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PubMed1991

Fertility of workers chronically exposed to chemically contaminated sewer wastes.

Few studies have investigated the reproductive effects of exposure to chemical mixtures. The purpose of this study was to assess fertility in males exposed to mixed industrial and domestic wastes. A detailed reproductive history was obtained from the wives of 231 employees in order to evaluate fertility. Daily work records were used to define exposure status. To ascertain problems of infertility, the ratios of observed live births to expected live births (generated from U.S. birth probabilities) for exposed and nonexposed groups were calculated, and the ratios of these Standardized Fertility ratios (SRFs) were compared. Other analyses considered the couples' contraceptive history and preexposure versus postexposure experience. Though multiple statistical approaches were used to examine the data, the conclusion of this study was that exposure to chemical mixtures was not associated with a decrease in the couples' fertility.

Air Pollutants, Occupational↗

PubMedDate not supplied

Exposure to organic solvents during pregnancy and oral clefts: a case-control study.

Prior studies on the relationship between maternal exposure to organic solvents in relation to oral clefts have been inconsistent. We re-examined this relationship in a case-control study conducted in the Rhône-Alpes region of France during the years 1985 to 1989. For each case, we selected two controls without congenital anomalies in the same delivery unit born during the same month. We interviewed each mother within the first five days after delivery about previous reproductive history and exposures during the first two months after conception. If the mother had an occupational activity at that time, we asked her occupational physician to confirm the exposures. We compared maternal exposure to any organic solvent between 200 infants with cleft lip and/or cleft palate and 400 controls and the estimated odds ratio was 1.62 (95% CI 1.04-2.52). Then we compared exposures to nine subgroups of solvents. Only the ratio associated with halogenated aliphatic solvents (4.40, 95% CI 1.41-16.15) was significantly different from unity. Control of potential confounders-sex of child, family history, maternal epilepsy-did not alter this odds ratio estimate.

Analysis of Variance↗

PubMed1990

Pregnancy, breast feeding, and oral contraceptives and the risk of epithelial ovarian cancer.

To quantify the effects of cumulative months of pregnancy, breast feeding, and oral contraceptive use on the risk of developing epithelial ovarian cancer, the authors used data collected for the Cancer and Steroid Hormone Study--a multicenter, population-based, case-control study. Detailed reproductive histories were obtained from 436 women aged 20-54 with epithelial ovarian cancer newly diagnosed between December 1980 and December 1982, and from 3833 women aged 20-54 selected at random from the same geographic areas. Estimated relative risks of epithelial ovarian cancer were 0.6 (95% confidence interval (CI) 0.5-0.8) for women who had ever been pregnant, 0.6 (95% CI 0.5-0.8) for women who had ever breast fed, and 0.5 (95% CI 0.5-0.7) for women who had ever used oral contraceptives. Logistic regression analysis revealed a strong trend in decreasing risk of epithelial ovarian cancer with increasing cumulative months of pregnancy; this effect was less pronounced in women aged 50-54 than in younger women. In contrast, a marked reduction in risk was associated with ever having breast fed or used oral contraceptives, while the decrease in risk from additional months of either of these exposures was less than that for pregnancy.

Adult↗

PubMed2005

Chromosomal abnormalities and birth defects among couples with colchicine treated familial Mediterranean fever.

OBJECTIVE: To determine whether colchicine prescribed for familial Mediterranean fever is teratogenic. STUDY DESIGN: Reproductive histories were analyzed from 326 couples referred for prenatal diagnosis because 1 partner was affected. Numbers of chromosomal abnormalities and birth defects were compared with numbers expected from published rates. RESULTS: There were 901 pregnancies, and amniocentesis had been performed in 566, all but 3 conceived while taking colchicine. Seven numerical chromosomal abnormalities were found, not statistically significantly greater than the 4.99 expected from maternal age and gestation of diagnosis (P = .24): unbalanced structural abnormalities were 6, compared with 3.22 expected (P = .11). There were 7 birth defects, a considerably lower rate than reported in local malformation registers. CONCLUSION: The current policy of routine amniocentesis in pregnancies of couples taking colchicine should not be changed until sufficient data accumulates to establish whether the higher number of chromosomal anomalies in this group is significant.

Abnormalities, Drug-Induced↗

PubMed2006

Interspecific embryo transfer from mouflon (Ovis gmelini musimon) to domestic Corriedale sheep in Argentina.

An interspecific embryo transfer program was conducted for genetic improvement and increasing the number of offspring from a flock of mouflon sheep in Argentina. The female donor mouflons were divided into three groups, G1 (n=5), G2 (n=4) and G3 (n=5). The total NIH-FSH-P1 dose given to each donor on the superovulatory treatment was 260, 200 and 160 mg for G1, G2 and G3, respectively. The mouflons in G3 were maidens, while the others were multiparous. Domestic Corriedale ewes (n=60) were synchronized and used as recipients. The embryo recovery and transfer was performed by a surgical method. Mouflons (n=13) responded to the superovulatory treatment with an average of 9.1+/-2.8 ovulations. A low incidence of early luteal regression was found (1 out of 14 donors). Embryo recovery rates were 60, 31 and 76% in groups G1, G2 and G3, respectively. The percentage of transferable embryos obtained in G1 and in G2 exceeded 80%. None of the embryos obtained from G3 were of transferable quality. In G1, 25 transferable embryos were recovered and transferred to 13 recipients, resulting in a pregnancy rate of 76.9% (10/13). In G2, 10 embryos were transferred to 5 recipients, resulting in a 60% pregnancy rate (3/5). Lambing rate was 60% (15/25) and 30% (3/10) for G1 and G2, respectively. Thirteen lambs were born to the 14 donors following natural service after the embryo recoveries. This study demonstrates that the application of IET technology would have great reproductive impact, especially when the donor mouflon hinds are selected according to age and reproductive history.

Animals↗

PubMed2005

Genetic and environmental determinants of bone mineral density in Chinese women.

BMD is a complex trait determined by genetic and lifestyle factors. To assess the genetic and environmental determinants of BMD in southern Chinese women, we studied a community-based cohort of 531 pre- and postmenopausal southern Chinese women and assessed the influence of 12 candidate gene loci and lifestyle risk factors on spine and hip BMD. The candidate genes studied include estrogen receptor alpha (ESR1) and beta (ESR2), calcium sensing receptor (CASR), vitamin D receptor (VDR), collagen type Ialpha1 (COLIA1), and LDL receptor-related protein 5 (LRP5). Social, medical, reproductive history, dietary habits and lifestyle factors were determined using a structured questionnaire. Single nucleotide polymorphisms (SNPs) of the COLIA1 and LRP5 gene in Chinese were determined by direct sequencing. Nucleotide (nt) -1363C/G and -1997 G/T of COLIA1, nt 266A/G, 2220C/T and 3989C/T of LRP5 gene were analyzed. Using stepwise multiple linear regression analyses, body weight was the strongest predictor for BMD in premenopausal women (n = 262), which accounted for 15.9% of the variance at the spine, 20% at femoral neck, 17.1% at trochanter, 24.3% at total hip and 10.9% at the Ward's triangle. Other significant predictors were ESR1 Ivs1-397T/C genotype (2.2% at the spine); LRP5 2220C/T genotype (1.3% at the spine, 1.6% at the trochanter); LRP5 266A/G genotype (1.1% at Ward's triangle); age at menarche (1.3% at trochanter) and age (2.0% at Ward's triangle). As for postmenopausal women (n = 269), body weight ( approximately 25% at various sites) and age (approximately 16% at femoral neck, trochanter, total hip and Ward's triangle sites) were the strongest predictors of BMD. Other significant predictors were age at menarche (4.4% at spine, 0.7% at femoral neck, 1.4% at trochanter, and 1.4% at Ward's triangle); weight bearing physical activity (2.1% at trochanter and 1% at total hip); calcium intake (1.1% at femoral neck, 0.9% at trochanter, and 1.7% at total hip) ; height (0.7% at trochanter); and ESR2 1082A/G genotype (0.8% at trochanter). We conclude that BMD at various sites and at different time span of a woman is modified by different genetic and lifestyle factors, suggesting that BMD is highly dependent on gene-environmental interactions.

Base Sequence↗

PubMed2004

Assessing congenital uterine anomalies: the role of three-dimensional ultrasonography.

Congenital uterine anomalies are associated with a range of adverse reproductive outcomes but may also be found incidentally. Their significance in women with normal reproductive histories, who do not have a history of recurrent miscarriage or infertility, has been uncertain. The absence of these data has made it difficult to understand the true significance of congenital uterine anomalies found in women with adverse pregnancy outcomes. The advent of transvaginal three-dimensional ultrasonography has enabled the accurate, non-invasive, outpatient diagnosis of congenital uterine anomalies. It has enabled large-scale screening and morphological analysis of congenital uterine anomalies.

Abortion, Habitual↗

PubMed2004

Psychological stress and the risk of breast cancer: a case-control study.

OBJECTIVE: To determine whether psychological stress, in the form of past life events and stress at work, was associated with the development of breast cancer. METHODS: The study was based on a case-control study of 257 women with breast cancer operated during 1993-1998 in Szczecin (Poland) hospitals and 565 controls, free of any cancer diagnosis. The subjects were sent a detailed questionnaire including questions on sociodemographic data; lifestyle (lifetime recreational and sport activities, occupational physical activity, diet); reproductive history; experience of psychological stress. The subjects reported major stressful life events, stress of daily activity and experience of stress at work. Logistic regression analyses were used to estimate the odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: After adjustment for age and other potential confounders, we found that women with major life events, stress of daily activity, and depression had 3.7 times higher risk for breast cancer, compared to those which did not experience such stress (OR = 3.70; 95% CI, 2.61-5.26). Women who reported experience of stress at work had a nonsignificant 16% higher risk for breast cancer compared with those who reported no stress (OR = 1.16; 95% CI, 0.82-1.64). A higher proportion of cases (89.1%) than controls (71.1%) reported that their job was stressful, very fretful or very responsible or experienced a major life event (OR = 4.29; 95% CI, 2.66-6.92). CONCLUSION: These findings suggest an association between major life events and breast cancer.

Adult↗

PubMed2004

Lactational amenorrhea as a method of family planning in Egypt.

Because of the potential importance of the lactational amenorrhea method (LAM) as a family-planning option in Egypt, we analyzed data from the 1995 Egyptian Demographic and Health Survey (EDHS) to study breastfeeding practices, use of contraception, reproductive history and sociodemographic factors for 5504 mothers with children under 3 years. According to the EDHS data, about 80% of Egyptian women breastfed for at least 6 months, and 40% breastfed for 15-18 months. Over half of breastfeeding mothers used no additional contraception. Thirty-six percent of mothers breastfeeding children younger than 6 months who reported using no additional contraception were exclusively breastfeeding and amenorrheic, but only 4% reported relying on breastfeeding for family planning. We also held eight focus group discussions with breastfeeding mothers from urban and rural Upper and Lower Egypt on their use of contraceptive methods, breastfeeding, lactational amenorrhea and LAM. Participants showed strong recognition of the contraceptive effects of breastfeeding but differed widely in their understanding of lactational infecundability and knowledge of LAM as a method. These results suggest that LAM would be widely acceptable to Egyptian women, but that an educational program about the method is needed.

Adolescent↗

PubMed2005

Night work and breast cancer risk: a systematic review and meta-analysis.

The association between occupations that involve night shift work (a surrogate for exposure to light at night with subsequent melatonin suppression) and breast cancer risk is uncertain. We therefore conducted a systematic review and meta-analysis of observational studies to assess the effects of night work on breast cancer risk. Data sources were MEDLINE from January 1960 to January 2005, experts in the field, bibliographies, and abstracts. Search terms included night work terms, flight personnel terms, cancer terms, and risk terms. Independent data extraction by two authors using standardised forms was performed. The method of DerSimonian and Laird was used to derive combined estimates and Egger's; and Begg and Mazumdar's tests for publication bias were conducted. Based on 13 studies, including seven studies of airline cabin crew and six studies of other night shift workers, the aggregate estimate for all studies combined was 1.48 (95% CI, 1.36-1.61), with a similar significant elevation of breast cancer risk among female airline cabin crew (standardised incidence ratio (SIR), 1.44; 95% CI, 1.26-1.65), and female night workers (relative risk (RR), 1.51; 95% CI, 1.36-1.68) separately. We found some evidence suggesting confounding due to incomplete adjustment for breast cancer risk factors, with smaller effects in the studies that more completely adjusted for reproductive history and other confounding factors. Egger's and Begg and Mazumdar's tests for publication bias showed no significant asymmetry (P>0.05). Studies on night shift work and breast cancer risk collectively show an increased breast cancer risk among women. Publication bias is unlikely to have influenced the results.

Aircraft↗

PubMed2005

Low blood lead concentration in association with infertility in women.

This study investigated the relationship between low-level lead exposure and risk of infertility in women. Study participants consisted of 64 cases recruited at a private infertility clinic and 83 control women from the postpartum clinic unit at a medical center in Kaohsiung, Taiwan. With informed consent, venous blood samples were obtained from subjects, during their early follicular phases (the 1st to 5th days of the menstrual cycle), for measuring concentrations of lead and hormones. Information on other potential risk factors associated with infertility, including reproductive history, Chinese herbal Medicine use, dairy product consumption, residential environment, and sociodemographic status, was obtained during an in-person interview. The mean blood lead level (BLL) in infertile women was significantly higher than that in controls (3.55 vs 2.78 microg/dL, P=0.007). Compared to women with BLL < or = 2.5 microg/dL, women with BLL>2.5 microg/dL were associated with a threefold increased risk for infertility (adjusted odds ratio=2.94, 95% confidence interval 1.18-7.34), after controlling for age, body mass index, smoking, Chinese herbal Medicine use, and irregular menstruation. Women's BLL was a significant predictor of the serum estradiol concentration also. These findings suggest an important role of very low BLL in the risk of infertility in women.

Adult↗

PubMed2004

Successful spontaneous pregnancies in women older than 45 years.

OBJECTIVE: To characterize the reproductive history of women who delivered an infant after a spontaneous pregnancy after the age of 45 years. DESIGN: Observational study. SETTING: University departments. PATIENT(S): Two hundred nine women who conceived spontaneously and had their most recent delivery after the age of 45 years. INTERVENTION(S): Review of all individual medical charts for a complete history of all pregnancies. MAIN OUTCOME MEASURE(S): Gravidity, parity, and spontaneous abortion (SAB) rate. RESULT(S): The mean (+/-SD) age at last delivery was 45.7 +/- 0.9 years (range: 45-49). The mean parity was 9.6 +/- 4 children (range: 2-20): 81% of the women were grandmultiparas (> or =6 deliveries) and 46% were grand-grandmultiparas (> or =11 deliveries). The mean number of SAB was 1.9 +/- 1.9 (range: 0-9). Increased parity did not have a protective effect on abortion rate: 12.9% for parity 2-5, 15.6% for parity 6-10, and 21.3% for parity 11-20. Women in the study group differed significantly in their SAB rate from a general population: 11.3% vs. 17.7% at age 39, 13.2% vs. 33.8% at age 44, and 9.1% vs. 33.8% at age 45. CONCLUSION(S): Women who conceived at or after 45 years of age were mostly grandmultiparas. Although multiparity in itself did not affect SAB rates, this measure was remarkably low in our exceptionally fertile group as compared with the rates published for a general population. This unique group of grandmultiparous women might possess a genetic propensity that delays the normal rate of ovarian and oocyte senescence.

Abortion, Spontaneous↗

PubMed2006

Use of a gestational carrier for a patient with recurrent adverse pregnancy outcomes from early onset severe pre-eclampsia.

OBJECTIVE: To describe the first reported case of gestational carrier treatment to prevent severe early onset pre-eclampsia. DESIGN: Case report. SETTING: A university-based reproductive endocrinology and infertility clinic and a tertiary care hospital. PATIENT(S): A 29-year-old woman and her husband with three consecutive pregnancies complicated by early onset severe pre-eclampsia causing fetal demises at 22 and 24 weeks gestation; a neonatal death at 25 weeks gestation; and life-threatening maternal hemolysis, elevated liver enzymes, and low platelets. INTERVENTION(S): An IVF procedure in the patient using her husband's sperm with the transfer of two embryos to a friend who offered to be a gestational carrier. MAIN OUTCOME MEASURE(S): Successful IVF cycle in the patient and uncomplicated pregnancy and delivery in the gestational carrier. RESULT(S): The gestational carrier achieved a pregnancy and progressed without complications to delivery of a healthy, 3.2-kg infant at 39 weeks gestation. CONCLUSION(S): The use of a gestational carrier deserves consideration as a treatment option in patients with poor reproductive histories because of early onset severe pre-eclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome. This experience also suggests that development of pre-eclampsia may be in large part maternally rather than embryologically or paternally driven.

Abortion, Habitual↗

PubMed2006

High incidence of chromosomal abnormalities in oocyte donors.

Oocyte donors are chosen among phenotypically normal and fertile women who are not expected to carry any chromosomal abnormality. A high incidence of balanced structural chromosomal rearrangements has been found within oocyte donors. This result raises the question of a possible bias in their recruitment with respect to their familial background and/or personal reproductive history.

Adult↗

PubMed2005

Generalized anxiety following unintended pregnancies resolved through childbirth and abortion: a cohort study of the 1995 National Survey of Family Growth.

The psychological consequences of induced abortion are complex and subject to both considerable controversy and methodological criticisms. While many women report feelings of relief immediately after the procedure, others report feelings of anxiety, which they attribute to their abortions. The purpose of the present study was to examine risk of generalized anxiety following unintended pregnancies ending in abortion or childbirth using a large representative sample of American women. Among all women, those who aborted were found to have significantly higher rates of subsequent generalized anxiety when controlling for race and age at interview. Implications of the findings are discussed. In particular, findings highlight the clinical relevance of exploring reproductive history in therapeutic efforts to assist women seeking relief from anxiety.

Abortion, Induced↗

PubMed2004

Use of hormone replacement therapy in Italian women aged 50-70 years.

OBJECTIVES: The aim of the present cross-sectional analysis was to describe patterns and determinants of use of hormone replacement therapy (HRT) in a large sample of women attending mammographic screening. METHODS: Between 1999 and 2001, 8533 women aged 50-70 years were recruited by 11 screening centres, and structured interviews were made collecting information on socio-demographic characteristics, lifestyle habits, medical and reproductive history (overall response rate 87%). RESULTS: Current HRT use was reported by 6.9% of women (n=585), the average duration of use being 3.5 years; 13.2% were ever HRT users. Binomial and multinomial logistic regression (MLR) analyses showed that younger age, higher educational level, past mammographic examination and history of bilateral oophorectomy were the major predictors of current and ever HRT use. Current use was also more frequently reported by women who were thinner, nulliparae, had had induced menopause, had a later onset of menopause, with history of oral contraceptive use and hysterectomy without bilateral oophorectomy. By contrast, those who were diabetics or had positive history of cardiovascular disease were less likely to be current HRT users. No differences were found in HRT use according to marital status, type of occupation, menopausal status, smoking, history of breast cancer, hypercholesterolemia, hypertension and phlebitis. CONCLUSIONS: Our results support previous findings indicating that HRT use in Italian women is uncommon and of short duration. Current HRT users were less likely than non-users to report several characteristics associated with higher mortality and morbidity, in accordance with the healthy-user phenomenon described in other countries.

Aged↗

PubMedDate not supplied

The menopause in Spain: results of the DAMES (Decisions At MEnopause) study.

OBJECTIVE: To assess the symptomatology of menopause and the use of hormone therapy among women in Spain. METHODS: A survey conducted on a representative sample of 300 women aged 45-55 in Madrid. The instrument included closed- and open-ended questions about demographic and socio-economic information, health and reproductive history, symptoms in past month, use of health services, life style, and therapeutic decisions. RESULTS: Eighty-three percent of respondents report five or more symptoms. Joint pains, weight gain, mood changes and nervousness are the most frequently reported; just under half of respondents report hot flashes; 4/5 report emotional/mental symptoms. The frequencies of some symptoms vary with socio-economic status. Two-thirds of respondents have consulted physicians, and 10% are currently taking hormone therapy; the use of hormone therapy is lower among women from the lower strata. One-fifth of respondents use of nonconventional and alternative medications. Just under half of respondents find that menopause is difficult. CONCLUSION: Symptom reporting is relatively high, but general symptoms are more frequent than "core" menopausal symptoms. The use of hormone therapy is relatively low, but the use of alternative medicines is relatively high.

Diet↗

PubMed2005

Racial and ethnic disparities in breast cancer: a multilevel perspective.

Although the etiology of racial and ethnic disparities in breast cancer is complex, the studies reviewed here suggest many possible culprits. In the authors' model, outcomes at the cellular level reflect not only genetic constitution and the hormonal milieu but also the interactions of predictors at multiple levels. At the societal level, important predictors include toxin and hormone exposure, access to care, quality of care, and social support. At the individual level, reproductive history, exogenous hormone use, diet,exercise, and response to stress all may influence cellular outcomes. The smooth transition from normal cell function to apoptosis occurs when the interactions between factors at the societal, individual, and cellular levels are harmonious. Perturbations at the societal level, however, such as inferior quality of care, or at the individual level, such as exogenous hormone use,can have profound effects on cell biology and predispose to neoplasia. When these perturbations are systematic and vary by race or ethnicity, disparities in breast cancer incidence and mortality result. Increasing incidence of breast cancer among both men and women likely reflects important trends at the societal and individual levels. These trends may include increased toxin exposure, increased obesity, and changes in the timing and number of births. Efforts to reduce breast cancer incidence and disparities must consider societal and individual factors and the important effects these factors can have on normal cell function.

Adult↗