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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4.9 stars out of 29 votes

Contents: Ebook
Author: Lisa Olson
Official Website: www.pregnancymiracle.com
Price: $47.00

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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.

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 (socrei.org). They may choose to become board certified by the American College of OB GYN in Reproductive Endocrinology & Infertility (acog.org). 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 asrm.org. 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 (resolve.org) or the American Fertility Association (theafa.org). 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.

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.

Hysteroscopy

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...

Endometriosis and your fallopian tubes

Echinoderm Ovary

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...

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...

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...

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.

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

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.

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.

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...

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.

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.

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...

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...

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 Ever Happened To Gift And Zift

Report very similar pregnancy success rates when compared to IVF. However, GIFT and ZIFT are rarely performed anymore. The major reason is that both GIFT and ZIFT require a laparoscopy surgical procedure and general anesthesia. This makes GIFT and ZIFT considerably more expensive and more physically demanding than IVF. Given the additional costs and potential physical risks of surgery and anesthesia, it's difficult to justify GIFT or ZIFT in preference to IVF. Talk with your doctor to determine if GIFT or ZIFT is a realistic fertility treatment choice for you. Some doctors believe that it may be useful in certain situations. However, for the most part, many doctors say that GIFT and ZIFT are about ready to be reassigned to the history books.

Husband Wife Relationship

To some extent the nature of the relationship between a husband and wife depended on the way in which the marriage was executed. If it was the outgrowth of a premarital affair, there was less conflict and discomfort than if it was an arranged marriage between youths. However, there existed a built-in assurance that marriages would be conflict-ridden. When the young married couple discovered a pregnancy, both husband and wife were displeased by the prospect of sexual abstinence and the variety of taboos associated with impending childbirth. The husband blamed his wife for getting pregnant too soon and wondered why his antipregnancy magic was not effective. She resented his anger and worried that he would seek out a second wife during their enforced abstinence. They both rebelled against the restrictions on their freedom. The husband feared that a boy would be born, a son who would compete with him and cause conflicts, while the wife feared that she would bear a daughter for her husband...

Current Levels Of Us Trade

Ownership of traded germplasm is diverse, ranging from individual breeders, artificial insemination companies, national and multinational breeding companies, and governments. As a result, germplasm is being exchanged for a wide variety of purposes (e.g., research and altered productivity). Regardless of the trader the same phytosan-itary and multilateral and bilateral trade agreements control the movement and exchange of germplasm.

Selecting Your Egg Donor

Other women prefer to use anonymous donors. Some fertility clinics have egg donation programs, where women donate their eggs in exchange for money. Also, many fertility clinics encourage patients undergoing IVF to donate their leftover eggs to be used by another woman. By donating their leftover eggs, these patients generally receive a price break for their own IVF services. In either case, the fertility clinic will have information about the woman so that you will be able to read about her physical and intellectual characteristics. Another option is for you to place an ad in the newspaper and find a donor on your own. Your doctor and fertility clinic will provide you with guidelines for selecting the best egg donor for you. In addition, here are some things for you to consider to understand the ramifications of egg donation. A maximum age of 34 is recommended because younger women typically respond better to ovulation induction by producing more high-quality embryos and consequently...

Is there a legal contract between the egg donor and the recipient Be

Sure you have a legally binding contract with the egg donor. Even if the fertility clinic provides you with a form, it's best to have a reproductive law attorney review it. The important point is that the agreement states that the donor gives up all rights to the eggs and any children conceived from them. Is psychological counseling offered or required Most health care professionals recommend professional counseling for the donor, the recipient, and their partners. Egg donation and the IVF process can be physically and emotionally difficult for both parties. There are also ethical and social issues to explore. It's best to understand all of these demands prior to embarking on this difficult process. What are your pregnancy success rates with the egg donation process Ask about the pregnancy success rates at your particular fertility clinic. According to ASRM, the average live birth rate per transfer is about 43 percent for all egg donor programs.

Procreative and Reproductive Rights and Responsibilities

Some of the most cogent discussion of reproductive rights has come from a position that argues for empowerment of women generally. For instance, Hartmann (1995) succinctly presents this argument for government policy to address women's reproductive health needs rather than attempting to impose population control measures, which she stated often have denied women's rights in the area of fertility and family planning. 3. Men's Responsibility in Family Planning. This takes on the issue of more actively involving men in family planning, such as a consistent use of condoms, undergoing vasectomy (which is less risky than tubal ligation), and being receptive to research development that may lead to a male contraceptive pill (Ren etal., 2001).

Iiifigo staging systems

Based upon FIGO guidelines, the following examinations are appropriate to establish the stage of disease palpation and inspection of the primary tumor, palpation of groin and supraclavicular lymph nodes, colposcopy, endocervical curettage, conization, hysteroscopy, cystoscopy, proctoscopy, intravenous pyelogram (IVP), and radiographic examination of the lungs and skeleton.

How The Egg Donation Procedure Works

Your fertility doctor will explain the exact medications, their timing, and the necessary protocol requirements. The goal is to hormonally prepare the donor for egg production and retrieval and to prepare your uterus to receive the embryos that will be transferred. Ultrasound and blood tests may be performed to ensure that both the donor and recipient are properly prepared and ready to proceed. Once the eggs are developed, the donor will undergo an egg retrieval procedure. The standard IVF technique with ultrasound and needle is used to extract the eggs through the donor's vagina. Once the eggs have been harvested, they are taken to the laboratory, where they are evaluated for maturity and quality. The healthiest eggs are then inseminated with the male partner's sperm using the same fertilization technique as in IVF. (For a detailed description of the IVF process, see Chapter 7.) The embryos are transferred into the recipient's uterus within a few days after...

How The Embryo Donation Procedure Works

As the recipient, you must take fertility medicines to adjust your hormones and prepare your uterine lining for the upcoming embryo transfer. Your fertility specialist will discuss which fertility medications and protocols are necessary for your particular situation. Additionally, you will likely undergo various blood tests and pelvic ultrasound to make sure that your hormone levels and uterine lining are prepared and ready to receive the new embryos. transfer is the same as for IVF, where a special catheter and syringe is passed through the cervix and embryos inserted into the uterus. Hormones are given to help the embryos implant, grow, and develop. Pregnancy tests and ultrasound are performed within a couple of weeks to confirm pregnancy.

Neutralization Of Biological Reactions By Antibodies

The immunological manipulation of endocrine and allied reproductive regulatory systems provides us with an example of how both our basic knowledge and its applied dimensions have progressed through the interdisciplinary catalysis of immunology and reproductive biology. Over the first 70 years of the twentieth century, the complex feedback interactions between gonadotropins and steroids were described, resulting, for example, in new approaches to infertility (gonadotropin releasing hormone, GnRH), fertility control (the contraceptive pill) and the management of domesticated farm stock (progesterone sponges, prostaglandins). By the early 1970s, pure preparations of most of the generic hormones were available and their mechanisms of action had been tested through immunological neutralization. The discovery by Canfield and Pierce in 1971 of the sub-unit structures of the gonadotropins explained why previous attempts to immunize against the entire hormones - luteinizing hormone (LH),...

Bioethical Issues in the Concepts of Public and Private

Continued differentiation or bifurcation between the two spheres. Bioethics is deeply implicated in each of these broad, general theoretical tendencies that often touch on the private and the public, as in a case, for example, where a couple decides to conceive a child through artificial insemination by donor (AID). What happens to a society's view of the family and intergenerational ties if more couples resort to artificial insemination What is the effect on the psychosocial development of donor children What are the responsibilities, if any, of the donor father beyond the point of sperm donation for a fee Do contractual agreements suffice to cover not just the legal but also the ethical implications of such agreements Does society have a legitimate interest in such private choices, given the potential social consequences of private arrangements Should such procedures be covered by health insurance, whether public or private and hence share in a project of theoretical and moral...

Overview of Specific Factors of Aging Influencing Nutritional Requirements

The discussion of nutrient requirements and recommended dietary intakes of nutrients in older persons has proceeded on both the theoretical and empirical level. Since the peak years for human reproduction occur before advanced middle age, and well before older age begins, the forces of selective reproduction cannot exert themselves for Darwinian selection of traits favoring longevity in the evolution for any traits related to longevity per se or physiological sustained function. Hence, there is little evolutionary selection for nutrient requirements to achieve advanced age or for long-term survival. It is more for the preservation of comfort and function for those surviving to advanced age that optimization of nutritional intakes for the elderly would apply, that is for humanitarian and public health importance in the face of the physiological and anatomic changes of senescence.

Derivation Of Hes Cell Lines Harboring Specific Genetic Defects

Two methods of obtaining such lines are (1) genetic manipulation of existing hES cell lines and (2) derivation of hES cell lines from genetically compromised embryos. Since the chance that donated surplus embryos from the in vitro fertilization (IVF) program carry genetic diseases is relatively low, the preferable source of donated embryos would be non-retrieved embryos from the preimplantation genetic diagnosis (PGD) program. PGD is designed for couples who are carriers of genetic diseases to ensure the transfer of healthy embryos to the uterus by their examination prior to implantation. For this purpose, the embryos are grown in vitro to the 6-8 cell stage, at which point one or two cells are removed and analyzed either by polymerase chain reaction (PCR) or by fluorescence in situ hybridization (FISH).

General Considerations

Individuals who have multiple sexual partners, or whose partners have other partners, should be advised to consider one or more barrier methods, with the dual purposes of protection against sexually transmitted infections (STIs) and prevention of pregnancy. For couples who desire an optimal degree of pregnancy prevention, a combined approach of a barrier method plus a highly effective contraceptive will compensate for the relatively high pregnancy rate associated with barrier methods. Additionally, women in this category should not wear an IUD, as the risk of pelvic inflammatory disease (PID) and tubal infertility in IUD wearers is increased significantly in women with multiple sexual partners. For couples who are involved in a mutually monogamous relationship, no method of reversible contraception, including the IUD, increases the risk of PID or tubal infertility. 3. Sexual behaviors. A pattern of multiple sexual partners increases the risk of STIs. In...

Conclusions and Outlook

The final consideration belongs to ethical questions concerning the generation of hESC, which includes issues ranging from the donation of oocytes, in-vitro fertilization, and the need for the continuous sacrifice of human embryos to medical therapies at very early stages and with new scientific challenges of risk assessment 89-94 . This controversy in the therapeutic field 95 is fuelled by immense hopes, promises and commercial interest, and related efforts have suffered a number of recent high-profile set-backs. Yet, all of these topics are essentially absent in the case of hESC-based in-vitro screening systems for the replacement of animal tests.

Social And Ethical Issues

The status of contraception, sterilization and abortion services in the United States has always been linked to the various social and political movements that have been engaged with issues of women's role in society, reproduction and sexuality. Different groups have advocated for and against family planning for different reasons and with different levels of success. While issues pertaining to reproductive control have always caused some degree of social conflict, this has been especially true since the 1970s when the abortion debate intensified and spilled over to other reproductive health services. The emergence of HIV and rising rates of other sexually-transmitted diseases have also contributed to the controversy surrounding fertility control in the United States and abroad as the new millennium dawns. This entry begins with a discussion of fertility control in a historical context. One must be aware of this history in order to understand the current ethical debate and...

Social and Political Issues

Providers of Family Planning Services. Family planning services in the United States are offered by both private and public agencies. Public providers of family planning services at the local level include public health clinics in hospitals or neighborhood health centers, school-based clinics, Medi-caid managed-care organizations and hospital-based clinics. At the county, state, regional and national levels, various arms of government are involved with the setting of policy for these publicly supported clinics and in devising formulas to disburse funding. The major conduit for public funding of family planning services is Title X of the Public Health Act of 1970. Title X has never allowed funding for abortion services, however. In the private sector, abortion and family planning services are offered both by for-profit and not-for-profit clinics, managed care organizations and by private physicians. The not-for-profit Planned Parenthood Federation...

Current and Future Controversies

The future of accessible family planning services in the United States and abroad is unclear. During the administration of Bill Clinton, the influence of political conservatives in public policy debates about family planning was greatly diminished. Clinton's appointments to key health policy positions of individuals strongly committed to family planning, especially in the area of adolescent pregnancy prevention, sharply reversed the trends of the Reagan-Bush era. The abortion issue remains among the most politically explosive and unresolved issues in bioethics. Provision of abortion services has endangered funding for other family planning services and endangered the lives of providers and consumers alike. Concerns of political conservatives and anti-abortion groups have affected policy debates as diverse as end of life decision-making in New York State and Federal regulation of embryonic stem cell research. In August of 2002, George Bush revealed his decision on stem cell research....

Regulation of Contraceptive Technologies

This is the case especially since the litigation experience of the A. H. Robins Company, developer and marketer of the Dalkon Shield, an intrauterine contraceptive device. In a series of court cases in the early 1980s, this device was proved to cause pelvic inflammatory disease, infertility, birth defects, perforated uterus, and spontaneous abortion. In a series of jury verdicts throughout the United States, A. H. Robins was forced to pay compensatory damages and punitive damages because plaintiffs proved that the company had understood the dangers of the device, withheld this knowledge from prospective users, and misrepresented the nature and safety of the device (Mintz). Despite this experience, cases brought by women seeking recovery for harm from contraceptive devices have usually found the manufacturer liable only under theories of negligence for example, negligent failure to comply with the duty of care, negligent failure to warn of risks, or fraudulent misrepresentation...

Preimplantation Embryo Research

Preimplantation embryo research generally requires the associated procedure of IVF (although it would in principle be possible to retrieve an early embryo by flushing it from the uterus of a woman following in vivo fertilization of an ovum). Thus the question of research on preimplantation embryos did not arise until IVF techniques had been developed and validated, first in laboratory animals, then in humans. In 1959 M. C. Chang of the Worcester Foundation in Massachusetts was the first scientist to demonstrate unambiguously the fertilization of nonhuman mammalian oocytes in vitro. Chang's success was followed in 1969 by the first confirmed report of IVF with human gametes by three British researchers (Edwards et al.). Only nine years later the first human birth after IVF the infant's name was Louise Brown was reported by members of the same British research team (Steptoe and Edwards). Given that IVF is required for preimplantation embryo research, the risks to the woman of ovarian...

Research on Aborted Live Embryos and Fetuses

Three circumstances can be envisioned in which the question of research on formerly implanted, living embryos or fetuses could arise. First, the surgical removal of an ectopic pregnancy could provide a still-living embryo or fetus. Second, a spontaneous miscarriage could result in the delivery of a live embryo or fetus. Third, an already implanted embryo or fetus could be aborted by means that make it either possible or likely that an intact, living embryo or fetus will result from the abortion procedure.

Gender Roles in Economics

A village's major resident titles determined its status. A taupou drew high titles into her communities' compass by wedding a high title. After becoming pregnant, she returned to her natal village. High-title holders were selected on the strength of paternal and maternal lines. Taupou were chosen for their ancestry. Upon that chief's death, therefore, the taupou's son had a weighty claim and might bring the title back to his village. Like taupou, all high-status girls were to remain virginal their elders furthered family entitlements through arranged marriages with title-holding males or their sons. Undistinguished families encouraged their girls to lure scions of ranking families in informal marriages (avaga) because the children who descended from these unions had rights in the father's family estate. A girl who became pregnant from an elopement qualified for a piece of land from the boy's family that she shared with her group. If she bore a son who was serviceable, bright, and...

Duties to Future Persons

Heyd's argument has central implications for the law and ethics of reproductive behavior. Heyd seems to assume that the right to deny existence includes the freedom to create people without accountability. This would excuse parents and fertility clinics from any obligation to consider the welfare of the children whom they are trying to create.

Other Cross Sex Relationships

Bond, but also to a bond that may be established between their descendants. (It is also applied to the bond between talking chiefs and high chiefs.) Parties to a feagaiga are regarded as two complementary sides of a larger whole. Samoans not only abhor actual incest between categorical brothers and sisters, but any hint of sexuality when both are present. Crossing this line impugns the name of a family and is likely to ignite conflict. In old Samoa, incest between a brother and sister was believed to result in miscarriage. Miscarriages were called blood clots many spirits were believed to be born as blood clots.

Avoiding Injury by Substituting a Different Child

Giving content to our obligations to future persons in this manner was first discussed at length by Derek Parfit in his 1984 book, Reasons and Persons. Since then, others have applied the idea to reproductive technology (Brock Peters, 1989). Parfit offered the example of a woman who is advised by her doctor not to become pregnant until she recovers from a temporary illness that causes moderate birth defects. Under the but-for test, she does no harm by refusing to wait, because waiting would change the identity of the resulting children. Parfit called this counterintuitive result the non-identity problem. To cure this gap in our understanding of harmful conduct, Parfit proposed a principle that he called Q that obliged parents and providers to have the child who will suffer least. This principle has surprisingly broad application to reproductive decision making. Parents deciding which embryo to transplant as part of an IVF procedure are making a choice that would be governed by this...

Dealing With Family And Friends

Starting a family is supposed to be a personal and enjoyable experience. However, for couples with infertility issues or unconventional situations, such as lesbian couples or single women, it can be a very difficult situation. You come face-to-face with family and friends who may not be sensitive to your situation. They may or may not have good intentions, but they seem to believe that you will benefit from their Because most people view their infertility as a personal issue, they are often hesitant to share their experiences openly with family and friends. To a couple that has been diagnosed with infertility, unknowing friends and family may ask

Assisted Reproductive Technology

The assisted reproductive technologies include such procedures as intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI), to name a few. When you reach a decision to undergo one of these ART procedures, you may feel the conflicting emotions of both excitement and dread. It's normal to be excited, because this scientific approach offers tremendous breakthroughs and success in the world of fertility. With such high pregnancy rates and

Embryo And Polar Body Biopsy

Currently, most centers performing PGD use cells obtained from the six- to eight-cell cleavage stage (day 3 of embryonic development). 1 Embryo biopsy is a two-step procedure in which a hole is first drilled in the zona pellucida surrounding the embryo at this stage, and next, one or two cells are aspirated through it (Fig. 1). The hole made in the zona pellucida is usually 30-50 mm, and it is believed that a larger hole may be detrimental to embryo development and viability. 2 Until recently, most centers used acidified Tyrode's solution for zona drilling, but a noncontact laser method has become very popular and is also widely used for assisted hatching (references in Ref. 1 ). No controlled randomized studies have yet been conducted to compare the effects of acid Tyrode's solution or the laser on embryo viability. However, comparative data from the ESHRE PGD Consortium and others have shown no difference in pregnancy rates between these two methods. 1,3 Another controversy is...

Problems with Single Cell PCR

Single-cell PCR is technically demanding, with high risks of contamination and ADO. Contamination can occur from the operator's DNA or carryover of previous PCR products. This type of contamination can be avoided by working in sterile manners, using different pre- and post-PCR rooms and materials dedicated only for the setup of single-cell PCR. Another source of contamination is genomic DNA from the patients, e.g., maternal cumulus cells or sperms sticking to the zona pellucida accidentally sampled during biopsy procedures. To avoid the risk of paternal contamination, ICSI should be used to achieve fertilization in all cases of PCR-based PGD. Al-lele dropout is a phenomenon observed when one of the examined alleles fails to amplify during the PCR reaction. This can result in diagnostic errors, especially for autosomal dominant disorders, as ADO of the mutated allele would wrongly diagnose an affected embryo as healthy.

Preimplantation Genetic Diagnosis Applications

Finally, the most practical application of PGD is currently the preselection of aneuploidy-free embryos for IVF patients of advanced reproductive age and also detection of normal or balanced embryos in carriers of chromosomal translocations.1-3,17-1 The usefulness of PGD in assisted reproduction is obvious from the data on the prevalence of chromosomal abnormalities in the oocytes of women of 35 years and older, which is over 50 even by testing for only 5 chromosomes (chromosomes 13, 16, 18, 21, and 22). 16 This is comparable to those detected in preimplantation embryos in PGD for aneuploidies at the cleavage stage, taking into consideration additional fertilization-related abnormalities and paternally derived meiotic errors, which was shown to be as high as 60 . As mentioned, the origin of high frequency of mosaicism, comprising approximately half of the chromosomal abnormalities at the cleavage stage, is still unclear. A significant proportion of mosaic embryos may originate from...

Preimplantation Genetic Diagnosis PGD

Preimplantation genetic diagnosis (PGD), a technique used for the early diagnosis of genetic disorders in developing embryos, involves conducting a biopsy of the embryo to identify which cells may contain the disorder. Couples undergoing IVF procedure may have their embryos screened for an assortment of genetic disorders, and only genetically normal embryos will then be used for embryo transfer back into the woman's uterus. The purpose of PGD is to select only healthy embryos for transfer to the uterus with the goal of achieving more healthy pregnancies, fewer miscarriages, and fewer genetically abnormal offspring.

Prevention of NTD Occurrence

For the prevention of occurrence of NTDs, the US Public Health Service recommends that all women capable of becoming pregnant consume 0.4 mg of folic acid per day and that total folate consumption should not be more than 1.0 mg per day to avoid the possible risks of high intakes. The UK Expert Advisory Group recommends that women should take an extra 0.4 mg of folic acid daily from when they begin trying to conceive until week 12 of pregnancy. If a woman who has not been taking this additional amount of folic acid suspects that she may have just started a pregnancy, she should begin taking extra folic acid immediately and continue until week 12 of pregnancy. The US Public Health Service and the UK Expert Advisory Group have outlined three possible ways of achieving an extra intake of folate folic acid eating more folate-rich foods, eating foods fortified with folic acid, and taking folic acid as a medicinal or food supplement. It is recommended that women should use whatever source or...

Preimplantation Genetic Diagnosis

Amniocentesis, CVS, and maternal serum screening are performed after a pregnancy is confirmed or in progress. In contrast, preimplantation genetic diagnosis (PGD) occurs before the embryo implants in the womb. This technique is performed on an embryo that has been derived from in vitro fertilization (IVF) and is growing in a laboratory dish. At about the 8-cell (day 3) stage, a cell is removed and the DNA and chromosomes are checked using FISH or a probe for a specific gene. If the cell is free of the defects being probed, the remaining 7-celled embryo is implanted into the woman, where it continues development. PGD has been used to eliminate embryos with a variety of single-gene disorders, including metabolic disorders, dwarfism, cystic fibrosis, hemophilia, muscular dystrophies, and several other genetically inheritable diseases. The technique is being increasingly used in couples for whom IVF has repeatedly failed because they manufacture eggs or sperm that have abnormal numbers of...

Knowing and Meaning to Know

One can argue at this juncture that it has always been the case that all science involves this sort of venture of self generation, and many have noted that genetic knowledge is a matter of more facts amassed, as opposed to a greater interpretive power (Jonson). In this argument, genetic knowledge is not unlike the new understanding of gametes that took place in the middle of the 1800s, a form of understanding of human reproduction that implicated theology as well as science. The shift from Aristotelian notions of the beginning of life to theories first developed when lenses could be ground and microscopes constructed allowed a democracy of meanings to be attached to reproduction. Large shifts in understanding occurred throughout the seventeenth, eighteenth, and nineteenth centuries. Darwinian explanations marked ontological revolutions as well as epistemic ones, disrupting and destabilizing fixed philosophical, social, and theological ways of understanding nature and moral location.

Issues of Relationships and Kinship

Linked to the issue of identity are the issues of family, kinship, and citizenship. Increasingly, genetic identity is used as a way of describing these sorts of relationships. Families in earlier historical periods defined the boundaries of love and relationship. With each new genetic advance from in vitro fertilization to cloning, the question is raised about whether bonds of love and family would be severed, and in some extreme accounts, the question of whether both genders would be needed at all, as genetic materials that

Scientific Racism and Eugenics Cautionary Tales

During that period of state-sponsored racism, other nations, such as Great Britain, Norway, and France, were adopting their own brands of eugenics policies. Eugenics gave scientific authority to social fears and lent respectability to racial doctrines. Powered by the prestige of science, it was coupled with modernizing national projects that promoted claims of social order as objective statements grounded in the laws of nature (Dikotter). Unfortunately, history provides several examples of how the marriage of scientific racism and national political agendas has led to the unfair treatment of socially and politically vulnerable racial minorities. In South America, for example, eugenic policies have been the key to a national revival in which indigenous concerns over racially diverse and socially disparate societies have led to race-based initiatives to regulate human reproduction. Brazil and Argentina have experienced the use of science in the name of forging superior and cosmic...

Samburu Woman Giving Birth

The Samburu are sexually permissive toward young people. It is expected that girls and Imurran will be sexually active, and a mother will sometimes formally sanction a relationship between her daughter and an Imurran, who will give the girl a large gift of beads (Spencer, 1965 Straight, 2002). Lmurran and their beaded girlfriends are from the same exogomous clan, and thus cannot later marry. Lmurran and girls avoid pregnancy through the withdrawal method, as it is considered an abomination for an uninitiated girl to give birth. However, should a girl become pregnant, the women in her family will usually assist her in aborting, or else initiate her quickly. These days it is a common precaution to initiate girls early if they are attending boarding school.

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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