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Human fertility is part of biological anthropology embracing human population biology devoted to the analysis of the nature, caused, origin, and development of human variation at molecular, cellular, and whole body levels. The successful outcome of human fertility depends on the interactions of biochemical, physiological, and psychological processes whose disturbance results in slight variations in behavior and even total infertility. The Hutterites in the US have the highest average fertility with over 11 live births/women. Hunter-gatherer groups rarely have more than 4 children/woman. The case of a woman who gave birth to 67 children was recorded. Total infertility often occurs even in noncontracepting societies. The most important factor that determines the character of genetic variation within the human species seems to be comparative population growth, as this was the factor determining which populations spread and which became extinct. The study of the determinants of female fertility has attracted attention recently because pregnancy and motherhood affect daily life, and in turn, reproduction is also affected by daily life. Lactational amenorrhea plays a vital role in child spacing, but the mechanism of breast feeding is complex with factors of duration, frequency, milk production, and suckling frequency interwoven. Female reproduction comprises whole body function, nutrition, body composition (the recent debate on fat stores affecting the onset of fertility), physical work, and mental health all influencing the endocrinological state. Heavy physical labor and intensive training by sportswomen can result in amenorrhea. Beta-endorphins also play a role in lactational amenorrhea along with nutrition and body composition. Infectious and venereal diseases particularly affect fertility, yet genetics protect the placenta against falciparum malaria in sickle-cell trait women.
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PMID:Human fertility studies under field conditions. Introduction. 163 57

Subfecundity is caused by disease and nutrition as well as by genetic, environmental, and psychological components. Sexually transmitted diseases (STDs) are caused by 21 different pathogens of which syphilis, gonorrhea, and chlamydia are the most important. Syphilis is caused by the bacterium Treponema pallidum with incidence of 10% in Thailand. 20% in Papua New Guinea, and 40% in Ethiopia. Stillbirths in infected mothers range from 66% to 80%. Gonorrhea is caused by the bacterium Neisseria gonorrhoea and its incidence was 18% in female patients in Ugandan clinic. 20% of women in Africa with cervical gonorrhea develop salpingitis. The risk of pelvic inflammatory disease is several times higher in IUD users. The bacterium Chlamydia trachomatis caused infertility in 15.4% of men in a 1991 study. Herpes simplex virus 2 infects 15-30% of sexually active adults, and the chance of fetal transmission is 40% when maternal lesions are present. Diseases other than STDs include tuberculosis (TB) whose development is aided by conditions such as malnutrition, malaria, leprosy, syphilis, and African sleeping sickness. Genital TB causes a 5-50% rate of menstrual disorders including amenorrhea and a 55-85% rate of sterility in women. Malaria is caused by Plasmodium protozoa, and the feverish state included by it can lead to oligospermia. Severe malarial anemia can lead to fetal and maternal mortality. The protozoa Trypanosoma causes African sleeping sickness that produces azoospermia and impairs the pituitary gland and ovaries. Schistosomiasis (bilharzia) and filariasis have less direct effect on fecundity but they negatively impact nutritional status. Maternal nutrition substantially impacts fetal and infant survival. During the Dutch famine of 1944-45 there was a 50% decrease in births 9 months subsequently. A 10-15% weight loss results in amenorrhea.
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PMID:Endemic disease, nutrition and fertility in developing countries. 163 64

We report a case of congenital malaria in a 2-month-old baby girl, born in Singapore of a Singaporean mother, who presented with fever for one week, gross hepatosplenomegaly and anaemia (haemoglobin 5.6 g/dL) and thrombocytopenia. Peripheral blood films showed Plasmodium vivax. There was no local transmission at that time, but the mother had spent the first 6 months of her pregnancy in Pakistan, where she had been treated for prolonged fever at 4 months amenorrhoea with ibuprofen alone. The mother and 2 siblings were asymptomatic and repeatedly tested negative on blood films for malaria parasites, but the mother tested positive for antibodies to Plasmodium on the Fluorescent Antibody Test. The child was treated with oral chloroquine and made an uneventful recovery. We postulate that this is believed to be the first recent case of congenital malaria in Singapore since it was declared malaria free in 1982. The diagnosis should be considered in babies of mothers who have travelled to places where malaria is endemic, as maternal infection may be unrecognised, and the child may be asymptomatic at birth.
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PMID:A recent case of congenital malaria in Singapore. 904 13

A survey of reproductive health activities in 50 countries shows that 25% of family planning programs provided all types of reproductive health services: family planning or safe regulation of fertility, maternal health and nutrition, protection from sexually transmitted diseases (STDs), and reproductive rights. Integrated reproductive health services reduce duplication and the number of workers and facilities needed. A program providing postpartum care and family planning services in Honduras and Peru increased contraceptive prevalence and saved money. Yet, combining new health services into a family planning program may strengthen one component while hurting the other. Health planners need to reflect on how to integrate reproductive health activities. Family planning providers can screen for STDs, distribute condoms, maintain hygienic facilities, and guarantee that contraceptive services or procedures do not spread or exacerbate genital tract infections. A simple way is needed to evaluate their clients' STD risk, such as interviewing clients about symptoms. At some family planning clinics in Brazil, a cartoon soap opera helps clients in small groups discuss STDs. Family planning clients tend to be married women who generally are not a high risk group. Providers should not recommend a contraceptive method without first determining the client's STD risk. Clients should not choose a method without first considering their STD risk. Family planning prevents maternal deaths. For example, a community project in rural Bangladesh increased contraceptive prevalence, which in turn contributed to a 33% decrease in maternal mortality. Family planning caregivers can tell women about prenatal care, pregnancy complications, and the benefits of breast feeding, as well as provide them with iodine and iron supplements, tetanus toxoid, and malaria prophylaxis. They can counsel postpartum mothers about birth spacing methods (e.g., lactational amenorrhea method).
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PMID:Good reproductive health involves many services. 1229 Apr 67

In 1994, Congress provided dollar 40 M for biomedical research on issues of importance for military women. This supported 104 intramural and 30 extramural studies and launched an era of research to narrow the knowledge gap on protection and enhancement of health and performance of military women. Projects addressed issues specific to female physiology (e.g., gynecological health in the field, maternal malaria), problems with higher prevalence for women (e.g., marginal iron deficiency, stress fracture), and issues of drug and materiel safety that had only been extrapolated from studies of men (e.g., chemical agent prophylaxis, fatigue countermeasures). Several important assumptions about female physiology and occupational risks were found to be astoundingly wrong. Hormonal changes through the menstrual cycle were less important to acute health risks and performance than predicted, exercise did not increase risk for amenorrhea and consequent bone mineral loss, and women tolerated G-forces and could be as safe as men in the cockpit if their equipment was designed for normal size and strength ranges. Data on personal readiness issues, such as body fat, physical fitness, nutrition, and postpartum return to duty, allowed reconsideration of standards that were gender appropriate and not simply disconnected adjustments to existing male standards. Other discoveries directly benefited men as well as women, including development of medical surveillance databases, identification of task strength demands jeopardizing safety and performance, and greater understanding of the effects of psychosocial stress on health and performance. This surge of research has translated into advances for the welfare of service women and the readiness of the entire force; relevant gender issues are now routine considerations for researchers and equipment developers, and some key remaining research gaps of special importance to military women continue to be investigated.
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PMID:Biomedical research on health and performance of military women: accomplishments of the Defense Women's Health Research Program (DWHRP). 1631 15

This paper describes ethnopharmacological knowledge on the uses of Erythrina senegalensis DC (Fabaceae) in traditional medicine in three different areas (Dioila, Kolokani and Koutiala) in Mali. Data were collected using interviews of traditional healers selected randomly. The main reported diseases for which E. senegalensis was used by the traditional healers were amenorrhea, malaria, jaundice, infections, abortion, wound, and body pain (chest pain, back pain, abdominal pain etc). The fidelity level (which estimates the agreement of traditional healers on the same area about a reported use of the plant) was calculated to compare the results from the three areas. Certain differences were noticed, the most striking was the fact that amenorrhea was the most reported disease in Dioila and Kolokani with 21% of agreement for both areas, while this use was not reported in Koutiala at all. Similarities existed between the three areas on the use of the plant against malaria and infections, although with different degree of agreement among the healers. We also report the results of a literature survey on compounds isolated from the plant and their biological activities. A comparison of these results with the ethnopharmacological information from Mali and other countries showed that some of the traditional indications in Mali are scientifically supported by the literature. For instance, the use of E. senegalensis against infectious diseases (bilharzias, schistosomiasis, pneumonia etc.) is sustained by several antibacterial and antifungal compounds isolated from different parts of the plant. The comparison also showed that pharmacologists have not fully investigated all the possible bioactivities that healers ascribe to this plant.
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PMID:Ethnopharmacological uses of Erythrina senegalensis: a comparison of three areas in Mali, and a link between traditional knowledge and modern biological science. 1832 74