How Safe is Sex?

Sex or copulation is the primary tool for the reproduction of the human species. The young man across the street and his girlfriend next door wish that having sex could be structured, in such a way, that there is no attendant risk to it. However, unwanted pregnancies and incidents of sexually-transmitted diseases do occur. These make sexual contact less appealing for some. With the unprecedented advances in technology, what progress have we made in the area of birth control? It seems to be a lot if we based it on the data for the period 2015-2017 of the National Survey of Family Growth. It showed close to 47 million or 64.9% of women in the US in the 15-49 age category using some form of contraception.

Female sterilization or tubal ligation is the most preferred method of birth control at 18.6%. Although it involves a surgical procedure to seal or block the fallopian tube, it is popular because it does not affect sexual libido and does not have the side effects of other methods of contraception. Oral contraceptive pills came in close at 12.6%, mainly because of their convenience and affordability.  Long-acting reversible contraceptives (LARCs) like IUDs were at third with 10.3%. Bringing up the rear is the ever-reliable male condoms at 8.7%.

One can enjoy sex and stay away from unwanted pregnancies by using proven contraception methods. Be well-informed of the advantages and disadvantages of each, however, before making a choice. It is your body, after all.

by Dr. Barry Verkauf, author of the book, Sex, Science, Society, and Reproduction: The Pill that changed America

What is Holding Back Assisted Reproductive Technologies (ART)?

 According to the Center for Disease Prevention and Control (CDC), 1.9% or 73,254 of the 3,855,500 infant births in the US in the year 2017 were made possible with the use of Assisted Reproductive Technologies (ART). ART is a myriad of procedures that involve the removal of a woman’s eggs from her ovary, the eggs fertilization with a man’s sperm in a laboratory, and the re-insertion of the embryos that form into the woman’s uterus or to that of a surrogate. In vitro fertilization (IVF) is the leading example of ART. Variations have emerged like gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT). Cryopreservation of embryos is an important aspect of ART.

Despite its successes, ART is not yet widely used. One of the main reasons is the cost. A round of IVF will cost $12,000 that is above the reach of ordinary individuals. If the implantation of the embryo is not successful on the first attempt, more rounds will be needed, and the cost escalates. Other than the cost, ART can lead to multiple pregnancies. In the 2017 data, 14.7% of multiple births (twins, triplets) in the US were attributed to ART. Lastly, the emotional toll on failed ART rounds is high. It can lead to extreme anxiety and depression.

ART will continue to play a role in the future of reproduction. To make this a reality, there should be a concerted effort from all stakeholders to address the concerns that are holding ART back.

by Dr. Barry Verkauf, author of the book, Sex, Science, Society, and Reproduction: The Pill that changed America

Sex, Reproduction, and the Meaning of Life

 Reproduction and propagation of the human species are increasingly leaning toward advanced methods of assisted reproductive technologies, otherwise known as ART.  Under this increasing scenario, a mere skin biopsy from an individual can lead to the normal birth of his clone. With ART as the backbone of human reproduction, sexual copulation for some could graduate into just another form of entertainment.  

Assisted reproductive technologies encompass a gamut of procedures that involve the surgical removal of eggs from a woman's ovary, the subsequent artificial insemination of the egg with sperm in a laboratory setting, and the implantation of the embryo back into the woman's body or into another woman who agrees to be a gestational carrier.  In vitro fertilization as well as freezing and preservation of eggs, sperm, and embryos, are the more widely known aspects of ART.  Because the process can involve genetic testing before the implantation of the embryo, it is a widely held view in the scientific circles that we will eventually start to remove abnormal genes in embryos and/or introduce new ones to improve the quality of life using gene-editing technologies.  

The continuing advances in human reproductive technologies that stare us keenly in the face have caused us to recalibrate our view on sex and reproduction.  Could these eventually alter our beliefs on the meaning of life and what it means to be fully human? 

by Dr. Barry Verkauf, author of the book, Sex, Science, Society, and Reproduction: The Pill that changed America

The Pill: How to Make Love Without Worrying About Your Future – Sex and Science

The 1960s was a turning point for a sexual revolution in the United States.  Still reeling from the horrors of the Second World War and the 1930s depression, people in the United States and elsewhere were trying to bring normalcy to their lives and focused on family life.  As a result, the U.S. population shot up from 140,000,000 in 1945 to 180,000,000 in 1960, a dramatic 22% increase.  To answer the unprecedented population growth, the introduction of synthetic progesterone, more commonly known as the birth control pill, was approved by the FDA in 1960.  As a consequence, the introduction of synthetic progesterone and estrogen, coupled with the stirrings of the second wave of women's liberation, gave impetus to heightened sexual liberation for both men and women. At the same time, it enabled women to begin to stand toe-to-toe with men in asserting their rights and desires.

The newfound readiness to engage in sexual activity without worrying about pregnancy made women realize that they could be more in control of their destiny.  The birth control pill, and subsequent effective contraceptives, brought on a new sense of hope and desire among women to realize long-held dreams.  More women entered college, finished their academic degrees, and opted for advanced education.  Currently, there exists an equal number of women and men in medical and law schools.  Many women, having completed their education or often without completing them, entered the workforce and occupied positions traditionally handled by men.  In the hallowed halls of the Fortune 500, 41 women CEOs now occupy the pole position, an all-time high.

However, there were unintended consequences that came to the fore after the introduction of the pill. In 1960, there were 1600 births per 1000 women-years in this country. In 2015, that had dropped to 600 births per 1000 women-years.  Some have expressed concern that with an aging population we will not have enough of a younger population to support and serve the country.  Moreover, women have delayed marriage and childbearing increasing the likelihood of infertility becoming a potentially difficult issue for them to deal with as they age.  Thus, the "contraceptive pill" has affected American lives and society in more ways than can be imagined.  It has opened up a world of possibilities, especially for women.  No longer is sex and pregnancy the limiting factors they once were.

by Dr. Barry Verkauf, author of the book, Sex, Science, Society, and Reproduction: The Pill that changed America

In Vitro Fertilization-How to get Pregnant without Sex

The birth control pill, and other subsequent contraception, when used appropriately, prevent unwanted pregnancy. For pregnancies which occur and are not desired in the United States, Rowe versus Wade provides opportunity for termination of these pregnancies.  For most couples, pregnancy is a choice they desire, although for some it is as difficult to achieve as scaling Mount Everest. Over time, infertility has generally affected 11 to 15 percent of the population and may be contributed to by damaged fallopian tubes, difficulties with ovulation, inadequate sperm production by the male, and a few other issues.  While improvements in treatment methods of these deficiencies in recent years have increased their efficacy, only about 50% of infertile couples will conceive with their use.  Like a ray of light bursting in with hope, in vitro fertilization (IVF) came onto the scene with the first spectacular live birth in England, initiated by Drs. Edwards and Steptoe in 1978.  In the United States, under the aegis of Drs. Howard and Georgeanna Jones, America's first IVF pregnancy occurred in 1981 in Virginia. 

IVF involves the surgical collection of a woman's eggs and a man's sperm for fertilization, usually by masturbation, and fertilization occurs in the laboratory in a dish.  The resulting embryos are subsequently transferred into a woman's uterus for the pregnancy to proceed.  It may sound like a simple procedure, but it is not.  It is sufficiently convoluted that it requires the skill of a cadre of clinical, laboratory, and radiologic personnel.  The cost is usually about $18,000 per attempted cycle in the United States.  Each attempt has its emotional toll, as well. Nevertheless, it is sought after by most couples who do not conceive with simpler treatments.  IVF accounts for about 2% of babies born in the United States currently.  

It is said that when one door closes, a window somewhere opens. This seems to be the case with IVF, a welcome potential window for couples who can't conceive using traditional therapy methods.

by Dr. Barry Verkauf, author of the book, Sex, Science, Society, and Reproduction: The Pill that changed America

Contraception and the Pill-How to have Sex without Getting Pregnant

Individuals who value sexual freedom find the thought of unplanned pregnancy unnerving. Moreover, having a baby one may find impossible to raise or lose a job for a night of sexual satisfaction has deterred many from the full enjoyment of sex. G.D. Searle had this incongruity in mind when it laid down the groundwork for manufacturing the first hormonal birth control pill in Chicago in 1960.

Created to control a burgeoning population, the pill, a potent combination of female hormones estrogen and progesterone synthetically produced in a controlled laboratory environment, has opened up a whole avenue of sexual liberation. First taken every day for 21 days, the pill’s simple action of preventing the release of an egg from the ovary during ovulation by maintaining a constant level of the aforementioned hormones has proven to be very effective in preventing pregnancy. Recommended to be taken daily with regularity, it has surprisingly lowered incidents of ovarian and uterine cancers as well as acne and irregular periods. The latest figures from the National Survey of Family Growth indicate that it is popularly used as a form of contraception by 14% of women aged 15-49 in the United States.

Living your life and enjoying sex in the process if you choose should be the norm and not the exception. Getting pregnant should not get in the way of your life goals. Taking the pill is a no-brainer.

by Dr. Barry Verkauf, author of the book, Sex, Science, Society, and Reproduction: The Pill that changed America