Gynecology and reproductive health

Within the area of gynecology and reproductive health, there are various conditions that can impact the wellness of women.

Polycystic ovary syndrome (PCOS)

A condition impacting around 3.4% of women worldwide, PCOS is a hormonal disorder affecting ovulation¹ and causing other symptoms such as missed or irregular menstrual periods, excess hair growth, acne, infertility, and weight gain, as well as additional health complications.² PCOS has historically been difficult to diagnose; quantitative determination of anti-Mullerian Hormone in plasma or serum can help identify polycystic ovarian morphology to aid in a PCOS diagnosis. The biological and psychological effects of PCOS can be long-term, and impact physical and emotional well-being.²

Fertility

There are many different causes of infertility, and around one in six couples struggle with infertility worldwide.³ Infertility can be a significant burden on couples in many ways, from psychological stress to the financial strain of high out-of-pocket costs of treatment.⁴

Preeclampsia

One of the leading causes of fetal and maternal morbidity and mortality, preeclampsia affects up to 3-5% of pregnancies globally.⁵ Associated complications for mother or baby can lead to intensive care admissions, causing a serious burden on healthcare providers.⁶

Gestational diabetes

Temporarily triggered by pregnancy, gestational diabetes develops in 16.7% of all pregnancies.⁷ It usually resolves itself afterward, though for some women with gestational diabetes, it carries long-term implications as it increases the risk of developing type 2 diabetes later in life.⁷

Sexually transmitted infections (STIs)

Worldwide more than one million STIs are acquired every day. The majority of these infections can be asymptomatic, meaning they can go unnoticed for a long time.⁸ If left undetected and untreated, certain STIs have the potential to cause serious complications in women, such as infertility or risk to pregnancy or newborn babies during childbirth.⁸

Gynecologic Cancers

Cancers affecting the reproductive organs, such as ovarian, endometrial, and cervical, affect many women worldwide. Cervical cancer is the fourth most common cancer in women globally, with around 660,000 new cases seen in 2022.⁹

For too long, science has placed men in the forefront as the “default human”, leaving women overlooked and left behind. As a result, today, women are faced with inequities in treatment, care, and access to healthcare. Added to this, there are a number of specific challenges in gynecologic and reproductive care:

• Polycystic ovary syndrome (PCOS): It can be difficult to diagnose because its symptoms have a variety of potential causes, such as uterine fibroids, pelvic inflammatory disease, or polyps. Since misdiagnosis is common, women may live with PCOS symptoms for years before they are properly diagnosed.¹⁰
• Fertility: Though many factors can contribute to infertility, diminished ovarian reserve is one of the major causes.¹¹ As couples are waiting longer to have children, this becomes an important factor, as the ovarian follicle pool declines with age.^12,13,14,15 Ovarian reserve testing provides information about the remaining eggs and the number of fertile years a woman has left.¹²
• Preeclampsia: There are many challenges associated with preeclampsia such as a lack of effective treatment options, the balancing of maternal and fetal risks, and the need for a reliable test to assess disease severity and progression, as well as requirements for specialized care.^16,17,18,19
• Non-invasive prenatal testing: Pregnant women are routinely offered screening for trisomies but conventional screening has limitations. One out of every four Down syndrome cases in pregnant women is missed by traditional screening,²⁰ and invasive procedures such as amniocentesis are associated with a risk of miscarriage.²⁰
• Sexually transmitted infections (STIs): With STIs many people do not experience symptoms, and therefore do not seek diagnosis or treatment. Different anatomical sites can be associated with multiple STIs and therefore an open discussion of the patient’s sexual behavior and history is required for a full risk assessment.
• Gynecologic cancers: Early detection of gynecologic cancers can be difficult as often there are no symptoms until they are at a more advanced stage.²¹ Despite advances that make it nearly 100% preventable, cervical cancer remains one of the deadliest cancers in women. Screening with an HPV test provides significantly better sensitivity to identify women at risk compared to more traditional pap cytology that often misses disease; studies have shown that almost one in three women diagnosed with cancer had a normal pap cytology result. HPV DNA testing technology also makes it possible for patients to self-collect their cervical screening sample, which has the potential to significantly lower obstacles to care that many women in underserved communities face.^22,23