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CHAPTER ONE

INTRODUCTION


1.1              Background of the Study

Fertility is the natural capability to produce offspring. Fertility is the ability to reproduce; men who are fertile are able to father children and fertile women are able to get pregnant and carry their baby to full term, with a live birth nine months after conception. This all happens naturally as a result of sexual intercourse. Human fertility depends on factors of nutrition, sexual behavior, consanguinity, culture, instinct, endocrinology, timing, economics, way of life, and emotions (Lovett, 2007).

Of course, fertility can sometimes be a problem. When we are in our late teens and early 20s, our sex drive is high and our fertility levels also peak. This combination leads to a high level of unwanted teenage pregnancies in many countries in the western world and to a high birth rate in areas of poverty in the less developed world (Lovett, 2007).

As we age, our fertility starts to decline. This is particularly true in women; pregnancy rates for natural conceptions, and after infertility treatments, drop drastically between the ages of 35 and 40. This is thought to be one reason why fertility issues have been increasing steadily over the last 50 years in developed countries; women tend now to leave having a family until later because the pressure to work and have a career is greater (Lovett, 2007).

Around 10% to 15 % of couples who want to start a family face problems with their fertility (Lovett, 2007). This may be due to a problem with the male partner or the female partner, or a combination of the two. Although many people spend their early sexual life suppressing their fertility, when they want to have children and cannot, they feel cheated of an important part of normal life and this can cause severe emotional and social issues (Lovett, 2007).

Women have hormonal cycles which determine when they can achieve pregnancy. The cycle is approximately twenty-eight days long, with a fertile period of five days per cycle, but can deviate greatly from this norm. Men are fertile continuously, but their sperm quality is affected by their health, frequency of ejaculation, and environmental factors. Fertility declines with age in both sexes. In women the decline is more rapid, with complete infertility normally occurring around the age of 50 (Martin, 2013).

A woman's menstrual cycle begins, as it has been arbitrarily assigned, with menses. Next is the follicular phase where estrogen levels build as an ovum matures (due to the Follicular Stimulating Hormone (FSH)) within the ovary. When estrogen levels peak, it spurs a surge of Luteinizing Hormone (LH) which finishes the ovum and enables it to break through the ovary wall. This is ovulation. During the luteal phase, which follows ovulation LH and FSH cause the post-ovulation ovary to develop into the corpus luteum which produces progesterone. The production of progesterone inhibits the LH and FSH hormones which (in a cycle without pregnancy) causes the corpus luteum to atrophy, and menses to begin the cycle again (Lobo, 2005).

Peak fertility occurs during just a few days of the cycle: usually two days before and two days after the ovulation date. This fertile window varies from woman to woman, just as the ovulation date often varies from cycle to cycle for the same woman. The ovule is usually capable of being fertilized for up to 48 hours after it is released from the ovary. Sperm survive inside the uterus between 48 and 72 hours on average, with the maximum being 120 hours (5 days) (Lobo, 2005).

Natural fertility refers to the absence of parity-specific family planning, meaning that couples are not regulating their fertility based on their current parity. Family planning, on the other hand, is defined as when couples regulate their fertility (for example stop having children) after reaching a specific parity. Actual natural fertility is based on cohort parity: the fraction of women in a cohort who have reached a specific parity or number of children (Watcher, 2013).

Natural fertility is a concept developed by the French historical demographer Louis Henry to refer to the level of fertility that would prevail in a population that makes no conscious effort to limit, regulate, or control fertility, so that fertility depends only on physiological factors affecting fecundity. In contrast, populations that practice birth control will have lower fertility levels as a result of delaying first births (a lengthened interval between menarche and first pregnancy), spacing out the intervals between births, or stopping child-bearing at a certain age. Such control does not assume the use of artificial means of fertility regulation or modern contraceptive methods but can result from the use of traditional means of contraception or pregnancy prevention (for example coitus interruptus), or from social norms or practices regarding celibacy, the age at marriage and the timing and frequency of sexual intercourse, including periods of prescribed sexual abstinence Ansley Coale and other demographers have developed several methods for measuring the extent of such fertility control, in which the idea of a natural level of fertility is an essential component (Watcher, 2013).

Common reasons communities or individuals will practice natural fertility include concerns about developing medical conditions (including future infertility), pre-existing health conditions (including Polycystic Ovary Syndrome), cost of birth control, religious prohibition, lack of availability of birth control, and lack of information about birth control methods. Location also tends to be a factor in regards to the availability of both contraceptives and education on sexual practice. For example, less developed areas, including, but not limited to those extending throughout inland Africa lack access to the drugs necessary to control fertility or informative lessons describing their correct usage (Watcher, 2013).

Decision tables are a precise yet compact way to model complex rule sets and their corresponding actions. Decision tables associate conditions with actions to perform, but in many cases do so in a more elegant way. Each decision corresponds to a variable, relation or predicate whose possible values are listed among the condition alternatives. Each action is a procedure or operation to perform, and the entries specify whether (or in what order) the action is to be performed for the set of condition alternatives the entry corresponds to (Jorgensen, 2009).

The traditional method of regulating fertility of a woman is a cumbersome process; the person regulating the fertility need to study the fertility regulation algorithm which has different process based on individual case, that is, the person need to study the algorithm any time is to regulate the fertility of a woman. Majority of medical practitioners could not understand this algorithm which makes their work complex.

In this study, decision table will be design to form rules in modeling the traditional way of regulate female fertility which vary based on the menstrual cycle of the woman. The decision table will be followed strictly to develop a system which will make female fertility regulation easy and faster.

1.2              Statement of the Problem

All contraceptives (Artificial family planning methods) have potential adverse side effects, most of which affect the woman. Often contraception is sold as an easy solution for family planning, one that doesn’t harm anybody and lets you do whatever you want, but often the reality is often very unhealthy for women (LeMaire, 2017). Ingesting or inserting chemicals into our bodies to stop them from functioning as they are supposed to isn’t good for us as well (LeMaire, 2017).

In some resent researches, the adverse side effects of contraceptives are simply point out that depending on the method used; these may include a heightened risk of breast cancer, migraine headaches, high blood pressure, fatal blood clots, increased foetal abnormalities, and toxic shock syndrome (LeMaire, 2017).

The adverse side effects of contraceptives listed above has warrant the development of a system called Fertility Regulation Application that can be used to monitor the cycle of any woman which will assist all women in planning their family without any artificial family planning method.

1.3       Aim and Objectives

The aim of this project is to develop a fertility regulation application using decision table.         The Objectives are to:

                    i.            Formulate fertility regulation algorithm.

                  ii.            Develop a decision table from the algorithm.

                iii.            Implement the decision table using a High Level Programming Language (MATLAB).

1.4       Scope and Limitation of the Study

The scope of this project is to develop a fertility regulation application using Decision Table for women that will help them in monitoring their menstrual cycle themselves and will allow them in planning their family without any artificial family planning method.

This proposed application will be limited to female Fertility regulation and is limited to women that are having a regular menstrual cycle of 25 – 31 days.

1.5       Significance of the Study

This project will be helpful to couples in the following ways:

        i.            Increase awareness and knowledge of menstrual cycle, its phases and importance of conception.

      ii.            Putting pregnancy decision in the hands of couples especially women so as to have wanted pregnancies and children by choice.

    iii.            Promoting love, companionship and pleasure in marital life.

    iv.            Promoting fertility by choice and prevent anxiety of sub-fertility and infertility.

1.6       Definition of Terms

        i.            Decision Table: are a precise yet compact way to model complex rule sets and their corresponding actions.

      ii.            Fertility: is the condition the degree of being fertile. Fertile in human means ability of reproducing or ability of developing past the egg stage.

    iii.            Menstrual Cycle: is the recurring cycle of physiocological changes in the females of some animal species that is associated with reproductive fertility; especially the cycle in a human woman.

    iv.            Menstruation: this is the periodic discharge of menses, the flow of blood and cells from the lining of the uterus in females of humans and other primates.

      v.            Ovulation: is the release of an ovum from the ovary.


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