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Geneva, Switzerland, WHO, Department of Reproductive Health and Research, 2011.  p. (WHO/RHR/11.10)The primary goal of the present guidelines is to improve the quality of care and outcomes for pregnant women undergoing induction of labour in under-resourced settings. The target audience of these guidelines includes obstetricians, midwives, general medical practitioners, health-care managers and public health policy-makers. The guidance provided is evidence-based and covers selected topics related to induction of labour that were regarded as critical priority questions by an international, multidisciplinary group of health-care workers, consumers and other stakeholders. This evidence base includes chapters on indications, methods, treatment of uterine hyperstimulation and setting.
Geneva, Switzerland, WHO, 2011.  p.The primary goal of the present guidelines is to improve the quality of care and outcomes for pregnant women undergoing induction of labour in under-resourced settings. The target audience of these guidelines includes obstetricians, midwives, general medical practitioners, health-care managers and public health policy-makers. The guidance provided is evidence-based and covers selected topics related to induction of labour that were regarded as critical priority questions by an international, multidisciplinary group of health-care workers, consumers and other stakeholders.
Geneva, Switzerland, World Health Organization [WHO], 2006. 35 p.On 1--5 November 2004, in Bellagio, Italy, the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), organized a meeting entitled International Consensus Conference on Non-surgical (Medical) Abortion in Early First Trimester on Issues Related to Regimens and Service Delivery. This document is the result of the deliberations of the participants in that meeting, who included highly experienced researchers and clinicians in the area of medical abortion. Prior to the meeting health-care personnel providing abortion services in various countries were asked to provide a list of the most frequently asked questions about medical abortion. The meeting participants reviewed those questions and compiled answers to them based on the scientific literature and their own clinical experience. The answers are presented in this publication. (excerpt)
CRP Population Research. 1978 Nov; 33-34.The Contraceptive Development Branch (CDB) program conducts research in 2 areas: 1) reproductive processes and 2) product development. Research on reproductive processes improved the understanding of gamete transport and has better identified corpus luteum functions and the role of prostaglandins. The biology and biochemistry of the ovum has been studied, and in vitro fertilization investigated. The mechanism of spermatogenesis, sperm maturation, and subsequent fertilization have been observed. Moreover, CDB has participated in the distribution of a variety of reagents to the scientific community, to stimulate research on the antipregnancy vaccine. In the area of product development, the CDB continues experimenting with the synthesis of new chemicals to regulate human fertility, the issue of safety being the primary motivation of the program. Approximately 1100 new chemicals have been synthesized and tested on laboratory animals. A drug testing program was initiated in 1972, providing feedback of biological data, and representing the major drug testing effort in the U.S. Considerable progress has been made in the area of implantable and oral contraceptives, and in the area of devices for fertility regulation, and for sexual sterilization. Clinical studies sponsored by CDB are ongoing.
In: Diczfalusy, E., ed. Regulation of human fertility. (Proceedings of the WHO Symposium on Advances in Fertility Regulation, Moscow, USSR, November 16-19, 1976) Copenhagan, Denmark, Scriptor, 1977. p. 21-71This chapter reviews the hormonal changes which occur during the menstrual cycle. During the last days of the preceeding menstrual cycle, plasma levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH) increase. Follicular phase is characterized by gradually increasing estrogens. A few days preceding the LH surge, some little understood changes in estradiol, LH, and 17-hydroxyprogesterone, on one hand, and ACTH, cortisol, and aldosterone, on the other, occur. Evidence indicates that the estradiol peak occurs first, followed by a simultaneous rise and fall in LH and 17-hydroxyprogesterone values. The peak period of LH is about 32-44 hours long, during which time a rise in progesterone levels takes place. Other pituitary and steroid hormones (human chorionic gonadotropin, ACTH, prolactin, testosterine, androstenedione, cortisol, and aldosterone) show elevated levels during the periovulatory period. Ovulation occurs 16-48 hours after LH peak. The period following LH surge is characterized by rapidly increasing levels of progesterone, 17-hydroxyprogesterone, and 20-alpha-dihydroprogesterone, accompanied by moderately increasing estrogen levels to form the typical luteal-phase hormonal pattern. A luteal increase occurs also in levels of several other hormones, ranging from renin activity to angiotension, or from pregninolone to aldosterone. The last part of the luteal phase is characterized by rapidly declining levels of peripheral hormones. The perimenstrual phase around onset of heavy bleeding is characterized by gradually decreasing levels of progesterone, 20-alpha-hydroprogesterone, estradiol, and testosterone, associated with an incipient rise in LH and FSH levels.
A.I.D.'s research program to develop new and improved means of fertility control. (Statement, May 2, 1978)
In: United States. Congress. House of Representatives. Select Committee on Population. Population and development: research in population and development: needs and capacities. Vol. 3. Hearings, May 2-4, 1978. Washington, D.C., U.S. Government Printing Office, 1978. p. 287-319USAID, in attempts to develop and improve means of fertility control, spent $4.8 million on new ways to control corpus luteum function and block progestational activity, $4.4 million to develop gonadotropin releasing factors, and $6 million on prostaglandins as a means of inducing the menses or terminating pregnancy in the second trimester. Studies at Johns Hopkins University developed thyrotropin releasing hormones to ensure postpartum infertility without interfering with lactation. Research to improve current forms of birth control amounts to $16.5 million. Side effects of oral contraceptives, single aperture laparoscopic sterilization, reversible male sterilization, and tissue glues for non-surgical female sterilization are some of the new techniques being funded by USAID. $19 million has been allocated to evaluate contraceptive programs in developing countries. Funds have come from DHEW, the Ford foundation, the Population Council, pharmaceutical companies, and WHO. Although improved birth control is desireable, money is best spent supplying available methods to developing countries.
Journal of Reproduction and Fertility. April 1974; 37(2):487-498.The rapid decline in the introduction of new drugs in the U.S. can be attributed to the Kefauver-Harris Amendment to the Food and Drug Act of 1962 under which the Food and Drug Administration gets its authority. The regulatory requirements for contraceptive development have greatly curtailed research by pharmaceutical companies in this area. Such aspects as the patent life-span of 17 years when compared to the amount of overall development time to provide the necessary data for the regulatory agencies (for chemical contraceptives about 10 years) reduces the patent life to a point where for industry the commercial return for high research investment is extremely poor. Regulations specifying the kinds of animals used in testing or oral contraceptive (OCs) or the dose levels used in such species have questionable relevance to the human experience. Decisions by the regulatory agencies before marketing which are without appeal, such as the case of chlormadinone acetate, certainly affect the U.S. drug industry. Recent contraceptive development has occurred outside of the U.S. Adverse publicity by lay press increasing fears about OCs has also led to cutbacks in the research by pharmaceutical houses. The introduction of the Contraceptive Development Branch by the United National Institue of Child Health and Human Development in 1969 was a big step forward in directing research towards new approaches to contraception. However, industry has been slow to involve itself in this program because of the restrictive patent laws of the National Institutes of Health. The Expanded Program of the World Health Organization in support of training and of research in new contraceptives is anxious to enlist the support of the pharmaceutical idustry and will operate under more enlightened patent rules. The total estimated funds required to support research in the reproductive field is $500-$600 million over 5 years. It is suggested that industry will become involved again in contraceptive research if government will share the risk of contraceptive development. Our incomplete knowledge of the forms in which contraceptive steroids act at levels in man represent a major obstacle to better steroidal contraceptive development.
In: World Health Organization (WHO). World Health Organization expanded program of research, development and research training in human reproduction: fourth annual report. Geneva, Switzerland, WHO, November 1975. 65-69. (HRP/75.3)In this year's evaluation of the RTCs, performances were assessed in terms of research contributing to the objectives of the expanded program and internal reorganization of the institutions to fit the concept of a research and training center. The outcome was generally positive. A large amount of mission-oriented research has been conducted that either supports task force efforts directly or provides methodology required for this research. Considerable progress has been made in developing a prostaglandin vaginal suppository for 1st trimester termination of pregnancy. Each RTC has conducted a number of non-goal-oriented fundamental studies on entirely new approaches to fertility regulation. There has been a marked increase in the number of publications in the field of fertility regulation in the RTCs. Of the projects reviewed, the most impressive have been those that have used a team approach, for a coherent output has resulted which is considerably more significant than that from unrelated efforts of single scientists. The number of scientists involved in research on fertility regulation has increased in all the centers, and collaborative multidisciplinary and interdepartmental activities have grown. Research training has also been an important activity of the centers. Interinstitutional collaboration has greatly influenced the orientation of the centers and has been invaluable. A description of major research activities during the past year is given for the training centers.
In: Sciarra, J.J., Markland, C. and Speidel, J.J., eds. Control of male fertility. (Proceedings of a Workshop on the Control of Male Fertility, San Francisco, June 19-21, 1974). Hagerstown, Maryland, Harper and Row, 1975. p. 274-307Literature on research approaches to permanent and relatively reversible methods of male fertility control is reviewed. Sources and expenditures for research into male fertility control are noted. Permanent methods discussed include electrocautery of the vas, transcutaneous interruption of the vas, vasectomy clips, chemical occlusion of the vas, and passive immunization. Reversible methods reviewed include vasovasotomy, intravasal plugs, and vas valves. Current research into animal models, reversibility after vas occlusion, nonocclusive surgical techniques, pharmacological alteration of male reproductive function, including adrenergic blocking agents, steroidal compounds, inhibitors of gonadotropin secretion, clomiphene citrate, organosiloxanes, prostaglandins, alpha-chlorohydrin, heterocyclic agents, and alkylating agents, and delivery systems for antifertility agents is discussed. Research into semen storage and improved condoms is also reviewed. As a relatively low proportion of funds are committed to research in male fertility control, a greater investment in applied and clinical research is warranted.
War on Hunger. 1971 Oct 17-18; 5(10):1-3, 17-18.The Agency for International Development (AID) is involved in a world wide program of assistance for population activities. In 1973, $125,000,000 was authorized for population programs by the U.S. Congress. AID has provided funding to the U.N. population program, to the Pan American Health Organization, the International Planned Parenthood Federation, and numerous other international family planning organizations. Through country missions, AID has provided $100,000,000 in grants for population and family planning programs in 32 developing countries. AID has provided $21,000,000 for development of fertility control methods, with a particular emphasis on prostaglandin research. AID also provides support for agencies involved in demographic studies as well as to university population centers.