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

Our experience with laparoscopy as the primary means of assessment of the female genital tract is described in 279 women attending a subfertility clinic. Thirty-two per cent of patients with primary infertility and 60 per cent of patients with secondary infertility had significant pelvic disease. We feel that laparoscopy should replace other methods for the routine primary assessment of the genital tract in infertile women.
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PMID:An assessment of laparoscopy as the primary investigation in the subfertile female. 14 19

Polyglactic acid and polyglycolic acid suture materials were compared in rat uterine and abdominal wall tissues for inflammatory response and tissue fibrosis. By 90 days after surgery, the tissue inflammatory reaction and fibrosis were significantly less in response to polyglactic acid suture (Vicryl) in both uterus and skin as compared with the response to polyglycolic acid (Dexon). In addition, the over-all tissue response in skin was significantly greater than that in uterus for both suture materials. The potential importance of tissue fibrosis--particularly in oviductal surgery, over and above the formation of adhesions between one organ and another--is emphasized. It is concluded that (1) the magnitude of tissue response to suture material varies for different tissues, (2) the degree of tissue wall fibrosis does not necessarily correspond to external tissue adhesions, (3) adhesions are maximal at the surgical knots regardless of the suture material used, and (4) polyglactic acid suture material may be preferable to polyglycolic acid suture material for infertility surgery, in which a minimum of tissue reaction is imperative.
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PMID:Comparison of polyglactic and polyglycolic acid sutures in reproductive tissue. 14 12

During a 30-month period 229 couples were evaluated for infertility at the Naval Regional Medical Center, Oakland. Laparoscopy was used in all cases of otherwise unexplained infertility. The resulting laparoscopic examination of the female partner of 24 such couples demonstrated abnormal findings in 18 (75%). Of these 18 subjects, unsuspected endometriosis was found in 11 (46%) and peritubal adhesions in 7 (29%). Of the 229 couples evaluated, only 8 (3.5%) failed to show some etiologic factor associated with infertility. Thus, the previously reported 10 to 20% incidence of unexplained infertility is too high an estimate in view of the additional information made available through pelvic endoscopy.
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PMID:Unexplained infertility. A reappraisal. 14 73

The clinical, hormonal, cytogenetic, and ovarian histopathologic findings in 12 cases of premature ovarian failure are described. The scope and limitations of laparoscopic ovarian biopsy are discussed, as is the importance of radioimmunoassay of follicle stimulating and luteinizing hormones in comparison to ovarian biopsy for the diagnosis of premature ovarian failure. It is concluded that serum gonadotropin estimations and laparoscopic ovarian biopsies are complementary tools for the diagnosis of premature ovarian failure, and that 1 cannot replace the other for a final diagnosis. However, when facilities for radioimmunoassay for gonadotropins are not available, laparoscopic examination of ovaries and ovarian biopsies can alert the gynecologist to the diagnosis of premature ovarian failure. In the absence of a clinical response to clomid, the diagnosis could be confirmed. Early diagnosis can prevent the expense and time-consuming treatment for the associated problem of infertility.
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PMID:Premature ovarian failure. 14 94

A comparative study of hysterosalpingography (HSG) and laparoscopy in the investigation of infertility is presented. From 1973-1977, 352 cases were investigated with both HSG and laparoscopy. In 57.67% of the cases there was complete agreement between HSG and laparoscopy. The study included 168 cases of unexplained infertility and 184 cases with abnormal hysterosalpingographic findings. Pelvic adhesions were demonstrated in 151 cases by laparoscopy as compared to 76 cases in which its presence was only suspected by HSG. Laparoscopy revealed a 57.14% of associated pelvic pathology in cases of unexplained fertility. The present study concludes that laparoscopy as compared to HSG is not only more informative, but also more accurate and conclusive.
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PMID:Comparative evaluation of laparoscopy and hysterosalpingography in infertile patients. 14 55

Reconstructive oviductal surgery was performed on 205 private patients with primary and secondary infertility, who were selected from 1075 endoscopic examinations. Each patient underwent an infertility survey which included gamete formation, reception and deposition of gametes, nidation, post-coital, and semen analysis. Only those with tubal abnormalities, not responding to conservative therapy after a minimum period of six months following laparoscopic examination, were selected for tuboplasty. Spiral stents for fimbrioplasty and straight teflon tubing for mid-portion and cornua obstruction were employed. These stents were removed eight weeks post-surgery, under local anesthesia at the office. Of the 205 tuboplasties, 193 patients had sustained patency; 75 conceived; 7 aborted; and 1 had an ectopic pregnancy. Pregnancy occurred between 1 and 26 months after removal of the stents. Complications were very few. The use of Roland spiral teflon stents has resulted in a greater percentage in patency and pregnancy rates, as compared to those without use of stents.
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PMID:Advances in tuboplasty. 14 93

An assessment of the value of hysterosalpingography (HSG) and laparoscopy was made on the basis of a comparison of the respective findings obtained during routine investigation of 105 women attending the Infertility Clinic. The results of the two procedures concurred in 76% of the women; in the remaining cases, apparently normal findings on HSG had to be rectified on the basis of laparoscopic investigation and vice versa. The divergent results are discussed in detail. In particular, intramural obstruction of the tubes diagnosed on HSG often appears to be merely functional and the presence or absence of adhesions in the region of the tubes must be viewed with reservation. HSG and laparoscopy should be considered complementary, not rival procedures.
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PMID:[The place of laparoscopy in the investigation of infertility (author's transl)]. 14 70

We present a series of 20 patients who underwent uterine suspension performed through a laparoscope, as part of conservative treatment for infertility and pelvic pain. The operative technique is easily mastered by a skilled laparoscopist who is prepared to deal with intra- or postoperative complications. Avulsion of the round ligament was the most serious complication experienced. Operating time was brief, and the hospital stay was short.
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PMID:Uterine suspension through the laparoscope. 14

Males with Down's syndrome frequently present incomplete sexual development and are presumed to be sterile. The intent of this study is to clarify the aetiology of diminished sexual function in men with trisomy 21. Single dose LH-RH stimulation tests were performed in 6 men with Down's syndrome. Compared to a control group of 6 mentally retarded, institutionalized males, the subjects with Down's syndrome had markedly elevated basal FSH and slightly elevated basal LH concentrations. The FSH response to LH-RH stimulation was notably increased in the Down's syndrome group, while the LH response showed a lesser increase. Testosterone concentrations were found to be comparable in the two groups. The results are consistent with the clinical assumption that males with Down's syndrome have decreased spermatogenesis and infertility and that their Leydig cell function is less affected.
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PMID:LH-RH testing in men with Down's syndrome. 15 Jan 88

The clinical significance of varicoceles depends on their frequency and on the fact that they may produce infertility. The available operative forms of treatment are unsuccessful in about 10% of patinents. In these cases it is desirable to elucidate the very variable drainage pattern by means of transfemoral phlebography with the patient erect. The method was employed in 13 patients and demonstrated continuity of the testicular vein, or of one of its tributaries, in twelve. If the testicular vein appears to be absent, one must consider the possibility of a venous short circuit or drainage of the pampiniform plexus into the external iliac vein. In four patients out of the 13, scrotal phlebography in addition for complete definition was necessary.
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PMID:[Phlebography of the testicular veins for varicoceles and their recurrences (author's transl)]. 15 48


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