Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0021359 (infertility)
 26,075 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Several treatment choices remain for the couple with male factor infertility due to idiopathic male infertility or in couples in which specific therapy has failed. Empiric medical therapy continues as a viable option; however, the physician and patient must understand that the success rates with any of the pharmacological therapies remain suboptimal. In addition, this therapy should only be used for patients with idiopathic male infertility. It is not indicated for other classes of infertile males. Another option is that of IVF and related technologies. These technics continue to improve and we can expect more specific technics to be developed to optimize fertilization and pregnancy rates in those couples with male factor infertility. At the present time, the pregnancy rates achieved with this technology in male factor couples are less than those in non-male factor patients. In addition, all of these technics entail considerable expense, often not covered by insurance. The third alternative for the patient with idiopathic male infertility is that of therapeutic insemination with the husband's sperm. Recent studies combining ovarian hyperstimulation with IUI suggest a clear advantage of this technic over other insemination approaches. As this treatment is significantly less expensive and time-consuming than the prior therapies, it should be considered when choosing therapy. Additional choices the couple with male factor infertility should consider are adoption and therapeutic donor insemination. It is only after careful consideration of all the available options that an appropriate decision can be made. This will vary, depending on the particular clinical characteristics of the couple as well as their social and financial situation.
 ...
PMID:Assisted reproductive technics for the treatment of male factor infertility. 176 77

Two hundred twenty-four women underwent hysteroscopic evaluation without anesthesia after at least two failed attempts of in vitro fertilization and embryo transfer. One hundred fifty-three (68%) women were diagnosed as having mechanical infertility, and abnormal hysteroscopic findings were observed in 32 (21%). Forty-one women were diagnosed as having unexplained infertility (18%) and six (15%) had abnormal findings with hysteroscopy. Of the 30 couples who entered the in vitro fertilization regimen program because of male infertility, 4 (13%) had abnormal findings. The overall rate of abnormal findings was 19%; cervical canal and intrauterine abnormalities were found in 10 and 32 patients, respectively. Ten patients were treated during hysteroscopic evaluation procedure, and four patients subsequently underwent operative hysteroscopy under general anesthesia. We suggest that diagnostic hysteroscopy should be a routine procedure before in vitro fertilization and embryo transfer therapy.
 ...
PMID:Hysteroscopy in a program of in vitro fertilization. 177 Feb 74

Semen analysis stands as the most widely employed test for the diagnosis of male infertility. Subjectivity of evaluation and intra-individual variations of sperm concentration and motility are major limitations of this technique. Intra-individual variations are due to spontaneous circannual rhythmicity, to collection artifacts or to several environmental, physiological and pathological factors. The diagnostic and prognostic usefulness of semen analysis is related to strict compliance with the guidelines recently suggested by the World Health Organization. In recent years, the development of computerized systems provides an objective and rapid method for semen analysis, suitable for the study of more sophisticated parameters of sperm motility. Electron microscopy should be performed for the evaluation of ultrastructural abnormalities of spermatozoa in men with infertility of uncertain origin.
 ...
PMID:[Analysis of seminal fluid: modern aspects of an old examination]. 180 6

Varicocele normally presents itself in adolescence, with an incidence of 16 per cent. Less than one third of the boys, though, will suffer from male infertility in adulthood. Therefore, it seems excessive as well as imprudent to suggest surgery to all those patients. We worked out some parameters to identify "risky" cases of varicocele. From June to November 1990 we studied 45 patients from 10 to 16 years of age affected by varicocele, taking into consideration the following factors: puberal phase, symptomatology, degree of varicocele, testicular volume, Doppler ultrasound, hormonal profile. A Doppler ultrasound test evidenced a clinically undetected right reflux, in addition to a left varicocele, in 13 patients (34.4%). Sixty per cent of these 13 patients revealed a pathological response to LHRH test; this incidence is very close to that evidence in clinical bilateral varicocele. We believe that a right reflux showed by ultrasounds, represents a cause of further alteration in the patient's endocrinological balance in addition to increasing his risk of infertility. Purpose of this study was to draw a guideline for early diagnosis, correct treatment and follow-up of varicocele in peripubertal age.
 ...
PMID:[Early diagnosis and correct treatment of varicocele in puberty]. 183 23

Twenty-one patients with unexplained infertility underwent controlled ovarian hyperstimulation with buserelin acetate and human menopausal and chorionic gonadotropins, and follicular growth was monitored by ultrasonography and daily 17 beta-estradiol (E2) assays. Endometrial biopsy was performed when E2 levels were greater than or equal to 250 pg/mL per follicle and the follicular diameter was greater than or equal to 17 mm. As controls, we studied 20 preovulatory endometrial biopsies from patients with a male infertility factor. The biopsy material was examined at light, scanning, and transmission electron microscopes, and a morphometric analysis was performed. Preovulatory endometrial mucosa during controlled ovarian hyperstimulation showed accentuated proliferative aspects in both the glandular and stromal components and more frequent early secretory phenomena compared with the controls. The preovulatory progesterone (P) levels observed in our study seem to exclude the possibility that such early secretory aspects of the hyperstimulated endometrium are because of higher P concentrations in patients compared with controls.
 ...
PMID:Secretory changes in preovulatory endometrium during controlled ovarian hyperstimulation with buserelin acetate and human gonadotropins. 190 Dec 79

Partial zona dissection (PZD) increases the chances of fertilization by improving the access of spermatozoa to the perivitelline space (PVS) helping those spermatozoa unable to penetrate the zona pellucida (ZP) and possibly those poorly able to penetrate the oolemma. Problems arise in assessing semen to decide which parameters might indicate defects of this nature. PZD, by circumventing the ZP, may also increase the rate of polyspermy, especially in infertility where ZP and oolemmal penetration are not defective. Given these drawbacks, we performed PZD as routine treatment for male infertility in 70 in-vitro fertilization cycles. In three different groups, PZD proved to be either effective, ineffective or unnecessary. In the first group of 35 cycles, fertilization was 23% with initial PZD and 33% with PZD reinsemination (36% and 41% polyspermy respectively). No fertilization occurred following conventional insemination (CONV). Four pregnancies occurred in this group. In a second group of 19 cycles, fertilization did not occur with either PZD or CONV. In the final group of 16 cycles, fertilization was similar following both PZD and CONV, but polyspermy was 48% in the PZD category. Transfer of mixed PZD and CONV embryos in this group yielded 10 pregnancies. Assessment of all patient and seminal profiles, and those in an oligozoospermic subcategory, revealed no parameters of relevance to success or failure with PZD. However, one subgroup in the group of total failure to fertilize did have a significantly lower percentage of normal morphology (P less than 0.005), suggesting that degree of teratozoospermia may be a prognosticator of success using PZD.
 ...
PMID:Routine application of partial zona dissection for male factor infertility. 193 47

From January to July 1989, the DNA histogram of testicular open biopsies was done for 11 patients of primary infertility and 7 patients of a control group. There were 2 failures in these 36 specimens. The flow cytometric analysis revealed characteristic patterns in the relative numbers of haploid (1C), diploid (2C), and tetraploid (4C) cells. In the presence of normal spermatogenesis, the haploid compartment contained the majority of cells, followed by the diploid, and then the tetraploid (1C greater than 2C greater than 4C). The other diagnostic criteria of flow cytometry were as follows: hypospermatogenesis (2C greater than 1C greater than 4C), the maturation arrest (2C greater than 4C greater than 1C), and Sertoli-cell-only syndrome (2C, near 100%). According to the aforementioned diagnostic criteria, the results of DNA histograms were compared with the histopathology diagnosed by junior or senior pathologists. These patterns of DNA histograms correlated with the diagnoses by senior pathologists in 28 of 34 specimens (82.6%), while there were only 20 of 36 pathologic diagnoses (55.6%) which matched between junior and senior pathologists. It is shown that abundant experience is needed for testis pathologists to diagnose accurately. The DNA histograms correlate well with pathological findings, with the advantages of quantification and fewer specimens needed. In conclusion, testicular tubular cell DNA histograms appear to be a reliable modality in the evaluation of spermatogenesis. They provide the quantitative information of sperm maturation and help in making appropriate decisions in the management of male infertility.
 ...
PMID:Comparison between histopathology and DNA histogram of testis. 194 19

In this study, the prevalence of retarded endometrial development in the luteal phase of an infertile population (20/142 = 14%) was found to be significantly higher (P less than 0.05) than in that of a control, fertile population (3/68 = 4.4%). However, when the infertile subjects were subdivided into groups of different aetiology, it was found that women with endometriosis and unexplained infertility had a significantly higher prevalence of retarded endometrium (6/21 = 29%, 10/48 = 21% respectively; P less than 0.01 in both cases) than women with normal fertility; whereas the prevalence in women with tubal or male infertility (1/34 = 2.9% and 3/39 = 7.7%, respectively) was not significantly different from that in the fertile subjects. There were no significant differences in the progesterone profiles of the four groups of infertile subjects and the group of fertile subjects. Of the 15 cases of retarded endometrial development with known progesterone profile, two were associated with subnormal progesterone whereas the remaining 13 were associated with normal progesterone, the latter suggesting an abnormal response of the endometrium to a normal amount of progesterone. The findings suggest that further morphological study of the endometrium should be aimed at subjects whose infertility is unexplained or associated with endometriosis, in whom the prevalence of abnormal endometrium is increased.
 ...
PMID:Endometrial development in the luteal phase of women with various types of infertility: comparison with women of normal fertility. 195 35

Several aspects of reproductive technology are discussed. In tubal infertility, the choice between surgery or in vitro fertilization and embryo transfer (IVF-ET) is addressed. In cases with bilateral distal occlusion or otherwise bad prognosis, IVF is probably more successful and less expensive. IVF in unstimulated cycles has given promising results, with pregnancy rates comparable to the results from the National IVF-ET Registry. If these results can be confirmed by more studies they will probably have a great impact on the choice of treatment in tubal infertility. The results obtained with various transfer procedures in nontubal infertility have still to prove tubal transfer to be a more effective procedure than IVF. Finally, studies on microinsemination in male infertility or unexplained infertility with previous fertilization failure in IVF show promising results with the subzonal insemination and partial zona dissection procedures.
 ...
PMID:Assisted reproductive technology. 195 97

Testicular maldescent is one of the causes of male infertility. This paper illustrates that it was possible to determine that this pathology was present in 8.96% of the cases in 212 men who consulted for infertility at our service during 1987. When we compared clinical, hormonal and seminal studies with infertile subjects without testicular maldescent and with a group of 20 fertile patients, statistically significant differences were established, suggesting a poorer prognosis of fertility to the group with maldescent testes.
 ...
PMID:Testicular maldescent and infertility. 197 11


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>