Serious health consequences of delaying pregnancy, and the need for prevention of impaired fertility also known as subfertility and infertility

Simply put: We must talk prevention versus treatment of this health condition, which is not inevitable. On the present large scale, impaired fertility is anthropogenic – where anthropogenic means “caused or produced by humans”. When trying to conceive, it is highly advisable not to delay baby making beyond the optimal age of early 20s, and in any case to practice “focused intercourse”. In that connection (with said focus), “anthropogenic” acquires a positive connotation – even if my introduction is no longer exactly simply put!

Absolute Must: Focus on Fertile Window

The said focus on focused intercourse is an absolute must, and you save yourself a lot of grief that way because there can be no conception outside of the fertile window, whether subfertile or not. This should really be in your mind and in your heart when you are trying to conceive. And if you are, unfortunately, past the optimal age of early twenties, just try and don’t delay pregnancy any longer – for a good reason (or rather for several good reasons)!

To expand on this, let the scene be set by excerpts from a review in a medical journal written already 10 years ago by a consultant in reproductive medicine (director of an assisted conception unit in London): “ABC of subfertility. Extent of the problem”, BMJ 2003 August 23; 327(7412): 434–436 (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC188498/).

QUOTE: One in six couples [17%] have an unwanted delay in conception. Roughly half of these couples will conceive either spontaneously or with relatively simple advice or treatment.

Most couples presenting with a fertility problem do not have absolute infertility (that is, no chance of conception), but rather relative subfertility with a reduced chance of conception… so that only 4% remain involuntarily childless. As each couple has a substantial chance of conceiving without treatment, relating the potential benefit of treatment to their chances of conceiving naturally is important…  END QUOTE.

Encouraging (isn’t it?)

This is rather encouraging, isn’t it? The cited reproductive medicine specialist states further that spontaneous conception has about a 30% conception rate in the first month of trying, and the chance then falls steadily to about 5% by the end of the first year. Such statistical pronouncements are just that. The following citation is unarguably meaningful – and we do not gloss over the “timing of intercourse during the natural cycle”.

“The likelihood of spontaneous conception is affected by [= is dependent on] age, previous pregnancy, duration of subfertility, timing of intercourse during the natural cycle, extremes of body mass, and [any] pathology present. A reasonably high spontaneous pregnancy rate still occurs even after the first year of trying. A strong association exists between subfertility and increasing female age. The reduction in fertility is greatest in women in their late 30s and early 40s. For women aged 35-39 years the chance of conceiving spontaneously is about half that of women aged 19-26 years.” QUOTE UNQUOTE.

These things have been covered in the various earlier posts of this blog, with appropriate emphasis on said timing of intercourse during the natural menstrual cycle. That’s because, even if you did have a previous pregnancy and you do NOT have an extreme body mass and/or a pathology causing the difficulty to get pregnant, you (and anyone else) can only conceive during the short fertile period, the so-called fertile window.

… but: “Be a young mother!”

And, I go again as far as urging you, “Be a young mother!” As I said, this earnest recommendation is for a good reason. Because, in addition to what I have told you about before (e.g. in https://biozhena.wordpress.com/2012/04/18/the-perils-of-ivf-of-arts-of-giving-birth-at-old-age-part-2/ ), now see and grasp this:

Serious health consequences of delayed conception are beginning to appear in medical literature; that is, serious consequences for the mother, for the would-be mum.

For example, in a paper titled “Subfertility and risk of later life maternal cardiovascular disease” published in Hum. Reprod. 2012 Feb;27(2):568-75 (http://www.ncbi.nlm.nih.gov/pubmed/22131387). The authors gave this background: “Subfertility shares common pathways with cardiovascular disease (CVD), including polycystic ovarian syndrome [PCOS], obesity and thyroid disorders. Women with prior no or just one pregnancy are at an increased risk of incident CVD when compared with women with two pregnancies.”

They concluded that subfertility among women who eventually have a childbirth is a risk factor for cardiovascular disease. As if we all did not know that even without subfertility adding to it, heart disease is the leading cause of death among women [see http://www.health.harvard.edu/newsweek/Gender_matters_Heart_disease_risk_in_women.htm or literally millions of other web pages].

Jiří Anderle / Jiri Anderle
Bestia triumphans II
lept, měkký kryt / etching, vernis mou
1984, opus 271, 65 x 95,5 cm
http://www.galerieart.cz/prodej_anderle_2.htm
For the “triumphant beast” and Giordano Bruno’s story see http://twitpic.com/8r5lyi

More reasons to prevent subfertility

But there is not just the cardiovascular risk, as if that were not enough! Concerns about cancer risk in connection with subfertility have been raised in medical literature already about a decade ago, such as in the paper “Cancer risk associated with subfertility and ovulation induction: a review” – published in Cancer Causes Control 2000 Apr;11(4):319-44 (http://www.ncbi.nlm.nih.gov/pubmed/10843444).

However, there “the only consistent association observed is an increased risk of endometrial cancer for women with subfertility due to hormonal disorders. While positive findings in some studies on fertility drugs and ovarian cancer risk have aroused serious concern, the associations observed in most of these reports appear to be due to bias or chance rather than being causal.”

So, as always, more investigations are needed but the health concern does not go away. The paper concluded: “To discriminate between the possible carcinogenic effects of various ovulation induction regimens, subfertility disorders, and reproductive characteristics associated with subfertility, future studies should include large populations of subfertile women with sufficient follow-up time.”

Well, the truth is that my purpose – and the purpose of bioZhena Corporation – is to make the population of subfertile women as small as possible, by helping every one of you to determine in every menstrual cycle the very narrow fertile window for your focused intercourse, the fundamental requirement for getting pregnant.

This fundamental requirement you already know, I trust. If not, explore the bioZhena’s Weblog for clarification (you can use Table of Contents at https://biozhena.wordpress.com/table-of-contents-links-to-biozhena-posts/ or try searching the blog by means of the widget in the margin on the home page, shown as Search bioZhena’s Weblog – enter keyword, hit Enter). It is frustrating that one of my recent blog pieces had to be on the subject of only the best that you can do for your fertility awareness in the absence of the Ovulona™ – because our Ovulona is not yet available to you due to our lack of financing (see https://biozhena.wordpress.com/2012/12/14/end-of-the-year-and-trying-to-get-pregnant/ ).

Anthropogenic, iatrogenic

Meanwhile, here is another medical-literature paper, this time about cancer risk of drugs that the healthcare industry uses to help women get pregnant – after helping women to prevent pregnancy with another (the big P) drug, the anthropogenic cause of what experts have called the epidemic of impaired fertility: “Ovulation inducing agents and cancer risk: review of literature” published in Curr Drug Saf. 2011 Sep 1;6(4):250-8 (find the abstract at http://www.ncbi.nlm.nih.gov/pubmed/22129320).

The authors give the following summary: “Over the past decades, the use of ovulation inducing drugs has been increasing. A possible causal link between fertility treatments (especially [the widely used] clomiphene citrate and gonadotrophins) and various types of malignancies, including cancers of female reproductive system, thyroid cancer and melanoma, has been postulated. The majority of the available studies on this subject suffer from methodological limitations, including the small number of outcomes, short and incomplete follow-up, and inability to control for potential confounders.

Concerning ovarian cancer, while early studies led to the suggestion of an association between ovulation inducing agents and increased risk of malignancies, the majority of data do not support a causal link.

An increased risk was recently observed in women giving birth after in vitro fertilization (IVF), but it appeared to be consequential to the infertile status rather than the effect of fertility drugs. More controversial are the results concerning breast cancer with some investigations suggesting an increased risk after exposure to ovulation inducing agents, especially clomiphene citrate, whereas others not supporting this concept. A possible trend towards an increased risk has been reported by some authors for endometrial cancer.

Altogether, current data should be thus regarded as a signal for the need of further studies rather than being definitive in them.” END QUOTE.

After introduction of the anti-conception Pill

I must emphasize and impress on you the fact that subfertility and infertility became a societal problem of increasingly large proportions only after the introduction of the anti-conception Pill. “After 3 and up to 15 months of contraceptive pill use, there is a greater loss of the S crypt cells than can be replaced.” The S crypts of the endocervical canal are needed for conception.

To further cite Professor Erik Odeblad : “Complications arising from the use of the Pill are very frequent. Infertility after its use for 7-15 years is a very serious problem. S crypts are very sensitive to normal and cyclical stimulation by natural estrogens, and the Pill causes atrophy of these crypts. Fertility is impaired since the movement of sperm cells up the canal is reduced. Treatment is difficult.”

You can find more on this in my earlier post, Difficult to conceive – Google evidence that pregnancy complications and trying-to-conceive concerns shot up after the Pill launch in 1960s. (Regardless of what contraceptive proponents tell you.)

MARINA RICHTEROVÁ – Golgota, Hommage a P. Bruegel, 1998 and The Juliet, 2000

(Picture from https://biozhena.wordpress.com/2012/04/18/the-perils-of-ivf-of-arts-of-giving-birth-at-old-age-part-2/marina-richterova-golgota-hommage-a-p-bruegel-1998-and-the-juliet-2000/ )

Ignored. Now, the consequences

I am reminded of an insight expressed on the floor of the US Congress after the Pill made a big impact on society in the 1960s. In 1970, Dr. Hugh J. Davies of Johns Hopkins University told the US Senate in the Nelson Hearings about the contraceptive Pill: “Never before in history have so many people taken such powerful medication with so little information as to its actual and potential risks. …With the introduction of such active ingredients, we are actually setting up a massive endocrinological experiment with millions of healthy women.”

Well, decades later we are reaping the consequences of the massive experiment. Said millions of healthy women are not quite so healthy, are they? It is high time to fix this man-made problem.

In an earlier post I wrote: Iatrogenic medicine kicking Hippocrates where it hurts the most. Was it in the blog piece last-linked above?

How baby-making late in life evolved into subfertility and infertility, difficult conception, too long TTC

Way back, in the pre-contraceptive Pill days, the difficulty to become pregnant was not a widespread phenomenon, and mums were  younger than many are nowadays. If you want to see graphical proof of how the phenomenon came about in the previous century, review the attached paper Google evidence of increasing prevalence of subfertility. Should you not be a subfertility or infertility sufferer, and therefore not familiar with the acronym, TTC stands for Trying To Conceive.

The evolution of subfertility and infertility (as a big-time societal phenomenon) in the U.S. can be summarized based on data from http://www.infoplease.com/ipa/A0005074.html#ixzz2GBMSkUKy  [Information Please® Database, © 2007 Pearson Education, Inc.] as follows.

In 1940, births to mothers over 29 years old (30 to 49) were apparently almost as numerous as births to mums of the optimal fertility age 20-24: The ratio of 30-49 years old to the optimal-age group was 0.91 [here referred to as ratio a) =  data for 30–34 plus 35–39 plus 40–44 plus 45–49, this sum divided by data for 20–24], and the number of births in the most fertile age group of mums represented 31% of all births in the U.S.

In case you did not check out the above-linked attachment https://biozhena.files.wordpress.com/2012/12/google-evidence-of-increasing-prevalence-of-subfertility.pdf : The high number of 1940 births to older mothers [high ratio a)] is not so surprising in view of the growing number of books on subfertility and infertility in the 1940s, as seen in the respective Google Ngrams shown here and discussed in the attached PDF paper.

Ngram 3: infertility and contraception

In the present analysis of the historical birth rates, the age group of 25-29 is considered kind of neutral (neither optimal nor too old) whereas the 30-34 years old group is included among the too old ages for optimal fertility. This inclusion could be disputed – if we did not face the subfertility/infertility phenomenon, in which age is a significant factor. In any case, excluding the 30-34 age group from the aged-motherhood definition only delays the trend reversal – observed below in 1980 – by a decade.

I interject here a citation from the post referenced and linked at the end of this post, so that you’ll be well aware of the link between conception difficulties and advancing age, and of the adverse effect of the use of the Pill.

QUOTE: People have a hard time accepting that getting pregnant is not as easy as expected, when they finally decide to want a baby – usually way too late, and after her use of the Pill. The drug makes healthy young women in their best years to postpone family- and baby-making, it damages their cervical S-crypts thus causing difficulty to conceive and, by encouraging promiscuous sex life, it has caused an enormous increase in the prevalence of sexually transmitted diseases that also lead to infertility. Not just a double whammy, a triple whammy on womankind.  Sad, sad, sad. … Advanced age of the would-be Mum works against her on account of the Mother Nature’s Probabilistic Rules and Regulations of Baby-Making… END QUOTE.

An obgyn’s article on female subfertility in the Lancet invokes “two main factors that determine subfertility: duration of childlessness and age of the woman”. It is not likely that an obgyn would be as critical of the Pill as yours truly, although there have been exceptions. No further comment on this is needed or offered in this blog post. Instead, I share that another medical article from Britain reported that “the incidence of infertility was 0.9 couples per 1000 general population. The average age of women was 31 years, and the average time attempting conception was 18 months… At 12 months, 27% of all couples in the study achieved a pregnancy spontaneously and a further 9% with treatment.”

Here are the 1940 US birth statistics data from the referenced infoplease.com source:

Year	Total	Under 15	15–19	20–24	25–29	30–34	35–39	40–44	45–49
1940	2,558,647	3,865	332,667	799,537	693,268	431,468	222,015	68,269	7,558

And this is the calculation for the present analysis of the data:

a) 729,310/799,537 = 0.912

(ratio a is the sum of births to age groups from age 30 to age 49 divided by births to age group 20 – 24)

b) 799,537/2,558,647 =  0.312

(ratio b is births to age group 20 – 24 divided by total births in 1940)

By 1950 and 1960, the trend was good because ratio a) declined from 0.91 to 0.86 and then to 0.80 while the number of optimally aged young mothers rose slightly to 32% and then to 33.5%. These pre-Pill years were good years from this perspective, and the trend continued – even after the contraceptive Pill was introduced (in the 1960s), at least initially.

In 1970, there was a drop in the total number of births from the total of 1960 (4,257,850 births) and a dramatic drop in the number of births by aged mothers [ratio a) was 0.47] – and the births by the most fertile age group were up to 38% of all births. As though the contraceptive Pill worked in this sense (but only if we do not look at the significantly increased births by underage girls, especially the under 15)… Here is the 1970 data from the above source:

Year	Total	Under 15	15–19	20–24	25–29	30–34	35–39	40–44	45–49
1970	3,731,386	11,752	644,708	1,418,874	994,904	427,806	180,244	49,952	3,146

Unfortunately, in 1980 – that’s some 20 years after the Pill was introduced – the trend started to reverse while the total births continued to drop (and underage births dropped, too): Ratio a) of the number of aged mothers’ births to the most fertile age group’s births rose to 0.58 and births by the most fertile 20-24 year old mums represented now only 34% of total US births. The bad trend toward older-age motherhood continued.

By 1990, there were even more births to aging mothers than births to the most fertile age group, with ratio a) standing at 1.15 and the number of births to mothers of the optimal age group having dropped to a mere 26%.

The bad trend continued so that in 2000 advanced-age mothers exceeded the optimal-age group with ratio a) at 1.45, and with the optimally aged mums at 25% of total births. The trend continued further so that in 2009 advanced-age mothers exceeded the optimally aged mums by a factor of 1.53 [= ratio a)] and the optimal age group’s births dropped to 24% of total births. Data for 2009 are the most recent available data.

Tamara de Lempicka Quattrocento, 1937

Is the difference between way back and now the reason for one other elevated readership statistic here on bioZhena’s Weblog? It is intriguing to see that during the months of the highest numbers of US births/deliveries (late summer and autumn, well before the year-end Holiday Season), a highly viewed post this year was the one published around the time of Mother’s Day: Why too many young and not so young ladies could NOT receive flowers on Mothers’ Day. Why so many trying-to-conceive, why so much infertility = https://biozhena.wordpress.com/2012/05/14/why-too-many-young-and-not-so-young-ladies-could-not-receive-flowers-on-mothers-day-why-so-many-trying-to-conceive-why-so-much-infertility/ Say thank you to the social and medical advances of the twentieth century – primarily those of chemical birth control, the Pill.

What do you think of all this?

P. S. The Alphabet of bioZhena (glossary/primer) is at https://biozhena.files.wordpress.com/2020/01/aaee-the-alphabet-of-biozhena-011207-with-tracking.pdf

Cervix uteri and seven or eight related things

It seems worthwhile to reblog the December 2007 post about the basics. Including “why the bioZhena technology had to be invented. One way of saying this is: The available means, methods or products, were not good enough. Another way of putting this is to quote from medical literature…”

And then see how none of the methods determined ovulation with the required accuracy to be useful either as a conception aid or especially for birth control.

3-day fertile window with gender preselection vs. inaccurate old methods

Here is how our method (monitoring folliculogenesis in vivo) does it by generating the multi-featured cyclic profile that includes the definitive ovulation marker after the predictive signals, and here is how this compares with the older techniques. See how inaccurate is the ovulation assessment by the older means available to the users of NFP or FAM.

For more about the data in the above illustration, go see another old bioZhena post, “Regarding fetal sex preselection”, at   https://biozhena.wordpress.com/2007/12/02/regarding-fetal-sex-preselection/ .

If you want to learn more about how the Ovulona device does it, go to “About bioZhena Tech Pitch” at   https://biozhena.wordpress.com/about/about-biozhena-tech-pitch/ (inserted here in February 2019).

bioZhena's Weblog

For these and other terms, see the Alphabet of bioZhena at /2007/11/28/the-alphabet-of-biozhena/

Rerum Naturare Feminina. A Woman’s Natural Thing. In the lingua franca of the ancients.

The reader of this bioZhena’s Weblog article will or should be well aware that a woman’s menstrual cycle lengths are quite variable, as is the timing of her ovulation within those menstrual cycles. For evidence of this variability, see another blog post at https://biozhena.wordpress.com/2010/03/07/variability-of-menstrual-cycles-and-of-ovulation-timing/ (opens in new tab/window). Our focus on the cervix uteri is clarified below in this article.

Cervix:

The narrow lower part of the uterus (womb), with an opening that connects the uterus to the vagina. It contains special glands called the crypts that produce mucus, which helps to keep bacteria (and other microbes, including sperm for most of the cycle) out of the uterus and beyond. Sometimes called the neck of the womb, it protrudes into the vagina. The region…

View original post 1,356 more words

Stress and fertility: How stress affects the inherently narrow fertile window

This blog post appears as the third result in Google search on “bioZhena” (without the quote marks). The complete title is:

Stress and fertility

How stress affects the inherently narrow fertile window

To read the whole post, click on either of the antique-book images or on Reblogged from bioZhena’s Weblog:

Before you go there, here is a little update. New research into stress and fertility was published since I wrote the blog post in December 2007, and here is a summary of an article titled “Stress puts double whammy on reproductive system, fertility” (see http://esciencenews.com/articles/2009/06/15/stress.puts.double.whammy.reproductive.system.fertility ).

 

QUOTE: The new research shows that stress also increases brain levels of a reproductive hormone named gonadotropin-inhibitory hormone, or GnIH, discovered nine years ago in birds and known to be present in humans and other mammals. This small protein hormone, a so-called RFamide-related peptide (RFRP), puts the brakes on reproduction by directly inhibiting GnRH.

The common thread appears to be the glucocorticoid stress hormones, which not only suppress GnRH but boost the suppressor GnIH – a double whammy for the reproductive system. END QUOTE

 

Unlike any other fertility monitoring technology, bioZhena’s Ovulona™ is a Smart Sensor™ in vivo monitor of folliculogenesis. Unlike any other fertility monitor, the Ovulona is basically involved with the always-present stress responses – through monitoring certain end-organ effects on folliculogenesis. The other techniques monitor only this or that circulating hormone – not good enough. The end-organ effect(s) is what counts.

 

Again, to read the whole post, click on either of the antique-book images or on Reblogged from bioZhena’s Weblog

 

For a 2012 update go to What is the mechanism of stress and how does it affect reproduction. An update. And: Be a young mother! (Ovulona™-related published scientific findings by others about disruption of fertility, about PCOS or Poly Cystic Ovarian Syndrome, how stress suppresses ovulation, about the hypothalamic amenorrhea of stress and postpartum blues/depression, about a CRH placental clock which determines the length of gestation and the timing of parturition and delivery, and the role of CRH in premature labor. How old age affects folliculogenesis as a stressor. Even how acute stress may induce ovulation in women.)

bioZhena's Weblog

Please click through to the 2019 revision of this post at

https://biozhena.wordpress.com/stress-and-fertility-fertile-window-ovulation/

How stress affects the inherently narrow fertile window

Stress can do unwanted things to a woman and her menstrual cycle. In a nutshell, stress can make a woman completely infertile in this menstrual cycle (e.g., LPD, see below), or it can change the timing of her fertile window (the time of ovulation included) within the menstrual cycle. Any of this can cause problems and lead to more stress…

The medical term is stress response, and it refers to the overall reaction of the organism to any adverse stimulus, whether it be of physical, mental or emotional kind, internal or external. The purpose is to adapt to challenge, and this goes on all the time. (C’est la vie! Real life is a never-ending series of stress responses.) Should the compensating reaction of the organism be inadequate or inappropriate, a…

View original post 1,455 more words

Difficult to conceive – Google evidence that pregnancy complications and trying-to-conceive concerns shot up after the Pill launch in 1960s

Regardless of what contraceptive proponents tell you

On this day when Vaclav Havel passed away. In this post, I come out explicitly with an argument against the use of contraceptive pills and related agents (all Endocrine-Active Compounds [EACs]), because of the serious consequences of the sex steroid chemicals for women’s health. I start with evidence from Google statistics.

It is possible to examine the English-language literature for the frequency of addressing certain topics over a period of time. I already did this in the recent post “Seven billion people – after half a century with the Pill”.

Let’s look at data from Google Ngram Viewer about the statistics of the occurrence of certain topics (such as difficult birth) in all books published in English. The data is obtained via http://books.google.com/ngrams/info – for anyone to examine.

Briefly, when we enter phrases into the Google Books Ngram Viewer, it displays a graph showing how frequently those phrases occurred in a corpus of books (here English-language books) over the selected years (here 1900 to 2000). The data is normalized by the number of all books published in each year.

Here we have a comparison of statistics of three phrases:

pregnancy complications (blue),

difficult birth (red), and

trying to conceive (green).

Ngram 6: pregnancy complications, difficult birth, trying to conceive

The topic of difficult birth exhibits an almost linear growth over the century, even though there are discernible steps in the early years such as the step that followed the plateau (flat portion) lasting from about 1915 to just before 1930, when it “shoots up to catch up with” the overall trend. And, overall, the red curve grows steadily from 1900 to 2000.

In contrast, the blue curve of pregnancy complications and the green curve of trying-to-conceive both shoot up only after 1960, the decade of the introduction of the contraceptive pill. The steep rise in pregnancy complications books (blue) starts soon after 1960. The rise in the number of books about trying-to-conceive (green) starts in mid-1970s and is also distinctly faster than the steady growth over the century of books on difficult birth (red), although it is slower than the pregnancy complications that started going up some ten years earlier.

Of course, the green trying-to-conceive curve is not uninteresting in the early decades of the century, either, if only because it appears that the late Victorians had a significant interest in the topic, much higher than in the other two and especially as compared to pregnancy complications (blue). I’ll leave any discussion of the trend there to others, although the downward trend in the first half of the century would seem consistent with the rise of the birth control movement and with the consequences of two World Wars, and the Great Depression in between.

Peter Paul Rubens, Allegory of War, c. 1628

Those two generations had it tough but, on the other hand, their health, the health of humankind, was not yet assaulted by the sex-steroid chemicals that were introduced in the 1960s.

In a previous bioZhena’s Weblog post, you can see evidence that oral contraceptive use directly and negatively impacts the cervical crypts, which brings about the difficulty to conceive. The bottom line is this: “After 3 and up to 15 months of contraceptive pill use, there is a greater loss of the S crypt cells than can be replaced.” The S crypts are needed for conception.

To further cite Professor Erik Odeblad: “Complications arising from the use of the Pill are very frequent. Infertility after its use for 7-15 years is a very serious problem. S crypts are very sensitive to normal and cyclical stimulation by natural estrogens, and the Pill causes atrophy of these crypts. Fertility is impaired since the movement of sperm cells up the canal is reduced. Treatment is difficult.”

This is a serious problem because, according to medical literature, most American women, “approximately 85% of U.S. women will use the OC (oral contraception) for an average of five years.¹ However, women’s OC use, similar to other chronic medications, is often inconsistent and transient.² Reported six-month OC discontinuation rates vary from 18% to 50%.^3,4,5 Unintended pregnancy often follows OC discontinuation” END OF QUOTE. (Am J Obstet Gynecol. 2007 April; 196(4): 412.e1–412.e7)

These data can be read and understood as the double-whammy put on or dealt to American reproductive and public health. That is the high prevalence of trying-to-conceive problems (sub-fertility and infertility) and at the same time the very high rate of unintended pregnancies.

Lion_Hunt_Mosaic in Pella

zb.jpg

While many proponents of chemical contraception minimize or gloss over the side effects of contraceptive chemicals, it is known that “OCPs (oral contraceptive pills) have several known metabolic effects including increased production of clotting factors resulting in increased risk of venous thromboembolism, increased gallstone formation during the first year of use, and increased risk of liver adenomas (Speroff and DeCherney 1993)” – cited from Ther Clin Risk Manag. 2008 October; 4(5): 905–911 (paper from University of Vermont College of Medicine and Reproductive Endocrinology and Infertility, Women’s Health Care Services)

That said, studies mainly focus on side effects such as amenorrhea, the incidence of breakthrough bleeding and spotting, compliance, discontinuation rates or patient satisfaction, headaches, genital irritation, tiredness, bloating, and menstrual pain.

To cite from said medical publication “Evaluation of extended and continuous use oral contraceptives”, Ther Clin Risk Manag. 2008 October; 4(5): 905–911 QUOTE [emphasis mine]:

In a normally menstruating woman who is not taking contraceptive hormones, progesterone is only present in appreciable quantities during the luteal phase of the menstrual cycle [meaning: after ovulation], after the development of the endometrium. When combination OCPs are administered, the effect of the progestational agent takes precedence over the estrogen component in the reproductive tract, and the endometrium demonstrates this progestin effect (Moyer and Felix 1998). The result is a thin, decidualized (transformed) endometrium with atrophied glands that is not receptive to embryo implantation. Progestins also cause thick, impermeable cervical mucus, preventing sperm from reaching the uterine cavity, and also decrease tubal mobility, altering the movement of sperm and oocytes through the fallopian tube (Johnson et al 2007; Rossmanith et al 1997) END OF QUOTE.

This is consistent with the Erik Odeblad findings about the fine structure of the cervical tissues. http://humrep.oxfordjournals.org/cgi/content/full/18/9/1782

Edward_Burne-Jones_Maria_Zambaco_1870

Further to the examples of studies about the mainly short-term effects of chemical contraception, here are examples of published findings about the harmful long-term effects of the sex steroid chemicals administered to healthy women. This is not a systematic review, merely a couple of examples.

BONE HEALTH:

The conclusion of “Effects of Depot Medroxyprogesterone Acetate and 20 μg Oral Contraceptives on Bone Mineral Density” [Obstet Gynecol. 2008 October; 112(4): 788–799]is as follows:

QUOTE Use of very low-dose OCP (Oral Contraceptive Pill) may result in a small amount of bone loss. DMPA (depot medroxyprogesterone acetate) use results in greater bone loss, but this is largely reversible at the spine. Use of very low-dose OCPs after DMPA discontinuation may slow bone recovery.

As a result, the Food and Drug Administration issued a warning in 2004 advising women to limit its use to ≤2 years.

Oral contraception (OC) containing only 20 μg ethinyl estradiol (EE) may also adversely affect bone health, especially if used during adolescence. END OF QUOTE [emphasis mine].

HEART HEALTH:

According to J Clin Endocrinol Metab. Author manuscript; available in PMC 2011 November 9 (Published in final edited form as: J Clin Endocrinol Metab. 2007 August; 92(8): 3089–3094), “whether OCP use in healthy young women is associated with increased CV (cardiovascular) risk is controversial. However, a recent meta-analysis of 14 studies showed that current use of low-dose OCPs increased the risk for myocardial infarction by 84% (37). More data are available regarding CV risk associated with estrogen/progestin use in older women… The Heart and Estrogen/Progestin Replacement Study showed an early increase in events and no benefit overall in women with known CV disease, and the Women’s Health Initiative (WHI) trial demonstrated an increase in CV events in healthy women (38, 39).” END QUOTE.

René Boyvin, The rape of Europa, c. 1545-55

In Greek mythology Europa (Greek Ευρώπη Eurṓpē) was… seduced by the god Zeus in the form of a bull, who breathed from his mouth a saffron crocus^[14] and carried her away to Crete on his back… and so see Wikipedia for the whole story. Oh, and should this not be clear, the metaphor here pertains to the man-made OCP [Oral Contraceptive Pill] accomplishment…

Max Beckmann, The rape of Europa (1933)

Returning to Odeblad’s results on the consequences of the Pill for the cervix uteri, that is on how contraceptive chemicals make it difficult to conceive later – and reiterating the take-home message put forward previously in “About atrophy, reproductive aging, and how it’s really not nice to fool Mother Nature – or with”:

Natural aging of cervical S crypts (= cervical aging of a woman never pregnant and never on the Pill):

S crypts, which are needed for conception, are down to 20% at 40 years of age, at the natural aging rate -2% per year. Here you have the reason why a too mature age leads to sub-fertility and to infertility. My remark: The optimal age for motherhood has always been and always will be the early twenties of a woman’s life.

Atrophy acceleration effect of 10 years on the Pill:

S crypts are down to mere 10% at 40 years of age. Here is why it’s not nice to fool Mother Nature, why it’s not good to mess with her design. Fertility is drastically reduced. The Pill is an archetypal anthropogenic Endocrine-Active Compound [man-made EAC]. It was brought up previously in this blog how there are very many of these EACs, all insulting the female body and health; some – like chemical contraceptives – by design. Having invoked the design, I am reminded that the original designers of the Pill had no idea about contraception – they were pushing the frontiers of steroid chemistry… (not this particular application of one kind of steroids).

Atrophy slow-down or beneficial effect of pregnancies:

S crypts only down to 40% at 40 years of age. Here you see Mother Nature’s design in action. Pregnancy slows down the inherent rate of natural cervical aging (atrophy, deterioration). The effect of 4 pregnancies was measured in the Odeblad research. This is not to argue for 4 pregnancies per lifetime – it’s merely how the difference between with and without was made more “easily” measurable in the very difficult studies.

And again, the bottom line is this: “After 3 and up to 15 months of contraceptive pill use, there is a greater loss of the S crypt cells than can be replaced. …S crypts are very sensitive to normal and cyclical stimulation by natural estrogens, and the Pill causes atrophy of these crypts. Fertility is impaired since the movement of sperm cells up the canal is reduced.” END QUOTE.

In case you’d like to view the Carlo Adelio Galimberti picture accompanying the concluding words, please re-visit the cited earlier post. The concluding words were and still would be: While the story of Laodamia and Protesilao is touching, I merely want to ask that girls, ladies and their physicians do not moon the messenger.

P. S.

Vaclav Havel would smile at the image of “mooning” Laodamia. I smile at the thought of his riding the children’s scooter (kolobezka) along Saint Peter’s heavenly corridors (looking for Olga? Since Pani Dagmar remained down there?). He reportedly did that scooter-running in the “labyrinthine” corridors of Prague Castle…

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/

Trying to conceive, TTC, or the frustration of sub-fertility & infertility

Existing approaches to TTC, Trying To Conceive, are not satisfactory – and cannot be, without FOLLICULOGENESIS IN VIVO™

Here is the premise: To #conceive a #pregnancy the couple must absolutely do their TTC in the woman’s #fertile time, which is a window of 3 days: https://biozhena.wordpress.com/2010/05/25/difficult-conception-tied-to-pregnancy-complications-addressed/ . The unspoken corollary is that advancing age does not help, and neither do things that pollute our life, that is all those various stressors.

Besides which, you need to know not only when your ovulation is approaching but also that it actually occurs. No guessing, no mere assuming that it does, or that it did.

Human ovulation caught on camera by Dr Donnez

This photo of the ovulation event is unique, and it clearly cannot be the answer to the necessity of knowing that ovulation occurs in the menstrual cycle of interest to you. Also unique is that the Ovulona™ will do the determination of ovulation for you automatically – in your hands, at your convenience, with no discomfort. It’s one part of the FOLLICULOGENESIS IN VIVO™ simple self-monitoring procedure with the Ovulona™. In doing so, you’ll gather and automatically store in the device data of diagnostic significance to your healthcare providers. Your physician’s decisions should be guided by the folliculogenesis cyclic profile. Yours, too.

Here now, how TTC people need our Ovulona: Disgusted with peeing on a stick, writes stressed out, frustrated, messed up @socalledttclife: “On to IUI #4 we go” [IUI = Intra Uterine Insemination procedure], http://ow.ly/351yf .

She blogs: “…Progesterone supps suck. No, really, Crinone is now numero uno on my most hated list right there behind peeing on a stick and betas. It totally MESSED with my head this cycle. It made me crampy, it gave me headaches, it delayed my period—ALL of the things that are usually early pregnancy symptoms. Damn you, Crinone!”

This is one example and one reason why a month ago the following tweeting dialog took place: RT @resolveorg What’s the one thing you wished the public knew about #infertility?

bioZhena’s answer = Before #fertility #drugs, try right timing http://to.ly/5dUR . Definitely! Read on.

Quite apart from the fact that even the artificial reproductive procedures such as said IUI have to be performed at the right time in the patient’s cycle to have a chance succeeding. Before undergoing the “heroic procedures” of Artificial Reproductive Technologies [ARTs], explore the normal natural approach, and – naturally – you need a reliable timing tool to know when exactly your 3-day fertile window occurs. Good thing you are still this side of 35, although it would be much better if you were this side of 25. Or 30, at least. But that’s water under the bridge… unfortunately.

Water under the bridge… How many bridges?

Per Google Alert, Today’s TTC Trying To #Conceive forum has 4 results that are symptomatic of the TTC world – and how that world needs our Ovulona diagnostic tool with essential folliculogenesis data for the physicians:

1. Conceiving in our 20s http://www.mothering.com/discussions/showthread.php?p=16007861

2. healthy excersise while TTC – TTC- Trying to conceive Group so im a gymaholic… Before I go to my GP again with yet another silly question, what do you girls think, with your experience and knowledge, about my standard work out ‘plan’ below? Is this too much while TTC? … Thoughts? Please don’t make me not do it 😦

social.kidspot.com.au/topic.php?topic_id=8490

3. First time TTC with clomid and really nervous, any suggestions?? Forum · PCOS Treatments and Conditions · Infertility and Trying to Conceive; First time TTC with clomid and really nervous, any suggestions? …
www.soulcysters.net/showthread.php?t=317229&page=2

4. Pregnancy Forum UK : UK Pregnancy Forum Parenting and Baby forum …
hey all i had a positive opk on fri am but this morning days later had twinges on left hand side which feel like op is it possible that i have only just …
178.19.113.123/viewtopic.php?f=8&t=114228&view…

#PCOS patients should monitor folliculogenesis & the effects of any treatment on it. See http://to.ly/MJU , and for what it is go to http://to.ly/757m , and see how an obgyn physician related to the technology even early on when it was still in a rather crude prototype form: http://to.ly/vG0 .

As we expressed earlier in this blog:

It is advisable – and safer – to go about TTC, Trying To Conceive, without the use of chemicals, especially man-made chemicals, and note that herbal preparations are chemicals too. Monitoring (measuring) the effects of anything you ingest is basically a must, if you do not play “Russian roulette” with yourself, your offspring, your family.

#Obese peri-pubertal girls may have hyperandrogenemia which can be forerunner of #PCOS: http://to.ly/6PrK .

Not all #women with #PCOS have difficulty achieving #pregnancy, but anovulation is a common problem: http://to.ly/5mjs .

#PCOS problems are more about #prevention of diseases due to PCOS = #endometrial #cancer #diabetes #heart disease #strokes: http://to.ly/5mjs . Per @JoshGitalis : Insulin resistance is an underlying biochem. imbalance in not only type 2 #diabetes, but #CVD, #hypertension, #PCOS, and colon/breast cancer.

RT @kevinmd Too many young children are medicated with powerful #drugs http://goo.gl/fb/xXu5q – Too many #women too. Will this ever be seen as abuse?

Durer, Albrecht – The Temptation Of The Idler (or The Dream Of The Doctor)

Difficult #conception is tied to #pregnancy complications: https://biozhena.wordpress.com/2010/05/25/difficult-conception-tied-to-pregnancy-complications-addressed/  #fertility TTC #conceive #womenshealth .

#Natural vs. #Clomid in Dr. Randine Lewis: From #Infertility to Motherhood, http://to.ly/60v6 . Wrote the #medical doctor:

“I was experiencing hormonal problems. My joints ached, I had lower back and knee pain, I had to urinate frequently, I had night sweats, I was experiencing hair loss and my periods were extremely irregular and sometimes nonexistent.

A medical work-up revealed my estrogen and progesterone levels were alarmingly low, resulting in my inability to conceive. The doctor recommended that I take Clomid, a drug designed to hyperstimulate a woman’s ovaries to produce more eggs, thus increasing the chances of pregnancy. This advice seemed wrong to me; what about the underlying problem? Was it not unwise to hyperstimulate my ovaries when the problem obviously resided in my whole hormonal system?”

Now, put that in context with More About Clomid, Serophene, Clomiphene citrate or Clomifene, https://biozhena.wordpress.com/2010/06/25/more-about-clomid-serophene-clomiphene-citrate-or-clomifene/ . Why popping pills is not the best.

Is #ovulation enough to #conceive? No. You have to satisfy 4 factors, 4 prerequisites:

1. good health,

2. right insemination timing,

3. fertilization works,

4. embryo lives, is not lost to early embryonic mortality.

#Stress can do unwanted things to #women & #menstrual cycles: https://biozhena.wordpress.com/stress-and-fertility-fertile-window-ovulation/ . Check this out. Sub-fertility can result.

Every year past the optimal fertile age of early twenties is making things harder – on would be mom, on baby, on healthcare system, on humankind.

Consequences of conception difficulties should not be taken lightly. See why.

STOP PRESS

And now, for a more explicit and detailed info, go to the 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/

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

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 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

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.

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

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/

About atrophy, reproductive aging, and how it’s really not nice to fool Mother Nature – or with

I have taken it upon myself to popularize Prof. Erik Odeblad’s classic findings about the biophysics of the tissues and secretions of cervix uteri, and how they translate into reproductive physiology and hence to reproductive medicine – at home and in the doctor’s office.

  Emeritus Professor Erik Odeblad    “The cervix is a precision organ as complex as the eye”

My ulterior motive is that I want to be understood when harking back to the British commercial’s exclamation that warned about too arrogant an attitude towards Mother Nature. Or, maybe I aim at the wisdom of the saying (“It’s not nice to fool Mother Nature!”) to be appreciated particularly within the given field of endeavor and/or endeavour – that is, reproductive management. Even if it were only in a segment of it.

In the Alphabet of bioZhena (which is no Alphabet of Ben Sira, though we model on it somewhat), https://biozhena.files.wordpress.com/2007/11/aaee-the-alphabet-of-biozhena.pdf , there is an entry about Atrophy and what it does to a woman as years go by, how “atrophy of mucosal surfaces takes place, accompanied by several problems.”

Jan Amos Komenský (Comenius) Says Farewell to…

In this blog post I focus on aging – and thus atrophy – of the cervix, leaving aside the inevitable corresponding phenomena in other parts of the reproductive system.

The focus on the cervix is due to bioZhena’s focus on the cervix… which in our scheme of things is the supreme monitor of the complex reproductive goings on that Mother Nature designed in order to cope with all that complexity. After you’ve read the Alphabet article on atrophy, you might scroll down to the entry there about the cervix, which will take you also through cervical cancer and cervical mucus, besides a couple of other things cervical. That will or would be a nice preparation for, or introduction to, what follows.

Two sketches by Emeritus Professor Erik Odeblad to illustrate his saying, “The cervix is a precision organ as complex as the eye”. Click (right-click) on the image to see the details. And read on about the details. The fine structure of the cervical canal wall, schematized on the right, is based on examination of mucus samples obtained with a suction syringe from the various parts of the cervical canal of human volunteers for physico-chemical examination.

When, at the inception of the project, we decided to focus on the given part of the anatomy, Erik Odeblad’s work logically and inevitably became a part of the background. He used the NMR (nuclear magnetic resonance) technique of physical chemistry to perform the complicated investigation of cervical mucus, and he produced the classical evidence for the difference between the “fertile” mucus macromolecules that allow the passage of the sperm, and the “infertile” cross-linked glycoprotein molecular network that does not. (To this day I remember his usage of “undulations”…)

In fact, this early information, which involved the thiol-disulfide (sulphydryl-disulphide) redox couples in the glycoprotein macromolecule, had much to do with our early hypothesis of the mechanism of our measurements. Never mind that his work was in the context of the subjective self-examination used in NFP, which did not work for the female member of the team! Had it worked for her, there would probably not be any Ovulona™ for monitoring folliculogenesis in vivo (FIV™ – which has utility well beyond fertility status determination)!

With atrophy being the general biological aspect of aging (and with the initially very large number of ova or eggs in the young female’s ovaries decreasing as she matures and ages), the cervix similarly “undergoes a natural process of development and aging. The surface area of the cervix that is given over to the mucus secreting glands [“crypts”] gradually diminishes with age.”

Odeblad defines three types of the (endo)cervical glands, which he (and others too e.g. Embryology.CH and Eurocytology.EU since at least the 1970s) calls the “crypts”:

• S crypts produce S mucus, which forms string-like channels and provides transport (“swimming lanes”) for sperm cells. (“Produces a wet, lubricative sensation at the vulva.” That’s for the NFP sympto-thermal method use, the Billings method and/or the Creighton Model NaProEducation Technology method, the classical NFP or FAM – the latter, Fertility Awareness Method, publicized by Ms. Toni Weschler’s 2002 book Taking Charge of Your Fertility .)

• L crypts produce L mucus, which eliminates low-quality sperm and provides a structure to support what he calls the S and the P mucus. P is a reference to the so-called Peak mucus of NFP or FAM.

• G crypts produce G mucus, which is “an impenetrable gestagenic mucus formed in the lowest cervical crypts. Prevents sperm entry to the cervix and is part of the immune system which protects the woman’s reproductive system from infection.” A remark from dictionary.com: gestagen (jěs’tə-jən, -jěn’) n. A substance, such as a steroid hormone, that affects the uterus in a manner similar to progesterone. And a remark from a scientific commentator: This G mucus is characterized by the oxidized state of the mentioned redox couples, causing cross-linking in the glycoprotein mucin, which prevents microbes including sperm from entering. Visualize this as closed -S—S- gates (as opposed to the open gate form -SH   HS- of the “reduced” state of the redox couples; “reduced” meaning “electronated and hydrogenated”, the opposite of “oxidized”).

Mondrian_Evolution

There are three fundamental principles at work.

1. Natural baseline aging, and this is fundamental – a more or less linear decrease in the number of all three kinds of these glands or crypts, at somewhat different rates: S the fastest, L somewhat slower, G slower still.

2. Slow-down of the aging atrophy by pregnancy.

3. Acceleration of the aging atrophy by the Pill [and/or by other endocrine-active compounds, EACs – this is a logical extrapolation, speculative, but must be assumed].

Now, then.

1. Natural baseline aging, fundamental – a more or less linear decrease in the number of all three kinds of these glands or crypts:

“The number of S crypts decreases from teen age. They are first replaced by L crypts starting at the base of the cervix. Later G crypts replace the L crypts.”

Thus, from Odeblad’s graph [rate reckoned from 15 yrs old to 40 yrs old]:

S crypt baseline decrease or diminution (or atrophy) rate:

50% / 25 years = 2% per year.

At 50 years old, S crypts are at some 10%.

Profile of cervical crypts of a baseline woman – never pregnant & never on the Pill

Representative profile of cervical crypts

(percentage of cervix occupied by active crypts)

for a woman who goes through life without pregnancy or use of the Pill.

This is a baseline profile.

Here is Erik Odeblad’s schematic of the crypts on the surface of the cervical canal:

Carefully mapped lateral wall of the cervix of a 20 year old virgin           (reported by Emeritus Professor Erik Odeblad, Department of Medical Biophysics, University of Umeå, S-90187, Umeå, Sweden)

This is Professor Odeblad’s artist’s impression of cervical mucus secretions:

Schematics of cervical mucus secretions

Key to colors:

Blue         = S mucus

Yellow     = L mucus

Red          = G mucus

Green      = P mucus of which there are several sub-types

Pink         = Z granules

Professor Odeblad’s explanatory notes:

Z granules – the enzyme in the Z granules combines with the P mucus to create a liquefying effect.

P mucus – there are a number of sub-types of this mucus, the most relevant for fertility are P2 and P6. P2 could be present as early as the beginning of the fertile phase possibly having a role in liquefying the G mucus. P6 is mostly confined to the upper part of the cervix, occurring close to the Peak of fertility, and having a role in conveying sperm. It creates a very wet and lubricative sensation at the vulva.

F mucus – comes from the cells scattered throughout the length of the cervical canal and has no known special function.

For a recent evidence of four different morphological mucus types, namely L, S, P and G, see “Morphological characterization of different human cervical mucus types using light and scanning electron microscopy” by M. Menárguez, L.M. Pastor and E. Odeblad, Human Reproduction, Vol. 18, No. 9, 1782-1789, September 2003 –  http://humrep.oxfordjournals.org/cgi/content/full/18/9/1782

Citation: “The distribution of crypt zones in the cervix depends on age, number of pregnancies and use of contraception. In a non-pregnant woman, aged 25–30years and not having used contraception, the cervix averages 22 mm in length and 6 mm in diameter at ovulation. The crypt distribution starting from below and moving upwards is as follows: the G crypts dominate in the lowest 4–5 mm; then there is a zone of L crypts occupying the next 9–10 mm; this is followed by the S zone, for 5–6 mm; and the highest 3–4 mm contains the P crypts.”

When you read the paper, you detect that he has a very special knack for sampling the respective mucus types from the said crypts. Hat off! Work with human experimental subjects is no stroll in the park, to put this mildly.

2. Slow-down of atrophy aging by pregnancy:

Profile of cervical crypts of a 4x pregnant woman

Representative profile of cervical crypts

(percentage of cervix occupied by active crypts)

for a woman who goes through life with four pregnancies and no use of the Pill.

Pregnancy – S crypt diminution rate from Odeblad’s graph

[4 pregnancies, no Pill, rate reckoned from 15 yrs old to 40 yrs old]:

30% / 25 years = 1.2% per year.

At 50 years old, S crypts are at some 20%.

3. Acceleration of atrophy aging by the Pill [and/or by other endocrine-active compounds, EACs – a logical extrapolation]

Representative profile of cervical crypts

(percentage of cervix occupied by active crypts)

for a woman who goes through life without pregnancy and uses the Pill for 10 years

Pill – S crypt diminution rate from Odeblad’s graph

[no pregnancy, Pill for 10 years (18 to 28 yrs old), rate reckoned from 15 yrs old to 40 yrs old]:

60% / 25 years = 2.4% per year.

At 50 years old, S crypts are at some 5%.

This includes the slow down of the diminution gradient during the last 12 years of no Pill.

Compare this with diminution/atrophy rate during the 10 years on the Pill:

65% – 25% = 40% / 10 years = 4% per year.

This is double the baseline rate of cervical atrophy.

It’s more than 3 times higher than the pregnancy-slowed atrophy rate.

Three concluding remarks by Prof. Odeblad:

“Regression when taking the Pill is different for estrogen-dependent crypts (L and S) and progesterone-dependent crypts (G) which may in part overdevelop.”

“The study of the effects of contraceptive pills on the cervix is a difficult task. A considerable amount of work is required for each patient and the time required spans many years, up to 10 years or more. Many women also want to change to other pills or to other methods of contraception, or perhaps now want to become pregnant. It also happens that some pills are withdrawn from the market. To these difficulties are added the normal age changes in the cervix and the dynamic processes which are of constant occurrence. After 3 and up to 15 months of contraceptive pill use, there is a greater loss of the S crypt cells than can be replaced.” (“Some Notes on the Cervical Crypts”, Dr E. Odeblad, Bulletin of the Ovulation Method Research and Reference Centre of Australia, Vol 24 No 2 June 1997, p31)

Citations and graphics reproduced from http://www.billings-ovulation-method.org.au/act/cervix/ageing.shtml .

“Complications arising from the use of the Pill are very frequent. Infertility after its use for 7-15 years is a very serious problem. S crypts are very sensitive to normal and cyclical stimulation by natural oestrogens, and the Pill causes atrophy of these crypts. Fertility is impaired since the movement of sperm cells up the canal is reduced. Treatment is difficult.” He also wrote: “After 3 to 15 months of contraceptive pill use, there is a greater loss of the S crypt cells than can be replaced … A pregnancy rejuvenates the cervix by 2-3 years, but for each year the Pill is taken, the cervix ages by an extra year.” Web reference:  http://www.billings-ovulation-method.org.au/act/pill.html .

Comment on implications for treatments of certain symptoms

For example, the suggested method [Weschler, Toni (2002). Taking Charge of Your Fertility (Revised ed.). New York: HarperCollins. p. 52] of thinning cervical mucus to help achieve pregnancy by taking the OTC expectorant drug guaifenesin, which is thought to act by increasing the volume and reducing the viscosity of secretions.

The drug is also used to treat the symptoms of primary dysmenorrhea [severe uterine pain during menstruation ] where another treatment of choice is combined oral contraceptives [COCs]. Such treatments are administered to adolescents as well as to mature women because dysmenorrhea is a very common and serious problem (25% of women and up to 90% of adolescents ).

In both cases, the expectorant and the contraceptives are administered without knowledge of their mechanism of action in the given problem. Focus is on treating symptoms, not the underlying causes. The patient is the detector of any effect. How does the expectorant drug use correlate with the secretions of the different types of cervical mucus on the one hand, and with the folliculogenesis cyclic profile on the other? Is there any connection? If not, what does the drug do to the different crypts? And what the COCs do to them?

Is the expectorant so selective that it might do the right thing? Reduce type G? Enhance type S mucus? Does oxidation of the guaifenesin help reduce the cross-linked mucin type G in the cervical canal? As simple and pretty as that? (Even prettier if guaifenesin were not to be an EAC, an endocrine-active compound … which inactivity does not look likely – http://www.who.int/ipcs/publications/en/ch3.pdf .)

Would it not be nice to have a rationale for how the small guaifenesin molecule can have a good effect on both sub-fertility/infertility and dysmenorrhea?

Could it be that guaifenesin works bioelectrochemically in the same oxidation-reduction (redox) manner on the enzyme cyclooxygenase in the prostaglandin cascade, which is a cascade of redox reactions – producing an anti-inflammatory effect that translates as suppression of pain? (On a personal note, why not capitalize here at least conceptually on our ancient Wellcome Research Labs work, even before receiving – presumably – the first pension money from Glaxo Smith Kline?)

It’s easier to contemplate in general the effect of the contraceptive drug, which will presumably depend on the contents of the estrogenic and gestagenic components (modeling on Odeblad’s findings)…

Is there a connection between pain, cervix and ovaries, ovarian reserves? Maybe an abnormal depletion of, via ovarian cysts? Will the number of follicular waves and/or other features in the Ovulona cyclic profile – and correlated with ultrasound and MRI – show any such abnormality? Might the Ovulona be useful for diagnosis here, convenient, simple (inexpensive)? Wouldn’t that be nice?

Is cyclooxygenase inhibition detected by the cervix, does it show in the cyclic profile? Does said prostaglandin synthesis inhibition alter the number of follicular waves – while reducing the pain?

Answers to questions like these are needed. Keep in mind that ovulation is an inflammatory process, and since we detect it in the cyclic profile, it is reasonable to pose the above prostaglandin theory questions about the COX-2 (cyclooxygenase) inhibition.

Summarizing Odeblad’s results and the take-home message:

Baseline outcome of cervical S crypts aging: S crypts down to 20% at 40 years of age. Here you have the reason why mature age leads to sub-fertility and to infertility.

Atrophy slow-down effect of 4 pregnancies: S crypts down to 40% at 40 years of age. Here you see Mother Nature’s design in action. Pregnancy slows down the inherent rate of cervical aging (atrophy, deterioration). Naturally, this is not to argue for 4 pregnancies per lifetime – it’s merely how the effect was made measurable.

Atrophy acceleration effect of 10 years on the Pill: S crypts down to 10% at 40 years of age. Here is why it’s not nice to fool Mother Nature, why it’s not good to mess with her design. The Pill is an archetypal anthropogenic Endocrine-Active Compound [man-made EAC], and it was brought up in the previous post how there are very many of these EACs, all insulting the female body and health, some – like chemical contraceptives – by design.

While the story of Laodamia and Protesilao is touching, I merely want to ask that girls, ladies and their physicians do not moon the messenger.

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 Clomid, Serophene or, generically, clomiphene citrate. A critical look, part 1.

In relation to folliculogenesis, the mechanism of menstrual cycling, which we monitor in vivo – to get away from drugs as much as possible.

Last night I re-tweeted this:

RT @FertilAidAmy What is Clomid…? http://blog.fairhavenhealth.com/ = it’s NOT recommended to take it for >6 cycles, and it causes decreased fertile mucus

Then I found that there is no entry about Clomid in the Alphabet of bioZhena. Yet, Clomid is a very frequently administered medication for women with difficulty conceiving, “prescribed to women that are trying-to-conceive to induce ovulation. Clomid is often prescribed to women with irregular cycles that either experience irregular ovulation or don’t ovulate at all” (http://blog.fairhavenhealth.com/ ).

Clomid was also involved in a peculiar episode when a business-incubator director took me once to a local hospital’s young lady gynecologist thinking that, because she was written about in the local newspaper, she was just right for bioZhena Corporation’s quest for good people and/or “strategic allies”. Instead, the take of the young physician, who took several calls from upstairs during the “interview”, was something along the lines, “I don’t see what’s in it for me with your technology. When they [subfertility sufferers] come to us, we put them on Clomid, and that’s that…”.

Dali - Longlegs

Well, let’s look at what the “that’s that” is about. The referenced tweet mentioned, within the allowed 140 characters, two features. One, that Clomid should not be taken for more than 6 menstrual cycles. And two, that it is known to reduce the amount of the all-important fertile mucus, which is the cervical mucus form occurring only during the run up to ovulation. This essential temporary change is for the purpose of opening the cervical canal for the penetration of the sperm and, in fact, for what is called the capacitation of the sperm. At all times outside of the fertile window, the fertile mucus is replaced by the protective type of cervical mucus, which prevents the entry of microbes including sperm into the uterus and beyond.

For a concise overview of this essential mucus, read the article Cervical mucus (under C) in the Alphabet of bioZhena, at  https://biozhena.files.wordpress.com/2007/11/aaee-the-alphabet-of-biozhena.pdf . There we cite a noted expert on the subject, Dr. Erik Odeblad, and the gist of his message is: “Complications arising from the use of the Pill are very frequent. Infertility after its use for 7-15 years is a very serious problem. S crypts are very sensitive to normal and cyclical stimulation by natural estrogens, and the Pill causes atrophy of these crypts. Fertility is impaired since the movement of sperm cells up the canal is reduced.”

You can imagine that this will have something to do with the reason why the woman becomes a patient and is now prescribed the fertility drug.

One other thing about the drug is the issue of the official “10-per-cent possibility that Clomid could produce twinning”, described by a physician’s blog post at KevinMD.com about “one of the largest malpractice awards in Canadian history. At issue is how the patient understood the discussion of the risks of Clomid”: http://to.ly/5cE7 .

Sublime moment by Salvador Dali

Clomid is the brand name for the fertility drug clomiphene citrate. Clomiphene citrate may also be sold under the brand name Serophene or as the generic version called clomiphene citrate (http://to.ly/5cIc ).

Here is a bit more scientific take on how it works, cited from Wikipedia (http://en.wikipedia.org/wiki/Clomifene ):

Therapeutically, clomiphene is given at day 2 of menses [menstruation]. By that time, FSH level is rising steadily, causing development of a few follicles [in the ovary].

Let’s interject a clarification: This timing is called the recruitment stage of folliculogenesis, during which LH induces an “angiogenesis” factor from the theca cells, increasing the blood supply and estrogen synthesis by the recruited cohort of follicles.

The term “selection” indicates the reduction of the recruited group of follicles down to the species-characteristic ovulatory quota, which in women and related primates is one. Selection is the culmination of recruitment on day 6 ± 1. “Typically only one of the two ovaries sponsors recruitment and selection of the single dominant follicle, which is destined for ovulation.” We detect the selection stage as the first marker in our ovulographic™ (or folliculogenesis in vivo™) cyclic profile. Refer to the bioZhena tech pitch page http://to.ly/xE6 and/or to http://to.ly/MJU , http://to.ly/MWl .

Back to the language of the Wikipedia article: Follicles in turn produce the estrogen, which circulates in serum. Clomiphene acts by inhibiting the action of estrogen on the pituitary [gland, or hypophysis, in the brain]. [It] binds to estrogen receptors and stays bound for long periods of time.

This prevents normal receptor recycling and causes an effective reduction in hypothalamic estrogen receptor number. As a result, the body perceives a low level of estrogen… Since estrogen can no longer effectively exert negative feedback on the hypothalamus, GnRH secretion becomes more pulsatile, which results in increased pituitary gonadotropin (FSH, LH) release. Increased FSH level causes growth of more ovarian follicles, and subsequently rupture of follicles resulting in ovulation. END OF QUOTE.

Salvador Dali - Geopoliticus Child Watching the Birth of the New Man

From another Wikipedia article, about GnRH (http://en.wikipedia.org/wiki/GnRH ):

At the pituitary, GnRH [Gonadotropin Releasing Hormone (synthesized and released from neurons within the hypothalamus )] stimulates the synthesis and secretion of the gonadotropins, (that is) follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These processes are controlled by the size and frequency of GnRH pulses, as well as by feedback from androgens and estrogens. Low-frequency GnRH pulses lead to FSH release, whereas high-frequency GnRH pulses stimulate LH release. …the frequency of the pulses varies during the menstrual cycle, and there is a large surge of GnRH just before ovulation.

To reiterate, Clomiphene acts by inhibiting the natural action of estrogen on the pituitary gland in the brain, interfering with – or, shall we say, altering, manipulating – the process of folliculogenesis. Women’s health revolves around folliculogenesis and its complex control mechanism by the brain and by the ovaries.

To give you a sense of said complexity of the biology we are working with when we monitor folliculogenesis in vivo, we cite the specialist, Dr. Ernst Knobil: “The mechanism is believed to involve the circhoral* clock of the hypothalamic GnRH pulse generator, on which the circamensual** ovarian clock is obligatorily dependent”. [*Occurring cyclically about once an hour, pulses from the brain; ** about once a month.] From Knobil’s memorial lecture The Wisdom of the Body Revisited, available online at http://physiologyonline.physiology.org/cgi/content/full/14/1/1 .

During the reproductive years, pulse activity is critical for successful reproductive function as controlled by feedback loops. Cited in conclusion from the Wikipedia GnRH article referenced above. (The Wikipedia also has an article about the cervix and cervical mucus, at http://en.wikipedia.org/wiki/Cervical_mucus#Cervical_mucus .)

15- Word(le) greetings from bioZhena's follicular waves

A wordle is a toy for generating “word clouds” from text.

In this case the entire bioZhena’s Weblog as it was in November 2009 — 15 most prevalent words.

It is advisable – and safer – to go about TTC, Trying To Conceive, without the use of chemicals, especially man-made chemicals, and note that herbal preparations are chemicals too. Monitoring (measuring) the effects of anything you ingest is basically a must, if you do not play “Russian roulette” with yourself, your offspring, your family.

The above wordle, the “greetings from bioZhena’s follicular waves”, is a reminder that, before resorting to the chemical route, the innocuous “right time” approach is indicated (because it does not go against – it goes with – the natural biology of the body).

Have you noticed that the powerful Clomid is an estrogen agonist/antagonist? (Acting like estrogen or against estrogen. Tricky, yes? You bet. Or play roulette…)

Difficult conception tied to pregnancy complications – addressed

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

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

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

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

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

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

Clearly, none of this is music to your ears!

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

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

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

Allegory of Music by Francois Boucher

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Chances of achieving pregnancy critically dependent on the timing of insemination

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

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

Bronzino – Allegory of Venus

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

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

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

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

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

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

Probability of pregnancy as a product of four probabilities:

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

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

Women and the health of humankind

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

Alfons Mucha – Job

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

Premature births, a big huge problem with serious consequences.

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

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