However the IVF induced pregnancy has again raised the spirits. The case of 58 year old mother brought into sharp focus the ethical and social issues involving assisted reproductive treatment programs.

It is important to bring out that Cicily lost her two children to an illness and an accident, and she has been craving for a child. The age was not on her side and the only thing she could rely on was the IVF treatment with eggs from a donor and of course hormonal therapy.

Doctors emphasis that they do not support cases like, targeting the age of a mother. However, Cicily had a specific problem and she was well informed about the potential risks.

Of course a case like this will raise many ethical questions, such as should there be an age cap for fertility treatments and whether should there be a distinction in who should be treated and who shouldn’t. Is that ethical?

After all – the family that undergoes treatment is well aware of the risk they are taking, and they are the one taking the risk. From both medical and ethical standpoint doctor has to take into account the mother’s health, her existing health conditions and the problems which mother can develop during pregnancy. Pregnancy at that age can pose a great risk not only for the newborn but for a mother too.

My thought on the case: every case is unique – every woman is unique: some are healthier in their 50s then some at the age of 20.

Congratulations to a healthy son from my heart!!

Dr. Woodruff emphasized that almost 150,000 people younger than 45 are diagnosed with cancer each year in United States.  It is not precisely known how many women and girl lose their fertility and if that specific fertility loss is directly connected with cancer because there are many factors involved, some among them are type of cancer therapy treatment, and of course the age at which treatment starts.

The main drawback for fertility in cancer treatment is chemotherapy. Chemotherapy causes infertility by attacking follicles and immature eggs in the ovaries.

Radiation treatment to the abdomen and pelvis, which is also the type of cancer treatment damages the follicles as well as the uterus. And if there is radiation treatment involved to the brain, this can disrupt the delicate hormonal balance which is needed for fertility.

There are two main and most popular options for women want to preserve fertility.

One of the most popular and most studied is egg banking. Oncofertility specialists are making egg banking available to more patients. Egg banking also is much more effective now than it was five or ten years ago, because the eggs can be frozen better. However, there are disadvantages, because egg banking is not possible for every woman. For example, girls who have not yet gone through puberty or for women who cannot postpone cancer treatment while they take hormones to stimulate production of mature eggs.

However, there is another option, which is about preserving ovarian tissue. During the procedure an ovary is removed via an operating telescope (laparoscopy) and the ovary is sliced into strips, frozen, and stored. Following cancer treatment, or whenever a woman is ready to have a child, the ovarian tissue can be thawed and transplanted back into her body. Sounds surreal, doesn’t it? But worldwide there have been about 20 live births resulting from this procedure and there were several cancer patients involved. The main advantage of this therapy is that no hormonal therapy is needed to stimulate the egg and that this therapy can be used on a child. There is a dark side: transplantation does carry the potential risk of reintroducing cancer cells back into the body, so the procedure is not recommended for women who have had ovarian cancer or blood system cancers.

However, no exact details about free IVF in Quebec have been provided yet; this includes information such as what is the date when Quebec medicare will start paying for IVF and what is the criteria (if any) that will apply for free IVF; for example will criteria include age, infertility cause, marital status and sexual orientation etc.

It is also not known whether accompanying costs such as medication, ICSI/ testicular sperm extraction (TESE), assisted hatching, donor sperm/eggs, embryo freezing/storage/thawing, etc) will be covered, and whether treatment will be funded at private clinics or only at hospital-based programs.

It is interesting that Quebec is not the first province in Canada to cover in vitro fertilization. One of the pioneers was British Columbia and Ontario that has been funding in vitro fertilization process since the beginning of 80’s. However, in mid 90’s Ontario Ministry of Health has limited the funding expenses to 3 cycles from egg retrieval to through to embryo transfer.

Additionally criteria bellow is the limiting factor.

Woman must be younger than 40 years old by the time the treatment starts. Woman must have both fallopian tubes blocked or missing but not due to sterilization which must be of course supported by medical records. Woman must be a resident of Ontario and Canadian citizen or landed immigrant or refugee. The criteria does not end here because even women who meet criteria mentioned above Ontario Health Insurance does not cover the total cost of IVF that include expenses for fertility medications, laboratory services, embryo freezing and storage, ICSI, TESE, assisted hatching etc.. These are all expenses that must be covered by the patient, and the expenses are not small at all.

What did women use for menstruation in 18th century for example? Have you ever thought of that?

Actually it is almost impossible or at least very hard to say for sure how women managed their periods not so long ago. Perhaps the reason men rule(d) the world is the fact very little is recorded about female issues such as menstruation.
Some women even used tampons, pads (“rags” and commercial ones), sponges, grass and other absorbent materials that were very probably popular for thousands of years. And very possible most American and European women used nothing: they were bleeding into their clothes or wore nothing!?

Sabine Hering and Gudrun Maierhof, in Die unpäßliche Frau (“The Indisposed Woman,” Pfaffenweiler, Germany, 1991) write that most women made their own pads. Besides, German women almost never used commercial menstrual pads in the late 19th century. Or in some cases, just like rural German women, urban women wore nothing at all – which means when they were menstruating, they were leaving a trail of blood behind them.

I would also like to bring out that we should keep in mind that prior 20th century due to life style women menstruated less frequently comparing today. To begin with, they started menstruating later – most often in late teens and they also stopped earlier, of course if they lived long enough to experience menopause.

Women married earlier, used less contraception and had more children, which reduced menstruation for longer periods of time. Additionally, they breastfeed their children for longer time which also contributed to the fact they weren’t menstruating every month.

I never thought the history of menstruation could be so… interesting? It is shocking to be remembered that what seems to be completely normal and necessity today, seemed a luxury and even non-existent century ago.

Sometimes woman even doesn’t know she had miscarriage, especially if woman doesn’t know she was pregnant.  Signs and symptoms of miscarriage are quite subtle and even undetectable.

These numbers will surprise you… Between 20% and 50% of pregnancies end in miscarriage. These numbers cannot be exactly detectable for the reason already mentioned:  symptoms of miscarriage during the early stages of pregnancy are very hard to detect. However, when pregnancy is detected approximately 10% of pregnancies ends in miscarriage, and if this happens, it is between the 7^th to 12^th weeks of pregnancy. For most miscarriages there is no known cause, some are caused because of complications and defects in the chromosomal development of the fetus, while other miscarriages are caused by infections, traumas, anatomical abnormalities and certain systemic diseases, such as diabetes. Of course some miscarriages are caused because of risky lifestyle habits such as alcohol drinking, smoking, drug abuse and even caffeine drinks. On the other hand, it is a misconception that sexual intercourse or exercise can cause abortion.

As already mentioned signs of miscarriage during the early stages of pregnancy have very few symptoms or even no symptoms. The most common sign of miscarriage includes vaginal spotting, bleeding and cramps. A lot of times early miscarriage can be mistaken for a menstrual period. Woman might also experience passing a tissue through the vagina or fluid leaking. In cases clotty tissue passes, tissue should be taken to a doctor for examination. During miscarriage woman might also experience abdominal pain or low back pain.

An ovarian cyst is a hormonal related disorder, caused by the overproduction of male hormones in the female body. Ovarian cyst may be single or multiple and it can occur in one or both ovaries. Most ovarian cysts are benign, but approximately 15 percent are cancerous. That is why examination is always necessary.

Types of Ovarian Cyst

There are five common types of ovarian cysts: functional cysts, endometrial cysts, cystadenomas, dermoid cysts and polycystic ovaries.

Functional cysts develop on follicle or corpus luteum as part of the natural function of the ovary. These cysts are not big and they usually dissolve after certain period of time.
Endometrial cysts, also known as “chocolate cysts”, because they’re filled with dark blood, form as a result of endometriosis. They continue to grow and could become as large as grapefruit. These cysts could cause an infertility.
Ovarian cystadenomas are new and abnormal formations that develop from the ovarian tissue. They could be filled with watery fluid or thick gelatinous material, growing up to 12 inches.
Dermoid cysts are also neoplasms similar to cystadenomas, with one difference. They consist of skin or related tissue such as hair, teeth or bone instead of fluid like the cystadenomas. Dermoid cysts grow between 2 and 4 inches.
Polycystic ovaries is a condition in which the follicles never erupt from the ovaries. This condition is also known as polycystic ovarian syndrome or disease (PCOS), and it’s directly linked with difficulty in conceiving.

How to Recognize Symptoms of Ovarian Cysts

Cysts may grow quietly and go unnoticed until they are found on routine examination. However, if they are ruptured or become large enough, the following symptoms may occur:

• Intense abdominal pain (symptom in all types of cysts)
• Late, bleeding between or irregular periods (symptom occurring in corpus luteum cysts and polycystic ovaries)
• Heavy menstrual flow (symptom occurring in polycystic ovaries)
• Infertility (symptom occurring in polycystic ovaries and endometrial cysts)
• Internal bleeding (symptom occurring in endometrial cysts)
• Severe menstrual cramps (symptom occurring in endometrial cysts)
• Pain with sexual intercourse (symptom occurring in endometrial cysts)
• Pain during a bowel movement (symptom occurring in endometrial cysts)
• Weight gain (symptom occurring in polycystic ovaries and endometrial cysts)

If any of symptoms is present you should visit your doctor for further tests and treatment immediately.

Treatment of Ovarian Cysts

Treatment of ovarian cysts depends on many factors, including the type of cyst, its size, location, the type of material it contains and the woman’s age.

Functional cysts usually require a “watch and wait” approach. These cysts tend to dissolve over time and treatment is not needed. The doctor may require pelvic exam and/or ultrasound after two menstrual cycles. If the cyst is still present and keeps growing (over 2 inches) the doctor may recommend a laparoscopy to remove the cyst. If functional cyst comes and goes, birth control pills may be prescribed, because they reduce the hormones that promote cysts’ growth and they also prevent formation of large cysts.

Endometrial cysts, cystadenomas and dermoid cysts should be removed surgically. If the cyst is small enough it could be removed via laparoscopy. But if the cyst is over 2 ½ inches in diameter, treatment varies from cysterectomy (removal of cyst only) to total abdominal hysterectomy, usually when cyst is cancerous.

Treatment for polycystic ovaries varies. The major symptom of polycystic ovaries is infertility, and whether the woman is trying to conceive or not determines the treatment for PCOS.
If the woman is trying to conceive, the doctor will prescribe Clomid which stimulates ovulation. If the woman is not trying to conceive, but has infrequent or no periods, the doctor will prescribe Provera, that restores normal menstrual flows.

The best advice for you is to visit your doctor regularly for routine examination, especially if you have one of the symptoms mentioned above. Ovarian cyst is not major reason for infertility, but if you’re trying to get pregnant having a cyst, you should determine the type and treatment that will help you conceiving.

Researchers have proved on animal studies that PFOS and PFOA are in close connection with toxic effects in the livers, immune systems, and reproductive systems. In people o the other hand, the same chemicals are in relation with the number of children: women who had lower levels of PFOS and PFOA in their blood had more children compared to women with higher levels of the same chemical found In blood.

Basing on their research, scientists calculated that women with the most PFOS in their blood were up to 134% more likely to have needed half year or more to conceive a baby, while females with the most PFOA were up to 154% more likely to have trouble getting pregnant.

But do not worry …

There is a solution to everything: it is possible to make your own household cleaner – a cleaner that is less toxic, less expensive and even more effective than some brand products that you might purchase.

Basically, you will need water, vinegar, washing soda, rubbing alcohol and in some cases dish detergent, borax and ammonia. With these ingredients you will be able to make your own homemade cleaners.

For example, to clean your floors, you will only need to dissolve one cup of vinegar in warm water, and the homemade cleaner is done, and works excellent on wax floors. However, if you are cleaning wood floors, use the recipe, but never put the cleaner directly on the floor. First, you must dip the mop until almost dry.

If you would like, you can combine essential oils (such as lavender or orange etc) and you get a scented home too, but I do not recommend this on wooden floor.

If you need a tough scrubbing type cleaner, you will need to sprinkle some baking soda onto the areas you want to clean.  Leave baking soda to react with the surface and after 5 minutes scrub well with a cloth.

A window cleaner can be made in a spray – at least I think it is the most practical to do so. Combine one teaspoon dish detergent, up to 5 tablespoons of vinegar and two or three cups of warm water. Shake and voila: your own window cleaner, ready to spray and clean (tip: clean windows with newspaper – works great!)

If you need a soft scrub cleaner, something that will work in your bathroom and will clean sinks and bathtub, combine 1 tablespoon of baking soda and one teaspoon of dishwashing detergent. Mix well and apply on surface – leave there for about 5 minutes to react with the surface and scrub well with a cloth.