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Biomedical subjects

M Glezerman

Publications and source records attributed to M Glezerman.

At least 127 records · Page 7Linked to original sources
PubMed1981

[Gonadotrophin therapy (author's transl)].

Strict selection of patients is of paramount importance with a view to obtaining optimum results in the treatment of infertile men with gonadotrophins (HMG/HCG). The use of algorithmic tables permits the exclusion of cases of primary orchiopathy, or of genetic or other causes of infertility independent of the endocrine system. Within the scope of a retrospective study this paper gives an account of the results obtained with gonadotrophin therapy in 25 men presenting severe oligozoospermia. The patients had been selected according to the above-mentioned algorithmic schedule, and their serum levels of FSH, LH and testosterone were determined before and after GNRH stimulation. The present study establishes criteria for the selection of such patients as can be treated successfully with gonadotrophin.

Chorionic Gonadotropin↗
PubMed1981

Two hundred and seventy cases of artificial donor insemination: management and results.

Whenever male infertility is resistant to therapy, artificial donor insemination (AID) may be employed as a very efficient tool to provide the infertile couple with the desired child. Two hundred and seventy cases of AID were reviewed for the following information: indication for AID, age of the female partner, length and type of infertility, socioeconomic state, ovulatory pattern prior to and following initiation of the AID program, acceptance of the procedure by the male partner, and outcome of pregnancies. The over-all pregnancy rate was 85.2%. There were 159 live births, 2 perinatal deaths, 38 spontaneous abortions, 1 ectopic pregnancy, and 1 therapeutic abortion due to rubella infection. Forty patients discontinued treatment with or without notification. Treatment success was significantly affected by age of the woman, duration of infertility, socioeconomic state of the couple, and the husband's acceptance of the AID procedure. Of all pregnancies, 86.5% occurred within six treatment cycles. Repeated pregnancies required similar numbers of treatment courses per pregnancy.

Abortion, Incomplete↗
PubMed1980

Sperm storage in the human cervix: a quantitative study.

Twenty-five women scheduled for hysterectomy for nonmalignant disease participated in the study. Sperm storage in endocervical crypts was examined in three groups of patients: nine women pretreated with estrogen and inseminated with normal semen, nine women pretreated with gestagen and inseminated with normal semen, and seven women pretreated with estrogen and inseminated with abnormal semen. The number of crypts containing spermatozoa (colonized crypts) and the sperm density per crypt were examined in serially sectioned cervices. In estrogen-pretreated cervices both the percentage of colonized crypts and the sperm density were significantly higher than in gestagen-pretreated cervices. Large and giant crypts proved to be the main storage facility for spermatozoa. The localization of crypts along the endocervical canal did not influence sperm storage. The quality of semen appeared to be of critical importance to sperm storage. The percentage of colonized crypts and sperm density were severly reduced in patients inseminated with abnormal semen.

Cervix Mucus↗
PubMed1978

Asherman's syndrome--a self-limiting disease?

Intrauterine adhesions (Asherman's syndrome) may follow curettage in a recently pregnant uterus. Treatment consisting of dilatation and curettage and possibly the insertion of an intrauterine device usually is started early. The success rate is high. Very few cases of spontaneous recurring menstruation have been reported, and none of them have been based on hysterosalpingographic evidence of adhesions. The pregnancy outcome is generally poor in those cases of assumed spontaneous resolution. We present a case of spontaneous restitution of a functional uterine cavity and normal menstruation following Asherman's syndrome. Subsequent pregnancy was uneventful. A short review of the literature is presented, and the possible self-limiting character of the disease is discussed.

Adult↗
PubMed1976

Retrograde ejaculation: pathophysiologic aspects and report of two successfully treated cases.

The ejaculatory process consists of two stages. During the first stage the semen is pumped into the posterior urethra and during the second stage the semen is propelled via the urethra through the external meatus. A pathologic second stage may lead to retrograde ejaculation of the semen into the urinary bladder. Attempts to achieve fertility in such patients can be made in two ways; namely through procedures to restore antegrade ejaculation (mainly using alpha-sympathomimetic agents) and procedures to regain viable and fertile sperm from the urinary bladder after sexual intercourse, with subsequent artificial insemination. The latter way of treatment was used in two patients who were referred for infertility and in whom retrograde ejaculation had been diagnosed. Postcoital urinary specimens were obtained by micturition and centrifuged. In one patient the sediment was washed with a nutrient solution; the other patient received alkalizing agents prior to intercourse in order to neutralize the urinary pH. The wives were inseminated on appropriate days and conceived. Both delivered healthy babies after uneventful pregnancies.

Adult↗
PubMed1976

Varicocle in oligospermic patients: pathophysiology and results after ligation and division of the internal spermatic vein.

We have followed for up to 32 months 51 oligospermic patients with varicoceles who underwent high ligation and division of the left spermatic vein. Of these patients 59.9 per cent had improvement in total sperm count, 47.1 per cent in sperm motility and 42.1 per cent in the morphological pattern of the spermatozoa. Pregnancies were reported by 13 patients. Improvement in sperm motility occurred first, followed by improvement in morphology. The last improvement was in total sperm count. We suggest that the observation period after a varicocele operation be restricted to 9 months, in which time about 75 per cent of the expected improvement takes place. A clinical classification for the degree of varicocele is proposed. No correlation between size of the varicocele and treatment results could be observed. A classification of sperm analysis is proposed, using a 3-digital index that might enable better comparison of sperm analysis and better communication among physicians. We could not define a specific group of oligospermic patients who might benefit more than other groups from a varicocele operation. Pathophysiological pathways leading to impaired spermatogenesis in patients with varicoceles are discussed.

Fertility↗
PubMedDate not supplied

Brain metastases in epithelial ovarian carcinoma; two case reports.

The cases of two patients with epithelial ovarian carcinoma who had been treated with surgery and cisplatin-containing combination chemotherapy and had developed brain metastases are described. Modern protocols for management of advanced-stage epithelial ovarian carcinoma have resulted in prolonging the lives of the patients sufficiently for central nervous system metastases to become apparent and possible resistence of the 'blood brain' barrier to the currently used chemotherapeutic agents may have left the CNS 'unprotected' from metastases.

Brain Neoplasms↗
PubMedDate not supplied

Relatively reduced values of plasma alpha-fetoprotein at early second trimester of pregnancies with hypertensive disorders.

Hypertensive disorders during pregnancy implicate placental pathologic conditions, which may interfere with the normal passage of alpha-fetoprotein (AFP) to the maternal blood. We compared the levels of maternal serum (MS) in early second trimester of pregnancies complicated by hypertensive disorders with those of matched controls. The distribution in the study group of MS-AFP multiple of median values was significantly different from the distribution in the control group. Moreover, up to multiple of the median 1.00, the number of hypertensive patients was larger than the number of normotensive pregnant women. The mean level of multiples of the median in the study group was significantly lower than that of the control group (p value = 0.003, 95% confidence interval: -0.30, -0.05). In the analysis of the distinct types of hypertension, the difference remained significant for 85 women in the moderate hypertension subgroup (p value = 0.032, confidence interval: -0.34, -0.02) and was not significant for the severe hypertension subgroup of 22 women (p value = 0.24, 95% confidence interval: -0.57, 0.15) and chronic hypertension subgroup of women (p value = 0.52, 95% confidence interval: -0.44, 0.00). The trend was consistent in all the subgroups. Relatively low values of maternal serum AFP at early second trimester of pregnancies with hypertensive disorders may be a result of placental pathologic involvement and can help in the identification of the women at risk.

Adolescent↗
PubMedDate not supplied

The fertile eunuch syndrome. An isolated leydig-cell failure?

In two patients exhibiting eunuchoid features in association with normal sized testes and complete spermatogenesis concommittant with only occasional Leydig cells between the tubuli, (proven by testicular biopsy) an attempt was made to elucidate the factors leading to this condition. Both patients responded with significant rise in both plasma FSH and LH after administration of synthetic GnRH indicating pituitary responsiveness. However, no rise in either FSH or LH could be observed after administration of clomiphene citrate during three weeks of treatment indicating hypothalamic unresponsiveness to chemical stimuli. Although plasma testosterone levels rose significantly after administration of Human Chorionic Gonadotropin, estradiol remained unchanged during three weeks of HCG administration. A hypothesis is discussed which defines this syndrome in these two cases as primary Leydig cells failure, expressed in the inability of these to transform testosterone into estrogens, thus depriving pituitary and hypothalamus from a proper steroidal milieu necessary to adequate functioning.

Adult↗
PubMedDate not supplied

Reifenstein's syndrome--a target cell failure.

The features of Reifenstein's Syndrome comprise hypospadias, microtestes, gynecomastia, azoospermia and elevated gonadotropins. The disease is inherited as either a male limited autosomal dominant or as a X-linked recessive trait and affects only genetic males. A case is reported suffering from this condition. Pituitary function was evaluated using the GnRH-test and appeared to be normal. Prolactin and testosterone values were in the normal range. The patient was a phenotype male and sexual function was satisfactory. Primary tubular failure resulting in hypergonadotropic hypogonadism was diagnosed. No other relatives were found to be affected. The syndrome seems to be due to relative insensitivity of Leydig cells to androgens.

Adult↗
PubMedDate not supplied

Treatment of male infertility with human gonadotrophins: selection of cases, management and results.

To obtain optimal results with gonadotrophic therapy (HMG/hCG) in infertile males, strict selection of patients is of paramount importance. The use of algorithmic schemes permits the exclusion of patients with primary testicular failure, genetic and non-endocrine causes of infertility. This paper describes a retrospective study on the results of gonadotrophic therapy in 25 severe oligozoospermic males, preselected according to the above scheme and in whom levels of FSH, LH and Testosterone before and during GnRH stimulation were assessed. This study indicates that low basal levels of FSH, concomitant with low or lack of FSH response to GnRH stimulation may be useful in selection of patients with a fair chance of success for gonadotrophic therapy.

Chorionic Gonadotropin↗