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Results for “Infertility--determinants”

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16 recordsLinked to original sources

PubMed1981

Seminal plasma fructose, zinc, magnesium and acid phosphatase in cases of male infertility.

Determinations of fructose, zinc, magnesium and acid phosphatase were performed in seminal plasma from male partners in 225 barren couples. No specific changes in the concentrations of these substances could be observed in men showing either visible or palpatory abnormalities of the external genitals, the prostate or of the seminal vesicles, extreme changes in the number, morphology or motility of the sperms, increased sperm antibody titre or abnormal serum levels of testosterone or gonadotrophins. However, when the prostatic fluid contained numerous leukocytes, the concentrations of zinc, magnesium and acid phosphatase were significantly lower than in men having a cytologically normal prostatic fluid. Determinations of these substances may thus be of aid in the diagnosis of chronic prostatovesiculitis.

Acid Phosphatase↗

PubMed1994

Effectiveness of infertility treatments: choice and comparative analysis.

Choice of infertility treatments usually depends on a balance of the chances of conceiving with or without treatment, and with more or less complex and costly treatments, and on other factors such as duration of infertility and the woman's age. Pregnancies often occur independent of treatment and prospective controlled trials are needed. Comparability between reported results requires pregnancy and birth rates to be calculated in a time-specific or cycle-specific way. Cumulative rates are preferable to account for the usual tendency of fecundity to fall progressively. This review focuses on such published data in order to assess the relative effectiveness of treatments, both conventional and assisted conception methods. The main conclusions are: (1) The only treatments that can achieve a normal chance of pregnancy are the ovulation induction methods in cases of oligomenorrhea/amenorrhea, and the assisted conception methods for other female causes and unexplained infertility. (2) Tubal/pelvic infective damage and endometriosis require new severity classifications which are sensitive to functional potential before and after surgery, and in vitro fertilization (IVF) would often be indicated as the primary choice. (3) Duration of unexplained infertility determines the need and therefore benefit of any of the treatments used, of which the assisted conception methods are by far the most effective. (4) Interpretation of reported results of treatments for 'male factor' infertility is critically affected by the diagnostic accuracy of defining sperm dysfunction. (5) In cases of well-defined sperm dysfunction there is little or no therapeutic benefit to the chance of natural conception, nor by intrauterine insemination; there is moderate success by IVF, but no proven benefit over standard IVF by any micromanipulative method except probably intracytoplasmic sperm injection.

Female↗

PubMed1992

Cloning and functional expression of a mouse gonadotropin-releasing hormone receptor.

GnRH plays a pivotal role in the reproductive system, and GnRH analogs have wide therapeutic applications ranging from the treatment of prostatic cancer to infertility. Determination of the predicted structure of the GnRH receptor (GnRHR) would illuminate the mechanisms of receptor activation and regulation and allow directed design of improved GnRH analogs. We report the cloning of a cDNA representing the mouse GnRHR and confirm its identity using Xenopus oocyte expression. Injection of sense RNA transcript leads to the expression of a functional, high affinity GnRHR. Expression of the GnRHR using gonadotrope cell line RNA, however, is blocked by an antisense oligonucleotide. In situ hybridization in the rat anterior pituitary reveals a characteristic GnRHR distribution. The nucleotide sequence encodes a 327-amino acid protein which has the seven putative transmembrane domains characteristic of G protein-coupled receptors, but which lacks a typical intracellular C-terminus. The unusual structure and novel potential regulatory domain of the GnRHR may explain unique aspects of its signal transduction and regulation.

Amino Acid Sequence↗

PubMed1990

Blood/seminal serotonin levels in infertile men with varicocele.

Seminal and blood serotonin levels were measured in 37 men with varicocele and in 33 men without palpable varicocele. Elevated levels of blood serotonin and lower levels of seminal serotonin were found in oligozoospermic men with varicocele as compared with men having varicocele but normal seminal quality. No differences in seminal serotonin levels were observed in oligozoospermic men without varicocele. Elevated levels of blood serotonin and lower levels of seminal serotonin in semen in men with varicocele were associated with low sperm count, low sperm motility, low fructose levels, and high citric acid levels. It would appear that serotonin may play a role as an infertility determinant in subjects with varicocele.

Adult↗

PubMed1993

The "forgotten" intrauterine device: a cause of infertility.

We present a case of infertility due to a "forgotten" IUD. Users of intrauterine devices are reported to have an increased risk of frank or subclinical genital infections which later may be the cause of infertility. Other mechanisms of causing infertility are possible. During the last two years we have seen three infertile patients with an IUD in situ. Two had ovulation, and one got pregnant immediately after the IUD was removed.

Adult↗

PubMed1987

Smoking, alpha 1-antitrypsin and decreased fertility in women.

There is epidemiologic evidence that smoking by women is associated with decreased fertility. Little is known about the biological mechanism(s) that might underlie a direct association. The effect of smoking on genital secretions, including levels of alpha 1-antitrypsin (AlAT), has not been studied. Low midcycle levels of AlAT appear to favour fertility by facilitating sperm migration and/or penetration. Smoking increases serum levels of functional AlAT. Since AlAT is produced only in the liver, levels in other tissues may reflect serum levels. It is postulated that smoking-induced increases in serum AlAT result in higher levels of AlAT in genital secretions, including those at midcycle, thereby impeding fertility. Support of an effect of serum AlAT levels on fertility is provided by studies of AlAT deficient persons, in whom fertility seems to be enhanced. An adverse effect of smoking on fertility through an increase in genital tract AlAT levels would be reversible.

Cervix Uteri↗

PubMed1997

Iatrogenic secondary infertility caused by residual intrauterine fetal bone after midtrimester abortion.

Eleven women with secondary infertility had ultrasonographic findings of intrauterine calcification. Infertility developed in all women after operative termination of midtrimester pregnancy. Dilation and curettage or hysteroscopic removal confirmed residual fetal bony fragments. The removal of these bony fragments was associated with therapeutic success for infertility.

Abortion, Induced↗

PubMed1997

Age-related decline in fertility: a link to degenerative oocytes?

OBJECTIVE: To determine whether the age-related decline in fertility is due to degenerative oocytes or to aneuploidy. DESIGN: Retrospective. SETTING: Fertility center of a public and tertiary institution. PATIENT(S): One hundred fifty-one women (ages 24 to 44 years) undergoing 158 cycles of conventional IVF or IVF with intracytoplasmic sperm injection (ICSI) between January 1993 and December 1995 were divided into three age groups (group 1, < or = 34 years; group 2, between 35 and 39 years; and group 3, > or = 40 years). They were selected on the basis of available oocytes that remained unfertilized after IVF and that had analyzable chromosomes. INTERVENTION(S): Standard pituitary down-regulation and ovarian stimulation with FSH and hMG were done for both IVF and ICSI patients. In addition, all patients were given luteal phase support with P, administered orally, via pessaries, or by IM injections from the day of transfer. MAIN OUTCOME MEASURE(S): Fertilization rates and pregnancy rates (PRs), and cytogenetic analyses of unfertilized oocytes. RESULT(S): Although fertilization rates were not different among women in groups 1, 2, and 3 (50.9%, 49.3%, and 37.9%, respectively), PRs were significantly lower between groups 1 and 3 (43.2% versus 14.3%). A total of 383 oocytes were examined, of which 287 (75%) could be karyotyped. Of these, 201 oocytes showed a normal 23,X karyotype (70%), 40 (13.9%) were aneuploid, 24 (8.4%) were diploid, 12 (4.2%) had structural aberrations, and 13 (4.5%) had single chromatids only. No increase in the aneuploidy rate was detected between groups 1 and 2 (14.8% versus 12.4%). However, highly significant differences in the rate of oocyte chromosome degeneration, characterized by chromosomes splitting into unassociated chromatids, were observed with increasing age (group 1, 23.7%; group 2, 52.0%; and group 3, 95.8%). CONCLUSION(S): It seems that the age-related decline in fertility may be due more to degenerative oocytes than to aneuploidy. A decline in the number of oocytes retrieved with age may be of less importance than the decline in oocyte quality. Women in the older age group have a higher chance of achieving pregnancy from ovum-donation programs than by persisting in using their own aged oocytes, which have a very poor prognosis for success.

Adult↗

PubMed1999

Effect of seminal oxidative stress on fertility after vasectomy reversal.

OBJECTIVE: To evaluate seminal oxidative stress in men after vasectomy reversal and to determine whether seminal oxidative stress could predict fertility after vasectomy reversal. DESIGN: Measurement of seminal reactive oxygen species (ROS) and total antioxidant capacity (TAC) in normal donors, men who were fertile after vasectomy reversal, and men who were infertile after vasectomy reversal. SETTING: A male infertility clinic of a tertiary care center. PATIENT(S): Thirty men who underwent vasectomy reversal and 17 normal donors. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Semen characteristics, seminal ROS, and TAC were measured with chemiluminescence assays in samples from donors and reversal patients. RESULT(S): Mean adjusted seminal ROS (log [ROS+1]) was higher in infertile reversal patients (2.38+/-0.25) than in normal donors (1.30+/-0.14). Seminal ROS was also higher in all (fertile and infertile reversal combined) reversal patients than in donors. Total antioxidant capacity did not differ between groups. The ROS-TAC score, a composite index of seminal oxidative stress, was a significant predictor of fertility. A ROS-TAC score of 45 or greater had a positive predictive value of 73% in predicting fertility. CONCLUSION(S): Seminal oxidative stress is associated with vasectomy reversal. The ROS-TAC score is a possible predictor of infertility after vasectomy reversal.

Adult↗

PubMedDate not supplied

Smoking and pregnancy.

Smoking during pregnancy is associated with many adverse outcomes, including fetal and neonatal death. These consequences are tragic in many ways, but perhaps the greatest tragedy is that they are preventable if the smoker ceases to smoke during pregnancy. Although in some instances the so-called constitutional hypothesis is difficult to disprove, the available evidence seems more than convincing that it is smoking itself, and not the smoker's unique constitution, that is responsible. Cessation from smoking is clearly advisable at any time, but more so during pregnancy when every cigarette affects both the smoker and her unborn child.

Abnormalities, Drug-Induced↗

PubMed1999