March 16,, 2013 Dear ProLife Colleague, The February AAPLOG CME meeting provided excellent and unique content. The entire summary is found at: https://www.aaplog.org/aaplog-annual-educational-meeting/ The 12th educational symposium delved deeply into behavioral aspect of reproductive health, reproductive biology, medical ethics, clinical aspects of women’s health care, and psychological effects of abortion. This letter summarizes speakers 4,5, and 6. Nathan Hoeldtke introduced us to genetic screening as it will be practiced in future decades. The most significant of new developments is the detection and analysis of cell-free DNA in maternal blood. As early as 10 weeks, 99% of Down syndrome fetuses can be detected with this technology. The technology is sufficiently advanced such that the entire genome of a fetus has been sequenced from cell-free DNA from maternal blood without paternal DNA. Although not yet standard of care or covered by insurance, this testing is offered now at some university centers. It is sobering that this test is so quick and easy in early pregnancy, and could easily be added to standard prenatal panels without adequate informed consent. This test has the potential to essentially eliminate other more invasive forms of prenatal testing for Down syndrome. Sister Mary Diana Dreger, an internal medicine physician and bioethics expert, gave an unusually lucid explanation of why physicians are not just technicians. Physicians are capable of appreciating moral truth and discerning the difference between good and evil. Just because a technology exists does not mean that it should be utilized. Physicians can perform actions expressive of societal values but these are not specifically medical ethics. Joseph Stanford gave an excellent presentation on the menstrual cycle and what is known about fertility. He explained the bases for the various types of natural family planning programs, as well as presenting fertility therapies based on current knowledge. He gave us examples of variability in pre and post-ovulatory portions of the cycle, as well as evidence of the poor knowledge most women have regarding their fertility. His research has shown that many women are interested in natural family planning, regardless of religion, educational level or income. He also gave examples of excellent outcomes of current fertility therapies (NaproTechnology) based on natural family planning, compared to assisted reproductive technologies (IVF). Monday: summaries of final 3 speakers.
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