The EPF activity of 67 sera, obtained during the 6th to 9th week of pregnancy, was determined using the rosette inhibition test. The sera of uncomplicated pregnancies (n = 9) and of women with habitual abortions who came to delivery during the most recent pregnancy (n = 10) contained the highest EPF activity during the 6th week of gestation. When pregnancies ended in another abortion (n = 10) the EPF was never detected, or disappeared at least 1-2 weeks before abortion. In the absence of EPF activity the relative risk of abortion was 7.6 (first determination) or 20.0 (second determination 1 week later). In comparison, the risk was lower when the more commonly used pregnancy parameters (HCG 4.4 (5.7), estradiol 2.6 (4.9), or progesterone (2.7 (2.7)) were depressed. Our results suggest that the EPF determination has high prognostic value in patients with high risk pregnancies and in pregnancies which follow treatment for sterility.

Abortion, Habitual↗

PubMedDate not supplied

Impact of heavy metals on hormonal and immunological factors in women with repeated miscarriages.

In 111 women with repeated miscarriages, the urinary excretion of heavy metals was determined in a challenge test with the chelating agent 2,3-dimercaptopropane-1-sulphonic acid in addition to hormonal, chromosomal, immunological and uterine investigations. The heavy metal excretion was correlated to different immunological (natural killer cells, T cell subpopulations) and hormonal (progesterone, oestradiol, prolactin, thyroid stimulating hormone) parameters. We conclude that heavy metals seem to have a negative impact on ovarian as well as on pituitary function. The heavy metal-induced immunological changes may interfere with the physiological adaptation of the immune system to the state of pregnancy with the result of a miscarriage. The observed heavy metal-induced hormonal and immunological changes may be important factors in the pathogenesis of repeated miscarriages.

Abortion, Habitual↗

PubMedDate not supplied

Routine hormone load tests are unnecessary in infertile men.

A sample of 225 men examined at the Infertility Service Unit of this hospital had spermiograms, standardized in accordance with WHO guide lines, and a hormone stimulation test with injection of gonadotropin releasing hormone, thyrotropin releasing hormone, and ACTH. The serum concentrations of the following hormones were assessed: follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, oestradiol (E), thyroid stimulating hormone, cortisol, 21-desoxycortisol, 17-hydroxypregnenolone, 17-hydroxyprogesterone, dehydroepiandrosterone, dehydroepiandrosteronesulphate, androstenedione, testosterone (T), and dihydrotestosterone. The results of the spermiograms were found to be related to the concentrations of the following hormones: FSH, LH, T, and E. Thyroid and adrenal function in men without signs of endocrinological diseases failed to influence spermatic parameters.

Adrenocorticotropic Hormone↗

PubMedDate not supplied

Hormone load tests in infertile male patients.

The recognition that discreet hormonal abnormalities may cause ovulation disorders in women suggested that the male partner of infertile women might also suffer from unrecognized hormonal dysfunction amendable to substitution therapy. We obtained a combined stimulation test with gonadotropin-releasing hormone (GnRH), thyreotropin-releasing hormone (TRH), and ACTH in 225 males with childless spouses, when the couple sought to have children for at least one year. The following hormone levels were determined: estradiol (E), thyroid-stimulating hormone (TSH), prolactin, testosterone (T), dihydrotestosterone (DHT), androstenedione(A), 17-OH-pregnenolone (17-OH-Preg), 17-OH-progesterone (17-OHP), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), cortisone (F), and 21-desoxycortisone (21DF). Basal and stimulated, and adrenal-testicular steroids with and without ACTH stimulation failed to demonstrate a relevant relationship to semen parameters. Gonadotropin levels had a significant negative correlation to all important semen parameters (testicular volume, sperm count, motility, morphology, and vitality) and were positively correlated to spermiogenetic defects. Stimulated LH values were more clearly associated with spermiogenetic defects than basal LH. Nonetheless, basal FSH concentrations were more informative than LH. Stimulated prolactin values were positively correlated with both gonadotropin and with sperm morphology. E concentrations had a significant positive correlation with both basal and poststimulation DHEAS values, and showed a highly negative correlation with sperm count, morphology, and vitality. In comparison, good sperm parameters were associated with high poststimulation T concentrations. The results of this study suggest that basal FSH and E concentrations, as well as the stimulated LH, T, and prolactin determinations, should be included in the evaluation of male sterility.

Adrenal Cortex Hormones↗

PubMedDate not supplied

Influence of serum prolactin on semen characteristics and sperm function.

The role of serum prolactin (sPRL) in male infertility is still unclear. For assessing the clinical significance of prolactin determination during infertility investigation, serum samples of 204 males attending the Infertility Clinic of Heidelberg were examined during a 1-year period. None of the patients exhibited galactorrhoea or complained of impotence. Results were correlated with age, duration of infertility, sperm count, motility, morphology, viability, and other parameters of routine sperm analysis and postcoital testing (PCT). Additionally, in vitro sperm penetration testing (SCMPT) in cervical mucus of partners and donors was performed as an important measure of functional sperm capacity. The subsequent pregnancy rate was determined after 6 months. Prolactin levels ranged from 1.4 to 24.7 ng/mL, with a median of 5 ng/mL. Only one patient had prolactin levels out of the normal range (greater than 20 ng/mL). No significant correlation of sPRL concentration was found with results of semen analysis, PCT outcome, or SCMPT. The functional sperm capacity was better in the groups of patients with sPRL above the median level (P less than .005). No significant difference in pregnancy rate was found between the high (greater than 5 ng/mL) and low (less than or equal to 5 ng/mL) prolactin groups; these were 20% and 26%, respectively. The results suggest that routine screening of asymptomatic male patients during infertility investigation for sPRL concentration is not helpful for assessing fertility prognosis. Prolactin should be preferentially determined in patients with clinical symptoms of hyperprolactinemia to exclude pituitary adenoma.

Adult↗

PubMedDate not supplied

[Tocolytic treatment with fenoterol. I. Prospective study of the effect of tocolysis on the condition of the newborn infant and early childhood development up to 4 years of age].

From 1976 to 1979 a prospective study was run at the Women's Hospital of Heidelberg in which every women was registered who attended the hospital before the 20th week of pregnancy. After delivery the infants' development was followed up to four years. During this time 404 women received fenoterol and 74 of them had premature deliveries. While 20% of the women were primarily treated with fenoterol before the 20th week of pregnancy (threatened abortion, cerclage), 80% received the drug in the 2nd and 3rd trimester (premature contractions, abnormal fetal heart rate pattern, premature opening of the external os etc.). Risk factors and early childhood development were compared with 465 women seen in the same time who had never needed fenoterol. The data of the patients' history, the course of pregnancy, and the state of the newborn, revealed that the risk of premature delivery in spite of tocolytic treatment was highest in young women, women with low bodyweight, women with a history of miscarriages, women with threatened abortion and women with anaemia during pregnancy. In correspondence with prematurity, the development of these children was delayed. The same factors of risk were demonstrated in women with successful tocolytic treatment and delivery after the 37th week of pregnancy, although their neonates were in a markedly better state. Early childhood development in this group did not differ from that in the group of women with deliveries after the 37th week and without tocolytic treatment.

Birth Weight↗

PubMedDate not supplied

Relationship of sperm acrosin activity to semen and clinical parameters in infertile patients.

Acrosin activity (aa) was routinely measured in 189 infertile men who attended the hospital between March 1984 and January 1985. The evaluation of the male included semen analysis, microbial screening, postcoital testing (PCT), in vitro sperm penetration test (SPMT), and screening for anti-sperm antibodies in serum. The strongest positive correlations of aa were found for sperm motility, count, morphology, vitality and volume. In presence of a poor PCT result, aa was significantly reduced, even in patients with good motility in native semen. A similar result was obtained with the SPMT: reduced sperm density and poor sperm motility in the capillary after 2 hours were significantly correlated to reduced aa. Smokers exhibited lower aa in presence of normal sperm count and motility. In the infertile group aa was significantly lower than in the group of men whose spouses conceived. On the basis of our results, the routine determination of aa is not necessary, but it provides additional prognostic information in couples with unexplained infertility.

Acrosin↗

PubMedDate not supplied

[Control of uterine contractions with fenoterol. II. Significance of the beginning, duration and manner of therapy for the status of the newborn infant and early childhood development up to 4 years of age].

From 1976 to 1979, 404 pregnant women were treated with the tocolytic agent Fenoterol. The data of pregnancy, delivery and the children's development up to four years of age were computerized and correlated to the duration, beginning date and type of treatment. Compared to long lasting tocolytic treatment, delivery was significantly earlier after short term treatment, resulting in acompromined development of the infants. Early start of treatment and long lasting application, mainly the case in high risk pregnancies, postponed the delivery and induced normal development of the children. When the intravenous route was necessary the state of the newborn and the post partum development were less satisfactory than after oral medication, the latter developing without complications. Based on our results, late damages of Fenoterol on developmental parameters up to four years of children's age appear to be non existent.

Administration, Oral↗