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PubMed1998

The changing moral landscape of human reproduction: two moments in the history of in vitro fertilization.

Ethical attitudes toward in vitro fertilization (IVF) have varied historically. This paper discusses the changes in views about the morality of human IVF by exploring the response to a pair of critical moments in the history of this reproductive technology: the announcement of the first successful IVF experiment by John Rock and Miriam Menkin in 1944 and the first successful IVF live birth of Louise Brown in 1978. By exploring public and private reactions to these two events in the context of wider social and political developments, this paper demonstrates the degree to which our notions of the morality of medical experimentation and of reproductive technologies are socially constructed and historically contingent.

England↗
PubMed1993

A labor perspective on workplace reproductive hazards: past history, current concerns, and positive directions.

The Supreme Court's March 1991 ruling in United Automobile Workers (UAW) versus Johnson Controls barring corporate "fetal protection policies" was a major victory for women's employment rights and has health and safety implications for both sexes. However, 2 years after the Court's decision, the union's work is far from over. The UAW has yet to see what policy Johnson Controls will implement in place of the old one. Formulating solutions to the concerns of workers who are exposed daily to reproductive health hazards on the job will continue to be on labor's agenda. Preventing hazardous exposures is the first priority. This goal would be furthered by setting occupational health and safety standards designed to protect workers' general and reproductive health. Support for the Comprehensive Occupational Safety and Health Reform Act (COSHRA) would also positively affect health and safety in the workplace. Where hazards have not yet been abated, the framework of transfers and income protections for all workers with temporary job restrictions should be examined. The Legal/Labor Working Group convened at the Occupational and Environmental Reproductive Hazards Working Conference authored guidelines for developing a model reproductive hazards policy. These recommendations can serve as a guide for implementation of nondiscriminatory and health-protective policies by employers.

Female↗
PubMed2003

The impact of reproductive and menstrual history on bone mineral density in Chinese women.

Low bone mineral density (BMD) is an important risk factor for osteoporotic fractures. The impact of gynecological history on BMD is of great concern, but the results are largely inconsistent. In this study, we investigated the association of gynecological history with BMD in 214 postmenopausal women (60.4 +/- 5.7 yr), as well as with peak bone density (PBD) in 428 premenopausal women (30.8 +/- 5.3 yr) from Shanghai City in China. BMD was measured at lumbar spine (L1-4) and total hip by dual energy X-ray absorptiometry. Raw BMD values were adjusted by age, age2, height, and weight. In the postmenopausal group, more parity had significantly detrimental effects on BMD at both the spine and hip (p < 0.01). The age of the first delivery, the duration of lactation, and the age at menarche did not show significant impacts on BMD (p > 0.05). More years since menopause only had marginally significant decreasing effects at the spine (p = 0.09), but not at the hip (p > 0.10). In the premenopausal group, none of the three reproductive factors had significant impact on PBD (p > 0.05); the age of menarche inversely affected PBD at both the spine (p < 0.01) and hip (p < 0.05). Our results suggest that some gynecological events might influence BMD variation in healthy Chinese women.

Absorptiometry, Photon↗
PubMed2000

Reproductive and menstrual history of females with fragile X expansions.

FRAXA premutations have been associated with premature ovarian failure (POF) or menopause before the age of 40. We have studied women in families ascertained because of a mentally retarded full mutation relative and determined their age of menopause, serum hormone levels in premenopausal individuals and the outcome of any pregnancies. Survival analysis was used as a measure of menopause and demonstrated a significant decrease in age of menopause in premutation carriers compared with their full mutation carrier and normal relatives. Serum FSH was also raised in premutation carriers, although oestradiol, inhibin A and inhibin B were not significantly different. However, we did not find an excess of dizygous twins or pregnancy loss/trisomies, both of which are associated with aging ovaries. Thus premutation carriers as a group have an earlier menopause and raised serum FSH but do not appear to manifest other features of an aging ovary.

Age Factors↗
PubMed1988

Clinical significance of aerobic bacterial flora of the uterus, vagina, vestibule, and clitoral fossa of clinically normal mares.

Swab specimens for bacterial culture were obtained from the uterus, vagina, vestibule, and clitoral fossa of 48 mares that had normal reproductive tracts, no history of reproductive problems, and no inflammation on evaluation of endometrial biopsy. The mares were predominantly Thoroughbred and Standardbred. Swab specimens of the vagina were obtained through a sterile speculum; swab specimens of the uterus were obtained by use of a double-guarded, occluded culture instrument. Fifteen (31%) of the uterine swab specimens and 20 (42%) of the vaginal swab specimens yielded growth on aerobic culture; however, only 2 (4%) of the uterine swab specimens and 4 (8%) of the vaginal swab specimens yielded growth of more than 10 colonies. In contrast, 21 (44%) of the vestibular swab specimens and 45 (94%) of the clitoral fossa swab specimens had moderate (greater than 10 colonies in 1 quadrant) to heavy (colonies in 2 or 3 quadrants) growth of organisms on culture. Of organisms considered to be potential pathogens, Streptococcus zooepidemicus and Escherichia coli were found on bacteriologic culture of several clitoral fossa swab specimens and of some vestibular swab specimens. We did not isolate any potential pathogens from uterine or vaginal swab specimens. It appears that 1 to 10 colonies of nonpathogenic organisms could be recovered from the uterus in a substantial number of clinically normal mares even when double-guarded swabbing techniques are used, and we suggest that prebreeding culture requirements be modified to reflect this. Also, our findings indicate that the vulvovaginal fold, rather than the cervix, might be the major barrier to ascending bacterial contamination of the reproductive tract.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1981

Reproductive events and family history as risk factors for breast cancer in northern Alberta.

Reproductive events and family history as risk factors for breast cancer in northern Alberta were investigated with the use of data from a computerized population-based registry. Women aged 30 to 79 years attending diagnostic breast clinics at the Cross Cancer Institute from 1971 through 1975 constituted the two study groups; 1232 women had diagnosed breast cancer (malignant disease group) and 602 women were clinically free of all types of breast disease (control group). An increased relative risk of breast cancer was found in women with a family history of breast cancer, those who gave birth to their first term infant at age 30 years or older, those in whom more than 15 years elapsed between menarche and that birth, and those with a late natural menopause. There was a decreased risk, relative to nulliparity, in the postmenopausal women who first gave birth to a term infant 5 years or less after menarche. Artificial menopause (bilateral oophorectomy), parity and age at menarche had no apparent effect on the risk. The pattern of risk factors in northern Alberta differed from that reported for other geographic areas, including other provinces of Canada, thus emphasizing the need for local studies in the planning of screening programs.

Adult↗
PubMed2002

Chemical defense of early life stages of benthic marine invertebrates.

Accurate knowledge of factors affecting the survival of early life stages of marine invertebrates is critically important for understanding their population dynamics and the evolution of their diverse reproductive and life-history characteristics. Chemical defense is an important determinant of survival for adult stages of many sessile benthic invertebrates, yet relatively little consideration has been given to chemical defenses at the early life stages. This review examines the taxonomic breadth of early life-stage chemical defense in relation to various life-history and reproductive characteristics, as well as possible constraints on the expression of chemical defense at certain life stages. Data on the localization of defensive secondary metabolites in larvae and the fitness-related consequences of consuming even a small amount of toxic secondary metabolites underpin proposals regarding the potential for Müllerian and Batesian mimicry to occur among marine larvae. The involvement of microbial symbionts in the chemical defense of early life stages illustrates its complexity for some species. As our knowledge of chemical defenses in early life stages grows, we will be able to more rigorously examine connections among phylogeny, chemical defenses, and the evolution of reproductive and life-history characteristics among marine invertebrates.

Adaptation, Physiological↗
PubMed2007

Reproductive factors and family history of breast cancer in relation to plasma prolactin levels in premenopausal and postmenopausal women.

Many reproductive factors are associated with breast cancer risk, potentially through a hormonal pathway. The peptide hormone prolactin is essential in mammary development and lactation and may be a link between risk factors and breast cancer. While higher prolactin levels are associated with increased breast cancer risk, few determinants of prolactin levels are known. We conducted a cross-sectional analysis among 1,089 premenopausal and 1,311 postmenopausal women within the Nurses' Health Study (NHS) and the NHS II to examine the associations of reproductive factors, benign breast disease and family history of breast cancer with plasma prolactin levels. Parous women had significantly lower prolactin levels than nulliparous women (parous vs. nulliparous multivariate-adjusted geometric means = 14.1 ng/mL vs. 16.6 ng/mL, p<0.001 for premenopausal and 9.1 vs. 10.1, p=0.04 for postmenopausal women), although levels did not decrease with increasing number of children for either premenopausal (p-trend = 0.23) or postmenopausal (p-trend = 0.07) parous women. Age at first birth was not associated with prolactin levels. The reduction in prolactin levels among parous premenopausal women appeared to attenuate with increasing time since first birth, but the trend was not statistically significant (p-trend = 0.12). Age at menarche, duration of lactation and benign breast disease were not associated with prolactin levels. Family history of breast cancer was associated with significantly higher prolactin levels when compared with no family history among premenopausal (15.9 ng/mL vs. 14.3 ng/mL, p=0.04) but not postmenopausal (p=0.73) women. In conclusion, the associations of parity and family history with breast cancer risk may be mediated, at least in part, by prolactin levels.

Adult↗
PubMed2002

Life-history theory, fertility and reproductive success in humans.

According to life-history theory, any organism that maximizes fitness will face a trade-off between female fertility and offspring survivorship. This trade-off has been demonstrated in a variety of species, but explicit tests in humans have found a positive linear relationship between fitness and fertility. The failure to demonstrate a maximum beyond which additional births cease to enhance fitness is potentially at odds with the view that human fertility behaviour is currently adaptive. Here we report, to our knowledge, the first clear evidence for the predicted nonlinear relationship between female fertility and reproductive success in a human population, the Dogon of Mali, West Africa. The predicted maximum reproductive success of 4.1+/-0.3 surviving offspring was attained at a fertility of 10.5 births. Eighty-three per cent of the women achieved a lifetime fertility level (7-13 births) for which the predicted mean reproductive success was within the confidence limits (3.4 to 4.8) for reproductive success at the optimal fertility level. Child mortality, rather than fertility, was the primary determinant of fitness. Since the Dogon people are farmers, our results do not support the assumptions that: (i) contemporary foragers behave more adaptively than agriculturalists, and (ii) that adaptive fertility behaviour ceased with the Neolithic revolution some 9000 years ago. We also present a new method that avoids common biases in measures of reproductive success.

Adaptation, Physiological↗
PubMed1996

Protective effect of depot-medroxyprogesterone acetate on surgically treated uterine leiomyomas: a multicentre case--control study.

OBJECTIVE: To assess the protective effect of depot-medroxyprogesterone acetate (DMPA) on uterine leiomyomas. DMPA has been widely used in Thailand for many years; uterine leiomyomas is the most common female tumour. DESIGN: A multicentre hospital-based case--control study. SETTING: University and regional hospitals. PATIENTS: Cases were all newly diagnosed patients with pathologically proven diagnosis of uterine leiomyomas, who were admitted to eight hospitals in three regions of Thailand from January 1991 to June 1993. Three controls matched with cases by sex, age within five years and date of admission within three months were recruited. MAIN OUTCOME MEASURES: Information on socio-demographic factors, personal and family history, current disease, reproductive and contraceptive history was collected from cases and controls by interview. RESULTS: There were 910 cases and 2709 controls. After univariate and unconditional multiple logistic regression analysis, risk factors associated positively with uterine leiomyomas are tubal ligation, family history of uterine leiomyomas, higher education, obesity and abortion. In contrast, DMPA, use of oral contraceptives, higher parity and smoking are associated with a lower relative risk suggesting that they have a protective effect against uterine leiomyomas. This causative relation is further strengthened by the strong duration-response relation between DMPA and uterine leiomyomas. This protection may persist for more than 10 years after the last dose. CONCLUSION: We have demonstrated a strong, duration dependent protective effect of DMPA against uterine leiomyomas.

Adult↗
PubMed1981

Reproductive performance in rats with different histories of malnutrition.

1. Reproductive competence, as measured by weight gain during pregnancy, duration of pregnancy and foetal outcome, was assessed in primiparous rats (4--6 months of age) with various histories of malnutrition. 2. Although weight gain during pregnancy was reduced in rats with intergenerational malnutrition, the duration of pregnancy and number of live births did not differ from well-fed controls, suggesting adaptation of these measures to long-term dietary deprivation. 3. Rats malnourished from birth through pregnancy (one generation of malnutrition) had fewer live births than did rats with chronic, intergenerational malnutrition or well-fed controls rats. 4. Gestation was prolonged and weight gain accelerated among female rats with histories of intergenerational malnutrition, who had been provided with an adequate diet from birth through pregnancy.

Animals↗
PubMed2002

A cohort study of reproductive factors and family history of breast cancer in southern Sweden.

BACKGROUND: Studies have been contradictory regarding the hypothesis that reproductive risk factors of breast cancer as parity and age at first full-term pregnancy (AFFP) operate differently in women with and without a family history of breast cancer. METHODS: The overall tumour incidence and breast cancer incidence related to fertility factors were followed in a population based cohort of 29,508 women aged 25-65 when interviewed between 1990 and 1992 in south Sweden. At the end of the follow up in December 1999, the cohort constituted 226,611 person years. The risk of breast cancer in relation to reproductive factors were studied in women with at least one first degree relative with breast cancer and compared with women without a family history. FINDINGS: A total of 1145 malignant tumours were seen and 1166.6 were expected (SIR = 0.98, 95% CI = 0.93-1.04). Slightly more breast cancer cases were seen 434 than expected 387.69 (SIR = 1.12, 95% CI = 1.02-1.23). A family history of breast cancer among a first degree relative was present in 1615 women . Forty-five breast cancers were seen among these women while 24.27 was expectecd (SIR = 1.85, 95% CI = 1.35-2.48). Nulliparous women with a family history of breast cancer had a higher risk of breast cancer, SIR = 1.76, 95% CI = 0.64-3.82, compared with nulliparous women without a family history, SIR = 1.13, 95% CI = 0.99-1.29. Similarly women with parity 1-2 with a family history had a higher SIR = 1.81, 95% CI = 1.16-2.69 compared with women without a family history having 1-2 children, SIR = 1.13, 95% CI = 0.99-1.29. In women with > or = 3 children those with a family history continued to have a high SIR = 1.98, 95% CI = 1.11-3.27 compared with women without a family history SIR = 0.90, 95% CI = 0.73-1.09. An early full-term pregnancy was protective in both groups. A higher risk than nulliparous women were seen after age 25 in the family history group and after age 30 in the sporadic cancer group. INTERPRETATION: Women with a first degree family history of breast cancer do not experience the sameprotection from a high number of pregnancies as women without a family history. However, an early first full-term pregnancy seems to offer a substantial protection in the family history group if undertaken before age 20. This suggest that reproductive factors tend to operate differently in the two groups of women.

Adult↗
PubMed1995

Reproductive factors and family history of breast cancer in relation to plasma estrogen and prolactin levels in postmenopausal women in the Nurses' Health Study (United States).

Parity, age at first birth, age at menarche, and a family history of breast cancer have each been associated consistently with breast cancer risk. Whether this increase in risk is mediated, at least in part, through changes in endogenous hormone levels is unclear. We conducted a cross-sectional study of the relationships between these factors and plasma hormone levels in 216 healthy postmenopausal women in the Nurses' Health Study (United States). The hormones evaluated were estradiol, percent and total free estradiol, percent and total bioavailable estradiol, estrone, estrone sulfate, and prolactin. After controlling for age, body mass index (weight/height2), and alcohol use, we observed inverse associations between estrone sulfate and parity (r = -0.15, P = 0.03) and between percent bioavailable estradiol and age at first birth (r = -0.17, P = 0.02). Although women with a family history of breast cancer tended to have higher estrogen levels compared with women without such history, the differences were not statistically significant. Age at menarche was not related significantly to any of the hormones. These data provide some additional evidence that the inverse relationship observed between parity and breast cancer risk may be mediated, at least in part, through decreased estrogen levels. Our data do not support a substantial influence of either family history of breast cancer or age at menarche on postmenopausal estrogen or prolactin levels.

Adult↗
PubMed1993

Previous cancer and radiotherapy as risk factors for lung cancer in lifetime nonsmokers.

A history of previous primary cancer and of radiotherapy were investigated as risk factors for lung cancer in lifetime nonsmokers in a hospital-based case-control study. By design, subjects with a previous tobacco-related primary (of the lung, larynx, oropharynx, esophagus, kidney, bladder, or pancreas) were excluded. Information was available on 30 male and 47 female lung cancer cases and 87 male and 132 female controls, all lifetime nonsmokers, interviewed in hospitals in four United States cities between 1985 and 1990. In males, neither a history of a previous primary nor a history of radiotherapy was associated significantly with lung cancer; however, the numbers of exposed cases were small. In females, after adjustment for age, education, hospital, lifetime environmental tobacco-smoke exposure, and body mass index, both a history of a reproductive primary and a history of radiotherapy were associated significantly with lung cancer (odds ratio [OR] = 4.9, 95 percent confidence interval [CI] = 1.4-17.7, and OR = 4.4, CI = 1.3-15.1, respectively). Due to a high correlation between a history of a reproductive primary and a history of radiotherapy in the cases, it was not possible to estimate the effect of one exposure independent of the other. These results are consistent with the possibility that endocrine factors may play a role in some lung cancers in women.

Adenocarcinoma↗