Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infertility is a health-care problem which has very definite physiological, psychological and social implications. Infertile couples are continually reminded of their plight--the structure of society is based on the family unit; simple activities such as shopping are a constant reminder, the shops being geared to the family; the neighbours fill their cars with all the paraphernalia which accompanies children--the stigma of infertility often leads to mental disharmony, marital difficulties, divorce, and in some cultures to ostracism. The suffering experienced by infertile people is very real. We need to remind ourselves that we are treating 'people who are infertile' rather than 'infertility'. Our care goes beyond their physical treatment--their stresses and strains are our concern and we must be careful not to add additional stress to their existing problems. Successful treatment can transform their lives: 'They are bright, healthy, beautiful children--a dream come true. Our lives are transformed and complete. Thank you a million times.' Failure after years of trying is all the more painful. The availability of effective, informed, independent and involved counselling is essential.
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PMID:Counselling, care in infertility: the ethic of care. 220 11

104 laparoscopy were performed in infertile women. Apart from the routine evaluation of organs of pelvis small the particular attention was drown to the presence of stigma on the surface of corpus luteum. The sigma was present in 41 cases (39.42%). It was shown that the presence of the stigma allows to recognize the examined infertile women as on ovulating one. It was also stated that the evaluation of the presence of the stigma is an important method in diagnosis of ovulation, particularly in the so-called unexplained infertility.
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PMID:[Laparoscopy in the differential diagnosis of causes of female infertility. I. Significance of the presence of ovulation stigma]. 252 74

It is probable that one or several conditions may exist in which the oocyte is not released at the expected time of ovulation but where the follicle luteinizes around it. This cannot be demonstrated with the usual criteria for ovulation. A diphasic temperature curve, normal increase in progesterone and secretory development in the endometrium are observed. The reason for this phenomenon is not known but it may be induced experimentally by intake of prostaglandin-synthesis-inhibitors. It is difficult to determine with certainty in the individual case whether the egg has been released. The presence of an ovulation opening, a stigma which may be seen on the follicle by laparoscopy, marked increase in the concentration of progesterone and 17-beta-oestradiol in the peritoneal fluid and ultrasound demonstration of a collapsed follicle are good indicies. Defective release of the egg cell probably occurs periodically in cycli in normal fertile women but the condition appears to be more frequent in infertile women with endometriosis, with changes after pelvic inflammation and with "unexplained" infertility. As definite criteria for the condition are not available, no convincing investigations of the frequency are available and no controlled investigations of therapeutic method exist. Gametic intrafallopian transfer and in vitro fertilization and embryo transfer have been proposed as therapeutic measures.
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PMID:[The LUF syndrome. A possible cause of unexplained infertility]. 278 55

To evaluate the role of ultrasound in diagnosing luteinized unruptured follicle (LUF), 37 women with unexplained infertility were examined for two to three menstrual cycles. Laparoscopy or laparotomy was performed on days 16 to 18 of the third study cycle in 25 patients. The LUF syndrome was suspected at ultrasound examination in 57 of 100 cycles observed. In the remaining 43 cycles, follicular collapse was observed in 33, and 10 were diagnosed as anovulatory. At laparoscopy or laparotomy on 25 patients, 18 of the 21 patients diagnosed as having LUF by ultrasound had a corpus luteum without a stigma. The other three cases diagnosed as LUF by ultrasound had ovulation stigmata. Additional findings in the 25 patients who underwent laparotomy or laparoscopy were endometriosis in 7 (5 of whom had LUF as well), ovulation in 5, bilateral hydrosalpinx in 1, and inability to visualize the ovaries because of adhesions in 1. The LUF syndrome was not a consistent change in the ovulatory pattern of most of the patients. It occurred by ultrasound diagnosis in three consecutive cycles in only 34% of patients.
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PMID:Diagnosis of luteinized unruptured follicle (LUF) syndrome by ultrasound. 622 25

The frequency of the luteinized unruptured follicle (LUF) was determined in a population of 220 regularly cycling women, infertile for at least two years. Laparoscopy was performed during the very first days of the luteal phase. In 26 women without other demonstrable cause of infertility, a diagnosis of LUF was made based on the absence of an ovulation stigma and the low concentrations of progesterone (P) and 17 beta-oestradiol (E2) in peritoneal fluid (PF). Twenty of these 26 women underwent a culdocentesis 72-96 hours after the serum LH-rise in a following cycle. In 19 out of 20, low P and E2 concentrations in PF were again found, suggesting the recurrence of LUF. Subsequently, ovulation was induced with human menopausal gonadotrophins (hMG) alone (n = 4), or in combination with human chorionic gonadotrophin (hCG, n = 9). At carefully timed culdocentesis (at LH/hCG + 72-96 hours), P concentration in PF was high in the hMG-hCG treated women but remained low in those given hMG alone. The combination of hMG and hCG may be a valuable treatment of LUF.
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PMID:Incidence, recurrence and treatment of the luteinized unruptured follicle syndrome. 623 40

To elucidate the etiology of infertility due to endometriosis, we autografted endometrial or adipose tissue to the pelvic peritoneum of 21 cynomolgus monkeys. These primates were divided into five groups: control animals with adipose tissue autografts (n = 5), animals with microscopic endometriosis (n = 5), animals with mild endometriosis (n = 5), animals with moderate endometriosis (n = 4), and animals with severe endometriosis (n = 2). During three subsequent menstrual cycles, each animal underwent (1) serial assay of peripheral serum gonadotropins and steroids; (2) mating timed according to daily serum 17 beta-estradiol; and (3) laparotomy to document an ovulatory stigma. The chemical and term pregnancy rates were lower among monkeys with moderate or severe endometriosis, as compared with control animals. The impaired fertility in monkeys with endometriosis appeared to be mediated primarily by failure of follicular rupture and/or pelvic adhesions.
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PMID:Etiology of infertility in monkeys with endometriosis: luteinized unruptured follicles, luteal phase defects, pelvic adhesions, and spontaneous abortions. 642 Jan 99

A series of 407 infertile patients underwent luteal phase laparoscopy and endometrial biopsy as a part of their infertility workup. In 91% of the patients, a good correlation between the results of endometrial biopsy and those of laparoscopy was found. In 8% of the patients a secretory endometrium was found, but the laparoscopy did not show any luteal structures on the ovaries. Seventy-one percent of the patients had corpora lutea, but the stigma was only present in 17.5% of the series with secretory endometrium. Because of the stigma findings, only 326 patients with secretory endometrium were evaluated. The stigma was more frequently seen when laparoscopy was performed between day 17 and day 19 of the cycle. On the other hand, the stigma was also more frequently seen when laparoscopy was performed between 10 and 12 days before the actual onset of the next period. We conclude that the frequency of stigmata at the corpus luteum is a matter of the time in the cycle when laparoscopy is performed, and the particular cycle length of the patient should be considered.
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PMID:The corpus luteum in infertile patients found during laparoscopy. 645 92

Peritoneal fluid and serum were collected from 78 patients at the time of laparoscopy. Twenty-two were fertile controls (CTL), and 56 were infertility patients, who were subdivided into three main groups: endometriosis (EMS), pelvic adhesions (ADH), and ovarian dysfunction (OvDF). Based on control group data, biochemical criteria indicative of the presence of a stigma, S(+), were established: (1) serum progesterone (P) greater than or equal to 2 ng/ml, (2) peritoneal fluid P greater than or equal to 50 ng/ml, and (3) peritoneal fluid/serum ratio of P greater than or equal to 3. Direct visualization by laparoscopy showed that 21% CTL, 75% EMS, 69% ADH, and 56% OvDF subjects had luteinized unruptured follicle (LUF) syndrome. Biochemical criteria, however, demonstrated only 7% CTL, 37% EMS, 23% ADH, and 56% OvDF subjects had LUF. Peritoneal fluid estradiol (E2) and P concentrations and total content were significantly lower in LUF than in non-LUF patients, whereas serum E2 and P concentrations were not different between the two groups. Values for testosterone and androstenedione in peritoneal fluid and serum were similar between these two groups. Endometrial dating in LUF versus non-LUF patients were also similar. The usual indicators of ovulation, i.e., serum P, endometrial dating, and basal body temperature, failed to identify LUF. The diagnosis of LUF can be best made by P assay of peritoneal fluid and serum.
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PMID:Peritoneal fluid and serum steroids in infertility patients. 654 Feb 10

The finding of more luteinized unruptured follicles in women who are under investigation for unexplained infertility compared with fertile women suggests that the syndrome does exist and probably plays a causative role in the infertility of these patients. The levels of oestradiol 17-beta and progesterone found in the peritoneum in the early luteal phase showed a much higher figure when there has been rupture of the follicle with a haemorrhagic corpus luteum and a stigma as compared with luteinized unruptured follicles. It does seem to us worth while to obtain some of the peritoneal fluid in order to estimate the levels of hormones and to diagnose more often the unruptured follicle syndrome whenever laparoscopy in undertaken in the early luteal phase.
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PMID:[The unruptured luteinized follicle. Determination of estradiol and progesterone in peritoneal fluid]. 666 98

The luteinized unruptured follicle syndrome is a frequent phenomenon, occurring in half of our women with regular cycles and infertility. Progesterone concentrations and 17 beta-oestradiol concentrations were assayed in peritoneal fluid of women during the luteal phase. Up to day 20 of the cycle, the concentrations were significantly higher in women with an ovulation stigma than in women without an ovulation stigma on their corpus luteum. The range of concentrations was sufficiently different in the early luteal phase to be used diagnostically, the only limitation being the presence of a cystic corpus luteum. We suggest that the assay of progesterone and 17 beta-oestradiol in peritoneal fluid should be done in all women with infertility and biphasic basal body temperature charts in order to diagnose the luteinized unruptured follicle syndrome.
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PMID:Diagnosis of the luteinized unruptured follicle syndrome by steroid hormone assays on peritoneal fluid. 743 65


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