A study of the impact of large scale abortions on the fertility rates in India.
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OBJECTIVE: To evaluate the effectiveness of microsurgical shunts for secondary varicocele repair after ligation-like procedures, focusing on long-term functional outcomes. DESIGN: Long-term survey (mean follow-up, 8.5 years) of infertile men after secondary microsurgical reconstructive varicocelectomy. SETTING: University-based medical center. PATIENT(S): Thirty-four infertile men (group A, <30 years of age; and group B, >30 years) with recurrent palpable varicocele after varicocelectomy, according to Ivanissevich (n = 28), or after angiographic vein occlusion (n = 6). Ten patients presented bilateral recurrence. INTERVENTION(S): Microsurgical shunts between spermatic vein and inferior epigastric vein. MAIN OUTCOME MEASURE(S): Sperm count, pregnancy rate, and ultrasound evaluation of varicosity. RESULT(S): Complete disappearance of varicosity was achieved in 97.06% of patients, while in 2.94%, a consistent reduction in size was observed. In patients with severe infertility, a significant postoperative increase in seminal parameters was observed. Pregnancy rates were 43.75% in group A and 22.22% in group B. CONCLUSION(S): Microsurgical drainage in patients with recurrent varicocele after ligation-like procedures was shown to be an effective minimally invasive treatment, with immediate hemodynamic recovery of testicular venous outflow and excellent long-term results in patients with left or bilateral recurrences.
An evaluation of the foaling rate achieved in the Hannoverian breed in Germany between 1815 and 1973 showed that during this period no improvement of the reproductive rate was achieved. The decennial foaling percentage remained within 50--60% except for those decades which included the two World Wars and their aftermaths. The annual foaling percentage remained maximal until the number of mares covered/stallion rose above 80 and it also remained high throughout the reproductive life of the stallion. Only in the oldest stallion (32 years) was there a significant lowering of fertility.
OBJECTIVE: To adapt and develop a method for finding out what proportion of the variation among small areas in the number of births to married women is excess (systematic) variation over and above the chance (random) variation. METHODS: We adopted a two-stage sampling procedure to select 20 sub-centres in south India. We contacted all households and collected information on recent births and socioeconomic variables from all ever married women aged 15-49 years. Systematic and random components of variance were estimated using Poisson regression, adjusting for socioeconomic factors. RESULTS: Of the observed variance in fertility, 65% is explained by the estimated systematic variation. Though many important explanatory variables are considered, the systematic variance is significant mainly among illiterate women, those aged under 18 years at marriage, the marginalized population, and those with labourer husbands. CONCLUSIONS: Poisson regression can be adapted to estimate the random and systematic components of variation in fertility among small areas. The systematic component of variance can further be adjusted for socioeconomic factors. Identification of the significant predictors will help health planners develop necessary interventions at the small area level.
To evaluate new therapeutical concepts for male subfertility, we tested the effects of exogenous recombinant bovine growth hormone (rbGH) on various endocrine and metabolic parameters both in blood and in seminal plasma of bulls. Sperm quality was assessed morphometrically and by monitoring the number of successful artificial inseminations (AIs) defined as non-return rates (NRR). Aliquots of 450 semen samples were used from each bull and each experimental period (4 wk before, 14 weeks during and 6 wk after treatment). Six out of ten sires (average age 8.4 years) were treated every two weeks with 640-mg depot formulated rbGH (Eli Lilly). Four bulls received vehicle only. Blood plasma bGH, IGF-I, insulin and glucose concentrations were increased with rbGH treatment. In seminal plasma there was no effect of rbGH treatment on fructose and citrate or on testosterone concentrations. With one exception, rbGH-treated bulls had greater IGFBP-3 concentrations in seminal plasma. Motility of spermatozoa after freezing and thawing was increased compared with pretreatment rates. Most interestingly, the number of successful AIs was increased by an average of 6.0% NRR when ejaculates from rbGH-treated bulls were used.
We studied the relationships between "pretransfer" parameters (number of follicles, oocytes, and embryos) and the result (occurrence and quality of pregnancy) obtained by transferring one, two, or three embryos. The analysis concerns 186 pregnancies compared with 186 implantation failures. The chances for an oocyte to cleave or for a pregnancy to continue decreased when the number of preovulatory follicles increased. The number of transferred embryos increased with oocyte cleavage rate in nonpregnant patients and in patients with an ongoing pregnancy, but such a relation was not found in the case of failed pregnancy (biochemical pregnancies and abortions). Failed pregnancies occurred in patients who demonstrated the highest oocyte cleavage rate (94.1%), compared with 81.2% for implantation failure and 84.8% for ongoing pregnancy (P less than 0.01). The cleavage rate was also higher in cases of multiple, compared with single, ongoing pregnancies after the transfer of three embryos (79.7% versus 64.5%, P less than 0.001). An important finding was the higher survival rate after triple-embryo transfer in patients, yielding numerous oocytes. The survival rate (fetuses per transferred embryos) after the transfer of three embryos was 14.9% in patients yielding five oocytes, versus 7.7% in patients yielding 3.4 oocytes (P less than 0.05). These results are related to oocyte and embryo viability and uterine ability for pregnancy.
This study shows that there is certain tendency to asssign more value to the observation of follicular growth by ultrasound than to hormonal levels "per se". However, the appreciation of growth is only part of the phenomenon of development and ovarian maturity, for that, surveillance with hormonal monitor of ovarian response keeps with a most important role in Assisted Reproduction Clinica. The basal levels, mainly of FSH and in a less degree LH, inversely correlate with the amount of retrieved ovocytes. Estradiol values should be interpreted with a fixed point of reference, as the day of HCG administration, and a direct relation is seen between estradiol levels and captured ovocytes; however, is of highest usefulness to value the conduct of estradiol level, with the knowledge that the prognosis for good capture rates improves with ascending values and above 700 pg in the day of HCG administration.
The survival and developmental capacity of bovine oocytes after cryopreservation are greatly impaired, possibly due to organelle damage caused by freezing procedures. Distributions of chromosomes, microtubules, and microfilaments in bovine oocytes matured in vitro were examined after cooling, ethylene glycol (EG) exposure, or freezing. Oocytes were incubated after treatment for 20 min or 1 or 3 h, fixed, and evaluated using specific fluorescent probes. Abnormal cytological features increased over control levels after cooling or EG exposure and rewarming. Changes observed in oocytes during prefreezing manipulations included chromosome dispersal and clumping, microtubule depolymerization and alteration of spindle structure, and formation of craters and discontinuity in cytoskeletal actin staining. Freezing also led to an increase in the occurrence of cytological abnormalities. Less than 31% of frozen-thawed oocytes contained a normal chromosome arrangement 3 h postthaw (versus 90% of controls). Only 7-14% of frozen-thawed oocytes had normal spindles (versus 59-71% of controls). Normal distribution of filamentous actin was observed in less than 30% of oocytes postthaw (versus 62-89% of controls). These results indicate that the steps in a conventional freezing procedure cause irreversible alterations in multiple cytological components of bovine oocytes, demonstrating the need for improved strategies for preventing cellular damage during cryopreservation procedures.
BACKGROUND: This prospective study evaluated the effect of weight reduction on anthropometric indices and ovarian morphology in anovulatory overweight patients with polycystic ovary syndrome (PCOS). METHODS: Thirty-three anovulatory overweight patients with PCOS were enrolled in the study. All had patent Fallopian tubes and chronic anovulation: 27 of them were oligo-amenorrhoeic. The partners were normospermic. Patients were prescribed a 1200 kcal/day diet, and physical exercise was recommended. Anthropometric indices and ovarian imaging parameters were assessed at baseline and after weight loss of 5 and 10%. RESULTS: Twenty-five patients (76%) lost at least 5% of their body weight. Eleven of these patients (33%) reached a 10% decrease in weight. Waist circumference at the umbilical level, hip circumference, four skin folds, body mass index and fatty mass ratio were significantly reduced after 5 and 10% weight loss. Ovarian morphology changed during the diet: we observed a significant reduction in ovarian volume and in the number of microfollicles per ovary. Among the 27 patients with oligo-amenorrhoea, 18 had a resumption of regular cycles and 15 experienced spontaneous ovulation; 10 spontaneous pregnancies occurred in patients who lost at least 5% of their weight. CONCLUSIONS: Weight loss through a controlled low-calorie diet improves anthropometric indices in obese PCOS patients, reduces ovarian volume and microfollicle number and can restore ovulatory cycles, allowing spontaneous pregnancy.
PURPOSE: The aim of this study was to investigate whether the hCG-oocyte collection interval has any influence on the oocyte recovery rate, fertilization rate, and outcome of IVF-ET cycles. METHODS: Five hundred thirty-three consecutive patients undergoing their first IVF-ET treatment cycle at King's Assisted Conception Unit between 1993 and 1995 were included in this study. RESULTS: There was no significant difference in the oocyte recovery rates, fertilization rates, or outcome of IVF-ET treatment among the hCG-oocyte collection intervals examined (33-41 hr). None of the 533 women studied had ovulated before oocyte collection. CONCLUSIONS: The results do not suggest a trend toward increased ovulation more than 36 hr after hCG administration.
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Cross-sections of human spermatic cords and vasectomy specimens were prepared and the number and cross-sectional area of nerves were determined. On average, about one-half of all nerves in the near neighborhood of the vas deferens were resected during vasectomy. The total cross-sectional area of the nerves along the vasectomy specimens amounted to about one-half of the total area in the spermatic cord samples. The data support the hypothesis that removing nerves to the vas deferens during vasectomy could result in poor functional results after vasovasostomy, i.e., that powerful contraction of the proximal vas deferens and epididymis could be lacking.
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Patients undergoing diagnostic hysterosalpingography because of infertility often become pregnant soon after the procedure. Since the discontinuation of Salpix in March 1980, the use of Sinografin for hysterosalpingography has increased. The pregnancy rate after hysterosalpingography using Sinografin has never been reported, however, and now 156 such patients have been evaluated. The pregnancy rate was 10.9% in those who had only a hysterosalpingogram and 26.3% in those who received adjunctive therapy. These results are comparable to those previously reported for hysterosalpingography using water-soluble contrast material, but less than the results using oil-soluble contrast.
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