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In 1997, physicians and researchers Ambre Olsen, Virginia Smith, John Bergstrom, Joyce Colling, and Amanda Clark published, “Epidemiology of Surgically Managed Pelvic Organ Prolapse and Urinary Incontinence,” in the journal Obstetrics and Gynecology. In their article, the authors retrospectively analyzed data from patients who underwent surgery for pelvic organ prolapse or urinary incontinence two years prior in 1995. Often due to a weakening of or damage to their pelvic muscles, women with pelvic organ prolapse can experience a descent of pelvic organs into the lower pelvis and vagina. People with urinary incontinence can experience bladder control issues and urinary leaks. According to the authors, an estimated fifty percent of women who have previously given birth have had a prolapse. In their article, Olsen and colleagues analyze factors such as race, age, and weight in women who had surgery to treat pelvic organ prolapse and ultimately advocate for a standard assessment for the severity of those conditions.
In 1996, a team of researchers associated with the International Continence Society published “The Standardization of Terminology of Female Pelvic Organ Prolapse and Pelvic Floor Dysfunction” in American Journal of Obstetrics and Gynecology. Pelvic organ prolapse is characterized by the descent of the pelvic organs into the lower portion of the pelvis and is often caused by a weakening of the muscles and ligaments that normally hold the organs in place. The authors concluded that physicians and researchers needed to develop a system of standardized terms to use to describe the anatomical position of pelvic organ prolapse in women. They propose using terms that emphasize the location of the prolapse rather than just the involved organ. They also suggest that the system utilizes a series of examinations and imaging to uniformly describe and quantify pelvic organ prolapse. The article by Bump and colleagues was one of the first to call for a standardized system using specific terms to communicate findings about pelvic organ prolapse systematically across clinical and academic research settings.
In 2013, Cynthia Daniels and a team of researchers at Rutgers University in New Brunswick, New Jersey, founded the Informed Consent Project. Daniels and the researchers assessed the medical accuracy of information within state-authored informational materials for abortion. States give those materials to women who want an abortion, but using their research, the Informed Consent Project found some information from those materials to be inaccurate, misleading, and coercive. The Informed Consent Project gathered a panel of researchers and medical specialists to review the information about embryological and fetal development from twenty-three states’ informational materials. They found that approximately one-third of that information was inaccurate. The work of the Informed Consent Project challenges abortion-specific informed consent laws, highlighting medical inaccuracies in state-authored informational materials as evidence that women’s consent to abortion may be based on false or misleading statements.
In 1983, researchers Alan Trounson, John Leeton, Carl Wood, Mandy Besanko, and Angelo Conti published the article “Pregnancy Established in an Infertile Patient After Transfer of a Donated Embryo Fertilized In Vitro” in The British Medical Journal. In the article, the authors discuss one of the first successful experiments using in vitro fertilization, or IVF, with the use of a human donor embryo at the Monash University and Queen Victoria Medical Center in Melbourne, Australia. Prior to the article’s publication, it was uncertain whether scientists could successfully use human donor embryos in IVF techniques. Although the pregnancy ended in a miscarriage ten weeks later, it showed that IVF was possible for those who needed to use someone else’s donated egg cells. Trounson and his colleagues’ paper provided a basis for future IVF pregnancies using donated embryos and helped develop a treatment option for men and women who could not conceive through sexual intercourse alone.
Edwin Carlyle Wood, also known as Carl Wood, was a physician who helped develop in vitro fertilization, or IVF, treatments. From 1964 to 1992, Wood worked as a professor of obstetrics and gynecology at Monash University in Melbourne, Australia, where he was one of the first in the world to lead a team of physicians to establish IVF as a proven treatment for infertility. IVF refers to a medical procedure in which scientists inseminate an egg cell with a sperm cell outside of the body, such as in a glass dish in a clinical setting. Wood helped establish some of the first successful IVF pregnancies and births, and his findings throughout his years of practice helped to standardize the procedure. Wood also advocated for the right for women to have an abortion, and co-founded the Family Planning Association of Victoria in Australia at a time when there were not many abortion clinics in operation. Through his early contributions to IVF, Wood provided new options for people to have offspring, which as of 2021, has up to a 21.3 percent chance of producing a live birth.
Franklin William Stahl studied DNA replication, bacteriophages, and genetic recombination in the US during the mid-twentieth and early twenty-first centuries. With his colleague Matthew Meselson, Stahl performed an experiment called the Meselson-Stahl experiment, which provided evidence for a process called semi-conservative DNA replication. Semi-conservative replication is a process in which each strand of a parental DNA double helix serves as a template for newly replicated daughter strands, so that one parental strand is conserved in every daughter double helix. Those findings supported the Watson-Crick Model for DNA replication proposed in 1953 by James Watson and Francis Crick, convincing many biologists about DNA’s structure and replication in the 1950s. Stahl’s genetics research, especially that of DNA replication, showed researchers how genetic information is distributed within a cell and is passed down from cell to cell.
On 29 September 1973, researchers David De Kretzer, Peter Dennis, Bryan Hudson, John Leeton, Alexander Lopata, Ken Outch, James Talbot, and Carl Wood published “Transfer of a Human Zygote,” in The Lancet. In the article, the authors describe an experiment that resulted in one of the first pregnancies established via in vitro fertilization, or IVF. Prior to the article’s publication in 1973, there was no published evidence demonstrating whether IVF treatment would work in humans, although evidence existed showing that IVF worked in other mammals for breeding purposes. At the end of the article, the authors state that the embryo failed to implant into the wall of the patient’s uterus, leading to a miscarriage less than a week after the authors found evidence of pregnancy in the patient. The authors of “Transfer of a Human Zygote” were some of the first researchers to perform IVF, although unsuccessfully, which contributed to the overall understanding of IVF as an emerging technology.
In 2007, Ishola Agbaje, Deirdre Rogers, Carmel McVicar, Neil McClure, Albert Atkinson, Con Mallidis, and Sheena Lewis published “Insulin Dependent Diabetes Mellitus: Implications for Male Reproductive Function,” hereby “Diabetes Mellitus: Implications,” in the journal Human Reproduction. In their article, the authors explore the effects of elevated blood sugar in the form of diabetes mellitus on the quality of male sperm. When investigating possible fertility issues, fertility specialists often study semen, the male reproductive fluid that contains sperm cells to detect changes in sperm count, movement, and structure. In “Diabetes Mellitus: Implications,” the authors use both conventional semen analysis and technical molecular methods to assess the quality of sperm from diabetic and non-diabetic men. The authors found that men with diabetes had higher levels of DNA damage within their sperm and highlighted a need for additional research on the link between diabetes and male reproductive health.
In 1920, Joseph Bolivar DeLee published the article, “The Prophylactic Forceps Operation,” in which he describes how physicians can manually remove a neonate from a laboring woman’s vagina with the use of sedating drugs and forceps. The procedure, according to DeLee, resulted in decreased rates of complications and mortality for both the woman and neonate. DeLee claimed the procedure could reduce damage to the woman such as prolapse, or when internal pelvic organs push down and sometimes protrude from the vagina, and fatal infant brain bleeding. He also suggested that physicians make an incision from the woman’s anus to vagina to accommodate the use of forceps, a procedure later known as an episiotomy. In “The Prophylactic Forceps Operation,” DeLee proposed the technique and use of his procedure, adding to the growing debate in the early twentieth century on the best way to medically assist women during delivery.
Endometriosis is a condition characterized by the growth of the endometrium, or the tissue that lines the uterus, outside of the uterus, and it is diagnosed through the presence of endometriotic lesions in the pelvic region. The disease is most often associated with abnormal and painful vaginal bleeding. Currently, minimal literature exists concerning the management of endometriosis in low and middle-income countries (LMICs), which may influence the lack of a cultural competent understanding of menstruation in LMICs and, therefore, a lack of evidence-based policies concerning menstruation.