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PubMed1975

Current status of luteinizing hormone-releasing hormone in diagnosis and treatment of disorders in reproductive function.

The concept of the hypothalamic regulation of the function of the anterior pituitary was established by experiments involving the interruption of blood supply from the hypothalamus to the pituitary, transplantation of pituitary to sites away frm the hypothalamus and the effects of various lesion and electrical stimulation experiments with the hypothalamus. These experiments were the result of the concept proposed by Harris in 1937 that the pituitary gland may be controlled by the brain through substances carried to it by the portal vessels arising in the hypothalamus. The first direct evidence of the presence of a hypothalamic factor that could bring about the release of pituitary LH was provided independently in 1960 by McCann and co-workers and in 1961 by Harris and co-workers. The releasing factors and their physiological role was a subject of great interest, and porcine LH-RH was isolated by Schally et al. in 1971, followed by the isolation of ovine LH-RH by Guilleman and co-workers. The structure of the releasing factor has been established with no species differences between the ovine and porcine preparation and the decapeptide which has been synthesized. The use of LH-RH on various experimental animals has been done extensively, and evidence of the release of both LH and FSH has been obtained. In the absence of concrete evidence for a separate FSH-RH at this time, the above observation has led to the speculation that there is a single releasing factor that brings about the release of both FSH and LH. Both natural hormone from either ovine or porcine origin and the synthetic decapeptide have biological activity in the human. However, the rhesus monkey seems to be much less sensitive, and the question of a species difference has been raised. This subject has been reviewed in considerable detail by Schally and co-workers.

Adolescent↗
PubMed1994

[C-polymorphism of chromosomes in female reproductive system disorders].

Frequencies of extreme C segments of chromosomes 1, 9, and 16 were studied in patients with isolated gonadotropin deficiency (I), gonadotropin resistant ovary (I), and polycystic ovarian disease (III). Increased chromosome 9 heterochromatin was revealed for all syndromes, and increased chromosome 1 heterochromatin was revealed for groups II and III. Identical changes in heterochromatic parts of chromosomes, linked with increased heterochromatin, probably suggest a lack of specificity for the syndromes studied.

Chromosomes, Human, Pair 1↗
PubMed1994

Disorders of reproduction.

Human reproduction is an exceedingly complex process susceptible to insult at many stages. The targets of reproductive injury include the male and female worker as well as the conceptus. Because research into the reproductive and developmental effects of occupational exposures is relatively new, there are significant gaps in our knowledge of specific agents, their mechanisms of action, and their adverse effects. At the same time, workers increasingly are turning to their primary health care providers with concerns about potential reproductive hazards. Evaluation of patients includes identifying occupational agents with suspected reproductive or developmental effects, defining exposure parameters, and making estimates of risk based on the best available data. Management includes patient counseling and intervention to decrease hazardous exposures through workplace controls or temporary job transfers and leaves. By taking an occupational history, identifying possible work-related problems, and making appropriate referrals, primary care physicians can have an important role in the diagnosis, treatment, and prevention of adverse reproductive outcomes.

Abortion, Spontaneous↗
PubMed2003

Is fertility declining in dairy cattle? A retrospective study in northeastern Spain.

The past few decades have seen a dramatic increase in infertility and reproductive disorders associated with a rising milk yield. Herein, we present a 10-year (from 1991 to 2000) retrospective survey of these factors using data from a reproductive management program performed on high-yielding dairy herds in north-east Spain. The data series included 12,711 lactations. The year was divided into warm and cool periods. Data were obtained from cows first inseminated or examined 45-70 days postpartum. The reproductive tract of each animal was examined by palpation per rectum within 43-48 days postpartum. Cows were then weekly examined until insemination or until postpartum Day 70. Cows with a corpus luteum were synchronized for estrus and timed AI. Cows showing natural estrus in the same period were also inseminated. All inseminations were pooled as a single group and inseminated cows were considered cyclic. Inactive ovaries and ovarian cysts were recorded as ovarian disorders. Incomplete uterine involution, endometritis and pyometra were grouped as uterine disorders. Overall cyclicity and pregnancy rates of all AI cows, and cyclicity and pregnancy rates corresponding to the warm period significantly decreased over the 10-year period, yet remained practically constant during the cool period. The incidence of inactive ovaries in the entire population and that corresponding only to cows examined during the warm period significantly increased with time but was similar during the cool period. Ovarian cysts were more frequent during the warm (12.3%) than during the cool (2.4%) period, though these proportions were maintained throughout the study. The incidence of uterine disorders significantly decreased with time and did not differ between cool and warm periods. Milk yield per cow and year increased from 7800 kg in 1991 to 10,200 kg in 2000. Regression analysis revealed that, for all cows and those inseminated or examined in the warm period respectively, each 1000 kg increase in average milk yield was related to decreases of 3.2 and 6% in pregnancy rate, 4.4 and 7.6% in cyclicity, and to increase of 4.6 and 8% in the incidence of inactive ovaries. The rate of uterine disorders decreased 1.1% regardless of season. Our overall results clearly reflect the increased infertility and incidence of reproductive disorders over the study period. This occurred simultaneous to increasing average milk yield. Nevertheless, under our study conditions, a cool environment appears to preserve fertility and reduce the risk of reproductive disorders irrespective of the milk yield. These findings prompt the need to improve management practices by attempting to reduce the effects of factors provoking stress.

Animals↗
PubMed1992

Reproductive functions in eating disorders.

This article reviews current knowledge about the effects of anorexia nervosa, bulimia nervosa and partial syndromes on ovulation, menstruation, sexuality, fertility, pregnancy and fetal-infant health. Eating disorders may result in failure to ovulate, oligomenorrhea, amenorrhea, reduced sex drive, infertility, hyperemesis gravidarum, low maternal weight gain in pregnancy, small babies for gestational date, low birth weight infants, increased neonatal morbidity and problems in infant feeding. The available information suggests that clinicians should inquire about nutritional intake, a history of eating disorders and weight reducing behaviours as part of the routine assessment of patients with the disorders of reproductive function listed above. If an eating disorder is discovered before conception, the woman should be encouraged to delay pregnancy until the eating disorder is treated and effectively under control. If the woman is pregnant, early diagnosis and treatment are essential to reduce maternal and fetal complications. The infants of eating-disordered women should be carefully followed to ensure adequate nutritional intake. Problems in reproductive function related to eating disorders offer rich opportunities for multispecialty collaboration in primary and secondary prevention programmes directed toward both mother and infant.

Anovulation↗
PubMed1990

Incidence and seasonality of reproductive disease conditions in small ruminants in Nsukka area, Nigeria.

Between 1978 and 1988 reproductive disorders were found at the University of Nigeria Veterinary Teaching Hospital in 99 (9.8%) and 8 (10.5%) of 1013 goat and 78 sheep patients, respectively. The major reproductive diseases diagnosed in goats were dystocia (49.5%), abortion (17.2%), milk fever (12.1%), and mastitis (10.1%). In sheep the main disorders were abortions (37.5%), pregnancy toxaemia (25%), and milk fever (25%). These and other reproductive disorders were generally higher in the dry season, except for dystocia and mastitis in goats. 66.7% of sheep abortions occurred in trypanosomiasis patients, 41.2% of sheep abortions were associated with small ruminant pest patients.

Abortion, Veterinary↗
PubMed2003

Interictal EEG discharges, reproductive hormones, and menstrual disorders in epilepsy.

We evaluated reproductive endocrine function in women with unilateral temporolimbic epilepsy and normal control subjects to assess the effects of epilepsy, epilepsy laterality, and antiepileptic drug use on the cerebral regulation of hormonal secretion. The findings indicate that reproductive endocrine function differs between women with epilepsy and normal control subjects. Significant differences exist at all levels of the reproductive neuroendocrine axis, that is, hypothalamus, pituitary, and peripheral gland. Differences show significant relationships to the epilepsy itself as well as to medication use. Reproductive neuroendocrine changes occur in a stochastic manner such that the laterality of unilateral temporolimbic discharges is associated with predictable directional changes in hormonal secretion at all levels of the reproductive neuroendocrine axis. These directional changes are consistent with the finding that different reproductive disorders may develop in relation to left- and right-sided temporolimbic epilepsy. Hormonal changes can show close temporal relationship to the occurrence of interictal epileptiform discharges and may vary in relation to the laterality of the discharges. Antiepileptic drugs differ in their effects on reproductive hormone levels. There are notable differences between enzyme-inducing and noninducing drugs. Menstrual disorders are more common among women with interictal discharges as well as women with abnormal hormonal findings.

Adolescent↗
PubMed1998

Descriptive epidemiological study on culling and deaths in eight dairy herds.

OBJECTIVES: To describe the production and reproduction characteristics of the population under investigation and to compare them with the target population of non-seasonally calving dairy herds, to describe the pattern of culling with respect to length of productive life and length of time after calving, and to identify stages of the production cycle that are associated with increased risk of culling from the dairy herd. DESIGN: A longitudinal population study of eight non-seasonally calving dairy herds in the Camden district of New South Wales. RESULTS: The production and reproduction characteristics of this population were broadly similar to herds participating in the New South Wales Agriculture Dairy Herd Improvement scheme. In agreement with recent surveys, risk of culling increased with increased parity. This was accounted for specifically by increased risk of culling for calving disorders, reproductive tract lesions, and disorders of the udder. Risk of culling for failure to conceive appeared to remain constant throughout productive life. The overall risks for culling were greatest during the first 9 days after calving and 300 days after calving. CONCLUSION: Reducing the incidence of calving-associated disorders, attention to reproductive management and control of herd mastitis offer opportunities to reduce involuntary culling rates in this population.

Animals↗
PubMed2000

Lateral asymmetry in activation of hypothalamic neurons with unilateral amygdaloid seizures.

PURPOSE: Reproductive disorders are unusually frequent among women with temporal lobe seizures. The particular type of disorder may be related to the laterality and focality of epileptiform discharges. Here we examined whether unilateral amygdaloid seizures activate hypothalamic neurons involved in reproductive function and reproductive endocrine secretion in female rats and whether such activation shows lateral asymmetry. METHODS: Numbers of Fos-immunoreactive (Fos-ir) neurons in various hypothalamic regions were compared for three groups of animals: (a) unilateral amygdala-kindled, (b) implanted but unstimulated, and (c) unimplanted. RESULTS: Fos-ir neurons showed strong ipsilateral occurrence in the medial preoptic, ventrolateral part of the ventromedial, and ventral premammillary nuclei, sexually dimorphic regions involved in reproductive endocrine regulation. No significant lateral asymmetry was observed for other investigated hypothalamic regions. CONCLUSIONS: Unilateral amygdaloid seizures activate hypothalamic neurons that regulate reproductive endocrine secretion in a laterally asymmetric fashion. This may explain the clinical association of different reproductive endocrine disorders with left and right temporal epileptiform discharges.

Amygdala↗
PubMed1998

Guidelines for the care of women with epilepsy.

Antiepileptic drug (AED) selection in women of reproductive age should consider efficacy, tolerability, interactions with contraceptive medications, and teratogenicity. Women planning a pregnancy should be counseled regarding the need for compliance with therapy and the risk for birth defects. All women with epilepsy who are of childbearing potential should receive folate supplementation. Vitamin K supplementation is recommended during the final month of pregnancy. Withdrawal of AED therapy in seizure-free women can be considered before conception. Women who require AED therapy should receive AED monotherapy rather than polytherapy when at all possible. Medication changes post conception do not significantly reduce the risk for major fetal malformations and may compromise seizure control. Breastfeeding is generally safe for women taking AEDs. Menstrual disorders, reproductive endocrine disorders, ovulatory dysfunction, and infertility appear to be relatively common in women with epilepsy.

Abnormalities, Drug-Induced↗
PubMed1998

Contraception in women with special medical needs.

Over 10% of women of reproductive age have experienced a serious chronic physical disorder. Reproductive health issues including contraception are frequently ignored in these individuals. Clinicians should have available current knowledge regarding interactions between contraception and these conditions.

Adolescent↗
PubMed2005

Bipolar disorder in women: reproductive events and treatment considerations.

OBJECTIVE: Bipolar disorders are prevalent in women. Women with bipolar disorder often present with different clinical features than men. Reproductive events and hormonal treatments may impact the course of bipolar disorder. Our main objectives are to i) assess the impact of reproductive events on the course of the disorder, and ii) to discuss the relationships between reproductive events and psychiatric treatments. METHOD: A literature search was conducted of MEDLINE journals from 1965 to present. Manual literature searches were also conducted. We review the presentation, clinical course, and treatment considerations of bipolar disorder in women, with emphasis on treatment considerations in the context of reproductive events. Treatment-related issues such as teratogenicity, breastfeeding, polycystic ovarian syndrome, weight gain and obesity, and medication interactions with oral contraceptives are reviewed. RESULTS: Women with bipolar disorder may be more vulnerable to mood episodes in the context of reproductive events, particularly postpartum. In women of reproductive age, mood stabilizers must be selected with teratogenic risks in mind, with the highest reported risks in pregnancy with valproate, and the greatest concern during breastfeeding with lithium use. In the areas of the perimenopause and polycycstic ovarian syndrome, more data are needed to advise treatment decisions. CONCLUSION: We urgently need further study in these areas to deliver care that is appropriate to women with bipolar disorder.

Anticonvulsants↗