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

This paper examines the association between traditional practices of female genital cutting (FGC) and adult women's reproductive morbidity in rural Gambia. In 1999, we conducted a cross-sectional community survey of 1348 women aged 15-54 years, to estimate the prevalence of reproductive morbidity on the basis of women's reports, a gynaecological examination and laboratory analysis of specimens. Descriptive statistics and logistic regression were used to compare the prevalence of each morbidity between cut and uncut women adjusting for possible confounders. A total of 1157 women consented to gynaecological examination and 58% had signs of genital cutting. There was a high level of agreement between reported circumcision status and that found on examination (97% agreement). The majority of operations consisted of clitoridectomy and excision of the labia minora (WHO classification type II) and were performed between the ages of 4 and 7 years. The practice of genital cutting was highly associated with ethnic group for two of the three main ethnic groups, making the effects of ethnic group and cutting difficult to distinguish. Women who had undergone FGC had a significantly higher prevalence of bacterial vaginosis (BV) [adjusted odds ratio (OR)=1.66; 95% confidence interval (CI) 1.25-2.18] and a substantially higher prevalence of herpes simplex virus 2 (HSV2) [adjusted OR=4.71; 95% CI 3.46-6.42]. The higher prevalence of HSV2 suggests that cut women may be at increased risk of HIV infection. Commonly cited negative consequences of FGC such as damage to the perineum or anus, vulval tumours (such as Bartholin's cysts and excessive keloid formation), painful sex, infertility, prolapse and other reproductive tract infections (RTIs) were not significantly more common in cut women. The relationship between FGC and long-term reproductive morbidity remains unclear, especially in settings where type II cutting predominates. Efforts to eradicate the practice should incorporate a human rights approach rather than rely solely on the damaging health consequences.
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PMID:The long-term reproductive health consequences of female genital cutting in rural Gambia: a community-based survey. 1155 30

Mycoplasma genitalium was first isolated from men with non-gonococcal urethritis (NGU) more than 20 years ago. Use of polymerase chain reaction technology has shown it to be a cause of acute NGU and probably chronic NGU, almost independently of Chlamydia trachomatis, but there is no substantial evidence that it causes acute or chronic prostatitis. In women, M. genitalium is not associated with bacterial vaginosis, but it is strongly associated with cervicitis and endometritis and serologically with salpingitis and tubal factor infertility. Further studies may show M. genitalium to be associated, perhaps causally, with epididymoorchitis, neonatal disease and reactive arthritis. Furthermore, its potential for enhancing HIV transmission needs to be explored. M. genitalium is susceptible to various broad-spectrum antibiotics, but M. genitalium-associated diseases are probably best treated with azithromycin.
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PMID:Mycoplasma genitalium -- an up-date. 1186 Jun 89

According to World Health Organization estimates, there are 333 million new cases of sexually transmitted diseases (STDs) each year. The total number of reproductive tract infections (RTIs) is even higher since these infections may have few visible symptoms, especially in women. Left untreated, however, RTIs can lead to infertility. Common symptoms include: unusually thick or foul-smelling vaginal or urethral discharge, genital sores, anal sores, genital itching, pain when urinating and during sexual intercourse, painful swelling in the lymph glands or groin, and lower abdominal pain. The open sores associated with STDs such as syphilis, chancroid, and genital herpes greatly increase the risk of HIV transmission, as may STDs such as gonorrhea that are associated with urethral or vaginal discharge. To facilitate the prompt diagnosis and treatment of RTIs, this article briefly describes the diagnosis and long-term effects of gonorrhea, syphilis, chancroid, chlamydia, pelvic inflammatory disease, genital herpes, genital warts, candida, and bacterial vaginosis.
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PMID:Common infections. 1234 38

One-hundred and seventy two couples which went for the first time to the Infertility Service of the National Institute of Endocrinology from June 1999 to June 2000, were studied to find out the frequency of Trichomonas vaginalis infection in this group, and determine its interaction with a number of clinical and risk variables. The results yielded that 10.5% were positive to the parasite, the prevailing symptom was leukorrea in women and 96.6% of men showed no symptoms. It was highly significant the fact of having a previous pathological history that might be related to infertility and current T. vaginalis infection. This protozoon was frequently associated with Candida sp. and causative agents of bacterial vaginosis in women and Haemophilus influenzae in men. This parasite seems to play an important role as a likely causative agent to be considered in fertility problems.
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PMID:[Frequency of Trichomonas vaginalis infection in couples with fertility problems]. 1584 32

Perturbation of the normal lactobacilli-dominated vaginal microflora is associated with reproductive failure and adverse pregnancy outcomes, ranging from early pregnancy loss to late miscarriage and preterm birth. As high rates of bacterial vaginosis are observed with IVF patients, abnormal vaginal microflora presumably explain, at least to some extent, reproductive failure as well as the increased risk of adverse pregnancy outcome seen in these patients. Accordingly, there may be a window of opportunity for improving IVF success rates and outcomes. At present, a screen-and-treat procedure to restore the normal vaginal microflora is not a routine part of the infertility work-up and treatment. While Gram staining of vaginal smears would offer an inexpensive and validated means for screening and diagnosis, probiotics that contain live lactobacilli capable of re-colonizing the vagina may offer an elegant and safe choice of treatment. Carefully designed trials using well characterized probiotic strains and treatment regimens are still required to evaluate the effect of probiotics on IVF-embryo transfer pregnancy rates.
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PMID:Vaginal lactobacilli, probiotics, and IVF. 1641 27

Mycoplasmas comprise a big group of organisms consisting of one hundred eighty species which are found in nature as parasites of humans, other mammals, reptiles, fishes and plants, or living as commensals. The group commonly referred to as genital mycoplasmas comprise species most often found in the genitourinary tract of sexually active adults as common commensal inhabitants, or pathogens which can cause many different infections. The species we are most interested in this work are called: Mycoplasma genitalium, Mycoplasma hominis and Ureaplasma urealyticum. There is no doubt that they can cause non-gonococcal urethritis (NGU) in both men and women and bacterial vaginosis (BV), cervicitis, endometritis. Infection can spread to the upper port of female genital tract and it can lead to pelvic inflammatory disease, or if it happens during pregnancy--to chorioamnionitis and further pregnancy complications. Even though mycoplasmas have been known and described since 1898, the problem of their morbidity and the possible influence they have on human fertility is still not clear. Similar to research from 30 years ago, connecting Chlamydia trachomatis with infertility, new scientific work as well as the dynamic development of diagnostics procedure, especially more common use of PCR method, may be helpful in discovering the potential role genital mycoplasmas play in infertility.
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PMID:Genital mycoplasmas--morbidity and a potential influence on human fertility. 1740 Nov 88

The group of organisms commonly referred to as genital mycoplasmas comprise species most often found in genitourinary tract of sexually active adults as common commensal inhabitants, or pathogens which can possibly cause many different pathologies like: non-gonococcal urethritis, bacterial vaginosis, cervicitis, endometritis or pelvic inflammatory disease. The problem of their morbidity and the possible influence they have on human fertility is still not clear. The aim of this study was to find out whether two investigated species- Ureaplasma urealyticum and Mycoplasma hominis can be detect more often in a group of infertile women. 74 women participated in the study and were assigned to one of 2 groups of patients: infertile women and fertile women without any sign of genital tract infection. Swabs from the cervical canal of the uterus and the fluid from the Douglas pouch were taken during the gynecological examination and laparoscopic procedure. Two diagnostic methods were used: biochemical method- commercial diagnostic kit- Mycoplasma IST 2 and PCR method. The results showed that Ureaplasma urealyticum and Mycoplasma hominis were detected among both fertile and infertile women with nearly the same frequency, much more often in cervical canal than in the Douglas pouch. Ureaplasma urealyticum was more common pathogen than Mycoplasma hominis in both groups and locations. The achieved results point out that the role of genital mycoplasmas in human infertility is still unclear and require further investigations.
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PMID:[Frequency of detection of Ureaplasma urealyticum and Mycoplasma hominis in cervical canal and the Douglas pouch of infertile and fertile women]. 1792 14

This study was conducted to evaluate the presence of bacterial vaginosis (BV) and its association with cervical tumour necrosis factor alpha (TNF-alpha) and interferon gamma (IFN-gamma) levels in idiopathic infertility. Forty idiopathic infertile women and twenty fertile controls were recruited from the Department of Obstetrics and Gynaecology, El Shatby Maternity Hospital, Alexandria. High vaginal swabs were smeared and assessed by Gram staining for the presence of BV using Nugent's scoring system. Cervical mucus samples were collected at midcycle and assayed for IFN-gamma and TNF-alpha by enzyme linked immunosorbent assay (ELISA). Bacterial vaginosis was identified in 25% (10/40) of the infertile group and in 10% (2/20) of controls. The mean concentrations of TNF-alpha (232.2 +/- 51.6 pg/ml) and IFN-gamma (127 +/- 26.8 pg/ml) were significantly higher in the infertile group compared with controls (P < 0.001). Infertile women with BV showed significantly higher cervical levels of TNF-alpha (649 +/- 126.8 pg/ml) and IFN-gamma (350 +/- 59.2 pg/ml) than those with normal (62.2 +/- 8.1, 31.4 +/- 4.1 pg/ml respectively) and intermediate (252.5 +/- 21.4, 170 +/- 17.3 pg/ml respectively) vaginal flora (P < 0.001). A significant correlation was found between TNF-alpha and IFN-gamma concentrations in the idiopathic infertile group (r = 0.984, P < 0.001) as well as the fertile control group (r = 0.881, P < 0.001). In conclusion, BV is associated with elevated cervical mucus levels of TNF-alpha and IFN-gamma. The induction of these proinflammatory cytokines by an altered vaginal ecosystem may play a role in the etiology of idiopathic infertility. This may have potential applications in the diagnosis and treatment of female infertility.
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PMID:Association of abnormal vaginal flora with increased cervical tumour necrosis factor--alpha and interferon--gamma levels in idiopathic infertility. 1797 10

Increase in vaginal secretion pH is an indicator of bacterial vaginosis (BV), but is yet to be in use as a diagnostic tool by clinicians. Similarly, no reports are available on the effect of cervical chlamydia infection and different reproductive manifestations on vaginal secretion pH. This study evaluated the use of vaginal pH for screening of BV, the effect of Chlamydia trachomatis (C. trachomatis) infection, and different reproductive manifestations on vaginal pH of women attending the gynecology outpatient department of a general hospital. Vaginal pH was recorded while diagnosing infections in 358 women, among which 45 were with repeated spontaneous abortion, 79 with infertility, 185 had sign and symptoms of lower genital tract infection, and 49 had no history or symptom of any complications or infections. Normal vaginal pH, BV, and C. trachomatis infection were observed in 72.6, 21.5, and 10.1% of women, respectively. BV and C. trachomatis were observed in 78.6 and 4.1% of women, respectively, with high vaginal pH; 12.3% of women with normal vaginal pH had C. trachomatis infection. C. trachomatis infection or different reproductive manifestations do not lead to change in vaginal pH but high vaginal pH correlated with BV and should be used as a simple tool for its diagnosis.
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PMID:Use of vaginal pH in diagnosis of infections and its association with reproductive manifestations. 1880 73

Bacterial vaginosis (BV) is a common disorder of the genital tract in women characterized by an alteration of the normal acidic lactobacilli-predominant vaginal ecosystem to a vaginal environment dominated by Gardnerella vaginalis, mycoplasma species and anaerobes, with an increase in pH. The present study evaluated whether BV is associated with reproductive complications in women. BV was screened with a Gram stain of vaginal smear and interpretation was done using the Nugent score. Wet mount and polymerase chain reaction were used to screen other infections. Among 510 enrolled women, 72 (14.1%) had BV. Statistical analysis between the BV negative and positive population revealed a significant association (P = 0.0001) with infertility. In pregnant women, the infection rate was low (P = 0.01). Multiple infections such as Candida, Chlamydia and human papilloma virus were observed in 4.2%, 15.3% and 8.3% of BV-infected women, respectively. Results suggest that BV infection is associated with infertility and its absence leads to pregnancy, emphasizing its screening and treatment.
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PMID:Bacterial vaginosis: a cause of infertility? 1983 94


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