Transcript 780 KB - Life Network Foundation Malta

Emergency Contraception
Morning after pill
Factors to consider
• Language manipulation
Bias towards abortion
means that new life is not
respected.
• Begining of a new life
occurs at fertilization
An embryo with complete
genetic make up comes
into being.
• Pregnancy
1965 - ACOG defines
pregnancy as starting
following implantation.
According to the ‘doctored
definition’ abortifacient
now conveniently means
‘anything that interferes
with an established
pregnancy.’
1
Funding for contraceptive research
Consider :
• Funds mainly come from those who have a
pecuniary interest ie the manufacturing
companies
• Which research is being quoted?
• Most global companies or institutions backing a
lot of these studies are pan global pro abort
companies.
Examples; WHO, Bill &Melinda Gates Foundation,
Guttmacher Institute,United Nations Population
Fund etc
2
The fundamental question to ask is
not if the drug is “abortifacient,” but
whether or not the emergency
contraceptive is embryocidal .
Does it have an action which can kill
an embryo?
3
Emergency Contraception
Morning after pill
4
• LNG and Ella are very different drugs with very
different mechanisms of action.
• Lumping together two very different drugs
and calling them 'morning-after pills' allows
for clever confusion of what is known about
the mechanism of action of each drug,”
• wrote Dr. Harrison, a Michigan-based
obstetrician and gynaecologist ( AAPLOG)
5
Emergency contraceptives can:
• 1. Prevent the ovary from making and/or
releasing an egg
• 2. Prevent the sperm from meeting the egg in
the tube
• 3. Prevent the embryo from surviving the
passage through the tube to the lining of the
uterus
• 4. Prevent the embryo from implanting in the
lining of the uterus
• 5. Prevent the embryo who has already
implanted from surviving to day 28.
6
Levonogestel (LNG) Emergency
Contraception
Contraceptive or abortifcient?
7
Leveonogestrel ( Plan B, Next Choice)
• LNG is a progesterone.
• Progesterone is a hormone that must be in a
woman’s body for her to be able to allow the
embryo to implant and develop the placental
connections between the embryo and the
mother.
8
The question of mechanism of action
is fundamentally a scientific one.
• Effectiveness of LNG EC to prevent pregnancy
depends on when it is given, before or after
ovulation.
9
Mechanism of Action Of LNG
1. Progestins are artificial hormones which resemble natural
progesterone, but do not have all the actions of natural
progesterone.
2. LNG works poorly as an emergency contraceptive, because
it does not have much effect after fertilization. It can delay
the release of an egg if taken several days before the LH
surge.
3. But, if it is taken immediately before the LH surge, egg
release will still happen, but the LH surge will be
decreased, causing a luteal phase defect .
4. If a woman has already released an egg and takes LNG,
there seems to be little if any effect on her embryo. Single
dose LNG after egg release probably does not affect either
progesterone production or implantation.
10
Fertile Window ( days -5 to -1)
• Fertile window
• Days -5 to -1
• Ovulation day (0) and
after
11
The period of time that is
concerning, is when LNG EC is given
before ovulation,
in the fertile window.
12
Study by Noe et al
Day of ovulation (0 to +1)
• As expected, the effectiveness of LNG EC given on the day of ovulation or later - was
basically non-existent
• (7 expected and 6 actual pregnancies).
13
LNG is a poor anovulant
Consider this:
• when LNG EC was given in the fertile
window, breakthrough ovulations
occurred 62 out of 87 times
(71% of cases).
14
LNG has Preovulatory Effects :
• lower luteal phase hormone levels
• decreased endometrial receptivity (as evidenced
by glycodelin-A levels)
• shorter luteal phase or earlier bleeding, and
• very high intrauterine pH levels to as high as 9
(which is a 10-fold increase above the normal
intrauterine pH).
15
From study by Noe et al
In stark contrast,
the effectiveness of LNG EC - given in
the fertile window (-5 to -1 days
before ovulation) – to prevent of
pregnancy was complete
(13 expected but 0 actual
pregnancies).
16
Informed Choice
• Dr. Trussell and Dr. Raymond (both worldrenowned, staunch supporters of
contraception) admit in their review of LNG,
“to make an informed choice, women must
know that [emergency contraceptive pills]…
may at times inhibit implantation of a
fertilized egg in the endometrium.”
• Who are we to ignore this FACT?
17
Conclusion
• Given that breakthrough ovulations occur the
majority of the time when LNG EC is given in
the fertile window, together with the scientific
support in favor of postfertilization effects
that follow, leads to the conclusion that
postfertilization effects of LNG EC have NOT
been ruled out, but rather, likely occur at a
significant rate.
• To state otherwise is statistically improbable
and scientifically untenable.
Patrick Yeung Jr., M.D. and Donna Harrison, M.D.
18
Ella One
(Ulipristal Acetate)
19
• If taken before a woman ovulates, Ella will
interfere with progesterone action and prevent
the egg from being released.
• But the critically important question is what
happens when you take Ella after ovulation.
• Ella blocks the action of progesterone at the
level of the ovary, and blocks the action of
progesterone at the endometrium, both of
which interfere with implantation.
20
• Ella (ulipristal) is an Anti-hormones
/Progesterone blockers - effectively block the
actions of natural progesterone.
• Without sufficient progesterone, an embryo is
unable to implant in the womb, and will also die
after implantation due to the uterine lining not
sufficiently nourishing the embryo.
• Ella (ulipristal) is as effective in blocking
progesterone as is the abortion drug RU-486.
• Yet, Ella is called an “Emergency
Contraceptive”because that is the indication the
manufacturer sought approval for from the FDA.
21
• Both RU-486 and Ella can also directly destroy
the corpus luteum of the ovary , so that it
cannot make progesterone to support the early
pregnancy.
• Progesterone blockers--RU-486 (mifeprex) and
ulipristal (Ella)--can directly destroy the embryo
by directly blocking the action of progesterone
in the womb.
• So, both RU-486 and ulipristal can both prevent
implantation and can cause abortion after
implantation.
22
• Dr Harrison, who was present at the Food and
Drug Administration Advisory Committee's hearing
on the approval of Ella, recalled the presentation
of data showing that the drug “is around 95
percent effective” in preventing pregnancy.
• “One of the Advisory Committee members
repeatedly pointed out to the manufacturers that
there was no way the effectiveness of Ella could be
explained by delaying ovulation alone,” she
recalled.
• “This fact does not take an FDA Advisory
Committee member to figure out. If Ella works
even when a woman takes it after ovulation, then
of course it doesn’t work in that woman by
preventing ovulation.”
23
• Harrison noted that Ella also has “a bigger problem.”
Although it is used as emergency contraception, studies
supporting its approval by the government showed that the
dose in question “is high enough … to increase the
miscarriage rate if a pregnancy is recognized.”
• “In point of fact,” the doctor observed, “any drug which can
act to prevent pregnancy after a woman has ovulated
must have some post-fertilization effect.”
• “Whether it kills the embryo directly, or prevents the
embryo from travelling down the tube, or prevents the
embryo from implanting, or interferes with ovarian
function, or increases immune rejection of the embryo, or
directly destroys the placenta, some mechanism must be
in place to interfere with the normal embryo functioning
and then kill the living embryo.”
24
The Precautionary Principle
• a strategy to cope with possible risks
where scientific understanding is yet
incomplete,
such as the risks of nano technology,
genetically modified organisms and systemic
insecticides.
25
The Precautionary Principle is defined
as follows:
•
•
•
•
•
•
When human activities may lead to morally unacceptable harm that is scientifically
plausible but uncertain, actions shall be taken to avoid or diminish that harm. Morally
unacceptable harm refers to harm to humans or the environment that is
threatening to human life or health, or
serious and effectively irreversible, or
inequitable to present or future generations, or
imposed without adequate consideration of the human rights of those affected.
The judgement of plausibility should be grounded in scientific analysis. Analysis should
be ongoing so that chosen actions are subject to review. Uncertainty may apply to, but
need not be limited to, causality or the bounds of the possible harm.
Actions are interventions that are undertaken before harm occurs that seek to avoid or
diminish the harm. Actions should be chosen that are proportional to the seriousness
of the potential harm, with consideration of their positive and negative consequences,
and with an assessment of the moral implications of both action and inaction. The
choice of action should be the result of a participatory process.
Source:
• http://www.precautionaryprinciple.eu/
26
Studies presented to supplement
presentation.
Dr Miriam Sciberras BChD(Hons) MA
Bioethics
Chairman Life Network Foundation
Malta
27