Fertility Miracle

Pregnancy Miracle Book

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. This is the exact 5-step process Lisa used to get pregnant twice at age 43 and 45 after battling infertility for more than a decade and being told by her doctors she would never have kids of her own. What I love about the Pregnancy Miracle is that it is a very rare, highly unique and potently powerful system for getting pregnant with very high success rate. I have read many similar books on this topic but most of them are incomplete. Either they dont tell how to correctly practice these techniques, or they do not tell what things to avoid. In this regard I found The Pregnancy Miracle to be quite complete. Continue reading...

Pregnancy Miracle Summary


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Author: Lisa Olson
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Highly Recommended

The very first point I want to make certain that Pregnancy Miracle definitely offers the greatest results.

As a whole, this book contains everything you need to know about this subject. I would recommend it as a guide for beginners as well as experts and everyone in between.

Pelvic factor infertility

Pelvic factor infertility is caused by conditions that affect the fallopian tubes, peritoneum, or uterus. Tubal factor infertility is a common sequela of salpingitis. Appendicitis, ectopic pregnancy, endometriosis, and previous pelvic or abdominal surgery can also damage the fallopian tubes and cause adhesion formation. 2. Endometriosis is another condition involving the peritoneal cavity that is commonly associated with infertility. Uterine abnormalities are responsible for infertility in about 2 of cases. Examples of uterine abnormalities associated with infertility are congenital deformities of the uterus, leiomyomas, and intrauterine scarification or adhesions (Asherman's syndrome). 3. The mainstay of treatment of pelvic factor infertility relies on laparoscopy and hysteroscopy. In many instances, tubal reconstructive surgery, lysis of adhesions, and ablation and resection of endometriosis can be accomplished laparoscopically.

Interstitial Deletions and Male Infertility

Interstitial deletions in male-specific regions on chromosome Yq are a major source of infertility (AZF) (32,33) (Table 1). Of the commonly affected regions (AZFa, AZFb and AZFc), AZFb and AZFc are located within an approx 8-Mb interval and are mostly comprised of five large IR (P1-P5), each consisting of a complex array of direct and inverted blocks harboring male-specific genes. Large ( 90 kb) regions of near-perfect identity exist among these IRs nevertheless, the breakpoints strongly cluster toward the IR spacers (i.e., the regions that separate the two inverted repeat sequences) where, in some cases, they took place between sequences that shared no homology. These features are consistent with a cruciform-mediated mechanism for the deletions (21,33).

Cervical factor infertility

Cervical factor infertility is suggested when well-timed PCTs are consistently abnormal in the presence of a normal semen analysis. Cervical factor infertility results from inadequate mucus production by the cervical epithelium, poor mucus quality, or the presence of antisperm antibodies. 2. Patients with an abnormal PCT should be screened for an infectious etiology. The presence of immotile sperm or sperm shaking in place and not demonstrating forward motion is suggestive of immunologically related infertility. Sperm-cervical mucus and antisperm antibody testing are indicated when PCTs are repeatedly abnormal, despite normal-appearing cervical mucus and normal semen analysis. sperm maturation, and sperm delivery. Intrauterine insemination is

Frequency Of Infertility

It is estimated that about 15 of couples have difficulty in conceiving or are outright infertile. There are numerous contributing factors, some of which can be helped by resorting to Assisted Reproductive Technology or ART, which comprises artificial insemination, in vitro maturation (IVM) of oocytes, in vitro fertilization (IVF), embryo culture and embryo transfer. For presumptively infertile women aged up to about 37, the outcome of clinical IVF (in this general context meaning IVF together with embryo culture and transfer) is good, with an average of about 32 of treatment cycles in the United States resulting in a live birth (Wright et al., 2003). But for women approaching 40 or over, the efficiency of IVF drops sharply, to only about 5 after the age of 42 (Wright et al., 2003). Similarly, the incidence of natural conceptions falls progressively towards the age of 40, prior to overt menopause. The reasons for this precipitous drop in fertility are...

Ovarian factor infertility

Clomiphene citrate (Clomid, CC) is the most cost-effective treatment tor the treatment of infertility related to anovulation or oligo ovulation, . The usual starting dose of CC is 50 mg day for 5 days, beginning on the second to sixth day after induced or spontaneous bleeding. Ovulation is expected between 7 and 10 days after the last dose of CC. CC is 5 to 10 . Approximately 33 of patients will become pregnant within five cycles of treatment. Treatment with CC for more than six ovulatory cycles is not recommended because of low success rates.

Unexplained Infertility

The term unexplained infertility should be used only after a thorough infertility investigation has failed to reveal an identifiable source and the duration of infertility is 24 months or more. History, physical examination, documentation of ovulation, endometrial biopsy, semen analyses, PCT, hysterosalpingogram, and laparoscopy should have been completed. 2. Because couples with unexplained infertility lack an identifiable causative factor of their infertility, empirical treatment with clomiphene therapy increases the spontaneous pregnancy rate to 6.8 per cycle compared with 2.8 in placebo-control cycles. For optimal results, gonadotropins should be used for ovulation induction. Intrauterine insemination, in vitro fertilization and gamete intrafallopian transfer (GIFT) are additional options. References See page 146.


Infertility is defined as failure of a couple of reproductive age to conceive after 12 months or more of regular coitus without using contraception. Infertility is considered primary when it occurs in a woman who has never established a pregnancy and secondary when it occurs in a woman who has a history of one or more previous pregnancies. Fecundability is defined as the probability of achieving a pregnancy within one menstrual cycle. It is estimated that 10 to 20 of couples are infertile.

Male Infertility

According to three of four studies, oral vitamin E supplementation can effectively treat some forms of male infertility (Geva et al 1996, Kessopoulou et al 1995, Rolf et al 1999, Suleiman et al 1996). Doses used varied from 200 mg day to 800 mg day. As with many other conditions, treatment may be best suited to those individuals with elevated oxidative stress levels, although this requires further investigation.

Greco Roman Medicine

From the vantage point of Western civilization, Greco-Roman medicine has been the major source of our medical tradition. The health hazards associated with obesity were clearly noted in the medical writings of Hippocrates, where he states, ''Sudden death is more common in those who are naturally fat than in the lean'' (58). These traditions also note that obesity was a cause of infertility in women and that the frequency of menses was reduced in the obese.

What The Guidelines Cover

Blastocysts made for reproductive purposes and later obtained for research from IVF clinics. 2. Blastocysts made specifically for research using IVF. To provide local oversight of all issues related to derivation and research use of hES cell lines and to facilitate education of investigators involved in hES cell research, all institutions conducting hES cell research should establish an Embryonic Stem Cell Research Oversight (ESCRO) committee. The committee should include representatives of the public and persons with expertise in developmental biology, stem cell research, molecular biology, assisted reproduction, and ethical and legal issues in hES cell research. The committee will not substitute for an Institutional Review Board but rather will provide an additional level of review and scrutiny warranted by the complex issues raised by hES cell research. The committee will also review basic hES cell research using preexisting anonymous cell lines that does not require consideration...

The Meaning of Motherhood

Inhorn's insights (1994, 1996) about childless women in urban Egypt is an example of research that is not part of mainstream demography but can inform demographic research. In this society, particularly among poor migrants who have moved from rural to urban centers, women's status and power are so powerfully tied to the bearing and raising of children that to be childless is a disaster. When these women moved to the city, they lost other sources of power, income, and even identity, and those losses made children even more important. Inhorn lived and talked with women who were searching for cures to their infertility and came to understand the cultural necessity of bearing children for women in this part of the world. She notes that ''indeed, it is from the study of infertility that issues of pronatalism, or child desire, are perhaps best understood. Namely, those who are missing children and who therefore have had much cause to reflect on their object of desire are often in the best...

Nuclear Transfer To Generate Stem Cells

Most work on hES cells has taken place with a relatively small number of cell lines obtained from excess blastocysts donated from in vitro fertilization (IVF) programs. The genetic makeup of the cells is not controlled in any way, and genetic variation among lines needs to be considered when results from different lines are compared. Experience from research with mES cells shows that ES cell lines can differ markedly in their differentiation efficiencies. Being able to control the genotype of ES cells would be valuable for various reasons, most notably the desire to generate ES cells with genotypes known to predispose to particular diseases. In the case of single-gene defects, one could achieve that goal by deriving hES cells from discarded morulae or blastocysts that were identified with preimplantation genetic diagnosis (PGD) procedures (Verlinsky et al, 2005) as carrying mutations or by generating the appropriate mutation by gene targeting of established hES cell lines. However,...

Clinical Presentation

Most fallopian tubes submitted as surgical pathology specimens are a component of larger specimens and symptomatology specifically related to pathology in the fallopian tube is relatively rare. However, ectopic pregnancies occur in the fallopian tube and usually present with abdominal pain. If there is associated haemoperitoneum the pain is severe and associated with signs of peritonism. Other fallopian tube pathologies may result in abdominal pain or patients can present with infertility. With neoplasms or other pathological lesions causing enlargement of the fallopian tube there may be a palpable abdominal mass with or without associated ascites. Fallopian tube pathology is occasionally discovered incidentally during abdominal or pelvic imaging.

Lymphovascular Supply

Clinical features related to uterine pathology are most commonly those of abnormal uterine bleeding. In premenopausal patients this may take the form of menorrhagia (heavy periods), dysmenorrhoea (painful periods) or a variety of other forms of abnormal uterine bleeding. In postmenopausal patients, the most common symptomatology is postmenopausal bleeding. This should always be taken seriously and uterine malignancy excluded. Other symptomatologies related to uterine pathology include a palpable abdominal or pelvic mass, pain within the pelvis or abdomen (often deep seated), a feeling of fullness within the abdomen and uterine prolapse. Uterine pathology may also be associated with symptoms such as constipation, urinary frequency or infertility.

DNA mismatch repair genes

MMR gene mouse models have been created but inactivation generally results in the development of lymphomas rather than gastrointestinal tumors (reviewed in Wei et al., 2002). Interestingly, the PMS1 mouse model does not display any tumor burden and a number of the other MMR knockouts have meiotic phenotypes resulting in reduced fertility or infertility, highlighting the role of these genes in gametogenesis. These models are helping our understanding of the other functions of MMR genes, which include methylation tolerance and hyper-recombination between divergent sequences (de Wind et al., 1995), a role in the cell-cycle checkpoint mechanisms (Koi et al., 1994) and

Universal Leukoreduction

TRIM was cited as clinically important in patients undergoing renal transplantation and in women who have had multiple miscarriages (29). A multicenter, controlled study found no evidence of such an effect, however, and the authors recommended against allogeneic mononuclear infusions as a treatment for unexplained, recurrent miscarriage

Nonneoplastic Conditions

Varicocele abnormal dilation and tortuosity of veins in the pampiniform plexus of the spermatic cord probably due to insufficiency of venous valves. It is often associated with infertility. Ninety per cent are on the left and 10 bilateral. Treatment consists of ligation or occlusion of the left spermatic vein and after treatment 40-55 are fertile.

Conventional Techniques for Skeletal Determinations

Greulich And Pyle Atlas

In the evaluation of physical development in children, variations in maturation rate are poorly described by chronological age. Thus, for many decades, scientists have sought better techniques to assess the degree of development from birth to full maturity. Measures of height, weight, and body mass, although closely related to biological maturation, are not sufficiently accurate due to the wide variations in body size. Similarly, the large varia

Survivorship Issues And Hrql

To understand the magnitude of HRQL issues among cancer survivors, we have classified these concepts into discrete domains, however it is understood that they represent a highly interrelated and dynamic system. Adhering to this model of self-reported health, the late effects of cancer can have wide spread ramifications. For example, many of the late physical effects (e.g., pain, fatigue, urinary incontinence, infertility) can also have significant emotional and social consequences. Since those with increasing age also represent a large segment of cancer survivors, it is sometimes difficult to determine whether physical changes are predominantly age or cancer related (e.g., fatigue, decreased libido, weakness). Apart from the observed physical changes, the psychosocial and existential issues acknowledged by survivors

Reproductive biology

Females have a single estrus that occurs less than 10 days postpartum (except in the California sea lion where it is 30 days). Most females mate only once per estrus, rarely twice. If they fail to mate, estrus may last less than two days (36 hours in the northern fur seal). If they mate, estrus may be terminated by coitus (the Whitten effect). Females of most species mate indiscriminately with whichever male is nearest when they enter estrus. Females usually do not mate with juvenile or peripheral males because adult males exclude them from the breeding sites. However, in colonization situations, when males intercept females on their way to feeding (South American and Hooker's sea lions), or in captivity, females of some species readily mate with juvenile or peripheral males. Pregnancy rates may exceed 90 in some age classes of females.

Follicle Stimulating Hormone Luteinizing Hormone

There are a limited number of human studies regarding how V. agnus-castus directly effects luteinizing hormone (LH) or follicle-stimulating hormone (FSH) (26,27). In a 1994 case report by Cahill et al., a 32-year-old woman undergoing unstimulated in vitro fertilization (IVF) treatment took V. agnus-castus for one cycle without consulting her physician. During this cycle, she had symptoms of mild ovarian hyperstimulation in the luteal phase. Her FSH and LH levels prior to day 13, the predicted day of LH surge in the IVF cycle, were reviewed and found to be much higher than normal. Reviewing five other cycles of this patient and finding normal pituitary gonadotrophin file and normal follicular ovarian responses, the authors suggest that V. agnus-castus was the causative agent (27).

Consequences of Repeat Expansion

It has also been appreciated recently that expansion can have different consequences depending on the number of repeats. For example, as discussed by Tassone and Hagerman in this volume, carriers of FMR1 alleles with 59200 repeats are at risk for fragile X associated tremor and ataxia syndrome (FXTAS) and fragile X associated premature ovarian failure (FXPOF). However, carriers of alleles with more than 200 repeats have a completely different disorder, fragile X mental retardation syndrome (FXS). FXTAS and FXPOF are thought to represent gain-of-function disorders resulting from the effects of the expanded repeats in the transcript, while FXS results from loss-of-

Patterns Of Occurrence

Germ Cell Testicular Cancer

In recent decades, remarkable advances in treatment have led to dramatically improved survival of testicular cancer patients in the industrialized world. In the United States, the improvement has been greatest among white persons, and survival is associated with socioeconomic status in many areas.314'20,21 However, it is now evident that survivors are at an elevated risk of several undesirable sequelae, including infertility,22 23 sexual dysfunction,24 other types of cancer,25 26 and second occurrences of testicular cancer.26-35 (See also Chapters 27 and 28.)

Maternal effects on HPG function and mating behavior

Solicitation behaviors in the female rat are highly dependent on context. In smaller confines, the most common pattern of paracopulatory (or pro-ceptive) behavior is that of hopping, darting, and ear wiggling. However, when a receptive female is tested in a larger area that affords the opportunity to retreat from the male, the approach-withdrawal pattern prevails and reveals the females ability to pace the mating with the male (Erskine, 1989). Female rats pace the rate of male intromissions and thus ejaculation by withdrawal from the male following each intromission. The latency to return to the male is longer after ejaculation than after an intromission, which in turn is longer than after a mount with an intromission (Erskine et al., 2004 Yang and Clemens, 1996). As testing proceeds over the courses of multiple ejaculatory sequences, the interintromission interval increases (Coopersmith et al., 1996). Testing in the pacing chamber revealed considerable differences in sexual behavior...

Superovulation Of Rhesus Monkeys And Flushing Embryos From The Reproductive Tract

The term superovulation is used liberally in human clinical IVF, but in that context it implies ovarian stimulation with gonadotropins to recruit large numbers of follicles, which are then aspirated prior to ovulation to recover oocytes. In animal studies, superovulation usually means allowing or inducing gonadotropin-stimulated follicles to ovulate into the oviduct, followed by collection from the reproductive tract of oocytes for IVF or of embryos for further study in vitro. The U.S. cattle breeding industry has been transformed by the application of artificial insemination together with ''Multiple Ovulation and Embryo Transfer'' (MOET Gearhart et al., 1989), which results in the collection of perhaps 10-20 high-quality embryos for transfer to recipient females. Collection of flushed embryos from non-stimulated rhesus monkey females is feasible, as shown by years of effort at the Wisconsin National Primate Research Center (Wolfgang et al., 2001). While these embryos are enormously...

Payment for Medicaid Services

States may impose nominal deductibles, coinsurance, or copayments on some Medicaid beneficiaries for certain services. The following Medicaid beneficiaries, however, must be excluded from cost sharing pregnant women, children under age 18, and hospital or nursing home patients who are expected to contribute most of their income to institutional care. In addition, all Medicaid beneficiaries must be exempt from copayments for emergency services and family planning services.

Evidence for Ovarian Senescence in Rhesus Monkeys

Female Lifespan Ovarian Reserve

Of years as a means to stimulate ovaries of infertile women to produce large numbers of follicles and oocytes. However, such ovarian stimulation for ART becomes ineffective once the ovarian reserve is seriously depleted and oocyte quality is reduced (Hansen et al., 2003). Female rhesus macaques are excellent models for studying the loss of reproductive capacity with increasing age. They are reproductively active over about 20 years starting at about age 5, and undergo similar pathological and hormonal changes to human females nearing the end of their reproductive lifespan (Shideler et al., 2001). Although there have been several reports on ovarian changes in macaques, including oocyte numbers, most studies examined younger females and did not study older animals (ages 15-25) that would be expected to show ovarian senescence. In view of this, our laboratory conducted a study of the ovarian reserve in rhesus macaque females across a wide age range (ages 1-25), covering the entire...

Presentation of Germ Cell Tumors

The swelling within the testis may be noticed by the patient or his sexual partner. The presence of tes-ticular atrophy, which is a predisposing factor for GCT, may make the swelling more readily apparent. Atrophy of the testis can occur as a result of cryp-torchidism (especially when it has not been corrected until late childhood), infection (particularly mumps orchitis), or torsion or local trauma. Some men with testicular tumors and atrophic testes may present to an infertility clinic and be diagnosed on examination in that setting.2

Category X Drugs Absolute Contraindication In Pregnancy

Diethylstilbestrol is a synthetic estrogen that was used to prevent spontaneous abortion in women. Many women who were exposed to DES in utero have reproductive system disorders including cervical hood, T-shaped uterus, hypoplastic uterus, ovulatory disorders, infertility, premature labor, and cervical incompetence. These women are also subject to increased risk of adenocarcinoma of the vagina later in life.

Damon J Vidrine DrPh Ellen R Gritz PhD

The reason (or reasons) for this birth cohort effect is not known however, several variables that are associated with a significantly increased risk have been identified, including cryptorchidism,7 hormonal factors,8,9 high body mass index (BMI),10 and increased physical activity.11 While the exact mechanisms for these relationships are not clear, it is hypothesized that exposure to androgens may be the key to these findings exposure to androgens may decrease BMI and increase physical activity.10,11 Other findings suggest that maternal exposure to exogenous hormones is a significant risk factor for testicular cancer.12 Additional risk factors related to hormone levels include late onset of puberty12 and increased body height.11,12 Fertility problems are frequently reported as a side effect of testicular treatment, but these problems may actually be present prior to the cancer diagnosis. Evidence suggests that men with less than the expected number of children (based on their age) have...

Sex Chromosomes and Their Genes

Sperm Blood Vessels

Code a variety of proteins that function in both sexes, participating in or controlling such activities as bone growth, signal transduction, the synthesis of hormones and receptors, and energy metabolism. The members of the second functional group of Y chromosome genes are very similar in DNA sequence to certain genes on the X chromosome, but they are not identical. These genes are expressed in nearly all tissues, including those found only in males. The third group of genes includes those unique to the Y chromosome. Many of them control male fertility, such as the SRY gene. Some cases of male infertility can be traced to tiny deletions of these parts of the Y chromosome. Other genes in this group encode proteins that participate in cell cycle control proteins that regulate gene expression enzymes and protein receptors for immune system biochemicals.

Consideration of Zebrafish as Models for Aging

Development and disease because of its many advantages (Jagadeeswaran et al., 2005 Streisinger et al., 1981). One advantage is that zebrafish embryos are transparent, so a developing embryo and its morphology could be easily observed. Breeding zebrafish under laboratory conditions is extremely easy the embryos grow for 72 hours until they hatch. Other advantages include high fecundity (the female fish can lay up to 200 eggs), short generation times, ease of in vitro fertilization, and amenability for large-scale mutagenesis. In addition, features such as transparency of embryos and generation of diploids from haploid eggs make the model even more attractive for identifying recessive mutations. Described below are the principles of genetics in zebrafish and how mutants are isolated and mapped to identify the genes that are affected. Mutagenesis is performed by dipping zebrafish males in ethylnitrosourea (ENU) to cause multiple, random point mutations throughout the genome of the germ...

Combinations Of Genetic And Nutritional Factors

Phenyketonuria (PKU) deficiency is a rare defect of amino acid metabolism with a frequency of about 1 per 15,000 in White populations. Because it is a single gene defect and PKU deficiency is identified during newborn screening in all states in the United States, the sequella of MR can be prevented with adherence to a strict diet during infancy and early childhood. The realization that the sequella of PKU can be prevented by strict diet during childhood unfortunately overlooked the fact that the female survivors who then became pregnant needed to go onto the diet perinatally,

Seminiferous tubules Cycle of the Seminiferous Epithelium

In this way, the time required for the labeled cells to go through the various stages can be determined. Several generations of developing cells may be present in the thickness of the seminiferous epithelium at any given site and at any given time, which produces the characteristic cell associations. Autoradiographic studies have revealed that the duration of the cycle of the seminiferous epithelium is constant, lasting about 16 days in humans. In humans it would require about 4.6 cycles (each 16 days long), or approximately 74 days, for a spermatogonium produced by a stem cell to complete the process of spermatogenesis. It would then require approximately 12 days for the spermatozoon to pass through the epididymis. Approximately 300 million sperm cells are produced daily in the human testis. The length of the cycle and the time required for spermatogenesis are constant and specific in each species. Therefore, in any pharmacologic intervention (e.g.,...

Reproduction in marsupials

Ulation does not affect the cycle and the female can become pregnant again as her first young (litter size usually is one) move to the pouch. The second fertilized egg undergoes diapause (halt in development) until the first young either reaches adulthood or dies. In this case, the diapause is facultative or changes length depending on circumstances such as food availability or season. Then, the second egg immediately resumes development so that birth occurs as soon as the mother's pouch is available. So at any one time, the female can have three young one in the placenta, one in the pouch, and one joey out of the pouch and still suckling.

Testimony on the Anabolic Steroid Control Act of 2004

The perils of anabolic steroid use are well known. In Olympic sport, the most notable, systematic state-supported program of doping with anabolic steroids was conducted by the East Germans from 1974 until the Berlin Wall fell. One of the anabolic substances developed by the East Germans as part of their doping program was androstenedione. In the body, androstenedione metabolizes into the anabolic steroid, testosterone. The documented side effects of the East German steroid program, particularly for women athletes, were tragic. These side effects include damage to the liver and reproductive system, susceptibility to cancers, and permanent masculinization of women. It is also well known that men who abuse steroids and steroid precursors risk serious health consequences including gynecomastia, baldness, shrunken testicles, infertility and susceptibility to aggressive behavior or rage. For adolescents who use steroids the side effects can include all of the above, as well as a strong...

Carrier Testing Of Adolescents Pros And Cons

If one wants to introduce carrier testing or screening, the question is raised To whom and when should it to be offered There is potential for its application at different times in life, with concommitant advantages and disadvantages before birth (embryonic testing) at birth (neonatal testing), in school (adolescent testing), at adult pre-pregnancy, premarital or family planning clinics (preconceptional testing), at pregnancy clinics (prenatal testing of the parents)(Dierickx, 1997a). gan of minors on the basis of the combined decision right (Nys, 1995). In the Norwegian law on assisted reproduction and genetics, it is stated that genetic testing of a child under the age of 16 may only be carried out with the consent of the parents or guardians (Bulletin of Medical Ethics, 1994). The existing practice of consent, obligatory education in Belgium, and the legislation in some other countries appears to create the opportunity for the carrier testing of students between 16 and 18 after...

Frequency Of Chromosome Errors In Primates

It is well established that aneuploidy is common in human oocytes and IVF embryos, and that the frequency of these anomalies increases with age, especially after age 25 (Munne and Cohen, 1998 Munne et al., 2002). Several studies have reported frequencies up to 50 for aneuploidy (Gras et al., 1992) and as high as 48 for mosaicism (Munne et al., 2002). In the latter study, as many as 84 of cells in ''chaotic mosaic'' embryos were abnormal. However, all the data are from oocytes and IVP embryos of infertile women, in which occurrence of chromosome anomalies may be especially marked compared with the general population, and may also be exacerbated by gonadotropin stimulation for IVF. Moreover, humans are not suitable experimental subjects for studying the etiology or frequency of aneuploidy in the general population. In order to study these questions, a suitable experimental model is needed, which clearly needs to be a nonhuman primate. However, no study has adequately examined the...

Mutations Affecting Membrane Proteins Cause Diseases

Cystic fibrosis (CF) is a recessive genetic disorder prevalent among whites in North America and certain parts of northern Europe. It is characterized by chronic bacterial infections of the airways and sinuses, fat maldigestion due to pancreatic exocrine insufficiency, infertility in males due to abnormal development of the vas deferens, and elevated levels of chloride in sweat ( 60 mmol L).

The Azoospermia Phenotype

The complete absence of sperm cells from semen may seem like a simple phenotype, unambiguously ascertained by an examination of semen, but sperm count can be affected by many factors (such as time since the last ejaculation, substance abuse, frequency of hot baths, and even dental caries) and can, thus, vary considerably in a single individual (2). A discussion of this variation lies outside the scope of the present chapter here we note that sperm count can be regarded as a continuous trait (Fig. 1) with azoospermia grading into oligozoospermia (few sperm) and the normozoospermic state, and will not distinguish between the first two, so that the phenotype under consideration here would more accurately be described as azoo- or oligozoospermia. Although azoospermia, in the strict sense, leads to infertility under natural conditions (this can sometimes be overcome by assisted reproduction), the relationship between oligozoospermia and fertility (producing offspring) is complex but can...

Blastocyst Culture for Deriving Human Embryonic Stem Cells

Success in producing a human embryonic stem cell line depends largely on the quality of the 5-d-old embryo (blastocyst) used. Such blastocysts are grown from frozen-thawed d 1-3 surplus embryos left over from infertility clinics and donated for stem cell research with informed patient consent. Knowledge, therefore, of the culture conditions and embryo scoring systems that are used to generate high-quality blastocysts are crucial. This chapter describes an extended microdroplet culture protocol using two-stage sequential culture media with morphological and polarized optical parameters for embryo scoring for each day of embryonic growth to help produce high-quality blastocysts. The chances of success of producing a human embryonic stem (hES) cell line depends largely on the quality of 5-d-old embryos (blastocysts) used. Embryos provided for this purpose are usually surplus embryos left over from in vitro fertilization clinics and frozen at cleavage stages (two pronuclear, four-cell and...

Of Vitamin A Supplementation in the Early 1970s

Out by the personnel of the primary health centers, maternal and child health centers, and family-planning centers (121). From 1973 to 1975, the government of Indonesia conducted a pilot program of high-dose vitamin A capsules every 6 mo to every preschool child in 20 selected subdistricts in the island of Java (122). In 1972, the Ten-Year Health Plan approved by the Third Special Meeting of Ministers of Health of the countries of the Americas adopted the formal goal to reduce the prevalence of vitamin A deficiency by about one-third and to promote legislation to enforce the fortification of foods with vitamin A (123). Vitamin A fortification of sugar was implemented in Guatemala in 1974 with the underlying rationale of improving growth and increasing resistance to infectious diseases in children (124). In the late 1970s, the Indonesian government also began to consider vitamin A fortification of wheat flour, sugar, or monosodium glutamate (MSG) (125). After further deliberation, of...

Errors in Chromosome Number

We are all products of a sperm fertilizing an egg. Humans have twenty-two pairs of chromosomes, plus the sex chromosomes. After meiosis, the sperm should have twenty-two chromosomes plus either the X or Y chromosome, and the egg should have twenty-two chromosomes plus an X chromosome (see figure 7.1). But sometimes, errors occur in the process of meiosis, and a given gamete is either missing a chromosome or has more than one copy of a particular chromosome. . When this happens, and the egg or sperm that has an aberrant number of chromosomes is involved in making a new individual, of course, that individual will have a wrong number of chromosomes. Because there are so many genes on each chromosome, such errors would be expected to be very deadly. A great majority of fetuses with abnormal chromosome numbers do not survive to birth. Thus, chromosomal abnormalities explain some cases of infertility and pregnancy loss. Indeed, up to 50 percent of first-trimester spontaneous abortions are...

Side Effects Of Hormonal Therapy Similarities And Differences

Hormonal therapy for prostate cancer eventually produces decreases in libido and potency in virtually all patients regardless of the modality used.34,124 Additional side effects include lethargy, depression, anorexia, breast swelling with or without tenderness, hot flashes, anemia, and osteoporosis with potential for pathological fracture.14,125-130 Most side effects, including impotence and infertility, are slowly reversible with cessation of therapy. However, reduced bone mineral density often does not reverse after prolonged hormonal suppression. There is a consensus that irreversible changes occur more often after suppression of longer than 18-24 months.

Estrogen Progesterone and Androgen Receptors

Reproductive and homeostatic systems, respectively. The sex steroid receptors ER, PR, and AR direct transcription of genes involved in sexual development, differentiation, and specification (Tables 3.4, 3.5). As a result of their growth-promoting activities in these processes, these receptors are pharmacologically targeted in a number of neoplastic reproductive tissues. Receptors ERa and ERjS are predominantly expressed in reproductive tissues, as well as in vasculature, cardiac muscle, and bone. Their activity is subject to estradiol availability, which is regulated by hormonal cascades generated from the ovary and other steroidogenic tissues. Confirmation of the role of ERs in the regulation of the reproductive tract was achieved by targeted deletion of ERa and ERjS alleles in transgenic mice, which develop normally but are infertile or suffer ovarian dysfunction, respectively.296,297 In addition to reproductive maintenance, specialized roles for ERs include regulation of bone...

Telomeric Rearrangements

Chromosomal anomalies may be numerical or structural. Structural changes result from the breakage and rearrangement of chromosome parts, and animal experiments have shown that they can be induced by a variety of exposures, including ionizing radiation and certain viral infections and toxic substances. They occur as duplications, deletions, translocations, insertions, or inversions of chromosome parts or as rings on selected chromosomes. Numerical anomalies arise through nondisjunction during meiosis or mitosis, through lagging of chromosomes at anaphase of cell division, or through fertilization by two sperm (i.e., triploidy). Chromosomal anomalies as a whole contribute more to fetal loss than to live births and MR. Kline, Stein, and Susser (1989) estimated that from 8 weeks after the last menstrual period, the proportion of chromosomal aberrations lost by miscarriage exceeds 90 for all but trisomy 21 (DS), XXX, XXY (Klinefelter syndrome), and XYY. In survivors after birth in...

Avian Models For Reproductive And Neuroendocrine Aging

Avian reproductive anatomy lends itself well to studies of basic mechanisms controlling female fertility and reproductive aging (Johnson, 2000 Holmes et al., 2003). Most adult female birds have only one functional ovary. Unlike the mammalian ovary, however, in which developing follicles are contained in a capsule, the avian ovary has a lobular structure like a bunch of grapes, with a yolky hierarchy of large preovulatory follicles readily accessible on the outside. This arrangement makes it practical to measure or administer hormones, growth factors or other substances directly from or into individual follicles.

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) represents a spectrum of infections and inflammatory disorders of the uterus, fallopian tubes, and adjacent pelvic structures. PID may include any combination of endometritis, salpingitis, tubo-ovarian abscess, oophoritis, and in its more extreme manifestation, pelvic peritonitis. One out of every 10 women will have at least one episode of PID during her reproductive years. At least one-quarter of women with PID will have major complications, including infertility, ectopic pregnancy, chronic pelvic pain, tubo-ovarian abscesses, and or pelvic adhesions.

Genetic Counseling and Genetic Testing

The counselor helps the family interpret the genetic risks and explains various reproductive options that are available, including prenatal diagnosis, artificial insemination, and in vitro fertilization. A family's decision about future pregnancies frequently depends on the magnitude of the genetic risk, the severity and effects of the condition, the importance of having children, and religious and cultural views. The genetic counselor helps the family sort through these factors and facilitates their decision making. Throughout the process, a good genetic counselor uses nondirected counseling, which means that he or she provides information and facilitates discussion but does not bring his or her own opinion and values into the discussion. The goal of nondirected counseling is for the family to reach its own decision on the basis of the best available information. 4. An older woman becomes pregnant or wants to become pregnant. There is disagreement about the age at...

Diseases of genomic imprinting

As assisted reproductive technologies (ARTs) are increasingly used to overcome infertility, there is concern that the children conceived may be susceptible to imprinting disorders involving chromatin modification (Maher et al., 2003). As yet, the evidence that ART may be associated with genetic imprinting disorders is inconclusive (Schieve et al., 2004). Parenthetically, Dnmtl overexpression causes genomic hypermethylation, loss of imprinting, and embryonic lethality (Biniszkiewicz et al., 2002). In addition, somatic cell nuclear transfer often results in multiple imprinting errors (Young and Beaujean, 2004). Loss of imprinting mechanisms can also be observed in many cancers involving reactivation of the normally silent allele of a growth-promoting

Bloodinjury And Injection Phobia

Only three studies using groups of subjects have been recorded (Ost, Fellenius & Sterner, 1991 Ost, Hellstrom & Kaver, 1992 Ost, Sterner & Fellenius, 1989), all by the same group. They have addressed both the fear of anticipated procedures and fall in blood pressure on exposure to blood. Applied tension enabled the subjects to raise their blood pressure. That, and in vivo exposure, reduced most measures of fear but was not successful in maintaining blood pressure on testing without applied tension. Subjects with comorbid disorders were excluded in all reports. However, impairment was partially addressed in all studies, most notably by Ost, Hellstrom and Kaver (1992) in whose study eight of 35 women allowed themselves to become pregnant and so endure venupunctures because they had overcome their fear of injections. However, the number of subjects who came to accept injections is not clear. This is disappointing given the need to enable some subjects, such as diabetics, to receive...

Directions For Future Research

What little research that has been done has focused on the time of the initiation of treatment, at the time of recurrence, or during the terminal phase of the disease.77 All three of the cancer sites reviewed can impact partners of a survivor, but at present there are very few studies on how couples overcome this challenge. In our review, several studies found major changes in sexual functioning even after 5 years after diagnosis. Only few have looked at interventions that can help the couples to deal with this experience.92-94 Men and women treated for Hodgkin's disease as well as younger women treated for breast cancer may have to cope with infertility. More research should be focused on the impact of cancer survivorship on family members. Interventions for family members who are at higher risk for getting cancer should be a priority as well as interventions to improve family resilience for persons at higher risk for poorer outcomes such as families in which...

Cardiovascular Complications

Chemotherapy, particularly alkylating agents like cyclophosphamide, can induce infertility and, in women, premature menopause, with its attendant problems of hot flashes, mood swings, vaginal dryness, and urinary incontinence. Cyclophosphamide is commonly used in breast cancer, but management of the menopausal symptoms is complicated by the fact that hormone replacement therapy is considered contraindi-cated in patients with a history of breast cancer. Consequently, other treatments must be used for hot flashes, such as antidepressants.52 This example illustrates the importance of both recognizing the symptoms related to ovarian failure in a cancer patient in which it would be otherwise unexpected, and having knowledge of the oncologic considerations of the therapies being chosen. In general, the younger a patient is, the more likely they are to have their fertility preserved after chemotherapy.53 However, breast cancer patients are usually advised to delay childbearing for at least 2...

Female Reproductive System Disorders

Premenstrual syndrome Interest in EPO supplements as a potential treatment for PMS began in the early 1980s, largely as a result of investigational work published by David Horrobin. In the Journal of Reproductive Medicine be reported on positive results obtained in three double-blind placebo-controlled studies and two open trials in women with premenstrual syndrome (Horrobin 1983).

Does He have an Endocrinological Cause to His ED

Androgen and prolactin levels are of particular concern. Hyperprolactinaemia occurs secondary to stress, drugs (such as neuroleptics and infertility treatments), cirrhosis, breast manipulation, or pituitary adenoma tumour. A high level of circulating prolactin causes inhibition of gonadotrophin releasing hormone which lowers levels of testosterone. Men with low testosterone levels may exhibit a decrease in sexual interest. Causes of low testosterone include renal failure, hypogonadism, bilateral cryptorchidism, other hypothalamic-pituitary-gonadal axis

Causes and symptoms

Prevalence of Type II diabetes in American society and for the appearance of Type II diabetes in children, previously a rarity. Because obesity promotes degenerative disease of joints and heart and blood vessels, it increases the need for some surgical procedures. At the same time, surgical complication rates are higher in obese patients. Obesity contributes to fatigue, high blood pressure, menstrual disorders, infertility, digestive complaints, low levels of physical fitness, and to the development of some cancers. The social costs of obesity that include decreased productivity, discrimination, depression, and low self-esteem, are less easily described and measured. Worldwide, obesity has reached epidemic proportions in the last thirty years, affecting both sexes and all ethnic, age, and socioeconomic groups. More than 50 of adults in the United States currently fall into overweight or obese classifications, and 22 of preschool children are classified as overweight. The increasing...

Neoplastic Conditions

Intratubular germ cell neoplasia (ITGCN) in situ stage of germ cell neoplasia seen in 90-100 of testes adjacent to germ cell tumours. There is an association with infertility (0.4-1.0 ), cryptorchidism (2-8 of patients) and in the contralateral testis in patients with prior testicular tumour (5 ). Fifty per cent progress to germ cell tumour in five years. Histology shows large seminoma-like cells present along a thickened hyalinised tubular basement membrane. Spermatogenesis is usually absent. There is positive staining with PLAP (97 of cases) and PAS without diastase (glycogen). It can be treated with low-dose radiation but watchful waiting (clinical, ultrasound examination and serum markers) is advocated by some.

Modeling Human Disease through Targeted Overexpression

Several clinical studies have shown a correlation between hypersecretion of LH and functional ovarian hyperandrogenism (FOH), infertility, and miscarriage in women (Barnes et al., 1994 Ehrmann et al, 1995 Franks, 1995 Regan et al., 1990 Shoham et al., 1993), suggesting that chronically elevated LH impairs fertility. Unfortunately, no studies show a direct relationship between hypersecreted LH and reproductive abnormalities. Because LH is secreted in regulated pulses (Gibson et al., 1991) and its serum half-life is short (20-30 min Niswender et al., 1974), it is difficult to devise protocols for chronic administration of exogenous LH that mimic endogenous pulse patterns of LH. To circumvent this limitation, the authors devised a transgenic approach where elevated hormone levels are maintained chronically, without requiring multiple injections, supraphysiologic dosing, or appreciable dampening of the hypothalamic-pituitary-gonadal axis. In summary, a transgenic strategy has been...

Female Reproductive Effects

Manifestations such as subfertility, infertility, intrau-terine growth retardation, spontaneous abortions, malformations, birth defects, postnatal death, learning and behavior deficits, and premature aging. Because it is difficult to obtain detailed information concerning effects on the reproductive system in humans, evidence is usually limited to animal data or studies on fertility and spontaneous abortions. Pregnancy loss is the endpoint most frequently used to monitor effects on female reproductive function, starting from early losses, which contain a large proportion of chromosomal abnormalities and may represent 35-40 of human pregnancies. The remaining 10-15 later abortions are clinically manifest, and some have been linked to environmental factors (Miller et al, 1980 Runnebaum et al., 1997). Thus, there seems to be a remarkably high background rate of fetal loss in humans. Knowledge about pathogenetic mechanisms of female reproductive damage is limited. Effects may be direct,...

Nonculture Tests for C trachomatis

Recent prevalence studies of C. trachomatis infection in sexually active adolescent girls suggest that testing for C. trachomatis should be offered twice per year to this population (Johnson et al., 2002). A recent cost effectiveness study in women attending family planning clinics revealed that a strategy that combined use of PCR on cervical specimens in women receiving pelvic examinations, and PCR of urine in women with no medical indication for a pelvic examination prevented the most cases of pelvic inflammatory disease and provided the highest cost savings (Howell et al., 1998).

Placental Regulation Of Maternal Endocrine Function And Behavior

The placenta, developed from the cell lineage of fetal trophectoderm, exerts considerable influence on maternal endocrine function. Progesterone is the steroid hormone that dominates pregnancy and is necessary to sustain pregnancy. High levels of progesterone during pregnancy are a function of the fetal placenta either directly (primates) or indirectly (rodents) by production of placental hormones that sustain the ovarian corpus luteum. Progesterone has a broad spectrum of effects by acting on many maternal tissues (Keverne, 2006). Notable among these is the brain, particularly the hypothalamus (Fig. 8.1). In the hypothalamic region of the brain, high levels of progesterone exert a negative feedback on the pulsatile release of gonadotropin-releasing hormone (GnRH) preventing ovulatory cycles and curtailing female sexual behavior. The GnRH neurons are not themselves steroid receptive cells but it is thought that negative feedback inhibition occurs via the action of steroids on...

Mitochondrial Fate After Scnt

If not actively eliminated, then to what degree might donor cell mitochondria in SCNT embryos be eliminated by attrition, persist at a low level, or assume a replicative advantage over endogenous mitochondria Mitochondrial heteroplasmy was not observed in sheep clones (Evans et al., 1999). In SCNT embryos made with Bos indicus, donor nuclei transferred to Bos taurus oocytes, donor cell mitochondria were nearly undetect-able in cloned fetuses (Hiendler et al., 2003) and calves (Meirelles et al., 2001). However, donor cell mitochondria were not eliminated in monkey-to-rabbit or panda-to-rabbit NT embryos (Chen et al., 2002 Yang et al., 2003). Mitochondrial heteroplasmy was also reported for nuclear transfers made between Holstein and Luxi Yellow cow (Han et al., 2004), and in other studies involving bovine species (Takeda et al., 2003 Steinborn et al., 2002). Embryonic blastomere nuclear transfer in Macaca mullatta produces offspring with mitochondria from both the recipient oocyte and...

Empirical Findings

As noted earlier, natural fertility results if there are no attempts to control family size. In practice, however, natural fertility is frequently operationalized as involving no contraception or abortion (Henry 1961). Fertility is high in natural fertility populations but how high Females can have children as early as the midteens and can continue until the late 40s. Theoretically, women could have nearly one birth per year. Thus the theoretical maximum fertility, in the absence of all behavioral constraints, could be as high as 35 births On the other end of the natural fertility spectrum lie the Dobe Kung hunter-gathers, residents of the Kalahari Desert in Africa prior to 1975 (Howell 1979, 2000). The reported TFR for this natural fertility population was about 4.5 births per woman. Thus, the question, How can natural fertility populations be so different from each other, and why are even the highest observed rates much lower than the theoretical maximum '' In short, the...

Embryonic Stem and Primordial Germ Cells Are Pluripotent

Figure 45.1 The Inner Cell Mass (ICM) of a human blastocyst is a source of embryonic stem cells. A blastocyst is derived from a embryo created by in vitro fertilization. The arrows denote the inner cell mass of the blastocyst found internal adjacent to the blastocoels (the hollow core). These 30 or so cells have the potential to become embryonic stem cells under proper culture conditions. If implanted into a receptive uterus, they have the potential to also become a fetus. Figure 45.1 The Inner Cell Mass (ICM) of a human blastocyst is a source of embryonic stem cells. A blastocyst is derived from a embryo created by in vitro fertilization. The arrows denote the inner cell mass of the blastocyst found internal adjacent to the blastocoels (the hollow core). These 30 or so cells have the potential to become embryonic stem cells under proper culture conditions. If implanted into a receptive uterus, they have the potential to also become a fetus.

Glaucoma Medical Therapy In Pregnancy

Although glaucoma is infrequently diagnosed in pregnant patients, occasionally patients with preexisting glaucoma become pregnant. Whenever medications are prescribed for glaucoma, the clinician considers the potential for systemic effects on the patient. In pregnant women, this concern extends to the developing child, as well. One major advantage to the use of topical medications for glaucoma is the reduced systemic absorption and coincident decrease in systemic symptoms. There is little literature demonstrating adverse events of topical medications during pregnancy.1,2

Implications Of Mitochondrial Anomalies For

Mitochondrial dysfunction is suggested as a prime cause of low oocyte and embryo quality and hence the low efficiency of human ART on a per-embryo basis. Not surprisingly, attention has been drawn to possible effects of current ARTs on mitochondrial function. The coexistence of different mitochondrial genomes in the same cell is termed mitochondrial heteroplasmy. There is evidence that heteroplasmy in some infants resulted from ''ooplasm transfer,'' a technique involving injection of ooplasm from oocytes from young women into oocytes from older women patients in an effort to improve their developmental competence (Cohen et al., 1998). In this procedure, about 10 of the ooplasm from an oocyte of a presumptively fertile donor was microinjected into a recipient oocyte from an older, infertile patient with presumptively compromised oocyte quality (Cohen et al., 1998). However, this transfer would introduce numerous cytoplasmic components into the recipient oocytes, including proteins and...

Physical examination for the man

The cornerstone of any infertility evaluation relies on the assessment of six basic elements (1) semen analysis, (2) sperm-cervical mucus interaction, (3) ovulation, (4) tubal patency, and (5) uterine and (6) peritoneal abnormalities. Couples of reproductive age who have intercourse regularly without contraception have approximately a 25-30 chance of conceiving in a given menstrual cycle and an 85 chance of conceiving within 1 year.

Research Exemplars

Knodel was initially drawn to the topic of breast-feeding by his concern for explaining differentials in natural fertility before the onset of the secular fertility transition. Bavaria, with its customary avoidance of nursing, had one of the highest fertility rates in Europe as well as very high mortality. Other factors affecting fecundity prior to the advent of birth control are less easy to identify, although there was a clear, and in some villages considerable, rise in fecundability between the mid-18th and the mid-19th century, perhaps as a result of changes in nutrition during that period (Knodel 1988 285-286). This rise makes it more difficult to identify the time of the beginning of the fertility transition because it operates in the opposite direction of the effect of family limitation to maintain relatively stable levels of aggregate marital fertility (as measured for instance by the index Ig). Knodel uses other indexes to date the beginnings of family limitation the...

The safety of sperm washing

The technique of processing sperm from HIV-positive men prior to the insemination of their HIV-negative partners was first published by Semprini et al. in 1992. The first inseminations with sperm, washed free of HIV, were carried out in Italy and Germany as early as 1989 and 1991, respectively. Up to mid 2003, more than 1,800 couples had been treated in about 4,500 cycles, applying various techniques of assisted reproduction. More than 500 children have been born with no single seroconversion reported in the centers closely following the protocol of washing and testing the sperm prior to assisted reproductive techniques. Most of the European centers that offer assisted reproduction to HIV-discordant couples, are part of the CREATHE-network, which aims to optimize treatment and safety of the methods as well as to compile an extensive database. There are high hopes that soon sufficient clinical cases can be reported to demonstrate the safety and reliability of sperm washing.

Deletions Encompassing the AZFb Interval

When overlapping deletions elsewhere in the genome result in similar phenotypes, it is usual to assume that the critical genes underlying the phenotype map to the region of overlap. This viewpoint has not been adopted for the overlapping AZFb AZFc deletions causing male infertility on Yq, probably for historical reasons. The overlap of the deletions contains only members of gene families and not entire families. Is loss of these members primarily responsible for the phenotype, with modifications by flanking genes, or do similar phenotypes arise from the loss of genes in the nonoverlapping regions

Early Clues to Yq Complexity

Surveys of infertile patients and controls (either fertile or normozoospermic individuals) provided further examples of deletions that were not associated with azoospermia, either because they were found only in controls, or were transmitted by the fathers of infertile patients. In one large-scale evaluation using 48 STSs and 920 fertile individuals, 11 men (1.2 ) were found to show deletions of single STSs that removed one of four different loci (12). One of these was Amelogenin on Yp, but the other three (sY207, sY269, and sY272) are repeated sequences with copies lying withinAZFb or AZFc, as defined at that time. These four deletions were assumed to represent polymorphisms, but in the same study, deletions of other single STSs (e.g., sY75, sY126) were found only in infertile patients. Are these related to the patient's infertility or not

Poverty and Inequality

New scienti c and medical technologies are having dramatic effects on the cost-effectiveness, ef ciency, and competence of health care (e.g., microsurgery, organ transplantation, genetic testing screening, gene therapy, in vitro fertilization). Genetic information and its communication to individuals and families are sensitive issues that have both psychological and ethical implications (Lerman, 1997). Following the production of a sheep clone, DollyZ (Wilmut, Schnieke, McWhir, Kind, & Campbell, 1997), the cloning of humans is likely soon to become technically possible. In spite of reassurances from a professor of fertility studies (Winston, 1997), this prospect raises profound ethical questions among health professionals, patients, and families (Human Genetics Commission, 2000).

Equality of access and discrimination

Serious concerns have also been raised about the potential uses of PGD and genetic screening for non-therapeutic applications, like gender selection, and the possibility of its perpetuating or even amplifying gender discrimination. Accepting and endorsing the concept that perfectly healthy embryos would be discarded, or pregnancies terminated, merely because the fetus was the 'wrong' gender is prima facie unethical. Bioethi-cists, however, tend toward unanimous agreement that an argument exists in favour of gender selection when the motivation is the screening out of gender-linked genetic diseases (so-called 'therapeutic' selection). Some even propose that it might be an acceptable consideration for achieving gender-balanced family planning.80 80 The legal position in the United Kingdom on the use of PGD for family planning purposes, and in particular, the selection of a potential ''saviour sibling'' was determined by the House of Lords in the recent case of R ( on the application of...

Review of the Procurement Process

Regardless of the source of funding and the applicability of federal regulations, an Institutional Review Board or its equivalent should review the procurement of gametes, blastocysts, or somatic cells for the purpose of generating new hES cell lines, including the procurement of blastocysts in excess of clinical need from infertility clinics, blastocysts made through in vitro fertilization specifically for research purposes, and oocytes, sperm, and somatic cells donated for development of hES cell lines through nuclear transfer. When donor gametes have been used in the in vitro fertilization process, resulting blastocysts may not be used for research without consent of all gamete donors. To facilitate autonomous choice, decisions related to the production of embryos for infertility treatment should be free of the influence of investigators who propose to derive or use hES cells in research. Whenever it is practicable, the attending physician responsible for the infertility treatment...

Heres toMour Herbal Health

Exercise caution when trying an herbal formula, especially if it's meant to be taken internally. If you're pregnant, ingesting some herbs may increase the risk of miscarriage. These include comfrey, feverfew, mugwort, southernwood, tansy, and wormwood. If you're pregnant or undergoing medical treatment, consult a physician before trying any herbal formula.

Knowledge And Rationality

In the case of a test result revealing a certain genetic abnormality, the consequences for a person's freedom seem to be highly ambiguous, however (Quaid, 1994). On the one hand, a person clearly gains certain advantages from this knowledge with regard to life planning and family planning. He or she can adjust plans to the purported health expectations. On the other hand, with genetic knowledge a lot of uncertainties arise it cannot be predicted when the up-to-now asymptomatic person will start suffering from symptoms, how severe these symptoms will be, what the course of the disease in this individual case will look like exactly, etc. The mere knowledge of genetic status often does not lead to any concrete certainty about the future course of life. Difficulties arise in cases in which, by means of a genetic diagnosis, nothing but an elevated risk or a predisposition to a multifactorial condition has been stated. Thus, difficulties in adequately assessing and interpreting the results...

The Special Status of the Human Embryo

Yet even in our own society, where many hold this view in a philosophical sense, it has not been adopted as a matter of cultural practice. For example, the natural loss of an embryo in normal human reproduction is not recognized as a death that requires a funeral, and the disposal of human embryos after completion of infertility treatments is not treated as murder by the legal system. Nonetheless, in the United States in particular, hES cell research is eligible for limited federal funding because the current administration wishes to acknowledge the view of some that the destruction of embryos required to obtain new cell lines gives such lines a moral taint.

Regulation Of hEs Cell And Nt Research In Other Countries

There is no international consensus yet on whether and how to pursue hES cell research. For example, in February 2005, a committee of the U.N. General Assembly abandoned attempts to craft a global treaty on NT research and satisfied itself with a plurality vote in favor of a nonbinding resolution calling for a ban on all forms of human cloning or genetics research that are contrary to human dignity, a phrase left to the interpretation of member countries.31 Thus, the regulation of hES cell research varies from country to country. In many cases, there is no law explicitly addressing such research. In some countries, such as Poland and Italy, the research is forbidden or substantially curtailed. In others, however, there seems to be a trend toward liberalization of the laws. France and Germany, for example, have taken steps to permit research on cell lines derived from surplus in vitro fertilization (IVF) blastocysts,32 and Japan33 and Sweden34 have lifted restrictions on making...

G Procurement Of Gametes Blastocysts Or Cells For hEs Generation

An IRB, as described in federal regulations at 45 CFR 46.107, should review the procurement of all gametes, blastocysts, or somatic cells for the purpose of generating new hES cell lines, including the procurement of blastocysts in excess of clinical need from infertility clinics, blastocysts made through IVF specifically for research purposes, and oocytes, sperm, and somatic cells donated for development of hES cell lines derived through NT or by parthenogenesis or androgenesis. 3.3. When donor gametes have been used in the IVF process, resulting blastocysts may not be used for research without consent of all gamete donors. 3.5. To facilitate autonomous choice, decisions related to the creation of embryos for infertility treatment should be free of the influence of investigators who propose to derive or use hES cells in research. Whenever it is practicable, the attending physician responsible for the infertility treatment and the investigator deriving or proposing to use hES...

Materials and Methods

This study included 305 women, participants of three studies involving MD, 97 were from a cross-sectional study (21), 7 from an isoflavone intervention study (22), and 201 from a soy intervention study (23). For the latter two studies, baseline mammograms and urine samples were used for the analysis. After the approval of the Committee on Human Studies at the University ofHawaii, all subjects provided informed consent. Women for all three studies were recruited at mammography clinics in Honolulu. Eligible women had no previous history of BC and required a normal mammogram at baseline. The subjects for the intervention studies were free of serious medical conditions, had regular menstrual periods, intact uterus and ovaries, were not on oral contraceptives or other hormones, and had no intention of becoming pregnant within a year. Due to the nature of the nutritional intervention, only women who reported a dietary consumption of 7 servings of soy food week...

Compilation of Recommendations

To provide local oversight of all issues related to derivation and research use of hES cell lines and to facilitate education of investigators involved in hES cell research, all institutions conducting hES cell research should establish an Embryonic Stem Cell Research Oversight (ESCRO) committee. The committee should include representatives of the public and persons with expertise in developmental biology, stem cell research, molecular biology, assisted reproduction, and ethical and legal issues in hES cell research. The ESCRO committee would not substitute for an Institutional Review Board but rather would provide an additional level of review and scrutiny warranted by the complex issues raised by hES cell research. The committee would also serve to review basic hES cell research using preexisting anonymous cell lines that does not require consideration by an Institutional Review Board. Regardless of the source of funding and the applicability of federal regulations, an Institutional...

Agricultural Databases

The dairy industry supports an industry-level system to allow efficient use of artificial insemination with semen from elite sires. These systems allow real-time identification of cows and matching with sires that are suitable for mating based on a measure of inbreeding between the two individuals. Organizations, such as the National Dairy Herd Improvement Association (http www.dhia.org ), promote development of data standards and systems for integration of data across states.

Establishment Of An Institutional Embryonic Stem Cell Research Oversight Committee

To provide oversight of all issues related to derivation and use of hES cell lines and to facilitate education of investigators involved in hES cell research, each institution involved in hES cell research should establish an Embryonic Stem Cell Research Oversight (ESCRO) committee. The committee should include representatives of the public and persons with expertise in developmental biology, stem cell research, molecular biology, assisted reproduction, and ethical and legal issues in hES cell research. It must have suitable scientific, medical, and ethical expertise to conduct its own review and should have the resources needed to coordinate the management of the various other reviews required for a particular protocol. A pre-existing committee could serve the functions of the ESCRO committee provided that it has the recommended expertise and representation to perform the various roles described in this report. For example, an institution might elect to constitute an ESCRO committee...

Potential Strategies For Improving The Health Of Sexual Minorities Groups In The City

The dominant strategy adopted to improve the access of LGBT people to appropriate, non-homophobic health care has been the creation and expansion of LBGT clinics. These clinics began as special sessions (principally treating STI's) within LGBT community centers or at free or community health clinics. Over time the combination of HIV AIDS funding and other third party reimbursement (public and private) for health services have caused these clinics to separate from (and in many cases eclipse in size) their home institutions. The largest LGBT health clinics - including Callen Lorde in New York City, Chase Brexton in Baltimore, Fenway in Boston, Howard Brown in Chicago, and the Los Angeles Gay & Lesbian Community Service Center - serve thousands of patients annually and provide services ranging from primary care and family planning to mental health and substance abuse counseling. A second, related strategy has been the development of LGBT-orientated specialty clinics - largely for HIV...

Male Reproductive Effects

Recent evidence indicates that the human male reproductive capacity has deteriorated considerably during the past five decades. In industrialized countries, a substantial number of couples seek in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) because of poor semen quality.

Insertion of the Transgene into the Germ Line

Bovine oocytes are generally collected from slaughtered heifers or obtained from cows superovulated with PMSG or prostaglandin. To circumvent surgical procedures and in vivo fertilization, Krimpenfort et al. (1991) have used an in vitro fertilization and embryo production procedure. The technique for DNA microinjection is similar to those described earlier centrifugation, e.g., at 12,000 x g for 10 min, is necessary to visualize pronuclei. Microinjected cow embryos are usually cultured in vitro to the morula-blastocyst age at which time they are transferred nonsurgically to suitable recipients. The techniques and efficiency of gene transfer in cows have been described by Roschlau et al. (1989) and McEvoy and Sreenan (1990). In summary, oocytes may be fertilized in vivo or in vitro. In vivo fertilization may be controlled by artificial insemination of a super-ovulated animal at the stage where the oocyte has matured in the ovary. An alternative pathway is to isolate follicular oocytes...

Gillian K Reeves Emily Banks Timothy Ja

Tailed review of the relationship between both these types of hormonal preparations and cancer has been compiled by the International Agency for Research on Cancer (IARC).6 The latter review includes details of many of the individual studies and summarizes the results of the main collaborative reanalyses. Three large randomized controlled trials of postmenopausal hormone therapy have also published results with respect to breast cancer and their findings have been reviewed recently.7 Other specific types of exogenous hormone that have been examined in relation to breast cancer risk include diethylstilbestrol, which was commonly used during pregnancy in the 1950s, and fertility-enhancing drugs, such as clomiphene citrate, which have been used since the late 1960s.8 However, the amount of data on breast cancer risk in relation to these latter two types of hormonal preparation is substantially less than that available for hormonal contraceptives and post-menopausal hormone therapy.

Fertility Enhancing Drugs

Women who undergo treatment for infertility can be exposed to a variety of hormonally active drugs, including clomiphene citrate, human menopausal gonadotrophin, and gonadotrophin-releasing hormone. Studies examining the relationship between use of fertility drugs and breast cancer risk have been hampered by small numbers of women and the inability to adequately control for all important confounding factors. Bearing this in mind, their findings have been generally reassuring, showing no significant increase in the risk of breast cancer in infertile women treated with fertility drugs compared to infertile women who did not receive such treat-ment.24-27 However, a recent study reported a significant, transient excess of breast cancer in the 12 months following ovulation stimulation for in vitro fertilization compared to the general female population,25 and there remains considerable uncertainty about the effect of fertility drugs on breast cancer risk.

Combined Oral Contraceptives

Figure 6.1 Relative risk (RR) of breast cancer in ever-users of combined oral contraceptives compared with never-users. Each relative risk estimate and its 99 confidence interval (CI) is plotted as a black square and a line. The area of each square is proportional to the amount of statistical information available for that particular estimate. Amer Canc Soc, American Cancer Society Canadian NBSS, Canadian National Breast Screening Study CASH, Cancer and Steroid Hormones FPA, Family Planning Association RCGP, Royal College of General Practitioners SE, standard error WISH, Women's Interview Study of Health WHO, World Health Organisation. (Adapted from the Collaborative Group on Hormonal Factors in Breast Cancer.3)

Nonhuman Primates as Models for Developing ART

Because the rhesus monkey is a good model for obtaining information about reproduction in primates, the use of ART procedures in this species might reveal details about preimplantation events, including age-related phenomena, that could be relevant to the problem of IVF failure in older human females. Ovarian stimulation, IVF and embryo culture, collectively known as ''in vitro production'' (IVP) are well-established techniques for a variety of species (Bavister and Boatman, 1993 Bavister, 1995). These ARTs are useful and even commercially viable in domesticated animals, and have long been employed in research with rodents and other species. The success of ART in addressing infertility problems in humans, though not as efficient as it could be, is well known (Olivennes and Frydman, 1998). In contrast, ART has been employed far less frequently or effectively with nonhuman primates, in spite of the huge potential benefits for biomedical and reproductive research. The techniques for...

Animal Models For Studying Infertilty

It is very difficult to study the etiology of chromosomal or mitochondrial defects in humans, or to relate such deficiencies to developmental outcomes, simply because the principal focus in humans is to help infertile women to become pregnant and have healthy babies. This goal is antithetical to basic research because the latter usually involves destructive analysis of oocytes and embryos. Human oocytes and embryos that are surplus to clinical needs and available for research are scarce, and may not be representative of developmentally competent oocytes and embryos. As a result, it is not surprising that the majority of research on oocyte and embryo function has been done with animal material, usually from rodents although sometimes with suitable domesticated animals, such as cattle and pigs. The problem with this approach, though it is logical, is that gamete physiology and even basic reproductive strategies can vary considerably in different mammals, so that it may be difficult to...

Theoretical Models

Natural Fertility and the Fertility Transition Louis Henry was led to the study of historical populations by his interest in the proximate determinants of natural fertility, i.e., the fertility of married couples that did not attempt to limit the number of their children by resorting to contraception or abortion. He did not invent the term natural fertility, which was commonly used before him to refer to the reproductive regime of high-fertility populations of the past. In early writings, Henry had called them ''non-Malthusian populations'' and qualified their fertility as biological the terms were clearly inappropriate. He took an important step by providing a way of identifying natural fertility in statistical series, i.e., when the fertility of married couples was not a function of the number of children they already had. By comparing successive marriage cohorts of individuals in family reconstitutions, it was possible to distinguish clearly between the behavior of early cohorts...

Availability Of Monkeys For Research

In spite of their great value as models for studying mechanisms of infertility in primates, macaque monkeys suffer from one major drawback they are not readily available in substantial numbers for this purpose. This is ironic, because the United States has the largest nonhuman primate research infrastructure in the world, in the form of the eight National Primate Research Centers supported by the NIH. Each of these centers has several thousand nonhuman primates, and rhesus monkeys comprise a large proportion of the total. However, the great demand for this species for AIDS-related research means that few animals are available for other kinds of research, including infertility studies. It may be time to ask if priorities for allocation of monkeys to research studies should be reassessed.

Identifying Resistance

We see another kind of resistance in Kenya. There, among the Luo, women's use of contraceptives may be undermining men's control over their families. In that setting, men's dominance has rested on their ability to control important material and symbolic wealth and the connections those various components of wealth and prestige could bring Cattle were used primarily as bridewealth, which legitimated control over the women who would produce the children that would perpetuate the husband's lineage'' (Watkins, Rutenberg, and Wilkinson 1997 216). While men continue their economic control and domination today, they have not been able to control women's reproduction in the same way. Watkins and her colleagues attribute this change to the new family planning programs, introduced by outsiders to the culture, which have made contraception easy to obtain. Consequently, Luo women have been able to make decisions about contraception and reproduction that their husbands may disagree with. While...

Prophylaxis of Venous Thromboembolism

Patients with a previous history of HIT may require an alternative anticoagulant to prevent venous thromboembolism if they require prolonged bed rest and or surgery or become pregnant. UFH cannot be used, particularly during the first 1 or 2 mo after the onset of HIT when HIT antibodies still circulate. Thereafter, although HIT antibodies are usually undetectable, and the risk of recurrent HIT is possibly relatively low (Warkentin and Kelton, 2001), most physicians are understandably reluctant to re-administer heparin in this situation.

Management of glandular cell abnormalities

Atypical glandular cells of undetermined significance (AGUS) . Colposcopically directed biopsy and endocervical curettage is recommended in all women with AGUS smears, and abnormal endometrial cells should be investigated by endometrial biopsy, fractional curettage, or hysteroscopy.

Immunosurgical Isolation of Inner Cell Mass

Donated human embryos are cultured according to standard IVF protocols to the blastocyst stage. The method of immunosurgery is performed as described by Solter and Knowles (9). It involves the removal of the zona pellucida followed by incubation of the embryo in antibody solution that binds to the proteins of trophectoderm cells but not to the inner cell mass cells then lysing trophectoderm cells with guinea pig compliment.

Penetrance expressivity and genetic modifiers

Infertility in male CF patients is due to obstructive azoospermia secondary to bilateral absence of the vas deferens. A similar autosomal recessive condition with no other CF manifestions is classified as congenital bilateral absence of vas deferens (CBAVD). Remarkably, 50-65 of patients with CBAVD have at least one mutated CFTR allele, whereas 10 have two mutated alleles. Furthermore, patients with six other milder pulmonary diseases that are subsets of the CF spectrum have been shown to have at least one CFTR mutation (Zielenski and Tsui, 1995). We must conclude that these phenotypes result from a dominant effect of the CFTR mutation, or that there is an undected mutation in the second allele - perhaps regulatory - or a mutation in another unlinked gene or

Respect for Donors of Human Embryos and Gametes

Like other modern technologies associated with human reproductive capacities, hES cell research often involves donated embryos or oocytes. There is a set of minimal conditions that applies to the process of obtaining embryos and gametes for research purposes, normally from in vitro fertilization clinics. Those conditions are reflected in policies, guidelines, and practices in the United States and elsewhere. They include restrictions on monetary and other inducements, separation between clinical decisions and decisions to donate, and the requirement of voluntary informed consent of donors through a process that has been approved by an Institutional Review Board (IRB), as specified in federal regulations for the protection of human subjects in research (45 CFR 46.107 see Chapter 4 for further discussion). A measure of respect for donors is the assurance that research using donated materials is limited to qualified investigators and that studies have scientific merit. Those issues are...

Sources Of Oocytes For Nt Es Cells

At current rates of success of generation of NT blastocysts and ES cells, one major limitation of expansion of this approach will be the availability of oocytes for NT. Current and possible future sources of such oocytes include excess oocytes and unfertilized oocytes from IVF procedures, oocytes matured from ovariectomies or fetal ovaries from pregnancy terminations, oocyte donation, derivation of oocytes from nonreproductive material, and use of nonhuman oocytes. Excess oocytes and unfertilized eggs from IVF procedures. During IVF, hormonal induction is used to generate oocytes for fertilization in vitro. Often, more oocytes are generated than are needed for reproductive purposes, and some oocytes may be available for research donation. In addition, after IVF, not all oocytes are successfully fertilized, and unfertilized oocytes would otherwise be discarded if not donated for research. Experiments to explore use of such oocytes for NT derivation of hES cells have been approved and...

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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