Many women appear to experience menstrual disturbances after tubal sterilization. In this study the ovarian function in such women was investigated. Serial measurements of FSH, LH, estradiol and progesterone were performed throughout the... more
Many women appear to experience menstrual disturbances after tubal sterilization. In this study the ovarian function in such women was investigated. Serial measurements of FSH, LH, estradiol and progesterone were performed throughout the study cycle in 23 previously sterilized patients, 14 with menstrual disturbances (group I--symptomatic) and 9 with normal cycles (group II--asymptomatic). A group of 28 parous women served as controls. Among 23 patients, luteal phase progesterone was elevated in 19, and in 4 it was undetectable (anovulatory). All four anovulatory patients belonged to group I. Anovulatory cycles were also characterized by tonic elevated LH levels. Mean midluteal progesterone values were lower in group I (8.5 ng/ml) than in group II (13.8 ng/ml) and in the controls (16.5 ng/ml). Mean midluteal progesterone was lower than 10 ng/ml in 78% of group I, 44% of group II and 15% of the control patients.
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To describe the rate of rise of beta-hCG levels in normal single gestations after uterine and tubal embryo transfer. A prospective study from 1991 through 1992 in which infertility patients who conceived after ovulation induction and ET... more
To describe the rate of rise of beta-hCG levels in normal single gestations after uterine and tubal embryo transfer. A prospective study from 1991 through 1992 in which infertility patients who conceived after ovulation induction and ET were monitored with serum beta-hCG levels. Infertility unit at Rush-Presbyterian-St. Luke's Medical Center in Chicago, Illinois. Ninety-eight women conceived after ovarian stimulation and ET. This study included only patients who conceived after uterine ET (n = 12) and tubal ET (n = 25) and had an exponential rise of beta-hCG levels and sonographic evidence of an intrauterine gestation. The rate of rise of mean beta-hCG levels after ET preceded that of tubal ET by 24 hours until day 14 when the two approximate each other. There appears to be a unique interaction between the trophoblast and endometrial surface that may account for the early detection of beta-hCG after uterine versus tubal ET.
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The effect of danazol on pulsatile luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol (E2) secretion was examined in eight premenopausal women by serial blood sampling on day 10 of the control and first treatment... more
The effect of danazol on pulsatile luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol (E2) secretion was examined in eight premenopausal women by serial blood sampling on day 10 of the control and first treatment cycles and during 2 subsequent months of treatment. The mean frequency of LH pulses decreased, while the mean pulse amplitude and increment increased (P less than 0.05). The mean LH concentrations were significantly suppressed in four of eight subjects. The mean frequency of E2 pulses, mean increment, and mean integrated area were decreased (P less than 0.05). The mean integrated FSH area did not change significantly during treatment, and we were not able to demonstrate unequivocal FSH pulses. We conclude that danazol in premenopausal women (1) lowers serum E2 concentrations by decreasing the frequency and increment of E2 pulses, (2) prevents compensatory gonadotropin rise, and (3) lowers the frequency but increases the amplitude and increment of LH pulses. The latter change reflects probably divergent effects of the drug on the pituitary and hypothalamus and results in an inconsistent lowering of basal LH levels.
Research Interests: Endocrinology, Biology, Menstruation, Medicine, Humans, and 15 moreInternal Medicine, Hypothalamus, Fertility and Sterility, Female, Clinical Sciences, Pituitary Gland, Adult, Time Factors, Luteinizing Hormone, Estradiol, Follicle stimulating hormone, Pulsatile Flow, Danazol, Paediatrics and reproductive medicine, and Gonadotropin
Research Interests: Endocrinology, Medicine, Progesterone, Humans, Internal Medicine, and 15 moreTestosterone, Female, Ovulation, Ovulation Induction, Estrogen, Globulin, Clinical Sciences, Estrogens, Protein Binding, Globulins, Clomiphene, hydrocortisone, Adrenal cortex hormones, Paediatrics and reproductive medicine, and Chorionic gonadotropin
Research Interests: Endocrinology, Chemistry, Biology, Medicine, Pregnancy, and 15 moreProgesterone, Humans, Internal Medicine, Fertility and Sterility, Female, Ovulation Induction, Clinical Sciences, Public health systems and services research, Fertilization in Vitro, Follicular Fluid, Estradiol, Leuprolide, hyperprolactinemia, Paediatrics and reproductive medicine, and Chorionic gonadotropin
Research Interests: Medicine, Catheterization, Prospective studies, Pregnancy, Humans, and 13 moreFertility and Sterility, Female, Fluoroscopy, Clinical Sciences, Public health systems and services research, Methotrexate, Ectopic Pregnancy, Catheter, Ostium, Fallopian Tube, Hysterosalpingography, Fallopian tubes, and Paediatrics and reproductive medicine
Lumbar bone mineral density (BMD) was evaluated by dual photon absorptiometry (DPA) in 38 women with laparoscopically diagnosed and staged endometriosis. DPA was performed before and at the completion of 26 weeks of treatment with either... more
Lumbar bone mineral density (BMD) was evaluated by dual photon absorptiometry (DPA) in 38 women with laparoscopically diagnosed and staged endometriosis. DPA was performed before and at the completion of 26 weeks of treatment with either gonadotropin releasing hormone agonist (GnRHa) or danazol. Twenty-five women received GnRHa either nasally or subcutaneously and 13 women received danazol 200 mg four times daily by mouth. During treatment amenorrhea and suppressed estradiol levels were observed in all patients. Each patient took a supplement of oral calcium 1 gm daily. DPA (reproducibility +/- 1.5%) was read by a single observer unaware of the treatment assignment of the patient. The mean (+/- standard error) of the entire group prior to treatment was 98.8% +/- 0.03% of a control population of women from the same geographic area matched for race, age, and weight. At the completion of treatment, BMD was slightly decreased in the GnRHa group and marginally increased in the danazol group but neither change was significant. Women with endometriosis have lumbar BMD in the normal range and ovarian suppression with either GnRHa or danazol produces no significant change in BMD.
Research Interests: Minerals, Medicine, Progesterone, Humans, Internal Medicine, and 15 moreFemale, Clinical Sciences, Adult, Endometriosis, Bone Mineral Density, Ovary, Luteinizing Hormone, Triptorelin, Bone and Bones, Estradiol, Follicle stimulating hormone, Danazol, Amenorrhea, Gonadotropin releasing hormone agonist, and Paediatrics and reproductive medicine
Research Interests: Medicine, Pregnancy, Humans, Internal Medicine, Female, and 15 moreHormones, Clinical Sciences, Adult, Endometriosis, Gonadotropin Releasing Hormone, Hormone, Body Weight, Luteinizing Hormone, Laparoscopy, Estradiol, Follicle stimulating hormone, Leuprolide, Danazol, Endocrine System, and Paediatrics and reproductive medicine
Characteristics of follicular development and hormonal patterns were evaluated in 17 women with minimal endometriosis and 11 with unexplained infertility. The controls were 7 women with male factor infertility and 8 who conceived during... more
Characteristics of follicular development and hormonal patterns were evaluated in 17 women with minimal endometriosis and 11 with unexplained infertility. The controls were 7 women with male factor infertility and 8 who conceived during an investigational cycle. Women with minimal endometriosis had more and smaller follicles at luteinizing hormone (LH) surge, lower preovulatory estradiol (E2), and lower E2 at LH surge. Women with unexplained infertility had lower LH surges and a trend to a shorter follicular phase. Occult ovulatory dysfunction and may contribute to infertility in women with minimal endometriosis or unexplained infertility.
Research Interests: Fertility, Infertility, Medicine, Progesterone, Humans, and 12 moreFertility and Sterility, Female, Ovulation, Clinical Sciences, Gynecology, Adult, Public health systems and services research, Endometriosis, Female Infertility, Luteinizing Hormone, Estradiol, and Paediatrics and reproductive medicine
Research Interests: Endocrinology, Menstruation, Medicine, Prospective studies, Humans, and 14 moreInternal Medicine, Fertility and Sterility, Female, Hormones, Clinical Sciences, Adult, Public health systems and services research, Endometriosis, Prognosis, Ovary, Luteinizing Hormone, Danazol, Random Allocation, and Paediatrics and reproductive medicine
Research Interests: Obstetrics, Fertility, Infertility, Medicine, Twins, and 14 moreProspective studies, Pregnancy, Humans, Fertility and Sterility, Female, Ovulation Induction, Clinical Sciences, Public health systems and services research, Multiple Pregnancy, Gestation, Twin Pregnancy, Human Chorionic Gonadotropin, Paediatrics and reproductive medicine, and Chorionic gonadotropin
Preliminary reports indicate that products of human mononuclear phagocytes may contribute to the infertility associated with endometriosis. To determine whether the generation of reactive oxygen metabolites by blood monocytes and... more
Preliminary reports indicate that products of human mononuclear phagocytes may contribute to the infertility associated with endometriosis. To determine whether the generation of reactive oxygen metabolites by blood monocytes and peritoneal macrophages is altered in women with endometriosis, the present study evaluated luminol-enhanced chemiluminescence (CL) in cells at rest and following stimulation with phorbol myristate acetate (PMA) or serum-opsonized zymosan (SOZ). Peripheral venous blood and peritoneal fluid samples were collected from 60 infertile women undergoing diagnostic laparoscopy at midluteal phase and mononuclear phagocytic cell fractions were obtained by density gradient centrifugation. Whereas there was no significant difference between resting CL values in peripheral blood monocytes collected from women with and without endometriosis, PMA- and SOZ-stimulated monocyte CL was significantly greater in endometriosis patients. In contrast, there was a significant elevation in resting CL values when peritoneal macrophages from endometriosis patients were compared with macrophages obtained from patients with normal pelvic organs. It appears that chronic stimulation of macrophages in the peritoneal cavity provokes constitutive release of large quantities of reactive oxygen products in women with endometriosis. This may occur secondary to the accumulation of activated monocytes into the peritoneal cavity.
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The role of T-mycoplasmas as pathogens of the urinary and genital systems is still largely undetermined. SHEPARD (1954) first isolated T-mycoplasmas from patients with non-gonococcal urethritis, and since then some surveys have suggested... more
The role of T-mycoplasmas as pathogens of the urinary and genital systems is still largely undetermined. SHEPARD (1954) first isolated T-mycoplasmas from patients with non-gonococcal urethritis, and since then some surveys have suggested a causal relationship SHEPARD (1960), CSONKA ET AL.(1966), whilst other surveys have not supported this view. TAYLOR-ROBINSON ET AL (1969). With regard to women, marked variation in carriage rate have been noted; with a possible relationship to sexual activity. ARCHER (1968) studied 100 pregnant women, 94 women attending an Infertility Clinic, 98 women in a Geriatric Unit, and 106 nuns in an enclosed order, and found carriage rates of 58,51, 29 and 8 per cent respectively. Similarly, MARDH & WESTROM (1968) found that the carriage of T-mycoplasmas was significantly higher in pregnancy. (68.4% against 45.8% and 55.4% in non-pregnant females and females with signs of genital infection respectively). The possibility of an association between low birth weight and T-mycoplasma infection during pregnancy was considered and investigated by KLEIN ET AL(1969)and investigated and confir ed by BRAUN ET AL(1971) KUNDSIN & DRISCOLL(1970)postulated an aetiological role for T-mycoplasma in human reproductive failure and premature birth. A pathogenic role for genital mycoplasmas was demonstrated by SOLOMAN ET Al(1973)in a review of 11 cases of gynaecological sepsis, 3 due to T-strains, and the remainder M.hominis.
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Endometriosis is a perplexing disease of unknown etiology and poorly understood histogenesis. It affects women as well as menstruating females of other primate species and is characterized by ectopic i.e., outside of the uterine cavity,... more
Endometriosis is a perplexing disease of unknown etiology and poorly understood histogenesis. It affects women as well as menstruating females of other primate species and is characterized by ectopic i.e., outside of the uterine cavity, growth of endometrium. The growth and spread of endometriosis are controlled by the cyclic stimulation of ovarian hormones. After cessation of ovarian function e.g., during menopause, when ovarian estradiol and progesterone are no longer secreted, uterine as well as ectopic endometria undergo atrophy and endometriosis resolves.
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CA-125, a high-molecular-weight glycoprotein antigen, has been identified as a possible marker for endometriosis, with discrepant results. CA-72, another glycoprotein antigen, is expressed by a variety of adenocarcinomas, including... more
CA-125, a high-molecular-weight glycoprotein antigen, has been identified as a possible marker for endometriosis, with discrepant results. CA-72, another glycoprotein antigen, is expressed by a variety of adenocarcinomas, including endometrial carcinoma. This controlled, prospective study evaluated serum CA-125 and CA-72 levels in 35 consecutive patients with endometriosis of varying stages and in patients without endometriosis. Serum CA-125 and CA-72 were measured with immunoradiologic methods prior to diagnostic laparoscopy for infertility evaluation. Endometriosis, scored by American Fertility Society guidelines, was identified in 19 patients, and 16 patients had normal pelvic findings. CA-125 and CA-72 levels were not different between patients with no pelvic disease (controls) and women with stage I-IV endometriosis. The positive predictive value of CA-125 was 0%; the negative predictive value was 47%. The positive predictive value of CA-72 was 5%; the negative predictive value...
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Progesterone (P) and human chorionic gonadotropin (beta-hCG) levels were measured randomly or serially in 141 single clinical intrauterine pregnancies resulting from treatment of infertility. Seventy (group I) were conceived during... more
Progesterone (P) and human chorionic gonadotropin (beta-hCG) levels were measured randomly or serially in 141 single clinical intrauterine pregnancies resulting from treatment of infertility. Seventy (group I) were conceived during spontaneous cycles, 36 (group II) with clomiphene citrate, and 35 (group III) with menotropins (hMG). Each group was subdivided into subgroup A (normal pregnancies) and B (pregnancies ending in abortion). Thirteen percent of patients in group I aborted, 19% in group II, and 31% in group III (P less than .05). The overall mean (+/- SD) P level in group IA was 25.8 +/- 10.3 ng/mL and in group IB, 16.6 +/- 9.9 ng/mL (significantly lower, P less than .001); in group IIA the mean P level was 37.8 +/- 21.9 ng/mL and in group IIB, 22.9 +/- 17.9 ng/mL, again significantly lower (P less than .01). In subgroups IB and IIB, 11 of 16 patients showed early abnormal beta-hCG patterns; these findings suggest defective embryonic development and/or deficient corpus luteum...
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Research Interests: Genetics, Medicine, Prospective studies, Pregnancy, Humans, and 15 moreFemale, Male, Bacteria, Incidence, Contamination, Embryo Transfer, Adult, Bacterial infections, Fertilization in Vitro, Pelvic Inflammatory Disease, Follicular Fluid, Pregnancy Rate, Pregnancy Outcome, Assisted, and Paediatrics and reproductive medicine
Research Interests: Endocrinology, Obstetrics, Menstruation, Medicine, Pregnancy, and 15 moreProgesterone, Humans, Internal Medicine, Female, Ovulation, Periodicity, Adult, Protein Binding, Gonadotropins, Estradiol, Follicle stimulating hormone, estrone, Pregnanediol, Medical and Health Sciences, and Chorionic gonadotropin
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... Page 5. Pathology, histogenesis and etiology of endometriosis 3 3 ... Am J Obstet Gynecol 141:377, 1981. 9. Ebers, G.: The Papyrus Ebers, quoted in Ridley, JH: The histogenesis of endometriosis: a review of facts and fancies. Obstet... more
... Page 5. Pathology, histogenesis and etiology of endometriosis 3 3 ... Am J Obstet Gynecol 141:377, 1981. 9. Ebers, G.: The Papyrus Ebers, quoted in Ridley, JH: The histogenesis of endometriosis: a review of facts and fancies. Obstet Gynecol Surv 23:1, 1968. 10. ...
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The incidence of endometriosis in the general female population is probably in the range of 1070 to 2 % (35, 37). In infertile women, endometriosis has been demonstrated by laparoscopy in 15% to 25% of cases and in patients with otherwise... more
The incidence of endometriosis in the general female population is probably in the range of 1070 to 2 % (35, 37). In infertile women, endometriosis has been demonstrated by laparoscopy in 15% to 25% of cases and in patients with otherwise unexplained infertility the frequency of endometriosis may be as high as 70% to 80% (18). In women with endometriosis, the frequency of infertility has been noted to be somewhere between 30% and 40% (17). It has been estimated that the risk of infertility is 20 times as great in women with endometriosis as in those without (37). Treatment of endometriosis, regardless of the method used, improves fertility and the post-treatment pregnancy rates are frequently used as indicators of the effectiveness of therapy. Thus, an association seems to exist between endometriosis and infertility. This article reviews current knowledge on the association between endometriosis and infertility and on the effectiveness of various therapeutic methods in improving the fertility of patients affected by endometriosis.
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Research Interests: Endocrinology, Fertility, Medicine, Pregnancy, Humans, and 13 moreInternal Medicine, Fertility and Sterility, Female, Clinical Sciences, Adult, Public health systems and services research, Endometriosis, Immunoglobulins, Pregnancy Outcome, Autoantibodies, Danazol, Random Allocation, and Paediatrics and reproductive medicine
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To determine if the total motile sperm count is predictive of IUI success and to apply life-table analysis to a large database of IUI procedures. Contingency table and life-table analyses were used to analyze a large group of couples (n =... more
To determine if the total motile sperm count is predictive of IUI success and to apply life-table analysis to a large database of IUI procedures. Contingency table and life-table analyses were used to analyze a large group of couples (n = 546) undergoing 1,205 cycles of therapeutic IUI with husband's sperm. Clinical infertility practice at a medical school referral center. Five hundred forty-six couples with varying etiologies of infertility. There was a trend toward an increasing percentage of conception with increasing total motile sperm count. Significance was reached when the total motile sperm count used for IUI exceeded 20 x 10(6). The cumulative pregnancy rate calculated from this data reached 52% after the sixth attempted cycle of IUI.
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Seventeen women complaining of infertility (one with primary amenorrhoea, 14 with secondary amenorrhoea, and two with oligomenorrhoea) all had hyperprolactinaemia and were treated with clomiphene citrate and human chorionic gonadotrophin... more
Seventeen women complaining of infertility (one with primary amenorrhoea, 14 with secondary amenorrhoea, and two with oligomenorrhoea) all had hyperprolactinaemia and were treated with clomiphene citrate and human chorionic gonadotrophin (HCG), and plasma oestradiol, FSH and LH levels were measured. Although adequate pre-ovulatory oestradiol levels were present, the surge of LH was absent until the injection of HCG after which all patients ovulated. There were 12 pregnancies in 9 patients resulting in 10 full-term livebirths, one premature livebirth and one continuing pregnancy. The relevance of these findings to the possible role of prolactin in amenorrhoea is discussed.
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ABSTRACT
Forty women with normal menstrual cycles who had been sterilized by tubal ligation or electrocoagulation requested tubal reconstruction. As part of their preoperative evaluation, progesterone measurements were obtained in the midluteal... more
Forty women with normal menstrual cycles who had been sterilized by tubal ligation or electrocoagulation requested tubal reconstruction. As part of their preoperative evaluation, progesterone measurements were obtained in the midluteal phase (5-10 days before the next menstrual period). This group of women had a significantly lower (P less than 0.005) mean midluteal progesterone level (9.4 +/- 4.7 ng/ml) than a control group of 24 women with infertile male partners attending the same clinic (17.4 +/- 7.1 ng/ml). In 25 (62%) of the sterilized women, progesterone levels were less than 10 ng/ml, whereas in the control group such low values were found in only 4 (17%) of the women. Thus, reduced midluteal serum progesterone concentration appears more common among women with prior tubal ligation or electrocoagulation than among a control population of apparently normal women.
Research Interests: Physiology, Obstetrics, Surgery, Research Methodology, Reproduction, and 18 moreBiology, Treatment, Health, Menstruation, Medicine, Side Effects, Progesterone, Humans, Female, Hormones, Obstetrics Gynecology, Adult, The Endocrine System Function, Luteinizing Hormone, Estradiol, Follicle stimulating hormone, Corpus Luteum, and Radioimmunoassay
The human sperm acrosome reaction (AR) can be induced in vitro by a variety of naturally occurring and synthetic compounds. The present investigation determined the effect of human natural cycle periovulatory follicular (hFF) and... more
The human sperm acrosome reaction (AR) can be induced in vitro by a variety of naturally occurring and synthetic compounds. The present investigation determined the effect of human natural cycle periovulatory follicular (hFF) and oviductal fluids (hOF) on the human sperm AR in dose-response fashion using the synchronous AR assay. When hFF (30% v/v) or hOF (40% v/v) was added to non-capacitated spermatozoa, no significant (P > 0.05) increase in the % AR was detected in comparison to the non-treatment control. When either of these compounds was added (10%, 20%, and 30% v/v hFF; 20%, 30%, and 40% v/v hOF) to capacitated spermatozoa (3 hour incubation), a significant (P < 0.05) stimulation of the AR was detected. Bovine oviductal fluid (bOF) was tested (20%, 30%, and 40% v/v) to determine if it might have an effect similar to hOF. In contrast to hOF, the highest concentration of bOF (40% v/v) tested failed to stimulate a significant (P > 0.05) increase in the % AR of capacitate...
Research Interests: Andrology, Humans, Female, Animals, Male, and 4 moreClinical Sciences, Cattle, Acrosome, and Follicular Fluid
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The objective of this study was to: (1) assess the relative prevalence of ovarian, thyroid, nuclear, and cardiolipin antibodies associated with premature menopause and unexplained infertility and (2) compare ovarian and thyroid antibodies... more
The objective of this study was to: (1) assess the relative prevalence of ovarian, thyroid, nuclear, and cardiolipin antibodies associated with premature menopause and unexplained infertility and (2) compare ovarian and thyroid antibodies in premature menopause, unexplained infertility, and the general population. Autoantibodies were evaluated in women with premature menopause (n = 30), unexplained infertility with (n = 38) or without (n = 15) prior gonadotropin-induced ovulation, and normal cycling controls (n = 12) and in a population of women obtained from a blood bank (n = 53). Antibodies to ovary (OVAB), thyroid (THYAB; thyroid peroxidase and thyroglobulin), cardiolipin, and eight nuclear antigens were assessed by enzyme immunoassay. Organ-specific antibodies (ovary and thyroid) were present with significantly greater frequency than non-organ-specific antibodies (nuclear and cardiolipin) in premature menopause and unexplained infertility (60% (50/83) vs 16% (13/83) respectively; P &lt; 0.0001). OVAB (53%, 44/83) were significantly more frequent than THYAB (30%, 25/83) in premature menopause and unexplained infertility (P = 0.0030). THYAB did not differ among all groups (P = 0.78). In premature menopause and treated or untreated unexplained infertility OVAB frequencies were 53, 61, and 33%, respectively, and were significantly more frequent than in the population (17%) (P = 0.0001). In unexplained infertility, individuals with no prior gonadotropin-induced ovulation had a lower frequency of OVAB than treated individuals (P = 0.07). The frequency distribution of optical density values for OVAB was significantly higher for premature menopause and unexplained infertility than for population or normal cycling women (P &lt; 0.0001). Thus, only ovarian antibodies were significantly more frequent than other antibody markers of autoimmunity in premature menopause and unexplained infertility.
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The goal of assisted reproductive technologies (ART) is to influence the recruitment of multiple, mature ovarian follicles. Several methods, including spontaneous cycle ART, clomiphene-based ART regimens, and gonadotropin regimens with... more
The goal of assisted reproductive technologies (ART) is to influence the recruitment of multiple, mature ovarian follicles. Several methods, including spontaneous cycle ART, clomiphene-based ART regimens, and gonadotropin regimens with and without adjuncts, are used. The controversies surrounding these techniques and their relative advantages and drawbacks are reviewed.