Effectiveness of Fertility Awareness–Based Methods for Pregnancy
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Lactational Amenorrhea Method
Lactational Amenorrhea Method Dr. Raqibat Idris [email protected] From Research to Practice: Training in Sexual and Reproductive Health Research 2017 Objectives of presentation • Define Lactational Amenorrhea Method (LAM) • Understand the mechanism of action of LAM • Know the efficacy of LAM • Know and describe the 3 criteria for LAM • Know the indication and contraindications for LAM • Know the focus and timing of counselling for LAM • List the advantages, disadvantages and health benefits of LAM • Know the elements of programming necessary for the provision of quality LAM services Introduction Breastfeeding delays the return of a woman’s fertility in the first few months following childbirth. Women who breastfeed are less likely to ovulate in this period. When compared with women who breastfeed partially or who do not breastfeed at all, women who breastfeed more intensively are less likely to have a normal ovulation before their first menstrual bleed postpartum (Berens et al., 2015). In a consensus meeting in Bellagio, Italy in 1998, scientists proposed that women who breastfeed fully or nearly fully while they remain amenorrhoeic in the first 6 months postpartum experience up to 98% protection from pregnancy. This formed the basis for the Lactational Amenorrhea Method and has since then been tested and confirmed by other studies (Berens et al., 2015; Van der Wijden et al., 2003; WHO, 1999). Berens P, Labbok M, The Academy of Breastfeeding Medicine. ABM Clinical Protocol #13: Contraception During Breastfeeding, Revised 2015. Breastfeeding Medicine. 2015 Feb;10(1):3-12. The World Health Organization multinational study of breast-feeding and lactational amenorrhea. III. -
Levosert 20Microgram/24 Hours Intrauterine Delivery System UK/H/3030/001/DC
PAR Levosert 20microgram/24 hours Intrauterine Delivery System UK/H/3030/001/DC Public Assessment Report Decentralised Procedure LEVOSERT 20MICROGRAM/24 HOURS INTRAUTERINE DELIVERY SYSTEM (levonorgestrel) Procedure No: UK/H/3030/001/DC UK Licence No: PL 30306/0438 ACTAVIS GROUP PTC ehf 1 PAR Levosert 20microgram/24 hours Intrauterine Delivery System UK/H/3030/001/DC LAY SUMMARY Levosert 20 microgram/24 hours Intrauterine Delivery System (levonorgestrel, intrauterine delivery system, 52mg (20 micrograms/24 hours)) This is a summary of the Public Assessment Report (PAR) for Levosert 20 microgram/24 hours Intrauterine Delivery System (PL 30306/0438; UK/H/3030/001/DC, previously PL 34096/0003; UK/H/3030/001/DC). It explains how Levosert 20 microgram/24 hours Intrauterine Delivery System was assessed and its authorisation recommended, as well as its conditions of use. It is not intended to provide practical advice on how to use Levosert 20 microgram/24 hours Intrauterine Delivery System. For practical information about using Levosert 20 microgram/24 hours Intrauterine Delivery System, patients should read the package leaflet or contact their doctor or pharmacist. Levosert 20 microgram/24 hours Intrauterine Delivery System may be referred to as Levosert in this report. What is Levosert and what is it used for? Levosert is an intrauterine delivery system (IUS) for insertion in the womb. It can be used in the following ways: • as an effective method of contraception (prevention of pregnancy); • for heavy menstrual bleeding (heavy periods). Levosert is also useful for reducing menstrual blood flow, so it can be used if you suffer from heavy menstrual bleeding (periods). -
My Changing Body: Puberty and Fertility Awareness for Young
My Changing Body: Puberty and Fertility Awareness for Young nd People, 2 Edition A Pilot Study in Guatemala and Rwanda Submitted December 2011 The Institute for Reproductive Health Georgetown University INSTITUTE FOR REPRODUCTIVE HEALTH GEORGETOWN UNIVERSITY WWW.IRH.ORG © 2011. Institute for Reproductive Health, Georgetown University Recommended Citation: My Changing Body: Puberty and Fertility Awareness for Young People, 2nd Edition. A Pilot Study in Guatemala and Rwanda. December 2011. Washington, D.C.: Institute for Reproductive Health, Georgetown University for the U.S. Agency for International Development (USAID). The Institute for Reproductive Health (IRH) is part of the Georgetown University Medical Center, an internationally recognized academic medical center with a three-part mission of research, teaching and patient care. IRH is a leading technical resource and learning center committed to developing and increasing the availability of effective, easy-to- use, fertility awareness-based methods (FAM) of family planning. IRH was awarded the 5-year Fertility Awareness-Based Methods (FAM) Project by the United States Agency for International Development (USAID) in September 2007. This 5-year project aims to increase access and use of FAM within a broad range of service delivery programs using systems-oriented scaling up approaches. This publication was made possible through support provided by the United States Agency for International Development (USAID) under the terms of the Cooperative Agreement No. GPO-A-00-07-00003-00. The contents of this document do not necessarily reflect the views or policies of USAID or Georgetown University. The FAM Project Institute for Reproductive Health Georgetown University 4301 Connecticut Avenue, N.W., Suite 310 Washington, D.C. -
Experiences and Practices of Women Using Fertility Awareness-Based Methods of Contraception
EXPERIENCES AND PRACTICES OF WOMEN USING FERTILITY AWARENESS-BASED METHODS OF CONTRACEPTION Cassandra Gonzalez September 2019 Experiences and Practices of Women Using Fertility Awareness-Based Methods of Contraception Cassandra Gonzalez 910609269050 Contact author: [email protected] or [email protected] MSc Program: Communication, Health, and Life Sciences, Specialization- Health and Society, Chair Group: Consumption and Healthy Lifestyles Supervisor: Dr. Chizu Sato Minor Thesis Code: CHL – 80424 Date Submitted: September 23, 2019 1 Abstract Fertility awareness-based methods of contraception (FABMs) are growing in popularity. Using a combination of social practice theory and a contraceptive decision- making framework, this research sought to understand the priorities, contexts, and influences that motivate women to turn to these methods and how they turn this choice into a practice over time. It also sought to understand how female health- focused smartphone applications and devices known as Femtech have contributed to the practice. Seven women were interviewed about their experiences using FABMs to avoid pregnancy. This research found that major motives for using FABMs as contraceptives were dissatisfaction with other available contraceptive options, feminist, women’s liberation, and “hippie” values, and a desire for increased body literacy. The respondents discovered FABMs largely through the internet and sometimes word-of-mouth. Social media, online communities, and FABM specialists were found to play substantial roles in providing FABM-related education and support. In-person communities including friends, family, and mainstream healthcare professionals were found to play minimal roles though partners often played important roles in the research and implementation processes and “alternative” healthcare providers were more supportive. -
INTRAUTERINE INSEMINATION of HUSBAND's SEMEN Departments
INTRAUTERINE INSEMINATION OF HUSBAND'S SEMEN B. N. BARWIN Departments of Physiology and Midwifery & Gynaecology, The Queen's University of Belfast, Northern Ireland (Received 11 th January 1973) Summary. Fifty patients with primary infertility were treated by intra- uterine insemination of the husband's semen which had been stored. Thirty patients had sperm counts of greater than 20 \m=x\106/ml with 50% motility and twenty patients had oligospermia (<20 \m=x\106/ml). The technique of storage of semen is reported and the intrauterine method described. The r\l=o^\leof the buffer solution is discussed in over- coming the complications of intrauterine insemination. A success rate of 70% is reported in the normospermic group and 55% in the oligo- spermic group over nine cycles of intrauterine insemination of husband's semen. INTRODUCTION One of the main problems confronting the gynaecologist in the investigation of infertility is the consistent finding of immotile spermatozoa, spermatozoa of low motility and low sperm count in the cervical mucus or semen (Scott, 1968). There was considerable controversy among earlier workers in the field that the sperm count was substandard if it fell below 60 106/ml but MacLeod (1962) has carried out considerable research in this field and it is now generally accepted that true oligospermia is represented by counts of less than 20 IO6/ ml provided the motility is good. SUBJECTS AND METHODS Selection of cases Fifty couples with primary infertility of between 3 and 14 years' duration were selected. The age distribution was between 24 and 41 years. In all cases, the wives had been subjected to a full clinical investigation. -
Instructions on Natural Family Planning
NORTH DAKOTA DEPARTMENT OF HEALTH Family Planning Program INFORMATION FOR FERTILITY AWARENESS BASED METHOD This method varies in efficacy and is dependent on correct and consistent use. BENEFITS: * Increased knowledge of reproductive cycle * Couples can work together * No menstrual changes * May achieve pregnancy if used in reverse RISKS/SIDE EFFECTS: * No serious side effects * May be less reliable with certain medications * May be less effective/difficult with irregular cycles *May require abstinence at certain times * May be less reliable if ill, breastfeeding or stressed *Requires discipline and commitment ALTERNATIVES: You have received information about the other methods of birth control that are available. For situations of suspected contraceptive failure, emergency contraception is available and offers a second chance to reduce the risk of unintended pregnancy. INSTRUCTIONS: You have received information about natural family planning/fertility awareness and how to use it. This method does not protect against STDs (sexually transmitted disease) or HIV. DECISION NOT TO USE: You may stop using natural family planning/fertility awareness at any time. A woman is most likely to become pregnant if she or her partner are not using a method of birth control. QUESTIONS: You may ask questions about this method at any time and may contact the clinic with further questions. Web sites for FABM/NFP information: https://www.nationalfamilyplanning.org/file/FABM_Guidelines_NFPRHA.pdf https://www.bedsider.org/methods/fertility_awareness http://www.tcoyf.com/wp-content/uploads/charts/TTA%20Classic%20Chart%20(F).pdf -
Helminth Infection, Fecundity, and Age of First Pregnancy in Women
RESEARCH | REPORTS PARASITOLOGY 70% of the population, the most common being hookworm (56%) and A. lumbricoides (15 to 20%) (11, 17). In both animal and human studies, parasites Helminth infection, fecundity, and have been shown to influence host reproduction via sexual behavior, brood or litter size, offspring age of first pregnancy in women size, incubation periods, conception rates, and pregnancy loss (18–22). In most cases, parasitism Aaron D. Blackwell,1,2,3* Marilyne A. Tamayo,4 Bret Beheim,2,5 reduces host reproduction by compromising Benjamin C. Trumble,1,2,3,6,7 Jonathan Stieglitz,2,5,8 Paul L. Hooper,2,9 reproductive organs or reducing energy budgets Melanie Martin,1,2,3 Hillard Kaplan,2,5 Michael Gurven1,2,3 (14, 23). However, among Tsimane adults, mor- bidity from intestinal helminth infections is low, Infection with intestinal helminths results in immunological changes that influence particularly for A. lumbricoides. Controlling for co-infections, and might influence fecundity by inducing immunological states affecting age and co-infection in our sample, hookworm conception and pregnancy. We investigated associations between intestinal helminths and infection is associated with slightly lower body fertility in women, using 9 years of longitudinal data from 986 Bolivian forager-horticulturalists, mass index (BMI) (generalized linear model, 2 experiencing natural fertility and 70% helminth prevalence. We found that different species b = –0.77 kg/m , P < 0.001) and hemoglobin (b = of helminth are associated with contrasting effects on fecundity. Infection with roundworm –0.19 g/dl, P =0.005),whereasA. lumbricoides is 2 (Ascaris lumbricoides) is associated with earlier first births and shortened interbirth intervals, not (b = –0.34 kg/m , P = 0.180; b = –0.07 g/dl, whereas infection with hookworm is associated with delayed first pregnancy and extended P = 0.413). -
American Family Physician
Natural Family Planning - American Family Physician http://www.aafp.org/afp/2012/1115/p924.html BRIAN A. SMOLEY, CDR, MC, USN, Camp Pendleton, California CHRISTA M. ROBINSON, LCDR, MC, USN, Naval Hospital Lemoore, Lemoore Station, California Am Fam Physician. 2012 Nov 15;86(10):924-928. Related editorials: Is Natural Family Planning a Highly Effective Method of Birth Control? Yes: Natural Family Planning is Highly Effective and Fulfilling (http://www.aafp.org/afp/2012/1115/od1.html) and No: Family Natural Family Planning Methods Are Overrrated (http://www.aafp.org/afp/2012/1115/od2.html). Patient information: See related handout on natural family planning (http://www.aafp.org/afp/2012/1115/p924-s1.html), written by the authors of this article. Related letter: Physicians Need More Education About Natural Family Planning (http://www.aafp.org/afp/2013/0801/p158.html) Natural family planning methods provide a unique option for committed couples. Advantages include the lack of medical adverse effects and the opportunity for participants to learn about reproduction. Modern methods of natural family planning involve observation of biologic markers to identify fertile days in a woman's reproductive cycle. The timing of intercourse can be planned to achieve or avoid pregnancy based on the identified fertile period. The current evidence for effectiveness of natural family planning methods is limited to lower-quality clinical trials without control groups. Nevertheless, perfect use of these methods is reported to be at least 95 percent effective in preventing pregnancy. The effectiveness of typical use is 76 percent, which demonstrates that motivation and commitment to the method are essential for success. -
NFP Related Research ……………………………………………
1 Winter/Spring 2000 ● Vol. 11, Nos. 1 and 2 Richard J. Fehring, DNSc, RN, Marquette University College of Nursing In this issue NFP Related Research ……………………………………………. 2 Pregnancy and Breastfeeding …………………………………….. 8 Contraception ……………………………………………………… 11 Research Briefs …………………………………………………….. 14 Under the Microscope ……………………………………………... 19 The Effectiveness of Natural Family Planning, Robert T. Kambic, MSH Current Medical Research is a publication of the Natural Family Planning Program of the United States Conference of Catholic Bishops.© Washington, DC: USCCB, 2011. The managing editor is Theresa Notare, PhD, Assistant Director. Permission is granted to reproduce in whole or in part, in print and/or electronically, with the following statement: Current Medical Research, NFPP/US Conference of Catholic Bishops, Washington, DC, volume # (year): page#. Used with permission. 2 Natural Family Planning United States Physicians Underestimate Effectiveness of Natural Family Planning A recent study conducted by researchers at the University of Missouri-Columbia, found that 79% of physicians in Missouri estimated the best possible effectiveness of natural family planning for avoiding pregnancy to be less than 91%. Sixty-five percent of those surveyed ranked the actual effectiveness of NFP to be 70% or less.1 The purpose of the study was to determine physicians' knowledge and practices of modern methods of NFP. The researchers assumed that modern methods of NFP are important for medical practice in order to help women and couples avoid or achieve pregnancy. A one page questionnaire on knowledge and practice of NFP was created by the researchers and mailed to 840 randomly selected physicians in Missouri. While 69% of the 547 respondents saw women for reproductive needs, only 46% mentioned NFP to at least some women when discussing family planning issues. -
F.8 Ethinylestradiol-Etonogestrel.Pdf
General Items 1. Summary statement of the proposal for inclusion, change or deletion. Here within, please find the evidence to support the inclusion Ethinylestradiol/Etonogestrel Vaginal Ring in the World Health Organization’s Essential Medicines List (EML). Unintended pregnancy is regarded as a serious public health issue both in developed and developing countries and has received growing research and policy attention during last few decades (1). It is a major global concern due to its association with adverse physical, mental, social and economic outcomes. Developing countries account for approximately 99% of the global maternal deaths in 2015, with sub-Saharan Africa alone accounting for roughly 66% (2). Even though the incidence of unintended pregnancy has declined globally in the past decade, the rate of unintended pregnancy remains high, particularly in developing regions. (3) Regarding the use of contraceptive vaginal rings, updated bibliography (4,5,6) states that contraceptive vaginal rings (CVR) offer an effective contraceptive option, expanding the available choices of hormonal contraception. Ethinylestradiol/Etonogestrel Vaginal Ring is a non-biodegradable, flexible, transparent with an outer diameter of 54 mm and a cross-sectional diameter of 4 mm. It contains 11.7 mg etonogestrel and 2.7 mg ethinyl estradiol. When placed in the vagina, each ring releases on average 0.120 mg/day of etonogestrel and 0.015 mg/day of ethinyl estradiol over a three-week period of use. Ethinylestradiol/Etonogestrel Vaginal Ring is intended for women of fertile age. The safety and efficacy have been established in women aged 18 to 40 years. The main advantages of CVRs are their effectiveness (similar or slightly better than the pill), ease of use without the need of remembering a daily routine, user ability to control initiation and discontinuation, nearly constant release rate allowing for lower doses, greater bioavailability and good cycle control with the combined ring, in comparison with oral contraceptives. -
Fecundity Selection Theory: Concepts and Evidence
bioRxiv preprint doi: https://doi.org/10.1101/015586; this version posted February 23, 2015. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY-NC-ND 4.0 International license. Fecundity selection theory: concepts and evidence Daniel Pincheira-Donoso1,3 & John Hunt2 1Laboratory of Evolutionary Ecology of Adaptations, School of Life Sciences, University of Lincoln, Brayford Campus, Lincoln, LN6 7DL, Lincolnshire, United Kingdom 2Centre for Ecology and Conservation, College of Life and Environmental Sciences, University of Exeter, Cornwall Campus, Penryn, Cornwall, TR10 9EZ, UK 3Corresponding author: [email protected] ABSTRACT Fitness results from the optimal balance between survival, mating success and fecundity. The interactions between these three components of fitness vary importantly depending on the selective context, from positive covariation between them, to antagonistic pleiotropic relationships when fitness increases in one reduce fitness of others. Therefore, elucidating the routes through which selection shapes life history and phenotypic adaptations via these fitness components is of primary significance to understand ecological and evolutionary dynamics. However, while the fitness components mediated by natural (survival) and sexual (mating success) selection have extensively been debated from most possible perspectives, fecundity selection remains considerably -
U.S. Medical Eligibility Criteria for Contraceptive Use, 2016
Morbidity and Mortality Weekly Report Recommendations and Reports / Vol. 65 / No. 3 July 29, 2016 U.S. Medical Eligibility Criteria for Contraceptive Use, 2016 U.S. Department of Health and Human Services Centers for Disease Control and Prevention Recommendations and Reports CONTENTS Introduction ............................................................................................................1 Methods ....................................................................................................................2 How to Use This Document ...............................................................................3 Keeping Guidance Up to Date ..........................................................................5 References ................................................................................................................8 Abbreviations and Acronyms ............................................................................9 Appendix A: Summary of Changes from U.S. Medical Eligibility Criteria for Contraceptive Use, 2010 ...........................................................................10 Appendix B: Classifications for Intrauterine Devices ............................. 18 Appendix C: Classifications for Progestin-Only Contraceptives ........ 35 Appendix D: Classifications for Combined Hormonal Contraceptives .... 55 Appendix E: Classifications for Barrier Methods ..................................... 81 Appendix F: Classifications for Fertility Awareness–Based Methods ..... 88 Appendix G: Lactational