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PubMed2001

A one-year experience with a capitated health care plan for infertility.

OBJECTIVE: To report on a one-year experience participating in a capitated healthcare plan for infertility. DESIGN: Prospective study. SETTING: University population. PATIENT(S): Reproductive-age women 15 to 50 years. INTERVENTION(S): The first-generation Lewin infertility algorithm and CATHI software were used to negotiate infertility services under a capitated arrangement for $0.50 per member per month. The following reports our experience for the fiscal year 1997. MAIN OUTCOME MEASURE(S): Infertility services rendered, pregnancy rate, cost of services, collection rates. RESULT(S): Five thousand forty-six women representing 39,689 member months generated 39 new and 198 return visits. Thirty-two percent of the patients required three visits or less; six patients generated 22% of the visits. Fifty-one percent listed infertility as one of their chief complaints; 31% had mixed diagnoses. Eight (7.6%) patients required surgery, 11 (10.5%) patients underwent either IVF or GIFT cycles. Total charges submitted were $176,636; the amount assigned to specialty care was $135,277, and to IVF/GIFT, $33,433. Total capitated payments, including copayments, was $126,256 under the reproductive medicine agreement and $32,891 under the infertility rider. This resulted in a 71% gross collections rate. CONCLUSION(S): This study indicates that entering into a capitated health care plan to provide an infertility benefit can produce a successful result.

Adolescent↗
PubMed2002

Clinical performance of the levonorgestrel intrauterine system in routine use by the UK Family Planning and Reproductive Health Research Network: 5-year report.

OBJECTIVES: This study was undertaken to determine the performance of the levonorgestrel intrauterine system (LNG IUS) in British women in routine clinical use. DESIGN: Doctors working in general practice and at family planning clinics throughout the UK who collaborate in the UK Family Planning and Reproductive Health Research Network were responsible for the fitting of 678 LNG IUSs. RESULTS: Gross cumulative event rates at 5 years per 100 women were pregnancy 1.0, expulsion 5.9, removal for bleeding problems 16.7, removal for pain 4.3, and removal for pelvic inflammatory disease (PID) 1.2. Removals were also required for side effects that may be due to absorbed levonorgestrel. Positive effects include effective contraception and considerably reduced quantity of bleeding for most participants. CONCLUSIONS: A need was identified to counsel women about the early bleeding problems including the possibility of oligomenorrhoea or amenorrhoea. This is considered to be very important as it will help women to persevere so that they can enjoy the longer-term benefits.

Adult↗
PubMed2004

Inter-annual plasticity of squid life history and population structure: ecological and management implications.

Population size and structure, as well as individual growth rates, condition, and reproductive output, respond to environmental factors, particularly in short-lived and fast-growing squid species. We need to understand the mechanisms through which populations respond to environmental conditions, to predict when or if established relationships, used as management tools to forecast recruitment strength, might break down completely. Identifying characteristics of successful recruits who have grown under different environmental scenarios may improve our understanding of the mechanistic connections between environmental conditions and the temporal variation in life history characteristics that ultimately affect recruitment. This 5-year study sought to determine the association between key life history characteristics of southern calamary Sepioteuthis australis (growth rate, body size, and patterns of repro-somatic energy allocation) and the environmental conditions experienced by individuals on the east coast of Tasmania, Australia. Among years, all population and individual parameters examined were highly variable, despite the environmental regime during the study not encompassing the extremes that may occur in this dynamic region. Temperature was not clearly associated with any of the individual or population differences observed. Populations of apparently similar abundance were composed of individuals with strikingly different biological characteristics, therefore seeking relationships between abundance and environmental parameters at gross levels did not shed light on the mechanisms responsible for population size. Importantly, inter-annual differences in squid size, condition, reproductive investment, and possibly growth rate, were sex-specific, indicating that males and females responded differently to similar factors. Among years differences in body size were extreme, both among the male component of the population and between genders. The relative importance of many size-based processes that contribute to population size and structure (e.g. predation, starvation, competition, and reproductive success) will therefore vary inter-annually.

Age Factors↗
PubMed1982

Chronic and reproduction studies in rats exposed to gasifier ash leachates.

Ash from the coal gasification process contains a broad spectrum of elements which through leaching (gasifier ash leachates) may enter into the environment. The health effect of such leachates i.e. complex mixtures of inorganic elements is insufficiently known. We investigated the effect of gasifier ash leachates in a chronic-(9-month) and in a three-generation reproduction study. The leachates were prepared weekly by water extraction of ash from a Lurgi coal gasification plant in Yugoslavia, and given to experimental animals instead of drinking water. In the chronic experiment exposed animals showed no changes in mortality rate, haematological findings, concentration of Fe, Zn, Mn in kidneys, liver, testicles and femur, as well as in femur composition and morphometry, gross pathology and organ histology. In the reproduction study the number of pregnancies, weight and number of newborns, and concentration of Fe, Zn, Mn in carcasses of sucklings were the same in control and experimental animals.

Animals↗
PubMed1984

Use of selenium in problem cattle herds.

A 150-cow beef herd had problems with diarrhea in all neonatal calves, with 50% mortality. Necropsy revealed changes consistent with colibacillosis. Vaccination of cows in late pregnancy with E coli and BVD vaccines reduced morbidity but did not eliminate the problem. Assays revealed low serum Se levels. Limited supplementation of Se in premix at 90 mg/lb premix, with 17 lb premix/ton feed, resolved the problem. A 70-cow dairy herd had long-term problems with increased numbers of cystic ovaries and retained placentas, and low conception rates. Serum Se levels were low; results of various other diagnostic tests were inconclusive. Dietary supplementation of Se greatly improved reproductive efficiency. Gross and microscopic lesions may not be inconclusive for a diagnosis of Se deficiency. Dietary supplementation of Se is recommended over injection.

Animal Feed↗
PubMed1977

Reproductivity of Japanese quail fed mercuric chloride in the absence of vitamin D.

Mercuric chloride (HgCl2) was tested at 16 p.p.m. Hg for vitamin D sparing activity by presenting it dietarily in the presence and absence of 25-hydroxycholecalciferol (25-HCC) to Japanese quail (Coturnix c. japonica) for 25 days. No gross signs characteristic of mercury poisoning were observed, but some predictable effects of vitamin D deficiency on avian reproduction were manifested within 10 days. Rate of lay, egg shell thickness, and hatchability of fertile eggs decreased markedly for birds on vitamin D-deficient diets. Shell-less eggs were laid by these birds after 20 days and laying stopped entirely on the 23rd day. Laying resumed within 5 days after diets were refortified with 25-HCC. There was no detectable interaction between HgCl2 and vitamin D.

Animals↗
PubMed2000

Farmer record of pregnancy status pre-slaughter compared with actual pregnancy status post-slaughter and prevalence of gross genital tract abnormalities in New Zealand dairy cows.

AIMS: To record the prevalence of gross abnormalities of the reproductive tract in culled New Zealand dairy cows, to determine how accurately farmers classify the pregnancy status of their animals and to establish if this was influenced by method of pregnancy diagnosis. METHODS: The reproductive tracts from 1134 cull dairy cows were examined after slaughter and evisceration for the presence of gross abnormalities, ovarian activity and pregnancy at a commercial abattoir. The farmers that had submitted these animals for slaughter were surveyed for information about the farm and herd from which each cow was derived and to establish whether the farmer believed each cow to be pregnant or not. The method that had been used to determine pregnancy status was recorded for each animal. RESULTS: Gross abnormalities were evident in 5.7% of reproductive tracts. Ovarian activity (presence of follicles 5 mm diameter and/or a corpus luteum) was apparent in 88% of non-pregnant cows. Pregnancy was detected in 39% of cows, of which 2.3% carried twins. The pregnancy status evident at slaughter varied from that reported by farmers in 7.0% of the 954 cows for which farmers were able to provide information. Of the cows that had been examined by palpation or ultrasound per rectum prior to slaughter, 10.3% that were recorded as non-pregnant by farmers were pregnant, and 3.2% of those recorded as pregnant were not. Of the cows that had not been examined, 3.8% of those recorded as nonpregnant by farmers were pregnant while 10.4% of those recorded as pregnant were not. There was no apparent association between gross genital tract abnormalities or ovarian activity and the misclassification of pregnancy status. Amongst cows that were pregnant at slaughter the foetus was significantly smaller in cows that had been recorded as 'not pregnant' after palpation or ultrasound examination than in cows that had been recorded as 'not pregnant' on the basis of farmer observation only. CONCLUSIONS: The prevalence of gross abnormalities of the reproductive tract was comparable to that reported in similar studies overseas. Farmer observation as a method of pregnancy detection overestimates pregnancy rate. Pregnancy status may be misclassified or misrecorded following palpation or ultrasound examination of cattle per rectum. Accurate classification of pregnancy status is dependent on the method and timing of pregnancy diagnosis and on minimising errors of diagnosis, cow identification and recording.

Journal Article↗
PubMed2004

Demography of soybean aphid (Homoptera: Aphididae) at summer temperatures.

Soybean aphid, Aphis glycines Matsumura, is now widely established in soybean, Glycine max L., production areas of the northern United States and southern Canada and is becoming an important economic pest. Temperature effect on soybean aphid fecundity and survivorship is not well understood. We determined the optimal temperature for soybean aphid growth and reproduction on soybean under controlled conditions. We constructed life tables for soybean aphid at 20, 25, 30, and 35 degrees C with a photoperiod of 16:8 (L:D) h. Population growth rates were greatest at 25 degrees C. As temperature increased, net fecundity, gross fecundity, generation time, and life expectancy decreased. The prereproductive period did not differ between 20 and 30 degrees C; however, at 30 degrees C aphids required more degree-days (base 8.6 degrees C) to develop. Nymphs exposed to 35 degrees C did not complete development, and all individuals died within 11 d. Reproductive periods were significantly different at all temperatures, with aphids reproducing longer and producing more progeny at 20 and 25 degrees C than at 30 or 35 degrees C. Using a modification of the nonlinear Logan model, we estimated upper and optimal developmental thresholds to be 34.9 and 27.8 degrees C, respectively. At 25 degrees C, aphid populations doubled in 1.5 d; at 20 and 30 degrees C, populations doubled in 1.9 d.

Animals↗
PubMed1983

Kidney function of pullets and laying hens during outbreaks of urolithiasis.

Renal function evaluations were conducted on pullets and laying hens during outbreaks of urolithiasis. The following parameters were measured: kidney weights; hematocrits; plasma concentrations of uric acid, calcium, inorganic phosphate, magnesium, sodium, and potassium; urine flow rates; glomerular filtration rates; renal plasma flow rates; urine pH; and relative clearances of inorganic phosphate, calcium, magnesium, sodium, potassium, and para-amino hippuric acid. The adequacy of renal portal perfusion was estimated by timed phenol red extraction. Considerable interindividual variability was noted, presumably due to differences in age and reproductive status. Intraindividual left versus right kidney comparisons also were made, since urolithiasis often is associated with macroscopic lesions of one kidney but not the other. The results indicate that even when gross lesions of only one kidney were present, specific tubular transport processes were similar in both kidneys. Urolithiasis did cause significant alterations in urine flow rates, glomerular filtration rates and renal plasma flow rates. it was concluded that the changes associated with urolithiasis reflect the expected compensatory hypertrophic responses of surviving kidney tissue to a reduction of renal mass. The physiological impact of this form of kidney damage appears to arise from reduced renal mass rather than from inappropriate renal handling of minerals or electrolytes.

Animals↗
PubMedDate not supplied

5-AZA-2'-deoxycytidine (5-AZA-CdR): a demethylating agent affecting development and reproductive capacity.

The objective was to evaluate the effects of 5-AZA-2'-deoxycytidine (5-AZA-CdR) on postnatal development and reproductive capacity. Pregnant mice were administered 1 mg kg-1 5-AZA-CdR at gestation day 10. The body weights of F1 control and treated (in uterine-exposed) pups were recorded. To evaluate the reproductive capacity, 5-AZA-CdR F1 males and females were mated with control mice. The presence of plugs and the number of pregnancies were recorded. The 5-AZA-CdR F1 male mice were killed. Total body, testes and epididymis weights were recorded. Spermatid head counting, histological analyses and serum testosterone levels were performed. Body weights of 5-AZA-CdR F1 mice were statistically lower than controls (P < 0.01), with the females more strongly affected (P < 0.05). Male mating capacity appeared to be more adversely affected. Mating of 5-AZA-CdR F1 males with control females resulted in a lower pregnancy rate compared with control mating groups (P < 0.01). Gross testicular and epididymis weights were lower in 5-AZA-CdR F1 mice (P < 0.01). However, testicular and epididymis weights in these mice were higher than controls when correlated to body weight (P < 0.01). In 5-AZA-CdR F1 male mice, all measured reproductive parameters, including total number of spermatid heads per testis, are significantly lower (P < 0.01) than the controls except for the number of spermatid heads per milligram of testis.

Analysis of Variance↗
PubMed1978

Effects of polybrominated biphenyl on milk production, reproduction, and health problems in Holstein cows.

PBB found in relatively low levels among animals present on a cross-section of Michigan farms during the time PBB was inadvertantly added to dairy feeds had no effect upon these animals' milk production, body weight, weight gain, breeding and reproduction performance, incidence of commonly experienced health problems, calving rate, and the health of their calves. No significant differences in these vital areas could be seen between Michigan animals exposed to PBB and equivalent Wisconsin animals which had not been exposed to PBB when both groups were subjected to equivalent management practices. No pattern of gross of histopathological lesions was seen upon necropsy between test animals and control animals.

Age Factors↗
PubMed2000

Chimaeric mice with disruption of the gene coding for phosphatidylinositol glycan class A (Pig-a) were defective in embryogenesis and spermatogenesis.

Mutations in the gene encoding PIG-A (phosphatidylinositol glycan class A) are found in patients with paroxysmal nocturnal haemoglobinuria (PNH), an acquired haematopoietic stem cell disorder. Individuals with hereditary PIG-A mutations have never been identified, which is also manifested by the difficulties in generating Pig-a knockout (KO) mice. This study investigated the effect of Pig-a mutations on the development of visceral and genital organs in addition to the haematopoietic system by the generation of Pig-a KO chimaeric mice. Of a total of 54 live births out of 1684 blastocysts injected, chimaerism for Pig-a knockout was detected in 29 mice, suggesting the importance of Pig-a in embryogenesis and in live birth. Quantification of the degree of chimaerism in different organs of the surviving chimaeric mice revealed extremely low levels of Pig-a KO cells in the liver and spleen. In contrast, high levels of KO signals were usually detected in the brain, heart, lung and kidney. Haematopoiesis proceeded normally in these chimaeric mice (as measured by 'complete blood cell counting') and the Pig-a KO cells were present at low levels in red blood cells and B lymphocytes but at high levels in T lymphocytes, although these KO cells did not gain any growth advantage. The effect of Pig-a knockout was also prominent in the reproductive system, another organ with high mitotic activity. Breeding the male chimaeras revealed a high rate of infertility and abnormality in the male genital organs, including abnormally shaped testes, epididymis and seminal vesicles. Even in the absence of gross abnormalities of the genital organs, low counts of motile sperm were also discernible. Pig-a KO sperm was detected in these organs; however, no transmission of the KO allele was observed. The results suggest a possible mechanism underlying the non-transmission of the Pig-a KO gene in germlines.

Animals↗
PubMed2006

Family size, fertility preferences, and sex ratio in China in the era of the one child family policy: results from national family planning and reproductive health survey.

OBJECTIVES: To examine the impact of the one child family policy in China on fertility, preferred family size, and sex ratio. DESIGN: Secondary analysis of data from the Chinese cross sectional national family planning and reproductive health survey, 2001. Interviews of representative sample of women aged 15-49. RESULTS: Data were obtained from 39,585 women, with a total of 73,202 pregnancies and 56,830 live births. The average fertility rate in women over 35 (n = 17,078) was 1.94 (2.1 in rural areas and 1.4 in urban areas) and for women under 35 (n = 11,543) 1.73 (1.25 and 1.79). Smaller families were associated with younger age, higher level of education, and living in an urban area. The male to female ratio was 1.15 and rose from 1.11 in 1980-9 to 1.23 for 1996-2001. Most women wanted small families: 35% preferred one child and 57% preferred two. CONCLUSION: Since the one child family policy began, the total birth rate and preferred family size have decreased, and a gross imbalance in the sex ratio has emerged.

Adolescent↗
PubMed2002

Does the milk of Callitrichid monkeys differ from that of larger anthropoids?

The generalization that anthropoid primates produce dilute milks that are low in protein and energy is based primarily on data from large monkeys of the families Cebidae and Cercopithecidae, as well as humans. The marmosets and tamarins (Callitrichidae) are not only much smaller in body size, but also typically raise multiple offspring during a relatively brief lactation. We hypothesized that selection for small body size and high reproductive rate might favor secretion of milk of higher energy and protein concentrations. To test this hypothesis, 46 milk samples collected from 10 common marmosets (Callithrix jacchus, ca. 350 g) were assayed for dry matter (DM), crude protein (CP), fat, and sugar; and gross energy (GE) was calculated from these constituents. We also assayed five samples collected from three golden lion tamarins (Leontopithecus rosalia, ca. 700 g) and six samples collected from a single pygmy marmoset (Cebuella pygmaea, ca. 150 g) over two lactation periods. All samples were collected between days 10 and 57 post partum, representing mid lactation for these species. The milks of these three species were similar, containing 14.0%, 16.1%, and 13.7% DM; 2.7%, 2.6%, and 2.9% CP; 3.6%, 5.2%, and 3.7% fat; 7.4%, 7.2%, and 7.8% sugar; and 0.76, 0.90, and 0.82 kcal/g for common marmosets, golden lion tamarins, and the pygmy marmoset, respectively. These species produced milks with energy values that were within the range reported for large anthropoids, albeit with slightly higher protein concentration. However, milk composition did vary substantially among individual common marmoset females, especially in the proportion of milk energy derived from fat. In contrast, CP as expressed as a percent of GE was remarkably constant among common marmoset females. Callitrichid milk appeared to be similar to that of larger anthropoid primates in GE, but was higher in CP and in the proportion of GE from CP. However, the small sample sizes for the golden lion tamarin and the pygmy marmoset, and the wide variation in milk composition found among common marmoset females cautions against definitively characterizing the milks of callitrichids from these data.

Animals↗
PubMed2004

Periodic abstinence in developing countries: an assessment of failure rates and consequences.

It is estimated that 27 million couples, representing 2.6% of all couples in the reproductive span, use periodic abstinence (PA). Using data from 15 national surveys in low and middle-income countries, this article assesses characteristics of PA users, knowledge of the fertile period, accidental conceptions while using PA and the reproductive consequences of these conceptions. Current users of PA (predominantly the simple calendar variant) tend to be more educated and urban than users of other methods. The method is preferred by young single women and older married women. The proportion of users with correct knowledge of the timing of ovulation ranges from 8% to 91%, with a median value of 62%. The median 12-month gross failure rate was 24 per 100 episodes. Net of other predictors of failure, correct knowledge of the timing of ovulation was associated with a 12% decrease in failure probabilities. Couples who experienced PA failure were more likely than couples who experienced failure with another method to carry the pregnancy to term. Nevertheless, PA still contributes to one-sixth of all abortions (or miscarriages) following contraceptive failure.

Adolescent↗
PubMed2003

Cystic disease in women: clinical characteristics and medical management.

Autosomal dominant polycystic kidney disease (ADPKD) is a dominantly inherited systemic disorder equally inherited in men and women characterized by renal cyst development and expansion ultimately leading to renal failure. ADPKD women have a slower rate of progression to renal failure, with a later age of entry into end-stage renal disease (ESRD) as compared with men. Renal cyst growth and renal expansion are the hallmarks of ADPKD, and women will develop renal insufficiency with smaller renal volume than their male counterparts. As well, women have different rates of occurrence of renal and extrarenal complications in ADPKD. Renal complications related to ADPKD, including hypertension and gross hematuria, occur more frequently in men than in women, whereas liver cystic disease occurs earlier and more frequently in women than in men. The presence of polycystic liver disease is related to pregnancy number and oral contraceptive pill use in ADPKD women. Importantly, massive polycystic liver disease requiring surgical intervention occurs primarily in ADPKD women. ADKPD women have a highly successful reproductive course. The chance of a successful pregnancy is excellent in ADPKD women and comparable to healthy unaffected women as long as prepregnancy blood pressure and renal function are normal. Fetal complication rates are no greater than in the general population; however, maternal complication rates in ADPKD women are high with an increased frequency of new or worsening hypertension as well as an increased occurrence of preeclampsia and preterm deliveries. Finally, increasing pregnancy number has minimal or no effect on renal outcome in ADPKD women.

Female↗
PubMed1986

Study of obesity in dogs visiting veterinary practices in the United Kingdom.

A total of 8268 dogs were surveyed in 11 veterinary practices in the United Kingdom during a period of six months in 1983. The primary purpose of the survey was to assess the level of obesity on a five point scale with properly identified criteria. Information on the clinical condition of each dog was also recorded as well as proportions of food types fed, particulars of breed, sex, age, sexual status and the dog's name. Results showed that 21.4 per cent of dogs in the survey were judged to be obese and 2.9 per cent gross; 1.9 per cent were judged as thin, 13.5 per cent lean and 60.3 per cent were optimum. Labradors were found to be the most likely breed to become obese. Neutered females were about twice as likely to be obese as entire females. The same trend was evident with neutered males. Circulatory problems were associated with dogs over 10 years old and those which were gross, rather than obese. A similar trend was discernable with articular/locomotor problems. Skin and reproductive problems showed little relationship with age or obesity. Neoplasia was much more prevalent in dogs over 10 years old but had little relationship with either sexual status or obesity rating. There was a high rate of usage of prepared food for all categories. The amount of fresh food fed decreased rapidly as the proportion of canned food increased, but the obese and non-obese dogs showed very little difference in the type of food fed.

Age Factors↗
PubMed1990

Influence of chronic alcohol administration on representative indices of puberty and sexual maturation in male rats and the development of their progeny.

The effects of chronic alcohol administration on reproductive endocrinology in the developing male rat were examined. Prepubescent male rats (25 days of age) were maintained on an alcohol liquid diet or were pair-fed a control diet until early adulthood and selected indices of sexual maturation were examined at weekly intervals. To determine whether sexually immature animals were more sensitive to the effects of alcohol than adults, fully mature male animals were exposed to an identical period of alcohol exposure and comparisons were made between the two groups. The results demonstrated that alcohol significantly affected many of the primary indices of puberty and sexual maturation. The normal pubertal increases in serum testosterone levels, the weights of the testes and secondary sex organs and beta-endorphin levels in the hypothalamus were substantially reduced in alcohol-exposed animals compared with controls. In contrast to these results, the effects of alcohol on reproductive endocrinology in the fully mature animal were transitory and of considerably less magnitude. After a 2-week alcohol-free period, male rats exposed to alcohol during development were bred with drug-naive primiparous females. Although the same number of pregnancies resulted from matings between alcohol-exposed males and drug-naive females compared with controls, litter sizes were significantly smaller in alcohol-derived offspring than in controls. In all other respects, such as body weights, sex ratios, mortality rates and gross developmental features (eye opening, incisor eruption and testes descent), alcohol-derived offspring were identical with controls. Upon closer examination, however, significant disturbances were detected in alcohol-derived male offspring.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗