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At least 19 recordsLinked to original sources
PubMed1979

Computer analysis of etiology and pregnancy rate in 636 cases of primary infertility.

Since the rate of pregnancy is a function of time, conventional pregnancy rates (number of patients achieving pregnancy per number of patients treated) are inadequate for counseling unless the follow-up period is specified. To overcome this problem, the expectancy of pregnancy for 636 cases of primary infertility was calculated with the assumption that the patients were followed up indefinitely. The overall "conventional" pregnancy rate was 38%, whereas the overall expectancy of pregnancy was 64%. Endometriosis was found to be the most common factor, comprising 25% of the cases, with a pregnancy rate of 31% and an expectancy of 52%. The expectancy of future pregnancy in a patient who has not achieved pregnancy by a given time is presented for each etiologic factor. This paper also presents a comparison of expectancies of pregnancy by different treatments, which may be helpful in selecting appropriate therapy.

Adult↗
PubMed1976

Inadequate cervical mucus--a cause of "idiopathic" infertility.

The purpose of this study was to investigate and treat a group of patients referred for "idiopathic" infertility in whom no apparent cause for infertility, apart from inadequate cervical mucus, was found. Hormone investigations revealed that these patients could be divided into two groups: those with low sex steroid profiles despite apparent ovulation, and a second group with normal sex steroid profiles. All patients were treated with ovulation-inducing agents in an attempt to produce "controlled" ovarian hyperstimulation and an improved cervical mucus. Four of six patients conceived. The rationale behind the use of ovulation-inducing agents in this situation is discussed.

Adult↗
PubMed1977

Lysis of periadnexal adhesions for correction of infertility.

A series of patients is presented in whom lysis of periadnexal adhesions was carried out for correction of infertility. These 35 couples had been infertile for at least 1 year prior to surgery. Seventy-seven per cent had been trying to conceive for more than 18 months. Following diagnostic evaluation, periadnexal adhesions were found to be the sole cause of infertility in 83% of cases. Subsequent to surgery, 63% of the patients conceived, 82% within 18 months, and 57% gave birth to at least one viable child. There can be no doubt that periadnexal adhesions represent true pathology. Although often seemingly insignificant in character, at the macroscopic level, they appear to play a major role at the microscopic level in impairing ovum pickup by the fallopian tube. Gynecologists should recognize the importance of these structures as mediators of a condition of relative sterility. Thus, despite the demonstration of tubal patency, the function of the rather delicate fimbria may be compromised by periadnexal adhesions, conglutinations, and hydatids so that only a fraction of those eggs that leave the ovary at ovulation reach the interior of the fallopian tube.

Adnexal Diseases↗
PubMed1978

Intraoperative internal spermatic vein phlebography in the subfertile male with varicocele.

Intraoperative internal spermatic vein phlebography was performed in 20 subfertile patients with a varicocele; 10 patients with varicoceles and left-sided indirect inguinal hernias without fertility problems served as controls. Phlebography was carried out during surgery with the patient supine and in a 45 degree anti-Trendelenburg position to stimulate an "erect" posture. In all 25 patients with a varicocele, valvular insufficiency was demonstrated at the renal-spermatic vein junction. When visualized, the position of the left adrenal vein in all instances was medial to or opposite the renal-internal spermatic vein confluence. This observation, reinforced by simultaneous determinations of cortisol levels in the internal spermatic and antecubital veins, practically excluded the validity of the theory of adrenal hormonal suppression of testicular tissues. In 40% of subfertile patients with a varicocele, double internal spermatic veins and reflux to the distended external spermatic (cremasteric) venous plexus were demonstrated. In no instance were such phenomena observed in the control groups. The not-infrequent failure of operative correction of varicocele seems to relate directly to such overlooked pathology. Broad clinical application of operative phlebography, especially in recurrent, persistent, or clinically advanced cases, will detect such anomalies and should reduce significantly the operative failures in the surgical correction of varicocele.

Adult↗
PubMed1979

Spermagglutinating antibodies and beta-spermagglutinins in sera from infertile and fertile women.

Sera from five groups of women were investigated by the tray agglutination technique for the presence of spermagglutinins: (1) 326 women from infertile couples, (2) 51 women in early pregnancy, (3) 65 women in advanced pregnancy, (4) 41 oral contraceptive users, and (5) 109 presumably fertile, nonpregnant women. By absorbing spermagglutinating sera with a cell-free eluate from spermatozoa, agglutination disappeared when due to a high-molecular weight compound with beta-mobility in preparative zone electrophoresis (denoted beta-spermagglutinin), whereas activity due to sperm antibodies was unchanged. Spermagglutinating sera occurred with comparable frequency among women from infertile couples, women in advanced pregnancy, and oral contraceptive users. The absorption study revealed agglutinating antibodies in a significantly higher frequency and in higher titers among women of infertile couples than among fertile women, in whom beta-spermagglutinins were found almost exclusively. These results demonstrate the importance of discriminating between sperm antibodies and beta-spermagglutinins in studies of sperm antibodies as a cause of infertility in women.

Agglutinins↗
PubMed1979

A comparison of gross and microsurgical techniques for repair of cornual occlusion in infertility: a retrospective study, 1968-1978.

A 10-year experience is recounted moving from traditional gross implantation methods to microsurgical anastomosis in the repair of cornual occlusion in infertility. Two gross surgical implantation techniques, one involving reaming out the intramural portion of the uterine tube and the other dissecting it out via a transfundal incision, are compared with microsurgical uterotubal anastomosis. The author reports a 4.7 times improvement in the term pregnancy rate after turning to microsurgery and describes his method for anastomosing the transected ampulla or isthmus to the intramural portion of the tube.

Fallopian Tubes↗
PubMed1975

Doxycycline treatment and human infertility.

The role of mycoplasmas in infertility was studied in 120 couples. During the twelve months of the study 27 couples (22-5%) conceived. T mycoplasmas were isolated from 63% of these couples, and Mycoplasma hominis from 18%, compared with 56% and 13%, respectively, in those who did not conceive. 88, with primary infertility of unascertained cause, took part in a controlled trial with doxycycline. The couples in the trial were allocated randomly to three groups: 30 received doxycycline, 28 received a placebo, and 30 couples were untreated. Although a twenty-eight-day course of doxycycline eradicated M. hominis and T-strain mycoplasmas from 27 (96%) of the 28 couples harbouring them, the rate of conception was no higher in those treated with the drug than in control groups. It is concluded that mycoplasmas are not associated with primary infertility and that, although doxycycline eradicates them, this drug is of no benefit in the treatment of primary infertility of unascertained cause.

Adult↗
PubMed1979

Infertility and cervical Chlamydia trachomatis infections.

Of the 51 women examined for infertility, 19.6 per cent were found Chl. trachomatis culture-positive. This differs, although not significantly, from the 9 per cent isolation rate among our general gynecological outpatients. The results suggest that Chl. trachomatis should be considered in women with unexplained infertility.

Adult↗
PubMed1979

The investigation of immunological infertility.

Immune reactions to spermatozoa may interfere with fertility in both males and females. These mechanisms may operate in a small, but significant, proportion of infertile couples, particularly when the duration of infertility is greater than three years. Antibodies to sperm may appear both in the blood and in genital tract secretions and their presence should be sought in both sites. The most suitable screening test for circulating anti-sperm antibodies in either partner is a method based on the complement-dependent antibody immobilization of sperm. This test may also be applied to cervical mucus as a routine in females. In males the detection of sperm immobilizing antibodies in blood serves as a reasonable guide to the existence of antibodies in seminal plasma where their presence may be confirmed using a gelatin agglutination test. Further information about the presence of locally secreted antibodies either in cervical mucus or in semen may be gained by using the sperm-cervical mucus contact (SCMC) test in which cross-testing with donor mucus or sperm will identify the site of local antibody production. Results based on immunofluorescence and sperm microagglutination methods are unreliable and lacking in correlation with continuing infertility and the routine use of these tests is not recommended.

Agglutination Tests↗
PubMed1978

Ureaplasma urealyticum (T. mycoplasma) and male infertility in topical countries.

In view of the potential role of ureaplasma urealyticum in reproductive failure, sample of semen from 100 Nigerian males was cultured in oxoid mycoplasma broth. In 39% of the patients, Uraeplasma uraelyticum was cultured. Of those with positive culture, 92.3% were infertile patients. Five subfertile males achieved pregnancy in their partners after eradication of the ureaplasma urealyticum by a course of tetracycline.

Humans↗