Nonsurgical female sterilization: comparison of intrauterine application of quinacrine alone or in combination with ibuprofen.
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Adult↗
Biomedical subjects
L Randić
Publications and source records attributed to L Randić.
Chromosome studies in patients with defective reproductive success.
PROBLEM: The objective of this study was to evaluate the contribution of chromosomal anomalies to decreased fertility in humans. METHOD OF STUDY: In order to investigate the aetiology of infertility in our population and to assess the karyotype in a group of infertile couples and individuals with fertility problems, 782 persons (259 couples, 158 male and 106 female) with different clinical diagnoses of sterility and infertility were analysed cytogenetically. RESULTS: The overall frequency of major chromosomal aberration was 13.1% (103/783), which suggests that fertility or sterility problems in this population are due to chromosomal aberrations. Couples experiencing repeated spontaneous abortions, having malformed children or having sterility problems had chromosomal abnormalities in 18.0% (47/259 couples) of the population studied, and constituted chromosomal disorders occured in couples seeking IVF and ICSI with prevalence of 22.2% (8/38 couples), especially minor mosaicism of sex chromosomes in the female partners. The prevalence of chromosome abnormalities in infertile men was 17.7% (28/158), and in subfertile females, it was 26.4% (28/106). CONCLUSIONS: These results could indicate an increased tendency to miotic sex chromosome non-disjuction in humans.
Chromosome Aberrations↗
An immunohistochemical study of leucocytes in human endometrium, first and third trimester basal decidua.
An immunohistochemical quantitative study of leucocyte subpopulations on fresh human endometrium and on biopsy specimens of first and third trimester basal decidua in normal (uncomplicated) pregnancies was performed. The most prominent population in endometrial and decidual stroma of basal decidua are macrophages. B cells as well as gamma/delta T cell receptor positive cells were found occasionally, scattered throughout the endometrial/decidual stroma. CD3+ cells were present in a relatively small number in the endometrium as well as in the first trimester basal decidua, but their number was elevated (doubled) in the third trimester of pregnancy. CD2+ cells showed a slight increase in first trimester basal decidua when compared with both endometrium and third trimester basal decidua. Cells with positive NKH-1 marker (CD56+) showed a significant increase in the first trimester, while in the third trimester their number diminished drastically. CD56:CD3 cell ratio increased to more than five times in first trimester basal decidua, while in the third trimester basal decidua decreased drastically. The mentioned increase of CD56+ cells in the first trimester and that of CD3+ cells at term suggests that these cells could have some specific function(s). However, it still has to be established whether the described quantitative changes of decidual leucocytes in basal decidua during pregnancy are of any importance for the mechanism(s) for the fetal allograft protection.
Antigens, CD↗
Ectopic pregnancy among past IUD users.
The relationship between return to fertility and pregnancy outcome in women with IUD removal for planned pregnancy as well as the frequency of ectopic pregnancy among all former IUD users in comparison with the general population was studied. The cumulative conception rate in the group of women with IUD removal for planned pregnancy (n = 748) was 93.7% after 5 years, 93.4% being intrauterine and 0.3% ectopic. Rates of ectopic pregnancy in women with IUD removed for planned pregnancy were 2.7/1000 women, 3.6/1000 deliveries and 2.9/1000 pregnancies vs. 3.9, 13.4 and 5.6 in the general population. Only when the number of deliveries is used as denominator, have these differences reached statistical significance (P less than 0.05). Except for bleeding/pain and PID removals (6.0 vs. 3.9), in all other groups of former IUD users the incidence of ectopic pregnancy was also lower than in the control group. From the results of this study it was concluded that former IUD users are not at an increased risk for ectopic pregnancy.
Adolescent↗
Cells adherent to copper-bearing intrauterine contraceptive devices determined by monoclonal antibodies.
The presence of nucleated cells adherent to copper-bearing IUDs removed from successful IUD users, as well as from those IUD users with accidental pregnancy, was determined by a panel of monoclonal antibodies. A significant decrease in the percentage of CD3+ cells-mature T lymphocytes was found in the cell population adherent to IUDs removed from pregnant compared to non-pregnant uteri (43 +/- 2.6 vs 34 +/- 1.5). Among these cells, the percentage of CD4+ cells was increased (from 22.9 +/- 1.9 to 30.4 +/- 2.0), and CD8+ was decreased (from 23 +/- 0.9 to 10.8 +/- 1.2). The percentage of HLA-DR+ cells was also decreased (from 24.3 +/- 1.7 to 16.7 +/- 1.8). B4+ cells (B lymphocytes) were present in a similar percentage on IUDs removed from pregnant as well as from non-pregnant uteri. Thus, the uterine cavity in the presence of an IUD, contains a consistent population of immunologically competent cells. The question still remains, whether the change in the number of nucleated cells present in the uterine cavity with an IUD could contribute to its antifertility effect.
Adhesiveness↗
[Ability to conceive after intentional interruption of intrauterine contraception].
Out of 3415 first insertions, the intrauterine contraceptive device was removed in 152 women (4.45%) owing to planned pregnancy. Nineteen cases dropped out of evidence, so that 133 remained for further analysis. Out of these 133 women, 120 (90.23%) became pregnant, the reamining 13 (9.77%) did not. In the first three months following the removal of the intrauterine contraceptive device, 77 women 57.89% conceived, 3--6 months after the removal 22 (16.54%), 6--12 months 18 (13.53%), and after one year 3 women (2.26%) were recorded pregnant. The ability to conceive is analysed according to the age of the women surveyed, the length of the use of intrauterine contraceptive devices, and the number of previous births and abortions. It is concluded that the use of intrauterine contraception has no influence on the later ability and speed of conception and that, for this reason, this contraception method could be considered fully reversible.
Abortion, Induced↗
[Pregnancy and delivery of young primiparas].
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Adolescent↗
Copper content in cervical mucus of women wearing plain and copper-bearing spring coils.
To test the hypothesis that the copper in copper-bearing intrauterine devices (IUDs) and its reaction with cervical mucus constitute the agent in preventing conception, the copper content of 300 samples of cervical mucus, 150 each from women wearing plain Spring Coil IUDs and those wearing Spring Coils containing 500 mg of copper, was determined at 3, 6 and 12 months after IUD insertion. Stoner and Dasler's modified spectrophotometric micromethod (Clin Chem 10:845, 1964) was used to quantify the copper content of the cervical mucus. Analysis showed no significant change in the copper content of the cervical mucus of women wearing plain Spring Coils compared to that of women not wearing IUDs; however, the amount of copper in the cervical mucus of women wearing copper-bearing Spring Coils was 5--6 times greater at midcycle 3, 6 and 12 months after insertion. Thus, we conclude that there is an important biologic basis for assuming that copper-bearing Spring Coils can inhibit sperm penetration through the cervical mucus and that they can initiate contraceptive activity at the cervical level.
Adult↗
[Family planning].
According to the fact that a great majority of women have expressed their wish to have only two children, two main questions have arised: what are the means that women use to limit their family size and what are the acceptable measures which the society can undertake to avoid further decline of crude birth rate in order to attain a stable population. Except for Kosovo and Macedonia, namely, in all other parts of Yugoslavia depopulating trends are present. Adequate data about contraceptive prevalence are not available, and according to some partial data, even among the women wanting no additional children, the percent of those planning no use of contraception is as high as 17.3 and further 21.2% are planning to rely on less effective contraceptive methods. The result of this situation is a relatively high number of induced abortions in Croatia 1989: 43227 or 77.7 per 100 live births). To improve this unfavourable situation, medical profession has to promote a wider use of contraception in general, particularly with more effective methods. Unfavoured decline of crude birth rate could be corrected, however, only through complex activities of long duration in order to achieve thorough improvement of the standard of living. With these improved living conditions more women would, most probably, want to have more than two children, thus avoiding the present depopulating trends in some parts of the country. On the other hand, any restriction of legal rights and availability of fertility regulation methods would be fully anachronistic and therefore unacceptable, since the only predictable result would be the increase of illegal abortions with all the well-known health risks and life-threatening conditions.
Contraception↗
[Fetal death in the 20th to the 36th week of pregnancy].
In the period from 1986 to 1988, intrauterine fetal deaths from 20-36 weeks of gestation and 500 gm and more birth weight were analysed in a prospective study from the clinical and pathomorphological point of view. There were 57 such fetal deaths or 7.96% of the total number of 716 births till the 36th week of gestation, while 42.4% of women with the intrauterine fetal loss were cigarette smokers during pregnancy vs. 29.1% of such women among all those who gave birth during the same period. Smokers faced a relative risk of 1.8 for the fetal loss between the 20th and the 36th week of gestation. From the clinical standpoint, the cause of death was presumed in 40 or 71.4% of cases, while only in 24 or 42.1% of autopsies could the pathomorphological disorder be considered the cause of the intrauterine death. In 47 or 82.5% of cases, the observed pathomorphological disorders of the placenta, fetal membranes or the umbilical cord could also have contributed to the fetal death. Most often, i.e. in 20 or 35.1% of cases, chorioamnionitis was diagnosed and in 13 (22.3%) cases disorders of the placental circulation. In 7 cases (12.3%) neither clinical nor pathomorphological potential cause of death could be found. From the health care point of view it is important to find out those risk factors of fetal mortality which are preventable. Smoking during pregnancy could be the most preventable risk factor of fetal death.
Adult↗
[Health risks in intrauterine contraception].
From 1968 till 1987, 8514 first insertions of different IUDs were performed; 7315 IUD users were regularly followed-up. In 4269 cases non-medicated and in 3046 cases medicated IUDs were inserted. All women were classified according to age, parity and the number of previous abortions. In the women analysed only one cervical perforation was found 3 months after the insertion of TCu 380 Ag (secondary perforation). In the group of non-medicated IUD users till the cut off date (February 29, 1988) 377 (8.8%) pregnancies were registered of which 10 were ectopic; at the same time there were 104 (2.4%) cases of PID. In the group of medicated IUD users 160 (5.3%) pregnancies with 11 ectopic and 90 (3.0%) cases of PID were observed. According to the age of users, in the group of women in their teens pregnancies appeared more often than in the older users, independent of the type of the IUD used. This difference was statistically significant (p less than 0.05). The highest percent age of PID was registered in mulliparous medicated IUD users: the difference in the PID appearance in nulliparous and multiparous medicated IUD users has also shown a statistical significance. Gross cumulative rates after 10 years of use fo non-medicated IUDs were 12.5 for pregnancy and 4.6 for PID, and after 15 years 14.6 and 6.2, respectively. For medicated IUDs after 10 years of use these rates were 9.4 for pregnancy and 8.3 for PID.
Female↗
[Advantages and disadvantages of IUD insertion immediately after abortion].
In 672 women the interval insertion of intrauterine contraception devices (IUD) was applied: Lippes loop D in 138 women. In 530 women the insertion was applied immediately after artificial abortion: Lippes loop C in 390 and Lippes loop D in 140 cases. Data on the effectiveness of intrauterine contraception were biostatistically treated. One- and two-year gross cumulative rates of pregnancy were 4.4 and 6.4, respectively 3.7 and 6.3 for the interval insertion of Lippes loop C and D, and 2.1 and 4.5, respectively 4.2 and 11.2 for the postabortion insertion of the same devices. Two-year cumulative rates of spontaneous expulsions of 18.5 and 8.1 for interval insertions were significantly higher than in the group of women in whom the insertion of the same devices was performed immediately after abortion and in whom these rates were 11.1 and 5.9. The removal of intrauterine contraception devices because of bleeding and pain, or because of both, with the rates of 6.4 and 3.2 in 100 women after a two-year use, was less frequent in the group of women in whom interval insertion was performed than in the group of postabortion insertions with the corresponding rates of 7.3 and 9.9, respectively. To prevent repeated abortions, a frequent use of postabortion IUD insertion is recommended. Only when an intensified bleeding is expected, it is advisable to postpone insertion at least until the first menstruation.
Abortion, Induced↗
[Fertility capability after the discontinuing use of various methods of fertility control].
The author draws attention to difficulties in assessing the degree of fertility after the use of various contraception methods, because prior to their application the women's initial fertility is not exactly examined. He gives a critical review of the experience reported so far on fertility after the interruption of hormonal and intrauterine contraception, sterilization, and artificial abortions. His conclusions is that none of the temporary contraception methods represents a considerable risk relating to future fertility if in each woman contraindications for their use are strictly obeyed.
Abortion, Induced↗
[Comparison of the effectiveness of metal and flexible plastic cannulas in abortion by vacuum aspiration].
A total of 300 abortions were performed--150 with each kind of cannula, selected at random. Except for the cannula, all other elements of abortion were the same and did not change during the whole study. The characteristics of women undergoing abortion did not differ either. The occurrence of complications in women having undergone abortion by the use of metal or the use of flexible plastic cannulas did not differ significantly, the duration of the procedure was the same, but the amount of the tissue exceeding 10 g which was obtained by the subsequent exploration of the uterus was significantly higher with the use of metal than with the use of flexible plastic cannulas. Also the metal cannula got obstructed in the course of the procedure significantly more frequently. The authors conclude that everything considered, the flexible plastic cannula is somewhat more efficacious than the metal one when used for the interruption of pregnancy up to the tenth week of gestation.
Abortion, Induced↗