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 Overview


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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.

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...

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.

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.

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...

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.

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.

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...

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...

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...

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.

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...

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.

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.

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.

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

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.

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.

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...

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. Fertility issues that require IVF Once the technique of in vitro maturation of eggs becomes refined and available, it will likely revolutionize IVF.

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....

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.

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...

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.


Your doctor may recommend a hysteroscopy procedure to evaluate if you could have an abnormality within your uterus. The hysteroscope is a thin telescope-like instrument that is inserted through your vagina and cervix and then into your uterus. This procedure provides the doctor with a way to view inside of your uterus and make a certain diagnosis. Sometimes, hysteroscopy is done in conjunction with a laparoscopy procedure (see below for discussion of laparoscopy). The hysteroscopy procedure has many uses. When it comes to fertility evaluation, this procedure is often performed to evaluate a defect in the shape or size of the uterus. For example, if the patient has a septate uterus, the hysteroscopy may be able to diagnose this condition and also remove the membrane at the same time. The procedure may also be used to diagnose the presence of fibroids, polyps, or adhesions. These lesions might be missed during the HSG procedure (discussed previously) thus the hysteroscopy provides...

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...

Measuring How Endometriosis Affects Your Reproductive and Other Organs

Endometriosis lesions can act and look differently in different areas, but all are detrimental. In addition, the amount of endometriosis isn't always an indicator of the damage or pain it causes a little endometriosis in one location can be much more damaging and painful than a lot of endometriosis somewhere else. In fact, doctors have known for a long time that the amount of visible endometriosis has very little bearing on the symptoms. In this section, we discuss the ways endometriosis can damage different organs. (See Chapter 7 to find out how these changes can affect your fertility.)

Prescription Medications

Certain prescription medications can have a negative impact on your fertility. For example, steroids (such as cortisone or prednisone) taken in high doses can prevent your pituitary gland from producing proper amounts of hormones. The resulting hormonal imbalance may interfere with your ovulation. It may also interrupt your normal menstrual cycle.

Traits Sought by Both Sexes

Adaptive gene combinations that would be fragmented if the mates were genetically dissimilar. Consistent with this idea, homogamy reduces the likelihood of miscarriage (Rushton, 1988 Thomas, Harger, Wagener, Rabin, & Gill, 1985) and low birth weight (Ober et al., 1987). In any case, people tend to choose similar mates, and similar mates stay together longer (Hill, Rubin, & Peplau, 1976). Of course, extreme consanguinity risks the deleterious effects of inbreeding depression.

Recent Or Past Use Of Contraception

Many women are concerned about how past use of contraception might affect their future fertility. In almost all cases, your fertility is returned to normal within a short time of discontinuing the contraception. Birth control pills prevent pregnancy by stopping the ovulation process. Almost always, birth control pills do not affect your future fertility. That's especially true if your menstrual periods were normal prior to beginning the pill. However, a few women who stop taking birth control pills experience some difficulty getting pregnant. A medical investigation may be a good idea if you have gone off birth control pills and still don't have normal menstrual periods within six months. Another type of contraception is the Depo-Provera hormone injection, which works by stopping ovulation. One shot is supposed to prevent pregnancy for three months. Unfortunately, many women who want to become pregnant often find that it takes between 6 and 16 months for their menstrual cycle and...

Environmental And Occupational Factors

Prolonged exposure to emotional stress, high temperatures, chemicals, radiation, or electromagnetic or microwave emissions may reduce your fertility. Various occupational hazards also exist within certain work environments. For example, the rubber, leather, and dry-cleaning industries use the solvent benzene, which may adversely affect your fertility. Flight attendants are exposed to radiation and high altitudes, which may reduce fertility. Doctors, nurses, and other hospital employees may be exposed to anesthesia, chemicals, and radiation, all of which can have a harmful effect. Even people who work nights or irregular shifts may be adversely affected in their fertility because of changes in their internal clock and natural biorhythms.

Preconception Counseling

If you have epilepsy and you are planning to have a baby, make an appointment to see your neurologist or epileptologist (a physician who specializes in the treatment of epilepsy) for preconception counseling before trying to become pregnant. Many important issues need to be discussed and understood before you become pregnant, some of which you may be aware of, but many of which you may not be. Unfortunately, women often wait until they are already pregnant before calling their doctor. This is a good time to talk about any changes in your epilepsy treatment that might be necessary. The baby's main organs and skeleton develop during the first 4 months of pregnancy, a period during which AEDs may affect the fetus the most. This is one of the major reasons your epilepsy treatment should be evaluated before you get pregnant.

Understanding dioxin exposure

If surgeries could increase the risk of endometriosis, then many other gynecologic procedures (hysteroscopy, hysterosalpingogram HSG , saline infusion sonohysterogram SIS , and the like check out Chapter 9 for more info on these procedures) would have a more profound effect than tubal ligations because these other procedures can actually force cells out the tube and into the pelvis. But these procedures don't cause endometriosis either.

Pasture Resource Availability

The number of pastures and their relative sizes can have a major influence on which crossbreeding systems are feasible. Some very effective crossbreeding systems, such as multibreed composites, can be conducted in a single breeding pasture. These systems allow relatively efficient use of heterosis, but do not allow as much opportunity to exploit breed differences as when multiple breeding pastures are available. In most cases, using a terminal sire breed will require one breeding pasture that is larger than the rest (or a group of breeding pastures that can be used similarly). If artificial insemination is an option, then the number of pastures available for use during the breeding season is less important.

Stacey Chillemis Experience

Many women with epilepsy have polycystic ovary syndrome, a condition characterized by irregular ovulation and menses. The ovaries of women with this condition fail to release an egg at a regular time each month, making conception difficult. The infertility caused by this syndrome is treatable. Polycystic ovary syndrome may be more common in women with epilepsy, and there is some evidence that one particular medication that is used to control seizures (sodium valproate) may also bring on this syndrome. If this is true and not all experts agree this effect may be reversible. It is worth noting that many doctors warn women who stop taking sodium valproate that they may get pregnant easily, and that they should use contraception if they do not wish to become immediately pregnant. The policy of some doctors is to screen all adolescent girls with epilepsy as well as women seeking preconception counseling for the presence of polycystic ovaries and the associated hormonal changes, and advise...

The role of model systems

This theme of perturbational analysis to reveal mechanisms means that the human embryo is not a system of choice, at least not after the 14-day limit set by the regulating authorities in Britain, and manifest in the Human Fertilization and Embryology Act, 1990 (and see Burn and Strachan, 1995 Table 1.1). Most dysmorphogenesis is likely to have its inception during the major stages of morphogenesis and organogenesis, starting with neurulation during the fourth week in the human embryo (Larsen, 2001). Disruptions earlier than that are likely to result in spontaneous abortion and be lost indeed, it has been estimated that at least 15 of all human pregnancies end as spontaneous abortions after implantation (Warburton and Fraser, 1964).

Positive Actions You Can Take to Reduce the Chance of Early Pregnancy Loss

If you have experienced recurrent miscarriage or other pregnancy loss, you can still feel hopeful for your upcoming pregnancies. You may be able to improve your chances of having a successful pregnancy by taking certain positive actions, such as these Undergo a complete medical workup before you try to get pregnant again. Work with your doctor to evaluate risk factors and causes of your past pregnancy loss.

Applications of Evolutionary Theory to Cultural Variation

An example illustrating links between cultural variation and evolution is the unusual degree of diversity in Tibetan marriage systems, including polygyny, polyandry, polygynandry, and monogamy. This variation, in Durham's view (1991, pp. 59-70), is a solution to female and male infertility. It allows an infertile couple to bring an additional wife, husband, or p'horjag (extra man) to the household so that heirs could be produced.

In vitro Fertilization

When performed by an experienced practitioner and in an experienced clinic, IVF generally results in pregnancy rates of about 28 percent after one attempt and 51 percent after three. One study has reported the pregnancy rate after six attempts as being 56 percent. Another has reported it as being 66 percent. Generally, one attempt at IVF is made per menstrual cycle. The IVF process begins when couples are first screened. Clinicians first must rule out infertility in the male partner. If the problem is with the female partner, various courses of treatment may be available. Generally, couples are expected to try to achieve pregnancy for a year after the initial screening In women whose ovaries are capable of generating viable eggs, the first step in IVF is referred to as superovulation. To increase the chance of success, the woman's ovaries are stimulated to develop many follicles. Normally, only one or perhaps two follicles develop and are released by an ovary during a single menstrual...

Laparoscopy In The Compromised Host

However Ekman et al15 performed hemodynamic measurements in 10 women undergoing laparoscopy for investigation of infertility. This study utilized relatively low abdominal insufflation pressures (5-8 mm Hg) and physiologic PEEP at 3.7 cm H2O. With low pressure insufflation and low PEEP, there were no changes

Gamete Intrafallopian Transfer

An alternative to IVF and intrauterine embryo transfer is gamete intrafal-lopian transfer (GIFT), introduced more than twenty years ago. In this procedure, the egg and sperm are collected as they would be for IVF procedures. However, instead of allowing fertilization to take place in a culture dish, the egg and sperm are transferred surgically into the woman's fallopian tube. This allows fertilization to occur in the fallopian tube, just as occurs in a natural pregnancy. The transfer can only be performed in women with healthy and functional fallopian tubes, and the sperm used for fertilization must be completely normal and capable of swimming. After the transfer is made, doctors have no way of knowing if normal fertilization actually takes place until an embryo has implanted in the uterine wall. However, the procedure's success rate (35 ) is higher than the success rate for IVF. Another related technique is zygote intrafallopian transfer, in which the egg is fertilized in vitro and...

Generally classifying menstrual pain

You can reduce much of the pain related to endometriosis by regulating your menstrual cycle (see Regulating your Menstrual Cycle to Reduce the Pain later in this chapter). Medication to prevent egg development and ovulation can keep pain from showing up on a monthly basis. Obviously, these medications aren't a good choice if you plan to get pregnant in the near future.

Donor Insemination and Egg Donation

Donor insemination is used when sperm are incapable of fertilizing the egg. Usually this occurs if the male produces very little or no sperm. Sometimes, donor sperm is used when the male partner is the carrier of a genetic disorder that could be transmitted to the baby. Sperm donors should be between ages eighteen and fifty-five, and all should be screened for genetic disorders, such as cystic fibrosis, and for various types of chromosomal abnormalities and infectious disease, including hepatitis, syphilis, cytomegalovirus, and HIV. As with the use of intrauterine insemination, the female partner undergoes ovarian stimulation to maximize the number of follicles released during ovulation. Pregnancy rates resulting from the use of donor insemination are between 32 percent and 50 percent after ten inseminations.

Divorce as Transition

Divorce is almost, but not entirely, as universal as marriage. A frequent reason for divorce is a wife's infertility, whether real or alleged (since the possibility of male infertility is often not recognized), or failure to bear sons. Whether the procedure is simple or complicated, terminating a marriage is an option open only to men in many societies. A divorced wife may be compelled to return to her natal family, who may not welcome her because the property which the divorcing husband and his family expended for her marriage must be returned. Typically the property, possibly in the form of cattle or pigs, has already changed hands in order to establish a marriage for the woman's brother or to acquire yet another wife for her father. Custody of children is not

Utilization Of The Frozen Germplasm

Examples where a germplasm bank has been valuable are the black-footed ferret in North America and the cheetah. Artificial insemination has been used successfully in the giant panda 9 and the elephant 10 although in the latter, cryopreserved semen was not used. These examples of flagship species help to publicize the importance of Fig. 2 Koalas born after artificial insemination with fresh semen a promise for the future for germplasm banking. (Photograph supplied by Dr. Steve Johnston, courtesy of the Lone Pine Koala Sanctuary, Queensland, Australia.) (View this art in color at Fig. 2 Koalas born after artificial insemination with fresh semen a promise for the future for germplasm banking. (Photograph supplied by Dr. Steve Johnston, courtesy of the Lone Pine Koala Sanctuary, Queensland, Australia.) (View this art in color at

Correlates of Extramarital Sex Norms

Norms regarding extramarital sex for women may be so overwhelmingly restrictive because husbands wish to avoid having their wives become pregnant by some other man. Unless a man then divorces such a wife, he will be investing time, energy, and resources in a child who is not genetically his own, a situation that evolutionary theory predicts men will vigorously attempt to avoid. In fact, infidelity is a very common reason for divorce across cultures and men are far more likely than a women to seek divorce from an unfaithful spouse (Broude, 1994).

Evasive strategies by the organism

These bacteria can survive within the phagocytic cells of the host. Extracts of B. abortus have been reported to inhibit phagosome-lysosome fusion in macrophages, degranulation of neutrophils and the oxygen-dependent antibacterial system of bovine neutrophils. The organisms may spread from the initial site of infection either within these cells or free in the bloodstream. They localize in certain target organs, such as lymph nodes, spleen, liver, bone marrow and, especially in animals, reproductive organs. The presence of mesoerythritol in the testes and placentae of ruminants and pigs stimulates enormous multiplication of brucellae in those tissues, leading to infertility and abortion. However, erythritol is absent in humans.

Oocyte Collection From Donor Females

The IVF procedure offers an alternative to producers who have genetically valuable cows that for some reason are unable to produce viable embryos through standard embryo collection procedures. This technology can be used with oocytes harvested from older nonovulating cows, females with physical injuries (e.g., lameness), and problem breeding cows (e.g., abnormal cervix). Good success has been reported using IVF procedures on supplemental oocytes harvested from cows with cystic ovarian disease. Today, oocytes are harvested from females by transvaginal ultrasound-guided collection procedures. To retrieve the oocytes for IVF, a trained professional inserts an ultrasound-guided stainless steel needle through the wall of the vagina near the cervix to extract oocytes from both ovaries of the donor female. This approach can also be used to harvest oocytes from prepubertal heifers and during the first trimester of gestation in pregnant cows. With IVF the potential exists for more embryos to...

Genitourinary Chlamydial Infection

Chlamydia trachomatis infection of the genitourinary tract is the most common bacterial STD in both the United States (> 4 million new cases per year) and worldwide (> 50 million new cases per year). Many infected individuals of either sex are asymptomatic but symptomatic urethritis is common in men, whereas women may present with a mucopurulent cervicitis and acute salpin-gitis. The most serious complication of infection in men is epididymitis. Without treatment, more than 40 of infected women may develop pelvic inflammatory disease, which may lead to tubal infertility or increased risk of ectopic pregnancy. Pregnant women may transmit their infection to their babies as they pass through the infected endocervix at the time of delivery. The baby may develop a mild, neonatal conjunctivitis and or afebrile pneumonia. Infection stimulates host inflammatory and immune responses, but the immunity is of short duration and reinfection occurs frequently.

Utilization Of Sexsorted Sperm

The first sex-selected mammalian offspring were rabbits born following surgical insemination of sexed sperm. 5 Later, in a milestone achievement, a similar system was used to produce sex-selected piglets, demonstrating the utility of the system for pre-selecting the sex of offspring in domestic livestock. 6 The first calves born were from embryos derived from IVF with sex-sorted sperm, but most of the recent work in cattle has been done using

Sperm Mediated Gene Transfer

The simplest, but most controversial, method of gene transfer involves merely mixing a transgene with spermatozoa and using them to fertilize oocytes, either in vitro or by artificial insemination. The use of sperm-mediated transfer in mice by Dr. Lavitrano 8 was initially discounted as unrepeatable by many investigators. During the past decade, research on this procedure has persisted and many investigators report successful gene transfers by this technique. Unfortunately, only a few studies have provided convincing evidence that the transgene was unaltered before or during the integration process and capable of expressing appropriately in the resulting transgenic animals. 9

Obstetriciansgynecologists Obgyns

These health care providers are the ones that most women go to for basic female needs, such as Pap smears, birth control, female infections, and routine pregnancy and delivery. As far as fertility evaluation, the OB GYN is capable of beginning some initial testing and treatment. For example, your OB GYN doctor may order blood tests, perform a laparoscopy, or prescribe a trial of a low-dose fertility medication. The amount of fertility evaluation and treatment that your OB GYN can provide is likely the result of the doctor's own training, interest, and comfort in the field of fertility. However, at some point, if you do not become pregnant from these preliminary methods, you will likely want to see a fertility specialist, the reproductive endocrinologist.

Plasticity of Embryo Development

Zygotes and early embryos are not bound to an absolute set of physiochemical or nutritional conditions for successful development. For example, there are several commercial manufacturers of culture media systems for human embryo development in clinical infertility treatment, all of which differ in concentrations of key constituents. The ability of embryos to develop adequately under varying conditions has been referred to the 'plasticity' of embryo development. Nevertheless, we now recognise that there is an associated cost of the inherent requirements for adaptation to less than optimal environmental parameters.17,18 While adaptation is often not reflected in easily measurable immediate changes in embryo morphology or viability, there is increasing evidence it leads to perturbation of the programming process which underpins phenotype in fetal and postnatal life.19

CD46 in other biological areas

In reproductive biology, CD46 is abundantly expressed at the maternal-fetal interface, on fetal tissue and on the inner acrosomal membrane of spermatozoa. Alterations in function or expression of CD46 may play a role in habitual abortion or infertility. The surprising acrosomal site for CD46 expression may be part of the egg-sperm attachment mechanism and or protect against C3b deposition during penetration by spermatozoa.

Good Vibrations Making Sure The Specialist Meets Your Emotional Needs

It is vitally important that you have a good feeling about the fertility specialist, the office staff, and the clinic itself. The process of fertility evaluation and treatment is stressful enough. That's why it's especially critical that you sense a good connection and feel comfortable around your fertility specialist.

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...

Youve Chosen Your Specialist Now What

If you are able, it's best to bring your medical records, test results, and report summaries with you for your new doctor's review. One of the doctor's first priorities will be to evaluate whether you have a fertility problem. The specialist will go over your complete medical history. You will be asked many questions about your medical conditions, gynecological issues, and the nature of your sexual relations. There will be considerable focus on your menstrual cycle, past pregnancies, sexually transmitted disease history, and birth control. You will also be asked about medications that you take, your family medical history, and your personal and lifestyle habits. Your partner may be asked many of these same questions. Just do your best to answer the questions and try to provide as many details as possible.

Risk of Fetal Malformation

Fetal malformation, developmental delay, growth delay, or in utero death are the usual consequences reported. There is a linear relation between the radiation dose and the risk of delays in mental development (Biy-ani and Joyce 2002a). Several experimental studies in animals show that the risk of irradiation during the first weeks of pregnancy often obeys the all-or-nothing law miscarriage or absence of malformation (Gorton and Whitfield 1997). Below 50 mGy, the risk of malformation seems negligible even if minimal biochemical modifications are possible. This threshold value is well under the dose delivered by radiological diagnostic tests (plain abdomen 1 mGy radiograph, 1 min of image intensifier 2 mGy) (Denstedt and Razvi 1992).

Growth Factor and Cytokine Environment and Long Term Development

Several studies have linked their impact on blastocyst development with implantation success. However the significance of depriving the embryo of growth factors for long-term health and viability of the fetus is more difficult to evaluate and has just begun to be explored. It seems imperative to address this since in human IVF and assisted reproductive technologies in animals, preimplantation embryos are generally cultured in media that do not contain growth factors. Their absence is clearly a major deficit when the in vitro and physiological environments are compared. Experimental strategies employing embryo transfer after manipulation of the cytokine environment in vitro, or in vivo through use of genetic strategies, provide the best approach. This overcomes the confounding issue of endogenous

Whose fertility is affected by endometriosis

Although you may feel like you're the only one in the world not able to get pregnant, you're not alone. Having trouble getting pregnant is a major concern for women with endometriosis. The following statistics show the widespread effects of this disease on infertility 1 About one in six couples suffers from infertility. That's a lot of people about 6 million people (2 to 3 million couples) in the United States alone. 1 Endometriosis is responsible for around 30 percent of these infertility cases. 1 Thirty percent of laparoscopic surgeries for unexplained infertility result in a diagnosis of endometriosis. 1 About 40 percent of women with endometriosis have some degree of infertility. How long should I try to get pregnant on my own Most people start trying to get pregnant with the attitude that it will occur quickly, like five minutes after they consider the idea Unfortunately, becoming pregnant isn't easy for many women with endometriosis although, if your endometriosis is mild, you...

Husband Wife Relationship

Divorce, except in cases of infertility or infidelity, is to be avoided at all costs for the sake of the children. If there is a divorce, children younger than 10 stay with mothers and those that are older than 10 may live with either their mother or their father. The court decides and grants custody of the children in divorce cases.

Clinical Description

Cystic fibrosis is often considered the most common serious autosomal recessive disease in Caucasians of northern European ancestry. It is a multiorgan condition, characterized by abnormally viscous secretions from epithelial cells in various tissues, leading to duct obstruction and infections. The most prominent and potentially lethal site for these phenomena is the lung, but CF patients also may suffer from pancreatic exocrine insufficiency, intestinal obstruction (called meconium ileus in the perinatal period), diabetes, biliary cirrhosis, growth retardation and failure to thrive, dehydration because of excessive salt loss in sweat, and sinusitis. In addition, virtually all males with classical CF exhibit a congenital malformation, bilateral absence of the vas deferens (CBAVD), causing infertility.

Molecular Genetics

As more patients and mutations have been studied, the range and complexity of the molecular genetics have continued to grow. For example, some male individuals with CFTR mutations may present only with CBAVD and no classical CF symptoms, being ascertained during workups for infertility. Furthermore, one of the more common mutations, R117H, may be associated with either CF or CBAVD, depending on which form of an intronic


Your doctor will discuss your HSG test results with you. If uterine fibroids are noted, they may or may not require treatment, depending on their size and position within your uterus. Blocked fallopian tubes are a fairly common finding among infertility patients. It has been estimated that almost 35 percent of infertility cases are due to blockage of one or both fallopian tubes. If this is your situation, your doctor will discuss treatment options. (See Chapter 1 for more information.) A shortcoming of the HSG procedure is that it may not detect small lesions such as small polyps or fibroids within the uterus. It also does not provide any information whatsoever regarding the ovaries. On the positive side, a 2002 New Zealand study conducted at the University of Auckland showed an increase in conception rate in the months following the HSG procedure. This is thought to be due to the fluid dye pumped through the uterus and fallopian tubes during the HSG. This flushing of fluid may open...

When ovarian tissue stops functioning it disrupts the normal hormonal environment of the ovary which can then affect

K had a young patient with problems of infertility but no other complaints. On examination, he discovered huge endometriomas on each ovary. These cysts were so large that this 28-year-old woman had only a thin layer of ovary with virtually no ovarian tissue. She never did get pregnant. Losing even a small amount of ovarian tissue results in decreased ovarian reserve and possible infertility. Ask your doctor what method he prefers to use in surgery and why (check out Chapter 11 for different surgical methods). Let him explain to you the pros and cons of all the options. In the end, it's your body and you have the final say.

Infection Tests On Semen

Certain viruses and bacteria can lead to infertility. Therefore, doctors will check for their presence in both partners. Some of the infection testing is done by evaluating a blood sample (see preceding). Other testing involves evaluating a semen sample. The semen will be checked for the presence of white blood cells. If a large number of white blood cells are present, this may indicate an infection. The semen may also be tested for specific bacteria and viruses. Following are the key infections typically checked during a basic fertility evaluation of semen

Checking out other hormonal problems Luteal phase defect

Your menstrual period usually arrives 14 days after ovulation, unless you're pregnant. A condition called luteal phase defect (LPD, luteal referring to the time after ovulation) can cause your period to arrive sooner than 14 days. This shortened luteal phase means the embryo doesn't have time to implant well and results in an early miscarriage.

Non TestisSpecific Core Histone Variants

The H2AX variant, which is involved in DNA double-strand break (DSB) surveillance and repair, also operates during meiotic recombination (Lewis et al. 2003a). H2AX disruption in mice induces infertility in the male and an absence of DNA cleavage and alignment in synapsis during zygotene and early pachytene (Celeste et al. 2002).

Other Tests For Sperm

In recent years, medical research has shown that certain abnormalities found within the sperm's DNA can lead to infertility. In such cases, even a man with completely normal standard semen analysis may not be able to bring about pregnancy. That's because the sperm with the abnormal DNA is not able to fertilize the egg. The computerized assisted analysis of sperm motion helps the fertility specialist show a relationship between sperm motility and fertility. This method of measuring sperm movement and speed is more precise than the basic evaluation done during a semen analysis. The hamster test is a test of the sperm's ability to penetrate hamster eggs. This test may be recommended when the male partner has a normal semen analysis and the woman has no obvious fertility problem, but pregnancy is still not occurring. etrate a certain percentage of eggs may indicate male infertility and require other testing. This test may be performed prior to IVF to see if that technology will be...

Epigenetic Reprogramming Occurs in Early Development

In animal models, techniques that involve manipulation of the early embryo such as cultur-ing, nuclear transfer or in vitro fertilization (IVF) can lead to unusual patterns of gene expression and these changes have been attributed to epigenetic events.10 In humans there is a growing concern that techniques such as IVF and intracytoplasmic sperm injection (ICSI) are associated with low birth weight and alterations to parentally imprinted gene expression. This has arisen from the finding that children produced using IVF appear to have an increased risk for imprinting disorders including Beckwith-Wiedemann and Angelman syndrome.13

Leadership in Public Arenas

Bali are the hamlet (banjar) and customary village (desa adat). Married men attend the monthly meetings and often decide policies and implement regulations on issues, such as family planning or village water supply, that directly affect women. Men and women alike say that women are shy and reluctant to engage in public political debates some women say that they reject participation in local decision-making because they are already too busy. This ideology of male leadership is very much in line with state gender ideology, which assumes male leadership and headship in public institutions, government departments, and organizations, and advocates a domestic role for women.

Testicular Sperm Extraction Tese And Testicular Sperm Aspiration Tesa

Sometimes your fertility specialist may recommend a special type of testicular biopsy. This procedure may be advised when the male partner has a completely normal physical examination but is not producing sperm. TESE TESA can be used to provide viable sperm for use during IVF. Sperm from men who have suffered past injury or sperm duct blockage can be obtained and used to father a child through IVF. Viable sperm can also be obtained from men who have undergone prior vasectomies, without reversing the vasectomy itself.

Dna Methylation During Normal Development

The essential role of DNA methylation in mammalian development is highlighted by the fact that mutant mice lacking each of the enzymes (generated by gene targeting) are not viable and die either during early embryonic development (Dnmtl and Dnmt3b) or shortly after birth (Dnmt3a). The knockout of Dnmt3l leads to male infertility and the failure to establish imprints in female eggs. Disruption of Dnmt2 did not reveal any obvious effects on genomic DNA methylation. The biological role of Dnmt2 is still elusive however, a possible role in centromere function has been suggested.

Abnormal Dna Methylation Patterns In Clones

To establish a potential correlation between global DNA methylation levels and the developmental potential of cloned embryos, one study compared the genomewide methylation status among spontaneously aborted cloned fetuses, live cloned fetuses, and adult clones in bovine. When genomewide cytosine methylation levels were measured by reverse-phase high performance liquid chromatograph (HPLC), they found that a significant number of aborted fetuses lacked detectable levels of 5-methylcytosine. In contrast, when seemingly healthy adult, lactating clones were compared to similarly aged lactating cows produced by artificial insemination, comparable DNA methylation levels were observed. The authors suggested that the survivability of cloned cattle is related to the global DNA methylation status. All evidence suggests that a correct global methylation status is required for development. However, subtle changes might be compatible with normal development and result only in minor or no...

Choice And Definition Of Problems To Be Studied

Methods that cross disciplinary boundaries or include combinations of methods traditionally used in separate fields may provide more appropriate approaches. For example, heart disease is caused not only by genetic and physiological factors but also by social psychological factors such as smoking and stress. Jean Hamilton (1985) has called for interactive models that draw on both the social and the natural sciences to explain complex problems. Some of the biological solutions such as Depo-Provera or Norplant implants (Washburn) favored for addressing teen pregnancy in some African-American and American Indian populations will be less effective without accompanying strategies based upon research from the social and behavior sciences on raising self-esteem, increasing education, and dealing with underlying family dynamics. Stripped of the complex of social, economic, educational, and family dynamics issues that may contribute to teen pregnancy, Norplant implants and Depo-Provera may...

The cause of high levels of chromosome abnormality in human embryos

Unfortunately, it is not possible to carry out similar studies on embryos from natural conceptions, but it is of great interest that the classical observations of Hertig et al. (1954) on in vivo fertilized embryos included a high proportion of cells with 'nuclear abnormalities' (binucleate cells, for example), a type of abnormality also frequently seen in embryos from IVF cycles. If the frequent occurrence of chromosomal mosaicism and chaotically dividing embryos also applies to in vivo conceptions, this may explain the relatively poor rate of embryonic implantation in the human species.

Relative parental risks age translocations inversions gonadal and germinal mosaics

These couples require genetic counselling and in most cases appropriate prenatal diagnosis can be offered, ensuring that an ongoing pregnancy is chromosomally balanced. However, a minority of such couples experience repeated early miscarriages or primary infertility for this sub-group pre-implantation diagnosis with selective transfer of embryos is appropriate (Conn et al., 1998, 1999 Munne et al., 1998b). It is of considerable interest that follow-up studies on embryos from such cases that are not transferred due to chromosomal imbalance have shown exceptionally high levels of mosaicism in these couples with fertility problems (Conn et al. 1998 Iwarson et al, 2000 Simopoulou et al., 2003). These findings suggest that in this sub-group, couples are the victims of two pathologies, abnormal chromosome segregation at meiosis, due to the rearrangement, and an increased susceptibility to the factors that are responsible for high levels of mosaicism in...

Starting with Simple Treatments

After conducting the appropriate diagnostic tests (see the preceding section), you doctor can determine what is causing your infertility. The good news Infertility caused by endometriosis is treatable. If you have mild, Stage I or Stage II endometriosis, you may not need to jump right into the big guns of infertility treatment, such as IVF. Most fertility experts recommend treating infertility from mild endometriosis as if it were unexplained. In other words, start with treatments that don't require you to remortgage your house. This section looks at some of the simple treatments available. If you're not ovulating at all, your doctor may suggest ovulation induction (OI) to get you to produce an egg. If you're already ovulating but not getting pregnant, he may suggest OI to produce more than one egg, on the theory that producing more than one egg is more likely to result in pregnancy. If Clomid doesn't help you get pregnant within a few months, then your doctor may recommend injectible...

Vitamins and Nutrients

Just about everyone knows about the importance of taking a daily prenatal vitamin. But did you know it's best to begin taking them even before you become pregnant A good prenatal vitamin can supply you with important nutrients and increase your chance of conceiving. Even the best and most well-balanced diet in the world cannot contain all of the essential nutrients. That's why you should take a good prenatal vitamin, even when you are just starting to consider becoming pregnant. For those of you who have difficulty swallowing pills, chewable and liquid forms of prenatal vitamins are available. Talk with your pharmacist or doctor. Nutritionists have concluded that even slight vitamin and mineral deficiencies may interfere with egg and sperm production or lead to miscarriage. Therefore, both women and men should supplement their diets with these important nutrients. It may take several months of vitamin supplementation before you notice a change in your general health or boost in your...

Progesterone supplements

Progesterone therapy is another simple treatment that may help you achieve pregnancy. Because a lack of adequate progesterone can cause infertility in several ways, including luteal phase defect, your doctor may recommend additional progesterone after ovulation to be sure your levels are sufficiently high. Considering alternative treatments for infertility Many of the same methods for overcoming the pain of endometriosis (see Chapter 12) may be used to help you get pregnant. Traditional Chinese Medicine (TCM) using herbs or acupuncture have been utilized by many women, although success rates are hard to verify. Several years ago, the medical journal Fertility and Sfer 7 fy published an article suggesting that acupuncture could improve pregnancy rates when used in conjunction with IVF. (See Chapter 12 for more on choosing an acupuncturist.)

Chapter References

Landers DV, Sung ML, Bottles K, et al Does addition of anti-inflammatory agents to antimicrobial therapy reduce infertility after murine chlamydial salpingitis Sex Trans Dis 20 121, 1993. 11. Sellors SW, Mahony JB, Chernesky MA, et al Tubal factor infertility An association with prior chlamydial infection and asymptomatic salpingitis. Fertil Steril 49 451, 1988.

TABLE 1071 Some Major Differences between Partial and Complete Moles

Symptoms of GTN are continued bleeding after dilation and curettage for hydatidiform mole or bleeding after a pregnancy event (e.g., vaginal delivery, cesarean section, ectopic pregnancy, miscarriage, or abortion). Patients with metastasis may present with dyspnea, cough, chest pain, central nervous system abnormalities, or vaginal mass. The most common site for metastasis is the vagina, followed by the lung.

Fertilization with sperm in a laboratory

IVF also involves ovarian hyperstimulation, that is, you take drugs (primarily through an injection) that stimulate your body to produce more eggs than normal. How does IVF bypass the problems of endometriosis No one does IVF for fun your doctor will only suggest it if he thinks it will help overcome your fertility problems. IVF bypasses several of the inhibiting factors of endometriosis. For example, it

Finding a Gynecologist

When I (coauthor Sharon) first started working in an infertility clinic, I was amazed at how many women didn't have a regular gynecologist (or GYN a specialist in women's health issues). Some GYNs are also obstetricians, or OBs doctors who deliver babies. (See the sidebar Gynecologist or obstetrician What's the difference in this chapter.) Some women had their family practice doctor do Pap smears and breast exams, which can be just fine, but many women weren't having any screenings. They didn't want their family doctor to do the tests, and they didn't have a GYN, so these women were skipping a crucial part of their health care. But these same women were coming to our clinic to find out why they weren't getting pregnant.

Potential Future Applications

A number of infertility clinics have advocated the use of FISH analysis in clinical sperm samples from infertile patients. As mentioned above, infertile men certainly have an increased frequency of chromosome abnormalities in their sperm cells. Furthermore, studies have shown that specific men with an increased frequency of sperm chromosome abnormalities have fathered chromosomally abnormal pregnancies, for example, a man with a frequency of XY disomy 14 times higher than controls fathered a fetus with 47,XXY Klinefelter syndrome, 32 and men with an elevated frequency of disomy 21 sperm fathered children with Down syndrome (trisomy 21), shown to be paternally derived. 14 In addition, a number of studies have demonstrated that men with macrocephalic sperm have a very high frequency of sperm aneuploidy and diploidy. 33,34 Thus the addition of FISH analysis of sperm cells might be a useful investigation in male factor infertility, especially in cases known to have a high risk of...

Certain Prescription Medications

Before you try to conceive, have a complete physical examination and medical checkup. One reason is to detect any new medical conditions that may require treatment. Another reason is to review your medications and make sure it is safe to continue taking them as you try to become pregnant. Your doctor will want to review your list of current prescription medications. Although many medications can be safely taken during pregnancy, some may increase your chance of miscarriage or cause potential harm to the fetus. Be sure to

Chemical Toxins And Radiation

Some substances found at home or in your workplace could potentially reduce your fertility and harm your fetus once you become pregnant. These environmental toxins can prevent normal growth of the fetus and even cause physical or mental defects. If you or your partner might be exposed to a potentially harmful substance, take steps to avoid it. Think about your home and workplace. Jobs involving heavy metals such as lead or mercury, chemicals in pesticides, or chemicals used in certain manufacturing (such as painting or printing) processes may be harmful to your fertility. Some of these toxins have been shown to damage sperm. These environmental toxins may also cause problems with the development of your unborn baby's central nervous system. Jobs that involve a high level of radiation can adversely affect the fertility of men and women. It can also hurt the developing fetus. Try to avoid contact with radiation as you try to conceive and once you become pregnant. The American College of...

Socialization of Boys and Girls

Boys and girls usually play in gender-segregated groups. In coastal towns, soccer (football) is the preferred team sport for boys and almost any round object that can be kicked will be used as a ball. Girls may practice dance steps and chase each other in games of tag. Occasionally, a mixed-sex group of children will enact some adult activity, such as a development rally or witchcraft investigation. If family resources are limited, only the boys, or one boy, may be chosen to attend formal school. Parents fear that girls who are sent to school may become pregnant and leave before they acquire enough education for the wage sector. This common scenario is responsible for the very disparate numbers of boys and girls in the educational system. In general, boys are expected to be more active, aggressive, and mobile than girls. Although all young people are expected to behave with great respect towards their elders, girls are instructed to cast their eyes down and sit with their legs pressed...

Natural Ways to Monitor Your Own Fertility

One of the best ways of naturally boosting your fertility is to pinpoint exactly when you are ovulating. That's the time period when you are the most fertile. You maximize your chances of becoming pregnant if you have sexual intercourse just before your egg is released. Several natural family-planning methods can help you figure out when you are ovulating. The most popular techniques are the rhythm (calendar) method, the basal body temperature method, and the cervical mucus method. Each of these techniques is discussed in detail next. Many women perform all three systems because when combined together, these methods will increase your chances of conceiving. That's because they are a very effective way to track your menstrual cycle and let you determine exactly when you are ovulating.

100 Pregnancy Tips

100 Pregnancy Tips

Prior to planning pregnancy, you should learn more about the things involved in getting pregnant. It involves carrying a baby inside you for nine months, caring for a child for a number of years, and many more. Consider these things, so that you can properly assess if you are ready for pregnancy. Get all these very important tips about pregnancy that you need to know.

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