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PubMed1984

Survey of reproductive hazards among oil, chemical, and atomic workers exposed to halogenated hydrocarbons.

Several halogenated hydrocarbons are suspected of causing adverse reproductive effects. Because of such concerns, the Oil, Chemical, and Atomic Workers International Union surveyed the reproductive histories of two groups of workers. One group worked at plants engaged in the production or use of halogenated hydrocarbons (exposed) whereas the others had no such opportunity for exposure (nonexposed). Although a low response rate precludes firm conclusions, the 1,280 completed questionnaires provide useful data for generating hypotheses in this developing field of interest. A history of diagnosed cancer was reported more frequently among exposed workers. The infant mortality rate was also significantly elevated among the offspring of exposed workers. No risk gradient was observed for episodes of infertility, fetal loss, congenital defects, or low-birthweight offspring. Concerns with nonresponse, exposure characterization, possible confounding factors, and limited statistical power are addressed. The results provide further suggestions which help to direct studies of occupational reproductive risks.

Abnormalities, Drug-Induced↗

PubMed2001

Metabolic disorders and breast cancer risk (United States).

OBJECTIVE: To clarify the hormonal context of breast cancer etiology we used data from a large, population-based case-control study to investigate the relationship between breast cancer risk and a history of diabetes mellitus, disorders associated with estrogen stimulation (uterine fibroids, endometriosis, gallstones), and disorders associated with androgen stimulation (acne, hirsutism, and polycystic ovaries). METHODS: Breast cancer patients between 50 and 75 years old were identified from state-wide tumor registries in Wisconsin, Massachusetts, and New Hampshire; controls were randomly selected from drivers' license lists (age less than 65) or Medicare enrollment files (age 65-74). Information on reproductive history, medical history, and personal habits was obtained by telephone interview. A total of 5659 cases and 5928 controls were interviewed and provided suitable data. RESULTS: There was no overall association between breast cancer risk and reported history of diabetes mellitus, endometriosis, uterine fibroids, gallstones, or cholecystectomy. However, the disorders with androgenic associations all conferred an increased risk: the overall odds ratio (OR) for a history of acne was 1.4 (95% CI 1.0-1.9), that for hirsutism was 1.2 (95% CI 0.81-1.8), and that for polycystic ovaries 1.6 (95% CI 0.8-3.2). Diabetes mellitus diagnosed before age 35 conferred an odds ratio of 0.52 (95% 0.25-1.1), while diabetes diagnosed at a later age was associated with an increased risk (OR = 1.2, 95% CI 1.0-1.4). CONCLUSIONS: Androgen-related phenomena are likely to be important in the etiology of breast cancer.

Aged↗

PubMed1998

Hysteroscopic septum resection in patients with recurrent abortions or infertility.

Fifty-seven patients who underwent hysteroscopic septum resection between January 1991 and December 1996 were studied; nine patients presented with recurrent abortions, 46 with infertility (26 primary and 20 secondary), one with dysmenorrhoea and one with an asymptomatic complete septum. Their reproductive history included 78 pregnancies: 69 (88.4%) abortions, two (2.6%) ectopics, two (2.6%) preterm deliveries and five (6.4%) term deliveries. In patients with infertility, the incidence of unexplained infertility was 19.6% and the incidence of endometriosis was 26.1%. After hysteroscopic septum resection, 42 patients were interested in pregnancy. All patients with recurrent abortions conceived spontaneously. Twenty-one (63.6%) infertile patients achieved a pregnancy, 13 (61.9%) of them after treatment with various assisted reproduction techniques. The reproductive outcome after septum resection yielded 44 pregnancies, including three sets of twins and one set of triplets reduced to twins: 11 (25%) abortions, one (2.3%) ectopic pregnancy, two (4.5%) preterm deliveries (both twins), 28 (63.7%) term deliveries and two (4.5%) as-yet ongoing pregnancies. It seems that the hysteroscopic treatment of uterine septum has a beneficial effect on pregnancy outcome. A septate uterus does not seem to be an infertility factor. The achievement of pregnancy is normal in patients with recurrent abortions, while the chances of conception in patients with infertility seem to be similar to those for the general infertile population.

Abortion, Habitual↗

PubMed2001

The risk for congenital heart defects in offspring of individuals with congenital heart defects.

BACKGROUND: Congenital heart defects (CHDs) occur in approximately 1% of all live births. Although most CHDs are of unknown etiology, a family history of CHDs is a known risk factor, and offspring of individuals with CHDs are at a higher risk of having CHDs. The aim of this study was to investigate the relative risk for CHDs to offspring of individuals with CHDs. METHODS: The prevalence rates of CHDs in offspring of 203 individuals with CHDs and 282 individuals without CHDs were investigated. The study participants completed a questionnaire that included information on medical and reproductive history, lifestyle indicators, and family history of CHDs and other congenital malformations. The prevalence rates of CHDs in offspring were calculated. RESULTS: The prevalence of CHDs was 3.1% (18/575) in offspring of individuals with CHDs and 1.3% (8/589) in offspring of individuals without CHDs. The adjusted odds ratio for CHDs to offspring of parents with CHDs was 1.73 (95% confidence interval [95% CI] 0.89-2.44, p=0.02). The estimated relative risk for offspring to females with CHD was higher than for males [2.3 (95% CI 1.1-4.7, p=0.03) versus 1.31 (95% CI 0.48-4.30, p=0.66), respectively]. There was no suggestion of association between CHDs and maternal smoking, alcohol consumption, and use of medication during pregnancy. CONCLUSIONS: Offspring of parents with CHDs are at a higher risk for CHDs compared with the general population. Couples where one member is affected with CHD should receive pre-conceptional or pre-natal genetic counseling and should be informed about the magnitude of the potential risk of CHDs to the offspring.

Family Health↗

PubMed1998

Reproductive dysfunction in women with Albright's hereditary osteodystrophy.

Most individuals with Albright's hereditary osteodystrophy (AHO) have deficient expression or function of G(s alpha), the alpha subunit of the guanine nucleotide binding protein that stimulates adenylyl cyclase, and are resistant to parathyroid hormone (PTH) and other hormones that act via stimulation of adenylyl cyclase. To determine the incidence and etiology of ovarian dysfunction in women with AHO, we examined the reproductive history and hypothalamic-pituitary-ovarian axis in 17 affected women aged 17-43 yr. All patients had typical PTH resistance and an approximately 50% reduction in erythrocyte G(s alpha) activity, (0.43 +/- 0.03 vs. 0.92 +/- 0.08 for normal control subjects, P < 0.001). Fourteen of the 17 patients (76%) were oligomenorrheic or amenorrheic, more than half had delayed or incomplete sexual development, and only two had a history of earlier pregnancy. Most women were mildly hypoestrogenic, with normal to slightly elevated serum gonadotropin levels. Computer analysis of 24 hour LH measurement showed that the frequency of LH peaks/24 h in AHO women varied widely, but as a group they were not statistically different from a group of normal women studied in the early follicular phase. Administration of 100 microg synthetic GnRH produced normal FSH and LH responses. We conclude that reproductive dysfunction is common in women with AHO and probably represents partial resistance to gonadotropins.

Adolescent↗

PubMed1991

Resocialization of a group of ex-laboratory chimpanzees, Pan troglodytes.

In order to determine if socially deprived chimpanzees could establish an integrated social unit and reproduce, a group of wild-born individuals from a single-cage laboratory environment were released onto a small island in a South Florida tourist park in 1975. The present study was undertaken during June and July of 1988 to evaluate the long term results of the experiment and to document the reproductive history of the chimpanzees since their release on the island. The evidence presented in this paper suggests that it is possible for laboratory chimpanzees to be resocialized and to reproduce successfully.

Agonistic Behavior↗

PubMed2000

A maternal vegetarian diet in pregnancy is associated with hypospadias. The ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood.

OBJECTIVE: To investigate the possible role of the maternal diet, particularly vegetarianism and consumption of phytoestrogens, in the origin of hypospadias, which is reported to be increasing in prevalence. SUBJECTS AND METHODS: Detailed information was obtained prospectively from mothers, including previous obstetric history, lifestyle and dietary practices, using structured self-completed questionnaires during pregnancy. Previously recognized associations with environmental and parental factors were examined, focusing particularly on the hypothesized hormonal link. Multivariate logistic regression was used to identify independent associations. RESULTS: Of 7928 boys born to mothers taking part in the Avon Longitudinal Study of Pregnancy and Childhood, 51 hypospadias cases were identified. There were no significant differences in the proportion of hypospadias cases among mothers who smoked, consumed alcohol or for any aspect of their previous reproductive history (including the number of previous pregnancies, number of miscarriages, use of the contraceptive pill, time to conception and age at menarche). Significant differences were detected for some aspects of the maternal diet, i.e. vegetarianism and iron supplementation in the first half of pregnancy. Mothers who were vegetarian in pregnancy had an adjusted odds ratio (OR) of 4.99 (95% confidence interval, CI, 2.10-11.88) of giving birth to a boy with hypospadias, compared with omnivores who did not supplement their diet with iron. Omnivores who supplemented their diet with iron had an adjusted OR of 2.07 (95% CI, 1.00-4.32). The only other statistically significant association for hypospadias was with influenza in the first 3 months of pregnancy (adjusted OR 3.19, 95% CI 1.50-6.78). CONCLUSION: As vegetarians have a greater exposure to phytoestrogens than do omnivores, these results support the possibility that phytoestrogens have a deleterious effect on the developing male reproductive system.

Diet, Vegetarian↗

PubMed1993

Reproductive factors and survival from ovarian cancer.

During a 29-year screening follow-up of 63,090 Norwegian women, 644 women were found to have an ovarian cancer with known metastatic status as their first malignancy. Of these women, 419 subsequently died of ovarian cancer. As reproductive factors, particularly parity, are risk factors for ovarian cancer, we investigated possible relationships between reproductive history and survival from ovarian cancer. Except for an improved survival in women with more than one abortion, no significant relationships were found.

Abortion, Spontaneous↗

PubMed1988

Personal and family history of lung disease as risk factors for adenocarcinoma of the lung.

To identify risk factors for adenocarcinoma of the lung, a population-based case-control study of 336 female cancers of this cell type and an equal number of neighborhood controls was conducted between 1983 and 1986. After adjusting for personal smoking, personal and family histories of lung disease emerged as additional risk factors. A personal history of any lung disease was associated with a 40% increase in risk [smoking adjusted relative risk (SARR) = 1.4, 95% confidence interval (CI) = 1.0, 2.0] with a more marked increase in risk for lung diseases occurring during childhood (SARR = 1.9, 95% CI = 1.2, 3.2) and for tuberculosis (SARR = 10.0, 95% CI = 1.1, 90.1). Family histories of tuberculosis (SARR = 2.0, 95% CI = 1.1, 3.6) and of lung cancer (SARR = 3.9, 95% CI = 2.0, 7.6) were also risk factors for adenocarcinoma of the lung. Increasing risk was observed with decreasing intake of dietary beta-carotene. After adjusting for personal smoking, women in the lowest quartile of intake showed a two-fold increased risk relative to those in the highest quartile of intake (P = 0.003). There were also some suggestive differences between cases and controls in their reproductive history and hormone use.

Adenocarcinoma↗

PubMedDate not supplied

International maternity care monitoring: results of a pretest.

This report gives the preliminary results of a pretest cosponsored by the International Fertility Research Program and the International Federation of Gynaecology and Obstetrics. It includes data on 33 116 deliveries in 20 maternity centers in Latin America, Europe, Africa and Asia. The findings are organized around four themes: (a) family formation and reproductive history, (b) family health, (c) management of this delivery and (d) desired family size and family planning practices.

Adult↗

PubMed2002

Menstrual and reproductive factors and risk of non-Hodgkin lymphoma: the Iowa women's health study (United States).

BACKGROUND: Endogenous sex hormones, particularly estrogens, modulate the immune system, and non-Hodgkin lymphoma (NHL) is a tumor that is related to immunologic status. METHODS: Self-reported menstrual and reproductive history and risk of NHL were evaluated in a cohort of 37,934 Iowa women who were aged 55-69 years when first enrolled in 1986. Through 1998, 261 cases of NHL were identified by linkage to the Iowa SEER Cancer Registry. RESULTS: After multivariate adjustment there was no association between NHL incidence and age at menarche, age at menopause, type of menopause, history of infertility, number of miscarriages, or history of induced abortion, while there were suggestive inverse associations with nulliparity (RR=0.65; 95% CI 0.36-1.16) and years of ovulation (RR = 0.76 for >37 compared to <28 ovulatory years: p-trend = 0.07). Among parous women there was no association with number of livebirths or age at first livebirth, but there was an inverse association with number of children who were breast-fed (RR=0.52 for breast-feeding >2 children versus none; 95% CI 0.33-0.82). CONCLUSIONS: Overall, menstrual and reproductive factors were not strongly related to NHL incidence. The inverse association with breast-feeding is novel but requires confirmation in other studies.

Abortion, Induced↗

PubMed2006

Evolutionary history of vegetative reproduction in Porpidia s.L. (Lichen-forming ascomycota).

The evolutionary history of gains and losses of vegetative reproductive propagules (soredia) in Porpidia s.l., a group of lichen-forming ascomycetes, was clarified using Bayesian Markov chain Monte Carlo (MCMC) approaches to monophyly tests and a combined MCMC and maximum likelihood approach to ancestral character state reconstructions. The MCMC framework provided confidence estimates for the reconstructions of relationships and ancestral character states, which formed the basis for tests of evolutionary hypotheses. Monophyly tests rejected all hypotheses that predicted any clustering of reproductive modes in extant taxa. In addition, a nearest-neighbor statistic could not reject the hypothesis that the vegetative reproductive mode is randomly distributed throughout the group. These results show that transitions between presence and absence of the vegetative reproductive mode within Porpidia s.l. occurred several times and independently of each other. Likelihood reconstructions of ancestral character states at selected nodes suggest that--contrary to previous thought--the ancestor to Porpidia s.l. already possessed the vegetative reproductive mode. Furthermore, transition rates are reconstructed asymmetrically with the vegetative reproductive mode being gained at a much lower rate than it is lost. A cautious note has to be added, because a simulation study showed that the ancestral character state reconstructions were highly dependent on taxon sampling. However, our central conclusions, particularly the higher rate of change from vegetative reproductive mode present to absent than vice versa within Porpidia s.l., were found to be broadly independent of taxon sampling.

Ascomycota↗

PubMed2002

Weight change in relation to natural menopause and other reproductive and behavioral factors in Japanese women.

PURPOSE: To evaluate the effect of menopause on weight change in Japanese women. METHODS: Community-based sample of 828 Japanese women who were premenopausal and aged 40 to 54 years completed a self-administered questionnaire asking information on demographic factors, body size, reproductive history and dietary and behavioral factors in 1992. They responded to a follow-up questionnaire asking weight and menopausal status in 1998. RESULTS: Women gained weight modestly, on average, 0.17 kg during the 6-year study period. Weight gain was significantly higher in women who remained premenopausal at follow-up than those who had natural menopause during the study period. Weight gain was significantly associated with early menarche in women who had natural menopause and with high parity in women remained premenopausal. CONCLUSION: Reproductive factors rather than sociodemographic and behavioral factors appeared to be associated with weight change during the perimenopausal period. Onset of menopause may diminish weight gain. In contrast, early menarche and high parity showed relationships with weight gain.

Adult↗

PubMed1994

The impact of genetic counselling on females in fragile X families.

We report a retrospective study over the period 1981-1992 of the reproductive histories of 27 women, from 21 families, who were known or possible fragile X carriers. Eighteen women had cytogenetic and DNA linkage studies to establish their carrier risk. They subsequently received definitive carrier status information following the cloning of the gene in 1991. The remaining nine women had cytogenetic and mutation studies only. For 11 of the women their carrier risk was modified over the 11 year period. The results suggest that these women at risk of having a son with fragile X have carefully considered their reproductive choices. Three of the six women who were initially sterilised have had, or are awaiting, a reversal of sterilisation following clarification of their carrier status. There were 10 pregnancies to 10 women. Seven of the pregnancies were to women at "high" (40-100%) risk of being a carrier, and in this group only one woman chose to continue the pregnancy without prenatal diagnosis. Three pregnancies were to women at "medium" or "low" (< 39%) risk of being a carrier. None of the three chose prenatal diagnosis and one affected male was born to this group.

Female↗

PubMed1994

Infertility after 8 years of marriage: a pilot study.

With the objective of measuring the prevalence and duration of infertility in a developing country, a retrospective cross-sectional study was designed. The survey was conducted at the Department of Obstetrics and Gynaecology, Hospital Sn. Borja-Arriaran, Mother and Child Research Institute, University of Chile, Santiago, March-September 1990. The study population comprised 474 women 15-45 years old selected at random from the 11,289 weddings that took place in downtown Santiago, Chile, in 1982. The reproductive history for the preceding 8 years was obtained through home interviews with the women conducted by midwives. The main outcome measures were the prevalence and duration of infertility. The results in this sample showed a 7.04% (95% confidence interval 6.21-7.87) prevalence of infertility after 8 years of marriage with a mean duration of 23 months. It is concluded that after 8 years of marriage about one out of 25 women is infertile (4.01%). This identified a group of patients that would benefit from a programme of assisted reproductive technology.

Adolescent↗

PubMed1993

Evidence for a single gene effect causing polycystic ovaries and male pattern baldness.

OBJECTIVE: Polycystic ovary syndrome is one of the most common endocrine disorders but its aetiology remains unknown. It is highly prevalent within families, suggesting a genetic basic for the syndrome, but the mode of inheritance is unclear. The purpose of this study was to determine the mode of inheritance of polycystic ovary syndrome, within the families of affected individuals, by classic segregation analysis. DESIGN: All first degree relatives of affected individuals were screened for the presence or absence of polycystic ovaries in post-menarchal-premenopausal women and early onset male pattern baldness (MPB) in the males. In extended pedigrees, assignment of affected status in post-menopausal women was made by consideration of the clinical history alone. PATIENTS: Fourteen women (probands), presenting with a variety of clinical symptoms, were identified sequentially as having polycystic ovaries (PCO) by ultrasound scan. They were examined in detail to determine their family structure, clinical and endocrine status. Ten families were found to have sufficient members for further study. MEASUREMENTS: All family members had their body mass index calculated, their degree of hirsutism assessed using the Ferriman and Gallwey score and serum levels of gonadotrophins (FSH and LH), testosterone, prolactin and 17 alpha-hydroxyprogesterone measured by radioimmunoassay. A careful reproductive history was taken for each woman and any menstrual disturbance was noted. Obese probands had their glucose and insulin response to a standard 75-g oral glucose tolerance test determined. Each male family member was also assessed for the degree and time of onset of balding. RESULTS: First degree female relatives of affected individuals had a 51% chance of being affected. Early onset male pattern baldness (MPB) was found to be an accurate phenotype for obligate male carriers. Each family showed autosomal dominant inheritance for PCO with greater than 90% penetrance. CONCLUSIONS: We postulate that PCO and male pattern baldness are caused by alleles of the same gene which affect androgen production or action. The different frequencies of PCO and male pattern baldness arise from differing thresholds for phenotypic expression in females and males respectively. The modifying effects of other genes is the most likely explanation of the somewhat variable phenotype.

Adult↗

PubMed2005

Preimplantation testing for chromosomal disorders improves reproductive outcome of poor-prognosis patients.

The clinical impact of PGD was evaluated through the analysis of the reproductive outcome before and after PGD in the same group of poor prognosis IVF patients, undergoing PGD for chromosomal abnormalities. Based on a series of 2359 PGD cycles, resulting in the establishment of 498 chromosomal abnormality-free clinical pregnancies, the reproductive history prior to PGD was analysed. Of 483 previous pregnancies analysed in patients with 432 pregnancies generated after PGD for aneuploidies, 328 (68%) ended in spontaneous abortions, in contrast to 28.4% after PGD, with only 155 (32%) resulting in deliveries, compared with 71.9% take-home baby rates after PGD. The patients experienced 315 previous IVF attempts, resulting in the transfer of 706 embryos in 308 cycles, of which only 49 (6.9%) implanted, compared with a 34.9% implantation rate observed in the same patients after PGD. Similar analysis of the previous reproductive outcomes of 45 carriers of balanced translocations achieving pregnancies following PGD, showed even stronger clinical impact, with a reduction of spontaneous abortions from 87.8% to 17.8%, and improvement of take-home baby rate from 11.5% to 81.4% after PGD. The results demonstrate a strong clinical impact of PGD, resulting in improvement of implantation rate, reduction of spontaneous abortions and increase in the take-home baby rate.

Abortion, Spontaneous↗

PubMed2001

Natural selection at the MJD locus: phenotypic diversity, survival and fertility among Machado-Joseph Disease patients from the Azores.

Machado-Joseph Disease (MJD) is an autosomal dominant neurodegenerative disorder of adult onset, associated with the expansion of a (CAG)n tract in the coding region of the causative gene, localized on 14q32.1. Machado-Joseph Disease shows non-Mendelian features typical of other triplet repeat disorders, including clinical heterogeneity, variable age at onset and anticipation. Three phenotypes have been proposed (clinical types 1, 2 and 3). Type 1 is associated with early age at onset and a high repeat number of the CAG sequence, and Types 2 and 3 have later onset and lower numbers of CAG repeats. This paper investigates whether there is selection against the MJD gene, acting through differential survival. nuptiality and fertility associated with clinical type and age at onset. The study sample comprised 40 MJD patients from the Azores (Portugal) having fully documented reproductive histories and known dates of death. The proportion of married patients of each clinical type increased from 0.22 among Type 1 patients, to 0.40 in Type 2 and 0.95 in Type 3. Age at onset and length of survival were also associated with marital status, with the married cases having later mean age at onset and longer mean survival time. In the whole sample, clinical type was associated with fertility, with significantly fewer children born to Type 1 patients. Among married patients clinical type was not associated with age at marriage, reproductive span or number of children. No reduction of fertility was detected among married patients in whom the onset of MJD was below the age of 50. The authors' interpretation of these results is that the high-repeat CAG haplotypes associated with early age at onset and clinical Type 1 are selected against through reduced survival and fertility. The fertility component of selection is mediated by nuptiality rather than marital fertility.

Adolescent↗