International journal of fertility and menopausal studies最新文献

{"title":"Medical treatment of infertility associated with minimal to mild endometriosis.","authors":"R L Barbieri","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"41 4","pages":"393-5"},"PeriodicalIF":0.0,"publicationDate":"1996-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19859656","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 treatment is better than medical treatment for minimal or mild endometriosis.","authors":"G D Adamson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"41 4","pages":"396-9"},"PeriodicalIF":0.0,"publicationDate":"1996-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19859652","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 relationship of the postcoital test and semen characteristics to pregnancy rates in 200 presumed fertile couples.","authors":"A N Beltsos,&nbsp;S Fisher,&nbsp;M L Uhler,&nbsp;E D Clegg,&nbsp;M Zinaman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the postcoital test (PCT) and semen analysis (SA) in the prediction of pregnancy in 200 potentially fertile couples.</p><p><strong>Methods: </strong>200 couples without risk for infertility were prospectively followed for 1 year. Couples were attempting pregnancy for 12 menstrual cycles. In the first three cycles, the women underwent monthly PCTs and collected daily urines while the men provided bimonthly semen analyses. For the next nine cycles, the couples were monitored for pregnancy. The PCT included hours post-coitus, amount of mucus, spinnbarkeit, number of motile sperm, and percent of motile sperm. Since multiple PCTs and SAs were available for each couple, values were averaged to provide one mean value per couple. The Wilcoxon ranked sum test was used to detect differences in PCT and SA.</p><p><strong>Results: </strong>Pregnancy occurred in 163/200 couples (82%) in 12 cycles. Mean sperm count per high-power field (p = 0.01) and mean number of highly motile sperm (p = 0.03) were higher among women in whom pregnancy occurred. Amount of mucus and spinnbarkeit were similar between women who became pregnant and those who did not. Semen concentration, motile sperm count, and percent motile sperm were significantly higher among men whose partner conceived (P < .02). Only 93 couples (47%) had PCTs that were correctly timed.</p><p><strong>Conclusions: </strong>Measures predictive of pregnancy included vigorously moving sperm per high-power field, sperm concentration, motile sperm count, and percent motility. Mucus characteristics were not predictive of pregnancy. Additionally, a high number of sperm seen in the PCT correlated with a high number of motile sperm in the SA. These results support the use of the PCT for initial evaluation of the infertile couple.</p>","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"41 4","pages":"405-11"},"PeriodicalIF":0.0,"publicationDate":"1996-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19859654","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":"Androgen replacement therapy in women: myths and realities.","authors":"P R Casson,&nbsp;S A Carson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In recent years, much attention has been directed at the potential of androgen replacement in the menopausal woman. Testosterone (T) replacement, in various forms, is widely used. However, evidence is lacking for a profound T deficiency state with natural menopause. Data confirming efficacy are also scant, and side effects have been demonstrated with prolonged therapy. The adrenal androgens, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S), also in contradistinction to T, decline substantially with age. Preliminary studies involving replacement of physiologic levels of DHEA have demonstrated some potential benefits: enhancement of the immune system and enhancement of the growth hormone axis. However, long-term trials have not been performed to date, so this modality of androgen replacement remains in the realm of clinical investigation. Ovarian and adrenal androgen replacement in menopausal women, while theoretically appealing, remains imperfect to date and should be used judiciously, if at all.</p>","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"41 4","pages":"412-22"},"PeriodicalIF":0.0,"publicationDate":"1996-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19859658","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 \"cons\" of laparoscopic myomectomy in women who may reproduce in the future.","authors":"C Nezhat","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Several concerns must be addressed before LM will be accepted in place of laparotomy. Uterine healing and the extent of adhesion formation associated with laparotomy must be compared with those associated with the laparoscopic approach in which sutures are used. Women of childbearing age who require a myomectomy for an intramural fibroid should undergo either an abdominal myomectomy or a modified laparoscopic procedure to ensure proper closure of the myometrial defect. The laparoscopic approach is appropriate for pedunculated or subserosal fibroids when myometrial closure does not affect uterine bleeding.</p>","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"41 3","pages":"280-3"},"PeriodicalIF":0.0,"publicationDate":"1996-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19771198","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":"Current practices of commercial cryobanks in screening prospective donors for genetic disease and reproductive risk.","authors":"E A Conrad,&nbsp;B Fine,&nbsp;B R Hecht,&nbsp;E Pergament","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To determine how the screening practices of commercial semen banks vary from published guidelines, which factors influence cryobanks to exclude prospective semen donors for genetic reasons, and the current role of clinical geneticists/genetic counselors in evaluating prospective semen donors.</p><p><strong>Design: </strong>The genetic screening of prospective donors by commercial semen banks was evaluated using written questionnaires completed by bank directors. Responses were analyzed to determine exclusion criteria, adherence to published guidelines, and contribution of genetic professionals.</p><p><strong>Setting and participants: </strong>Semen banks were selected on the basis of membership in the American Association of Tissue Banks and commercial use of semen for artificial insemination by donor.</p><p><strong>Main outcome measure: </strong>Semen bank practices as reported by commercial semen bank directors.</p><p><strong>Results: </strong>Of 37 eligible banks, 16 responded. All screen prospective donors by medical/family history and physical examination, 94% have upper age limits; 63% examine for minor physical defects; 56% routinely karyotype; 81% screen men of ethnic groups at risk for Tay Sachs disease, sickle cell disease and thalassemia; 19% screen all donors; 25% screen all donors for cystic fibrosis and 50% only screen if family history positive. Donor rejection was based on three criteria: mode of inheritance of familial disorder, severity of disease, and availability of carrier/confirmatory testing of donor genotype. Ten of 16 banks have no genetic professional on staff.</p><p><strong>Conclusion: </strong>Commercial semen banks primarily rely on family history as the major exclusion criterion in genetic screening of donors. Considerable differences exist among semen bank practices in accordance with guidelines published by national agencies. Genetic professionals have a minimal effect overall on evaluation of semen donors.</p>","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"41 3","pages":"298-303"},"PeriodicalIF":0.0,"publicationDate":"1996-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19771200","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":"Medicogenetic features and surgical treatment of patients with congenital malformations of the uterus and vagina.","authors":"L V Adamian,&nbsp;K D Murvatov,&nbsp;Y A Sorour,&nbsp;Y A Kirillova,&nbsp;A Z Khashukoyeva","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To analyze clinical examination, surgical treatment, main features of the surgical plan, and course of the early postoperative period and immediate results of surgery in 624 patients with various malformations of the uterus and vagina.</p><p><strong>Methods: </strong>General clinical examination: endoscopic methods, including hysteroscopy and laparoscopy, cytogenetic and genealogic investigation, estimation of biochemical markers (serum levels) of patients with Müllerian anomalies (polymorphous and monomorphous loci).</p><p><strong>Results: </strong>Karyotype examination revealed that 90.7% of 86 patients examined had normal 46XX karyotype, while sex chromosome mosaicism was present in 9.3% of cases. Genealogic analyses have shown that 39.8% of probands' relatives had reproductive system disorders. Genetic analysis of genealogical trees of patients with malformations of uterus and vagina revealed the recessive type of inheritance. Utilization of up-to-date procedures (hysteroscopy, resectoscopy, laparoscopy) facilitates performing the operations for genital malformations, provides reduction of operation time and postoperative hospital stay, and considerably increases the efficacy of surgical treatment.</p><p><strong>Conclusions: </strong>Factors of heredity play an important role in etiology of congenital malformation of the uterus and vagina. Modern endoscopic procedures can be successfully used in differential diagnosis of genital malformations, as well as during surgical treatment.</p>","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"41 3","pages":"293-7"},"PeriodicalIF":0.0,"publicationDate":"1996-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19771202","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":"Ethical issues in obstetrics.","authors":"G Samsioe,&nbsp;A Abreg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ethical issues in modern obstetrics commonly relate to a conflict between the rights and possibilities of the fetus versus those of the mother. After delivery, when the fetus by definition is a child, all legal rights are granted to this new individual. Whether any rights should be given or offered to the fetus is dependent on the prevailing situation. General rules are difficult to give due to the rapid evolution of clinical medicine-too firm rules given today could well be an obstacle in the near future. All cultures have well-established opinions regarding issues related to pregnancy and childbirth. Cultural and religious dogmas are often in conflict with modern medical technology and financial issues. In several modern societies, state laws regulate legal abortion and other aspects of termination of pregnancy. Current laws often determine not only decisions but also the minds of doctors, as well as of patients. Advanced medical technology has yielded a possibility of selective feticide. Again our experience with this new technique is limited, and several issues of ethical importance may arise from the use of such techniques. The indications for a selective feticide are dependent upon the benefits and risks of the procedure itself, and also on the selection process of what fetus should be aborted. Clearly, no definitive rules could be given at this stage of development. The advice given to the woman by her doctor is of critical importance for the outcome of the given pregnancy, be it selective feticide or legal abortion. However, the prevailing social welfare system and the support a woman could be given by her society are also factors. Should she give birth to a child with an inborn error of metabolism, or some other chronic illness? Drug abuse, including alcohol and, indeed, also tobacco, constitutes a special problem. In Sweden, drug-addicted pregnant women are hospitalized during their last trimester. This policy results in a drug-free last trimester and a reduction of afflicted newborns. Should a similar approach also be enforced when dealing with abuse of alcohol and tobacco during pregnancy? The improvement of in vitro fertilization techniques has introduced a novel concept, the surrogate mother. In some countries, this is forbidden by law, in others, it is an accepted medical practice, but several medico-legal as well as ethical issues warrant further clarification. What are the legal rights of the surrogate mother? Should there be an age limit for surrogate mothers? Who is responsible for problems in the pregnancy itself? In cases of male infertility, ethical issues may arise. Should the child have a legal right to learn the name of the biological father? Should there be a limit for the use of donor sperm in respect to number of fertility attempts, as well as potential female patients who may use the same sperm donor?</p>","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"41 3","pages":"284-7"},"PeriodicalIF":0.0,"publicationDate":"1996-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19771292","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 addition of fructose or sodium citrate does not improve recovery rates of cryopreserved human spermatozoa.","authors":"A L Silva,&nbsp;R Yamasaki,&nbsp;M M de Sala,&nbsp;M da G Cabrera,&nbsp;M F de Sá","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of the addition of sodium citrate and/or fructose to medium containing egg yolk, glycerol and TEST buffer (TES(N-tris[hydroxymethyl] methyl-2-aminoethanesulfonic acid) plus Tris (hydroxymethyl)-aminomethane) on human sperm cryopreservation.</p><p><strong>Design: </strong>Sperm cryopreservation in three cryoprotective media, followed by thawing 3 weeks or 3 months later.</p><p><strong>Setting: </strong>University outpatient clinic.</p><p><strong>Material and methods: </strong>Twenty-two semen samples from fertile men were evaluated before and after freezing for 3 weeks or 3 months in three different cryoprotective media consisting of a stock solution (TEST-YOLK) to which 20% sodium citrate was added plus 2% fructose (TESTC I) or to which 20% sodium citrate, but no fructose, was added (TESTC-II).I MAIN OUTCOME MEASURES: Measurements of quantitative sperm motility, progressive motility, vitality and recovery rates before and after freezing.</p><p><strong>Results: </strong>Before freezing, the addition of the different media increased sperm progressive motility but did not change quantitative motility or vitality. Sample freezing reduced all the above variables both after 3 weeks and after 3 months, with no difference between the two freezing times. Semen analysis two hours after thawing showed a significant fall in both motility and vitality when compared with samples analyzed immediately after thawing. No significant differences in recovery rates were observed between media or within the same medium when the two freezing times (3 weeks and 3 months) were compared.</p><p><strong>Conclusion: </strong>The addition of sodium citrate and/or fructose to the cryoprotective medium does not improve sperm motility or vitality after freezing.</p>","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"41 3","pages":"304-9"},"PeriodicalIF":0.0,"publicationDate":"1996-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19771199","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 role of laparoscopy in myomectomy.","authors":"H M Hasson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"41 3","pages":"276-9"},"PeriodicalIF":0.0,"publicationDate":"1996-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19771204","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}