Dealing With Infertility

According to the Mayo Clinic, 10-15% of couples experience infertility.  Thankfully, after treatment, about 2/3 of those couples are able to get pregnant.  Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year for most people and six months in certain circumstances. 

There are many causes of infertility.  In approximately 1/3 of cases it is traced back to the woman, 1/3 of cases it is traced back to the man and 1/3 of the cases are due to both partners or the cause is unknown. 


The most common cause of infertility in women is a failure to ovulate.  A few causes of this are Polycystic Ovary Syndrome, where there is a hormone imbalance, and Functional Hypothalamic Amenorrhea, where excessive physical or emotional stress result in the loss of a period.  Besides these, it can also come from obesity and/ or weight gain, an ovarian tumor or cyst, weight loss including eating disorders and use of alcohol, tobacco and other drugs (including caffeine). 

In men, infertility is usually caused by a low sperm count or abnormal sperm development.  A specialist would look at the number of sperm, their motility and shape to determine if this is the cause.  These abnormalities can be caused by overheating of the testicles, unhealthy habits such as drugs and alcohol or medical conditions such as diabetes, cystic fibrosis, trauma or treatments like chemotherapy or radiation. 


There are numerous treatments available for people struggling with infertility.  Women can have ovulation stimulated with fertility drugs, have surgery, or do intrauterine insemination where healthy sperm are placed directly into the uterus.  Infertility in men can be addressed through medication or behavioral changes and surgery or hormones.  Couples may also choose to have a procedure such as in vitro fertilization which combines the sperm and egg in a lab and then implants the embryos into the uterus.  This method is only effective in 40% of the cases of women younger than 35 years of age and declines as the woman becomes older.
Coping with infertility can be difficult, especially when the cause is unknown.  The Mayo Clinic recommends a few steps you can take to prepare yourself for the journey ahead.  First be prepared by asking your doctor a lot of questions.  Next, set limits on what is appropriate and financially acceptable to you and your spouse.  Infertility is deeply emotional so knowing what you will and will not do before asked the question will save you much time and uncertainty.  

You will also want to consider other options if you are not able to become pregnant, such as adoption.  Finally, look for support from friends, family and support groups or counseling services.  Because infertility is so personal, many are unaware of how many struggle with it.  Linking yourself with others in your situation will be a great blessing. 

The church has many talks and personal stories linked to their website regarding infertility.  The following link will take you to stories of couples dealing with infertility as well as numerous talks by General Authorities and others on how to make it through this time in your life.
Another website geared specifically towards LDS couples dealing with infertility is: www.ldsinfertility.org 

There are many resources out there to help if you struggle with infertility.  Don’t hesitate to reach out to these sources or to talk to your doctor if you think something may be wrong.

Sources:
Infertility. (2013, September 18). Retrieved from http://www.nlm.nih.gov/medlineplus/infertility.html
Infertility fact sheet. (2012, July 16). Retrieved from http://www.womenshealth.gov/publications/our-publications/fact-sheet/infertility.html
Mayo Clinic Staff. (2013, July 19). Infertility. Retrieved from http://www.mayoclinic.com/health/infertility/DS00310
Nazario, B. (2011, July 28). Understanding ovulation and fertility: Facts to help you get pregnant. Retrieved from http://www.webmd.com/baby/ss/slideshow-understanding-fertility-ovulation 
Pictures:
http://www.atlantainfertility.com/
http://9images.blogspot.com/2013/03/sad-hug-couple-back-cute.html

Breast Cancer Awareness Month

October is National Breast Cancer Awareness Month.  Breast Cancer is so common among women that 1 in 8 will be diagnosed in their lifetime and it is the second leading cause of death in women.  The good news is that the death rate from breast cancer has declined 34% since 1990 due to better screening, earlier detection and improved treatments. 

What puts a person at risk for developing breast cancer?
While there are risk factors associated with breast cancer (being a woman, over 55 years old, have a family history of breast cancer, never having given birth, to name a few), 60- 70% of people with breast cancer have no connection to the risk factors.  According to www.nationalbreastcancer.org common myths of things that cause breast cancer include wearing underwire bras, implants, deodorants, antiperspirants, mammograms, caffeine, plastic food serving items, microwaves, and cell phones.

Men are not immune to breast cancer and approximately 2,200 men will be diagnosed each year.  Breast cancer in men has a higher fatality rate because it often goes undetected longer.  Men should also be aware of the signs of breast cancer.

How do you know if you have breast cancer?

Most of the time, there are no symptoms of having breast cancer, however there are signs you can look for.  Signs include a lump or swelling in the breast, a change in breast size or shape, swelling in the armpit or discharge from the nipple.

In the past, providers have recommended doing monthly self-breast exams to search for any lumps or abnormalities.  It is now more common for providers to advise being familiar with your own breasts so that when changes happen, you notice them more quickly.  This may be done by a monthly breast exam, but not necessarily.

It is also important to note that just because there is a lump does not mean it is cancerous. 

Performing a Self-Breast Exam
There are many great resources online to show you how to perform a self-breast exam.  We suggest following one of the links below for a step-by-step guide (pictures included).

National Breast Cancer Foundation: http://www.nationalbreastcancer.org/breast-self-exam     



Famous People with Breast Cancer
Angelina Jolie post surgery

Many women in the media have had breast cancer including singer Sheryl Crow, Good Morning America host Robin Roberts, TODAY show host Hoda Kotb, Greasestar Olivia Newton-John, and former first lady Nancy Regan.  Actress Angelina Jolie and former America’s Got Talent co-host Sharon Osborne both elected to have a double mastectomy because they carry the gene that has been linked to breast cancer.  Neither were diagnosed, but had the surgery as a precaution.

For more information on breast cancer, including ways to be involved in promoting awareness, visit www.nationalbreastcancer.orghttp://www.cancer.org/
Sources:
Abramovitch, S. (2013, May 14). They stand with angelina: 12 courageous celebrities who battled breast cancer. Retrieved from http://www.hollywoodreporter.com/gallery/they-stand-angelina-12-courageous-522209
Anderson, T. (2013). 10 celebrities who battled breast cancer. Retrieved from http://www.health.com/health/gallery/0,,20307103,00.html
Movva, S. (2013, August 21). A visual guide to breast cancer. Retrieved from http://www.webmd.com/breast-cancer/ss/slideshow-breast-cancer-overview
National Breast Cancer Foundation. (2012). Breast self exam. Retrieved from http://www.nationalbreastcancer.org/breast-self-exam 
Simon, S. (2013, October 1). Report: Breast cancer death rates down 34% since 1990. Retrieved from http://www.cancer.org/cancer/news/news/report-breast-cancer-death-rates-down-34-since-1990

Pictures:
http://www.psmag.com/health/women-of-1970s-professional-career-increased-risk-of-breast-cancer-58095/
http://kintalk.org/discussion/breast-cancer-in-lynch-syndrome-still-a-quandary
http://www.wespeaknews.com/world/angelina-jolie-makes-first-public-appearance-post-surgery-212400.html

What's a Pap Smear?

The pap smear.  You’ve probably heard of it but don’t know what it really consists of.  Many women in the BYUI/ LDS culture we live in are unaware of what a pap smear is and why it is important because abstinence is practiced before marriage. 

A pap smear is done to check for signs of cervical cancer.  The cancer is generally caused by infection of the human papilloma virus (HPV).  According to the Centers for Disease Control, in 2010 (the most recent year information is available) there were 11,818 women diagnosed with cervical cancer and 3,939 women died from cervical cancer.  As a nation, the rate of cervical cancer was 7.5 cases per 100,000.  This rate has steadily declined since 1999 when the rate was 9.8 per 100,000.  The CDC attributes this decline to an increase of women getting pap smears.

It is rare for a woman who has never been sexually active to have HPV.  However, providers recommend getting a pap smear starting at age 21, regardless of sexual activity and having the test repeated every three years.  This is due to the fact that cervical cancer can be influenced by other factors besides sexual activity. 

The Student Health Center will schedule pap smears.  It is recommended that you are not on your period.  The best time to have one done is 10-20 days after the first day of your last period.     

For more information, visit the websites listed below.

Sources:
Centers for Disease Control and Prevention. (2010). Us cancer statistics: Interactive map. Retrieved from http://apps.nccd.cdc.gov/DCPC_INCA/DCPC_INCA.aspx
Office on Women’s Health. (2012, July 16). Pap test fact sheet. Retrieved from http://www.womenshealth.gov/publications/our-publications/fact-sheet/pap-test.html
Pruthi, S. (2011, June 24). Pap smear. Retrieved from http://www.mayoclinic.com/health/pap-smear/AN01635

From the Land of the Liberty Bell: Investigate the NSA

by Andy Hoover, Legislative Director, ACLU of PA

Here in Pennsylvania, we have a full-time legislature, so as the lobbyist for the Pennsylvania affiliate of the ACLU, I have plenty of opportunities for face time with state legislators and staff. Since June, I’ve been hearing a similar refrain repeatedly: NSA surveillance is a major problem. We deal with a lot of state-level surveillance legislation, and I’ve joked with legislators and staff that Edward Snowden has made my job a lot easier.
Last week, the Pennsylvania House of Representatives formalized that concern by passing a resolution to protest the NSA’s sweeping surveillance activities and to call on Congress to create a special committee to investigate and to recommend revisions to the USA PATRIOT Act and for reforms at the NSA and the FBI. The vote on House Resolution 456 wasn’t even close.

The final tally: 194 to 2.

As an observer of civil liberties trends in the Pennsylvania General Assembly, I was not surprised by this overwhelming bipartisan vote. Our state House has made it clear on repeated occasions that it is serious about privacy. In October of 2012, the House defeated legislation to require DNA collection from people who have been arrested but not convicted of a crime. Two weeks ago, the House passed an amendment to require prosecutors to obtain a search warrant before they can access data from a prescription drug monitoring program. Both of these victories for civil liberties happened despite the objections of the Office of the Attorney General and the Pennsylvania District Attorneys Association.

The Pennsylvania House has good reason to worry. Since June, disclosure after disclosure has revealed that the NSA is vacuuming up the call records of nearly all Americans and is filtering through the contents of our international communications. The disclosures haven’t stopped though, and with each disclosure more and more Americans are saying “Stop watching us.”  

Our state House made a strong statement in passing HR 456. We hope that Sens. Bob Casey, Jr.  and Pat Toomey and the rest of Pennsylvania’s congressional delegation get the message clearly and support the USA FREEDOM Act introduced by Rep. Jim Sensenbrenner (R-Wis.) and Sen. Patrick Leahy (D-Vt.) this week. Among other things, the billrightly ends the indiscriminate collection of American call records, as well as prohibits the bulk collection of any other records, and requires a court order before the government can search through its databases containing the international communications of Americans.  

Pennsylvanians won’t stand for an overly-intrusive government that pokes its nose in our daily lives.


Big Blow for Women’s Health in Texas

By Mike Garvey, Clara Bell Duvall Reproductive Freedom Project Intern

These days, it seems that victories for abortion access and rights are rare. The news frequently portrays stories about restriction, not expansion, of access. So, supporters of access received something of a win Monday, when a district court judge in Texas issued a permanent injunction on a particular provision – that doctors performing abortions must have hospital admitting privileges within 30 miles of the site – of a restrictive new state abortion law. The ruling was the result of a lawsuit brought by, among others, the ACLU, Planned Parenthood, the Center for Reproductive Rights, and a number of women’s health centers in Texas. The judge in this case ruled that the provision had nothing to do with safety and more to do with placing an undue burden on a woman seeking an abortion. 

But Thursday, the Fifth Circuit of Appeals – following an emergency appeal by the state – overturned the ruling, allowing the law to go into effect while a legal case against it moves forward in court.

This isn’t a small decision. It’s a disaster. Because the law was allowed to go into effect, according to the New York Times, as many as 13 of Texas’ 36 health centers that currently provide abortion services will be forced to stop providing them.

What the appeals court’s decision won’t decrease, however, is the number of women who decide that abortion is the right course of action for them. These are women who might live in areas those 13 clinics would ordinarily serve. They’re women who, because of this restrictive law, will be forced to travel long distances and potentially plan multi-day trips to access abortion services. They’re women who might not be able to afford to travel. They’re women who, having no feasible option, might decide to undergo an unsafe abortion. 

The appeals court itself found that the regulation might increase the cost of accessing a provider while simultaneously decreasing the number of providers. But because those are incidental effects of a regulation that serves a “valid purpose,” the regulation was allowed to stand.

The assertion that this provision is about women’s health is laughable. Texas is a huge state. Did its government not grasp that the admitting provisions requirement would make it close to impossible for poor and rural women to access abortion?

We know the answer – the effect of decreased access isn’t incidental. This is a law signed by a governor whose stated goal is to wipe out abortion, period. It’s the intent of a state government that doesn’t trust women to make decisions about their own lives, and values its own misguided judgment more than the people who actually provide abortion care. No, it’s not incidental. It’s patently intentional and leading us back to a pre-Roe world.

Mike Garvey is an MSW candidate at the University of Pennsylvania.