ACN_7.14_Full Issue digital | Page 9

NEWS

Female Physicians Face Higher Rates of Infertility and Pregnancy Complications

As female physicians tend to delay pregnancy until after their residencies , they are more susceptible to fertility issues . Nearly one in four female physicians who try to have a baby are diagnosed with infertility , according to a survey published in the Journal of Women ’ s Health in 2016 . This is almost double the rate of the general public .
Women who are surgeons face similarly high rates of infertility . A survey of 692 female surgeons published in JAMA Surgery in July 2021 found that 42 % had suffered a pregnancy loss – more than double the rate of the overall population . Additionally , nearly half of the surgeons surveyed had experienced pregnancy complications .
Training for doctors in the U . S . takes around 10 years , including medical school , residencies , and fellowships . On average , female physicians complete medical training at age 31 , and the age when most women doctors first give birth is 32 , compared with 27 for nonphysicians , according to a 2021 study .
Sleep deprivation , poor diet , and lack of exercise associated with the demands of medical training and careers can also take a toll on female doctors ’ health
IMBRUVICA ® ( ibrutinib ) IMBRUVICA ® ( ibrutinib )
Table 8 : Adverse Reactions Reported in at Least 10 % of Patients in the IMBRUVICA Arm in Patients with CLL / SLL in iLLUMINATE ( continued )
IMBRUVICA + Obinutuzumab ( N = 113 )
All Grades (%)
Grade 3 or Higher (%)
Chlorambucil + Obinutuzumab ( N = 115 )
All Grades (%)
Grade 3 or Higher (%)
Body System Adverse Reaction §
Gastrointestinal disorders
Diarrhea
34
3
10
0
Constipation
16
0
12
1
Nausea
12
0
30
0
Musculoskeletal and
connective tissue disorders
Musculoskeletal pain *
33
1
23
3
Arthralgia
22
1
10
0
Muscle spasms
13
0
6
0
Respiratory , thoracic and
mediastinal disorders
Cough
27
1
12
0
Injury , poisoning and
procedural complications
Infusion related reaction
25
2
58
8
Vascular disorders
Hemorrhage *
25
1
9
0
Hypertension *
17
4
4
3
General disorders and
administration site conditions
Pyrexia
19
2
26
1
Fatigue
18
0
17
2
Peripheral edema
12
0
7
0
Infections and infestations
Pneumonia *
16
9
9
4 †
Upper respiratory tract
14
1
6
0
infection
Skin infection *
13
1
3
0
Urinary tract infection
12
3
7
1
Nasopharyngitis
12
0
3
0
Conjunctivitis
11
0
2
0
Metabolism and nutrition
disorders
Hyperuricemia
13
1
0
0
Cardiac disorders
Atrial fibrillation
12
5
0
0
Psychiatric disorders
Insomnia
12
0
4
0
The body system and individual ADR terms are sorted in descending frequency
order in the IMBRUVICA arm .
* Includes multiple ADR terms
†
Includes one event with a fatal outcome .
E1912 : Adverse reactions described below in Table 9 reflect exposure to
IMBRUVICA + rituximab with a median duration of 34.3 months and exposure
to FCR with a median of 4.7 months in E1912 in patients with previously
untreated CLL / SLL who were 70 years or younger .
Table 9 : Adverse Reactions Reported in at Least 15 % of Patients in the IMBRUVICA Arm in Patients with CLL / SLL in E1912
Fludarabine + IMBRUVICA + Cyclophosphamide Rituximab + Rituximab ( N = 352 )
( N = 158 )
All Grades (%)
Grade 3 or Higher (%)
All Grades (%)
Grade 3 or Higher (%)
Body System Adverse Reaction
General disorders and
administration site conditions
Fatigue
80
2
78
3
Peripheral edema
28
1
17
0
Pyrexia
27
1
27
1
Pain
23
2
8
0
Table 9 : Adverse Reactions Reported in at Least 15 % of Patients in the IMBRUVICA Arm in Patients with CLL / SLL in E1912 ( continued )
Fludarabine + IMBRUVICA + Cyclophosphamide Rituximab + Rituximab ( N = 352 )
( N = 158 )
All Grades (%)
Grade 3 or Higher (%)
All Grades (%)
Grade 3 or Higher (%)
Body System Adverse Reaction
Musculoskeletal and
connective tissue disorders
Musculoskeletal pain *
61
5
35
2
Arthralgia
41
5
10
1
Gastrointestinal disorders
Diarrhea
53
4
27
1
Nausea
40
1
64
1
Stomatitis *
22
1
8
1
Abdominal pain *
19
2
10
1
Vomiting
18
2
28
0
Constipation
17
0
32
0
Skin and subcutaneous tissue
disorders
Rash *
49
4
29
5
Bruising *
36
1
4
1
Vascular disorders
Hypertension *
42
19
22
6
Hemorrhage *
31
2
8
1
Nervous system disorders
Headache
40
1
27
1
Dizziness
21
1
13
1
Peripheral neuropathy *
19
1
13
1
Respiratory , thoracic and
mediastinal disorders
Cough
32
0
25
0
Dyspnea
22
2
21
1
Infections and infestations Upper respiratory tract
29
1
19
2
infection
Skin infection *
16
1
3
1
Metabolism and nutrition disorders
Hyperuricemia
19
1
4
0
Decreased appetite
15
0
20
1
Psychiatric disorders Insomnia
16
1
19
1
The body system and individual ADR terms are sorted in descending frequency
order in the IMBRUVICA arm .
* Includes multiple ADR terms
Table 10 : Select Laboratory Abnormalities ( ≥ 15 % Any Grade ), New or Worsening from Baseline in Patients Receiving IMBRUVICA ( E1912 )
IMBRUVICA + Rituximab ( N = 352 )
All Grades (%)
Grade 3 or 4 (%)
Fludarabine + Cyclophosphamide + Rituximab ( N = 158 )
All Grades (%)
Grade 3 or 4 (%)
Hematology abnormalities Neutrophils decreased
53
30
70
44
Platelets decreased
43
7
69
25
Hemoglobin decreased
26
0
51
2
Chemistry abnormalities Creatinine increased
38
1
17
1
Bilirubin increased
30
2
15
0
AST increased
25
3
23
< 1
Based on laboratory measurements per IWCLL criteria