Errores históricos de la planificación familiar

March 23, 2008
Birth Control for Others

By NICHOLAS D. KRISTOF

FATAL MISCONCEPTION

The Struggle to Control World Population.

By Matthew Connelly.

Illustrated. 521 pp. Harvard University Press. $35.

The first large-scale scientific test of family planning took place in Khanna, India, beginning in the early 1950s. Backed by the Rockefeller Foundation and the Harvard School of Public Health, researchers asked 8,000 villagers how often they had sex, whether they wanted to conceive and the details of the women’s menstrual cycles. The researchers met the villagers monthly and provided contraceptives, while closely monitoring another group that was given no contraceptives. After five years, the women given contraceptives had a higher birth rate than those who hadn’t received any assistance.

That initiative was an early warning that population policy can be very difficult to get right. In “Fatal Misconception,” Matthew Connelly, an associate professor of history at Columbia University, carefully assembles a century’s worth of mistakes, arrogance, racism, sexism and incompetence in what the jacket copy calls a “withering critique” of “a humanitarian movement gone terribly awry.”

Efforts to control population have long been ferociously controversial, and the United States under George W. Bush refuses to provide a penny of funding for the United Nations Population Fund because of its supposed (but in fact nonexistent) links to forced abortion in China. Critics of family planning programs will seize gleefully upon this book, and that’s unfortunate, because two propositions are both correct: first, population planners have made grievous mistakes and were inexcusably quiet for too long about forced sterilization in countries like India and China; and second, those same planners have learned from past mistakes and today are fighting poverty and saving vast numbers of lives in developing countries.

“Fatal Misconception” is to population policy what William Easterly’s “White Man’s Burden: Why the West’s Efforts to Aid the Rest Have Done So Much Ill and So Little Good” (2006) was to foreign aid: a useful, important but ultimately unbalanced corrective to smug self-satisfaction among humanitarians. Connelly scrupulously displays a hundred years of family planners’ dirty laundry, but without adequately emphasizing that we are far better off for their efforts. One could write a withering history of medicine, focusing on doctors’ infecting patients when they weren’t bleeding them, but doctors are pretty handy people to have around today. And so are family planners.

Viagra reduce la fertilidad

Men who take Viagra ‘put their fertility at risk’

Robin McKie, science editor
The Observer,
Sunday February 24 2008

Using Viagra may be damaging men’s fertility, researchers have warned. Experiments suggest that the anti-impotence drug can harm sperm and may prevent some men from fathering families.

In particular, young men who use the drug recreationally could impair their ability to have families. And fertility clinics that prescribe Viagra to help men produce sperm for IVF treatments could be preventing some couples from conceiving.

‘I think it is worrying that some IVF clinics are using Viagra in order to boost fertility results,’ said Dr David Glenn, a consultant gynaecologist at Queen’s University Belfast. ‘Couples that go there for treatment are, by definition, already having problems getting pregnant. Giving male partners something that could make the problem worse is scarcely the right approach.’

Glenn’s research, which is to be published in the journal Fertility and Sterility, is based on two sets of experiments. The first involved taking sperm samples from volunteers and then bathing them in weak solutions of Viagra. The aim was to produce a Viagra level equivalent to that found in the blood of a man who had taken a single 100-milligram tablet.

Vitrificación de óvulos

 

Óvulos a salvo y siempre jóvenes

Una nueva técnica facilita la congelación de ovocitos para una maternidad futura

CARMEN MORÁN  -  Madrid
EL PAÍS  -  Sociedad - 26-12-2007

Una pareja decide congelar un embrión para el día de mañana implantárselo a ella y tener un hijo. Pero al cabo de un tiempo se separan. El juez vino a sentenciar algo así: el coche para ella, la casa para él y el embrión de ambos no lo podrá usar ninguno sin el consentimiento del otro. Una situación similar a ésta ya ha ocurrido. Lo cuenta la directora del Instituto de Infertilidad (IVI) de Valencia, Amparo Ruiz. Efectivamente, ése es un riesgo a la hora de congelar el embrión, que depende de la voluntad de dos. ¿Hay fórmulas más prácticas?
Una nueva técnica, que Ruiz califica de “revolucionaria”, podría ayudar a las mujeres que entran en los 35 sin que hayan tenido oportunidad de tener hijos pero no descarten hacerlo más adelante: la vitrificación de óvulos.

La congelación lenta, con la que se conservan sin muchos problemas el esperma o los embriones, no da buenos resultados para los óvulos. Sin embargo, la vitrificación preserva ese material en plasma, evitando así que las cuñas del hielo, al congelar en líquido, dañen el material, por explicarlo de una forma sencilla. “Esto permite tres cosas fundamentales: que las mujeres que tengan que pasar por quimioterapia puedan extraer tejido ovárico antes para acceder a la maternidad con posterioridad; que se pueda crear un banco de ovocitos, como se hace con los espermatozoides; y la autodonación”, dice Ruiz.

Placer, procreación y selección natural

Journal of Homosexuality, Vol. 51(2) 2006

Sexual Pleasure, Procreation
and Natural Selection
WITH PLEASURE: THOUGHTS ON THE NATURE OF HUMAN
SEXUALITY. Paul Abramson and Steven Pinkerton. New York:
Oxford University Press, 2002.
The pulses of vigorous theorizing about sexuality that started up about
thirty-five years ago show no signs of abating. The first pulse came from
feminist writers, who insisted that sex be satisfying to women as well as
to men. Anne Koedt’s (1973) widely discussed essay, “The Myth of the
Vaginal Orgasm,” noted that penile-vaginal intercourse often failed to
give women orgasms. The essay valorized clitoral stimulation by a male
or female partner for this purpose, even when it takes forms that cannot
lead to conception. Soon after, gay liberation gave birth to “social
constructionism,” a perspective that theorized sexual orientation to be a
socio-cultural creation. More recently, evolutionary psychology has
sought to explain sexual behavior and interests as the product of natural
selection and sexual selection.
With Pleasure, by Paul Abramson and Steven Pinkerton (2002),
builds on the foundations laid by feminism, gay liberation and evolutionary
psychology, and thus gives us the opportunity of seeing the uses
to which these developments are being put in current theorizing about
sexuality.1 The volume is a chimera, partly an exposition of scientific
ideas, and partly an effort to persuade readers of the desirability of certain
social and cultural changes. Readers will find an abundance of material
on various aspects of human (and sometimes non-human) sexuality. The
authors not only summarize and sometimes criticize research and ideas of
others, but also develop provocative ideas of their own.
Central to the authors’ project is the goal of reconstituting theorizing
about sex so that its central organizing principle is not procreation, but
pleasure. This is a direction for theorizing that would have been unimaginable
fifty years ago. Social change of the last half-century, including
the widespread use and cultural acceptance of contraception, the more
controversial decriminalization of abortion, the large-scale entry of
women into the paid labor force and their consequent need to control
their fertility, and the flourishing of feminist and gay social movements
enabled this theoretical enterprise.

Fertilidad y eyaculación frecuente

Daily sex can help to repair sperm, says fertility doctor

Ian Sample in Washington
October 16 2007

Frequent sexual activity improves the genetic quality of sperm and may help some couples conceive, fertility specialists have found.

A study of men attending a fertility clinic revealed that genetic defects in their sperm fell substantially after going on a programme that required them to engage in sexual activity daily for a week. Fertility doctors commonly advise men trying for a baby to abstain from sexual activity for two to three days, because it boosts the number of sperm they produce. The latest finding suggests that men who have healthy sperm counts but poor quality sperm can improve the genetic material in the cells by engaging in sex more often.

Genetic damage can reduce the chances of a sperm fertilising an egg, or can lead to the formation of an embryo that fails to implant properly or is miscarried.

Verdades silenciadas del aborto

Verdades silenciadas del aborto

EVA RODRÍGUEZ ARMARIO
EL PAÍS - 18-09-2007

Durante mucho tiempo se ha hablado del recurso al aborto como una prestación casi exclusiva de la sanidad privada debido a que las clínicas acreditadas para el aborto en España vinieron a cubrir una necesidad social que ningún otro colectivo se atrevió a solucionar. De hecho, fue un grupo de profesionales el que decidió atender esta necesidad y soportar individualmente los posibles problemas legales, civiles y penales, creando una serie de centros médicos que dieran una solución digna a la demanda de unas mujeres que hasta ese momento tenían que hacer turismo abortivo o arriesgar su vida para abortar. Esta realidad innegable nos lleva a preguntarnos acerca de las causas que han propiciado que el 97% de los abortos se realice en clínicas privadas.
Para la Asociación de Clínicas Acreditadas para la Interrupción del Embarazo (ACAI), la ambigüedad de las dos principales leyes que regularon la interrupción del embarazo (la Ley del Aborto 9/1985, de 5 de julio, y el Real Decreto 2409/1986, de 21 de noviembre) ha sido un elemento clave para que fueran las clínicas privadas, y no los hospitales públicos, las que llevaran a cabo esta prestación. La ambigüedad procede de que la ley sólo autoriza la interrupción del embarazo en los casos de violación, malformación del feto y grave peligro físico o psíquico de la embarazada, y exige para ello unos requisitos basados en dictámenes preceptivos.

Registro de donantes de óvulos

La donación de óvulos sigue sin control

No hay registro de donantes pese a que la ley española lo exige desde 1988 y ahora también la UE

CARMEN GIRONA - Madrid
EL PAÍS - 26-06-2007

El retraso de la maternidad y los crecientes problemas de fertilidad por diversas causas han propiciado un aumento de las demandas de fecundación asistida. La gestación con óvulos de donante se ha convertido en la técnica más eficaz y más demandada por las mujeres mayores de 40 años. Sin embargo, un año después de aprobarse en España la nueva ley de reproducción asistida todavía no existe ningún sistema nacional que garantice el control y las buenas prácticas de estas técnicas ni se ha creado el registro que ya estaba previsto en la ley de 1988. La ley establece un límite de seis descendientes por cada donante, pero nadie controla que eso sea realmente así y un donante puede ir a diferentes centros. Los expertos reclaman la creación del registro de centros y de donantes que exige la normativa española y que también establece la Unión Europea. “Llevamos años intentando que el Ministerio de Sanidad cree estos registros. Los últimos intentos de la comunidad científica para colaborar con el ministerio no han prosperado, y la respuesta a una iniciativa realizada con el apoyo de la Sociedad Española de Andrología, la Asociación para el Estudio de la Biología de la Reproducción y la Sociedad Europea de Fertilidad ha sido positiva pero insuficiente”, afirma Buenaventura Coroleu, presidente de la Sociedad Española de Fertilidad (SEF).
En la misma línea se pronuncia Montserrat Boada, coordinadora del Programa de Fecundación in Vitro y Donación del Servicio de Medicina de Reproducción Asistida del Instituto Dexeus de Barcelona: “No se han cumplido las sucesivas leyes españolas y ahora tampoco las directivas europeas que establecen un registro único disponible para España y resto de los países comunitarios”, afirma.

Madres adolescentes

  Madres antes que mujeres

La psicoanalista Laura Kait estudia el embarazo adolescente a través de jóvenes gestantes de una residencia tutelada

I. DE LA FUENTE  -  Madrid
EL PAÍS  -  Sociedad - 19-06-2007

No eran aún mujeres y fueron madres. O al menos tuvieron que decidir con 16 o 17 años no ya si deseaban serlo sino si querían o podían. Más del 50% de los embarazos adolescentes se salda con una interrupción voluntaria de la gestación. En Cataluña, el porcentaje alcanza a más del 65% y en Madrid, en torno al 55%. La comunidad balear se haya a la cabeza de las interrupciones, junto con Cataluña, Madrid, Aragón y Murcia. En total, en 2005 se registraron 12.883 abortos en gestantes de 15 a 19 años (en 2004 fueron 11.677).
Tres de cada diez jóvenes, sin embargo, continúan con el embarazo, bien por razones religiosas o por un explícito apoyo familiar. Algunas se han convertido en hijas-madres dentro de su propio hogar: madres que dan el pecho o el biberón a una diminuta criatura aún más fragil que ellas, y a la que cuidan con tesón determinadas horas del día. Sólo unas horas. Porque además de ser madres, son hijas adolescentes. Como la madrileña Vanessa (nombre supuesto): interrumpió el bachillerato hace tres años, a raíz de la gestación de su hijo, se planteó trabajar como camarera cuando nació el bebé y, ahora, con más realismo, ha vuelto a estudiar para acceder mejor al mercado laboral.

Pruebas de fertilidad en casa

June 4, 2007
At-Home Fertility Screening Available for Men
By RONI CARYN RABIN

Many men, faced with the prospect of going to the doctor for a fertility evaluation, will tell you: they would rather just stay home.

Now they can.

A new at-home screening test, called Fertell, lets couples find out if they have fertility problems without stepping into a doctor’s office. The test has his and hers components — a screening test for men that is the first at-home device to measure the concentration of motile sperm, and a test for women that measures a hormone considered a marker of egg quality.

The availability of the two-in-one test helps drive home the message that both men and women can contribute to infertility, experts say.

Sobre el parto

Cradle or grave
Michele Pridmore-Brown

Tina Cassidy
BIRTH
A history
320pp. Chatto and Windus. Paperback, £12.99.
978 0 7011 8119 2

Marsden Wagner
BORN IN THE USA
How a broken maternity system must be fixed to put women and children first
305pp. University of California Press. $24.95; distributed in the UK by Wiley. £15.95.
978 0 520 24596 9
Mary Briody Mahowald
BIOETHICS AND WOMEN
Across the life span
286pp. Oxford University Press. £23.99 (US $39.95).
978 0 19 517617 9

Much of birthing women’s misery can be traced to “cephalo-pelvic disproportion”. Bipedalism severely constrains our hip size – and big brains mean that even though babies are born too early in their development for anyone’s comfort, they are still likely to get stuck in the birth canal. Rather aptly known as Eve’s curse, the brain–pelvis stand-off is an evolutionary compromise that leaves little margin for error. This stand-off accounts for the fact that most women experience far more pain during childbirth than their primate cousins; for an African proverb stating that pregnant women have one foot in the grave; and for the fact that the skill of an attendant can easily make the difference between life and death. Up to the 1930s or so, it is estimated that about 1 per cent of birthing women died (and far more of their babies).

Historically, women with cramped pelvises were likely to expire into the oblivion of that 1 per cent. But one case stands out for creating a notable swerve in British royal history. In 1817, the popular and vivacious Princess Charlotte, King George IV’s twenty-one-year-old daughter, suffered from a now textbook case of cephalopelvic disproportion; two weeks overdue and weighing 9 lbs, her baby was far too big for her pelvis, and after fifty hours of active labour, he was delivered stillborn. Charlotte herself expired five hours later from internal bleeding. Since she was King George’s only legitimate child, his throne passed to his brother, and then to his niece, who became Queen Victoria. This is an oft-told tale in obstetrics – and one in which history on a grand scale was altered by the too-narrow straits of one woman’s pelvis.

Reproducción asistida

April 22, 2007
Children on Demand
By POLLY MORRICE

EVERYTHING CONCEIVABLE
How Assisted Reproduction Is Changing Men, Women, and the World.

By Liza Mundy.

406 pp. Alfred A. Knopf. $26.95.

At the start of this lucid, mostly approving look at how humans are tinkering with the age-old project of reproducing ourselves, Liza Mundy meets one of the British scientists whose tenacity in perfecting in vitro fertilization made possible the birth, nearly 30 years ago, of the first test-tube baby. The embryologist Robert Edwards charms her, and not just with his enduring zest for the procedure he helped invent. “Eye hoop they all have babies!” he declares in what Mundy, a writer for The Washington Post Magazine, calls his “wonderfully nonestablishment, workingman’s burr.” “What coood be better than a baby?”

That rhetorical question sums up an essential principle of Mundy’s book: that “having children and loving children is an unstoppable urge; that humans, or many humans, have an overpowering need to have — to be — a family.” Yet while “Everything Conceivable” is based on the proposition that people crave babies, it has a larger thesis to prove: that the increasingly complicated ways people are going about making babies is transforming babies and the world. Mundy seeks to make sense of assisted reproduction, a sprawling topic that now includes lesbian and single mothers who use sperm (and sometimes egg) donors, gay men who enlist surrogates and couples who “adopt” one of the nearly half-million frozen human embryos stored in tanks of liquid nitrogen across the United States.

Dudas sobre la infertilidad

Juancho García Velasco

El número de parejas con problemas de fertilidad es cada vez mayor. Afortunadamente, la reproducción asistida avanza con rapidez y muchos casos tienen hoy en día solución. Juancho García Velasco, director del Instituto Valenciano de Infertilidad de Madrid, respondió a las dudas de los internautas sobre este tema.

 

Deseo de procrear

April 1, 2007
Baby Lust
By PEGGY ORENSTEIN

Here is a smattering of things I did during the six-year quest to conceive my daughter: interrupt love-making to squirt raw egg whites into myself with a turkey baster (it’s reputed to abet the feminine fluid that speeds sperm to egg); substitute two teaspoons of Robitussin for my morning coffee (its main ingredient thins and loosens mucous in the lungs, and although there is no actual proof, it’s thought to work similar juju farther south); down ovulation-stimulating pills that triggered fits of rage; inject myself with the urine of postmenopausal Italian nuns (the original source of some fertility drugs, though it’s hard to imagine how the goods are gathered); chug unidentifiable herbal potions that tasted like garden mulch; squander what would have been the college fund on long-shot in-vitro-fertilization treatments; imperil my marriage.

Here is what I did not do: stock up on Häagen-Dazs. That, apparently, was my mistake. According to data gleaned from the Nurses Health Study at the Harvard School of Public Health and published earlier this year in the journal Human Reproduction, women who consume ice cream at least twice a week have a 38 percent lower risk of ovulation-related infertility than those who indulge a mere once a week. What’s more, the piously health-conscious — women who eat two or more servings of low-fat dairy products, particularly yogurt, a week — are twice as likely to have trouble becoming pregnant as those who eat less than one serving of the skinny stuff.

El negocio de la infertilidad

INFERTILIDAD: EL GRAN NEGOCIO
Cuando no se puede, siempre nos quedará la ciencia

por Paco Rego fotografías de Álvaro Villarrubia

Casi 800.000 parejas españolas, una de cada seis, tienen dificultades para concebir hijos. Muchas de ellas recurren a alguno de los 172 centros especializados de nuestro país. Sólo en 2006 han nacido 12.000 bebés por diferentes métodos de reproducción asistida. Mientras esta especialidad médica se ha transformado en un negocio –tener un niño en un centro privado puede costar hasta 25.000 euros–, expertos consultados por Magazine ofrecen sus consejos para que no fracase el método natural. Entre ellos, no obsesionarse, practicar algún deporte y «hacerlo» durante la ovulación en días alternos.

¿Niño o niña?

February 6, 2007

Second Opinion

Girl or Boy? As Fertility Technology Advances, So Does an Ethical Debate

By DENISE GRADY

If people want to choose their baby’s sex before pregnancy, should doctors help?

Some parents would love the chance to decide, while others wouldn’t dream of meddling with nature. The medical world is also divided. Professional groups say sex selection is allowable in certain situations, but differ as to which ones. Meanwhile, it’s not illegal, and some doctors are already cashing in on the demand.

There are several ways to pick a baby’s sex before a woman becomes pregnant, or at least to shift the odds. Most of the procedures were originally developed to treat infertility or prevent genetic diseases.

The most reliable method is not easy or cheap. It requires in vitro fertilization, in which doctors prescribe drugs to stimulate the mother’s ovaries, perform surgery to collect her eggs, fertilize them in the laboratory and then insert the embryos into her uterus.

Familias posmodernas

 

Postmodern families

Michele Pridmore-Brown

Rosanna Hertz
SINGLE BY CHANCE,
MOTHERS BY CHOICE
How women are choosing parenthood
without marriage and creating the new
American family
304pp. Oxford University Press. $26
0 195 17990 0

In Jane Austen’s Pride and Prejudice, Elizabeth Bennett’s ageing and still single friend Charlotte Lucas is, at twenty-seven, faced with a kind of Hobson’s choice. She must decide between accepting the marriage proposal of the pompous clergyman Mr Collins, whom she describes as neither sensible nor agreeable – and spinsterhood, which would essentially mean falling off the social landscape into a kind of wasteland. She chooses the former. Charlotte is clever, educated in the manner of her day, and eminently sensible. However, without a dowry or a strikingly pretty face to attract men with fortunes, her options are almost nil. Given her advanced age (by the standards of the time), she must not so much choose as settle for Mr Collins if she wishes to have a “respectable establishment” and children. Her virtue lies in graciously accepting her fate.

Single women have been redefining spinsterhood or rather relegating the negative connotations of the condition (being unchosen, having few options) to the dustbins of history for the past half century. Many of their latter-day sisters are reproductive entrepreneurs at the vanguard of social revolution, not because they necessarily want to be – indeed Rosanna Hertz in Single by Chance, Mothers by Choice calls them “reluctant revolutionaries” – but because marriage simply did not happen in their twenties and thirties. Either Mr Right (or Ms Right, for that matter) failed to materialize and they refused to settle for a Mr Collins – or for any variety of reasons, they found it in their best interests to separate out romantic and parenting relationships. In short, they opted for motherhood without marriage or a long-term cohabiting partner. These women are creating a new taxonomy for kin relations and family-making and, according to Hertz, quietly but irrevocably laying the groundwork for a new model of the family.