Posts Tagged ‘cervix uteri’

About the Added Bonus of Folliculogenesis Monitoring – Automatic Pregnancy Detection

January 10, 2010

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It will really be advisable for women to use the Ovulona™ personal fertility monitor as advocated. Whether pregnancy is hoped for or pregnancy-avoidance is the purpose, diligent routine use of the Ovulona will bring benefits.

What benefits? Not only the correct scientific reckoning of the expected period of gestation (usually spoken of as the EDD or EDC) but also the subject of this article: The automatic immediate detection of pregnancy, which is built into the bioZhena process of menstrual cycle (folliculogenesis) monitoring.

See and hear about this in the narrated slide at https://biozhena.files.wordpress.com/2016/11/single-slide-narrated-best-wealth-of-info-in-menstrual-cycle-profile-signature.pps . Here is an image of the slide:

wealth-of-information-inherent-in-cyclic-profile-signature

We expect that the personal cervix monitoring will be continued after conception has been detected – whether planned or unplanned – for the reason of watching out for or guarding against the possibility of early pregnancy loss (EPL).

Immediate detection

The detection of EPL is based on the understanding of the post-ovulation part of the menstrual cyclic profile signature. In the event of an EPL, the menstrual cyclic profile (which cannot physiologically continue after conception and/or implantation occurs) is logically expected to come back, alerting the woman to try getting pregnant again as soon as possible. This urgency is to reduce the probability of recurring spontaneous abortion as documented in medical literature.

As a 2010 study concluded: Women who conceive within six months of an initial miscarriage have the best reproductive outcomes and lowest complication rates in a subsequent pregnancy. You can read a CNN article about the British Medical Journal published study at http://www.cnn.com/2010/HEALTH/08/05/miscarriage.try.again.asap/ . We cite the original BMJ publication at the very end of this post.

“Ask Medical Doctor” [http://www.askmedicaldoctor.com ] is a web site that provides numerous examples where it follows that our Ovulona™ personal fertility device will be just what the customer needs. And her OBGYN, too.

As an example, here is a posted question (courtesy of @pregnancydoc tweet) [http://www.askmedicaldoctor.com/medical/doctor/index.php?xq=63935 ]:

“I quit the nuva ring at the end of november, and had a short cycle. I was only on it for a month. My husband an I are trying to conceive. Last week I had a blood pregnancy test, which was negative. As well as the week before. Now I’m almost a week late. I’ve also experienced a little bit of breast tenderness, stomach tenderness, and lower back pain. what’s up?”

Answer by Dr.Bhumika Aggarwal on Fri 08, Jan 2010 10:33pm:

“Hi, Yes you could be pregnant. The only way to know the confirmed cause is a clinical examination by an OBG specialist and if required an ultrasound examination. You could take a urine pregnancy test at home – that would only help a week after you have missed your periods. You should get a blood test for beta HCG levels which would confirm or rule out a pregnancy. This is confirmatory for pregnancy in cases where the urine pregnancy test kit is not helpful. It would be best to consult your doctor without any delay. Regards.”

Commenting on the Ovulona advantage

The above case is not unusual, including the fact that, after quitting hormonal contraception, the menstrual cycle(s) will tend to be short, out of whack. More to the point, however, is that, with the routinely used Ovulona, pregnancy will be detected immediately, by the disappearance of the follicular waves normally appearing in the luteal phase of the cycle [the days after ovulation], whether the cycle is short, long or what have you.

Where the physician talks about the urine and blood pregnancy testing is where it gets interesting. When Dr. B. A. writes, “that would only help a week after you have missed your periods”, with the Ovulona the detection will be immediate and, importantly, the Ovulona will make it possible to monitor the progress of the pregnancy. Where the doctor writes, “You should get a blood test”, that will no longer be the only option for the woman in the early days of uncertainty about her pregnancy status, or in the subsequent early stage of pregnancy.

The point is this: The hCG level in the blood shows the presence of the conceptus, and the immediate disappearance of the follicular waves is expected to show the presence of the conceptus before the hCG test can. The reason is that the hCG test requires a certain minimal level of the human Chorionic Gonadotropin (hCG) to be reached, and then the blood concentration peaks on the analytical instrument’s readout that the service lab will use.

This is how the pregnancy shows in the lab test for hCG:

Conceptus signature - small

Conceptus signature – small

Figure from Proc. Natl. Acad. Sci. U.S.A. 96 (6): 2678–81 (March 1999)

http://www.pnas.org/content/96/6/2678.figures-only or http://to.ly/OYI

See also http://en.wikipedia.org/wiki/Human_chorionic_gonadotropin, or http://www.webmd.com/baby/human-chorionic-gonadotropin-hcg .

“Once the fertilized egg implants, the developing placenta begins releasing hCG into your blood.” “hCG appears in the blood and urine of pregnant women as early as 10 days after conception” [http://www.nlm.nih.gov/medlineplus/ency/article/003510.htm ].

“In non-pregnant women, hCG levels are normally undetectable. During early pregnancy, the placenta produces hCG and its level in the blood doubles every two to four days” [http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/TipsandArticlesonDeviceSafety/ucm109390.htm ].

Nothing is perfect, and “hCG kits can detect a wide and varying range of different hCG-related molecules in serum or urine samples” rather than just the one molecule they want to detect [http://www.hcglab.com/index.html ].

“The primary role of hCG in the maternal organism is to serve as a signal to the ovary to maintain the corpus luteum, which would regress if it were not rescued by hCG. … It appears that exponentially increasing amounts of hCG are required to prolong the functional lifespan of the corpus luteum, which explains why the corpus luteum survives early pregnancy but regresses during unfertilized menstrual cycles…” [Parry, S, Glob. libr. women’s med., (ISSN: 1756-2228) 2008 http://to.ly/P0z ]. Corpus luteum (yellow body) is defined as a yellow, progesterone-secreting, mass of cells that forms from an ovarian follicle after the release of a mature egg (i.e., ovulation), http://to.ly/P0B . It is what becomes of the follicle after ovulation.

How it works

Against that background, we bring up the following expected effect of conception on the folliculogenesis profile as it is tracked by the Ovulona and used by the woman at home. The data accumulated in the memory of the device will be available for use by her physician and the healthcare system.

Précis: When conception occurs, the normal folliculogenesis process changes due to the developing pregnancy (i.e., due to the conceptus). Conception can only occur upon ovulation, and when it does then the change happens – immediately. The follicular waves that normally occur after ovulation can no longer appear.

Upon conception, the maternal menstrual cycling is overruled, taken over, by the conceptus and the placenta. Conceptus is defined as the product of conception at any point between fertilization and birth. It includes the embryo or the fetus as well as the extra-embryonic membranes [http://to.ly/P0t , conceptus is from Latin, something conceived; see concept].

The disappearance of the follicular waves will be immediate, and easily detectable. Importantly, as with the monitoring of folliculogenesis for the purpose of either achieving or avoiding pregnancy, it will be presented to the woman at home in plain English as “pregnancy detected” on the display of her Ovulona device.

A very important (and unprecedented) additional advantage of our technique is that any loss of the pregnancy will also be detected in the process of continued routine monitoring during the pregnancy. This is advisable because many conceptions end in natural loss, i.e., the early death of the conceptus. E. g., “absence of TLX antigen recognition due to sharing of maternal-paternal TLX antigen profiles may not allow anti-TA1 activity and may lead to subsequent fetal rejection”, http://www.profelis.org/webpages-cn/lectures/reproductive_physiology_2.html (http://to.ly/P1S ).

Seriousness of the EPL problem

Between one quarter and one third of pregnancies may fail hours or days after implantation [  http://www.hcglab.com/hyperglycosylated.htm , citing Prenat. Diagn. 1998;18:1232–40 and J. Endocrinol. 2002; 172: 497-506]. But see also Further References, below, where the incidence is put at 75%+ of all attempts to conceive – the most common complication of human gestation.

In view of the fact that “treatment of women who present with cramping and spotting in the first trimester of pregnancy would be better guided by a sensitive and specific test that would reliably categorize prognoses for pregnancies”, it is worthwhile to speculate as follows. Since “progesterone appeared to be the single most specific biomarker for distinguishing viable from nonviable pregnancies” [Obst. Gynecol. 2000, Vol. 95, Issue 2, pp. 227-231, http://to.ly/P39 ], and in view of our sensor’s mode of operation (and the expected response to conception), we might even speculate that differentiating between viable and non-viable pregnancies might be attempted with our technique, too.

As throughout the whole text in this article, speculate is the key word.

Further References:

Efficiency and Bias in Studies of Early Pregnancy Loss, Clarice R. Weinberg, Irva Hertz-Picciotto, Donna D. Baird and Allen J. Wilcox, Epidemiology, Vol. 3, No. 1 (Jan., 1992), pp. 17-22, http://to.ly/P3s

Early Pregnancy Loss,  http://emedicine.medscape.com/article/260495-overview Note: Chief Editor is Lee P. Shulman, MD – one of bioZhena Corporation’s Board of Medical Advisors.

Excerpted:

Early pregnancy loss is unfortunately the most common complication of human gestation, occurring in at least 75% of all women trying to conceive. Most of these losses are unrecognized and occur before or with the next expected menses. Of those that are recognized, 15-20% are spontaneous abortions (SABs) or ectopic pregnancies diagnosed after the pregnancy is clinically recognized.

The incidence of spontaneous miscarriage is10-15%, whereas the rate of recurrent miscarriage is 3-5%.

Approximately 5% of couples trying to conceive have 2 consecutive miscarriages, and approximately 1% of couples have 3 or more consecutive losses. Early pregnancy loss is defined as the termination of pregnancy before 20 weeks’ gestation or with a fetal weight of

The gestational age at the time of the SAB can provide clues about the cause. For instance, nearly 70% of SABs in the first 12 weeks are due to chromosomal anomalies. However, losses due to antiphospholipid syndrome (APS) and cervical incompetence tend to occur after the first trimester. END QUOTE.

Medline ® Abstracts for References 3-5,7-9 of ‘Spontaneous abortion: Risk factors, etiology, clinical manifestations, and diagnostic evaluation’ http://to.ly/P4e

Citing from one abstract on the list: “Preterm death of the human conceptus is common.”

Conclusion of a 2003 paper from China: We demonstrated substantial EPL in the non-clinically pregnant cycles and a positive relation between EPL and subsequent fertility. EPL = Early Pregnancy Loss. The conception rate per cycle was 40% over the first 12 months.

Conclusion of a 2010 British Medical Journal paper from Scotland: Women who conceive within six months of an initial miscarriage have the best reproductive outcomes and lowest complication rates in a subsequent pregnancy.                          

See it at: http://www.bmj.com/content/341/bmj.c3967.full?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=Bhattacharya&searchid=1&FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT

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Parturition means birthing (birth) and dystocia a difficult one

January 9, 2008

And what is a parturition alarm?

For these and other entries, see the Alphabet of bioZhena at

https://biozhena.wordpress.com/2007/11/28/the-alphabet-of-biozhena/

Parturition alarm:

This is a concept that has to do with the need to know when labor or delivery is beginning, because the birthing female may be in need of help.

At the time of writing the first Alphabet draft more than five years ago, an Internet search produced only one such technology, a pressure-sensing girth, suitable for the horse breeder only, because it utilizes the fact that the horse mare lies on her side only in the process of parturition. To illustrate, we borrow a nice picture from a more recent publication found in today’s search on parturition alarm, which search still shows a preponderance of equine innovations:

Equine birth alarm

In the originally noted publication, reference was made to some other method that would detect the emergence of the amniotic sac or of the foal from the vulva (vaginal orifice) but that was not a satisfactory solution. In the horse-breeding arena, about 5-6% of births require help. Various approaches to the birth alarm solution have been attempted.

These days, there are quite a few patents etc. found in the parturition alarm search. And even 5 years ago, a patent from New Mexico University should have been found because their intra-vaginal parturition alarm patent (basically for cows) was published in 1987.

In human obstetrics, where most births take place in hospitals, determining the right time of confinement would be very beneficial. bioZhena (and/or its sister company, bioPecus) will investigate our vaginal sensor technology – suitably modified – with a view to developing a parturition alarm applicable to any mammal.

Also relevant in this context is the implication of the Ovulona making available the menstrual cycle (folliculogenesis) data over many months or cycles before conception. This will enable a more accurate anticipation of the EDD, Expected Date of Delivery. You will understand this better below, under Parturition. I highly recommend that you check out Figuring Your Due Date, too – from the Midwife Archives.

Let us put it this way: Since this is the bioZhena blog (and not bioPecus, for veterinary tools), the EDD issue must be addressed first, before any parturition alarm developments. Because we are primarily concerned with the Rerum Naturare Feminina.

And it would still be of great interest to hear from an expert Latinist about the correct way of saying this in plural, the Natural Thing of Women, the Women’s Natural Thing…

This being a reference to /2007/12/16/cervix-uteri-and-seven-or-eight-related-things/ .

Parturition:

The process of giving birth; childbirth. [From Late Latin parturitio, from Latin parturitus, past participle of parturire, to be in labor.]

Parturition is illustrated at http://www.mhhe.com/biosci/esp/2001_saladin/folder_structure/re/m2/s5/ .

The illustration’s legend indicates that physicians usually calculate the gestation period (length of the pregnancy) as 280 days: 40 weeks or 10 lunar months from the last menstrual period (LMP) to the date of confinement, which is the estimated date of delivery of the infant [EDD].

Indubitably, due dates are a little-understood concept:

“Truth is, even if you know the exact date when you ovulated, you still can only estimate the baby’s unique gestational cycle to about plus or minus two weeks” [ http://www.gentlebirth.org/archives/dueDates.html ]. Why should that be? Because of the variability of your menstrual cycle lengths? (They vary even if you do not think so).

Statistically, the gestation time for human babies has a mean of 278 days and a standard deviation of 12 days, an uncomfortably large spread. The old Naegele Rule of a 40-week pregnancy was invented by a Bible-inspired botanist Harmanni Boerhaave in 1744 and later promoted by Franz Naegele in 1812. It is still believed to work fairly well as a rule of thumb for many pregnancies. However, the rule of thumb also suggests: “If your menstrual cycles are about 28 days, quite regular, and this is not your first child, your physician’s dating is probably fine. If your cycles are longer or irregular, or if this is your first child, the due date your physician has given you may be off, setting you up for all kinds of problems” (induction, interventions, C-section among them).

This is where the bioZhena technology can be expected to provide help, making it possible to reckon the EDD with recorded menstrual cycle (folliculogenesis history) data rather than merely with the LMP + 280 days. This, once properly researched, may be expected to have a significant impact on obstetric management. — Any comments?

It is ironic that, in this age of technological medicine, American women worry about their birthing process not being allowed to take its own natural course on account of an ancient method of predicting the EDD.

Ironically, the 40 week dogma – which is the gestational counterpart of the unacceptable calendar method of birth control (the so-called “Vatican roulette”) – does not reconcile the 295+ days of the 10 lunar months; and yet, at the same time, the U.S. has an unusually high perinatal death rate, resulting from high statistics of too early (preterm) labor. Quid agitur? See also under Gestation.

Dystocia or birthing difficulty:

Dystocia is difficult delivery, difficult parturition. From Latin dys-, bad, from Greek dus-, ill, hard + Greek tokos, delivery. Calf losses at birth result in a major reduction in the net calf crop. Data show that 60% of these losses are due to dystocia (defined as delayed and difficult birth) and at least 50% of these calf deaths could be prevented by timely obstetrical assistance. The USDA web site http://larrl.ars.usda.gov/physiology_history.htm is apparently no longer there but when it was it indicated that an electronic calving monitor was being developed to determine maternal and fetal stress during calving. These studies are important since they are leading the way for developing methods to reduce the $800 million calf and cow loss that occurs each year at calving in the USA’s beef herds.

In analogy with the superiority of in vivo monitoring of folliculogenesis versus tracking behavioral estrus (heat), in vivo monitoring of the progress towards parturition must be a priori a more promising approach.

The telemetric version of the BioMeter – the animal version of the Ovulona technology – will hopefully provide a tool for these efforts. Once tested on animals, human use will be a logical extension of the endeavor. (Or endeavour, should it take place in Europe! Smiley…)

Comment about the EDD and/or EDC issue, and request for input:

Again, EDD stands for Estimated Day of Delivery, while EDC stands for Estimated Day of Confinement.

Per Encyclopedia of Childhood and Adolescence, article Gestation Period and Gestational Age [ http://findarticles.com/p/articles/mi_g2602/is_0002/ai_2602000272 ], ” a gestation period of thirty-eight weeks (266 days) is calculated for women who are pregnant by a procedure such as in vitro fertilization or artificial insemination that allows them to know their exact date of conception.”

The Ovulona device from bioZhena will provide to the woman user a very simple means to record the day of any intercourse. In every cycle, whether pregnancy is planned or not. This must become a part of the routine. The information will be electronically recorded along with the daily or almost-daily measurement data inherent in the use of the Ovulona. With that menstrual cycling history data, this intercourse-timing information will be available for optional use by the woman’s physician(s).

Therefore, the routine use of the Ovulona will provide for an equivalent of the above-referenced 38-week (266 days) calculation available to the women receiving IVF or artificial insemination.

This alone should be an improvement on the current way of EDD/EDC assessment.

In addition, an investigation should be undertaken into the question of whether any inference can be drawn from the woman’s menstrual cycle history prior to the conceptive intercourse. Any comments on this would be welcome, even about anecdotal or subjective or tentative observations that may be available already. However non-scientific, however tentative, however uncertain an individual answer or input from you may be…

E.g., do women with more or less regular cycles tend to exhibit a regular gestation period, and vice versa?

And, certainly, what evidence is available in medical literature (or maybe in unpublished records?) about the outcomes of the IVF and/or artificial insemination pregnancies, i.e., about their documented gestation periods? Does the 38 weeks projection work? Always? If not always, can anything be correlated with any deviation?

Do women with distinctly irregular menstrual cycles tend to have non-regular gestation periods?

The complicating effect of first versus subsequent pregnancy has already been noted, of course…

Conceivably, there is no such preliminary info available, and we shall have to try and gather even these preliminary data in a systematic manner, but – no question asked, nothing learned… Public or private input would be appreciated.

Birthday, and how it relates to the bioZhena enterprise – eukairosic™ diagnostic tools

December 28, 2007

Today is a major anniversary related to the bioZhena enterprise. Namely, a round-number (and not small) birthday of the offspring whose begetting had much, if not everything, to do with the inception of the project.

The biologically educated member of the would-be parental team insisted that medical help would have to be the very last resort, as she did not wish to be poked in and subjected to the various medical procedures available in the country of the proud Albion (that, alas, no longer ruled the waves!), where this awakening was going on. The image of what she resented getting into is telling, and it’s not even the whole story.

Woman in stirups sketch

Awakening on the part of said couple, who till then took steps to minimize or theoretically avoid getting in the family way, owing to circumstances. As in too many instances the world over, the “awakening” was left until somewhat too late. I do not wish to talk about age specifics, but you probably know that particularly female fertility (more accurately put, fecundity or fecundability) decreases starting around or even before the Christ’s age, and so – in retrospect – it was no great surprise to find that achieving pregnancy was not as simple as expected. At the time, actually, this was a great surprise…

At the time, yours truly was not an expert in the field that deals with certain practicalities of the most important aspect of life, by which many of us mean procreation, reproduction, and its management. I am referring to some insight into the practicalities on the female side of things procreative, which insight was not there at the time – but the better half knew the basic fundamental that I now delight in referencing as eukairosic.

In a nutshell, the word refers to the right time, opportune time – exactly what we are about the strategic or “right time; the opportune point of time at which something should be done.” A window of opportunity is kairos time.

For more about this, the Wikipedia article can be recommended, at http://en.wikipedia.org/wiki/Kairos . Let’s cite: Kairos (καιρός) is an ancient Greek word meaning the “right or opportune moment,” or “God’s time” [sic; thus said – but this should say “gods’ time”]. The ancient Greeks had many gods, and two words for time, chronos and kairos. While the former refers to chronological or sequential time, the latter signifies “a time in between”, a moment of undetermined period of time in which “something” special happens. What the special something is depends on who is using the word. END QUOTE.

If you visit that article, you will probably understand why I would like to look at the possibility of adopting as our company logo QUOTE a monochrome fresco by Mantegna at Palazzo Ducale in Mantua (about 1510 C.E.) that shows a female Kairos (most probably Occasio)… UNQUOTE.

You will also appreciate that, since we are not theologians, and because “eu-“ is the Greek prefix meaning well or good or true or easy, my choice of the adjective that we want to trademark as descriptive of bioZhena’s wares is eukairosic™.

And so here, for the sake of accurate definition, is one other item from The Alphabet of bioZhena – /2007/11/28/the-alphabet-of-biozhena/

Fecundability and fecundity:

Fecundability is the probability of achieving pregnancy within one menstrual cycle – about 20% or maybe 25% in normal couples [sic; the probability depends on many factors, including age – vide infra, or see below].

Fecundity is the ability to achieve a live birth.

Fecundability is strongly influenced by the age of the partners, and it is maximal at about age 24. There is a slight decline at ages 24 – 30, and a rapid decline after age 30.

The words are derived from Latin fecundus, fecund, from the root of fetus, via Old French fecond. Fecund means fruitful in children, or prolific.

As for the eukairosic diagnostic tools, their utility goes beyond reproductive management. Due to folliculogenesis (menstrual cycling), even things such as administration of medications or certain diagnostic examinations must be performed at the right time within the menstrual cycle…

Scire quod sciendum

fecundoscitus!!! 🙂

Thus spoke the exegete and father of Barnaby and Petrushka, Vaclav Kirsner © 2007

 ‘To know what is to be known’.


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