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Biomedical subjects

J Donnez

Publications and source records attributed to J Donnez.

At least 145 records · Page 8Linked to original sources
PubMed1987

[Unruptured luteinized follicle syndrome and experimental endometriosis in the female rabbit].

To study the effect of endometriosis on follicular rupture, endometrial tissue was autografted to New Zealand White rabbits. Endometrium was surgically implanted into the peritoneal cavity. Human chorionic gonadotropin was administered to induce ovulation. The viability of the implants was demonstrated histologically during three subsequent laparotomies, the number of corpora lutea and stigmata were counted. Ovaries were then removed and ovarian serial sections were examined. In rabbits with peritoneal induced endometriosis, the percentage of stigmata per corpora lutea was significantly decreased. Macroscopic study was confirmed by histological examination. Indeed, a high incidence of entrapped oocytes was found in rabbits with peritoneal endometriosis. Our data demonstrated that endometriosis induced a failure of follicular rupture.

Animals↗
PubMed1986

Prognostic factors of fimbrial microsurgery.

From January 1978 to December 1983, 600 infertile women underwent microsurgery for tubal infertility. Only 257 women with the same extent of distal lesions on both sides or with unilateral occlusion (after contralateral salpingectomy) were considered. Patients were classified in four subgroups on the basis of the extent of occlusion. After fimbrioplasty for occlusion of degree I and salpingostomy for occlusion of degree II, the term pregnancy rate was more than 50%. After salpingostomy for occlusion of degrees III and IV, the term pregnancy rate was, respectively, 25% and 22%. The ectopic pregnancy rate was the highest (12%) after salpingostomy for occlusion of degree IV. After microsurgical salpingolysis, the term pregnancy rate reached 64%, whereas the ectopic pregnancy rate was as low as 2%. Ampullary dilatation, as determined by hysterosalpingography and laparoscopy, influences the postoperative pregnancy rate. Fimbrial microbiopsies were taken, and the ciliated cell percentage was obtained. Results suggest that the ciliation index is a valuable method of prognosis of tubal surgery. In conclusion, the pregnancy rate after distal surgery is related to the tubal morphologic findings: ampullary dilatation, fimbrial ciliated cell percentage, and tubal wall thickness.

Fallopian Tubes↗
PubMed1986

Prognostic factors influencing the pregnancy rate after microsurgical cornual anastomosis.

Eighty-two women with symmetric cornual blockage were selected for evaluation of the results of microsurgical anastomosis in relation to data from preoperative hysterosalpingography and histologic study of excised tubal specimens. Serial sections from 164 occluded tubal portions were examined. The term pregnancy rate was 44%. Several prognostic factors influencing the postoperative pregnancy rate were revealed: maximized tubal length; preserved intramural portion; absence of chronic inflammation; absence of tubal inclusion in the tubal wall; and absence of tubal endometriosis.

Fallopian Tube Diseases↗
PubMed1986

Loss of adrenergic innervation in induced rabbit hydrosalpinx.

Ligation of the proximal and distal ends of the rabbit oviducts was used to induce hydrosalpinges. The adrenergic innervation of the induced hydrosalpinx was studied. Depletion of adrenergic innervation in rabbit hydrosalpinges was found. Our findings suggest that not only mucosal changes, but also loss of adrenergic nerves must be taken into account as factors in the pathology of hydrosalpinx.

Animals↗
PubMed1986

[Microsurgery of distal tubal lesions. Analysis of 270 operated cases].

Between 1978 and 1983, more than 600 microsurgical tubal operations were performed. Only 270 women with the same extent of distal tubal lesions on both sides or with unilateral tubal occlusion after heterolateral salpingectomy were considered in this study. The authors propose a classification of distal tubal lesions in order to analyze the results of microsurgery. After fimbrioplasty, salpingolysis and salpingostomy for distal occlusion without ampullary dilatation, the term pregnancies rate is more than 50%. The pregnancy rate after salpingostomy for hydrosalpinx is 25%. The prognosis after microsurgery for distal tubal lesions is related to ciliated cells percentage. The prognosis of microsurgical salpingostomy for thick-walled hydrosalpinx is poor. In these cases, in vitro fertilization should be the treatment of preference. In conclusion, the ampullary diameter and the fimbrial ciliated cells percentage are prognostic factors of distal tubal microsurgery.

Constriction, Pathologic↗
PubMed1986

[Morphological modifications in experimental hydrosalpinx].

Hydrosalpinges were mechanically induced in rabbits by ligation of the proximal and distal ends of the oviduct. Isthmic and ampullary biopsies were obtained at 2, 4 and 6 months after ligation. Deciliation and decrease of epithelial height were observed in the ampulla, but not in the isthmus. Microstereological study shows a decrease of both the number and the relative volume of capillaries in the ampullary muscularis. Considering the parallelism of time and localization between deciliation and reduction of vascularization, we suggest that epithelial deciliation is caused by vascular disorders. Our study shows also adrenergic denervation occurring in the muscularis.

Animals↗
PubMed1985

Cyclic changes in ciliation, cell height, and mitotic activity in human tubal epithelium during reproductive life.

The percentage of ciliated cells, the height, and the mitotic index of human oviductal epithelium were studied during the menstrual cycle and under progestogens. A total of 141 fallopian tubes were examined. During the menstrual cycle, a process of ciliation and deciliation was observed. Maximal ciliation was attained around the time of ovulation, particularly in the fimbria where significant differences were noted. Deciliation was observed under progestogen therapy, but this progestogen effect was easily reversible. The decrease of epithelial height observed after ovulation was also found after progestogen therapy. Cyclic mitotic activity was noted during the menstrual cycle. Estrogens influence the mitotic activity of tubal epithelium, whereas endogenous progesterone and progestogens inhibit this estrogenic effect.

Cell Cycle↗
PubMed1985

Ovulation instantaneously modifies women's peritoneal fluid characteristics: a demonstration from an in vitro fertilization program.

Concentrations of P and E2 were measured in serum and PF obtained from 34 laparoscopies performed in 18 patients for oocyte retrieval in an in vitro fertilization program. Samples from group A (28 patients who had not ovulated at laparoscopy) and group B (6 patients who had ovulated very shortly before laparoscopy) were compared. No difference was observed in serum steroid levels between the two groups; however, group B showed a 100-times increase in E2 concentration and a 200-times increase in P concentration measured in the PF. In conclusion, we can postulate that this sudden and large increase in PF steroids after ovulation is initially solely dependent on the mechanic rupture of the follicle and not on its luteinization.

Ascitic Fluid↗
PubMed1984

Fimbrial ciliated cells percentage and epithelial height during and after salpingitis.

Microbiopsies of 191 fimbriae were obtained from 146 patients undergoing laparotomy for acute salpingitis, or tubal surgery after salpingitis. The biopsies were classified in four groups according to the diagnosis at laparotomy: salpingitis, distal occlusion, peritubal adhesions or tuberculosis. The biopsies belonging to the group of distal occlusion were further classified in four sub-groups according to the extent of the lesions observed during the hysterosalpingography and laparoscopy. Since the crucial role of the ciliated epithelium in the ovum transport has been established, the percentage of ciliated cells and the epithelial height were determined in the groups and compared to those observed in fimbriae obtained from fertile women during an ovulatory cycle. Significant differences were noted in all groups when compared to fertile women. Acute salpingitis provoked a rapid and severe deciliation which recovered 3 months after triantibiotherapy. In the groups of distal occlusion, there was a significant correlation between the rate of deciliation and the extent of lesions. This suggests that deciliation of tubal epithelium is a sequela of salpingitis and that the extent of disease allows a prognosis of the percentage of ciliated cells.

Biopsy↗
PubMed1984

Tubal polyps, epithelial inclusions, and endometriosis after tubal sterilization.

Histologic findings in 133 previously ligated fallopian tubes of women who underwent subsequent hysterectomy and bilateral salpingectomy were compared with those of 50 normal fallopian tubes and related to four surgical procedures for sterilization. Dilatation of proximal tubal lumen, flattening of the folds, polyps, and increase of mitotic activity of the epithelium was subsequent to tubal occlusion in any case, regardless of the type of sterilization. After sterilization by ring, ligation, and coagulation, the incidence of epithelial inclusions was significantly different from that observed after sterilization by clips. Focal endometriosis was only found after tubal ligation and coagulation. It is suggested that epithelial inclusions were the result of surviving fragments of tubal epithelium translocated in the tubal wall during the procedure, and that endometriosis was caused by implantation of expelled menstrual products through the open lumen into the healed ligation area.

Endometriosis↗
PubMed1984

Immunoreactive relaxin surge in the peritoneal fluid of women during the midluteal phase.

Relaxin was assayed in the peritoneal fluid (PF) of 176 women with normal ovulatory cycles. Validation of the assay in this fluid was carefully established. Relaxin was rarely detected before day 20 of the cycle. From days 21 to 24, all samples contained detectable concentrations of the peptide, ranging between 75 and 775 pg/ml. Apparition of relaxin in the PF was not directly related to the ovulatory follicular rupture. It was also delayed, compared with the postovulatory rise of plasma and peritoneal progesterone. Relaxin is thus present in the PF only during the period propitious to human embryo implantation.

Body Fluids↗
PubMed1983

Changes in ciliation and cell height in human tubal epithelium in the fertile and post-fertile years.

A total of 162 fallopian tubes was obtained from a sample of subjects comprising fertile women with regular ovulatory cycles, post-menopausal women taking no hormonal drugs and post-menopausal women receiving oestrogen therapy in various forms. During the menstrual cycle the highest percentage of ciliated cells was found, in all of the three tubal portions studied, around ovulation time. The epithelial height decreased significantly subsequent to ovulation. After more than 1 yr had elapsed following the menopause, the percentage of ciliated cells and epithelial height decreased significantly. Very low values were observed in women 10 yr after the menopause. In women receiving oestrogen therapy for more than 10 yr following the onset of menopause - conjugated equine oestrogens (CEE), 1.25 mg/day - the percentage of ciliated cells was significantly higher than that in subjects not receiving hormonal therapy. Similar data were obtained in the case of women taking oestriol (2 mg/day). The data presented demonstrate that oestrogen therapy influences the ciliation and height of oviductal epithelium.

Cell Count↗
PubMed1983

Peritoneal fluid volume, 17beta-estradiol and progesterone concentrations in women with endometriosis and/or luteinized unruptured follicle syndrome.

Data on the presence of an ovulation ostium and the volume and the concentrations of estradiol (17 beta-estradiol) and progesterone In women with endometriosis (n = 80) and women with luteinized unruptured follicle (LUF) syndrome (n = 32) are reported and compared with data obtained from normal ovulatory women, previously reported. in women with endometriosis, less ovulation ostia were observed, the difference being significant in moderate and severe endometriosis. During the luteal phase, no statistical difference was found in the amount of peritoneal fluid of women with endometriosis. Estradiol and progesterone levels in the peritoneal fluid of normal women and women with mild endometriosis were not significantly different. Lower steroid concentrations found in peritoneal fluid of women with moderate (phase days 20-22) and severe endometriosis (phase days 14-19 and 20-22) may explain the high incidence of infertility reported in these women (peritoneal steroids deficiency). During the phases days 14-19 and 20-22, very low peritoneal steroid concentrations were found in women with LUF syndrome. It is suggested that progesterone assay in peritoneal fluid is an aid to diagnose the luteinized unruptured syndrome.

Adult↗
PubMed1983

[Etiologic factors in tubal sterility].

Between the years 1977 and 1982, laparoscopy was performed on 900 patients where the diagnosis of infertility was made in our department. In the patients' histories events which were considered relevant to subsequent tubal pathology were studied in detail. These potential risk factors were further analyzed and related to the finding of tubal pathology at the time of diagnostic laparoscopy. Patients with moderate or severe endometriosis were excluded from this study, because the high incidence of tubal adhesions in these women rendered it impossible to analyse the relationship between potential risk factors in the patients' histories and the incidence of tubal infertility. The incidence of tubal disease in patients with only one risk factor was compared to patients with no such factors in their history. The incidence of tubal pathology was significantly higher in all categories except the group who had undergone only uncomplicated appendicectomy. Highly significant differences were found after salpingitis, ovarian cystectomy or wedge resection and "complicated" appendicitis. The risk of a low-grade salpingitis was increased after induced abortion and IUD usage. The incidence of tubal pathology (33.7%) in patients without risk factors lends support to the assumption that salpingitis can occur without obvious clinical symptoms and appears to justify laparoscopy and use of antibiotic treatment if salpingitis is suspected in young women, even though clinical symptoms are absent.

Adult↗
PubMed1982

Incidence of pathological factors not revealed by hysterosalpingography but disclosed by laparoscopy in 500 infertile women.

Hysterosalpingography and laparoscopy were performed in 500 infertile women. Results obtained by both techniques were compared. Taking into consideration only the tubal patency, the present study shows an agreement in 90% of cases. In total of 980 fallopian tubes examined, fimbrial conglutination was suspected in 79 tubes (8%) and diagnosed by laparoscopy in 154 tubes (15.7%). Peritubal adhesions with tubal patency are a frequent pathology (23.8%) and hysterosalpingography alone permits the diagnosis in only 68.8% of the cases confirmed by laparoscopy. Other additional findings by laparoscopy are frequent: endometriosis was found in 124 women. Isolated periovarian adhesions were disclosed in 48 women. The high incidence of unsuspected pathology is an additional support in favor of laparoscopy in each case of infertility.

Adult↗
PubMed1982

Incidence of the luteinized unruptured follicle syndrome in fertile women and in women with endometriosis.

One-hundred normal fertile women with normal luteal phase and 118 women with endometriosis underwent luteal phase laparoscopy before day 22. The luteal phase was ascertained by the presence of secretory endometrium and serum progesterone levels higher than 3 ng/ml. The ovaries were carefully inspected for the presence or absence of an ovulation ostium. The percentage of ostii that was observed in fertile women (91%) was similar to that observed in women with mild endometriosis (85%). However, in women with moderate and severe endometriosis, significantly less ostii were noted, respectively 72 and 51%. It is therefore argued that the absence of an ovulation ostium (so-called luteinized unruptured follicle syndrome, LUF) is more frequent in women with moderate and severe endometriosis and may contribute to infertility in this group of women.

Adult↗