General Medical News
Can sunlight, in fact, cure diseases?
This is what a recent article in Scientific American, indeed, suggests (1): Sunshine appears especially effective when the immune system must be calmed down, and that, of course, applies especially to autoimmune conditions, like multiple sclerosis (MS) and type 1 diabetes.
Illustrations in this article, including the one shown here, were made by Taylor Callery.
It was in the mid-1970s that researchers found in small animal cancer models that UV lights apparently can induce cancers. But it took a few additional years until the mechanism underlying this association became clear: UV light suppressed a mouse’s natural immune response. And since then, it has become quite apparent that UV light calms especially inflammation in the skin, the central nervous system, the pancreas, and the gut.
What does this mean practically in daily medical practice: UV light boxes emitting only a narrow bandwidth of light that does not cause cancer have now for years been used in the treatment of psoriasis (of course, also an autoimmune disease). And these light boxes are now also increasingly used (4 minutes per side per day is all that’s needed) in MS patients.
Why are we featuring this article here in The Reproductive Times? Because immunosuppression is, of course, also sometimes needed in reproductive medicine: Women with autoimmune diseases or just women with repeated pregnancy loss due to an overactive immune system could be candidates. It seems that 4 minutes per day of light treatment may most certainly be worth a try if it saves patients from much more invasive treatments.
Reference
Jacobsen R. Surprising ways that sunlight might heal autoimmune diseases. Scientific American. June 2025. https://www.scientificamerican.com/article/surprising-ways-that-sunlight-might-heal-autoimmune-diseases/
Food is medicine – all about nutrition, weight, & obesity
Are there differences in effectiveness between the new weight loss medications?
You bet there are, and that should not surprise, because studies of individual drugs reported different degrees of weight loss. Now, however, The New England Journal of Medicine published a head-to-head comparison trial between Tirzepatide [a long-acting glucose-dependent insulinotropic polypeptide (GIP) together with a glucagon-like peptide-1 (GLP-1) receptor agonist] and semaglutide, which is only a long-acting GLP-1 receptor agonist. Some people would also call these two medications the second and first generation of this new family of life- and medicine-changing drugs. Tirzepatide is available under two different brand names, even though it’s the same medication combination: Mounjaro®for diabetes and Zepbound® for weight loss. Eli Lilly makes both, and they are interchangeable. Semaglutide is the active ingredient in Ozempic® , Wegovy®, and Rybelsis®, all made by NOVO Nordisk
And the outcome was clear: Among obese participants, though without diabetes, Tirzepatide was the better one, producing within 72 weeks larger weight loss and greater loss of waist circumference.
Reference
Aronne et al. N Engl J Med 2025;393():26-36
Expanding benefits of GLP-1 agonists
A short recent Commentary article in Cell Reports Medicine is worth mentioning because it well summarizes the amazing expansion of discovered medical benefits that GLP-1 agonists appear to offer beyond just blood sugar control and weight loss, their initial purposes.
As the article well summarizes, these medications have, by now, been demonstrated to reduce rates of chronic kidney disease, myocardial infarction, stroke, and cardiovascular death in people with type 2 diabetes. They also improve symptoms and outcomes in people with heart failure with preserved ejection fraction, the majority with concomitant obesity and often type 2 diabetes. Benefits have also been demonstrated in separate trials of people with metabolic dysfunction-associated liver disease (MASLD), sleep apnea, osteoarthritis, and peripheral artery disease. The paper is definitely worth reading.
Reference
Gonzalez-Rellan MJ, Drucker DJ. Cell Reports Med 2025;6(7):102214
The value of weight loss for obese women wanting to conceive
So, we all know that weight loss is good for fertility: It improves the chance of spontaneous pregnancy, but also improves the pregnancy chance with practically all fertility treatments. And then weight loss also reduces pregnancy complications. Reproductive Biology and Endocrinology, which increasingly publishes interesting papers (also reflected in its steadily rising impact factor) now published a paper by a consortium of U.S investigators that demonstrated how even relatively small weight loss already matters.
In an unfortunately only retrospective cohort study at a university multidisciplinary program for women with reproductive disorders and obesity, all participants from program start in November 2021 until July 2023, were included in the analysis. The primary outcome was percent body weight loss at 3 months. Secondary outcomes included weight loss at 6 months and achievement of >5% and >10% weight loss at each time point.
Among 237 participants, 88.2% desired pregnancy, and among those, 63.2% of participants were willing to postpone pregnancy attempts/fertility treatments so that they could focus on weight loss for at least 3 months. They consequentially achieved significantly greater weight loss at 3 months compared to those who continued pregnancy attempts (mean −4.8% vs. -2.5%, P=0.004) and were more likely to achieve >10% body weight loss at 3 months (14.0% vs. 2.20%, P=0.031). Those who achieved >5% weight loss by 6 months were more likely to achieve pregnancy within the first 6 months of trying to conceive (34.1% vs. 7.7%, P=0.004). In other words, just a 5% loss of bodyweight achieved in 3 months already significantly improved pregnancy chances.
Quite a lesson for patients as well as treating physicians!
Reference
Schon et al., Reprod Biol Endocrinol; 2025;23:89
Look for our later posting this week. We will be discussing several more interesting articles under this heading.
General fertility & infertility
“Ovarian aging,” a missing diagnosis in reproductive medicine
This was the heading of a recent Commentary in Nature Medicine by three colleagues from Northwestern University in Chicago (1) and how correct the three authors were when then concluding that “recognizing ovarian aging as a formal diagnosis—akin to how obstetrics adopted ‘advanced maternal age,’ would transform reproductive medicine, public health and research into women’s health.”
For one selfish reason, we here at the CHR, of course, could not agree more with those three authors because we have been using the term “ovarian aging” in our daily work, research, and publications for decades. We, indeed, have gone even a step further by coining, also already decades ago, the term “premature ovarian aging” (POA)—when describing a usually younger woman with lower functional ovarian reserve (FOR, i.e., higher FSH and lower AMH than she would be expected to demonstrate at her age).
And why is that important?
In principle unfortunately some important conclusions from these two “new” diagnoses were not sufficiently explored in the Commentary: (i) One crucial conclusion is that these diagnoses, indeed, require age-specific “normal” and “abnormal” hormone levels (as well as antral follicle counts—AFCs—for those who still use those) to describe the ovarian age correctly as either normal, younger than expected, or older than expected. (ii) The recognition that there is a “natural” aging process that on average ends with menopause at roughly age 51 and a “premature” aging process which – if it leads to menopause before age 40—we arbitrarily have given the name “primary ovarian insufficiency” (POI) or premature ovarian failure (POF) and—if menopause happens after age 40 but before age 51—as “early menopause.” These arbitrary cut-offs make absolutely no sense because physiology, of course, works in graduations. (iii) What, however, is most often overlooked is the typical POA patient, who in most cases may still have the usual age of 51 when reaching menopause, but on that journey from a very young age on, always has lower FOR than ca. 90% of women her age.
The reason is that roughly 10% of all women, independent of race and ethnicity, suffer from POA, but only 10% of these 10% (i.e., 1% of the total female population) experience POI. And the 9% with only POA are too often overlooked, even in decent fertility clinics.
Which brings us to (iv), the very important reason why the diagnosis of POA should not – and cannot - be overlooked: A 28 year-old patient with mild POA may have ovaries that behave only mildly “older”—maybe like 32-year-old ovaries with only mildly high FSH and mildly low AMH; but severe POA at the same age—for example, mimicking 44 year-old ovaries—may already have significantly elevated FSH levels and very low AMH and sometimes even already undetectable levels. And even in confirmed POA patients, whether a patient’s ovaries behave like 32- or 44-year-old ovaries, therefore, makes quite a difference in how such a patient must be treated and what her pregnancy chances will be.
And the same may, of course, also be true at more advanced ages: Here, too, for example, a 43-year-old patient may have appropriate FOR considering her age, or either poorer or better FOR. Once again, in which of these patient groups the patient finds herself will define her treatment options and her treatment outcomes.
But a big “Bravo” for our Chicago-based colleagues who have finally brought this important subject to the pages of one of the highest-ranked medical journals in the world!
Reference
Hughes et al. Nature Med. https://doi.org.10.1038/s41591-025-03733-4. ahead of print
Do pregnancies after clomiphene citrate (CC) treatments suffer from more stillbirths or neonatal deaths?
According to investigators from Australia, as reported in the JCEM, that exactly appears to be the case, though not to a really threatening degree (1). Among singletons without CC, the numbers looked as follows: Stillbirths 6.6/1,000 births; neonatal deaths 2.1/1,000; with CC, the numbers were 10.2/1,000 and 3.1/1,000. Combined counted as perinatal deaths, these numbers reached significance [OR 1.54, 95% CI 1.15, 0.07].
There are several reasons why we are skeptics, though one, of course, cannot just ignore a study involving 242,077 births: (i) The study involved deliveries between 2003 and 2015. Why? What stopped in 2016? (ii) Despite the huge number of cases, the study reached significance only once; stillbirths and neonatal deaths were combined, suggesting a really absolutely minimal effect. An (iii) we could understand it if the medication caused early pregnancy problems, but why extremely late and neonatal problems? What’s the mechanism(s)?
Reference
Moore et al. J Clin Endocrinol Metab 2025;110:1818-1827
The tie-up of infertility with later heart disease in women
That infertility is some ways is connected to later heart disease in women has by now been known for quite some time. Reporting from a combined meeting of the European Societies for Pediatric Endocrinology and (adult) Endocrinology, HealthDay newsletter now reported on a pooled data set of 21 studies involving 179,000 women with infertility and almost 3.4 million without and found a 17% increased risk of heart disease, 16% increased risk of stroke, and 14% increased risk of health conditions affecting the heart or blood vessels. Younger women bore the greatest risk, with 20% higher odds of heart disease among those under age 40 (1).
Still perplexing in its causality—if there is one—the association has, by now, to be considered solid. Now we need to learn to understand it.
Reference
Thomson D. HealthDay. June 18, 2025. https://www.healthday.com/health-news/women-health/infertility-tied-to-heart-problems-in-women
An important Supreme Court ruling regarding gender transition of children and older youth
Though the CHR has not been involved in gender transition treatments, we do recognize the obvious potential relevance of such treatments for fertility and infertility of some affected individuals. Likely, no media outlet has been as committed to its coverage of gender transition treatments for children and older youths as The Free Press. And—fully sharing that publication’s outlook on the subject—we here at The Reproductive Times have repeatedly before noted articles from The Free Press.
Among those were some truly remarkable articles at a time when most other media either ignored the subject or, completely removed from reality, just repeated outrageously supportive comments by medical professionals and hospital spokespeople of such treatments. Two articles deserve special mention, one from the original whistleblower nurse at an Indianapolis hospital and a second about a whistleblower surgeon in Houston who disclosed that his hospital, in contrast to what it represented to the public, life changing surgeries on transitioning children were still performed.
Emily Yoffe / Photo Courtesy of Bethesda Magazine
It, therefore, is only appropriate that we are giving here The Free Press the honor of referencing its article by senior editor, Emily Yoffe, on the recent landmark decision of the U.S. Supreme Court, which ruled that states can restrict the ability of minors to get transition treatment (1). As she correctly noted in the heading of the article, it has been long overdue!
Reference
Yoffe E. The Free Press. June 18, 2025. https://www.thefp.com/p/the-end-of-youth-gender-transition