Acta Europaea fertilitatis最新文献

{"title":"The number of follicles and ovarian volume in the assessment of the response to clomiphene citrate in polycystic ovarian syndrome.","authors":"C Fiçicioğlu,&nbsp;M Api,&nbsp;S Ozden","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether the number of follicles and ovarian volume have any significance in evaluating the response to clomiphene citrate treatment in Polycystic ovarian syndrome (PCOS).</p><p><strong>Design: </strong>A prospective study of 70 infertile women, 44 of which were diagnosed with PCOS.</p><p><strong>Setting: </strong>Zeynep Kamil Women and Children's Hospital Infertility Polyclinic.</p><p><strong>Main outcome measures: </strong>Follicle numbers and volumes in both ovaries, hormonal profile, response to Clomiphene Citrate (CC). Ovarian volume was significantly greater in PCOS cases than controls. However ovarian volume in the CC nonresponders was significantly greater than in CC responders in the PCOS group. The number of small follicles was significantly higher in PCOS cases than controls, and in the CC nonresponder group this number was also significantly higher than in CC responders. Endocrine features of patients with PCOS revealed that FSH, LH/FSH, DHEAS and Androstenedion do not discriminate between patients who respond to CC and those who do not respond. However, Testosterone (T) and LH levels differ significantly in responders and nonresponders. Small multiple follicles (> 9) and enlarged ovarian volume (> 6.8 ml) were the most prominent transvaginal ultrasonographic features of ovaries in CC nonresponsive patients with PCOS. Higher levels of T, LH, and significantly higher number of small follicles were associated with lack of CC response. These ultrasonographic features and laboratory assays could be clinically useful for distinguishing better the CC nonresponders from responders.</p>","PeriodicalId":7016,"journal":{"name":"Acta Europaea fertilitatis","volume":"26 3","pages":"101-4"},"PeriodicalIF":0.0,"publicationDate":"1995-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20048362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective study of couples with a history of recurrent spontaneous abortion.","authors":"S Maione,&nbsp;L Lamberti,&nbsp;C Alovisi,&nbsp;F Armellino","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Clinical treatment of recurrent spontaneous abortion (RSA) is still a matter of debate due to the absence of an univocal definition of the term. As a consequence of the reproductive history of the couple, there is still uncertainty regarding the moment when the problem of recurrent abortion arises and this prevents the start of diagnostic evaluation and therapy. In addition to a critical review of the literature, the aim of this study was to evaluate whether two successive abortions with the same partner are sufficient to suggest that the couple should undergo diagnostic test, or if it would be more sensible to wait for other reproductive failures. The study was performed in 50 couples suffering from recurrent abortion who attended the Laboratory of Cytogenetics in the Department of Animal Biology at Turin University for caryotyping in order to exclude the presence of chromosomal aberrations. Interviewed by telephone, out of 50 couples 41 presented the necessary requisites for being included in the study. Follow-up ranged between a maximum of 8.5 years and a minimum of 1 year (mean of 4.7 years). From the data collected it emerged that the probable cause of RSA was identified in 21 out of 41 couples enrolled in the study group (51.2 per cent). In the remaining 20 couples tests were within normal ranges. In all diagnosed cases the reproductive problem was identified with one or more alterations present in women. Among the hypothesized cause of RSA, uterine abnormalities were the most frequent (19.5 per cent), followed by immunological problems (17.1 per cent), etiologic factors of hormonal origin (12.2 per cent), one single case of genital infection (2.4 per cent), one balanced chromosomal translocation (2.4 per cent) and at last only one case of cervical incompetence of (2.4 per cent). The diagnosis was determined effectively in 85.7 per cent of couples. Of 20 couples who had not shown any abnormalities, 80 per cent had had a healthy child without any abortions and with the same partner. In conclusion, diagnostic tests performed finally identified the cause of RSA in 43.9 per cent of the couples who completed the procedure; vice versa, 39.0 per cent of couples solved the problem without the need for diagnostic tests; finally, the remaining 18.1 per cent were unable to carry pregnancy to term. By comparing our results to those reported by other authors, we believe that the probability of identifying the cause of RSA and curing it is sufficiently high to justify the start of the diagnostic evaluation of the problem as early as the second abortion in view of the stress on the couple produced by repeated reproductive failures.</p>","PeriodicalId":7016,"journal":{"name":"Acta Europaea fertilitatis","volume":"26 3","pages":"95-100"},"PeriodicalIF":0.0,"publicationDate":"1995-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20048361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chlamydial serology and histerosalpingography in predicting tubal disease in infertility patients.","authors":"C Fiçicioğlu,&nbsp;M Api","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To evaluate the role of Chlamydial serology and hysterosalpingography (HSG) in predicting tubal disease, alone or combined with versus laparoscopy, which is known to be the gold standard but an invasive procedure. In 135 patients who suffered from infertility for at least 2 years admitted to Zeynep Kamil Women and Children's Hospital, Department of Infertility between January 5, 1993 to March 18, 1995. Chlamydial antibody titers were measured, HSG were performed. Tubal disease was identified by laparoscopy. 19 patients with endometriosis and 22 patients who could not be followed were excluded from study group. The final study group comprised 94 patients who had antibody titers, HSG laparoscopy. Sensitivity, specificity, positive and negative predictive values of each diagnostic test were calculated, differences in proportions and means were calculated using chi 2 test and analysis of variance, respectively. For HSG, sensitivity was 88.9%, specificity was 78%, positive predictive value (PPV) was 71% and negative predictive value (NPV) was 92%. For chlamydial antibody titers, sensitivity was 52%, specificity was 68%, PPV was 37% and NPV was 80%. For both HSG and Chlamydial antibody titers, sensitivity was 34%, specificity was 64%, PPV was 36% and NPV was 62%. In our study population 35 (37%) of the infertile women had tubal factor identified by laparoscopy and 37% of these had positive Chlamydial antibody titers. These findings indicate that in our population tubal factor has an important place among causes of infertility but in its etiology Chlamydial infection does not seem to play a major role contrary to previous reports. This can be explained by lower incidence of Chlamydial infections due to infrequency of multipartner sexual relationships and advanced age of first intercourse among women in society. Measurement of antibody titers neither by itself nor in Combination with HSG were not found to be cost-effective and beneficial. We propose conventional HSG as a single, cost-effective procedure since it is also almost as predictive as laparoscopy in detecting tubal disease among our infertile population.</p>","PeriodicalId":7016,"journal":{"name":"Acta Europaea fertilitatis","volume":"26 3","pages":"109-12"},"PeriodicalIF":0.0,"publicationDate":"1995-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20048886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The echoguide embryo transfer maximizes the IVF results.","authors":"Y Prapas,&nbsp;N Prapas,&nbsp;A Hatziparasidou,&nbsp;S Prapa,&nbsp;M Nijs,&nbsp;P Vanderzwalmen,&nbsp;G Vlassis,&nbsp;E E Jones","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The performance of two different methods of embryo transfer for IVF has been evaluated in 132 consecutive embryo transfers. Thirty Eight pregnancies were achieved, corresponding to a pregnancy rate of 28.7% of all embryos transfers. The embryo transfer under ultrasound control was used in 61 cases of our study whereas 71 cases were performed with the \"clinical feel\" method without ultrasound control. The echoguide embryo transfer procedure yielded a significantly higher pregnancy rate than the blind method (36.06% versus 22.6%). The mean number of embryos transferred per attempt was similar in the two groups (3.1 +/- 0.1 and 3.0 +/- 0.1) as was the quality. The randomized comparative study will continue in order to get more data.</p>","PeriodicalId":7016,"journal":{"name":"Acta Europaea fertilitatis","volume":"26 3","pages":"113-5"},"PeriodicalIF":0.0,"publicationDate":"1995-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20048893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of body composition during low-dose estrogen oral contraceptives treatment.","authors":"M Franchini,&nbsp;C Caruso,&nbsp;S Nigrelli,&nbsp;C Poggiali","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To determine in a prospective study if the use of two low-dose estrogen oral contraceptives is associated with changes in weight or body composition.</p><p><strong>Design: </strong>80 outpatients referring to the family planning service, aged 18-43 years were randomly assigned to a treatment with the EE/desogestrel or EE/gestodene association, 20 patients with IUD, aged 26-40 years, were selected as a control group. Anthropometric data and body composition were taken at enrollment and after 6 and 12 months.</p><p><strong>Main outcome measures: </strong>Anthropometric measurements included body mass index (BMI), body composition estimated by mean of Bioelectrical Impendance Analysis (BIA).</p><p><strong>Results: </strong>In the three groups weight, BMI, and total body water (TBW), and body cellular mass (BCM) remained unchanged during the study period.</p><p><strong>Conclusions: </strong>The use of EE/desogestrel and EE/gestodene is not associated with significant variations of body weight and body composition during one year treatment.</p>","PeriodicalId":7016,"journal":{"name":"Acta Europaea fertilitatis","volume":"26 2","pages":"69-73"},"PeriodicalIF":0.0,"publicationDate":"1995-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20048357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use and results of laparoscopic chromoperturbation in women previously examinated by hysterosalpingography.","authors":"K L Rausmussen,&nbsp;B Skaalum,&nbsp;I H Christensen,&nbsp;L Schierup","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Laparoscopic chromoperturbation in superior to hysterosalpingography in the evaluation of infertile women. Referring women to both investigations is therefore cost ineffective and unacceptable for the patient. To estimate the magnitude of this problem, the records of all women referred to hysterosalpingography in our department during 1989-92 were reviewed. We registered the result of the hysterosalpingography, whether or not she later had laparoscopic chromoperturbation and the results of this procedure if done. One hundred and eighteen women were included. Fifty eighty had a laparoscopic chromoperturbation (49%). The fertility prognosis obtained at hysterosalpingography was different from the fertility prognosis found by laparoscopic chromoperturbation in 34 percent of the women. Women with an abnormal hysterosalpingography had significantly more often a complicated gynecologic history. It is suggested that testing for tubal patency as a primary infertility investigation should be reserved for women with an adverse gynecologic history. Laparoscopic chromoperturbation is the method of choice.</p>","PeriodicalId":7016,"journal":{"name":"Acta Europaea fertilitatis","volume":"26 2","pages":"85-6"},"PeriodicalIF":0.0,"publicationDate":"1995-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20048359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controlled ovarian hyperstimulation in women > or = 40 years old undergoing IVF-ET: mid-luteal versus early follicular (flare-up) GnRH analog regimens.","authors":"A Borini,&nbsp;M R Trevisi,&nbsp;M G Bafaro,&nbsp;M Cattoli,&nbsp;L Bianchi,&nbsp;C Flamigni","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this study was to compare results obtained using two different GnRH analogue regimens in women > or = 40 undergoing IVF cycles. Patients using GnRH-a from mid-luteal phase of the previous cycle (group A) needed more days of ovarian stimulation than patients GnRH-a in the follicular phase of the same cycle \"flare-up\" (group B) (11.7 +/- 1.3 vs 10.8 +/- 2 respectively). Group A patients developed more follicles and obtained more oocytes than group B (9.2 +/- 4.9 vs 6.1 +/- 4.4; And 7.6 +/- 4.7 vs 4.2 +/- 3.2, respectively). The cancellation rate was significantly higher in B than A (20 vs 8.6%, respectively). Pregnancy rates however were significantly lower in \"flare-up\" than in mid-luteal group (3 vs 14% per cycle, 4.7 vs 17% per patient, 3.8 vs 15.2% per oocyte retrieval and 5.4 vs 18.8% per transfer, respectively). Different results obtained in the two groups suggest that Gn-RH-a long protocol allows better ovarian stimulation and consequently improved pregnancy rate than \"flare-up\" in women > or = 40 years old.</p>","PeriodicalId":7016,"journal":{"name":"Acta Europaea fertilitatis","volume":"26 2","pages":"59-61"},"PeriodicalIF":0.0,"publicationDate":"1995-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20048355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A murine model of adenomyosis: the effects of hyperprolactinemia induced by fluoxetine hydrochloride, a selective serotonin reuptake inhibitor, on adenomyosis induction in Wistar albino rats.","authors":"C Fiçicioğlu,&nbsp;H I Tekin,&nbsp;P F Arioğlu,&nbsp;I Okar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate whether fluoxetine given to castrated and noncastrated rats caused hyperprolactinemia and its effects with respect to adenomyosis.</p><p><strong>Design: </strong>Fluoxetine, a serotonin reuptake inhibitor, was given to Wistar Albino rats for 98 days to produce hyperprolactinemia. The drug was given to two groups consisting of castrated and noncastrated rats and compared to two groups of castrated and noncastrated controls. Prolactin levels were measured and the uteri of the rats were removed for histopathological analysis at the end of 98 days.</p><p><strong>Setting: </strong>Marmara University School of Medicine, Department of Histology and Embryology, Zeynep Kamil Women and Children's Hospital.</p><p><strong>Main outcome measures: </strong>Serum prolactin levels, uterine histopathology.</p><p><strong>Results: </strong>The prolactin levels of castrated and noncastrated groups treated with fluoxetine were statistically significantly higher when compared to their respective control groups. Histological studies revealed 11 cases of adenomyosis, all within the noncastrated group receiving fluoxetine.</p><p><strong>Conclusion: </strong>It was suggested that high serum prolactin levels cause degeneration of myometrial cells in the presence of ovarian steroids that results in a myometrial invasion by endometrial stroma. This invasion eventually progresses to adenomyosis.</p>","PeriodicalId":7016,"journal":{"name":"Acta Europaea fertilitatis","volume":"26 2","pages":"75-9"},"PeriodicalIF":0.0,"publicationDate":"1995-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20048358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrauterine insemination with husband's semen as alternative to other assisted reproduction techniques.","authors":"F Ferraro,&nbsp;M Costa,&nbsp;A Ferraiolo,&nbsp;P Anserini,&nbsp;V Remorgida,&nbsp;G Capitanio","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The objectives of this study was to assess the efficacy and clarify how many intrauterine insemination cycles can justifiably be proposed, in terms of cost and benefits for the patient, as alternative to other assisted reproduction procedures. Two hundred and twenty infertile couples were referred to our centre and six intra-uterine insemination cycles in combination with controlled ovarian hyperstimulation were proposed for them. A total of 650 treatment cycles were completed. The indications of intra-uterine insemination were male factor (147 couples), cervical factor (31 couples), male and cervical factor (30 couples) and unexplained infertility (12 couples). Superovulation was induced in 92 patients with human menopausal gonadotrophins, in 90 with clomiphene citrate, in 22 with FSH HP, while in 16 patients the intra-uterine inseminations were carried out during spontaneous cycles. Considering the entire population, a mean monthly pregnancy rate equal to 8.9% was obtained and a cumulative pregnancy rate equal to 39% at the end of six intra-uterine insemination cycles. In particular, in the patients treated with HMG+hCG, a mean monthly pregnancy rate equal to 10.9% and a cumulative pregnancy rate to 46% at the end of the six cycles were obtained. In conclusion, when the indications allow, we believe it is justified to propose six cycles of intra-uterine insemination in combination with controlled ovarian hyperstimulation with HMG and hCG. The theoretical probability of success at the end of six cycles has proved comparable and advantageous in terms of cost and risks for the patient, if compared with other assisted reproduction techniques.</p>","PeriodicalId":7016,"journal":{"name":"Acta Europaea fertilitatis","volume":"26 2","pages":"63-7"},"PeriodicalIF":0.0,"publicationDate":"1995-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20048356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic tubal surgery. A retrospective comparative study of open microsurgery versus laparoscopic surgery.","authors":"Y Prapas,&nbsp;N Prapas,&nbsp;A Papanicolaou,&nbsp;S Asprodinis,&nbsp;G Vlassis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this study is to compare retrospectively the outcome of patients that underwent tubal surgery by laparotomy or laparoscopy by the same surgeon Thirty two women that presented with distal tubal obstruction were treated by laparoscopic tubal surgery and 38 by laparotomy and microsurgery. Patients were equally matched for age, duration of infertility and severity of disease. In all cases there were no injuries to adjacent groups and no additional surgery was needed. The duration of surgery was 35-60 min for laparoscopy and 70-120 min for laparotomy and mean duration of hospital stay was 2 and 7 days respectively. Of the 32 cases that underwent laparoscopic surgery 10 had intrauterine pregnancies (31.25%) and 2 ectopic (6.2%). Conversely 11 (28.9%) of the 38 cases with tubal microsurgery resulted in intrauterine pregnancy and 4 (10.5%) in ectopic. Our results suggest that laparoscopic tubal surgery is the method of choice for the treatment of distal tubal obstruction.</p>","PeriodicalId":7016,"journal":{"name":"Acta Europaea fertilitatis","volume":"26 2","pages":"81-3"},"PeriodicalIF":0.0,"publicationDate":"1995-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20048360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}