Difficult conception tied to pregnancy complications – addressed

For, women bear great responsibility for the health of the yet to be born children.

“High-risk pregnancies are more likely in women who have difficulty getting pregnant, with or without help from hi-tech fertility treatments.”

Read more about this in the article from which this is cited, at: http://doctor.ndtv.com/storypage/ndtv/id/004480/type/news/Difficult_conception_tied_to_pregnancy_complications.html

In a nutshell, the article reports the outcome of an Australian analysis of the pregnancies of more than 2,000 subfertile women who sought A.R.T. fertility treatment between 1991 and 2001. The outcome is that these women were more likely to have pregnancy complications than a control group of twice as many women who became pregnant and “gave birth without using any assisted reproductive technique”.

The article gives as examples of complications higher incidence of pre-eclampsia (a potentially dangerous condition, marked by high blood pressure and protein in the urine) and of cesarean sections, premature births and low birth weight babies, and even higher infant mortality.

As if this were not enough, another, more recent, Hum. Reprod. 2013 Jan;28(1):125-37 review and meta-analyses of 14 studies, concluded that women with a long time to pregnancy are at an increased risk of preterm birth (https://www.ncbi.nlm.nih.gov/pubmed/23042798).

Clearly, none of this is music to your ears!

Now, it is logical to highlight the attributes of our Ovulona™ diagnostic technology in this context. The Ovulona is uniquely well positioned to assist, including the management of the early-stage pregnancies associated with subfertility and infertility.

The Ovulona™ addresses this, unlike any other conceptive-aid diagnostic device

The Ovulona FIV™ technology is unlike the various other conceptive-aid products (aka ovulation predictor kits and similar fertility self-help products such as certain smart phone apps) available in the marketplace today (the link added in January 2017). This is not only because of the unprecedented precision of determining the 3 days of the fertile window, which no other technique but our Folliculogenesis In Vivo™ (FIV™) technology can offer.

Allegory of Music by Francois Boucher

The other conceptive aids assume (but do not determine the boundaries of) a wider fertile window, and they merely assume ovulation without actually detecting it – because their techniques cannot detect it, and because detecting ovulation clinically is complicated and expensive.

The clinical detection of ovulation by ultrasound is also inconvenient and painful. It is painful because the technique is only about 80% reliable and so the good specialist will perform additionally two unpleasant tests (counting on your high pain threshold) in order to confirm the conclusion based on seeing the collapsed follicle in your ultrasound picture – the change seen the day after ovulation as a diminution of the presumed dominant follicle.

All this is also why medical scientists have had difficulties determining the fertile window. However, a very well designed 1992 study in Auckland, New Zealand showed the three days of the fertile window: 77% boys born on day 1 of the fertile window, 69% girls born on fertile day 3 (ovulation), and in between on day 2 of the fertile window, 70% boys and 30% girls (in that study of 55 births).

The 3-day fertile window was also evident in the data of a less well designed 1995 study that came out of the NIH. Both studies suffered from the use of inaccurate methods of estimating ovulation, resulting in data point outliers that they interpreted as indicative of a fertile window wider than 3 days – with much lower pregnancy rates on the flanks of said 3 days. Fertile window of 6 days has been in the public mind since the 1995 study that caused a sensation at the time (because 6 is much better than the previously believed 10 or even 13 or 14) – and so, the problems with achieving pregnancy have continued to this day.

An earlier post summarized this as follows [ https://biozhena.wordpress.com/2010/03/23/critique-of-birth-control-efficacies-in-nfp-as-published-by-marquette-university-researchers ]:

The old approaches to detecting fertility status are to be referred to as peri-ovulation methods. Where the prefix refers not to the Peri of Persian folklore (earlier regarded as malevolent!) but to the Greek meaning of about, around, near or enclosing – in this case ovulation. Surely, peri-ovulation or peri-ovulatory is a more palatable word than fuzzy.

In the context of the tie up between conception difficulties and pregnancy complications, the Ovulona FIV advantage is the following threesome – if “advantage” is even the right word. It really is a must.

The three things a woman needs to know to avoid unintended childlessness

There are three things that a woman experiencing difficulty to conceive needs to know. They are:

1. Know from your underlying folliculogenesis profile in the present menstrual cycle when exactly your 3 days of the fertile window occur.

2. Know within a couple of days after the detected ovulation whether your conceptive intercourse (intended to conceive) did or did not result in conception.

3. Know whether the early stage of pregnancy progresses well or not.

While numbers 2 and 3 are yet to be elaborated by bioZhena in clinical trials contingent upon funding, they are inherent in the principle of the FIV technique, discussed throughout the bioZhena’s Weblog .

https://biozhena.files.wordpress.com/2016/11/single-slide-narrated-best-wealth-of-info-in-menstrual-cycle-profile-signature.pps

The original medical paper, referenced in the doctor.ndtv.com article cited at the top, was not found in Fertility and Sterility issues of the last three months. But, one of the pertinent papers we did come across there revealed, based on a survey of several hundred female undergraduates at a North American university:

“Although most women were aware that fertility declines with age, they significantly overestimated the chance of pregnancy at all ages and were not conscious of the steep rate of fertility decline. Surprisingly, women overestimated the chance of pregnancy loss at all ages, but did not generally identify a woman’s age as the strongest risk factor for miscarriage.” The paper concluded: “Education regarding the rate at which reproductive capacity declines with age is necessary to avoid unintended childlessness among female academics and professionals” [Fertility and Sterility, Volume 93, Issue 7, 1 May 2010, Pages 2162-2168].

Chances of achieving pregnancy critically dependent on the timing of insemination

The reported overestimating of the chance of pregnancy – and by the same token also the predicament of people seeking to achieve pregnancy – can perhaps be understood in light of the following statistical factors.  Any woman has a 90% chance to be healthy at the time the sexual intercourse is occurring; the fertilization rate could then be intuited to average also 90%.  But it does not because of the inherent 25% loss to early embryonic mortality [EEM] or miscarriage, spontaneous abortion, so that a successfully inseminated healthy female has a significantly decreased chance of successful pregnancy.

As a consequence, the probability of achieving pregnancy is critically dependent on whether the insemination (natural or artificial) occurs at the right time (i.e. during the so-called fertile window). Contemplate the reason why this Bronzino picture of Allegory of Venus is so small.

Bronzino – Allegory of Venus

Here is how critical this timing is for healthy women: Even if the probability of determining the insemination time correctly were 90%, the resulting probability of successful pregnancy from any one particular insemination event would be only 55%.  Get this! Only 55% under perfect conditions. This is because the probability of pregnancy is the combination of four individual probabilities:  90% x 90% x 75% x 90% = 55%.

That is, the statistical formula for the probability of successful conception of pregnancy multiplies the probabilities of being in good health, of successful insemination, of not miscarrying the conceptus, and of the probability of correct timing of the conceptive intercourse. Thus:

P-health x P-fertilization x P-non-abort x P-insemination timing = P-pregnancy

For example, a 60% success rate of correct timing brings the overall rate of pregnancy down to a mere 36%, and this goes down to a mere 30% if the correct timing probability is only 50%, in healthy fertile couples.

But then, even a quick search for data on EEM (Early Embryonic Mortality] suggests that human EEM is likely much higher than the above-considered 25%, possibly even as high as about 83% (“only one embryo in six survives to term”), and certainly appears likely around 50% in healthy women. (Different studies come up with different results.)

Hence the probability of pregnancy is lowered from the approximate 36% or 30%, and it can be much lower if the timing of insemination (intercourse) is off, if the probability of correct insemination timing is low. See the adverse effect of wrong timing of the attempt to get pregnant (Insemination timing probability) on the probability of success (Pregnancy probability) in the following table.

Probability of pregnancy as a product of four probabilities:

Health	Fertilization	Non-abort	Insemination timing	Pregnancy probability
.9	.9	.15	.5	.06
.9	.9	.15	.9	.11
1	.95	.55	.5	.26
1	.95	.45	.5	.21

Pertaining to the health factor, another study published in the same specialist journal showed that women who were obese adolescents had significantly higher odds of remaining childless compared with normal weight women [ Fertility and Sterility, Volume 93, Issue 6, April 2010, Pages 2004-2011].

Women and the health of humankind

Childlessness is one thing, and the enormous responsibility that women carry on their shoulders is another. That is, responsibility for the health of the as yet unborn children. Like it or not, a woman’s health and lifestyle both have significant consequences for the offspring.

Alfons Mucha – Job

Cigarettes are a big huge problem, causing harm to your unborn, and that’s smoking at any time, not just in pregnancy.

Premature births, a big huge problem with serious consequences.

Difficult births requiring the use of forceps, the pincer-like tool they might use to pry the baby’s head out of you with – that, surely, the baby could do without, if only the birth were not difficult…

These are just a few examples highlighting the major responsibility of womankind for the health of humankind. Healthcare, its rules and regulations and funding, better be geared to that.

Tags: bioZhena, conception, difficult to conceive, fertility, folliculogenesis, infertility, ovulation, pregnancy complications, probability of pregnancy, trying-to-conceive