Tips for Dealing with Online Pornography

There are many steps you can take to safeguard your children and teenagers from pornography on the Internet. First, your family should establish rules regarding Internet use. It can be helpful to create an online agreement.

It is also important to discuss the dangers of pornography with your children and teenagers. They should be warned about sexual predators and taught how to protect themselves from exploitation.

Safety Rules

In the Federal Bureau of Investigation's A Parent's Guide to Internet Safety, parents are recommended to teach their children the following safety rules:

• Never arrange a face-to-face meeting with someone you meet online.
• Never upload pictures of yourself onto the Internet to people you don't personally know.
• Never give out identifying information such as your name, home address, school name, or telephone number.
• Never download pictures from an unknown source, as there is a good chance there could be sexually explicit images.
• Never respond to messages or bulletin board postings that are suggestive, obscene, belligerent, or harassing.
• Whatever you are told online may or may not be true.

Protecting your Child or Teen from Internet Pornography and Victimization:

• Talk to your child or teenager about sexual victimization and potential on-line danger.
• Spend time with your children online. Have them teach you about their favorite web sites and teach them about the responsible use of online resources.
• Keep the computer in a common room in the house, not in your child's bedroom.
• Utilize parental controls provided by your service provider and/or blocking software.
• Monitor your child's use of chat rooms. Chat rooms are often prowled by sex offenders.
• Maintain access to your child's online account and randomly check his/her e-mail. Be up front with your child about your access and the reasons why.
• Find out what computer safeguards are utilized by your child's school, the public library, and at the homes of your child's friends.
• Understand, even if your child or teen was a willing participant in any form of sexual exploitation, that he/she is not at fault and is the victim. The offender always bears the complete responsibility for his or her actions.

source : The Federal Bureau of Investigation's A Parent's Guide to Internet Safety

Internet or Computer Addiction -- Break Addiction

How can you break addiction to the Internet?

The first step is recognizing that there is a problem. Overcoming denial should be followed by other treatment steps, including:

• Identifying specific problem areas
• Generating a behavior modification plan, such as setting a timer for usage, planning a daily schedule, keeping a log of moods when going online, matching time spent online with time spent socializing face-to-face and taking part in non-computer related activities
• Focusing on other areas for needed skill enhancement, such as problem solving, assertiveness, social skills, overcoming shyness, anger control
• Assessing for other disorders like depression or anxiety that may need medical treatment.
• Assistance in locating or forming a support group for other people who are trying to regain control over their computer use.

If you suspect you are addicted to the Web, consult a therapist in your area, preferably one who specializes in addiction. In addition, you might join a support group. One online group can be found at the Center for Internet Addiction Recovery.

Dr. David Greenfield offers suggestions to help manage Internet use before it becomes a problem:

• Consider taking a technology holiday
• Find other interests
• Exercise
• Watch less television
• Talk to your friends and family about what is happening in your life
• Try counseling or psychotherapy to assist you in dealing with the addictive behavior
• Consider a support group
• Develop new relationships and friendships
• Talk to others about your overuse of the Internet
• Shorten your Internet sessions

How can I help computer-obsessed friends?

• Be a good role model. Manage the computer use in your own life well
• Introduce them to some other people who are fun, interesting, and who handle their computer use sensibly.
• Get them involved in some non-computer related fun.
• Support their desire for change if they think they have a problem.
• Encourage them to seek professional counseling.

source: http://www.helpguide.org/

Strategies to Trap and Hold Viewers by Internet Pornography and Cybersex

While offensive and distasteful to many users, most Internet porn is not illegal. Countries have different cultural standards and legislation regarding sexual material, and content that is banned in one jurisdiction may be easily accessible on servers in another.

For parents, one of the most disturbing aspects of the Internet is the easy access it gives kids to porn. Hard-core sexual images, which were once very difficult to acquire, are now just a mouse click away. Teens, particularly adolescent males, have always been driven by natural curiosity to seek out pornography. This hasn't changed. What's different is the easy access the Internet gives kids to deviant or violent sexual content, which may have an influence on their developing attitudes towards sexuality and relationships.

The Strategies

The online porn industry uses many strategies to promote use of their sites, including:

• Pop-up windows: trap users in an endless loop of porn.
• Home page hijacking: (planting a Java script command on computers to change the user's default home page to a porn site). Changing the home page back to its original setting appears to solve the problem until the computer is rebooted; then the offensive site re-appears as the home page.
• Stealth sites: a variety of techniques, including buying up expired domain names, exploiting common misspellings, or using well-known names of companies or artists.
• Hidden key words that are picked up by search engines: Porn operators bury key words, including brand names of popular toys or names of pop artists, in the code of their Web sites to lead children and teens to their sites.

source: http://www.helpguide.org/

Cyber Brain Washing

Knowing what can happen to you, your friends or even your children won’t necessarily help. Heavy users will tell you that the Net will change you. If you spend enough time on-line, the rest of the world starts to look unreal or strange. You may not even notice the change. There is no sure way to know if you will get hooked or how long it can take. Here’s how it happens.

Prolonged chats on-line and mouse clicking on the Internet will produce what psychologist call a dissociative state. Net users separate from reality and enter cyber reality. Anyone with children has seen how children can watch television for countless hours. Children and even adults watching television long enough will enter a "hypnotic trance." They "meld" into the television and disconnect from reality. Limited use is a form or healthy recreation or escape. Prolonged and repeated use can create problems.

People can disappear into a good book or a movie, but there is always an end to a book or a movie. The Internet is especially addictive because the Net is endless, interactive, social and exploding with never ending images and information. The Net offers exciting relationships 24 hours a day all over the world. Before the Internet children and couples stopped working and talking with their friends after dark. Spending the evening together reading, playing games and watching television together was the norm. But not anymore.

How do people get caught up in the Net? For one thing, human beings are curious. We like to see more and do more. Many of us like to travel. When we can’t travel, we like to read books and go to movies. We like to feel competent and in control. Human beings like to feel better and they don’t like to feel bad. We like to do things that feel good and avoid things that feel worse. We especially like doing pleasurable things more and more. Being on the Internet is not necessarily about having a good time. Being on-line might make you feel better but it might just change how you feel. It can be an escape from reality that isn’t necessarily better for you. For some people, a painful or disgusting fantasy is preferable to a less painful or disgusting reality.

Have you ever noticed that some people watch television even when there is nothing good to watch. And instead of turning the TV off, they resort to channel switching. The act of switching channels repeatedly is an annoying process that makes the rest of us want to leave the room or take the remote control away from somebody. The Net is a lot like television only the Net is timeless, interactive, challenging and endless.

Psychologists explain the seduction and addictive nature of the Net primarily in terms of a behavior modification process called a variable reinforcement schedule. That means you don’t know how much of a reward you will get and when for your behavior. A variable reinforcement schedule is the most addictive reward system. Slot machines are designed and operate in the same principle.

When you keep playing a slot machine, the odds are that you will eventually loose everything. But the human brain loves the possibilities and excitement of "winning" in the moment and it ignores the long term consequences. The occasional win doesn’t make up for the overall loss. People play anyway because the occasional win is highly rewarding for those who play long enough. Some people can walk away and stay away. Other can’t walk away or they always come back.

The Internet is also more addictive than a slot machine – especially once they begin to master the technology. Playing on the Net can give you self-confidence. A slot machine doesn’t. The most common rewards from a slot machine are those curious noises, spinning pictures and flashing lights. Once in a while a person wins some money.

Would you believe it, a cable modem is more addictive than a slower dial-up modem. Most people had no patience for the Internet when they had a dial up modem. The rewards were slow and boring. That changed when high speed modems allowed for rapid "clicking" and responses. People with high speed modems are now disappearing into a world where they wait anxiously for the result of the next click. The surprise, shock value and speed in which a person gets these "hits" of information and imagery are the key to creating a compulsion and addiction. Time begins to have no meaning when your next "hit" is just a "click" away. There is no time to think about something else you could or should be doing - unless you are waiting. People don’t think of what else they should be doing and they increasingly find there is always time for one more click and one more chat.

More than a slot machine, everything on the Internet is an adventure with social opportunities. It can be mildly or tremendously exhilarating. People feel rewarded when they finally figure it out why their software or a web site is not working. Every improvement in your skills including upgrades in software and your access to new and exciting links can produces a mind altering change in your brain chemistry. The most powerful change is called a dopamine rush. Dopamine is a chemical in the brain that controls brain function including decision making, impulsiveness, and it is released when you experience certain stimulation. It can improve your mood, confidence and produce a feeling of pleasure.

source: http://www.crisiscounseling.com/

Internet or Computer Addiction

What is Internet or Computer Addiction?

• A student has difficulty getting his/her homework done because computer games occupy all after-school time.
• Someone connects to the Internet at 9:00pm and suddenly discovers it is dawn and he/she has not left the computer.
• A wife is distraught because her husband has replaced their sexual relationship with Internet porn and online sex.

Searching for information, skimming news headlines, downloading your favorite songs, or placing bids on eBay … the options are endless. We all enjoy the benefits of the Internet. But at what point does frequent online activity become too frequent and become a source of significant problems in someone’s life? Internet addiction is generally defined as spending so much time online that Internet use adversely affects marriages, family and social life, work, and psychological and physical well-being.

What are signs and symptoms of Internet or Computer Addiction?

As with any other addiction, a computer addict is likely to have several of the experiences and feelings on the list below. How many of them describe you or someone close to you?

• Have mixed feelings of well-being and guilt while at the computer.
• Lose control of time while on the computer; want to quit or cut down, but are unable to.
• Neglect friends, family and/or responsibilities in order to be online.
• Lie to your boss and family about the amount of time spent on the computer and what you do while on it.
• Feel anxious, depressed, or irritable when your computer time is shortened or interrupted.
• Use the computer repeatedly as an outlet when sad, upset, or for sexual gratification.
• Develop problems in school or on the job as a result of the time spent and the type of activities accessed on the computer.
• Have financial problems due to on-line purchases or gambling.
• Become tempted to get involved in relationships with strangers, which may put you at risk for victimization or jeopardize your safety.

What are physical or medical problems associated with Computer Addiction?

Being addicted to the computer also can cause physical discomfort or medical problems:

• Carpal Tunnel syndrome (pain, numbness, and burning in your hands that can radiate up the wrists, elbows, and shoulders)
• Dry eyes
• Backaches
• Severe headaches
• Eating irregularities, such as skipping meals
• Failure to attend to personal hygiene
• Sleep disturbances

Who is most at risk for Internet addiction?

According to the Center for Internet Addiction Recovery, Internet addiction affects people of varying ages, cultural backgrounds, occupations, and educational levels. The following problems are likely triggers for internet addiction:

• Substance Abuse. Over half of Internet addicts suffer from other addictions, mainly to drugs, alcohol, smoking, and sex.
• Mental Illness.Trends show that Internet addicts suffer from emotional problems such as depression and anxiety-related disorders and often use the fantasy world of the Internet to psychologically escape unpleasant feelings or stressful situations.
• Relationship Troubles. In almost 75% of cases, Internet addicts use applications such as chat rooms, instant messaging, or online gaming as a safe way of establishing new relationships and more confidently relating to others.

source: http://www.helpguide.org/

Infertility -- Fast Facts

• Approximately 6.1 million couples in the United States ‑- or 10 percent of all couples of childbearing age ‑- have difficulty conceiving, according to the National Women's Health Resource Center (NWHRC).
• About one-third of infertility cases can be attributed to males, another one-third to females and the remaining one-third to both members of a couple. At least 10 percent of infertility cases go unexplained, although these couples often later succeed in becoming pregnant.
• Ovulation abnormalities and sperm deficiencies are responsible for two-thirds of infertility problems.
• About 20 percent of infertility cases are the result of fallopian tube disease, according to the NWHRC.
• Between 30 and 40 percent of women with endometriosis are infertile, according to the National Institutes of Health (NIH).
• The sexually transmitted diseases (STDs) chlamydia and gonorrhea are the most important preventable causes of infertility, according to the U.S. Centers for Disease Control and Prevention (CDC).
• Between 75 and 85 percent of fertility problems are diagnosed after a patient's initial evaluation.
• Most women are about 30 percent less fertile in their late 30s than they were in their early 20s, according to the National Women's Health Resource Center.
• In 85 to 90 percent of all cases, infertility is treated with either medication or surgery, according to the NWHRC. Just 5 percent of infertility treatments involve in vitro fertilization or other kinds of assisted reproductive technologies, in which a laboratory is used to try to help a couple become pregnant.
• More than 70,000 babies have been born in the United States using assisted reproductive technologies, including 45,000 born as a result of in vitro fertilization, according to the NWHRC.
• Women are most fertile during ovulation, which occurs around the 14th day of their menstrual cycle. However, the exact time of ovulation varies among women due to normal differences in the length of the menstrual cycle.
• When no fertility problems are present, the average couple between ages 29 and 33 has about a 20 to 25 percent chance of becoming pregnant during any given menstrual cycle, according to the NWHRC.
• The greatest odds of fertilization occur in the first 12 hours after the sperm are ejaculated in the vagina. However, sperm can fertilize the egg for up to 72 hours after ejaculation.

source: http://health.ivillage.com/

Low-Tech Ways to Help You Get Pregnant

Getting pregnant can be difficult for some people. If you suffer from infertility you may need a whole range of services to help you conceive. Usually most doctors start with simple ideas before resorting to big guns like in vitro fertilization. Here are 10 low-tech things that might help you conceive if your are having trouble getting pregnant.

1. Ovulation Prediction

Figuring out exactly when you ovulate is important to getting pregnant. Rather than leaving it up to random chance each moth, if you have sex near ovulation you will increase your chances of getting pregnant with each menstrual cycle. It can also be done using a basal body temperature (BBT) thermometer.

2. Men should wear boxers

Don't laugh -- the oft recommended boxer shorts versus briefs is actually a helpful thing for men. This can help prevent overheating of the testicles, which can damage sperm.

3. Baby Making Sex

Are you timing intercourse to meet with ovulation? Are you using the best positions to enhance the positioning of the sperm near the cervix? These simple factors can influence your ability to conceive.

4. Female Orgasm

We know that the man needs to have an orgasm for pregnancy to occur, but did you know that female orgasm is also relevant to conception? Her orgasm actually helps draw the semen into the cervix. So be sure that you're not forgetting this part of the process.

5. Elevate your hips after intercourse

It truly is beneficial if you can elevate your hips and buttocks after having sex. This keeps the semen closer to the cervix and prevents leakage of this precious fluid. It really only needs to be done for about 20 minutes. It can easily be accomplished by propping your hips up on a pillow and laying in bed for a bit. Try a quick nap or some pillow talk to make the time go more quickly.

6. Are there other signs of ovulation?

Check for other signs of ovulation like cervical fluid changes. Remember the stretchy, copious cervical fluid is indicative of ovulation and being fertile. A lack of cervical fluid, or dry, sticky mucous is more non-fertile mucous. There are also other signs like mittelschmertz, or "middle pain," a small abdominal pain sometimes felt by women at the time of ovulation.

7. Don't douche

Douching is actually harmful to conception. It can aggravate some types of infection and disturb the normal state of the vagina, making it more difficult to conceive. If you douche, you may want to discontinue this practice.

8. Exercise?

Exercise is a great way to stay healthy and to keep your weight under control. But too much exercise can cause problems with conception, including amenorrhea, or no periods. If you are having odd cycles you may want to back off of strenuous exercise and see if there is a difference in your periods.

9. Overall health

Have both you and your partner had a physical to check for potential problems in conceiving? This might include a check for previous sexually transmitted infections or diseases (STI/STD) which can cause silent problems with your fertility like internal scarring of the reproductive tissues. They will also talk to you about staying healthy to get pregnant.

10. What's going in your mouth?

Is any medication you are taking interfering with your fertility? This goes for you and your partner. Not only does it mean prescription medications, but also social and recreational drugs like alcohol and tobacco. You may also want to see a nutritionist for help in making sure your diet is just right in getting pregnant.

Source: http://infertility.about.com/

Infertility -- Coping Skills

Coping with infertility can be difficult. It's an issue of the unknown — you can't predict how long it will last or what the outcome will be. Infertility isn't necessarily solved with hard work. The emotional burden on a couple is considerable, and plans for coping can help.

Planning for emotional turmoil

• Set limits. Decide in advance how many and what kind of procedures are emotionally and financially acceptable for you and your partner and attempt to determine a final limit. Fertility treatments may be expensive and often not covered by insurance companies, and a successful pregnancy often depends on repeated attempts. Some couples become so focused on treatment that they continue with fertility procedures until they are emotionally and financially drained.
• Consider other options. Determine alternatives — adoption, donor sperm or egg, or even having no children — as early as possible in the fertility process. This can reduce anxiety during treatments and feelings of hopelessness if conception doesn't occur.
• Talk about your feelings. Locate support groups or counseling services for help before and after treatment to help endure the process and ease the grief should treatment fail.

Managing emotional stress during treatment

• Acupuncture. This ancient therapy may benefit couples who are undergoing fertility treatment.
• Practice relaxation. Cognitive behavior therapy, which uses methods that include relaxation training and stress management, has been associated with higher pregnancy rates.
• Express yourself. Reach out to others rather than repressing guilt or anger.
• Stay in touch with loved ones. Talking to your partner, family and friends can be very beneficial. The best support often comes from loved ones and those closest to you.

Managing emotional effects of the outcome

• Failure. The emotional stress of failure can be devastating even on the most loving and affectionate relationships and for people who've prepared well for the possibility of failure. Don't hesitate to seek professional help if the emotional burdens become too heavy for you or your partner.
• Success. Some studies have indicated that even if fertility treatment is successful, women experience increased stress and fear of failure during pregnancy. Other research suggests that women who achieved pregnancy using fertility treatments felt increasingly better and had higher self-esteem and less anxiety as the pregnancy progressed than did women whose pregnancies didn't involve medical intervention.
• Multiple births. A successful pregnancy that results in multiple births introduces new complexities and emotional problems. The risk of depression is higher in women who have multiple births.
• Parenting. Once a child arrives, parents are more likely to be more anxious and have less confidence and self-esteem. Discuss becoming parents with your partner and plan for the many changes — challenging and rewarding — that a child will bring to your lives.

source: http://www.mayoclinic.com/

Infertility -- Complications and Prevention

You and your partner have tried for months, perhaps for even more than a year. But despite sexual intercourse without birth control, you've been unable to conceive a child.

If you've been trying to conceive for more than a year, there's a good chance that something may be interfering with your efforts to have a child. Infertility, also known as subfertility, is the inability to conceive a child within one year. Infertility may be due to a single cause in either you or your partner, or a combination of factors that may prevent a pregnancy from occurring or continuing.

Infertility differs from sterility. Being sterile means you're unable to conceive a child. With sterility, you or your partner has a physical problem that precludes the ability to conceive. A diagnosis of infertility simply means that becoming pregnant may be a challenge rather than an impossibility.

Complications

Complications of being infertile often involve strong emotions and may trigger negative feelings between you and your partner. These may include:

• Depression
• Guilt
• Anger
• Stress
• Disappointment
• Resentment
• Blame
• Fear of losing partner because of infertility
• Diminished confidence and self-esteem

Prevention

Most types of male infertility aren't preventable. However, avoid drug and tobacco use and excessive alcohol consumption, which may contribute to male infertility. Also, high temperatures can affect sperm production and motility. Although this effect is usually temporary, avoid hot tubs and steam baths.

If you're a man who's uncertain about whether you would eventually like to become a father, don't undergo permanent sterilization, such as a vasectomy. Although surgery to reverse this condition is possible, risks are involved that could affect fertility in other ways.

A woman can increase her chances of becoming pregnant in a number of ways:

• Exercise moderately. Regular exercise is important, but if you're exercising so intensely that your periods are infrequent or absent, your fertility is likely to be impaired.
• Avoid weight extremes. Being overweight or underweight can affect your hormone production and cause infertility.
• Avoid alcohol, tobacco and street drugs. These substances may impair your ability to conceive or produce a healthy child. Don't drink alcohol or smoke tobacco. Avoid illegal drugs such as marijuana and cocaine.
• Limit medications. The use of both prescription and nonprescription drugs can decrease your chance of getting pregnant or keeping a pregnancy. Talk with your doctor about any medications you take regularly.

Source: http://www.mayoclinic.com/

The Relationship Between Age and Fertility

Delayed child bearing is becoming increasingly common in western societies for several reasons: many couples prefer to rear their children only after establishing a stable relationship and financial security, also, there are increasing numbers of late and second marriages.

Although pregnancies in women approaching 50 and beyond are occasionally reported, there is a decrease in fertility (the ability to achieve a pregnancy) with advancing age. The decline is gradual over the reproductive life span of the woman; it is particularly noticeable over the age of 30 and accelerates between 35 and 40 so that fertility is almost zero by the age 45.

The risk of miscarriage is also increased with ageing e.g. the risk of miscarriage at age 25-29 years is 10% while the risk at age 40-44 is 34%. Furthermore, advanced maternal age is associated withan increased risk of chromsomally abnormal offspring.

Why does fertility decline with increasing age?

• Ageing of the ovaries is the most prominent factor and is part of the normal ageing changes that affect all organs and tissues. Most women have about 300,000 eggs in their ovaries at puberty. For each egg that matures and is released (ovulated) during the menstrual cycle, at least 500 eggs do not mature and are absorbed by the body. By the time the woman reaches menopause which usually occurs between 50-55 years, there are only several thousands eggs remaining. As the woman ages, the remaining eggs in her ovaries also age, making them less capable of fertilization and their embryos less capable of implanting.
• Fertilization is associated with a higher risk of genetic abnormalities e.g. chromosomal abnormalities such as Down syndrome with increasing age. The risk of a chromosomal abnormality in a woman age 20 years is 1/500 while the risk in woman age 45 is 1/20.
• Gynecological problems such as pelvic infection, tubal damage, endometriosis, fibroids, ovulation problems etc tends also to increase with age. As the woman gets older, she has more time to develop these conditions, which will adversely affect her fertility.
• Sexual function is also decreased with ageing e.g. libido, frequency of intercourse etc.
• The effect of ageing in endometrial receptivity (ability of the endometrium to receive the embryo) is controversial. There is increasing evidence that the receptivity decreases with age.
• Ageing does not just affect women, but also men to a much lesser degree. It affects sperm and coital frequency. There is no maximum age at which men are not capable of conceiving a child.
• Advanced maternal age increases the risk of autosomal dominant diseases such as Marfans syndrome, neurofibromatosis and achondroplasia.

Investigation of infertility in older women

• It is advisable to seek the advice of your doctor/ specialist sooner than later so investigations and treatment can be started without undue delay.
• Several tests may be useful in assessing the fertility potential in older woman e.g. blood tests to examine the levels of the hormones FSH, LH, estradiol and inhibin on day 3 of your menstruation.
• You will be more likely to be counseled about the risk of miscarriage and chromosomal abnormalities in relation to your age. In addition to the potential complications of pregnancy such as high blood pressure, bleeding and diabetes.

Treatment options for infertility in older women

There are limited options for treating older women who are menopausal or perimenopausal. Older women usually respond poorly to ovarian stimulation and the live birth rates even with IVF treatment are significantly lower than with younger women.

Age	40	41	42	43	44 or over
Live birth rate per egg collection	15%	11%	8%	5%	2%

Data adapted from SART report 2000

In addition, older are at increased risk of having medical problems in their pregnancies and deliveries. In order to improve the success rate of IVF treatment in older women, some clinics recommend assisted hatching, blastocyst embryo transfer, preimplantation diagnosis and only transfer normal embryos. Furthermore in some countries the transfer of high number of embryos is recommended. Other options of treatment include:

• Egg donation using eggs donated by younger woman.
• Embryo donation if the male partner also has a sperm problem.
• Surrogacy if a woman (traditional surrogate) agrees to become pregnant using the male partner sperm and her own eggs.
• Adoption and foster care.
• Accepting child-free living.

source: http://www.ivf-infertility.com/

Infertility -- Risk Factor

Many of the risk factors for both male and female infertility are the same. They include:

• Age. Age is the strongest predictor of female fertility. After about age 32, a woman's fertility potential gradually declines. A woman does not renew her oocytes (eggs). Infertility in older women may be due to a higher risk of chromosomal abnormalities that occur in the eggs as they age. Older women are also more likely to have health problems that may interfere with fertility. The risk of miscarriage also increases with a woman's age. A gradual decline in fertility is possible in men older than 35.
• Tobacco smoking. Women who smoke tobacco may reduce their chances of becoming pregnant and the possible benefit of fertility treatment. Miscarriages are more frequent in women who smoke.
• Alcohol. There's no certain level of safe alcohol use during conception or pregnancy.
• Body mass. Extremes in body mass — either too high (body mass index, or BMI, of greater than 25.0) or too low (BMI of lower than 20.0) — may affect ovulation and increase the risk of infertility.
• Being overweight. Among American women, infertility often is due to a sedentary lifestyle and being overweight.
• Being underweight. Women at risk include those with eating disorders, such as anorexia nervosa or bulimia, and women following a very low-calorie or restrictive diet. Strict vegetarians also may experience infertility problems due to a lack of important nutrients such as vitamin B-12, zinc, iron and folic acid. Marathon runners, dancers and others who exercise very intensely are more prone to menstrual irregularities and infertility.

source: http://www.mayoclinic.com/

Infertility -- The Different Causes

The goals of evaluating infertile couples are to determine the cause of infertility and hence make recommendations about the treatments available and evaluate the chances that such treatments will help. In approximately 30% of infertile couples, the cause is identified only in the female and in 30% the cause is identified only in the male. In 30% of couples, causes can be detected in both partners. In about 10% of cases, the underlying cause is not yet found by the current diagnostic methods. Test.

source: http://www.ivf-infertility.com/

Ovulation -- Detection

The initial infertility evaluation should always try to document ovulation. This can not always be done with absolute certainty. The human egg is microscopic. This means that it is invisible to the naked eye and cannot be seen without the aid of a microscope. Therefore, when you think about it the only real way to absolutely confirm the egg's release from the ovary is to achieve a pregnancy or to identify the egg under the microscope after flushing the microscopic egg out from the pelvis, fallopian tube or uterus (which is possibly immoral and certainly both impractical and difficult).

Useful methods of documenting ovulation

1. Obtaining the history of regular menstrual cycle intervals off all medication.

This is the oldest technique of documenting ovulation and it is both simple and fairly reliable. Additional support occurs if each menstrual flow is consistent in amount, there are premenstrual symptoms reflecting that hormonal shifts are occurring, and the menstrual intervals have been regular for a long period of time (eg., years). It should be confirmed that the cycle intervals are regular off all medication since some medications regulate the menstrual cycle (such as birth control pills).

2. The basal body temperature (BBT) record

This is another potentially useful source of information about ovulation. A woman's early morning temperature increases a little more than a half degree Fahrenheit after ovulation due to the effect of increased progesterone on her temperature regulator (which is in the hypothalamus of the brain). Typically, the woman's temperature rises from less than 98 degrees (prior to ovulation) to greater than 98 degrees (after ovulation). The classic biphasic pattern on the BBT record is good supportive evidence that ovulation is occurring. Unfortunately, up to 10% of women may not have a biphasic BBT record despite regular ovulation.

3. Cervical mucus characteristics

The cervical mucus is strongly influenced by estrogen and progesterone. The most commonly noted changes that can be seen by a woman include amount and elasticity (stringy quality) of the mucus. Just prior to ovulation, there is abundant elastic clear mucus at the cervix, the time of "maximal wetness." In my experience, there are only a relatively small handful of women sufficiently motivated to consistently check for changes in mucus. Although popular in some circles, I have not encouraged use of this method of detecting ovulation

4. Ovulation predictor kits

A modern and accurate way to test for ovulation relies on detection of the LH surge with ovulation predictor kits. The sudden increase in circulating LH when there is a mature egg in the ovary triggers that egg to undergo the final maturational steps that allow it to become fertilized by sperm and also triggers the egg's release from the ovary. One advantage of the ovulation predictor kits is detection prior to ovulation. These kits become positive about a day prior to ovulation since the circulating LH must be metabolized, processed through the kidneys and excreted from the bladder in urine to allow for detection. The ovulation predictor kits are useful in timing intercourse or artificial inseminations with sperm.

5. Random luteal phase progesterone concentration

The luteal phase of the menstrual cycle is characterized by high circulating progesterone concentrations. The uterine endometrium undergoes structural changes in the presence of progesterone that can be seen histologically (under the microscope). Pathologists can date the endometrium with respect to the day of ovulation with good accuracy. Therefore, a luteal phase endometrial biopsy has been used to confirm ovulation. Also, a random serum progesterone concentration in the luteal phase may confirm ovulation. One disadvantage of the random serum progesterone concentration is that the level is pulsatile with large changes every 5-15 minutes, so that if you obtained 3 different serum levels on the same day you could receive three very different concentrations. Cutoffs for deciding that ovulation has occurred are controversial with a wide range of accepted values from about 4 ng/ml to 10 ng/ml.

Additional techniques

The other available methods of ovulation detection are considerably more involved and are rarely warranted in the clinical setting. The additional effort and expense of this testing can be significant and the additional information gained is usually not useful clinically. These additional techniques include

1. Serial ultrasonography,

Daily transvaginal sonograms look for the development and eventual collapse of an ovarian follicle. This is expensive, time consuming and not much more informative than the ovulation predictor kit. It is also not uncommon to "miss ovulation" since the follicle can collapse with the release of the egg and reaccumulate with fluid to form the corpus luteum cyst (which can look like a follicle) between ultrasounds.

2. Frequent blood sampling,

Blood can be sampled up to every few (usually 10-15) minutes for days looking for subtle changes in hormone values that reflect ovulation. This testing is the "gold standard" for ovulation detection but is usually only useful in research where the additional gathered information may change the research findings. Clinically, this level of precision is not needed.

3. Flushing the body for eggs or embryos,

This is restricted to experimental settings, where the pelvic cavity or the uterine cavity is flushed and the washings are examined microscopically for the presence of eggs or embryos. This can involve minor surgical procedures, there are serious ethical and moral concerns and the retrieved products are not usually viable.

source: http://www.drdaiter.com/

Ovulation -- What Normally Occurs?

At puberty, a woman begins to ovulate. Ovulation is the release of a mature fertilizable egg from the ovary. Ovulation should continue throughout a woman's reproductive lifespan typically at regular monthly intervals.

At each of the two ends of the reproductive lifespan, after the onset of puberty and prior to menopause, menstrual cycle intervals may be irregular and generally longer in duration.

A woman has an estimated 300 to 400 thousand eggs contained within her ovaries at the time of puberty. She is usually presumed to have no remaining eggs at menopause, although research has recently demonstrated that she may actually have a few hundred eggs remaining at menopause. Since a normal reproductive lifespan typically covers the ages 14 to 44 there are about 30 years of ovulation with about 12 ovulations per year for a total of about 300 to 400 ovulations. Thus, a woman "uses up" an average of about 1000 eggs per menstrual cycle (300 to 400 thousand eggs in 300 to 400 ovulations).

It is not clear whether these eggs are used at a uniform rate over the entire reproductive years or whether there is a certain time period of rapid loss. It does appear that about 10-15 years prior to menopause (at about the age 37-38 and continuing for up to a few years) there is a period of accelerated loss of follicles with an initial shortening of the egg maturing phase of the menstrual cycle (follicular phase). This period of accelerated loss does not fully account for the enormous loss of eggs over the reproductive lifespan.

A follicle is a cyst in the ovary containing an egg. Most likely, of the 1000 eggs that are committed for any given cycle only a small number of follicles (maybe 5-25) actually begin the process of maturation at the onset of the cycle.

Ovulation can be interrupted by physiologic events (such as during pregnancy or breast feeding), medication (such as oral contraceptive pills), or pathology (such as hormonal or anatomic abnormalities).

source: http://www.drdaiter.com/

Myths and Facts About Sunscreen and Sunburn

Review common myths and facts about sunscreen, such as whether or not you can get a sunburn on a cloudy day or when you are in the shade, so that your kids are protected from the sun.

Myth: Can you get a sunburn on a cloudy day?

Yes, clouds don't block the UV rays that cause sunburn, so you can still get a sunburn when it is cloudy outside.

Fact: Since UV rays can be reflected off of water, sand, snow, and concrete, you can even get a sunburn in the shade.

Myth: Does a sunscreen with an SPF of 30 provide twice the protection as one that has an SPF of 15?

No, a sunscreen with an SPF of 15 provides protection against 93% of UVB rays, while one with an SPF of 30 provides 97% protection. Keep in mind that a sunscreen with an SPF of 2 only provides 50% protection, so be sure to use a sunscreen with an SPF of at least 15-30. Many experts question whether using a sunscreen with an SPF above 30 provides much more protection, since you are already blocking 97% of UVB rays.

Fact: You should apply your sunscreen 15-30 minutes before you are going to be exposed to the sun. Since it takes time for the sunscreen to be absorbed by your skin, you should apply it in advance. If you wait until you are already outside or until your child shows signs of getting red, then he will have a longer period of being unprotected and will be more at risk for getting a sunburn.

Myth :Do you need to use sunscreen if you have dark skin or already have a tan?

Yes, everyone should use a broad spectrum sunscreen all of the time when they are going to be out in the sun. Even people with deeply pigmented skin, who rarely burn, should use sunscreen. According to the Environmental Protection Agency, 'everybody, regardless of race or ethnicity, is subject to the potential adverse effects of overexposure to the sun. So use sunscreen, no matter your race or ethnic origin, or whether or not you already have a tan, because it is a myth that people with dark skin don't need sunscreen. A 'base tan' isn't a substitute for sunscreen either.

Fact: SPF is an acronym for sun protection factor.

Myth: Do you have to reapply sunscreen if it says that it is 'waterproof' or that it has 'all day protection'?

Yes, no sunscreen is truly waterproof. Instead, they can be water resistant and need to be reapplied every few hours or according to the manufacturer's instructions. And no sunscreen really provides all day protection. Even with an SPF of 50+, you should still reapply it every 2 hours, or sooner if you have been in the water or sweating a lot.

Fact: Using a sunscreen or sunblock does block your body's ability to make Vitamin D from sun exposure. While some experts use that fact to recommend unprotected sun exposure, if your child is following nutrition guidelines for drinking milk, then she should be getting enough Vitamin D. And many experts think that the amount of sun exposure needed to get enough Vitamin D is minimal, especially if you have fair skin, and may just equal a few minutes a day. Most children probably get enough sun exposure for making Vitamin D from their daily activities when they are not wearing sunscreen. Talk to your Pediatrician if you think your child needs more Vitamin D, especially if he doesn't drink milk, has very dark skin, and/or is rarely in the sun.

Myth: Does a combination sunscreen and insect repellent provide good protection against both the sun and insect bites and stings?

While you can use a combination product to protect your children against both the sun and bugs, it may not be a good idea.

Fact: Remember that you should reapply sunscreen every few hours, while you usually don't reapply an insect repellent very often, or at all. Also, most experts think that insect repellents lower the SPF of sunscreens. So while a combo product might provide protection, it likely doesn't provide good protection, unless your child is only going to be outside for a few hours.

References

USA EPA. Sun. The Burning Facts. May 2001.
CDC. Insect Repellent Use and Safety. August 3, 2005