Book notes

Finished reading The NaPro Technology Revolution:  Unleashing the Power in a Woman's Cycle. Yes, all 400 pages of it!  It was good, enlightening, sobering, encouraging and overwhelming all at the same time.

Here are a few notes that I took:

In PCOD women, 61% of their ovulations (often 6 or fewer per year) are defective in some way.  That alone drastically reduces chances of conception!  That means if I ovulate 6 times this year, only 2-3 of them will be viable chances... a woman of normal fertility would have 12-13 chances in a year.

Androgen levels can be treated medically, but the gonadotropin levels respond only to surgery.

Benefits after surgery (ovarian wedge resection) include:

1. decrease in testosterone, free testosterone, androstenedione, & DHEAs. 
2. LH comes down significantly while FSH remains the same - correcting the ratio
3. over 90% return to regular cycles.

Long-term medical impact from PCOD (besides the obesity, abnormal hair growth, skin problems):

1. 7x increased risk of heart attack and heart disease due to lower HDL, higher triglycerides, higher homocysteine levels.
2. by age of 40, 40% of PCOD women have Type II diabetes
3. increased risk of endometrial cancer due to elevated insulin levels and unopposed estrogen (because of long follicular phases without ovulation to produce progesterone).
4. 3x increased risk of postmenopausal breast cancer
5. increased risk of hysterectomy because of dysfunctional uterine bleeding
6. ovarian cancer risk increased
7. women with PCOD are more likely to have chronic fatigue syndrome

He states that all too often we are asking "Is ovulation occurring?" when we should be asking "Are there defects in ovulation?"
Quote:  "In actuality, when one studies ovulation closely by daily ultrasound and hormonal parameters, one realizes that there are a number of different "ovulatory events" that mimic ovulation but are either completely annovulatory or represent a significant defect in the ovulation mechanism.  An example of an ovulatory defect that is anovulatory is the luteinized unruptured follicle syndrome.  An example of an ovulatory defect in which the ovulation process is significantly defective is the immature follicle.  While ultrasound is commonly used in the ART programs to monitor ovulation inducing medications, it is rarely used for studying spontaneous ovulation patterns and their defects.  The latter is extremely important if one is to design treatment strategies that meet the specific demand of the underlying problem."

It goes into descriptions of several different types of ovulatory dysfunction and the follicular and luteal phase deficiencies associated with them, along with symptoms.  Intriguing and mind boggling!