30-Second Takeaway
- Low-dose Cu 175 mm² IUD shows very low 5-year pregnancy and expulsion rates with declining bleeding- and pain-related discontinuation.
- Artificial-cycle FET alters uterine artery Dopplers and is linked to higher preeclampsia, challenging current screening assumptions in ART pregnancies.
- Prior cesarean independently lowers IVF live-birth rates after first embryo transfer compared with prior vaginal birth.
Week ending February 28, 2026
Targeted updates in contraception, ART, hypertensive pregnancy risk, HPV, ovarian cancer perioperative care, and endometrial cancer
Five-year data support efficacy and tolerability of a low-dose copper IUD
In this phase 3 single-arm trial, 1,601 women had successful placement of a nitinol-framed Cu 175 mm² IUD. Among 1,397 women evaluable for pregnancy, the Pearl Index was 0.94 at 1 year and 1.02 cumulatively through 5 years. Life-table pregnancy rates were 1.3% at 1 year and 4.1% at 5 years, indicating durable contraceptive efficacy. Bleeding and pain caused 8.7% discontinuation in year 1 but only 1.9% in year 5, and expulsions occurred in 4.7% over 5 years. Clinicians can counsel that this low-dose copper IUD provides highly effective contraception with decreasing bleeding- and pain-related discontinuation over time.
Artificial-cycle FET modifies uterine perfusion and increases preeclampsia risk
This retrospective single-center cohort included 27,495 singleton pregnancies with second-trimester UtAPI assessment, of which 3,948 followed ART conception. Artificial-cycle FET pregnancies showed lower second-trimester UtAPI (0.73 MoM) than natural conception, ovulation-induction, fresh transfer, or natural-cycle FET. UtAPI differences persisted into the third trimester in a large subset, despite discontinuation of exogenous hormonal therapy. Despite lower UtAPI, artificial-cycle FET was associated with a higher incidence of preeclampsia compared with other conception modes. These findings suggest Doppler-based preeclampsia screening algorithms may underestimate risk in artificial-cycle FET pregnancies and warrant recalibration.
Surgeon volume explains only a small part of racial gaps in hysterectomy modality
Using the Premier Healthcare Database, 367,593 women undergoing hysterectomy for benign indications from 2016 to 2023 were analyzed. Black women had 46% higher odds of being treated by a low-volume surgeon compared with White women (OR 1.46, 95% CI 1.42-1.50). Patients of low-volume surgeons had 2.24-fold higher odds of abdominal versus minimally invasive hysterectomy (95% CI 2.17-2.30). Mediation analysis showed surgeon volume was a statistically significant determinant but explained only 2.7–3.1% of the race–modality association. System-level efforts to improve equitable access to minimally invasive hysterectomy must therefore address broader structural and referral pathways beyond surgeon volume.
References
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Additional Reads
Optional additional studies from this edition.