Contraception - Chemical Methods / Hormonal Contraception / Emergency / Morning After Pill

October – February 2014: Birth Control

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New! Hormonal Contraceptives Increase Risk of Gestational Diabetes

New! ‘The Pill’ Shrinks Ovaries, Cuts Egg Numbers

Link Between Breast Cancer and Contraceptives, Too Big to Ignore

A Reasoned Response to Guttmacher Hysteria

Abortifacients, Emergency Contraception, and Terminating Pregnancy

Family Planning and Abortion: Two Sides of the Same Coin

Studies Show All Emergency Contraceptives Can Cause Early Abortion

Who is In Control?: Microchip Contraceptives

New Studies Show All Emergency Contraceptives Can Cause Early Abortion

Despite Condoms and “Safe Sex”, 50,000 New Annual USA HIV Infections

New Study Links Birth Control Pill with Multiple Sclerosis

Hormonal Contraceptives Nearly Double Stroke Risk in Women: American Heart Association

Two-Thirds (2/3, 66%) of Women Seeking Abortions Were Using Contraception When They Conceived; 40% Were Using 'The Pill'

Old But Good: Infertility Drugs and the Risk of Breast Cancer, F&S 2003 …

Hormonal Contraceptives Increase Risk of Gestational Diabetes

In a recent health study, doctors found that women with a history of hormonal contraceptive use had 40 percent greater chance of developing gestational diabetes mellitus (GDM).

Health reserachers discovered the correlation by analyzing health data from ~2741 pregnancies — data collected for two surveys conducted by the Missouri Pregnancy Risk Assessment Monitoring System (PRAMS) in 2007 and 2008. [17 July 2014, www.upi.com; ALL News, Aug-Sept 2014]

‘The Pill’ Shrinks Ovaries, Cuts Egg Numbers

The birth control pill significantly affects ovarian reserve— or the number of immature eggs in a woman’s ovaries— which can be a predictor of future fertility.

This is according to a team in Denmark, who reported to the European Society of Human Reproduction and Embryology annual meeting last month that two markers for the ovarian reserve are markedly suppressed after prolonged birth control pill use: the levels of anti-Mullerian hormone (AMH) in the blood, and the number of early (antral) follicles (AFC) in the ovary.  Ovaries are also markedly shrunken after prolonged pill use.
See ABSTRACT — http://www.eshre2014.eu/~/media/Files/Munich/Press/Abstract%20Birch.pdf

“During the last three years we have counseled 900 women, and 300 men, about their ability to conceive naturally,” team leader Kathrine Birch Petersen told Bioscience Technology via email. “The proportion of oral contraceptive users was 28 percent. We were surprised to find several young women with apparent diminished ovarian reserve parameters (ovarian volume, AFC and AMH). We found out it was due to the pill.”

Masking naturally diminished ovarian reserve

Birch Peterson’s Fertility Assessment and Counseling Clinic at Copenhagen University Hospital is a public clinic in the Capital Region of Denmark. “The Clinic was initiated due to the increasing number of fertility treatments in Denmark,” says Birch Petersen. “Every tenth child is born after assisted reproduction.”

Her team decided to assess the reliability of preconception lifestyle and biological factors as predictors of fertility. Available evidence, which the new study does not challenge, has indicated that reproductive cycles return after a few months post-pill, with pregnancy likely among younger women within about six months.
[ http://www.ncbi.nlm.nih.gov/pubmed/19701043 ]

But one concern for women taking birth control pills long term has been whether reproductive status is masked by them.

The phrase “ovarian reserve” refers to the ability of ovaries to churn out oocytes (eggs) that are fertilization-competent.  The Danish group found that AMH and AFC levels were 19 percent and 16 percent lower, respectively, in pill users than in women not taking the pill. Furthermore, ovarian volume was significantly smaller by between 29 and 52 percent— with the greatest shrinkage occurring in women aged 19 to 29.9 years.

The study looked at 833 women (aged 19 to 46 years) attending the Fertility Assessment and Counseling Clinic from August 2011 to April 2012, both users and non-users of birth control pills. About 30 percent were former pill users.

Even after statistical adjustment for age, body-mass index, smoking, maternal age at menopause, maternal smoking during pregnancy and prematurity, AMH levels were still up to 30 percent lower, and AFC levels were up to 20 percent lower, in pill users than non-pill users.

Not permanent

Birch Petersen’s team does not believe these changes are permanent.

But as a result of the study, she said, women in the Pre-conceptional

Care Program who have been on the contraceptive pill are now advised that their ovaries may look older and smaller, and may possess only a few small antral follicles, with low levels of AMH for a period of time after stopping. They are told this likely does not reflect future fertility for most women.

But it could matter to women undergoing premature menopause. Naturally diminished ovarian reserves could be masked by the above. It is therefore possible ovarian reserve assessment should be repeated after stopping birth control pills.

“Worldwide, 160 million women are on the pill,” Birch Petersen told Bioscience. “One percent will go into early menopause before the age of 40. The pill can mask the symptoms of early menopause, and this is why women could consider repeating the tests after six months [off the pill], if they have a low ovarian reserve.”

Next up, says Birch Petersen: “To examine what happens with the ovarian reserve parameters after one, three and six months.” The team will be writing a paper on the conference data and sending it out for publication this fall.

BioScience Technology Note: This story has been updated to correct a typo. 160 million women are on the pill, not 16 million.
[ 08/21/2014, Cynthia Fox, http://www.biosciencetechnology.com/articles/2014/08/%E2%80%98-pill%E2%80%99-shrinks-ovaries-cuts-egg-numbers ]

 

 

Link Between Breast Cancer and Contraceptives, Too Big to Ignore

by Denise Hunnel, M.D.

An article in the most recent issue of Cancer Research ['Recent Oral Contraceptive Use by Formulation and Breast Cancer Risk among Women 20 to 49 Years of Age', 1 August 2014,http://cancerres.aacrjournals.org/content/74/15/4078.abstract — see Abstract below] details yet another study demonstrating a link between breast cancer in young women and the use of oral contraceptives.

The authors point out that their study is unique because it relies on electronic pharmacy records, instead of just self-reporting, to accurately verify contraceptive use. In addition, they look at the various formulations of hormonal contraceptives to elucidate variances in risk dependent upon which contraceptive is used. They looked at the contraceptive use of 1,100 women between the ages of 20 and 49 who had been diagnosed with breast cancer and compared them to a control group of nearly 22,000 women.

What they found was that there was an overall 50% increase in the risk of breast cancer in women who had used any oral contraceptive in the last year. This risk was independent of family history.

They also identified specific risks associated with the different contraceptive formulations, noting that the larger the estrogen component of the contraceptive, the greater the increased risk.

Moderate strength estrogen contraceptives increased the risk of breast cancer by 1.6 fold.

High dose estrogen contraceptives increased the risk of breast cancer by 2.7 fold.

The use of the popular triphasic oral contraceptives that are supposed to more closely mimic the body’s natural hormonal variations actually more than tripled the breast cancer risk.

The progestin component of oral contraceptives also contributed to the breast cancer risk with the increased risk varying from 1.5 fold to 3 fold, depending on which progestin is used.

Breast Cancer Screening

Breast cancer in women between the ages of 20 and 49 is very different than breast cancer in post-menopausal women. Younger women usually have a more aggressive form of breast cancer that is less responsive to therapy. Therefore, anything that increases the risk of breast cancer in younger women will increase the number of women who die from breast cancer. Urging young women to avoid hormonal contraceptives seems to be a reasonable step to fight this disease.

Therefore, it is surprising to hear the lead investigator of this study downplaying the significance of their findings. Dr. Elisabeth Beaber of the Fred Hutchinson Cancer Research Center in Seattle, Washington states, “Given that these results have not yet been replicated and the importance of assessing both the benefits and risks of oral contraceptive use, we cannot make any clinical recommendations based on results from this single study.”

As she clearly pointed out in her article, this is not the only study that has found a relationship between oral contraceptive use and breast cancer. Her study collected the data on contraceptive use more accurately than previous studies and still found the risk of breast cancer significantly increased in oral contraceptive users. What benefits could possibly outweigh this risk? Decreased acne? Less menstrual cramping? Lighter periods?

Some will be quick to point out the possibility of decreased risk for ovarian cancer as a compensatory benefit of oral contraceptive use. The lifetime risk of being diagnosed with breast cancer is 1 in 10. The lifetime risk of being diagnosed with ovarian cancer is about 1 in 72. Therefore, to suggest that the decreased risk of ovarian cancer with oral contraceptives balances the increased risk of breast cancer is like saying you will double or triple your risk of being involved in an automobile crash in order to decrease your risk of being involved in a train accident. It just doesn’t make sense.

There is a great deal of political pressure to avoid condemning oral contraceptives.

The lobbying to make hormonal contraceptives a mandated benefit of the Affordable Care Act and the reticence to allow religious exemptions to this mandate are evidence of the power of contraception advocates.

Too many women erroneously believe they cannot be successful unless they render themselves sterile. It is the purveyors of this myth who are waging the real war on women.
The lives of young women are being sacrificed because of this radical feminist ideology. It is time for medical professionals to speak clearly and without apology about the dangers of hormonal contraception.

[Dr. Denise Jackson Hunnell is a Fellow of Human Life International. She graduated from Rice University with a BA in biochemistry and psychology. She earned her medical degree from The University of Texas Southwestern Medical School. She went on to complete a residency in family medicine at Marquette General Hospital, Marquette, Michigan. Upon completion of her training, Dr. Hunnell served as a family physician in the United States Air Force. She was honorably discharged. She continued to practice medicine all over the country as her husband’s Air Force career kept them on the move. In order to better care for her family, Dr. Hunnell retired from active clinical practice and focused her professional efforts on writing and teaching.
 Read more… http://www.truthandcharityforum.org/link-between-breast-cancer-and-contraceptives-too-big-to-ignore/ ]

ABSTRACT
Recent Oral Contraceptive Use by Formulation and Breast Cancer Risk among Women 20 to 49 Years of Age
[doi: 10.1158/0008-5472.CAN-13-3400 Cancer Res August 1, 2014 74; 4078;     Elisabeth F. Beaber, Fred Hutchinson Cancer Research Center]

Abstract
Previous studies of oral contraceptives and breast cancer indicate that recent use slightly increases risk, but most studies relied on self-reported use and did not examine contemporary ora

l contraceptive formulations. This nested case–control study was among female enrollees in a large U.S. integrated health care delivery system. Cases were 1,102 women ages 20 to 49 years diagnosed with invasive breast cancer from 1990 to 2009. Controls were randomly sampled from enrollment records (n = 21,952) and matched to cases on age, year, enrollment length, and medical chart availability. Detailed oral contraceptive use information was ascertained from electronic pharmacy records and analyzed using conditional logistic regression, ORs, and 95% confidence intervals (CI). Recent oral contraceptive use (within the prior year) was associated with an increased breast cancer risk (OR, 1.5; 95% CI, 1.3–1.9) relative to never or former OC use. The association was stronger for estrogen receptor–positive (ER+; OR, 1.7; 95% CI, 1.3–2.1) than estrogen receptor–negative (ER-) disease (OR, 1.2, 95% CI, 0.8–1.8), although not statistically significantly different (P = 0.15). Recent use of oral contraceptives involving high-dose estrogen (OR, 2.7; 95% CI, 1.1–6.2), ethynodiol diacetate (OR, 2.6; 95% CI, 1.4–4.7), or triphasic dosing with an average of 0.75 mg of norethindrone (OR, 3.1; 95% CI, 1.9–5.1; Pheterogeneity compared with using other oral contraceptives = 0.004) was associated with particularly elevated risks, whereas other types, including low-dose estrogen oral contraceptives, were not (OR, 1.0; 95% CI, 0.6–1.7).

Our results suggest that recent use of contemporary oral contraceptives is associated with an increased breast cancer risk, which may vary by formulation. If confirmed, consideration of the breast cancer risk associated with different oral contraceptive types could impact discussions weighing recognized health benefits and potential risks. Cancer Res; 74(15); 4078–89.
    Accepted May 24, 2014.
doi: 10.1158/0008-5472.CAN-13-3400 Cancer Res August 1, 2014 74; 4078
 http://cancerres.aacrjournals.org/content/74/15/4078.abstract
 

A Reasoned Response to Guttmacher Hysteria
By Denise Hunnell, M.D.

The Guttmacher Institute, an organization founded as the research arm of Planned Parenthood and dedicated to the promotion of contraception and abortion, issued a statement calling for action to ensure free hormonal contraception, abortion inducing drugs and sterilization for all women. In this statement, the Guttmacher Institute declares that in light of the recent Supreme Court decision that exempts closely held corporations from the HHS mandate, measures are needed to make sure no woman is excluded from the “myriad of health benefits” of hormonal contraception.

What are these health benefits that contraception and abortion advocates claim should trump religious liberty? According to the fact sheet cited by the Guttmacher Institute, the primary benefits are the ease of spacing births, lighter menstrual periods, less pain with menstrual periods and the improvement of acne. What the Guttmacher Institute conveniently fails to mention are the myriad of serious side effects that accompany hormonal contraceptive use.

For example, use of hormonal contraceptives increases the risk of the most aggressive form of breast cancer, triple negative breast cancer, by 400%. In addition, hormonal contraceptives double the transmission rates for HIV. It is well established that hormonal contraceptives are associated with potentially lethal blood clots and strokes. In fact, Bayer, the maker of the oral contraceptive Yaz, has paid over $400 million to settle lawsuits related to contraceptive-related blood clots.

The National Cancer Institute fact sheet confirms hormonal contraceptives are associated with an increase in cervical cancer and liver tumors. These are just a few of the detrimental health effects that the Guttmacher Institute ignores for the sake of lighter periods and a clear complexion.

The simple truth is hormonal contraceptives, abortion-inducing drugs, and sterilization are not essential to women’s health and, in fact, are often harmful. They are elective medical interventions that take a perfectly functioning reproductive system and render it sterile, incurring the risk of serious side effects in the process. This is the antithesis of true preventive medicine that maintains health and prevents disease.

The Guttmacher Institute then argues that 99% of women use some form of contraception during their reproductive years so it must be necessary. They base this statistic on a National Health Statistics Report issued in 2013. In citing this statistic, the Guttmacher Institute implies that because 99% of American women have elected to use some form of contraception at least once between the ages of 15 and 44, the Federal Government has a compelling interest to make sure all women have access to hormonal contraception at no cost.

Using the same logic, I could argue that 99% of American women have eaten chocolate at least once between the ages of 15 and 44 and therefore the Federal Government should guarantee free chocolate to women. At least chocolate doesn’t cause cancer or strokes.

However, as much as I would like to advocate for free chocolate, the logic does not hold. Both using hormonal contraceptives and eating chocolate are elective, non-essential activities. There is no compelling government interest to make either free chocolate or free birth control pills available to every American woman.

In addition, the Guttmacher Insitute cites this statistic to bolster their argument that a government mandate for free contraception is critical for access to contraception. However, if 99% of women have been able to utilize contraception without a government mandate in place, there does not seem to be any obstacles to access. The Guttmacher Institute is advocating for a solution to a problem that does not exist!

Taking a closer look at the National Health Statistics Report, it also becomes evident that the Guttmacher Institute is exaggerating the significance of this report. The statistics are based on the voluntary responses of around 12 thousand women. However, this was only 77% of those surveyed. Nearly a quarter of those surveyed refused to answer the questions about contraceptive use. Therefore, there is a selection bias in the answers that is not accounted for in the cited statistics.

Furthermore, the 99% statistic being touted by the Guttmacher Institute means that 99% of the women who did answer the questions on contraception admitted to using some form of contraception on at least one occasion when they were between the ages of 15 and 44. This includes not only women who have used hormonal contraception, but also those women who used barrier methods such as condoms or a diaphragm, women who used spermicides, and women who used fertility awareness methods like Natural Family Planning (NFP).

The Guttmacher Institute is actually counting women who use NFP as justification for a government mandate to provide free hormonal contraception.

The facts do not support the Guttmacher Institute claim that women will suffer if they do not receive hormonal contraceptives, abortion inducing drugs, and sterilization procedures at no cost. These are elective procedures and non-essential to good health. Any health benefits of these interventions are outweighed by serious side effects.

By the Guttmacher Institute’s own admission, women currently have no trouble obtaining contraceptives so there is no barrier to access. Hormonal contraception, abortifacients, and sterili

zation are still as legal and accessible as they have ever been. All the Supreme Court said is that a woman’s desire to disrupt her reproductive system does not trump the First Amendment to the United States Constitution and religious liberty.
[10 July 2014, http://www.truthandcharityforum.org/a-reasoned-response-to-guttmacher-hysteria/ ]

Abortifacients, Emergency Contraception, and Terminating Pregnancy

One of the more controversial issues in the Supreme Court case concerning Hobby Lobby is the company's claim that some of the “emergency contraceptives” demanded by Obamacare and the HHS mandate are actually “abortifacients.” The mainstream denial of this claim, supposedly backed by science, has largely revolved around a tendentious use of terms and a confusion about the real moral issues involved.

The defenders of emergency contraception, such as Guttmacher’s Sneha Barot, like to claim that:

    "major medical organizations . . . as well as U.S. government policy, consider a pregnancy to have begun only when the entire process of conception is complete, which is to say after the fertilized egg has implanted in the lining of the uterus."

So, according to this putatively scientific definition, conception is distinct from fertilization and pregnancy occurs only with the actual implanting of the embryo in the uterine lining. According to this definition of conception, anything that interferes with any part of this process, whether a physical barrier, hormonal regulation of ovulation (or sperm production), the destruction of the embryo prior to implantation, or prevention of successful implantation, can intelligibly be called contraceptive.

Similarly, if pregnancy only occurs once conception is complete with implantation, then it is intelligible to claim that abortion is best understood as the termination of a pregnancy—not the destruction of an embryo. This also explains the medical practice of calling early miscarriage “spontaneous abortion.” Along these same lines, a method could only properly be called abortifacient insofar as it can cause (from the Latin facio) an abortion, which, in turn, is only possible after implantation.

These definitions allow emergency contraception advocates such as the Office of Population Research at Princeton University to make blanket assertions such as: “There is no point in a woman's cycle when the emergency contraceptive pills available in the United States would end a pregnancy once it has started” (emphasis added). Using the definitions of contraception and pregnancy given above, that statement could very well be true, even if the “contraceptive pills” in question directly kill a living embryo or prevent its implantation.

The rhetoric sounds good. Emergency contraception does not prevent “pregnancy,” therefore no “abortion” is involved, and no “abortifacient” methods are used.

However, this tendentious exercise in lexicography leads these advocates to confuse the real issue. Consider Sneha Barot’s claim that

    if pregnancy were synonymous with the act of fertilization, all of the most effective reversible contraceptive methods—including oral contraceptive pills, injectables and IUDs—could be considered, at least theoretically, to be possible abortifacients.

Barot apparently takes it as obvious that these methods are not abortifacients, and therefore that pregnancy is not synonymous with fertilization. But, of course, whether some of these methods are abortifacients is exactly what’s in question. It doesn’t matter whether pregnancy is defined as synonymous with fertilization, but whether the methods in question directly kill an embryo or prevent its implantation.

The Principle of Double Effect

Ultimately, the moral question of abortion has little to do with the proper understanding of pregnancy at all. We can see this by reflecting on the fact that terminating a pregnancy is not evil per se. Any time a child is delivered by caesarian section, the pregnancy is terminated, but obviously there is no direct moral evil in that procedure. In fact, some pro-life moralists have even argued that some terminations of pregnancy are morally legitimate even if they result in the death of the child.

This line of argument makes use of the Principle of Double Effect (PDE), which broadly holds that an act is morally permissible insofar as it meets four conditions (this formulation is derived from David Oderberg): (1) the intended effect of the act must not be intrinsically evil (e.g., aiming at the death of an innocent); (2) any evil side effects of the act must be unintended (though they may be foreseen); (3) the good intended effect must be at least as causally direct as any unintended side effect (i.e., one cannot do evil so that good may come of it); finally, (4) the intended good must be proportionate to any unintended evils (i.e., the good must “outweigh” the evil).

This method of moral reasoning has allowed some of these pro-life moralists to argue that in certain extreme circumstances it is morally permissible to terminate a pregnancy in a way that results in the death of the innocent child, so long as that death is not directly intended.

Rarely, an embryo will implant within its mother’s body outside the uterus (an ectopic pregnancy). While there have recently been extremely rare cases of ectopic pregnancy that were safely brought to birth (through caesarian section), it had traditionally been considered a death sentence for both the mother and child. For these reasons, some adherents of PDE have argued that it is permissible to remove the child surgically from the mother (intact) even though this foreseeably results in the death of the child. Simultaneously, these same moralists argue that the use of a chemical abortifacient to destroy the embryo is impermissible.

They reason that the surgical removal of the intact child is a medical treatment directly intended to save the mother’s life. Killing the child is no part of that treatment (even as a means); were the technology available to save the child’s life that would certainly be done. So the child’s death is a foreseeable but unintended side effect of the surgery to treat the mother, and that foreseeable death is proportionate when weighed against the life of the mother.

On the other hand, a chemical abortifacient would violate the PDE because, in treating the mother, the death of the child would be directly pursued. In other words, in the abortifacient case, the mother is being treated by means of killing the child. The child’s death is not merely foreseen, it is actively pursued. That is also why the surgeon must remove the child intact; otherwise, the child’s death would be directly pursued as a means.

Whether or not this particular analysis of ectopic pregnancy is ultimately correct, and we must be careful not to misuse the PDE as has sometimes been done, these examples clearly show that the moral defect of abortion lies not with the termination of the pregnancy, but with the direct killing of the child. In fact, one leading pro-life philosopher has argued that the ultimate solution to the abortion problem might lie in the technological development of artificial wombs. This would, at least in theory, allow the intact removal of “unwanted” embryos without necessarily resulting in their deaths.

If we return to the emergency contraception case, then it is apparent that the real issue is the mechanism by which they work

, not what counts as pregnancy. While there are good reasons to think that contraception (understood merely as the prevention of fertilization) is itself morally defective, it is clearly a lesser evil than the destruction of an innocent human being. So I will mostly set the contraception question aside and focus on the destruction question.

The Unintended Evil: Killing an Innocent Human Being

On the one hand, the advocates of emergency contraception are quick to claim that “emergency contraceptive pills prevent pregnancy primarily, or perhaps exclusively, by delaying or inhibiting ovulation.” Obviously, if no ovum is released, then fertilization is impossible. In that case, the moral concern is solely with contraception, not homicide. However, as Donna Harrison previously argued at Public Discourse, there are good empirical reasons to believe that some of the methods in question in the Hobby Lobby case “can and do cause embryos to die after fertilization.”

It seems fair to say that the emergency contraception advocates’ hedge that emergency contraception works “primarily, or perhaps exclusively, by delaying or inhibiting ovulation” (emphasis added) reflects lingering doubt about exactly how the methods work, even among those committed to promoting their use.

This is a telling hesitation, a kind of residual honesty in admitting the possibility that, in at least some of the cases, these methods directly result in the death of embryos. (Hedging phraseology of this sort occurs on numerous online discussions, including both of those previously linked and the Mayo Clinic. The New York Times approvingly notes a recent movement to remove these hedges.) I suspect this hedging represents a kind of bad faith, and this in turn explains their repeated appeals to authority and attempts to take refuge in medical definitions of pregnancy and abortion that are morally irrelevant.

In the end, of course, none of the linguistic hairsplitting matters. What really matters in the morality of abortion is not whether a pregnancy has been terminated, but whether an innocent human being has been murdered. Understanding the mechanism of how these methods work is an empirical, scientific question about which there seems to be controversy within the medical community itself. However, I think it is significant that even the advocates of emergency contraception admit uncertainty about how the methods work and whether they kill embryos or prevent implantation.

From a moral perspective, if there is any plausible reason to believe that one of the consequences of the drugs is—even occasionally—the death of embryo, then they are morally equivalent to abortifacients that work after implantation. The fact that the intended purpose of the drugs is to prevent ovulation is ultimately immaterial if their actual consequence is to kill living embryos or prevent implantation.

Ultimately, even if one thinks that the prevention of fertilization is morally indifferent, surely it is not worth pursuing at the cost of innocent human life. That is, it would not meet the proportionality requirement (4) of PDE. Furthermore, if contraception is itself an evil, then there is absolutely no good to set against even the possibility of killing an innocent human being, so proportionality would not even enter into it.

[Matthew Lu, Apr 14, 2014, Public Discourse, http://www.lifesitenews.com/news/abortifacients-emergency-contraception-and-terminating-pregnancy?utm_source=LifeSiteNews.com+Daily+Newsletter&utm_campaign=408130d2c0-LifeSiteNews_com_US_Headlines_06_19_2013&utm_medium=email&utm_term=0_0caba610ac-408130d2c0-326232694 ]

Family Planning and Abortion: Two Sides of the Same Coin

Women claiming their pregnancies are unwanted were “trying hard” to avoid becoming pregnant at the time of conception, according to new data from the British Pregnancy Advisory Service (bpas).

Two thirds of the women who had an abortion at bpas were using a contraceptive, with the contraceptive pill being the most popular.  None of the conclusions of the report indicated that the women lacked access to “modern methods of family planning” or that any false perceptions they may have had regarding their own fertility was due to being denied comprehensive sexuality education.

The chief executive of the British Pregnancy Advisory Service, Ann Furedi, said:

    “An unintended pregnancy is often a happy accident – and a large proportion of births in this country are unplanned…Ultimately women cannot control their fertility through contraception alone, and need accessible abortion services as a back-up for when their contraception lets them down.”

The UK has a long-established national health service, and is in many ways a model of what international development organizations would like to export to the developing world.  Maternal health statistics in Western Europe are among the best in the world, meaning that carrying a pregnancy to term, even an unintended one, is unlikely to entail risking one’s health or life.

Furthermore, as pro-life groups have consistently reported, increasing contraceptive use is frequently linked to increased abortion rates.

Pro-lifers are often attacked for not doing enough to promote contraception (or, in many cases, for opposing it on moral grounds) on the basis that abortion is best prevented by increasing contraceptive use.  One prominent Catholic who famously bought this line of reasoning is Melinda Gates, who claims to oppose abortion, yet has vowed to make access to contraception a main focus of her life’s work.

The best counter-arguments to this often come from abortion advocates themselves, like Anne Furedi above and RH Reality Check’s Marge Berer, who wrote the following:

    “The answer is not to promote contraception in order to reduce unsafe abortion, as the [Gates Family Planning] Summit did. The answer is to promote contraception to reduce unwanted pregnancy and provide safe abortion to every woman who finds herself with an unwanted pregnancy. That is the way to make unsafe abortion history. Abortion will not go away unless men and women stop having sex with each other or everyone is sterilised. So forget it!”

So much for “happy accidents,” then.
[Rebecca Oas, Ph.D., Apr 09, 2014, Turtle Bay and Beyond,  http://www.lifesitenews.com/news/family-planning-and-abortion-two-sides-of-the-same-coin?utm_source=LifeSiteNews.com+Daily+Newsletter&utm_campaign=263bb05b12-LifeSiteNews_com_US_Headlines_06_19_2013&utm_medium=email&utm_term=0_0caba610ac-263bb05b12-326232694 ]

 

Studies Show All Emergency Contraceptives Can Cause Early Abortion

Whether the plaintiff is Hobby Lobby, the Little Sisters of the Poor or one of the hundreds of other plaintiffs suing the Obama Administration, what’s primarily at stake in the challenges to the HHS “contraceptive mandate” is, of course, whether the federal government can lawfully force employers to violate their conscience by requiring them to provide insurance coverage for all forms of “contraception” approved by the federal Food and Drug Administration (FDA).

The lawsuits are about religious liberty and conscience rights. They are not about “sex” (as Linda Greenhouse asserts). Nor are they about the use of contraceptives per se because, in fact, many plaintiffs taking part in the 90-plus lawsuits do not in principle object to contraceptive use. It is likely that all plaintiffs

do object, however, to abortion-inducing drugs and they rightly believe that some forms of “contraception” have post-fertilization mechanisms of action (MOAs) that can cause the death of a human embryo. This is especially true with emergency “contraceptives.”

Yet despite all the considerable evidence regarding the abortifacient effect of emergency contraceptives (EC),  mandate proponents—Lillian Tamayo, President and CEO of Planned Parenthood of South Florida, for example—continue to deride those who contend that ECs can induce abortion.

Her view is valid only if one accepts the Orwellian-newspeak-definition of conception—“the implantation of a fertilized ovum”—adopted by the American College of Obstetricians and Gynecologists (ACOG) in 1965 to obscure the reality that all hormonal contraceptives are potentially abortifacient. For the rest of the world, fertilization and conception are synonymous and mark the beginning of a new living organism.[i]

According to the ACOG view, pregnancy begins only when an embryo implants in the uterine lining (endometrium), so that causing the death of a week-old child by means that include blocking implantation is not an abortion.

A 2012 ACOG Committee Opinion expresses this clearly: “Emergency contraception is not effective after implantation; therefore it is not an abortifacient.” This statement is doubly misleading because mifepristone (or RU-486, the “abortion pill”) is also used as an EC in several countries. It effectively kills embryos for six weeks after implantation, and it is, perhaps, only a matter of time before the FDA approves RU-486 for EC use.

This sort of doublespeak concerning conception, pregnancy and abortion inevitably requires further terminology-twisting. One can no longer refer to embryo implantation as that implies the presence of a human being; the embryo is instead called a “fertilized egg,” although he is a unique human being with his own complete set of DNA. In his first hours of existence, the embryo even signals the mother to get her immune system to stand down, prompting her body to release Early Pregnancy Factor, an immunosuppressive protein that is detectable in maternal blood as early as 24 hours after fertilization.

Nonetheless, many people, including Pam Belluck, a former New York Times reporter, ignore such facts and instead accept the statements of contraceptive proponents at face value. She suggests that believing EC to be abortion-inducing “is probably rooted in outdated or incorrect scientific guesses about how the pills work.”

To the contrary. The latest studies, using precise and rigorous methods to assess the MOAs of emergency contraceptives, provide conclusive evidence that pre-ovulatory (i.e., contraceptive) MOAs (for example, delay or inhibition of ovulation and interference with sperm mobility) cannot alone account for the relative efficacy of ECs in preventing established (implanted) pregnancies.

A look at the current state of the science regarding the three most common types of emergency contraception available in the United States is instructive: the Copper-T IUD (marketed as ParaGard® T 380A Intrauterine Copper Contraceptive), Ulipristal acetate (marketed as Ella® and ellaOne®), and levonorgestrel EC or LNG-EC (marketed as Plan B®, Plan B One-Step® and Next Choice®).

Paragard T 380: Although the Copper-T IUD is used far less frequently than Plan B (due to its $475 cost and safety fears), we’ll address it first because its MOAs have never been disputed. Paragard emits copper ions, creating an environment toxic to sperm, ova, and embryos.

The FDA lists three MOAs—“interference with sperm transport or fertilization, and prevention of implantation.”[ii] But when Paragard is used as an “emergency contraceptive” and inserted 1-5 days after intercourse, sperm have long since arrived in the upper fallopian tube/oviduct and fertilization may already have taken place. Sperm have been found in the fallopian tubes within five minutes to two hours after insemination.[iii] Managing Contraception (11th ed.) concedes as much: “In the month that [Paragard] is inserted as an emergency contraceptive, it may act by interfering with implantation.”[iv] Embryos unable to implant die.

Ella® (ellaOne®): Nor is there serious scientific dispute over the anti-implantational MOA of Ella (Ulipristal acetate).  Ella’s FDA-approved Drug Label states “alterations to the endometrium that may affect implantation may also contribute to efficacy.” 

Ella and RU-486 act by blocking progesterone receptors in the endometrium.

This action can prevent the endometrium from becoming capable of receiving and nurturing the embryo. It thwarts implantation and, in the more potent formulation of RU-486, can deprive an implanted embryo (up to nine weeks’ gestational age) of the oxygen and nutrition it needs to survive.

Two little-known aspects of Ella bear mentioning.

An analysis of pooled data from three trials, published in November 2013 by Vivian Brache and colleagues,[v] found that Ella delayed ovulation for five days in 58.8% (20/34) of cycles.

In addition to a 41.2% failure rate in delaying ovulation (potentially allowing fertilization to occur), there is another great drawback with the use of Ella as EC.

Because Ella only delays, but does not disrupt, ovulation, it will eventually occur after a prolonged fertile period. Unprotected intercourse during the prolonged fertile period can result in an unexpected pregnancy in the same cycle (before onset of menses).[vi]

Plan B: Early research speculating on the MOAs of LNG-EC produced more confusion than clarity. Many factors contributed to the incoherence, e.g., small subject pools, imprecise dating of key events in the patients’ reproductive cycles, and a widespread, flawed assumption that the MOAs present with daily use of LNG or other progestin-only pills (mainly thickening of cervical mucus to impede sperm mobility) would also occur with one-time, post-coital EC use.

To assess both Plan B’s MOA and efficacy, one must determine for each patient in the study—(1) whether or not unprotected intercourse occurred during the six-day fertile period of the menstrual cycle (when a woman is capable of becoming pregnant), and (2) whether EC was administered prior or subsequent to the peak level of luteinizing hormone (LH peak), which triggers ovulation in about 24 hours.

Transvaginal ultrasound (TVUS) measurement of the dominant ovarian follicle, along with ascertaining urinary levels of LH and estrogen, yields precise dating of anticipated ovulation. TVUS observation of the ruptured ovarian follicle from which the ovum emerged, is the best means of determining that ovulation occurred. Earlier studies used less precise tools.

Two recent literature reviews critique the older studies and also report on the findings of new, larger studies which used more accurate methods. All point to Plan B’s having a predominantly post-fertilization (abortifacient) MOA when it is given during a woman’s fertile period.

The first review, published in Gynecological Endocrinology[vii] by Bruno Mozzanega and Erich Cosmi  (Department of Gynecology and Obstetrics, University of Padua), unsparingly critiques a Joint Statement of the International Consortium for Emergency Contraception (ICEC) and the International Federation of Gynaecology and Obstetrics (FIGO).

The Joint Statement declared that the “primary and possibly only” MOA of LNG-EC is the “inhibition or delay of ovulation” and that “LNG-ECPs cannot prevent implantation.” Mozzanega and Cosmi explain that ICEC/FIGO’s conclusions were derived from a review of only seven studies with a combined total of only 142 patients, who were further stratified into different subgroups (making statistically meaningful conclusions impossible). Flawed methodology marked some of the seven studies; “conclusions” were contradicted by actual findings in others; and larger, more rigorous studies were ignored completely.

In December 2013, Rebecca Peck, MD and Rev. Juan R. Vélez, MD, PhD published an exhaustive review of the scientific literature on Plan B’s MOAs. After pointing out the errors and inconsistencies in studies purporting to show that Plan B has only or mainly pre-ovulatory (contraceptive) MOAs, the authors examine several large and rigorous studies that demonstrate Plan B’s high likelihood of post-fertilization (abortifacient) MOAs.

Interim and final results of one of the largest studies to date were published in 2010 and 2011 by Gabriela Noé and colleagues. Noé et al. were able to calculate the efficacy of LNG-EC given before and after ovulation among patients who requested EC at family planning clinics. In the 2010 paper, 86% of the women who had intercourse during their fertile period and who received LNG-EC before ovulation, nevertheless ovulated.

This contradicts the notion that ovulation delay or inhibition is Plan B’s only or primary MOA. Had they not taken EC, 13 pregnancies would have been expected to occur among these women, but not one expected embryo survived to implant. In contrast, among women who had intercourse during their fertile period and received LNG-EC on their day of ovulation or later, seven pregnancies would have been expected (in the absence of EC) and six established pregnancies resulted. This suggests that LNG-EC is largely ineffective in preventing an established pregnancy if taken at or after ovulation.

Their final findings, published in 2011, are based on data from 450 women. Among those who had intercourse during their fertile period and who were given LNG-EC prior to ovulation, 80% nevertheless ovulated. A contraceptive failure rate of 92% occurred among a subset of women who had intercourse two days before ovulation and received LNG-EC promptly. Sixteen pregnancies would have been expected among the group of women who received EC pre-ovulation. No established pregnancies occurred, i.e., no embryos survived to implant. In the group that received LNG-EC after ovulation, however, 8.7 pregnancies could have been expected and 8 occurred.

To summarize: It is possible that Plan B may delay ovulation when given before or at the beginning of the fertile period, when the chance of pregnancy is slim to none, and therefore, it is not “needed” to prevent pregnancy. When given after intercourse in the fertile period and before the LH peak that triggers ovulation, Plan B fails to act as a contraceptive 80-92% of the time; it acts instead as an abortifacient, eliminating all embryos likely to have been conceived. When given on the day of ovulation or later to prevent pregnancy from intercourse during the fertile period, it almost always fails to prevent established pregnancies.

Peck and Vélez also reviewed other studies whose findings suggest that Plan B has post-fertilization MOAs that may result in the death of an embryo prior to implantation. Among these findings are: slowed transport of the embryo to the uterus resulting in an ectopic pregnancy or the embryo’s delayed arrival in the uterus (after the brief four-day implantation window); diminished luteal (post-ovulatory) levels of LH and progesterone that prevent the changes to the endometrium needed to permit implantation; a shortened luteal phase (indicating that something is awry and the endometrium did not become hospitable to implantation and pregnancy support); and direct changes to the endometrium that block implantation.

The November 2013 Brache et al. analysis of pooled EC studies compares the efficacy of LNG (Plan B), Ulipristal acetate (Ella), a third EC (meloxicam), LNG+meloxicam, and placebo. Their findings lend support to the conclusions of Peck/Vélez and Mozzanega/Cosmi that Plan B is only minimally effective in delaying ovulation when given in the fertile period immediately preceding ovulation. Brache et al. found that Plan B was no more effective than a placebo in delaying/inhibiting ovulation. In fact, it was even less effective than placebo because the progesterone in Plan B helped to trigger ovulation within 48 hours.

Given the dangers to the future of conscience rights posed by the Affordable Care Act, an honest debate over the “contraception mandate” is a necessity.  But that debate can only take place by calling things what they are instead of attempting to redefine them into things they are not.  Numerous studies have shown that the most popular emergency contraceptives can cause the death of embryos.  For the sake of full and accurate informed consent for patients and for the sake of the integrity of the medical profession and research community, this reality must be acknowledged.  Only then will we be able to make informed decisions about our personal healthcare and healthcare policy.

Susan E. Wills, Esq. is an Associate Scholar with the Charlotte Lozier Institute.

——————————————————————————–

[i] E.g., “”The development of a human begins with fertilization, a process by which the spermatozoon from the male and the oocyte from the female unite to give rise to a new organism, the zygote;”
[Sadler, T.W. Langman's Medical Embryology. 7th edition. Baltimore: Williams & Wilkins 1995, p. 3]; “Although life is a continuous process, fertilization is a critical landmark because, under ordinary circumstances, a new, genetically distinct human organism is thereby formed…. The embryo now exists as a genetic unity;” [O'Rahilly, Ronan and Muller, Fabiola. Human Embryology & Teratology. 2nd edition. New York: Wiley-Liss, 1996, pp. 8, 29; "Zygote. This cell, formed by the union of an ovum and a sperm (Gr. zyg tos, yoked together), represents the beginning of a human being. The common expression 'fertilized ovum' refers to the zygote." [Moore, Keith L. and Persaud, T.V.N. Before We Are Born: Essentials of Embryology and Birth Defects. 4th edition. Philadelphia: W.B. Saunders Company, 1993, p. 1];

[ii] FDA-approved Drug Label (through June 10, 2013). On June 11, 2013, the F.D.A. approved a manufacturer-requested change to ParaGard’s label, adding “possibly” before “prevention of implantation.”

[iii] A list of studies can be found in footnote 106 of R. Peck and J. Vélez, “The Postovulatory Mechanism of Action of Plan B: A Review of the Scientific Literature,” The National Catholic Bioethics Quarterly 13.4 (Winter 2013):000-000; available at http://ncbcenter.org/document.doc?id=584; accessed January 9, 2014.

[iv] M. Zieman and R.A. Hatcher, Managing Contraception (Tiger, GA: Bridging the Gap Foundation, 2012), p. 76.

[v] V. Brache et al., “Ulipristal Acet

ate Prevents Ovulation More Effectively than Levonorgestrel: Analysis of Pooled Data from Three Randomized Trials of Emergency Contraception Regimens,” Contraception 88.5 (November 2013) 611-618.

[vi] Brache et al., 616-617.
[vii] B. Mozzanega and E. Cosmi, “How Do Levonorgestrel-Only Emergency Contraceptive Pills Prevent Pregnancy? Some Considerations,” Gynecological Endocrinology 27.6 (June 2011) 439-442.
[Charlotte Lozier Institute, January 15, 2014, Susan Wills, JD, LLM, http://www.lozierinstitute.org/emergencycontraceptives/ ]

 

 

Who is In Control?: Microchip Contraceptives
 
Just when one begins to believe that science has pushed the God-playing envelope to the limits, it seems as though the proverbial envelope sprouts wings. Since the decriminalization of contraception in the 1965 case, Griswold vs. Connecticut, the smorgasbord of contraceptive medications and devices has reached an excessive number. From the Pill, to the patch, to the shot, to the sponge, to the ring, to IUDs and beyond, the average gynecology patient is left overwhelmed with the various ways to engage in an active sex life without the “risk” of pregnancy. But, wait. There is more. What is next in the Wonderful World of “Reproductive Freedom?” Ladies, allow me to introduce you to The Chip.

A contraceptive microchip was initially developed by professors at the Massachusetts Institute of Technology in the 1990s as a method of gradually releasing chemicals to help with osteoporosis. Bill Gates proposed the use of this technology in 2012 as yet another method of birth control. The chip, whose development is largely funded by the Gates Foundation, may be implanted in the arm, abdomen, or buttocks. It contains enough levonorgestrel to last the wearer 16 years, and is released in daily doses. If the wearer decides she may want to become pregnant during those 16 years, the device may be turned off from a remote control.

MicroCHIPS, the company in charge of the production of the contraceptive microchip, plans to have the chip on the market by 2018, provided it makes it through clinical trials, and is approved by the Food and Drug Administration. The dosage could be remotely controlled by a doctor. A developer of the chip insists that it has a secure encryption, so the risk of hacking, he claims, is impossible. And yet, many recall that hacking in to the U.S. Government was supposedly impossible – an assumption disproved by Edward Snowden.

It is almost as if we are in a futuristic novel. There are already ethical issues with contraception in general, including potential links to cancer as well as sometimes preventing an embryo from implantation. The chip would take ethics to a new low, reducing the human body into a machine to be controlled. Despite the fact that the chip may be turned off as easily as an iPod, the fact remains that there is literally an electronic foreign object in a woman’s body that is made to manipulate the body’s natural process. And, anyone who has ever operated a Windows Computer (and witnessed it crash in the middle of a college final, for example) knows, electronics cannot always be counted on.

While many can speak of the countless amazing and ethical doctors out there, I cannot help but wonder about those who perhaps have ascribed to the ever-common population control theory. Since these microchips are painless and simple to insert, is it feasible to think that perhaps they may be implanted during a routine PAP smear without the patient ever knowing? I certainly hope not.

What is the greatest concern, perhaps, are the dozens of writers who are lauding this technology as one of the greatest advances in modern medicine. First of all, Bill and Melinda Gates are not doctors, and their personal vendetta to perfect contraception, of all things, is a mystery to many, myself included. Why is there a need for yet another method of contraception?

While the Gates have been known to blame many of the world’s problems on a lack of access to contraception, their seemingly militant one-sided pet project to expand access to “120 million women and girls in the poorest countries” has been to simply inject or implant women with long term contraceptives that in America are not often used due to their severe and dangerous side effects. Melinda Gates said, “I have been able to do the things that made me happiest, because I have been able to decide when to have my children. Bill and I love our kids so much, and we’re grateful that we had the option of expressing our love by timing our pregnancies.” When are people going to wake up and realize that contraception is not going to solve any problems?

And why, WHY would anyone think that it is a good idea to microchip oneself?

One of the most disturbing aspects of this contraceptive microchip is, in my opinion, the relinquishing of free will. Now an electronic device (which other human beings potentially have access to) is controlling one’s fertility… This new technology not only prevents women from welcoming new life, but potentially also gives others the power to make that most intimate of decisions.

President John F. Kennedy said, “Conformity is the jailer of freedom and the enemy of growth.”

How true this is about the “family planning” myth.

Contraception is no longer even a question of ethics is so many arenas. It is simply accepted without question.

In the name of liberation and reproductive freedom, women are on a fast track to reduce their bodies to robots to be controlled, relinquishing their free will.

The future has arrived, ladies. It’s time to reclaim who we are called to be, and to reclaim own our dignity with grace and reverence.
[18 July 2014, Brittany Higdon,
http://www.truthandcharityforum.org/who-is-in-control-microchip-contraceptives/ ]

 

 

 

 

 

New Studies Show All Emergency Contraceptives Can Cause Early Abortion

Whether the plaintiff is Hobby Lobby, the Little Sisters of the Poor or one of the hundreds of other plaintiffs suing the Obama Administration, what’s primarily at stake in the challenges to the HHS “contraceptive mandate” is, of course, whether the federal government can lawfully force employers to violate their conscience by requiring them to provide insurance coverage for all forms of “contraception” approved by the federal Food and Drug Administration (FDA).

The lawsuits are about religious liberty and conscience rights. They are not about “sex” (as Linda Greenhouse asserts). Nor are they about the use of contraceptives per se because, in fact, many plaintiffs taking part in the 90-plus lawsuits do not in principle object to contraceptive use. It is likely that all plaintiffs do object, however, to abortion-inducing drugs and they rightly believe that some forms of “contraception” have post-fertilization mechanisms of action (MOAs) that can cause the death of a human embryo. This is especially true with emergency “contraceptives.”

Yet despite all the considerable evidence regarding the abortifacient effect of emergency contraceptives (EC),  mandate proponents—Lillian Tamayo, President and CEO of Planned Parenthood of South Florida, for example—continue to deride those who contend that ECs can induce abortion. Her view is valid only if one accepts the Orwell

ian-newspeak-definition of conception—“the implantation of a fertilized ovum”—adopted by the American College of Obstetricians and Gynecologists (ACOG) in 1965 to obscure the reality that all hormonal contraceptives are potentially abortifacient. For the rest of the world, fertilization and conception are synonymous and mark the beginning of a new living organism.[i]

According to the ACOG view, pregnancy begins only when an embryo implants in the uterine lining (endometrium), so that causing the death of a week-old child by means that include blocking implantation is not an abortion.

A 2012 ACOG Committee Opinion expresses this clearly: “Emergency contraception is not effective after implantation; therefore it is not an abortifacient.”

This statement is doubly misleading because mifepristone (or RU-486, the “abortion pill”) is also used as an EC in several countries. It effectively kills embryos for six weeks after implantation, and it is, perhaps, only a matter of time before the FDA approves RU-486 for EC use.

This sort of doublespeak concerning conception, pregnancy and abortion inevitably requires further terminology-twisting. One can no longer refer to embryo implantation as that implies the presence of a human being; the embryo is instead called a “fertilized egg,” although he is a unique human being with his own complete set of DNA. In his first hours of existence, the embryo even signals the mother to get her immune system to stand down, prompting her body to release Early Pregnancy Factor, an immunosuppressive protein that is detectable in maternal blood as early as 24 hours after fertilization.

Nonetheless, many people, including Pam Belluck, a former New York Times reporter, ignore such facts and instead accept the statements of contraceptive proponents at face value. She suggests that believing EC to be abortion-inducing “is probably rooted in outdated or incorrect scientific guesses about how the pills work.”

To the contrary. The latest studies, using precise and rigorous methods to assess the MOAs of emergency contraceptives, provide conclusive evidence that pre-ovulatory (i.e., contraceptive) MOAs (for example, delay or inhibition of ovulation and interference with sperm mobility) cannot alone account for the relative efficacy of ECs in preventing established (implanted) pregnancies.

A look at the current state of the science regarding the three most common types of emergency contraception available in the United States is instructive: the Copper-T IUD (marketed as ParaGard® T 380A Intrauterine Copper Contraceptive), Ulipristal acetate (marketed as Ella® and ellaOne®), and levonorgestrel EC or LNG-EC (marketed as Plan B®, Plan B One-Step® and Next Choice®).

Paragard T 380: Although the Copper-T IUD is used far less frequently than Plan B (due to its $475 cost and safety fears), we’ll address it first because its MOAs have never been disputed. Paragard emits copper ions, creating an environment toxic to sperm, ova, and embryos. The FDA lists three MOAs—“interference with sperm transport or fertilization, and prevention of implantation.”[ii] But when Paragard is used as an “emergency contraceptive” and inserted 1-5 days after intercourse, sperm have long since arrived in the upper fallopian tube/oviduct and fertilization may already have taken place. Sperm have been found in the fallopian tubes within five minutes to two hours after insemination.[iii] Managing Contraception (11th ed.) concedes as much: “In the month that [Paragard] is inserted as an emergency contraceptive, it may act by interfering with implantation.”[iv] Embryos unable to implant die.

Ella® (ellaOne®): Nor is there serious scientific dispute over the anti-implantational MOA of Ella (Ulipristal acetate).  Ella’s FDA-approved Drug Label states “alterations to the endometrium that may affect implantation may also contribute to efficacy.”  Ella and RU-486 act by blocking progesterone receptors in the endometrium. This action can prevent the endometrium from becoming capable of receiving and nurturing the embryo. It thwarts implantation and, in the more potent formulation of RU-486, can deprive an implanted embryo (up to nine weeks’ gestational age) of the oxygen and nutrition it needs to survive.

Two little-known aspects of Ella bear mentioning.

An analysis of pooled data from three trials, published in November 2013 by Vivian Brache and colleagues,[v] found that Ella delayed ovulation for five days in 58.8% (20/34) of cycles. In addition to a 41.2% failure rate in delaying ovulation (potentially allowing fertilization to occur), there is another great drawback with the use of Ella as EC. Because Ella only delays, but does not disrupt, ovulation, it will eventually occur after a prolonged fertile period. Unprotected intercourse during the prolonged fertile period can result in an unexpected pregnancy in the same cycle (before onset of menses).[vi]

Plan B: Early research speculating on the MOAs of LNG-EC produced more confusion than clarity. Many factors contributed to the incoherence, e.g., small subject pools, imprecise dating of key events in the patients’ reproductive cycles, and a widespread, flawed assumption that the MOAs present with daily use of LNG or other progestin-only pills (mainly thickening of cervical mucus to impede sperm mobility) would also occur with one-time, post-coital EC use.

To assess both Plan B’s MOA and efficacy, one must determine for each patient in the study—(1) whether or not unprotected intercourse occurred during the six-day fertile period of the menstrual cycle (when a woman is capable of becoming pregnant), and (2) whether EC was administered prior or subsequent to the peak level of luteinizing hormone (LH peak), which triggers ovulation in about 24 hours. Transvaginal ultrasound (TVUS) measurement of the dominant ovarian follicle, along with ascertaining urinary levels of LH and estrogen, yields precise dating of anticipated ovulation.

TVUS observation of the ruptured ovarian follicle from which the ovum emerged, is the best means of determining that ovulation occurred. Earlier studies used less precise tools.

Two recent literature reviews critique the older studies and also report on the findings of new, larger studies which used more accurate methods. All point to Plan B’s having a predominantly post-fertilization (abortifacient) MOA when it is given during a woman’s fertile period.

The first review, published in Gynecological Endocrinology[vii] by Bruno Mozzanega and Erich Cosmi  (Department of Gynecology and Obstetrics, University of Padua), unsparingly critiques a Joint Statement of the International Consortium for Emergency Contraception (ICEC) and the International Federation of Gynaecology and Obstetrics (FIGO).

The Joint Statement declared that the “primary and possibly only” MOA of LNG-EC is the “inhibition or delay of ovulation” and that “LNG-ECPs cannot prevent implantation.” Mozzanega and Cosmi explain that ICEC/FIGO’s conclusions were derived from a review of only seven studies with a combined total of only 142 patients, who were further stratified into different subgroups (making statistically meaningful conclusions impossible). Flawed methodology marked some of the seven studies; “conclusions” were contradicted by actual findings in others; and larger, more rigorous studies were i

gnored completely.

In December 2013, Rebecca Peck, MD and Rev. Juan R. Vélez, MD, PhD published an exhaustive review of the scientific literature on Plan B’s MOAs. After pointing out the errors and inconsistencies in studies purporting to show that Plan B has only or mainly pre-ovulatory (contraceptive) MOAs, the authors examine several large and rigorous studies that demonstrate Plan B’s high likelihood of post-fertilization (abortifacient) MOAs.

Interim and final results of one of the largest studies to date were published in 2010 and 2011 by Gabriela Noé and colleagues. Noé et al. were able to calculate the efficacy of LNG-EC given before and after ovulation among patients who requested EC at family planning clinics. In the 2010 paper, 86% of the women who had intercourse during their fertile period and who received LNG-EC before ovulation, nevertheless ovulated.

This contradicts the notion that ovulation delay or inhibition is Plan B’s only or primary MOA. Had they not taken EC, 13 pregnancies would have been expected to occur among these women, but not one expected embryo survived to implant.

In contrast, among women who had intercourse during their fertile period and received LNG-EC on their day of ovulation or later, seven pregnancies would have been expected (in the absence of EC) and six established pregnancies resulted.

This suggests that LNG-EC is largely ineffective in preventing an established pregnancy if taken at or after ovulation.

Their final findings, published in 2011, are based on data from 450 women. Among those who had intercourse during their fertile period and who were given LNG-EC prior to ovulation, 80% nevertheless ovulated. A contraceptive failure rate of 92% occurred among a subset of women who had intercourse two days before ovulation and received LNG-EC promptly. Sixteen pregnancies would have been expected among the group of women who received EC pre-ovulation. No established pregnancies occurred, i.e., no embryos survived to implant. In the group that received LNG-EC after ovulation, however, 8.7 pregnancies could have been expected and 8 occurred.

To summarize: It is possible that Plan B may delay ovulation when given before or at the beginning of the fertile period, when the chance of pregnancy is slim to none, and therefore, it is not “needed” to prevent pregnancy. When given after intercourse in the fertile period and before the LH peak that triggers ovulation, Plan B fails to act as a contraceptive 80-92% of the time; it acts instead as an abortifacient, eliminating all embryos likely to have been conceived. When given on the day of ovulation or later to prevent pregnancy from intercourse during the fertile period, it almost always fails to prevent established pregnancies. [ed. would cause early abortion]


Peck and Vélez also reviewed other studies whose findings suggest that Plan B has post-fertilization MOAs that may result in the death of an embryo prior to implantation. Among these findings are: slowed transport of the embryo to the uterus resulting in an ectopic pregnancy or the embryo’s delayed arrival in the uterus (after the brief four-day implantation window); diminished luteal (post-ovulatory) levels of LH and progesterone that prevent the changes to the endometrium needed to permit implantation; a shortened luteal phase (indicating that something is awry and the endometrium did not become hospitable to implantation and pregnancy support); and direct changes to the endometrium that block implantation.

The November 2013 Brache et al. analysis of pooled EC studies compares the efficacy of LNG (Plan B), Ulipristal acetate (Ella), a third EC (meloxicam), LNG+meloxicam, and placebo.

Their findings lend support to the conclusions of Peck/Vélez and Mozzanega/Cosmi that Plan B is only minimally effective in delaying ovulation when given in the fertile period immediately preceding ovulation.

Brache et al. found that Plan B was no more effective than a placebo in delaying/inhibiting ovulation. In fact, it was even less effective than placebo because the progesterone in Plan B helped to trigger ovulation within 48 hours.

Given the dangers to the future of conscience rights posed by the Affordable Care Act, an honest debate over the “contraception mandate” is a necessity.  But that debate can only take place by calling things what they are instead of attempting to redefine them into things they are not. 

Numerous studies have shown that the most popular emergency contraceptives can cause the death of embryos.  For the sake of full and accurate informed consent for patients and for the sake of the integrity of the medical profession and research community, this reality must be acknowledged.  Only then will we be able to make informed decisions about our personal healthcare and healthcare policy.

Susan E. Wills, Esq. is an Associate Scholar with the Charlotte Lozier Institute.

[i] E.g., “”The development of a human begins with fertilization, a process by which the spermatozoon from the male and the oocyte from the female unite to give rise to a new organism, the zygote;”
[Sadler, T.W. Langman's Medical Embryology. 7th edition. Baltimore: Williams & Wilkins 1995, p. 3]; “Although life is a continuous process, fertilization is a critical landmark because, under ordinary circumstances, a new, genetically distinct human organism is thereby formed…. The embryo now exists as a genetic unity;” [O'Rahilly, Ronan and Muller, Fabiola. Human Embryology & Teratology. 2nd edition. New York: Wiley-Liss, 1996, pp. 8, 29; "Zygote. This cell, formed by the union of an ovum and a sperm (Gr. zyg tos, yoked together), represents the beginning of a human being. The common expression 'fertilized ovum' refers to the zygote." [Moore, Keith L. and Persaud, T.V.N. Before We Are Born: Essentials of Embryology and Birth Defects. 4th edition. Philadelphia: W.B. Saunders Company, 1993, p. 1];

[ii] FDA-approved Drug Label (through June 10, 2013). On June 11, 2013, the F.D.A. approved a manufacturer-requested change to ParaGard’s label, adding “possibly” before “prevention of implantation.”

[iii] A list of studies can be found in footnote 106 of R. Peck and J. Vélez, “The Postovulatory Mechanism of Action of Plan B: A Review of the Scientific Literature,” The National Catholic Bioethics Quarterly 13.4 (Winter 2013):000-000; available at http://ncbcenter.org/document.doc?id=584; accessed January 9, 2014.

[iv] M. Zieman and R.A. Hatcher, Managing Contraception (Tiger, GA: Bridging the Gap Foundation, 2012), p. 76.

[v] V. Brache et al., “Ulipristal Acetate Prevents Ovulation More Effectively than Levonorgestrel: Analysis of Pooled Data from Three Randomized Trials of Emergency Contraception Regimens,” Contraception 88.5 (November 2013) 611-618.
[vi] Brache et al., 616-617.

[vii] B. Mozzanega and E. Cosmi, “How Do Levonorgestrel-Only Emergency Contraceptive Pills Prevent Pregnancy? Some Considerations,” Gynecological Endocrinology 27.6 (June 2011) 439-442.
[15 Jan 14,  Susan Wills, JD, LLM, Charlotte Lozier Institute, http://www.lozierinstitute.org/emergencycontraceptives/ ; PFLI Pharm Facts E-News, 25 Mar 14]

 

Despite Condoms and “Safe Sex” 50,000 New Annual USA HIV Infections

Despite decades of calling sex with a condom “safe sex,” or even worse, “safer sex,” there are still 50,000 new infections in the USA each year. And now, a federal panel is calling for HIV testing to be offered to all adolescents and adults to the age of 65.

From the LA Times story:

    The recommendation from the U.S. Preventive Services Task Force seeks to address one of the key challenges in the fight against HIV/AIDS: The window during which patients respond best to treatment is also the time when symptoms of the disease are least noticeable. “HIV is a critical public health problem, and there are still 50,000 new infections per year,” said Dr. Doug Owens, a task force member and professor of medicine at Stanford University. “There’s very good evidence that treatment is effective when given earlier, at a time when people are often asymptomatic. So the only way they would know that they had HIV, or that they needed treatment, is to be screened.”

    Based on a review of more recent data–including evidence that as many as 25% of people who carry HIV in the U.S. have no idea they are infected–task force members concluded that early detection would “result in substantial public health benefits” that outweighed any risks of widespread screening.

Based on what was reported, it would appear that the Task Force did not issue a clarion call for restricting one’s sexual behavior. That’s par for the course. I saw a story recently of a vaccine trial with some 2,000 volunteers that was stopped because more people got HIV with the vaccine than without it. That certainly implied that at least some of the subjects were willing to risk infection by engaging in risky behaviors.

This is truth: The only actual “safe sex” is that between mutually monogamous, uninfected partners. Anything else is risk. Sex with condoms is properly called “less safe,” since it provides some but not absolute protection. And sex with no protection at all is ”unsafe.” That isn’t moralism. It is basic health science.

LifeNews.com Note: Wesley J. Smith, J.D., is a special consultant to the Center for Bioethics and Culture and a bioethics attorney who blogs at Secondhand Smoke.
[Wesley J. Smith | Washington, DC | LifeNews.com | 4/30/13,  http://www.lifenews.com/2013/04/30/despite-condoms-and-safe-sex-50000-new-annual-usa-hiv-infections/ ]

New Study Links Birth Control Pill with Multiple Sclerosis

A new study has found that women who use the contraceptive pill may be as much as 50 percent more likely to develop multiple sclerosis.

The study was conducted by the Kaiser Permanente Southern California medical group, under the leadership of Dr. Kerstin Hellwig, and contradicts previous research that had suggested that use of the pill reduces its likelihood. 

According to the press release issued by the American Academy of Neurology, “Women who had used hormonal contraceptives were 35 percent more likely to develop MS than those who did not use them. Those who had used the contraceptives but had stopped at least one month before symptoms started were 50 percent more likely to develop MS.”

“A total of 29 percent of the women with MS and 24 percent of those without MS had used hormonal contraceptives for at least three months in the three years before symptoms began. The majority used estrogen/progestin combinations.”

“These findings suggest that using hormonal contraceptives may be contributing at least in part to the rise in the rate of MS among women,” said Hellwig.

Although there are a number of factors that need to be considered, according to the World Health Organization, incidences of MS are much higher in wealthier parts of the world, especially among wealthier segments of those societies, which would also coincide with heavier contraceptive pill use. In Europe and North America the incidence of MS is approximately 80 in 100,000, and occurs most often in women between ages 20 and 40. Women are twice as likely to get it as men.

The new research will be presented at the American Academy of Neurology’s annual meeting in Philadelphia at the end of April and yet it is doubtful that the findings will greatly influence pill use.

Even Hellwig was herself dismissive of the implications of her study for everyday behaviour. “There may be some environmental factor that we have not been able to allow for, we are not telling women to stop using the pill,” she said.

According to the Guttmacher Institute, in 2010, approximately 17 percent of women aged 15-44 were using the pill, while about 80 percent of sexually-active women have used it at some point.
[28 Feb 2014, Colin Kerr, Philadelphia, http://www.lifesitenews.com/news/new-study-links-birth-control-pill-with-multiple-sclerosis?utm_source=LifeSiteNews.com+Daily+Newsletter&utm_campaign=1b80ba8773-LifeSiteNews_com_US_Headlines_06_19_2013&utm_medium=email&utm_term=0_0caba610ac-1b80ba8773-326232694 ]
 
 

 

 

 

 

Hormonal Contraceptives Nearly Double Stroke Risk in Women: American Heart Association

February 7 is “National Wear Red Day,” sponsored by the American Heart Association (AHA) to draw attention to the risk of heart disease and stroke in women.  On Thursday, the organization released new stroke prevention guidelines specifically for women, reminding them that hormonal contraceptives like birth control pills increase their risk of hypertension (high blood pressure), blood clots and stroke – especially for women who are over 40, overweight, smoke or suffer from migraine headaches.

“If you are a woman, you share many of the same risk factors for stroke with men, but your risk is also influenced by hormones, reproductive health, pregnancy, childbirth and other sex-related factors,” said neurologist Cheryl Bushnell, M.D., the guidelines’ lead author, in a statement. “The risk factors that are unique to women need to be recognized, and women can start decreasing their risk much earlier than they thought, even in the childbearing years.”

According to the guidelines, use of oral contraceptives nearly doubles the risk of stroke in women, who die from stroke at a much higher rate than men. Stroke is the third-leading cause of death in women, accounting for 60 percent of all stroke deaths, according to the AHA.

Citing the “well-established risk” of birth control use by older women, cigarette smokers, and those who suffer from hypertension or migraines, the guidelines recommend that women be screened for high blood pressure before starting on the pill.  The guidelines also suggest that users of oral contraceptives who have one or more additional risk factors for stroke – such as hypertension, migraines or obesity – pursue “aggressive treatment” of those risk factors while on the pill.

While this is the first time the AHA has come out with stroke prevention guidelines specifically targeted at women, it is not the first time the organization has highlighted the risks oral contraceptives present to women’s cardiovascular health.

“Doctors and researchers have found a link between birth control pills and an increase in blood pressure among some women,” the AHA says in their fact sheet about birth control and heart disease. “They say that it is more likely to occur in women who are already overweight, have kidney disease or have a family history of high blood pressure.”

According to
the AHA, nearly two-thirds of American women are overweight (BMI 25+), including 60.2 percent of white women, 79.9 percent of black women, and 78.2 percent of Mexican-American women.  Nearly half of black women over 20 suffer from high blood pressure, while nearly one-third of white and Hispanic women do.

But even women without such risk factors can succumb to the dangers of oral contraceptives.  A number of high-profile deaths and injuries of young, otherwise healthy women after beginning a birth control regimen have led to investigations and warnings by health organizations around the world.

In the United Kingdom, 18-year-old beauty queen Georgie Holland suffered a stroke and partial blindness after taking the oral contraceptive Yasmin, which is heavily marketed to young girls.  The teen spent a week in the hospital, suffered permanent damage to her vision, and must now take daily blood thinners to prevent another stroke.  Her doctors blame the birth control pill for her ordeal.

In Canada, another 18-year-old, Marit McKenzie, died of a brain hemorrhage after taking another contraceptive pill, Diane-35, which was ostensibly prescribed to control her acne.  The same drug has also been implicated in the deaths of 27 Dutch women, most of them under 30.

Another Canadian, Marie-Claude Lemieux, suffered a stroke and total paralysis at age 29, after just six months on birth control pill Tri-Cyclen.  It took nearly three years of physical therapy for her to regain partial control of one of her fingers, which allows her to communicate with her husband and the outside world.  Lemieux, who had no risk factors for stroke aside from use of the pill, told Quebecois newspaper La Presse, “Nobody mentioned the risk [of the pill] and I believed that since it was approved, it was not dangerous.”
[7 Feb 2014, Kirsten Andersen, WASHINGTON, D.C.,  http://www.lifesitenews.com/news/american-heart-association-warns-hormonal-contraceptives-nearly-doubles-str?utm_source=LifeSiteNews.com+Daily+Newsletter&utm_campaign=4eec55b6b2-LifeSiteNews_com_US_Headlines_06_19_2013&utm_medium=email&utm_term=0_0caba610ac-4eec55b6b2-326232694 ]

 

 

 

Two-Thirds (2/3, 66%) of Women Seeking Abortions Were Using Contraception When They Conceived, 40% Were Using 'The Pill'

[Ed. Similar Surveys in France, other European nations, and in the U.S. have shown very similar results. Two studies by the Alan Guttmacher Institute found that over half — 54% and 56% — of women at abortion facilities were using birth control the month they conceived.]

The claim that increasing contraception reduces abortion received a death blow this week from the UK’s biggest abortion provider. Figures from the British Pregnancy Advisory Service (BPAS) reveal that a staggering two-thirds of women having an abortion were using a contraceptive at the time they conceived.

“Ultimately women cannot control their fertility through contraception alone, and need accessible abortion services as a back-up for when their contraception lets them down,” said Ann Furedi, BPAS’ chief executive, in a press release.

BPAS looked at the contraceptive use of 156,751 women aged 15 and over visiting its clinics for an abortion between January 2011 and December 2013.

“Two thirds (66%) of women having an abortion at BPAS reported using a form of contraception when they conceived. 40% of these say they were using the contraceptive pill, the most popular prescribed contraceptive in the UK,” the abortion organization stated in a report titled “Women trying hard to avoid unwanted pregnancy.”

Figures on condom use for preventing pregnancy were almost as dismal as those of the pill.

Over a third of women (35%), about 54,862, having an abortion at BPAS became pregnant while using condoms.

Furedi tried to downplay the failure behind contraception. “An unintended pregnancy is often a happy accident,” she said in a press release. "Contraception fails and sometimes we fail to use it properly. In our experience women are trying hard to avoid unwanted pregnancy, or sometimes vastly underestimate their own fertility.”

Furedi’s statement on abortion as a solution for failed contraception echoes those of Joyce Arthur, founder and executive director of the Abortion Rights Coalition of Canada, who admitted last year that “[m]ost abortions result from failed contraception.”

While proponents of legal abortion often argue that increasing contraceptive use reduces abortion, pro-life critics say the dramatic rise in abortion numbers across the globe over the last few decades is directly linked to the influx of contraceptive pills and devices.

Dr. Malcolm Potts, former medical director of the International Planned Parenthood Federation, predicted in 1973 that as “people turn to contraception, there will be a rise, not a fall, in the abortion rate.”

Anthony Ozimic, communications manager for the UK’s Society for the Protection of Unborn Children (SPUC), told LifeSiteNews that there is a “growing body of evidence that the provision of contraception not only fails to prevent unplanned pregnancies but results in unborn children being victimised to death as the unwelcome consequences of so-called contraceptive failure.”

A 2012 Russian study found that while Russian women had the highest rate of contraceptive use when compared to surrounding countries, they also had the highest abortion rate. The researchers were clearly perplexed when they found “higher odds of modern contraception” led to a “higher level of abortion,” calling their findings “contradictory,” “unexpected,” and “paradoxical.”

A 2011 Spanish study found that as use of contraceptive methods increased in a sample of more than 2,000 Spanish women (49.1% to 79.9%), the rate of abortion in the group doubled in the same period. The researchers were clearly puzzled by the findings of their 10-year study, calling it “interesting and paradoxical” that the large increase in elective abortions was associated with a remarkable increase in the number of women who used contraceptive methods.

Research from the pro-abortion Guttmacher Institute showed in 2011 that a majority of abortions took place in America after contraception failure, stating that “54 percent of women who have abortions had used a contraceptive method [usually condom or the pill] during the month they became pregnant.”

One UK government report found that cuts to contraception did not increase abortion rates, as expected, but may have actually decreased them.

[see http://www.lifesitenews.com/news/two-thirds-of-women-seeking-abortions-were-using-contraception-britains-lar    for imbedded links]
[5 Feb 2014, Peter Baklinski, WARWICKSHIRE, UK,  http://www.lifesitenews.com/news/two-thirds-of-women-seeking-abortions-were-using-contraception-britains-lar ]

 

 

Infertility Drugs and the Risk of Breast Cancer: Findings from the National Institute of Child Health and Human Development Women’s Contraceptive and Reproductive Experiences Study
When compared with controls, women with breast cancer were more likely to have had fewer full-term pregnancies, their first full-term pregnancy at a later age, an earlier menarche, and a family history of breast cancer.
Burkman. Infertility drugs and breast cancer risk. Fertility & Sterility, vol 79, no 4, April 2003. http://reproductivefacts.org/uploadedFiles/ASRM_Cont

ent/News_and_Publications/Selected_Articles_from_Fertility_and_Sterility/infertilitydrugsbreastcancer.pdf