Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003128 (anovulation)
 1,718 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Laparoscopic diagnosis of pelvic schistosomiasis and the possible effects of this lesion on fertility were examined at the Ain Shams University Hospital in Cairo, Egypt over the 1977-1980 period. All infertile patients who came from endemic areas were thoroughly investigated for schistosomiasis. During the first 2 years of the study, there were 13 patients aged 23-38 years with pelvic schistosomiasis. Exploration was undertaken in all cases and atraumatic adnexolysis was performed. In 3 patients myomectomy was also performed. Ovulatory defects were treated in 5 patients with 100-200 mg of clomiphene citrate administered daily for 5 days, beginning on the 2nd day of the menstrual cycle. In 2 women who failed to respond to a high dose of clomiphene citrate, Pergonal and human chorionic gonadotropins were used. Ambilhar was given to all patients for 6 days to treat schistosomiasis. The cervix was cauterized in 7 women who revealed bilharzial cervicitis. All patients were followed up for 15 months after treatment. All patients complained of primary infertility, the duration of which ranged from 4-14 years. Cervical erosion was present in 5 women, vaginal granulation in 2, and vaginal sandy patches in another 2 women. Pelvic examinations revealed the presence of coporel myomata in 3 patients. Cervicovaginal smears were positive for schistosomal ova in 3 patients. In all patients, the whole length of both fallopian tubes was visualized. These tubes revealed changes that indicated the presence of both periadnexal adhesion and intramural lesions. In all patients the uterine cavity was either normal sized or enlarged. The tubes were whitish, thickened, elongated and coiled. The ovary and the coiled ampullary portions of the tube were encapsulated in dense whitish adhesions. Methylene blue test confirmed the preservation of tubal patency. Bilharzial sandy spots and nodules were detected in all patients. Cervical biopsies revealed the presence of active or healed bilharzial cervicitis in 7 cases (53%). Repeated premenstrual endometrial biopsies showed normal secretory endometrium in 8 women, defective luteal phase in 3 women, and anovulation in 2 women. Laparoscopic biopsies showed a characteristic active or healed bilharzial lesion. As a result of treatment, there were 6 normal intrauterine pregnancies (46.2%). In 1 woman, pregnancy ended in abortion during the 10th gestational week. Ectopic pregnancy was reported in only 1 woman (7.7%). The study results suggest that pelvic schistosomiasis among infertile women is probably much more frequent than previously thought. In about 50% of patients atraumatic adnexolysis, cauterization of cervical lesions, and correction of luteal defects may be followed by pregnancy.
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PMID:Pelvic schistosomiasis and infertility. 612 46