Free Help for Caregivers

“Powerful Tools for Caregivers” is a free series of six weekly classes to help family caregivers reduce stress, improve self-confidence, communicate feelings better, find balance, make tough decisions and locate needed resources.

Two experienced class leaders conduct the series with interactive lessons, discussions and brainstorming to help caregivers choose and use the right tools for them.

The classes use the Caregiver Helpbook, developed specifically for the class.

The classes are free, thanks to support from the Jewish Federation of Greater Atlanta and the Meyer Balser Naturally Occurring Retirement Community.

Classes will be held at the Meyer Balser NORC at the William Breman Jewish Home, 3150 Howell Mill Road, Buckhead, on Thursdays from Oct. 15 to Nov. 19. Each 90-minute session will start at 4:30 p.m.

To get more information or to register, contact Anne Davis at 404-355-5696 or agdavis@meyerbalser.org. Advance registration is required.

JCC Helps Girls Defend Selves

The Marcus Jewish Community Center is teaming up with Atlanta-based Divas in Defense to provide two sets of self-defense workshops for sixth- to 12th-grade girls.

The weekly Tuesday-night classes start Oct. 13 at the Marcus JCC, 5342 Tilly Mill Road, Dunwoody. Girls Can Fight Too! is for sixth- to eighth-graders and meets at 6:30. Fierce and Fabulous for ninth- to 12th-graders meets at 7:45. Each class lasts an hour.

“Navigating through the difficult dynamics that adolescence, middle and high school present is daunting,” said Colette Steel, a mother of teen girls and the chairwoman of the BBYO Parent Committee. “I am proud that the MJCCA is taking this matter seriously and providing the resources to arm our daughters — both literally and figuratively — with the life skills they need to navigate the challenges they face.”

Girls Can Fight Too! covers basic self-defense, bullying prevention, Internet safety and personal empowerment. Fierce and Fabulous includes basic self-defense, personal and street safety, boundary setting, and personal empowerment.

To get more information or register, visit www.atlantajcc.org/teens, or call 678-812-3978. The cost of either series is $140 for JCC members and $180 for nonmembers.

“This class appealed to me because I was looking for a forum that would enable my daughter to be with other girls her age and learn how best to protect herself,” said Lea Jane Bay, whose 11-year-old is registered for Girls Can Fight Too!

Cancer Drug Disappoints on Fertility

A breast cancer drug with promise for resolving unexplained infertility without increasing the risk of multiple births apparently does not deliver, according to a comparative study.

“The question was could we reduce the risk of twins and triplets without negatively impacting the total number of women who can conceive,” said Dr. Michael P. Diamond, a reproductive endocrinologist and the chairman of the obstetrics and gynecology department at the Medical College of Georgia at Georgia Regents University in Augusta.

In a study published in the New England Journal of Medicine, researchers showed that pregnancy rates and live birth rates were significantly lower in women treated with letrozole, an aromatase inhibitor that enables ovulation, than in those receiving the front-line drugs gonadotropin and clomiphene. The live birth rate was 32.3 percent in women taking gonadotropin and 18.7 percent with letrozole.

The cancer drug has been used off-label for infertility for several years because of anecdotal reports that it could help women conceive with less risk of multiple births. Diamond participated in another study published last summer, also in NEJM, that showed letrozole was better than clomiphene at improving the rates of ovulation, conception, pregnancy and live birth in women with polycystic ovary syndrome.

PCOS affects 5 percent to 10 percent of reproductive-age women whose major infertility problem is that they don’t ovulate.

But letrozole’s success in women with PCOS does not hold up when the cause of infertility is unclear.

While patients with unexplained infertility taking letrozole did have a significantly lower number of multiple births than those taking gonadotropins, those rates were comparable to clomiphene, said Diamond, the new study’s corresponding author. Letrozole therapy did result in a significantly reduced number of multiple births compared with gonadotropin, but its rates were 2½ times those of clomiphene.

“The conclusion for couples with unexplained infertility is that clomiphene probably still remains the first-line therapy,” Diamond said of a widely used drug that enables production of more eggs and the hormones that support them.

Women taking gonadotropin, which is given by shot rather than by tablet, had the highest rate of pregnancy and live births but also the highest multiple birth rate, Diamond noted. There were no significant differences among the three treatments regarding birth defects or newborn complications.

The study looked at 900 women ages 18 to 40 with unexplained infertility at 12 centers across the nation through the Cooperative Reproductive Medicine Network of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

A third of patients were randomly assigned to receive up to four cycles of ovarian stimulation with gonadotropin, clomiphene or letrozole; there was no placebo group. Researchers obtained an investigational new drug application with the Food and Drug Administration for the study because letrozole is approved only for breast cancer treatment.

Like clomiphene, letrozole tricks the body into making more estrogen. Clomiphene, which is a selective estrogen receptor modulator, binds to estrogen receptors when estrogen levels are high so the brain gets the message to make even more, Diamond said.

“In a typical monthly cycle, there is usually one follicle and one egg that develop to the point of ovulation,” Diamond said. “What happens with the fertility drugs, you are overriding the mechanisms which usually only lead to development of one dominant follicle and release of one egg.”

Women are diagnosed with unexplained infertility if they have been trying for a year to get pregnant and have no obvious problems, such as a lack of ovulation, an abnormal uterus or evidence of inflammation, such as endometriosis.