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

Since predetermination of ovulation would be helpful in treatment of sterility, a quick, sensitive, and specific radioreceptor assay (RRA) for measurement of actual LH concentrations in human serum has been developed. Using partially purified membrane receptors from bovine testes, our assay system enabled precise measurement of LH within 4 hours. The detection limit of the present method is 0.78 ng LER 960/ml serum. The method was used to detect ovulation during four observation cycles each in eleven women who were undergoing treatment for infertility, such as recommended intercourse or artificial insemination because of reduced fertility of their husbands. In all women ovulations could be predicted by LH surge and were verified by laparoscopy within 36 hours. Insemination was carried out at the time of the characteristic increase of LH values around mid-cycle. Pregnancy occurred in three women during the observation period.
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PMID:Ovulation timing by a radioreceptor assay for human luteinizing hormone. 2 1

Studies of prolactin secretion in humans have confirmed the concept, derived originally from animal investigations, that prolactin is predominantly controlled by tonic inhibition from the hypothalamus. The locus of action of dopamine and dopaminergic agents such as the ergot alkaloids inhibiting prolactin secretion appears to be primarily at the pituitary level, though a hypothalamic action to increase secretion of prolactin inhibitory factor may also contribute. Prolactin hypersecretion, through any of several possible mechanisms, is frequently but not always found in patients with galactorrhea. Recent studies have shown that hyperprolactinemia is considerably more common than was previously appreciated among patients without galactorrhea. It is present in at least two-thirds of all patients with pituitary tumors and in a significant minority of patients with secondary amenorrhea. Its clinical measurement in these conditions is therefore of considerable diagnostic importance. Whatever the pathophysiology of its production, hyperprolactinemia of all forms is responsive to treatment with the newer ergot alkaloids. The potential use of these agents for therapeutic purposes, particularly in the treatment of infertility, appears to be wider than was originally anticipated.
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PMID:The pathophysiology of hyperprolactinemic states and the role of newer ergot compounds in their treatment. 2 6

One hundred nineteen Jamaican women who underwent myomectomy from 1964 to 1969 were followed up for 5 to 9 years. Infertility was the most common presenting complaint. Preoperative hysterosalpingograms were performed on 61 patients and were abnormal for the majority of these patients. Surgery revealed submucous fibroids in 41 patients and pelvic inflammatory disease in 51 patients. The pregnancy rate following myomectomy was 18.5%, but successful outcomes occurred in only 9.2% of the cases. Pregnancy was unsuccessful for all patients who underwent both myomectomy and tuboplasty. Twenty-three patients had a recurrence of myoma, and 13 of these underwent subsequent hysterectomy.
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PMID:Myomectomy in infertile Jamaican women. 2 71

A vaccine capable of causing active immunity against one or more key elements of conception would have several advantages over currently available methods of fertility regulation. It would be amenable to mass use, would require only periodic follow-up, and would not require continuous user motivation. Although natural infertility attributable to immunologic factors has been amply documented, the natural mechanism has been only partially delineated. Consequently, researchers trying to develop a workable vaccine are taking various approaches. This report includes a discussion of autoimmune aspermatogenesis, anti-zona pellucida, anti-nonhormonal placenta-specific protein vaccines, and immunization against female and/or early embryonic antigens, including current approaches to the development of an anti-human chorionic gonadotrophin (HCG) vaccine. The potential advantages and disadvantages of the various immunologic methods are discussed, and the author concludes that although the problems associated with present methods of immunologic contraception are substantial they can be resolved.
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PMID:The present and future of immunologic approaches to contraception. 2 74

The problems of male sterility are considered in the light of fundamentals underlying the embryology and histophysiology of spermatogenesis and its hormonal control. Some forms of infertility are now understood but no treatment for them has yet been found. The mechanisms of other forms still elude firm definition: this is the case of, among others, some oligoasthenospermias in which, according to our experience, excessive estrogen production appears to play a physiopathologic role. In the prevailing uncertainty about therapeutic methods, the best short-term solutions in this field are in-vitro enhancement of the sperm's fecundating power and the improvement of artificial insemination techniques.
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PMID:[Current considerations on male secretory sterility]. 2 66

Abnormalities of testicular descent represent the most common genitourinary anomaly in men. Many aspects of testicular maldescent remain controversial. The etiology of the undescended testis is still not known, but results of experimental work in rats strongly support the hormonal theories. Distinction between the truly undescended testis and the retractile testis remains a problem, making retrospective analysis of previous data confusing. Newer aspects of diagnosis of nonpalpable testes include the human chorionic gonadotropin test, herniography, venography and arteriography. Routine aspects of surgical therapy have changed little in recent years, although newer techniques, such as microsurgical procedures and innovative scrotal anchoring methods, are now available. Malignant tumors and infertility are the most worrisome complications. Evidence is presented to suggest that prognosis is related not only to choice of therapy but also to its timing. The recent evidence for Sertoli cell dysfunction, if substantiated may resolve some of the controversies.
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PMID:Current concepts of the undescended testis. 3 Jan 78

An improved substrate-film technique has been developed for the assay of released proteinase from individual human spermatozoa. During the preparation of the thin gelatin membrane, it is pretreated with formaldehyde and NaOH. These agents alter the plasma membrane and the outer acrosomal membrane of the spermatozoon, facilitating the release of acrosomal enzymes. This effect is further enhanced by the addition of albumin to the incubation mixture. More than 90% of the spermatozoa in a normal ejaculate give a reaction by this method. It reaches a maximum after 4 hours of incubation and does not increase further even up to 12 hours. No difference in the reaction between washed and unwashed ejaculated spermatozoa can be found. The nature of the proteolytic activity and its possible significance in infertility are discussed.
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PMID:An improved assay technique for the proteolytic activity of individual human spermatozoa. 3 Jul 8

Twelve patients with primary infertility due to a defective luteal phase associated with hyperprolactinemia and galactorrhea are reported. All were treated with 2-bromoergocryptine. During the first cycle of therapy, the serum prolactin level decreased in all cases, and galactorrhea disappeared during the second cycle of therapy. Seven women responded to 2-bromoergocryptine, as was reflected in their endometrial biopsies. The remaining five were given clomiphene citrate on the second and sixth days of the next 2-bromoergocryptine cycle. Three of these patients responded favorably to this combined therapy. Six pregnancies were reported during therapy. The results of follow-up after labor or abortion suggested that these cases represent a latent stage of the amenorrhea-galactorrhea syndrome.
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PMID:Galactorrhea and the defective luteal phase of the menstrual cycle. 3 6

In this review, the pathological findings from testicular biopsies of men suffering from various types of infertility are presented. The causes of male infertility are divided into three major categories: pretesticular, testicular, and post-testicular causes. The pre-testicular causes of infertility may be defined as extra-gonadal endocrine disorders, such as those originating in the hypothalamus, pituitary, or adrenals, which have an adverse effect on spermatogenesis. The testicular causes of infertility are primary defects of the testes. The post-testicular causes of infertility consist primarily of obstructions of the ducts leading away from the testes. Cases in which the spermatozoa are normal in number but greatly impaired in motility, presumably due to faulty maturation or improper preservation of the spermatozoa during their sojourn in the epididymides, or due to biochemical abnormalities of the seminal plasma, are also included in the postesticular category.
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PMID:Pathological aspects of the infertile testis. 3 55

The significance of sperm antibodies in human fertility was investigated. Indirect immunofluorescent, macroagglutination, and immobilizing sperm antibody estimations were performed as part of a prospective study on a group of 63 infertile couples. The clinical use of the tests was evaluated by considering the pregnancies that occurred and the causes of infertility that were discovered in the subsequent year. The indirect immunofluorescent test showed more positives in seminal fluid (1/3) than elsewhere, although in 62% of the couples at least 1 of the media tested was positive and in 14.3% something was positive in both partners. Both male and cervical factors were implicated, and in this media there were less positives pregnant with the acrosome and midpiece patterns absent. No pregnancies were involved in the positives of the macroagglutination test; in the 3 cases where the male was involved, the cause was asthenozoospermia. The immobilization results showed the greatest number of positives in seminal plasma with male and cervical factors featured prominently. In this group pregnancy was achieved when ovulation was stimulated. It appears that if a clinical use is to be derived from these tests in the search for antisperm antibodies as a cause of infertility, testing the male, and especially seminal plasma, appears to correlate best. If treatment is recommended, it should be for the man.
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PMID:Significance of sperm antibodies in human fertility. 3 23


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