Prevention and Care Of Animals with Cancer 
	Half of our dogs and cats will have cancer in their lifetimes,
and yet as pet owners, most of us know little or nothing about 
caring for an animal with cancer. 
	The holistic approach treats the whole animal, ignites the body's internal healing force and stimulates 
the body's natural abilities to heal itself. The information presented here is an essential 
resource for anyone who has a pet with cancer to 
understand the underlaying conditions that can predispose your furry kid to cancer. 
	According to the Journal of the American Veterinary Medical Association, 
vaccine-associated sarcoma (VAS) is a 
type of malignant tumor found in cats (and rarely, dogs and ferrets) which has been linked to certain 
vaccines. VAS has become a concern for veterinarians and cat owners alike and has
resulted in changes in recommended vaccine protocols. These sarcomas have been most commonly 
associated with rabies and feline leukemia virus vaccines, but other vaccines 
and injected medications have also been implicated.
	Immune Suppression from Veterinary Chemotherapy
	 Chemotherapy and radiation treatments can profoundly weaken the immune system and increase infection risk. 
 Both Japanese and Chinese clinical studies found that the immune-suppression that results 
from chemotherapy cancer treatment can be prevented by using immune support isolates. 
Keep in mind that the elimination of dying or dead cancer cells is monitored 
by the immune system. 
       
	 Italian, Japanese and American studies tell us 
that the use of immune support isolates to boost immune function after 
surgery significantly improves the chances of cancer-free future.
	Peter S. Nelson, of the Human Biology Division at the Fred Hutchinson Cancer 
Research Center in Seattle, and colleagues, write about their findings in a paper 
published online on 6 August in Nature Medicine. "Cancer cells inside the body 
live in a very complex environment or neighborhood. Where the tumor cell resides 
and who its neighbors are influence its response and resistance to therapy." 
    The reason chemotherapy eventually fails when treating advanced cancer, said 
Nelson, is because the dose you would need to give the patient to wipe out the
cancer would also kill the patient. In the lab, you can
"cure" almost any cancer: you just give a huge dose of toxic chemotherapy 
to the cancer cells in the petri dish.
	Animals with cancer have special nutritional needs
 
Animals used to be able to subsist on good food alone, but the food chain has been adulterated 
and depleted of nutrients. Supplements are concentrated foods that can make up for the deficiencies 
in our foods today, and Dr Goldstein believes every pet should be on some form of supplementation. 
In cancer patients this is even more important. Dr Goldstein DVM strongly recommends 
	avoiding grains and other carbohydrates for all dogs, but especially for cancer patients. 
	If your dog has cancer, he really needs a high protein, high fat diet containing 
	raw meat and its fat, as nature intended. The immune system is a protein-based system. In cancer 
patients, the body is constantly searching for more protein because the immune system is failing … 
so it draws protein from the muscles.
	
Nutrient-Rich Pet Supplement Improves your Pets' Health and help reduce pain and inflammation. It is a precise formula of 
vitamins, minerals, enzymes, herbs and antioxidants that performs synergistically to bring together all the vital ingredients 
required to improve your pet’s health and keep them healthy. 
	"The results of a clinical trial suggest that 74.7% of common diseases in dogs and 63% of common 
diseases in cats can be eliminated without medical intervention over a period of one year with 
proper diet modifications and an understanding of the healing process as exhibited through healing 
episodes. Approaching disease from the perspective of health is the most powerful means of 
eliminating disease." William Pollak D.V.M.
	Cancer patients who are undergoing chemotherapy or radiation which greatly weaken the immune system, 
can greatly benefit from taking immune support supplementation which serves to protect the body from 
opportunistic infections, which often occur during these treatments. 
		
	
In her book, 'Managing 
the Side Effects of Chemotherapy and Radiation Therapy', Marylin 
J.Dodd, RN, PhD, describes side effects associated with radiation therapy. 
Dr. Dodd has 25 years of research experience helping patients and their 
families manage the side effects of cancer treatment. She is a professor 
of nursing at the University of California, San Francisco School of Nursing.
	Instead of weakening the body with poisons and radiation, 
the far more rational (and genuinely scientific) approach is to strengthen the body, to give it the 
nutritional tools that allow it to fight the cancer and at the same time use appropriate 
nutritional means that weaken and take the power away from the cancer. We find that in 
most instances, this not only allows longer survival times, but does so with a vastly improved quality of life.
 
	
	Cancer in Animals Associated with Toxic Chemicals
	
A hospital-based case-control study of companion dogs examined the risk 
of developing canine malignant lymphoma associated with the use of chemicals 
in and about the home. The study indicated that owners in households 
with dogs that developed malignant lymphoma applied 2,4-dichlorophenoxyacetic 
acid (2,4-D) herbicides to their lawn and/or employed commercial lawn care companies
to treat their yard significantly more frequently than 
control owners (odds ratio = 1.3). In addition, the risk of canine malignant 
lymphoma rose to a twofold excess with four or more yearly owner applications 
of 2,4-D. The findings in this study are consistent with occupational 
studies in humans, which have reported modest associations between agricultural 
exposure to 2,4-D and increased risk of non-Hodgkin's lymphoma, the 
history and epidemiology of which are similar to those of canine malignant 
lymphoma.
 
	Asbestos, Cancer and Your Pets
	Not only can dogs inhale asbestos brought in by their owners, but dogs 
can also drag asbestos dust into the home on their fur or feet if they've 
been in a location where asbestos is present, such as near an older 
building that's being demolished. That's why it's always necessary to 
keep tabs on the whereabouts of your dog, as it may impact his health 
and that of your family. Veterinarians who've studied dogs with mesothelioma 
have also come to the conclusion that exposure to other toxic materials 
may also increase the risk of
the animal developing mesothelioma. Those 
substances include pentachlorophenol, often used as an herbicide, algaecide, defoliant,
wood preservative, germicide, or fungicide. Studies have 
shown that Bouvier des Flandres, Irish Setters, and German Shepherds 
are at greatest risk for tumor development and the disease is more common 
in male than in female dogs.
In addition, the risk of canine malignant lymphoma rose to a twofold 
excess with four or more yearly owner applications of 2,4-D. The findings 
in this study are consistent with occupational studies in humans, which 
have reported modest associations between agricultural exposure to 2,4-D 
and increased risk of non-Hodgkin's lymphoma, the history and epidemiology 
of which are similar to those of canine malignant lymphoma.
  Insecticides Associated with Bladder Cancer in Dogs - A statistically significant 
association between exposure to topical flea and tick sprays and the 
occurrence of bladder cancer in dogs has been found. The risk of bladder 
cancer was increased further in dogs living in proximity to areas sprayed 
regularly with insecticides for mosquitoes. An increased rate of bladder 
cancer in humans has recently been reported (Journal of Toxicology and 
Environmental Health, 1989(28): 407-414).
  What about flea sprays and shampoo?
  Excerpt from Catherine O'Driscoll's writing
  "Did you know that many flea collars contain carbaryl? Do you know 
what carbaryl has been shown to do to animals in laboratories? It causes 
cancer, mutates cells, and causes birth defects. How safe is it for 
your dog to wear a flea collar around his neck for up to four months? 
And why do the manufacturers tell us to stop our children touching the 
collar? And the flea sprays - read the instructions. Are you told not 
to breathe in whilst spraying your dog? Can you tell your dog not to 
breathe? And what's in all the flea killing shampoos? One of them, at 
least, contains a chemical that has been shown to cause cancer if taken 
in through the skin!"
  
   
	
If it's not OK for your child, why is it OK for your dog?
   "...We have a dog shampoo in England that contains piperonyl butoxide. 
This has been shown to cause cancer in animals when absorbed through 
the skin. We have a flea collar containing carbaryl. This is a mutagen, 
and has been shown to be carcinogenic and teratogenic in laboratory animals
  Cancer of the thyroid and toxic chemicals
   Email May 2001- testimonial from Laura
	 "My poodle has recently been diagnosed with cancer of the thyroid 
and given a life sentence of 6 months. After hours and hours of crying 
and staying up all night just "watching" her, I got on tons of websites 
and read tons of articles on processed foods, chemicals, and exactly 
what environmental factors could have caused Genie's cancer. I live 
in a beautifully maintained townhouse community and think there is a 
connection between the lawn fertilizer and her cancer. I used to bring 
her to the vet every year for her vaccinations and felt great after 
we left...like when you leave the dentist. Little did I know I was killing 
her slowly. I will no longer give her or my cat another vaccine (my 
cat's name is Lillie!!). I now am more informed, but unfortunately for 
Genie, it's too late. Your article inspired me to pursue my Association's 
use of chemicals for the lawn. I am also now feeding my animals organically 
based, home made food. Good bye to Mighty Dog and Friskies. I thought 
the most expensive brands were the best. Now I realize I have been feeding 
fecal matter, roadkill and euthanized companion animals (domesticated 
dogs and cats) to my furry children. I am much wiser and hope that my 
new found wisdom extends the life of my Genie just a little longer. 
Thanks for writing back and keep going with what feels right in your 
heart." - Laura
  
	A Strong Immune System can Beat and Prevent Cancer
     
	Jodie Gruenstern DVM "Conventional vets have a 
limited number of tools to treat cancer. Their options primarily 
involve surgical removal, radiation, chemotherapy or immune suppression.
I use a variety of immune support remedies. All my cancer protocols 
include a fresh, raw, species-appropriate, starch-free diet to starve 
the cancer, with blended, dark, leafy greens for their antioxidant properties."
	Dr Ian Billinghurst DVM “Apart from eliminating all 
carcinogens from a dog’s life (a clear impossibility) the most important
thing we can all do is feed our dogs a genome appropriate diet. This is 
the single most important thing any dog parent can do to ensure maximum 
possible freedom from this terrible scourge.”
	When Dr Greg Ogilvie was head of internal medicine and oncology at 
Colorado State University, he researched the correlation of diet to cancer.  
One of his big findings was that the byproducts of grain metabolism – glucose and lactate – feed cancer cells. 
	Sick or injured Animals feel abandoned when left in a pet hospital 
and agonize emotionally when separated from their families. The separation stress, 
the fear and loneliness can dramatically suppress the immune 
system and weaken the animal further. 
  We all know the importance of an optimal immune system, not only after surgical 
procedures or fighting disease and serious illness, but 
also in your patient's or pet's everyday wellness. Recent in vitro and 
in vivo studies over baseline immune response. The NK cell is the animal's 
first line of defense against many pathogens... bacteria, viruses, parasites, and of course malignant tumor cells.
	Animal Cancer Remission Testimonials
	
My 15 year old Dachshund dog Charlie started bleeding from both ends whenever he went to the bathroom. 
When he was diagnosed with a cancerous tumors in his colon, the veterinarian 
suggested surgery, chemo and radiation, which I told him I couldn't afford. 
He gave Charlie just a few more weeks to live. I was devastated. I prayed a 
lot and I want to thank God that He led me to do research online to find a
holistic healing protocol through Shirley's Wellness Cafe.  After just 3 days 
on this unique immune booster Charlie stopped bleeding. A month later I
took him back to the vet for a check up and the doctor was amazed, he 
thought it was a different dog, he said he didn't know hat to say except 
that the tumor was gone. I explained to him that I'd been giving Charlie 
a very special immune booster for the past 4 weeks and a lot of prayers 
and he said that i must have a direct connection to God then cuz then cuz Charlie is doing great.  Esther Lopez
	"In February 2010, my dog, Sammy, a 10 year old pure-bred Lhasa Apso, started 
acting lethargic and not his usual playful self. He didn’t seem to be 
able to jump up on the furniture or go up and down stairs. He was very 
unsure of himself. Sammy was notorious for eating socks and I thought 
maybe he had swallowed something that was making him sick. We took him 
to the family vet who ran blood work and took an x-ray of his stomach. 
I was called the next day and told that Sammy’s blood work came back 
normal and that the x-rays also appeared normal. Because we were both 
puzzled as to what was wrong with Sam, the vet suggested we send the 
x-rays to a specialist for review. Two days later I was called and told 
that Sammy had a two-inch tumor wrapped around his adrenal gland. The 
vet suggested the name of a doctor who specialized in animal cancers. 
Needless to say, I was devastated.
	
	
 Sammy and I made the journey
to the animal oncologists office where an ultra sound was
performed and it confirmed that Sammy did, in fact, have 
a tumor. Because of its location near a major blood vessel, 
surgery was not an option. He would probably not survive. 
I was told he could be put on a chemotherapy type drug but
it could have serious drug related side-effects. I declined 
the medication and they told me to take him home and make 
him as comfortable as possible and enjoy the time I had 
remaining with him. With tears pouring down my face, I 
asked how long, but they wouldn’t give me an estimate. 
I was heartbroken and Sammy sensed my emotions.
	
I am a person who believes that we can heal ourselves naturally.
I was on a mission to save my dog. I found the website “Shirley’s
Wellness Cafe” for people and their pets. I read everything I		
could about animal cancer and the testimonials from veterinarians 
across the country who have treated pets/animals with immune 
foundation product. I ordered the product and started giving 
the capsule to Sammy twice a day. After one month, I decreased 
the pill to once a day. It has been nineteen months since Sammy 
started his daily dose HE IS STILL WITH ME! He is running, playing, 
jumping, and climbing up and down the stairs. Sammy has been back to
our regular vet several times for follow-ups and his doctor is 
always amazed that he is still alive. He is now 12 1/2 years old. 
His 13th birthday will be on March 3rd, 2012". Janet C. Painesville, OH
	
"My cat was diagnosed with Feline Leukemia and the vet
considered euthanasia. - Nefret was about 8 weeks old when I found her.  I was 
going to work and looked over into my neighbors driveway and saw what I thought 
was a baby rabbit...all ears.   The animal got up and started to wobble down the
driveway and I realized it was a kitten.  I went over to investigate and found 
a VERY sick kitten.  I took her into the house and gave my daughter instructions 
on how to care for her until I got home.  I made a vet appt. for that afternoon.  
The vet examined her.  She was severely dehydrated, malnourished, had a major 
case of hookworms, diarrhea,  and a severe respiratory infection.  She also tested 
positive for feline leukemia.  The vet suggested, at that point,  to consider euthanasia.  
We didn't opt for that and were sent home with an antibiotic and a kitten kit.
Nefret was on the antibiotic for 10 days and was still snotty and sneezing. 
We were given a second course of the same antibiotic.  About 5 days into the
second course, I came home to find her fairly unresponsive and very warm.  
I immediately called the vet and was given the euthanasia option again and 
	was told this was fairly typical of 
cats testing positive for feline leukemia.  I asked for a stronger antibiotic 
instead, said a prayer and went on the net to do some research on alternatives to traditional treatment for this disease.  
	
	
I learned about a unique immune booster that holistic veterinarians were 
using with excellent outcome.  I ordered a bottle overnighted. Nefret received 
a dose with her morning food and again in the evening.  Her response was amazing.  
Within two days she was acting like a normal, wild and wonderful kitten.   
She is a little over six months old now.  She was spayed about 5 weeks ago
and had a full blood work-up done at that time.  Her blood work came back absolutely 
normal. The vet was amazed and  couldn't believe that this was the same kitten. 
She continues to receive her supplement just with her morning food and I will 
continue that for her lifetime.   I now have a bundle of pure energy and joy in my life". 
Libby McCourt, - Winchester, Virginia
	Also See:
	Testimonials of Animals Cured of Various types of Cancer At Home
	
	Can Homeopathy Cure Animal Cancer? 
	
A growing number of  veterinarians are turning to homeopathic veterinary 
medicine as a safe and effective alternative to conventional veterinary 
practice including the use of antibiotics. There is so much that can 
be done for an animal, bird, or reptile that is ailing by utilizing homeopathic 
medicine.
	"Cancer like other diseases is curable in veterinary homeopathy. 
Why and how ? To understand this, one has to understand the basic principle of homeopathy. 
According to the principle of cure in Homeopathy, there is nothing that is incurable 
provided there is sufficient energy, and Vital Force in the patient at the time 
of taking to or resorting to homeopathic treatment. According to homeopathic scientists, 
without the cause, there cannot be a disease. So the cause should be traced. If we find 
out the root of the disease than there must be a medicine for it." Dr Eli G Jones, MD
	The Definitive Holistic Medicine Guide to Caring for Your Dog and Cat
	by Martin Goldstein D.V.M.
	Dr. Goldstein--a graduate of the Cornell University College of Veterinary 
Medicine explains his approach to alternative treatment: what it is, 
how it works, and why it's especially important that animals be treated 
holistically. Holistic pet care essentially revolves around the notion 
that the best way to cure an animal who is ill is to help the animal 
cure itself. We are not the true healers of our pets--they are. By treating 
the root of the problem instead of its symptoms, holistic medicine enables 
our pets to regain and maintain their own health. In his practice, Dr. 
Goldstein has had extraordinary success treating cancer and leukemia.
  "I have been providing our dogs with alternative health 
treatments since 1995. I was fed up with conventional care--too many 
pills that merely masked underlying illnesses and no real treatment. 
Our dogs have glowing health and everyone remarks on their vigor and 
beautiful coats. Dr. Goldstein, because of his successes with cancer 
and chronic illnesses, has conventional veterinarians quaking in their 
boots. So much of medicine is run by the profit motive, totally denying 
the Hippocratic oath taken by doctors and vets. Think of the marketing 
of pet foods and vaccinations in the office of the vet--two of the biggest 
money-makers in the industry. It is no wonder those boots are quaking. 
I implore you to read this book for the sake of your pets' health."A 
reader from San Diego, California
	Cancer treatment for pets can be done at home. In this site Ron Conley 
discusses what you need to know about how to treat cancer naturally in 
both pets and people. Natural ways to fight cancer at home using non-invasive 
therapies and treatments. Many people have shown an interest in keeping up to 
date on Natasha's condition, on her successful treatments which is why 
Ron is publishing this weekly newsletter. This will keep you informed 
regarding Natasha's breast / skin cancer progression and treatment with 
Flax Oil / Birch Bark Poultices / supplements and diet modification.
	
	The Role of Glutathione in Animal Cancer
	
	Glutathione may well be the most important molecule your furry companion and its 
human parent need to stay healthy and prevent disease. It’s a key for preventing aging, cancer, heart disease. 
	Glutathione metabolism is able to play 
both protective and pathogenic roles. It is crucial in the removal 
and detoxification of carcinogens, and alterations in this pathway, can have a profound effect on cell survival. 
 
	
	Animals Need Omega 3 Essential Fatty Acids to Beat Cancer
	
Further research indicates that horses fed flax and injected with 
the deadly organism Escherichia coli were better protected than those 
not fed flax, suggesting enhanced immunity in these animals. Select 
Alaskan sled dog mushers are fortifying their dogs diets with flax oil 
as it serves as a source of valuable energy, keeps less desirable saturated 
fats mobile in the blood stream, increases oxygen uptake to the cell, 
decreases recovery time from strenuous exercise, and prevents and heals 
worn and chaffed paws. Numerous studies conducted on animals and humans 
show that flax has powerful anti-tumor properties and may reduce tumor 
size by 50%.
	A testimonial about flaxseed oil and cancer 
 
	"My dog Shilo, a 3 1/2 years old Golden Retriever, was diagnosed with Leukemia of the 
bone marrow. He was diagnosed on March 19, '99 and the next day I started 
him on 3 tablespoons of flaxseed oil and cottage cheese and within hours 
his energy improved. Four days later, on March 24th, I took him back 
to the vet and they did a blood test and were baffled because his white 
cell count was normal, his red blood cells were normal, and his platelets 
were clotting normal, he had no fever, and he was acting like a normal 
dog and they didn't understand. On April 13th he had another test and 
no cancer cells. HE HAS BEEN CANCER FREE SINCE MARCH 24th 1999. Just 
think I spent over $2000.0 on vets to find out what he really needed 
was a bottle of flax seed oil that costs about $12.00. 
Before this he was a very sick dog 
and according to the vets he was suppose to be dead by now."
	Fish Oil Helps Prevent Cancer
	Several mechanisms have been proposed by which the intake of 
	marine fats may lower the risk of cancer. Among the most important of these 
is the inhibition of eicosanoid biosynthesis from arachidonic acid (AA; 
20:4n-6), an omega-6 fat metabolized in the body from linoleic acid. 
Eicosanoids are a class of compounds derived from polyunsaturated acids 
and include prostaglandins, hydroxyeicosatetraenoic acids, and leukotrienes. 
Prostaglandins are oxygenated, unsaturated cyclic fats that perform 
a variety of hormone-like actions. Those converted from AA by the cyclooxygenase-2 
enzyme, notably prostaglandin E2 (PGE2), have been linked to carcinogenesis 
in several types of studies:
  * Animal experiments of mammary tumor development,
   * Studies of the proliferation of breast and prostate cancer cell lines 
in vitro, and
   * Human studies of fish oil intake, epithelial cell proliferation rates, 
and PGE2 biosynthesis.
  Tumor cells typically produce large amounts of AA-derived PGE2, which 
may impede immune system function, possibly through its role in the 
generation of suppressor T cells. Fish oils inhibit cyclooxygenase-2 
and the oxidative metabolism of AA to PGE2.
  
  Overcoming Chemotherapy Sickness 
  
"A recent client of mine is a woman with breast, bone and liver cancer 
who started taking Marine Phytoplankton about two weeks ago. Previously 
unable to keep anything down and having very little energy, she is now 
very excited and is experiencing a complete turnaround. She has worked 
up to two ounces a day, has much improved energy, and can now eat with 
no problem. Her pH has come up from 5.6 to 6.2 as well. Prior to starting 
on this program, she had undergone chemotherapy and radiation, which 
made her quite ill. Her blood work, after about 10 days, has improved. 
Needless to say, she is ecstatic and grateful to have been exposed to 
Marine Phytoplankton. Her family can't believe the change!" D. W.
	
	 Marine Phytoplankton are a rich source 
of glyconutrients. Advanced cancer patients experienced amazing regressions 
of malignant melanoma, renal cell carcinoma, colorectal carcinoma, lung 
cancer, nasopharyngeal carcinoma, and malignant hydrothorax. Research 
have shown glyconutrients to:
  
   - Reduce the Toxic Effects of Chemotherapy and Radiation 
- In one study, glyconutrients was shown to enhance the 
effects of radiation in combating lung cancer, allowing a lower 
dose to be used. Other research indicates that glyconutrients can 
protect against some of the noxious side effects of chemotherapy 
and radiation.
 
   - Increases Lymphocyte Count - Lymphocytes are 
specialized white blood cells that are of crucial importance to 
the adaptive part of the body's immune system. The adaptive portion 
of the immune system mounts a tailor-made defense when dangerous 
invading organisms penetrate the body's general defenses. Glyconutrients 
increases lymphocyte count and helps to activate them when the body 
is under attack.
 
   - Enhances Body's Production of Cancer-Fighting IL-2 -
Glyconutrients polysaccharides have been shown in Chinese studies 
to enhance the production of IL-2, a crucial cytokine (cell protein) 
that induces potent anti-tumor responses in a variety 
of cancers. Glyconutrients also kills tumor cells by inducing apoptosis, 
a process in which cancer cells are broken down and recycled.
 
   - Helps Manage and Fight Cancer Patients receiving 
a cancer drug together with glyconutrients exhibited response rates 
up to 250 percent better than those obtained by the drug alone. 
These advanced cancer patients experienced amazing regressions of 
malignant melanoma, renal cell carcinoma, colorectal carcinoma, 
lung cancer, nasopharyngeal carcinoma and malignant hydrothorax. 
Remission of cancers in patients treated with glyconutrients lasted 
significantly longer than those treated without glyconutrients .
 
  
  
	Bee pollen as a healthy supplement
  One of the most important articles ever published on bee pollen comes 
from our own United States Department of Agriculture. This article, 
entitled "Delay in the Appearance of Palpable Mammary Tumors 
in C3H Mice Following the Ingestion of PolIenized Food," is 
the work of William Robinson of the Bureau of Entomology, Agriculture 
Research Administration. It was published in the Journal of the National 
Cancer Institute way back in October 1948, five decades ago. According 
to the article, Dr. Robinson started with mice that had been specially 
bred to develop and subsequently die from tumors. 
	He explains, "The age at which mice of this strain developed tumors ranged from 18 to 
57 weeks, with an average appearance at 33 weeks. Tumor incidence was 
100 percent." Given the fact that cancer is the number-two killer in 
the United States (heart disease is number one), we can all certainly 
agree that this is an electrifying article. What happened from it? Nothing. 
Even the National Cancer Institute, which published it, failed to follow 
up on this very promising line of research. It was dropped with no explanation."
  Bee pollen was fed to hundreds of animals over a period of two years 
by scientist-researcher Dr. Remy Chauvin of the Institute for Bee Culture 
in Bures-sur-Yvette, France. Reporting to the French Academy of Medicine 
in 1956, Chauvin said, there were no side effects in the test animals. 
Furthermore, the use of bee pollen gave the animals increased vitality 
and improved "powers of reproduction" because of boosted fertility.