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Comparison among different ovarian stimulation regimens for assisted procreation procedures in patients with endometriosis.

The objective of our study was to establish the most adequate ovarian stimulation regimen for assisted procreation in endometriotic patients. It consisted of a retrospective analysis comparing the use of the gonadotrophin-releasing hormone analogue (GnRHa) buserelin either for 3 months or for 3 weeks and continued with ovarian stimulation with human menopausal gonadotrophin (HMG), and the use of clomiphene citrate in association with HMG for in-vitro fertilization (IVF) and embryo transfer, gamete intra-Fallopian transfer (GIFT) and zygote intra-Fallopian transfer (ZIFT). A total of 145 patients with endometriosis in 174 cycles were divided into two groups according to the revised American Fertility Society staging of the disease (group A, stages 1 and 2; group B, stages 3 and 4). The use of GnRHa significantly increased the number of oocytes retrieved. GnRH analogues for 3 months gave the highest fertilization rate for groups A and B. The cleavage, pregnancy and delivery rates, although higher in the groups treated with analogues, did not reach statistical significance. A higher number of patients had an embryo transfer in the groups treated with GnRHa (P < 0.05). Treatment with GnRHa for either 3 months or for 3 weeks proved to be more efficient than clomiphene citrate-HMG for assisted procreation procedures in patients with endometriosis.

Adult↗

The origins of fatherhood: an ancient family process.

Despite appearances to the contrary (fostered by anthropocentric nursery stories), a distinct role for male parents does not exist in nature. Fatherhood was invented by humans during the agricultural revolution about six thousand years ago. Symbolized by the new god-king, it incorporated the mother's originally superior role in primate families--the control or ownership of children. The male deity could even make his own offspring without female help. This inflated political figure was designed to compensate for the male's modest role in procreation, once the facts of life were known. Patriarchy was born out of an envious attack on mothers.

Agriculture↗

Reproductive toxicity of occupational mercury. A review of the literature.

OBJECTIVES: This paper aims to give the dental practitioner insight into the potential reproductive effects of handling dental silver amalgam, c.q. mercury. DATA SOURCES: Experimental studies on animals, case reports and epidemiologic studies. STUDY SELECTION: Experimental animal studies show high doses/concentrations of mercury to increase the risk of reproductive disorders, e.g. infertility, spontaneous abortion, stillbirth and congenital malformations. Some case reports suggest an association between the disorders in humans and high levels of mercury. Therefore, the present article reviews epidemiological studies on the relationship between occupational exposure to mercury, mainly as vapour in the dental practice, and females' procreative ability. Studies concerning the reproductive effects of males' occupational mercury body burden are scarce. The reproductive risk of patients' mercury uptake from silver amalgam fillings is assessed. CONCLUSIONS: It seems warranted to conclude that negative reproductive effects from exposure to mercury in the dental office are unproven, but safe levels have not been established. Seemingly problems are unlikely to occur, unless a poor hygiene causes the mercury concentration in the air to exceed females' time-weighted long-term Threshold Limit Value (TLV). Consequently, in view of the in general low amounts of mercury stemming from dental amalgam fillings, the population at large is at even less risk than dental staff. The effects of occupational elemental mercury concentrations lower than the TLV on the menstrual cycle, conception, male fertility and children's behaviour need, however, more research.

Animals↗

Intermittent detection of hepatitis C virus (HCV) in semen from men with human immunodeficiency virus type 1 (HIV-1) and HCV.

HCV is usually transmitted via the blood, but HCV RNA has been detected recently in seminal fluid. This study was done to study HCV seminal shedding and factors that could influence the presence of HCV in the seminal fluid of men coinfected with HCV and HIV-1. HCV and HIV-1 genomes were assayed in multiple paired blood and semen samples obtained from 35 men enrolled in an assisted medical procreation protocol. HCV RNA was found intermittently in semen samples from 9 patients (25.7%). Samples from 9 men with HCV RNA in their semen and 26 men without were compared to further analyze these parameters. No correlation was found between HCV RNA in the seminal fluid and age, HCV virus load, the duration of HIV-1 infection, HIV treatment, the CD4(+) cell count, HIV-1 virus load or HIV-1 detection in the semen. The intermittent detection of HCV RNA in semen samples support the systematic search for HCV RNA in semen and the use of processed spermatozoa in assisted medical procreation of infertile HCV serodiscordant couples.

Adult↗

[Genetic screening in children].

Before giving a prescription on a genetic test, it is necessary to estimate if a real direct benefit exists for the children. This is right if the disease occurs during childhood and teenage and when the genetic status identified early may improve care, prevention and people accompaniment or if, on the contrary, knowing that the children has no risk to develop a disease will save him from a particularly restricted medical observation. At the opposite, letting him know his future may, for sure, cause him some trouble (disruption). The parents' distress and their hope for getting a negative test result should not be more important than the child's interest which has to prevail over his parents'. If the child has no risk to develop a genetic disease himself and if the risk concerns only his descendants, there is no reason for knowing his genetic status before he makes plans himself for his procreation.

Adolescent↗

[Genetic counselling. I. Definition and present status (author's transl)].

Genetic counselling is a medical action which must be carried out by a M.D. specialized in genetics. Genetic counselling is peculiar in that couples rather than individuals are involved. Furthermore it is not concerned with the health of the consultants but with that of their expected children. Genetic counselling is not restricted to the statistical estimation of a risk; it raises important problems of psychology and behaviour. Finally, eugenic considerations about the diffusion of deleterious genes should not be taken into account in genetic counselling, which is given in the interest of individuals, not of the society. The increasing demand for genetic counselling is due to the change of the reproductive pattern. People do not want only to fix the size of their family, but also to avoid any accident of procreation.

Family Planning Services↗

Daughter of Charity.

Members of religious orders, male and female, take the three vows of religion--poverty, chastity and obedience. To renounce one's rights to personal possessions, to sexual experience and family life and in determining one's own future may, on initial examination, appear somewhat negative. However, priests, brothers and nuns in religious orders, are encouraged to adopt a more positive attitude in taking the vows. By relinquishing their rights to personal property and to procreate, and by accepting God's will in the expressed desires of their religious superiors, they can be released from the responsibilities inherent in these areas of human activity and, provided there is a spirit of generosity, achieve a degree of freedom which would not be otherwise possible. For instance, if, at the request of her religious superior, a Sister is sent from one area of the country to another, she can do so immediately. There is no house to sell, no family members to consider and no concerns about whether it is the right place for her to be. This, in turn, leaves her free to undertake the work or activity for which she was sent, without guilt feelings for those left behind and for what might have been.

Christianity↗

[Changes of the German embryo protection law from a physician's point of view].

It is a legitimate question to ask of reproductive medicine, whether it does meet the actual nedds of the people involved. Although te conveying of information and counselling has been much improved, there are still deficiencies. Artificial insemination (for lesbian couples also) should be based on a solid juridical foundation to allow more appropriate counselling to be provided. As studies on parents and procreated children after egg donation have shown that there are no developmental abnormalities, it appears that the prohibition of oocyte donation is outdated. Preimplantation genetic diagnosis (PGD), human embryo selection and research on the human embryo will continue tobe issues that lead to controversy-laden ethical discussions. Ideas on the graded protection of human life might lay the foundation for a pragmatic consensus for further discussions.

Germany↗

[Laparoscopic myomectomy: preparation for procedure and operation technique].

Uterine leiomyomata are the commonest neoplasms of the female reproductive system in the procreative age. In these cases operation is still a treatment of choice. The procedure's range depends on: number, size and localisation of the myomas, patient's age and possession of children. Currently uterine leiomyomata are removed more frequent by endoscopic operations. We present the technique of laparoscopic myomectomy taking into consideration very important problem--patients' qualification this procedure. We pay attention to necessity of precise closing the wound in layers after removed myoma, which seems to prevent uterine rupture during pregnancy and labour. We also present some controversial aspects of using GnRH analogues. In summary we emphasise benefits of laparoscopic myomectomy particularly for women in the procreative age, who are planning pregnancy.

Antineoplastic Agents, Hormonal↗

[Radiotherapy for prevention of postoperative periarticular calcinosis. Using fractionated irradiation after total endoprosthesis of the hip joint].

According to the Literature, and confirmed by our own experience, fractionated postoperative radiation administered after total hip replacement can, with a high degree of reliability (13 out of 14 patients), prevent postoperative ossification. At least in the case of elderly patients beyond the age of procreation, it is superior to alternative therapeutic measures (biphosphonates, prostaglandin synthesis inhibitors).

Aged↗