Black Women’s Hair Styling Choices Can Cause Hair Loss

FRIDAY, March 4, 2016 (HealthDay News) — Hair styling practices may be causing black women to experience hair loss, which is a major problem that often goes undiagnosed, a new survey finds.

While genetics may play a key role in hair loss among black women, styling practices such as braiding, weaves and chemical relaxing may also increase their risk of hair loss, said dermatologist Dr. Yolanda Lenzy, a clinical associate professor at the University of Connecticut in Farmington.

She joined with the Black Women’s Health Study at Boston University’s Slone Epidemiology Center to survey nearly 5,600 black women about their experiences with hair loss.

Almost 48 percent said they had suffered hair loss on the crown or top of the scalp.

“When hair loss is caused by styling practices, the problem is usually chronic use. Women who use these styling practices tend to use them repeatedly, and long-term repeated use can result in hair loss,” said Lenzy.

Even though hair loss is common among black women, more than 81 percent of respondents said they had never consulted a doctor about it.

The leading cause of hair loss in black women is a condition called central centrifugal cicatricial alopecia (CCCA). This condition causes inflammation and destruction of hair follicles that results in scarring and permanent hair loss, researchers said.

About 41 percent of survey respondents had levels of hair loss consistent with CCCA. But, fewer than 9 percent said they had been diagnosed with the condition.

Along with self-monitoring, women can ask their hair stylists to alert them to signs of hair loss, Lenzy suggested.

There are a number of treatment options for hair loss in women, she added, including avoiding tight hair styles that put pressure on hair follicles and limiting use of chemical relaxers.

The findings were to be presented Monday at the American Academy of Dermatology’s annual meeting, in Washington, D.C. Findings presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

More information

The American Hair Loss Association has more about women’s hair loss.

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Safe Treatments Available for Expectant Moms’ Skin Conditions

FRIDAY, March 4, 2016 (HealthDay News) — There are a number of safe and effective ways to treat chronic skin conditions in pregnant women, a dermatologist says.

“If there is a way to manage your skin condition without medication during pregnancy, that is the preferred option,” said Dr. Jenny Eileen Murase, an assistant clinical professor of dermatology at the University of California, San Francisco.

“If you have a condition that does require medication, however, a board-certified dermatologist can help you identify a treatment that’s safe for both you and your baby,” she added in an American Academy of Dermatology news release. The release was timed to coincide with the academy’s annual meeting, which starts Friday in Washington, D.C.

Eczema is the most common rash dermatologists see in pregnancy, Murase said. “Expectant mothers often see their existing eczema get worse or have a flare for the first time in many years,” she said.

Topical corticosteroids can be used to treat eczema in pregnant women with eczema. Mild or moderate steroids are preferred to the stronger types. Stronger creams should only be used for a short time if initial treatment is unsuccessful, she noted.

Diluting topical corticosteroids with a moisturizer helps heal skin and reduces the amount of medication needed, Murase said.

Psoriasis is another condition that can flare during pregnancy, she explained.

Systemic medications — oral or injectable drugs — shouldn’t be used during pregnancy, unless there is a clear medical need. Preferred options include topical treatments such as moisturizers, emollients and low-to-moderate-dose corticosteroids. Breast-feeding mothers should avoid applying strong topical corticosteroids to the nipple area so that they don’t pass the drug to their baby, according to Murase.

If pregnant women require additional treatment for psoriasis, narrowband ultraviolet B or ultraviolet B phototherapy can be used. However, Psoralen with ultraviolet A (known as PUVA) should be avoided, because psoralen may enter breast milk and cause light sensitivity in babies, Murase said.

Several treatments can be used for acne in pregnant women. A good option is topical benzoyl peroxide. It’s safe and widely available. It can also be used with the topical antibiotic clindamyacin, she said.

Moderate and severe acne can be treated with antibiotics and topical therapy. Cephalosporin antibiotics are the best option, she said. Erythromycin and azithromycin (Zithromax) may also be acceptable. But pregnant women shouldn’t use tetracycline antibiotics, Murase said.

More information

The American College of Obstetricians and Gynecologists has more about skin conditions during pregnancy.

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New Tests May Help Combat Melanoma, Expert Says

FRIDAY, March 4, 2016 (HealthDay News) — Genetic and molecular tests can be valuable in helping to diagnose and treat deadly melanoma skin cancer, a dermatologist says.

The tests are widely available in the United States, and many are covered by insurance or offered at no extra cost, said Dr. Emily Chu. She is an assistant professor of dermatology and pathology and laboratory medicine at the University of Pennsylvania, in Philadelphia.

Melanoma rates in the United States have doubled over the past three decades, according to the U.S. Centers for Disease Control and Prevention. Tissue biopsy is typically used to diagnose skin cancer, but biopsy results aren’t always definitive. In such cases, genetic and molecular tests can help determine if a patient has skin cancer, Chu said.

She added that such tests may also help identify the most effective treatments for patients with advanced melanoma.

Continuing research into specific melanoma mutations and targeted treatments could lead to more effective therapies in the future, the researcher said.

“Although genetic and molecular testing for melanoma has advanced in recent years, it’s still an emerging field. I think it will only get better,” Chu said in an American Academy of Dermatology news release timed to coincide with the academy’s annual meeting, which begins Friday in Washington, D.C.

While genetic and molecular tests are helpful, Chu explained that their results have to be considered along with other information.

“Genetic and molecular tests are a valuable tool in our arsenal for fighting melanoma,” Chu said. “When used appropriately, these tests can provide dermatologists with important information to assist them in melanoma diagnosis and treatment, allowing them to provide patients with the best possible care.”

More information

The U.S. National Cancer Institute has more on melanoma.

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Can Certain ‘Poor Carb’ Diets Raise Nonsmokers’ Lung Cancer Risk?

FRIDAY, March 4, 2016 (HealthDay News) — Even people who’ve never smoked can get lung cancer, and a new study suggests their risk for the disease may rise if they eat a diet rich in certain carbohydrates.

These so-called “high glycemic index” diets — regimens that trigger higher levels of insulin in the blood — tend to be heavy in refined, “poor quality” carbs, one expert explained.

“The glycemic index and glycemic load are methods to estimate the quality and quantity of dietary carbohydrates,” said Dr. Rishi Jain, a medical oncologist at Fox Chase Cancer Center in Philadelphia. “Examples of foods with a high glycemic index include white bread and white potatoes.”

Jain explained that as rates of obesity and heart risk factors rise in the United States, so does the number of Americans with “insulin resistance,” a precursor to diabetes. And he said insulin-linked disorders, which are often tied to high-glycemic diets, “have been implicated as potential contributors to a variety of chronic conditions, including certain cancers.”

Could lung cancer be one of those malignancies? Dr. Xifeng Wu, chair of cancer prevention at the University of Texas MD Anderson Cancer Center in Houston, conducted the new study to help answer that question.

Her team looked at the health and dietary histories of more than 1,900 people with lung cancer and more than 2,400 people without the disease.

The investigators looked specifically at the intake of foods with a high glycemic index, such as the white bread and potatoes cited by Jain.

Overall, people who registered in the top fifth in terms of a high-glycemic diet had a 49 percent greater risk of developing lung cancer versus those in the bottom fifth, Wu’s team reported.

But the trend was even stronger when the study focused on people who had never smoked. In that group, those who scored highest in terms of a high-glycemic diet had more than double the odds of lung cancer compared to never-smokers who had the lowest glycemic index scores.

Wu and her colleagues reported their findings March 4 in the journal Cancer Epidemiology, Biomarkers & Prevention.

According to Wu, focusing on never-smokers is important because it eliminates smoking as a confounding risk factor — giving a clearer picture of the potential role of diet in lung cancer risk.

“Although smoking is a major, well-characterized risk factor for lung cancer, it does not account for all the variations in lung cancer risk,” Wu said in a journal news release. “This study provides additional evidence that diet may independently, and jointly with other risk factors, impact [the risk for] lung cancer.”

Why might there be a relationship between diets high in certain carbohydrates and lung cancer?

According to study co-author Stephanie Melkonian, high-glycemic diets are linked to insulin resistance, which in turn may encourage the activity of certain cellular “growth factor” chemicals that are known to play a role in cancer.

The researchers stressed that their study can’t prove cause-and-effect, and it also failed to take into account the potential role of other illnesses, such as diabetes, high blood pressure or heart disease.

However, Jain agreed that the downstream effect of a high-glycemic diet on cellular growth factors might explain the link to lung cancer risk.

He added that “this association was more pronounced in nonsmokers, suggesting that increased intake of poorer quality carbohydrates may be more detrimental in this group.”

Overall, “this study contributes to the growing evidence that poor dietary habits and obesity play a critical role in cancer development,” Jain said.

More information

To find out the glycemic index of your favorite foods, head to the American Diabetes Association.

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Loose-Fitting Football Helmets Tied to Worse Concussions in Teens

By Maureen Salamon
HealthDay Reporter

FRIDAY, March 4, 2016 (HealthDay News) — High school football players wearing loose helmets suffer worse concussion effects than players whose helmets fit properly, new research suggests.

Young athletes with loose helmets had the highest rates of concussion symptoms, such as drowsiness, hyper-excitability and sensitivity to noise. Their concussions also lasted longer and were more severe, the study found.

“Concussions are very complicated injuries, but [loose helmets] could be one more risk factor for experiencing more severe concussions,” said study author Dr. Barry Boden. He’s a sports medicine specialist at The Orthopaedic Center in Rockville, Md.

“There’s been a lot of interest in concussions but there really hasn’t been much focus on how helmets fit,” Boden added. “So we thought this study would be unique and original, and wanted to see if there were any issues that contributed to concussions.”

Boden’s research is scheduled to be presented Friday at the annual meeting of the American Academy of Orthopaedic Surgeons in Orlando, Fla. Studies presented at meetings typically haven’t been peer-reviewed or published, so the results are considered preliminary.

Concussion is a mild form of traumatic brain injury. These injuries can be caused by a jolt, bump or blow to the head, according to the U.S. Centers for Disease Control and Prevention.

Concussions are caused by sports injuries as well as car accidents, falls and other trauma. Symptoms include headaches, memory and thinking difficulties, and emotional and sleep disturbances, according to the CDC.

USA Football, the national governing body for amateur football in the United States, issued a rule in 2012 aiming to ensure proper helmet fit for high school athletes.

But, Boden said it wasn’t yet clear how effective the rule might be.

The lingering effects of football-related concussions have also dominated discussions about the safety of professional and college football.

Boden and his colleagues reviewed national high school sports-related injury data collected over nine years. The data included information on more than 4,500 first-time concussions.

Football players with improperly fitting helmets who suffered concussions had much higher rates of drowsiness, hyper-excitability and noise sensitivity than those with helmets that fit correctly. Helmet fit was determined by an athletic trainer, the study authors said.

In addition, the study found that players with concussions who were wearing helmets lined with an air bladder had higher rates of light and noise sensitivity. They also had concussions of longer duration, compared to players with foam- or gel-lined helmets, the study revealed.

Helmets lined with air bladders can deflate, leaving it looser on the head, according to the study researchers.

Dr. Mark Riederer, a sports medicine expert who wasn’t involved with the new research, said all high schools should have athletic trainers who can check the fit of football helmets before players take the field.

“I wouldn’t necessarily rely on coaches, kids or parents to check that,” Riederer said. He’s a clinical assistant professor of pediatric orthopaedic surgery and sports medicine at the University of Michigan Health System in Ann Arbor.

“If your head is not secured well in the helmet itself… it doesn’t surprise me that you’d have a higher concussion severity,” Riederer said.

More information

Learn more about helmet fit and safety from the U.S. Centers for Disease Control and Prevention.

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After Hip Replacement, Therapy at Home May Be Effective

By Don Rauf
HealthDay Reporter

FRIDAY, March 4, 2016 (HealthDay News) — Surgeons often recommend outpatient physical therapy to help hip replacement patients get moving again, but researchers report that a home exercise program may work just as well.

Experts say that physical therapy plays a vital role in recovery after hip replacement. And this new study of 77 patients found they obtained similar results no matter which therapy option they pursued after receiving their new hip.

“Our research found that the physical therapy does not necessarily need to be supervised by a physical therapist [for hip replacement patients],” said study author Dr. Matthew Austin, director of joint-replacement services at Rothman Orthopaedic Specialty Hospital in Bensalem, Pa. “The expense and time required of outpatient physical therapy, both for the patient and the patient’s caretakers, may not be the most efficient use of resources.”

More than 300,000 total hip replacements are performed each year in the United States, according to the U.S. Centers for Disease Control and Prevention. Hip replacement, or arthroplasty, is a surgical procedure in which parts of the hip joint are removed and replaced with new, artificial parts. The surgery is intended to restore function to the joint.

For their study, Austin and his colleagues randomly assigned half of the 77 hip replacement patients to two months of formal outpatient physical therapy, with two to three sessions a week. The others did only prescribed exercises on their own for two months.

Patient progress was measured at one month and six months after the operation. Investigators evaluated them according to ability to walk, use stairs, sit comfortably, flex and other factors that gauge motion.

No significant differences were found between the two groups.

The study authors concluded that treatment for hip replacement might move away from routinely prescribing formal physical therapy.

Another orthopedist agreed that a home exercise program appears helpful after hip replacement.

“Certainly, this study has demonstrated that patients do just as well with the less expensive patient-directed exercise program as they do with the formal [outpatient physical therapy],” said Dr. Wayne Johnson, an orthopedic surgeon in Lawton, Okla. He is also an associate professor at the University of Oklahoma Southwest Family Medicine Department.

“Patients may also find it more convenient to perform their exercise program at home to minimize the additional time and transportation cost, in addition to the health-care cost savings,” Johnson added.

Traditionally, hip replacement patients have undergone 8 to 12 weeks of postoperative rehabilitation, said Johnson.

Austin said that physical therapy sessions can range in cost from $10 to $60 each for non-Medicare patients, and patients may require a total of 20 to 30 treatments.

Patient-directed home exercise programs may include gait training, walking, strengthening of quadriceps [muscles in front of the thigh], one-legged standing, side-lying routines for muscles in the hip region, and stair-climbing. Exercises are intended to improve strength, flexibility, endurance and movement.

Each patient’s care should be tailored to his or her needs, the study authors said. For example, postoperative physical therapy might benefit patients who are extremely frail or those who don’t progress well after the surgery, Austin pointed out.

Most patients who undergo total hip replacement are between the ages of 50 and 80, according to the American Academy of Orthopaedic Surgeons.

People who have this operation typically have painful joint damage that interferes with their daily activities, making it difficult to walk or even put on socks, the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases says. The damage is often caused by arthritis or a fracture.

The study findings were to be presented Friday at the annual meeting of the American Academy of Orthopaedic Surgeons, in Orlando, Fla. In general, data and conclusions presented at meetings are considered preliminary until published in a peer-reviewed medical journal.

More information

For more on hip replacement, head to the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.

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Women Often Overestimate Odds That Early Breast Cancer Will Return, Spread

By Kathleen Doheny
HealthDay Reporter

THURSDAY, March 3, 2016 (HealthDay News) — Many women treated for early breast cancer overestimate the odds of it spreading to another organ, and those fears can diminish their quality of life, new research suggests.

The study involved more than 1,000 women newly diagnosed with either very early breast cancer, known as DCIS (ductal carcinoma in situ), or low-risk invasive cancer (LRI). All were at low risk for what’s called distant recurrence — cancer spreading to organs throughout the body.

But more than one-third of those with DCIS and one quarter of those with low-risk invasive tumors overestimated their risk for distant recurrence, said Sarah Hawley, a professor of medicine at the University of Michigan School of Medicine.

Even women with a very favorable outlook after treatment significantly misjudged their risks, Hawley said. “They provided a risk number estimate more than double their actual risk,” she said.

She found the more patients exaggerated their risk, the more they worried about recurrence, which affected their quality of life.

Doctors differentiate between local recurrence, when cancer returns to the site of the first tumor or close to it, and distant recurrence, or metastatic breast cancer, when cancer spreads to a different organ. Metastatic breast cancer is not curable and needs to be managed as a chronic disease, according to the Johns Hopkins Breast Center.

In this study, Hawley focused only on fear of distant recurrence. She considered a perceived risk of more than 10 percent for DCIS and more than 20 percent for low-risk invasive cancer as an overestimate.

Less-educated women were more likely than those with more schooling to fear the worst, she found.

Those who overestimated risk were two to three times more likely to worry about recurrence than those who did not overestimate, Hawley found.

Some of these women also had lower mental health and physical health scores, she said.

Hawley believes doctors can help patients understand their odds for wide-range spreading of cancer by using both numbers or percentages and wording such as “low” or “moderate,” Hawley said. Also, women can educate themselves and ask their physicians to explain the risks in these terms, she suggested.

The study findings don’t surprise Dr. Linda Bosserman, clinical assistant professor of medicine at the City of Hope Medical Group, in Rancho Cucamonga, Calif.

“I believe these findings are consistent with other studies which consistently show patients overestimate the risk of cancer recurrence,” said Bosserman, who wasn’t involved in the study.

Hawley and Bosserman agreed that doctors should strive to be specific with each patient about individual risk. “It can be a hard discussion,” Bosserman said.

But knowing that the recurrence risk with early breast cancer is often low “can be a relief and often also helps them [patients] better weigh the risks and benefits” of therapies, she said.

Some patients fear even slight risk and choose “every possible therapy” that might reduce their risks. Others, when given appropriate information, are able to weigh the pros and cons of each course of action, Bosserman said.

Hawley presented the findings recently at an American Society of Clinical Oncology meeting in Phoenix. Research presented at medical meetings is usually considered preliminary until published in a peer-reviewed journal.

More information

To learn more about breast cancer recurrence, see American Cancer Society.

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Psychosis Plus Pot a Bad Mix: Study

By Dennis Thompson
HealthDay Reporter

THURSDAY, March 3, 2016 (HealthDay News) — People diagnosed with psychosis will probably have a longer, harder struggle to maintain their mental health if they’re regular marijuana users, British researchers report.

And those who just experienced their first episode of psychotic illness are 50 percent more likely to need subsequent hospitalization for their condition if they use marijuana, according to findings published online March 3 in the journal BMJ Open.

They also spend longer periods in the hospital, averaging 35 more days in mental health wards during a five-year period than those with psychosis who don’t use pot.

Finally, marijuana users don’t seem to respond to anti-psychotic medications as well as non-users, said lead researcher Rashmi Patel, a clinical lecturer with the Department of Psychosis Studies at King’s College London.

“We’re not entirely sure why that is, but it’s possible for whatever reason cannabis [marijuana] use makes it less likely that anti-psychotic treatment will work as well in people with psychotic disorders,” Patel said.

Psychosis occurs when a person loses touch with reality. They may hallucinate, suffer from delusions, or experience disorganized thoughts and speech.

Psychosis is a symptom of a larger medical problem, which can include mental health disorders like schizophrenia and bipolar disorder. Alcohol, prescription drugs, dementia, brain diseases or stroke also can cause psychotic symptoms, according to the U.S. National Institutes of Health.

Previous research has linked marijuana use to increased risk of psychosis, but not much is known about the effect pot can have on someone with an established psychotic disorder, Patel said.

For this study, Patel and his colleagues reviewed the electronic health records of slightly more than 2,000 people treated for a first episode of psychosis between 2006 and 2013. They were treated at the South London and Maudsley NHS Foundation Trust, one of the largest providers of mental health services in Europe.

About 46 percent of the patients used marijuana. The researchers tracked all of the patients for up to five years to see if pot played a role in their ongoing mental health problems.

Pot users had an average of 1.8 hospital admissions up to five years after their first visit, compared to 1.2 admissions for non-users, the researchers found.

Marijuana users suffering psychosis were more likely than non-users to require compulsory detention in a hospital under England’s Mental Health Act, and to require more days of treatment in a hospital.

Those using pot also were more likely to have more prescriptions for different antipsychotics, and to require treatment with clozapine — a strong antipsychotic reserved for difficult-to-treat schizophrenia, the study authors said.

“We found a really quite significant association of cannabis use with poor outcomes,” Patel said. “It’s pretty clear there’s a strong link, although we can’t say what the mechanism is behind that.”

No one knows much about how psychosis works in the brain, and so it’s difficult to say why pot seems to make matters worse, said Dr. William Carpenter Jr., a professor of psychiatry and pharmacology at the University of Maryland School of Medicine.

It could be that marijuana is affecting the brain in some specific way that worsens psychosis, or the drug’s normal action simply might help make a person’s grasp on reality more tenuous, he said.

“It could be that anything that lowers our normal ability to tell what’s real from unreal would increase our symptoms,” Carpenter said.

Mitch Earleywine, an advisor to the marijuana legalization group NORML, said pot is one of any number of challenges to a hold on reality that should be avoided by people with psychosis.

“People with diagnosed psychotic disorders should stay away from cannabis. They should also stay away from alcohol, be careful about keeping their sleep cycle straight, avoid too much caffeine, carefully time their antihistamines, etc.,” said Earleywine, a professor of psychology at the State University of New York at Albany.

Patel and Carpenter agreed that since this was an observational study, it also could be that the reported link is coincidental and marijuana does not directly cause these poor outcomes.

Nonetheless, the study does “raise valid concerns about potential negative effects,” said Dr. Scott Krakower, assistant unit chief of psychiatry at Zucker Hillside Hospital in New Hyde Park, N.Y.

“Outpatient programs should actively incorporate screening tools for substance abuse in their practice, in an effort to recognize these warning signs earlier in high-risk individuals,” he said.

More information

For more on psychosis, visit Yale University.

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Heavy Coffee Drinkers Show Lower Risk of Multiple Sclerosis

By Amy Norton
HealthDay Reporter

THURSDAY, March 3, 2016 (HealthDay News) — People who drink a lot of coffee may have a lower risk of developing multiple sclerosis (MS), a new large study suggests.

Researchers found that among more than 6,700 adults, those who downed about six cups of coffee a day were almost one-third less likely to develop MS than non-drinkers were.

And the link was not explained away by factors such as people’s age, education or income levels, or smoking and drinking habits.

Still, experts stressed that the findings do not prove that coffee, or big doses of caffeine, fight MS.

Nor is anyone suggesting that people drink more java to ward off the disease, said lead researcher Anna Hedstrom, of the Karolinska Institute in Stockholm, Sweden.

She said the findings do add to evidence that coffee “may have beneficial effects on our health” — but there is no way to make any specific recommendations.

Elaine Kingwell, a researcher at the University of British Columbia, in Vancouver, Canada, agreed.

There could still be other explanations for the coffee-MS connection, she said. Plus, past studies looking at this same question have come to inconsistent conclusions, explained Kingwell, who wrote an editorial published with the study. It appeared March 3 in the Journal of Neurology, Neurosurgery & Psychiatry.

All of that said, there is reason to believe coffee could protect against MS, both Hedstrom and Kingwell noted.

In previous research, scientists have found that caffeine can protect lab mice from developing an MS-like condition — by blocking part of the inflammatory process that damages nerves in the brain and spine.

In humans, MS arises when the immune system mistakenly attacks the protective sheath around nerve fibers in the brain and spinal cord. Depending on where the damage occurs, people can suffer muscle weakness, numbness, vision problems and difficulty with balance and coordination.

A number of studies have linked higher coffee intake to lower risk of diseases that involve degeneration in brain cells, including Parkinson’s disease and Alzheimer’s. When it comes to MS, the evidence has been mixed, possibly, in part, because many studies have been small, Hedstrom explained.

So, her team looked at two study groups: a Swedish group that included 1,620 people with MS and 2,788 without the disease; and a U.S. group of 1,159 MS patients and 1,172 adults free of the disease.

Overall, people who’d averaged 30 ounces of coffee a day — around six standard cups — were almost one-third less likely to have MS than non-drinkers were.

The results were similar when the researchers looked at people’s coffee habits five to 10 years before their MS symptoms had begun (or, for people without MS, coffee habits during that same time period).

But, Kingwell said, there are issues with relying on people’s recollection of their diet years ago. And if some people with MS had stopped drinking coffee because of their symptoms, that could affect their memory of their earlier habits, she added.

“There is not enough evidence here to suggest that people should drink several cups of coffee per day,” Kingwell said.

Still, she added, the findings are “interesting” and warrant more research. If researchers can figure out why coffee, or possibly caffeine, is tied to MS, Kingwell said, that could give clues about the underlying causes of the disease or possibly lead to new treatments.

More information

The National Multiple Sclerosis Society has more on risk factors for MS.

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Is It Possible to Choose a Baby’s Gender Through IVF?

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Chrissy Teigen, who has talked publicly about her struggles with infertility, recently told People that she had the option of choosing a female embryo while undergoing in vitro fertilization (IVF). For anyone unfamiliar with the IVF process, the option to choose the gender of your baby may seem futuristic, even controversial. But gender selection actually happens quite often in fertility clinics around the country—and it’s just one small aspect of the genetic testing that can take place before a mom-to-be even gets pregnant.

It’s all possible thanks to a procedure known as pre-implantation genetic diagnosis (PGD) or pre-implantation genetic screening (PGS), says Avner Hershlag, MD, chief of the Center for Human Reproduction at North Shore University Hospital in Manhasset, New York. During IVF, a doctor creates embryos by combining a woman’s eggs with a man’s sperm in a lab. When those embryos are a few days old, the prospective parents can choose to have them screened for genetic abnormalities using PGD.

RELATED: 7 Moms Look Back on Their Infertility Struggles

This means that the embryos are put under a microscope, and (very delicately) a few cells are removed. The cells are then analyzed to ensure that they have a normal genetic makeup—that is, two copies of chromosomes 1 through 23.

Doctors also take a close look at the X and Y chromosomes to check for abnormalities there; and at that point, the gender of each embryo, XX or XY, becomes obvious. When the prospective parents are briefed on which of their embryos are healthy and viable, they may also be told which are female and which are male.

“If more than one embryo is normal, and there happen to be both males and females, we don’t impose on patients which one they should use,” Dr. Hershlag says. “If all other things are equal, it becomes their personal choice.” (Patients can also choose to freeze other healthy embryos for use in later pregnancies.)

What’s the catch?

This type of genetic screening comes at a cost. Most clinics charge anywhere from a few hundred to a few thousand dollars for PGD. (Some clinics charge per embryo, while others charge a lump sum.) This is on top of the expense of basic IVF, which averages $12,400, according to the American Society for Reproductive Medicine.

When you consider the investment patients are making, the additional cost for PGD may not seem so high, Dr. Hershlag points out. It may indeed be worth it to ensure a successful pregnancy, and a healthy baby—never mind one of a specific gender.

This is especially true, he adds, for women who have had multiple miscarriages, or who are in their mid-30s or older. (The risk of having a genetically abnormal embryo goes up as a woman gets older.)

RELATED: 15 Factors That Affect a Woman’s Fertility

Prospective parents who are carriers of genetic diseases may also want to ensure they don’t pass on those traits, like the BRCA gene. “We are creating babies who don’t have to worry,” says Dr. Hershlag. “Instead of having extremely high lifetime risks, their risk levels are now the same as anyone else’s.”

Now that the technology exists, “it’s almost unfathomable to me to transfer an embryo whose genetics are unknown,” says Dr. Hershlag. “At this point, the only obstacle to doing it for every IVF patient is financial.” Right now virtually no insurance companies cover PGD—many don’t even cover IVF. But Dr. Hershlag hopes that will change in the future. “[The insurance companies] need to understand that if we are creating healthier babies, we will ultimately save money on testing and treatment in the long run.”

What about couples who simply want a daughter (or son)?

Some clinics do practice “family balancing” for parents with children of one gender who want a child of the other sex. But with first-time parents who have no fertility or genetic concerns, it’s “really unacceptable” for doctors to use IVF and PGD solely for gender selection, Dr. Hershlag says. He worries that it could lead to sexist preferences and lopsided populations, as seen in other countries. “I warn people against going to clinics that don’t have clear ethical guidelines, because they will also be less reputable,” he says. “In our clinic, we mainly screen embryos for health. And if a patient wants to know the gender as a byproduct, I see very little wrong with that.”

RELATED: 9 Things Every Woman Must Know About Her Fertility

Could genetic screening go a step further?

Could PGD, say, help parents choose a tall, athletic, brown-eyed girl? Experts say the science isn’t there yet—and even if it were, it’s unlikely that many doctors would agree to assist such a highly controlled pregnancy. In 2009, a fertility clinic in New York City advertised the “pending availability” of such services, but removed its ad after receiving a disapproving letter from the Vatican. And last year, the United Kingdom became the first country to approve a procedure known as three-parent IVF, which combines the DNA of two mothers and a father—but only in cases in which a woman could pass on genetic health conditions to her baby.

For now, PGD is used primarily to help parents have less stressful pregnancies and healthier babies—enormous, life-changing benefits in their own right.

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