Rachel Swanson
Rachel Swanson is a health commentator who discusses fertility optimization. She was featured on Dr. Perlmutter's podcast in an episode focused on approaches to improving fertility. No published research is listed in the provided context.
24 claims checked on air: 2 overstated 22 supported
What they said on air - overstated
Individuals with PCOS are at increased risk of long-latency chronic diseases including heart disease, neurodegeneration, and some cancers.
"So basically, what I can confidently say is that individuals with PCOS, which as you know one of the primary underlying reasons for that is insulin resistance, there is hundreds and hundreds of very high-quality studies showing that they are at increased risk of pretty much every long-latency chronic disease that there is." (said at 0:17:16)
While extensive observational research and meta-analyses demonstrate that individuals with polycystic ovary syndrome (PCOS) have an elevated risk for cardiometabolic disorders (including composite cardiovascular disease, myocardial infarction, and stroke) as well as specific hormone-related malignancies such as endometrial cancer, claiming that 'hundreds and hundreds of very high-quality studies' link PCOS to 'pretty much every long-latency chronic disease that there is' (including neurodegenerative diseases) is an overstatement. The association varies substantially depending on the disease entity, and evidence for many chronic conditions is either mixed, null, or constrained by residual confounding (such as obesity).
- partial: 2023 International Evidence-Based Polycystic Ovary Syndrome Guideline Update: Insights Fro… (Journal of the American Heart Association 2024) · cited 74x in the literature
"PCOS was associated with higher risk of composite CVD (OR, 1.68 [95% CI, 1.26-2.23]; I 2 = 71.0%), composite ischemic heart disease (OR, 1.48 [95% CI, 1.07-2.05]; I 2 = 81.0%), myocardial infarction (OR, 2.50 [95% CI, 1.43-4.38]; I 2 = 83.3%), and stroke (OR, 1.71 [95% CI, 1.20-2.44]; I 2 = 81.4%)." (abstract, results, passage verified)
pubmedfull study (doi)
A healthy, Lactobacillus-dominated vaginal microbiome without dysbiosis is associated with a shorter time to conceive, successful embryo implantation, and improved IVF success rates.
"So whereas a healthy vaginal microbiome, so that means absent of dysbiosis, dominated by certain lactobacilli, it really it really sets the stage for amazing things to happen. And that includes getting pregnant faster. So that's associated with a shorter time to conceive. This helps embryos implant successfully. Of course, this is like a window into the endometrial microbiome as well. Um, this also predicts better IVF success." (said at 0:30:18)
The evidence for an association between a Lactobacillus-dominated vaginal microbiome and reproductive outcomes is mixed and limited by low certainty. In assisted reproduction (IVF), a systematic review and meta-analysis found that vaginal dysbiosis is associated with a higher risk of early pregnancy loss and lower clinical pregnancy rates, but found no statistically significant impact on live birth rates, with overall evidence quality rated as very low under GRADE criteria. Additionally, prospective evidence in non-assisted conception found that cultivable vaginal Lactobacillus was not significantly associated with fecundability or shorter time to conceive.
- partial: The Association between Vaginal Dysbiosis and Reproductive Outcomes in Sub-Fertile Women U… (Pathogens (Basel, Switzerland) 2021) · cited 50x in the literature
"Across all methods, VD is a significant risk factor for early pregnancy loss in IVF (Relative risk (RR) = 1.71 95%CI 1.29-2.27). Moreover, a predefined sub-analysis of studies using molecular methods for VD diagnosis showed a significant reduction in the clinical pregnancy rate when compared to normal vaginal microbiota patients (RR = 0.55 95%CI 0.32-0.93). However, regardless of diagnostic methodology, VD did not significantly influence live birth rate (LBR)." (abstract, results, passage verified)
pubmedfull study (doi) - contradicts: Cultivable vaginal Lactobacillus is not associated with fecundability in Kenyan women atte… (Fertility and sterility 2022) · cited 1x in the literature
"In unadjusted analysis, there was no association between cultivable Lactobacillus at the prior visit and fecundability (FR, 0.92; 95% CI, 0.73-1.16); results were similar after adjustment for age, frequency of condomless sex, and study site (adjusted FR, 0.92; 95% CI, 0.72-1.18)." (abstract, results, passage verified)
pubmedfull study (doi)
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