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Recently, BRCA testing has garnered considerable attention, especially in the realm of reproductive medicine. BRCA1 and BRCA2 mutations are known to significantly increase the risk of breast and ovarian cancers. But as we begin considering their routine inclusion in IVF workups, we must ask: Are we proactively protecting future generations, or are we crossing into ethically uncertain territory?
In India, regulatory guidelines limit the number of donations from a donor to only a single recipient, placing significant constraints on donor selection. Moreover, potential genetic risks are already evaluated during donor screening through a detailed family and medical history. Sperm banks are careful to exclude donors with a known history of hereditary diseases that could impact the offspring. In addition, donors undergo stringent infectious disease screening, including sexually transmitted diseases like HIV, hepatitis B and C, and syphilis, to safeguard recipient health. These processes significantly mitigate both genetic and health-related risks.
This is not to undermine the value of BRCA or other genetic testing when clinically indicated. BRCA testing should be offered in IVF when there is a relevant personal or family history of cancers or where BRCA genes have been detected in the family. Couples who have experienced repeated miscarriages or have had a previous pregnancy loss where a genetic abnormality was found may benefit from more comprehensive genetic testing.
For women above the age of 35, another layer of screening becomes important: preimplantation genetic testing for aneuploidy (PGT-A). This is not about hereditary mutations but chromosomal abnormalities, which are more common as maternal age advances and lead to conditions like Down’s Syndrome in the child or recurrent miscarriages and IVF failures. PGT-A screens the embryos ensure that only chromosomally normal embryos are transferred into the uterus thus improving IVF success rates in older women.
Genetic screening plays a valuable role in safeguarding the health of future generations, but its use must be balanced with clinical relevance and ethical responsibility. The patients need extensive counselling on the procedure as it is invasive testing where afew cells are removed from the embryo and tested. In a small percentage because of mosaicism in embryo, there are also false positive reports (where abnormality is detected when none exists) and false negative reports (where abnormality exists but the report states a normal embryo). Patients must also be made aware of alternative methods of testing the child during pregnancy like NIPT (non invasive prenatal testing) and level 2 ultrasound during pregnancy to help them to take an informed decision.
However, incorporating BRCA testing or any advanced genetic screening into the routine workup for all IVF patients can significantly increase the financial burden of an already expensive procedure. While such tests are undoubtedly important in certain high-risk cases, they should be recommended judiciously, based on personal or family history, recurrent pregnancy loss or IVF failures, or previously identified genetic abnormalities. A targeted, case-by-case approach remains the most ethical and effective path forward in reproductive care.
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The U.S. fertility rate dropped to its lowest recorded point in 2024, with fewer than 1.6 children per woman, according to newly released data from the Centers for Disease Control and Prevention (CDC). The statistic marks a continuation of a nearly two-decade-long trend in declining birth rates, one that has shifted the United States closer to the demographic profile of Western European countries.
For context, a fertility rate of 2.1 children per woman is considered the “replacement level,” the point at which a generation can, theoretically, replace itself. The U.S. hovered near that threshold until the late 2000s. But since then, it has slipped steadily, and 2024’s rate of 1.599 puts it well below what’s needed for generational stability without immigration.
Behind the numbers are real-world pressures shaping family planning decisions. Today’s young adults are marrying later, starting families later—or opting out entirely. Financial uncertainty plays a significant role.
“People are concerned about whether they can afford to have children—not just the cost of childbirth, but long-term needs like childcare, housing, and health insurance,” said Karen Guzzo, director of the Carolina Population Center at the University of North Carolina. “Worry is not a good moment to have kids.”
The cost of raising a child in the U.S. has climbed steadily, outpacing wage growth in many parts of the country. And while millennials and Gen Z have higher educational attainment than previous generations, they also carry more debt, face steeper housing markets, and often work in jobs with fewer benefits.
To understand the drop in fertility, it's important to zoom out. In the early 1960s, during the postwar baby boom, the U.S. total fertility rate peaked around 3.5. But by the mid-1970s, it had plummeted to 1.7, largely due to the availability of birth control, changing gender roles, and cultural shifts around family size.
There was a brief rebound in the early 2000s, with the rate rising to 2.1 in 2007. But the 2008 financial crisis triggered another sharp downturn—and the recovery in births never quite came.
According to the CDC’s National Center for Health Statistics, the fertility rate in 2023 was 1.621, before dipping further to 1.599 in 2024.
Concerned about declining birth rates, the Trump administration has recently taken steps to try to stimulate family formation. These include:
However, experts remain skeptical of these measures. "These are largely symbolic moves,” said Guzzo. “They don’t address the real obstacles facing families, like paid parental leave, affordable childcare, and housing affordability. Until those are on the table, you’re not going to see a meaningful change.”
While the overall fertility rate declined, total births actually rose in 2024. According to the CDC’s finalized data, there were about 33,000 more births than the previous year, bringing the annual total to just over 3.6 million babies.
This may seem contradictory at first glance. But demographers say it makes sense once you factor in changes in population estimates.
The U.S. Census Bureau updated its estimates for the number of women of childbearing age. The increase in this demographic—largely driven by immigration offset small increases in births in certain age groups, leading to a recalculated (and lower) birth rate.
Initial projections earlier in 2024 suggested that women in their late 20s and 30s were having more children. But the updated report, based on a more complete dataset, found:
So while there may have been slightly more babies born, the pool of women able to give birth also grew—especially due to immigrant populations—pulling the overall fertility rate downward.
Not necessarily. Unlike countries like Japan or Italy, where shrinking populations are already straining healthcare systems and economies, the U.S. population is still growing, thanks largely to immigration. And while birth rates are falling, experts emphasize that this is often a delay, not an outright decision never to have children.
“What we’re seeing is people having kids later, not necessarily choosing not to have them at all,” said Root. “The U.S. still has a natural increase—more births than deaths.”
That said, the economic and policy environments matter. In countries like Sweden and France, which offer strong parental leave policies and subsidized childcare, birth rates have remained more stable despite similar social trends.
As debates about immigration and population policy heat up, the fertility rate is increasingly seen as more than just a demographic metric—it’s a political one.
A sustained drop below replacement level, without compensatory immigration, could eventually lead to workforce shortages, strains on entitlement programs, and broader economic shifts. But solutions, experts argue, will require more than one-time bonuses or headline-grabbing executive orders.
If the U.S. wants to encourage family formation, it will need to invest meaningfully in family support systems: paid leave, healthcare, housing, education, and affordable childcare. Otherwise, the gap between ideal family size and actual fertility will continue to widen.
The drop to a 1.599 fertility rate in 2024 is a milestone but not an emergency. It's a reflection of changing cultural, economic, and personal dynamics in American life. Addressing it will require real policy innovation, not just political talking points.
For now, Americans are still having children, just on their own timeline, and often with more questions than confidence.
Most of us brush twice a day, some of us floss, and the enthusiastic few even use a mouthwash that burns like fire. But there’s one thing we’re all guilty of skipping, and that is tongue scraping. Skipping this tiny but mighty step could be the reason your oral hygiene isn’t quite hitting the mark. And it's not just about bad breath.
What is the white film on your tongue in the morning?
That whitish layer on your tongue when you wake up is not just sleep residue or leftover toothpaste. It's a delightful mix of bacteria, dead cells, food debris and other gunk. Tongue scraping removes this film before it gets a chance to cause trouble.
This Is What Happens If You Don’t Scrape
1. Bad Breath
No matter how minty your toothpaste or fancy your mouthwash, if your tongue is coated in bacteria, you’re going to have bad breath. Halitosis is often caused by anaerobic bacteria that sit on the tongue and release foul-smelling sulphur compounds. A few scrapes each morning can keep that stink in check.
2. Taste Suffers
Ever feel like food doesn’t taste quite as good as it used to? It might be because your taste buds are trapped under layers of gunk. Scraping the tongue helps clear the surface, making your sense of taste sharper and more responsive.
3. Overall Health Affected
The mouth is connected to the rest of your body, and poor oral hygiene has been linked to a range of health issues, from heart disease to diabetes. The bacteria on your tongue can enter your bloodstream through micro-abrasions in your mouth, causing inflammation in other parts of your body.
It’s an Ancient Practice
While influencers are only now discovering the joys of tongue scraping, this practice has been around for centuries, particularly in Ayurveda, where it’s considered an essential part of morning cleansing rituals. Traditional medicine has long acknowledged the tongue as a mirror to internal health, and scraping is believed to help remove toxins and stimulate digestive enzymes.
The Right Way to Do It
Adding this simple step to your routine could mean fewer dental visits, fresher breath, and even better digestion.
We know. We know. Willingly dipping yourself into freezing water is not everyone's idea of a good time. In fact, it’s the stuff most nightmares are made of. But people are queuing up to do it. Whether it’s a tub full of ice cubes or a freezing lake at 6am, cold plunges are a thing. While you will be surprised to know the benefits, first know what exactly happens when you put your body through this temporary torture.
From giving your mood a caffeine-free lift to helping muscles relax, here's what makes cold plunging the icy wellness trend for your body and brain.
1. Boosts Your Mood
A few minutes in icy water can deliver a euphoric high. That’s because cold exposure triggers a rush of endorphins, your body’s natural feel-good chemicals. It also reduces cortisol, the stress hormone. Some studies even suggest that cold water immersion can help ease symptoms of depression and anxiety.
2. Recovers Muscles
Ever wonder why athletes dunk themselves in icy baths post-game? Cold plunges help reduce inflammation, speed up muscle recovery, and soothe soreness. When you expose your body to extreme cold, blood vessels constrict. Once you’re out and warming up, they dilate, increasing blood flow to tired muscles.
3. Improves Sleep
Taking a cold plunge can actually help you sleep better. Post-immersion, your body enters a state of deep relaxation once it warms back up. Your nervous system settles down, and your sleep hormones kick in more efficiently.
4. Boosts Immune System
Regular cold plunges may also give your immune system a little kick in the pants. The cold stimulates white blood cell production, which helps your body fight off illness. Some studies have found that people who practise cold water immersion regularly tend to get fewer colds and recover faster.
5. Makes Your Skin Glow
Cold water tightens your pores, reduces puffiness, and boosts circulation to your skin. It’s basically nature’s version of a toner. Plus, by reducing inflammation and flushing out toxins, your skin is left looking brighter, fresher, and decidedly more awake than you feel.
6. Teaches You to Breathe
Ever tried to breathe normally when your body is screaming from shock? Cold plunges force you to master your breath. That slow, deep breathing you’re encouraged to do during the first freezing minute? It’s not just to stop you from panicking. It actually helps train your nervous system to stay calm under pressure, build mental resilience, and reduce anxiety over time.
In a nutshell, cold plunging isn’t just a weird wellness trend. It’s a full-body and mind experience that comes with some genuinely impressive health benefits. Yes, it’s uncomfortable. Yes, you’ll want to scream. But after a while, you might just find yourself looking forward to it.
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