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Biomedical subjects

S Parenteau-Carreau

Publications and source records attributed to S Parenteau-Carreau.

6 recordsLinked to original sources

Fertility of fully breast-feeding women in the early postpartum period.

OBJECTIVE: To examine bleeding between 6 and 8 weeks postpartum in fully breast-feeding women and its association with fertility as assessed by hormone analysis. METHODS: Seventy-two fully breast-feeding women were followed prospectively from 42 days postpartum. Vaginal bleeding was recorded daily. Women who experienced bleeding were compared with women who did not with respect to time of ovulation and time of first menses. RESULTS: Nearly half of the women experienced some vaginal bleeding or spotting between 6 and 8 weeks postpartum. These women eventually menstruated and ovulated earlier than the women who did not bleed, but the differences were not significant. The study had 34% and 45% power to detect a 20% difference in the proportion menstruating and ovulating, respectively, at 6 months postpartum, and 10% and 16% power to detect the same differences at 1 year. Seven women experienced ovarian follicular development before day 56, but neither bleeding nor follicular development was associated with ovulation in any woman in the first 8 weeks postpartum. CONCLUSIONS: It is unlikely that vaginal bleeding in fully breast-feeding women in the first 8 weeks postpartum represents a return to fertility.

Female↗

The natural family planning--lactational amenorrhea method interface: observations from a prospective study of breastfeeding users of natural family planning.

Methods of natural family planning are sometimes difficult for women to use during lactation. When this is so, the lactational amenorrhea method may prove useful. Researchers agree that a fully breastfeeding woman who is amenorrheic is 98% protected from pregnancy for up to 6 months after delivery. The fertility status of 74 users of natural family planning during the time they would have been protected by the lactational amenorrhea method is examined. Underlying hormonal profiles show that there was little ovarian activity during this time. Eight ovulatory events occurred during the period of protection by the lactational amenorrhea method, of which four fulfilled minimum criteria for adequacy; there were no pregnancies during this period. However, some women did report experiencing fertile mucus symptoms during this time that were often unrelated to estrogen production. Using the lactational amenorrhea method rather than natural family planning allows them to avoid unnecessary abstinence.

Amenorrhea↗

Self-palpation to assess cervical changes in relation to mucus and temperature.

Women experienced in cervical self-palpation recognize fertile characteristics when the cervix is high, open, soft, and straight; this happens under estrogenic influence. The cervix is said to show infertile signs when it is low, closed, firm, and lying against the vaginal wall; that change occurs quickly under progesterone influence. The objective of this study was to assess the time relationship among changes in the cervix observed by self-palpation, changes in cervical mucus as observed by women, and the shift in basal body temperature during ordinary cycles. A total of 215 symptothermal charts from natural family planning users were analyzed. The duration of the change from the maximum fertility characteristics to the postovulatory return to definite signs of infertility was measured. This duration ranged from 1 to 7 days, with a mean of 2.65. The timing of maximum fertility signs in the mucus was compared with that of maximum fertility signs in the cervix: it varied from 3 days before to 6 days after, with a mean of 0.48 day. The timing of the first high temperature was compared with that of return to definitely infertile characteristics: it varied from 6 days before to 3 days after, with a mean of -0.69 day. Some of the variation may be due to the presence of inexperienced users in the sample. However, a mean difference of half a day between the most fertile cervix and the most fertile mucus on one hand and between the first day of infertile cervix and the first high temperature on the other hand suggest that the cervical changes could be useful indicators of estrogen and progesterone actions.

Adult↗

Breastfeeding and the symptothermal method.

This prospective study was conducted among experienced users of periodic abstinence methods in Sydney, Montreal, and Birmingham (England) in order to describe the relationship between a laboratory measurement of ovulation and the natural symptoms of fertility during breastfeeding. Daily urinary estrogen and pregnanediol glucuronide assays were used to estimate the date of ovulation and to determine potentially fertile days. A standard set of Symptothermal Method (STM) rules was applied to daily STM records to assess the correspondence of the natural symptoms of fertility to the underlying hormonal profile. The STM symptoms and rules accurately identified 77-94 percent of the women's potentially fertile days, but abstinence was also recommended on about half of the days when the women were not fertile. An integrated set of common rules for STM use during breastfeeding is highly sensitive but not specific in its ability to screen for ovulation.

Adult↗