Title : Natural family planning through the view of personalized and precision reproductive healthcare: An option for clinicians, geneticists and caregivers to realize the potential of genomics-informed care to secure the individualized human biosafety and planetary demographics
Abstract:
A new systems approach to diseased states and wellness result in a new branch in the healthcare services, namely, personalized & precision medicine (PPM). PPM as a New Model of Healthcare Services is the Science and ART, Illustrating application of sets of the different Tools of the Model at the Population, Community and Individuals to achieve the implementation of PPM concept, it is necessary to create a fundamentally new strategy based upon the subclinical and predictive recognition of biopredictors of hidden abnormalities long before the disease clinically manifests itself. PPM as being the Grand Challenge to forecast, to predict and to prevent is rooted in a big and a new science generated by the achievements of systems biology and translational medicine, whilst integrating platforms of OMICS and IT-technologies. NIH (Bethesda, MD, USA) have the Unique Decision had on setting up in USA a Clinical Research Network including Centers of PPM, Centers for Personalized & Precision Pediatry (CPPP) and Reproductive Precision Medicine Centers (RPMC, e.g., at Columbia University). The concept of PPM and RPMC has been applied in reproductive medicine long before its popularization. The causes of infertility are various, and factors influencing the success rates of ART are complicated; hence, every step of reproductive medicine, such as the diagnosis of infertility causes and transfer of healthy embryos, needs to be precise. One of the better known uses of PPM-related resources in reproductive medicine and family planning and female infertility is the genetic test that most accurately determines how receptive a woman’s endometrium (inner uterine lining) is for implanting an embryo. Genomics and proteomics tests represent examples of methods to investigate the molecular level of male infertility as well. Perhaps what is currently being offered as personalized treatment of infertile patient is more based on “the best expert opinion of the attending clinician” than “the best evidence-based data available”. In this sense, The Columbia University Reproductive Precision Medicine Center is perfectly positioned to be a global leader in the development and implementation of these approaches. And PPM and personalized and precision genomics as the major part of the Reproductive medicine & Family planning are a new and exciting field with the potential to significantly improve medical care for pregnant women and newborns. Moreover, natural family planning (NFP) empowers women to control their reproductive health and approach fertility as a normal biological process. In general, four major types of genomic biomarkers are crucially important and valuable for PPM-related services: Diagnostic, Predictive, Monitoring and Prognostic ones, to be used in most of genomic testing platforms. Among the testing panels are: Carrier testing, Pre-symptomatic & Predictive Testing, Pre-conception testing, Newborn testing, Prenatal testing (NIPT), Nutriogenomic and Pharmacogenomic testing. Improved patient (or persons-at-risk) outcomes must consider not only increased survival, or quality of life, but also improved clinical decision support (CDS) & making! Each decision-maker values the impact of their decision to use PPM on their own budget and well-being, which may not necessarily be optimal for society as a whole. It would be extremely useful to integrate data harvesting from different databanks for applications such as prediction and personalization of further treatment to thus provide more tailored measures for the patients resulting in improved patient outcomes, reduced adverse events, and more cost effective use of health care resources. A lack of medical guidelines has been identified by the majority of responders as the predominant barrier for adoption, indicating a need for the development of best practices and guidelines to support the implementation of PPM! Meanwhile, Family planning specialists have the unique and exhilarating responsibility to help ensure that young patients derive maximal benefit from genomics which, in turn, will provide the family planning specialists new and often unexpected insights into the biological basis of health and disease and will afford new health care options requiring informed and sometimes challenging choices of physicians and patients. So, developing reproductology-related expert-driven competency in genomics is a daunting task, but one that the specialty can and must accomplish in the near future. Achieving such competency will provide effectively integrating genomics into practice, will improve reproductology-related experts’ effectiveness in caring for patients current health concerns and will make experts the guides to lifelong health. For reproductive medicine, precision has always been a criterion in every procedure, including etiology-oriented examination, specific diagnosis, identifying healthy embryos, WOI, and accurate implantation. Combined with genetic information and a large volume of biomedical data, an unknown territory of reproductive medicine will be explored, and the mechanisms underlying the causes of infertility that we do not yet know will be elucidated. The application of PPM has become a guideline for the development of medicine, especially for reproductive medicine. As you might see from the above-mentioned, PPM has drastically changed and is keeping on changing the landscape of healthcare. Meanwhile, Personalized and Precision Reproductive Medicine (PPRM) is still in its infancy, without clear guidance on treatment aspects that could be personalized and on trial design to evaluate PPM-based treatment effect and benefit–harm balance. While the rationale for a PPRM-driven approach often relies on retrospective analyses of large observational studies or real-world data, solid evidence of superiority of a PPRM-driven approach will come from randomized trials comparing outcomes and safety between a PPRM-driven and one-size-fits-all strategy. Organized into five parts, childhood and emerging adulthood; childbearing; reproductive control; violence; and beyond reproduction, the volume encompasses a life-course perspective in understanding women’s and men’s sexual and reproductive health. A more efficient, targeted randomized trial design may recruit only patients or couples for which the PPRM-driven approach would differ from the previous, standard approach. Continued investment in effective prevention and treatment strategies is essential to protect adolescents' sexual and reproductive health. PPM as being the Grand Challenge to forecast, to predict and to prevent is rooted in a big and a new science generated by the achievements of systems biology and translational Medicine (TM). So, just keep you on the way to understand that the Grand Change and Challenge to secure our health and wellness are rooted not in Medicine, and not even in Science! Just imagine Where. In the upgraded Hi-Tech Culture! Implementation of PPM requires a lot before the current model “physician-patient” could be gradually displaced by a new model “medical advisor-healthy person-at-risk”. This is the reason for developing global scientific, clinical, social, and educational projects in the area of PPM to elicit the content of the new branch.
