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Fertility, infertility, and pregnancy

Fertility, infertility, and pregnancy. The phenomena Ethical issues. How to become pregnant. 1. Engage in sexual intercourse repeatedly. 2. If not yet pregnant, repeat step 1. For most couples, that script works well. For some couples, it doesn’t: Infertility. Conception.

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Fertility, infertility, and pregnancy

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  1. Fertility, infertility, and pregnancy The phenomena Ethical issues

  2. How to become pregnant • 1. Engage in sexual intercourse repeatedly. • 2. If not yet pregnant, repeat step 1. • For most couples, that script works well. • For some couples, it doesn’t: Infertility

  3. Conception • Sperm meets ovum: Zona pellucida • Sperm action: Enzymes and exocytosis • Fertilization: Chromosome pairing • Implantation: • Amnion, chorion, and placenta • Umbilicus • Zygote-morula-blastocyst-embryo-fetus

  4. Infertility • Inability to conceive • Identifying the contributing partner

  5. Male problems: • Low sperm count • Defective sperm • Low motility • Disease effects: diabetes, STIs • Drug effects, especially alcohol • Damaged testes: cryptorchidism, mumps, trauma • Autoimmune response to sperm • Hormonal problems: pituitary, thyroid

  6. Female problems: • Irregular ovulation, anovulation • Low body fat • STI damage to Fallopian tubes: PID • Reproductive system disease • Endometriosis • Aging • Allergic reactions to sperm or semen

  7. Methods for dealing with infertility • Behavioral methods • Timing methods, male and female • Calendar method: Day 14 • Basal body temperature • Take oral temperature with an electronic thermometer early in the morning, before rising. • Temperature is 97.8oF a few days before ovulation • Dips 0.4o to 0.8o the day before ovulation • Rises to 98.4o after ovulation. • The woman is fertile for 4 to 20 hours after ovulation • After 3 days of 98.4o, the couple is no longer fertile.

  8. More behavior methods • OTC test kits for LH in urine or saliva • Cervical mucus: roll between fingers • Thin, slippery, and clear around ovulation time • A mucus plug indicates the end of fertility • Males should reduce frequency of intercourse to increase sperm count

  9. More methods • Control position to recruit gravity • Reader’s Digest method: Male should penetrate deeply, hold position for ejaculation, withdraw slowly • Change of venue • Change of underwear • Change of ambient temperature • Decrease athletic activity • Relax

  10. Artificial enhancement of fertility • Artificial insemination, husband donor • Artificial insemination, third party donor • In vitro fertilization • Fertility enhancing drugs • Ovum and oocyte transplants

  11. Ethical and social issues • Whose sperm? Whose eggs? • What do we do with extra embryos? • Eugenics • Selective reduction/abortion • Use of tissue from aborted babies • Sex selection • Surrogate motherhood

  12. Contraception • Why use contraceptive procedures? • Margaret Sanger and the Comstock laws • The Pivot of Civilization • http://onlinebooks.library.upenn.edu/webbin/gutbook/lookup?num=1689 • Why not use contraceptive procedures? • Roman Catholic teaching

  13. Choosing contraceptive procedures • Effectiveness • Convenience • Aesthetics • Equality/sharing • Availability • Consequences

  14. Contraceptive methods • Contraception vs. contra-implantation • Abstinence and calendar methods • Barrier methods • Spermicides • Implantation blockers • IntraUterine Devices (IUDs) • Progestasert T • Copper T 380A

  15. Hormonal methods • Female • Male • The pill(s) • Norplant • Depo-Provera • Patch • Emergency contraception • Mifepristone (RU-486)

  16. Sterilization procedures • Tubal ligation • Ovariectomy • Hysterectomy • Vasectomy • Orchidectomy

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