Assessment of reproductive disorders and birth defects in communities near hazardous chemical sites: introduction.
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Pelvic pain is common in adolescents and can result from a number of physiological and pathological etiologies, both gynecologic and nongynecologic in origin. The evaluation, diagnosis, and management of these conditions involve both medical and surgical approaches. In this review, the authors present a comprehensive approach to the care of adolescents with pelvic pain associated with dysmenorrhea, endometriosis, and obstruction of the genital tract.
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The classic concept of endometriosis as a cause of infertility is challenged. Traditionally, both surgical and medical therapy have focused on alleviation of symptoms, prevention of disease progression, and promotion of fertility. In spite of significant developments in medical and surgical approaches, the optimal therapy for treating endometriosis-associated infertility has yet to be established. The relationship between prevalence of fecundity and stage of the disease was studied according to the type of management. Of 151 women who were consecutively proved by laparoscopy to have endometriosis stage I and II, operative laparoscopy was performed in 49, medical treatment in 59, and expectant management in 43 cases. During a 24-month period, the cumulative pregnancy rates were 36.7%, 30.5%, and 20.9%, respectively. Survival analysis over the 20 weeks of pregnancy showed that the probability of carrying the pregnancy beyond this week was 30.6%, 25.4%, and 16.2%, respectively. Of 64 patients with advanced disease, 34 (53%) became pregnant during the 2-year follow-up period. A significantly increased pregnancy rate was found for the first year as compared to the second (76% vs. 24%). The existence of adhesions affected adversely the outcome of the treatment when early achievement of pregnancy is considered. Diagnosis and treatment of endometriosis was beneficial for the infertile women. Laparoscopic surgery seems to be the best treatment in these cases, as it increases the fecundity and involves minimal risk.
Corticotropin-releasing hormone (CRH) is a key mediator of endocrine, autonomic, behavioral, and immune responses to stress. The ability of CRH to induce hormonal stress responses has been used to investigate the functionality of the hypothalamus-pituitary-adrenal axis, and consequently the activity of hypothalamic CRH neuronal systems. Indeed, CRH administration to humans causes prompt release of ACTH, followed by secretion of cortisol, aldosterone and other adrenal steroids. CRH hypersecretion/hyperactivity has been associated to major depression, anxiety-related disorders, anorexia nervosa, Alzheimer's and Parkinson's diseases and progressive supranuclear palsy. During pregnancy the human placenta and its accessory membranes are the major sites of CRH synthesis and secretion. Placental CRH secretion is autonomous, but increasing evidence indicates that maternal or fetal conditions may influence such secretion. Therefore, the emerging concept is that in the event of acute or chronic metabolic, physical or infectious stress, the placenta takes part in a stress syndrome by releasing CRH, which may contribute to restore local blood flow and to influence the timing of delivery. The CRH released by the placenta is measurable in maternal plasma and other biological fluids and may be used to diagnose subclinical processes anteceding pregnancy complications such as pre-eclampsia and preterm delivery.
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INTRODUCTION: Obesity and overweight correlate with endocrine disorders in women, polycystic ovary syndrome, there are more atretic follicles in the ovary of obese women, overweight affects ovulation, pregnancy rates and outcomes in natural as well as in treated cycles. Similarly starvation correlates with menstrual cycle disturbances with anovulation. MATERIAL AND METHODS: The study includes 309 IVF treatment cycles performed in our IVF centre between 1/1/97 and 30/6/99. The patients were divided into five groups according to nutrition evaluated by body mass index (BMI). The parameters of IVF treatment includes the number of follicles, the number of collected oocytes, the recovery rate, the number of fertilized oocytes, the fertilization rate, the number of cleaved embryos, the cleavage rate, the clinical pregnancy rate, the take home baby rate, the miscarriage rate. The unpaired t-test was used in statistical analysis. RESULTS: There were found statistically significant less number of cycles with more than 10% fertilized oocytes and lower recovery rate in the obese and overweight women. CONCLUSIONS: Overweight and obesity significantly affect the parameters and outcomes of IVF treatment. The fertilization of the oocytes failed more often in the obese and overweight women. The lower pregnancy rates were achieved although the high oocytes recovery and high normal cleaved embryos were found in the obese women. The cause of the bad IVF treatment outcomes in the obese women seems to be probably the affected quality of the oocytes with lower fertilization and implantation potential eventually affected endometrium quality. The overweight reduction is the important part of infertility treatment in obese women.
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After a review on the viral agents playing a role in diseases of cattle those related to the occurrence in the genital tract are described. They may be causing abortion or local reactions leading to a reduced fertility and/or be of importance for the embryo transfer. Bovine herpesvirus type 1 (BHV1) and the bovine virus diarrhoea virus (BVDV) are the agents most widely distributed in Europe. Both are of economic importance, described in detail and vaccines available discussed.
OBJECTIVE: To determine the prevalence of chromosomal aberrations in infertile couples undergoing in vitro fertilization (IVF). DESIGN: Cytogenetic analysis of peripheral blood lymphocytes in the group of patients undergoing IVF. Detection of chromosomal aberrations in the fetuses after IVF. SETTING: Department of Medical Genetics and Fetal Medicine, Medical Faculty, Palacký University and the University Hospital, Olomouc. METHODS: Cultivation of peripheral blood lymphocytes or fibroblasts of amniotic fluid. Using fluorescent in situ hybridization in cases of mosaicism. RESULTS: Out of 638 patients undergoing treatment for male or female infertility, 595 had normal karyotype and 43 (6.8%) had abnormal karyotype. There were detected 9 (1.4%) cases of balanced chromosomal rearrangements, 2 (0.31%) cases of deletion of Y chromosome, 2 (0.31%) cases of inversion, 2 (0.31%) cases of marker chromosome, 5 (0.78%) cases of gonosomal aneuploidy (47,XXY) and 23 (3.65%) cases of gonosomal mosaicism--out of the 22 (3.5%) cases of low-level mosaicism. In the small group of pregnant patients after IVF investigated for the risk of genetic disorders included in our study (n = 60) the frequency of chromosomal abnormalities was 9 (15%). CONCLUSIONS: Our data show that a high number of infertile couples is affected by chromosomal aberrations which occur more frequently in females than in males. It is caused by high frequency of low-level gonosomal mosaicism in the group of infertile women. Chromosomal analyses are highly recommended before each IVF procedure.
Gonadotropin-releasing hormone (GnRH) agonists show promise as new therapeutic agents with considerable potential for clinical applications in endocrinology, gynecology, pediatrics, and oncology. GnRH agonists are derived from GnRH. This article reviews the physiology and neuroendocrine effects of GnRH and discusses clinical applications of the native substance and its analogs.
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In highly developed countries the prophylactic medical examinations to evaluate health effects of exposure and general health condition of the workers started early in the past. Nowadays, there is an increasing trend of developing new methods for early detection of occupational and work--related diseases. Thus the individuals oversensitive to the agents of the working environment could be prevented from exposure. However, the gap between the capacities that the new methods offer theoretically and their actual application in the prophylactic examinations still remains quite large. Part I of the present study has been devoted to three essential problems of public concern which have been specified in the paper's subtitles.
In highly developed countries, prophylactic medical examinations to evaluate the general health condition of workers and health effects of exposure to toxins have, in the past, been administered early in their work history. Presently, there is a trend towards developing new methods of early detection of occupational and work-related diseases. Thus, individuals oversensitive to agents in their working environment could be prevented from exposure. However, the gap between the capabilities offered theoretically by new methods and their practical application in prophylactic examinations remains quite large. Part I of the presented study is focused on three essential issues of public concern specified in the given subtitles.