Latest News

Hi Everyone,

I wish to advise that I have now joined the newest state of the art IVF service on the Gold Coast namely Monash IVF.

I am very excited to be able to offer the best care for my fertility patients through these facilities. The focus at Monash IVF has always been ‘putting patients first’ and that has always been my belief.

If  you wish to enquire or undergo fertility treatment, please do not hesitate to call my office or please check out the

Monash IVF website via my quick links.

Finally, I wish to thank everyone for all their continuing support…


Iodine in pregnancy

It has been noted for many years that Iodine is an essential micronutrient in pregnancy. Severe iodine deficiency in the mother can lead to cretinism and mental retardation in the newborn. World Health Organiziation has listed maternal iodine deficiency as a main cause of newborn brain impairment worldwide. The developing fetus is dependent on the mother’s thyroid hormone production for its brain development which in turn is dictated by natural dietary intake or supplementation of iodine. It is likely that low levels of maternal iodine consumption, especially in early pregnancy are associated with poor brain performances in their offspring.

A study in England followed up the children of over 1000 women who had their urinary iodine levels tested in the first 12 weeks of pregnancy. The study found that the children’s verbal, reading and IQ scores related to the mother’s iodine levels during her early pregnancy stage. Poorer childhood performances were associated with lower iodine measurements. (Lancet 2013;382:331-7)

Therefore it is recommended that all pregnant women should receive sufficient iodine in their diets by eating seafood or by taking iodine supplement of 150µg-220µg per day

Seafood – dietitians recommend two to three meals of seafood per week to get the beneficial fish oils. Eating fish twice a week will also provide most adults with enough iodine to fulfill their average iodine requirement.
Bread – is now made using iodised salt in Australia. Organic breads and ‘no added salt’ breads are the only exceptions to this rule.
Seaweed (kelp), dairy products and eggs – provide additional dietary sources of iodine.
Some vegetables – may contain iodine, but only if they are grown in iodine-rich soils.


Getting healthy before falling pregnant

There are advantages in not being overweight prior to conception. There is evidence that when women who are overweight conceive, careful weight control during pregnancy can improve outcome. It is known that obesity is associated with increased chances of caesarean or instrumental (vacuum or forceps) delivery, haemorrhage (or excessive bleeding), infection and longer stays in hospital. In addition, the mother is more likely to suffer from pregnancy induced diabetes and high blood pressure. There is also greater likelihood of the need of neonatal intensive care for their baby.

In a recent study in the UK, it was found that dietary, rather than lifestyle interventions, were more effective in controlling weight gain. This is a similar guide put out by the American Institute of Medicine, which recommends the following guidelines for recommended weight gain by pre-pregnancy body mass index:


Obesity

 

As well as raising a woman’s risk of breast cancer, obesity is strongly linked to endometrial cancer (cancer of the uterus/womb). This is caused by the excessive fat cells converting natural male type hormones to oestrogen derivative hormones. The excess oestrogen effect causes stimulation to the lining of the uterus. This is not opposed by progesterone hormone and therefore leads to endometrial hyperplasia (overgrowth of the lining of the uterus) then developing further into cancer of the uterus. Thus severely overweight women are 10 times more likely to develop endometriod cancer (cancer of the uterus) than those with normal weight (body mass index). (BJOG 2013;120:791-4).


Peanut Allergy

For many years the question of whether peanuts should be avoided or encouraged to prevent allergies has plagued mothers. According to recent trials, the answer is encouraged in the first year of life. In research published last year and now followed-up in the UK, in a high-risk group of infants, 20% developed a peanut allergy if the nuts were avoided versus 5% when they were consumed Even when peanut ingestion was discontinued for 12 months (from age 5 years to 6 years) and restarted, this did not increase rates of allergy. From these trials it seems the safest way to prevent allergy to peanuts is to give them to children to eat early in life.

(Du Toit et al NEJM 2016;374:1435-43)


Lactation and progression to diabetes

Lactation is one of many things that improves glucose metabolism. It is therefore possible that breast feeding could protect women who are at risk of developing Type 2 diabetes. One particular high-risk group are mothers who suffered from gestational diabetes mellitus (GDM) during their pregnancy. To further investigate the benefits of breast-feeding, a group of scientists followed 1000 women who suffered from GDM and observed whether breast feeding had an influence on the rates of contracting Type 2 diabetics or not. The report found 12% of these GDM mothers later developed type 2 diabetes. However the likelihood of a Type 2 diabetes diagnosis was decreased in women who breast fed more frequently and with longer duration. As the authors put it “Lactation may prevent diabetes mellitus after GDM delivery” and this benefit is another reason why encouraging breast feeding, where possible is so important.

(Gunderson et al Ann Int Med 2015;163:889-98).


Flu vaccinations and newborn babies infections

In the first 6 months of life, contracting influenza or the flu can lead to serious adverse outcomes and possible complications. Currently, flu vaccines do not protect infants in this age group. However, immunizing mothers during their pregnancy can produce passive immunity and therefore prevent infections in the newborn infants. This has been confirmed by a large retrospective study conducted within the United States. The study tracked 250 000 pregnancies in the last 10 years for maternal influenza immunization and infant flu infection rates within 6 months of birth. The rate of infants contracting the flu in the immunised mothers group was 1.3 per 1000 while for non-immunised mothers the rate rose to 3.7 per 1000. Furthermore, the studies found that rates for hospitalisation of infants suffering from the flu were higher for infants of non-immunised mothers. This studies confirms that influenza immunisation during pregnancy should be a public health priority and heavily impacts infant wellbeing.

(Shakib et al Pediatrics 2016;137:e20152360).


IVF and Breast Cancer Risk

For many years, studies have linked oestrogen and progestogen hormones to the risk of breast cancer. This association is complex and includes both endogenous and exogenous hormones. Recently researchers have raised the question about risks of breast cancer with IVF treatment as there are significant hormone manipulation during an IVF cycle. Through this study researchers tracked over 25 000 women with a mean age of 33 years who underwent ovarian stimulation as part of their IVF management and followed them over 20 years. The results have shown that the incidences of breast cancer were the same for the IVF group as for those not receiving IVF. From this study it appears that IVF hormonal treatments do not affect a woman’s risk of developing breast cancer.

(van den Belt-Dusebout et al JAMA 2016; 316:300-12).


Body Fatness and Cancer Risk

The International Agency for Research on Cancer’s latest report has advised that an increase in body fatness relates to increased risks of cancer development. Body fatness and weight gain throughout one’s lifetime are largely determined by modifiable risk factors, such as excess energy intake (unhealthy amounts of food and drink) and physical inactivity (low amounts of exercise). The following list describes the cancers whose risks are most increased by obesity (in order of highest to lowest risks):

  • Uterus
  • Oesophagus
  • Stomach liver and kidney
  • Pancreas
  • Large bowel and gall bladder
  • Ovary, thyroid and breast

NEJM (Lauby-Secretan et al 2016;375:794-8)


Health & Development Aid Abroad

Dr Lee has also been able to carry out medical aid work here in Australia as well as abroad. This is through being a Committee Member of the board for Health and Development Aid Abroad – Australia Fund Inc.www.hada.org.au – HADA is a volunteer organization established since 1998 for establishing medical, educational, and agricultural and sanitation programs in countries of need.


Next