Research at the MGH is interwoven throughout more than 30 departments, centers and units and is conducted with the support and guidance of the MGH Research Institute. The Research Roundup is a monthly series highlighting studies, news and events.
Low-normal thyroid levels may affect a woman’s fertility
New research suggests that a slightly underactive thyroid may affect a women’s ability to become pregnant, even when the gland is functioning at the low end of the normal range. The study found that women who have unexplained infertility were nearly twice as likely to have higher levels of a hormone that stimulates the thyroid gland than women with infertility related to a known cause.
Thyroid-stimulating hormone (TSH) is produced by the pituitary gland and tells the thyroid gland to produce more hormones when needed. Elevated TSH levels can be a sign that the thyroid gland is underactive. The researchers, led by Pouneh K. Fazeli, MD, MPH, of the MGH Neuroendocrine & Pituitary Tumor Clinical Center, compared TSH levels in female patients between the ages of 18 and 39 who had difficulty conceiving. Of that group, 187 women had difficulty conceiving for unknown reasons, while 52 had partners with severe male factor infertility.
The researchers found that women with unexplained infertility had significantly higher levels of TSH than those whose infertility had a known cause. More research is needed to determine whether treating higher TSH levels with thyroid hormone can improve the chance of getting pregnant.
New evidence supports HIV screening in young adulthood
Research led by Anne Neilan, MD, MPH, of the MGH Division of Infectious Diseases and the Medical Practice Evaluation Center, finds that 25 is the best age to screen for HIV among people not at high risk for the disease.
The Centers for Disease Control and Prevention (CDC) currently recommends that every American be tested for HIV at least once between ages 13 and 64. Given that large age range, Neilan and her research team sought to refine the recommended age range to make screening more effective.
The study used data from the CDC that documented new diagnoses of HIV from 2009 to 2013. In that period, the highest rates of new infections were among people ages 22 to 25. Using a computer simulation model it had developed, the research team determined that testing at age 25 would be the most effective in improving rates of diagnosis and individual outcomes, as well as the most cost-effective.
The results do not apply to youth at high risk of contracting HIV, who should be screened more frequently.
Many brain tumor patients do not receive adequate end-of-life care
Patients with brain tumors called malignant gliomas often experience quickly deteriorating physical health, and the average survival time for the aggressive and highly fatal glioblastomas is 15 months. Previous research has demonstrated the benefits of hospice services for patients with terminal illnesses, but no prior study has analyzed how glioma patients use these services.
The MGH Cancer Center team, led by Justin Jordan, MD, MPH, analyzed information from a database of nearly 12,500 patients who were treated for and died from malignant gliomas.
They found that 37 percent of patients received no hospice care prior to death. For those who did use hospice services, the average length of stay was 21 days. However, 23 percent of patients enrolled less than a week before death, and 11 percent enrolled less than three days before death, probably limiting the benefits they and their families could receive from hospice services.
Further research is needed to understand barriers to hospice enrollment for patients with malignant gliomas.
Read more articles from the 01/26/18 Hotline issue.