WOOMB International

Science of Fertility

Gillian Barker, Rome 2023

Thank you for giving me this opportunity to talk to you all today. It is wonderful to be here in Rome and seeing you all in person. I have been asked to speak about the work of the late Professor James Boyden Brown. More specifically the hormone profiles of the Continuum of ovarian activity. For those of you who do not know, Professor Brown was my mentor. I worked in the laboratories that were set up and headed by him at the Royal Women’s Hospital in Melbourne Australia.

In the title of his last publication in Human Reproductive Update1, he says this is a “reinterpretation of his earlier findings”. How early did it all begin? I guess it really began in 1947, but his life began in 1919. James Brown was born in New Zealand in 1919. By the age of 21 he had gained his Masters in Chemical Engineering.

After working in the Hospital Pathology department during the Second World War, in 1947 he gained a scholarship to work in Scotland. The Clinical Endocrinology Research Unit was headed by Professor Guy Marian, who was one of the world leaders in oestrogen discovery and research. While working in Edinburgh Jim gained his PhD and published several papers.

Before we go any further and talk about his discoveries, we need to have a basic understanding of the term “Continuum of Ovarian Activity”. It is said a woman’s fertility begins with her first bleed at menarche and ends with her last bleed at menopause. For most of her life she will have fertile ovulatory cycles.

The studies have shown that the young girl, as she traverses from amenorrhea to fertile ovulatory cycles, may have bleeding that is not menstruation; she may have cycles that are not fertile. There is a continuous gradation from no follicular activity to fertile ovulatory cycles. The studies have also shown that as a woman approaches menopause there is a decline in fertility before she become amenorrhoeic. Once again it is a continuous gradation but in reverse to the young woman.

During her lifetime the woman may have one, two or three children. After the birth of these babies, especially if she is breastfeeding, then once again as she traverses from lactational amenorrhea to fertile ovulatory cycles, she may have bleeding that is not menstruation and cycles that are not fertile.

During her life she may experience stress – perhaps during exam time or as she approaches her wedding day. Maybe it is later in life – perhaps when she has sick and aging parents or maybe due to teenage children. Stress can have an effect on the cycle causing infertility for a short time. The winding up or winding down of fertility is a normal progression during the woman’s reproductive life and is the basic concept of the Continuum of Ovarian Activity.