International journal of fertility and menopausal studies最新文献_第7页

Regulation of estrogen/progestogen receptors in the endometrium. 子宫内膜中雌激素/孕激素受体的调节。

International journal of fertility and menopausal studies Pub Date : 1996-01-01

R F Casper

{"title":"Regulation of estrogen/progestogen receptors in the endometrium.","authors":"R F Casper","doi":"","DOIUrl":"","url":null,"abstract":"Patient acceptance of standard cyclic hormonal replacement therapy (HRT) has been poor. One major cause of non-acceptance is thought to be the resumption of menses as a result of induced withdrawal bleeding. In order to prevent bleeding, continuous combined estrogen and progestin HRT has been utilized. However, most publications report irregular breakthrough bleeding in a majority of patients receiving the continuous HRT regimen. The cause of the irregular bleeding remains unclear at present. It is known that the continuous presence of progestin causes down-regulation of estrogen and progestin receptors and endometrial atrophy. Endometrial atrophy may result in withdrawal of stromal support for blood vessels leading to dilatation and extravasation of blood. In addition, progestin has been implicated in neovascularization, possibly by stimulation of vascular endothelial growth factor (VEGF). Finally, programmed cell death and apoptosis appear to occur in endometrial stroma after prolonged exposure to progesterone and may contribute to breakthrough bleeding. We have developed a novel interrupted progestin HRT regimen in which estrogen is given continuously, but with progestin administered in a 3-days-on and 3-days-off schedule. The rationale for this regimen is to prevent total receptor down-regulation by allowing estrogen to up-regulate estrogen and progestin receptors during the progestin-free periods. Interrupting the progestin may also prove to be favorable in reducing neo-angiogenesis. Clinically, we have demonstrated low bleeding rates in menopausal women, and in premenopausal women on long-term GnRH-agonist treatment for endometriosis or severe PMS, in whom the interrupted regimen has been used for addback HRT. Further basic and clinical studies, preferably in prospective randomized trials, are required to demonstrate reduced bleeding and improved patient acceptance compared to continuous combined HRT.","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"41 1","pages":"16-21"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19648401","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}

引用次数: 0

The effect of varying inseminating sperm concentration in male factor and non-male factor infertility during in vitro fertilization. 不同授精精子浓度对体外受精过程中男性因素和非男性因素不育的影响。

International journal of fertility and menopausal studies Pub Date : 1995-11-01

M L Uhler, R P Buyalos

{"title":"The effect of varying inseminating sperm concentration in male factor and non-male factor infertility during in vitro fertilization.","authors":"M L Uhler, R P Buyalos","doi":"","DOIUrl":"","url":null,"abstract":"Objective: To assess the effect of varying inseminating sperm concentrations on fertilization rates and polyspermy in human in vitro fertilization (IVF).Subjects and methods: Eighty-six couples who completed 107 consecutive IVF cycles were assigned to one of three groups according to the results of their semen analysis (SA), sperm penetration assay (SPA), and titers of antisperm antibodies (ASA). Group 1 (non-male factor) had normal results for SA, SPA and ASA; group 2 had one abnormal result; and group 3 had two or more abnormal results. Inseminating concentrations of 50,000, 250,000, or 500,000 progressively motile sperm/oocyte were prospectively assigned to groups 1, 2 and 3, respectively.Main outcome measures: Incidence of polyspermy and fertilization rates.Results: A total of 992 oocytes were available for analysis. The fertilization rate of 61% for non-male factor patient (group 1) was significantly higher than for male-factor patients [group 2 (48%) and group 3 (43%; P < .01)]. The incidence of polyspermy was 3.3%, 5.5%, and 0% for groups 1, 2 and 3, respectively, and did not differ significantly between the non-male factor and male factor groups (P = .16). Polyspermic fertilization was increased in both mature (4.1%) and postmature (5.7%) as compared to immature oocytes (1.4%; P < .05).Conclusion: In male factor infertile couples, increasing the inseminating concentration to 250,000 or 500,000 motile sperm/oocyte does not result in an increase in the incidence of polyspermy but does not improve fertilization rates.","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"40 6","pages":"322-8"},"PeriodicalIF":0.0,"publicationDate":"1995-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19722581","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}

引用次数: 0

Induced midtrimester abortion and future fertility--where are we today? 人工流产和未来生育——我们今天在哪里?

International journal of fertility and menopausal studies Pub Date : 1995-11-01

S Lurie, Z Shoham

引用次数: 0

Tubal surgery of IVF--making the best choice in the 1990s. 试管受精输卵管手术——90年代的最佳选择。

International journal of fertility and menopausal studies Pub Date : 1995-11-01

M J Novy

引用次数: 0

Serum levels of follicle-stimulating hormone and luteinizing hormone after subcutaneous administration of human menopausal gonadotropin during pituitary suppression. 垂体抑制期间皮下注射促性腺激素后血清促卵泡激素和黄体生成素水平。

International journal of fertility and menopausal studies Pub Date : 1995-11-01

I J Duijkers, Y M Magnusson, H M Hollanders

{"title":"Serum levels of follicle-stimulating hormone and luteinizing hormone after subcutaneous administration of human menopausal gonadotropin during pituitary suppression.","authors":"I J Duijkers, Y M Magnusson, H M Hollanders","doi":"","DOIUrl":"","url":null,"abstract":"Objective: The present study investigated the pharmacokinetics of a single subcutaneous dose of human menopausal gonadotropin (hMG) on serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) concentrations.Subjects and methods: Six healthy female volunteers, aged 20-40 years, with regular menstrual cycles and normal endocrine profiles, who were not receiving any hormonal medication, were treated with the gonadotropin-releasing-hormone agonist buserelin to suppress endogenous gonadotropin release. One volunteer dropped out during treatment. When the serum estradiol concentration had fallen to below 500 pmol/L, an injection of 150 IU hMG (HumegonR) was given subcutaneously. Immediately before injection and 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 15, 20, 24, 48 and 96 hours after, blood samples were drawn for determination of FSH and LH concentrations.Results: The baseline FSH level was 2.8 IU/L, and peak concentration (6.8 IU/L) was reached 12 hours after hMG injection (median values). Exogenous LH could not be measured because of the presence of endogenous LH.Discussion: The pattern of serum FSH concentrations after a single injection of hMG was found to resemble that seen after intramuscular hMG administration, although the peak FSH value was reached somewhat later.","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"40 6","pages":"307-10"},"PeriodicalIF":0.0,"publicationDate":"1995-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19722576","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}

引用次数: 0

Primary therapy for tubal disease: surgery versus IVF. 输卵管疾病的主要治疗:手术与体外受精。

International journal of fertility and menopausal studies Pub Date : 1995-11-01

B Gocial

引用次数: 0

The use of fibrin sealant in in vitro fertilization and embryo transfer. 纤维蛋白密封胶在体外受精和胚胎移植中的应用。

International journal of fertility and menopausal studies Pub Date : 1995-11-01

Z Ben-Rafael, J Ashkenazi, M Shelef, J Farhi, I Voliovitch, D Feldberg, R Orvieto

{"title":"The use of fibrin sealant in in vitro fertilization and embryo transfer.","authors":"Z Ben-Rafael, J Ashkenazi, M Shelef, J Farhi, I Voliovitch, D Feldberg, R Orvieto","doi":"","DOIUrl":"","url":null,"abstract":"Objective: To evaluate the role of fibrin sealant for embryo transfer (ET) and the effect of patient mobilization after ET on pregnancy rates.Design: A prospective, randomized, controlled study.Methods: Two hundred eleven patients who were admitted to the IVF Unit over a period of 6 months participated in the study. Patients who had three or more embryos were randomly divided into two groups: group 1 (study group), in which ET was performed using fibrin sealant, and group 2, who served as the controls. Ovulation induction was carried out using the long GnRH-a suppression protocol.Results: Comparison of the results regarding the implantation and pregnancy rates and ectopic pregnancy rate revealed a nonsignificant difference between the two groups. However, analysis of the results according to the patients' age revealed a significant increase in pregnancy (P < .05) and implantation (P < .01) rate in elderly patients (aged 39-42) using fibrin sealant for ET as compared with controls. Furthermore, we found that bed rest has no advantage over patient mobilization after ET.Conclusion: The use of fibrin sealant for ET is advantageous in elderly women, but has no apparent effect on the success rate or ectopic pregnancy rate in younger patients. Immediate mobilization does not jeopardize the results of IVF-ET.","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"40 6","pages":"303-6"},"PeriodicalIF":0.0,"publicationDate":"1995-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19721410","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}

引用次数: 0

Endometrial biopsy findings in infertility: analysis of 12,949 cases. 不孕症子宫内膜活检结果:12949例分析。

International journal of fertility and menopausal studies Pub Date : 1995-11-01

S Sahmay, E Oral, E Saridogan, L Senturk, T Atasu

{"title":"Endometrial biopsy findings in infertility: analysis of 12,949 cases.","authors":"S Sahmay, E Oral, E Saridogan, L Senturk, T Atasu","doi":"","DOIUrl":"","url":null,"abstract":"Objective: Endometrial biopsy has been an important way of assessing infertile couples for several years. In this review of a wide-ranging series of endometrial biopsies of infertile couples in the Turkish population it was our aim to find the distribution of results according to the years 1956-1966, 1967-1980, 1981-1992.Setting: University hospital.Subjects: 12,949 endometrial biopsies, referred to our gynecological pathology laboratory for infertility investigation between 1956 and 1992.Method: Patient report files from pathology laboratory data, analyzed retrospectively. The assessment of the biopsies is made by the same pathologist.Results: 78.8% of cases had primary infertility, 21.2% secondary. Most of them were in the age group 26-35 years (48.8%). 37.58% of cases were found to show normal secretory endometrium, 20.95% proliferative endometrial changes, and 28.22% signs of luteal phase defect (LPD). Other local endometrial factors were also encountered, but in 1.79% the sample was considered insufficient for diagnosis. Moreover, in nine cases, malignancy was diagnosed with the help of endometrial biopsy. During the study period, cases of normal secretory endometrium and tuberculous endometritis were observed to decrease and LPD to increase significantly. It is worthy to note that in only 28 (0.21%) cases had endometrial biopsies been performed during a pregnancy cycle.Conclusion: We conclude that endometrial biopsy not only shows the hormonal response of endometrium but gives additional information about the local factors of endometrium concerning atrophy, specific and non-specific infections, and malignancy.","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"40 6","pages":"316-21"},"PeriodicalIF":0.0,"publicationDate":"1995-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19722579","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}

引用次数: 0

A practical guide to prescribing estrogen replacement therapy. 开具雌激素替代疗法处方的实用指南。

International journal of fertility and menopausal studies Pub Date : 1995-09-01

S L Corson

{"title":"A practical guide to prescribing estrogen replacement therapy.","authors":"S L Corson","doi":"","DOIUrl":"","url":null,"abstract":"Discounting vaccinations, menopausal hormone replacement constitutes the most widely practiced form of long-term prophylactic therapy. Long acknowledged as a means of retarding net bone density loss, sufficient data have accumulated to document the cardioprotective aspects of estrogen replacement therapy (ERT). Not surprisingly, new questions concerning long-term effects on various tissues and interaction with progestins have arisen. Given that ERT alone increases risk for endometrial cancer to unacceptable levels, addition of progestins can fully obviate that risk. To what extent, however, do various progestins mute the beneficial estrogen effect on cholesterol lipoproteins and locally in the arterial wall? Does long-term ERT increase the risk for breast cancer and who is at greatest risk? Does the route of ERT matter with respect to metabolic changes? Considering that a woman may spend fully one third of her life in the postmenopausal state, it behooves physicians as primary care providers and as consultants to understand the pros and cons of ERT. Modulation of dose, route and agent, as well as the protocol for therapy, all affect long-term patient compliance. In order to sustain motivation, education of the patient is mandatory, and that process starts with the physician.","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"40 5","pages":"229-47"},"PeriodicalIF":0.0,"publicationDate":"1995-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19535867","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}

引用次数: 0

Visual findings and histologic diagnosis of pelvic endometriosis under laparoscopy and laparotomy. 盆腔子宫内膜异位症的腹腔镜和开腹手术的视觉表现和组织学诊断。

International journal of fertility and menopausal studies Pub Date : 1995-09-01

M Ueki, M Saeki, T Tsurunaga, M Ueda, N Ushiroyama, O Sugimoto

{"title":"Visual findings and histologic diagnosis of pelvic endometriosis under laparoscopy and laparotomy.","authors":"M Ueki, M Saeki, T Tsurunaga, M Ueda, N Ushiroyama, O Sugimoto","doi":"","DOIUrl":"","url":null,"abstract":"Objective: To assess the diagnostic value of visual findings in the diagnosis of endometriosis from the histological point of view.Study design: 212 specimens from 107 patients with benign (74.8%) or malignant (25.2%) disease were obtained by biopsy or resection under laparoscopy (65 patients) or laparotomy (42 patients). Ages ranged from 19 to 62 (mean age 36.4). Visual findings were classified according to the criteria established by the Endometriosis Committee of the Japan Society of Obstetrics and Gynecology in 1993. Specimens were stained with hematoxylin-eosin, and 15 cases with periodic acid-Schiff stain or silver impregnation stain.Results: Among pigmented lesions, endometriosis was found in 73.0% of specimens from the pelvic peritoneum and in 56.4% of those from the ovaries. Blueberry spots in the pelvic peritoneum as well as ovarian chocolate cysts showed the highest positive rate. In the presence of multiple or complex pigmented lesions of the pelvic area, the rate was still higher (88.6%). Those rates were due to our inclusion of inaccurate and incomplete biopsy specimens. Endometriosis of nonpigmented lesions was found in only 11 patients (12.0%) who also had pigmented lesions and/or adenomyosis.Conclusion: The laparoscopic diagnosis of endometriosis can be made only when multiple complex pigmented lesions are observed, but, otherwise, histopathological confirmation is necessary.","PeriodicalId":79342,"journal":{"name":"International journal of fertility and menopausal studies","volume":"40 5","pages":"248-53"},"PeriodicalIF":0.0,"publicationDate":"1995-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19535870","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}

引用次数: 0