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Many women become pregnant because they do not use contraceptives properly, a study suggests.

Research carried out in France has found that one in three pregnancies is unplanned.

But of these, two out of three occur when couples are using contraceptives, such as the Pill or condoms.

The researchers said doctors should do more to ensure women who do not wish to become pregnant use the most suitable forms of contraception.

Dr Nathalie Bajos and colleagues at the Hospital de Bicetre, in Paris, based their findings on a survey of almost 3,000 women across France.

Unplanned pregnancies

They found that 1,034 of these women had become pregnant unexpectedly. Half subsequently decided to have an abortion.

But of these, 65% said they had been using contraception: 21% said they had taken the Pill; 21% had used the "natural method"; 12% had used condoms; and 9% had used an intra-uterine device (IUD).

The survey found that most of these women had become pregnant because they had not used the contraceptive properly.

For instance, 60% of those on the Pill said they became pregnant after forgetting to take a tablet.

One in three of those who used an IUD said it had been in the wrong position or had fallen out. Almost half of those who had used condoms said they had torn or slipped off.

But a large proportion of women said they did not know why their contraception had not worked.

This included one in five of those taking the Pill, over half of those using an IUD and one in five of those using condoms.

The doctors said the findings suggested many women were simply using the wrong type of contraception for them.

"What this research shows most clearly is that there is often a mismatch between a women's contraceptive needs and the methods they use," Dr Bajos said.

She pointed out that while the Pill is regarded as being very effective it is not suitable for every woman, such as those who do not have intercourse regularly or those whose lifestyle prevents them from taking tablets regularly.

Dr Bajos said doctors should work more closely with patients to ensure they are using the most suitable type of contraceptive.

"When a doctor prescribes a contraceptive, he or she should not think just of the theoretical perspective, but take into account the woman's life."

She added: "It is absolutely essential to differentiate between what are the theoretically most effective methods of contraception and what is the most practicable method for a particular women at a particular time in a particular relationship."

The fpa, formerly the Family Planning Association, welcomed the findings.

Its chief executive Anne Weyman said: "The lessons of this study are equally applicable in the UK.

"To avoid unplanned pregnancies, it's essential women are aware of all the contraceptive choices available, and that professionals are fully trained to take into account the different factors that impact on effective contraceptive use, such as lifestyle, age and type of relationship."

The study is published in the journal Human Reproduction.

BBC News

Life was simpler thousands of years ago. In Biblical times, the secret to a happy marriage was nothing more than a honey-based alcoholic drink.

Newly-weds were encouraged to drink mead every night for one lunar month after they tied the knot.

The fruits of their so-named honeymoon would then appear nine months later, in the form of a bouncing baby.

Sex life

Now scientists at the Royal Society of Chemistry in London are setting out to determine whether there is any truth in the ancient myth that mead is, indeed, the key to a healthy sex life.

Researchers are seeking the help of prospective honeymooners willing to drink mead every evening for 30 days after they exchange their vows.

They will select one couple who will be asked to keep a nightly record of the effects or otherwise of the ancient brew.

The findings will be published in November to coincide with UK Chemistry Week, which will highlight the role of chemistry if daily life.

The society has already placed an order for a dozen bottles of mead to help the couple on their way.

Mead is an alcoholic liquor made by fermenting a mixture of honey and water.

The drink has its roots in Babylon more than 4,000 years ago. While popular with newly-weds, it was also hailed by soldiers who poured it on wounds in the belief it helped them to heal more quickly.

"Mead was not just drunk as a wine but was believed to have magical powers revitalising and healing," said Jerome Schooler, who runs Britain's largest mead maker, Lurgashall Winery in Sussex.

"As a result of this, Mead was the elixir to prolong life. People thought if they drank it they would be immortal."

Researchers at the Royal Chemistry Society are hoping their study will unearth some of the science behind the myth.

"There is some serious science in it," said Claire McLoughlin of the society.

"Mead was believed to increase virility and fertility and as in many myths and legends there is a basis in science because mead is rich in B vitamins and also rich in amino acids which are the building blocks of protein so do increase stamina."

Couples who are interested in volunteering to take part in the study can email the society at emsleyb@rsc.org

BBC News

Nearly one young man in 10 is infected with a sexually transmitted disease which can make women infertile, researchers suggest today.

The level of chlamydia found in tests on nearly 800 army recruits is up to five times higher than previous studies have indicated and may mean that the scale of the disease has been severely underestimated.

The government has recently introduced a screening programme for the disease but it is mainly aimed at young women attending clinics.

The most recent figures from the health protection agency show that in 2001, 71,125 people were diagnosed with the disease in England, Wales and Northern Ireland, but up to another 200,000 young women were probably carrying the bug without their knowledge.

The disease can cause severe pelvic pain and infertility but the effect on men is generally less severe. It is easily treated with antibiotics but many people have chlamydia without knowing it.

Researchers at Edinburgh royal infirmary and Catterick army garrison, North Yorkshire, say in the Lancet medical journal that of the 798 men given urine tests, 78 were found to have chlamydia. Of these, 69 revealed no symptoms and the others had symptoms so mild that they had not reported them to medical examiners.

The men tested were mostly aged between 16 and 25. Since some recruits may never have had sexual intercourse, the rate of infection was probably higher than the 9.8% recorded, the researchers said. There was no indication that the recruits were any more sexually active than any other group of young men.

Gordon Scott, who led the research, said: "Our finding that the rate of asymptomatic infection was higher than that usually cited (50%) shows the importance of involving men as well as women in opportunistic testing for chlamydia."

The Department of Health said it would be promoting greater testing among men.

James Meikle, health correspondent
The Guardian

Scientists have discovered a gene which is crucial to male fertility.

Researchers made the discovery by chance, while looking into the genetic causes of heart disease.

They genetically engineered mice so they did not have the Fkbp6 gene.

Researchers found no link between the gene and heart disease, but they did find that all the sperm cells in the male mice died, meaning they were completely infertile.

The females' oocyte cells - cells in the early stages of egg development - were unaffected.

The Canadian team which carried out the research say the discovery of the gene could provide a focus for the development of a male contraceptive pill.

It could also lead to the development of a test for the 15% of couples around the world who are infertile to see if a lack of the Fkbp6 gene is the cause.

'Unexpected'

When the researchers studied the mouse sperm cells and tissue, they found they completely lacked spermatids, the male germ cells which eventually develop into spermatozoa.

The lack of the Fkbp6 gene was identified as the cause of their infertility.

The research is published in the magazine Science.

Dr Josef Penninger, professor of medical biophysics and immunology at the University of Toronto who led the research, said: "That this gene would control male fertility was completely unexpected.

"We found no link between this gene and heart disease but we did find that our male mice were unable to breed.

"When we investigated further, we found that the size of the testes of our mice were massively reduced and that they produced no sperm cells.

"Fkbp6 only acts in sperm cells and we found no other defects in our mice besides sex-specific male infertility.

"While our male mice showed normal sexual behaviour and had normal levels of sex hormones, they completely lacked sperm cells.

"So it's possible that Fkbp6 might be the perfect target for the development of a male birth control pill."

Japanese researchers had seen a similar mutation in rats with aspermia, a lack of sperm.

Matching chromosomes

The Canadian team found the Fkbp6 gene is also crucial to the process of matching up maternal and paternal chromosomes.

Fkbp6 is part of the protein complex that binds maternal and paternal chromosomes in oocytes and sperm cells.

Normally, each chromosome matches up with a chromosome of the same structure, position and origin.

In the mice which did not have Fkbp6, the chromosomes were unable to find their correct partners and, instead, paired with non-corresponding chromosomes.

This kind of defect can lead to a condition called aneuploidys, where there are too many or too few chromosomes. It is a leading cause of spontaneous miscarriages in humans and a trait in many human cancer cells.

The researchers say proteins produced by the Fkbp6 gene, and other genes in the same family, are essential for chromosome pairing to work.

BBC News

As many as one in 10 young men may have the sexually transmitted infection chlamydia without knowing it, a study suggests.

Tests carried out in Scotland on almost 800 army recruits found that 78 were carrying the infection.

The vast majority showed no signs of having chlamydia.

The figures are in line with similar studies on young women, which have suggested that one in 10 also has the infection without knowing it.

Official figures show more and more people are being diagnosed with chlamydia across the UK.

Infections soar

A total of 10,580 cases were reported in Scotland in 2001, the latest year for which figures are available. This was up almost 30% on the previous 12 months.

Chlamydia is now the most common STI in England, Wales and Northern Ireland. In 2001, 71,055 people were diagnosed with the infection, up 10% on the previous year.

Female symptoms

• An unusual vaginal discharge
• Pain when passing urine
• Bleeding between periods
• Pain during sex or bleeding after sex
• Low abdominal pain

• White or cloudy, watery discharge from the tip of the penis
• Pain or a burning sensation when passing urine
• Testicular pain and/or swelling

England is facing a public health crisis because of an alarming increase in sexually transmitted infections (STIs), an expert in sexual health has warned.

Professor Michael Adler, who helped develop the government's sexual health strategy, said that over the past decade the country's sexual health had deteriorated.

The number of infections have increased alarmingly, leaving clinics struggling to cope with demand, he said in an editorial in the journal Sexually Transmitted Infections.

Professor Adler added that there was a growing shortage of consultants in genito-urinary medicine (Gum) and some people were forced to wait over a month for an appointment at a Gum clinic.

"Changes in sexual behaviour, regardless of sexual orientation, can only continue to drive this situation," he warned.

"It is no exaggeration that we now face a public health crisis in relation to sexual health."

In the Health of the Nation report in 1992 the government set targets to reduce the incidence of STIs.

But the professor said that cases of chlamydia and gonorrhoea have risen by more than 70% since 1997. Cases of HIV and Aids were set to rise by around 10% a year and infectious syphilis cases had risen by 374% since 1997.

Recruitment of extra Gum consultants was currently 90% below target, he added.

Professor Adler, of the Royal Free and University College Medical School in London, said the strategy on sexual health and HIV was supposed to deliver better services and place a greater emphasis on preventative strategies.

Yet only ?47.5m had been allocated for the next two years, which was not enough to cover even one part of the strategy - the national roll-out of chlamydia screening programme.

The professor warned: "Sexual health is not an NHS or political priority. Until it becomes so we will witness further failure upon further failure."

A Department of Health spokesman said: "We share the concerns expressed by professor Adler about worsening sexual health and recognise that there are important public health issues to be addressed.

"This is why we have developed the first ever national sexual health and HIV strategy."

The spokesman added that implementation of the strategy was still at an early stage, stressing it was a 10-year programme with no quick fixes.

"We must both improve and modernise services, and also seek to change individuals' behaviour, drawing on the best evidence of what works in achieving this," he said.

Staff and agencies
The Guardian

Sperm may smell their way to the egg, which researchers say could lead to advances in contraception and fertility treatments.

German researchers trying to work out how sperm find their way to their intended destination have identified an odour receptor in testicular tissue, usually found in the sensory nerve cells of the nose.

In laboratory tests, the receptor kick-started a process where sperm were drawn towards concentrations of an artificial scent called bourgeonal, which triggers the receptor in nasal cells.

The next stage of the research is to find the sperm-attracting substance produced by the female reproductive system. The same process has been seen in sea urchins, where sperm cells seek out sperm-attracting substances produced by sea urchin eggs.

If successful, this could help fertility doctors identify the most mobile sperm, increasing the chances of successful treatment.

Contraception

Dr Marc Spehr of the Ruhr-Universitat, Bochum, who led the research, said: "If a natural equivalent to bourgeonal is, at least in part, responsible for successful pathfinding or screening of fertile sperm, then it should be possible to use bourgeonal within IVF treatments."

"Some of the difficulties experienced in IVF treatments may be linked to the 'quality' of sperm. "Bourgeonal might be used in the future to find the motile and fast sperm cells that are needed for fertilization."

A substance called "undecanal" which appears to block the affect of bourgeonal was also identified.

Dr Spehr said undecanal could be used to design new contraceptives. He said: "One of the greatest problems in contraception these days is the use of hormones. "If undecanal can inhibit egg-sperm communication, this drug might be used, after a great deal of future research, to prevent undesired pregnancies.

"One could speculate about delivery of undecanal into the female genital tract or even about drugs containing equivalents to undecanal that could be used by men."

Behaviour

Odorant receptors have been identified on sperm before, but this study shows they seem to be involved in regulating sperm's behaviour.

Researchers cloned the receptor and used human embryonic kidney cells to look at how it behaved.

When the receptor moved towards concentrations of the sperm attractant, it sets of a similar physiological process as it does when it triggers when a smell is being detected by the nose.

Dr Allan Pacey, senior lecturer in andrology at Sheffield University, told BBC News Online: "This study is potentially very exciting as scientists have been searching to demonstrate whether or not sperm really are attracted to the egg in mammals.

"What it illustrates is that the process of sperm transport to the egg is not just about sperm swimming around until they find an egg.

"It is likely to be highly coordinated and involving a number of different mechanisms of which odorant receptors may play an important role.

"They have added another piece to the jigsaw. But it's a big puzzle. "What has yet to be shown is what sperm are actually attracted to, if anything, but this should now be possible using the techniques described in this paper."

He said it may be possible to screen for the absence or presence of the receptor as a diagnostic test to explain why some men are have more difficulty than others in conceiving with their partner.

The research is published in the magazine Science.

BBC News

The Green Party in the southern Spanish city of Granada has come up with a novel way to attract young voters.

As part of its manifesto for the municipal elections on 25 May, the party is proposing issuing "sex vouchers" to young voters so they can get half-price rooms in decent hotels.

The leading Madrid daily El Mundo , in a piece headlined "Half-price sex in Granada", says the idea is a variation on the theme of subsidising public transport or pleasure trips for pensioners.

The daily says the Greens are seeking to give the youngsters a "safe and secure environment" in which to have sex.

It quotes Greens spokesman Francisco Garrido as saying the region where Granada is located, Andalusia, "has one of the highest rates of unwanted pregnancies".

"Garrido has justified the proposal for sex vouchers not only because it is a success in other European cities, but also because Granada youth, and by extension Spanish youth, frequently find it difficult to enjoy sexual relations freely in a secure environment," the daily notes.

Safe and secure

The Greens hope the scheme will encourage young people to enjoy their "sexual initiation" having safe sex, with advice available in the designated hotel rooms.

The city council will need to get city hotels to sign up to the initiative and agree to "lower their prices", El Mundo says. But the chance of the proposal ever seeing the light of day is thought negligible.

The Greens currently share two seats on the Granada council with another left-wing party, whose views on the topic are not made clear.

However, according to El Mundo, Mr Garrido's e-mail is "overflowing with insults and threats from the extreme right".

Not all the warnings have been unfriendly. One neighbour of Mr Garrido claiming to be a member of the Opus Dei religious movement approached him with a warning.

"As a neighbour," he said earnestly, "I have to tell you that by propagating immorality, you'll go to hell and I assure you that hell exists."

There is no indication of Mr Garrido's response.

BBC News

Sales of contraceptive drug over the counter are 'encouraging unsafe sex'

Selling the morning-after pill over the counter has muddied the messages being sent to teenage girls about safer sex, nurses will warn this week.

A row over the issue has split the Royal College of Nursing, with staff divided over whether the measure to reduce unplanned pregnancies risks backfiring - or whether it has simply removed from thousands of women the trauma of unnecessary abortions.

Pharmacists have been trained to ask about the circumstances in which a woman thinks she has become pregnant, and health problems that may make the pill unsuitable. They are not supposed to sell it to girls under 16, although in practice teenagers who look older than their years may slip through the net.

However some members of the RCN's expert adolescent health team are concerned that quizzing young girls in a crowded pharmacy does not allow the time and privacy to go through preventative health messages about unprotected sex or risky behaviour.

'There are some people who think that selling the morning-after pill over the counter is not a good enough practice - that the advice isn't as good as a nurse would give,' said one RCN source.

'The assessments are supposed to be confidential and you can't really start going into the details of someone's sexual health in a shop.'

The morning-after pill is listed on the agenda for debate at the nursing union's annual conference in Harrogate this week, but meetings were continuing over the weekend over whether the discussion would be allowed amid internal protests.

A million courses of emergency contraception a year are taken in Britain, and until January 2001 they were only available from family planning clinics, GPs and Accident and Emergency departments.

But the Levonelle brand, which works by preventing a fertilised egg becoming implanted in the womb and can be taken up to 72 hours after unprotected sex, is now sold without a prescription in pharmacies, making it much more easily available.

The Family Planning Association, which along with the British Medical Association has strongly backed the move, said it appeared to be working well.

'We know that the majority of women use emergency contraception once in a year, regardless of where they get it from, and for them it's a wake-up call - it gives you a scare,' said a spokeswoman.

'Most women do assess what they are doing afterwards precisely because they don't want to be in that position again. We are all in favour of it remaining in pharmacies.'

A recent survey suggested almost one in five 16-year-olds had taken the morning after pill, with 3 per cent taking it more than once, suggesting one scare had not put them off.

But the Office of National Statistics also found last year that the number of 16- to 29-year-olds deliberately risking unprotected sex because they simply did not like using contraception had gone down, while the proportion of 16 and 17-year-old girls who had not had sex in the previous year had jumped by 9 per cent between 1999 and 2000. Those who did have sex had fewer partners, suggesting messages were getting through.

Members of the RCN's adolescent health team raised the issue for debate. But its sexual health team is understood to be firmly in favour of emergency contraception being sold over the counter believing it prevents unwanted pregnancies.

Official figures suggest only about a third of women taking emergency contraception get it from pharmacists, with the rest still going to a doctor. Superdrug, one of the largest chains selling it, found the greatest demand was from professional women aged 25 to 35, who may be too busy to go to a clinic or surgery with restricted opening hours.

Gaby Hinsliff, chief political correspondent
The Observer

Many women become pregnant because they do not use contraceptives properly, a study suggests.

Research carried out in France has found that one in three pregnancies is unplanned.

But of these, two out of three occur when couples are using contraceptives, such as the Pill or condoms.

The researchers said doctors should do more to ensure women who do not wish to become pregnant use the most suitable forms of contraception.

Dr Nathalie Bajos and colleagues at the Hospital de Bicetre, in Paris, based their findings on a survey of almost 3,000 women across France.

Unplanned pregnancies

They found that 1,034 of these women had become pregnant unexpectedly. Half subsequently decided to have an abortion.

But of these, 65% said they had been using contraception: 21% said they had taken the Pill; 21% had used the "natural method"; 12% had used condoms; and 9% had used an intra-uterine device (IUD).

The survey found that most of these women had become pregnant because they had not used the contraceptive properly.

For instance, 60% of those on the Pill said they became pregnant after forgetting to take a tablet.

One in three of those who used an IUD said it had been in the wrong position or had fallen out. Almost half of those who had used condoms said they had torn or slipped off.

But a large proportion of women said they did not know why their contraception had not worked.

This included one in five of those taking the Pill, over half of those using an IUD and one in five of those using condoms.

The doctors said the findings suggested many women were simply using the wrong type of contraception for them.

"What this research shows most clearly is that there is often a mismatch between a women's contraceptive needs and the methods they use," Dr Bajos said.

She pointed out that while the Pill is regarded as being very effective it is not suitable for every woman, such as those who do not have intercourse regularly or those whose lifestyle prevents them from taking tablets regularly.

Dr Bajos said doctors should work more closely with patients to ensure they are using the most suitable type of contraceptive.

"When a doctor prescribes a contraceptive, he or she should not think just of the theoretical perspective, but take into account the woman's life."

She added: "It is absolutely essential to differentiate between what are the theoretically most effective methods of contraception and what is the most practicable method for a particular women at a particular time in a particular relationship."

The fpa, formerly the Family Planning Association, welcomed the findings.

Its chief executive Anne Weyman said: "The lessons of this study are equally applicable in the UK. "To avoid unplanned pregnancies, it's essential women are aware of all the contraceptive choices available, and that professionals are fully trained to take into account the different factors that impact on effective contraceptive use, such as lifestyle, age and type of relationship."

The study is published in the journal Human Reproduction.

BBC News