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

Findings in a study of 100 Nigerian males supported the contention that ureaplasma urealyticum may have an inhibitory influence on fertility. When semen samples from 20 normal males, 17 males with sperm counts of 20-39 million/ml, and 63 males with sperm concentrations less than 20 million/ml were cultured in an oxoid mycoplasma broth, ureaplasma urealyticum was cultured in 39 of the samples. 36 of these 39 positive cultures were from males with sperm counts of less than 20 million/ml. Those patients with positive cultures and their wives were treated with tetracycline and within 6 months of treatment, conception occurred in the wives of 5 of the males with sperm concentrations of 20-35 million/ml. Apparently there is a tendency for the ureaplasma urealyticum to attach to sperm cells, and this may have an inhibitory effect on fertilization. Since positive cultures were obtained from 3 of the fertile males, it is possible that ureaplasma urealyticum is pathogenic for some individuals but not for others. This study does not prove that there is a cause and effect relationship between ureaplasma urealyticum and infertility; however, in view of the high infertility rates in many parts of Africa, tetracycline or doxycycline therapy is routinely recommended for males with ureaplasma urealyticum in their ejaculate and for their wives. Included is the formula for the oxoid mycoplasma broth and a table showing the number and distribution of positive and negative cultures by sperm concentration.
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PMID:Ureaplasma urealyticum (T. mycoplasma) and male infertility in topical countries. 10 40

A review of pharmacological therapy in male infertility shows that apart from specific therapy with gonadotropins in hypogonadotropic hypogonadism, treatment in normogonadotropic idiopathic oligozoospermia and asthenozoospermia is still empirical and often unsuccessful. Modern therapy is based on three pharmacological groups of compounds: gonadotropins, androgens and kininogenases, the latter releasing pharmacologic active kinin peptides from kininogen. In addition, antiestrogens and gonadotropin-releasing hormones seem to be promising agents for the near future. The use of antibiotics is of great importance in the therapy of male genital tract infections which often to a reduced fertility. Several other drugs (amino acids, psychopharmaceuticals, spasmolytic agents, trijodothyronine, glucocorticoids, vitamins) seem to be suitable in individuals cases, but in greater group of patients these agents do not improve fertility. Using the mentioned hormonal and nonhormonal pharmacological agents considerable progress can be demonstrated in the therapy of male infertility. However, before initiating any therapy it is important to exclude patients whose cause of infertility is untreatable or those who require surgery. Finally, it is hoped that additional progress in treatment of male infertility will soon be made possible by further improvement of fundamental research in andrology. Especially important is the development of better criteria for selection of patients for any form of therapy in order to make more specific and less empirical approaches for treatment of male infertility available.
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PMID:Recent progress in pharmacological therapy of male subfertility--a review. 10 19

With an original statistical study which employes the analysis of variance and the harmonic analysis, the authors evaluated the levels of LH and FSH obtained from 5 female patients of the infertility clinic. These subjects, apparently free from endocrine disorders, underwent a 7-hour test consisting of samples obtained at 20 minute intervals. By a double-antibody RIA method, we assayed LH and FSH in quintuplicate or triplicate in each sample and counted the tubes twice consecutively. In all subjects for LH and in 3 subjects for FSH we detected a real ultradian pulsatile release of the hormone. Period and amplitude of the LH fluctuations vary according to the phase of the menstrual cycle (follicular phase: short period and low amplitude; luteal phase: long period and high amplitude). No change in amplitude was observed for FSH, while the period in two cases varied in accordance with LH. In two cases we found multiple periods in the fluctuations of one hormone during the same test.
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PMID:The ultradian pulsatile release of gonadotropins in normal female subjects. 12 Oct 12

A 2-hour solid-phase radioimmunoassay (RIA) is described for determination of luteinizing hormone (LH) concentrations to detect ovulation. Time of ovulation was determined in 7 women. For comparison, 4 hourly values around midcycle were measured by 2-hour RIA. The 2-hour RIA sensitivity was .78 ng/ml of serum and could be increased by prolonged incubation. The coefficients of within and between assay variation at the 50% inhibition level were 7 and 13%, respectively. The mean index of discrimination between standard RIA and 2-hour RIA was 1.02, expressed by the slope of the regression curve. The coefficient of correlation was .97. In all women, the LH surge was detected by 2-hour RIA, and the subsequent ovulation was verified within 30 hours by endoscopic examination of ovaries as well as serum progesterone concentrations of more than 5 ng/ml on the 5th day after ovulation. Prospective ovulation timing can be done by this simple, accurate method. The 2-hour RIA can be useful in infertility therapy such as artificial insemination.
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PMID:Detection of ovulation by a radioreceptor assay for human luteinizing hormone. 12 40

A young patient with secondary amenorrhea and primary infertility is described. After a gynecological-endocrinological exploration including laparoscopy, the diagnosis indicates secondary hypergonadotropic, hypo-estrogenic normo-androgenic amenorrhea. The anatomopathological examination of an ovarian biopsy revealed an intact follicular apparatus, thus disproving the suspected diagnosis of climacterium praecox. Since very high gonadotropin doses could not induce an ovulation, it was concluded that the rare combination of secondary amenorrhea and the gonadotropin-resistant ovary syndrome must be present. The pathogenesis of this syndrome is discussed.
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PMID:The gonadotropin-resistant ovary syndrome in association with secondary amenorrhea. 12 35

A total of 415 women treated for laparoscopically verified pelvic inflammatory disease (PID) were reviewed after 9.5 years. Of these, 88 (21.2 per cent) were involuntarily childless after one or more infection; in 72 cases (17.3 per cent) this was due to tubal obstruction; 263 (63.4 per cent) women became pregnant; 64 (15.4 per cent) were voluntarily childless. Tubal occlusion was diagnosed after one infection in 12.8 per cent, after two infections in 35.5 per cent, and after three or more infections in 75 per cent of the women. Tubal occlusion was more common after nongonorrheal than after gonorrheal salpingitis. Infertility varied with the inflammatory changes seen at laparoscopy. The ratio between ectopic and intrauterine pregnancies after the infections was 1/24. Chronic abdominal pain was reported by 18.1 per cent of the women. Corresponding findings in 100 healthy control subjects were: involuntary childlessness in three despite normal Fallopian tubes, one ectopic in 147 intrauterine pregnancies, and chronic abdominal pain in five cases.
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PMID:Effect of acute pelvic inflammatory disease on fertility. 12 23

The primary use of laparoscopy is as a surgical tool, with sterilizations being the overwhelming indication. The laparoscope is used less frequently as a non-surgical tool, with the major indication being for diagnosing infertility and/or amenorrhea, and for evaluation of obscure pelvic pain. There would seem to be several indications for laparoscopy that have been neglected, these being in confirming the diagnosis of acute pelvic inflammatory disease; in the evaluation of malignancies and abdominal-pelvic trauma; and the surgical treatment of pelvic pain. Lapar-The majority of these contraindications are relative, and depend soley on the laparoscopist's ability and his clinical judgment. The problems of hernias seem to have been over-emphasized. The laparoscopist should be aware of potential problems with umbilical hernia, and he probably can ignore hiatal hernias except when they are large and quite symptomatic. However, generalized abdominal peritonitis, significant hemoperitoneum with intestinal obstruction are felt by most authors to be absolute contraindications. The most frequent complications of laparoscopy involve the physoperitoneum. Except for cardiac arrest the most serious complications involve electrical burns to small bowel.
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PMID:Indications, contraindications and complications of laparoscopy. 12 9

The clinical experience in diagnostic laparoscopy is dealt with under the conditions of the Department of Gynaecology and Obstetrics at Erlangen University. Among 700 cases the indications were infertility (34,4%), pelvic pain 27,4%), suspected ectopic pregnancy (7,9%), endocrinologic cases and malformations (18,9%), pelvic mass without symptoms (8,6%) and others (2,8%). The laparoscopic findings are shown. Important diagnostic clues otherwise missed were found in about half of the patients. In 122 women a laparotomy could be disregarded. One should be aware of diagnostic errors especially in ovarian tumors. Biopsy may help in assessment of ovarian function. In tumor diagnosis, however, it is rather dangerous. Difficulties of the methos (2,9%) and complications (1%) are discussed.
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PMID:[Report on 700 gynaecologic cases in diagnostic laparoscopy (author's transl)]. 12 14

Besides its diagnostic value, laparoscopy is a useful operative tool in the treatment of infertility. We have used dilatation of phimotic tubal ostia and salpingolysis by laparoscopy as our primary approach. In the total series of 33 cases a pregnancy rate of 42.1 percent was obtained.
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PMID:Laparoscopic tubal surgery in infertility. 12 96

Reproductive biology has developed into a major subspecialty in gynecology. This study is a retrospective analysis of a private patient population in which the major presenting complaint was infertility. The 324 cases reviewed are divided into three groups: group1-congenital lesions (subdivided into anatomic defects and endocrine disorders); group 2-infectious disorders and genital neoplasias; and group 3-iatrogenic causes of anovulation. Direct visualization of the internal genitalia combined with a hysterogram gives positive proof of tubal patency and allows the surgeon to develop a plan of therapy. By visualizing the ovaries, he obtains the information necessary for the proper choice of ovulatory stimulating agents. Laparoscopy is not a new procedure but has been used increasingly in modern medicine. Better optic resolution and new operative instrumentation have been a great help to the fertility specialist. The laparoscope spans the gap between palpation and exploratory laparotomy.
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PMID:Infertility diagnosed by laparoscopy: review of 324 cases. 12 25


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