowel syndrome varies from country to country, ranging from 0.2% in India to 29.2% in Croatia, using the Rome III criteria, and ranging from 0.4% in India and Ghana to 21.3% in United States, using the Rome IV criteria (8). Similarly, the global prevalence rates for endometriosis in the general population ranged from 0.7 to 8.6% (4). This highlights the importance of recognizing that irritable bowel syndrome and endometriosis can burden people of any race and from any country of origin, even though they can vary widely regarding presentation and response to treatment (43). Studies investigating endometriosis or irritable bowel syndrome individually were sparse for the geographical regions of South America, Central America, Africa, and Asia (8). However, the studies conducted in the United States reported the highest prevalence rate of endometriosis (48), and the highest prevalence rate of irritable bowel syndrome when using the Rome IV diagnostic criteria (11). Moreover, the studies conducted in the United States showed that people with endometriosis had the highest odds (5.65, 5.30) of having irritable bowel syndrome (see Figure 2). Thus, this points to further evidence that endometriosis is a significant contributory factor leading to irritable bowel syndrome. Needless to say, more investigation is needed regarding race/ethnicity and the association between endometriosis and irritable bowel syndrome.

Studies included in our meta-analysis used the Rome II, Rome III, and Rome IV criteria. The odds of irritable bowel syndrome in endometriosis increased with each subsequent updated version of the Rome criteria (odds ratio from 1.86 to 3.45 to 5.65), respectively. However, when interpreting these differences, one should also consider the significant heterogeneity that exists regarding study design and sample size. Moreover, recent studies have shown that the diagnostic outcomes for Rome II and Rome III criteria differ significantly (49), whereas there were comparable findings for Rome III and Rome IV criteria (50). Nevertheless, there is a markedly increased risk associated with endometriosis and irritable bowel syndrome, regardless of the criteria used to diagnose irritable bowel syndrome. The basis of the Rome criteria relies on its definition of irritable bowel syndrome in which recurrent abdominal pain is associated with defecation or a change in bowel habits (17). Thus, the Rome criteria classifies patients as different subtypes based on bowel habits: irritable bowel syndrome with predominant constipation (IBS-C), irritable bowel syndrome with predominant diarrhea (IBS-D), irritable bowel syndrome with mixed bowel habits (IBS-M) or irritable bowel syndrome, unclassified (IBS-U) (17). However, our data does not include information on these subtypes. Therefore, we cannot conclusively state whether endometriosis increases the risk of a specific subtype of irritable bowel syndrome over another, or if it increases the risk of all subtypes of irritable bowel syndrome.

Our meta-analysis included one study that used the visual analog scale for irritable bowel syndrome (VAS-IBS) to diagnose patients with irritable bowel syndrome. The VAS-IBS is a patient-centered questionnaire comprised of six categories: Abdominal Pain, Diarrhea, Constipation, Bloating and Flatulence, Abnormal bowel passage, and Vomiting and Nausea (20). The items in the VAS-IBS capture the main physical concerns people with irritable bowel syndrome might experience. All symptoms, except vomiting and nausea, support the diagnosis of irritable bowel syndrome. Even though the majority of studies in our meta-analysis used the Rome criteria to establish a diagnosis of irritable bowel syndrome, the VAS-IBS was shown to be an accurate and reliable questionnaire to diagnose irritable bowel syndrome (20).

Our literature search found two meta-analyses on endometriosis and irritable bowel syndrome (51, 52). Even though they had similar findings to ours regarding the increased association of endometriosis and irritable bowel syndrome, we believe that our review provides a more detailed analysis on various factors such as endometriosis diagnosis and irritable bowel syndrome diagnosis, and the pooled prevalence of irritable bowel syndrome in patients with endometriosis.

Strengths and limitations

Strengths of this meta-analysis include incorporation of all available studies, with subsequent sub-analyses. Both observational and interventional studies were included. In addition, most studies included in the meta-analysis have a quality assessment rating greater than 6. Moreover, by independently reviewing articles and selecting those that fit our criteria, we concluded with a large-scale study from various geographic regions of the world that include North America, Europe, Asia, Africa, and Oceana. This allowed us to interpret the risk of irritable bowel syndrome in people with endometriosis from an extensive and multiethnic perspective. In addition, this is the first meta-analysis to include a pooled estimate of the prevalence of irritable bowel syndrome in people with endometriosis.

Our study has a number of potential limitations. While select studies employed either the Rome II, Rome III, Rome IV, or the visual analog scale for irritable bowel syndrome (VAS-IBS) as their criteria to gather symptomatic data on irritable bowel syndrome, the majority of studies in this meta-analysis did not state what criteria were used to diagnose irritable bowel syndrome. The anatomical location of endometriosis and the IBS subtypes was not described as relevant description was not available in the included studies. Nonetheless, after subgroup analysis by whether criteria was used or not, pooled estimates revealed similar results in these groups. These estimates were also reflected in the overall combined odds ratio for all studies. Thus, omitting the criteria used for establishing irritable bowel syndrome did not pose any significant error in this analysis. Another limitation of this study is that data from the two largest retrospective cohort studies identified patients with endometriosis using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) 617.x codes, whereas all other studies stated that laparoscopy/laparotomy/clinical inspection was used as the mode of diagnosis. There is a significant variation in clinical diagnosis of endometriosis due to the costs and invasive diagnostic techniques including laparoscopic or surgical diagnosis. This has led to more reliance on radiological diagnosis for the same. Nevertheless, the surgical diagnostic methods are still considered the gold standard. Additionally, IBS diagnostic criteria are not based on standard guidelines or criteria. Most commonly used are the Manning and the Rome criteria which are possibly too general and vague for a specific diagnosis. Thus, an inevitable overlap occurs in the diagnosis of endometriosis and IBS (53).

Therefore, there was some inconsistency regarding identification of endometriosis. Nevertheless, our subgroup analysis regarding endometriosis diagnosis showed similar pooled estimates. However, despite these limitations, the diagnosis of irritable bowel syndrome remains a challenge with the fluctuation in symptoms and its symptoms mimicking other disorders like endometriosis (17).

Recommendations

Our database search revealed that no studies were conducted in Central America or South America, and only a solitary study each arose out of Africa and Asia. Thus, we recommend that studies be conducted in these regions of the world to give globally representative estimates of the risk associated with these conditions. Furthermore, since the majority of participants were investigated in retrospective cohort studies, we recommend that researchers conduct large-scale prospective cohort studies to investigate the risk of irritable bowel syndrome (preferably using the Rome IV criteria) in people with endometriosis (with diagnosis confirmed surgically). Moreover, we suggest that studies be conducted to investigate whether endometriosis predisposes to any specific subtypes of irritable bowel syndrome.

Conclusion

This review provides significant epidemiological evidence for the association between endometriosis and irritable bowel syndrome. People with endometriosis are three times more likely to have irritable bowel syndrome compared to people without endometriosis. Doctors should be mindful that patients with endometriosis can also have irritable bowel syndrome.

Data availability statement

The original contributions presented in this study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.

Author contributions

MN, MR, and SL contributed to the conception and design of the study. ME organized the database. PR and SN performed the statistical analysis. AV wrote the first draft of the manuscript. MN, MR, AV, and ME wrote the sections of the manuscript. All authors contributed to manuscript revision, read, and approved the submitted version.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

[worldfertilityservices-blog]

How to get reasonable and affordable IVF treatment cost in Singapore?

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How do fertility experts at World fertility services perform IVF & what's the estimated IVF cost in Singapore?

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How does a couple's age & body weight affect the IVF treatment cost in Singapore?

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[gynaespecialist]

Starting a family can be challenging for some couples due to infertility.

Starting a family can be challenging for some couples due to infertility. To understand this issue, let's explore the key factors that can make it difficult to have a child. Female infertility can stem from various causes, as explained by Dr. Christopher Ng, a renowned gynaecologist and fertility specialist at GynaeMD Women’s & Rejuvenation Clinic in Singapore.

[atlaspacificmedical]

Gonnorhoea And Herpes Doctor Singapore For Quality Treatment

Are you suffering from Herpes and it is making your life uncomfortable? It is important to consult from the best doctor, who can let you know why you are suffering from the same, what treatment they can give and how soon you can recover from the same. When we talk about Herpes, you should know that it results from infection where herpes simplex virus is responsible for the same. Contacting from the very same virus means it can sore or blister your mouth to genital areas as well as a person may suffer from other symptoms as well. There are two types of Herpes, one is - Herpes simplex virus type 1 or HSV-1 which causes oral herpes and it directly affects the mouth and surrounding skin but at the same time it can affect the genital areas too. Another one is Herpes simplex virus type 2 or HSV-2 which directly affects genital areas and it is generally sexually transmitted. It is said that there is no cure for herpes, but with the best treatment any patient can help managing the symptoms and reduce the chances of outbreaks recurring and transmission to partners. If you are suffering from the same, you must carry forward with the best Herpes Doctor Singapore and your problem will definitely get solved. You should know that HSV is a common virus and it is increasing day by day, affecting the lives of many. Meeting up with the suggested doctor means he will describe you everything from symptoms of genital and oral herpes, how to treat them, and how to prevent these infections. If you get rid of the same, you must visit to the recommended source and you will be happy with the results. Not only Herpes, but if you are suffering from Gonnorhoea, you can expect the support of the professionals who will ensure to help you with the best solutions. If you are suffering from the same, it is important to take the help of the experts quickly as them only one can stop this issue from transmitting. This is a sexually transmitted infection also known as STI, which is caused by the bacterium Neisseria gonorrhoeae. This problem easily targets warm, moist areas of the body, such as- eyes, vagina, urethra, throat along with female reproductive tract. You just visit to the suggested Gonnorhoea Treatment Singapore clinic and get the best treatment. It must be noted that if there is untreated Gonorrhea, it can lead to long-term health concerns and due to the same infertility may happen. Trusting on the best doctor can help you with the best treatment with antibiotics, which will cure the infection and help in lowering down the chances of experiencing health complications. For more details about the same, you must carry forward with the suggested health center and you will rest assured that your problem will get solved soon. Searching for the best solutions on Gonnorhoea Treatment Singapore can be easier for you, if you check up all the posts and reference website provided by the author. Must follow and grab great ideas.

[healthcare-domain]

Infertility Treatment Market Size, Share | 2026 | MarketsandMarkets

According to the new market research report "Infertility Treatment Market by Product (Equipment, Media, Accessories), Procedure (ART (IVF,ICSI, Surrogate), Insemination, Laparoscopy, Hysteroscopy, Patient Type (Female, Male), End User (Fertility Clinics, Hospitals, Research) - Global Forecast to 2026", published by MarketsandMarkets™, the global Infertility Treatment Market size is projected to reach USD 2.2 billion by 2026 from USD 1.5 billion in 2021, at a CAGR of 8.1% during the forecast period.

The decline in the fertility rate, increase awareness about the availability of infertility treatment procedures, rising number of fertility clinics, increasing public & private investments and growing technological advancements are expected to drive market growth in the coming years

The infertility treatment market include major Tier I and II suppliers of infertility treatment equipment, media & consumables are The Cooper Companies Inc. (US), Cook Group (US), Vitrolife (Sweden), Thermo Fisher Scientific, Inc. (US), Esco Micro Pte. Ltd. (Singapore), Genea Biomedx (Australia), IVFtech ApS (Denmark), FUJIFILM Irvine Scientific (US), The Baker Company, Inc. (US), Kitazato Corporation (Japan), Rocket Medical plc (UK), IHMedical A/S (Denmark), Hamilton Thorne Ltd. (US), ZEISS Group (Germany), MedGyn Products, Inc. (US), DxNow, Inc. (US), Nidacon International AB (Sweden), Gynotec B.V. (Netherlands), SAR Healthline Pvt. Ltd. (India), and InVitroCare Inc. (US). These suppliers have their manufacturing facilities spread across regions such as North America, Europe, Asia Pacific.

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COVID-19 has impacted their businesses as well. Logistical issues, managing patients with the disease, prioritizing patients with comorbidities and pre-existing conditions, and protecting public & hospital frontline workers from exposure to the COVID-19 infection are the major challenges faced by healthcare systems across the globe. One in six reproductive-aged couples experiences infertility, and many turn to treatments such as intrauterine insemination (IUI) and in vitro fertilization (IVF), which require in-person appointments to complete. In India, 30 lakh people seek infertility treatment every year, but only 5 lakh people undergo IVF/intrauterine insemination (IUI) procedures. During the COVID-19 pandemic, a 90% drop was observed in the number of people undergoing IVF cycles. The spread of COVID-19 has not only impacted fertility clinics owing to the cancellation of IVF treatments but has also impacted fertility decisions among couples who were opting for IVF treatment before the pandemic.

The rise in number of fertility clinics to support the market growth during the forecast period.

Significant rise in number of fertility clinics, coupled with the decline in the fertility rate across the globe. Along with this growing focus of players and government towards the launching and acquiring new fertility centers across the globe is likely to contribute towards the growth of the segment. The expansion of fertility clinics equipped with advanced technology is anticipated to increase the accessibility of infertility treatment devices among infertile couples.

Speak to Analyst: https://www.marketsandmarkets.com/speaktoanalystNew.asp?id=43497112

Asia Pacific likely to emerge as the fastest-growing infertility treatment market, globally

Geographically, the emerging Asian countries, such as China, India, Japan and Singapore, are offering high-growth opportunities for market players. The Asia Pacific point of care market is projected to grow at the highest CAGR of 9.1% from 2021 to 2026. Expansion of healthcare infrastructure and increase in disposable personal income, rising medical tourism in Asian countries, increasing healthcare expenditure, and growing awareness among people about infertility are supporting the growth of the infertility treatment market in the region.

Prominent players in this market are The Cooper Companies Inc. (US), Cook Group (US), Vitrolife (Sweden), Thermo Fisher Scientific, Inc. (US), FUJIFILM Irvine Scientific (US), Kitazato Corporation (Japan), and Hamilton Thorne Ltd. (US).

[fertility-service-clinic]

Things to Consider Before Visiting a Fertility Service Clinic

As technology as well as medical practices continue to advance, more couples are turning to fertility services in Singapore for their reproductive health issues. It should be noted that on average, it takes about five to seven months for couples to conceive. That said, you do not have to worry about a thing if it is taking more than a couple of months for you to get pregnant. 

But if it has been a year or two and there is still no success, then you should seriously consider visiting a fertility service clinic, especially if you are 40 or over. In line with this, it is best to familiarize with a couple of things before doing so. Some of the most notable ones are elaborated below. 

Are You Ovulating?

One of the first questions that your doctor is going to ask is whether you're ovulating (releasing an egg every month) or not. You might be able to find this out on your own before your appointment by keeping track of your basal body temperature (BBT) for a few months.

The fundamentals of fertility treatment

Your fertility service clinic specialist can put up a treatment plan after all of the testing is completed and you receive your diagnosis i.e. the reason for your infertility. Afterward, your specialist is going to come up with a treatment plan. 

Even if the tests are inconclusive and there's no obvious reason for your inability to conceive, treatment is still accessible. Expect to have a variety of alternatives, including lifestyle changes, fertility medicines, surgical treatments, and even intrauterine insemination (IUI) or in vitro fertilization (IVF).

Fertility drugs come with side effects

Most infertility treatments include ovulation stimulant medication. In certain cases, only medications are used, at least for the first few weeks or months of treatment. Fertility medicines are also used in more complex therapies like IVF; in line with this, it is important to note that the said medicines carry some hazards, which your doctor will discuss with you.

If you’ve made your decision, know that they include the risk of conceiving twins or older multiples, which can lead to pregnancy difficulties. Furthermore, a condition known as ovarian hyperstimulation syndrome (OHSS) is another negative effect of fertility medications. 

Fertility treatment can be challenging 

Together with drug side effects, people who undergo fertility treatments face a number of other issues, including the heightened vigilance and determination for drug treatments, the frequent (sometimes daily) trips to the fertility service clinic for blood work and ultrasounds, the cost, and disappointment if treatment fails.

It's critical to express how you're feeling, whether you're going through treatment or supporting a partner who is. If you're having trouble doing so, go to an infertility counselor who has been professionally educated to help people through the emotional minefields of fertility therapy.

Summing up

These are only some of the things that you should be familiar with if you and your partner are contemplating of having fertility services in Singapore. By doing so, you can develop the mindset that can play a role in the success of the treatment.

[pcossymptomsandtreatment]

Can IUI Help You To Get Pregnant If You Have PCOS?

Many conditions can affect female infertility and make it harder to consider. One of the most well-known reasons for female fruitlessness is ovarian polycystic, or PCOS, which is assessed to influence almost 10% of ladies all over the globe. 

How does PCOS sway infertility? 

PCOS is the aftereffect of a hormonal imbalance. Ladies with PCOS have unusual degrees of estrogen and progesterone, which can prompt expanded degrees of androgenic chemicals. Androgenic chemicals, similar to testosterone, are ordinarily perceived as male chemicals. 

The hormonal imbalance identified with PCOS can cause various incidental effects. Be that as it may, probably its greatest impact is compromised female ripeness. PCOS frequently makes ladies have rare periods, or some of the time no period by any means. On the off chance that a lady doesn't ovulate routinely, it is undeniably harder for her to become pregnant, because she has fewer timeframes when she is prolific, and it is hard to follow when ovulation will happen. 

IUI and ovarian acceptance 

Past the advantages of IUI treatment alone, PCOS patients can acquire considerably more benefits when IUI is joined with ovarian acceptance. During ovarian acceptance, our Scottsdale patients are given a progression of ripeness drugs. Infertility drugs give chemicals that are essential to female proliferation. 

Ovarian acceptance not just permits our ripeness experts to follow ovulation, with the goal that IUI treatment can be coordinated appropriately, however it likewise empowers the creation of more than one mature follicle. The more follicles that are delivered, the more eggs that can be delivered, subsequently allowing patients more opportunities for origination. 

How could IUI help? 

IUI pregnancy method stores sperm straightforwardly into the uterus. This methodology extraordinarily lessens the distance sperm should go to arrive at an egg, which makes it more probable that origination will be a triumph. All things considered, IUI is helpful because it allows ladies better opportunities of imagining during ovulation, which is vital when ovulation happens rarely. So, look for the best infertility clinic in Singapore and ask for the IUI pregnancy Singapore price.

IUI versus IVF: The quick realities 

The fundamental distinction between IUI and IVF is the number of eggs the female delivered and the spot of preparation. 

With an IUI, a lady is simply     expected to foster a couple of eggs. Sperm are saved inside the uterus,     which gives the sperm an early advantage yet requires normal treatment to     occur. 

In IVF, a lady is given more meds     to foster loads of eggs. Preferably, they create around 15 mature eggs.     The eggs are eliminated from the ovaries, prepared and created in a lab for     various days, and along these lines set back into the uterus as a     beginning phase undeveloped organism. 

Treatment Process: 

IUI: 

An IUI should be possible without any meds or various prescriptions to help create and ovulate a couple of eggs. Around day 14 of a lady's cycle, insemination happens which stores sperm inside the uterus. This incredibly expands the quantity of sperm at the intersection of the uterus and fallopian tubes, the distance they need to swim to meet the egg, and subsequently builds the odds of regular origination for some individuals. 

IVF: 

During IVF, drugs are normally taken for around 10 days to grow countless eggs. When many eggs have been created, a methodology happens where the eggs are taken out from the ovaries. The eggs are then prepared outside of the body in a lab. 

How they beat infertility 

An IUI helps beat infertility in two essential ways. 

v  Egg quality and ovulation: Medications are given to help develop and ovulate a couple of mature eggs (a few ladies may not ovulate in any case). 

v  Sperm Quality: An IUI puts sperm a lot nearer to its objective. IUI can expand the quantity of sperm that comes to the fallopian tube by 1000 times.

[drmonadahiya]

Best IVF Clinic in Noida

Dr. Mona Dahiya is a well-known name in the group of IVF Specialist doctors in India. Little Angel IVF is the best IVF Clinic in Noida, Gurgaon, Delhi NCR, owned and operated by Dr. Mona Dahiya. She specializes in the field of infertility and IVF and has undergone extensive training in premiere institutes of India and Singapore. Dr. Mona Dahiya is Best IVF Doctor in Noida with academic Qualifications from Top Institutes in India & Abroad. She has 20 years’ experience in the field of Obstetrics and Gynaecology.

[magicalpersonaluminary]

Best IVF Doctor in Gurgaon

Dr. Mona Dahiya is a well-known name in the group of IVF Specialist doctors in Gurgaon. Little Angel IVF is the best IVF Clinic in Noida,Gurgaon, Delhi NCR, owned and operated by Dr. Mona Dahiya. She specializes in the field of infertility and IVF and has undergone extensive training in premiere institutes of India and Singapore. Dr Mona Dahiya is Best IVF Doctor in Gurgaon with academic Qualifications from Top Institutes in India & Abroad. She has 20 years’ experience in the field of Obstetrics and Gynaecology.

[makuang12]

TCM for pregnancy singapore

The living style and eating habits can cause Infertility in women. Don’t need to worry as natural therapy and acupuncture show their positive response in conceiving. The doctors prefer tcm for pregnancy Singapore to control the male and female hormone. Come to Ma Kuang's main clinic for your reproductive health check-up.