Contemporary OB/GYN week in review: fertility anxiety, folic acid awareness, and more

This week at Contemporary OB/GYN®, we covered topics ranging from rising fertility anxiety in Gen Z to delayed cervical cancer treatment in Medicaid patients. Click the links below to read anything you might have missed from Monday, September 08, to September 12, 2025.

Natalia Llarena, MD, discusses rising fertility anxiety in Gen Z

In a recent discussion with Contemporary OB/GYN, Natalia Llarena, MD, FACOG, Reproductive Endocrinology and Infertility specialist and OB-GYN with HRC Fertility, highlighted the growing trend of fertility anxiety among younger women, particularly Gen Z.

Data show that approximately 72% of Gen Z women experience age-related fertility concerns, with many feeling this pressure as early as age 23 years. Nearly half report feeling compelled to have children before age 30 years. Llarena emphasized that while awareness of fertility challenges can be beneficial, panic often leads to rushed decisions about relationships or career paths.

She noted that part of the anxiety is rooted in biological realities, such as the well-documented decline in fertility with age. Still, she underscored that education is a key tool for reducing panic. Many women in their early 40s remain unaware of how age impacts fertility outcomes, underscoring the need for improved patient education.

Folic acid awareness influences supplement use before pregnancy

Intending to take folic acid supplements before pregnancy is more common among women with a Food and Nutrition major, awareness of neural tube defects (NTDs), and access to folic acid-related information, according to a recent study published in Cureus.

There were 47 respondents included in the final analysis, 51% of whom intended to take folic acid supplements before pregnancy while 49% did not. A significant association was reported between graduating with a Food and Nutrition major and being more likely to intend to take folic acid supplementation before pregnancy, with an odds ratio (OR) of 17.69.

Pregnancy experience was linked to an OR of 3.33 for this outcome, indicating a weak or non-significant association. ORs of 3.81 and 7.20 were reported for folic acid supplementation before pregnancy in patients with awareness of NTDs and access to folic acid information, respectively, highlighting significant associations.

Click here for the full article.

Jesus Gonzalez Bosquet, MD, PhD, highlights test for earlier ovarian cancer detection

In a recent interview with Contemporary OB/GYN, Jesus Gonzalez Bosquet, MD, PhD associate professor of obstetrics and gynecology at The University of Iowa, highlighted the efficacy of a machine learning model using blood-based biomarkers to identify ovarian cancer.

Ovarian cancer remains one of the most difficult gynecologic cancers to detect early, and this significantly impacts patient survival outcomes. According to Gonzalez Bosquet, the primary challenge is the lack of effective early screening or detection methods. Current tools, such as ultrasound and tumor markers, have been tested in multiple studies both in the United States and abroad, but none have demonstrated consistent accuracy.

As a result, most patients are diagnosed at advanced stages, where treatment options are limited and survival rates drop significantly. Gonzalez Bosquet noted that 5-year survival rates for early-stage ovarian cancer reach approximately 95%, but this falls between 40% and 50% for patients diagnosed at later stages, underscoring the need for earlier detection strategies.

Cervical cancer treatment delayed in Medicaid patients

Timely cervical cancer treatment is less likely among patients with Medicaid insurance, according to a recent study published in the American Journal of Obstetrics & Gynecology.

In those with timely treatment, 81.8% had Medicaid insurance vs 64.4% with delayed treatment. Rates of having no self-reported race were 36.9% and 19.2%, respectively, while rates of being in the third highest SVI quartile were 14.4% and 24.4%, respectively.

In a multivariate analysis, the odds of delayed treatment were increased 2.42-fold among patients with Medicaid vs private insurance, while significant associations were not observed for SVI and stage of disease. Overall, the data highlighted significant treatment delay for cervical cancer in Medicaid patients.

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ESC 2025 guidelines prioritize women’s autonomy in high-risk pregnancies

At European Society of Cardiology (ESC) Congress 2025, updated ESC guidelines were published, prioritizing giving women autonomy in making their own reproductive decisions.

This is accomplished through transparent dialogue and shared decision-making, especially in high-risk pregnancies with increased odds of a maternal or fetal event. Additionally, steps have been taken to avoid suggesting pregnancy termination to women with conditions such as pulmonary arterial hypertension that make their pregnancy high-risk.

“In our updated guidance, we have shifted away from a rigid 'pregnancy is forbidden' policy in high-risk cases to a model of shared decision-making, allowing women to make fully informed choices with appropriate psychosocial support,” said Julie De Backer, MD, PhD, professor at Ghent University.

Click here for the full article.