Re: The Rhythm Method And Embryonic Death
From: art fougner, md (evsono@pipeline.com)
Tue Jun 13 11:55:00 2006
Excellent post and points, Dean. Since it's estimated that 25% of all
conceptions miscarry, is God an abortionist?
art
At Tue, 13 Jun 2006, Dean Huffman . wrote:
>
>.
>
>Article in NY Times can be found at:
>http://www.nytimes.com/2006/06/13/health/13rhyt.html?pagewanted=2
>
>Article by Bovens can be found at:
>http://jme.bmjjournals.com/cgi/reprint/32/6/355
>
>--
>
>A Philosopher's Take on the Rhythm Method Is Rattling Opponents of Abortion
>
>The Rhythm Method and Embryonic Death
>
>(Journal of Medical Ethics) Luc Bovens, a philosopher at the London School of
>Economics, argues in the Journal of Medical Ethics that couples who try to
>prevent pregnancy by avoiding sex during the woman's most fertile time of month
>may be more likely to produce embryos that do not develop or implant in the
>womb.
>
>If this is correct, he writes, then "millions of rhythm method cycles per year
>globally depend for their success on massive embryonic death."
>
>Those who worry about early embryonic death should be as concerned about the
>rhythm method as they are about other forms of contraception, like Plan B, and
>about embryonic stem cell research, he asserts.
>
>Dr. Bovens's article has drawn swift response from abortion opponents in the
>United States and the United Kingdom, many of whom are proponents of natural
>family planning, an outgrowth of what was once called the rhythm method.
>
>These critics have taken aim at Dr. Bovens's analogy between early embryonic
>deaths that may occur because of the timing of intercourse and losses that may
>result from the use of contraception. They have also questioned the assumption
>that embryos conceived on the fringe of a woman's fertile window are less
>likely to be viable.
>
>Fertility experts say that there is little evidence to support this assumption
>but that there are some indications it may be valid.
>
>Dr. Bovens uses the term rhythm method to refer to any approach that allows
>couples to predict the woman's most fertile time of month, so that they can
>abstain from sex during that time. Traditionally, the term referred more
>narrowly to a strategy of counting calendar days from the woman's menstrual
>period, to estimate ovulation.
>
>Natural family planning is the more widely used, contemporary term for the broad
>range of techniques aimed at helping women to predict fertile days so they can
>avoid having sex then. These techniques may rely on cues like the presence of
>cervical mucus or small changes in body temperature, which occur around the
>time of ovulation. Dr. Bovens notes that some couples choose this approach
>because they worry that other forms of contraception, like birth control pills,
>may act in part by preventing an early embryo from implanting in the womb.
>
>However, if a fertilized egg produced on the fringe of the fertile window is
>less likely to develop and implant, he writes, "the same logic that turned
>pro-lifers away from morning after pills, I.U.D.'s and pill usage should make
>them nervous about the rhythm method."
>
>Dr. Bovens also contends that opponents of abortion ought to favor barrier
>methods, like condoms, because these are likely to cause fewer embryonic
>deaths. "Even a policy of practicing condom usage and having an abortion in
>case of failure would cause less embryonic deaths than the rhythm method," he
>writes.
>
>Joseph B. Stanford, an associate professor at the University of Utah School of
>Medicine who is against abortion, said Dr. Bovens's reasoning was flawed.
>
>There is a difference, he argued, between forming an embryo that is not viable —
>which may occur for couples using any form of family planning, including natural
>family planning — and taking an action, like using emergency contraception or
>birth control pills, that could prevent a viable embryo from developing. "For
>me, it's sort of like the difference between a miscarriage and an induced
>abortion," he said.
>
>Dr. Stanford and other critics also question Dr. Bovens's central assumption,
>that embryos formed outside of a woman's most fertile period are less likely to
>be viable. Fertility experts, too, say there is little direct evidence to
>support this assumption, though some believe it is possible.
>
>Roger G. Gosden, professor of reproductive medicine in obstetrics and gynecology
>at the Weill Medical College of Cornell University, said there were no "really
>solid studies demonstrating that the time of conception is related to the
>probability of conceiving a healthy conceptus."
>
>But, he added, "there are numerous indications that this is the case."
>
>A woman is most likely to become pregnant if she has sex close to the time of
>ovulation, and especially during the two to three days before the egg is
>released from the ovary. The egg is viable for only about 24 hours after
>ovulation. And if it is fertilized toward the end of that period, it is less
>likely to develop, possibly because of chromosomal errors, Dr. Gosden said.
>
>More specifically, he added, there is evidence that when an egg lingers in the
>reproductive tract, the cell's spindle apparatus, which holds the chromosomes,
>may weaken, causing the chromosomes to fall off. This may increase the
>likelihood of an abnormal chromosome number, should fertilization occur.
>
>In addition, there is an optimal window for implantation, roughly seven days
>after ovulation, Dr. Gosden said. Outside of this window, implantation is
>unlikely to occur, probably because of changes in the receptivity of the lining
>of the uterus.
>
>"Life is very tentative in its early, tender stages. It takes on a whole
>different significance and security" later on, he said.
>
>Fertility experts also cite work by Allen J. Wilcox of the National Institute of
>Environmental Health Sciences as evidence that when conception occurs at the
>later end of the woman's fertile period there may be an increased risk of
>embryonic loss.
>
>In a 1998 article published in Human Reproduction, Dr. Wilcox found that the
>loss of early embryos increased as the eggs got older.
>
>In an e-mail message, Dr. Wilcox said, "While our result is preliminary, the
>risk of pregnancy loss does seem to be highest on the last fertile day of the
>cycle."
>
>He added, "And it stands to reason that, if couples abstaining through their
>fertile days make a mistake, they are more likely to have intercourse on that
>last fertile day than on earlier days."
>
>The effectiveness of natural family planning techniques is said to range from
>greater than 90 percent for perfect practice to roughly 75 percent for typical
>practice. If implantation occurs, the users of natural family planning do not
>appear to be at higher risk of spontaneous abortion (or miscarriage).
>
>Ronald H. Gray of the Johns Hopkins Bloomberg School of Public Health called the
>evidence on this point "a mixed bag."
>
>In a 1995 study in the American Journal of Obstetrics and Gynecology, Dr. Gray
>found that women with a history of miscarriage and who had had "a conception
>distant from the day of ovulation" were more likely to have a pregnancy loss.
>But, the same did not seem to be true for women with no history of miscarriage.
>
>John Harris, editor of the Journal of Medical Ethics, said it was not clear
>whether Dr. Bovens's empirical assumptions were correct. But he said he hoped
>the article would foster debate. Our "whole attitude to the embryo is
>inconsistent and needs to be rethought," he said.
>
>Roughly 50 percent of naturally occurring conceptions do not result in
>implantation or a viable pregnancy, experts say. In many cases, the loss occurs
>so early that a woman has her period on schedule and does not even know that she
>has conceived.
>
>But Judie Brown, president of the American Life League, said that these issues
>were beside the point.
>
>Pregnancy, she said, is "a very natural process and so is the natural selective
>process that our body goes through to eliminate, for whatever reason, an embryo
>during the first few days of life."
>
>"There is nothing bad about that," she said. "There is nothing even to be
>debated about that. That is the way nature works."
>
--
art fougner, md
"I drank what?" - Socrates
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