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)

Gonorrhea is the most prevalent sexually transmitted disease (STD) in Nigeria. In fact, in 1963, WHO found Lagos to have the highest gonorrhea rate in the world. Recent surveys report gonorrhea prevalence to be as high as 28.1%. Further some studies show a clear association between gonorrhea and male and female infertility. Penicillinase producing Neisseria gonorrhea prevalence varies from 44.4% in Zaria to 80% in Ibadan. There is an increase in the prevalence of gonorrhea among girls, mostly due to sociocultural factors such as the belief that sexual intercourse with a girl who has urethritis cures the condition. Gonorrhea is not always the most common form of urethritis, however. For example, in a study in Ibadan, 61% of male urethritis cases had nonspecific urethritis. Further schistosomiasis often causes urethral symptoms like those of gonorrhea. Most women at STD clinics have vaginitis and vaginal discharge. Even though the prevalence of trichomoniasis and candidiasis are rather high (10.2-22.3% and 4.33.1% respectively), bacterial vaginosis is the leading cause of vaginitis and vaginal discharge in Nigeria. The predominant malignancy of women in Nigeria is cervical cancer which my be due to the high rates of infection of trichomoniasis and Herpes virus II. Another prevalent STD is syphilis, yet many people with the infection are asymptomatic. For example, a study reports that 10.3% of women in a prenatal clinic in Lagos tested positive for syphilis, but the physician believed only 1.5% had syphilis. Tropical venereal diseases still cause genital ulcers in Nigeria. Dermatophyte infection, genital warts, and pedicubsis pubis also occur, but scant data exist. Many people believe they have an STD and do not, yet they insist they do. This phenomenon may be a result of the common fear of infertility which results from STDs. In conclusion, the government should allocate adequate funds for health programs and research, particularly those associated with STDs.
 ...
PMID:Sexually transmitted diseases in Nigeria. A review of the present situation. 248 71

Pelvic inflammatory disease (PID) is a frequent infection in sexually active young women and results in adverse sequelae, including tubal-factor infertility and ectopic pregnancy. In the 1970s investigations using culdocentesis demonstrated that anaerobic bacteria played an important role in the etiology of PID. This finding has subsequently been confirmed by studies utilizing laparoscopy and/or endometrial biopsy to obtain specimens directly from the upper genital tract (uterine cavity and fallopian tube) of patients with acute PID. Recently, several investigations have shown an association between bacterial vaginosis and the development of acute PID. The microorganisms associated with bacterial vaginosis include anaerobes such as Prevotella bivia, other Prevotella species, and Peptostreptococcus species. These studies that have demonstrated the presence of bacterial vaginosis-associated bacteria in addition to the sexually transmitted organisms Neisseria gonorrhoeae and Chlamydia trachomatis suggest that treatment of acute PID must be broad spectrum in nature and effective against anaerobic bacteria as well as N. gonorrhoeae and C. trachomatis.
 ...
PMID:Role of bacterial vaginosis in pelvic inflammatory disease. 754 73

In a consecutive series, 30 women were interviewed and gynecologically examined after pelvic pouch operation because of inflammatory bowel disease. The examination displayed: colpitis in two, bacterial vaginosis in one and cervical cancer in situ in one of the women. Unwanted infertility was reported by five women, probably due to female factors in three. Sixteen women had felt sexually unattractive by the temporary ileostomy. At follow-up, after closure of the ileostomy, 23 women experienced a considerable sexual desire, 28 could experience orgasm and 20 nearly always had orgasm at intercourse. Insufficient vaginal lubrication during intercourse was reported by seven women. This could be explained by hormonal or other factors in four women and might be owing to side-effects of the operation in three. Four women reported slight deep dyspareunia and one superficial dyspareunia. The result indicated a low frequency of sexual problems after pelvic pouch operation.
 ...
PMID:Sexual life in women after colectomy-proctomucosectomy with S-pouch. 785 33

Most pelvic inflammatory disease (PID) is caused by the ascent of sexually transmitted disease pathogens from the endocervix. In fact, PID remains the most common serious complication of infection from sexually transmitted bacterial pathogens. PID also may be caused by normal vaginal micro-organisms (such as those associated with bacterial vaginosis) that have overgrown in the vagina. PID has been linked to the occurrence of long-term sequelae, most commonly and most importantly infertility and ectopic pregnancy. In many patients PID may remain undiagnosed and asymptomatic, and may not become evident until such long-term consequences become manifest. We briefly review the epidemiology of PID including case definitions, the prevalence of the problem, and causal pathways and associated risk factors. Risk factors for both PID and its sequelae are discussed in relation to the mechanism of ascent of associated etiologic agents from the lower to the upper genital tract.
 ...
PMID:Pelvic inflammatory disease. A brief overview. 820 79

Induced abortion is one of the most frequent surgical procedures in the UK. Even though it is considered safe, it sometimes has complications and long-term sequelae. Pelvic inflammatory disease (PID) is the most prevalent complication and can lead to chronic pelvic pain, pain during intercourse, infertility, and a higher risk of ectopic pregnancy. Chlamydia trachomatis is perhaps the leading etiologic agent for PID among women who have undergone induced abortion and who develop PID. Gonorrhea is another major etiologic agent for PID. Strategies used to try to reduce pelvic infection revolve around administration of antibiotic prophylaxis based on demographic features and on the presence of certain organisms in the genital tract that may increase their risk (e.g., C. trachomatis and Neisseria gonorrhoeae) and universal antibiotic prophylaxis for all women undergoing abortion. Most of the literature suggests that antibiotic prophylaxis does provide some protection against PID but does not clearly indicate who should be screened and for which pathogens and who should be treated and with which antibiotics. Demographic features useful for identifying who should receive antibiotic prophylaxis are: a history of PID, single status, nulliparity, and youth (especially reliable for chlamydial infection). Screening for bacterial vaginosis involves diagnosis based on 3 of 4 criteria: characteristic vaginal discharge, positive amine test, raised vaginal pH, and the presence of clue cells on microscopy of wet or stained preparations of vaginal discharge. Since C. trachomatis is the most important pathogen, drugs sensitive to it should be administered: tetracyclines and erythromycin. Screening women seeking abortion for sexually transmitted diseases (STDs) provides an opportunity to educate them about STDs and treatment compliance and to contact their partners for investigation, treatment, and contact-tracing to reduce the STD-infected pool in the community.
 ...
PMID:Preventing pelvic infection after abortion. 854 9

Mycoplasma hominis and Ureaplasma urealyticum can be isolated with considerable frequency from the human urogenital tract and are thought to cause various syndromes such as nongonococcal urethritis, pelvic inflammatory disease, pyelonephritis or infertility. The aim of this study was the evaluation of the presence of different genital pathogens in patients with sexually transmitted diseases (STD) and, in particular, the detection of mycoplasmas in individuals infected with genital microbes and an assessment of the presence of genital microorganisms in patients harbouring Mycoplasma hominis or Ureaplasma urealyticum. Furthermore, the occurrence of mycoplasmas in women with bacterial vaginosis was established. Specimens were collected from a total of 41,980 persons attending the Outpatients' Centre for Infectious Venero-Dermatological Diseases in Vienna from 1994 to 1996. Of all genital pathogens, Ureaplasma urealyticum was cultured most frequently in men and women. Mycoplasma hominis and Ureaplasma urealyticum were detected more often in the vaginal fluid than in the male urethra. By contrast, infection rates with Neisseria gonorrhoeae and Chlamydia trachomatis were higher in men than in women. In both men and women, trichomoniasis increased colonisation with Mycoplasma hominis, while mycoplasmas occurred less frequently together with genital candidiasis. Mycoplasma hominis was cultivated significantly more often in women with bacterial vaginosis than in those without. In contrast to urethral infections in men, cervical infections with Neisseria gonorrhoeae or Chlamydia trachomatis raised the incidence of Mycoplasma hominis in the vaginal fluid.
 ...
PMID:Mycoplasma hominis and Ureaplasma urealyticum in patients with sexually transmitted diseases. 928 64

Pelvic inflammatory disease (PID) is the must important gynecologic infectious disease. It causes not only serious clinical symptoms, life threatening complications, but also severe damage to the female upper reproductive tract. Among its important sequale are infertility due to tubal occlusion, ectopic pregnancy, dyspareunia, and chronic pelvic pain. The must important causative organisms are Neisseria gonorrhoeae, Chlamydia trachomatis, as well as anaerobic and facultative bacteria found in the vaginal flora of women with bacterial vaginosis. The author reviews the latest developments regarding the epidemiology, etiology diagnostics, medical and surgical therapy of the disease. The importance and possibilities of prevention are discussed.
 ...
PMID:[Inflammation of the pelvis minor]. 975 75

Pelvic inflammatory disease (PID) refers to infection of the uterus, fallopian tubes, and adjacent pelvic structures that is not associated with surgery or pregnancy. PID causes major medical, social, and economic problems worldwide. Long-term sequelae, most notably tubal factor infertility and ectopic pregnancy, are common and extremely costly to the healthcare system. The most important causative micro-organisms are Chlamydia trachomatis, Neisseria gonorrhoeae, and micro-organisms associated with bacterial vaginosis. The clinical spectrum of PID ranges from subclinical endometritis to severe salpingitis, pyosalpinx, tubo-ovarian abscess, pelvic peritonitis, and perihepatitis. Clinical diagnosis of PID has limitations. The clinical diagnostic criteria are insensitive and nonspecific, and false-positive and false-negative diagnosis is common; however, direct visual diagnosis is not always feasible, requires general anesthesia, and is costly. More research is needed of noninvasive diagnosis of PID. Current treatment guidelines call for broad-spectrum antimicrobial coverage. Screening for asymptomatic chlamydial infection is the mainstay of prevention of PID. Emerging evidence from randomized controlled trials provides strong evidence that intervention with selective screening for chlamydial infection effectively reduces the incidence of PID.
 ...
PMID:Pelvic inflammatory disease. From diagnosis to prevention. 989 75

Unexplained infertility, recurrent abortion, dysfunctional uterine bleeding, pelvic pain, premenstrual syndrome, premature labour, placental insufficiency and pre-eclampsia are examples of common obstetric and gynaecological problems that frequently defy adequate explanation. Bacterial vaginosis, a non-inflammatory condition, is associated with premature labour, but antibiotics administered topically provide less effective prophylaxis than those administered orally. This would indicate that bacterial vaginosis might be a marker for significant genital tract bacteria, but some pathology is dependent on micro-organisms ascending out of reach of topical antibiotics. The author was led to consider the hypothesis that micro-organisms, possibly those associated with bacterial vaginosis, surreptitiously inhabit the uterine cavity (bacteria endometrialis) where they are culprits of some common gynaecological and obstetric enigmas. The objective of this review is to provide an initial theoretical examination of this hypothesis. Bacteria in the endometrium have been associated with infertility. Antiphospholipids have been linked to recurrent miscarriage and pre-eclampsia and with infections including Mycoplasma. Pre-eclampsia might be explained by an exaggerated host response to intrauterine micro-organisms or bacterial toxins. The hypothesis that one common factor, bacteria endometrialis, could provide a plausible explanation for a variety of obstetric and gynaecological mysteries is particularly intriguing. There is sufficient evidence to justify further investigation.
 ...
PMID:Hypothesis on the role of sub-clinical bacteria of the endometrium (bacteria endometrialis) in gynaecological and obstetric enigmas. 1046 27

There is growing evidence that the pathogenic effects of bacterial vaginosis may not be confined to the lower genital tract. Possible associations with infertility and effects on fertilization and implantation were studied in patients undergoing in-vitro fertilization (IVF) treatment. High vaginal swabs taken at the time of oocyte collection were assessed by Gram staining. The prevalence of bacterial vaginosis and of intermediate and normal flora in 301 patients was 25.6, 14.0 and 60.4% respectively. Bacterial vaginosis was more prevalent in patients with tubal (31.5%, n = 149) compared with non-tubal (19.7%, n = 152) infertility (odds ratio (OR) 1.87, CI 1.11-3.18, P = 0.02). Bacterial vaginosis did not have an adverse effect on fertilization rate. Further, no significant difference in implantation rates was seen when comparing bacterial vaginosis (15. 8%, OR 1.03, CI 0.66-1.61) and intermediate flora (13.1%, OR 0.82, CI 0.45-1.52) with normal flora (15.5%). Though confidence intervals around the observations were relatively wide, the findings suggest that routine screening for bacterial vaginosis in the hope of improving the success of IVF treatment is not justified. The prevention of complications in pregnancy associated with bacterial vaginosis might be a more relevant indication for screening at the time of IVF treatment, in particular patients with tubal disease, if treatment were shown to be effective for that particular purpose. However, antibiotic treatment before IVF has been shown to be positively disadvantageous for IVF by encouraging other organisms.
 ...
PMID:The influence of bacterial vaginosis on in-vitro fertilization and embryo implantation during assisted reproduction treatment. 1046 22


1 2 3 4 5 Next >>