Natural Pregnancy

The Pregnancy Miracle

Lisa Olson is a chinese medicine researcher, alternative health and nutrition specialist, health consultant and former infertility sufferer. The Pregnancy Miracle book by Lisa Olson is quite extensive pregnancy book (279 pages in total) which focuses on 100% natural method for getting pregnant quickly and healthy. The goal of this book is to increase your fertility and make it easier for you to conceive a baby. Lisa Olson covers in detail about infertility, e.g. what are some of the main infertility causes in both men and women, plus how to detect signs of fertility naturally in order to get conceived quickly. Lisa also explains how the East and West differ in their views of infertility. Knowing the differences between these two views of treating infertility is important for you to appreciate the 5-step program and use it to the max. Best of all, the step-by-step, done-for-you system inside Lisa Olson's Pregnancy Miracle guide works without harmful infertility medication, magical creams, IUI or IVF procedures, crazy diets, herbal remedies, or weird vitamin/mineral therapy. Continue reading...

Pregnancy Miracle Summary


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My Pregnancy Miracle Review

Highly Recommended

I've really worked on the chapters in this book and can only say that if you put in the time you will never revert back to your old methods.

All the modules inside this book are very detailed and explanatory, there is nothing as comprehensive as this guide.

In Vitro Fertilization

Most donors of embryos are inseminated, so fertilization occurs in vivo. With in vitro fertilization (IVF), sperm are added to the oocytes in a test tube or petri dish. Usually, the processes of in vitro maturation, fertilization, and culture go together. IVF has been successful in all farm animals, but it has proven especially difficult in horses and has been commercially applied most frequently to cattle, especially to females with infertility problems. 5 To obtain oocytes from cows or mares, a long needle is inserted into the ovary through the vaginal wall in the same way that oocytes are recovered from infertile women for IVF. Ultrasonography is used to guide the needle so oocytes can be aspirated from ovarian follicles. An often used, alternative approach is to obtain oocytes from slaughterhouse ovaries to produce relatively inexpensive IVF-derived embryos for research, specific export markets, and for getting dairy cattle pregnant in heat-stressed environments.

Assisted Reproduction

While in vitro fertilization has been available for over two decades, more recently it has become possible to test the resulting embryos for genetic disorders when the embryos are between eight and sixteen cells in size. In this procedure, one to two cells are removed, and the section of DNA containing the gene in question is replicated and tested. Only those embryos identified to be free of risk (based on the DNA results) for developing the genetic disorder are implanted in the uterus. This technique is not widely available, however, and it is both expensive and time consuming. Thus, it is used only infrequently.

Going for the Big Guns Is In Vitro Fertilization IVF Necessary

If your fallopian tubes are completely blocked, in vitro fertilization (IVF the removal of eggs from your ovaries by a surgical procedure and fertilizing them with sperm in a Petri dish and then putting the embryos into the uterus) is not only the best way to become pregnant, it's the only way. (For much more information on getting pregnant with IVF, check out Fertility For Dummies by Jackie Meyers-Thompson and Sharon Perkins Wiley .) And if the tubes have partial closure, the risk of ectopic pregnancy also makes IVF the best way to go. Note In some cases of severe endometriosis, the tubes may be open but the rest of the anatomy is so distorted that pregnancy may never happen without IVF. If mild endometriosis seems to be your only problem and you've tried and tried to become pregnant but haven't been successful, your doctor may tell you IVF is the next step. Even though the exact reason for infertility isn't clear in this case, IVF may be the only way to achieve your goal. Two unique...

Whats the downside of IVF

So, you're thinking IVF is the perfect way to get pregnant, right Unfortunately, IVF isn't a bed of roses leading you to dirty diapers, empty bottles, and bundles of joy. You do need to consider the following cons before deciding if IVF is right for you 1 Cost IVF is very expensive, and not all insurance companies cover the cost. 1 Emotional strain Undergoing IVF can be stressful and frustrating, particularly if you have to do more than one cycle. The bottom line on IVF is that some women can't get pregnant without it. If you're one of them, it's worth every penny and all the emotional turmoil. Unfortunately, not even IVF can get everyone pregnant, which can be devastating after such a huge emotional and financial outlay.

Why Does Ivf Work Better Than Natural Intercourse

IVF is more effective than natural intercourse because of the following Instead of your having to wait for the eggs to ovulate naturally, with IVF the eggs are retrieved manually by your doctor. IVF bypasses the fallopian tubes because the eggs are retrieved directly from the ovaries and transferred directly into the uterus. Most IVF programs transfer several fertilized eggs back into your uterus to improve the chances of a successful pregnancy outcome.

Does Icsi Hurt And What Are The Risks

The man experiences essentially no risk or discomfort when sperm is collected, usually through masturbation or sexual intercourse with a special collection condom. However, as previously stated, in the case of severe male fertility problems, a testicular biopsy may be required to obtain sperm. Risks are infrequent with ICSI, but you need to be aware that they could occur. Risks include Some fertility experts speculate that a link exists between ICSI and an increased incidence of birth defects. However, extensive research has shown no increase in the rate of birth defects or other abnormalities due to the ICSI procedure. Some concern also exists that ICSI might increase the incidence of male infertility in male offspring. The thinking behind this theory is that in nature, the most viable and healthy sperm reaches and fertilizes the egg. However, with ICSI, the sperm are manually selected and injected and thereby bypass the natural selection process. Thus if rare sexual chromosomal...

Buddhism and Human Reproduction

Buddhist teachers will offer their particular interpretations of these principles, detailed rules are not given in any canonical text. Sexual misconduct, for example, is rarely defined and there is no position on contraception. Nor are there specific rules on suitability of marriage or sexual partners. The first precept might be interpreted as discouraging abortion however, termination of pregnancy is not absolutely forbidden, though it is considered highly undesirable. Buddhism would see the ideal situation as one in which the partners are mindful of the consequences of their actions and avoid a situation in which abortion is a consideration. If carried out, abortion should use a method that minimizes any suffering. (For Buddhist analyses of the abortion issue see Taniguchi, 1987, and Redmond, 1991.) In Japan, where abortion is used as a method of family planning, Buddhist monks are involved in practices that women use to atone for abortion.

How Is Icsi Performed

The ICSI procedure refers to the process of how the sperm fertilizes the egg and is typically performed in conjunction with another ART, such as IVF. The remainder of the steps are usually identical to IVF or another ART technique that your doctor may recommend. Because most of the time ICSI is performed in conjunction with IVF, the steps of these procedures are almost identical. Follow-up after ICSI Cryopreservation after ICSI Ovulation stimulation and egg retrieval follow the same steps as in the IVF procedure. The sperm used during your ICSI procedure almost always comes from your partner as opposed to a sperm donor. After all, the primary purpose of ICSI is to assist men with severe male fertility issues. So even if your partner has very poor sperm quality or quantity, his sperm are often still used successfully. The laboratory needs the semen specimen within a few hours after egg retrieval. The fresh semen is taken to the laboratory, where it is washed, concentrated, and...

Why Does Icsi Work Better Than Natural Intercourse

ICSI is more effective than natural intercourse because Instead of your having to wait for the eggs to ovulate naturally, with IVF the eggs are retrieved manually by your doctor. IVF bypasses the fallopian tubes because the eggs are retrieved directly from the ovaries and transferred directly into the uterus. Most IVF programs transfer several fertilized eggs back into your uterus to improve the chances of a successful pregnancy outcome.

Artificial Insemination

Because some dilution of semen can provide nearly as high a conception rate as the original collected sample, 100 progeny or more can result from a single ejaculate. In addition, semen can be frozen and kept for decades without any serious compromise to fertility. The ability to extend and freeze semen without decreasing its fertility facilitates progeny testing early in a bull's life. A progeny test involves obtaining dozens of daughters of a bull and allowing those daughters to calve and be milked so that their performance can be examined and a determination made on whether the bull is transmitting favorable traits to his offspring. After distribution of semen for a progeny test, most bulls are held in waiting until the outcome of the progeny test. Progeny testing many bulls provides an opportunity to select from among them, to keep only the best, and to use those few bulls to produce several thousand daughters and, in some cases, millions of granddaughters. Characteristics of U.S....

Homocysteine And Early Miscarriage

Clinical Background of Early Miscarriage The term miscarriage is used to emphasize the spontaneous interruption of pregnancy. For clinical and scientific reasons, it is important to avoid the international confusion on the duration of pregnancy when the term abortion is used because the range of pregnancy duration can be as wide as from 0 to 28 wk. Another reason for this distinction is that the causes for embryonic loss are quite different from those of fetal loss. We therefore tried to unravel literature reports in embryonic loss (up to 10 wk of menstrual age, or 8 wk postconceptional age) and fetal loss (from 10-8 wk up to the 16-24-wk period). The prevalence of neural tube defects in miscarriages is 10-fold higher compared to the prevalence at birth (52,53). Despite all research efforts, not much can be offered to a couple that experiences repeated recurrent early pregnancy loss. In only 5 of cases are factors associated with miscarriage found. Among the maternal factors, uterine...

Potential Causes Of Recurrent Miscarriage

Recurrent miscarriage can happen because of any of many possible reasons. Lifestyle Factors We've all heard about the dangers of tobacco, alcohol, and street drugs. They just aren't part of a healthy lifestyle. This is especially true as you try to conceive and also during your pregnancy. If you smoke during pregnancy, you are more likely to experience vaginal bleeding and miscarriage. Women who drink excessive alcohol or engage in illicit drug use have a definite increased risk of miscarriage. Medical experts believe that the majority of all miscarriages are caused by chromosomal problems within the fetus. Chromosomes are tiny structures within the cells of the body that contain genes. These genes are what determine a person's characteristics, such as sex, hair color, eye color, blood type, and so on. Both egg and sperm contain vast amounts of this genetic material. When the egg and sperm unite, a detailed series of intricate and complex steps must occur for them to form a fetus....

Does Ivf Hurt And What Are The Risks

Risks are infrequent with the IVF procedure, but you need to be aware that they could occur. Risks include Infection with a bacteria or virus could occur during the IVF procedure from contaminated equipment or the sperm itself. Because you are using fertility medication to induce ovulation, you have an increased risk of multiple pregnancy. However, in the case of IVF, your doctor will determine how many embryos to transfer back to your uterus and thereby keep it to a reasonable number. Talk with your doctor about the number of embryos that you will have transferred back to your uterus. You'll also want to address, ahead of time, what to do with any leftover embryos that cannot be transferred back during that treatment cycle. If your doctor suspects OHSS, the IVF will be canceled for that treatment cycle. (For a more detailed discussion of OHSS, see Chapter 6.) There has been some speculation about the possibility of linking IVF to an increased incidence of birth defects. It is known...

Intrauterine Insemination IUI

Intrauterine Insemination (IUI) may help you get pregnant more easily by putting the sperm a little closer to the egg. The journey for sperm is long and arduous, and sperm aren't particularly bright. Only 50 percent of a good sperm sample knows how to swim forward. Most sperm in any sample are imperfect and have serious problems they may IUI may offer an advantage in infertility because it weeds out the poorer sperm and, ideally, puts only the best swimmers much closer to the target. With any luck, all the bad stuff around the tubes and ovary (endotoxins, white blood cells, and the like) won't affect these macho sperm. IUI often takes place in conjunction with OI or controlled ovarian hyperstimulation. (See What's involved with IVF later in this chapter for more information on this treatment.) Egg-stimulating medications help multiple eggs to

Infertility and Fertility Enhancement

The links between the moral order and reproductive health are particularly marked in cases of infertility. The inability to bear a child is understood to reflect moral status, and in particular is usually blamed upon the woman who may suffer abuse and ostracism. In Africa, infertility carries a grave social stigma, and there is an elaborate range of traditional remedies used to address it (Ebin, 1994 Kielmann, 1998). Likewise, Chinese medicine reflects the cultural emphasis placed upon fertility (Farquhar, 1991) and women are often subjected to intense traditional and biomedical interventions to conceive (Handwerker, 1998). challenging kinship relationships and definitions (Kaplan, 1999 Modell, 1989). Although these technologies are increasingly available in developing countries, there is little work on the practices and meanings of amniocentesis and other reproductive technologies such as in-vitro fertilization (IVF) in these settings.

Fertility Testing for

Fertility specialists usually prefer to work with both partners. Therefore, no matter what your female fertility testing indicates, most men will also be evaluated for their own fertility. A key difference, however, is that if the male partner requires surgical treatment, he will probably be referred to a urologist (a doctor who specializes in the urinary tract). It's not surprising to discover that male fertility testing is typically much simpler and straightforward than a woman's. Part of that is because most of the male reproductive organs are located outside of the body. Another component is that male hormones are usually steadier and not subject to the monthly cyclic changes that women undergo. During your first appointment, the fertility specialist will ask you and your partner about your medical conditions, medications, lifestyle choices, and family history. Focus may be placed on identifying certain fertility risk factors, such as a history of mumps, undescended testicles, STD...

What About The Mans Role In

The sperm used during your IVF procedure may come from either your partner or a sperm donor. Most women prefer to use sperm from their partner. Unless your partner has a very low sperm count or extremely poor sperm quantity, his sperm can probably be used during the IVF process. That's because his sperm will be washed and concentrated and also specially treated in the laboratory to enhance their ability to fertilize your eggs. If he has very poor sperm function, he may need to produce several semen samples over a few days for the laboratory to have enough good-quality sperm for use on the day of fertilization.

How Successful Is Icsi

The success rate for ICSI is usually about 30 percent. This is essentially the same pregnancy rate as with IVF. However, this is a significant achievement because ICSI is primarily used in cases of severe male infertility. The success of the ICSI technique takes the anonymous sperm donor out of the picture, which eases much of the emotional difficulty that couples have when dealing with an outside third-party sperm donor. Of course, even more than with some of the other ART procedures, a high level of technical expertise is required to successfully perform ICSI, an exquisitely delicate and intricate technique.

Intrauterine Insemination

Intrauterine insemination is used when a couple's inability to conceive a child is caused by the sperm's inability to reach the egg. Sperm must move through the uterus and enter the fallopian tube before they can fertilize the egg. Anything that prevents the sperm from making this trip will block conception. Coital or ejaculatory disorders can limit the sperm's travels, sperm antibodies in the female reproductive tract can kill the sperm, and sperm may be unable to penetrate the cervical mucus.

In Vitro Fertilization and Surrogacy

In vitro fertilization, even with anonymously donated ovum or sperm, is usually accepted as enabling a couple to experience gestation and create a fam In vitro fertilization also raises the possibility of employing a woman to be a surrogate mother, acting as the carrier of a child who is expected to be raised by another woman. Women have contracted to render this service in exchange for having all their medical costs covered and in exchange for a stipend to be paid when the baby is delivered. The ethical and legal problems posed by such arrangements have drawn much attention, and many states regulate the boundaries of such agreements.

Finding a Fertility Specialist

Depending on your needs and particular situation, you'll probably go to your regular OB GYN physician for your initial fertility workup. If you become pregnant, that's terrific If you do not become pregnant under the care of your OB GYN physician, ask him or her about a referral to a fertility specialist. You will probably want to interview several fertility specialists before making your final choice. Feel free to ask your OB GYN to give you several names and tell you a little about each one. Also, ask your friends and coworkers if they have experience with a particular physician. Try to find out what they liked or did not like about that doctor. If there is a medical school in your area, call and ask about recommendations for fertility specialists.

Taking the Next Step Surgery to Treat Infertility

Your doctor may suggest surgery to help you get pregnant because 1 You've had no success with simple treatments. 1 You've had long-standing, unexplained infertility. 1 You're older than 35, more so if you're older than 40. i Your doctor strongly suspects endometriosis. This section looks at the different surgical options to help you get pregnant. You can also check out Chapter 11, which gives you much more in-depth info about your surgical options and removing your endometriosis.

Reproductive Endocrinologists Fertility Specialists

The reproductive endocrinologist has even more training than the OB GYN doctor. These doctors have completed all of the requirements of the OB GYN physician just discussed plus two to three additional years of fertility and reproductive procedure training. They are members of the Society for Reproductive Endocrinology and Infertility ( They may choose to become board certified by the American College of OB GYN in Reproductive Endocrinology & Infertility ( The primary role of the reproductive endocrinologist is to help you create your family. Most women use these doctors when they need additional assistance to become pregnant or avoid recurrent miscarriages. The reproductive endocrinologist is trained to diagnose and treat both female and male fertility issues. Of course, these doctors prescribe fertility medications and carry out advanced laparoscopy and hysteroscopic procedures. In addition, they can also boost your fertility with inseminations, in vitro...

Seeing an infertility specialist

If you haven't become pregnant within a reasonable time (see the sidebar, How long should I try to get pregnant on my own in this chapter to find out what a reasonable time is), you need to make an appointment with a doctor. Most people start with their gynecologist (GYN) or their family doctor. A hydrosalpinx can affect your ability to become pregnant. Your GYN may be able to help you with the initial diagnosis and treatment. (See Chapter 8 for tips on finding a doctor you can work with.) No matter what type of doctor you decide to see, she'll most likely suggest doing some diagnostic tests. The following sections describe these diagnostic tests (some overlap with tests in Chapter 9, but the tests in this chapter measure infertility). Although some of the tests may be simple blood tests or imaging studies, like ultrasounds or fluoroscopy, other tests are more invasive and uncomfortable. But all of them help ascertain the reason for infertility and guide your doctor toward the most...

If I Dont Become Pregnant Using Clomid Whats Next

Research shows that if you aren't pregnant after six cycles of Clomid, you are unlikely to become pregnant from this medication. In fact, about 80 percent of pregnancies that occur with Clomid are conceived during the first three months of use. In most situations, if you don't become pregnant after six months of taking Clo-mid, your doctor will recommend a different treatment. Many women go on to use other drug therapies, and some go directly to an assisted reproductive technology.

Fertility Testing for Women

Most women will undergo several basic tests and procedures during a fertility evaluation. Depending on your particular medical history and situation, some of these examinations may play a more important role for you than others. In most cases, the fertility tests can be completed within a few menstrual cycles. Certain tests must be done during a specific time of your monthly cycle. Your fertility doctor will most likely ask you to prepare for a few of these tests beforehand. So beware, you may have to do a little preparation and homework Following are descriptions of a variety of tests and procedures that you may encounter during your fertility evaluation.

The Causes of Infertility

Many couples who want to become pregnant often find that it's more difficult than they originally believed. Sadly, this problem is common. According to the American College of Obstetricians and Gynecologists, approximately 15 percent of couples in the United States may be infertile. This means that of the more than 40 million couples of childbearing age living together in the United States today, about 6 million of them may be affected by infertility issues. So if you are reading this book and have concerns about becoming pregnant, please know that you are not alone and that you have reason to feel optimistic and hopeful. Medical research has shown that if you are a healthy young couple and have sexual intercourse a couple of times each week, your chances are about one in five (that is 20 percent) of becoming pregnant during any one menstrual cycle. This figure starts to decline in a woman's late 20s and early 30s and decreases even more after age 35. A man's fertility also declines...

Overcoming Infertility in Endometriosis

Researchers have associated endometriosis with infertility for years a logical connection because 35 to 50 percent of infertile women also have endometriosis. However, new research into the causes of infertility in endometriosis shows that some women with endometriosis lack the molecules that allow embryos to attach to the uterine lining. Obviously, if the embryo can't attach, this problem prevents pregnancy even though fertilization may occur. This study also indicates that some genes in the uterus of endometriosis patients appear to function abnormally. As a result, infertility in endometrio-sis patients appears to be much more complicated than originally thought. Infertility isn't just the result of blocked fallopian tubes or other mechanical factors. The uterine lining may also have an inherent defect that prevents pregnancy. For women with severe infertility problems related to endometriosis, embryo freezing can be a godsend. Eggs can be taken during an egg retrieval cycle and...

In Vitro Maturation Of Eggs

As a result, much research is being focused on in vitro maturation of eggs. What this means is that immature eggs are removed from your ovaries, taken to the laboratory, and treated with special techniques to cause them to further develop and mature. The mature eggs could subsequently be used with various assisted reproductive technologies. This saves you from the discomfort of fertility medications and the physical demands of many tests and procedures and you gain substantial financial savings. Premature ovarian failure Fertility issues that require IVF Once the technique of in vitro maturation of eggs becomes refined and available, it will likely revolutionize IVF.

Natural Ways to Become Pregnant

If you are like most people reading this book, you really want to have a baby. And at some point, you feel like you might try almost anything to become pregnant and bring home a healthy baby. That's perfectly normal. But before embarking on lots of uncomfortable and expensive procedures, doesn't it make sense to first try to maximize your fertility naturally This situation doesn't apply to all women, for various personal reasons. However, most women prefer to try a natural approach to fertility, at least initially. This chapter discusses multiple ways to boost your fertility and maximize your chances to conceive naturally. This natural approach to fertility has been very successful. It is particularly useful among women and men who have been diagnosed with unexplained fertility concerns. A British study conducted by the University of Surrey examined a group of couples with a prior history of infertility. These men and women made healthful changes in lifestyle and diet and took...

How To Select Your Fertility Counselor

Start by talking with your own fertility specialist and medical staff at your fertility clinic. Fertility clinics may have counselors who are associated with the clinic and ready to help you, and if not, they likely have already compiled a list of good fertility counselors for your consideration. Some clinics also offer special relaxation and stress reduction programs to help you manage your overwhelming feelings. If these choices don't work, try the ASRM website They have a list of mental health professionals who specialize in fertility issues. Another alternative would be to contact a national support group such as RESOLVE ( or the American Fertility Association ( When narrowing down your search for a fertility counselor, feel free to interview several and see who best fits with your needs and values. Make sure you choose a counselor who is familiar with the emotional experience of infertility. It is also recommended that they have Experience in the...

Persevering Through Infertility Treatments Together

We've both spent years working with infertile patients and found that this area can really make or break a relationship. Because so many women with endometriosis suffer from some form of infertility, you and your loved one Finding out that you may have trouble conceiving can be devastating. Most people assume that having children is an inalienable right and they're shocked to find out it may not be that easy. Families dealing with infertility go through all the stages of grief denial, anger, bargaining, and rationalization before acceptance and dealing with the problem face on. (See Chapter 7 for a complete rundown on infertility issues that endometriosis can cause.) What can you do to help your partner through this difficult time of trying to get pregnant You can show the same support as you do with the rest of her problems (check out Helping without being a pain earlier in this chapter), plus a few more 1 Avoid the blame game. Your partner feels bad enough about the infertility....

Tips To Boost Your Fertilitynaturally

So by now you have an even better understanding of how your body is influenced by outside factors such as nutrition, exercise, stress, and lifestyle habits. You also know how to calculate your most fertile time of the month. Use this knowledge to boost your fertility. In addition, following are some more tips that you can try in hopes of becoming pregnant the old-fashioned way.

You Cant Get Pregnant If You Have Endometriosis

Even if you have endometriosis, you can get pregnant. In fact, 60 to 70 percent of women with endometriosis do conceive, but they may have a harder time than a woman without the disease. Although some women with endometriosis get pregnant easily, others need to see a fertility specialist (see Chapter 7 for more on fertility issues). The bottom line If you want to have kids and you have endometriosis, see a specialist and, if at all possible, have babies sooner rather than later in life.

Figuring Out Why Endometriosis Is a Major Cause of Infertility

Many women find out they have endometriosis because they've been unsuccessful at trying to get pregnant. They never mentioned the menstrual cramps, diarrhea, and pain that come with every period to their doctor (probably because their mom told them those symptoms were just part of being a woman). But now, after six months of trying to have a baby, they're beginning to suspect that mom's advice (Just relax and you'll get pregnant ) may not be all that accurate. How big a deal is endometriosis when you're trying to have a baby Endometriosis can be a very big deal, depending on where it is and how much you have. Are there ways to overcome endometriosis and have that bundle of joy you dream of Yes, but it's not always easy or cheap. But, first we give you a quick review of the normal steps to pregnancy so our discussion of endometriosis and infertility is easy to understand. We also look at the number of women with fertility problems due to endometriosis you'll see that you're not alone...

Pregnancy and Infertility

There are many causes of infertility. Abnormal semen causes the infertility problems of about 30 percent of couples seeking treatment. Tubal disease and endometriosis in the female partner account for another 30 percent. A female partner's failure to ovulate accounts for 15 percent, and the inability of sperm to penetrate the woman's cervical mucus accounts for another 10 percent. The final 15 percent of couples seeking treatment are infertile for reasons that cannot be diagnosed. Many couples can be helped to overcome infertility through hormonal or surgical interventions. Women experiencing ovulation disorders may benefit from treatment with oral drugs such as clomiphene citrate, or through the injection of gonadotropins, such as follicle-stimulating hormone, which has about a 75 percent success rate. Women with tubal disease can be helped by various types of reconstructive surgery, but the success rate is only about 33 percent.

How Successful Is

Overall, the success rate of IVF is between 25 and 50 percent per cycle. Rates vary based on a number of variables. In general, a higher success rate is more likely under these conditions You are willing and able to undergo the complete IVF procedure several times. Your IVF team is talented, skilled, and experienced.

Diagnosing Infertility Caused by Endometriosis

Infertility for any reason can make the road to pregnancy rocky emotionally, physically, and financially. Before embarking on that road, you want to know all you can about the landmines along the way. Finding the right person to help you is your first step. This section first identifies the importance of seeing a specialist in order to get a correct diagnosis (see Chapter 9 for more on tests used to diagnose endometriosis). This section also looks at the different tests you may undergo in order to reach a diagnosis of infertility.


Hysteroscopy is the direct visualization of the uterine cavity using a rigid or flexible fiberoptic instrument. Hysteroscopy can be done as an office procedure under intravenous sedation or in an operating room under general anesthesia, spinal or epidural anesthesia, or intravenous sedation. Hysteroscopy is done for both diagnostic and therapeutic purposes. The most common indication for hysteroscopy is abnormal vaginal bleeding. Other indications include uterine leiomyomata, intrauterine adhesions, proximal tubal obstruction, removal of intrauterine devices, m llerian anomalies, and infertility evaluation. Therapeutic applications include directed biopsies, removal of small myomata, and endometrial ablation for menorrhagia. Complications of hysteroscopy occur in approximately 2 percent of cases and include fluid overload, uterine perforation with possible damage to intraabdominal organs, infection, toxic shock syndrome, anesthesia reaction, postoperative bleeding, and embolism.7

How Is Ivf Performed

Your fertility specialist will perform your IVF in either the doctor's office or an outpatient surgery facility. To increase your chances of success, the IVF procedure must be very well organized and perfectly timed. Most IVF programs follow these important steps. Each of these stages is discussed in more detail immediately following the list. Follow-up after IVF Cryopreservation after IVF You should be as comfortable as possible during the embryo transfer. Many doctors offer a relaxing medication or sedative for this stage of IVF. Fortunately, the procedure is not uncomfortable and it only takes a few minutes to perform. Although embryo transfer is the shortest step in the IVF procedure, it is a very important and critical element of the entire process. Follow-Up After IVF Your doctor will give you instructions about what activities you should and should not do after your IVF. Many women prefer to take it easy and rest for the remainder of the day. Depending on your medical history...

Embryo Transfer Update

In recent years, a single-embryo on-the-farm collection approach has become popular with progressive dairymen. This approach uses no follicle stimulatory hormones to treat donor cows. Single embryos are collected from the highest producing cows in the herd and are then transferred individually to cows in the lowest producing group of the herd. Also, frozen embryos can be purchased commercially by producers for transplantation on a year-round basis. Pregnancy rates following transfer of excellent-quality frozen-thawed embryos are similar to those obtained after transfer of fresh embryos. The use of cryopreserved embryos is predicted to be the market growth area, with the potential for the use of frozen embryos in cattle herds being virtually unlimited.

Endometriosis and your fallopian tubes

Scarred Fallopian

Endometriosis inside the fallopian tube can partially or totally block that tube. This blockage may cause infertility or ectopic pregnancy. Unfortunately, even good imaging techniques, such as X-rays or ultrasounds, can't see inside the tubes. Likewise, during surgery, doctors have a difficult time seeing directly in the narrow tubes because the instruments used to view the pelvic cavity are too big to enter the tubes. Imagine a water balloon with fluid coming in and filling the balloon (tube). Because the end is closed, the balloon swells up. The inflammatory fluid in a blocked fallopian tube contains many chemicals, cells, and tissue that cause inflammation, which can lead to pain, fever, infertility, and even miscarriage. All three of the salpinxes (substances) can cause pain because a tube is swollen and stretched and all of these conditions are obvious causes of infertility. (Just like having your tubes tied, the sperm and egg can't meet.) Check out Figure 3-2 for examples of how...

Clinical Applications

Denaturing gradient gel electrophoresis is also useful for counseling in an effort to avoid new cases of human hereditary diseases. In X-linked human diseases, for example, carrier couples can alternatively do in vitro fertilization with male embryo implantation to avoid new disease cases. Because mutation detection is close to 100 when using DGGE, we can do prenatal diagnosis and counseling knowing that we will give an answer to the family question and that not one family member will remain excluded from the analysis.

Monitoring Needle Sharing

While chimeric individuals such as the one described above are most likely extremely rare in the general population, it is possible in theory for DNA testing from different tissues of a chimeric individual to not match one another and thus lead to a false exclusion. This situation may increase in frequency with the rise of in vitro fertilization since multiple eggs are sometimes fertilized in order to increase the success rate of the procedure.

Assisted Reproductive Technology

Transvaginal ultrasonographically guided aspiration of oocytes is used universally during in vitro fertilization. Previously, laparoscopic oocyte collection had been used, carrying the occasional complications of laparoscopic surgery, including those related to general anesthesia. Complications related to ultrasound-guided retrieval of oocytes are rare and include ovarian hyperstimulation syndrome, pelvic infections, intraperitoneal bleeding, and adnexal torsions. 1 1 and 15 However, the acute abdomen has developed hours to weeks after the procedure and has required prompt surgical intervention. 7. Hulka JF, Peterson JB, Phillips JM, Surrey MW Operative hysteroscopy American Association of Gynecologic Laparoscopists 1991 membership survey. J Reprod Med 38 572, 1993. 13. Dicker D, Ashkenazi J, Feldberg D, et al Severe abdominal complications after transvaginal ultrasonographically guided retrieval of oocytes for in-vitro fertilization and embryo transfer. Fertil Steril 59 1313, 1993....

Heterotopic Pregnancy

Usually the presence of an intrauterine pregnancy is sufficient evidence that an EP does not exist. However, in the case of patients who are taking progestational fertility agents, this assumption should not be made. The incidence of simultaneous intrauterine and extrauterine pregnancy (heterotopic pregnancy) in the general population is now thought to be as high as 1 per 4000 pregnancies, although historically this was only reported in 1 per 30,000 pregnancies. Those taking medications to enhance fertility are at much higher risk for heterotopic pregnancy. Patients who have a history of in vitro fertilization may have an incidence as high as 1 per 100 to 200 pregnancies.15 For this reason sonographic imaging of the entire pelvis should be completed even after identification of an obvious IUP.

Germ Line versus Somatic Cell Gene Therapy

Gene therapy using germ line cells results in permanent changes that are passed down to subsequent generations. If done early in embryologic development, such as during preimplantation diagnosis and in vitro fertilization, the gene transfer could also occur in all cells of the developing embryo. The appeal of germ line gene therapy is its potential for offering a permanent therapeutic effect for all who inherit the target gene. Successful germ line therapies introduce the possibility of eliminating some diseases

New Reproductive Technologies and New Forms of Kinship

Driven to try to overcome infertility (Inhorn, 1994 Kielmann, 1998). Much of this research, like many of the materials cited above, highlight the global, local, political, and economic strategies associated with the introduction of technological interventions, while at the same time documenting local responses to and experiences with both indigenous and newly imported technologies. Overcoming infertility, whether male or female, is set up as a matter of individual choice in contemporary society. Individuals become consumers of the new products of human gametes and fertilized embryos, a market enhanced through technological manipulation, advertising, and promotions. These medicalized objects become absorbed into the enterprise culture in which we moderns participate. Strathern argues that above all the new technologies enable rather than simply producing products per se they carry the connotations of service. Moreover, these technologies broach a distinction between body and machine...

Basal Body Temperature Bbt Method

After two or three months, you'll likely be able to detect a pattern in your recorded temperatures. Hopefully, you'll notice that your temperature rises slightly after ovulation. Many women find that their temperature is somewhat lower during the first part of their cycle. Then it will typically rise slightly (between 0.4 and 0.8 degrees F) on the day of ovulation. Your temperature may stay elevated until just before the start of your next period. If you become pregnant, the temperatures typically continue to be elevated.

The Future Emergence of Bioethics

A similar spectrum of responses from those writing within the Christian tradition is already evident as the questions of Bioethics 2 begin to focus discussion. The advent of in vitro fertilization in the late 1970s heralded a developing agenda in which the focus would cease to be on the old clinical ethics with its dilemmas grouped around the sanctity of life and move to the new manipulative powers of biotechnology. However, one decisive difference is now evident. As a range of fundamentally new questions is raised for biomedicine and the human good, the Christian mind is one generation removed from the influence of Ramsey and still further from the older tradition of candid theological engagement with the earlier issues of bioethics. The prospect of cloning and germline genetic interventions, coupled with crucial policy issues focused in patent law, reveal the paucity of Christian resources since the fundamental questions of anthropology that are at stake in these debates have been...

Hypothalamic Dysfunction Gonadotropin Secretion and Weight Loss

Supportive of the view that this type of hypotha-lamic amenorrhea is adaptive is the finding of one study that women in whom ovulation had been induced had a higher risk of having babies who were small for their age, and this risk was greatest (54 ) in those who were underweight. The authors of this study concluded that the most suitable treatment for infertility secondary to weight-related amenorrhea is dietary rather than induction of ovulation.

Ovulation Predictor Test

If you check your urine with the test dipstick each morning, the test will likely be negative until the day of your LH surge. When your LH surge occurs, the test will be positive. This indicates that you should ovulate within the next 24 to 36 hours. Once you learn to pinpoint the day before ovulation, you can use this knowledge to boost your fertility.

Ongoing Disputes about Zero Tolerance

Prominent African activists, including Olayinka Koso-Thomas (author of the main entry above), Nahid Toubia, and Raquiya Abdalla, have long advocated stopping all forms of genital mutilation and cutting while retaining the cultural and religious rituals that educate and welcome girls into adulthood and the community. They favor circumcision through words and family-planning education that includes telling young males about the health hazards to women and asking them to make a vow not to require circumcision as a condition of marriage. Those changes might accommodate important religious, cultural, economic, community, and family considerations without harming girls.

Alternative Medicine Exploring Nonconventional Treatments

As a patient, you will help yourself the most by becoming educated about all of your treatment options. Choose a competent, well-trained health care provider, no matter what form of treatment you choose. Also, understand the limitations of the various treatments. You may find that alternative medicine practices may benefit you and boost your fertility.

Fertility Drug Therapies

Most women who find their way into a fertility specialist's office will eventually end up taking some sort of fertility medication. This chapter explains some of the more common medications that you may encounter as you undergo your fertility treatments. Fertility medications usually refer to drugs that regulate your hormones and induce ovulation. In addition, you may come across other medications that are designed to treat specific fertility problems or enhance other fertility medications.

Attainment of Adulthood

Boys become men when they have gone through their initiation into one of the fraternities. For girls, marriage results in a relaxation of the tension brought about by the pressures on her to bring a husband into the house. She hopes to become pregnant soon, thus contributing to the continuity of the household and clan. Her early years of marriage are regarded as a happy time for most women, since she has met her goal and relations with her mother once again become warm and close.

Unexplained Pregnancy Loss

With the start of the homocysteine research in relation to NTD and the genetic mutations found, it was logical to also explore this fascinating field in early embryonic development. Hibbard (3) was the first to suggest a possible relationship between miscarriage and folate deficiency. An increased

What Are The Success Rates And Outcomes Associated With Clomid

Data indicates that approximately 80 percent of women who take Clomid will ovulate. However, only about 30 to 40 percent of women who take Clomid will actually become pregnant. Clomid is sometimes combined with an intrauterine insemination procedure, which may increase the pregnancy rate by about 3 to 4 percent.

General Recommendations For Treatment And Followup

When treating patients for STDs in the ED, it is important to remember that many STDs occur together follow-up and compliance for many ED patients are poor, and lack of treatment can contribute to infertility. For these reasons, a standardized approach is suggested for patients with suspected STDs. This should include

Antimicrobials And Reproductive Efficiency

Antibiotics are not as commonly used in diets for breeding animals as for growing pigs, but they have been shown to be quite effective when fed during certain stages of the reproductive cycle, such as at the time of breeding. Based on a summary of nine studies involving 1931 sows, feeding a high level of an absorbable antibiotic before and after breeding improved conception rate by 7 and improved litter size by one-half pig at the subsequent farrowing. 6 A summary of 13 studies (2338 litters) showed a slight improvement in survival and weaning weights of nursing pigs when antibiotics were included in the prefarrowing and lactation diet. 6 Long-term withdrawal of antibiotics from a swine herd was found to be associated with a marked reduction in reproductive performance. 10

How Does A Gonadotropin Work

Gonadotropins work to stimulate ovulation in the same way that your body's hormones should. The injection of high levels of FSH (and sometimes also LH) into your bloodstream stimulates your ovaries to develop multiple follicles and eggs. By increasing the number of developing eggs, you maximize your chances of becoming pregnant. Depending on what form of fertility treatment you are doing, you will proceed from here. Your doctor may simply recommend that you and your partner have intercourse. In other situations, you will be scheduled for an insemination or egg retrieval.

What Are The Success Rates And Outcomes Associated With Gonadotropins

It is also known that somewhere between 15 and 50 percent of women who take gonadotropins will actually become pregnant. When gonadotropins are combined with intrauterine insemination, women with unexplained infertility who are age 36 or younger experience a pregnancy rate of between 5 and 15 percent per cycle. The pregnancy rate drops for older women, and in fact, by age 40, the pregnancy rates with this form of treatment are quite low. (In such a case, an assisted reproductive technology such as IVF may be considered.) As with all fertility medication, there exists an increased chance for multiple pregnancies, which occur in approximately 20 percent of those women taking gonadotropins. Of those multiple gestation pregnancies, about 75 percent are twins and the remaining 25 percent are triplets or higher-order multiples.

Extremes of Growth and Development Intrauterine Growth Restriction and Macrosomia

Newborn birth weights have been steadily increasing since the 1970s throughout much of the developed world, although in developed countries, this increase has been tempered by the increased number of pre-term infants born as multiple births following in vitro fertilization procedures. However, the relative proportions of the two extremes of birth weight, very small infants with intrauterine growth restriction (IUGR) and those who are excessively large with macrosomia, remain constant, and within some populations are actually increasing.

Gonadotropin Releasing Hormone Agonists GnRHa Lupron Synarel Nafarelin Buserelin

GnRHa is not really a fertility medication however, it is often used as part of your IVF protocol. When used in this practice, GnRHa is given first to restrain your own body's hormones. Once your natural hormones have been suppressed, another medication (usually the gonadotropins discussed previously) will be given to induce ovulation. Using this protocol, the fertility specialist is able to precisely control the reproductive hormones and ovulation, thereby making conception more likely. GnRHa can also be used as treatment for painful endometriosis. Your reproductive hormones are shut down, your periods stop, and the pain associated with endo-metriosis is gone. When GnRHa is used in this way, your body is transformed into a temporary menopausal state and pregnancy cannot occur during this time. This use of GnRHa is mentioned here because many women with fertility issues suffer from endometriosis. Therefore, it is possible that this treatment may be presented to you as temporary relief...

Advances in Chromosomal Analysis

Chromosomal disorders and their relationship to health and disease are studied using the methods of cytogenetics. Cytogenetic analysis is now an integral diagnostic procedure in prenatal diagnosis. It is also utilized in the evaluation of patients with mental retardation, multiple birth defects, and abnormal sexual development, and in some cases of infertility or multiple miscarriages. Cytogenetic analysis is also useful in the study and treatment of cancer patients and individuals with hematologic disorders. The types of chromosomal abnormalities that can be detected by cytogenetics are numerical aberrations, translocations, duplications, deletions, and inversions.

Gonadotropin Releasing Hormone GnRH Antagonists Cetrotide Ganirelix

This is a relatively new class of medications used as part of your IVF or other assisted reproductive program. The purpose of this medication is exactly the same as GnRHa, to suppress your own body's hormones. Also as in the case of GnRHa, once your natural hormones have been suppressed, another medication (gonadotro-pins) will be given to induce ovulation. Using this protocol, the fertility specialist is able to precisely control the reproductive hormones and ovulation, thereby making conception more likely.

Understanding Disease Pathogenesis

Cystic fibrosis illustrates how our understanding of this disorder has changed through molecular genetics. What was previously a ''disease'' is now a syndrome because DNA-based knowledge has shown that a number of sporadic conditions are part of the cystic fibrosis spectrum. These include meconium ileus in the fetus, male infertility related to congenital bilateral absence of vas deferens (CBAVD), some forms of disseminated bronchiectasis,

Cultural Construction of Gender

Given this preoccupation with traditional family structure, infertility is considered a major tragedy. Every Israeli woman, without regard to an upper age limit, religion, or marital status, is eligible to request unlimited attempts at in vitro fertilization. Complete payments for these treatments are covered by her health insurance, until she has two children. The number of infertility clinics in Israel, per capita, is the highest in the world, with 24 units available to 5.5 million Israelis in the mid-1990s (Kahn, 2000). On the other hand, birth control is not covered by health insurance. Israel also grants special birth allowances large families receive massive monetary incentives from the state (Safir, 1993a).

Human Chorionic Gonadotropin hCG Novarel Pregnyl Profasi Ovidrel

When you become pregnant, your body produces a pregnancy hormone called human chorionic gonadotropin (hCG). It is produced by the placenta and is responsible for the rise in your progesterone level and the cause of many changes during pregnancy, including morning sickness. In fact, hCG is the hormone that home pregnancy tests detect to determine whether you are pregnant.

Antibodies to sperm membrane antigens

The significance of IgG antibodies, which predominate in serum and are transudated to semen (1 of serum concentration), is less clear, because in men from infertile couples IgG antibodies are rarely found without IgA antibodies also being present. The percentage of eggs being fertilized by in vitro fertilization (IVF) is usually reduced when the sperm reveal strong immunobead or MAR reactivity, but also here IgA may be playing the major role. In vitro experiments with human IgG antibodies have indicated that in certain cases they could block fertilization, but on the other hand vasovasostomized men with only IgG anti-sperm responses have been found to have the same high fertility rate as vasovasostomized men without sperm-specific antibodies. The explanation why responses with only IgG antibodies are rarely seen among men from infertile couples might therefore be that such men usually do not end up in infertility clinics Evidence of immunological subfertility or infertility, i.e....

Immunity to zona pellucida

In the mid-1970s, animal studies revealed that the zona pellucida (zp) contains several organ-specific glycoproteins (now known as ZP1, ZP2 and ZP3) and that antibodies to these antigens were capable of blocking fertilization in vitro. Human and porcine zp antigens showed cross-reactivity, and interest in this antigen-antibody system was therefore stimulated in 1977 when a high percentage of sera from infertile women by immunofluorescence was found to stain porcine zonae. However, when similar reactivities were subsequently observed, also with sera from fertile females and even with male sera, the specificity of the reactions had to be questioned, and when absorption with pig and human erythrocytes was found to remove the reactivity of most of the sera, serious doubt was raised concerning the presence and clinical significance of zona-specific antibodies. After 20 years and numerous studies there is still no convincing evidence for the occurrence of true zona-specific autoantibodies...

Data Collection as Social Exchange

Two anthropologists wanted to understand whether women in rural Nepal responded differently to sensitive questions from an outside interviewer working for the World Fertility Survey than they did to sensitive questions from an ethnographer who had lived in their midst for one year (Stone and Campbell 1984). The anthropologists did the comparison, and they found that women did respond differently. The ethnographers concluded that the World Fertility Survey was fully or partly unintelligible to 80 of the respondents. For example, women interpreted a question about whether they had heard of abortion as a question about whether they themselves had had an abortion they interpreted a question about whether they knew where to go to get family planning services as asking whether they themselves went to get those services there. The ethnographers concluded that women knew far more about family planning services than the survey suggested.

How Does Progesterone Work

During your regular monthly cycle, progesterone is made by the ovarian follicle (called the corpus luteum) just after ovulation. This progesterone circulates through your bloodstream and helps to stabilize and maintain your uterine lining (endome-trium) so that it will be ready for a fertilized egg. If pregnancy occurs, progesterone is required to maintain the pregnancy. If you don't become pregnant during that cycle, the progesterone levels decrease and eventually cause the lining of your uterus to shed, resulting in menstrual bleeding. Progesterone plays an important role in your menstrual cycle, hormonal balance, and ovulation. Supplemental progesterone can be helpful if you suffer from these fertility conditions.

How Do I Take Progesterone

Progesterone therapy usually begins two or three days after ovulation has occurred. Therapy continues until your menstrual period begins. If you become pregnant, progesterone therapy will continue, oftentimes until you have completed your first trimester of pregnancy. However, the length of time that you take progesterone will depend on your medical history, your specific fertility condition, and the recommendation of your specialist. Progesterone as a supplemental hormone is available in several forms

Premenopausal women

Endometrial hyperplasia with atypia on endometrial biopsy is further evaluated by hysteroscopy with dilatation and curettage. If the diagnosis remains unchanged (eg, no coexistent adenocarcinoma), treatment with continuous oral megestrol 40 mg two to four times per day is initiated. Hysterectomy is an alternative for women who are not planning future pregnancy.

How Do Aspirin And Heparin Work

If you have had prior miscarriages, they possibly were caused by a blood-clotting problem. Aspirin and heparin are both able to thin your blood and help to prevent the formation of blood clots. Women with antiphospholipid syndrome (see Chapter 2) possess an increased tendency to form clots within their blood vessels. This is especially troublesome during pregnancy when clotting problems occur within the placenta. This places the baby at risk and increases the chance of miscarriage and or stillbirth. Aspirin therapy reduces these risks by maintaining good placental blood flow between the mother and fetus.

Courtship and Marriage

Everyone is expected to marry after a certain age. In rural areas, those who are unmarried in their late twenties begin to bring shame to their family and those who die before marriage are treated as marginal, if not lesser, human beings in mortuary rites (Du, 2002). Severe chronic health problems were usually associated with the extremely rare cases in which individuals remained unmarried throughout their lives. The most important considerations of marriage choice are physical strength, diligence and working skills, a gentle personality, and a clean family background, especially not being accused of possessing a dangerous spirit called tawr. Most villagers found their own spouses. Typically between the ages of 13 and 16 in the 1990s, and between 15 and 18 prior to the 1980s, Lahu teenagers in rural Lancang started to play with boys or play with girls, activities serving as a prelude to finding a spouse. A traditional courtship ritual is to snatch the headcloth or hat from a member of...

Interventions For Highrisk Children

A few intervention efforts have recently been launched, often based on the notion that shorter duration between first psychotic episode and subsequent treatment is associated with a better prognosis 95,96 . Improved access to care and increased education efforts have been shown to reduce treatment delay 95 . Other intervention options include pharmacological treatment with antipsychotics initiated during the prodromal phase or perhaps earlier. The risks of such intervention are significant children may be more prone to side effects, including dyskinesias, and need careful monitoring 97 . The benefits of administering these medications, based on the possibility that they may develop schizophrenia, would need to be carefully weighed against the potential risks. Cornblatt's data from the Hillside Recognition and Prevention Project indicates that antidepressants in combination with a mood stabilizer and or anxiolytic were as effective as antipsychotics in yielding clinical improvements...

Making the Right Surgical Choice

Depending on your symptoms, your doctor may start with conservative surgery, such as a hysteroscopy or a dilation and curettage (D& C). Or your initial surgery for endometriosis may be a diagnostic laparoscope so your doctor can take a look around your pelvis and possibly remove endometrial implants. But if you've already had diagnostic surgery, you may decide to have a more radical treatment that's based on previous results. Unfortunately, surgery isn't always a miracle cure. In some circumstances, surgery may be too risky because it's unsafe for you or because it can do more harm than good. For example, to preserve your chances of getting pregnant, your doctor doesn't want to interfere with your ovaries. But some times the surgeon does everything possible, and the patient still has symptoms or still can't get pregnant. No surgeon is perfect, and no procedure is guaranteed to work.

Gender and Religion

Some Manjako of both sexes receive signs such as recurrent illness or extraordinary happenings that they are to become a healer-diviner (napene). Through a long series of rituals culminating in death and rebirth they develop the ability to see and communicate with bush spirits, who help them in their practice. They are more often male than female, though many women are successful diviners. Female diviners tend to specialize in fertility problems and children's health.

Quantitative Inheritance

Goats contribute significantly to the food resources of the world. Producers around the world will continue to seek genetics that they believe will increase their financial value and their existing genetic resources. The traditional mating systems pure breeding, artificial insemination (AI, which has been used in dairy goats), crossbreeding, development of synthetics, and variations thereof have been used with some success in developing countries. 11 Genetic progress in goat breeding will be realized when these mating systems are used judiciously, by matching goat genotypes with the environments and in tandem with modern genetic tools. Further readings on topics discussed are provided in Refs. 1 3,8 .

Scrotal Swelling and Scrotal Masses of Childhood

The clinical significance of varicocele rests primarily with the association between this condition and adult male infertility. While infrequently an immediate concern of the adolescent, there is ample evidence that the risks of testicular hypotrophy, declining semen parameters, and infertility progress the longer the varicocele remains untreated. Therefore, the identification of a varicocele represents an indication for urologic referral in conjunction with the boy's primary care physician. Urologists recommend surgical repair of varicoceles that are (1) bilateral, (2) painful, or (3) associated with a significant disparity in testicular size of greater than 2 cm 3 Rarely, a varicocele may develop as a consequence of an acute increase in inferior vena caval pressure, in turn the consequence of an intra-abdominal tumor or vena caval thrombosis. Spermatoceles and Epididymal Cysts Sperm-containing cysts of the rete testis or efferent ducts (spermatoceles), or of the epididymis...

Chromosomal Aberrations and Transposons

Translocations often cause human infertility, because they interfere with the normal distribution of chromosomes during meiosis. Chromosomes pair up before separating, as eggs or sperm are formed, and the correct pairing depends on matching sequences between them. Structural aberrations also include inversions and duplications of pieces of chromosomes.

Parental and Other Caretaker Roles

The same pattern potentially exists for fathers, but since these men's brothers, and their other classificatory fathers, live in other households, their care is seldom sought. The child's mother's husband is the primary father (MH F), but the Canela also have contributing fathers. They believe that semen introduced into a woman's womb after she has become pregnant becomes part of the fetus. Thus, the men who have contributed in this way become ethnobiological fathers to the fetus, sharing common blood, in addition to the mother's husband. Contributing fathers occasionally give their contributed-to children food, but they are not significant caretakers, and they do not assume the care of orphans related to them in this way.

The Transmission of Life

Artificial insemination assists spouses to procreate when they cannot conceive through normal sexual intercourse. In such cases, the sperm of the husband is artificially introduced into the wife's child-bearing organs. There are differences of opinion in the Orthodox church regarding this procedure. A major objection is that this is a totally unnatural practice. But since other unnatural practices such as cooking food, wearing clothes, using technical devices such as eye-glasses and hearing aids, and performing or undergoing surgery are considered morally acceptable, this argument loses much of its force. More cogent is the argument that artificial insemination separates baby-making from love-making, which is a way of emphasizing the unity of the spiritual and bodily dimensions of marriage. In the case of artificial insemination by husband (AIH), the personal, social, and spiritual context seems to indicate that AIH is morally acceptable. The opposite holds...

Cystic Fibrosis Definition and Etiology

In CF, there is widespread dysfunction of exocrine glands that causes chronic pulmonary disease pancreatic enzyme deficiency intestinal obstruction in the neonate (distal intestinal obstruction syndrome) liver disease infertility, especially in males and abnormally high concentrations of electrolytes in sweat, resulting from the failure of salt reabsorption in the sweat gland ducts. This is the most common inherited disease in Caucasian populations. A gene located on chromosome 7, coding for the protein called cystic fibrosis transmembrane regulator (CFTR), is defective. CFTR acts as a cyclic-AMP-activated chloride channel blocker. More than 800 mutations of the gene have been identified, and they are categorized into five classes on the basis of CTFR alterations. The most predominant mutation, which accounts for approximately 70 of all the CTFR genes worldwide, is A508, but there is geographical variation and it is less common in non-white races.

Toward an Anthropology of Birth

The landmark 1978 publication of Jordan's Birth in Four Cultures inspired a generation of anthropologists to pursue empirically based comparative studies of birth and legitimized the grounded study of human reproduction (Ginsburg & Rapp, 1991). Jordan referred to her own approach as biosocial, with an emphasis on the feedback between biology and culture. Prior to Jordan's work, there was a distinct lack of data useful for a holistic comparison of childbirth, and almost no research based on direct observation of normal births. Medical reports presenting cross-cultural examples tend to focus on physiology, and often on abnormal features of birth. Jordan sought to emphasize the social interactional aspects of birth, such as the nature of the decision-making process during parturition, and the extent of material and emotional support for the woman during pregnancy and labor. Broadly, she proposed a biosocial framework for the collection and analysis of data, that would integrate local...

Female Homosexual Systems

Still, there are clear descriptions of gender-stratified female homosexuality. Among the Chuckchee, two women who adopted male dress, speech, and work activities eventually married girls, and one of the wives became pregnant by a cohusband. Records of gender-stratified female homosexuality also appear from ancient China and Japan. A chronicle of the Han emperor Cheng (32-7 bc) reports that his wife had a dui shi (husband-wife) relationship with a female student who then became the emperor's concubine so that both could enjoy the girl's sexual favors (Murray, 2000). During the Tokugawa period (1615-1867 ce) lesbianism was common in the shoguns' harems, and there are references to women dressed as males who sought female prostitutes. Japanese theater companies also included women who took on male roles and became enamored of their female counterparts (Leupp, 1994). Gender-stratified lesbian relationships have also been described in Sumatra and Java (Murray, 2000).

Developmental Steps and Moral Status

This descriptive effort, however, is not based on the belief that the facts speak for themselves. They emphatically do not. In fact, many ethical controversies about the ethics of in vitro fertilization, embryo research, therapeutic cloning, abortion and the like, are less about ethics in the strict sense as they are about expressing divergent interpretations of biology. The marshalling of biological fact to support apodictic statements of moral status involves many, usually unspoken, bridge principles. These principles involve highly complex notions, such as unity, individuality, potentiality, and continuity. It is a common misconception that these theoretical concepts constitute stable, common sense notions that are merely applied to biological entities and processes. In actuality, these concepts are themselves given new meanings and qualifications in the very process of using them to make sense of biological facts. Between the realm of ontological...

Early History of Embryo Research

These investigations, in turn, were based on many years of research with animal models, where virtually all research in the United States has been supported with federal funding. It was hoped that procedures developed in animal studies could later be applied to human reproduction and embryology, especially to the understanding and alleviation of human infertility. Attempts at laboratory fertilization of human oocytes (precursor eggs) showed some promise as early as 1944 in the work of American obstetrician-gynecologist John Rock and scientist Miriam Menkin. From that time until the birth of the first child conceived through IVF in 1978, various approaches were tried in order to achieve a pregnancy and live birth. The work of Robert Edwards, British reproductive endocrinologist, culminated in the birth of Louise Brown after he collaborated with Patrick Steptoe, an obstetrician who utilized laporoscopy for viewing and recovering a mature ovarian follicle...

US Funding and Regulation of Embryo Research

National Commission for the Protection of Human Subjects recommended guidelines for federal funding of research involving human fetuses, but stipulated that these guidelines did not cover research on IVF or on embryos resulting from IVF. It proposed that an Ethical Advisory Board be appointed to review such protocols, and this recommendation was incorporated into federal regulations. In 1978 an Ethics Advisory Board (EAB) was appointed to recommend a policy on federal funding for research involving IVF. In its 1979 report the EAB concluded that research on IVF was ethically acceptable for federal funding under these conditions that all federally funded research is directed toward establishing the safety and efficacy of IVF all gametes used to develop embryos in research protocols are provided by married couples and no embryos are preserved in the laboratory beyond fourteen days of development. The EAB's rationale was based on two main points. First, it would be...

Public Policy in Other Countries

The earliest comprehensive legislation on reproductive technologies was enacted in the State of Victoria, Australia in 1984. The Infertility (Medical Procedures) Act addressed embryo research by prohibiting research that might damage the embryo or make it unfit for implantation. This prohibition appeared to outlaw any IVF or embryo research that was not directed toward benefiting each individual embryo. UNITED KINGDOM. The issue of the regulation of reproductive technologies and embryo research was particularly pressing in the United Kingdom because of the publicity given to the birth of Louise Brown in England in 1978. The Warnock Committee was appointed to study the matter, and its 1984 report recommended national regulation of assisted reproduction. It also recommended that research on embryos resulting from IVF be permitted up to the fourteenth day after fertilization, under the jurisdiction of a licensing body. Based on the Warnock Report, the Human...

The Aftermath in the United States and Beyond

Despite President Clinton's directive that NIH not fund research involving the creation of embryos, most types of research on IVF and human embryos were still eligible for federal funding. However, in its next appropriations bill Congress reversed its previous stance and prohibited NIH from funding any research that might involve damaging or destroying human embryos. In 2003 this prohibition was still in effect. As of April 2003, Germany, Austria, and Ireland prohibit embryo research unless intended to benefit the individual embryo subject. Germany does allow some importation of established stem cell lines for research. France prohibits any embryo research that would harm the embryo. However, in January 2002 the French assembly passed a bill that, if enacted, would permit research using surplus embryos originally created for reproductive purposes. Sweden allows research on surplus embryos up to day fourteen, including research on deriving stem cell lines. Creating IVF embryos solely...

Women of Reproductive Age 2049Years

Health-based interventions, such as family planning and longer birth spacing, are assumed to have a more direct effect on women's nutritional status, but the inputs and outcomes rarely, if ever, include issues related to improving the nutritional status of women. However, the potential is there to change this. The role of iron folic acid supplements remains equivocal, except where severe deficiency exists. Insufficient data are available to justify the provision of free multiple micronutrient supplements through the public health system, although there is some rationale to improve micronutrient status before these women become pregnant so that they are in

Bringing Embryos into Existence for Research

One of the most contentious issues in embryo ethics is the question of whether it is ever justifiable to bring human embryos into existence specifically for research purposes. Many would argue that research use of surplus embryos remaining after the completion of infertility treatment is ethically acceptable, since these embryos are destined to be destroyed in any case. At the same time, they may hold that the development of embryos for research purposes, so-called research embryos, is not morally justified. The development of embryos for research purposes has been characterized as a novel practice that requires particular justification. Referring to embryos created through nuclear cell transfer, the President's Council on Bioethics in 2002 claimed that such research creation of embryos would constitute crossing a major moral boundary (p. 132). Yet decades of research on human IVF beginning in the 1930s required investigation of various methods of laboratory fertilization, followed by...

Extracorporeal Embryos

Science fiction fantasies about the artificial uterus notwithstanding, only the very first stages of human development can occur outside the female body. Since 1978, in vitro fertilization followed by embryo transfer has been a common treatment of fertility problems. The growth of ovarian follicles is stimulated by the administration of gonadotropins. Oocytes are then collected by laparoscopy and placed in an appropriate culture medium. Sperm is added and cleavage occurs in culture until the blastocyst is transferred in the uterus. With in vitro fertilization, the early embryo became much more accessible to human intervention, and this has raised ethically perplexing possibilities. Interventional research on early embryos has become possible, raising the question of whether it is ethical to produce human embryos for research purposes, or whether research should be done, if at all, only on spare embryos. These occur when some embryos are no longer needed for fertility treatment, even...

Cloning of Mammals Dolly

Only one surrogate mother became pregnant, and she only had one live lamb, named Dolly. The success rate was very low, but Dolly has been proven to be a true clone She has all the characteristics of a Finn-Dorsett sheep. Independent scientists used a technique called DNA fingerprinting to show that Dolly's DNA matched the donor mammary cells but did not match that of other sheep in the Finn-Dorsett flock, nor did her DNA match that of her surrogate mother or the egg donor. Similar results have been obtained by Ryuzo Yanagimachi at the University of Hawaii, who worked with several generations of cloned mice.

Pathophysiology And Epidemiology

Tubal ligation is also a risk factor for EP. The more tissue-destructive the ligation procedure, the higher the EP rate. Extrauterine pregnancy rates as high as 51 percent of pregnancies have been reported with laparoscopic tubal electrocautery, as compared with rates of 12 percent using nonlaparoscopic methods. Infertility surgery on the fallopian tube has a reported 2 to 7 percent incidence of subsequent EP. Any patient who requires surgery for treatment of an EP is also at a higher risk of developing a subsequent EP. In general, future pregnancies following any prior tubal surgery should be suspected of being ectopic. It is not clear whether this higher incidence of EP is secondary to the underlying disease state or a result of the surgical procedure. IUDs have also been implicated in EP, with 3 to 4 percent of pregnancies occurring with an IUD in place estimated to be ectopic. Increased risk of EP is independent of the type of device. Following discontinuation of the IUD, the risk...

Current Catholic Teaching

In 1987 the Catholic Church provided guidance on reproductive medicine and embryo research in Donum vitae (Respect for human life). Donum vitae poses and then answers a key question how could a human individual not be a human person The Magisterium has not expressly committed itself to an affirmation of a philosophical nature, but it constantly reaffirms the moral condemnation of any kind of procured abortion (Congregation for the Doctrine of the Faith, 1987, part I, no. 1). In other words, immediate hominization is not affirmed doctrinally but its implications are fully asserted morally, not just for abortion some weeks into a pregnancy but in regard to the embryo at the earliest moment. Donum vitae insists

What About Gamete Intrafallopian Transfer GIFT and Zygote Intrafallopian Transfer ZIFT

GIFT is a procedure where the eggs and sperm are placed directly into the woman's fallopian tube during a laparoscopy procedure. The ovaries are stimulated with fertility medications, and the mature eggs are retrieved during an ultrasound guided procedure, much like IVF. However, with GIFT, the eggs are mixed with the washed, enhanced sperm and then placed directly into the fallopian tube during a laparos-copy. The eggs are (hopefully) fertilized within the woman's body, unlike IVF, which fertilizes the eggs in a laboratory. ZIFT is a combination of GIFT and IVF. For the ZIFT procedure, fertilized eggs are placed directly into the woman's fallopian tube during a laparoscopy procedure. As with the other techniques, the ovaries are stimulated with fertility medications, and the mature eggs are retrieved during an ultrasound guided procedure. Then, like IVF, the eggs are mixed with the washed, enhanced sperm in the laboratory and monitored for fertilization. The only difference is where...

Pregnancy Guide

Pregnancy Guide

A Beginner's Guide to Healthy Pregnancy. If you suspect, or know, that you are pregnant, we ho pe you have already visited your doctor. Presuming that you have confirmed your suspicions and that this is your first child, or that you wish to take better care of yourself d uring pregnancy than you did during your other pregnancies; you have come to the right place.

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