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 11,717 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

A 21-year-old male is described with camptodactyly, skeletal changes, ptosis and infertility, which suggests a novel malformation syndrome distinct from other camptodactyly syndromes.
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PMID:Camptodactyly, skeletal changes, ptosis and infertility in a male: a new syndrome? 1166 8

Blepharophimosis/ptosis/epicanthus inversus syndrome (BPES) is an autosomal dominant disorder that is characterized by distinctive eyelid abnormalities. Two clinical subtypes have been described in which type I, but not type II, is associated with premature ovarian failure. Both types of BPES are linked to 3q22-23, and the gene has recently been identified as the putative forkhead transcription factor FOXL2. We report mutation screening of FOXL2 in two families with this condition. The two mutations detected were frameshift mutations resulting from a small insertion or duplication within the gene. Both mutations would result in the production of novel carboxyl terminii, one terminating the predicted protein earlier than the wild type, and the other giving rise to a larger protein product, assuming these proteins or their mRNA were not degraded. Based on the present data, this would suggest that the first family should be type I and the second, type II. Although there is evidence of infertility in the first family, all 3 females in the youngest generation have normal pelvic ultrasound and hormone levels, suggesting that the divide between types I and II may not be as distinct as has been suggested.
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PMID:Two families with blepharophimosis/ptosis/epicanthus inversus syndrome have mutations in the putative forkhead transcription factor FOXL2. 1196 May 81

The reproductive organs of 20 Estonian Holstein Breed (EHF) cows and three heifers, culled because of infertility, were studied by palpation per rectum and ultrasonography. In addition, pathoanatomical and pathohistological studies were carried out after slaughtering. The pathohistological study revealed that small cysts often (12 animals) existed in culled cows, whose diameter was less than 2.5 cm. These cysts were frequently accompanied by changes in secondary and Graafi follicles, rete ovarii, ovarian stroma, and the endometrium. Three cows had follicular cysts in the ovaries, which were 25-35 mm in diameter. Two cows revealed luteal cysts in the ovaries; one of them had vaginal prolapse. Four animals (one heifer and three cows) manifested tumours or tumour-like malformations: ovarian endosalpingiosis, germ and stromal cell tumour, oviductal myolipoma, and haemangiosarcoma in the uterine blood vessels. One heifer had been culled because of two abscesses in the vaginal wall close to the cervix and another had chronic endometritis. The research findings indicate that the most common cause of infertility in the culled cows was cystic degeneration in ovaries (85%), accompanied by pathological changes elsewhere in the reproductive organs. We claim that these changes are responsible for the low pregnancy rate after the treatment of ovarian cysts. The second most common reason was genital tumours (15%). In heifers, infertility is rare and its causes are heterogeneous.
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PMID:Pathological changes in the reproductive organs of cows and heifers culled because of infertility. 1244 Jul 92

This pilot study is the first to identify female genital schistosomiasis (FGS) in an Egyptian community setting. The year-long interdisciplinary study, in a small hamlet (ezba), combined clinical assessment with an in-depth study of the social context of reproductive health. Schistosoma haematobium ova were found in 16.7% of women in the study (21/126). Half of the women who agreed to a full gynecological examination (43 of 86) had evidence of reproductive morbidity due to schistosomiasis, either schistosome eggs in the cervix or sandy patches, tissue changes in the reproductive tract. Other reproductive tract morbidities included infections (vaginitis 40%, chronic cervicitis 75%, pelvic inflammation 9%) and prolapse (54%). FGS was associated with dysparunia, abnormal vaginal discharge, vaginal or cervical polyps, contact bleeding, vulval itching and chronic cervicitis. Community members recognized S. haematobium as a health problem, but did not believe that it affected reproductive health. Indeed, they had little awareness of reproductive health and the possible impact of reproductive morbity on women's arduous daily tasks. There was no discussion of any reproductive health issues (except infertility) between women or between spouses. The study identified a number of factors that would affect the identification and treatment of FGS, and reproductive health care in general; (1) the neglect of women's health: (2) misconceptions about reproductive health and family planning; and (3) limited access to, and use of formal health care. The paper ends with a brief discussion of the significance of our findings about FGS, strategies to increase awareness of FGS, and the need for future research.
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PMID:The social context of reproductive health in an Egyptian hamlet: a pilot study to identify female genital schistosomiasis. 1465 48

A translocation breakpoint 171 kb 5' of the transcription start of FOXL2 causes blepharophimosis/ptosis/epicanthus inversus syndrome (BPES) and associated premature ovarian failure. The breakpoint falls within another gene, MRPS22, that has been sequenced in 500 kb of continuous DNA. MRPS22 encodes 20 exons and a number of alternative transcripts. Three CpG islands (>91% identical) are followed by noncoding exons 4-12 and coding exons 13-20. The 3'UTR extends into the 3'UTR of COPB2. Based on the sequence, three reported translocations that cause BPES all fall within intron 6 of MRPS22. Comparisons reveal conserved segments in introns 6, 11, and 12 of human and mouse. Notably intron 11 sequence is also deleted in goat PIS syndrome (which combines craniofacial defects, female infertility, and XX sex reversal). The conserved sequences are candidates for models in which they are distant enhancers or otherwise affect higher order chromatin structure to impose long-range cis regulation of FOXL2 expression.
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PMID:FOXL2 inactivation by a translocation 171 kb away: analysis of 500 kb of chromosome 3 for candidate long-range regulatory sequences. 1508 Nov 6

In a Slovene patient with primary amenorrhoea without an association with blepharophimosis/ptosis/epicanthus inversus syndrome (BPES), a novel 30 bp deletion was identified in the FOXL2 gene. We report the clinical features of this woman who has spontaneously conceived and delivered two live healthy babies. The novel deletion was predicted to remove 10 out of 14 alanines (A221_A230del), from the polyalanine tract downstream of the winged helix/forkhead domain of the FOXL2 protein. The patient's parents and sister were shown not to carry this deletion. Despite seeing an anovulatory secretory pattern of FSH, follicles developed spontaneously. Persistent and consistent monitoring have practical implications for genetic and fertility counselling in the era when women with premature ovarian failure usually seek ovum donation. The role of FOXL2 in the development of infertility is still unclear, but several lines of evidence suggest that it plays a central role in follicle development.
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PMID:A novel 30 bp deletion in the FOXL2 gene in a phenotypically normal woman with primary amenorrhoea: case report. 1545 70

A 30 year old nulligravidfemale attended gynaecological OPD for investigation of primary infertility. Local examination revealed presence of a dark pigmented area in the posterior lip of the cervix. The biopsy from cervix showed, squamous metaplasia of the lining epithelium with presence of granules of melanin pigment in the basal layer. Schmorl's stain for melanin and immunohistochemical staining for S-100 and HMB-45 showed strong positivity in these cells. Melanosis of the uterine cervix is usually an incidental finding in females with uterine prolapse in their fifth and sixth decade. The origin of melanin containing cells in the uterine cervix is debatable till date. Amongst the various possibilities for the origin of these cells in the uterine cervix, neural origin is probably more acceptable than epithelial cell origin. The combined expression of melanocytic and Schwanian markers in the index case, suggest a biphasic differentiation of melanin containing cells in the uterine cervix. Although the exact histogenesis and clinical significance of these are still unknown, a long term follow-up is needed to study the nature of these lesions to look for any precursor lesion for development of malignant melanoma.
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PMID:Melanin containing cells of the uterine cervix and a possible histogenesis--a case report. 1547 Nov 17

Reproductive health is not merely an absence of disease or disorder, rather it is a condition in which reproductive process is accomplished in a state of complete physical, mental and social well being according to WHO. Reproductive morbidity encompasses obstetric morbidity including conditions during pregnancy, delivery and the post-partum period; and gynecological morbidity including conditions of the reproductive tract such as reproductive-tract infections, cervical cell changes, genital prolapse, malignancies and infertility. The first step towards achieving the needs of women as consumers and providers is to do baseline research so that the nature and magnitude of the problem is assessed. Bajhang is one of the poorest, most deprived and remotest districts in the Far Western development region of Nepal. The status of all women is very low and their situation is very difficult. This study was conducted during a gynecological camp for a period of six days from 10th-15th March, 2003, in the district hospital of Bajhang at Chainpur. All women who attended the gynecological camp were included in the study. The 6 days period, total 530 women had attended the camp. Among them 273 (51.5%) had gynecological problems. Uterovaginal prolapse was the leading morbidity found in 97 women (18.3%) followed by subfertility (14.2%) and reproductive tract infections(13.9%). Only 22.0% women were using family planning methods. This study shows that a large number of women are seeking help for gynecological problems, hence emphasizing the importance of research in this area. Such studies have a pronounced impact in settings where no information on gynaecological morbidities exists and where there is an absence of consensus on the extent of such morbidity. This study not only gives us a baseline data about the most prevalent gynaecological problems in the remote area, it may help us in planning future reproductive health programs also.
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PMID:An overview of reproductive health of women in Bajhang district. 1651 75

Foxl2 is a forkhead transcription factor essential for proper reproductive function in females. Human patients carrying mutations in the FOXL2 gene display blepharophimosis/ptosis/epicanthus inversus syndrome (BPES), an autosomal dominant disease associated with eyelid defects and premature ovarian failure in females. Recently, animal models for BPES have been developed that in combination with a catalogue of human FOXL2 mutations provide further insight into its molecular function. Mice homozygous mutant for Foxl2 display craniofacial malformations and female infertility. The analysis of the murine phenotype has revealed that Foxl2 is required for granulosa cell function. These ovarian somatic cells surround and nourish the oocyte and play an important role in follicle formation and activation. Mutations upstream of FOXL2 in humans, not affecting the coding sequence itself, have also been shown to cause BPES, which points to the existence of a distant regulatory element necessary for proper gene expression. The same regulatory sequences may be deleted in the goat polled intersex syndrome (PIS), in which FoxL2 expression is severely reduced. Sequence comparison of FoxL2 from several vertebrate species has shown that it is a highly conserved gene involved in ovary development. Thus, the detailed understanding of Foxl2 function and regulation and the identification of its transcriptional targets may open new avenues for the treatment of female infertility in the future.
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PMID:Foxl2 function in ovarian development. 1664 86


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