Posts Tagged ‘pregnancy’

The fallacy of ovulation calculators, calendars and circulating-hormone detectors

February 13, 2012

Don’t let them lead you by the nose with likely this and probable that! You need to know for sure.

When it comes to the crucial timing of ovulation, it is astonishing to see the fallacies and delusions propagated on the web – and that this includes even certain generally respected mainstream sources. How they declare, for example: If you’re trying to get pregnant, use this tool to find out when you likely ovulate and are most fertile.

Never mind that “most fertile” makes absolutely no sense because there is no such thing as a little fertile, more fertile and most fertile!

Ladies (and teenage young ladies included!), you either are fertile today or you are not: You either can conceive today or not.

It is either or.

You either are fertile today or you are not. It is not a little bit fertile, or more fertile, or most fertile. Like, you cannot be a little bit pregnant… you either are, or you are not.

Besides which, if you want to conceive a pregnancy, you must know with certainty that ovulation happens when you try to conceive – not merely that it is likely to happen. Unless you are reproductively ill or menopausal, it is always likely to happen at some point but the mere likelihood is not very helpful. Conception absolutely requires ovulation so that the released (ovulated) egg has a chance to be fertilized.

You must have a way of detecting ovulation at home and, based on that instrumentally recorded information, we will also help you with the Expected Date of Delivery (EDD), because that is how it works. Not the LMP (Last Menstrual Period) but the date of the conceptive ovulation — that’s the ovulation with which you became pregnant because your ovulated egg became fertilized. The date of ovulation is the date from which the EDD must be computed.

Ovulation caught on camera

Ovulation caught on camera by Dr. Donnez – impressive but not a practical method of detecting ovulation

Fast forward to the principle that’s behind the take-home message of this post and that’s systematically arrived at by the end of this post:

Briefly: Tracking systemic effects (hormones in circulation) is not good enough for fertility status determination, especially if the purpose is pregnancy avoidance.

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To be blunt about the language of “likely ovulate” and “most fertile”: Such language simply reflects their inability to be definitive about it – and they therefore resort to guesstimating ovulation, calling it a calculation.

Numerous websites proffer their ovulation calculators when you search online for “ovulation”. A free, printable ovulation calendar and ovulation calculator to help you…, ovulation calculator can help you find the best time to conceive (as if there was some worse time when to conceive!), a calculator to generate your ovulation calendar and determine the best time…, our free Ovulation Calendar helps you predict your most fertile time of the month (ovulation) so that you can achieve pregnancy. Etc.

Notably and significantly, they do NOT promote this for natural (behavioral) pregnancy avoidance (birth control) but only as a tool for assisting conception – as if these were not the two sides of the same coin. They do not because they would get into trouble if they did.

A common approach relies on detecting, in a woman’s urine, the luteinizing hormone (LH) that typically surges on the ovulation day. The LH surge (sharp narrow peak in LH concentration) occurs a few hours before ovulation. Because that is really too late for anticipating ovulation, a related but more sophisticated fertility monitor additionally detects also a metabolite of estrogen, i.e., another hormone, which anticipates the LH surge by about a day.

The worst flaw of systemic hormone monitoring

Fundamentally the most serious detriment is the fact that ovulation as such is not detected by said fertility device or any other such available in the marketplace. Ovulation is merely assumed to occur some hours after the LH surge – but the surge of the LH hormone is merely a trigger signal sent by the brain to the ovary. It says, “ovary, let go of the ovum in our dominant follicle”, but it does not say that the ovary in fact did (or does).

This is a fundamental flaw because ovulation is known to fail to occur in approximately 20% of the follicles. Those follicles, triggered by the LH, undergo the cyclic event of follicle rupture but, despite the rupture, the egg does not come out – there is no ovulation.

Human ovulation caught on camera

In 20% of LH-triggered cases, the egg is not released so ovulation, as photographed here by Dr. Donnez, does not occur

Ovulation also fails to occur with another type of follicles, the so-called luteinized unruptured follicles. Yet, the LH surge can be seen in either case, and is therefore a false indicator.

Furthermore, when stress causes a delay of ovulation or absence of ovulation despite the LH surge signal (signal from the brain to the ovary), this cannot be detected and handled by the urinary hormone-based approach. As you can imagine, with our stressful lifestyle and environment, this is a very serious flaw that results in many disappointments. Our technology will make a big difference in managing the situation.

George Condo - Field of Figures

George Condo – Field of Figures sold for $450,000 at Skarstedt Gallery’s booth Published: June 14, 2011

Since, unlike our Ovulona™ Smart Sensor™ technology, their method depends on biochemical reagents and since the supply of the reagents is limited, their product’s user has to estimate on which day of her menstrual cycle she should start using the hormone-monitoring device when peeing into a cup. She does the estimating based on her previous menstrual cycle(s) as though the length and the timing of the present menstrual cycle were the same as in her previous cycle(s). Alas, that’s not so. Because of the variable lengths of successive cycles in most women, this is a weak feature in their design (even though they are getting away with it).

A key practical problem of the referenced 2-hormone device (the Clearblue® Fertility Monitor) is that the monitored urinary concentration of the estrogen metabolite E3G peaks only about 12 to 24 hours prior to the LH surge. This is not early enough to serve as a marker of the beginning of the fertile phase.

Fertile day 1 not identified

Their research or marketing literature may claim that “a sustained rise in E3G can be used to identify the start of the fertile phase”, referring to the slow gradual increase that eventually becomes the peak of E3G concentration. However, the idea to use an ill-defined rise – rather than the peak in the cyclic profile of the estrogen metabolite – is not a viable solution to the fertile window problem.

Even if the ill-defined E3G rise in the urine were correlated with a clearly defined stage of the egg development towards ovulation, a serious problem is that the rate of the E3G rise differs from cycle to cycle, as do the blood concentrations of E3G. The initially slow increase of the E3G concentration in the urine proceeds at different rates in different cycles, not only at different rates in different women. The E3G rise cannot be predictably associated with the beginning of the fertile period, and it cannot serve as a marker.

Hypothalamus-Pituitary-Gonad Feedback Loop

Schematic diagram of interaction between the LH and FSH hormone-generating glands in the brain (hypothalamus and pituitary) and those of the ovary (female gonad) generating estrogen and progesterone

The reasons are as follows:

1. Estrogen is known to have both stimulatory and inhibitory effects on LH secretion and, to be effective as a stimulant, it must rise to its peak levels (> 150 to 200 pg/ml) and must remain elevated for at least 36 hours [J. Hotchkiss and E. Knobil in E.Y. Adashi, J.A. Rock and Z. Rosenwaks, editors: Reproductive Endocrinology, Surgery and Technology, Lippincott-Raven Publishers, 1996].

In fact, the E3G rise indicates something else:

2. The E3G profile does not reflect the local interplay of estrogen with progesterone because it only reflects clearance of one of at least 10 metabolites of estrogen from peripheral blood circulation into the urine, after oxidative conversion in the liver.

Whatever the rate of this clearance process in the given woman in the given menstrual cycle, there are “local mechanisms due to which the quantification of ovarian steroids in peripheral blood or in urine is rendered interesting but of little value in predicting the genital end-organ effect” [C.J. Verco, in A.M. Siegler, editor: The Fallopian Tube. Basic Studies and Clinical Contributions, Futura Publishing Company, 1986].

The decades old problem is fundamental

This makes for the same basic flaw as that suffered by other monitors of peripheral hormones whether the hormone be progesterone (BBT monitoring) or estrogen (conductivity of saliva or of vaginal fluids).

Thus, the 2-hormone approach is in the end as inaccurate as the other LH-detecting techniques (the OPKs, Ovulation Predictor Kits). Therefore, like the other hormone monitoring methods, it cannot be approved and proffered for pregnancy avoidance since the failure rate would be unacceptably high. In fact, a law suit ensued in England, when the original developer company did sell the LH-and-estrogen monitor as a “contraceptive system”, and a number of unintended pregnancies resulted to the users.

The fundamental point is this: The effects of the local and acute regulatory mechanisms (referenced under 2 just above) remain undetected by the old techniques that work with the peripheral biomarker variables.

Ovarian vein-to-artery exchange of steroids, prostaglandins and other bioactive substances is a local transfer mechanism which enables local regulation of ovarian, tubal and uterine functions. The local, as opposed to peripheral, blood concentrations of the steroid hormones are also believed to work with the innervation of the female genital tract (the cervix in particular).

The effects of these local and acute regulatory mechanisms remain undetected by the old so-called prior art techniques that work with peripheral biomarker variables. In contrast, our Ovulona™ detects them – via the cervix, the natural monitor of the female reproductive system.

Gustav Klimt - Medicine mural (complete view)

Gustav Klimt – Medicine mural – Klimt’s primary subject was the female body

The flawed assumption of similar timing of menstrual cyclic events from one cycle to another has been a problem for the BBT and the BBT thermometers. Since the late sixties, the microprocessor technology has been applied by a number of people to the well-tried basal body temperature [BBT] approach to family planning that was originally hoped to work for pregnancy avoidance.

Smart phone apps with the BBT?

The BBT approach is no longer recognized as medically valid even if it may be acceptable to some of the older physicians, and to the younger buyers of an expensive microcomputerized BBT monitor offered from Europe and/or to the users of the more recent smart phone apps based on BBT monitoring.

This is because the so-called basal body temperature is a systemic variable that reflects, among other things, progesterone rise in peripheral blood after ovulation, usually one or two days later.  It is a very indirect and non-specific biomarker. Even though in some women in some cycles a little-understood dip in the temperature graph may apparently be observed one day before the temperature rise, it is clear that the BBT method is of little value due to its lack of predictive capability and due to its fundamental unreliability. The BBT-rise data is known to have a large error bar since the rise can occur from 3 days before to 3 days after ovulation.

For a more detailed critique of the BBT monitoring approach and a rebuttal of a particular European product, peruse Critique of BBT monitoring – DuoFertility rebuttal. Also read a note on 3 things that differentiate our technique from the smartphone apps and particularly the most recent, Natural Cycles .

Briefly: Tracking systemic effects (hormones in circulation) is not good enough for fertility status determination, especially if the purpose is pregnancy avoidance.

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Purveyors of the old “prior art” technologies get away with it because of the high demand for any help with the serious and growing problem of sub-fertility, more commonly called trying-to-conceive or difficult getting pregnant. When the purveyors publish anecdotal evidence of “efficacy” in the form of thank-you letters from women who did achieve pregnancy, we should keep in mind that the women received help in focusing on trying to hit the fertile period regardless of whether the given technology actually did work or not.

If any of the “prior art” did work reliably, it would be used as a pregnancy-avoidance tool, which is not the case (with the one exception noted above, a reservation included suggesting that only women with self-assessed regular cycles opted to buy the BBT-and-calendar based app with its 11 “unsafe” days offered to the user instead of the true fertile window).

Venus, Cupid, Folly, and Time (also called An Allegory of Venus and Cupid and A Triumph of Venus) is an allegorical painting by the Florentine artist Agnolo Bronzino. It is now in the National Gallery, London. Artist     Agnolo Bronzino Year     circa 1545 Type     Oil on wood Dimensions     146 cm × 116 cm (57 in × 46 in) Location     National Gallery, London Its meaning, however, remains elusive. Cupid, along with his mother (Venus) and the nude putto, to the right, are all posed in a typical Mannerist figura serpentinata form. The two central figures are easily identified by their attributes as Venus and Cupid. For example, she holds the golden apple she won in the Judgement of Paris, while he sports the characteristic wings and quiver. Both figures are nude, illuminated in a radiant white light. Cupid fondles his mother's bare breast and kisses her lips. The bearded, bald figure to the upper right of the scene is believed to be Time, in view of the hourglass behind him.[2] He sweeps his arm forcefully out to his right. Again, it is difficult to interpret his gesture with any certainty The old woman rending her hair (see detail at right) has been called Jealousy—though some believe her to represent the ravaging effects of syphilis[2] (result of unwise intercourse).

Venus, Cupid, Folly, and Time (also called An Allegory of Venus and Cupid and A Triumph of Venus) is an allegorical painting by the Florentine artist Agnolo Bronzino – circa 1545.  The bearded bald figure to the upper right is believed to be Time…

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Now go see about “Instant detection of pregnancy and of Early Pregnancy Loss, EPL – the adversary of Trying To Conceive, TTC – especially after age 25″ at https://biozhena.wordpress.com/2010/11/11/instant-detection-of-pregnancy-and-of-early-pregnancy-loss-epl-the-adversary-of-trying-to-conceive-ttc-especially-after-age-25/

And should you be an investor and/or wish to find out more, check out  Home Page of bioZhena’s Weblog

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Saint Nicholas Day, his legend, and our modern day’s prematurity, EDD calculation, gestational age, problem with LMP

December 8, 2010

Could high prevalence of prematurity be a consequence of motherhood not being the top job held by society in high esteem? A modern paradox.

December 5 is the eve of St. Nicholas Day, the patron Saint of many people, cities and countries – including the largest one [ http://en.wikipedia.org/wiki/Saint_Nicholas#Deeds_and_miracles_attributed_to_Saint_Nicholas ]. St. Nicholas is remembered and celebrated in similar ways in some countries, rewarding well-behaved children but not the misbehaving ones… Which is why St. Nicholas, known as Svaty Mikulas, visits the children at home, in certain parts of Central Europe, in the evening along with an Angel and a Devil (Cert). The Saint asks the parents about the kids’ conduct…

Josef Lada_Mikulas, andel a cert

Josef Lada - Mikulas doma

Josef Lada – Mikulas doma

I share with you a depiction of the tradition drawn by Josef Lada in the troubled 1930s, an idyllic tradition of an industrial people, which they keep to this day…

Besides numerous miracles, this most popular of Saints was and is reputed for gift-giving (hence the commercialized Santa Claus transformation morphing St. Nicholas  with a Western or Northern European Father Christmas later on in the month of December).

There are numerous legends about Saint Nicholas’ miracles and his deeds of help. Perhaps the most famous one is about the three daughters of an impoverished man who could not afford a proper dowry for them, dowry being an ancient habit, the original purpose of which “was to provide ‘seed money’ or property for the establishment of a new household” – and we are now talking about the 300s CE [Christian Era].

The saint Bishop of Myrna saved the girls from the fate of slavery and prostitution by secretly dropping “three purses (one for each daughter) filled with gold coins through the window opening into the man’s house”, which gift made the young girls “eligible” again. It is also said that he dropped the gift down the chimney where stockings were hanging “over the embers to dry, and that the bag of gold fell into the stocking”. That’s beside the point because we are not discussing Santa of Christmas, but rather we are remembering St. Nicolas of December 6.

Jan_Steen_Het_Sint_Nicolaasfeest, The Feast of St. Nicholas

Jan_Steen_Het_Sint_Nicolaasfeest,                               The Feast of St. Nicholas

In those times many, many centuries ago, the chief purpose of young women’s life was motherhood, naturally within a marriage, hence the said dowry habit. In our times, many things have changed, including, unfortunately, young women’s attitude towards motherhood. Well, not just young women’s attitude…

Motherhood must be held in high esteem to reverse the trend reflected by an outcry in tweeter-sphere that’s a part of life nowadays: “I never felt marginalized as a woman until I became a mother”. Now this is very sad. Sad for society since the opposite should be the case.

Motherhood is the most important “job” in the world, and this is not some cute old-fashioned thought. Women bear enormous responsibility for the health of the nation, of humankind. Society should pamper them. Meaning: Society should be organized based on the recognition of Mother Nature’s design, which design – with the optimal years for motherhood in the early twenties – does not go away only because nowadays we can do all kinds of things – including octuplet pregnancies at grandmotherly age.

One consequence of the referenced changes is the currently common delays in getting married, and especially delays in bringing children into the world, starting a family. In other words, the unfortunate consequence is motherhood in later years of life than Nature intended. And then there are other consequences. Among them, prematurity.

Lou Beach, Preggers

Lou Beach, Preggers

@DrJenGunter not too long ago tweeted on prematurity, the most common cause of infant morbidity and mortality in the U.S.: “I just wrote a book on prematurity. Personal and professional experience”. See The Preemie Primer: A Complete Guide for Parents of Premature Babies–from Birth through the Toddler Years and Beyond [Paperback], Jennifer Gunter MD (Author) at http://www.amazon.com/Preemie-Primer-Complete-Premature-Babies/dp/0738213934/

Here is a citation [from http://www.preemieprimer.com/ ]:

My son Victor has dystonic cerebral palsy. He weighed 843 g at birth and had a grade 2 IVH. The bleed resolved in the NICU without hydrocephalus.

He is seven years old now. He is very stiff and is so shaky on a bicycle that we have given up trying for now. He couldn’t stand on one foot until he was 5. It took a very long time for him to get the hang of swimming and at the age of seven he is by no means a fish, but I feel if he were to fall in a pool he could keep his head above water. His digestive tract is very affected, but we have figured out ways to minimize these issues. It took countless hours of OT and thousands of hours of him practicing, but his writing is beautiful and God know where he gets his spelling ability from. He hopscotches like a pro. He is reading a grade level ahead. All without a CT scan or an MRI.

Based on his exam and his problem areas I am sure his cerebellum is a mess. In fact, I wonder if I would have pushed him so hard if I had seen a brain scan before we left the NICU?

“What we know about prematurity” is reviewed by the March of Dimes Campaign at http://www.marchofdimes.com/Mission/prematurity_indepth.html .

Today more than 1,400 babies in the United States (1 in 8 [= 12.5%]) will be born prematurely. Many will be too small and too sick to go home. Instead, they face weeks or even months in the newborn intensive care unit (NICU). These babies face an increased risk of serious medical complications and death; however, most, eventually, will go home. … In fact, the rate of premature birth increased by more than 20 percent between 1990 and 2006. … The rate fell to 12.3 percent in 2008 from 12.7 in 2007, a small but statistically significant decrease.

Why women deliver early? In nearly 40 percent of premature births, the cause is unknown. However, researchers have made some progress in learning the causes of prematurity. Studies suggest that there may be four main routes leading to spontaneous premature labor.”

Štyrský, Marriage

Štyrský, Marriage

Do refer to the referenced article for more about the four main causes:

  1. Infections and/or inflammation.
  2. Maternal or fetal stress.
  3. Bleeding.
  4. Stretching.

And then there is this: These four routes are not the only things to consider. Other factors, such as multiple pregnancy, inductions and cesarean sections, can also play a role. (Mostly man-made factors, we note. I say “mostly” because some multiple pregnancies happen also to women who did not get pregnant through the Artificial Reproductive Technologies… )

Prematurity is bad for infant, parents, and public health. We at bioZhena propose to contribute to the reduction of its prevalence, by making the FOLLICULOGENESIS IN VIVO™ [FIV™] technology available for routine use by women and their physicians. As a particular example, in relation to the referenced other factors, we propose to make it possible to compute the Expected Date of Delivery (EDD) based on the expectant mothers’ folliculogenesis data.

The idea is to get away from the gestation calculation popularized about 200 years ago in 1812 by a Dr. Naegele, for whom the 40 weeks or 10 lunar months rule of obstetrics is named. This rule of 280-day gestation assumes that the mother ovulates on day 14 of a 28 day menstrual cycle, which the readers of bioZhena’s Weblog know that it is an unrealistic assumption.

America in 1812, the time of Dr. Naegele’s 200 years of fame

America in 1812, the time of Dr. Naegele’s 200 years of fame

Napoleon & carabiniers_in_front_of_Moscow_1812

Napoleon & carabiniers_in_front_of_Moscow_1812

Allegedly*, it was Dr. Hermanni Boerhaave, in his time a highly respected academic physician, botanist and chemist, who read in the Bible that pregnancy should last 10 lunar months. He is said to have formulated – in the 1700s – a way of calculating the expected date of delivery (EDD).

Thus, expectant mothers get EDD today based on the myth of the baroque-era Boerhaave … Yet, already Aristotle taught that “the human fetus is expelled … at any period of pregnancy …; moreover, when the birth takes place in the eighth month, it is possible for the infant to live.”

The gist of the bioZhena hypothesis is this: The EDD can be projected quite well from ultrasonic measurements of the unborn baby’s head and body size, but for a more convenient, affordable and consequently more practical solution, we propose to seek a correlation between the Ovulona FIV™ attributes such as cycle length and the EDD/EDC. Importantly, this will be done by using the date of insemination, which will be easily – electronically – recorded by the user of the Ovulona™ as an integral part of the routine.

Trying to be fair or considerate to the women’s healthcare classics, I report an obgyn.net paper at http://www.obgyn.net/fetal-monitoring/fetal-monitoring.asp?page=cotm/9807/cotm_9807 . It is titled “’Back to the Future’ for Hermaani Boerhaave, or, ‘A rational way to generate ultrasound scan charts for estimating the date of delivery’” by Dr David J R Hutchon, Consultant Obstetrician, Memorial Hospital, Darlington, England. This is about the ultrasound approach, and he comments that: QUOTE “the approach mimics, in modern terms, the method originally formulated by Boerhaave. … If Boerhaave had had an ultrasound scanner, his paper might have read something like, ‘It is proved by numerous observations that 99 out of 100 births occur 22 weeks (at 18 weeks gestation) after the biparietal diameter of the fetus is 40mm’ (Fig 1).”

Besides his Figure 1, I also share Mr Hutchon’s (a British medical doctor, when Consultant, becomes Mr again) Fig. 2, “Regression analysis showing line fit plot. The number of days between scan and delivery has been converted to conventional gestation by subtracting from 280. The lower and upper dotted lines represent delivery at 42 and 37 weeks respectively.” QUOTE UNQUOTE.

Gestation age vs. crown rump length by DJR Hutchon

Gestation age vs. crown rump length by DJR Hutchon

Gestation vs. biparietal diameter by Hutchon

Gestation vs. biparietal diameter by Hutchon

Biparietal diameter is the (outer – inner) measurement of the fetal skull echo. Crown-rump length (CRL) is the measurement of the length of human embryos and fetuses from the top of the head (crown) to the bottom of the buttocks (rump). In humans, the fetal stage of prenatal development starts at the beginning of the 11th week in gestational age, which is the 9th week after fertilization. These are the Wikipedia reported definitions. The two weeks between 9 and 11 assume the “regular” length of the menstrual cycle, which is a theoretical assumption that could very likely be incorrect in practice, in the given woman and in the given last cycle of hers (because regularity is a myth, too). Well, look at the scatter in the data points, it’s telling.

In addition to the convenience, affordability and practicality of the bioZhena approach, do not overlook the feature that the data will be personal to the given woman, and the measurement will not refer to LMP. It will not rely on the woman’s recollection of her last menstrual period (instead, it will refer to the last electronically recorded intercourse); and it will not subject the baby to unnecessary ultrasound radiation.

For more on the topic, try under Gestation in the Alphabet of bioZhena https://biozhena.files.wordpress.com/2007/11/aaee-the-alphabet-of-biozhena.pdf (or https://biozhena.wordpress.com/2007/11/28/the-alphabet-of-biozhena/ ). See also the discussion under Parturition, where we express the expectation that parturition management will be revolutionized by the introduction of the Ovulona into obstetric and gynecological practice.

Anderle - Pasek 06

Anderle – Pasek 06

Summary Definitions [quoted from http://www.righthealth.com/topic/Fetal_Age ]:

Gestation is the period of time between conception and birth, during which the fetus grows and develops inside the mother’s womb.

Gestational age is the time measured from the first day of the woman’s last menstrual cycle [LMP] to the current date. It is measured in weeks. A normal pregnancy can range from 38 to 42 weeks.

Infants born before 37 weeks are considered premature. Infants born after 42 weeks are considered postmature. (Note: 42 x 7 = 294).

Especially with the challenged menstrual cycles that are particularly irregular in length, referencing the LMP in the reckoning can easily introduce a significant error. Perhaps that is why the above summary definition of normalcy is 38 to 42 weeks but prematurity is “before 37 weeks”? (A week here, a week there…) Read also the earlier post https://biozhena.wordpress.com/2008/01/11/about-the-edd-andor-edc-issue-and-a-request-for-input-from-readers/ .

Tomáš Císarovský  - Kukátko

Tomáš Císarovský – Kukátko

280 may have been in the Bible, but it ain’t necessarily right. We’ll see whether 266 is, and whether it is a worldwide constant, which is doubtful. If for no other reason, global constancy is doubtful because it was reported from India that “Mean gestational age at the onset of labour for women native to the area of study was 272 days (standard deviation 9 days). Pregnancies beyond a duration of 280 days showed significantly increased perinatal morbidity.” (Referencing the above righthealth.com definitions, we see 294 – 280 = 14. A week here, a couple of weeks there…)

Well, 272 – 14 = 258. Not 266, and that number is of interest because per Encyclopedia of Childhood and Adolescence, ”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” (article Gestation Period and Gestational Age).

And then you have the oprah.com article, which asks, “Will the labor start naturally on time, or will the baby be so late that induction or Caesarean section is necessary?”: http://www.oprah.com/relationships/Is-Pregnancy-Really-40-Weeks-Long . While debating the validity of the word “necessary” is not the point here, the author there refers to data from studies that concluded greater than 280 days due dates (288 days in one study), of which one study was in Sweden.

A hypothesis can be that hot climates may lead to lower gestation periods than cold climates. This would be a hypothesis based on two data points and a common sense for “the babies taking longer when it’s cold outside”… We’ll want to compare, say, data from Inuits and Lapps on the one hand with data from equatorial Africa and Philippines and/or Indonesia on the other. Logically, we’ll control for factors known or suspected as being involved, such as those four main causes listed above – and age, parity and other factors already explored by people such as Mittendorf in the 1980s.

Kupka - Creation de l homme

Kupka – Creation de l homme

The idea is that routine use of the Ovulona will provide for an equivalent of the above-referenced 38-week (266 days) calculation, which is available to the women receiving IVF or artificial insemination. The data will be personal and the geography of the birth will be noted (as well as ethnicity), with data sooner or later coming from all corners of the world.

Capturing and working with the fertilization date should, by and of itself, be an improvement over the current way of EDD/EDC assessment. An improvement over the paradox of modern obstetrics and gynecology handling the most important aspect of reproduction by means of some biblical myth, and having become more and more interventionist probably at least in part because of that myth. Reference a recent tweet: Maternity Care In America Rife With Systematic Failures l Being #Pregnant http://su.pr/2j91wY “most people don’t know normal birth”. This refers to the medical staff.

That these thoughts are sensible, and that the chief problem is the LMP, is supported by ultrasound studies such as “Gestational age and induction of labour for prolonged pregnancy” by Jason Gardosi, Tracey Vanner, and Andy Francis (Perinatal Research, Audit and Monitoring, Department of Obstetrics and Gynaecology, Queen’s Medical Centre, Nottingham, UK) in British Journal of Obstetrics and Gynaecology, July 1997, Vol. 104, pp. 792-797 – [http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.1997.tb12022.x/pdf].

Citing from this study of more than 24.5 thousand pregnancies: Menstrual dates [LMP data] systematically overestimated gestational age at term when compared with scan dates… suggesting that most pregnancies which are considered ‘prolonged’ according to menstrual dates are in fact mis-dated. The median gestational age for induced labours was 286 days by last menstrual period but only 280 days by scan, and most (71.5%) inductions done post-term (> 294 days) according to menstrual dates were not post-term if scan dates alone are used to calculate the gestational age.“

This study was a retrospective analysis of computer files of 24,675 pregnancies delivered in a teaching hospital between 1988 and 1995.

Here is their graphical summary of distribution of deliveries as a function of gestational ages by ultrasound scan dates.

Deliveries vs. gestational ages by ultrasound scan dates

Deliveries vs. gestational ages by ultrasound scan dates

Their most explicit statement in support of our conviction and plan is this citation: “Even if the date of the last menstrual period is recalled with accuracy, delay in ovulation can result in over-estimation of the true gestational age, which results in an apparent prolongation of pregnancy.” The authors also cite a 1972 paper in American Journal of Obstetric and Gynecology in support of the just cited statement.

The Gardosi et al. paper concluded: Regardless of obstetric and maternal views of the advantages and disadvantages of routine induction policies, our results suggest that most post-date inductions are unwarranted on the basis of gestational age. The incidence of prolonged pregnancies can be considerably reduced by establishing dates by ultrasound alone.

Needless to say, a similar graph for deliveries in India would show the spontaneous labor peak earlier (272 days by one study in tropical Manipal) while a Scandinavian graph would be shifted in the opposite direction; both were referenced above.

I’ll be darned if the introduction of the Ovulona into the gestation arena should not bring some order and peace (as opposed to the mess and anxieties of today). As I wrote in the conclusion of the related January 11, 2008 article: It is perfectly realistic a vision that, in future, an expectant mother’s EDD and/or EDC will be assessed based on her folliculogenesis (FIV™) data.

The EDD/EDC will be computed automatically and provided by her own Ovulona Smart Sensor™. And no Saint Nicholas miraculous assistance will be required by the future users – although we will not write here the same for bioZhena.

———

* I write “allegedly” because I spent many an hour looking for evidence of truth in this allegation, only to find the Dutch man an impressive medico-scientific mind and an impressive likeable character – but no evidence of the biblical dogma ascribed to him. As I write this note, I am going once more through the tedious but interesting Dr. Boerhaave’s “Academical lectures on the theory of physic” of AD 1744. The man’s fame and authority was such that “a Chinese mandarin, seeking advice, addressed his letter to ‘Boerhaave – Europe’, and it was delivered”. See http://books.google.com/books?id=QTUVAAAAQAAJ&printsec=frontcover&dq=Hermanni+Boerhaave+1744&source=bl&ots=NCeCN4gLdd&sig=SoUA_WS6iSkh2A8WpBX7S4o54Uw&hl=en&ei=ebP-TP2WBIX2tgO12-mvCw&sa=X&oi=book_result&ct=result&resnum=4&ved=0CB8Q6AEwAw#v=onepage&q&f=false

Instant detection of pregnancy and of Early Pregnancy Loss, EPL – the adversary of Trying To Conceive, TTC – especially after age 25

November 11, 2010

Early Pregnancy Loss is also known as #stillbirth or #miscarriage, or Early Embryonic Mortality (EEM), and the Ovulona™ is a tool of evidence-based personalized medicine.

After the optimum fertility age of the early twenties, achieving motherhood gets more difficult. It becomes even more essential than before to know your three fertile days, during which – and only during which – conception can occur.

The simple basic principle is: Fertility status detection must be easy and reliable. PLUS early pregnancy detection is really important, and it should be built-in, an integral part of the conception-aiding tool.

Why? Because:

1) early in pregnancy the conceived baby would be harmed by some of the medications taken by the woman, e.g. by a psychiatric medication with teratogenic effect (harmful to the fetus, causing a congenital disorder);

and 2) because of the annual 600,000 miscarriages – per CDC statistics – out of the 6 million US births, which means that at least some 10% of pregnancies are lost to early pregnancy loss (EPL), miscarriage, stillbirth.

Many EPLs go unnoticed. The EPL is a part of the TTC [Trying To Conceive] or subfertility/infertility problem. Our Ovulona monitor of FOLLICULOGENESIS IN VIVO™ is the prospective solution for managing the problem.

The Ovulona™ detects the 3 fertile days for conception, and it will also automatically detect pregnancy immediately upon conception. Similar to early pregnancy loss — its detection is the inverse of pregnancy detection, which both involve the follicular waves. Like this:

Follicular waves disappear = pregnancy detected

versus

waves reappear in early pregnancy =  early pregnancy loss detected.

Furthermore, the cyclic profile data captured by the Ovulona can be used by your healthcare provider to assess what is going on, and provide more effective help.

DIFFICULT USE OF EXISTING OPKs [Ovulation Prediction Kits] is shown in the following tweet by a @WannaBeMom: “1st month using opk. Do the lines usually start light and then get darker day by day or do they ever go back & forth b4 ovulation?”

Our electronic device will take the WannaBeMoms into a different world of baby-making.

Honey is Sweeter than Blood by Salavador Dali, 1941

Honey is Sweeter than Blood by Salavador Dali, 1941

For a woman in her 30s who has had a miscarriage or even two or three, “any delay in attempting conception could further decrease the chances of a healthy baby”, says CNN reporting on a medical study, http://www.cnn.com/2010/HEALTH/08/05/miscarriage.try.again.asap/ .

Study: Women who conceive within six months of miscarriage reduce risk of another.”

November 2016 review and meta-analysis (data on more than a million women): “With an Inter Pregnancy Interval of less than 6 months, the overall risk of further miscarriage and preterm delivery  were significantly reduced.”

These are fundamental principles.

And another principle, not brought up by the CNN or by the study itself, is that a tool for monitoring the early stage of pregnancy for EPL is most desirable. We’d say, mandatory. The Ovulona device monitors (or tracks the process of) folliculogenesis in vivo, which includes the follicular waves that occur after ovulation. The waves disappear upon conception because the reproductive system does not go into another menstrual cycle – it’s pregnant.

In case of EPL, Early Pregnancy Loss (miscarriage), the waves will come back. Early Pregnancy Loss, or Early Embryonic Mortality, is quite a common sad experience of many of us.

The essential point made here is that the woman’s and her physician’s decisions should be guided by the folliculogenesis cyclic profile (and/or its distortion due to distress of any kind). The woman and her doctor should not make decisions or pass recommendations working in the dark, and the data, on which any decision should be based, must be personal to the given patient.

That’s what the Ovulona from bioZhena is for. Personalized medicine. Evidence based medicine.

Automatic pregnancy detection is inherent in the Folliculogenesis In Vivo™ cyclic profile (follicular waves disappear).

This is a screen shot of one of my narrated slides about “what’s going on here” – view (and hear) the slide at https://biozhena.files.wordpress.com/2015/07/single-slide-unprecedented-wealth-of-info-narrated.pps.

Note specifically that: The follicular waves, which occur after ovulation [when the body prepares for the next menstrual cycle], cannot remain in place after fertilization succeeds and conception takes place [because the post-ovulation regime change is even more profound]. That is the principle of instant detection of pregnancy. As opposed to the waiting for the HPT [Home Pregnancy Test] result.

HCG or Human Chorionic Gonadotropin laboratory signature

HCG or Human Chorionic Gonadotropin laboratory signature of the biomarker – detected in a pregnant woman’s urine about 2 weeks into her pregnancy by a HPT home-use urine test – as a color change (into which color the HPT reduces the illustrated complex lab signature)

Should the conceptus [product of conception, early embryo] be lost to EEM, Early Embryonic Mortality (miscarriage), the follicular waves come back to be seen by the Ovulona. That’s the principle of early detection of the miscarriage, and of detecting the return of the non-pregnant condition.

Trying to conceive again should be based on the personal FIV™ [FOLLICULOGENESIS IN VIVO] cyclic profile data generated by the woman trying to have a baby. This is a principle of evidence-based medicine. Personalized medicine.

Entre Les Trous De La Memoire by Appia

The Ovulona is intended to help people such as those writing in a forum as follows:

My partner and i started trying for a baby in jan And Concieved in the first month. Unfortunately in march at 8 weeks I had a miscarriage. We have been trying since with no luck. Could something be wrong. Please help this is really getting me down. http://www.netdoctor.co.uk/interactive/discussion/viewtopic.php?t=57881&f=5

We got pregnant the first cycle with both my ds and dd. I am most likely moving to cycle #11 with this baby. We did conceive on the second cycle of trying with baby #3 but we miscarried a week later. Nothing since then. I’m not sure why this time is taking so much longer. http://www.mothering.com/discussions/showthread.php?p=16029816

Can anyone advise? My daughter has been trying to get pregnant for several years. Her husband is fine. My daughter has now been asked to go for a scan which scared the life out of me (you automatically think something is horribly wrong). Can someone tell me what the scan is about – what sort of scan is it? http://www.netdoctor.co.uk/interactive/discussion/viewtopic.php?t=31528&f=5

The information contained in the folliculogenesis cyclic profile, as illustrated in the slide captured above, is meaningful and can help the healthcare provider to answer questions such as these.

How follicular waves will be used for early detection of pregnancy, and for early detection of miscarriage, EPL – to TTC again asap

August 25, 2010

In this post we talk again about the feature introduced in an earlier post, https://biozhena.wordpress.com/2010/01/10/about-the-added-bonus-of-folliculogenesis-monitoring-automatic-pregnancy-detection .

This time we focus on the importance of the utilization of the follicular waves not only for practically instant pregnancy detection, but also for a similarly early detection of miscarriage or early pregnancy loss (EPL, also known as spontaneous abortion, SAB). Refer to Early Pregnancy Loss,  http://emedicine.medscape.com/article/260495-overview . Note: Chief Editor is Professor Lee P. Shulman, MD, FACOG – one of bioZhena Corporation’s Board of Medical Advisors.

Sonography scene. Some contrast vis-à-vis the Ovulona™!

Sonography scene.   Some contrast vis-à-vis the home-use Ovulona™!

Excerpted from said Medscape overview: 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 is 10-15%, 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 below 500 g. An article in http://www.cnn.com/2010/HEALTH/08/05/miscarriage.try.again.asap/ summarized the conclusion that “any delay in attempting conception could further decrease the chances of a healthy baby”.

This is a fundamental concept. Further they write, with reference to the original BMJ publication, “Study: Women who conceive within six months of miscarriage reduce risk of another… The women who conceived within six months also had better overall outcomes. They were about 10 percent less likely to have a C-section or a preterm delivery, and about 15 percent less likely to have a baby of low birth weight than the women who waited up to a year.”

This is a highly suggestive conclusion, implying the need to know as soon as possible. The sooner the better for attaining happiness.

Angelo Bronzino - Allegory_of_Happiness, 1564

Angelo Bronzino – Allegory_of_Happiness, 1564

Another fundamental principle, not brought up by CNN or by the study itself, is that a tool for automatic monitoring of the early stage of pregnancy to watch out for EEM [Early Embryonic Mortality] is desirable, to put it mildly. Our Ovulona™ device is perfect for that. The Ovulona monitors folliculogenesis in vivo, which includes the follicular waves occurring after ovulation. The waves disappear upon conception (the pregnant system does not go preparing for another menstrual cycle, which the follicular waves signify).

The follicular waves disappear as soon as conception takes place and the woman is in early stages of pregnancy. In case of miscarriage, the waves will come back. The point made here is that the woman’s and her obgyn’s decisions about trying for pregnancy again should be guided by diagnostic data. The data on which any decision should be based must be personal to the given patient – not based on statistical outcomes of studies such as the one referenced above.

That’s what the Ovulona™ from bioZhena is for, the tested and the putative uses of which are discussed throughout the bioZhena’s Weblog.

For a pictorial overview with a written narrative, you can go to http://to.ly/VCF (http://s755.photobucket.com/user/vaclavkirsner/library/Second%20album/Pregnancy%20and%20birth%20control%20how-to%20by%20bioZhena?sort=2&page=1 ) and peruse the 6 pictures with brief written explanations of the basics of FIV™, the ovulographic™ monitoring of folliculogenesis in vivo™.

This one of the 6 illustrations, http://to.ly/1k9L, is about “what’s going on here”.  In other words, what is FOLLICULOGENESIS IN VIVO™, the mechanism of the cyclic profiles, the mechanism of menstrual cycles as detected (and passed on to the Ovulona sensor) by the cervix uteri. Should you want to listen to my spoken narrative, click on the image or on the link below.

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

The unprecedented wealth of information inherent in the FIV™ cyclic profile

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

The bottom line is this: The multitude of repeatable features of the cyclic pattern makes it possible to determine the boundaries of the fertile window for every individual menstrual cycle.

A key distinction of our technique is that the “dynamic range” of the cyclic profile data (the vertical span) is the same in all cycles and in all women. This – in addition to the repeatable features of the pattern – facilitates electronic interpretation of the data. Only the timing of the various features varies from cycle to cycle, and we work with that.

The cyclic pattern exhibits a number of well-defined peaks and troughs, with the first post-menstruation minimum (or trough, nadir) occurring typically already on cycle day 6, 7 or 8. That’s the selection stage of folliculogenesis (which follows on the stage of recruitment, days 1 – 5). The signal then rises to a maximum (long-term predictive peak, driven by the maturation of the dominant follicle), the highest reading level of the cycle. Over the next several days, the readings fall toward the minimum before the short-term predictive peak. We have found the ovulation-marker minimum after this short-term predictive peak to correlate with urinary LH and FSH peaks (hormones).

Based on data, we interpret the ovulation marker to be an instantly detected effect of the steroid hormone switch that occurs at ovulation (estrogen to progesterone dominance). The follicular waves, which occur after ovulation [when the non-pregnant system prepares for the next menstrual cycle], cannot remain in place after conception takes place [the regime change is even more profound].

That is the principle of instant detection of pregnancy. Should the conceptus be lost to EEM, Early Embryonic Mortality (miscarriage), the follicular waves come back. That’s the principle of early detection of miscarriage also known as spontaneous abortion [SAB], and of detecting and monitoring the return of the non-pregnant condition.

059q Book of hours

059q Book of hours

Trying to conceive again should be based on the personal FIV™ [FOLLICULOGENESIS IN VIVO™] data generated by the patient, that is, by the woman trying to conceive. This is a principle of evidence-based medicine. Personalized medicine.

STOP PRESS And now, go and check out the 2012 post “The fallacy of ovulation calculators, calendars and circulating-hormone detectors” at https://biozhena.wordpress.com/2012/02/13/the-fallacy-of-ovulation-calculators-calendars-and-circulating-hormone-detectors/

A few more peri-vernal equinox tweets on #conceiving, #fertility, achieving #pregnancy & #baby gender contrary to Shettles

March 21, 2010

While NFP users know that fertility awareness is a must for birth control

We all know that the peri in the title does not refer to any “one of a large group of beautiful, fairylike beings of Persian mythology…”. We know that “peri” is in fact a prefix meaning “about” or “around” and “near”, appearing in loanwords from Greek, such as in the title here [http://dictionary.reference.com/browse/peri].

Peri - 1865

Peri - 1865

And now for the last few tweets; again somewhat edited, since here we do not have the 140 character limit. And again with clickable links to further information, including the #hash tags with all sorts of tweets there by anybody using a given hash tag, in the manner of the Twitter social networking mechanism.

These tweets should do it for this departure into the so-called microblogging. Do check out http://to.ly/VCF for what a reliable #fertility tool is about. Read up on it http://to.ly/vUz

Here is a birth control product that will be in the competition category when we go into the birth control market: http://twitpic.com/1971ez – This is the device used to insert the ‘Mirena’ coil into the patient’s uterus. Sent via TwitPic. Retweeted by you and 1 other. The reason why this was re-tweeted by yours truly was to highlight the invasiveness of the pictured device, which bears no comparison with ours (quite apart from our device not inserting into the uterus). But, of course, our product is not out yet, with all its user-friendly and otherwise beneficial attributes. Any comments, dear reader, would be appreciated.

RT@pregnancyorg: Read about your cycles getting #pregnant before #conceiving http://ow.ly/1l765 — and then I suggest you also read http://to.ly/VCF and http://to.ly/vUz

RT@Averyugya81: ARTs [Artificial Reproductive Technologies] for #infertility treatment may pass on genetic defects – warns ART pioneer http://to.ly/1pOJ . This is reminiscent of the development when Father of the Pill Dr. Djerassi turned against oral contraception, promoting instead what he called “the Jet-Age Rhythm Method”, by which he meant fertility awareness (aided by technology, hence the reference to jet age)

RT@Averyugya81: How often do I have to have sex to get #pregnant? http://to.ly/1pPi

Adam and Eve by Tamara de Lempicka - solarized

How often?

– Every day for 20 days with 69% chance of success, write statisticians http://to.ly/1phs (from day x to day y of your cycle)

If this continues to be pleasuresome, carry on for months on end to overcome the odds. Else, you need focus, and see my earlier tweets. Fight statistics! (With pleasuresome determination and with the aid of a deterministic timing tool… in the offing)

Again: The odds are against us! #pregnancy #birth control #fertility #startup angel-investor-find-and-match… same difference! Odds are very low (without that focus)

@pregnancyorg‘s gender selection http://to.ly/1qkx seems to perpetuate the Shettles recipe. However, evidence http://to.ly/1nyK http://to.ly/1qmz contradicts Shettles (whose claims have the reputation of not being backed by or based on any properly designed clinical studies). Here is a summary of a solid study, which – for the lack of “Perfect” – employed three “Imperfect Measures” of ovulation as defined in the previous post. The three gave similar results. Female births at (or near) ovulation, male births 2 days earlier (or so)

Birth distribution by gender - France et al., focused NFP TTC study

Birth distribution by gender - France et al., focused NFP TTC study

The uncertainty expressed by the “or near” and “or so” is the consequence of the “Imperfect Measures”, but the trend is clear. Also rather clear is that the low birth counts flanking the high ones are data outliers due to measurement errors inherent in “Imperfect Measures”. For more on this, go to the earlier post at https://biozhena.wordpress.com/2007/12/15/fetal-sex-pre-selection-%E2%80%93-the-fundamentals

Baby gender pre-selection will require a clinical study as stringent as the France et al. study was, but performed with our Ovulona instead of the inaccurate methods (BBT, Peak mucus, LH rise as opposed to LH surge apex)

Delville - Satan Treasures, 1895

Delville - Satan Treasures, 1895

RT@BabyMed: So can you get pregnant from having sex on your period? http://bit.ly/29yLQJ — THE absolute requirement is a RELIABLE #fertility monitor. (Persistent monitoring in the interest of evidence-based medicine)

RT@BabyMed: So can you get pregnant from having sex on your period? Yes, but only if the cycle is very short, which would be due to a very short follicular phase, which you can only detect with a RELIABLE monitor. (Not to track merely one, two or even three hormones in body fluids – you need to follow FIV™, Folliculogenesis In Vivo™)

RT@bioZhena RT@BabyMed: Furthermore, you want our built-in #pregnancy detection because it will see you #pregnant right away (not only about two weeks later), and – importantly – our device will also see if the pregnancy is lost, which happens quite frequently. See  https://biozhena.wordpress.com/2010/01/10/about-the-added-bonus-of-folliculogenesis-monitoring-automatic-pregnancy-detection . Early embryonic mortality is very high (according to some sources significantly more than 50%), and most of the losses of the conceptus occur early on, prior to 12 weeks. Mostly they occur sub-clinically, without the knowledge of the mother (by one expert source, 52% of all women who conceive experience early miscarriage…)             

RT@bioZhena: RT@BabyMed: Can #pregnancy result from sex on period? Yes, if it’s a very short cycle (due to a very short follicular phase) – which is unlikely – as the pre #ovulation phase is rarely that short. Since teenage cycles tend to be irregular and often short, this is of particular interest to sexually-active teens.  You must MONITOR your cycles if you don’t want any such surprise

RT@bioZhena: RT@BabyMed: Can #pregnancy result from sex on period? See here how unlikely it appears http://to.ly/1k9L . Unlikely, if the shortest follicular phase is 6 days. Menstrual bleeding would have to be as close to ovulation as 4 days, to make the answer unequivocally positive; that would mean cycle length of 18 days (or 16 to 20 days). Very rapid dominant follicle maturation. Until this (shortest follicular phase question) is investigated with our Ovulona monitor of Folliculogenesis In Vivo™ [FIV™], there is probably little data to invoke. I would be interested in any evidence.

Further peri-vernal equinox tweets on #conceiving, kairos time and #fertility, achieving #pregnancy, caution about in vitro & appearances

March 20, 2010

And NFP users still know that fertility awareness

is for birth control, too

As previously noted, language aware readers and subject matter aficionados know that the “peri” in the title does not refer to any “one of a large group of beautiful, fairylike beings of Persian mythology …” nor, for that matter, to “any lovely, graceful person” such as you are.

You already know that “peri” is a prefix meaning “about” or “around” and “near”, appearing in loanwords from Greek [http://dictionary.reference.com/browse/peri]. Just like here, whereby we take notice of the Spring Equinox – when the Sun rises exactly in the east, travels through the sky for exactly 12 hours and sets exactly in the west – this year on March 20 “, today.

And, “anyone standing on the equator at noon will not cast a shadow” [http://www.wilsonsalmanac.com/book/mar20.html]. Lovely thought [entertained in snowbound Colorado Rockies]! Then another idea, not necessarily lovely – but a key concept: The dictionary does not tell that this is one of the instances of “kairos time” of the Earth! For the meaning of “kairos time” you can check out an earlier post here, https://biozhena.wordpress.com/2007/12/28/birthday-and-how-it-relates-to-the-biozhena-enterprise-%E2%80%93-eukairosic%E2%84%A2-diagnostic-tools

Spring Equinox

Spring Equinox (aka rovnodennost)

But now for some more of the tweets (again a little edited, since here we do not have the 140 character limit. And still – in the usual manner – with clickable links to further information, including more tweets of all sorts via the #hash tags).

Do you chart your #fertility cycles? If so, would you like to include our FIV cyclic profile http://to.ly/VCF in your charts? Do let me know if interested #pregnancy #birth 7:24 PM Mar 16th

If you have not yet explored bioZhena’s Weblog http://to.ly/vUz do visit http://to.ly/1kXE Variability of menstrual cycles and ovulation timing. Read on kairos time. 8:05 PM Mar 16th

A collage that depicts our message. After disappointments, once you determine your exact “kairos time” in the cycle you want to conceive in, you’ll get the #pregnancy you wish for http://tweetphoto.com/14671191 8:38 PM Mar 16th

Collage of 3 pics with 15-WordlegreetingsfrombioZhenasf-3.jpg

Collage of 3 pics with 15-WordlegreetingsfrombioZhenasf-3.jpg

Mistiming intercourse is the chief cause of apparent #infertility http://to.ly/1ppi . With a certain Fertility Monitor, they claim that 50% of users got #pregnant in the 1st cycle, and 92% in the 3rd. 196 women provided this statistic, out of 276 women asked. “The issue of early intervention with [clinical] tests and medications were highlighted, resulting in escalating costs and strain on the couple.”  2:02 AM Mar 17th

RT@bioZhena Compare the cost of the certain Fertility Monitor, which – unlike ours – requires monthly reagent sticks, from ~$250 (1cycle) to some $550 (10 cycles). Compare that to the average cost of ART medical treatment, which they report was $6,637 for the surveyed women, with a median medical evaluation cost $1,075 per cycle 2:06 AM Mar 17th

Kirchner Modern Bohemia

... with a median medical evaluation cost $1,075 per cycle ...

Numerous papers http://to.ly/1pq1 show improved #pregnancy rates and effective #birth control with #fertility monitors. That is with focus on determining the #fertile window 2:20 AM Mar 17th

Statisticians reported on day-specific probabilities of #pregnancy with data from 2 studies that used what they called (correctly) Imperfect Measures of ovulation http://to.ly/1pqh They did not ask: Perfect Measure of ovulation soon? 2:34 AM Mar 17th

*Perfect Measure*of ovulation resides in deterministic versus statistical approach.  *Imperfect* (fuzzy) replaced by accurate #fertility determination that indicates the first fertile day and the last fertile day, day 1, day 2, day 3, boom, boom, boom 2:49 AM Mar 17th

Fertile window of opportunity to conceive

Fertile window as determined by the Ovulona, and how it compares with the BBT

You should understand: No in vitro diagnostics (out of body), no circulating hormones like LH and/or estrogen can ever make a RELIABLE #fertility monitoring method because fertility is the result of a complex integration or interplay of numerous neuroendocrinological signals. This or that hormone in a body fluid does not do that. (It’s merely one of many input signals. In case of the BBT, more like an output.)

Similar caution applies to NFP observations of #fertility signs. Mucus is a measure of estrogen. It does NOT show the boundaries of the #fertile window, it only indicates ovulation is likely, but not when, and not really if

Your #cervix receives #fertility signals from the active ovary and from your brain. But understand that the cervix appearance and feel only indicates approaching #ovulation, not ovulation as such

The appearance of the cervix, like (the appearance of) ovarian ultrasound will indicate that ovulation was yesterday. Or, more accurately put, ultrasound indicates that the follicle collapsed and PERHAPS (80% probability) released the egg

Monitoring your #fertility signs is better than nothing BUT if it’s not helping you to get #pregnant, it will #stress you out and make things worse

Until you use a definitive deterministic tool, “better than nothing” is arguable if you take it from the statisticians that having intercourse about every day for 20 days is 60% likely to result in conception

Of course, you would still have ~40% probability of not achieving #pregnancy so what is new. That is the meaning of #subfertility. Need a solid tool that determines the 3-day fertile window, boom, boom, boom (but stress may prolong this – in a detectable manner).

Our deterministic tool avoids statistics and probabilities, and detects ovulation after anticipating it from what the cervix is saying electronically now, in this cycle. Most of the time not fertile, and then for a few precious days, #fertile

Songs of Innocence and of Experience

Songs of Innocence and of Experience

To sum up: Appearances are no real measures, they are only approximate.  Approximate is not good enough for #fertility status – to get #pregnant or, especially, to avoid getting pregnant. And, especially, if you want to try for a desired baby gender.

***

FOR MORE ABOUT ALL THIS GO TO THE 2012 ARTICLE https://biozhena.wordpress.com/2012/02/13/the-fallacy-of-ovulation-calculators-calendars-and-circulating-hormone-detectors/ = The fallacy of ovulation calculators, calendars and circulating-hormone detectors. Don’t let them lead you by the nose with likely this and probable that! You need to know for sure.

Peri-vernal equinox tweets on #conceiving, #fertility status, achieving #pregnancy in the era of #infertility – “a modern epidemic”

March 20, 2010

NFP aficionados know that fertility awareness is for birth control, too

And language aficionados will know that the peri in the title does not refer to any “one of a large group of beautiful, fairylike beings of Persian mythology, represented as descended from fallen angels and excluded from paradise until their penance is accomplished.” Nor, for that matter, to “any lovely, graceful person.”

Peri or Paeri of Persian folklore and mythology

Peri or Paeri of Persian folklore and mythology

Peri is a prefix meaning “about” or “around” and “near”, appearing in loanwords from Greek [http://dictionary.reference.com/browse/peri]. Just like here, whereby we invoke the Spring Equinox – when the Sun rises exactly in the east, travels through the sky for exactly 12 hours and sets exactly in the west – this year on March 20. “And anyone standing on the equator at noon will not cast a shadow” [http://www.wilsonsalmanac.com/book/mar20.html]. Lovely!

So then, now for the tweets (a little edited, since here we do not have the 140 character limit, and – in the usual manner – with clickable links to further information, including the #hash tags).

1)         2009 sales of #fertility LH kits at $272M outpaced #pregnancy tests http://to.ly/1p8Q Not exactly surprising since ~30% of US women do not get #pregnant in 6 or 12 months 12:04 PM Mar 16th

2)         #Infertility is “a modern epidemic”. In 17 studies, 56% of the relevant sub-population (range 42–76%) in developed countries sought medical help http://to.ly/1pdo but less than 1/2 of them received care 2:30 PM Mar 16th

3)         Unintended pregnancies = “global epidemic”. US family planning is “uniquely deficient” (50%) http://to.ly/1pcB Cause: high contraceptive failure rates 2:34 PM Mar 16th

4)         Leading causes of unintended pregnancy are closely related to #contraceptive failure. Failure rates: 31% the Pill, 18% condoms, 5% 3-month injectable #birth control 2:43 PM Mar 16th

5)      Medscape OBGYN: #fertility awareness can be highly satisfactory #birth control & #family planning method http://to.ly/1peK http://to.ly/1peM 3:14 PM Mar 16th

6)      RT @bioZhena #fertility awareness [FA] is a great #birth control & #family planning method especially for women 30+ years of age, and those who are able to practice FA without a teacher 3:23 PM Mar 16th

7)      Statisticians: Best frequency of sex for unfocused conception attempts is every 2 or 3 days http://bit.ly/d9tCfm to avoid exhaustion. Else, everyday 5:32 PM Mar 16th

8)      RT@bioZhena But even sex every day for 20 days from day 6 to day 25 only computes as 69% probability of conception. So what else is new in the world of sub- #fertility, wanting #pregnancy but being put into the sub- #fertile category 5:34 PM Mar 16th

9)      Trying to get #pregnant without knowing when-to frequently does not work for a long time. Yet, often all that’s needed is knowing your actual fertile window in the present cycle http://to.ly/VCF 7:18 PM Mar 16th

10)  For #fertilityawareness, NFP for #pregnancy and/or #birthcontrol, we have the tool for you http://to.ly/VCF — or, rather, will have, once funded. Comments? 7:19 PM Mar 16th

Major studies decades ago revealed variability of menstrual cycles

March 10, 2010

But people are still naïve about the basic cause of the difficulty to achieve pregnancy

Sex education at school, its quality or otherwise, is likely to have much to do with fertility problems later in life. Many women (men, too, of course) can use the  keyboard with all their fingers (as well as their thumbs!) but have poor understanding of the basic functioning of their reproductive system.

colonial classroom

colonial-classroom.jpg

That ignorance is well known, and is underlying the fertility problems. You should see the pregnancy doctors’ tweets – replying to some incredible questions, and then the talk of various mysteries!

A shining example is this tale of “mysterious conception”. For the whole story see the Alphabet of bioZhena under M, “Mysterious conceptions (OR THE NONEXISTENCE THEREOF)” on page 34 or thereabout, from which I cite:

QUOTE:  It appears that we must dwell on this topic, because of stories and notions propagated in various pertinent circles. This writing has been prompted by page 176 in the excellent 1999 book “Woman” by Nathalie Angier, where the Pulitzer laureate relates the story of the mysterious conception of her only child. Mysterious, because it occurred, she believes and makes her readers believe, outside of ovulation and of the fertile window.

The reason for this entry in the Alphabet of bioZhena is that there is NO SUCH THING AS MYSTERIOUS CONCEPTIONS, there is only lack of information, or ignorance of the facts. We might say, intellectual misconceptions lead to “mysteries” in terms of conception, of babies conceived supposedly when conception was biologically impossible, and vice versa, some women have difficulties conceiving for the same fundamental reason. We shall use Ms. Angier’s case to make this point. UNQUOTE.

To drive the point home, here is an excerpt from John J. McCarthy, Jr. and H.E. Rockette, “Prediction of ovulation with basal body temperature”, Journal of Reproductive Medicine, Volume 31 (No.8), Supplement, 742 – 747, 1986.

Referencing particularly large studies from 1967 and 1977, these BBT experts had this to say all those years ago (and never mind their “prediction” in the cited title whereas the BBT is well known to be no predictor):

QUOTE:  Cycle regularity is often assumed by both women and their physicians. The suggestion, that the BBT graph of the previous cycle can be used to identify the day of ovulation in the current cycle, requires nearly absolute cycle regularity. [However, note this:] The data collected by 1,085 women, who provided at least 6 or more charts each, were studied for cycle length variability. … The cycle length range was more than five days for 56% of the women who submitted 6 graphs, and for 75% of those with 12 graphs. … Absolute regularity was not demonstrated in as few as six cycles. Even when the cycle length that deviated the most was eliminated, less than 1% (8 of 1,085 women) had no variation in cycle length. When the number of cycles was extended to 12, no woman had variability of less than two days in cycle length. END OF QUOTE.

In real life, you realize, no cycle can be eliminated from the experience, and every day matters. Two days are very likely to make the difference between conception and the lack of it. And/or cause an unwanted pregnancy, for that matter.

middendorf_on_the_ball.jpg

Middendorf  – On the ball

The above findings are therefore the basis on which we can say quite categorically that nobody is as regular as a metronome (and nobody conceives in an anovulatory cycle), that there is no such thing as absolute regularity, whether 28 days or otherwise.

If you are in the sub-fertile category of people finding it difficult to become pregnant, you are likely to have cycle variability of more than 5 days over those months of your fruitless efforts that define your category. More likely than being one of the 0.74% of the population with no variation in cycle length, which under ideal conditions may also mean no variation in the time of ovulation. Persistent monitoring is well advised.

Variability of menstrual cycles and of ovulation timing

March 7, 2010

See how this complicates things whether you want pregnancy or want to avoid it

And yes, stress has something to do with it

In the previous post, I suggested that the terminology that speaks of sub-fertility or reduced fertility is misleading. If you did not stumble over it wondering why, then I am glad for you (I should say, for both of you!). Because you “got it” and you will now think of taking some appropriate steps, and those will NOT be to your insurance agent and/or – more likely – to your bank! (Referencing the high costs of the A.R.T., Artificial Reproductive Technologies.)

Because you understand that, until proven otherwise, your situation should be termed one of “instant conceptive gratification cannot be obtained probably due to wrong timing”. Nothing reduced or sub- about that! And, the adjective “conceptive” is meant to indicate that the hope is that the other kind of gratification has obtained. The one I referred to as physio-pleasure, but that would be a topic for another time…

Since you are not likely to have reviewed the menstrual variability references given in the previous post, I will document the notion of wrong time with our data. I mean the data from a small clinical trial carried out with a prototype of our core technology, the Ovulona™ for home use. This trial was performed by an independent group at Marquette University NFP clinic – with patients attending the clinic to learn NFP for one of two reasons: either because they experienced difficulties in achieving pregnancy, or because they wanted to learn NFP [Natural Family Planning] as a means of birth control. Or, maybe, they wanted to use NFP for both, at different phases of their lives.

We can look at data of 10 women, 2 cycles each, reviewing here the ovulation data obtained with said prototype of our Ovulona device.

The data are systematically documented (along with two reference methods for comparison) in the attached 1-page document (Variability of menstrual cycles), and I am doing my utmost to boil it all down for you to as brief a briefing as possible.

Listing of two consecutively detected ovulation days (ovulation marker detected by our device), and noting whether the cycle was subsequently categorized as regular or irregular, goes like this:

Ovulation day number in 2 consecutive cycles

Patient #1 16 (regular) 17 (regular)
Patient #2 14 (regular) 17 (irregular)
Patient #3 17 (regular) data absent
Patient #4 15 (irregular) 14 (irregular)

The list goes on, and you should know that “irregular” means “challenged”, and means something of a problem that our modern lifestyle presents to the biology of our women.

One patient provided data from her four cycles, and the variability was – not surprisingly – even more pronounced (-5 days, +5 days, -3 days):

Patient #9

18 (irregular)

13 (regular)

Patient #9

18 (irregular)

15 (regular)

The following table shows the wide spread of the differences between ovulation days in two consecutive menstrual cycles of 10 women attending said NFP clinic.

Summary of 10 patients, 2 consecutive cycles each

Patient #

Ovulation days in 2 consecutive cycles

Difference between those cycles

Regular cycles or not

Age

Has given birth already or not

1

16, 17

+1

both regular

35

mother

2

14, 17

+3

2nd  irregular

33

mother

3

17, NA

NA

first regular

42

mother

4

15, 14

-1

both irregular

33

mother

5

20, NA

NA

first regular

30

mother

6

19, 18

-1

both irregular

38

mother

7

16, 15

-3

both regular

29

no children

8

21, 24

+3

2nd irregular

19

no children

9

18, 13

-5

first irregular

41

no children

10

10, 12

+2

2nd irregular

22

no children

Differences from -5 to +3 days are recorded in this small sample, and the one woman with 4 cycle records showed +5 days, too, which illustrates that the more cycles are followed, the larger the spread of ovulation days becomes (this is “cycle irregularity” in the conventional, usual sense).

These are differences between just two successive menstrual cycles. The situation becomes more involved when many more cycles are reviewed, as has been done in the studies years ago using BBT charting data. The data of those long-term studies of many menstrual cycles charted by many women are still used today by biostatisticians studying things such as the possibility of sequential predictions of menstrual cycle lengths – the cycle length being primarily dependent on the pre-ovulation part of the cycle (in absence of any complications).

Here is a very good example of cycle length variability of a woman who charted well over a hundred of her menstrual cycles ( ref.: Figure 1 http://biostatistics.oxfordjournals.org/content/11/4/741/F1.large.jpg in Paola Bortot, Guido Masarotto, and Bruno Scarpa, “Sequential predictions of menstrual cycle lengths”, Biostat (2010) 11 (4): 741-755 http://biostatistics.oxfordjournals.org/content/11/4/741.full ).

Variability of menstrual cycle lengths of a woman who charted more than 100 cycles

Variability of menstrual cycle lengths of a woman who charted more than 100 cycles

I should remind you that our meaning of regularity is as indicated and documented in the attached summary, “Variability of menstrual cycles”. Regular cycles are those where our ovulation marker is within 1 day of LH peak or of the day of Peak mucus (Pk).

Our meaning of irregularity is defined as those cycles where the ovulation marker day data is not within 1 day of said hormone-detecting parameters (LH and estrogen, respectively), and is always higher – signifying delayed ovulation (delayed with respect to the hormonal signals).

As I said above, “irregular” in our parlance means “challenged”, and it means something of a problem that our modern lifestyle presents to the biology of our women. More often than not, the challenge is stress, which I discussed in this blog earlier in at least two posts. Our FIV technology (aka the Ovulona personal monitor) detects the effects of stress, and helps to deal with the consequences in terms of its effect on fertility status.

STOP PRESS

And now, go and check out the 2012 post “The fallacy of ovulation calculators, calendars and circulating-hormone detectors” at https://biozhena.wordpress.com/2012/02/13/the-fallacy-of-ovulation-calculators-calendars-and-circulating-hormone-detectors/

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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