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Results for “Fertility Pattern Method”

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PubMed1991

Familial correlates of sexually active pregnant and nonpregnant adolescents.

The relationship of familial, demographic, and individual characteristics to the probability of pregnancy was examined among 124 sexually active adolescent females. Logistic regression analyses revealed that adolescent pregnancy status was a function of a combination of demographic and familial variables. Adolescents who were pregnant at the time of the study perceived their families as having low levels of family strength, perceived communication with parents as closed, came from homes characterized by family fragmentation (i.e., only one parent or no parent living in the home), came from low-income households, were unlikely to use any method of birth control, and were more likely to be married than their nonpregnant counterparts.

Adolescent↗

PubMed2004

Staining of human sperm with fluorochrome-labeled inhibitor of caspases to detect activated caspases: correlation with apoptosis and sperm parameters.

BACKGROUND: Detection of apoptosis in sperm samples may help evaluate sperm quality. Recently, it has been suggested that in some ejaculated sperm populations, apoptosis is caspase dependent. The aim of this study was to investigate the presence of activated caspases and examine possible correlations with apoptosis and sperm parameters in semen samples prepared for IVF. METHODS: To detect activated caspases, neat semen from infertile patients and sperm prepared by PureSperm gradient were stained with the fluorescein isothyocyanate-Val-Ala-Asp-fluoromethylketone (FITC-VAD-fmk) and analysed by flow cytometry. Cell death was determined by DNA fragmentation (TUNEL) and mitochondrial membrane potential. Sperm parameters were studied by conventional microscopy. RESULTS: FITC-VAD-fmk stained sperm cells in situ and the subcellular labeling pattern was compatible with the known localization of caspases. A significant correlation was found between the frequency of FITC-VAD-fmk stained cells and cell death markers. In both prepared sperm and neat semen a negative correlation was found between the percentage of FITC-VAD-fmk positive cells and standard parameters (concentration/motility). FITC-VAD-fmk positive cells negatively correlated with high fertilization rates after IVF. CONCLUSIONS: Labelling of sperm cells with the activated caspases-reacting fluorochrome provides a sensitive assay for detection of sperm apoptosis. This cytometric assay can be helpful to test sperm before IVF.

Amino Acid Chloromethyl Ketones↗

PubMed1998

The dog as a model system to study epididymal gene expression.

Advances in understanding the role of the epididymis in human sperm maturation and fertility are dependent upon the availability of appropriate model systems in which to examine regulatory mechanisms and functions in a controllable fashion. Of a number of mammalian species studied by us and others, we suggest that the dog epididymis offers an excellent compromise in terms of the similarity of the specific genes expressed to those in the human, their mode of regulation, and the availability of tissues suitable for cell culture studies. We have developed a set of important tools in the form of epididymis-specific canine cDNA clones and cell culture methods, with which to examine the functioning of the epididymal epithelial cells in vitro, as well as the expression of specific genes in vivo, under normal and pathological conditions (e.g. cryptorchidism). Using this model system, we have elaborated the regional patterns of gene expression in vivo for several of the major secretory protein genes of the canine epididymis, and we have examined the importance of androgens and temperature on gene expression in vitro.

Animals↗

PubMed2004

Are borderline tumors of the ovary safely treated by laparoscopy?

OBJECTIVES: To evaluate the risk of the laparoscopic approach to patients with borderline ovarian tumors compared to the laparotomic management. METHODS: We treated or followed in our institution 479 women with borderline ovarian tumor. Sixty-two patients had fertility-sparing surgery followed by restaging or follow-up intervention: 30 operated by laparoscopy, 32 by laparotomy. Restaging surgery was performed in five cases and second-look surgery in 57. RESULTS: The diameter of the cyst is significantly lower in patients treated by laparoscopy, especially in women who underwent cystectomy (4.7 cm) compared to oophorectomy (10 cm, P = 0.008). Rupture of the cyst and stage IC were more frequent in the laparoscopic group. After a median follow-up of 61 months for the laparoscopic group and 77 months for the laparotomic group, we observed 11 patients (37%) with persistent disease after primary laparoscopy (adnexa, five cases; peritoneal implants, three cases; both patterns, three cases). After primary laparotomy, no patients showed early persistence of tumor, and ovarian relapses were diagnosed in seven women (22%) 33-138 months after laparotomy. The univariate analysis for the risk of neoplastic persistence after primary laparoscopy shows that patients with cysts greater than 5 cm have a higher risk (odds ratio 9.7, P = 0.02) compared to smaller cysts. No other factors proved significant, but the odds ratios for patients with serous tumor (5.8), stage IC (2.0), and those undergoing cystectomy (1.9) suggest a relationship to the probability of persistence. CONCLUSION: Laparoscopic treatment in borderline ovarian tumors should be reserved to masses not greater than 5 cm. When conservative therapy is desired, the entire affected ovary should be removed. If the neoplasia is bilateral, cystectomy could be allowed in women who wish to preserve fertility, although they are at high risk of relapse.

Adult↗

PubMed2004

Female sterilization in Latin America: cross-national perspectives.

Fertility levels have dropped substantially in Latin America in recent decades, fuelled by increased contraceptive use and notably a method mix skewed towards female sterilization. This study examined choice of female sterilization in four Latin American countries: Brazil, Colombia, the Dominican Republic and Peru. Data were drawn from national Demographic and Health Surveys conducted in 1995--1996. Discrete-time hazard models were used on the five-year calendar modules of women's reproductive histories to consider the effects of a number of sociodemographic and contextual determinants as they pertained to status at the moment of the event. The results revealed that the likelihood of a woman's having undergone contraceptive sterilization was increasing over time in Brazil and Peru, suggesting that the potential for future growth of this method remains strong. A consistent pattern of increased probability of sterilization with higher education was seen across all countries, seemingly dispelling certain controversial claims that the procedure may have been disproportionately performed on the poor. At the same time, the multilevel analytical approach pointed to significant cluster-level random effects, suggesting that there were additional unmeasured contextual influences on women's propensity to choose sterilization.

Adolescent↗

PubMed2003

Invited commentary: the potential for monitoring of fecundity and the remaining challenges.

In the epidemiologic study of reproductive capacity, the assessment of fecundity as a functional measure is complementary to approaches that focus on biomedical mechanisms and/or that use biomarkers such as semen quality. More research is needed on time trends, spatial patterns, and particular groups, especially those exposed to potentially toxic agents. Although specific research projects will always be important, much could be gained by general population surveillance, which could be introduced into existing multipurpose surveys and repeated periodically. The core measurement would be time to pregnancy, which can be carried out using a short, acceptable questionnaire that has good validity at the group level. This should be accompanied by questions on time periods of unprotected intercourse that do not end with conception, to avoid bias resulting from exclusion of relatively infertile couples. Information is also required on contraceptive failures, recent contraceptive use, and other covariates and possibly on behavioral variables, such as the degree of planning and persistence in trying to conceive, and couples' knowledge of fertile days of the menstrual cycle. Existing statistical methods can deal with possible biases due to "accidental" pregnancies and the effects of fertility treatment. Further methodological work is needed to avoid or measure more subtle biases, for example, to determine the best way to deal with pregnancies occurring to couples whose approach to family formation is relaxed, for whom the concept of "pregnancy planning" does not apply.

Female↗

PubMed2003

Expression of IGF2 and IGF receptor mRNA in bovine nuclear transferred embryos.

Incomplete reprogramming of the donor cell nucleus after nuclear transfer (NT) probably leads to the abnormal expression of developmentally important genes. This may be responsible for the low efficiency of cloned animal production. Insulin-like growth factor 2 (IGF2) and IGF2 receptor (IGF2R) are imprinted genes that play important roles in preimplantation development. To obtain an insight into abnormal gene expression after nuclear transfer, we assessed the transcription patterns of IGF2-IGF2R in single in vitro fertilised and cloned embryos by reverse-transcription polymerase chain reaction (RT-PCR). IGF2R expression did not differ significantly but IGF2 was more highly expressed in cloned embryos than in IVF embryos (p < 0.05). This was confirmed by a quantitative RT-PCR method. Thus, incomplete reprogramming may induce abnormal transcription of IGF2 in cloned embryos.

Animals↗

PubMed2000

Chemical analysis of the developmental pattern of polysialylation in chicken brain. Expression of only an extended form of polysialyl chains during embryogenesis and the presence of disialyl residues in both embryonic and adult chicken brains.

Recent studies have demonstrated the involvement of two polysialyltransferases in neural cell adhesion molecule (N-CAM) polysialylation. The availability of cDNAs encoding these enzymes facilitated studies on polysialylation of N-CAM. However, there is a dearth of detailed structural information on the degree of polymerization (DP), DP ranges, and the influence of embryogenesis on the DP. It is also unclear how many polysialic acid (polySia) chains are attached to a single core N-glycan. In this paper we applied new, efficient, and sensitive high pressure liquid chromatography methods to qualitatively and quantitatively analyze the polySia structures expressed on embryonic and adult chicken brain N-CAM. Our studies resulted in the following new findings. 1) The DP of the polySia chains was invariably 40-50 throughout developmental stages from embryonic day 5 to 21 after fertilization. In contrast, glycopeptides containing polySia with shorter DPs, ranging from 15 to 35, were isolated from adult brain. 2) Chemical evidence showed glycan chains abundant in Neu5Acalpha2,8Neu5Ac were expressed during all developmental stages including adult. 3) Levels of both di- and polySia were found to show distinctive changes during embryonic development.

Animals↗

PubMed1981

Proteins of human semen. I. Two-dimensional mapping of human seminal fluid.

The proteins in human seminal plasma were mapped by high-resolution two-dimensional electrophoresis (ISO-DALT and BASO-DALT systems). When analyzed under dissociating conditions, samples from normal fertile males revealed a pattern of over 200 proteins, ranging in mass from 10 000 to 100 000 daltons. Comparison of the mapped proteins from these males and those who had undergone vasectomy allowed us to identify one series of glycoproteins as missing from the semen from vasectomized individuals. Glycoproteins isolated by affinity chromatography with use of concanavalin A were also mapped. Some of the protein spots were identified either by co-electrophoresis with purified proteins or by the electrophoretic transfer of proteins to nitrocellulose sheets and subsequent detection by immunological procedures. The proteins identified include a number of serum proteins as well as prostatic acid phosphatase and creatine kinase. Proteolytic events shown to occur during the liquefaction of semen that occurs early after collection indicate the importance of carefully controlled collection and preparation methods for clinical evaluation of seminal plasma. Ethylenediaminetetraacetic acid and phenylmethylsulfonyl fluoride inhibit this proteolysis.

Concanavalin A↗

PubMed1998

Measuring the impact of HIV on fertility in Africa.

OBJECTIVES: To review evidence for the impact of HIV on fertility from empirical sources pertaining to African populations and to discuss the implications for surveillance based on antenatal clinic populations. METHODS: The theoretical equivalence between the fertility rate ratio for HIV-positive to HIV-negative women and the relative odds of being infected for pregnant women compared with the general female population is demonstrated. This equivalence is used to compare fertility differentials measured in cohort studies with those calculated indirectly from antenatal clinic data. Data from case-control studies and theoretical predictions from a model of the proximate determinants of fertility and HIV incidence are used to obtain plausible explanations of the fertility differences. Estimates of population attributable change are made. RESULTS: Fertility of HIV-positive women is lower than that of HIV-negative women, in all but the youngest age-group, and the differential increases with women's age and epidemic duration. Selection for early start of sexual activity explains the reverse pattern at younger ages. Lower fertility amongst HIV-positive women causes a population attributable decline in total fertility of the order of 0.4% for each percentage point HIV prevalence in the general female population. CONCLUSIONS: In populations that do not use contraceptives, HIV-positive women have lower fertility principally as a result of foetal losses consequent to infection with HIV and coinfection with other sexually transmitted diseases; behavioural factors tend to enhance this differential. Other factors being equal, HIV prevalence estimates based on antenatal surveillance underestimate true prevalence in women in the childbearing years.

Adolescent↗

PubMed2001

Assessing uterine receptivity in 2001: ultrasonographic glances at the new millennium.

The understanding and control of embryo implantation represents the major challenge for assisted reproductive technologies. Along with developments in basic research and efforts to optimize embryo quality, the improvement of noninvasive and reliable methods to assess uterine receptivity constitutes an important step toward meeting such a challenge. Today, ultrasound-based approaches to evaluate endometrial echogenicity and uterine perfusion and contractility are available for practical use. Increasing evidence indicates that echogenic patterns of the endometrium reflect histologic processes that are involved in the establishment of receptivity. This constitutes a possible explanation for the reported association between premature hyperechogenic patterns of the endometrium and poor implantation rates. Nevertheless, additional studies aiming at correlating further morpho-biochemical events in the endometrium with its echogenicity patterns are needed. Further, developments in vascular assessment by Doppler, Doppler-related, and vascular detection technologies will also be instrumental in monitoring and improving vascular changes that lead to uterine receptivity. Finally, data supporting the hypothesis that uterine contractility, as visualized by ultrasound, influences in vitro fertilization-embryo transfer (IVF-ET) pregnancy rates encourage further investigation on both the regulation and control of uterine contractions. This article discusses some of the advantages and limitations of ultrasonographic assessments of uterine receptivity in the perspective of the new millennium.

Embryo Implantation↗

PubMedDate not supplied

High fertility among Indochinese refugees.

From 1975 to 1988, nearly 900,000 Indochinese refugees were resettled in the United States. This paper examines patterns of fertility among these refugees from Cambodia, Laos, and Vietnam who have exhibited high levels of reproduction since their arrival. Data are drawn from sample surveys in San Diego and San Francisco, CA. Fertility levels were found to exceed five children per ever-married woman, a level that is consistent with perceptions of ideal family size in the homeland. Fertility levels were significantly higher among rural second-wave refugees than in the more urban first-wave groups. One explanation for the high fertility is that couples have migrated from areas where fertility is high, and they have not yet adapted their reproductive behavior to the low fertility environment of the United States. This possibility is reinforced by a general gender preference for boys and exacerbated by the fact that, while a majority of women are aware of methods of fertility control, access is still limited by cultural and financial barriers, and the motivation to use family planning still appears to be relatively low. The data suggest that this refugee population will continue to put pressure on maternal and child health resources, and that continued residence in the United States could lead to desires to limit family size, thus increasing demand for methods of fertility control.

Adult↗

PubMed1990

Urinary hormonal profile during the first cycle of low-dose oral contraceptive pills in women.

Ovarian function was studied in ten normal fertile women before and during the first cycle on a low-dose micropill containing 30 mcg ethinyl estradiol and 150 mcg L-norgestrel. In a control cycle and the first treatment cycle, steroid metabolites estrone-3-glucuronide (E1-3G) and pregnanediol-3 alpha-glucuronide (Pd-3G) were measured in daily early morning urine (EMU) samples. Also, luteinizing hormone (LH) was estimated during the expected periovulatory period. During the first cycle of micropill intake, ovarian function was suppressed in all cases. This is evidenced by significantly lower E1-3G and Pd-3G and absent midcycle LH peak compared to control cycles. The pattern of steroid metabolites was almost flat with no peaks. It is concluded that there is no need to cover the first cycle of micropill intake with other contraceptive methods.

Adolescent↗

PubMedDate not supplied

Seasonality of birth and conception to teenagers in Texas.

We study the births to teenagers during the years 1964-2000 and analyze separately the three main racial/ethnic groups in Texas (White, Hispanic, and African American), as well as married and unmarried teens during the years 1994-2000. By using traditional statistical methods of analysis and a filter based on the multiresolution wavelet analysis, we draw inferences about the times of the year when adolescent females of different racial/ethnic and marital groups have the highest probability for pregnancy ending in live birth. Multiple factors influencing teen pregnancy are identified and associated with temporal features of social, cultural, educational, and familial processes. In particular, we detect links between unmarried teen conception times and school terms, and weekly birth patterns associated with scheduled c-sections that differ according to racial/ethnic groups.

Adolescent↗

PubMed1986

Clinical aspects of induced abortion in South Australia from 1970-1984.

Clinical changes, and their implication, in medically induced abortion within South Australia from 1970-1984 were assessed by analysis of legally required reports provided by operating practitioners. In the past 15 years vacuum aspiration has largely replaced dilatation and curettage for early abortions, and intrauterine chemical methods have greatly decreased the use of hysterotomy for late abortions. A marked improvement in gestational pattern has also occurred, and recorded complication rates have been halved for all gestational ages. Sterilization rates at the time of abortions increased with increasing age and with increasing gravidity, but the total rates, adjusted for age and gravidity of patients, have changed little in the past 15 years.

Abortion, Induced↗

PubMed1985

Diaphragm method contraceptors: implications for service organization and delivery.

Despite dissemination of modern contraceptive techniques among college women, unplanned pregnancy and pregnancy termination rates remain a major health issue. An investigation of 495 college women who use the diaphragm method of contraception was conducted in order to estimate pregnancy occurrence, to better understand factors related to successful use, and to profile service utilization patterns. Data were collected by medical record audit and client survey. Fifteen percent of the diaphragm clients reported a diaphragm-related pregnancy; clinical effectiveness was estimated to be 88% with a rate of 9.75 pregnancies per 100 woman years of diaphragm use. A variety of demographic, personal history, and behavioral variables were found to be related to three dependent variables: pregnancy, consistent diaphragm use, and accurate diaphragm use. Review of clinic service utilization for this group of patients demonstrated considerable resource use, including frequent switching of prescription contraception methods. Considering all pregnancies, diaphragm related or not, 27% of the study subjects reported at least one unplanned pregnancy. Abortion was elected in 98% of these cases. There is general agreement about the need to focus on education, information, and service measures to reduce the incidence of unintended fertility. Many universities have family planning services available, yet unsuccessful outcome continues to be a concern. Specific and practical protocols for service implementation need clearer definition. Thus, the implications of this research for the content and organization of clinic services are discussed with reference to counseling and education and other systems strategies.

Abortion, Induced↗

PubMed1992

Contraceptive use projections: 1990 to 2010.

Factors that will affect both contraceptive use and choice of method during the next 20 years are reviewed. Two factors are predictable: the changing age distribution of women and the revised upper-age limits for oral contraceptive use, with the effect of the latter as yet unknown. Less predictable factors include the number of women in each age group at risk for pregnancy, the effects of delayed childbearing and sterilization, and the impact of new contraceptive methods. Unpredictable factors include adverse publicity about oral contraceptives and breast cancer, concern about sexually transmitted diseases and acquired immunodeficiency syndrome, and changes in the availability of legal abortion. Numbers of women using oral contraception, other reversible methods, sterilization, and no method are projected from 1990 to 2010 under the assumption that use patterns in each age group resemble those observed in 1988. We conclude that discrepancies between projections of contraceptive use and fact are likely to occur because of the unpredictable nature of these few important variables.

Abortion, Legal↗

PubMed1987

A multicentered phase III comparative clinical trial of depot-medroxyprogesterone acetate given three-monthly at doses of 100 mg or 150 mg: II. The comparison of bleeding patterns. World Health Organization. Task Force on Long-Acting Systemic Agents for Fertility Regulation Special Programme of Research, Development and Research Training in Human Reproduction.

A multicentered phase III clinical trial was conducted in seven countries to compare two dosages of depot-medroxyprogesterone acetate (DMPA), 100mg and 150mg, given every 90 days. Contraceptive efficacy and side-effects of both regimens were reported previously. Their effect on vaginal bleeding patterns is the object of this paper. A total of 1216 women were randomly assigned to a dose group and 1156 of them provided a menstrual diary. The comparison of the bleeding patterns is made using a 90-day reference period approach and following the guidelines published by WHO. In addition, the longest bleeding/spotting episode and the longest bleeding/spotting-free interval are calculated over the entire diary length. The only difference found between the two dose groups is a higher incidence of amenorrhea with the 150mg regimen. Overall, there is a high degree of consistency between the reasons given by individual women for discontinuing the contraceptive method and their vaginal bleeding pattern during the 90 days preceding discontinuation. However the data revealed large between-centre differences, both in the incidence of specific patterns, and in the identification by women of bleeding problems as reasons for discontinuation. This last point suggests that the life-table analysis underestimates the true incidence of menstrual irregularities. Comments on the reference period analysis method are made.

Amenorrhea↗