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

Seventy-four patients with either endocrine and/or infertility problems were subjected to laparoscopic ovarian biopsy. The patients were divided into 4 categories: those with primary amenorrhea, secondary amenorrhea, ovarian androgenic hyperfunction, and infertility. The results were critically examined to evaluate the procedure in the investigation and treatment of each of these disorders. It was concluded that laparoscopic ovarian biopsy is most helpful in primary amenorrhea but justified in secondary amenorrhea only if a histologic diagnosis of premature ovarian failure is though to be essential. Patients with ovarian androgenic hyperplasia should not be candidates for the procedure as the laparoscopic appearance of the ovaries offered equally valuable information and the hazards of biopsy in this particular group of patients outweighed its diagnostic and therapeutic usefulness. The ovarian biopsy offered very little benefit for the infertility patients.
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PMID:Assessment of the role of laparoscopic ovarian biopsy. 13 12

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 luteinizing hormone/follicle-stimulating hormone-releasing hormone (LH/FSH-RH) test was performed in 70 women with amenorrhoea or anovulatory infertility, or both, and a clomiphene stimulation test was also performed in 24 of these patients. Most patients responded to LH/FSH-RH with significant increases in LH and FSH. In women with gonadal dysgenesis or premature ovarian failure exaggerated responses were observed after LH/FSH-RH and there was no change in high basal LH levels after clomiphene. Patients with absent or impaired responses to LH/FSH-RH failed to respond to clomiphene. All patients with anovulatory menstrual cycles responded to both LH/FSH-RH and clomiphene, while seven out of 13 amenorrhoeic patients with a normal LH/FSH-RH response showed an early LH rise during clomiphene treatment and six were unresponsive. These results suggest a difference between the two groups at hypothalamic level with consequent therapeutic implications.
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PMID:Use of clomiphene and luteinizing hormone/follicle stimulating hormone-releasing hormone in investigation of ovulatory failure. 109 37

A genetic analysis is necessary to gain a greater understanding of the complex developmental processes in mammals. Toward this end, an insertional transgenic mouse mutant has been isolated that results in abnormal germ-cell development. This recessive mutation manifests as infertility in both males and females and is specific for the reproductive organs, since all other tissues examined were histologically normal. A developmental analysis of the gonadal tissues demonstrated that the germ cells were specifically depleted as early as day 11.5 of embryonic development, while the various somatic cells were apparently unaffected. Therefore, the mutated locus must play a critical role in the migration/proliferation of primordial germ cells to the genital ridges of developing embryos. In addition, females homozygous for the mutation could potentially be a valuable animal model of a human syndrome, premature ovarian failure. This mutation has been named germ-cell deficient, gcd.
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PMID:Germ-cell deficient (gcd), an insertional mutation manifested as infertility in transgenic mice. 192 40

Oocyte donation has come of age. It is now an integral part in the management of infertility, providing hope to patients who were previously considered permanently infertile. The procedure is no longer used only to treat patients with premature ovarian failure, but also to treat patients with failed in vitro fertilization procedures and those patients who are carriers of genetic disorders. Recently, very encouraging results in the treatment of women above the age of 40 have been reported; the pregnancy rate of those below and above the age of 40 is almost identical, providing clear evidence that the endometrium retains its ability to nurture developing embryos despite advancing age. The future of oocyte donation will probably lie in the ability to mature pre-antral immature oocytes obtained from ovaries removed during standard surgical procedures and fertilizing them in vitro.
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PMID:Ovum donation. 195 1

Infertility resulting from premature ovarian failure in two independent patients was treated using a combination of steroid replacement, oocyte donation and gamete intrafallopian transfer (GIFT). Following ovarian stimulation four oocytes were retrieved from a volunteer donor undergoing simultaneous laparoscopic sterilisation. Two oocytes were subsequently replaced into each recipient's fallopian tube together with capacitated sperm from their respective husbands. In one recipient (Turner's syndrome) an intrauterine sac with fetal heart present was observed by ultrasound six weeks post GIFT whereas in the second recipient (premature menopause) plasma beta-hCG reached a peak value of 954mIU/ml eighteen days after GIFT before decreasing rapidly in the absence of ultrasound evidence of pregnancy. Intramuscular administration of progesterone appeared to be necessary during the post-GIFT period for maintenance of pregnancy. The above treatment was carried out on a predominantly out-patient basis in a small assisted conception unit based in a teaching hospital.
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PMID:Clinical and biochemical pregnancy in two respective recipients without ovarian function following gamete intrafallopian transfers using oocytes from a single donor. 223 89

Thirteen procedures of oocyte donation by the gamete intra-Fallopian transfer (GIFT) technique are described. The patients included six women with premature ovarian failure, four normally cycling women with unexplained infertility who responded poorly to super-ovulation induction in preparation for GIFT, and lastly one woman carrier of a 16/21 balanced translocation. Two patients had oocytes donated on two occasions. Oocyte donors were recruited either among the patients' relatives (n = 4), or among GIFT or IVF patients (n = 8), who altruistically donated their extra oocytes. Donors were superovulated and oocytes collected laparoscopically or vaginally under ultrasound guidance. Donors did not suffer any complications. Recipients were given exogenous estrogens, and exogenous progesterone was added from the day of donation. Seven clinical pregnancies were obtained (53.8% per attempt); one set of triplets aborted at 14 weeks. Donation took place on replacement day 12-18 and pregnancies were obtained in patients receiving oocytes throughout this temporal window. The increasing availability of embryo-freezing facilities will probably reduce the number of ova available for donation. Therefore, the patients' families may become a precious source of donated eggs, especially for those patients having large families, with strong family ties.
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PMID:Oocyte donation by gamete intra-fallopian transfer to amenorrhoeic and cycling patients given replacement steroids. 260 54

In vitro fertilization and embryo transfer or gamete (or zygote) intra-Fallopian transfer after ovum donation were performed in 16 patients with primary or secondary amenorrhea, associated with chromosome abnormalities. The patients showed the wide range of (mostly X) chromosome abnormalities characteristic for women with primary or premature ovarian failure. Four of these patients became pregnant and three of them have delivered healthy infants with a normal karyotype. This pregnancy rate is far superior to the accepted fertility figure in these patients. When these results were compared with the fertility treatment results of three other groups of women with absent ovarian function (1. ovarian dysgenesis; 2. surgical castration; 3. premature menopause) but with a normal 46,XX karyotype, no difference in treatment efficiency could be detected. These results offer a promising approach for the treatment of infertility in agonadal patients with chromosome aberrations.
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PMID:Chromosome studies and fertility treatment in women with ovarian failure. 276 72

Ten women with infertility, regular menses, and elevated plasma FSH concentrations after a failed in vitro fertilization attempt were studied throughout a spontaneous menstrual cycle. Plasma estradiol, progesterone, inhibin, LH, and FSH concentrations were measured by RIA on days 1, 8, 15, and 22 and compared with the ovarian steroid and gonadotropin profiles obtained from seven endocrine-normal women. The elevated FSH concentrations in the hypergonadotropic group were not associated with significant changes in E2 and P4, but an increase in LH concentrations was found on days 1, 8, and 22 (medians of 18 and 4, 17 and 6, and 7 and less than 3 U/L for the hypergonadotropic and normal groups, respectively; P less than 0.01). Their plasma inhibin concentrations [213, 242, 747, and 561 U/L (median values on days 1-7, 8-14, 15-21, and 22-28)] were normal. Autoantibodies to adrenal, thyroid, or ovary were present in five (50%) women, and antiovarian antibodies were present in 4. Two women gave a family history of thyroid disease, and one woman was hypothyroid. Repeat assessment 3-6 months revealed persistently elevated FSH concentrations in five (63%) of eight women; the other three had normal ovarian steroid and gonadotropin concentrations. The triad of infertility, regular menses, and elevated plasma FSH concentrations describes a group of women with occult ovarian failure, a condition of compensated granulosa cell function, which may be an early stage of premature ovarian failure. These women with occult ovarian failure had an impaired response to ovarian hyperstimulation and may be at increased risk of developing polyglandular autoimmunity.
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PMID:Occult ovarian failure: a syndrome of infertility, regular menses, and elevated follicle-stimulating hormone concentrations. 314 14

Antimitotic chemotherapy and radiation therapy can induce temporary or permanent infertility in men, transitory amenorrhea or premature ovarian failure in women, and genetic mutations responsible of foetal deaths or congenital malformations in the progeny. Alkylating agents and radiotherapy can provoke definitive male infertility and ovarian failure, but individual susceptibility seems quite variable. In man, return of spermatogenesis can still be observed more than 10 years after treatment and pregnancies are obtained with very low sperm counts. In women, the progressive depletion of the follicular pool explains the increasing frequency of ovarian failure, with lower doses of treatment. Antimitotic and immunosuppressive therapy can also induce irreversible lesions in children's gonads.
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PMID:[Fertility after antimitotic treatments]. 770 65


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