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The Columbia Encyclopedia, Sixth Edition | 2008 | The Columbia Encyclopedia, Sixth Edition. Copyright 2008 Columbia University Press. (Hide copyright information) Copyright

fertility drug any of a variety of substances used to increase the possibility of conception and successful pregnancy. Different methods are used to correct or circumvent the many different functional disorders of both males and females that can interfere with conception and childbearing (see infertility ). The term fertility drug primarily refers to drugs that mimic or stimulate production of a hormone necessary for conception, but it may also be used to refer to the hormones themselves, when they are administered as part of a program of infertility treatment.

The most common cause of female infertility is failure to ovulate. In certain cases this can be corrected with the drug clomiphene citrate (Clomid, Serophene). Introduced in 1967, clomiphene stimulates the release of the gonadotropic hormones : follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH functions to stimulate the ovarian follicle (the egg and its surrounding fluid and hormones); LH triggers ovulation. In some studies, clomiphene has been associated with an increased risk of ovarian cancer. Clomiphene is also used to stimulate spermatogenesis in men with low sperm counts.

Human menopausal gonadotropin, or menotropin (Pergonal), introduced in 1970, is an extract from the urine of menopausal women. It contains FSH and LH and encourages ovulation. It is often given together with human chorionic gonadotropin (HCG), a hormone secreted by the placenta during pregnancy and obtained from the urine of pregnant women. Its action is similar to that of luteinizing hormone. In males the same combination is given to increase testosterone production, which in turn increases sperm production.

Urofollitropin (Metrodin) is essentially follicle-stimulating hormone without luteinizing hormone. It is used especially in women with polycystic ovary syndrome, who tend to have too little FSH and too much LH. A frequent result of ovulation induced by these drugs is the production of more than one ovum (egg) in a month, and subsequent multiple births .

Progesterone is a female sex hormone that induces secretory changes in the lining of the uterus essential for successful implantation of a fertilized egg. It is released by the ovary after the ovum is released. It is administered in cases where fertilization of the ovum does occur but where there is evidence that the uterine lining is unable to support the developing fetus, as in repeated miscarriages or bleeding during pregnancy.

See also DES (diethylstilbestrol).

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fertility drugs

World Encyclopedia | 2005 | © World Encyclopedia 2005, originally published by Oxford University Press 2005. (Hide copyright information) Copyright

fertility drugs Drugs taken to increase a woman's chances of conception and pregnancy. One cause of female sterility is insufficient secretion of pituitary hormones; this can be treated with human chorionic gonadotropin or clomiphene citrate, although use of the latter can result in multiple births. In cases where fertilization occurs, but where the uterine lining is unable to support the fetus, the hormone progesterone may be used. Infertility cannot always be corrected with drugs.

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fertility

The Oxford Companion to the Body | 2001 | | © The Oxford Companion to the Body 2001, originally published by Oxford University Press 2001. (Hide copyright information) Copyright

fertility The French word ‘fertilité’ entered the English language in 1490 to characterize the richness of the soil. By the seventeenth century, writers adapted ‘fertility’ to describe creative imaginations. In the course of the nineteenth century, the term ‘fertility’ came to account for the number of children a woman bore. In this period, too, fertility and another French term, ‘fécundité’, were used to refer to female procreative abilities. In 1866 J. M. Duncan differentiated fecundity from fertility with this explanation: ‘… by fecundity I mean the demonstrated capability to bear children … fertility implies fecundity, and also introduces the idea of number of progeny’ (The Oxford English Dictionary, 1989, 2nd edn). After 1866, especially among demographers, fertility increasingly came to refer to the number of live children a woman delivered.

Technically, fertility simply denotes successful production of offspring. This requires the development in the potential parents of mature eggs (ova) and sperm, sexual intercourse, the opportune encounter between sperm and egg in the woman's body, fertilization, implantation of the embryo in the uterus, successful antenatal development, and a safe birth. In the human female, the opportunity for fertilization lasts only a day or two following ovulation (the release of an ovum), which occurs about every 28 days, in the middle of the menstrual cycle. Sperm are present in vast numbers in the semen, so that, despite many hazards along the way, some survive the necessary journey to the egg. Given the typical frequency of coitus between habitual partners of reproductive age, the odds are in favour of pregnancy occurring within a few months of the first encounter, in the absence of contraception or any specific physical cause for infertility.

Fertility, however, is not simply the expression of a woman's bodily capacity to procreate (fecundity). Recent anthropological and feminist theory advocates understanding fertility as the product of individual actions situated within a particular historical and cultural context. Women and men, responding to local and global changes in the political economy and available resources (e.g. social networks, abortifacients, and contraceptives), act as individuals to produce the family arrangement they prefer (Greenhalgh 1995).

Women and men promote or control their fertility to meet particular needs and concerns at different moments in their life cycle, and these needs and concerns alter depending upon their sexual partner and the changing circumstances of their lives. A woman might attempt, for example, to limit her fertility with an extramarital partner, but not her spouse. Or a widow might attempt to control her fertility after her husband's death in her attempt to retain a particular social standing in her community or limit the economic strains on her household.

People negotiate the circumstances of their fertility differently according to their social position and their personal needs, interests, and concerns. In many societies, bearing a child grants a woman adult status in her community, provides her with a legitimate place in the adult community, and garners her political power in her household and sometimes in her community. The desire to have a child has led many women who wish to conceive to seek the assistance of herbalists, ritual experts, and clinics. The efficacy of fertility treatments depends not only on the male and female partners' reproductive capacities, but also on their financial ability to pay for the treatment and the quality of the drug or procedure. Places where women and men can have their fecundity tested and treated abound throughout the world.

The desire to limit fertility exists in concert with the wish to procreate, and many women experience both desires in their lifetimes. Women in countries around the world seek contraceptives and abortions to limit their fertility, with or without the consent of their partners. A recent study by Bledsoe and colleagues in West Africa, for example, found that some women who have just had a miscarriage elect to use contraceptives for a period to give their bodies a chance to recuperate before they choose to become pregnant again.

Beyond individual preferences, however, fertility responds to a number of factors. Chief among them are health, nutrition and environmental factors. A woman's nutritional status, age, and experience of disease contribute to the probability of subfecundity (reduced capacity to conceive), miscarriages, and stillbirths. The tragedy experienced by residents of the Love Canal, New York State, where unsuspecting families lived on toxic waste dumps, provides an example of how environmental hazards have increased the incidence of miscarriage.

Cultural and religious values relating to the onset and duration of sexual relationships, use of contraceptives, and frequency of coitus (with a fecund male), determine a woman's exposure to the possibility of pregnancy. Obviously, women who begin their reproductive careers immediately after the onset of puberty have a greater window of opportunity to experience pregnancy than women who delay childbearing. Additionally, women in societies that condone the sexual relationships of women before, between, and after marriages could feel more comfortable being pregnant during more of their childbearing years than women living in less open communities. However, the ease with which a women can contract sexual liaisons does not directly translate into a socially sanctioned pregnancy and birth. Experiences of miscarriages and the duration of breastfeeding are also factors in the time during which a woman can get pregnant. The longer the breastfeeding period, the longer the possibility of lactational amenorrhoea — the time when a women is unlikely to be ovulating and therefore to get pregnant. Referred to as the ‘proximate determinants of fertility’ by demographers, myriad factors impinge on a woman's reproductive experiences.

Governmental programmes and policies that attempt to limit or promote women's fertility also affect the number of children a woman bears. For example, China's urban policy of one child per family sends a strong message to the community about the importance of controlling fertility. In contrast, when a country limits women's access to contraceptives or abortion, as some states in the US do, some women are forced to bear children they are not able to raise.

Women's fertility outcomes are also a response to international pressures. The economic crises of the 1980s and 1990s that plagued many African countries forced many Africans into extreme poverty. The recognition that poverty limits a woman's or couple's ability to care for many children leads women and men to limit the number of children they have. In Kenya, for example, where an unstable government is unable to pay international debts and secure internal peace, demographic studies conducted during the 1990s linked the decline of women's fertility to the current economic crisis. Kenyan women and men faced with growing uncertainty in their everyday lives are electing to limit their fertility.

Sheryl A. McCurdy

Bibliography

Bledsoe, C.,, Bahja, F.,, and Hill, A. G. (1998) Reproductive mishaps and Western contraception: an African challenge to fertility theory. Population and development review. 24 (1), 15–59.
Greenhalgh, S. (ed) (1995). Situating fertility: anthropology and demographic inquiry. Cambridge University Press.
King, M. (1990). All in the family? The incompatibility and reconciliation of family demography and family history. Historical Methods, 23 (1), 32.
Levine, D. (1987). Reproducing families: the political economy of England's population history. Cambridge University Press. Cambridge, New York.


See also conception; contraception; fertility rites; infertility; pregnancy.
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COLIN BLAKEMORE and SHELIA JENNETT. "fertility." The Oxford Companion to the Body. Oxford University Press. 2001. Encyclopedia.com. 27 Nov. 2009 <http://www.encyclopedia.com>.

COLIN BLAKEMORE and SHELIA JENNETT. "fertility." The Oxford Companion to the Body. Oxford University Press. 2001. Encyclopedia.com. (November 27, 2009). http://www.encyclopedia.com/doc/1O128-fertility.html

COLIN BLAKEMORE and SHELIA JENNETT. "fertility." The Oxford Companion to the Body. Oxford University Press. 2001. Retrieved November 27, 2009 from Encyclopedia.com: http://www.encyclopedia.com/doc/1O128-fertility.html

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Free newspaper and magazine articles

Free Article Possible increased risk of ovarian cancer with fertility drugs.
Magazine article from: FDA Consumer; 4/1/1993
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News Wire article from: AP Worldstream; 8/27/2008
Free Article Novo Nordisk and Schering sign research and development agreement on fertility drugs.
Business Wire; 9/24/1996

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