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Query: UMLS:C0021359 (infertility)
 26,075 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

No sperm count should be regarded too low to consider extensive treatment in order to improve semen or to correct any possible abnormalities in femal partners. The infertile couple should be given devoted care and advice to improve their sexual relations and their psychological attitude towards the problem of infertility. A pregnancy rate of 51.9% where the husband's count was less than 10 million/ml, offers adequate support for this statement. In cases of mental trauma inflicted on patients by a verdict of inability to achieve parenthood--on people who have already suffered severe psychological shock and tension resulting from a period of infertility--discouragement lessens the already doubtful chances of achieving pregnancy. In no circumstance should oligozoospermic patients receive treatment for infertility unless a chromosomal analysis has been completed and found normal, since our rate of chromosomal anomalies (11.4%) in a group of oligozoospermic patients is considered to be too high.
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PMID:Oligozoospermia: a seven-year survey of the incidence, chromosomal aberrations, treatment and pregnancy rate. 0 90

A case report of male infertility associated with testicular microlithiasis is presented. This rare condition has not previously been associated with infertility. A variable maturation arrest was observed in the spermatogenic epithelium. The question of whether the microliths are the cause of the infertility or whether both conditions are the result of some unknown agent must await further elucidation.
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PMID:Testicular microlithiasis with sterility. 0 76

Twenty-four couples facing longstanding primary or secondary infertility underwent semen analysis, PCT, functional evaluation of menstrual cycle, hysterosalpingography and laparscopy. All clinical findings were normal with the exception of PCT which was positive in 13 and negative in 11. All the women underwent a multiple approach investigation of local and circulating antibodies production as well as cell-mediated immunity against live spermatozoa. Sperm Immobilization Test (SIT) and Spermatotoxicity Tests (STT) were performed in a single experimental design on cervical mucus and blood serum. Leucocyte Migration Inhibition Test in presence of sperms (LMIT) was done on peripheral leucocytes. Local antispermatic activity in the cervical mucus was negative in all PCT positive cases, and positive in six out of 11 PCT negative cases. SIT and STT were both positive in cervical mucus and in blood in one case only. No correlation could be found between PCT and serum SIT, STT or LMIT. The fertility pattern expressed by the number of pregnancies per years of exposure, already low in the whole group, was even lower in the sub-groups with positive immunological factors. Positive immunological factors do not exclude the possibility of conception but appear to be associated with a reduced rate of conception.
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PMID:Immunological factors and post coital test in unexplained infertility. 0 90

Basal body temperature (BBT) charts taken during the cycle of conception in cases that resulted in spontaneous abortion appear to provide the best available information concerning events associated with time of fertilization in doomed gestations. This study is based on a series of 227 patients who had early spontaneous abortion occurring between January 1967 and December 1974. A diagnosis of pregnancy initiated regular assays of urinary estrogen and pregnanediol excretion. Patients were instructed to report any bleeding episode which might occur, and to preserve all tissues that might be expelled. A total of 11 basal body temperature charts were obtained from patients who had subsequent early spontaneous abortion. Chromosome studies and histologic investigations were conducted. Another group of 11 consecutive BBT records were obtained from patients who had normal deliveries. The study shows that women with normal cycles experience a midcycle temperature rise requiring 1 to 3 days. In subsequent patients, this time limit was exceeded in 7 out of 11 cases of early abortion, and in 4 of 11 fertilization that resulted in an apparently normal gestation and infant. As temperature rise resulted from vigorous progesterone secretion by the corpus luteum, subnormal levels indicate inadequate steroidogenesis in the early luteal phase, and falling estrogen and progesterone levels predicted fetal demise in all cases. These findings are useful in the management of early pregnancy that follows repeated spontaneous first trimester abortions or a prolonged period of infertility. They also confirm experimental and clinical evidence regarding the role of ovulation defects in the occurrence of various types of reproductive wastage, including early abortion, anatomic and chromosome defects of the embryo and others. Prospective studies of cycles of conception through BBT recordings/hormone assays may shed light in the understanding of defects of human reproduction.
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PMID:Basal body temperature recordings in spontaneous abortion. 1 Feb

An understanding of the basic mechanisms of hormone action is becoming an important part of a clinician's training. With the advent of radioreceptor assays and their comparison with radioimmunoassays, we are becoming increasingly aware that the normal physiological function of a hormone is not necessarily dependent on "normal" levels of hormone being present in the plasma. Even if plasma levels are normal, if a particular target cell lacks the receptor for the particular hormone the target tissue will not respond to the hormone. It has been shown, for example, by many workers that steroid hormones act on their cells via a receptor located in the cytoplasm of the target cells (1-4). Since the presence or absence of such receptors are becoming increasingly important in terms of unexplained infertility, endometrial carcinoma and breast cancer, it is necessary that the practicing clinician be familiar with the concept of receptors and have some understanding of their mode of action. In this brief presentation, I will explain certain terminology and summarize the state of the art so that you can critically read the literature concerning new developments in the area of hormone action which is to become increasingly important in the next few years. I will discuss some of the aspects of the mechanism of peptide hormones such as LH and FSH but will devote most of my attention discussing the details of steroid hormone action since our knowledge in this area is much more complete. I will also explain the terms frequently discussed in the literature concerned with hormone-receptor interactions.
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PMID:Hormone-receptor interactions--basic mechanisms. 1 18

A comparison of hysterosalpingography and laparoscopy was carried out on 79 infertile women. Out of these, 60 had abnormal and 19 had normal hysterosalpingograms. Of the 19 patients with normal X-rays, nine (47%) had abnormal findings during laparoscopy. In 62% of patients with abnormal hysterosalpingograms, laparoscopic findings confirmed the radiological diagnosis, however in 38% the findings differed. Though hysterosalpingography is an important part of infertility evaluation, a final and definite diagnosis requires endoscopic evaluation of the pelvis.
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PMID:A comparative study of hysterosalpingography and laparoscopy in the investigation of infertility. 1 10

A series of patients is presented in whom lysis of periadnexal adhesions was carried out for correction of infertility. These 35 couples had been infertile for at least 1 year prior to surgery. 77% had been trying to conceive for more than 18 months. Periadnexal adhesions were found to be the sole cause of infertility in 83% of those who eventually conceived. Subsequent to surgery, 63% of the patients conceived, 82% within 18 months, and 57% gave birth to at least 1 viable child. There is no doubt that periadnexal adhesions represent true pathology. Although often seemingly insignificant in character at the macroscopic level, they appear to play a major role at the microscopic level in impairing ovum pickup by the fallopian tube. Gynecologists should recognize the importance of these structures as mediators of a condition of relative sterility. Thus, despite the demonstation of tubal patency, the function of the rather delicate fimbria may be compromised by periadnexal adhesions, conglutinations, and hydatids so that only a fraction of those eggs that leave the ovary at ovulation reach the interior of the fallopian tube.
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PMID:Lysis of periadnexal adhesions for correction of infertility. 1 87

Twenty couples suffering from unexplained infertility have been tested in mixed leucocyte culture to determine if the wives were preimmunized against their husbands. The wives were tested against their husbands and four unrelated persons, and thymidine incorporation was measured on the third and fifth days of culture. No evidence was found that would indicate a preimmunization of the wife against her husband as an explanation for their infertility. A slight MLC stimulatory capacity was found in sera from infertile women.
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PMID:Mixed lymphocyte culture responses in infertile couples. 2 Apr 10

356 15-35 year old patients with secondary amenorrhea were studied. In all cases amenorrhea had persisted for 12 months or more. The best prognosis was found in patients with postpill amenorrhea with 95% recovery in 6 years. Lowest recovery rates, 56-61%, were seen in patients with anorexia nervosa and idiopathic functional amenorrhea. Of those with an organic etiology, ovarian failure was diagnosed in 22 patients who showed no follicular response after large doses of human menopausal gonadotropin (HMG). Relative ovarian failure was diagnosed in 5 patients who responded to HMG, the Stein-Leventhal syndrome was found in 9 patients, an adrenal adenoma was present in 1 patient; a pituitary tumor was diagnosed in 1 patient, 3 patients had organic brain lesions, and intrauterine synechiae were present in 3 patients. 93 of the 308 patients with functional amenorrhea gave a history of self-induced weight loss. In 56 patients, amenorrhea began after oral contraceptives ceased. 17 of 22 patients with anorexia nervosa were in the recovery stage. Psychogenic factors were present in 55 cases. 18 patients had galactorrhea and amenorrhea. In 5 of these the symptoms appeared after contraceptive treatment was stopped; they were classified as functional. No known etiological factor was found in 62 patients. The principal treatment was estrogen-progesterone substitution. Clomiphene, 100 mg/day for 5 days, was given to 105 patients with functional amenorrhea. Patients with infertility should be treated 1st with clomiphene-human chorionic gonadotropin or tamoxifen. If no response is obtained, bromocriptine with clomiphene are recommended. Induction of ovulation with exogenous gonadotropin was carried out for patients who did not respond to clomiphene. 27 healthy children were born after gonadotropin-induced ovulation.
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PMID:Etiology, clinical features and prognosis in secondary amenorrhea. 2 Apr 14

Hitherto, seminal plasma maltase has been measured with maltose as substrate; this method is time consuming and lacks specificity. The use of a synthetic substrate, p-nitrophenol-alpha-D-glucopyranoside, allows accurate and rapid determination of this activity. When maltase is added to the incubation medium (the substrate and reduced glutathione in potassium phosphate buffer, pH 6.8), maintained at 37 degrees C, hydrolysis of the original substrate to p-nitrophenol goes at a constant rate during 4 h. Under optimal conditions of incubation, the Michaelis constant of the reaction, calculated by the Hanes method, was 2.92 +/- 0.84 (SD) X 10(-3) for six different semen samples. Isomaltase appeared to be absent from seminal plasma. The enzyme is stable to freezing and slow thawing and can be stored for at least 26 days at -80 degrees C. Its molecular weight is 259 000. Tris(hydroxymethyl)aminomethane (pH 6.8) exerts a noncompetitive inhibition on the enzyme activity. In 68 men 23 to 45 years old, whose semen analyses were normal, the seminal plasma maltase activity was 467 +/- 135 (SD) mU/g of protein. It was generally decreased in patients with infertility disorders.
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PMID:P-Nitrophenol-alpha-D-glucopyranoside as substrate for measurement of maltase activity in human semen. 2 9


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