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PubMed2005

Age-related differences in serum gonadotropin (FSH and LH), salivary testosterone, and 17-beta estradiol levels among Ache Amerindian males of Paraguay.

Age-related differences in serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), salivary testosterone, and 17-beta estradiol levels are reported for Ache Amerindian males (n = 17; mean age, 37.1 +/- 14.2 SD) of Paraguay in order to explore population variation in patterns of male reproductive senescence in a foraging/agricultural community. Hormone associations were examined to test various hypotheses for age-related differences in hypothalamic-pituitary function. Significant increases in FSH (r = 0.75, P < 0.0005) and LH (r = 0.65, P < 0.01) were noted in association with aging. No significant correlation was observed between morning or evening testosterone and age. Morning and evening estradiol levels were associated with morning and evening testosterone, respectively (morning, r = 0.53, P = 0.05; evening, r = 0.63, P = 0.02). Evening estradiol was also positively associated with LH (r = 0.66, P = 0.02), suggesting testicular production to be an important source of circulating estradiol. Morning estradiol tended to rise with age, but was not significant (r = 0.39, P = 0.15). Anthropometric measurements of height, weight, body mass index, and fat percent did not change significantly with age. In contrast to testosterone, age-related differences in gonadotropin levels may be independent of energetic status, less variant, and more universal among male populations. Implications for gonadotropin function and aging on human male reproductive senescence and life histories are discussed.

Adult↗
PubMed2005

Case-control study of risk factors for breast cancer in Nigerian women: a pilot study.

OBJECTIVE: To evaluate the risk factors for breast cancer among women in Midwestern and Southeastern Nigeria. DESIGN: A case control study. SETTING: University of Benin Teaching hospital, Benin City and University of Port Harcourt Teaching Hospital, Port Harcourt in Nigeria. SUBJECTS: Fifty one women with diagnosis of breast cancer and their age- and sex matched controls were included in the study. INTERVENTIONS: Data was collected during a 30 minute period after obtaining written informed consent using interviewer-administered questionnaires. RESULTS: Parity > 4 (OR = 0.50, 95% Cl 0.17, 1.46) and duration of breast feeding > 60 months (OR = 0.58, 95% Cl 0.23, 1.48) were associated with reduced risk of breast cancer while birth order > 3 (OR = I.50, 95% Cl 0.25, 8.98), age at first full term pregnancy>20 years (OR = 2.50, 95% Cl 0.78, 7.97) and longer duration of reproductive period (OR = 1.25, 95% Cl 0.34, 4.66) were associated with increased risk of breast cancer. CONCLUSION: The study has shown that high parity and long duration of breastfeeding are associated with reduced risk while high birth order and late age at first full-term pregnancy are associated with increased risk of breast cancer.

Adult↗
PubMed2002

Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third National Health and Nutrition Examination Survey, 1988-1994.

BACKGROUND: Recent reports of rickets among African American children drew attention to the vitamin D status of these infants and their mothers. African American women are at higher risk of vitamin D deficiency than are white women, but few studies have examined determinants of hypovitaminosis D in this population. OBJECTIVE: We examined the prevalence and determinants of hypovitaminosis D among African American and white women of reproductive age. DESIGN: We examined 1546 African American women and 1426 white women aged 15-49 y who were not pregnant and who participated in the third National Health and Nutrition Examination Survey (1988-1994). Hypovitaminosis D was defined as a serum 25-hydroxyvitamin D concentration < or =37.5 nmol/L. Multiple logistic regression was used to examine the independent association of dietary, demographic, and behavioral determinants of hypovitaminosis D. RESULTS: The prevalence of hypovitaminosis D was 42.4 +/- 3.1% ( +/- SE) among African Americans and 4.2 +/- 0.7% among whites. Among African Americans, hypovitaminosis D was independently associated with consumption of milk or breakfast cereal <3 times/wk, no use of vitamin D supplements, season, urban residence, low body mass index, and no use of oral contraceptives. Even among 243 African Americans who consumed the adequate intake of vitamin D from supplements (200 IU/d), 28.2 +/- 2.7% had hypovitaminosis D. CONCLUSIONS: The high prevalence of hypovitaminosis D among African American women warrants further examination of vitamin D recommendations for these women. The determinants of hypovitaminosis D among women should be considered when these women are advised on dietary intake and supplement use.

Adult↗
PubMed2002

Early pregnancy loss following assisted reproductive technology treatment.

BACKGROUND: In women treated by assisted reproductive technology (ART), early pregnancy loss (EPL) reduces the initial success. Risk factors for EPL, however, have not been comprehensively studied. This study assesses some potential risk factors in ART pregnancies. METHODS: Altogether 1196 pregnancies, defined as serum hCG >or=10 IU/l on day 16 +/- 1 after oocyte retrieval, were included in this study. EPL was defined as pregnancy loss that occurred before 6-7 weeks gestation. Risk factors investigated were maternal age, body mass index (BMI), smoking and polycystic ovary syndrome (PCOS) status, infertility aetiology, response to stimulation, quality and number of embryos replaced and treatment type. RESULTS: Overall EPL was 16%. The risk of EPL was not linearly related to either age or BMI. Though women >40 years old had an increased risk, this was not significant after adjusting for other factors. The risk in both lean (BMI <18.5 kg/m(2)) and very obese (BMI >35 kg/m(2)) women was also not significantly higher in multivariate analysis. There was no effect of PCOS. Smoking or transfer of 'poor quality' embryo(s) was associated with a significant increased risk of EPL after adjusting for other factors. CONCLUSION: Smoking and transferring poor quality embryos increased EPL, while the effects of age, obesity and other risk factors were not significant in a multivariate analysis.

Abortion, Spontaneous↗
PubMed2004

Molecular genetics of human male infertility: from genes to new therapeutic perspectives.

Genetic lesions causing human male infertility are manifold. Besides gross chromosomal aneuploidies and rearrangements, microdeletions and single gene defects can interfere with male fertility. Male fertility is not only dependent on genes controlling the male germ line but also on genes of the networks functional for male gonad development and male somatic development, respectively. It is popular to unravel these netweorks with mouse gene knock-out mutants displaying reproductive defects. However, substantial arguments can be given for more functional studies directly on the human genes, because multiple reproductive proteins evolve quickly most likely for adopting to the specific needs of the species class. Prominent examples are mutations of the FSHR gene causing different pathologies in mouse and human and the DAZ gene family not found in the mouse genome but in the human genome with an essential male fertility function. Therefore this review is focussed on a comprehensive overview of human genes known with mutations causing male infertility (AR; AZF gene families; CFTR, DM-1, DNAH gene family, FGFR1, FSHR, INSL3, KAL-1, LGR8- GREAT, LHR, POLG). Then some human genes are described well recognised as functional in spermatogenesis and male fertility although gene specific mutations causing infertility were not yet identified (CREM, CDY1, DAZL1, PHGPx, PRM-1, PRM-2). They are designated as "spermatogenesis phase marker" or "male fertility index" genes, because they are useful tools for diagnosing the patient's spermatogenesis disruption phase and for predicting the presence and quality of his mature sperms. Current therapeutic protocols for human male infertility do usually not cure the specific gene defect but try to bypass it using Artificial Reproductive Technology (ART). Putative imprinting defects in the early embryo probably associated with the used ART protocol and an increase of chromosome abnormalities in the ART offspring now strongly asks for a significant improvement of this outcome requesting urgently more basic research on the genes functioning in the human male germ line and during early human embryogenesis.

Animals↗
PubMed2001

Implications for evaluating the impact of family planning programs with a reproductive health orientation.

In 1994, Jain and Bruce proposed an index--HARI, an acronym for Helping Individuals Achieve their Reproductive Intentions--to measure success or failure of family planning programs with a reproductive health orientation. HARI applies the principle of individual rights and well-being to the assessment of these programs. The index measures two components: the achievement of an individual's reproductive intentions and the avoidance of severe reproductive health problems associated with an individual's efforts to achieve her stated reproductive intentions. A family planning program can be deemed successful if an individual is able to avoid having an unintended pregnancy (or is able to have a wanted child) within the stipulated period and if she experiences no severe reproductive health problems in the process. If these conditions are not met, the program could be deemed a failure. The HARI index has not yet been applied in field conditions. This report illustrates the procedure for estimating HARI by using data from a panel survey conducted in Peru. It discusses the usefulness and limitations of the index in assessing the success or failure of a family planning program with a reproductive health orientation.

Evaluation Studies as Topic↗
PubMed2004

'O father: where art thou?'--Paternity assessment in an open fission-fusion society of wild bottlenose dolphins (Tursiops sp.) in Shark Bay, Western Australia.

Sexually mature male bottlenose dolphins in Shark Bay cooperate by pursuing distinct alliance strategies to monopolize females in reproductive condition. We present the results of a comprehensive study in a wild cetacean population to test whether male alliance membership is a prerequisite for reproductive success. We compared two methods for inferring paternity: both calculate a likelihood ratio, called the paternity index, between two opposing hypotheses, but they differ in the way that significance is applied to the data. The first method, a Bayesian approach commonly used in human paternity testing, appeared to be overly conservative for our data set, but would be less susceptible to assumptions if a larger number of microsatellite loci had been used. Using the second approach, the computer program cervus 2.0, we successfully assigned 11 paternities to nine males, and 17 paternities to 14 out of 139 sexually mature males at 95% and 80% confidence levels, respectively. It appears that being a member of a bottlenose dolphin alliance is not a prerequisite for paternity: two paternities were obtained by juvenile males (one at the 95%, the other at the 80% confidence level), suggesting that young males without alliance partners pursue different mating tactics to adults. Likelihood analyses showed that these two juvenile males were significantly more likely to be the true father of the offspring than to be their half-sibling (P < 0.05). Using paternity data at an 80% confidence level, we could show that reproductive success was significantly skewed within at least some stable first-order alliances (P < 0.01). Interestingly, there is powerful evidence that one mating was incestuous, with one calf apparently fathered by its mother's father (P < 0.01). Our study suggests that the reproductive success of both allied males, and of nonallied juveniles, needs to be incorporated into an adaptive framework that seeks to explain alliance formation in male bottlenose dolphins.

Animals↗
PubMed2006

Defining constant versus variable phenotypic features of women with polycystic ovary syndrome using different ethnic groups and populations.

CONTEXT: The phenotype of women with polycystic ovary syndrome (PCOS) is variable, depending on the ethnic background. OBJECTIVE: The phenotypes of women with PCOS in Iceland and Boston were compared. DESIGN: The study was observational with a parallel design. SETTING: Subjects were studied in an outpatient setting. PATIENTS: Women, aged 18-45 yr, with PCOS defined by hyperandrogenism and fewer than nine menses per year, were examined in Iceland (n = 105) and Boston (n = 262). INTERVENTION: PCOS subjects underwent a physical exam, fasting blood samples for androgens, gonadotropins, metabolic parameters, and a transvaginal ultrasound. MAIN OUTCOME MEASURES: The phenotype of women with PCOS was compared between Caucasian women in Iceland and Boston and among Caucasian, African-American, Hispanic, and Asian women in Boston. RESULTS: Androstenedione (4.0 +/- 1.3 vs. 3.5 +/- 1.2 ng/ml; P < 0.01) was higher and testosterone (54.0 +/- 25.7 vs. 66.2 +/- 35.6 ng/dl; P < 0.01), LH (23.1 +/- 15.8 vs. 27.6 +/- 16.2 IU/liter; P < 0.05), and Ferriman Gallwey score were lower (7.1 +/- 6.0 vs. 15.4 +/- 8.5; P < 0.001) in Caucasian Icelandic compared with Boston women with PCOS. There were no differences in fasting blood glucose, insulin, or homeostasis model assessment in body mass index-matched Caucasian subjects from Iceland or Boston or in different ethnic groups in Boston. Polycystic ovary morphology was demonstrated in 93-100% of women with PCOS in all ethnic groups. CONCLUSIONS: The data demonstrate differences in the reproductive features of PCOS without differences in glucose and insulin in body mass index-matched populations. These studies also suggest that measuring androstenedione is important for the documentation of hyperandrogenism in Icelandic women. Finally, polycystic ovary morphology by ultrasound is an almost universal finding in women with PCOS as defined by hyperandrogenism and irregular menses.

Adolescent↗
PubMed1997

[Comparative characteristics of cellular composition of the lymphoid structure of various regions of the human intestine in early childhood].

Using microscopic methods and statistic analysis lymphoid structures of large and small intestine walls and appendix were studied in 4-7 years children. The highest cell reproductive activity was detected in duodenal walls being slightly lower in appendix and group lymphoid vessels. The highest ratio of plasma cells was found in duodenum, ileal lymphoid patches and cecum, where the index was 7-fold higher than index of appendix and ileum. Lamina propria of intestinal mucosa is characterized by small fraction of mitotically dividing cells and undifferentiated cell forms, especially in cecum walls. However, the latter shows the greatest percentage of plasma cells.

Appendix↗
PubMed2003

Variable preferences for sexual dimorphism in height as a strategy for increasing the pool of potential partners in humans.

Human mate preferences are known to be related to a number of morphological traits. Those relating to female waist-to-hip ratio or body mass index and to male height appear to be distinctive mate-choice criteria and are known to be related to reproductive success. In addition to absolute height, a possibly important mate-choice criterion may be relative height, i.e. the extent of sexual dimorphism in stature (SDS = male height/female height) between oneself and a potential partner. Here, I demonstrate that people adjust their preferences for SDS in relation to their own height in order to increase the potential pool of partners. This causes nonlinearity in assortative mating in relation to height and shows that in relation to intrapopulational SDS both men and women are responsible for stabilizing selection.

Adult↗
PubMed1993

Reproductive factors as predictors of bone density and fractures in women at the age of 70.

The importance of reproductive and other health and social factors as predictors of bone mineral density (BMD) and fractures was investigated in a longitudinal study of 70-year-old women. At 70 years of age there was no correlation between menarcheal age, menopausal age, duration of fertile period and parity and BMD or a history of fractures. Bilateral oophorectomy (mean age at surgery 45.3 +/- 3.6 years) and the duration of tobacco smoking were negatively correlated to BMD at 70 years of age. Tobacco smoking was positively correlated to a history of fractures and body mass index (BMI) was negatively correlated to a history of fractures at 70 years of age. In a stepwise multiple regression model, height, body mass index and a history of hysterectomy were found to have a contributory, positively-correlated independent explanatory value for BMD at 70 years. In a logistic multiple regression analysis, bilateral oophorectomy was the only independent explanatory factor for fractures at 70 years of age. BMD was lower in women who had undergone bilateral oophorectomy compared with controls at 70 years of age. Hysterectomized women without bilateral oophorectomy showed a higher BMD in the right calcaneus at 70 years of age compared with controls. When comparing the reduction in bone mineral density between 70 and 76 years of age, the fifth quintile (women with the highest BMD) at 70 years of age decreased 2.7 times more (P < 0.01) than the first quintile. A longitudinal examination between 70 and 76 years revealed that BMD at the age of 70 was a significant (P < 0.01) predictor for fractures occurring between 70 and 76 years of age.

Aged↗
PubMed2002

Evidence of free leptin in human seminal plasma.

Leptin is an adipose tissue-secreted hormone that actively participates in the regulation of energy homeostasis. Besides this principal role, leptin has been implicated in a large variety of neuroendocrine, paracrine, and autocrine actions involved in the regulation of reproductive function in both experimental animals and humans. Although the participation of leptin in female reproduction is well established, any role in male reproductive function is at best tenuous. The aim of this study was to ascertain whether true leptin is present in human seminal fluid and the tissue of its production. Pooled human seminal plasma obtained from healthy donors showed by direct radioimmunoassay (RIA) the presence of radioimmunoassayable leptin. Serial dilutions of unextracted semen paralleled the RIA standard curve, also devoid of interference in the assay. To prove that this activity was true leptin, seminal plasma was subjected to size-exclusion chromatography, which showed that leptin immunoreactivity eluted with the same partition coefficient as cold leptin, 125I-leptin, and 125I-leptin preincubated with seminal plasma. The results demonstrate that true leptin was present in semen in a free form, i.e., without binding proteins. The presence of leptin charge variants in seminal plasma was assessed by anion-exchange chromatography, which showed two peaks of leptin inmunoreactivity, while 125I-leptin eluted as a single peak. Preincubation of 125I-leptin with seminal fluid converted the single peak into a double peak, indicating that components of the seminal fluid introduce a charge variation in leptin. Leptin levels in seminal plasma of 40 healthy men were 0.95+/-0.19 ng/mL while in 5 vasectomized men the levels were 0.92+/-0.25 ng/mL, suggesting that testicular tissues were not the source of seminal leptin. No correlation was observed between leptin concentrations in semen and the physical characteristics of semen samples or physical characteristics of spermatozoids, such as concentration, motility, vitality, or morphology. In conclusion it was unambiguously demonstrated that human leptin is present in seminal fluid, with at least two charge variants and no binding proteins, the most likely source being either seminal vesicles or prostate tissue. The role of seminal fluid leptin in the male reproductive function or sperm capacitation is at present unknown.

Adult↗
PubMed2004

Reproductive outcomes after pregnancy complicated by maternal-fetal surgery.

OBJECTIVE: The reproductive outcomes for women after the pregnancy complicated by maternal-fetal surgery were evaluated to obtain evidence-based information for prenatal risk counseling. STUDY DESIGN: The retrospective review identified 83 women with maternal-fetal surgery from a single institution (1996-2002). These women were sent a consent form and a questionnaire to document postoperative problems, fertility, obstetric outcomes, and psychosocial concerns in pregnancy after the index fetal therapy. Institutional Review Board approval was obtained from Committee for Protection of Human Subjects. RESULTS: The total return rate was 55 (66%). The pregnancy rate was 62% (18% spontaneous abortion, 24% preterm delivery, and 58% term delivery). Complications were reported in 12 of 34 pregnancies (35%), including uterine dehiscence/rupture (12%/6%), cesarean hysterectomy (3%), and antepartum hemorrhage requiring transfusion (9%). CONCLUSION: The reproductive outcome of uterine dehiscence, rupture, and hysterectomy was 12%, 6%, and 3%, respectively, after a pregnancy complicated by maternal-fetal surgery. The uterine rupture rate is similar to the rupture rate after "classical" cesarean section (4%-9%).

Female↗
PubMed1976

Experimental studies on the influence of male alcoholism on pregnancy and progeny.

Chronic alcoholism was induced in male albino rats by an oral self-administration technique. Obvious signs of intoxication, withdrawal symptoms and reduced reproductive performance, as well as decreased serum glucose and serum testosterone levels, were observed in these animals. Notable differences were detected in prenatal mortality, mean litter size and sex ratio between the offspring of male alcoholic rats and the corresponding controls. In the alcohol-treated group the placental index was markedly reduced. However, the mean growth index showed no significant differences between the experimental and control groups.

Abortion, Spontaneous↗
PubMed2005

Left ventricle myocardial performance index derived either by conventional method or mitral annulus tissue-Doppler: a comparison study in healthy subjects and subjects with heart failure.

OBJECTIVES: The aims of this study were to investigate the clinical agreement between myocardial performance index (MPI) measured conventionally and by pulsed-wave tissue Doppler (PW-TD) of the mitral annulus, and to test whether PW-TD MPI can accurately differentiate between healthy subjects and patients affected by congestive heart failure (CHF) with mild to moderate reduction of systolic function. BACKGROUND: Calculation of MPI using PW-TD may have advantages over conventional left ventricle inflow/outflow tract pulsed-wave Doppler (PWD) method; for example, all of the data needed for PW-TD MPI calculation can be derived from one single cardiac cycle, whereas with PWD at least two different cycles are needed. Thus, heart rate variability does not interfere with PW-TD MPI. METHODS AND RESULTS: In group A, we included 70 healthy adults with normal left ventricular ejection fraction and normal diastole, whereas for group B we studied 50 patients with CHF and left ventricular ejection fraction between 35% and 45%. MPI measured with PWD was statistically different (P < .0001) from MPI measured with PW-TD both in group A (0.33 +/- 0.09 vs 0.42 +/- 0.09) and group B (0.69 +/- 0.15 vs 0.79 +/- 0.12). Nonetheless, clinical agreement existed between the two methods in the single subject. Receiver operating characteristic curves showed very high accuracy for both methods to discriminate patients with CHF from healthy subjects; the optimal cutoff point was different and specific to each method: 0.50 for the conventional method and 0.60 for the PW-TD method. CONCLUSION: We found clinical agreement between MPI measured in the same subject with the conventional PWD method and with PW-TD. Both methods had similarly high diagnostic accuracy for CHF, but this study supports the use of a higher MPI cut-point for best diagnostic accuracy when using the new PW-TD method. SUMMARY: We performed a study in healthy adults and in patients with congestive heart failure to investigate the clinical agreement between MPI measured conventionally and by PW-TD of the mitral annulus. We found mild agreement between MPI measured by the conventional method and by PW-TD. Both methods had high diagnostic accuracy for CHF. PW-TD method requires a higher MPI cut-point for best diagnostic accuracy.

Adult↗
PubMed2001

The perceptions of Lutheran pastors toward prenatal genetic counseling and pastoral care.

The purpose of this study is to explore a theological perspective toward genetic counseling. A survey was sent to 207 ministers within the Evangelical Lutheran Church of America (ELCA), to determine their perspectives toward four different scenarios in a prenatal genetic counseling setting. The four different scenarios included situations involving Huntington disease, Down syndrome, trisomy 18, and anencephaly. Nearly all ELCA Lutheran pastors perceived genetic counseling as beneficial and useful and wanted to be involved in the decision-making process for whether or not to terminate pregnancy. Their views toward termination of pregnancy varied depending on the severity of the genetic abnormality. Severity in this study was based upon life compatibility. As the severity of the genetic abnormality increased, the percentage of Lutheran pastors who viewed termination as an option increased from 23% (Down syndrome) to 62% (anencephaly). A better understanding of how spiritual leaders view genetic counseling would provide an insight into how genetics and religious beliefs together play a significant role in shaping the decisions of those faced with abnormal pregnancies.

Abortion, Eugenic↗
PubMed2003

Rating the risk factors for breast cancer.

OBJECTIVE: To update and summarize evidence of risk factors for breast cancer. SUMMARY BACKGROUND DATA: Women who are at high risk for breast cancer have a variety of options available to them, including watchful waiting, prophylactic surgery, and chemoprevention. It is increasingly important to accurately assess a patient's risk profile to ensure that the cost/benefit ratio of the selected treatment is favorable. METHODS: Estimates of relative risk for documented risk factors were obtained from seminal papers identified in previous reviews. These estimates were updated where appropriate with data from more recent reports using large sample sizes or presenting meta-analyses of previous studies. These reports were identified from a review of the Medline database from 1992 to 2002. RESULTS: Risk factors that have received a great deal of publicity (hormone use, alcohol consumption, obesity, nulliparity) present a relatively modest relative risk for breast cancer (<2). Factors associated with a prior history of neoplastic disease or atypical hyperplasia and factors associated with a genetic predisposition significantly affect the risk of breast cancer, with relative risks ranging from 3 (for some cases of positive family history) to 200 (for premenopausal women positive for a BRCA mutation). CONCLUSIONS: More precise tools, based on techniques of molecular biology such as microarray analysis, will be needed to assess individual risk for breast cancer.

Alcohol Drinking↗