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Hysterectomy following sterilization.

Using record linkage data derived from Scottish hospital discharge summaries, admissions to gynaecological units and hysterectomy rates have been studied following sterilization. The average annual gynaecological admission rate per 1000 women was 43.7 in the group of sterilized women and 21.5 in the control subjects. The average annual hysterectomy rate was 9.3 in the sterilized women and 2.5 in the control subjects. Although there were differences in age and pregnancy number between cases and controls, these did not account for the observed differences. This study was not able to determine whether the increase in gynaecological morbidity was due to the sterilization procedure or to the characteristics of the women sterilized.

Adult↗

Comparison of interval and postabortal/puerperal laparoscopic sterilization with the tubal ring procedure.

During a 5-year period, 344 women underwent laparoscopic sterilization with the tubal ring. Complications and failure rates were compared in intervals and postabortal/puerperal procedures. Only 9% were lost to follow-up, and 50% underwent a hysterosalpingoghraphy (HSG). The comparison of interval and postabortal/puerperal procedures showed no significant differences in complication rates, but postabortal/puerperal laparoscopy had a significantly lower failure rate than interval procedures (p less than 0.01). It was found that women whose laparoscopy was carried out despite peroperative complications had a significantly higher risk of sterilization failure (p less than 0.005). It is concluded that postabortal/puerperal laparoscopic sterilization with the tubal ring procedure is as safe as interval sterilization, and it is strongly recommended that peroperative complications with tubal ring sterilization should result in a reversion of the laparoscopy to a laparotomy and, if not, that the women be referred for HSG.

Abortion, Spontaneous↗

Fertility, sterilization, and population growth in Shanti Nagar, India: a longitudinal ethnographic approach.

The results of the 1981 Indian census showed a slight increase in the rate of population growth despite an energetic governmental campaign to reduce fertility, the growing use of contraception, a substantial number of sterilized persons, and a declining birthrate. The longitudinal ethnographic analysis of population data from Shanti Nagar dating from the 1950s and the 1970s suggests that the growth rate of the population might be better understood if analytical emphasis were to be shifted somewhat from birth and death rates to survivorship, that is, the average number of living children per mother, thus focusing attention on the family, the social unit in which the decisions are made that give rise to national demographic rates and averages. Currently, the principle fertility decision that a Shanti Nagar couple must make is whether to undergo sterilization and how many children are deemed necessary before taking this step. Analysis of the Shanti Nagar data shows that women of completed fertility in the 1970s had more living children than comparable women in the 1950s, and that even the sterilized couples of the 1970s had only slightly fewer children than the almost entirely noncontracepting women of the 1950s. Although the age of women at their own (or their husbands') sterilization is falling and the operation takes place after fewer children than formerly, the average sterilized couple nonetheless has more than 4 children instead of the 2 or 3 that the Government of India prefers. An analysis of the relationship to fertility of various modernization variables, such as urbanization and enhanced economic status, fails to show any consistent correlation of such variables with reduced fertility. School attendance by females is perhaps the most promising of the modernization veriables, but its effect is somewhat ambiguous and relatively weak until women achieve the college level. Current trends suggest that soon after 2025, India may surpass China as the world's most populous nation.

Asia↗

Risk factors for regret after tubal sterilization: 5 years of follow-up in a prospective study.

The Collaborative Review of Sterilization is a prospective, multicenter study that interviewed 7,590 women before they underwent tubal sterilization and then conducted yearly follow-up interviews that included questions on sterilization regret. These women contributed 26,641 observations (for up to 5 years after the procedure, 1978 to 1988) to an analysis of the presterilization characteristics most consistently associated with poststerilization regret. Young age at the time of sterilization was the strongest predictor of regret, regardless of parity or marital status; among women 20 to 24 years of age at sterilization, an average of 4.3% reported regret over the follow-up period. The rate of regret was significantly lower for women 30 to 34 years of age (2.4%).

Adult↗

Sterilization regret among Puerto Rican women.

This study examined sterilization regret among Puerto Rican women with contraceptive tubal sterilizations (TS) using retrospective data from a population-based survey of women aged 15 to 49 years. Twenty-one percent of the 846 respondents expressed some regret, with 11% stating definite dissatisfaction with the decision. Factors associated with regret were young age at TS, absence of daughters, someone else making the decision to be sterilized, medical indications for TS, sterilization failure, and living with a new marital partner. There were no significant effects associated with the timing of sterilization, whether interval or postpartum, or with the type of last delivery. Other factors not independently associated with regret included years since TS, parity, education, and age at follow-up.

Adolescent↗

Menstrual pattern changes following laparoscopic sterilization: a comparative study of electrocoagulation and the tubal ring in 1,025 cases.

This investigation compared the effects of the laparoscopic occlusive techniques of unipolar electrocoagulation and the tubal ring on subsequent menstrual patterns. The question of whether sterilization, in general, causes menstrual pattern changes is also addressed. The 1,025 cases constituted a data set collected by investigators at five institutions in five countries. After controlling for prior contraceptive use, the two techniques were compared with respect to menstrual cycle regularity, cycle length, flow duration, amount of flow, dysmenorrhea and intermenstrual bleeding. In this series, approximately 10% to 50% (depending on the menstrual parameter) of the menstrual pattern changes seen within six months following sterilization could be attributed to the discontinuation of the Pill or IUD at the time of sterilization. The majority of the women experienced no menstrual pattern changes following sterilization. There was no statistically significant difference between the two occlusion techniques in terms of the proportion of women who reported changes in any of their menstrual parameters. The theory that sterilization causes menstrual pattern changes rests on the hypothesis that the greater the degree of destruction of the uteroovarian vascular anastomosis (as with unipolar electrocoagulation), the greater the amount of subsequent menstrual pattern disturbance. Our findings suggest that this hypothesis is not valid.

Adult↗

Late complications of sterilization according to method.

By using a patient questionnaire, we checked the effects of two tubal sterilization procedures (high-frequency [HF] and endocoagulation techniques) in relation to late complications. In the years following high-frequency sterilization, 23 women (8.9%) had hysterectomies; in the endocoagulation group only 9 patients (2.3%) underwent hysterectomy. Patients sterilized by the unipolar high-frequency technique required one to three curettages in 7.8% of cases, whereas only 2.1% of the endocoagulation group required this procedure. Seventy-nine patients in the high-frequency group (30.9%) exhibited menstrual disorders as compared to only 45 (11.7%) in the other group. The combination of menstrual irregularities and menopausal complaints was found in 7.4% of the HF group, while only 2.8% of the endocoagulation group experienced these problems. Menopausal complaints only, without menstrual disorders, occurred in 4.7% and 3.9% of the women, respectively. Eighty-five percent of 330 patients sterilized by the Semm endocoagulation technique had no menstrual complaints or menopausal symptoms; in the HF group this was the case for 160 women (62%). Our results demonstrate that late postoperative complications arise less often in patients sterilized by endocoagulation.

Adult↗

Pregnancy after failed tubal sterilization.

OBJECTIVE: To review the pregnancy outcome in patients with failed tubal sterilization treated in our hospital and to compare the incidence of ectopic pregnancy in our study group with the experience at other military hospitals and with the incidence of ectopic pregnancy in similar patients reported in the literature. STUDY DESIGN: A registry of failed tubal sterilization was started at our hospital in 1989. We entered all information regarding the type of procedure and pregnancy outcome as the patients presented for care. Information on the experience at other military hospitals was obtained through review of data provided by the epidemiology section of the Health Services Command, San Antonio, Texas. RESULTS: From 1989 to 1991, 12 patients with failed tubal sterilization received care at our hospital. Eight patients (67%) had ectopic pregnancies. Of 137 patients identified through the Health Services Command, 49 (36%) had ectopic pregnancies. CONCLUSION: The literature reports a 5-90% incidence of ectopic pregnancy after failed tubal sterilization. The data from our registry and from the Health Services Command corroborate the increased likelihood of ectopic pregnancy in patients with failed tubal sterilization and underscore the need for close follow-up of these patients until the location of the pregnancy is documented.

Adult↗

Characterization of defects in adult germline development and oogenesis of sterile and rescued female hybrids in crosses between Drosophila simulans and Drosophila melanogaster.

Crosses between Drosophila melanogaster and D. simulans normally result in progeny that are either inviable or sterile. Recent discovery of strains that rescue these inviability and sterility phenotypes has made it possible to study the developmental basis of reproductive isolation between these two species in greater detail. By producing both rescued and unrescued hybrids and examining the protein product staining patterns of genes known to be involved in early germline development and gametogenesis, we have found that in crosses between D. simulans and D. melanogaster, hybrid female sterility results from the improper control of primordial germline proliferation, germline stem cell maintenance, and cystoblast formation and differentiation during early oogenesis. Rescued hybrid females are fertile, yet they generally have lower amounts of adult germline from the outset and show a premature degeneration of adult germline cells with age. In addition, older rescued hybrid females also exhibit mutant egg phenotypes associated with defects in dorso-ventral patterning which may result from the improper partitioning of cytoplasmic factors during early oogenesis that could stem from the early defect. Although a variety of germline and oogenic defects are described for the hybrid females, all of them can potentially result from the same underlying primary defect. Hybrid males from these same crosses, on the other hand, have no detectable germline in adult reproductive tissues, even when hybrid sterility rescue strains are used, indicating that male sterility and female sterility stem from distinctly different developmental defects.

Animals↗

Characterization of radish mitochondrial atpA: influence of nuclear background on transcription of atpA-associated sequences and relationship with male sterility.

We have previously shown that the mitochondrial gene atpA, encoding the alpha subunit of F1 ATP synthase, is associated with DNA rearrangements and nuclear-specific transcript patterns in the male-sterile cytoplasm of Ogura radish. Here we present a detailed characterization of this gene from both the normal (fertile) and Ogura (male-sterile) cytoplasms of radish to determine if it is involved in Ogura cytoplasmic male sterility. The normal and Ogura radish atpA loci are virtually identical for 3.8 kb, including a 507 codon open reading frame whose product is approximately 92% identical to other plant ATPA polypeptides. Rearrangement breakpoints have been identified 613 bp 5' and 1663 bp 3' to the atpA coding region. The 5' rearrangement breakpoint is located within a repeated sequence that has been associated with other rearrangement events in radish mitochondria. The previously identified transcript difference results from transcription originating upstream of this rearrangement site. Although the presence of this transcript is affected by nuclear background, analyses in several different sterile and fertile nuclear backgrounds indicate that the presence of this transcript is not strictly correlated with male sterility. In addition, normal levels of ATPA polypeptide are present in sterile plants containing the Ogura cytoplasm.

Amino Acid Sequence↗

Alloplasmic male-sterile Brassica lines containing B. tournefortii mitochondria express an ORF 3' of the atp6 gene and a 32 kDa protein. off.

Analyses of mitochondrial transcription and in organello translation were performed with the Brassica tournefortii cytoplasm. This cytoplasm causes alloplasmic male sterility when combined with the nuclear genomes of B. napus and B. juncea. Mitochondrial RNA and protein banding patterns were compared between the fertile wild species B. tournefortii, an alloplasmic male-sterile B. juncea line, an alloplasmic male-sterile B. napus line and an alloplasmic B. napus line with restored fertility. The analyses were carried out to identify differences in gene expression and to investigate whether alterations in gene expression accompanied male sterility. A difference in transcription patterns between the fertile B. tournefortii and the alloplasmic lines was found for the atp6 gene. The atp6 region was investigated further, since a similar alteration in atp6 transcription has been observed in two other Brassica cytoplasms which are associated with cytoplasmic male sterility (CMS). The additional longer atp6 transcript detected in the alloplasmic lines in the present study was found to contain an open reading frame (ORF) located downstream of the atp6 gene. DNA sequencing revealed that the ORF, orf263, could encode a protein with a predicted molecular weight of about 29 kDa. In organello analysis detected two proteins of 29 and 32 kDa respectively, which were found only in the alloplasmic lines. Furthermore, the 32 kDa protein accompanied male sterility since it was absent in alloplasmic plants restored to fertility. The protein analysis might indicate that orf263 is translated and causes CMS.

Amino Acid Sequence↗

Several nuclear genes control both male sterility and mitochondrial protein synthesis in Nicotiana sylvestris protoclones.

Male sterile plants appeared in the progeny of three fertile plants obtained after one cycle of protoplast culture from a fertile botanical line and two androgenetic lines of Nicotiana sylvestris. These plants showed the same foliar and floral abnormalities as the cytoplasmic male sterile (cms) mitochondrial variants obtained after two cycles of culture. We show that male sterility in these plants is controlled by three independent nuclear genes, ms1, ms2 and ms3, while no changes can be seen in the mitochondrial genome. However, differences were found between the in organello mitochondrial protein synthesis patterns of male sterile and parent plants. Two reproducible changes were observed: the presence of a new 20 kDa polypeptide and the absence of a 40 kDa one. Such variations were described previously in mitochondrial protein synthesis patterns of the cms lines. Fertile hybrids of male sterile plants showed normal synthesis patterns. The male sterile plants are thus mutated in nuclear genes involved in changes observed in mitochondrial protein synthesis patterns.

Cloning, Molecular↗

Alloplasmic male-sterile Brassica juncea with Enarthrocarpus lyratus cytoplasm and the introgression of gene(s) for fertility restoration from cytoplasm donor species.

A new cytoplasmic male sterility (CMS) source in Brassica juncea (2n = 36; AABB) was developed by substituting its nucleus into the cytoplasm of Enarthrocarpus lyratus (2n = 20; E(l)E(l)). Male sterility was complete, stable and manifested in either petaloid- or rudimentary-anthers which were devoid of fertile pollen grains. Male sterile plants resembled the euplasmic B. juncea except for slight leaf yellowing and delayed maturity. Leaf yellowing was due mainly to higher level of carotenoids rather than a reduction in chlorophyll pigments. Female fertility in male-sterile plants varied; it was normal in lines having rudimentary anthers but poor in those with petaloid anthers. Each of the 62 evaluated germplasm lines of B. juncea was a functional maintainer of male sterility. The gene(s) for male-fertility restoration ( Rf) were introgressed from the cytoplasm donor species through homoeologous pairing between A and E(l) chromosomes in monosomic addition plants (2n = 18II+1E(l)). The percent pollen fertility of restored F(1) ( lyr CMS x putative restorer) plants ranged from 60 to 80%. This, however, was sufficient to ensure complete seed set upon by bag selfing. The CMS ( lyr) B. juncea compared favourably with the existing CMS systems for various productivity related characteristics. However, the reduced transmission frequency of the Rf gene(s) through pollen grains, which was evident from the sporadic occurrence of male-sterile plants in restored F(1) hybrids, remains a limitation.

Brassica↗

A new cytoplasmic male sterility system for hybrid seed production in Indian oilseed mustard Brassica juncea.

We report a novel cytoplasmic male sterility (CMS) system in Brassica juncea (oilseed mustard) which could be used for production of hybrid seed in the crop. A male sterile plant identified in a microspore derived doubled haploid population of re-synthesized B. napus line ISN 706 was found to be a CMS as the trait was inherited from the female parent. This CMS, designated '126-1', was subsequently transferred to ten different B. juncea varieties and lines through inter-specific crosses followed by recurrent backcrossing. The F(1)s of inter-specific crosses were invariably partially fertile, but irrespective of the variety/line used, the recipient lines became progressively male sterile over five to seven generations and could be maintained by crossing the male sterile lines with their normal counterparts. The male sterile lines were found to be stable for the trait under both long and short day conditions. CMS lines when crossed with lines other than the respective maintainer line were restored for fertility, implying that any variety could act as a restorer for '126-1' cytoplasm in B. juncea. These unique features in maintenance and restoration of CMS lines coupled with near normal floral morphology of the CMS lines have allowed the use of '126-1' cytoplasm for hybrid seed production. The uniqueness of '126-1' has been further established by Southern hybridization with mitochondrial DNA probes and by a histological study of the development of male sterile anthers.

Brassica napus↗

Fine mapping of S32(t), a new gene causing hybrid embryo sac sterility in a Chinese landrace rice (Oryza sativa L.).

Ketan Nangka, the donor of wide compatibility genes, showed sterility when crossed to Tuanguzao, a landrace rice from Yunnan province, China. Genetic and cytological analyses revealed that the semi-sterility was primarily caused by partial abortion of the embryo sac. Genome-wide analysis of the linkage map constructed from the backcross population of Tuanguzao/Ketan Nangka//Ketan Nangka identified two independent loci responsible for the hybrid sterility located on chromosomes 2 and 5, which explained 18.6 and 20.1% of phenotypic variance, respectively. The gene on chromosome 5 mapped to the previously reported sterility gene S31(t), while the gene on chromosome 2, a new hybrid sterility gene, was tentatively designated as S32(t). The BC1F2 was developed for further confirmation and fine mapping of S32(t). The gene S32(t) was precisely mapped to the same region as that detected in the BC1F1 but its position was narrowed down to an interval of about 1.9 cM between markers RM236 and RM12475. By assaying the recombinant events in the BC1F2, S32(t) was further narrowed down to a 64 kb region on the same PAC clone. Sequence analysis of this fragment revealed seven predicted open reading frames, four of which encoded known proteins and three encoded putative proteins. Further analyses showed that wide-compatibility variety Dular had neutral alleles at loci S31(t) and S32(t) that can overcome the sterilities caused by these two genes. These results are useful for map-based cloning of S32(t) and for marker-assisted transferring of the neutral allele in hybrid rice breeding.

Base Pairing↗

Association of misexpression with sterility in hybrids of Drosophila simulansand D. mauritiana.

Recent studies have identified genes associated with hybrid sterility and other hybrid dysfunctions, but the consequences of introgressions of these "speciation genes" are often poorly understood. Previously, we identified a panel of genes that are underexpressed in sterile male hybrids of Drosophila simulans and D. mauritiana relative to pure species. Here, we build on this reverse-genetics approach to demonstrate that the underexpression of at least five of these genes in hybrids is associated with hybrid sterility and that these five genes are coordinately regulated. We map one upstream regulator of these genes to a region previously shown to harbor one or more factors causing hybrid sterility. Finally, we show that the genes underexpressed in hybrids are often highly conserved, as might be predicted for downstream targets of the genetic changes that cause hybrid sterility. This approach integrates forward genetics with reverse genetics to show a proximate consequence of the introgression of particular hybrid sterility-conferring regions between species: underexpression of genes necessary for normal spermatogenesis.

Animals↗

Mitochondrial atp6 transcript editing during microgametogenesis in male-sterile sorghum.

A marked reduction of mitochondrial atp6 transcript-editing capability in sorghum anthers and pollen has been invoked as a factor in the loss of viability of male gametophytes in lines carrying the IS1112C male-sterile cytoplasm. We initiated a systematic examination of transcript editing of sorghum atp6 during microgametogenesis, from microspores through pollen, in two sets of male-fertile and near-isogenic, male-sterile lines. Transcript editing in cDNA populations from fertile lines indicated an average of about 90% editing among 15 sites examined. Parallel samples from sterile lines demonstrated a detectable reduction in editing efficiency, most evident in late pollen samples. However, editing efficiency in these cells averaged 80%, substantially higher than the 20% previously observed. Thus male-sterile lines retain substantial atp6-editing efficiency in an environment where the sterility and fertility restoration traits are stably expressed. Drastically reduced editing of atp6 transcripts in anthers and pollen of male-sterile sorghum is not demonstrable in a field environment; and thus it is not a factor in the loss of microgametophyte viability in this system.

Base Sequence↗

The effects of sterile or infected bile and dropped gallstones in abdominal adhesions and abscess formation.

BACKGROUND: The effects of gallstones and sterile or infected bile on postoperative adhesions and abscess formation were investigated in Sprague Dawley rats. METHODS: The first three groups were injected intraperitoneally with serum saline, sterile bile, or infected bile, respectively. Laparotomy was adjusted to the next seven groups. Serum saline, sterile bile, and infected bile were injected in the fourth through sixth groups intraperitoneally, respectively. Gallstones were placed intraabdominally to the seventh through ninth groups. The injections of sterile bile in group 7 and of infected bile in group 8 were added to laparotomies. Only laparotomy was carried out in group 10. RESULTS: Abscess formations were seen only in infected-bile-injected groups. Significant adhesion formations were seen in infected-bile groups. Sterile bile and/or gallstones had no significant effect in abscess or adhesion formation. CONCLUSIONS: Results suggest that noninfected gallstones and sterile bile, even in combination, do not increase postoperative intraabdominal complications in rats.

Abdomen↗