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Thinking About Ob/GynAuthor: Antonia Roberts and Howard Herrell
A fresh and evidence-based perspective of all things related to obstetrics and gynecology. Follow us on Instagram @thinkingaboutobgyn or visit thinkingaboutobgyn.com for show notes and more. Language: en-us Genres: Health & Fitness, Medicine Contact email: Get it Feed URL: Get it iTunes ID: Get it |
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Episode 12.7 How Evidence Breaks Down In IVF Add-Ons, Ectopic Care, And New Surgical Tech
Episode 7
Wednesday, 30 September, 2026
We dig into how good stories and elegant mechanisms can seduce clinicians into using fertility and surgical “add-ons” long before the evidence is ready. We also connect policy, access, and misinformation to a disturbing rise in ectopic pregnancy deaths, then end with what better studies should look like when patient safety is on the line. • why low-dose naltrexone becomes a fertility add-on despite unclear mechanisms • biologic plausibility versus proof, and why theory cannot replace trials • what the available LDN data looks like, including weak endpoints and missing live birth outcomes • practice inertia, file drawer bias, and when a therapy belongs in routine care • ProPublica’s ectopic pregnancy mortality signal and how to interpret CDC WONDER data • COVID-era care disruptions, hospital closures, and delayed early pregnancy evaluation • Dobbs-era legal ambiguity, chilling effects, and implications for methotrexate timing • a new Nature Medicine finding on ISM2 as an early biomarker for preeclampsia and fetal growth restriction • V-NOTES versus vaginal hysterectomy trial design problems, including power, exclusions, and comparators • conflicts of interest, blinding failures, and how low-quality studies pollute meta-analyses Everybody remember to get your ABOG stuff done in the next month or so. Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram. 0:34 Low-Dose Naltrexone For Fertility8:38 Evidence Gaps And Practice Inertia17:14 Ectopic Pregnancy Deaths Are Rising22:00 Access Problems And Social Media Misinformation24:15 Abortion Bans And Delayed Ectopic Care29:32 ISM2 Biomarker For Preeclampsia Risk32:31 V-Notes Versus Vaginal Hysterectomy Study41:40 Power, Outcomes, And Unfair Comparisons47:50 Conflict Of Interest And Broken Blinding55:09 Where V-Notes Came From1:01:31 Skills, Tradeoffs, And Final RemindersFollow us on Instagram @thinkingaboutobgyn.
