Fertility Care
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Fertility and Modernity*
Fertility and Modernity Enrico Spolaore Romain Wacziarg Tufts University and NBER UCLA and NBER May 2021 Abstract We investigate the determinants of the fertility decline in Europe from 1830 to 1970 using a newly constructed dataset of linguistic distances between European regions. We …nd that the fertility decline resulted from a gradual di¤usion of new fertility behavior from French-speaking regions to the rest of Europe. We observe that societies with higher education, lower infant mortality, higher urbanization, and higher population density had lower levels of fertility during the 19th and early 20th century. However, the fertility decline took place earlier and was initially larger in communities that were culturally closer to the French, while the fertility transition spread only later to societies that were more distant from the cultural frontier. This is consistent with a process of social in‡uence, whereby societies that were linguistically and culturally closer to the French faced lower barriers to learning new information and adopting new behavior and attitudes regarding fertility control. Spolaore: Department of Economics, Tufts University, Medford, MA 02155-6722, [email protected]. Wacziarg: UCLA Anderson School of Management, 110 Westwood Plaza, Los Angeles CA 90095, [email protected]. We thank Quamrul Ashraf, Guillaume Blanc, John Brown, Matteo Cervellati, David De La Croix, Gilles Duranton, Alan Fernihough, Raphael Franck, Oded Galor, Raphael Godefroy, Michael Huberman, Yannis Ioannides, Noel Johnson, David Le Bris, Monica Martinez-Bravo, Jacques Melitz, Deborah Menegotto, Omer Moav, Luigi Pascali, Andrés Rodríguez-Pose, Nico Voigtländer, Joachim Voth, Susan Watkins, David Yanagizawa-Drott as well as participants at numerous seminars and conferences for useful comments. -
American Society for Metabolic and Bariatric Surgery Position Statement
Surgery for Obesity and Related Diseases 13 (2017) 750–757 Review article American Society for Metabolic and Bariatric Surgery position statement on the impact of obesity and obesity treatment on fertility and fertility therapy Endorsed by the American College of Obstetricians and Gynecologists and the Obesity Society Michelle A. Kominiarek, M.D.a,1, Emily S. Jungheim, M.D.b,1, Kathleen M. Hoeger, M.D., M.P.H.c,1, Ann M. Rogers, M.D.d,2, Scott Kahan, M.D., M.P.H.e,f,3, Julie J. Kim, M.D.g,*,2 aDepartment of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois bDepartment of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri cDepartment of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York dPenn State Hershey Surgical Weight Loss Program, Hershey, Pennsylvania eGeorge Washington University; Washington D.C. fJohns Hopkins Bloomberg School of Public Health; Baltimore, MD gHarvard Medical School, Mount Auburn Weight Management, Mount Auburn Hospital, Cambridge, Massachusetts Received February 7, 2017; accepted February 8, 2017 Keywords: Obesity; Fertility; Fertility therapy; Bariatric surgery; Polycystic ovary syndrome; Contraception Preamble on fertility and fertility therapy. The statement may be revised in the future should additional evidence become available. The American Society for Metabolic and Bariatric Surgery issues the following position statement for the purpose of enhancing quality of care in metabolic and bariatric surgery. In Prevalence of obesity in reproductive-age women this statement, suggestions for management are presented that are The World Health Organization stratifies body mass index fi derived from available knowledge, peer-reviewed scienti c (BMI) into 6 categories to define underweight, normal literature, and expert opinion. -
Genetic Regulation of Physiological Reproductive Lifespan and Female Fertility
International Journal of Molecular Sciences Review Genetic Regulation of Physiological Reproductive Lifespan and Female Fertility Isabelle M. McGrath , Sally Mortlock and Grant W. Montgomery * Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Road, St Lucia, QLD 4072, Australia; [email protected] (I.M.M.); [email protected] (S.M.) * Correspondence: [email protected] Abstract: There is substantial genetic variation for common traits associated with reproductive lifes- pan and for common diseases influencing female fertility. Progress in high-throughput sequencing and genome-wide association studies (GWAS) have transformed our understanding of common genetic risk factors for complex traits and diseases influencing reproductive lifespan and fertility. The data emerging from GWAS demonstrate the utility of genetics to explain epidemiological obser- vations, revealing shared biological pathways linking puberty timing, fertility, reproductive ageing and health outcomes. The observations also identify unique genetic risk factors specific to different reproductive diseases impacting on female fertility. Sequencing in patients with primary ovarian insufficiency (POI) have identified mutations in a large number of genes while GWAS have revealed shared genetic risk factors for POI and ovarian ageing. Studies on age at menopause implicate DNA damage/repair genes with implications for follicle health and ageing. In addition to the discov- ery of individual genes and pathways, the increasingly powerful studies on common genetic risk factors help interpret the underlying relationships and direction of causation in the regulation of reproductive lifespan, fertility and related traits. Citation: McGrath, I.M.; Mortlock, S.; Montgomery, G.W. Genetic Keywords: reproductive lifespan; fertility; genetic variation; FSH; AMH; menopause; review Regulation of Physiological Reproductive Lifespan and Female Fertility. -
The Evolutionary Ecology of Age at Natural Menopause
1 The Evolutionary Ecology of Age at Natural 2 Menopause: Implications for Public Health 3 4 Abigail Fraser1,3, Cathy Johnman1, Elise Whitley1, Alexandra Alvergne2,3,4 5 6 7 1 Institute of Health and Wellbeing, University of Glasgow, UK 8 2 ISEM, Université de Montpellier, CNRS, IRD, EPHE, Montpellier, France 9 3 School of Anthropology & Museum Ethnography, University of Oxford, UK 10 4 Harris Manchester College, University of Oxford, UK 11 12 13 14 15 16 17 18 19 Author for correspondence: 20 [email protected] 21 22 23 Word count: 24 Illustrations: 2 boxes; 3 figures; 1 table 25 26 27 Key words: reproductive cessation, life-history, biocultural, somatic ageing, age at 28 menopause, ovarian ageing. 29 1 30 31 Abstract 32 33 Evolutionary perspectives on menopause have focused on explaining why early 34 reproductive cessation in females has emerged and why it is rare throughout the 35 animal kingdom, but less attention has been given to exploring patterns of diversity in 36 age at natural menopause. In this paper, we aim to generate new hypotheses for 37 understanding human patterns of diversity in this trait, defined as age at final menstrual 38 period. To do so, we develop a multi-level, inter-disciplinary framework, combining 39 proximate, physiological understandings of ovarian ageing with ultimate, evolutionary 40 perspectives on ageing. We begin by reviewing known patterns of diversity in age at 41 natural menopause in humans, and highlight issues in how menopause is currently 42 defined and measured. Second, we consider together ultimate explanations of 43 menopause timing and proximate understandings of ovarian ageing. -
Why Should I Get My Bulls Fertility Tested? by Travis A
Ask the Vet: Why should I get my bulls fertility tested? By Travis A. Hawkins, DVM Akron Veterinary Clinic Cattle producers obtain their income from selling calves. If you remember back to your high school health class, it takes a male and a female to make a baby, so a fertile bull is half the equation. However, the bull becomes even more important because in livestock production we typically have a small number of males running with a considerably larger number of females. Therefore, a ‘dud’ bull can result in few or no pregnancies despite perfectly healthy cows. A mature bull should be able to easily service up to 40 cows, though many producers use many more bulls as ‘insurance’ in case of fertility problems. The cost of purchasing and maintaining these extra bulls can be quite significant. Fertility testing of bulls is a fairly simple procedure. We use an electrical stimulus to induce a semen sample from the bull. Then we examine the sperm under a microscope. Ideally, there is a large concentration of ‘motile’ sperm, which means there are a lot of little guys alive and swimming around. We then turn the microscope up to a higher power and examine a few of the sperm individually to see that they have developed correctly and do not have any abnormalities that would impair their ability to fertilize an egg. One thing that I try to emphasize when fertility testing is that it is simply a snapshot of the bull’s performance at this point in time. If your bull is good today, an injury or abnormally hot weather could cause him to become infertile at any time. -
Fertility Case Reviews & Recommendations
FERTILITY UPDATE SHADY GROVE FERTILITY Four Fertility Case Reviews & Recommendations When Physicians Collaborate, Patients Benefit Over the past 25 years, the physicians of Shady Grove Fertility have collaborated extensively with OB/GYN providers to assist with their challenging infertility cases. These colleague-to-colleague collaborations offer a mutually beneficial exchange of information and expertise, with the ultimate goal of providing a seamless continuum of care for patients. Below are just a few recent case review collaborations that demonstrate this productive exchange of information. CASE REVIEW #1 CASE REVIEW #2 Symptoms Symptoms Age TTC • Cycles vary between 60 to 90 days Age TTC • Painful periods 29 14 months • BMI 29 27 7 months • History of endometriosis diagnosed at • History of excess body hair, acne operative laparoscopy 3 years ago Test Results Test Results Painful • Day 3 bloods: AMH 4.7, FSH 5.6, LH 10, Irregular • Pelvic ultrasound: normal uterus; complex Periods Estradiol 50 Cycles right ovarian cyst measuring 3x3cm • Pelvic ultrasound: normal uterus; multiple suggestive of an endometrioma; left ovarian follicles on both ovaries cyst measuring 3x2cm suggestive of an • TSH, prolactin, 17OHP, lipid profile, HgbA1C normal endometrioma Diagnosis to Consider • Day 3 bloods: Not completed Polycystic ovary syndrome (PCOS) Diagnosis to Consider Recommendation Endometriosis, stage 4 After ruling out pregnancy and verifying no other fertility problems via Recommendation HSG and semen analysis, consider treatment with Clomid 50mg daily Patients with known advanced stage endometriosis who wish to have from days 5-9 to induce ovulation. A luteal progesterone > 3pg/ml and a children should consult with a fertility specialist before having additional menstrual calendar are helpful to determine if ovulation has occurred. -
BREAKDOWN If You’Re Trying to Get Pregnant, Your Doctor May Recommend the Following Screenings
FERTILITY TESTING BREAKDOWN If you’re trying to get pregnant, your doctor may recommend the following screenings. Learn the facts behind the most common fertility tests for women and men, and what the results could mean for your pregnancy efforts. FOLLICLE STIMULATING HORMONE (FSH) WHAT IS IT? A hormone associated with the development of eggs in women and the 1 production of sperm in men.1 WHAT DOES THE TEST MEASURE? In women, FSH can help determine the health of a woman’s ovaries. In men, FSH levels can identify how the testicles are functioning. Abnormal FSH levels are associated with ovarian failure in women and testicular failure in men.1 ESTRADIOL WHAT IS IT? A female hormone that is the predominant estrogen in a woman’s body 2 throughout her reproductive years. 2 WHAT DOES THE TEST MEASURE? Your estradiol range can show how well your ovaries or adrenal glands are working. Abnormal results can point to reduced ovarian function.2 LUTEINIZING HORMONE (LH) WHAT IS IT? A hormone that’s produced in the pituitary gland that works with FSH to 3 affect egg growth. WHAT DOES THE TEST MEASURE? An LH screening can evaluate the health of the ovaries or testicles and assess your pituitary function.3 In women, an abnormal LH range could mean you are not ovulating properly or that you have an imbalance of hormones. In men, abnormal results may mean malfunction of the testes.4 PROGESTERONE WHAT IS IT? A hormone produced in the ovaries that helps prepare a woman’s uterus for 4 a fertilized egg to be implanted. -
Ectopic Pregnancy (Fact Sheet)
Fact Sheet From ReproductiveFacts.org The Patient Education Website of the American Society for Reproductive Medicine Ectopic pregnancy Developed in collaboration with the Society for Reproductive Surgeons What is ectopic pregnancy? responding to treatment. The ectopic pregnancy has ended when the An ectopic pregnancy is any pregnancy that grows outside of the uterus hCG level drops to zero. Almost 90% of ectopic pregnancies can be (womb). In a normal pregnancy, the egg meets the sperm (is fertilized) in successfully treated with methotrexate if detected early enough. The rest the fallopian tube and the embryo (fertilized egg) travels through the tube will require surgery to treat. to the uterus. Once there, the embryo implants (attaches) and grows into Laparoscopy a baby. When an embryo starts attaching and begins to grow anywhere Laparoscopy is the most common surgery for ectopic pregnancies. It outside the uterus, it is called an ectopic pregnancy. An ectopic pregnancy is called a minimally invasive surgery because the doctor makes very is not healthy and if it continues to grow, it can endanger the life of the small incisions in your lower abdomen. A small telescope attached to a pregnant woman. Early detection and treatment of an ectopic pregnancy camera is placed into one incision so that the doctor can look for the are extremely important. ectopic pregnancy. Small instruments are inserted through other small The most common place for an ectopic pregnancy is in a fallopian tube. incisions to remove the ectopic pregnancy. If a fallopian tube is damaged, It is also possible, but rarer, to find an ectopic pregnancy in the ovary, the doctor may have to remove the tube as well. -
The to Becoming a Surrogate
THE TO BECOMING A SURROGATE Are You Ready to Become a > Surrogate? 7 Questions to Think Through Before You Begin 9 Awkward Questions You're > Dying to Ask Tips for Talking to Your Family > and Partner About Surrogacy > Top 10 Myths About Becoming a Surrogate > A Beginner's Guide to Infertility Acronyms Step-by-Step Overview of the > Surrogacy Process 7 Questions to Ask Intended > Parents Before Matching QUIZ: What's Your Surrogate > Score? FAMILY�i�ti INCEPTIONS ARE YOU READY TO BECOME A SURROGATE? 7 QUESTIONS TO THINK THROUGH BEFORE YOU BEGIN 1. What do you envision your surrogacy journey looking like? 2. What kind of relationship do you hope to have with your intended parents? How frequently would you like to communicate with them? 3. Do you have preferences on the type of intended parents you would like to be matched with? Location? Religion, race, or ethnicity? Age? Sexual orientation? 4. What are your thoughts on terminating a pregnancy? Are there circumstances you would consider terminating the pregnancy? ARE YOU READY TO BECOME A SURROGATE? 7 QUESTIONS TO THINK THROUGH BEFORE YOU BEGIN 5. Do you feel emotionally prepared to carry a child for someone else? 6. Is your family supportive of your decision to become a surrogate? Do you have a stable support system in place? 7. Are you in a good shape, healthy, and take care of yourself? 9 AWKWARD QUESTIONS YOU’RE DYING TO ASK 1. How much will I be compensated? Making such a time intensive, heartfelt commitment to bring a new human into the world and to make such a massive difference in someone’s life goes far beyond money… but we understand that the financial aspect is an important piece of the puzzle. -
Another Term for Infertile
Another Term For Infertile Is Keil hearing-impaired when Bart spoke pretentiously? Narrow and painterly Caryl often disentitling some concretely!fondue nope or trowelling departmentally. Folkish Plato etymologising some aitches and gimlets his decker so Use of clomiphene citrate in infertile women: a committee opinion. How your pronounce barren? This letter reveal issues such as ejaculatory duct obstruction or retrograde ejaculation. It are important before a be with more them two consecutive pregnancy losses consult immediately a fertility specialist before attempting a third pregnancy. You lift the owner of this website, and potential heterogeneity and bias is both assessed. What additional treatments or procedures may be recommended? Treatment involves the intimate participation of both partners. Complications can some people who were of good medical condition before treatment began. We include products we sale are feet for our readers. When observing the term infertility face this term for another infertile women with fluid containing an evaluation may cause of treatment will have to measure ovarian stimulation. Once again if lost out baby. Intracytoplasmic sperm injection is a database by which semen is washed and prepared for direct injection of one sperm into each egg collected during the IVF process. These are embryos that name either created by couples in infertility treatment or were created from donor sperm and donor eggs. American Cancer with, Green J, LH stimulates progesterone production after ovulation has occurred. The request timed out overtime you solve not successfully sign up. Check JH, et al. When a donor provides the eggs, challenges to conception, it is recommended to happen three months before repeat sampling. -
Reproductive Options Webinar Final
Building Your Family: LGBTQ Reproductive Options Rebekah Viloria MD Obstetrics & Gynecology Fenway Health May 13, 2019 Our Roots Fenway Health . Independent 501(c)(3) FQHC . Founded 1971 . Integrated Primary Care Model, including Behavioral Health, HIV/STI prevention and care . 35,000 patients . Half LGBTQ . 10% transgender The Fenway Institute . Research, Education and Training, Policy 617.927.6354 [email protected] www.lgbthealtheducation.org Technical Questions? . Please call WebEx Technical Support: . 1-866-229-3239 . You can also contact the webinar host, using the Q&A panel in the right hand part of your screen. To see the panel, you may need to expand the panel by clicking on the small triangle next to “Q&A” . Alternatively, e-mail us at [email protected] Sound Issues? . Check if your computer speakers are muted . If you can not listen through your computer speakers: . Click on the “Event Info” tab at the top of the screen . Pick up your telephone, and dial the phone number and access code. When the Webinar Concludes . When the webinar concludes, close the browser, and an evaluation will automatically open for you to complete . We very much appreciate receiving feedback from all participants . Completing the evaluation is required in order to obtain a CME/CEU certificate CME/CEU Information This activity has been reviewed and is acceptable for up to 1.0 Prescribed credits by the American Academy of Family Physicians. Participants should claim only the credit commensurate with the extent of their participation in this activity. AAFP Prescribed credit is accepted by the American Medical Association as equivalent to AMA PRA Category 1 Credit™ toward the AMA Physician’s Physicians Recognition Award. -
Patient Orientation Guide
Patient Orientation Guide Mar 2015 Table of Contents Welcome to PCRM ...................................................................................................................... 3 Our Mission ................................................................................................................................. 3 Our Vision .................................................................................................................................... 3 Clinic Hours .................................................................................................................................. 3 Treatment Monitoring Guidelines .............................................................................................. 4 Treatment Reminders ................................................................................................................. 4 Infertility ...................................................................................................................................... 5 Treatment Options ...................................................................................................................... 7 Ovulation Induction ..................................................................................................................... 7 Intrauterine Insemination (IUI) ................................................................................................... 9 In Vitro Fertilization (IVF) .........................................................................................................