conception

Pregnancy Pathway…Important Notes from Wonderrobyn

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The fol­low­ing are notes from co-author Robyn Bran­ca­to, CNM (cer­ti­fied nurse mid­wife) who prac­tices in New York City, or, as she is know here: Won­der­robyn! You can read about both authors in the About tab above. Here they are on the beach in San Diego, when they gave a talk at con­fer­ence there a cou­ple years ago. Robyn on the left, Ann on the right.

Robyn and Ann, Pathway authors

Robyn and Ann, Path­way authors

1. Addi­tion to Small Rant: “Resist the temp­ta­tion to watch A Baby Sto­ry on TLC! It does not por­tray birth accu­rate­ly, as they con­dense 15 hours of labor into 30 min­utes and play up the dra­ma so that you will be on the edge of your seat! In the major­i­ty of women, birth is not that dan­ger­ous.”

2. Regard­ing: When does con­cep­tion occur? “This is a real­ly inter­est­ing post… I love the dis­cus­sion about at what point con­cep­tion occurs! Per­son­al­ly, I like the Bib­li­cal notion of quick­en­ing. Even though this varies from woman to woman and can range any­where from 16 to 22 weeks ges­ta­tion, it seems like the most nat­ur­al the­o­ry.”

Dear Read­er:  What do YOU think? Did you read the con­cep­tion post on March 23, ’09?

3. About sperm & preeclamp­sia. “Is the con­nec­tion between bar­ri­er meth­ods and preeclamp­sia actu­al­ly estab­lished? I have read stud­ies stat­ing the con­trary — that bar­ri­er meth­ods have no effect on preeclamp­sia rates.”

HURRAY! THIS REQUIRES FURTHER CONSIDERATION.

More infor­ma­tion: The immune mal­adap­ta­tion the­o­ry sug­gests that tol­er­ance to pater­nal anti­gens, result­ing from pro­longed expo­sure to sperm, pro­tects against the devel­op­ment of preeclamp­sia. Thus, bar­ri­er meth­ods and being young may pre­dis­pose women to this major dis­or­der of preg­nan­cy.

Evi­dence exists on both sides of this the­o­ry. Here are two recent stud­ies (one of each) that read­ers may find help­ful in under­stand­ing this idea. Keep in mind that oth­er fac­tors than just sperm expo­sure may be affect­ing research find­ings. But, it does seem that under some con­di­tions, bar­ri­er meth­ods and amount of expo­sure to sperm can affect the preg­nan­cy itself.

Ness RB,  Markovic N, Harg­er G, Day R. Bar­ri­er meth­ods, length of pre­con­cep­tion inter­course and preeclamp­sia, Jour­nal: Hyper­ten­sion in Preg­nan­cy 23(3):227–235. 2005.  Results did not sup­port the immune mal­adap­tion the­o­ry.

Youse­fi Z, Jafarnezhad F, Nas­rol­lai S, Esmaeeli H. Assess­ment of cor­re­la­tion between unpro­tect­ed coitus and preeclamp­sia, Jour­nal of Research in Med­ical Sci­ences 11(6):370–374. 2006. In a matched con­trols study, women with <4 months cohab­i­ta­tion or who used bar­ri­er meth­ods had high­er risks of devel­op­ing preeclamp­sia than those with >4 months cohab­i­ta­tion. Oral con­tra­cep­tion users had a low­er preeclamp­sia rate than those who used no oral con­tra­cep­tion.

In a com­men­tary arti­cle in OB/GYN News ‚  July 1, 2002, the fol­low­ing note was made by Dr. Jon Einars­son: With insuf­fi­cient expo­sure, preg­nan­cy may induce an immune response and preeclamp­sia in some women with pre­dis­pos­ing fac­tors such as an endothe­li­um that already is sen­si­tive to injury due to age, insulin resis­tance, or pre­ex­ist­ing hyper­ten­sion.

Is there a plain and sim­ple truth about sperm expo­sure and preg­nan­cy risks? Alas, no. But, know your cir­cum­stances. If you are young, pro­tect your­self. Wear a con­dom. When you are ready to be a mom, you will be ready to fig­ure out your risks. So, this, too fol­lows the axiom:

Events in life are rarely plain and nev­er sim­ple.

Pregnancy Pathway, Conception — Review & Small Rant!

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REVIEW: Evi­dence is clear - pre-preg­nan­cy mater­nal health sta­tus, includ­ing phys­i­cal fit­ness, healthy nutri­tion and an uncom­pro­mised immune sys­tem affect the health and well-being of both moth­er and off­spring, in both short and long term.

This is the mes­sage sum­ma­ry from our first two areas of dis­cus­sion:  Pre­con­di­tions and Con­cep­tion — the green and sand col­ored sec­tions on the chart below.

pregnancy_pathway

COMING ATTRACTIONS: We are about to move on to the blue sec­tion — Preg­nan­cy!!  So, book­mark this Blog for future ref­er­ence!

Also, you can sub­scribe to this Blog by click­ing on Blog Info in the upper right cor­ner and then click­ing on Sub­scribe in the drop down menu.

But, yes, you guessed it, first we have a small rant!

SMALL RANT: When we note that fit­ness, nutri­tion and a healthy immune sys­tem play sig­nif­i­cant roles in the out­come of preg­nan­cy and the future health of moth­er and child, we are appeal­ing to young peo­ple of child­bear­ing age to be care­ful about your bod­ies. The alliance of egg and sperm shapes the world. With 6.5 Bil­lion egg/sperm com­bi­na­tions (yes, peo­ple) present­ly liv­ing on earth, our resources are stretched. With time, either we get more picky about doing this, or the 3rd rock from the sun (remem­ber that show?) is cooked.

Humor­ous incur­sion: In case you need fur­ther enlight­en­ment on this whole area, there is a great web­site that will help you out. Be pre­pared to be amused and amazed!

The Truth about Eggs and Sperm

Hope­ful­ly, this gets you in the right mood and keeps you smil­ing. After all, once you actu­al­ly are preg­nant, we have more seri­ous mat­ters to dis­cuss.

Pregnancy Pathway, Conception — Prior Sperm Exposure

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Today:  Sperm!!!

For com­plete graph­ic, see Feb. 5 or 23 post.

The mother's prior sperm exposure can affect her pregnancy.

The mother’s pri­or sperm expo­sure can affect her preg­nan­cy.

Not every sperm is your friend! Sperm expo­sure — like so many expo­sures — affects our immune sys­tem. Women who have babies with more than one father may be at risk for dis­or­ders of preg­nan­cy because the chal­lenges to their immune sys­tem have been exten­sive. And, very young women who become preg­nant are at increased risk of some dis­or­ders because they have had very lit­tle expo­sure to sperm.

In addi­tion, women who have pri­mar­i­ly and exten­sive­ly used bar­ri­er meth­ods of con­tra­cep­tion may be at risk for dis­or­ders for rea­sons sim­i­lar to young women with lit­tle expo­sure. Unlike women whose immune sys­tem has had too much chal­lenge due to preg­nan­cies by sev­er­al men, women with lit­tle expo­sure may not have a strong defense against for­eign DNA. Please do not take this as a rea­son to not use a con­dom — one of the bar­ri­er meth­ods along with a diaphragm and cer­vi­cal cap. Rather, if you use a bar­ri­er method of con­tra­cep­tion, keep in mind that your body’s adjust­ment to preg­nan­cy may take time.

For more infor­ma­tion on bar­ri­er meth­ods, to go the Amer­i­can Col­lege of Obste­tri­cians and Gyne­col­o­gists’ online pam­phlet: ACOG Pam­phlet on Bar­ri­er Con­tracetp­tion.

Anoth­er way sperm can affect the preg­nan­cy is that the com­bi­na­tion of the mother’s and father’s nat­ur­al immune respons­es may be strong against the tro­phoblast implan­ta­tion. This is not some­thing  you can know ahead of time. Also, women are eight times more like­ly than men to devel­op autoim­mune dis­or­ders. One rea­son may be the pre­na­tal expo­sure to for­eign DNA encoun­tered in preg­nan­cy.

Keep in mind that by get­ting good pre­na­tal care, exer­cise, suf­fi­cient rest, stress man­ag­ment and healthy nutri­tion, you do all with­in your pow­er to have a healthy preg­nan­cy. Your health care provider will deter­mine your risk fac­tors that may affect preg­nan­cy out­come and treat you in an appro­pri­ate man­ner.

Moms and babies enjoy exercise together!

Moms and babies enjoy exer­cise togeth­er!

Once your baby comes, there will be time to max­i­mize health for both of you. Exer­cis­ing togeth­er is great fun!

Get­ting there may require some patience, but the reward is well worth it.

When you are look­ing around for sperm, use your head. The same behav­ior that pro­tects you from infec­tions you nev­er want to get, pro­tects you from sperm you don’t real­ly want to meet. When the time comes to adopt some sperm, find out about it’s cre­den­tials!

Pregnancy Pathway, Conception — Health Status

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Today: How the mother’s health sta­tus at the time of con­cep­tion affects the preg­nan­cy.

For com­plete graph­ic, see Feb. 5 or 23 post.

The Impact of Health Status at the time of conception.

The Impact of Health Sta­tus at the time of con­cep­tion.

When a woman becomes preg­nant, her health can be a major fac­tor how her preg­nan­cy will pro­ceed. If she has been exposed to a vir­u­lent infec­tion, it may have an impact on how well the implan­ta­tion goes. If she has meta­bol­ic syn­drome, she is at risk for com­pli­ca­tions such as ges­ta­tion­al dia­betes.

On the oth­er hand, if she has tak­en care of her­self, is phys­i­cal­ly fit and well nour­ished, is well rest­ed and has not been exposed to ill­ness­es that induce dra­mat­ic changes in her immune sys­tem, she has done her best to cre­ate a sit­u­a­tion in which her body is best pre­pared for the rig­ors of preg­nan­cy.

There are still genet­ic and envi­ron­men­tal fac­tors that can affect the course of the preg­nan­cy, but behav­ior is the one fac­tor that women have con­trol over. At Danc­ing Thru Preg­nan­cy we are fond of the notion that if you know a cer­tain behav­ior is the best for a sit­u­a­tion, it is smart to chose that behav­ior; if you do not, you are sab­o­tag­ing your­self.

So, if preg­nan­cy is in your head­lights, eat right, exer­cise, and be cau­tious about expo­sure to ill­ness and infec­tion. Wash your hands, use one of the hand cleansers, prac­tice safe sex (okay, so if you are try­ing to get pg, this may change, but in the mean­time!).

We wel­come com­ments on what you are doing to be healthy for preg­nan­cy!

Curl-up! Strong abs are part of physical fitness!

Curl-up! Strong abs are part of phys­i­cal fit­ness!

Pregnancy Pathway, Conception

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Today: Con­cep­tion!

For com­plete graph­ic, see Feb. 5 or 23 post.

bubblus_conception

The health of the moth­er and her pri­or expo­sure to sperm have a dra­mat­ic effect on con­cep­tion. To find out why and how, we have to start with this ques­tion: 

What is con­cep­tion?

Is it fer­til­iza­tion, a process by which an egg absorbs a sperm, engulf­ing the male’s half of the genet­ic code? Per­haps it is the point at which this egg/sperm con­coc­tion (the cor­pus) reach­es the uterus and the tro­phoblast cells begin to invade the endometri­um (uter­ine lin­ing)?

Trophoblast Invastion? No...Chihuly glass exhibit at the Desert Botanical Gardens, Phoenix AZ

Tro­phoblast Invas­tion? No…Chihuly glass exhib­it at the Desert Botan­i­cal Gar­dens, Phoenix AZ

Tro­phoblast inva­sion caus­es spi­ral arter­ies in the mother’s cir­cu­la­tion to open and form a pool that will nour­ish the fetus. Depend­ing on the “dis­cus­sion” between the mother’s immune sys­tem and tro­phoblast, this inva­sion may go well or poor­ly. How well it goes will affect the course of the preg­nan­cy.

Or, what about the point around 8 weeks post onset of last men­stru­al cycle at which the respon­si­bil­i­ty for nour­ish­ment of these cells is trans­ferred from the cor­pus to the pla­cen­ta? By this point about 30% of poten­tial preg­nan­cies have spon­ta­neous­ly abort­ed because of genet­ic or inflam­ma­tion prob­lems.

Anoth­er can­di­date is the Quick­en­ing, the point the Bible refers to as the start of life. This is  the occa­sion — around 4 months post onset of last men­stru­al cycle — when the moth­er first sens­es move­ment in her womb. Is this con­cep­tion? It cer­tain­ly ris­es to the test of con­scious­ness of a phe­nom­e­non (oth­er­wise known as a con­cept).

What if the engulf­ing of the sperm hap­pens in a dish in the lab­o­ra­to­ry? What if large dos­es of egg induc­ing med­ica­tions are required to prompt eggs to mature and con­sid­er engulf­ing sperm? What if hor­mones are required to allow the first few cells to grav­i­tate toward and inbed them­selves into a uter­ine sur­face not real­ly that friend­ly to their con­tin­u­a­tion?

You can see that it is not a sim­ple mat­ter to estab­lish a start­ing point. There are sev­er­al process­es that must go right to form a viable human. All along the way, the mother’s health plays a key role. Inter­est­ing­ly, the extent of expo­sure to the father’s sperm also plays a role, as do immune fac­tors in the com­bined mother’s and father’s genes.

08

Most impor­tant for our         pur­pos­es here is that women who are reg­u­lar aer­o­bic exer­cis­ers pri­or to preg­nan­cy or who begin in ear­ly preg­nan­cy show reduced risk for devel­op­ments of the pla­cen­ta that pro­duce a dys­func­tion­al preg­nan­cy.

Upcom­ing posts will dis­cuss mater­nal health and sperm expo­sure in more detail.