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Sample records for initiating infertility treatment

  1. First Contact: the intersection of demographics, knowledge, and appraisal of treatment at the initial infertility visit

    Science.gov (United States)

    CHILDRESS, Krista J.; LAWSON, Angela K.; GHANT, Marissa S.; MENDOZA, Gricelda; CARDOZO, Eden R.; CONFINO, Edmond; MARSH, Erica E.

    2015-01-01

    Objective To determine the impact of the initial infertility visit on treatment-related knowledge, patient anxiety, and appraisals of treatment. Study Design Prospective survey. Setting Academic medical center. Patients 234 English-speaking women, ages 18-50, attending their first infertility visit Intervention(s) Participants completed a survey assessing health literacy, knowledge, anxiety, and appraisals of the treatment process before and after their infertility visit. Main Outcome Measure(s) 1) Knowledge of infertility and treatment and, 2) Anxiety and appraisal scores. Results Most participants were white and earned >$100,000/year and had at least a college education. Baseline knowledge of reproductive anatomy, ART, and fertility factors was modest, but improved after the initial visit. Factors associated with higher knowledge included higher education and income, White or Asian ethnicity, and English as their primary language. Patient appraisals of treatment represented by the positive (Challenge) and negative (Threat and Loss) subscale scores on the Appraisal of Life Events (ALE) scale, changed from the pre-visit survey to the post-visit survey. Negative appraisals of treatment and anxiety scores decreased and positive appraisals of treatment increased after the initial visit. Lower knowledge was associated with higher positive appraisal scores lower health literacy was associated with higher anxiety and appraisal scores (positive and negative) post-visit. Black women had higher Challenge scores compared to White and Asian women. Hispanic women had higher anxiety scores than non-Hispanic women. Conclusions Infertility patients have modest baseline knowledge of fertility and infertility treatment. The initial infertility visit can improve this knowledge and decrease both negative appraisals of treatment and anxiety levels. Differences in knowledge and appraisal were seen across ethnic groups and other demographic variables. Physicians should individualize

  2. Infertility, infertility treatment, and fetal growth restriction

    DEFF Research Database (Denmark)

    Zhu, Jin Liang; Obel, Carsten; Hammer Bech, Bodil

    2007-01-01

    OBJECTIVE: To examine the association between infertility, with or without treatment, and fetal growth, as well as perinatal and infant mortality. METHODS: From the Danish National Birth Cohort (1997-2003), we identified 51,041 singletons born of fertile couples (time to pregnancy 12 months or less......), 5,787 born of infertile couples conceiving naturally (time to pregnancy more than 12 months), and 4,317 born after treatment. We defined small for gestational age (SGA) as the lowest 5% of birth weight by sex and gestational age. RESULTS: Crude estimates suggested an increased risk of perinatal...... effect on fetal growth. A small-to-moderate increased risk of perinatal mortality in infertile couples cannot be ruled out due to the small number of cases. LEVEL OF EVIDENCE: II. Udgivelsesdato: 2007-Dec...

  3. Evaluation and treatment of infertility.

    Science.gov (United States)

    Lindsay, Tammy J; Vitrikas, Kristen R

    2015-03-01

    Infertility is defined as the inability to achieve pregnancy after one year of regular, unprotected intercourse. Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years. Causes of infertility include male factors, ovulatory dysfunction, uterine abnormalities, tubal obstruction, peritoneal factors, or cervical factors. A history and physical examination can help direct the evaluation. Men should undergo evaluation with a semen analysis. Abnormalities of sperm may be treated with gonadotropin therapy, intrauterine insemination, or in vitro fertilization. Ovulation should be documented by serum progesterone level measurement at cycle day 21. Evaluation of the uterus and fallopian tubes can be performed by hysterosalpingography in women with no risk of obstruction. For patients with a history of endometriosis, pelvic infections, or ectopic pregnancy, evaluation with hysteroscopy or laparoscopy is recommended. Women with anovulation may be treated in the primary care setting with clomiphene to induce ovulation. Treatment of tubal obstruction generally requires referral for subspecialty care. Unexplained infertility in women or men may be managed with another year of unprotected intercourse, or may proceed to assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization.

  4. Psychosocial Problems during Infertility Treatment

    Directory of Open Access Journals (Sweden)

    Nurcan Kirca

    2013-06-01

    Full Text Available Infertility is a complex situation crisis which is often psychologically-threatening and emotionally stressful for both partners as well as economically expensive and causes physical pain due to the operations performed for diagnosis and treatment purposes. Infertility has physical, psychological, social, emotional and financial impacts. Infertile couples are under a great social pressure, and need to conceal the problem as it is exceptionally private for them. Infertile individuals are destitute of support when they do not share their pregnancy problems with their families and relatives. Couples define their infertility experience as the most stressful experience of their lives.

  5. Prospective longitudinal cohort study on cumulative 5-year delivery and adoption rates among 1338 couples initiating infertility treatment

    DEFF Research Database (Denmark)

    Pinborg, A; Hougaard, C O; Andersen, Anders Nyboe

    2009-01-01

    BACKGROUND The objective was to assess crude 5-year delivery rates after assisted reproductive technology (ART) treatment, intrauterine inseminations (IUI), spontaneous conceptions (SC) and adoptions in a large infertile cohort. METHODS A prospective longitudinal survey comprised 1338 infertile...... couples starting public infertility programmes offering IUIs and three free ART cycles during 2000-2001. The cohort was cross-linked with the National Medical Birth Register to obtain delivery rates for all 1338 couples. More detailed data were available from 817 women responding to a 5-year follow......-up questionnaire (response rate 74.7%). Fifty-seven percent (466/817) of the couples had received treatment prior to inclusion in the study with an average of 4.1+/-2.8 infertility treatments before referral. RESULTS Of the 1338 couples, 69.4% had at least one delivery within 5-years of follow-up. For women

  6. Infertility, infertility treatment and behavioural problems in the offspring

    DEFF Research Database (Denmark)

    Zhu, Jin Liang; Obel, Carsten; Basso, Olga

    2011-01-01

    Behavioural patterns in children of infertile couples may be influenced by both the underlying causes of infertility and stress in the couples. Treatment procedures, such as culture media and manipulation of gametes and embryos, may also result in developmental problems. We examined behavioural...... problems in children as a function of infertility and infertility treatment, using data from three population-based birth cohorts in Denmark (Aalborg-Odense Birth Cohort, Aarhus Birth Cohort and Danish National Birth Cohort). Information on time to pregnancy and infertility treatment was collected during...... to pregnancy of >12 months and no infertility treatment had a behavioural pattern similar to children of fertile parents. Teachers reported a higher total difficulties score for children born after infertility treatment, but no significant differences were seen on any subscales of the teachers' report...

  7. Infertility.

    Science.gov (United States)

    Jose-Miller, Alaina B; Boyden, Jennifer W; Frey, Keith A

    2007-03-15

    Infertility is defined as failure to achieve pregnancy during one year of frequent, unprotected intercourse. Evaluation generally begins after 12 months, but it can be initiated earlier if infertility is suspected based on history or if the female partner is older than 35 years. Major causes of infertility include male factors, ovarian dysfunction, tubal disease, endometriosis, and uterine or cervical factors. A careful history and physical examination of each partner can suggest a single or multifactorial etiology and can direct further investigation. Ovulation can be documented with a home urinary luteinizing hormone kit. Hysterosalpingography and pelvic ultrasonography can be used to screen for uterine and fallopian tube disease. Hysteroscopy and/or laparoscopy can be used if no abnormalities are found on initial screening. Women older than 35 years also may benefit from ovarian reserve testing of follicle-stimulating hormone and estradiol levels on day 3 of the menstrual cycle, the clomiphene citrate challenge test, or pelvic ultrasonography for antral follicle count to determine treatment options and the likelihood of success. Options for the treatment of male factor infertility include gonadotropin therapy, intrauterine insemination, or in vitro fertilization. Infertility attributed to ovulatory dysfunction often can be treated with oral ovulation-inducing agents in a primary care setting. Women with poor ovarian reserve have more success with oocyte donation. In certain cases, tubal disease may be treatable by surgical repair or by in vitro fertilization. Infertility attributed to endometriosis may be amenable to surgery, induction of ovulation with intrauterine insemination, or in vitro fertilization. Unexplained infertility may be managed with ovulation induction, intrauterine insemination, or both. The overall likelihood of successful pregnancy with treatment is nearly 50 percent.

  8. Infertility, infertility treatment and twinning: the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Zhu, Jin Liang; Basso, Olga; Obel, Carsten

    2007-01-01

    BACKGROUND: We have previously observed that an increasing time to pregnancy (TTP) is associated with a reduced frequency of twin deliveries in couples not receiving infertility treatment. By using updated information, we assessed the frequencies of dizygotic (DZ) and monozygotic (MZ) twin...... deliveries as a function of infertility (TTP > 12 months), as well as infertility treatment. METHODS: From the Danish National Birth Cohort (1997-2003), we identified 51 730 fertile couples with TTP 12 months and 5163 infertile couples who conceived after treatment. Information on zygosity, available...... for part of the cohort (1997-2000), was based on standardized questions on the similarities between the twins at the age of 3-5 years. RESULTS: Compared with fertile couples, the frequency of DZ twin deliveries was lower for infertile couples conceiving naturally (odds ratio 0.4, 95% confidence interval 0...

  9. Treatments for Diseases That Cause Infertility

    Science.gov (United States)

    ... its symptoms is available from the NICHD PCOS topic page . Treatments for infertility in women with PCOS include ... this topic can be found on the NICHD topic page on endometriosis . Treatments for the infertility that can ...

  10. OVARIAN AGING AND INFERTILITY TREATMENT

    Directory of Open Access Journals (Sweden)

    Helena Meden Vrtovec

    2003-12-01

    Full Text Available Background. Due to changes in the socio-economic environment the first pregnancy is being more often postponed to advanced age; an increasing number of women seek medical help for infertility in their late thirties. Degenerative processes in the ovary start as early as after 35 years of age. When the woman is over 38, the signs of hormonal changes occur (FSH, inhibin, the menstrual cycle changes, and fertility is being increasingly reduced. Infertility treatment by assisted reproduction technology (ART has proved less efficient in older than in younger women.Material and methods. In a retrospective analysis we evaluated the success rates achieved with homologous intrauterine insemination (IUI, in vitro fertilization and embryo-transfer (IVF-ET, intracytoplasmic sperm injection (ICSI, and compared them in regard to the women > 38 years vs. < 38 years.Results. After IUI the pregnancy rate in the women over 38 was 3.7% per patient (1.5% per cycle and 28.0% (9.9% in the women younger than 38 years. After IVF-ET the pregnancy rate in the over 38-year group was 16% per patient (14% per cycle, and 28% per patient (25% per cycle in the less than 38-year group. After ICSI, the pregnancy rate in the group over 38 years was 11% per patient (9% per cycle, and 25% per patient (22% per cycle in the less than 38-year group. In the analysed population, the spontaneous abortion rate was 26.0% in the group of women aged over 38 years, and 14.0% in the group of women aged less than 38 years.Conclusions. Before introduction of an ART procedure the woman with advanced age should be properly counselled and well informed about poor success of their infertility treatment and high spontaneous abortion rate.

  11. Novel immunotherapeutic approaches for treatment of infertility.

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    Abdolmohammadi-Vahid, Samaneh; Danaii, Shahla; Hamdi, Kobra; Jadidi-Niaragh, Farhad; Ahmadi, Majid; Yousefi, Mehdi

    2016-12-01

    One of the most important reasons of infertility and human reproductive failure is related to uncontrolled immunological response of maternal immune system to early embryo or fetus, that cause rejection of this semi-allograft. Therefore, a tolerance in the immune system is essential to modulate the reactions against the fetus to avoid rejection. The immune system imbalance during implantation or pregnancy may lead to implantation failure or miscarriage. So, use of immunosuppressive or immunomodulator agents can be helpful to prevent immunological attack. Initially, there was a focus on steroids like prednisolone or intralipids in treatment of miscarriage that suppressed the activity of most immune cells, Intravenous Immunoglobulin (IVIG) was then introduced with various mechanisms. Nowadays, novel and specific strategies are established such as monoclonal antibodies and cytokines. More recently, Tacrolimus and Cyclosporine, which were utilized in prevention of transplantation reject, are used as immunosuppressive factors in modulation of immune responses against the fetus. This review is focused on the main immunotherapeutic methods of infertility treatment.

  12. Infertility and the use of infertility treatments in Finland: prevalence and socio-demographic determinants 1992-2004.

    Science.gov (United States)

    Terävä, Anna-Niina; Gissler, Mika; Hemminki, Elina; Luoto, Riitta

    2008-01-01

    To examine changes in the use of infertility treatments by time, the causes of infertility, lifetime prevalence of subfertility, and the use of infertility treatments by socio-demographic factors. Aggregate IVF statistics (1992-2004) and two nationally representative cross-sectional surveys (1997 and 2002). Total number of IVF, ICSI and FET treatments initiated more than tripled between 1992 and 2004. The proportion of tubal injury as a cause of infertility treatment decreased over time while other female factors, male factor and multiple causes became more common. Self-reported lifetime subfertility was 16.0% in 2002 among women aged 25-64 years. Subfertility differed notably by age and education: young less educated women and older more educated women more frequently reported subfertility. Use of hormone therapy to treat subfertility (1997 and 2002) and participation in infertility treatments or medical examinations (2002) was more common among urban, highly educated and affluent women. The use of infertility treatments increased and the proportions of causes of infertility have changed over time. Self-reported subfertility differed by age and education. There are socio-demographic differences in the use of infertility treatments.

  13. Parental Infertility, Fertility Treatment, and Childhood Epilepsy

    DEFF Research Database (Denmark)

    Kettner, Laura O.; Ramlau-Hansen, Cecilia H.; Kesmodel, Ulrik S.

    2016-01-01

    BACKGROUND: A few studies have indicated an increased risk of epilepsy in children conceived by fertility treatment possibly due to characteristics of the infertile couple rather than the treatment. We therefore aimed to investigate the association between parental infertility, fertility treatment....... RESULTS: A total of 60 440 pregnancies were included, and 0.8% of the children developed epilepsy.The primary analyses showed no association between parental infertility or fertility treatment, and the overall risk of childhood epilepsy (hazard rate ratios (HRs); 95% confidence intervals (CIs): 1.08 (0......, and epilepsy in the offspring, including the subtypes of epilepsy; idiopathic generalised epilepsy and focal epilepsy. METHODS: This cohort included all pregnancies resulting in liveborn singletons from the Aarhus Birth Cohort, Denmark (1995-2013). Information on time to pregnancy and fertility treatment...

  14. Understanding Infertility and the Potential Role of Stem Cells in Infertility Treatment: A Short Communication

    OpenAIRE

    Chirputkar R; Vaidya A

    2015-01-01

    Infertility is increasing at a great rate across the globe. Various male as well as female factors are known to contribute to infertility. Although hormonal replacement therapy and assisted reproduction treatments like in vitro fertilization and intracytoplasmic sperm injection are well established clinical modalities to treat infertility, stem cells are now being considered as potentially new therapeutic agents for the treatment of infertility due to their high differentiation potential. Sev...

  15. Hypnosis in the treatment of functional infertility.

    Science.gov (United States)

    Gravitz, M A

    1995-07-01

    The literature was reviewed and found to contain sparse information regarding the applicability of clinical hypnosis in the treatment of functional infertility. Two cases were then described in which hypnosis based on imagery and a relaxation strategy was successful in facilitating pregnancy in both instances. The treatment was considered to have resulted in beneficial modification of attitude, optimism, and mind-body interaction.

  16. Treatments for Infertility Resulting from Polycystic Ovary Syndrome (PCOS)

    Science.gov (United States)

    ... Information Clinical Trials Resources and Publications Treatments for Infertility Resulting from PCOS Skip sharing on social media ... reason for these problems. Before beginning treatment for infertility possibly related to PCOS, be sure that your ...

  17. Infertility

    Science.gov (United States)

    ... MALE INFERTILITY Male infertility may be due to: Decreased number of sperm Blockage that prevents the sperm ... from woman to woman. Infertility problems and miscarriage rates increase ... a successful pregnancy if childbearing is delayed until after age 35. ...

  18. Infertility

    Science.gov (United States)

    Infertility means not being able to become pregnant after a year of trying. If a woman can ... keeps having miscarriages or stillbirths, that's also called infertility. Infertility is fairly common. After one year of ...

  19. What Treatment Options Are Available for Male Infertility?

    Science.gov (United States)

    ... Publications What treatment options are available for male infertility? Skip sharing on social media links Share this: ... deliver a live-born infant, in most cases, infertility has no other outward symptoms. The evaluation of ...

  20. [Treatment options for age-related infertility].

    Science.gov (United States)

    Belaisch-Allart, Joëlle

    2010-06-20

    There has been a consistent trend towards delayed childbearing in most Western countries. Treatment options for age-related infertility includes controlled ovarian hyperstimulation with intrauterine insemination and in vitro fertilization (IVF). A sharp decline in pregnancy rate with advancing female age is noted with assisted reproductive technologies (ART) including IVF. Evaluation and treatment of infertility should not be delayed in women 35 years and older. No treatment other than oocyte donation has been shown to be effective for women over 40 and for those with compromised ovarian reserve, but its pratice is not easy in France hence the procreative tourism. As an increasing number of couples choose to postpone childbearing, they should be informed that maternal age is an important risk factor for failure to conceive.

  1. Treating Infertility

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Treating Infertility Home For Patients Search FAQs Treating Infertility Page ... Treating Infertility FAQ137, March 2015 PDF Format Treating Infertility Gynecologic Problems What is infertility? What treatment options ...

  2. Infertility treatments and counselling in the context of patriarchy ...

    African Journals Online (AJOL)

    Infertility treatments and counselling in the context of patriarchy among Ijebu, south ... Infertility, as a social and cultural problem affecting individuals and families, makes ... 62% agreed that government should intensify legislation, health education; legal ... Infertility, Health-seeking behaviour, Counselling, Gender inequality.

  3. Infertility, infertility treatment and twinning: the Danish National BirthCohort

    DEFF Research Database (Denmark)

    Zhu, Jin Liang; Basso, Olga; Obel, Carsten

    2007-01-01

    BACKGROUND We have previously observed that an increasing time to pregnancy (TTP) is associated with a reduced frequency of twin deliveries in couples not receiving infertility treatment. By using updated information, we assessed the frequencies of dizygotic (DZ) and monozygotic (MZ) twin...... deliveries as a function of infertility (TTP>12 months), as well as infertility treatment. METHODS From the Danish National Birth Cohort (1997-2003), we identified 51 730 fertile couples with TTPwith TTP>12 months and 5163 infertile couples who conceived after treatment. Information on zygosity, available...... for part of the cohort (1997-2000), was based on standardized questions on the similarities between the twins at the age of 3-5 years. RESULTS Compared with fertile couples, the frequency of DZ twin deliveries was lower for infertile couples conceiving naturally (odds ratio 0.4, 95% confidence interval 0...

  4. SURGICAL TREATMENT OF ENDOMETRIOSIS IN INFERTILE PATIENTS

    Directory of Open Access Journals (Sweden)

    Andrej Vogler

    2003-12-01

    Full Text Available Background. Endometriosis is nowadays probably the most frequent cause of infertility or subfertility and is revealed in approximately 30–40% of infertile women. The association between fertility and minimal or mild endometriosis remains unclear and controversial. Moderate and severe forms of the disease distort anatomical relations in the minor pelvis, resulting in infertility. The goals of endometriosis treatment are relief of pain symptoms, prevention of the disease progression and fertility improvement. Treatment of stages I and II endometriosis (according to the R-AFS classification may be expectative, medical or surgical. In severely forms of the disease (stage III and IV the method of choice is surgical treatment. Combined medical and surgical treatment is justified only in cases, in which the complete endometriotic tissue removal is not possible or recurrence of pain symptoms occur. Nowadays, laparoscopic surgical treatment is the golden standard being the diagnostic and therapeutic tool during the same procedure. The aim of this study was to evaluate the fertility rate after surgical treatment of different stages of endometriosis.Patients and methods. In prospectively designed study 100 infertile women were included. The only known cause of infertility was endometriosis. In group A there were 51 patients with stage I and II endometriosis, whereas in group B there were 49 patients with stage III and IV of the disease. Endometriosis was diagnosed and treated laparoscopically. Endometriotic implants were removed either with bipolar coagulation or CO2 laser vaporisation, whereas adhesions were sharp or blunt dissected, and endometriomas stripped out of ovaries. Pregnancy rates were calculated for both groups of patients, and statistically compared between the groups.Results. Mean age of patients was 29.25 (SD ± 4.08 years and did not significantly differ between the groups of patients (29.5 years in group A and 29 years in group B. In

  5. Infertility, infertility treatment and psychomotor development: the Danish National Birth Cohort.

    Science.gov (United States)

    Zhu, Jin Liang; Basso, Olga; Obel, Carsten; Hvidtjørn, Dorte; Olsen, Jørn

    2009-03-01

    Babies born of infertile couples, regardless of treatment, have a higher risk of preterm birth and low birthweight, conditions associated with delayed development. We examined developmental milestones in singletons as a function of parental infertility [time to pregnancy (TTP) > 12 months] and infertility treatment. From the Danish National Birth Cohort (1997-2003), we identified 37 897 singletons born of fertile couples (TTP 12 months), and 3309 born after infertility treatment. When the children were about 18 months old, mothers reported 12 developmental milestones by responding to structured questions. We defined a failure to achieve the assessed milestone or the minimal numbers of milestones in a summary (motor, or cognitive/language skills) as delay. Naturally conceived children born of infertile couples had a pattern of psychomotor development similar to that of children born of fertile couples, but increasing TTP correlated with a modest delay. When the analysis was restricted to infertile couples (treated and untreated), children born after treatment showed a slight delay in cognitive/language development (odds ratio 1.24, [95% confidence interval 1.01, 1.53]) for not meeting at least three out of six cognitive/language milestones); children born after intracytoplasmic sperm injection (ICSI) had the highest estimated relative risk of delay for most milestones, especially motor milestones. These results suggest that a long TTP may be associated with a modest developmental delay. Infertility treatment, especially ICSI, may be associated with a slight delay for some of these early milestones.

  6. Ethical and legal dilemmas in infertility treatment

    Directory of Open Access Journals (Sweden)

    Dragojević-Dikić Svetlana

    2004-01-01

    Full Text Available One of the main characteristics of the new millennium is the affirmation of human rights in all aspects of human existence, with the intention of turning declarative statements into reality. Development of up-to-date assisted reproductive technologies (ART and their application in infertility treatment have raised numerous ethical, legal, religious, social and other questions. In vitro fertilization, donation of gametes, embryos and pre-embryos, cryopreservation of gametes, embryos, ovarian and testicular tissues, embryo transfer, genetic reproductive techniques, cloning and other sophisticated methods used in infertility treatment require cooperation between the medical and legal professions. Ethical aspects of human reproduction and assisted fertilization are based on full respect of the life of an individual even before conception, from pre-embryo stage, via embryo stage and fetus stage to a newborn infant. Regarding investigative and clinical projects, this standpoint implies the legalization of all ART procedures, unencumbered exchange of information and consensus about their application, and adherence to the basic ethical principles of autonomy benefit, justice and common welfare. Ethical postulates provide unequivocal directions in the creation of new life and resolve all possible ethical dilemmas, protecting the rights of doctors and participant in relevant procedures alike and reasserting the crucial principle - respect of human dignity.

  7. Treatment of infertility in men with spinal cord injury

    DEFF Research Database (Denmark)

    Brackett, N.L.; Lynne, C.M.; El Dib, Hussein Ibrahim El Desouki Hussein

    2010-01-01

    Most men with spinal cord injury (SCI) are infertile. Erectile dysfunction, ejaculatory dysfunction and semen abnormalities contribute to the problem. Treatments for erectile dysfunction include phosphodiesterase type 5 inhibitors, intracavernous injections of alprostadil, penile prostheses...... of intrauterine insemination increases as the total motile sperm count inseminated increases. In vitro fertilization and intracytoplasmic sperm injection are options in cases of extremely low total motile sperm count. Reproductive outcomes for SCI male factor infertility are similar to outcomes for general male...... factor infertility...

  8. Treatment of infertility in men with spinal cord injury

    DEFF Research Database (Denmark)

    Brackett, N.L.; Lynne, C.M.; El Dib, Hussein Ibrahim El Desouki Hussein

    2010-01-01

    Most men with spinal cord injury (SCI) are infertile. Erectile dysfunction, ejaculatory dysfunction and semen abnormalities contribute to the problem. Treatments for erectile dysfunction include phosphodiesterase type 5 inhibitors, intracavernous injections of alprostadil, penile prostheses...... of intrauterine insemination increases as the total motile sperm count inseminated increases. In vitro fertilization and intracytoplasmic sperm injection are options in cases of extremely low total motile sperm count. Reproductive outcomes for SCI male factor infertility are similar to outcomes for general male...... factor infertility...

  9. Ozone Therapy in Treatment of Female Infertility

    Directory of Open Access Journals (Sweden)

    Maradi A. Burduli

    2015-03-01

    Full Text Available Ozone therapy and physiotherapy have been successfully used in obstetric practice. The paper summarizes the results of studies on the use of ozone therapy in the postoperative rehabilitation of gynecological patients operated on for female infertility of various origins. Biomechanisms systemic impact methods of ozone therapy on the human body to meet the requirements of the tactics of the impact on the etiopathogenic mechanisms of chronic inflammatory diseases of the pelvic organs and their complications. It is advisable to wider use of ozone therapy in the complex treatment standards gynecological patients. Postoperative rehabilitation, including ozone therapy, can have a significant impact on the clinical course of gynecological and extragenital pathology, pregnancy rate and its outcomes.

  10. Infertility Evaluation and Treatment among Women in the United States

    Science.gov (United States)

    Kessler, Lawrence M.; Craig, Benjamin M.; Plosker, Shayne M.; Reed, Damon R.; Quinn, Gwendolyn P.

    2013-01-01

    Objective To examine the characteristics of women seeking infertility evaluation and treatment. Design Cross-sectional survey based on in-person interviews, followed by two-step hurdle analysis. Participants 4,558 married or cohabitating women ages 25–44 Setting U.S. household population of women based on the 2006–2010 National Survey of Family Growth Intervention None Main Outcome Measure(s) Likelihood of seeking preliminary infertility evaluation. Likelihood of seeking infertility treatment once evaluated. Treatment type provided. Results 623 women (13.7%) reported seeking infertility evaluation, of which 328 reported undergoing subsequent infertility treatment. Age at marriage, marital status, education, health insurance status, race/ethnicity, and religion were associated with the likelihood of seeking infertility evaluation. For example, the predicted probability that a non-White woman who married at 25 will seek evaluation was 12%. This probability increased to 34% for White women with a graduate degree who married at age 30. Among women who are evaluated, income, employment status, and ethnicity correlated strongly with the likelihood of seeking infertility treatment. Infertility drug therapy was the most frequent treatment used. Reproductive surgery and in vitro fertilization (IVF) were used the least. Conclusions The use of infertility services is not random and understanding the socio-demographic factors correlated with use may assist new couples with family planning. Roughly 50% of the women evaluated for infertility progressed to treatment, and only a small proportion were treated with more advanced assisted reproductive technologies (ARTs) such as IVF therapy. Future research aimed at improving access to effective healthcare treatments within the boundaries of affordability is warranted. PMID:23849845

  11. Models Predicting Success of Infertility Treatment: A Systematic Review

    Science.gov (United States)

    Zarinara, Alireza; Zeraati, Hojjat; Kamali, Koorosh; Mohammad, Kazem; Shahnazari, Parisa; Akhondi, Mohammad Mehdi

    2016-01-01

    Background: Infertile couples are faced with problems that affect their marital life. Infertility treatment is expensive and time consuming and occasionally isn’t simply possible. Prediction models for infertility treatment have been proposed and prediction of treatment success is a new field in infertility treatment. Because prediction of treatment success is a new need for infertile couples, this paper reviewed previous studies for catching a general concept in applicability of the models. Methods: This study was conducted as a systematic review at Avicenna Research Institute in 2015. Six data bases were searched based on WHO definitions and MESH key words. Papers about prediction models in infertility were evaluated. Results: Eighty one papers were eligible for the study. Papers covered years after 1986 and studies were designed retrospectively and prospectively. IVF prediction models have more shares in papers. Most common predictors were age, duration of infertility, ovarian and tubal problems. Conclusion: Prediction model can be clinically applied if the model can be statistically evaluated and has a good validation for treatment success. To achieve better results, the physician and the couples’ needs estimation for treatment success rate were based on history, the examination and clinical tests. Models must be checked for theoretical approach and appropriate validation. The privileges for applying the prediction models are the decrease in the cost and time, avoiding painful treatment of patients, assessment of treatment approach for physicians and decision making for health managers. The selection of the approach for designing and using these models is inevitable. PMID:27141461

  12. Associations of Psychosocial Factors with the Stress of Infertility Treatment

    Science.gov (United States)

    Schneider, Myra G.; Forthofer, Melinda S.

    2005-01-01

    This study investigated psychosocial factors thought to be associated with perceived stress over the course of infertility treatment. The research was based on secondary analysis of data from the Study of Marriage, Family, and Life Quality with a sample of 128 people who completed an infertility-related stress instrument at all three measurement…

  13. Distributive justice and infertility treatment in Canada.

    Science.gov (United States)

    Nisker, Jeff

    2008-05-01

    An exploration of distributive justice in Canadian infertility treatment requires the integration of ethical, clinical, and economic principles. In 1971, American philosopher John Rawls proposed a theoretical model for fair decision-making in which "rational" and "self-interested" citizens are behind a "veil of ignorance" with respect to both their own position and the position of other decision-makers. Rawls proposed that these self-interested decision-makers, fearing that they are among the least advantaged persons who could be affected by the decision, will agree only upon rules that encode equality of opportunity and that bestow the greatest benefit on the least advantaged citizens. Regarding health policy decision-making, Rawls' model is best illustrated by Canadian philosopher Warren Bourgeois in his panel of "volunteers." These rational and self-interested volunteers receive an amnestic drug that renders them unaware of their health, social, and financial position, but they know that they are representative of diverse spheres of citizens whose well-being will be affected by their decision. After describing fair decision-making, Bourgeois considers the lack of a distributive justice imperative in Canada's Assisted Human Reproduction Act, in contrast to legislation in European nations and Australia, summarizes the economic and clinical considerations that must be provided to the decision-makers behind the "veil of ignorance" for fair decisions to occur, and considers altruism in relation to equality of access. He concludes by noting that among countries with legislation governing assisted reproduction Canada is alone in having legislation that is void of distributive justice in providing access to clinically appropriate infertility care.

  14. Treatment of Chinese Herbal Medicine for Female Infertility.

    Science.gov (United States)

    Jiang, Dan; Li, Lily; Zeng, Bai-Yun

    2017-01-01

    Female infertility is when a woman of reproductive age and sexual active, without contraception, cannot get pregnant after a year and more or keeps having miscarriages. Although conventional treatments for infertility such as hormone therapy, in vitro fertilization and many more, helped many female patients with infertility get pregnant during past a few decades, it is far from satisfactory with prolonging treatment time frames and emotional and financial burden. In recent years, more patients with infertile problems are seeking to alternative and complementary medicines to achieve a better outcome. In particular, Chinese herbal medicine (CHM) is increasingly popular for treating infertility due to its effectiveness and complimentary with conventional treatments. However, the mechanisms of action of CHM in treating female infertility are not well understood. In this chapter authors reviewed research development of CHM applied in many infertile models and CHM clinical studies in many conditions associated with female infertility, published in past 15 years. The data of review showed that CHM has either specific target mechanisms of action or multitarget mechanisms of action, via regulating relevant hormone levels in female reproductive system, improving ovary function, enhancing uterine receptivity. More studies are warranted to explore the new drugs from CHM and ensure safety, efficacy, and consistency of CHM. © 2017 Elsevier Inc. All rights reserved.

  15. Psychological determinants of life satisfaction in women undergoing infertility treatment

    Directory of Open Access Journals (Sweden)

    Aleksandra Anna Dembińska

    2016-01-01

    Full Text Available Background Infertility treatment is a long-term process, spread out over months, or even years, and carries no guarantee of success. It generates an incessant state of uncertainty which becomes a chronic state of psychological discomfort. Each stage of treatment may become a source of more trouble. Women deciding to undergo infertility treatment are exposed to many negative feelings concerning different aspects of their life. Participants and procedure The present study was an attempt to understand psychological determinants of life satisfaction in women undergoing infertility treatment. The study group included 470 women treated for infertility. Results Patients perceiving more social support in general, as well as more of the support types used in the study, i.e. emotional, instrumental, informational and institutional support, and support from family and friends, have better self-esteem, higher acceptance of their infertility, higher satisfaction with life, higher hope as an emotional state, and lower levels of anxiety and depression. Three negative emotional states, i.e. anxiety, depression and irritation, are predictors influencing (lowering life satisfaction of women struggling with infertility. The strongest of these predictors is depression, which is also a factor lowering the acceptance of one’s own infertility. The conducted analyses revealed that predictors influencing the life satisfaction of patients treated for infertility are self-esteem and acceptance of one’s own infertility (apart from the aforementioned emotional state – anxiety, depression, irritation. It was found that the higher the self-esteem and acceptance of one’s own infertility, the higher was the satisfaction with life. Conclusions Knowledge of these determinants is extremely valuable for medical personnel conducting treatments, because, according to many studies, the psychological state of women suffering from procreation problems is connected not only with

  16. Hijama (wet cupping) for female infertility treatment: a pilot study

    OpenAIRE

    Hassan Abduljabbar; Anhar Gazzaz; Samiha Mourad; Ayman Oraif

    2016-01-01

    Background: To assess the effectiveness of wet cupping (Hijama) as a treatment of female factor infertility. The primary outcome measured was pregnancy rates after Hijama. The secondary outcome measured was the effect on the reproductive hormonal profile before and after Hijama. Methods: A pilot clinical study was conducted for the use of Hijama as treatment for female infertility at King Abdulaziz University Hospital from September 2013 to May 2015. Inclusion criteria included: patients w...

  17. Assessing infertility-related stress: the factor structure of the Fertility Problem Inventory in Italian couples undergoing infertility treatment.

    Science.gov (United States)

    Donarelli, Zaira; Gullo, Salvatore; Lo Coco, Gianluca; Marino, Angelo; Scaglione, Piero; Volpes, Aldo; Allegra, Adolfo

    2015-01-01

    The factor structure of the Fertility Problem Inventory (FPI) and its invariance across gender were examined in Italian couples undergoing infertility treatment. About 1000 subjects (both partners of 500 couples) completed two questionnaires prior to commencing infertility treatment at a private Clinic in Palermo, Italy. Confirmatory Factor Analysis demonstrated that the original factor structure of the FPI was partially confirmed. Two correlated factors (Infertility Life Domains and Importance of Parenthood) were obtained via a post hoc Exploratory Factor Analysis. Finally, the invariance of this factor structure across gender was confirmed. The study supported the relevance of two interrelated factors specific to infertility stress which could help clinicians to focus on the core infertility-related stress domains of infertile couples.

  18. Screening, brief intervention, and referral to treatment for opioid and other substance use during infertility treatment.

    Science.gov (United States)

    Wright, Tricia E

    2017-08-01

    Opioid use and misuse have reached epidemic proportions in the United States, especially in women of childbearing age, some of whom seek infertility treatments. Substance use is much more common than many of the conditions routinely screened for during the preconception period, and it can have devastating consequences for the woman and her family. Substance use can worsen infertility, complicate pregnancy, increase medical problems, and lead to psychosocial difficulties for the woman and her family. The reproductive endocrinologist thus has an ethical and medical duty to screen for substance use, provide initial counseling, and refer to specialized treatment as needed. This article provides an overview of screening, brief intervention, and referral to treatment (SBIRT), a public health approach shown to be effective in ameliorating the harms of substance use. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  19. The effects of infertility on sexual functions and dyadic adjustment in couples that present for infertility treatment.

    Science.gov (United States)

    Güleç, Gülcan; Hassa, Hikmet; Yalçın, Elif Güneş; Yenilmez, Cınar

    2011-01-01

    The aim of this study was to determine the effects of infertility on sexual functions and dyadic adjustment in infertile couples that seek infertility treatment. The Beck Depression Inventory (BDI), Golombok-Rust Inventory of Sexual Satisfaction (GRISS), and Dyadic Adjustment Scale (DAS) were administered to the infertility group (n = 220) and control group (n = 110). None of the study participants had an Axis I psychiatric disorder. There wasn't a significant difference in BDI score between the 2 groups. None of the study participants had clinical depression. Men in both groups reported more problems according to GRISS total scale and subscale scores (except the avoidance subscale) than the women. Women in both groups reported more problems according to GRISS avoidance subscale score than did the men. Men in the control group reported more problems on the GRISS frequency subscale, as compared men in the infertile group. Women in the control group reported more problems based on GRISS total score, and GRISS frequency, satisfaction, touch, and avoidance subscale scores, as compared to the women in the infertile group. The men in the infertile group were more satisfied with dyadic adjustment than the women in the infertile group. The men and women in the control group had higher DAS total score, and DAS consensus and emotional expression subscale scores. The differences in sexual functions between the infertile and control groups were not significant. Both women and men in the infertility group reported more dyadic adjustment problems than those in the control group.

  20. Mental health status of infertile couples based on treatment outcome

    Directory of Open Access Journals (Sweden)

    Mohammad Hosein Baghianimoghadam

    2013-06-01

    Full Text Available Background: Infertility is accompanied by numerous psychological and social problems. Infertile couples are more anxious and emotionally distressed than other fertile people. Previous studies suggested that infertility is more stressful for women than men. Objective: The purpose of this study was to determine the status of general health of infertile couples. Materials and Methods: This cross-sectional study evaluated general health of 150 infertile couples attending to Yazd Research and Clinical Center for Infertility that were selected consequently. The data were gathered by the researchers, based on face to face interview before and after three months of treatment by two questionnaires. The first questionnaire had questions on demographic information and the second one was the General Health Questionnaire-28 (GHQ-28. This questionnaire has four sub- scales areas. All data were transferred directly to SPSS 15 and analyzed. Results: The mean age of women was 28.3 and men were 32.4 years. The scores for all sub- scales of GHQ in women were more than men. There was significant difference between age and general health at physical symptoms scales (p=0.002, anxiety and sleep disorders (p=0.003. The age group 25-29 years had higher scores (more than 7 than other age groups. There was significant difference between the scale of social dysfunction and results of treatment. Conclusion: Our results, similar to the previous studies have revealed negetive social and mental effects of infertility on women is more than men, so there is need that they be educated specially.

  1. Pregnancy rate following bromocriptine treatment in infertile women with galactorrhea.

    Science.gov (United States)

    Eftekhari, Nahid; Mohammadalizadeh, Sakineh

    2009-02-01

    Infertility is one of the most common causes of women refer to gynecology clinics. Galactorrhea is defined as one of the causes of infertility caused by luteal phase defect and anovulatory cycles. The study aim was to investigate the effect of bromocriptine on pregnancy rate in infertile women with galactorrhea with or without high prolactin level. In a prospective study, consecutive women with infertility and galactorrhea who referred to Afzalipour Hospital and a private clinic during 5 years from May 2001 to May 2006 were included. The study was conducted on 205 infertile women (18-39 years) with galactorrhea. They were treated with 2.5 mg bromocriptine BID for up to 6 months. The mean duration of sterility was 43.1 +/- 37.1 months (range, 12-16). 76.1% of patients showed positive signs for pregnancy. The pregnancy rate was 81.7% in the patients with high prolactin level (>20 ng/dl) and 74.3% in the patients with normal prolactin level (P = 0.26). There was a significant difference between mean duration of treatment with bromocriptine in women with and without pregnancy, 103.71 and 193.03 days, respectively (P galactorrhea, we suggest treatment with bromocriptine in these patients regardless of serum prolactin level.

  2. Treatment strategies for the infertile polycystic ovary syndrome patient.

    Science.gov (United States)

    Tannus, Samer; Burke, Yechiel Z; Kol, Shahar

    2015-11-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Infertility is a prevalent presenting feature of PCOS, and approximately 75% of these women suffer infertility due to anovulation. Lifestyle modification is considered the first-line treatment and is associated with improved endocrine profile. Clomiphene citrate (CC) should be considered as the first line pharmacologic therapy for ovulation induction. In women who are CC resistant, second-line treatment should be considered, as adding metformin, laparoscopic ovarian drilling or treatment with gonadotropins. In CC treatment failure, Letrozole could be an alternative or treatment with gonadotropins. IVF is considered the third-line treatment; the 'short', antagonist-based protocol is the preferred option for PCOS patients, as it is associated with lower risk of developing ovarian hyperstimulation syndrome (specifically by using a gonadotropin--releasing hormone agonist as ovulation trigger), but with comparable outcomes as the long protocol.

  3. Reassessment of the laparoscopy role in the investigation of infertility and treatment plan determination

    Institute of Scientific and Technical Information of China (English)

    Sebastio F de Medeiros; Mrcia MW Yamamoto; Bianca B Galera; Matheus AS de Medeiros; Jacklyne S Barbosa

    2012-01-01

    Objective:To reassess the importance of laparoscopy in infertility investigation treatment plan determination.Methods:The study enrolled237 patients with infertility duration >1 year.A complete investigation was performed in all patients and male factor was evaluated by medical history and semen analysis.In the case of normal semen or mild-to-moderate oligozoospermia, the female evaluation included screening for infection diseases, transvaginal ultrasound, hormone parameter, hysterosalpingography, and laparoscopy.The final treatment plan was decided according to laparoscopy findings and any modification of the initial proposal was taken as treatment change. Results:At laparoscopy, normal pelvic cavity was found in5.5%, endometriosis in76.4%, pelvic adhesion in17.2%, ovarian adhesion in24.8%, peritubal adhesion 15.2%, unilateral tubal occlusion in21.1%, bilateral tubal occlusion in5.5%, and tubal sacculation, kinking, constriction, or fibrosis in46.3%.Operative interventions during laparoscopy were endometriosis ablation/excision(74.6%), adhesiolysis(27.4%), and endometrioma cystectomy(4.6%). Laparoscopy determined to switch the initial treatment plan in85(35.8%) patients.Conclusions:Pelvic cavity abnormalities, primarily endometriosis, have high prevalence in infertileBrazilian women.Laparoscopy provides a precise diagnosis of tuboperitoneal factor and may switch the initial treatment plan in at least one third of patients.

  4. Treating Infertility

    Science.gov (United States)

    ... by a number of factors. Both male and female factors can contribute to infertility. What treatment options are available for infertility? Treatment ... problems. A common problem that leads to male infertility, varicocele , sometimes can be ... are hormonal problems treated in women? Abnormal levels of hormones ...

  5. Surrogate motherhood as a medical treatment procedure for women's infertility.

    Science.gov (United States)

    Jovic, Olga S

    2011-03-01

    The content of this work is conceived on the research of the consequences of surrogate motherhood as a process of assisted procreation, which represent a way of parenthood in cases when it is not possible to realize parenthood through a natural way. Surrogate motherhood is a process in which a woman (surrogate mother) agrees to carry a pregnancy with the intent to give the child to the couple with whom she has made a contract on surrogate maternity after the birth. This process of conception and birth makes the determination of the child's origin on its mother's side hard to determine, because of the distinction of the genetic and gestation phases of the two women. The concept of surrogate motherhood is to appear in two forms, depending on the existence or the non-existence of the genetic link between the surrogate mother and the child she gives birth to. There are gestation (full) and genetic (partial) surrogates each with different modalities and legal and ethical implications. In Serbia, Infertility Treatment and the Bio-medically Assisted Procreation Act from 2009 explicitly forbids surrogate motherhood, despite the fact that an infertile couple decides to use it, as a rule, after having tried all other treatment procedures, in cases when there is a diagnosis but the conventional treatment applied has not produced the desired results. Given the fact that no one has the right to ignore the sufferings of people who cannot procreate naturally, the medical practice and legal science in our country plead for a formulation of a legal framework in which to apply surrogate motherhood as an infertility treatment, under particular conditions.

  6. Prediction of Infertility Treatment Outcomes Using Classification Trees

    Directory of Open Access Journals (Sweden)

    Milewska Anna Justyna

    2016-12-01

    Full Text Available Infertility is currently a common problem with causes that are often unexplained, which complicates treatment. In many cases, the use of ART methods provides the only possibility of getting pregnant. Analysis of this type of data is very complex. More and more often, data mining methods or artificial intelligence techniques are appropriate for solving such problems. In this study, classification trees were used for analysis. This resulted in obtaining a group of patients characterized most likely to get pregnant while using in vitro fertilization.

  7. Survey of reasons for discontinuation from in vitro fertilization treatment among couples attending infertility clinic

    Directory of Open Access Journals (Sweden)

    Grishma Kulkarni

    2014-01-01

    Full Text Available Background: With the increase in infertility burden, more and more couples are opting for in vitro fertilization (IVF. Despite the availability of various treatment options, the major concern that needs to be addressed is the reasons why such couples, initially motivated so strongly, drop out in fairly high numbers from IVF cycles. With this point of view the study was designed. AIM: The objective of this study was to explore the reasons why couples discontinue fertility treatment. Settings and Design: This retrospective study was carried out among couples in the age group of 20-40 years who opted for IVF at Tertiary care hospital and a private infertility center. Materials and Methods: Medical records for 3 years (2009-2012 were taken out and included in the study for analysis. Socio-demographic details along with indication for IVF and reasons for drop-separate IVF therapy were recorded on case record form and were analyzed. Results: Twenty-one percent of the patients had tubal pathology, thus making it the commonest female related factor for indication of IVF. Oligoasthenospermia (13% was the commonest cause of male related infertility factor. Financial burden was the primary cause for terminating treatment in majority of the IVF cases. Conclusions: Financial burden (62.5% was the commonest reason for drop out among couples from IVF cycle.

  8. Perspectives of complementary and alternative medicine (CAM) practitioners in the support and treatment of infertility.

    Science.gov (United States)

    O'Reilly, Erin; Sevigny, Marika; Sabarre, Kelley-Anne; Phillips, Karen P

    2014-10-14

    Infertility patients are increasingly using complementary and alternative medicine (CAM) to supplement or replace conventional fertility treatments. The objective of this study was to determine the roles of CAM practitioners in the support and treatment of infertility. Ten semi-structured interviews were conducted in Ottawa, Canada in 2011 with CAM practitioners who specialized in naturopathy, acupuncture, traditional Chinese medicine, hypnotherapy and integrated medicine. CAM practitioners played an active role in both treatment and support of infertility, using a holistic, interdisciplinary and individualized approach. CAM practitioners recognized biological but also environmental and psychosomatic determinants of infertility. Participants were receptive to working with physicians, however little collaboration was described. Integrated infertility patient care through both collaboration with CAM practitioners and incorporation of CAM's holistic, individualized and interdisciplinary approaches would greatly benefit infertility patients.

  9. Maternal self-esteem after successful treatment for infertility.

    Science.gov (United States)

    Cox, Sara Jane; Glazebrook, Cris; Sheard, Charlotte; Ndukwe, George; Oates, Margaret

    2006-01-01

    To [1] investigate self-esteem during pregnancy after previous infertility and [2] establish the relationship among self-esteem, anxiety during pregnancy, and parenting self-efficacy. Limited prospective study. A regional infertility clinic and antenatal clinic. Seventy women who had conceived through assisted reproductive technology and 111 women who had conceived naturally. Measures of self-esteem, anxiety, and parenting self-efficacy. Self-esteem, anxiety, and parenting self-efficacy. Women who had conceived through IVF treatment did not differ in terms of self-esteem during pregnancy from those who had conceived naturally. All of the women in the present study displayed levels of self-esteem that were within the normal range. Self-esteem increased as pregnancy progressed. Self-esteem was negatively correlated with anxiety during pregnancy. As self-esteem increased, anxiety decreased. Self-esteem at the start of pregnancy (18 weeks) and anxiety in the early stages of parenthood (6 weeks postpartum) predicted parenting self-efficacy. Self-esteem in the early stages of pregnancy, for both women who conceived through IVF and women who conceived naturally, is related to self-reported levels of parenting efficacy. Coaching and mentoring through antenatal clinics in the early stages of pregnancy should be tailored to incorporate advice regarding self-esteem in addition to management of pregnancy and psychological well-being.

  10. Increased incidence of infertility treatment among women working in the plastics industry

    DEFF Research Database (Denmark)

    Hougaard, K.S.; Hannerz, H.; Feveile, H.

    2009-01-01

    Several plastic chemicals adversely affect reproductive ability. This study examined the possible association between employment in the plastics industry and infertility. Dynamic cohorts of economically active women and men were followed for hospital contacts due to infertility in the Danish...... infertility were observed among female plastic workers, as opposed to an expected 87.15 cases, i.e. relative risk was 1.23 (95% CI: 1.01-1.48). For male workers the numbers were 41 respectively 49.9 cases, with relative risk being 0.82 (95% CI: 0.59-1.11). The increased incidence of infertility treatment...

  11. Risk of major congenital malformations associated with infertility and its treatment by extent of iatrogenic intervention.

    Science.gov (United States)

    Farhi, Jacob; Fisch, Benjamin

    2007-06-01

    Cumulative evidence from large cohort studies, multicenter studies, and meta-analyses suggests that assisted reproductive technologies are associated with an elevated risk of congenital malformations. Theoretically, there are several putative factors in infertility treatments which may be related to the development of congenital malformations. These include, in part, the exposure to gonadotrophin stimulation and the exposure to supra-physiological levels of E2; the altered physiological environment of implantation; the in-vitro culture conditions at early stages of embryonic development; the artificial selection of sperm for fertilization and the sperm injection process in ICSI and the process of embryo cryopreservation. However, it is also possible that the culprit is not the infertility treatment that leads to the increased risk of congenital malformations but a factor or factors inherent to infertile patients. The aim of this review is to present the current data, summarize it and define the association between major congenital malformation and different types of infertility treatments as well as to infertility per se. We conducted an extensive search of the medical literature (Pubmed, 1985-2006) to identify all data relating major congenital malformations to infertile couples, infertility treatments or to characteristics of the infertile population. The rates of congenital malformations associated with infertility were analyzed by the degree of iatrogenic intervention to better define the relative risks. The findings confirmed the increased risk of congenital malformations in relation to in vitro fertilization even in singleton infants. There was no difference in the occurrence of major congenital malformations by either the laboratory maneuvers of sperm or embryos of varying complexity or by the specific medications used for ovarian stimulation or luteal support. Increased risk for congenital malformations was also found in infertile couples in relation to

  12. Diagnosis and treatment of infertility-related male hormonal dysfunction.

    Science.gov (United States)

    Kathrins, Martin; Niederberger, Craig

    2016-06-01

    Treatment of infertility-related hormonal dysfunction in men requires an understanding of the hormonal basis of spermatogenesis. The best method for accurately determining male androgenization status remains elusive. Treatment of hormonal dysfunction can fall into two categories - empirical and targeted. Empirical therapy refers to experience-based treatment approaches in the absence of an identifiable aetiology. Targeted therapy refers to the correction of a specific underlying hormonal abnormality. However, the tools available for inferring the intratesticular hormonal environment are unreliable. Thus, understanding the limitations of serum hormonal assays is very important for determining male androgen status. Furthermore, bulk seminal parameters are notoriously variable and consequently unreliable for measuring responses to hormonal therapy. In the setting of azoospermia owing to spermatogenic dysfunction, hormonal therapy - relying on truly objective parameters including the return of sperm to the ejaculate or successful surgical sperm retrieval - is a promising treatment. This approach to the treatment of fertility-related hormonal dysfunction in men contrasts with the current state of its counterpart in female reproductive endocrinology. Treatment of male hormonal dysfunction has long emphasized empirical therapy, whereas treatment of the corollary female dysfunction has been directed at specific deficits.

  13. Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice

    Directory of Open Access Journals (Sweden)

    Anderson Sanches Melo

    2015-11-01

    Full Text Available Polycystic ovary syndrome represents 80% of anovulatory infertility cases. Treatment initially includes preconception guidelines, such as lifestyle changes (weight loss, folic acid therapy to prevent the risk of fetal neural tube defects and halting the consumption of tobacco and alcohol. The first-line pharmacological treatment for inducing ovulation consists of a clomiphene citrate treatment for timed intercourse. The second-line pharmacological treatment includes the administration of exogenous gonadotropins or laparoscopic ovarian surgery (ovarian drilling. Ovulation induction using clomiphene citrate or gonadotropins is effective with cumulative live birth rates of approximately 70%. Ovarian drilling should be performed when laparoscopy is indicated; this procedure is typically effective in approximately 50% of cases. Finally, a high-complexity reproduction treatment (in vitro fertilization or intracytoplasmic sperm injection is the third-line treatment and is recommended when the previous interventions fail. This option is also the first choice in cases of bilateral tubal occlusion or semen alterations that impair the occurrence of natural pregnancy. Evidence for the routine use of metformin in infertility treatment of anovulatory women with polycystic ovary syndrome is not available. Aromatase inhibitors are promising and longer term studies are necessary to prove their safety.

  14. Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice.

    Science.gov (United States)

    Melo, Anderson Sanches; Ferriani, Rui Alberto; Navarro, Paula Andrea

    2015-11-01

    Polycystic ovary syndrome represents 80% of anovulatory infertility cases. Treatment initially includes preconception guidelines, such as lifestyle changes (weight loss), folic acid therapy to prevent the risk of fetal neural tube defects and halting the consumption of tobacco and alcohol. The first-line pharmacological treatment for inducing ovulation consists of a clomiphene citrate treatment for timed intercourse. The second-line pharmacological treatment includes the administration of exogenous gonadotropins or laparoscopic ovarian surgery (ovarian drilling). Ovulation induction using clomiphene citrate or gonadotropins is effective with cumulative live birth rates of approximately 70%. Ovarian drilling should be performed when laparoscopy is indicated; this procedure is typically effective in approximately 50% of cases. Finally, a high-complexity reproduction treatment (in vitro fertilization or intracytoplasmic sperm injection) is the third-line treatment and is recommended when the previous interventions fail. This option is also the first choice in cases of bilateral tubal occlusion or semen alterations that impair the occurrence of natural pregnancy. Evidence for the routine use of metformin in infertility treatment of anovulatory women with polycystic ovary syndrome is not available. Aromatase inhibitors are promising and longer term studies are necessary to prove their safety.

  15. [Reproductive medicine: more than the diagnosis and treatment of infertility].

    Science.gov (United States)

    Fauser, B C J M

    2005-09-03

    The young specialty of reproductive medicine has developed tremendously in barely 30 years and has taken a prominent place in the field of obstetrics and gynaecology. In addition to the diagnosis and treatment of infertility, reproductive medicine comprises a large number of medical activities, most of which affect women in almost all phases of life, from shortly after puberty to old age. A key role is played by the pathophysiology of ovarian function and ovarian hormones. Requests for medical assistance concern: disorders of sexual development, the consequences for health in the short- and long-term of overweight and anovulation early in life, premature menopause and the need for hormone replacement, damage to the ovaries as a result of radio- or chemotherapy for cancer, the hormonal aspects of breast cancer, the hormonal aspects of sexuality and well-being, and counselling regarding contraception or menopausal symptoms and hormone replacement.

  16. Survey of the Situation of Infertile Women Seeking In Vitro Fertilization Treatment in China

    Directory of Open Access Journals (Sweden)

    Xuan Jin

    2013-01-01

    Full Text Available Background. In previous studies, people’s knowledge of reproductive health and infertile women’s psychological states was surveyed in several countries. However, there has been limited information concerning the psychological states of infertile women seeking treatment and the outcomes of in vitro fertilization (IVF in China. Methods. Infertile women were asked to complete short questionnaires on the day that their oocytes were retrieved; these questionnaires covered the durations of their infertility, levels of education, sources of pressure, and psychological states. Data concerning IVF outcomes were provided by embryologists and clinicians. The correlations between the duration of infertility and educational level, psychological state and education level, and psychological state and outcome of IVF were analyzed in the cohort study. Results. The duration of infertility in more than half of the females was longer than 5 years. Compared with less-educated women, women with higher levels of education sought treatment earlier and their rates of depressive symptoms were lower. There is an association between negative emotions and outcome of IVF. Conclusions. The survey of the situations of infertile women seeking IVF treatment in China indicates the importance of popularizing knowledge concerning reproductive health. Improving medical conditions, reducing the costs of treatment, and developing social culture will aid in relieving the stress of infertile women and improving assisted reproductive treatment.

  17. Rare chromosomal, genetic, and epigenetic-related risks associated with infertility treatment.

    Science.gov (United States)

    Kurinczuk, Jennifer J; Bhattacharya, Siladitya

    2014-08-01

    This article reviews the rarer chromosomal, genetic, and epigenetic-related risks of adverse child outcomes associated with infertility and its treatment. Excess structural chromosomal anomalies have been found in both male and female partners undergoing infertility treatment, and these risk direct transmission to offspring. Microdeletions of the Y-chromosome associated with male infertility have been transmitted to sons following treatment with intracytoplasmic sperm injection. It is thus possible that male offspring of men with infertility could experience fertility problems in adulthood. Infertility treatment for men with cystic fibrosis, or with congenital bilateral absence of the vas deferens in the absence of cystic fibrosis, who have azoospermia is now possible using surgically retrieved sperm. Transmission of known cystic fibrosis mutations can be avoided by testing the female partner prior to treatment and offering pre-implantation genetic diagnosis if she is a carrier. The effect of infertility and its treatment on genomic imprinting is of increasing concern as our understanding of the mechanisms of imprinting in germ cell development and embryogenesis expands. At present, it is far from clear whether there are longstanding effects of infertility per se or of its treatment on the health of adults who were conceived following assisted reproductive technologies, but available data suggest that this should be of concern and long-term follow-up studies are required. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. [Professor LAI Xinsheng's treatment experience of infertility by Tongyuan needling technique].

    Science.gov (United States)

    Li, Yuemei; Meng, Zhenzhen; Wang, Ranran

    2015-03-01

    Professor LAI Xinsheng's treatment experience of infertility mainly by Tongyuan needling technique for both females and males is summarized. Tongyuan needling technique is a treatment method of leading qi to its primordial location mainly through viscera back-shu points that can dredge the governor vessel and tonify the spirit and conception vessel points in abdomen and abdominal front-mu points, and according to state of illness acupoints for opening the 4 gates or five shu points are combined; reinforcing and reducing manipulations of acupuncture are applied for reference. With the method of listing cases, professor LAI Xinsheng's Tongyuan needling technique is detailedly introduced in different aspects, such as the treatment of polycystic ovary syndrome infertility and male infertility and improving the success rate of test-tube baby, and the manipulation of Tongyuan needling technique is summarized, indicating that Tongyuan needling technique is worth vigorously prompting in clinical treatment of infertility.

  19. Anxiety and depression after failure of assisted reproductive treatment among patients experiencing infertility.

    Science.gov (United States)

    Maroufizadeh, Saman; Karimi, Elaheh; Vesali, Samira; Omani Samani, Reza

    2015-09-01

    To investigate the impact of the number of previous infertility treatment failures on anxiety and depression. In a cross-sectional study, individuals (men and women, but not couples) aged at least 18 years who had a history of infertility and could read and write in Persian were enrolled at the Royan Institute, Tehran, Iran, between November 1, 2013, and February 28, 2014. Participants provided demographic and infertility information and completed the Persian version of the Hospital Anxiety and Depression Scale (HADS). Overall, 330 patients (122 men, 208 women) were included. Mean scores on the HADS anxiety and depression subscales (HADS-A and HADS-D) were 8.40±4.51 and 5.95±3.54, respectively. In multiple regression analysis, mean HADS-A scores were significantly higher for patients with one treatment failure (9.57±4.58) than for those without a history of treatment (7.79±4.13; P=0.003). HADS-D scores were significantly higher for patients with two failures (6.92±3.69) than for those with no previous treatment (5.59±3.79; P=0.019). Patients with infertility have increased depression and anxiety after infertility treatment failure. Counseling or treatment for these potential psychological effects should be considered after infertility treatment failure. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  20. The treatment of infertility in polycystic ovary syndrome: a brief update.

    Science.gov (United States)

    Costello, Michael F; Misso, Marie L; Wong, Jennifer; Hart, Roger; Rombauts, Luk; Melder, Angela; Norman, Robert J; Teede, Helena J

    2012-08-01

    Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility. Lifestyle change alone is considered the first-line treatment for the management of infertile anovulatory PCOS women who are overweight or obese. First-line medical ovulation induction therapy to improve fertility outcomes is clomiphene citrate, whilst gonadotrophins, laparoscopic ovarian surgery or possibly metformin are second line in clomiphene citrate-resistant PCOS women. There is currently insufficient evidence to recommend aromatase inhibitors over that of clomiphene citrate in infertile anovulatory PCOS women in general or specifically in therapy naive or clomiphene citrate-resistant PCOS women. IVF/ICSI treatment is recommended either as a third-line treatment or in the presence of other infertility factors.

  1. The role of Tadalafil in treatment of infertility

    Institute of Scientific and Technical Information of China (English)

    Giorgio Cavallini; Giulio Biagiotti

    2012-01-01

    Objective: It was the aim of this research to assess whether Tadalafil 5 mg once daily can improves the sperm count of unexplained infertile males with erectile deficiency induced by the emotional stress of attempting to father children. Methods: Two groups, each made up of 30 unexplained infertile males with psychogenic erectile deficiency related to attempts to father children received Tadalafil 5 mg once daily (Group 1) or a placebo (Group 2) for one month. Unexplained infertile men are intended as normospermic men who could not father children over a one year period and whose female partner is free of factors causing infertility. The endpoints were:differences between the groups in restoring erectile response, modifying sperm count, side effects and modifications of sperm analyses with respect to resolution or not of the erectile deficiency irrespective of the substance (Tadalafil or placebo) used. The means were compared using analysis of variance and the percentages using the chi square test. Results:The patients who received Tadalafil had their sperm volume, concentration and motility increased, but not the percentage of typical forms. Patients who received a placebo had no significant improvement. Additional analyses indicated that sperm volume, concentration and motility (but not morphology) significantly increased only in the patients who restored erectile response to sexual stimulation, independently of Tadalafil or placebo administration. No significant side effects were present. Conclusions: It is thought that therapies aimed at removing emotional stress linked to the performance anxiety of fathering children might improve sperm count in unexplained infertile couples.

  2. Is there a place for nutritional supplements in the treatment of idiopathic male infertility?

    Directory of Open Access Journals (Sweden)

    Davide Arcaniolo

    2014-09-01

    Full Text Available Objective: Infertility affects 15% of couples in fertile age. Male factor is a cause of infertility in almost half of cases, mainly due to oligoasthenoteratozoospermia (OAT. The purpose of this study is to review the effects of nutritional supplements as medical treatment for idiopathic male infertility. Material and methods: A Pub Med and Medline review of the published studies utilizing nutritional supplements for the treatment of male infertility has been performed. Results: Clinical trials on Vitamin E, Vitamin A, Vitamin C. Arginine, Carnitine, N-Acetyl-Carnitine, Glutathione, Coenzyme Q10, Selenium and Zinc were reviewed. Although there is a wide variability in selected population, dose regimen and final outcomes, nutritional supplements both alone and in combination seems to be able to improve semen parameters (sperm count, sperm motility and morphology and pregnancy rate in infertile men. Conclusions: There are rising evidences from published randomized trials and systematic review suggesting that nutritional supplementation may improve semen parameters and the likelihood of pregnancy in men affected by OAT. This improvement, however, is not consistent and there is a wide variation in the treatment regimens used. Well designed and adequately powered RCTs are needed to better clarify the role of nutritional supplements as treatment for male infertility.

  3. Women's Perceptions of Immediate and Long-Term Effects of Failed Infertility Treatment on Marital and Sexual Satisfaction.

    Science.gov (United States)

    Pepe, Margaret V.; Byrne, T. Jean

    1991-01-01

    Examined immediate and long-term effects of infertility treatment on the marital and sexual relationship, as perceived by women (n=40) who failed to become pregnant during treatment. Results indicated infertility treatment significantly affected both marital and sexual satisfaction after treatment was terminated, as well as during treatment. (ABL)

  4. Severe male infertility after failed ICSI treatment-a phenomenological study of men's experiences

    Directory of Open Access Journals (Sweden)

    Hellström Anna-Lena

    2011-02-01

    Full Text Available Abstract Background Male-factor infertility underlies approximately 30% of infertility in couples seeking treatment; of which 10% is due to azoospermia. The development of assisted reproductive technology (ART, enabling the use of epididymal or testicular sperm for fertilization of the partner's oocytes, has made biological fatherhood possible for men with obstructive azoospermia. There is limited knowledge of men's experience of their own infertility. The aim of this study was to describe men's experiences of obstructive azoospermia infertility. Methods Eight men with obstructive azoospermia, who had terminated Swedish public health system ART treatment two years previously without subsequent childbirth, were interviewed using a descriptive phenomenological method. Results The essence of the phenomenon is expressed with a metaphor: climbing a mountain step by step with the aim of reaching the top, i.e. having a child and thus a family with a child. Four constituents are included (1 inadequacy followed by a feeling of redress (2 marginalisation, (3 chivalry (4 extension of life and starting a family as driving forces. Conclusions Knowledge of men's experiences of their own infertility is important as a supporting measure to increase the quality of care of infertile couples. By adopting this facet of gender perspective in fertility treatment guidelines, care can hopefully be optimized.

  5. Family-Related Opinions and Stressful Situations Associated with Psychological Distress in Women Undergoing Infertility Treatment

    Directory of Open Access Journals (Sweden)

    Jiro Takaki

    2014-09-01

    Full Text Available The purpose of this study is to investigate how family-related opinions and stressful situations are related to psychological distress in women undergoing infertility treatment. The subjects in this cross-sectional study were recruited from female patients undergoing infertility treatment (n = 2540 at 70 infertility treatment institutions in Japan. Because of non-participation or missing data, the number of subjects included in the analysis was 635 (response rate, 25.0%. The family-related opinions and stressful situations were evaluated using the original questions. Psychological distress was assessed using a self-report measure, the Kessler Six-question Psychological Distress Scale (K6. The K6 scores of the following participants were significantly (p < 0.05 and independently high: those with more frequent miscarriage/stillbirth/abortions, those with repeated miscarriages as the cause of infertility, those with infertility of unknown causes, those living with no child, those having a low joint income with their partner, those with the opinion that “women should devote themselves to their household duties” those who had considered stopping treatment, those without the opinion that “married life without children is favorable” and those who had experienced stressful situations such as inadequate explanation by doctors, frustration of multiple failed attempts, differences of opinion with the partner, and lack of knowledge regarding when to stop treatment. Family-related opinions and stressful situations associated with psychological distress in women undergoing infertility treatment are outlined. The results of this study may contribute to the prevention of and care for psychological distress in female patients undergoing infertility treatment.

  6. Physician and patient use of and attitudes toward complementary and alternative medicine in the treatment of infertility.

    Science.gov (United States)

    Clark, Natalie A; Will, Matthew A; Moravek, Molly B; Xu, Xiao; Fisseha, Senait

    2013-09-01

    To determine use of and attitudes toward complementary and alternative medicine (CAM) among infertility patients and subspecialty physicians. Infertility patients were asked to complete anonymous written surveys at an academic infertility practice; members of the Society for Reproductive Endocrinology and Infertility were electronically surveyed. Both groups were assessed regarding their use of and attitudes toward CAM. The response rate was 32.1% (115/358) among patients and 22.6% (225/995) among physicians (Pinfertility patients requires greater physician attention and justifies further study on the risks and benefits of integrating CAM into the biomedical treatment of infertility. Published by Elsevier Ireland Ltd.

  7. Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review.

    Science.gov (United States)

    Palomba, Stefano; Homburg, Roy; Santagni, Susanna; La Sala, Giovanni Battista; Orvieto, Raoul

    2016-11-04

    In the literature, there is growing evidence that subfertile patients who conceived after infertility treatments have an increased risk of pregnancy and perinatal complications and this is particularly true for patients who conceived through use of high technology infertility treatments. Moreover, high technology infertility treatments include many concomitant clinical and biological risk factors. This review aims to summarize in a systematic fashion the current evidence regarding the relative effect of the different procedures for high technology infertility treatments on the risk of adverse pregnancy and perinatal outcome. A literature search up to August 2016 was performed in IBSS, SocINDEX, Institute for Scientific Information, PubMed, Web of Science and Google Scholar and an evidence-based hierarchy was used to determine which articles to include and analyze. Data on prepregnancy maternal factors, low technology interventions, specific procedures for male factor, ovarian tissue/ovary and uterus transplantation, and chromosomal abnormalities and malformations of the offspring were excluded. The available evidences were analyzed assessing the level and the quality of evidence according to the Oxford Centre for Evidence-Based Medicine guidelines and the Grading of Recommendations Assessment, Development, and Evaluation system, respectively. Current review highlights that every single procedure of high technology infertility treatments can play a crucial role in increasing the risk of pregnancy and perinatal complications. Due to the suboptimal level and quality of the current evidence, further well-designed studies are needed.

  8. Women who conceived with infertility treatment were more likely to receive planned cesarean deliveries in Taiwan.

    Science.gov (United States)

    Chien, Li-Yin; Lee, Yu-Hsiang; Lin, Yu-Hung; Tai, Chen-Jei

    2015-06-01

    The objective of this study was to examine the effect of conception with infertility treatment on planned cesarean delivery. The participants were from a panel of primiparous pregnant women in northern Taiwan. The data analysis included 771 women with a singleton pregnancy, of whom 160 had a planned cesarean delivery and 611 who had a vaginal delivery. The study women answered structured questionnaires during the second and third trimesters of pregnancy, and at one-month postpartum. Women who conceived with infertility treatment were more likely to have planned cesarean deliveries than women who conceived without it (44.7% versus 18.1%, p infertility treatment were 2.95 times (95% CI: 1.47-5.92) more likely to have planned cesarean deliveries. The increased risk for planned cesarean deliveries among singleton women who conceived with infertility treatment cannot be explained by older maternal age or higher number of morbidities during pregnancy. Counseling for women who conceive with infertility treatments may be needed to decrease unnecessary cesarean deliveries.

  9. A new rapid and effective method for treatment of unexplained infertility

    DEFF Research Database (Denmark)

    Edelstam, G.; Sjosten, A.; Bjuresten, K.

    2008-01-01

    BACKGROUND: Artificial insemination (intrauterine insemination by husband or artificial insemination by husband) is often tried as first treatment for couples with unexplained infertility. Perturbation has previously proved to increase the chance of achieving pregnancy for these couples. The effect...... and insemination cycles for couples with unexplained infertility. METHODS: In a prospective, open study, the patients were randomized, the day before ovulation, during a clomiphene citrate stimulated cycle to either perturbation with low-dose local anaesthetic or no perturbation before insemination. RESULTS......: The perturbation treatment significantly enhanced the clinical pregnancy rate and was well tolerated. No complications were noted. The combined treatment of clomiphene citrate, perturbation and insemination can be used as a cost-effective, first-line treatment for couples with unexplained infertility...

  10. Infertility, infertility treatment, and achievement of pregnancy in female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study cohort.

    Science.gov (United States)

    Barton, Sara E; Najita, Julie S; Ginsburg, Elizabeth S; Leisenring, Wendy M; Stovall, Marilyn; Weathers, Rita E; Sklar, Charles A; Robison, Leslie L; Diller, Lisa

    2013-08-01

    Previous studies have shown decreased pregnancy rates and early menopause in female cancer survivors; however, infertility rates and reproductive interventions have not been studied. We investigated infertility and time to pregnancy in female childhood cancer survivors, and analysed treatment characteristics associated with infertility and subsequent pregnancy. The Childhood Cancer Survivor Study (CCSS) is a cohort study including 5 year cancer survivors from 26 Canadian and US institutions who were younger than 21 years at the time of diagnosis between Jan 1, 1970, and Dec 31, 1986, and a sibling control group. We included women aged 18-39 years who had ever been sexually active. We gathered demographic, medical, and reproductive data via a baseline questionnaire, and quantified exposure to alkylating agents and radiation therapy. Self-reported infertility, medical treatment for infertility, time to first pregnancy in survivors and siblings, and the risk of infertility in survivors by demographic, disease, and treatment variables were analysed. 3531 survivors and 1366 female sibling controls who enrolled between Nov 3, 1992, and April 4, 2004, were included. Compared with their siblings, survivors had an increased risk (relative risk [RR] 1·48 [95% CI 1·23-1·78]; pinfertility (ie, >1 year of attempts at conception without success), which was most pronounced at early reproductive ages (RR 2·92 [95% CI 1·18-7·20], p=0·020, in participants ≤24 years; 1·61 [1·05-2·48], p=0·029, in those aged 25-29 years; and 1·37 [1·11-1·69], p=0·0035, in those aged 30-40 years). Despite being equally likely to seek treatment for infertility, survivors were less likely than were their siblings to be prescribed drugs for treatment of infertility (0·57 [95% CI 0·46-0·70], pinfertility. Although survivors had an increased time to pregnancy compared with their siblings (p=0·032), 292 (64%) of 455 participants with self-reported clinical infertility achieved a

  11. Sperm Cryopreservation before Testicular Cancer Treatment and Its Subsequent Utilization for the Treatment of Infertility

    Directory of Open Access Journals (Sweden)

    Jana Žáková

    2014-01-01

    Full Text Available Aims. In this study we report our results with storage of cryopreserved semen intended for preservation and subsequent infertility treatment in men with testicular cancer during the last 18 years. Methods. Cryopreserved semen of 523 men with testicular cancer was collected between October 1995 and the end of December 2012. Semen of 34 men (6.5% was used for fertilization of their partners. They underwent 57 treatment cycles with cryopreserved, fresh, and/or donor sperm. Results. A total of 557 men have decided to freeze their semen before cancer treatment. Azoospermia was diagnosed in 34 men (6.1%, and semen was cryopreserved in 532 patients. Seminoma was diagnosed in 283 men (54.1% and nonseminomatous germ cell tumors in 240 men (45.9%. 34 patients who returned for infertility treatment underwent 46 treatment cycles with cryopreserved sperm. Totally 16 pregnancies were achieved, that is, 34.8% pregnancy rate. Conclusion. The testicular cancer survivors have a good chance of fathering a child by using sperm cryopreserved prior to the oncology treatment, even when it contains only limited number of spermatozoa.

  12. The diagnosis and treatment of male infertility in the new millennium.

    Science.gov (United States)

    Marmar, J L

    2001-01-01

    Treatment of male infertility accomplished far-reaching advances in the past decade. Semen analysis has given rise to sperm function tests. Microsurgery, e.g., reversal of vasectomy, has reached new heights in sperm retrieval directly from the testis/epididymis and in intracytoplasmic sperm injection (ICSI). Furthermore, genetic testing-for an ever-widening range of anomalies-is the norm in modern clinical practice. This review of what is possible, and now even common, in male infertility treatment focuses on sperm function, and then deficits/anomalies and their treatment; and testicular function and dysfunction, with descriptions of hormonal and surgical techniques that now offer fatherhood to men with types of infertility that strongly imply the need for genetic counseling.

  13. Individualized cost-effective conventional ovulation induction treatment in normogonadotrophic anovulatory infertility (WHO group 2)

    NARCIS (Netherlands)

    Eijkemans, MJC; Polinder, S; Mulders, AGMGJ; Laven, JSE; Habbema, JDF; Fauser, BCJM

    2005-01-01

    BACKGROUND: Conventional treatment in normogonadotrophic anovulatory infertility (WHO 2) consists of clomiphene citrate (CC), followed by exogenous gonadotrophins (FSH) and IVF. Response to these treatments may be predicted on the basis of individual patient characteristics. We aimed to devise a pat

  14. Differences in women's psychological well-being based on infertility treatment choice and outcome.

    Science.gov (United States)

    McCarthy, M Patrice; Chiu, Sheau-Huey

    2011-01-01

    The empirical foundation regarding women's experiences with infertility is influenced by the use of clinically based populations of women who are seeking medical assistance to conceive. Although the experience of infertility and involuntary childlessness is recognized as a significant life stressor characterized by a loss of control, bodily integrity, and identity, little is understood about women who perceive an infertility problem but do not seek treatment. A secondary analysis was conducted by using a national probability sample from the National Survey of Fertility Barriers. Women (N = 142) who self-reported perceptions of fertility problems were placed in 1 of 3 groups based on the decision to seek/not seek treatment and treatment outcome. When we controlled for marital status, women who conceived with medical assistance reported significantly higher levels of life satisfaction and held parenting as more important than women who sought treatment and did not conceive and women who did not seek treatment. Women who did not seek treatment for perceived infertility problems reported a decreased sense of the importance of parenthood but also reported lower levels of self-esteem and life satisfaction than women who sought treatment, regardless of treatment outcome. © 2011 by the American College of Nurse‐Midwives.

  15. Role of laparoscopic surgery in treatment of infertility

    Directory of Open Access Journals (Sweden)

    Ivanka Šijanović

    2012-02-01

    Full Text Available The role of laparoscopy in assisted reproduction is disputed by many. A rising problem of infertility is battled by an increasingnumber of centres for reproductive medicine in the region. Nevertheless,there is a large number of indications and conditionswhere laparoscopic surgery should not be avoided as a therapeuticchoice or an aid in assisted reproductive techniques (ART.The number of centres where laparoscopic surgery is performed is significantly higher than the number of reproductive centres; anumber of gynaecologists educated in laparoscopic gynaecologyis growing, making it more available for patients.

  16. Evaluating Infertility

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Evaluating Infertility Home For Patients Search FAQs Evaluating Infertility Page ... Evaluating Infertility FAQ136, June 2012 PDF Format Evaluating Infertility Gynecologic Problems What is an infertility evaluation? When ...

  17. Evaluating Infertility

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Evaluating Infertility Home For Patients Search FAQs Evaluating Infertility Page ... Evaluating Infertility FAQ136, June 2012 PDF Format Evaluating Infertility Gynecologic Problems What is an infertility evaluation? When ...

  18. Examining Infertility Treatment and Early Childhood Development in the Upstate KIDS Study.

    Science.gov (United States)

    Yeung, Edwina H; Sundaram, Rajeshwari; Bell, Erin M; Druschel, Charlotte; Kus, Christopher; Ghassabian, Akhgar; Bello, Scott; Xie, Yunlong; Buck Louis, Germaine M

    2016-03-01

    An increasing percentage of births are conceived with assisted reproductive technology (ART) and other infertility treatment. Despite findings that such treatments may be associated with diminished gestation and birth size, scarce data exist regarding infertility treatments and children's development in the United States. To assess the use and type of infertility treatment in relation to children's development through age 36 months. Prospective cohort study (conducted 2008-2014) that sampled based on infertility treatment and plurality. Included in the study were infants born between 2008 and 2010 in New York state (excluding New York City) whose parents completed developmental screening instruments through 36 months of age. A total of 4824 mothers (97% of 4989) completed 1 or more developmental screening instruments for 5841 children, including 1830 conceived with infertility treatment and 2074 twins. Maternal self-report of any infertility treatment was further categorized into ART and ovulation induction/intrauterine insemination. Assisted reproductive technology use was previously validated by linkage with the Society for Assisted Reproductive Technology-Clinical Outcome Reporting System. Five developmental domains (fine motor, gross motor, communication, personal-social functioning, and problem-solving ability), as measured by the parental completion of the Ages and Stages Questionnaires at 4, 8, 12, 18, 24, 30, and 36 months of age. Generalized linear mixed modeling techniques estimated adjusted odds ratios (aORs) and 95% CIs for use and type of infertility treatment in relation to failing a developmental domain. Data were stratified by plurality and weighted for the sampling scheme. There were 1422 mothers (29.5%; mean [SD], age, 34.1 [5.2] years) who underwent infertility treatment. Infertility treatment was not associated with risk of their children failing any developmental domain (aOR, 1.33; 95% CI, 0.94-1.89). Assisted reproductive technology was

  19. Does infertility cause marital benefit? An epidemiological study of 2250 women and men in fertility treatment

    DEFF Research Database (Denmark)

    Schmidt, Lone; Holstein, Bjørn; Christensen, Ulla

    2005-01-01

    OBJECTIVE: To investigate (i) marital benefit, e.g., that infertility has strengthen the marriage and brought the partners closer together among people beginning fertility treatment and (ii) communication and coping strategies as predictors of marital benefit 12 months later. METHODS: A prospective...... the infertility as a secret, difficult marital communication, and using active-avoidance coping (e.g., avoid being with pregnant women or children, turning to work to take mind off things) were among men significant predictors for low marital benefit. No significant predictors were identified among women...

  20. An Analysis of the Concept of Partnership in the Couples Undergoing Infertility Treatment.

    Science.gov (United States)

    Ying, Liying; Loke, Alice Yuen

    2016-01-01

    The elements of a partnership in the couples undergoing infertility treatment are not well understood. This article aims to fill the gap by using Rodger's evolutionary method of concept analysis. The attributes of the concept partnership that were identified are a process of joint hardship, sharing, intracouple communication, and mutual support. The antecedents are love and attraction for each other, agreement, and interpersonal skills. The consequences are marital benefit, improvement in psychological status, and quality of life. A middle-range model for partnership in relationship to infertile couples is proposed. The understanding of the phenomenon of partnership will enable the researchers to develop interventions, identify the appropriate assessment instruments, and to determine directions for future research on effort to support infertile couples through their hardship.

  1. Combined manual therapy techniques for the treatment of women with infertility: a case series.

    Science.gov (United States)

    Kramp, Mary Ellen

    2012-10-01

    Current management options for infertility, including hormone therapy, intrauterine insemination, and in vitro fertilization, tend to be expensive, are not necessarily covered by insurance, and carry different levels of short-term and long-term health risks. Many of the issues that contribute to infertility can be traced to scar tissue, fascial restriction, and lymphatic congestion in the pelvic region. Manual therapy techniques exist to release fascial restrictions, to mobilize tight ligaments, and to drain congested lymphatics, all of which can be applied to the reproductive system. In this case series, 10 infertile women were treated with 1 to 6 sessions of manual therapy applied to the pelvic region. Techniques included muscle energy, lymphatic drainage, and visceral manipulation. Six of the 10 women conceived within 3 months of the last treatment session, and all 6 of those women delivered at full term.

  2. Chromosomal polymorphisms are associated with female infertility and adverse reproductive outcomes after infertility treatment: a 7-year retrospective study.

    Science.gov (United States)

    Cheng, Ran; Ma, Yaxian; Nie, Ying; Qiao, Xiaoyong; Yang, Zhilan; Zeng, Rujun; Xu, Liangzhi

    2017-07-01

    Data from 19,950 women were retrospectively analysed to determine the effect of chromosomal polymorphisms on female infertility and pregnancy outcome; fertile women were used as controls. Frequency of chromosomal polymorphisms and adverse pregnancy outcomes were compared between groups. A significantly higher incidence of chromosomal polymorphisms was found in total infertile patients, and patients with tubal infertility, ovulatory dysfunction, cervical and uterine abnormalities, and unexplained infertility compared with controls (5.53% [P Infertile women had a higher incidence of 9qh+ and inv(9) compared with controls (P chromosomal polymorphisms on female infertility (adjusted OR 1.662, 95% CI 1.551 to 1.796, P infertility groups, miscarriage rates were higher in women with chromosomal polymorphisms than in women with normal chromosomes (4.95% versus 0.96%, P = 0.001 and 6.17% versus 1.08%, P Chromosomal polymorphisms adversely affected spontaneous miscarriage rates (adjusted OR 1.625, 95% CI 1.514 to 1.769, P = 0.005). Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  3. ANTIOXIDANT DEFENSE SYSTEM CORRECTION IN TREATMENT OF PAYIENTS WITH INFERTILITY AND PERITONEAL ENDOMETRIOSIS

    Directory of Open Access Journals (Sweden)

    Dubinskaya, E.D.

    2016-09-01

    The findings suggest that the efficiency of the proposed comprehensive treatment techniques (laparoscopy and subsequent course of therapeutic plasmapheresis of patients with peritoneal endometriosis and infertility and with point mutations in the gene NAT2. The use of plasmapheresis  is pathogenetically justified in patients of the studied group.

  4. Polycystic ovary syndrome: current infertility management.

    Science.gov (United States)

    Aubuchon, Mira; Legro, Richard S

    2011-12-01

    This review summarizes the diagnosis of polycystic ovary syndrome and management of associated infertility. The goal is to guide clinicians through basic evaluation, initial treatment, and briefly describe more complex therapies.

  5. Management of Unexplained Infertility

    Directory of Open Access Journals (Sweden)

    Ozgur Kan

    2014-06-01

    In the management of the unexplained infertility, the initial treatment must be observational approach and changing the life style. It is demonstrated that using only the clomiphene citrate or intrauterine insemination is not effective. For this reason, as the patients age and ovarian reserve considered, after the observational approach, the initial treatment must be the combination of clomiphene citrate and intrauterine insemination. With this approach, pregnancy rate is rises to 10 percent for a cycle. Management wise, choosing the cheapest effective treatment for increased fertilization should be the priority, before moving onto more expensive and aggresive approaches. Apart from the diagnostic work-up, which more or less the same for every patient, treatment protocol should be individualised for every infertile couple. [Archives Medical Review Journal 2014; 23(3.000: 506-518

  6. Looking at Infertility Treatment through The Lens of The Meaning of Life: The Effect of Group Logotherapy on Psychological Distress in Infertile Women

    Directory of Open Access Journals (Sweden)

    Anahita Khodabakshi Koolee

    2013-01-01

    Full Text Available Background: Women in particular suffer from psychological stress when diagnosed with infertility.Psychosocial interventions are known to not only prevent and lessen various mental problems,but also to play a positive role in physical health and pregnancy rates. The aim of this study isto determine the unique impact of spiritual psychotherapy on concerns about infertility and theirperceived psychological stresses.Materials and Methods: This study was a randomized clinical trial. The study population includednearly 800 infertile couples who attended the Maternity and Gynecology Clinic of Jahrom Universityof Medical Sciences, Jahrom, Iran. We enrolled65 people who were randomly divided into twogroups, experimental (n=33and control (n=32. The experimental group received spiritual grouppsychotherapy counseling for 12 sessions, 2 hours per week for a 3 months period. The controlgroup did not receive any intervention, but due to ethical considerations, we gave a presentation (onesession about infertility treatment for this group after the research process was completed. We usedtwo questionnaires to obtain data, the Penn State Worry Questionnaire (PSWQ and Perceived StressScale (PSS. Data analysis was done by descriptive and analytic statistics using SPSS 16 software.Results: Psychological intervention in the treatment group significantly decreased the PSWQ(p=0.004. There were significant differences in the mean score of the PSWQ in both groups asdetermined by analysis of covariance (ANCOVA; p=0.009. Psychological intervention in thetreatment group decreased the level of perceived stress, when compared with the control group.According to ANCOVA there were significant differences between the mean PSS scores of bothgroups (p=0.01.Conclusion: Logotherapy is related to stress reduction and can decrease psychiatric symptomsof worry and perceived stress. This approach tends to improve an infertile person's ability todeal with their problem of finding the

  7. Dyadic goal appraisal during treatment for infertility: how do different perspectives relate to partners' adjustment?

    Science.gov (United States)

    Thompson, Elizabeth H; Woodward, Julia T; Stanton, Annette L

    2012-09-01

    Infertility often is a dyadic stressor that constitutes blockage of a major life goal. This study's primary aims were to examine heterosexual partners' goal appraisals during treatment for infertility and to test whether the direct effects of and interactions between partners' goal-related perceptions were associated with each partner's adjustment. Women (n = 37) receiving fertility treatment and their male partners (n = 37) completed measures of goal appraisal and psychological adjustment. Partners did not differ on ratings of the importance of the goal of parenthood, but women indicated lower perceived chance of becoming pregnant and higher perceived goal blockage than their partners. Goal appraisals were moderately correlated between partners and uncorrelated with the number of treatment procedures undergone by the couple. Women reported greater depressive symptoms, more infertility-specific thought intrusion, and lower positive states of mind than their partners. Women's appraisal of greater likelihood of becoming pregnant was psychologically protective, but greater perceived likelihood of becoming pregnant reported by their partners was associated with women's negative psychological adjustment. Examining the associations between couples' goal appraisals and psychological adjustment may aid in developing targeted interventions to promote psychological adjustment to infertility. The small sample may have prevented identifying interactions between partners' goal assessment measures.

  8. Elevated antithyroid peroxidase antibodies indicating Hashimoto's thyroiditis are associated with the treatment response in infertile women with polycystic ovary syndrome.

    Science.gov (United States)

    Ott, Johannes; Aust, Stefanie; Kurz, Christine; Nouri, Kazem; Wirth, Stefan; Huber, Johannes C; Mayerhofer, Klaus

    2010-12-01

    In infertile women suffering from polycystic ovary syndrome (PCOS), anti-thyroid peroxidase antibodies values exceeding the upper level of normal were found in significantly more clomiphene citrate resistant patients compared clomiphene citrate responders and metformin responders. Thus, elevated antiTPO levels are associated with poor treatment response in infertile women who suffer from PCOS.

  9. TCM Treatment of Male Immune Infertility--A Report of 100 Cases

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To observe the therapeutic effect of Yikang Tang (益抗汤 Yikang Decoction) for male immune infertility. Methods: 100 cases of male immune infertility in the treatment group were treated with Yikang Decoction, while 100 cases treated with prednisone as the controls. Physical exam, routine semen and prostate exams, and exams for presence of anti-sperm antibody (AsAb) and mycoplasma in the serum or seminal plasma were carried out. Results: 1) The serum and seminal plasma AsAb levels decreased significantly (P<0.01) in both the groups after treatment, with a more remarkable effect in the treatment group. 2) The sperm density and percentage of motile spermatozoa increased significantly in the two groups,but more significantly in the treatment group after treatment. The pregnancy rate of their wives was higher in the treatment group than that in the control group (P<0.01). 3) The sperm agglutination rate in the two groups decreased, but more significantly in the treatment group after treatment. 4) The improvement rate of the symptoms and the stability of the therapeutic effect were more dramatic in the treatment group than that in the control group (P<0.01)after termination of drug administration. Conclusion: The Yikang Decoction has a more stable effect for male immune infertility than prednisone.

  10. Defining Infertility

    Science.gov (United States)

    ... Home FAQs Frequently Asked Questions Quick Facts About Infertility FAQs About Infertility FAQs About the Psychological Component of Infertility FAQs About Cloning and Stem Cell Research SART's ...

  11. [Advantages of the use of Andro-Gin device for treatment of secretory infertility].

    Science.gov (United States)

    Aleksandrov, V P; Koren'kov, D G; Nikolaeva, E V

    2006-01-01

    The trial included 144 patients aged from 24 to 46 years with secretory infertility in the presence of chronic prostatitis of 2 to 13 year duration. The study group consisted of 96 patients who received conventional treatment in combination with physical factors provided by the unit APK-ELM-01 Andro-Gin. The control group consisted of 48 patients on conventional treatment alone. The results were processed mathematically and statistically. The patients were examined before, 2 weeks, 1 and 6 months after the treatment. Positive response was greater in the study group: better parameters of prostatic secretion, spermogram. Normalization of all the parameters occurred in 95 and 80% patients of the study and control groups, respectively. Thus, Andro-Gin is effective for treatment of chronic prostatitis with secretory infertility.

  12. Effects of Nursing Care Based on Watson’s Theory of Human Caring on Anxiety, Distress, And Coping, When Infertility Treatment Fails: A Randomized Controlled Trial

    National Research Council Canada - National Science Library

    Yeter Durgun Ozan; Hülya Okumuş

    2017-01-01

    ...: Watson's theory of human caring is recommended as a guide to nursing patients with infertility treatment to decrease levels of anxiety and distress, and to increase the positive coping style among infertile women...

  13. Effects of integrative medicine treatment on 48 infertile patients with diminished ovarian reserve

    Institute of Scientific and Technical Information of China (English)

    YU Jin; PAN Fang

    2008-01-01

    Objective:To observe the effect of integrative medicine treatment on infertile patients with diminished ovarian reserve(DOR).Methods:Forty-eight infertile patients with DOR were treated with integrative medicine from May 2004 to December 2006 in our center.Patients were divided into 3 groups:failed IVF-ET in 16 cases(IVF group),prema-ture ovarian failure in 9 cases(POF group)and DOR due to other causes in 23.cases(OV ↓ group).Yu's Follicle Replenishing Recipe(YFRR)was administered daily in all cases,and usually different dosages of estrogen were dia-lectically added according to the view of life network regulation.Symptoms,BBT,ovulation rate,pregnancy rate and serum sex hormones measuring on cycle Day 3(or day 3 after withdrawal bleeding)were observed before and af-ter treatment.Results:During the treatment,symptoms were gratefully relieved in all 48 patients,and the pregnancy rate was 40%.Ovulation rate significantly increased from 17%(8/48 before treatment)to 56 %(27/48 after treatment)(P0.05).Conclusion:The integrative medicine treatment not only increases ovulation rate and pregnancy rate in infertile patients with DOR,but also calms down their symptoms.

  14. The History and Challenges Surrounding Ovarian Stimulation in the Treatment of Infertility

    Science.gov (United States)

    Beall, Stephanie A.; Decherney, Alan

    2014-01-01

    OBJECTIVE To examine the history of superovulation for ovulation induction, its contributions to reproductive medicine and its impact on multiple births. DESIGN A search of the relevant literature using Pubmed and other online tools. RESULT(S) Infertility has been a condition known and studied for thousands of years. However, it was not until this past century that effective treatments were developed. With the advancement of our knowledge of the hypothalamic-pituitary axis, therapies utilizing gonadotropins were developed to stimulate ovulation. Not only were we now able to treat anovulatory infertility, but also induce superovulation for in vitro fertilization. With these successes came consequences, including increased multiple pregnancies. Several countries recognized the high costs associated with multiple births and implemented regulations on the infertility industry. The rate of triplet and higher-order multiples has declined over the past decade. This is largely attributed to a decreased number of embryos transferred. Nonetheless, the twin rate has remained consistently high. CONCLUSION(S) Superovulation has become a routine medical therapy used for ovulation induction and in vitro fertilization. With the development of this technology have come effective therapies for infertility and new ethical and medical challenges. Since the advent of gonadotropin therapy we have already developed technologies to improve monitoring and decrease hyperstimulation and high order multiple pregnancies. In the future, we anticipate new tools devised to optimize one embryo for one singleton live birth. PMID:22463773

  15. Oral antioxidant treatment partly improves integrity of human sperm DNA in infertile grade I varicocele patients.

    Science.gov (United States)

    Gual-Frau, Josep; Abad, Carlos; Amengual, María J; Hannaoui, Naim; Checa, Miguel A; Ribas-Maynou, Jordi; Lozano, Iris; Nikolaou, Alexandros; Benet, Jordi; García-Peiró, Agustín; Prats, Juan

    2015-09-01

    Infertile males with varicocele have the highest percentage of sperm cells with damaged DNA, compared to other infertile groups. Antioxidant treatment is known to enhance the integrity of sperm DNA; however, there are no data on the effects in varicocele patients. We thus investigated the potential benefits of antioxidant treatment specifically in grade I varicocele males. Twenty infertile patients with grade I varicocele were given multivitamins (1500 mg L-Carnitine, 60 mg vitamin C, 20 mg coenzyme Q10, 10 mg vitamin E, 200 μg vitamin B9, 1 μg vitamin B12, 10 mg zinc, 50 μg selenium) daily for three months. Semen parameters including total sperm count, concentration, progressive motility, vitality, and morphology were determined before and after treatment. In addition, sperm DNA fragmentation and the amount of highly degraded sperm cells were analyzed by Sperm Chromatin Dispersion. After treatment, patients showed an average relative reduction of 22.1% in sperm DNA fragmentation (p = 0.02) and had 31.3% fewer highly degraded sperm cells (p = 0.07). Total numbers of sperm cells were increased (p = 0.04), but other semen parameters were unaffected. These data suggest that sperm DNA integrity in grade I varicocele patients may be improved by oral antioxidant treatment.

  16. Transforming hope: the lived experience of infertile women who terminated treatment after in vitro fertilization failure.

    Science.gov (United States)

    Su, Tsann-Juu; Chen, Yueh-Chih

    2006-03-01

    Assisted reproductive treatments provide the hope of pregnancy for infertile women, but do not always turn this hope into reality. The purpose of this study was to explore the lived experience of infertile women who terminated treatment after in vitro fertilization (IVF) failure. Using a qualitative research design, 24 subjects were recruited who had experienced IVF failure and decided to terminate their treatment. Data were collected through interviews, and analyzed using interpretive research strategies of phenomenology. This study protocol was reviewed and approved by the University Review Board for Research. Informed consent was obtained from each subject. The theme of lived experience which emerged from the data was "transforming hope". This theme included three categories: (1) accepting the reality of infertility, (2) acknowledging the limitations of treatment involving high technology, and (3) re-identifying one's future. The results illustrated that counseling for these women should involve the provision of both positive and negative information, evaluation of the response to treatment, and assistance in defining their future.

  17. Combined conventional/antioxidant "Astaxanthin" treatment for male infertility: a double blind, randomized trial

    Institute of Scientific and Technical Information of China (English)

    F. H. Comhaire; Y. El Garem; A. Mahmoud; F. Eertmans; F. Schoonjans

    2005-01-01

    Aim: To evaluate the treatment of male infertility with a strong natural antioxidant, in addition to conventional treatment.Methods: Using a double blind, randomized trial design, 30 men with infertility of ≥12 months and female partners with no demonstrable cause of infertility received conventional treatment according to the guidelines of the World Health Organization (WHO), and either a strong antioxidant Astaxanthin 16 mg/day (AstaCarox(R), AstaReal AB,Gustavsberg, Sweden) or placebo for 3 months. The effects of treatment on semen parameters, reactive oxygen species (ROS), zona-free hamster oocyte test, serum hormones including testosterone, luteinizing hormone (LH),follicle stimulating hormone (FSH) and Inhibin B, and spontaneous or intrauterine insemination (IUI)-induced pregnancies were evaluated. Results: ROS and Inhibin B decreased significantly and sperm linear velocity increased in the Astaxanthin group (n = 11), but not in the placebo group (n = 19). The results of the zona-free hamster oocyte test tended to improve in the Astaxanthin group in contrast with the placebo group, though not reaching statistical significance.The total and per cycle pregnancy rates among the placebo cases (10.5 % and 3.6 %) were lower compared with 54.5 % and 23.1% respectively in the Astaxanthin group (P = 0.028; P = 0.036). Conclusion: Although the present study suggests a positive effect of Astaxanthin on sperm parameters and fertility, the results need to be confirmed in a larger trial before recommending Astaxanthin for the complementary treatment of infertile men.

  18. Infertility-related stress in men and women predicts treatment outcome 1 year later

    DEFF Research Database (Denmark)

    Boivin, J; Schmidt, Lone

    2005-01-01

    stress, psychology, psychosocial, reproduction, marital, gender, counselling, infertility, in vitro fertilization, fertility......stress, psychology, psychosocial, reproduction, marital, gender, counselling, infertility, in vitro fertilization, fertility...

  19. Surgical treatment of male infertility in the era of intracytoplasmic sperm injection - new insights

    Directory of Open Access Journals (Sweden)

    Sandro C. Esteves

    2011-01-01

    Full Text Available Assisted reproductive technology is an evolving area, and several adjuvant procedures have been created to increase a couple's chance of conceiving. For male infertility, the current challenges are to properly accommodate old and new techniques that are both cost-effective and evidence-based. In this context, urologists are expected to diagnose, counsel, provide medical or surgical treatment whenever possible and/or correctly refer male patients for assisted conception. Urologists are sometimes part of a multiprofessional team in an assisted reproduction unit and are responsible for the above-cited tasks as well as the surgical retrieval of sperm from either the epididymides or testicles. We present a comprehensive review of the surgical treatment options for infertile males, including the perioperative planning and prognostic aspects, with an emphasis on the role of microsurgery in the optimization of treatment results. This review also discusses current techniques for sperm retrieval that are used in association with assisted reproductive technology and includes sperm retrieval success rates according to the technique and the type of azoospermia. New insights are provided with regard to each surgical treatment option in view of the availability of assisted conception to overcome male infertility.

  20. Effect of infertility treatment and pregnancy-related hormones on breast cell proliferation in vitro.

    Science.gov (United States)

    Cooley, Anne; Matthews, Laura; Zelivianski, Stanislav; Hardy, Ashley; Jeruss, Jacqueline S

    2012-01-01

    Breast cancer development involves a series of mutations in a heterogeneous group of proto-oncogenes/tumor suppressor genes that alter mammary cells to create a microenvironment permissive to tumorigenesis. Exposure to hormones during infertility treatment may have a mutagenic effect on normal mammary epithelial cells, high-risk breast lesions and early-stage breast cancers. Our goal was to understand the association between infertility treatment and normal and cancerous breast cell proliferation. MCF-10A normal mammary cells and the breast cancer cell lines MCF-7 [estrogen receptor (ER)-positive, well differentiated] and HCC 1937 (ER-negative, aggressive, BRCA1 mutation) were treated with the weak ER activator clomiphene citrate and hormones that are increased during infertility treatment. Direct effects of treatment on cell proliferation and colony growth were determined. While clomiphene citrate had no effect on MCF-10A cells or MCF-7 breast cancer cells, it decreased proliferation of HCC 1937 versus untreated cells (P= 0.003). Estrogen had no effect on either MCF-10A or HCC 1937 cells but, as expected, increased cell proliferation (20-100 nM; P≤0.002) and colony growth (10-30 nM; Pinfertility regimens on ER-positive breast cancer cells and validate the potential protective effect of pregnancy-related exposure to hCG.

  1. FSH treatment in infertile males candidate to assisted reproduction improved sperm DNA fragmentation and pregnancy rate.

    Science.gov (United States)

    Garolla, Andrea; Ghezzi, Marco; Cosci, Ilaria; Sartini, Barbara; Bottacin, Alberto; Engl, Bruno; Di Nisio, Andrea; Foresta, Carlo

    2016-07-27

    The purpose of this study is to evaluate whether follicle-stimulating hormone treatment improves sperm DNA parameters and pregnancy outcome in infertile male candidates to in-vitro fertilization.Observational study in 166 infertile male partners of couples undergoing in-vitro fertilization. Eighty-four patients were receiving follicle-stimulating hormone treatment (cases) and 82 refused treatment (controls). Semen parameters, sexual hormones, and sperm nucleus (fluorescence in-situ hybridization, acridine orange, TUNEL, and γH2AX) were evaluated at baseline (T0) and after 3 months (T1), when all subjects underwent assisted reproduction techniques. Statistical analysis was performed by analysis of variance.Compared to baseline, cases showed significant improvements in seminal parameters and DNA fragmentation indexes after follicle-stimulating hormone therapy (all P fragmentation index and lower double strand breaks (P fragmentation, which in turn leads to increased pregnancy rates in infertile males undergoing in-vitro fertilization. In particular, double strand breaks (measured with γH2AX test) emerged as the most sensible parameter to follicle-stimulating hormone treatment in predicting reproductive outcome.

  2. Successful treatment of unilateral cryptorchid boys risking infertility with LH-RH analogue

    Directory of Open Access Journals (Sweden)

    Faruk Hadziselimovic

    2008-06-01

    Full Text Available INTRODUCTION: Infertility is the primary concern for boys with uni- or bilateral undescended testes. An early and seemingly successful orchiopexy does not improve fertility in a substantial number of cryptorchid males. We confirmed that LH-RH analogue (LH-RHa treatment induces an increase in and maturation of the germ cells; however, it was uncertain if treatment would improve the chance of fertility later in life. MATERIALS AND METHODS: Thirty unilateral cryptorchid boys, with an average age of 3 years at the time of surgery, were included in the study. Testicular biopsy showed that they had impaired testicular maturation and were therefore at high risk for infertility. Fifteen of the 30 unilateral cryptorchid boys were treated with 10 µg LH-RHa (Buserelin nasal spray, administered on alternate days for a period of 6 months, following orchiopexy. The control group consisted of 15 cryptorchid boys who had been treated by Schoemakers type of orchiopexy, alone. After puberty, the ejaculates of both groups were analyzed. RESULTS: All males in the untreated group were severely oligospermic, with 20% being azoospermic. In contrast, 86% of the treated ex-cryptorchid males had a sperm concentration within the normal range; this was significantly different from the sperm concentration found in the untreated group (p = 0.000008. CONCLUSION: For the first time, we demonstrate that infertility in cryptorchidism can be successfully corrected when suitably treated with a LH-RHa. Sperm parameters normalized following therapy in the majority of cryptorchid males who, untreated, would have remained infertile. This innovative hormonal treatment will have a profound effect on the current recommended surgical treatment of boys with undescended testes.

  3. Accurate Diagnosis as a Prognostic Factor in Intrauterine Insemination Treatment of Infertile Saudi Patients

    OpenAIRE

    Isa, Ahmed Mostafa; Abu-Rafea, Basim; Alasiri, Saleh Ahmed; Al-Mutawa, Johara; Binsaleh, Saleh; Al-Saif, Sameera; Al-Saqer, Aisha

    2014-01-01

    Background The study meant to define the prognostic factors that help in prescribing intrauterine insemination (IUI) for infertility treatment which remains an area of continuous improvements. Methods The diagnostic indications of a cohort of IUI-treated patients and their corresponding pregnancy rates (PRs) were randomly and prospectively studied among Saudi cohort of 303 patients for a period of 20 months. The indications of IUI cases were statistically analyzed for those eligible patients ...

  4. Stem Cells as New Agents for the Treatment of Infertility: Current and Future Perspectives and Challenges

    Directory of Open Access Journals (Sweden)

    Vladislav Volarevic

    2014-01-01

    Full Text Available Stem cells are undifferentiated cells that are present in the embryonic, fetal, and adult stages of life and give rise to differentiated cells that make up the building blocks of tissue and organs. Due to their unlimited source and high differentiation potential, stem cells are considered as potentially new therapeutic agents for the treatment of infertility. Stem cells could be stimulated in vitro to develop various numbers of specialized cells including male and female gametes suggesting their potential use in reproductive medicine. During past few years a considerable progress in the derivation of male germ cells from pluripotent stem cells has been made. In addition, stem cell-based strategies for ovarian regeneration and oocyte production have been proposed as future clinical therapies for treating infertility in women. In this review, we summarized current knowledge and present future perspectives and challenges regarding the use of stem cells in reproductive medicine.

  5. Psychosomatic aspects in idiopathic infertility: effects of treatment with autogenic training.

    Science.gov (United States)

    O'Moore, A M; O'Moore, R R; Harrison, R F; Murphy, G; Carruthers, M E

    1983-01-01

    It has long been recognised that there is a relationship between emotional stress and some forms of infertility. We have endeavoured to estimate "stress' levels before and after Autogenic Training in 15 couples with infertility of at least two years' duration. Potential stress markers were: plasma prolactin, total urinary free cortisol and catecholamines, and four psychological tests: Spielberger State-Trait anxiety scale, Taylor Manifest Anxiety Scale, the Cattell 16 personality factor questionnaire, and the Eysenck Personality Questionnaire. A control group of ten normal couples was included for comparison. The biochemical finding of higher mean prolactin levels in the female patients vs their controls was of particular interest. The significant reduction of the prolactin level, in parallel with decreased anxiety scores following treatment, supports the hypothesis that the elevated prolactin levels in these patients are indeed linked with emotional stress.

  6. A randomized prospective comparison between intrauterine insemination and fallopian sperm perfusion for the treatment of infertility.

    Science.gov (United States)

    Karande, V C; Rao, R; Pratt, D E; Balin, M; Levrant, S; Morris, R; Dudkeiwicz, A; Gleicher, N

    1995-09-01

    To determine if the pregnancy rates (PRs) in infertile women could be improved with fallopian sperm perfusion in comparison with IUI. Randomized prospective analysis. Academically affiliated infertility center. Consecutive patients undergoing controlled ovarian hyperstimulation (COH). After hCG administration, patients were randomized to either IUI or fallopian sperm perfusion. Pregnancy rates with the two treatment modalities. Of 240 COH cycles, those randomized to IUI included 44 clomiphene citrate (CC) (group I) and 76 gonadotropin (group III) cycles. Patients receiving fallopian sperm perfusion included 44 cycles of CC (group II) and 76 cycles of gonadotropin (group IV) treatment. The overall PRs per cycle (10.8% versus 10.8%) were similar for IUI and fallopian sperm perfusion, respectively. The PRs were also similar when compared for ovulation induction with CC (6.8% versus 9.1%) and gonadotropins (13.2% versus 11.8%). We conclude that fallopian sperm perfusion offers no advantage over IUI. Because the process of fallopian sperm perfusion is more time consuming and more costly (because of increased media usage), fallopian sperm perfusion does not seem indicated as a routine infertility therapy and should not replace IUI.

  7. Infertility and Its Treatments in Association with Autism Spectrum Disorders: A Review and Results from the CHARGE Study

    Science.gov (United States)

    Lyall, Kristen; Baker, Alice; Hertz-Picciotto, Irva; Walker, Cheryl K.

    2013-01-01

    Previous findings on relationships between infertility, infertility therapies, and autism spectrum disorders (ASD) have been inconsistent. The goals of this study are first, to briefly review this evidence and second, to examine infertility and its treatments in association with having a child with ASD in newly analyzed data. In review, we identified 14 studies published as of May 2013 investigating infertility and/or its treatments and ASD. Overall, prior results showed little support for a strong association, though some increases in risk with specific treatments were found; many limitations were noted. In new analyses of the CHildhood Autism Risk from Genetics and the Environment (CHARGE) population-based study, cases with autism spectrum disorder (ASD, n = 513) and controls confirmed to have typical development (n = 388) were compared with regard to frequencies of infertility diagnoses and treatments overall and by type. Infertility diagnoses and treatments were also grouped to explore potential underlying pathways. Logistic regression was used to obtain crude and adjusted odds ratios overall and, in secondary analyses, stratified by maternal age (≥35 years) and diagnostic subgroups. No differences in infertility, infertility treatments, or hypothesized underlying pathways were found between cases and controls in crude or adjusted analyses. Numbers were small for rarer therapies and in subgroup analyses; thus the potential for modest associations in specific subsets cannot be ruled out. However, converging evidence from this and other studies suggests that assisted reproductive technology is not a strong independent risk factor for ASD. Recommendations for future studies of this topic are provided. PMID:23965925

  8. Diagnosis and treatment of male infertility associated with immotile ciliasyndrome: a report of 6 cases

    Institute of Scientific and Technical Information of China (English)

    Fei Qian-jin; Huang Xue-feng; Ye Bi-lu

    2011-01-01

    Objective:To investigate the clinical characteristics,diagnosis and treatment of male infertility associated with immotile cilia syndrome (ICS).Methods:The clinical data of six cases of male infertility associated with ICS were reviewed retrospectively.Results:The clinical features in all cases included chronic or recurrent infections of the upper and lower airways and male infertility.Sinusitis,bronchitis and bronchiectasis were found in all cases and situs inversus totalis found in two cases.Sex hormone levels,chromosome karyotype and Y chromosome microdeletion (AZF) in all cases were normal.All cases were diagnosed as severe asthenospermia by routine semen analysis.Five cases had no motile spermatozoa in semen,while there were less than 0.2% of motile sperm in one case.The total sperm count and sperm viability were normal in four cases and there were very few immotile sperm in two cases.Transmission electron microscopic examination of sperm flagellum revealed disarrangement or a partial absence of 9 + 2 microtubules and/or an absence of the dynein arms in six cases.The bronchial cilia in one case showed to be devoid of inner dynein arms.Five cases underwent six intracytoplasmic sperm injection (ICSI) cycles and the rates of fertilization,embryo cleavage and good quality embryos were 50.0%,69.2% and 55.6%,respectively.Two clinical pregnancies and one chemical pregnancy were achieved,with one birth of a healthy baby boy.Conclusions:The ultrastructural defect of cilia or flagellum is the most important diagnostic criteria of ICS.ICSI is an effective treatment for male infertility associated with ICS.

  9. Infertility Treatment and Fertility-Specific Distress: A Longitudinal Analysis of a Population-Based Sample of U.S. Women

    Science.gov (United States)

    Greil, Arthur L.; McQuillan, Julia; Lowry, Michele; Shreffler, Karina M.

    2011-01-01

    Because research on infertile women usually uses clinic-based samples of treatment seekers, it is difficult to sort out to what extent distress is the result of the condition of infertility itself and to what extent it is a consequence of the experience of infertility treatment. We use the National Survey of Fertility Barriers, a two-wave national probability sample of U.S. women, to disentangle the effects of infertility and infertility treatment on fertility-specific distress. Using a series of ANOVAs, we examine 266 infertile women who experienced infertility both at Wave 1 and at Wave 2, three years later. We compare eight groups of infertile women based on whether or not they have received treatment and on whether or not they have had a live birth. At Wave 1, infertile women who did not receive treatment and who had no live birth reported lower distress levels than women who received treatment at Wave 1 only, regardless of whether their infertility episode was followed by a live birth. At Wave 2, women who received no treatment have significantly lower fertility-specific distress than women who were treated at Wave 1 or at Waves 1 and 2, regardless of whether there was a subsequent live birth. Furthermore, fertility-specific distress did not increase over time among infertile women who did not receive treatment. The increase in fertility-specific distress was significantly higher for women who received treatment at Wave 2 that was not followed by a live birth than for women who received no treatment or for women who received treatment at Wave 1 only. These patterns suggest that infertility treatment is associated with levels of distress over and above those associated with the state of being infertile in and of itself. PMID:21645954

  10. Infertility treatment in women over 40 years of age.

    Science.gov (United States)

    Feinman, M A

    1997-06-01

    Women experience a sharp decline in fecundity after the age of 40. Most research points to decreasing oocyte competency and ovarian function as the main causes of this downward trend. Aggressive treatment with in vitro fertilization, laboratory techniques that improve the implantation ability of embryos, and ovum donation can help many of these women achieve healthy pregnancies. Such medical advances are accompanied by new ethical challenges.

  11. Causal ACTH-Depot Therapy during Pregnancies following Infertility Treatment

    Directory of Open Access Journals (Sweden)

    Rudolf Klimek

    2012-01-01

    Full Text Available The aim of this paper was to confirm the efficacy of adrenocorticotropin depot (ACTH-depot therapy in pregnancies with threatened miscarriage and preterm delivery through the desired stimulation of the adrenal glands controlled by the rest of organism. The activity of hypothalamic-pituitary-adrenal axis plays a key role in pregnancy. Such naturally stimulated endogenous corticosteroid hormones are free from unwanted side effects of their synthetics analogs. Low level of maternal blood ACTH and insufficient increase of induced by hypothalamic hormones oxytocinases (cystine-β-aminopeptidases were indication to ACTH-depot therapy (0.5 mg/week in our consecutive prospective studies. Contrary to antenatal use of synthetic corticosteroids, there are no temporal limits of this therapy, which has to be more often recommended into clinical prevention of fetal morbidity, treatment of premature delivery, and finally elimination of the newborn's mortality caused by the neuroendocrinological gestoses.

  12. Social Perception of Infertility and Its Treatment in Late Medieval Italy: Margherita Datini, an Italian Merchant's Wife.

    Science.gov (United States)

    Nam, Jong Kuk

    2016-12-01

    Because the perception of infertility in medieval Europe ranged from the extremely religious view of it as a malediction of God or the devil's work, to the reasonable medical conception of it as a sort of disease to treat, it is very difficult to determine the general attitudes of ordinary people towards infertility. This article seeks to elucidate the common social perception of infertility and its treatment in late medieval Europe by analyzing the case of Margherita Datini, an Italian merchant's wife who lived in the 1400s. It relies heavily on the documents left by her and her husband, Francesco Datini; the couple left many records, including letters of correspondence between them. Margherita and those around her regarded infertility not as the devil's curse or a punishment by God but as a disease that can be cured. Margherita and her husband, Francesco, tried hard to cure their infertility. They received treatment and prescriptions from several doctors while also relying on folk remedies, religious therapies, and even magical remedies. The comparative analysis of Datini documents, medical books, and theoretical treatises or prescriptive essays by clerics suggests that the general perception of infertility in medieval Europe was located between the extremely religious and modern medical conceptions of it.

  13. Female Infertility

    Science.gov (United States)

    Infertility means not being able to get pregnant after at least one year of trying (or 6 ... woman keeps having miscarriages, it is also called infertility. Female infertility can result from age, physical problems, ...

  14. Infertility FAQ's

    Science.gov (United States)

    ... 3286 After hours (404) 639-2888 Contact Media Infertility FAQs Recommend on Facebook Tweet Share Compartir Frequently Asked Questions What is infertility? In general, infertility is defined as not being ...

  15. Congenital malformations among babies born following letrozole or clomiphene for infertility treatment.

    Science.gov (United States)

    Sharma, Sunita; Ghosh, Sanghamitra; Singh, Soma; Chakravarty, Astha; Ganesh, Ashalatha; Rajani, Shweta; Chakravarty, B N

    2014-01-01

    Clomiphene citrate (CC) is the first line drug for ovulation induction but because of its peripheral antiestrogenic effect, letrozole was introduced as the 2nd line drug. It lacks the peripheral antiestrogenic effect and is associated with similar or even higher pregnancy rates. Since letrozole is a drug for breast cancer, its use for the purpose of ovulation induction became controversial in the light of studies indicating an increased incidence of congenital malformations. To evaluate and compare the incidence of congenital malformations among offsprings of infertile couples who conceived naturally or with clomiphene citrate or letrozole treatment. A retrospective cohort study done at a tertiary infertility centre. A total of 623 children born to infertile women who conceived naturally or following clomiphene citrate or letrozole treatment were included in this study. Subjects were sorted out from medical files of both mother and newborn and follow up study was done based on the information provided by parents through telephonic conversations. Babies with suspected anomaly were called and examined by specialists for the presence of major and minor congenital malformations. Other outcomes like multiple pregnancy rate and birth weight were also studied. Overall, congenital malformations, chromosomal abnormalities were found in 5 out of 171 (2.9%) babies in natural conception group and 5 out of 201 babies in the letrozole group (2.5%) and in 10 of 251 babies in the CC group (3.9%). There was no significant difference in the overall rate of congenital malformations among children born to mothers who conceived naturally or after letrozole or CC treatment. Congenital malformations have been found to be comparable following natural conception, letrozole and clomiphene citrate. Thus, the undue fear against letrozole may be uncalled for.

  16. The effect of health-promoting lifestyle education on the treatment of unexplained female infertility.

    Science.gov (United States)

    Kaya, Yeliz; Kizilkaya Beji, Nezihe; Aydin, Yunus; Hassa, Hikmet

    2016-12-01

    This study aimed to reveal the 1) awareness, 2) improvements of a health-promoting lifestyle on women with unexplained infertility having at least one of the risk factors that have been indicated to negatively affect fertility (smoking, body mass index lower than 18.5kg/m(2) and more than 25kg/m(2), over-exercising or not exercising at all, alcohol consumption, caffeine consumption of more than 300mg/day, and high levels of stress) by means of health-promoting lifestyle education, 3) the effect of this improvement on the result of assisted-reproduction treatment in terms of clinical pregnancy. 64 women diagnosed with unexplained infertility were divided into a group receiving Health-Promoting Lifestyle (HPL) education and a control group. 1) Risk Factors Questionnaire (BMI, Smoking, Alcohol, Stress, Exercise, Caffeine), 2) Depression, Anxiety and Stress Scale, 3) Health-Promoting Lifestyle Profile II. The health promoting lifestyle was given to the education group. The Risk Factors Questionnaire; Depression, Anxiety, Stress Scale and Healthcare-Promoting Lifestyle Profile II were also administered after the first-second-third month of education but before ART treatment. A statistically significant decrease was found in the average levels of four variables as; BMI (peducation and control group consequently (p=0.02). Health-promoting lifestyle education was found to be effective in reducing the lifestyle risk factors for infertility and increasing the success rates of assisted reproduction treatment by correcting these risk factors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Congenital malformations among babies born following letrozole or clomiphene for infertility treatment.

    Directory of Open Access Journals (Sweden)

    Sunita Sharma

    Full Text Available Clomiphene citrate (CC is the first line drug for ovulation induction but because of its peripheral antiestrogenic effect, letrozole was introduced as the 2nd line drug. It lacks the peripheral antiestrogenic effect and is associated with similar or even higher pregnancy rates. Since letrozole is a drug for breast cancer, its use for the purpose of ovulation induction became controversial in the light of studies indicating an increased incidence of congenital malformations.To evaluate and compare the incidence of congenital malformations among offsprings of infertile couples who conceived naturally or with clomiphene citrate or letrozole treatment.A retrospective cohort study done at a tertiary infertility centre.A total of 623 children born to infertile women who conceived naturally or following clomiphene citrate or letrozole treatment were included in this study. Subjects were sorted out from medical files of both mother and newborn and follow up study was done based on the information provided by parents through telephonic conversations. Babies with suspected anomaly were called and examined by specialists for the presence of major and minor congenital malformations. Other outcomes like multiple pregnancy rate and birth weight were also studied.Overall, congenital malformations, chromosomal abnormalities were found in 5 out of 171 (2.9% babies in natural conception group and 5 out of 201 babies in the letrozole group (2.5% and in 10 of 251 babies in the CC group (3.9%.There was no significant difference in the overall rate of congenital malformations among children born to mothers who conceived naturally or after letrozole or CC treatment.Congenital malformations have been found to be comparable following natural conception, letrozole and clomiphene citrate. Thus, the undue fear against letrozole may be uncalled for.

  18. Infertility with Testicular Cancer.

    Science.gov (United States)

    Ostrowski, Kevin A; Walsh, Thomas J

    2015-08-01

    Testicular germ cell cancer is one of the most curable cancers. Most patients are treated during their reproductive years, making infertility a significant quality of life issue after successful treatment. This focused review evaluates the factors that contribute to infertility and specific fertility risks with the various testicular cancer treatments. Timing of patient discussions and current fertility treatments are reviewed.

  19. Behaviours Of The Infertile Women with regard to Traditional InfertiHty Treatments And Influencing Factors.

    OpenAIRE

    KAYA, Dr. Mehmet Ali KURÇER Dr. Mücahit EĞRİ

    1999-01-01

    The aim of this study was to determine the behaviours of ınfertile women applying to Obstetric and Gynecology cünic at Turgut Özai Medicai Çenter in Malatya with regard to traditionai infertility treatments and relations with some demographic attribute. In this cross-sectionai study, 66 women applying to Obstetric and Gynecology cünic of Turgut Ozai Medicai Çenter between June and August 1997 were induded. The study was carried out using face to face questionnaire method. Nineteen women (28.7...

  20. Hepatitis B virus infection status and infertility causes in couples seeking fertility treatment-Indicator of impaired immune response?

    Science.gov (United States)

    Lao, Terence T; Mak, Jennifer S M; Li, Tin-Chiu

    2017-04-01

    The relationship between hepatitis B (HBV) infection in infertile couples seeking in vitro fertilization (IVF) treatment and infertility causes is unknown. A total of 831 infertile couples attending our unit seeking IVF during January to December 2015 were recruited. HBV infection was found in 6.3% and 7.3% of female and male partners, respectively, and infection in one or both partners was associated with less primary infertility (44.2% vs 55.1%, P=.038). Infected female partners had increased tubal (69.2% vs 43.2%, Pinfertility, while infected male partners were associated with increased tubal (62.3% vs 43.4%, P=.004) causes and reduced endometriosis (62.3% vs 73.9%, P=.050). Our results suggest HBV infection in either partner was associated with tubal infertility. HBV infection in either partner probably increases the risk of pelvic infection in female partner through impaired immune response to sexually transmitted infections, with consequent tubal damage and infertility. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. General psychopathology, anxiety, depression and self-esteem in couples undergoing infertility treatment: a comparative study between men and women.

    Science.gov (United States)

    El Kissi, Yousri; Romdhane, Asma Ben; Hidar, Samir; Bannour, Souhail; Ayoubi Idrissi, Khadija; Khairi, Hedi; Ben Hadj Ali, Bechir

    2013-04-01

    To compare measures of psychological distress between men and women undergoing ART in the Unit of Reproductive Medicine "UMR" in the Department of Obstetrics and Gynecology at "Farhat Hached" Hospital in Sousse, Tunisia. We conducted a gender comparative study of psychological profile in infertile couples. Recruitment was done during period from January to May 2009. 100 infertile couples with primary infertility were recruited. Scores of general psychopathology, depression, anxiety and self-esteem were evaluated. We administrated questionnaires on psychological factors among infertile couples before starting a new infertility treatment cycle. Psychological factors included the symptom check-list (SCL-90-R), the hospital anxiety and depression scale (HAD-S) and the Rosenberg self-esteem scale (RSE). Infertile women had higher scores than their spouses in the three global scores of the SCL-90-R and in several items such as somatisation, obsessive symptoms, interpersonal sensitivity and phobias. Scores of HADS were higher among women for both depression and anxiety. Scores of self-esteem were lower among women. Women endorsed higher psychological distress than men across multiple symptoms domains: general psychopathology, anxiety, depression and self esteem. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. Clinical Analysis of 32 Cases on Treatment of Infertility with Laparoscopic Hysteropexy

    Institute of Scientific and Technical Information of China (English)

    葛春晓; 刘梦美; 丁慧娟; 马莉

    1997-01-01

    The diagnosis and treatment for 32patients suffering from infertility, were established with the aid of laparoscopy. Among them, 14 cases were found to be of chronic pelvic inflammatory disease, 13 cases endometriosis and 2 cases simple habitual abortion. After performing conservative operative procedures for the treatment of the primary diseases, all of the 32 patients underwent the laparoscopic hysteropexy. This operative technique is simple and is easily mastered by experienced laparoscopists who are familiar with the pelvic anatomy and ready to deal with intra-or post-operative complications. Follow-up study of these 32 cases for 2 to 6 years showed an overall pregnancy rate of 56.3% (18/32), a live birth rate of 53.1% (17/32) and an abortion rate of 3.1% (1/32). The pregnancy rate after operation in the patients suffering from endometriosis was 85% (11/13), which was much higher than that of the patients with chronic inflammatory disease who had a pregnacy rate of 42.8% (6/14). The difference was highly significant (P< 0.01).These results indicate that in patients suffering from infertility due to various etiological causes, after treatment of the primary diseases, ventrohysteropexy, in selected cases, can be applied as a fertility-promoting measure.

  3. Treatment of varicocele infertility men patients of different Chinese medical syndrome types by integrative medicine treatment selection:a primary research

    Institute of Scientific and Technical Information of China (English)

    倪凯

    2013-01-01

    Objective To explore the optimal treatment selection for treating varicocele(VC) male infertility patients accompanied with oligozoospermia or azoospermia of different Chinese medical syndrome types by comparing the efficacies of integrative medicine.Methods One hundred and

  4. Cryopreservation of very low numbers of spermatozoa from male patients undergoing infertility treatment using agarose capsules.

    Science.gov (United States)

    Hatakeyama, Shota; Tokuoka, Susumu; Abe, Hiroyuki; Araki, Yasuyuki; Araki, Yasuhisa

    2017-07-01

    This study tried to cryopreserve low numbers of spermatozoa from men undergoing infertility treatments by inserting into agarose capsules. The capsules were transferred into a drop of cryoprotectant solution and injected 3-4 motile spermatozoa that were selected by the swim-up method by conventional intracytoplasmic sperm injection. These capsules were put on a Cryotop(®) and frozen in liquid nitrogen vapor, and then submerged into liquid nitrogen and subsequently thawed and recovered. The motile spermatozoa in the capsules were counted. Eventually, we cryopreserved 2142 motile spermatozoa in 702 agarose capsules from 26 male patients and 1356 (63%) spermatozoa maintained their motility after thawing. The spermatozoa motility rates after thawing (MRAT) ranged from 20.0% (5/25) to 95.1% (58/61) among patients. The median MRAT was 68.3% (interquartile range 46.1-75.7). The total number of motile spermatozoa collected by swim-up method strongly correlated with MRAT (r = 0.746). It was possible to cryopreserve spermatozoa from male patients undergoing infertility treatment using agarose capsules. However, there were wide differences in MRAT among patients. It seems the spermatozoa from semen where there were many motile spermatozoa may have higher freezing resistance. Further studies using this method in cryptozoospermic semen, testicular and epididymal spermatozoa are required.

  5. IMPACT OF SOME CYTOKINES TO EFFICIENCY OF INFERTILITY TREATMENT BY MEANS OF IN VITRO FERTILIZATION

    Directory of Open Access Journals (Sweden)

    N. O. Motovilova

    2012-01-01

    Full Text Available Abstract. Present study defines clinical, hormonal and immunological factors allowing to predict outcomes of IVF cycles in patients with combined forms of infertility at their reproductive age. Indices of gonadotrophic ovarian stimulation in IVF cycles in patients of reproductive age with combined forms of infertility depend on their age and cytokine contents in follicular fluid. Effectiveness of gonadotropin-induced ovarian stimulation is inversely dependent on the patients’ age, its increase is related to increased contents of pro-inflammatory cytokines in follicular fluid and increased expression of CCR1, along with decreased expression of CCR3 chemokine receptors in endometrium. Effectiveness of gonadotropin-induced ovarian stimulation depends on concentration of cytokines in the follicular fluid, which is argued by presence of a significant direct correlation between the number of growing follicles, oocytes and local contents of IL-10, IL-15, eotaxin, MIP-1β, RANTES, TNFα, IFNγ, and GMCSF. Free testosterone levels show a positive correlation with numbers of oocytes obtained from the ovarian punctate, and CXCR2 and CCR3 expression in endometrium, as well as a negative correlation was found with IL-4 contents in follicular fluid. In patients with negative IVF cycle outcomes, levels of IL-13 in follicular fluid upon ovarian stimulation proved to be twofold higher than those in patients with successful pregnancy after IVF. Prognosis for pregnancy in a cycle of treatment in patients with combined forms of infertility of reproductive age is determined by a patients’ story, and a variety of clinical, hormonal and embryological factors which can increase predictive accuracy of the IVF outcomes. To determine a probability of successful pregnancy after IVF cycle, an appropriate prognostic index is recommended, with a sensitivity levels of 93% and specificity of 89%.

  6. Infertility Research at the NICHD

    Science.gov (United States)

    ... Resources Interviews & Selected Staff Profiles Multimedia Focus on Infertility Research at the NICHD Skip sharing on social ... Unravel the Complex Causes of and Treatments for Infertility According to the Centers for Disease Control and ...

  7. Importing and exporting gametes and embryos under the Infertility Treatment Act 1995 (Vic): an unconstitutional restraint on free trade?

    Science.gov (United States)

    Miller, Solomon

    2003-11-01

    Since the introduction of the Infertility Treatment Act 1995 (Vic), it has been illegal to import into or export from Victoria a gamete or embryo outside the human body without the approval of the Infertility Treatment Authority. But is s 56 unconstitutional and therefore invalid by reason of contravening the freedom of interstate trade guarantee by s 92 of the Commonwealth Constitution? By exploring the nature and effect of s 56 this article demonstrates that s 56 may impose a "discriminatory" and "protectionist" burden that renders s 56 invalid.

  8. Clinical Holistic Medicine: Holistic Pelvic Examination and Holistic Treatment of Infertility

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2004-01-01

    Full Text Available In clinical holistic practice, it is recommended that ample time is spent with the gynecological or pelvic examination, especially in cases of women with suspected old emotional traumas following early childhood cases of incest or sexual abuse. The holistic principles of holding and processing should be followed with the purpose of healing the patient, re-establishing the natural relationship with the body, sexuality, and reproductive organs. Sexual violations are often forcibly repressed. It appears that the tissues that were touched during the violation often bear the trauma. It is characteristic of these patients that their love lives are often problematic and do not provide the necessary support to heal the old wounds in the soul and therapy is therefore indicated. When this is concerned with the reproductive organs, it poses particular difficulties, as the therapy can easily be experienced as a repetition of the original violation, not least due to the risk of projection and transference. There is, therefore, a need for a procedure that is familiar to and safe for the patient, for all work that involves therapeutic touching of sexual organs over and beyond what is standard medical practice. This paper presents one case story of earlier child sexual abuse and one case of temporary infertility. We have established a procedure of slow or extended pelvic examination, where time is spent to make the patient familiar with the examination and accept the whole procedure, before the treatment is initiated. The procedure is carried out with a nurse, and 3 h are set aside. It includes conversation on the present condition and symptoms; concept of boundaries; about how earlier assaults can be projected into the present; establishment of the therapeutic room as a safe place; exercises on when to say “stop”; therapeutic touch; visualization of the pelvic examination step by step beforehand; touching on the outside of the clothes with repetition of the

  9. N-acetyltransferase 2 (NAT2 Gene Polymorphisms and the Effectiveness of Infertility Treatment in Patients with Peritoneal Endometriosis

    Directory of Open Access Journals (Sweden)

    Ekaterina D. Dubinskaya

    2014-03-01

    Full Text Available Today, infertility has become a global issue. WHO ranks it the fifth among the major diseases of those below 60 years, after alcoholism, depression, injuries and eyesight disorders. Numerous studies conducted on the problems of infertility in endometriosis still do not offer clear answers regarding the pathogenesis and mechanisms of this disease and its influences on fertility. According to the survey results, point mutations of the NAT2 gene (NAT2*5 and NAT2*6 have been identified in 75.6% of the patients with infertility problems and the peritoneal form of endometriosis, that create “slow” allelic variants, which exceed the average index in the population. The peculiarities of the NAT2 gene polymorphisms have been proven to be associated with the effectiveness of the infertility treatment of female patients with peritoneal endometriosis. In the group of non-pregnant patients, the presence of с.341Т>C, c.481C>T, c.590G>A and c.803A>G heterozygous point mutations are 73.2, 73.2, 5.4, and 62.5%, respectively. The significant difference in the comparison of the allelic polymorphism during the various stages of the endometriosis was not identified. At stage III-IV endometriosis the frequency of three and more point substitutions was significantly higher. NAT2 gene polymorphisms can find use as an additional criterion for predicting the effectiveness of the infertility treatment of patients with peritoneal endometriosis.

  10. Current approach to male infertility treatment: sperm selection procedure based on hyaluronic acid binding ability

    Directory of Open Access Journals (Sweden)

    A. V. Zobova

    2015-01-01

    Full Text Available Intracytoplasmic sperm injection into an oocyte is widely used throughout the world in assisted reproductive technologies programs in the presence of male infertility factor. However, this approach can allow selection of a single sperm, which is carrying different types of pathologies. Minimizing of any potential risks, entailing the occurrence of abnormalities in the embryos development (apoptosis, fragmentation of embryos, alterations in gene expression, aneuploidies is a very important condition for reducing the potential negative consequences resulting the manipulation with gametes. Processes that could be influenced by the embryologist must be fulfilled in safe and physiological way as much as it is possible. Data of numerous publications reporting about the positive effects of using the technology of sperm selection by hyaluronic acid binding, let make a conclusion about the high prospects of this approach in the treatment of male infertility by methods of in vitro fertilization. The selection of sperm with improved characteristics, which determine the maturity and genetic integrity, provides an opportunity to improve the parameters of pre-implantation embryogenesis, having thus a positive effect on clinical outcomes of assisted reproductive technologies programs.

  11. HLA-G profile of infertile couples who underwent assisted reproduction treatment.

    Science.gov (United States)

    Costa, Cynthia Hernandes; Gelmini, Georgia Fernanda; Nardi, Fabiola Silva; Roxo, Valéria Maria Munhoz Sperandio; Schuffner, Alessandro; da Graça Bicalho, Maria

    2016-12-01

    HLA-G codes for a non-classical class I (Ib) protein which is mainly expressed in trophoblast cells. Many pieces of evidence pointed out its essential role conferring immunological tolerance to the fetus. Some HLA-G alleles have been linked to enhanced or reduced HLA-G protein levels expression, which have been associated with reproductive failure. In this study 33 couples undergoing ART (assisted reproduction treatment; n=66) and 120 couples who conceived naturally (controls; n=240) were enrolled in the study. Genotyping was performed by SBT and tagged an 1837bp at 5'URR as well as exons 2, 3 and4 of HLA-G. Alleles, genotypes and haplotypes were compared between infertile and control groups using Fisher Exact Test. The haplotype HLA-G(∗)010101b/HLA-G(∗)01:01:01 showed statistically significant higher frequency in control groups. The immunogenetics of infertility is complex and might be dependent on different genes involved in the establishment of a successful pregnancy. A better understanding of HLA-G alleles and haplotypes structure and how the genetic diversity at their regulatory sites could impact on their level of expression and build up the susceptibility or protection conditions may shed light on the comprehension of immunogenetics mechanisms acting at the fetus-maternal interface.

  12. [Treatment of chronic prostatitis caused by chlamydial and ureaplasmic infection and complicated with male infertility].

    Science.gov (United States)

    Kalinina, S N; Tiktinskiĭ, O L

    2010-01-01

    Etiologically, chronic prostatitis can result from urogenital latent infections caused by chlamydia, ureaplasma and others. First of all, such patients should be examined for urethritis. We examined 306 patients aged 23-45 years with chronic prostatitis caused by chlamydial and ureaplasmic infection. The samples were taken from the urethra, urine, prostatic secretion, ejaculate and were examined using direct immunofluorescence, polymerase chain reaction, culturing. We found spermatogenetic disorders in 50% patients, 35 (11.4%) patients had a deferent duct obstruction. The patients had also immunointerferon deficiency and alterations in prostatic echostructure. In chronic prostatitis caused by chlamydial-ureaplasmic infection the treatment must combine antibacterial drugs (vilprophen, unidox, solutab) with interferons (lavomax, genferon). Male infertility treatment should be started only after elimination of the bacterial infection.

  13. Antioxidants and Polyphenols: Concentrations and Relation to Male Infertility and Treatment Success.

    Science.gov (United States)

    Silberstein, Tali; Har-Vardi, Iris; Harlev, Avi; Friger, Michael; Hamou, Batel; Barac, Tamar; Levitas, Eli; Saphier, Oshra

    2016-01-01

    Oxidative stress is induced by reactive oxygen substances (ROS) that are known to affect male fertility. The aims of this study were to prospectively investigate and characterize total antioxidant and specifically polyphenols concentrations and their relations to sperm quality and fertility treatment success. During their infertility treatment, sixty-seven males were prospectively recruited to this study. After separation of the sperm from the semen sample, the semen fluid samples antioxidants and polyphenols concentrations were determined. Antioxidant concentration was significantly associated with sperm concentration and total motile count. Antioxidants concentration in the group of male with sperm concentration ≥ 15 × 10(6) was significantly higher than in the group of male with antioxidants concentration antioxidants or polyphenols concentrations. This is the first study that reports on polyphenols concentration within semen fluid. More studies are needed in order to investigate polyphenols role in male fertility.

  14. Patient centred care in infertility health care: direct and indirect associations with wellbeing during treatment.

    Science.gov (United States)

    Gameiro, Sofia; Canavarro, Maria Cristina; Boivin, Jacky

    2013-12-01

    To investigate whether different dimensions of patient centred care (PCC) were directly associated with wellbeing or indirectly, via lower concerns about medical procedures and/or increased tolerability of treatment. Cross-sectional study with 322 women and 111 men undergoing fertility diagnosis or treatment recruited online and in clinical setting. Participants completed questionnaires that assess PCC (PCQ-Infertility), individual (BSI Anxiety and Depression subscales) and relational wellbeing (FertiQoL Relational Domain), treatment concerns (CART Procedural Concerns scale) and tolerability (FertiQoL Tolerability Domain) and they filled a socio-demographic and fertility data file. All dimensions of PCC were positively associated with better wellbeing except for organization of care. Information provision and continuity of care were indirectly associated with better individual wellbeing, the first via lower treatment concerns and the second via higher treatment tolerability. Competence, accessibility, continuity and communication were indirectly associated with better relational wellbeing via higher treatment tolerability. Patient centred care promotes wellbeing during treatment. PCC is directly associated to wellbeing but also indirectly. The mode of action of the different PCC dimensions on wellbeing varies. To promote patients' wellbeing during treatment clinics should provide treatment related information and allow patients to establish a stable clinical relationship with a trustworthy and competent physician. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. The effect of metformin treatment on ICSI in infertile polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Firoozeh Akbari Asbagh

    2010-03-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Insulin resistance is common in women with Polycystic Ovary Syndrome (PCOS and can cause poor outcome of infertility treatment. The aim of our study was to assess the effect of treatment with metformin on outcome of Intra Cytoplasmic Sperm Injection (ICSI in infertile PCOS women."n"nMethods: A randomized clinical trial study was carried out in infertile women with PCOS, before ICSI, referred to infertility clinic of Mirza Koochackhan Hospital of Tehran University of Medical Science Tehran, Iran, between 2006 and 2008. The patients were randomized in two groups of metformin 500 mg Po, three times daily, six weeks before the ICSI cycle and placebo patients in each group were divided into BMI <28 kg/m2 and BMI ≥28 kg/m2."n"nResults: Of 52 study women 26(50% were in metformin group. mean age were 29.8±4.9 year in metformin group versus 29.4±5.9 year and placebo groups. Treatment with metformin, in subgroup of BMI <28 kg/m2, significantly increased number of mature follicle (p=0.01, embryo (p=0.04, oocytes (p=0.007 and mature oocytes (p=0.03 but in subgroup of BMI≥28 kg/m2, there was no significant difference in the metformin and placebo groups (p>0.05. Metformin treatment caused more chemical and clinical

  16. Unilateral adrenal tumor, erectile dysfunction and infertility in a patient with 21-hydroxylase deficiency: effects of glucocorticoid treatment and surgery.

    Science.gov (United States)

    Scaroni, C; Favia, G; Lumachi, F; Opocher, G; Bonanni, G; Mantero, F; Armanini, D

    2003-02-01

    In untreated congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21OHDS) the presence of adrenal and testicular tumors had been described; however little is known about the effect of the enzymatic defect on fertility in males. We studied a male adult patient affected by 21OHDS for infertility, after a long period of discontinuation of glucocorticoid therapy and then during resumption of treatment and 8 months after monoadrenalectomy. The initial spermatic count revealed azoospermia and testicular needle aspiration showed a cytological picture consistent with prepuberty. The morphofunctional study revealed a right adrenal mass with reduced uptake at radioscan. Treatment was resumed with onset of impotency, which improved after reduction of the dose of glucocorticoids. The patient was monoadrenalectomised and his spermatic count increased. The patient shows that corticosteroid therapy in 21OHDS should be continued lifelong to avoid adrenal hyperplasia with possible areas of autonomy and to allow regular fertility. Impotence during treatment is probably due to a decrease of excessive adrenal androgens while testicular androgen production is still suppressed.

  17. Kisspeptin, unexplained infertility and embryo implantation

    Directory of Open Access Journals (Sweden)

    Aaida Mumtaz

    2017-03-01

    Full Text Available Background Kisspeptin (KP is a neuropeptide that causes the release of the gonadotropin releasing hormone, which controls hypothalamo pituitary ovarian axis and exerts a number of peripheral effects on reproductive organs. The primary objective of this study was to compare baseline KP levels in females with different types of infertility and identify possible correlations with risk of failure to conceive, preclinical abortion and pregnancy after intracytoplasmic sperm injection (ICSI. Materials and Methods A longitudinal cohort study was carried out from August 2014 until May 2015 by recruiting 124 female patients undergoing ICSI, after obtaining ethical approval from the Australian Concept Infertility Medical Center. Cause of infertility due to male, female and unexplained factors was at a frequency of 32 (24%, 33 (31% and 59 (45% among the individuals respectively. KP levels were measured by ELISA assay before the initiation of the ICSI treatment protocol. Outcome of ICSI was categorized into three groups of non-pregnant with beta-human chorionic gonadotropin (β-hCG25 mIU/ml and no cardiac activity, and clinical pregnancy declared upon confirmation of cardiac activity. Results based on cause of infertility and outcome groups were analyzed by one-way ANOVA. Results Females with unexplained infertility had significantly lower levels of KP when compared with those with male factor infertility (176.69 ± 5.03 vs. 397.6 ± 58.2, P=0.001. Clinical pregnancy was observed in 28 (23% females of which 17 (71% had a female cause of infertility. In the non-pregnant group of 66 (53% females, common cause of infertility was unexplained 56(85%. A weak positive correlation of KP levels with fertilized oocytes and endometrial thickness was observed (P=0.04 and 0.01 respectively. Conclusion Deficiency of KP in females with unexplained infertility was associated with reduced chances of implantation after ICSI.

  18. Beneficial effect of food supplementation with the nutriceutical Improve® for the treatment of infertile couple

    Institute of Scientific and Technical Information of China (English)

    Frank H Comhaire; Wim Decleer

    2012-01-01

    Objective:To assess the possible benefit of food supplementation with the nutriceuticalImprove® for the treatment of the infertile couple.Methods:The treatment of diseases causing male or female infertility should be completed by the prescription of a judiciously formulated composite nutriceutical(Improve®NutriphytInc,Oostkamp,Belgium) which counteracts the pathogenic mechanisms involved in sperm and oocyte dysfunction, enhances cellular energy production, corrects oxidation-induced damage to the cell membrane and toDNA, and repairs mitochondrial insufficiency.The efficiency of this nutraceutical was tested in controlled trials and in assisted reproduction, including1888 infertile couples.Results:Complementary food supplementation with the nutriceuticalImprove® plus linseed oil improved the quantity and functional quality of spermatozoa, significantly increasing their fertilizing potential.This supplement with added fish oil enhanced female fertility with higher probablity of natural conception and ongoing pregnancy using techniques of assisted reproduction.Conclusions:Complementary food supplementation with the nutriceuticalImprove® has significant beneficial effects for the treatment of the infertile couple and reduces the cost per delivery.

  19. Priorities for family building among patients and partners seeking treatment for infertility.

    Science.gov (United States)

    Duthie, Elizabeth A; Cooper, Alexandra; Davis, Joseph B; Sandlow, Jay; Schoyer, Katherine D; Strawn, Estil; Flynn, Kathryn E

    2017-04-05

    Infertility treatment decisions require people to balance multiple priorities. Within couples, partners must also negotiate priorities with one another. In this study, we assessed the family-building priorities of couples prior to their first consultations with a reproductive specialist. Participants were couples who had upcoming first consultations with a reproductive specialist (N = 59 couples (59 women; 59 men)). Prior to the consultation, couples separately completed the Family-Building Priorities Tool, which tasked them with ranking from least to most important 10 factors associated with family building. We describe the highest (top three) and lowest (bottom three) priorities, the alignment of priorities within couples, and test for differences in prioritization between men and women within couples (Wilcoxon signed rank test). Maintaining a close and satisfying relationship with one's partner was ranked as a high priority by majorities of men and women, and in 25% of couples, both partners ranked this factor as their most important priority for family building. Majorities of men and women also ranked building a family in a way that does not make infertility obvious to others as a low priority, and in 27% of couples, both partners ranked this factor as the least important priority for family building. There were also differences within couples that involved either men or women ranking a particular goal more highly than their partners. More women ranked two factors higher than did their partners: 1) that I become a parent one way or another (p = 0.015) and 2) that I have a child in the next year or two (p building paths should be aware that: (1) patients balance multiple priorities as a part of, or beside, becoming a parent; and (2) patients and their partners may not be aligned in their prioritization of achieving parenthood. For infertility patients who are in relationships, clinicians should encourage the active participation of both partners as

  20. In-vitro maturation treatment for infertile women with polycystic ovary syndrome

    Institute of Scientific and Technical Information of China (English)

    Ye Bi-lu; Zhao Jun-zhao; Wang Pei-yt

    2011-01-01

    Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility.If PCOS infertile women fail to conceive after conventional induction of ovulation,the assisted reproductive therapy is an alternative method for pregnancy.In-vitro maturation is an efficient,more economical and simple method without ovarian hyperstimulation syndrome complication.

  1. Congenital malformations among 911 newborns conceived after infertility treatment with letrozole or clomiphene citrate.

    Science.gov (United States)

    Tulandi, Togas; Martin, James; Al-Fadhli, Raedah; Kabli, Nadia; Forman, Rachel; Hitkari, Jason; Librach, Clifford; Greenblatt, Ellen; Casper, Robert F

    2006-06-01

    To evaluate the incidence of congenital malformations among offspring of mothers who conceived with clomiphene citrate (CC) or with letrozole treatment for infertility. Retrospective study. 5 fertility centers in Canada. 911 newborns from women who conceived following CC or letrozole treatment. Examination of medical files of both mother and newborn, and cross-checked with the parents by telephone calls. Identified major and minor congenital malformations, birth weight, age of the mother, and type of treatment that led to the conception. Overall, congenital malformations and chromosomal abnormalities were found in 14 of 514 newborns in the letrozole group (2.4%) and in 19 of 397 newborns in the CC group (4.8%). The major malformation rate in the letrozole group was 1.2% (6/514) and in the CC group was 3.0% (12/397). One newborn in the letrozole group was found to have a ventricular septal defect (0.2%) compared to 4 newborns in the CC group (1.0%). In addition, the rate of all congenital cardiac anomalies was significantly higher (P: 0.02) in the CC group (1.8%) compared to the letrozole group (0.2%). There was no difference in the overall rates of major and minor congenital malformations among newborns from mothers who conceived after letrozole or CC treatments. However, it appears that congenital cardiac anomaly is less frequent in the letrozole group. The concern that letrozole use for ovulation induction could be teratogenic is unfounded based on our data.

  2. Initiation of Parkinson's disease treatment.

    Science.gov (United States)

    Reichmann, Heinz

    2008-09-01

    Parkinson therapy should be commenced as soon as patients feel impaired by motor or other symptoms. Recently it has been stated, however, to start treatment immediately after the diagnosis of PD has been made, in order to offer some neuroprotection to active dopaminergic neurons and to prevent deleterious compensatory mechanisms in dopaminergic cells. The selection of the medication depends on the state of the disease, the clinical symptoms, concomitant diseases and age. In de novo patients, most guidelines, including those of the German Neurological Society, advocate to start with a dopamine agonist. In my opinion, initial treatment with a MAO-B-inhibitor and subsequent combination with a long-acting dopamine agonist may be even more promising with regard to neuroprotection, modification of the disease, avoidance of dyskinesia and good motor improvement.

  3. Psychosocial Consequences of Infertility on Infertile Women.

    Science.gov (United States)

    Fatima, P; Rahman, D; Hossain, H B; Hossain, H N; Mughi, C R

    2015-10-01

    This study explores to find out the qualitative and quantitative psychosocial consequences of infertility in women coming for infertility treatment in tertiary infertility center. A total of 400 infertile couples who agreed to participate in the study were asked to fill up the questionnaires and later interviewed to access the psychosocial consequences of infertility on their personal life in a tertiary infertility clinic in Dhaka at Center for Assisted Reproduction (CARe Hospital), Dhaka from June 2011 to December 2011 and agreed to participate in the study were included in the study. The data was analyzed and the quantitative and qualitative psychosocial factors were evaluated. Four hundred infertile couple who filled the questionnaires was included in the study. Sixty three percent of the women belonged to age group >20 30 years at the time of interview. Regarding age at marriage 43.8% of the women were married by 20 years, 51.3% were married between 20 30 years. Mean±SD duration of present married life was 7.20±4.45 (range 1 to 28) years and 74.4% of the women were living with their husbands. Of them 75.5% women were housewife. When asked whether they knew what was the reason of infertility in the couple, 32.5% knew the cause was in the female partner, 14.5%, knew the cause was in the male partner, 10.3% knew the cause was in both partners, 21.5% knew cause of infertility was not in any of the partners, and 21.3% had no idea about the cause of infertility. The male partner's response about the issue of prognosis and outcome of couple's infertility revealed 37.3% believed their wives will conceive someday, 31.3% had no intention for a second marriage, 13% were indifferent, 11.3% blamed their wives for infertility and 4.8% threatened for a second marriage. Only 2.5% of the male partners were suggested on consulting and continuing treatment by specialist. The family pressure by in-laws and relatives towards their infertility was that 57.3% insisted on consulting

  4. The Use of Data Mining Methods to Predict the Result of Infertility Treatment Using the IVF ET Method

    Directory of Open Access Journals (Sweden)

    Malinowski Paweł

    2014-12-01

    Full Text Available The IVF ET method is a scientifically recognized infertility treat- ment method. The problem, however, is this method’s unsatisfactory efficiency. This calls for a more thorough analysis of the information available in the treat- ment process, in order to detect the factors that have an effect on the results, as well as to effectively predict result of treatment. Classical statistical methods have proven to be inadequate in this issue. Only the use of modern methods of data mining gives hope for a more effective analysis of the collected data. This work provides an overview of the new methods used for the analysis of data on infertility treatment, and formulates a proposal for further directions for research into increasing the efficiency of the predicted result of the treatment process.

  5. Grief responses and coping strategies among infertile women after failed in vitro fertilization treatment.

    Science.gov (United States)

    Lee, Shu-Hsin; Wang, Shu-Chuan; Kuo, Ching-Pyng; Kuo, Pi-Chao; Lee, Maw-Sheng; Lee, Meng-Chih

    2010-09-01

    Reproductive technology has increased the childbearing potential for many infertile women, but in vitro fertilization (IVF) failures are common, which often trigger grief responses and coping strategies to manage the stressful life event. The present cross-sectional study investigated 66 women who had experienced at least one failure with IVF treatment. The data were gathered by a self-administered structured questionnaire, and included the participant's personal profile, grief responses and the Jalowiec's coping scale. The most common grief response among the respondents was bargaining, followed by acceptance, depression, anger, denial, and isolation. The order of coping strategies used, from highest-to-lowest, were confrontative, optimistic, self-reliant, fatalistic, supportive, evasive, palliative, and emotive. Use and self-perceived effectiveness among all coping strategies had a high correlation, except emotion. Bargaining, the most common grief response, was associated with a variety of coping strategies. All coping strategies were correlated with grief responses. The results of identifying the grief responses and associated coping strategies of women who have undergone failed IVF treatment may assist nurses and other health care professionals in their efforts to provide appropriate information, care and psychological support.

  6. Breast Cancer and Infertility

    OpenAIRE

    2015-01-01

    Breast cancer is the most common malignancy among women and may accompany infertility. The relationship between infertility treatment and breast cancer has not yet been proven. However, estrogen exposure is well known to cause breast cancer. Recent advances in treatment options have provided young patients with breast cancer a chance of being mother [Archives Medical Review Journal 2015; 24(3.000): 317-323

  7. Medical Imaging and Infertility.

    Science.gov (United States)

    Peterson, Rebecca

    2016-11-01

    Infertility affects many couples, and medical imaging plays a vital role in its diagnosis and treatment. Radiologic technologists benefit from having a broad understanding of infertility risk factors and causes. This article describes the typical structure and function of the male and female reproductive systems, as well as congenital and acquired conditions that could lead to a couple's inability to conceive. Medical imaging procedures performed for infertility diagnosis are discussed, as well as common interventional options available to patients. © 2016 American Society of Radiologic Technologists.

  8. Infertility treatment and umbilical cord length-novel markers of childhood epilepsy?

    Directory of Open Access Journals (Sweden)

    Sari Räisänen

    Full Text Available BACKGROUND: Epilepsy is one of the most common neurologic disorders of childhood, affecting about 0.4-0.8% of all children up to the age of 20. METHODOLOGY: A population-based retrospective cohort study. Aim was to determine incidence and identify perinatal and reproductive risk factors of epilepsy in children born between 1989 and 2008 among women (n = 43,389 delivered in Kuopio University Hospital. Risk factors of childhood epilepsy were determined by using logistic regression analysis. PRINCIPAL FINDINGS: The incidence of childhood epilepsy was 0.7% (n = 302 of 43,389. Maternal epilepsy, major congenital anomalies and use of assisted reproductive technology (ART were associated with 4.25-, 3.61-, and 1.67- fold increased incidence of childhood epilepsy. A 10 cm increase in umbilical cord length was associated with a 15% decrease in the incidence of epilepsy (adjusted OR 0.85, 95% CI 0.78-0.94. However, the above reproductive factors accounted for less than 2% of total incidence, whereas maternal epilepsy proved to be the highest risk factor. CONCLUSIONS: Perinatal and reproductive factors were shown to be minor risk factors of childhood epilepsy, implying that little can be done in obstetric care to prevent childhood epilepsy. Infertility treatment and umbilical cord length, independent of gestational age and congenital malformations, may be novel markers of childhood epilepsy.

  9. Myoinositol as a Safe and Alternative Approach in the Treatment of Infertile PCOS Women: A German Observational Study

    Science.gov (United States)

    Schindler, Adolf Eduard

    2016-01-01

    The use of 2 × 2000 mg myoinositol + 2 × 200 μg folic acid per day is a safe and promising tool in the effective improvement of symptoms and infertility for patients with a polycystic ovary syndrome (PCOS). Using a questionnaire an observational study was performed under German gynecologists to collect data on ovulation and pregnancy rates in PCOS patients with infertility. In this observational study, 3602 infertile women used myoinositol and folic acid between 2 and 3 months in a dosage of 2 × 2000 mg myoinositol + 2 × 200 μg folic acid per day. In a subgroup of 32 patients, hormonal values for testosterone, free testosterone, and progesterone were analyzed before and after 12 weeks of treatment. The mean time of use was 10.2 weeks. During this time 70% of these women had a restored ovulation, and 545 pregnancies were obtained. This means a pregnancy rate of 15.1% of all the myoinositol and folic acid users. In 19 cases a concomitant medication with clomiphene or dexamethasone was used. One twin pregnancy was documented. Testosterone levels changed from 96.6 ng/ml to 43.3 ng/ml and progesterone from 2.1 ng/ml to 12.3 ng/ml (p < 0.05) after 12 weeks of treatment. No relevant side effects were present among the patients. This study could show that a new treatment option for patients with a PCOS and infertility is available. The achieved pregnancy rates are at least in an equivalent or even superior range than those reported by the use of metformin. PMID:27642297

  10. Emotional reaction to diagnosis of infertility in Kuwait and successful clients' perception of nurses' role during treatment

    Directory of Open Access Journals (Sweden)

    Omu Alexander E

    2010-03-01

    Full Text Available Abstract Background The unfulfilled desire of millions of infertile couples worldwide to have their own biological children results in emotional distress. This study evaluated the emotional reactions of couples attending a combined infertility clinic in Kuwait and successful clients' perception of nurses. Methods Quantitative and qualitative methods were used. The first phase was by structured interview using two standardized psychological scales: the 25-item Hopkins Symptom Checklist and Modified Fertility Adjustment Scale. Data were collected from 268 couples attending the combined infertility clinic, between October 2002 and September 2007. The second phase was a semi-structured interview of 10 clients who got pregnant following treatment. The interview explored their feelings and perception of the nurses' role. Interviews were transcribed verbatim and analyzed. Results The average duration of infertility was 4 years; 65.7% of the women and 76.1% of men suffered from primary infertility. Emotional reactions experienced were: anxiety in women (12.7% and men (6%, depression in women (5.2% and men (14.9% and reduced libido in women (6.7% and men (29.9%. Also in men, 14.9% experienced premature ejaculation, 5.2% weak ejaculation and 7.9% had impotence although 4.9% were transient. In the semi-structured interviews, the emotions expressed were similar and in addition to anger, feelings of devastation, powerlessness, sense of failure and frustration. In the survey, 12.7% of the men were found to show more anxiety than women (6%. Although all the 10 women interviewed confirmed they were anxious; only 4 of their partners were reported to be sad or anxious. Successful clients' perception of nurses' roles included nurses carrying out basic nursing procedures, communicating, educating about investigative and treatment procedures, providing emotional support by listening, encouraging, reassuring and being empathetic. Conclusions This study illuminates

  11. Psychiatric Aspects of Infertility

    Directory of Open Access Journals (Sweden)

    Hacer Sezgin

    2014-06-01

    Full Text Available Infertility can be defined as a crisis with cultural, religious, and class related aspects, which coexists with medical, psychiatric, psychological, and social problems. Relation between psychiatric and psychological factors stem from a mutual interaction of both. Family is an important institution in maintaining human existence and raising individuals in line with society's expectations. Fertility and reproduction are seen as universal functions unique to women with raising children as the expected result of the family institution. Incidence of infertility has increased recently and can become a life crisis for a couple. Even though not being able to have a child affects both sexes emotionally, women feel greater amounts of stress, pressure, anxiety, and depression.Consequences of infertility arise from short and long-term devastating effects on both individual's physical and mental health, and marital system. Many studies focus on infertility related psychological and psychiatric disorders (depression, anxiety, grief, marital conflict, gender differences, relation between the causes of infertility and psychopathology, the effects of psychiatric evaluation and intervention -when necessaryon the course of infertility treatment, pregnancy rates, and childbirth. The most important underlying causes of high levels of stress and anxiety that infertile women experience are the loss of maternity, reproduction, sense of self, and genetic continuity. In this review article is to investigate the relationship between medically unexplained symptoms and psychiatric symptoms. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 165-185

  12. Clinical Observation on Treatment of 2,062 Cases of Immune Infertility with Integration of Traditional Chinese Medicine and Western Medicine

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    To study the therapeutic effect of integrated traditional Chinese medicine and western medicine on female immune infertility. 3,496 women suffering from primary or secondary infertility had their ASAb, EMAb,AOAb and ACAb level tested, with the positive rate of 23.11%, 34.95%, 20.77% and 30.41% respectively.2,062 positive cases were periodically treated with the Chinese drug Xiaokangwan (消抗丸) plus dexamethasone, vitamin E and vitamin C for 2 periods as a course of treatment. At the end of a treatment course, the rate for the antibodies to turn negative reached over 85% and the average pregnant rate reached 36.66%. The treatment of immune infertility with the integrated approach can reduce or eliminate the influence of antibodies in the serum of patients on various links of pregnancy, thus reaching the goal of curing infertility.

  13. Treatment of infertility associated with deep endometriosis: definition of therapeutic balances.

    Science.gov (United States)

    Somigliana, Edgardo; Garcia-Velasco, Juan Antonio

    2015-10-01

    Deep endometriosis is a demanding condition that is associated with infertility. However, evidence supporting a direct link between deep endometriosis and infertility is weak. In fact, infertility in affected patients is more likely to be explained by the strong association between deep endometriosis and adhesions, superficial endometriotic implants, ovarian endometriomas, and adenomyosis. The purported beneficial effects of surgery on infertility are mainly based on the 40%-42% pregnancy rate (PR) after surgery observed in published case series. However, this level of evidence is questionable and overestimates the benefits of the intervention. Even if comparative studies are lacking, IVF may be a valid alternative. The procedure may be less effective in affected women compared with other indications and it is not without additional deep endometriosis-related risks. Some case reports suggest that lesions might progress during IVF causing ureteral or intestinal complications or can decidualize during pregnancy causing intestinal perforation, pneumothorax, and pelvic vessels rupture. Finally, in the decision-making process, physicians should also consider that women with a history of deep endometriosis may face an increased risk of pregnancy complications. In conclusion, clear recommendation for the management of infertile women with deep endometriosis cannot be extrapolated from the literature. The therapeutic decision should be based on a comprehensive evaluation that includes clinical history, instrumental findings, pain symptoms, risks of pregnancy complications, and the woman's wishes. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. 腹腔镜手术诊治女性不孕症的价值探讨%Discussion on Diagnosis and Treatment Value of Laparoscopy in Infertility

    Institute of Scientific and Technical Information of China (English)

    叶远征; 马彩玲

    2012-01-01

    腹腔镜手术在女性不孕症的诊治中可直观、方便且能迅速明确大部分不孕症的病因,使治疗有针对性,缩短治愈时间,辅助生育技术(ART)为生殖医学基础研究和临床治疗提供了新的方法,显著提高了对不孕症治疗的成功率和改善预后,特别是给输卵管阻塞性不孕患者带来了希望.但是腹腔镜手术与ART对不孕症的治疗的价值仍存在争议.%Laparoscopic operation could directly, conveniently quickly and clearly find the main causes of infertility in the diagnosis and treatment of female infertility, which the therapy targeted and shortened cure time. However, ART offer the new method for reproductive medicine basic research and clinical treatments, improves the treatment success rate and prognosis of infertility significantly, especially to tubal occlusion infertility and male sterility. But the laparoscopy in diagnosis and treatment for female infertility has been challenged and suspected with the development of ART. The purpose of this review is to summarize the value of laparoscopy in diagnosis and treatment of infertility caused by different factors.

  15. Infertility: Inability or Disability?

    Directory of Open Access Journals (Sweden)

    Abha Khetarpal

    2012-06-01

    Full Text Available Disability is a complex phenomenon. It reflects an interaction between features of a person’s body and features of the society in which he or she lives. International Classification of Functioning, Disability and Health (ICF, lays stress on the functional as well as the structural problem of a person. All the definitions of disability also include the disorders of the reproductive and endocrine system. So infertility and impotency should also be included in the category of disability. It affects the participation in areas of life and can have a disabling affect on an individual. Like any other disability the couple has to adapt and integrate infertility in their sense of self thus infertility comes as a major life crisis. Medically, infertility, in most cases, is considered to be the result of a physical impairment or a genetic abnormality. Socially, couples are incapable of their reproductive or parental roles. On social level, infertility in most cultures remains associated with social stigma and taboo just like the social model of disability. Couples who are unable to reproduce may be looked down upon due to social stigmatisation. Infertility can lead to divorces and separation leading to a broken family life. Without labelling infertility as a disability, it is difficult for the people to access services and welfare benefits offered by the government. Infertility treatments are highly sophisticated so they are very expensive and are even not covered by insurance and government aid.In the light of all this it becomes imperative to categorise infertility as disability.

  16. Ethical issues in infertility.

    Science.gov (United States)

    Serour, Gamal I; Serour, Ahmed G

    2017-03-01

    Infertility is a global medico-socio-cultural problem with gender-based suffering particularly in developing countries. Conventional methods of treatment for infertility do not usually raise ethical concerns. However, assisted reproductive technology (ART) has initiated considerable ethical debate, disagreement, and controversy. There are three ethical principles that provide an ethical basis for ART: the principle of liberty, principle of utility, and principle of justice. Medical ethics are based on the moral, religious, and philosophical ideas and principles of the society and are influenced by economics, policies, and law. This creates tension between the principles of justice and utility, which can result in disparity in the availability of and access to ART services between the rich and the poor. The moral status of the embryo is the key for all the ethical considerations and law regarding ART in different societies. This has resulted in cross-border ART. Conscientious objection of healthcare providers should not deprive couples from having access to a required ART service.

  17. Are attachment dimensions associated with infertility-related stress in couples undergoing their first IVF treatment? A study on the individual and cross-partner effect.

    Science.gov (United States)

    Donarelli, Zaira; Lo Coco, Gianluca; Gullo, Salvatore; Marino, Angelo; Volpes, Andrea; Allegra, Adolfo

    2012-11-01

    Are attachment anxiety and avoidance dimensions in female and male partners in couples seeking infertility treatment associated with her and his infertility-related stress? Attachment dimensions are significantly associated with several aspects of infertility stress in couples undergoing IVF treatment. Attachment dimensions of anxiety and avoidance (where highly anxious individuals fear rejection and are preoccupied with maintaining proximity to their partner and highly avoidant individuals are uncomfortable with intimacy and prefer to maintain distance from their partner) may influence the well being of individuals undergoing IVF/ICSI treatment. This study showed that one partner's attachment dimensions had a direct effect on the infertility-related stress of the other partner. Cross-sectional study of consecutive couples before starting their first IVF/ICSI treatment in 2009-2011 at the ANDROS clinic in Palermo, Italy. Three hundred and fifty-nine couples undergoing fertility treatments were invited to participate in the research. The final sample comprised 316 females and 316 males who filled out the psychological questionnaires (Experiences in Close Relationships; Fertility Problem Inventory; State scale of State-Trait Anxiety Inventory). The participants included patients who had a primary infertility diagnosis and were about to undergo their first IVF or ICSI treatment. Paired t-tests were used to examine gender differences on the study variables (attachment anxiety, attachment avoidance, infertility stress, state anxiety, etc.). Associations between infertility-related stress and the study variables were explored using hierarchical stepwise multivariate linear regression analyses. Attachment anxiety and attachment avoidance were significantly associated with global infertility stress in both women (β = 0.24, P infertility stress and relationship concerns were associated with their partners' attachment avoidance (β = 0.10 P infertility stress of women and

  18. Comparison of pharmacological and nonpharmacological treatment strategies in promotion of infertility self-efficacy scale in infertile women: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Hajar Pasha

    2013-06-01

    Full Text Available Background: The infertility is associated with psychological consequence including depression, and lack of self-efficacy. Objective: The aim of this study was to compare the pharmacological and no pharmacological strategies in promotion of self-efficacy of infertile women. Materials and Methods: A randomized controlled clinical trial was conducted on 89 infertile women who were recruited from Fatemeh Zahra Infertility and Reproductive Health Research Center and were randomized into three groups; cognitive behavioral therapy (CBT, antidepressant therapy with flouxetine 20 mg daily for 3 month, and a control group. All participants completed Infertility Self-efficacy Inventory (ISE and the Beck Depression Inventory (BDI at the beginning and end of the study. Results: The means ISE scores among the CBT, fluoxetine, and control groups at the beginning and end of the study were 6.1±1.6 vs. 7.2±0.9, 6.4±1.4 vs. 6.9±1.3 and 6.1±1.1 vs. 5.9±1.4 respectively. Both CBT and fluoxetine increased the mean of ISE scores more than control group after intervention (p<0.0001, p=0.033; respectively, but increase in the CBT group was significantly greater than flouxetine group. Finally, there was evidence of high infertility self-efficacy for women exposed to the intervention compared with those in the control group. Also, there was an improvement in depression. Both fluoxetine and CBT decreased significantly the mean of BDI scores more than the control group; decrease in the CBT group was significantly more than that in the fluoxetine group. Conclusion: CBT can serve as an effective psychosocial intervention for promoting self-efficacy of infertile women

  19. Sperm chromatin structure assay (SCSA): a tool in diagnosis and treatment of infertility

    Institute of Scientific and Technical Information of China (English)

    Mona Bungum; Leif Bungum; Aleksander Giwercman

    2011-01-01

    Diagnosis of male infertility has mainly been based on the World Health Organization (WHO) manual-based semen parameter's concentration,motility and morphology.It has,however,become apparent that none of these parameters are reliable markers for evaluation of the fertility potential of a couple.A search for better markers has led to an increased focus on sperm chromatin integrity testing in fertility work-up and assisted reproductive techniques.During the last couple of decades,numerous sperm DNA integrity tests have been developed.These are claimed to be characterized by a lower intraindividual variation,less intralaboratory and interlaboratory variation and thus less subjective than the conventional sperm analysis.However,not all the sperm chromatin integrity tests have yet been shown to be of clinical value.So far,the test that has been found to have the most stable clinical threshold values in relation to fertility is the sperm chromatin structure assay (SCSA),a flow cytometric test that measures the susceptibility of sperm DNA to acid-induced DNA denaturation in situ.Sperm DNA fragmentation as measured by SCSA has shown to be an independent predictor of successful pregnancy in first pregnancy planners as well as in couples undergoing intrauterine insemination,and can be used as a tool in investigation,counseling and treatment of involuntary childlessness.More conflicting data exist regarding the role of sperm DNA fragmentation in relation to fertilization,pre-embryo development and pregnancy outcome in in vitrofertilization and intracytoplasmic sperm injection (ICSI).

  20. Age, Body Mass Index, and Number of Previous Trials: Are They Prognosticators of Intra-Uterine-Insemination for Infertility Treatment?

    Directory of Open Access Journals (Sweden)

    Ahmed M. Isa

    2014-11-01

    Full Text Available Background: To examine whether pregnancy rate (PR of intrauterine insemination (IUI is related to certain demographic factors, such as age and body mass index (BMI, along with number of IUI cycles performed, a set of infertile Saudi women. Materials and Methods: During this prospective study (a 24-month period, 301 Saudi women with infertility underwent IUI in our infertility clinic. We investigated whether PR is correlated with patient age and BMI, and the number of IUI trials, in order to determine if they could be used as prognosticators of pregnancy success. Results: The highest PR was 14.89% for ages 19-25 and the lowest PR was 4.16% for ages 41-45, indicating no statistically significant difference among PR in all age groups (p value of 0.225. Also, in terms of BMI, the highest PR was 13.04% for BMI ≥35 and the lowest was 7.84% for BMI of <25 to 18.5, indicating no significant difference among different BMI groups (p value of 0.788. One-cycle treatment, as expected, was more successful (PR=12.84% than 2-cycle treatment (PR=5.75%, however, 3-5-cycles treatment still showed encouraging results (PR=17.24%; but the difference did not reach statistical significance (p value=0.167. Conclusion: PR after IUI treatment remained approximately 10% from 19 to 40 years of age and declined after 40. Although no significant difference was observed among different age groups, earlier treatment is still recommended. There was a positive but not statistically significant correlation between PR and patient’s BMI indicating that BMI is not a determining factor. There was also no correlation between PR and number of IUI trials. Patients can thus try as many times as they want before moving on to in vitro fertilization (IVF treatment.

  1. Endocrine disorders & female infertility.

    Science.gov (United States)

    Unuane, David; Tournaye, Herman; Velkeniers, Brigitte; Poppe, Kris

    2011-12-01

    Female infertility occurs in about 37% of all infertile couples and ovulatory disorders account for more than half of these. The ovaries are in continuous interaction with the other endocrine organs. The interplay may account for infertility occurring at different levels and may render the diagnosis of infertility a difficult exercise for the involved physician. A hypothalamic cause of female infertility should be considered in an appropriate clinical context, with tests pointing to a hypogonadotropic hypogonadism. It can be functional, physiological or related to organic causes. Hyperprolactinemia has well characterized effects on the normal gonadal function and treatment is well established. Acromegaly and Cushing's disease may impair fertility at different levels, mechanisms involved however remain ill defined. Thyroid disorders, both hyperthyroidism and hypothyroidism, can interact with the ovaries, through a direct effect on ovarian function, but autoimmunity may be involved, as well as alterations of the sex hormone binding protein levels. Primary ovarian disorders, such as the polycystic ovary syndrome and primary ovarian insufficiency are frequent diseases, for which novel treatments are currently being developed and discussed. We will propose an algorithm for the diagnosis and approach of the female patient presenting with infertility on the basis of the available evidence in literature. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. The Effects of Total Motile Sperm Count on Spontaneous Pregnancy Rate and Pregnancy After IUI Treatment in Couples with Male Factor and Unexplained Infertility

    Science.gov (United States)

    Hajder, Mithad; Hajder, Elmira; Husic, Amela

    2016-01-01

    Introduction: Male infertility factor is defined if the total number of motile spermatozoa (TMSC) asthenozoospermia (A), teratozoospermia (T) or combination (O+A+T) and azoospermia (A). Although this classification indicates the accuracy of findings its relevance for prognosis in infertile couple and the choice of treatment is questionable. Materials and Methods: The study included 98 couples with male infertility factor (bad spermiogram) and couples with normospermia and normal female factor (unexplained infertility). Testing group is randomized at: group (A) with TMSC> 3,106 / ejaculate and a spontaneous pregnancy, group (B) with TMSCl 3 x 106 / ejaculate and couples who have not achieved pregnancy. Main results: From a total of 98 pairs of men’s and unexplained infertility, 42 of them (42.8%) achieved spontaneous pregnancy, while 56 (57.2%) pairs did not achieve spontaneous pregnancy. TMSC was significantly higher (42.4 ± 28.4 vs. 26.2 ± 24, p 20 x 106 / ejaculate (RR = 1.7, 95% CI: 1.56-1.82, 5 x 106 / ejaculate are indicated for treatment with IUI. TMSC can be used as the method of choice for diagnosis and treatment of male infertility. PMID:26980930

  3. Regulatory T-cells and immune tolerance in pregnancy : a new target for infertility treatment?

    NARCIS (Netherlands)

    Guerin, Leigh R.; Prins, Jelmer R.; Robertson, Sarah A.

    2009-01-01

    Adaptation of the maternal immune response to accommodate the semi-allogeneic fetus is necessary for pregnancy success, and disturbances in maternal tolerance are implicated in infertility and reproductive pathologies. T regulatory (Treg) cells are a recently discovered subset of T-lymphocytes with

  4. Comparison of pharmacological and nonpharmacological treatment strategies in promotion of infertility self-efficacy scale in infertile women: A randomized controlled trial.

    Science.gov (United States)

    Pasha, Hajar; Faramarzi, Mahbobeh; Esmailzadeh, Seddigheh; Kheirkhah, Farzan; Salmalian, Hajar

    2013-06-01

    The infertility is associated with psychological consequence including depression, and lack of self-efficacy. The aim of this study was to compare the pharmacological and no pharmacological strategies in promotion of self-efficacy of infertile women. A randomized controlled clinical trial was conducted on 89 infertile women who were recruited from Fatemeh Zahra Infertility and Reproductive Health Research Center and were randomized into three groups; cognitive behavioral therapy (CBT), antidepressant therapy with flouxetine 20 mg daily for 3 month, and a control group. All participants completed Infertility Self-efficacy Inventory (ISE) and the Beck Depression Inventory (BDI) at the beginning and end of the study. The means ISE scores among the CBT, fluoxetine, and control groups at the beginning and end of the study were 6.1±1.6 vs. 7.2±0.9, 6.4±1.4 vs. 6.9±1.3 and 6.1±1.1 vs. 5.9±1.4 respectively. Both CBT and fluoxetine increased the mean of ISE scores more than control group after intervention (pself-efficacy for women exposed to the intervention compared with those in the control group. Also, there was an improvement in depression. Both fluoxetine and CBT decreased significantly the mean of BDI scores more than the control group; decrease in the CBT group was significantly more than that in the fluoxetine group. CBT can serve as an effective psychosocial intervention for promoting self-efficacy of infertile women. Registration ID in IRCT: IRCT2012061710048N1.

  5. Understanding Infertility - The Basics

    Science.gov (United States)

    ... Home FAQs Frequently Asked Questions Quick Facts About Infertility FAQs About Infertility FAQs About the Psychological Component of Infertility FAQs About Cloning and Stem Cell Research SART's ...

  6. Sexual Dysfunction and Infertility

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    ... Home FAQs Frequently Asked Questions Quick Facts About Infertility FAQs About Infertility FAQs About the Psychological Component of Infertility FAQs About Cloning and Stem Cell Research SART's ...

  7. Psychological Component of Infertility

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    ... Home FAQs Frequently Asked Questions Quick Facts About Infertility FAQs About Infertility FAQs About the Psychological Component of Infertility FAQs About Cloning and Stem Cell Research SART's ...

  8. Smoking and Infertility

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    ... Home FAQs Frequently Asked Questions Quick Facts About Infertility FAQs About Infertility FAQs About the Psychological Component of Infertility FAQs About Cloning and Stem Cell Research SART's ...

  9. Ovarian Drilling for Infertility

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    ... Home FAQs Frequently Asked Questions Quick Facts About Infertility FAQs About Infertility FAQs About the Psychological Component of Infertility FAQs About Cloning and Stem Cell Research SART's ...

  10. Stress and Infertility

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    ... Home FAQs Frequently Asked Questions Quick Facts About Infertility FAQs About Infertility FAQs About the Psychological Component of Infertility FAQs About Cloning and Stem Cell Research SART's ...

  11. Cryptic infertility and therapeutic options.

    Science.gov (United States)

    Check, J H

    2001-01-01

    Too often infertile patients are given a "herd type" fertility investigation which ultimately leads to expensive, time consuming, and risky in vitro fertilization. However, attention to certain simple details available by non-invasive methods, e.g., checking for premature luteinization, luteinized unruptured follicle syndrome, or performing the post-coital test at the appropriate interval, can lead to a quick solution of the infertility problem. Caution about persistent infertility related to iatrogenic factors, e.g., development of poor post-coital tests or excessively thin endometrium from clomiphene citrate, or development of luteinized unruptured follicle syndrome or premature luteinization by taking follicle maturing drugs, or creating a hostile environment from taking follicle maturing drugs when the woman already made a mature follicle (and would have had a higher success rate with luteal phase support with progesterone) will help achieve pregnancies without necessarily proceeding to the most expensive and invasive procedure of in vitro fertilization. Finally, many wasted cycles of treatment could be avoided by including the simple but very important hypo-osmotic swelling test and measurement of sperm autoantibodies with the first initial semen analysis.

  12. Effect of antitubercular treatment on ovarian function in female genital tuberculosis with infertility

    Directory of Open Access Journals (Sweden)

    Jai Bhagwan Sharma

    2016-01-01

    Full Text Available AIM: To evaluate the effect of antitubercular therapy (ATT on an ovarian function such as ovarian reserve, ovarian dimensions, and ovarian stromal blood flow. SETTINGS AND DESIGN: Prospective study design. MATERIALS AND METHODS: Fifty infertile women with female genital tuberculosis (FGTB without tubo-ovarian masses diagnosed by positive acid-fast bacilli culture or epithelioid granuloma on endometrial aspirate or positive polymerase chain reaction with positive findings on laparoscopy or hysteroscopy were recruited. The ovarian function tests were performed on day 2/3 as follicle-stimulating hormone (FSH levels and anti-Mullerian hormone (AMH levels. Ovarian dimensions (length, width, and depth were measured using a transvaginal ultrasound. Mean antral follicle count (AFC and ovarian stromal blood flow (peak systolic velocity [PSV], pulsatility index (PI, and resistive index [RI] were measured using a transvaginal ultrasound. All women were started on ATT for 6 months by directly observed treatment strategy. After completion of ATT, all the parameters were repeated. RESULTS: There was a significant increase in AMH (2.68 ± 0.97 ng/ml to 2.8 ± 1.03 ng/ml pre- to post-ATT, nonsignificant increase in FSH (7.16 ± 2.34 mIU/ml to 7.26 ± 2.33 mIU/ml post-ATT, significant increase in mean AFC (7.40 ± 2.12-8.14 ± 2.17, PSV in the right ovary (6.015-6.11 cm/s and left ovary (6.05-6.08 cm/s, PI in the right ovary (0.935-0.951 cm/s and left ovary (0.936-0.957 cm/s, and RI in the right ovary (0.62 ± 0.01-0.79 ± 0.02 and left ovary (0.65 ± 0.02-0.84 ± 0.01 with ATT. There was no significant change in mean ovarian dimensions (ovarian length, breadth, and width and summed ovarian volume with ATT. On laparoscopy, tubercles were seen in 27 (54% women. Caseous nodules and encysted ascites were seen in 8% cases each. CONCLUSION: ATT improves the ovarian function (AMH and AFC and ovarian blood flow in women with FGTB.

  13. Indonesian infertility patients’ health seeking behaviour and patterns of access to biomedical infertility care: an interviewer administered survey conducted in three clinics

    Directory of Open Access Journals (Sweden)

    Bennett Linda Rae

    2012-09-01

    Full Text Available Abstract Background Indonesia has high levels of biological need for infertility treatment, great sociological and psychological demand for children, and yet existing infertility services are underutilized. Access to adequate comprehensive reproductive health services, including infertility care, is a basic reproductive right regardless of the economic circumstances in which individuals are born into. Thus, identifying and implementing strategies to improve access to assisted reproductive technology (ART in Indonesia is imperative. The principle objectives of this article are to improve our understanding of infertility patients’ patterns of health seeking behaviour and their patterns of access to infertility treatment in Indonesia, in order to highlight the possibilities for improving access. Methods An interviewer-administered survey was conducted with 212 female infertility patients recruited through three Indonesian infertility clinics between July and September 2011. Participants were self-selected and data was subject to descriptive statistical analysis. Results Patients identified a number of barriers to access, including: low confidence in infertility treatment and high rates of switching between providers due to perceived treatment failure; the number and location of clinics; the lack of a well established referral system; the cost of treatment; and patients also experienced fear of receiving a diagnosis of sterility, of vaginal examinations and of embarrassment. Women’s age of marriage and the timing of their initial presentation to gynaecologists were not found to be barriers to timely access to infertility care. Conclusions The findings based on the responses of 212 female infertility patients indicated four key areas of opportunity for improving access to infertility care. Firstly, greater patient education about the nature and progression of infertility care was required among this group of women. Secondly, increased resources

  14. Indonesian infertility patients’ health seeking behaviour and patterns of access to biomedical infertility care: an interviewer administered survey conducted in three clinics

    Science.gov (United States)

    2012-01-01

    Background Indonesia has high levels of biological need for infertility treatment, great sociological and psychological demand for children, and yet existing infertility services are underutilized. Access to adequate comprehensive reproductive health services, including infertility care, is a basic reproductive right regardless of the economic circumstances in which individuals are born into. Thus, identifying and implementing strategies to improve access to assisted reproductive technology (ART) in Indonesia is imperative. The principle objectives of this article are to improve our understanding of infertility patients’ patterns of health seeking behaviour and their patterns of access to infertility treatment in Indonesia, in order to highlight the possibilities for improving access. Methods An interviewer-administered survey was conducted with 212 female infertility patients recruited through three Indonesian infertility clinics between July and September 2011. Participants were self-selected and data was subject to descriptive statistical analysis. Results Patients identified a number of barriers to access, including: low confidence in infertility treatment and high rates of switching between providers due to perceived treatment failure; the number and location of clinics; the lack of a well established referral system; the cost of treatment; and patients also experienced fear of receiving a diagnosis of sterility, of vaginal examinations and of embarrassment. Women’s age of marriage and the timing of their initial presentation to gynaecologists were not found to be barriers to timely access to infertility care. Conclusions The findings based on the responses of 212 female infertility patients indicated four key areas of opportunity for improving access to infertility care. Firstly, greater patient education about the nature and progression of infertility care was required among this group of women. Secondly, increased resources in terms of the number and

  15. Infertility: psychotherapeutic issues.

    Science.gov (United States)

    Rosenthal, M B

    1992-01-01

    In supportive therapy with infertility patients, the clinician tries to relieve dysphoria and enhance self-esteem. Dynamically informed supportive interventions are designed to decrease guilt that may relate to past sexual activities, sexually related diseases, or abortions. These interventions should also be empathetic, promote optimism and reality testing, help with problem solving, allow catharsis and ventilation, decrease feelings of isolation and loneliness, educate and clarify, and praise and encourage where appropriate. Mental health clinicians have an important role to play in the treatment of these patients, provided they learn enough about the psychology of the experience of infertility and about the technology utilized in its treatment. As the number of people seeking treatment for infertility grows, the need for skilled therapists for this population will grow at a parallel rate.

  16. Successful treatment of infertility in a female Sumatran orangutan Pongo abelii.

    Science.gov (United States)

    Maclachlan, Neil; Hunt, Gordon; Fowkes, Sarah; Frost, Melissa; Miller, John; Purcell-Jones, Gari; Sullivan, Peter; Barbon, Alberto; Routh, Andrew; López, Francisco J; Price, Eluned C

    2017-03-01

    In 2011, a female Sumatran orangutan housed at Durrell Wildlife Conservation Trust became infertile following a massive antepartum hemorrhage in labor and the delivery of a stillborn infant. The placenta was infected with Pantoea sp. Hysterosalpingography (HSG) revealed blocked fallopian tubes, and pressurized fallopian tube perfusion was used to reverse the tubal occlusion. She subsequently conceived and following an intensive training program, we were able to measure umbilical artery waveform analysis for fetal well-being and placental localization to exclude placenta previa, which could complicate pregnancy and lead to catastrophic hemorrhage. The female went on to deliver a healthy offspring. We suggest that these techniques should be considered for other infertile females in the global captive population. © 2017 Wiley Periodicals, Inc.

  17. The effect of an expressive writing intervention (EWI) on stress in infertile couples undergoing assisted reproductive technlogy (ART) treatment: A randomized controlled pilot study

    DEFF Research Database (Denmark)

    Matthiesen, Signe Maria Schneevoigt; Klonoff-Cohen, Hillary; Zachariae, Robert

    2012-01-01

    Objectives. Infertile couples undergoing fertility treatments may experience stress and could benefit from psychological intervention. Expressive Writing Intervention (EWI) has shown promising results on various psychological outcomes, yet only one study has applied the method to infertility......-related stress. Our aim was to assess feasibility and effectiveness of EWI for patients in treatment with Assisted Reproductive Technology (ART). Design and participants. Patients enrolling in their first ART treatment at the fertility clinic, Aarhus University Hospital, Denmark were offered to participate....... A total of 82 participants (45 women, 37 men), mean age: 33.17, were randomized to home-based EWI or neutral writing control group and completed an infertility-related stress questionnaire at treatment enrollment, 3 weeks later (at the time of down regulation), and 6 weeks after the intervention...

  18. Laparoscopy in the Diagnosis and the Treatment of Infertility (Analysis of 340 consecutive cases)

    Institute of Scientific and Technical Information of China (English)

    葛春晓; 刘梦梅; 丁慧娟; 曹雪芬

    1995-01-01

    Three hundred and forty patients suffering from primary and secondary infertility were investigated by laparoscopy with the following results. 1. The substantial and most common causes of infertility were related to chronic pelvic inflammatory disease and pelvic endometriosis. 2. Comparison of the result of chromopertubation under direct vision during laparoscopy with the preoperative results with hysterosalpingography and phenolphthaline tubal instillation test showed significant difference (P<0.01). In the tubal patent group the compatibility of the results was 90.2% and 79% respectively whereas in the obstructed tubal group the discrepancy between the results was 50.5% and 59% respectively. 3. With the aid of laparoscopic investigation, the underlying cause of infertility could be verified in 97.6% of the patients. In 53.2% of the cases 14 different kinds of operations were performed directly under the laparascope,while 12.9% of the cases required laparotomy. In 58.5% of the patients laparoscopy was performed in combination with hysteroscopy and 26 operations,consisting of uterine septum resection and intrauterine adhesiolysi8 were completed undder the monitoring of the laparoscope.

  19. Hospital mental health admissions in women after unsuccessful infertility treatment and in vitro fertilization: an Australian population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Louise M Stewart

    Full Text Available To examine the association between in vitro fertilization (IVF and later admission to hospital with a mental health diagnosis in women who remained childless after infertility treatment.This was a population-based cohort study using linked administrative hospital and registry data. The study population included all women commencing hospital treatment for infertility in Western Australia between the years 1982 and 2002 aged 20-44 years at treatment commencement who did not have a recorded birth by the end of follow-up (15 August 2010 and did not have a hospital mental health admission prior to the first infertility admission (n=6,567. Of these, 2,623 women had IVF and 3,944 did not. We used multivariate Cox regression modeling of mental health admissions and compared women undergoing IVF treatment with women having infertility treatment but not IVF.Over an average of 17 years of follow-up, 411 women in the cohort were admitted to hospital with a mental health diagnosis; 93 who had IVF and 318 who did not. The unadjusted hazard ratio (HR for a hospital mental health admission comparing women who had IVF with those receiving other infertility treatment was 0.50 (95% confidence interval [CI] 0.40-0.63. After adjustment for age, calendar year and socio-economic status the HR was 0.56 (95% CI 0.44-0.71.IVF treatment is associated with a reduced risk of hospital mental health admissions in women after unsuccessful infertility treatment. This may be explained by the healthy cohort effect.

  20. Infertility and Women

    Science.gov (United States)

    ... with production or quality of sperm. What causes female infertility? About 25 percent of women with infertility have ... 40 percent of infertility cases are due to female infertility, but just as many cases are due to ...

  1. Application of Artificial Neural Networks and Principal Component Analysis to Predict Results of Infertility Treatment Using the IVF Method

    Directory of Open Access Journals (Sweden)

    Milewski Robert

    2016-12-01

    Full Text Available There are high hopes for using the artificial neural networks (ANN technique to predict results of infertility treatment using the in vitro fertilization (IVF method. Some reports show superiority of the ANN approach over conventional methods. However, fully satisfactory results have not yet been achieved. Hence, there is a need to continue searching for new data describing the treatment process, as well as for new methods of extracting information from these data. There are also some reports that the use of principal component analysis (PCA before the process of training the neural network can further improve the efficiency of generated models. The aim of the study herein presented was to verify the thesis that the use of PCA increases the effectiveness of the prediction by ANN for the analysis of results of IVF treatment. Results for the PCA-ANN approach proved to be slightly better than the ANN approach, however the obtained differences were not statistically significant.

  2. Analysis of factors predicting success of metformin and clomiphene treatment for women with infertility owing to PCOS-related ovulation dysfunction in a randomised controlled trial

    NARCIS (Netherlands)

    N.P. Johnson; S. Bontekoe; A.W. Stewart

    2011-01-01

    Background: Metformin has failed to gain wide acceptance as a first-line treatment option for women with anovulatory infertility related to polycystic ovary syndrome. This study aimed to ascertain factors that predict fertility success with treatment that included metformin compared to standard (non

  3. The ter mutation in the rat Dnd1 gene initiates gonadal teratomas and infertility in both genders.

    Directory of Open Access Journals (Sweden)

    Emily Northrup

    Full Text Available A spontaneous mutation leading to the formation of congenital ovarian and testicular tumors was detected in the WKY/Ztm rat strain. The histological evaluation revealed derivatives from all three germ layers, thereby identifying these tumors as teratomas. Teratocarcinogenesis was accompanied by infertility and the underlying mutation was termed ter. Linkage analysis of 58 (WKY-ter×SPRD-Cu3 F2 rats associated the ter mutation with RNO18 (LOD = 3.25. Sequencing of candidate genes detected a point mutation in exon 4 of the dead-end homolog 1 gene (Dnd1, which introduces a premature stop codon assumed to cause a truncation of the Dnd1 protein. Genotyping of the recessive ter mutation revealed a complete penetrance of teratocarcinogenesis and infertility in homozygous ter rats of both genders. Morphologically non-tumorous testes of homozygous ter males were reduced in both size and weight. This testicular malformation was linked to a lack of spermatogenesis using immunohistochemical and histological staining. Our WKY-Dnd1(ter/Ztm rat is a novel animal model to investigate gonadal teratocarcinogenesis and the molecular mechanisms involved in germ cell development of both genders.

  4. Infertility Treatments and Determination of Fetus Gender don’t Challenge God’s Justice and Wisdom

    Directory of Open Access Journals (Sweden)

    Dezhkam, L

    2012-01-01

    Full Text Available Application of modern technology to cure barrenness has arisen challenges in various aspects some of which are ethical, legal and ideological. One of the ideological challenges, inserted in the above topic, has been discussed through this essay. The cause-effect system ruling the universe, helps a lot to determine God’s; the Almighty; Justice and Wisdom in creation. Therefore, the creation of the barren person, in the framework of that system, doesn’t conflict with His Justice and Wisdom. Of course, based on the penal justice, God will compensate these deficiencies by either giving rewards or mitigating the punishment. So, unveiling the creation mysteries-and the infertility of some diseases or the ability to do some affairs such as the selection of fetus gender doesn’t derange the best Divine system ruling the universe. Besides, these Facts prove the existence of such a system because if the relations weren’t established in the system, how could we access to these facts.By understanding the best system and the accurate determining of the ordination ruling it, we conclude that fetus gender selection and modern infertility treatments can’t be judged as the interference in God’s creation and the conflict with God’s Justice; rather the stability of the best system is proved through the occurance of such affairs.

  5. The role of antioxidant therapy in the treatment of male infertility: an overview

    Institute of Scientific and Technical Information of China (English)

    Francesco Lombardo; Andrea Sansone; Francesco Romanelli; Donatella Paoli; Loredana Gandini; Andrea Lenzi

    2011-01-01

    @@ In recent years,many studies have focused on the effect of oxidative stress,reactive oxygen species (ROS) and antioxidants on the male eproductive system.Under physiological conditions,sperm produces small amounts of ROS,which are needed for fertilisation,acrosome reaction and capacitation.However,if an increased production of ROS is not associated with a similar increase in scavenging systems,peroxidative damage of the sperm plasma membrane and loss of DNA integrity typically occur,which leads to cell death and reduced fertility.Furthermore,since there is no linear correlation between sperm quality and pregnancy rates,an improvement in semen parameters should not be the sole outcome considered in studies of antioxidant therapies.A definitive conclusion regarding the benefit of these therapies is difficult to obtain,as most of the previous studies lacked control groups,considered different antioxidants in different combinations and doses,or did not evaluate pregnancy rates in previously infertile couples.Even if beneficial effects were reported in a few cases of male infertility,more multicentre,double-blind studies performed with the same criteria are necessary for an increased understanding of the effects of various antioxidants on fertility.

  6. A Rare Case of Flare-Up of PID in Infertility Treatment

    Directory of Open Access Journals (Sweden)

    Leena Wadhwa

    2015-01-01

    Full Text Available Case Presentation. Mrs. X, 35 years old, case of primary infertility, was diagnosed to have genital tuberculosis on the basis of PCR positive and hysterolaparoscopy findings and received category I ATT for 6 months. Following ATT completion, her USG revealed no evidence of tuboovarian mass or hydrosalpinx. Since her tubes were patent, she underwent 3 cycles of ovulation induction and 2 cycles of IUI. The women presented with acute PID, five days after IUI, and was conservatively managed. She again presented 24 days after IUI with persistent low grade fever and abdominal pain. Suspecting relapse of genital tuberculosis, she was started on category II ATT. She had acute episodes of high grade fever with chills 2 weeks after starting ATT and MRI revealed bilateral TO masses suggestive of pyosalpinx. Emergency laparotomy was done, pus was drained, and cyst wall was removed and HPE was suggestive of chronic inflammation with few granulation tissues. ATT was continued for one year and the woman improved. Conclusion. The possibility of flare-up of PID (pelvic inflammatory disease in treated case of tuberculosis undergoing infertility management should be kept in mind and aggressive management should be done.

  7. Women more vulnerable than men when facing risk for treatment-induced infertility: a qualitative study of young adults newly diagnosed with cancer.

    Science.gov (United States)

    Armuand, Gabriela M; Wettergren, Lena; Rodriguez-Wallberg, Kenny A; Lampic, Claudia

    2015-02-01

    Being diagnosed with cancer constitutes not only an immediate threat to health, but cancer treatments may also have a negative impact on fertility. Retrospective studies show that many survivors regret not having received fertility-related information and being offered fertility preservation at time of diagnosis. This qualitative study investigates newly diagnosed cancer patients' experiences of fertility-related communication and how they reason about the risk of future infertility. Informants were recruited at three cancer wards at a university hospital. Eleven women and 10 men newly diagnosed with cancer participated in individual semi-structured interviews focusing on three domains: experiences of fertility-related communication, decision-making concerning fertility preservation, and thoughts and feelings about the risk of possible infertility. Data was analyzed through qualitative content analysis. The analysis resulted in three sub-themes, 'Getting to know', 'Reacting to the risk' and 'Handling uncertainty', and one main theme 'Women more vulnerable when facing risk for infertility', indicating that women reported more negative experiences related to patient-provider communication regarding fertility-related aspects of cancer treatment, as well as negative emotional reactions to the risk of infertility and challenges related to handling uncertainty regarding future fertility. The informants described distress when receiving treatment with possible impact on fertility and used different strategies to handle the risk for infertility, such as relying on fertility preservation or thinking of alternative ways to achieve parenthood. The negative experiences reported by the female informants may be related to the fact that none of the women, but almost all men, had received information about and used fertility preservation. Women newly diagnosed with cancer seem to be especially vulnerable when facing risk for treatment-induced infertility. Lack of shared decision

  8. Varicocele and male infertility

    DEFF Research Database (Denmark)

    Fuglesang Jensen, Christian S.; Østergren, Peter; Dupree, James M

    2017-01-01

    to explain the differential effect of varicoceles on infertility. As a consequence, careful patient selection for treatment based on couple fertility status, varicocele grade, and semen quality is critical for achieving a chance of a subsequent pregnancy. A substantial amount of data on the effects...

  9. Cyclic corticosteroid immunosuppression is unsuccessful in the treatment of sperm antibody-related male infertility: a controlled study.

    Science.gov (United States)

    Bals-Pratsch, M; Dören, M; Karbowski, B; Schneider, H P; Nieschlag, E

    1992-01-01

    In this double blind cross-over study, 20 infertile men, who had sperm antibodies detected by the mixed antiglobulin reaction (MAR test) in the ejaculate and by the tray agglutination test (TAT) in serum, were treated with 40 mg/day prednisolone or placebo from days 1 to 10 of the partners' menstrual cycle. Patients were randomly allocated to different treatment groups. While group 1 started with placebo followed by verum for three consecutive cycles, group 2 began with verum and continued with placebo. All patients had regular intercourse (n = 19) or intra-cervical insemination at ovulation (n = 1). A post-coital test or a sperm penetration test was performed during verum and placebo regimes. Blood samples were drawn from the male partner at this time to control the efficacy of prednisolone treatment by checking the TAT titre. No pregnancy occurred during prednisolone or placebo treatment. In eight of 12 patients, post-coital testing showed little improvement and antibody titres decreased in seven of 16 patients. Side-effects from medication were reported by eight patients (seven verum and one placebo cycle) and caused treatment to be discontinued in two cases. Five patients' partners conceived at a later stage by intrauterine insemination with spermatozoa prepared by 'swim up' (n = 3) or by in-vitro fertilization (IVF n = 2). Thus high dose corticosteroid therapy was ineffective in achieving pregnancies induced by infertile men positive for antisperm antibodies. Since side-effects of corticosteroids should not be underestimated in otherwise healthy men, other reproductive techniques such as intrauterine insemination or IVF should be offered to such couples.

  10. Infertility treatment in polycystic ovary syndrome: lifestyle interventions, medications and surgery.

    Science.gov (United States)

    Panidis, Dimitrios; Tziomalos, Konstantinos; Papadakis, Efstathios; Katsikis, Ilias

    2013-01-01

    Management of patients with polycystic ovary syndrome (PCOS) who wish to become pregnant should include exclusion of other diseases in the woman and additional fertility disorders in the couple. Before the initiation of any pharmacological intervention, the importance of lifestyle modifications should be stressed, particularly weight loss, increased exercise, smoking cessation and reduced alcohol consumption. The pharmacological treatment of choice for the induction of ovulation and for achieving live birth is the combination of metformin and clomiphene citrate. If this combination is unsuccessful, second-line treatments include the administration of gonadotropins and laparoscopic ovarian drilling. Induction of ovulation using clomiphene or gonadotropins leads to single live birth in 72% of cases, whereas laparoscopic ovarian drilling leads to live birth in 50% of cases. In vitro fertilization represents third-line treatment. Finally, individualized interventions can be implemented for the induction of ovulation depending on the specific characteristics of patients with PCOS. These interventions might deviate from the above-designated order of treatments in specific subgroups of patients with PCOS.

  11. High ratings of satisfaction with fertility treatment are common: findings from the Copenhagen Multi-centre Psychosocial Infertility (COMPI) Research Programme

    DEFF Research Database (Denmark)

    Schmidt, L; Holstein, B E; Boivin, J

    2003-01-01

    /delivery and the report of marital benefits resulting from the infertility experience. Lower social class was a significant predictor for satisfaction. CONCLUSIONS: Both men and women in fertility treatment had high ratings on medical and patient-centred care. It seemed that satisfaction with the psychosocial services...

  12. Child development and quality of parenting in lesbian families: no psychosocial indications for a-priori withholding of infertility treatment. A systematic review

    NARCIS (Netherlands)

    J.A.M. Hunfeld (Joke); B.C.J.M. Fauser (Bart); I.D. de Beaufort (Inez); J. Passchier (Jan)

    2002-01-01

    textabstractAmong fertility centres, much discussion focuses on whether to withhold infertility treatment from special patient groups (lesbians, prospective single parent(s), prospective parent(s) of relatively advanced age, or with severe diseases) because it is assumed that this

  13. A new method for sperm characterization for infertility treatment: hypothesis testing by using combination of watershed segmentation and graph theory.

    Science.gov (United States)

    Shojaedini, Seyed Vahab; Heydari, Masoud

    2014-10-01

    Shape and movement features of sperms are important parameters for infertility study and treatment. In this article, a new method is introduced for characterization sperms in microscopic videos. In this method, first a hypothesis framework is defined to distinguish sperms from other particles in captured video. Then decision about each hypothesis is done in following steps: Selecting some primary regions as candidates for sperms by watershed-based segmentation, pruning of some false candidates during successive frames using graph theory concept and finally confirming correct sperms by using their movement trajectories. Performance of the proposed method is evaluated on real captured images belongs to semen with high density of sperms. The obtained results show the proposed method may detect 97% of sperms in presence of 5% false detections and track 91% of moving sperms. Furthermore, it can be shown that better characterization of sperms in proposed algorithm doesn't lead to extracting more false sperms compared to some present approaches.

  14. Results of treatment of infertility in men by complex acetyl-L-carnitine and L-carnitine

    Directory of Open Access Journals (Sweden)

    V. V. Mikhaylichenko

    2014-12-01

    Full Text Available 100 patients with various forms of patozoospermii were randomly divided equally into 2 groups. First group of patients administered complex of acetyl-L-carnitine and L-carnitine (SpermAktin ® and alpha-tocopherol acetate for 3 months, in the second group of patients was carried out single-agent alpha-tocopherol acetate duration of 3 months. Ejaculate volume, viscosity and pH of seminal plasma, the concentration, motility and morphology were evaluated after 1.5 and 3 months of starting treatment. In the first group of infertile men showed a significant improvement in the quality and quantity of semen compared with the second patient group.

  15. Results of treatment of infertility in men by complex acetyl-L-carnitine and L-carnitine

    Directory of Open Access Journals (Sweden)

    V. V. Mikhaylichenko

    2014-01-01

    Full Text Available 100 patients with various forms of patozoospermii were randomly divided equally into 2 groups. First group of patients administered complex of acetyl-L-carnitine and L-carnitine (SpermAktin ® and alpha-tocopherol acetate for 3 months, in the second group of patients was carried out single-agent alpha-tocopherol acetate duration of 3 months. Ejaculate volume, viscosity and pH of seminal plasma, the concentration, motility and morphology were evaluated after 1.5 and 3 months of starting treatment. In the first group of infertile men showed a significant improvement in the quality and quantity of semen compared with the second patient group.

  16. Coping with infertility: a transcultural perspective.

    Science.gov (United States)

    Li, Jing; Liu, Botao; Li, Min

    2014-09-01

    To review the most important and interesting articles in infertility published in the last year. This systematic review covers 60 studies published in journals or dissertations in Science Direct and PubMed in the last year, including those related to prevention and treatment as well as related psychosocial services in infertility. We also propose some suggestions about coping with infertility in China. Infertility is a multidisciplinary problem that requires medical, social, and political efforts to prevent and offer infertile patients the best diagnostic, therapeutic, and psychosocial services. Cultural factors should be taken into consideration when designing coping strategies.

  17. Lycopene and male infertility

    Institute of Scientific and Technical Information of China (English)

    Damayanthi Durairajanayagam; Ashok Agarwal; Chloe Ong; Pallavi Prashast

    2014-01-01

    Excessive amounts of reactive oxygen species (ROS) cause a state of oxidative stress, which result in sperm membrane lipid peroxidation, DNA damage and apoptosis, leading to decreased sperm viability and motility. Elevated levels of ROS are a major cause of idiopathic male factor infertility, which is an increasingly common problem today. Lycopene, the most potent singlet oxygen quencher of all carotenoids, is a possible treatment option for male infertility because of its antioxidant properties. By reacting with and neutralizing free radicals, lycopene could reduce the incidence of oxidative stress and thus, lessen the damage that would otherwise be inlficted on spermatozoa. It is postulated that lycopene may have other beneifcial effects via nonoxidative mechanisms in the testis, such as gap junction communication, modulation of gene expression, regulation of the cell cycle and immunoenhancement. Various lycopene supplementation studies conducted on both humans and animals have shown promising results in alleviating male infertility-lipid peroxidation and DNA damage were decreased, while sperm count and viability, and general immunity were increased. Improvement of these parameters indicates a reduction in oxidative stress, and thus the spermatozoa is less vulnerable to oxidative damage, which increases the chances of a normal sperm fertilizing the egg. Human trials have reported improvement in sperm parameters and pregnancy rates with supplementation of 4-8 mg of lycopene daily for 3-12 months. However, further detailed and extensive research is still required to determine the dosage and the usefulness of lycopene as a treatment for male infertility.

  18. Lycopene and male infertility

    Directory of Open Access Journals (Sweden)

    Damayanthi Durairajanayagam

    2014-06-01

    Full Text Available Excessive amounts of reactive oxygen species (ROS cause a state of oxidative stress, which result in sperm membrane lipid peroxidation, DNA damage and apoptosis, leading to decreased sperm viability and motility. Elevated levels of ROS are a major cause of idiopathic male factor infertility, which is an increasingly common problem today. Lycopene, the most potent singlet oxygen quencher of all carotenoids, is a possible treatment option for male infertility because of its antioxidant properties. By reacting with and neutralizing free radicals, lycopene could reduce the incidence of oxidative stress and thus, lessen the damage that would otherwise be inflicted on spermatozoa. It is postulated that lycopene may have other beneficial effects via nonoxidative mechanisms in the testis, such as gap junction communication, modulation of gene expression, regulation of the cell cycle and immunoenhancement. Various lycopene supplementation studies conducted on both humans and animals have shown promising results in alleviating male infertility-lipid peroxidation and DNA damage were decreased, while sperm count and viability, and general immunity were increased. Improvement of these parameters indicates a reduction in oxidative stress, and thus the spermatozoa is less vulnerable to oxidative damage, which increases the chances of a normal sperm fertilizing the egg. Human trials have reported improvement in sperm parameters and pregnancy rates with supplementation of 4-8 mg of lycopene daily for 3-12 months. However, further detailed and extensive research is still required to determine the dosage and the usefulness of lycopene as a treatment for male infertility.

  19. Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility

    OpenAIRE

    Murto, Tiina; Bjuresten, Kerstin; Landgren, Britt-Marie; Stavreus-Evers, Anneli

    2013-01-01

    Background: Infertile women might get pregnant sometime after fertility treatment, but today, there is no prediction model on who will eventually have children. The objective of the present study was to characterize hormone levels in an arbitrary menstrual cycle in women with unexplained infertility and male infertility, and to determine the predictive value for long-term possibility of live birth. Methods: In this cross-sectional study, with 71 infertile women with diagnosis unexplained infe...

  20. In-vitro cervical mucus-sperm penetration tests and outcome of infertility treatments in couples with repeatedly negative post-coital tests.

    Science.gov (United States)

    Farhi, J; Valentine, A; Bahadur, G; Shenfield, F; Steele, S J; Jacobs, H S

    1995-01-01

    The results of in-vitro cervical mucus-sperm penetration tests and cross-hostility tests in 178 couples with repeatedly negative post-coital tests were recorded. Using a protocol of three cycles with intra-uterine inseminations (IUI) followed by three cycles with ovulation induction + IUI, the association between the cause of infertility, results of the in-vitro tests and the outcome of infertility treatment was investigated. We found that repeatedly negative post-coital tests are a good indicator of a cervical mucus-sperm penetration problem. The cross-hostility test clearly differentiates the abnormal factor in this interaction, and a good performance of the donors' spermatozoa in the cervical mucus correlates with increased pregnancy rate. In male factor infertility, failure of the husbands' spermatozoa to penetrate cervical mucus was not indicative of a deficient fertilization potential in vivo. In these patients a serious attempt should therefore be made to reverse the infertility by treatment with IUI or ovulation induction + IUI before attempting assisted reproduction. Women with polycystic ovaries and repeatedly negative post-coital tests should be investigated for sperm receptivity of the cervical mucus. Low receptivity of the cervical mucus may imply that endometrial receptivity and oocyte quality are also low. Ovulation induction and not IUI alone should therefore be used as the preferred mode of treatment to improve pregnancy rate.

  1. [The use of clomiphene citrate in ambulatory medicine practice in the Midi-Pyrénées area: compliance to national guidelines applicable to infertility diagnosis and to prescription and monitoring rules applicable to clomiphene citrate treatments].

    Science.gov (United States)

    Bigouroux, V; Roussel, H; Souche, A; Bourrel, R; Sciortino, V

    2004-11-01

    Evaluate the compliance to the national guidelines from ANDEM (1996) and AFSSAPS (2003) concerning the diagnosis of infertility, the prescription of clomiphene and the monitoring of these treatments. Retrospective study of female patients from 16 to 50 y.o. having benefited from reimbursement of clomiphene citrate treatment between 1st April 2002 and 30th June 2002. After random sampling stratified on age, data on diagnosis procedures and treatments were extracted from the Social Security reimbursement database. These data were validated and completed by patients' interviews. A total of 283 women were included. 30% were subject to the basic hormonal tests (FSH, LH, estradiol). The proportion of patients explored by hysterosalpingogram, post-coital test and echography were respectively 50%, 35% and 68%. A semen analysis was found in 60% of the partners. The complete set of recommended tests before start of treatment was realised in 1.5% of women. In 7% of cases, women were treated without prior exploration. The proportion of tests performed was comparable below and above the age of 35. 77% of treatments were initiated after at least one year of waiting for a spontaneous conception. 69% of women were monitored during treatment by other methods than clinical follow-up. Prescription of clomifene citrate is too frequently realised without compliance to guidelines applicable to infertility investigations and therefore without persuasive diagnosis. These practices can lead to loss of childbearing opportunities and complications.

  2. Varicocele and Male Factor Infertility Treatment : A New Meta-analysis and Review of the Role of Varicocele Repair

    NARCIS (Netherlands)

    Baazeem, Abdulaziz; Belzile, Eric; Ciampi, Antonio; Dohle, Gert; Jarvi, Keith; Salonia, Andrea; Weidner, Wolfgang; Zini, Armand

    2011-01-01

    Context: Varicocele is a common condition, found in many men who present for infertility evaluation. Objective: To assess the effect of varicocelectomy on male infertility. Evidence acquisition: A literature search was performed using Embase and Medline. Literature reviewed included meta-analyses an

  3. Clinical Effectiveness of Modified Laparoscopic Fimbrioplasty for the Treatment of Minimal Endometriosis and Unexplained Infertility

    Directory of Open Access Journals (Sweden)

    Sarah E. Franjoine

    2015-01-01

    Full Text Available Objective. To study the reproductive outcomes of modified laparoscopic fimbrioplasty (MLF, a surgical technique designed to increase the working surface area of the fimbriated end of the fallopian tube. We postulated that an improvement in fimbrial function through MLF will improve reproductive outcomes. Design. Retrospective cohort study. Setting. Academic tertiary-care medical center. Patients. Women with minimal endometriosis or unexplained infertility, who underwent MLF during diagnostic laparoscopy (n=50 or diagnostic laparoscopy alone (n=87. Intervention. MLF involved gentle, circumferential dilatation of the fimbria and lysis of fimbrial adhesions bridging the fimbrial folds. Main Outcome Measures. The primary outcome was pregnancy rate and the secondary outcome was time to pregnancy. Results. The pregnancy rate for the MLF group was 40.0%, compared to 28.7% for the control group. The average time to pregnancy for the MLF group was 13 weeks, compared to 18 weeks for the control group. The pregnancy rate in the MLF group was significantly higher for patients ≤35 ys (51.5% versus 28.8%, but not for those >35 ys (17.6% versus 28.6%. Conclusion. MLF was associated with a significant increase in pregnancy rate for patients ≤35 ys.

  4. Understanding Infertility - The Basics

    Medline Plus

    Full Text Available ... Facts About Infertility FAQs About Infertility FAQs About the Psychological Component of Infertility FAQs About Cloning and ... Page not found! Please click on one of the links in the navigation bar. FAQs Reproductive Health ...

  5. Understanding Infertility - The Basics

    Medline Plus

    Full Text Available ... Home FAQs Frequently Asked Questions Quick Facts About Infertility FAQs About Infertility FAQs About the Psychological Component of Infertility FAQs About Cloning and Stem Cell Research SART's ...

  6. Fertility Treatment, Use of in Vitro Fertilization, and Time to Live Birth Based on Initial Provider Type.

    Science.gov (United States)

    Boltz, Mandy W; Sanders, Jessica N; Simonsen, Sara E; Stanford, Joseph B

    2017-01-01

    To explore the relationship between the type of clinician (generalist vs subspecialist) initially seen by infertile women, the treatment received, and the time to pregnancy. We analyzed mixed-mode questionnaire data from 867 women with primary infertility enrolled into a retrospective cohort through population- and fertility clinic-based sampling. We compared women presenting first to generalist providers with women presenting first to fertility subspecialists, with the main outcomes of receiving in vitro fertilization (IVF), time to pregnancy, and live birth. The first contact for most (84%) women with infertility was a generalist provider. Only 8% of women sought care first from a fertility subspecialist, and these women were older and had been trying longer to conceive. Women who presented first to a generalist provider were less likely to receive IVF (adjusted odds ratio, 0.48; 95% confidence interval, 0.28-0.82), were equally likely to achieve pregnancy, and had similar times to pregnancy (adjusted hazard ratio, 1.11; 95% confidence interval, 0.80-1.53) compared with women who presented first to a subspecialist. Generalist providers are frequently the first point of care for women with difficulty conceiving and are uniquely positioned to promote the balanced management of infertility. © Copyright 2017 by the American Board of Family Medicine.

  7. Relevance of genetic investigation in male infertility.

    Science.gov (United States)

    Asero, P; Calogero, A E; Condorelli, R A; Mongioi', L; Vicari, E; Lanzafame, F; Crisci, R; La Vignera, S

    2014-05-01

    Genetic causes can be directly responsible for various clinical conditions of male infertility and spermatogenic impairment. With the increased use of assisted reproduction technologies our understanding of genetic basis of male infertility has large implications not only for understanding the causes of infertility but also in determining the prognosis and management of such couples. For these reasons, the genetic investigations represent today an essential and useful tool in the treatment of male infertility. Several evidences are available for the clinical practice regarding the diagnosis; however, there are less information relative to the treatment of the genetic causes of male infertility. Focus of this review is to discuss the main and more common genetic causes of male infertility to better direct the genetics investigation in the treatment of spermatogenic impairment.

  8. Practical approaches for design and analysis of clinical trials of infertility treatments: crossover designs and the Mantel-Haenszel method are recommended.

    Science.gov (United States)

    Takada, Michihiro; Sozu, Takashi; Sato, Tosiya

    2015-01-01

    Crossover designs have some advantages over standard clinical trial designs and they are often used in trials evaluating the efficacy of treatments for infertility. However, clinical trials of infertility treatments violate a fundamental condition of crossover designs, because women who become pregnant in the first treatment period are not treated in the second period. In previous research, to deal with this problem, some new designs, such as re-randomization designs, and analysis methods including the logistic mixture model and the beta-binomial mixture model were proposed. Although the performance of these designs and methods has previously been evaluated in large-scale clinical trials with sample sizes of more than 1000 per group, the actual sample sizes of infertility treatment trials are usually around 100 per group. The most appropriate design and analysis for these moderate-scale clinical trials are currently unclear. In this study, we conducted simulation studies to determine the appropriate design and analysis method of moderate-scale clinical trials for irreversible endpoints by evaluating the statistical power and bias in the treatment effect estimates. The Mantel-Haenszel method had similar power and bias to the logistic mixture model. The crossover designs had the highest power and the smallest bias. We recommend using a combination of the crossover design and the Mantel-Haenszel method for two-period, two-treatment clinical trials with irreversible endpoints.

  9. Chronic endometritis and infertility.

    Science.gov (United States)

    Park, Hyun Jong; Kim, You Shin; Yoon, Tae Ki; Lee, Woo Sik

    2016-12-01

    Chronic endometritis (CE) is a condition involving the breakdown of the peaceful co-existence between microorganisms and the host immune system in the endometrium. A majority of CE cases produce no noticeable signs or mild symptoms, and the prevalence rate of CE has been found to be approximately 10%. Gynecologists and pathologists often do not focus much clinical attention on CE due to the time-consuming microscopic examinations necessary to diagnose CE, its mild clinical manifestations, and the benign nature of the disease. However, the relationship between CE and infertility-related conditions such as repeated implantation failure and recurrent miscarriage has recently emerged as an area of inquiry. In this study, we reviewed the literature on the pathophysiology of CE and how it may be associated with infertility, as well as the literature regarding the diagnosis and treatment of CE. In addition, we discuss the value of hysteroscopic procedures in the diagnosis and treatment of CE.

  10. Chronic endometritis and infertility

    Science.gov (United States)

    Park, Hyun Jong; Kim, You Shin; Yoon, Tae Ki

    2016-01-01

    Chronic endometritis (CE) is a condition involving the breakdown of the peaceful co-existence between microorganisms and the host immune system in the endometrium. A majority of CE cases produce no noticeable signs or mild symptoms, and the prevalence rate of CE has been found to be approximately 10%. Gynecologists and pathologists often do not focus much clinical attention on CE due to the time-consuming microscopic examinations necessary to diagnose CE, its mild clinical manifestations, and the benign nature of the disease. However, the relationship between CE and infertility-related conditions such as repeated implantation failure and recurrent miscarriage has recently emerged as an area of inquiry. In this study, we reviewed the literature on the pathophysiology of CE and how it may be associated with infertility, as well as the literature regarding the diagnosis and treatment of CE. In addition, we discuss the value of hysteroscopic procedures in the diagnosis and treatment of CE. PMID:28090456

  11. Focus Issue on Male Infertility

    Directory of Open Access Journals (Sweden)

    Hideyuki Kobayashi

    2012-01-01

    Full Text Available Male infertility problems can occur when sperms are limited in number or function. In this paper, we describe the clinical evaluation of male infertility. A detailed history, physical examination, and basic semen analysis are required. In addition, ultrasound, karyotyping, and hormonal studies are needed to determine specific causes of infertility. In addition, the World Health Organization (WHO, 2009 has developed a manual to provide guidance in performing a comprehensive semen analysis. Among the possible reasons for male infertility, nonobstructive azoospermia is the least treatable, because few or no mature sperm may be produced. In many cases, men with nonobstructive azoospermia typically have small-volume testes and elevated FSH. Although treatment may not completely restore the quality of semen from men with subnormal fertility, in some cases a successful pregnancy can still be achieved through assisted reproductive technology.

  12. Infertility Infertilidad

    Directory of Open Access Journals (Sweden)

    Práxedes Rojas Quintana

    2011-08-01

    Full Text Available Literature review on the main issues related to infertile couples. It includes concept and classification, physiology of ovulation, causes in women and men, basic tests that are commonly performed evolution and prognosis, and health actions to provide appropriate orientation to the infertile couple. It is aimed at creating a teaching complementary material for Medicine and Nursing students, as well as for residents and specialists in general medicine and gynecology.Revisión bibliográfica sobre los principales temas referidos a la infertilidad de las parejas. Incluye concepto y clasificación, fisiología de la ovulación, causas en la mujer y en el hombre, exámenes complementarios básicos que se les realiza, evolución y pronóstico, así como acciones de salud para la orientación correcta de la pareja infértil. Tiene como objetivo crear un material de apoyo a la docencia, para estudiantes de la carrera de Medicina y de Enfermería, así como para residentes y especialistas en Medicina General Integral y Ginecoobstetricia.

  13. Male Infertility and Its Causes in Human

    Directory of Open Access Journals (Sweden)

    Toshinobu Miyamoto

    2012-01-01

    Full Text Available Infertility is one of the most serious social problems facing advanced nations. In general, approximate half of all cases of infertility are caused by factors related to the male partner. To date, various treatments have been developed for male infertility and are steadily producing results. However, there is no effective treatment for patients with nonobstructive azoospermia, in which there is an absence of mature sperm in the testes. Although evidence suggests that many patients with male infertility have a genetic predisposition to the condition, the cause has not been elucidated in the vast majority of cases. This paper discusses the environmental factors considered likely to be involved in male infertility and the genes that have been clearly shown to be involved in male infertility in humans, including our recent findings.

  14. Sexual behavior of infertile women: a qualitative study.

    Science.gov (United States)

    Bokaie, Mahshid; Simbar, Masoumeh; Yassini Ardekani, Seyed Mojtaba

    2015-10-01

    Infertility makes an essential challenge to the sexual life of couples, especially infertile women. When pregnancy does not happen, infertile women think that sexual intercourse is not fruitful and sexual desire became reduce gradually. Infertile women progressively forget that their sexual relationship is also a response to their natural need. This qualitative study was conducted to explore the infertility consequences in the sexual behavior of infertile women. This was a qualitative content analysis study; and it was part of a widespread study, used a sequential mixed-method and conducted from August 2014 until February 2015. A purposeful sampling was used to recruit infertile women who had referred to Yazd Research and Clinical Center for Infertility. Data gathering techniques employed in this research included in-depth semi structured open face-to-face interviews and field notes. Credibility, transferability, confirm ability, and dependability were assessed for the rigor of the data collection. Totally, 15 infertile women and 8 key informants were interviewed. Data analysis showed four themes about impact of infertility on female sexual behavior: 1/ Impact of infertility drugs on couple sexual behavior, 2/ Impact of assisted reproductive technologies on female sexual behavior, 3/ Timed intercourse during infertility and 4/ The psychological impact of infertility on sexual behavior. Some of Iranian infertile women could cope with their problems, but some of them were very affected by infertility drugs and assisted reproductive technologies procedures. Psychosexual counseling before medical treatment could help them to have a better sexual life.

  15. Disparities in access to effective treatment for infertility in the United States: an Ethics Committee opinion.

    Science.gov (United States)

    2015-11-01

    In the United States, economic, racial, ethnic, geographic, and other disparities exist in access to fertility treatment and in treatment outcomes. This opinion examines the factors that contribute to these disparities and proposes actions to address them.

  16. Mood disorders, psychiatric symptoms, and distress in women presenting for infertility evaluation.

    Science.gov (United States)

    Downey, J; Yingling, S; McKinney, M; Husami, N; Jewelewicz, R; Maidman, J

    1989-09-01

    Women who undergo treatment for infertility frequently report depression, but it is crucial to distinguish between subjective distress, symptoms, and clinical depressive disorders. In the initial assessment of a prospective, longitudinal study, 59 women presenting for infertility treatment were compared with 35 women presenting for routine gynecological care. Infertility patients and controls were not significantly different on self-report measures of partner satisfaction, sexual functioning, or self-esteem. There was also no difference in psychiatric symptomatology, or in the percentage of subjects who were currently experiencing or had ever experienced a major depressive episode. However, the infertility patients perceived themselves to have been already quite affected by their inability to conceive. For instance, 49.2% reported changes in their sexual functioning and 74.6% reported changes in their mood.

  17. Immunology and male infertility.

    Science.gov (United States)

    Mumford, D M

    1978-10-01

    This article has attempted to review evidence that suggests that immune factors may be operative in a small but significant number of infertile men. Although our current understanding of the possible processes by which autosensitization to previously sequestered reproductive antigens occurs is incomplete, there are laboratory assays presently available that give an indication, but do not prove, that immune factors may be contributing to the infertile state. Continued research is needed to develop new assays and more purified sperm antigens, which might enhance our knowledge of the underlying immunoreproductive changes. Until these are available, the following procedures should be considered when investigating a patient with infertility of suspected immune origin. The patient's history should be taken, and a physical examination should be performed. A complete blood count, urinalysis, and complete semen analysis and culture should be taken. Next, in vivo cervical tests (Sims-Huhner) are performed, followed by sperm antibody assessment (serum, semen) and perhaps in vitro cervical mucus sperm assays (especially the crossed hostility test). After the tests have been completed, the following possibe treatments exist: 1. Treatment of underlying infections 2. Correction of obstructions 3. Corticosteroid (or testosterone?) therapy 4. Washed sperm insemination 5. First portion of fresh ejaculate insemination 6. Artificial insemination with homologous donor 7. Adoption.

  18. CHROMOSOME ABNORMALITIES IN INFERTILITY

    Directory of Open Access Journals (Sweden)

    Mateja Smogavec

    2009-08-01

    Conclusions Chromosomal analysis is an important method in diagnostic procedures of infertility, because chromosomal abnormalities could play the important role in etiology of infertility and are more frequently detected in this group of patients compared to general population. In the infertile couples balanced chromosomal abnormalities are the main cause of spontaneous abortions. Sex chromosome aneuploidies are highly correlated to infertility of females and males.

  19. Development and evaluation of a multi-antigen peptide ELISA for the diagnosis of Chlamydia trachomatis related infertility in women.

    Science.gov (United States)

    Menon, Shruti; Stansfield, Scott H; Logan, Benignus; Hocking, Jane S; Timms, Peter; Rombauts, Luk; Allan, John; Huston, Wilhelmina May

    2016-07-17

    Chlamydia trachomatis results in tubal factor infertility in some women. Diagnosis of this tubal infertility is difficult and typically involves laparoscopy or hysterosalpingography to detect the tubal blockages. Numerous serological tests have been developed however are presently not used for diagnosis without subsequent surgical during the infertility investigation. This study aimed to develop a highly specific serological assay for chlamydial tubal factor infertility in women that could be used to recommend direct progression to IVF treatment for women who are positive. Women were recruited from a variety of settings including; women seeking fertility treatment, sexual health and GP consults, or antenatal care (n=259). The serological assay was developed using sera from a large group of women by using infertile MIF positive women with tubal damage as the positives compared to infertile, or acute infection, and/or fertile controls (negatives). The new multi-peptide ELISA was highly specific for the detection of tubal factor infertility (p=0.011) compared to another ELISA (p=0.022) and MIF (p=0.099). The sensitivity of the assay should be improved before clinical utility. Potentially a two-step testing protocol could be used during the initial infertility investigation where MIF followed by a highly specific ELISA could be used to recommend direct progression to IVF for women who are positive.

  20. The role of steroid hormone supplementation in non-assisted reproductive technology treatments for unexplained infertility.

    Science.gov (United States)

    Quaas, Alexander M; Hansen, Karl R

    2016-12-01

    Fertility treatment strategies are evolving, with a more rapid transition to assisted reproductive technology (ART) treatments after unsuccessful non-ART treatments. This trend increases the potential importance of adjuvant treatments in non-ART cycles, such as steroid hormone supplementation. It has been established that success rates of ART treatments are increased with the use of luteal support with progesterone. In the setting of non-ART cycles, however, the evidence is less clear, and clinical practices vary widely between providers and clinics. In this review, we aimed to provide an overview of the current evidence for the use of steroid hormone supplementation, including progesterone for luteal support, estrogens, androgens, and mineralocorticoids, in the setting of non-ART treatments for ovulatory women. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  1. The impact of infertility on sexuality: A literature review

    Directory of Open Access Journals (Sweden)

    Bruce Maycock3

    2011-11-01

    Full Text Available Background: Most studies address medical treatment of infertility and psychosocial outcomes caused by infertility-related stress, but few studies examine the infertility’s impact on sexuality.Aim: A literature review was conducted to answer the questions: 1 How is sexual self concept impacted in infertile individuals and their partners? 2 Does infertility have a negative impact on sexual relationships? 3 Is sexual function affected by infertility? In answering these questions, we may develop a better understanding of sexuality in the context of infertility, and thus better inform infertility management. Ultimately the aim is to improve the quality of life for infertile couples.Method: A literature search was conducted for publications from 1990 to 2011 via the electronic databases PubMed, PsycInfo and Scopus, which focused on sexuality in infertile subjects or couples.Results: In this review, all studies were descriptive quantitative studies which mapped the different aspects of sexuality in the context of infertility. The results suggested that infertility and its treatment approaches for fertilisationcould lead to changes in sexual self-esteem, sexual relationship and sexual function.Conclusion: The literature substantiated that many infertile subjects experienced trouble in various aspects of sexuality. However, further research should examine the reciprocal relations between sexual self concept, sexual relationship and sexual function in the context of infertility. How these changes affect the partners of infertile subjects should also be addressed.

  2. Abnormal vaginal colonization by gram-negative bacteria is significantly higher in pregnancy conceived through infertility treatment compared to natural pregnancy.

    Science.gov (United States)

    Kim, Ji Y; Sung, Ji-Hee; Chang, Kylie Hae-Jin; Choi, Suk-Joo; Oh, Soo-Young; Roh, Cheong-Rae; Kim, Jong-Hwa

    2017-03-01

    To compare abnormal vaginal colonization between natural pregnancy and pregnancy by infertility treatment in high-risk parturient women and to examine the association between abnormal vaginal colonization and early-onset neonatal sepsis (EONS). The clinical characteristics, vaginal culture result, and delivery outcome of patients who admitted to our high-risk unit between 2005 and 2014 were retrospectively reviewed and compared. We investigated the prevalence of EONS according to maternal vaginal colonization and examined the concordance between maternal vaginal bacteria and etiologic microorganism causing EONS. Among 1096 pregnancies, the rate of vaginal colonization by gram-negative bacteria, especially Escherichia coli was significantly higher in pregnancies by infertility treatment after adjustment of confounding variables (E. coli, OR [95% CI]: 2.47 [1.33-4.57], p = 0.004). The rate of EONS was significantly higher in neonates with maternal abnormal vaginal bacteria colonization (OR [95% CI]: 3.38 [1.44-7.93], p = 0.005) after adjusting for confounding variables. Notably, among microorganisms isolated from maternal vagina, E. coli and Staphylococcus aureus were consistent with the results from neonatal blood culture in EONS. Our data implicate a possible association between gram-negative bacteria colonization and infertility treatment and suggest that maternal vaginal colonization may be associated with EONS of neonates in high-risk pregnancy.

  3. Psychopathology, emotional aspects and psychological counselling in infertility: a review.

    Science.gov (United States)

    De Berardis, D; Mazza, M; Marini, S; Del Nibletto, L; Serroni, N; Pino, M C; Valchera, A; Ortolani, C; Ciarrocchi, F; Martinotti, G; Di Giannantonio, M

    2014-01-01

    Over the years, infertility has been variably defined. Infertility affects approximately 80 million people from all parts of the world. An important area of discussion has been represented by the possible causal link between psychopathology and infertility. In the past, the prevalence of psychiatric problems among infertile couples was estimated to be 25-60%. The incidence of depression and anxiety in infertile couples is significantly high than in fertile controls and in the general population respectively. Infertility has been linked to obsessive-compulsive symptoms, psychoticism, substance abuse and eating disorders. Psychological impact of infertility is greater in women than in men. Additionally, authors found that infertile patients were more alexithymic than healthy controls. In relation to the different needs, different psychological therapeutic interventions may be indicated. Psychological counseling can provide valuable assistance in dealing with infertility treatments and their eventual failures.

  4. Infertility trial outcomes: healthy moms and babies.

    Science.gov (United States)

    Silver, Robert

    2014-05-01

    Traditionally, the primary outcome of infertility trials has been a positive pregnancy test or a clinically recognized pregnancy. However, parents desire a healthy baby that grows up to be a healthy adult, rather than a positive pregnancy test. Too often results of infertility trials are lacking in crucial obstetric details. This is problematic because treatments for infertility have the capacity to increase the risk for a variety of adverse obstetric outcomes. This review will outline important obstetric variables that should be included when reporting infertility research. The rationale for including these data, precise definitions of the variables, and cost-effective strategies for obtaining these obstetric details will be highlighted.

  5. Infertility and Adenomyosis

    Directory of Open Access Journals (Sweden)

    Sebastiano Campo

    2012-01-01

    Full Text Available Classically, the diagnosis of adenomyosis has only been possible on a hysterectomy specimen, usually in women in their late fourth and fifth decades, and, therefore, evaluating any relationship with infertility was simply not possible. As a consequence, to this day, no epidemiologic data exists linking adenomyosis to a state of subfertility. Today, new imaging techniques have enabled a noninvasive diagnosis at a much earlier time and a number of single-case or small series reports have appeared showing that medical, surgical, or combined treatment can restore fertility in women with adenomyosis, an indirect proof of an association. At the functional level, several anomalies found in the so-called junctional zone, or inner myometrium, in adenomyosis patients have been shown to be associated with poor reproductive performance, mainly through perturbed uterine peristalsis. Additional evidence for an association comes from experimental data: in baboons, adenomyosis is associated with lifelong primary infertility, as well as to endometriosis. Finally, indirect proof comes from studies of the eutopic and ectopic endometrium in women with adenomyosis proving the existence of an altered endometrial function and receptivity. In conclusion, sufficient indirect proof exists linking adenomyosis to infertility to warrant systematic clinical studies.

  6. Seminal vesicles of infertile patients with male accessory gland infection: ultrasound evaluation after prolonged treatment with tadalafil, a selective phosphodiesterase-5 inhibitor.

    Science.gov (United States)

    La Vignera, S

    2013-12-01

    The aim of this study was to investigate possible ultrasound seminal vesicle (SV) changes in infertile patients with 'hypertrophic-congestive' (HCUF) or 'fibro-sclerotic' (FSUF) ultrasound form of male accessory gland infection (MAGI) after prolonged administration of tadalafil (TAD), a selective phosphodiesterase-5 inhibitor. Forty infertile patients with HCUF and 40 patients with FSUF and erectile dysfunction were selected and arbitrarily divided into two groups, who were prescribed TAD 5 mg daily for 3 months, the first 20 consecutive patients with HCUF (group A1) or FSUF (group A2) or placebo, the second 20 consecutive patients with HCUF (group B1) or FSUF (group B2). All patients underwent scrotal and prostate-vesicular transrectal ultrasound evaluation and semen analysis (WHO, 2010) before and after treatment. Group A1 patients showed a significant reduction in fundus/body ratio and higher pre- and post-ejaculatory body SV antero-posterior diameter difference compared with the other three groups. These patients showed also a significant increase in SV ejection fraction and a significant improvement in the total sperm count, progressive motility, seminal levels of fructose and ejaculate volume. These results suggest that infertile patients with HCUF had an improvement in SV ultrasound features suggestive of chronic inflammation after daily treatment with low doses of TAD.

  7. Endometriosis: Does It Cause Infertility?

    Science.gov (United States)

    ... Home FAQs Frequently Asked Questions Quick Facts About Infertility FAQs About Infertility FAQs About the Psychological Component of Infertility FAQs About Cloning and Stem Cell Research SART's ...

  8. Diagnostic Testing for Female Infertility

    Science.gov (United States)

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  9. Missing Motherhood: Jordanian Women's Experiences with Infertility

    Directory of Open Access Journals (Sweden)

    Hala Mahmoud Obeidat

    2014-01-01

    Full Text Available Aim, Background, and Introduction. Bearing and rearing children are an important part of life in nearly all cultures and are a central role for Jordanian Muslim women. Infertility can create anxiety, stress, and depression for couples who are infertile. Women frequently bear the emotional stigma of a couple’s infertility. There is a paucity of literature focusing on Jordanian Muslim women experiencing infertility and failed assistive reproductive technology. Therefore, this study explored these women’s lived experience. Methods. Qualitative data were collected through interviews with 30 Jordanian Muslim women who experienced failed assistive reproductive technology for infertility. Perceptions of experiences with failed treatment of infertility were documented and analyzed. Results. Major themes were identified: missing out on motherhood and living with infertility, experiencing marital stressors, feeling social pressure, experiencing depression and disappointment, having treatment associated difficulties, appreciating support from family and friends, using coping strategies, and fear of an unknown future. Discussion, Conclusion, and Implications for Clinical Practice. Being infertile significantly influences the physical, emotional, social, and spiritual health of Jordanian Muslim women as well as their quality of life. Perceived social support and personal coping strategies were used by study participants to mediate failed attempts to conceive. Designing and implementing culturally appropriate interventions for Muslim women globally who are experiencing infertility are essential.

  10. Effectiveness of bromocriptine monotherapy or combination treatment with clomiphene for infertility in women with galactorrhea and normal prolactin: A systematic review and meta-analysis.

    Science.gov (United States)

    Xue, Tao; Li, Shang-Wei; Wang, Yan

    2010-08-01

    Among women with unexplained infertility, 28% to 55% of patients with galactorrhea are normoprolactinemic. Bromocriptine, a common treatment for infertile women with hyperprolactinemia, has been used in the treatment of unexplained subfertility in women with galactorrhea and normal prolactin; however, its effectiveness and safety profile have never been determined. The aim of this study was to determine the relative effectiveness and safety profile of bromocriptine monotherapy or as an adjunct to clomiphene citrate in women with galactorrhea and normal prolactin levels. We conducted a search of the Cochrane Subfertility Review Group specialized register of controlled trials (March 2010), CENTRAL (The Cochrane Library, Issue 3, 2010), MEDLINE (1950-March 2010), EMBASE (1980-March 2010), and the China Biological Medicine Database (inception to March 2010) for relevant randomized controlled trials (RCTs) using the following terms: controlled, randomized, blinded, clinical trials, humans, galactorrhea, prolactin, bromocriptine, infertility, and subfertility. Additionally, reference lists of identified articles were searched for relevant articles. Of the 8 studies identified, 5 were excluded after full-text review for the following reasons: lack of a placebo group (2); difference in cointerventions (1); difference in end points (1); and systematic review (1). Therefore, 3 RCTs were included in this review. Bromocriptine administered in combination with clomiphene was found to be associated with a higher accumulative pregnancy rate compared with clomiphene monotherapy (fixed odds ratio [OR], 5.33; 95% CI, 2.62-10.88), and a lower miscarriage rate (fixed OR, 0.20; 95% CI, 0.05-0.76). Only 1 trial reported live birth as an outcome, and multiple pregnancy rates were poorly reported. Patient-reported adverse effects were mentioned in the studies, but reports were often incomplete. This review suggests the effectiveness of bromocriptine with clomiphene for infertility in

  11. Novel concepts in male infertility

    Directory of Open Access Journals (Sweden)

    Sandro C. Esteves

    2011-02-01

    Full Text Available Extraordinary advances have been achieved in the field of male infertility in the last decades. There are new concepts in sperm physiology and several modern tools for the assessment of spermatogenesis kinetics in vivo. New tests using molecular biology and DNA damage assays allow the clinician to correctly diagnose men so far classified as having idiopathic male infertility. In the field of treatment, microsurgery has increased success rates either for reconstruction of the reproductive tract or the retrieval of spermatozoa for assisted conception. Emerging evidence suggests that life-style and environmental conditions are of utmost importance in male fertility and subfertility. This review discusses several concepts that have changed over the last years, such as the duration of the spermatogenic cycle in humans, Y-chromosome infertility, the reproductive potential of non-mosaic Klinefelter syndrome men, the impact of paternal age and sperm DNA in male infertility, the role of antioxidants in the treatment of infertile men, the predictive factors and techniques for sperm retrieval in non-obstructive azoospermia, and the microsurgical treatment of clinical varicoceles. Whenever possible, levels of evidence are provided as suggested by the Oxford Center of Evidence-based Medicine.

  12. Is Infertility Associated with Childhood Autism?

    Science.gov (United States)

    Grether, Judith K.; Qian, Yinge; Croughan, Mary S.; Wu, Yvonne W.; Schembri, Michael; Camarano, Loretta; Croen, Lisa A.

    2013-01-01

    Concerns persist about a possible link between infertility and risk of autism spectrum disorders (ASD). Interpretation of existing studies is limited by racial/ethnic homogeneity of study populations and other factors. Using a case-control design, we evaluated infertility history and treatment documented in medical records of members of Kaiser…

  13. Is Infertility Associated with Childhood Autism?

    Science.gov (United States)

    Grether, Judith K.; Qian, Yinge; Croughan, Mary S.; Wu, Yvonne W.; Schembri, Michael; Camarano, Loretta; Croen, Lisa A.

    2013-01-01

    Concerns persist about a possible link between infertility and risk of autism spectrum disorders (ASD). Interpretation of existing studies is limited by racial/ethnic homogeneity of study populations and other factors. Using a case-control design, we evaluated infertility history and treatment documented in medical records of members of Kaiser…

  14. Exploration of Infertile Couples’ Support Requirements: A Qualitative Study

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    Fatemeh Jafarzadeh-Kenarsari

    2015-04-01

    Full Text Available Background: Due to high prevalence of infertility, increasing demand for infertility treatment, and provision of high quality of fertility care, it is necessary for healthcare professionals to explore infertile couples’ expectations and needs. Identification of these needs can be a prerequisite to plan the effective supportive interventions. The current study was, therefore, conducted in an attempt to explore and to understand infertile couples’ experiences and needs. Materials and Methods: This is a qualitative study based on a content analysis approach. The participants included 26 infertile couples (17 men and 26 women and 7 members of medical personnel (3 gynecologists and 4 midwives as the key informants. The infertile couples were selected from patients attending public and private infertility treatment centers and private offices of infertility specialists in Isfahan and Rasht, Iran, during 2012-2013. They were selected through purposive sampling method with maximum variation. In-depth unstructured interviews and field notes were used for data gathering among infertile couples. The data from medical personnel was collected through semi-structured interviews. The interview data were analyzed using conventional content analysis method. Results: Data analysis revealed four main categories of infertile couples’ needs, including: i. Infertility and social support, ii. Infertility and financial support, iii. Infertility and spiritual support and iv. Infertility and informational support. The main theme of all these categories was assistance and support. Conclusion: The study showed that in addition to treatment and medical needs, infertile couples encounter various challenges in different emotional, psychosocial, communicative, cognitive, spiritual, and economic aspects that can affect various areas of their life and lead to new concerns, problems, and demands. Thus, addressing infertile couples’ needs and expectations alongside their

  15. Genetic aspects of male infertility

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    Bartosz Witczak

    2015-01-01

    Full Text Available Currently, infertility affects up to 140 million people worldwide. It is considered that the male factor is responsible for nearly a half of problems in obtaining pregnancy. Increasingly, infertility treatment clinics, as well as standard examinations, also offer genetic tests in the diagnostics of the male infertility factor, such as: karyotype analysis, detection of Y chromosome microdeletions, and examination of the chromosome composition of sperm by the fluorescent in situ hybridisation method (FISH. Genetic factors, defined to date, which cover both chromosomal aberrations and monogenic disorders, are responsible for approximately 10–15% of cases of male infertility. Usually, their phenotypic manifestations are disorders in spermatogenesis, structural changes in the genital organs (e.g. reduced size of the testicles, or sperm dysfunction. Molecular studies intensively carried out in the area of diagnostics and treatment of infertility indicate an increasingly large number of relationships between genetic factors and fertility; however, many genes related with human fertility still remain unidentified.

  16. REVIEW ARTICLE: Infertility and Environment

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    Siddhartha Chatterjee

    2012-01-01

    Full Text Available Environment is coming up as one of the causative factors for many physical and mental diseases. Infertility is not only a medicalproblem; it is a social and psychological problem as well. Air and soil pollutions are disturbing the male and female reproductiveprocesses in various ways. Endocrine disruptors otherwise called Estrogen Mimics not only induce endometriosis, but can influence the reproductive process by competing with estrogen receptors. Insecticides and environmental toxicants also disrupt the reproductive process. Psychological stress is an important factor for infertility. This is also a stimulating factor for many gynecological conditions like Polycystic Ovary Syndrome (PCOS. In treating the infertile couples, psychological treatment & support areof equal importance as that of medical treatment.

  17. Genetics of human male infertility.

    Science.gov (United States)

    Poongothai, J; Gopenath, T S; Manonayaki, S

    2009-04-01

    Infertility is defined as a failure to conceive in a couple trying to reproduce for a period of two years without conception. Approximately 15 percent of couples are infertile, and among these couples, male factor infertility accounts for approximately 50 percent of causes. Male infertility is a multifactorial syndrome encompassing a wide variety of disorders. In more than half of infertile men, the cause of their infertility is unknown (idiopathic) and could be congenital or acquired. Infertility in men can be diagnosed initially by semen analysis. Seminograms of infertile men may reveal many abnormal conditions, which include azoospermia, oligozoospermia, teratozoospermia, asthenozoospermia, necrospermia and pyospermia. The current estimate is that about 30 percent of men seeking help at the infertility clinic are found to have oligozoospermia or azoospermia of unknown aetiology. Therefore, there is a need to find the cause of infertility. The causes are known in less than half of these cases, out of which genetic or inherited disease and specific abnormalities in the Y chromosome are major factors. About 10-20 percent of males presenting without sperm in the ejaculate carry a deletion of the Y chromosome. This deleted region includes the Azoospermia Factor (AZF) locus, located in the Yq11, which is divided into four recurrently deleted non-overlapping subregions designated as AZFa, AZFb, AZFc and AZFd. Each of these regions may be associated with a particular testicular histology, and several candidate genes have been found within these regions. The Deleted in Azoospermia (DAZ) gene family is reported to be the most frequently deleted AZF candidate gene and is located in the AZFc region. Recently, a partial, novel Y chromosome 1.6-Mb deletion, designated "gr/gr" deletion, has been described specifically in infertile men with varying degrees of spermatogenic failure. The DAZ gene has an autosomal homologue, DAZL (DAZ-Like), on the short arm of the chromosome 3 (3

  18. INVO Procedure: Minimally Invasive IVF as an Alternative Treatment Option for Infertile Couples

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    Elkin Lucena

    2012-01-01

    Full Text Available Intravaginal culture (IVC, also called INVO (intravaginal culture of oocytes, is an assisted reproduction procedure where oocyte fertilization and early embryo development are carried out within a gas permeable air-free plastic device, placed into the maternal vaginal cavity for incubation. In the present study we assessed the outcome of the INVO procedure, using the recently designed INVOcell device, in combination with a mild ovarian stimulation protocol. A total of 125 cycles were performed. On average 6.5 oocytes per cycle were retrieved, and a mean of 4.2 were placed per INVOcell device. The cleavage rate obtained after the INVO culture was 63%. The procedure yielded 40%, 31.2%, and 24% of clinical pregnancy, live birth, and single live birth rates per cycle, respectively. Our results suggest that the INVO procedure is an effective alternative treatment option in assisted reproduction that shows comparable results to those reported for existing IVF techniques.

  19. Exploration of Infertile Couples’ Support Requirements: A Qualitative Study

    OpenAIRE

    Fatemeh Jafarzadeh-Kenarsari; Ataollah Ghahiri; Mojtaba Habibi; Ali Zargham-Boroujeni

    2015-01-01

    Background: Due to high prevalence of infertility, increasing demand for infertility treatment, and provision of high quality of fertility care, it is necessary for healthcare professionals to explore infertile couples’ expectations and needs. Identification of these needs can be a prerequisite to plan the effective supportive interventions. The current study was, therefore, conducted in an attempt to explore and to understand infertile couples’ experiences and needs. Materi...

  20. The prevalence of ureaplasma urealyticum, mycoplasma hominis, chlamydia trachomatis and neisseria gonorrhoeae infections, and the rubella status of patients undergoing an initial infertility evaluation

    Science.gov (United States)

    Imudia, Anthony N.; Detti, Laura; Puscheck, Elizabeth E.; Yelian, Frank D.

    2008-01-01

    Purpose To determine the prevalence of positive test for Ureaplasma urealyticum (UU), Mycoplasma hominis (MH), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) infections, and their corresponding Rubella status when undergoing workup for infertility. Methods Retrospective chart review to determine infection status for UU, MH, CT, and NG as determined by cervical swab, as well as the serum Rubella antibody titer. Results A total of 46 patients of the patients reviewed were positive for UU (20.1%), three patients were positive for MH (1.3%), five patients were positive for CT (2.2%) and one patient was positive for NG (0.4%). Rubella immunity was confirmed in 90.3% of patients. Conclusion Approximately one quarter of women presenting to an infertility clinic seeking to conceive were found to have a positive test for UU, MH, CT or NG infection. Additionally, almost 10% of the patients were Rubella non-immune at the time of presentation for infertility evaluation. PMID:18202910

  1. Cognitive coping, goal adjustment, and depressive and anxiety symptoms in people undergoing infertility treatment : a prospective study

    NARCIS (Netherlands)

    Kraaij, V.; Garnefski, N.; Schroevers, M.J.; Weijmer, J.; Helmerhorst, F.

    2010-01-01

    The relationships between cognitive coping strategies, goal adjustment, and symptoms of depression and anxiety were studied in people with fertility problems. Both cross-sectional and prospective relationships were studied in a sample of 313 patients attending an infertility clinic. Self-report ques

  2. Cognitive Coping, Goal Adjustment, and Depressive and Anxiety Symptoms in People Undergoing Infertility Treatment A Prospective Study

    NARCIS (Netherlands)

    Kraaij, Vivian; Garnefski, Nadia; Schroevers, Maya J.; Weijmer, Janneke; Helmerhorst, Frans

    2010-01-01

    The relationships between cognitive coping strategies, goal adjustment, and symptoms of depression and anxiety were studied in people with fertility problems. Both cross-sectional and prospective relationships were studied in a sample of 313 patients attending an infertility clinic. Self-report ques

  3. Experiencing Male Infertility

    Directory of Open Access Journals (Sweden)

    Esmée Hanna

    2015-10-01

    Full Text Available This article examines the qualitative research literature that exists in relation to men’s experiences of male infertility. Since men have often been marginalized in the realm of reproduction, including academic research on infertility, it is important to focus on any qualitative research that gives voices to male perspectives and concerns. Given the distress documented by studies of infertile women, we focus in particular on the emotive responses and lived experiences of men in relation to infertility. In this article then, we present an analysis of the core themes across 19 qualitative articles, which include “infertility as crisis”; “emoting infertility- men as “being strong”’ “infertility as a source of stigma”; and the “desire for fatherhood.” In light of these insights, we identify key areas for future research and development including men’s emotional responses to infertility, how men seek support for infertility, the intersection between masculinity and infertility, the relationship between the desire to father and infertility, and the outcomes of infertility for men in terms of other aspects of their lives. We suggest that such research would facilitate making the experiences of men more central within our understandings of infertility within a field that has primarily been female focused.

  4. Knowledge, attitude, and practices of infertility among Saudi couples

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    Abolfotouh MA

    2013-07-01

    treatment by 6.7% and 44.2% of IVF patients, respectively. Compared with fertile patients, IVF patients were significantly less likely to favor divorce (38.5% versus 57.6%; P = 0.001 or marriage to a second wife (62.5% versus 86.2%; P < 0.001, if the woman could not have a baby. The patients with infertility had more favorable attitudes toward fertility drugs (87.5% versus 68.4%; P = 0.003 and having a test tube baby (92.4% versus 70.3%; P < 0.001. Child adoption was accepted as an option for treatment by the majority of IVF patients (60.6% and fertile outpatients (71.5%. Alternative treatments previously practiced by the IVF patients to improve fertility include practicing Ruqia (61%, using alternative medicine (42%, engaging in physical exercise (39%, eating certain foods (22%, and quitting smoking (12%. Conclusion: These findings have implications for health care providers regarding the reluctance that couples experiencing fertility problems may have, at least initially, to accept some interventions required for the couple to conceive. Keywords: infertility, knowledge, attitude, practice, KAP, misconceptions

  5. Women's beliefs about infertility and sexual behaviors: A qualitative study.

    Science.gov (United States)

    Bokaie, Mahshid; Simbar, Masoumeh; Ardekani, Seyed Mojtaba Yassini; Majd, Hamid Alavi

    2016-01-01

    Infertility is a reproductive health problem and its prevalence is increasing in developing countries. This problem has some significant effects on the sexual behaviors of infertile women, especially during infertility treatment periods. Discovering the existing beliefs in the field of sexual and reproductive health and also determining the misconceptions would define the educational needs for providing sexual health programs for infertile women. Women should be able to distinguish risky behaviors from healthy behaviors that falsely have been marked as infertility-related behaviors. This qualitative study was conducted to determine women's beliefs about infertility and sexual behaviors among Iranian infertile women. The present study was a qualitative conventional content analysis study conducted on 15 infertile women and 8 key informants until reaching data saturation. Guba and Lincoln evaluative criteria were used for ensuring rigor of the study. Data analysis defined three classes of beliefs that directly or indirectly affected sexual behaviors in infertile women: 1) Cultural, religious, or ethnic beliefs, 2) believing in the effect of diet on infertility, and 3) effect of the type of intercourse on getting pregnant. Three themes of religious, cultural, and ethnic beliefs, believing in the effect of diet on infertility, and the effect of the type of intercourse were the most important factors indicating sexual behaviors among infertile women. It seems that cultural and social matters are the most effective factors on sexual behaviors of infertile Iranian women.

  6. Primary infertility (image)

    Science.gov (United States)

    Primary infertility is a term used to describe a couple that has never been able to conceive a pregnancy ... to do so through unprotected intercourse. Causes of infertility include a wide range of physical as well ...

  7. Treating polycystic ovary syndrome and infertility.

    Science.gov (United States)

    McFarland, Cameron

    2012-01-01

    Between 4% and 18% of women worldwide are affected by polycystic ovary syndrome (PCOS) and have the hormonal imbalances that lead to the cascade of symptoms, including weight gain and obesity. One of the first suggested treatments for infertility associated with PCOS is weight reduction, which has been shown to increase the chance of spontaneous ovulation and menstruation. Pharmacologic treatment usually includes metformin alone or in conjunction with clomiphene; both have been shown to increase conception rates and decrease risk of preeclampsia once pregnancy is achieved. Limited research has been published about the efficacy of oral contraceptives in producing conception. If pregnancy still eludes women with PCOS after initial pharmacologic treatments, gonadotropin therapy by itself or in conjunction with assisted reproductive therapy is considered. These treatments come with higher expense, and increased risk, and require extensive counseling prior to implementation. Additional research is needed to better understand what risks exist for pregnant women with PCOS and for their newborns.

  8. [HYPERBARIC OXYGEN THERAPY IN THE TREATMENT OF MALE INFERTILITY ASSOCIATED WITH INCREASED SPERM DNA FRAGMENTATION AND REACTIVE OXYGEN SPECIES IN SEMEN].

    Science.gov (United States)

    Metelev, A Yu; Bogdanov, A B; Ivkinl, E V; Mitrokhin, A A; Vodneva, M M; Veliev, E I

    2015-01-01

    The aim of this study was to explore the potential of hyperbaric oxygenation (HBO) for reduction of sperm DNA fragmentation level and reactive oxygen species (ROS) in semen. The study included 90 men with idiopathic infertility. Patients of the treatment group (n = 60) underwent HBO before the vitro fertilization (IVF) procedure. In the control group (n = 30) IVF was carried out without prior cours of HBO. Sperm DNA fragmentation analysis was carried out using the TUNEL assay, the level of ROS in the ejaculate was measured by chemiluminescence. HBO treatment resulted in a significant decrease in the mean level of sperm DNA fragmentation from 33.2 ± 7.5 to 11.9 ± 5.9%, and the median ROS in sperm from 0.89 to 0.39 mV/s (p < 0.05). In the control group these changes were not statistically significant. Pregnancy after IVF occurred in 63.3% (38/60) of sexual partners of the treatment group men and in 36.7% (11/30) of the control group (p < 0.05). The high efficiency of HBO in overcoming the adverse effects of oxidative stress on sperm parameters allows us to consider it as a promising method for the treatment of men with idiopathic infertility.

  9. A cost-effectiveness evaluation comparing originator follitropin alfa to the biosimilar for the treatment of infertility

    Directory of Open Access Journals (Sweden)

    Gizzo S

    2016-12-01

    biosimilar. Sensitivity analyses confirmed the results of the base case model. Conclusion: This analysis indicated that the originator FSH is a cost-efficient treatment strategy for Italian and Spanish health services compared to the biosimilar and it would be worthwhile extending this evaluation to other countries. Keywords: FSH, follitropin alfa, biosimilar, infertility

  10. Prevalence of Infertility Problems among Iranian Infertile Patients Referred to Royan Institute

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    Mahdi Sepidarkish

    2016-09-01

    Full Text Available Background: Few studies have been conducted on the infertility problems in Iran. This study aimed to investigate the prevalence of infertility problems and related factors in Iranian infertile patients. Materials and Methods: In this cross sectional study, 405 infertile patients referred to Royan Institute, Tehran, Iran, between 2014 and 2015, were selected by simple random sampling. Participants completed the Fertility Problem Inventory (FPI including 46 questions in five domains (social concern, sexual concern, relationship concern, rejection of parenthood, and need for parenthood. Mean difference between male and female was verified using independent-samples Student’s t test. A generalized linear model (GLM was also used for testing the effect of variables on the fertility problems. Data was analyzed using Stata software version 13. Results: The mean age (SD of participants was 31.28 (5.42. Our results showed that 160 infertile men (95.23% were classified as very high prevalence of infertility problems. Among infertile women, 83 patients (35.02% were as very high prevalence of infertility problems, and 154 patients (64.98% were as high prevalence. Age (P<0.001, sex (P<0.001, a history of abortion (P=0.009, failure of previous treatment (P<0.001, and education (P=0.014 had a significant relationship with FPI scores. Conclusion: Bases on the results of current study, an younger male with lower education level, history of abortion and history of previous treatments failure experienced more infertility problems.

  11. General aspects of fertility and infertility.

    Science.gov (United States)

    Damario, Mark A

    2014-01-01

    Fertility rates have been declining in most Western nations over the past several decades, although it is not entirely clear if an increased rate of infertility substantially contributes to this. As compared to other species, the reproductive efficiency of humans is relatively low. Factors related to fertility include age, exposure to sexually transmitted diseases, frequency of intercourse, coital timing, as well as diet and lifestyle habits. Infertility is considered a disease due to its major disruption of major organ systems and life functions. An infertility evaluation is recommended after 12 months or more of regular, unprotected intercourse and may be considered after 6 months for those female patients over the age of 35 or with other known abnormalities. A proper infertility evaluation is a comprehensive examination of possibly identifiable infertility factors of both female and male partners, lending itself to the most appropriate and potentially effective treatment.

  12. Early Marriage: a Policy for Infertility Prevention

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Karimzadeh

    2008-06-01

    Full Text Available Female fertility begins to decline many years prior to the onset of menopause despite continued regular ovulatory cycles. Age related infertility is due to oocyte abnormalities and decreased ovarian reserve. Treatment of infertility when the cause is limited to decreased ovarian reserve is empirical at present except for oocyte donation. This mini review of the literature covers all available English biomedical journals that have been published from 1995 to 2008. The search based on combination of the words age, fertility, infertility, and oocyte abnormalities. The important findings from this search strategy are summarized and presented in the sub headings including female age and fertility, miscarriage and in vitro fertilization. Regarding infertility prevention, this mini review suggested that early marriage is a primordial, effective, inexpensive and easy way to prevent infertility.

  13. SERUM PROLACTIN ASSAY: AN IMPORTANT SCREENING METHOD IN PRIMARY AND SECONDARY INFERTILITY IN FEMALE

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    Sanjaya

    2016-02-01

    Full Text Available BACKGROUND Infertility represents a common condition nowadays with important medical, economic and psychological implications. Traditionally, measurement of Prolactin has been considered an important component of infertility workup in women. AIMS The study was designed to evaluate the serum prolactin assay in patients with primary and secondary infertility. METHOD In this retrospective case control study, we investigated one fifty (150 infertile women in the age range of 20-40 years attending Department of Obs. and Gynae. MLB Medical College, Jhansi, for infertility treatment. Fifty (50 fertile women with similar age range were selected as controls. The association between infertility and levels of serum Prolactin was reviewed. RESULTS Hyperprolactinemia was depicted in 24.66% infertile women. Prevalence of primary infertility was 68%, while that of secondary infertility cases was 32%. There was a correlation between Prolactin levels in infertile subjects (p <0.05. CONCLUSION There was higher prevalence of hyperprolactinemia in infertile patients

  14. [Evaluation of endometriosis fertility index in follow-up treatment of endometriosis combined with infertility patients after laparoscopic surgery].

    Science.gov (United States)

    Qian, R Y; Wu, X; Sheng, J; Zheng, P; Zhou, Q; Duan, A H; Zhang, J P; Zhang, Y L; Lu, D

    2017-04-25

    Objective: To explore the application of endometriosis fertility index (EFI) in guidance after laparoscopic surgery of endometriosis patients combined with infertility and to explore methods to improve pregnancy rate in different EFI groups. Methods: A prospective research was done in endometriosis patients combined with infertility in Beijing Obstetrics and Gynecology Hospital from January 2010 to June 2011, after laparoscopic surgery, these 146 patients were divided into 3 groups by EFI score. Using different pregnancy guidance, these patients had 5 years follow-up. Results: (1) The 5 years overall pregnancy rate was 89.0% (130/146). The pregnancy rate was 95.7% (45/47) in EFI≥9 group, 92.8% (77/83) in EFI 5-8 group and 8/16 in EFI≤4 group, three groups were all reach satisfactory pregnancy rate; the rate of the first two groups had no statistically significance (P=0.498), but had significant difference with the last group (Pinfertility after laparoscopic surgery. EFI score guidance, strict post-operation management and positive pregnancy scheme could significantly improve the pregnancy rate of endometriosis patients with infertility.

  15. Primary appraisal of infertility: evaluation of the psychometric properties of a Greek version of the Appraisal of Life Events scale (ALE) in a Sample of infertile women undergoing fertility treatment.

    Science.gov (United States)

    Gourounti, Kleanthi; Anagnostopoulos, Fotios; Vaslamatzis, Grigorios

    2010-10-01

    The Appraisal of Life Events is a self-report questionnaire that can be used retrospectively, asking respondents to reflect on the impact of a previously experienced event. The aim of this study was to examine the psychometric properties of the Greek version of the Appraisal of Life Events scale. The sample consisted of 137 women facing fertility problems and undergoing fertility treatment in a public hospital in Athens, Greece. The Appraisal of Life Events was 'forward-backward' translated from English to Greek language and was then pilot-tested to determine comprehensibility. Factor structure was investigated using exploratory factor analysis. Measures of stress (infertility-related stress, anxiety, depressive symptoms, mood states), personality traits (neuroticism, extraversion, optimism) and coping strategies were used to assess the convergent validity of the Appraisal of Life Events. Cronbach's α was used to measure internal consistency reliability. Two Appraisal of Life Events factors emerged from exploratory factor analysis. The threat and loss items were grouped together to form one factor. The original subscale of the challenge appraisal was reproduced. Convergent validity was confirmed by computing correlations between the two derived Appraisal of Life Events scales and the measures of stress, personality traits, and coping strategies. Internal consistency reliability was satisfactory (α = .79-.95). The Appraisal of Life Events had a meaningful factor structure and satisfactory reliability and convergent validity.

  16. Mucuna pruriens Reduces Stress and Improves the Quality of Semen in Infertile Men

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    Kamla Kant Shukla

    2010-01-01

    Full Text Available The present investigation was undertaken to assess the role of Mucuna pruriens in infertile men who were under psychological stress. Study included 60 subjects who were undergoing infertility screening and were found to be suffering from psychological stress, assessed on the basis of a questionnaire and elevated serum cortisol levels. Age-matched 60 healthy men having normal semen parameters and who had previously initiated at least one pregnancy were included as controls. Infertile subjects were administered with M. pruriens seed powder (5 g day−1 orally. For carrying out morphological and biochemical analysis, semen samples were collected twice, first before starting treatment and second after 3 months of treatment. The results demonstrated decreased sperm count and motility in subjects who were under psychological stress. Moreover, serum cortisol and seminal plasma lipid peroxide levels were also found elevated along with decreased seminal plasma glutathione (GSH and ascorbic acid contents and reduced superoxide dismutase (SOD and catalase activity. Treatment with M. pruriens significantly ameliorated psychological stress and seminal plasma lipid peroxide levels along with improved sperm count and motility. Treatment also restored the levels of SOD, catalase, GSH and ascorbic acid in seminal plasma of infertile men. On the basis of results of the present study, it may be concluded that M. pruriens not only reactivates the anti-oxidant defense system of infertile men but it also helps in the management of stress and improves semen quality.

  17. Matrix Metalloproteinases 2 and 9 and E-Cadherin Expression in the Endometrium During the Implantation Window of Infertile Women Before In Vitro Fertilization Treatment

    Science.gov (United States)

    Rocha, Andre M.; Ferreira, Fernando P.; Bonetti, Tatiana C. S.; Serafini, Paulo; Motta, Eduardo L. A.

    2014-01-01

    Objective: To evaluate the expression of endometrial matrix metalloproteinases (MMPs) 2 and 9 and E-cadherin in peri-implantation phase of infertile women who have undergone in vitro fertilization (IVF) cycles. Methods: This prospective study included 51 patients who underwent endometrial biopsy during the receptive phase in a menstrual cycle prior to IVF treatment. The samples were evaluated by tissue microarray for immunohistochemical study. Results: The expression of MMP-2, MMP-9, and E-cadherin in the endometrium prior to IVF treatment was not associated with pregnancy. There was a decrease in E-cadherin immunodetection, the higher the age of the patients, a negative relationship between E-cadherin and MMP-2, and a positive association between MMP-9 and E-cadherin. Conclusions: The MMP-2, MMP-9, and E-cadherin are expressed in the endometrium of infertile patients during the receptive phase of the natural menstrual cycle. However, there is no correlation between the expression of these molecules and the clinical IVF outcomes. PMID:24700054

  18. 毓麟珠治疗多囊卵巢不孕症的临床观察%Clinical Observation on the Treatment of Polycystic Ovarian Infertility with Yulinzhu

    Institute of Scientific and Technical Information of China (English)

    宫润莲

    2015-01-01

    目的观察毓麟珠治疗多囊卵巢不孕症的临床疗效。方法将不孕症患者进行综合检查,排除其他因素影响,诊断患者不孕症为多囊卵巢综合征所引起。结果毓麟珠在治疗多囊卵巢不孕症中取得了较好的疗效。结论毓麟珠治疗多囊卵巢不孕症安全有效。%Objective To observe the clinical curative ef ect of Yulin bead treatment of polycystic ovarian infertility. Methods The patients with infertility comprehensive examination, excluding the impact of other factors, the diagnosis of infertility caused by polycystic ovary syndrome. Results The Unicorn bead achieved good curative ef ect in the treatment of polycystic ovarian infertility. Conclusion The Unicorn bead is safe and ef ective in the treatment of polycystic ovarian infertility.

  19. Prevalence and predictors of infertility-specific stress in women diagnosed with primary infertility: A clinic-based study

    Directory of Open Access Journals (Sweden)

    Ansha Patel

    2016-01-01

    Full Text Available BACKGROUND: According to the existing literature on infertility, stress appears to be inevitably associated with infertility diagnosis and treatment in sub-fertile individuals. The epidemiological data on the prevalence and predictors of infertility-specific stress in cultural specific scenario are scarce. The objective of the present study was to estimate the prevalence of infertility-specific stress and identify predictors of infertility-specific stress in women diagnosed with primary infertility. MATERIALS AND METHODS: This cross-sectional study was conducted on 300 infertile married women, diagnosed with primary infertility. The tools used for the assessment were “semi-structured questionnaire ” compiled by the authors, “ICD-10 Classification of Mental and Behavioral Disorders (Clinical Descriptions and Diagnostic Guidelines, ” and “Psychological Evaluation Test for infertility. ” STATISTICAL ANALYSIS: Data were analyzed using SPSS (version 15. Chi-square test was used for univariate analysis followed by multiple logistic regressions between stress and the predictor variables. RESULTS AND DISCUSSION: The prevalence of stress among women was 80%. Univariate analysis revealed that predictors of stress were years of marital life, duration of infertility, infertility type, history of gynecological surgery, cycles of ovulation induction with timed intercourse and intra-uterine inseminations, present and past psychiatric morbidity, coping difficulties, gynecological diagnosis, and severity of premenstrual dysphoria. Multivariate analysis showed leading associations of stress with infertility type and coping difficulties.

  20. Use of the internet related to infertility by infertile women and men in Turkey.

    Science.gov (United States)

    Satir, Duygu Gulec; Kavlak, Oya

    2017-01-01

    To determine differences in use of the Internet related to infertility between infertile women and men, whether they benefit or are negatively affected from information on the Internet, and share this information with health professional. This cross-sectional study was carried out with 285 infertile women and 158 men between December 2015 and February 2016. Data were collected by a survey Form which included questions related to sociodemographic characteristics, related to infertility (duration of treatment, type of treatment) and questions about use of the Internet. Chi-square analysis was used to evaluate the differences in Internet use and independent variables for patients. Seventy-four percent of women and 68.4% of men used the Internet related to infertility. Women and men most often looked for information related to assisted reproductive technology and the causes of infertility. Men searched for information related to fertility drugs used in treatment significantly less than women. They often visited the websites of fertility centers and doctors. A high percentage of them have benefited from information on the Internet. Almost half of the women and men shared the information obtained from the Internet with health professional. Most frequently, infertile patients use the Internet to obtain information related to infertility and they benefited from information on the Internet. For health professional it is important to direct Internet users to safe and true information resources.

  1. Psychological and social aspects of infertility in men:an overview of the evidence and implications for psychologically informed clinical care and future research

    Institute of Scientific and Technical Information of China (English)

    Jane RW Fisher; Karin Hammarberg

    2012-01-01

    Research concerning the psychosocial aspects of infertility and infertility treatment focuses more often on women than men.The aim of this review was to synthesize the English-language evidence related to the psychological and social aspects of infertility in men and discuss the implications of these reports for clinical care and future research.A structured search identified 73 studies that reported data concerning the desire for fatherhood and the psychological and social aspects of diagnosis,assisted reproductive technology (ART) treatment and unsuccessful treatment among men with fertility difficulties.The studies are diverse in conceptualisation,design,setting and data collection,but the findings were reasonably consistent.These studies indicated that fertile and infertile childless men of reproductive age have desires to experience parenthood that are similar to those of their female counterparts; in addition,diagnosis and initiation of treatment are associated with elevated infertility-specific anxiety,and unsuccessful treatment can lead to a state of lasting sadness.However,rates of clinically significant mental health problems among this patient population are no higher than in the general population.Infertile men who are socially isolated,have an avoidant coping style and appraise stressful events as overwhelming,are more vulnerable to severe anxiety than men without these characteristics.Men prefer oral to written treatment information and prefer to receive emotional support from infertility clinicians rather than from mental health professionals,self-help support groups or friends.Nevertheless,structured,facilitated psycho-educational groups that are didactic but permit informal sharing of experiences might be beneficial.There are gaps in knowledge about factors governing seeking,persisting with and deciding to cease treatment; experiences of invasive procedures; parenting after assisted conception; adoption and infertility-related grief and shame among

  2. Psychological and social aspects of infertility in men: an overview of the evidence and implications for psychologically informed clinical care and future research

    Science.gov (United States)

    Fisher, Jane RW; Hammarberg, Karin

    2012-01-01

    Research concerning the psychosocial aspects of infertility and infertility treatment focuses more often on women than men. The aim of this review was to synthesize the English-language evidence related to the psychological and social aspects of infertility in men and discuss the implications of these reports for clinical care and future research. A structured search identified 73 studies that reported data concerning the desire for fatherhood and the psychological and social aspects of diagnosis, assisted reproductive technology (ART) treatment and unsuccessful treatment among men with fertility difficulties. The studies are diverse in conceptualisation, design, setting and data collection, but the findings were reasonably consistent. These studies indicated that fertile and infertile childless men of reproductive age have desires to experience parenthood that are similar to those of their female counterparts; in addition, diagnosis and initiation of treatment are associated with elevated infertility-specific anxiety, and unsuccessful treatment can lead to a state of lasting sadness. However, rates of clinically significant mental health problems among this patient population are no higher than in the general population. Infertile men who are socially isolated, have an avoidant coping style and appraise stressful events as overwhelming, are more vulnerable to severe anxiety than men without these characteristics. Men prefer oral to written treatment information and prefer to receive emotional support from infertility clinicians rather than from mental health professionals, self-help support groups or friends. Nevertheless, structured, facilitated psycho-educational groups that are didactic but permit informal sharing of experiences might be beneficial. There are gaps in knowledge about factors governing seeking, persisting with and deciding to cease treatment; experiences of invasive procedures; parenting after assisted conception; adoption and infertility

  3. Ketotifen, a mast cell blocker improves sperm motility in asthenospermic infertile men

    Directory of Open Access Journals (Sweden)

    Nasrin Saharkhiz

    2013-01-01

    Full Text Available Aim: This study aimed to evaluate the efficacy of ketotifen on sperm motility of asthenospermic infertile men. Setting and Design: It is a prospective study designed in vivo. Materials and Methods: In this interventional experimental study, a total of 40 infertile couples with asthenospermic infertility factor undergoing assisted reproductive technology (ART cycles were enrolled. The couples were randomly assigned to one of two groups at the starting of the cycle. In control group (n = 20, the men did not receive Ketotifen, while in experiment group (n = 20, the men received oraly ketotifen (1 mg Bid for 2 months. Semen analysis, under optimal circumferences, was obtained prior to initiation of treatment. The second semen analysis was done 2-3 weeks after stopped ketotifen treatment and sperm motility was defined. Clinical pregnancy was identified as the presence of a fetal sac by vaginal ultrasound examination. Statistical Analysis Used: All data are expressed as the mean ± standard error of mean (SEM. t test was used for comparing the data of the control and treated groups. Results: The mean sperm motility increased significantly (from 16.7% to 21.4% after ketotifen treatment (P < 0.001. This sperm motility improvement was more pronounced in the primary infertility cases (P < 0.003. The rate of pregnancy was 12.5% in infertile couples that their men receiving 1 mg/twice a day ketotifen. In 52% of infertile men′s semen, the percentage of sperm motility was increased from 5% to 35% and this sperm motility improvement was also observed in 33% of necrospermia (0% motility cases. Conclusion: These results suggest that ketotifen may represent as a novel therapeutic approach to improve sperm motility in the infertile men with cause of asthenospermia or necrospermia.

  4. Sexual behavior of infertile women: a qualitative study

    Directory of Open Access Journals (Sweden)

    Mahshid Bokaie

    2015-10-01

    Full Text Available Background: Infertility makes an essential challenge to the sexual life of couples, especially infertile women. When pregnancy does not happen, infertile women think that sexual intercourse is not fruitful and sexual desire became reduce gradually. Infertile women progressively forget that their sexual relationship is also a response to their natural need. Objective: This qualitative study was conducted to explore the infertility consequences in the sexual behavior of infertile women. Materials and Methods: This was a qualitative content analysis study; and it was part of a widespread study, used a sequential mixed-method and conducted from August 2014 until February 2015. A purposeful sampling was used to recruit infertile women who had referred to Yazd Research and Clinical Center for Infertility. Data gathering techniques employed in this research included in-depth semi structured open face-to-face interviews and field notes. Credibility, transferability, confirm ability, and dependability were assessed for the rigor of the data collection. Results: Totally, 15 infertile women and 8 key informants were interviewed. Data analysis showed four themes about impact of infertility on female sexual behavior: 1/ Impact of infertility drugs on couple sexual behavior, 2/ Impact of assisted reproductive technologies on female sexual behavior, 3/ Timed intercourse during infertility and 4/ The psychological impact of infertility on sexual behavior. Conclusion: Some of Iranian infertile women could cope with their problems, but some of them were very affected by infertility drugs and assisted reproductive technologies procedures. Psychosexual counseling before medical treatment could help them to have a better sexual life.

  5. Psychological Factors Affecting Infertile Women

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    Sati Unal

    2010-10-01

    Full Text Available AIM: This study was performed to determine the psychological factors affecting infertile women presenting at the infertility outpatients department. METHOD: The sample of this cross-sectional study consisted of 344 women who presented at the IVF center of a special branch hospital or a university hospital, March 2008 through September 2008, as determined by the non-random sampling method. All participating women gave their informed consent. The data were collected using the Data Form that consisted of questions on socio-demographic features and the Infertility Distress Scale (IDS. In the results, percentages were provided along with the Kruskal-Wallis H, Mann-Whitney U and Spearman correlation tests. RESULTS: The mean IDS was 39.01±9.6. There was a statistically significant linear relationship between the mean IDS score and age (r=0.106, p=0.048, marriage duration (r=0.232, p<0.001 and duration of desire to have a child (r=0.217, p<0.001. Women who were primary school graduates (X²=13.03, p=0.004, did not work (p=0.007, had no social security benefits (p=0.021 or from low socioeconomic status (X²=24.85, p<0.001 had significantly higher mean IDS scores. CONCLUSION: The results of this study show women become more adversely affected by infertility as their age, duration of marriage, and duration of desire to have a child increase. Women who are primary school graduates, do not work, have no social security benefits or have lower income are affected more negatively. We believe that taking these features into account when evaluating and planning supportive approaches for women presenting at the infertility treatment center and determining the psychological state of the women using the IDS will increase treatment success. [TAF Prev Med Bull 2010; 9(5.000: 481-486

  6. The efficacy of biologically active peptides derived from prostate tissue of bulls, in the treatment of excretory-toxic infertility, complication of chronic abacterial prostatitis

    Directory of Open Access Journals (Sweden)

    O. A. Nikiforov

    2014-10-01

    Full Text Available Aim. The paper discusses aspects of the etiopathogenesis of chronic abacterial prostatitis, results of the treatment of 126 patients with this pathology. Methods and results. The patients were divided into II group. I group received usual therapy, group II – standard drugs plus group of biologically active peptides derived from prostate tissue of bulls that have reached sexual maturity. The results analysis shows that use of biologically active peptides derived from prostate tissue of bulls, the age of sexual maturity, allows to achieve the best results of treatment of patients with excretory-toxic infertility, that is complication of chronic abacterial prostatitis compared with the control group. Conclusion. This new drug use helps to achieve a stable clinical effect and enhance the performance of the ejaculate.

  7. Hysterosalpingography in Infertility

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    Masuda Islam Khan

    2014-01-01

    Full Text Available Background: Infertility is a common medical problem. It can be due to problems in either partner, or both. Ovulatory dysfunction, tubal and peritoneal factors comprise the majority of female factor for infertility. Hysterosalpingography (HSG plays an important role in the evaluation of abnormalities related to the uterus and fallopian tubes. Objective: The aim of this study was to evaluate the hysterosalpingographic findings of women with infertility in our setting. Materials and method: This cross sectional study was carried out in the infertility centre at BIRDEM, Dhaka, Bangladesh during the period of September 2002 to February 2003. Out of 100 infertile patients 50 infertile women of reproductive age (21-40 years indicated for HSG were enrolled in this study. Results: Sixty percent patients had secondary infertility. Majority of the subjects of both primary and secondary infertility (55% and 60% were in 26-30 years age group. On HSG any sort of uterine pathology was found in 10% cases and unilateral and bilateral tubal block were present in 24% and 20% cases respectively. Conclusion: Hysterosalpingography, a safe, less invasive procedure, has an important role in diagnosing uterine and tubal factors of infertility.

  8. Perspective in infertility: the ovarian stem cells.

    Science.gov (United States)

    Silvestris, Erica; D'Oronzo, Stella; Cafforio, Paola; D'Amato, Giuseppe; Loverro, Giuseppe

    2015-08-07

    Infertility is a medical and social condition that affects millions of women worldwide and is today considered so far as a new disease. A considerable progress has been recently pursued in the field of the reproductive medicine and the infertility treatment may account for novel and modern procedures such as in vitro oocyte fertilization, egg donation, pregnancy surrogacy and preimplantation diagnosis. However, great interest has lately been reserved to the ovarian stem cells (OSCs) whose existence in woman ovaries has been proven. OSCs are thus suitable for developmental studies in infertility and in other clinical applications as endocrine derangements due to premature ovarian failure, or for infertility treatment after cancer chemotherapies, as well as in restoring the hormonal balance in postmenopausal age.

  9. [Risk factors associated to female infertility].

    Science.gov (United States)

    Romero Ramos, Ricardo; Romero Gutiérrez, Gustavo; Abortes Monroy, Ignacio; Medina Sánchez, Héctor Gerardo

    2008-12-01

    Incidence of female infertility is growing worldwide and the its rate varies from 10 to 20%. It has been reported diverse risk factors associated with this medical complication. To identify the risk factors with significant association with female infertility. A case-control study was carried out. There were included 440 patients, divided into 220 women with primary or secondary female infertility (cases) and 220 women without infertility recruited at mediate postpartum (controls). Twenty sociodemographic and clinical risk factors for female infertility were analyzed. Statistical analysis was performed with percentages, arithmetic media, standard error, Student t test and chi squared. An alpha value was set at 0.05. There were 6 factors with statistical significance: advanced age (p < 0.001), elevated body mass index (p < 0.001), age of onset of sexual activity (p < 0.001), prior pelvic surgeries (p < 0.001), and presence of stress (p < 0.001). Other risk factors such as smoking, chemical and radiological treatments, pelvic inflammatory disease, exercise, contraceptive use, alcohol intake, drugs, coffee, solvents, glue and insecticides, were not significant. There are clinical and demographic risk factors associated with female infertility. Them identification in women at reproductive age could diminish the frequency of female infertility and, thus, avoid them consequences.

  10. Psychological interactions with infertility among women.

    Science.gov (United States)

    Cwikel, J; Gidron, Y; Sheiner, E

    2004-12-01

    Despite the fact that various studies have demonstrated the importance of the mind-body connection and fertility, the psychosocial aspects of infertility have not been adequately addressed. Fertility treatments, ranging from medical monitoring, to hormonal remedies and in vitro fertilization (IVF), are both a physical and emotional burden on women and their partners. Psychological factors such as depression, state-anxiety, and stress-induced changes in heart rate and cortisol are predictive of a decreased probability of achieving a viable pregnancy. A couple that is trying to conceive will undoubtedly experience feelings of frustration and disappointment if a pregnancy is not easily achieved. However, if the difficulties progress and the man and or woman are labelled as having fertility problems, then this may result in a severe insult to self-esteem, body image, and self-assessed masculinity or femininity. Three types of relationships have been hypothesized between psychological factors and infertility. These include: (1) psychological factors are risk factors of subsequent infertility; (2) the experience of the diagnosis and treatment of infertility causes subsequent psychological distress; (3) a reciprocal relationship exists between psychological factors and infertility. The evidence for these three relationships is reviewed and an alternative approach to the treatment of infertility including stress evaluation that precedes or is concurrent to fertility treatment is suggested.

  11. Anti-Müllerian hormone levels in salpingectomized compared with nonsalpingectomized women with tubal factor infertility and women with unexplained infertility

    DEFF Research Database (Denmark)

    Grynnerup, Anna Garcia-Alix Haugen; Lindhard, Anette; Sørensen, Steen

    2013-01-01

    To investigate the consequence of salpingectomy on ovarian reserve by measuring anti-Müllerian hormone (AMH) levels before in vitro fertilization (IVF) treatment in salpingectomized women compared with nonsalpingectomized women with tubal factor infertility, women with unexplained infertility and...

  12. Dream changes following initiation of efavirenz treatment.

    Science.gov (United States)

    Velasco, María; Pareja, Juan Antonio; Losa, Juan Emilio; Valverde, José Francisco; Espinosa, Alfredo; Gujarro, Carlos

    2011-02-12

    The objective was to evaluate abnormalities in the quality of dreams after the use of efavirenz. Ten HIV patients without neuropsychiatric diseases underwent a polisomnography (PSG) study before and after efavirenz treatment, [after 10.4 (SD 5.4) days]. Patients were awoke after REM phases to record their dreams. All patients had therapeutic efavirenz plasma levels. Dreams were recalled in 84% before efavirenz and 43% after efavirenz (p=0.024). There were no differences in the mean number of words per dream before and after efavirenz treatment (61.9 versus 47.5, p=0.115). The proportion of dreams with no neutral emotional content (either pleasant or unpleasant) was 37.5% in the first night and 66.7% in the second night (p=0.046). There were a higher proportion of dreams with no neutral emotional content after efavirenz treatment in this group of patients. However, no longer dreams and no more dreams with negative emotional content were noted. Dream recall was lower after efavirenz treatment. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  13. Parental infertility and cerebral palsy in children

    DEFF Research Database (Denmark)

    Zhu, Jin Liang; Hvidtjørn, Dorte; Basso, Olga

    2010-01-01

    Children born after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) have been reported to have a higher risk of cerebral palsy (CP), perhaps due to the higher frequency of preterm birth, multiple births or vanishing embryo in the pregnancies. However, it has been suggested...... that the underlying infertility may be part of the pathway. In this study, we examined whether untreated subfecundity (measured by time to pregnancy) or infertility treatment was associated with an increased risk of CP in the offspring....

  14. Perspective in infertility: the ovarian stem cells

    OpenAIRE

    SILVESTRIS, ERICA; D’Oronzo, Stella; Cafforio, Paola; D’Amato, Giuseppe; Loverro, Giuseppe

    2015-01-01

    Infertility is a medical and social condition that affects millions of women worldwide and is today considered so far as a new disease. A considerable progress has been recently pursued in the field of the reproductive medicine and the infertility treatment may account for novel and modern procedures such as in vitro oocyte fertilization, egg donation, pregnancy surrogacy and preimplantation diagnosis. However, great interest has lately been reserved to the ovarian stem cells (OSCs) whose exi...

  15. Counseling-supportive interventions to decrease infertile women's perceived stress: A systematic review.

    Science.gov (United States)

    Yazdani, Fereshteh; Elyasi, Forouzan; Peyvandi, Sepideh; Moosazadeh, Mahmood; Galekolaee, Keshvar Samadaee; Kalantari, Fereshteh; Rahmani, Zahra; Hamzehgardeshi, Zeinab

    2017-06-01

    Infertility all around the world and in every culture is recognized as a stressful and critical experience that threatens individual, familial, marital, and social stability. Thus, in accordance with the importance of a woman's mental health and the possible impact of mental health on treatment outcome, finding a way to deal with perceived stress in women can help improve pregnancy outcomes. This study is a systematic review on reducing perceived infertility stress in infertile women. The current study was undertaken using multiple databases such as SID, Irandoc, Magi ran, Google Scholar, PubMed, Science Direct, Scopus, Cochrane library, and CINAHL selected from articles pertinent to the study. The selection of papers was undertaken from 1990 through May 2016. The methodological quality was assessed. The initial search yielded a list of 725 papers, and then reviewers studied titles and abstracts. Thereafter, 68 papers were incorporated, and researchers reviewed summaries of all of the searched articles. Finally, the researchers utilized the data gained from 29 full articles so as to compile this review paper. Reviewing the studies conducted on reducing infertility perceived stress, the researchers classified related findings into two main categories: supportive and counseling intervention. Considering the fact that there is an international agreement that fertility centers need to offer counseling programs for psychological problems of the infertile, it is especially important to recognize counseling-supportive interventions for decreasing infertile women's perceived stress and to program plans for decreasing women's perceived stress. By investigating counseling-supportive stress, we hope that this study has stepped forward toward health care agent's familiarity with decreasing infertile women's perceived stress and, therefore, improving treatment consequences.

  16. Effects of a psychological intervention on Quality of life in infertile couples

    Directory of Open Access Journals (Sweden)

    Nasrin Abedinia

    2009-09-01

    Full Text Available Objective: This study aimed to determine factors affecting depression in infertile couples and effect of psychological intervention on pregnancy rate of infertile couples.Materials and Methods: In this study, 638 infertile patients referring to a university infertility clinic were evaluated. Among them, 140 couples with different levels of depression in at least one of the spouses were found and the study was continued by dividing them randomly into two groups, entering a randomized clinical trial. Patients in the case group received 6-8 sessions of psychotherapy before infertility treatment and were given daily Fluoxetin 20- 60 mg at the same period, and the control group did not receive any intervention. Three questionnaires including Beck Depression Inventory (BDI, Stress Scale (Holmes-Rahe and a sociodemographic questionnaire were applied for all patients. Pregnancy rate was compared between two groups.Results: Depression was initially found in 48% of women and 23.8% of men. The mean±SD Beck scores fell from 18.7±9.7 to 10.7±5.8 in the group psychologically treated before receiving infertility treatment (P<0.001. Pregnancy rate was 47.1% in case group and 7.1% in control group. Pregnancy rate showed a significant relation with duration and cause of infertility and the level of stress in both groups (P< 0.001. Pregnancy rate was shown to be higher in couples with a second level of education in men (P< 0.001.Conclusion: The psychological intervention was found useful in alleviating depression and promoting pregnancy rate, it is crucial to mandate psychology counseling in all fertility centers.

  17. Male factor infertility and ART

    Institute of Scientific and Technical Information of China (English)

    Herman Tournaye

    2012-01-01

    For years,the management and treatment of male factor infertility has been ‘experience’ and not ‘evidence’ based.Although not evidence-based,current clinical practice involves extensive use of assisted reproductive techniques (ART).Where specific treatments are not indicated or have failed,ART have become popular adjunctive treatments for alleviating male factor infertility.According to the limited evidence available,intrauterine insemination (IUI) may be considered as a first-line treatment in a couple in which the female partner has a normal fertility status and at least 1x 106 progressively motile spermatozoa are recovered after sperm preparation.If no pregnancy is achieved after 3-6 cycles of IUI,optimized in vitro fertilization (IVF) can be proposed.When less than 0.5x 106 progressively motile spermatozoa are obtained after seminal fluid processing or sperm are recovered surgically from the testis or epididymis,intracytoplasmic sperm injection (ICSI) should be performed.Although the outcome of no other ART has ever been scrutinized as much before,no large-scale ‘macroproblems’ have as yet been observed after ICSI.Yet,ICSI candidates should be rigorously screened before embarking on IVF or ICSI,and thoroughly informed of the limitations of our knowledge on the hereditary aspects of male infertility and the safety aspects of ART.

  18. ETHNOBOTANICAL SURVEY OF PHOENIX DACTYLIFERA L. POLLEN USED FOR THE TREATMENT OF INFERTILITY PROBLEMS IN ALGERIAN OASES.

    Science.gov (United States)

    Selmani, Cherifa; Chabane, Djamila; Bouguedoura, Nadia

    2017-01-01

    The Phoenix dactylifera L. (date palm) is known for its traditional medicinal properties across the history of native population in Algerian Sahara. There is a large trend of consumption of date palm pollen preparations in many human infertility cases in our country. However, the validity has not been scientifically tested. There has been no direct scientific research on this application. This study was undertaken to identify cultivars with greater potential in the traditional medicine uses. To evaluate the effects of date palm pollen on some sexual behavioural parameters of male adult rats, we tested the role of pollen powder from Deglet Nour cultivar on some male reproductive parameters. An Ethnobotanical survey was conducted in 17 oases in southern Algeria to identify all cultivars with medicinal interest. Local people were interviewed with open questions. A questionnaire and personal interviews for data collection were designed to record important cultivars, parts used and preparations. To determine the active constituents of date palm pollen used in traditional medicine, a phytochemical screening was performed. The effects of oral administration of date palm pollen suspension on male adult rats were investigated on body and testicle weights, serum testosterone level. 131 prominent cultivars were found within 12 cultivars containing various parts with medicinal effects. Some primary and secondary metabolites were detected by phytochemical screening. The pollen increased the weight of the body, testicles and enhanced the serum testosterone level of male rats treated. The present survey has provided the identification and recognition of date palm cultivars used in traditional Saharan medicine. Date palm pollen could improve sexual activities in male infertility cases and may be attempted to derive drugs.

  19. Donation of oocytes as treatment for infertility in patients with premature ovarian failure: awarded the "Nicolau de Moraes Barros" prize for gynecology

    Directory of Open Access Journals (Sweden)

    José Gonçalves Franco Júnior

    Full Text Available A total of 7 cycles of embryo transfer by oocyte donation were performed on 5 patients with premature ovary failure (POF. All donors were under 35 of age and the recipients average age was 38.6 years. For synchronization between donor and recipient a semi programmed menstrual cycle was used by means of oral contraceptive followed by ovarian stimulation of donor with clomiphene citrate and human menopausal gonadotrophin. The recipients were easily adjusted to the donors by a flexible model of gradually increasing doses of estradiol valerianate. The average number of oocytes donated was 3.14 and average embryo cleavage rate was 80.2%. The average number of embryos transferred was 2.57. Embryo implantation rate was 22.2%. Clinical gestations occurred in 57.1% of the cycles. This series is probably the first one in Brazilian literature on oocyte donation as treatment for infertility in patients with premature ovarian failure.

  20. Cytogenetic of Male Infertility

    Directory of Open Access Journals (Sweden)

    Lutfiye Ozpak

    2011-08-01

    Full Text Available Infertility by definition, is not to get pregnant within one year of regular sexual relationship without protection, affects 15-20% of reproductive age couples. Approximately 30% of infertility cases are male originated. Male infertility is caused by endocrine-related genetic defects affecting urogenital system function. These defects adversely affect subsequent spermatogenesis, sexual function, fertility, early embryonic stage of sexual maturation. Autosomal and gonosomal, numerical and structural chromosome abnormalities and related syndromes rank at the top causes of male infertility. Similar chromosome abnormalities are detected in male infertility and as the rate of these abnormalities increase, it was found to reduce sperm count especially in azospermic and oligozoospermic men. [Archives Medical Review Journal 2011; 20(4.000: 230-245

  1. Unexplained male infertility: diagnosis and management.

    Science.gov (United States)

    Hamada, Alaa; Esteves, Sandro C; Nizza, Mark; Agarwal, Ashok

    2012-01-01

    Unexplained male infertility is a diagnosis reserved for men in whom routine semen analyses results are within normal values and physical as well as endocrine abnormalities were ruled out. In addition to erectile problems and coital factors, immunologic causes and sperm dysfunction may contribute to such condition. New etiologies of unexplained male infertility include low level leukocytospermia and mitochondrial DNA polymerase gene polymorphism. Contemporary andrology may reveal cellular and sub-cellular sperm dysfunctions which may explain subfertility in such cases, thus aiding the clinician to direct the further work-up, diagnosis and counseling of the infertile male. The objective of this article is to highlight the concept of unexplained male infertility and focuses on the diagnosis and treatment of this condition in the era of modern andrology and assisted reproductive techniques. Extensive literature review was performed using the search engines: Pubmed, Science-direct, Ovid and Scopus.

  2. Unexplained Male infertility: diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Alaa Hamada

    2012-10-01

    Full Text Available Unexplained male infertility is a diagnosis reserved for men in whom routine semen analyses results are within normal values and physical as well as endocrine abnormalities were ruled out. In addition to erectile problems and coital factors, immunologic causes and sperm dysfunction may contribute to such condition. New etiologies of unexplained male infertility include low level leukocytospermia and mitochondrial DNA polymerase gene polymorphism. Contemporary andrology may reveal cellular and sub-cellular sperm dysfunctions which may explain subfertility in such cases, thus aiding the clinician to direct the further work-up, diagnosis and counseling of the infertile male. The objective of this article is to highlight the concept of unexplained male infertility and focuses on the diagnosis and treatment of this condition in the era of modern andrology and assisted reproductive techniques. Extensive literature review was performed using the search engines: Pubmed, Science-direct, Ovid and Scopus.

  3. Basic infertility including polycystic ovary syndrome.

    Science.gov (United States)

    Brassard, Maryse; AinMelk, Youssef; Baillargeon, Jean-Patrice

    2008-09-01

    Infertility in women has many possible causes and must be approached systematically. The most common cause of medically treatable infertility is the polycystic ovary syndrome (PCOS). This syndrome is common in young women and is the cause of anovulatory infertility in 70% of cases. It is therefore an important condition to screen and manage in primary care medical settings. In the past 10 years, insulin sensitization with weight loss or metformin has been shown to be a safe and effective treatment for PCOS infertility that eliminates the risk of multiple pregnancy and may reduce the risk of early pregnancy loss as compared with ovulation-inductor drugs. The authors believe metformin should be considered as first-line therapy because it has the advantage to allow for normal single ovulation, for reduced early pregnancy loss, and, most importantly, lifestyle modifications and weight loss before pregnancy. Losing weight not only improves fertility but also reduces adverse pregnancy outcomes associated with obesity.

  4. Qualitative research on infertile Chinese couples' understanding of sexuality.

    Science.gov (United States)

    Zhuoran, Wang; Wanpeng, Liu; Tao, Peng; Coates, Rosemary

    2017-07-23

    Family physicians play an important role in the initial counselling and evaluation of infertility. Despite infertility regarded as a stressor and a life crisis for individuals or couples, little is known about the psychosexual aspects of infertility. On the basis that sexuality is a crucial part of quality of life, it is worthwhile to give more attention to sexuality of infertile couples during their time of experiencing infertility. This study aimed to gain insight into the dynamic features of the sexuality of infertile couples and to provide meaningful evidence for improving their quality of life. We employed a qualitative approach to conduct this study. Utilizing purposive sampling method, 56 participants (28 infertile Chinese couples) were recruited from the reproductive medicine centre of a general hospital, and in-depth interviews were conducted with each participant. Thematic content analysis was used to analyse the transcripts. Four themes emerged from the respondents' narratives; these themes relate to the infertile couples' understanding of sexuality: (i) gender identity, (ii) communication about sex, (iii) sexual life and (iv) sexual satisfaction. It was further found that Chinese culture's values of fertility, perceptions about sexuality and sex, social norms regarding gender, and expectations about marital sexual life can have significant effects on infertile Chinese couples' sexuality. These findings should be highly considered by family physicians in their practice to provide infertile couples with information related to sexual well-being, coping styles, relationship, etc.

  5. 王哲教授治疗高泌乳素血症性不孕症经验%Experience of Professor Wang Zhe Treatment of Hyperprolactinemia Infertility

    Institute of Scientific and Technical Information of China (English)

    郭志莉; 王哲

    2016-01-01

    Objective]The article summarizes the essentials of hyperprolactinemia infertility experience by Professor Wang Zhe. [Methods]From following Professor Wang Zhe clincial studies,summarize experience and thoughts of treating hyperprolactinemia infertility with a case. [Results]Professor Wang Zhe thinks the main reason for the occurrence of hyperprolactinemia infertility ,which is related to the dysfunction of the liver,spleen and kidney.The spleen rules transformation and transportation that like dryness and dislike dampness.The liver stores the blood and rules flowing and spreading, that is sensitive to boundaries and maintains the smoothness and harmony of movement throughout the body.The kidneys store the essence and rule birth and hiding, which is foundation of innate existence. Its main types are liver depression and deficiency of the kidney block and phlegm-dampness stagnation.Therapeutically,using Fu Qingzhu medicine for women in the study of Yangjingzhongyu Decoction and the Ye Tianshi treatment recipe for women refers to Cangfudaotan Decoction in the treatment,to achieve nourishing the liver and kidney, invigorating spleen for eliminating dampness.[Conclusion]Professor Wang has exquisite medical skills, rigorous academic attitude, and richly professional knowledge and clinical experience.She has unique insights and experience in treating hyperprolactinemia infertility.Professor Wang Zhe's experience hopes to expand ideas of the clinical diagnosis and treatment.%[目的]总结导师王哲教授治疗高泌乳素血症性不孕症经验。[方法]通过跟随王哲教授出诊和学习王哲教授的相关医案,并以两则代表性医案为重点,结合历代名家的相关论述,系统总结王哲教授治疗高泌乳素血症性不孕症的临证经验和学术观点。[结果]王哲教授认为,本病临床证型以痰湿阻滞和肝郁肾虚为主,其发病主要与脾、肝、肾关系密切。其在长期的医疗实践过程中归纳出补

  6. [Genetic aspects of male infertility].

    Science.gov (United States)

    2014-04-01

    We examined 118 men with infertility. Among them we identified phenotypic syndromes associated with infertility in 4 and chromosomal abnormalities in 16. Further molecular genetic study of 98 infertile men found that microdeletions in AZFc-locus had 3, pathological AR allele had 2, CFTR gene mutation had 4 of them. In 37 infertile men an increased DNA fragmentation index (>20%) was found.

  7. Counseling and diagnostic evaluation for the infertile couple.

    Science.gov (United States)

    Marshburn, Paul B

    2015-03-01

    Educating couples about natural means to improve fertility should include a discussion about appropriate timing to initiate a diagnostic evaluation for infertility. Complete infertility testing for both male and female factors allows directed care for all abnormalities to optimize chances for conception.

  8. Intracytoplasmic sperm injection in the treatment of male infertility due to obstructive or non-obstructive azoospermia

    Institute of Scientific and Technical Information of China (English)

    刘伟信; 黄萍; 王丽; 罗孟军; 岳利民; 郑煜

    2003-01-01

    Objective: To evaluate the effects of intracytoplasmic sperm injection (ICSI) ontreatment of infertility due to obstructive and non-obstructive azoospermia..Methods: A retrospective analysis of fertilization, cleavage, embryo implantationand pregnancy rates was done in 158 ICSI cycles including 112 obstructive azoospermiaand 46 non-obstructive azoospermia. Ovarian hyperstimulation and ICSI procedureswere performed by conventional protocol. The sperm was collected by percutaneous epi-didymal sperm aspiration (PESA) or testicular sperm extraction (TESE).Results:The fertilization rate (73.1% vs. 67.0%), cleavage rate (88.6% vs. 86.3%), embryo implantation rate (20.7% vs. 11.4%), clinical pregnancy rate per trans-fer cycle (35.7% vs. 19.6%) were obtained for obstructive and non-obstructiveazoospermia, respectively.Conclusion: The results revealed that in the cases of obstructive azoospermia, ferti-lization rate, embryo implantation rate and clinical pregnancy rate were significantlyhigher than those of non-obstructive azoospermia. But there was no significant differ-ence of the cleavage rate between two groups.

  9. Iatrogenic causes of infertility.

    Science.gov (United States)

    Schoysman, R; Segal, L

    1990-01-01

    The Authors review the list of the iatrogenic causes of infertility. In their opinion the more delicate the structure, the more heavy the price paid to clumsy or erroneous investigation. Such eventual incompetence may lead to further damage of the already existing situation. The Authors however look at the future with relative optimism: incidents become rarer, specialists in gynecology and infertility pay more attention to the delicacy of genital structures and there is an encouraging tendency to refer to infertility specialists those cases who need adequate work-up of their condition.

  10. Dasatinib and Doxorubicin Treatment of Sarcoma Initiating Cells

    DEFF Research Database (Denmark)

    Aggerholm-Pedersen, Ninna; Demuth, Christina; Safwat, Akmal;

    2016-01-01

    Background. One of the major challenges affecting sarcoma treatment outcome, particularly that of metastatic disease, is resistance to chemotherapy. Cancer-initiating cells are considered a major contributor to this resistance. Methods. An immortalised nontransformed human stromal (mesenchymal) s...

  11. 循证医学在治疗多囊卵巢综合征中的应用%Evidence-based Clinical Treatment for a Infertile Patient Diagnosed with Polycystic Ovary Syndrome

    Institute of Scientific and Technical Information of China (English)

    蔡召忠; 徐华; 连玉红; 魏娟; 瞿萍; 邓守恒

    2011-01-01

    采用循证治疗的方法为1例已婚未育PCOS患者制定合理的治疗方案,有效提高了治疗疗效和妊娠率.%We take an individualized evidence-based treatment for infertile patients diagnosed with polycystic ovary syndrome. The results showed that treatment efficacy and pregnancy rate had been significantly improved.

  12. Diagnostic Testing for Male Factor Infertility

    Science.gov (United States)

    ... Home FAQs Frequently Asked Questions Quick Facts About Infertility FAQs About Infertility FAQs About the Psychological Component of Infertility FAQs About Cloning and Stem Cell Research SART's ...

  13. Endometriosis and Infertility: Can Surgery Help?

    Science.gov (United States)

    ... Home FAQs Frequently Asked Questions Quick Facts About Infertility FAQs About Infertility FAQs About the Psychological Component of Infertility FAQs About Cloning and Stem Cell Research SART's ...

  14. What every gynecologist should know about male infertility: an update.

    Science.gov (United States)

    Esteves, Sandro C; Hamada, Alaa; Kondray, Victor; Pitchika, Aruna; Agarwal, Ashok

    2012-07-01

    Our article reviews the evolving concepts in the field of male infertility for gynecologists and other health professionals involved in the care of men and women experiencing difficulty in having a child. The increased knowledge will help in the better management and treatment of infertile couples. Review of literature through Pubmed, Science Direct, Online Library. Gynecologists are often the first healthcare providers to assess an infertile couple. Because half of all infertility problems stem from male factors, it is crucial for the gynecologist to remain updated on the main conditions that cause male infertility as well as current diagnostic tools and treatment options, including conventional strategies and assisted reproductive techniques. Extraordinary advances have been achieved in the field of male infertility over the past several years and many old concepts are now challenged. Therefore, it is imperative that male infertility physicians should update the gynecologists about the recent advances in the work-up of infertile men in terms of diagnosis and management. Such convention will help improve the standards of care for the infertile couple and enhance the cooperation between male and female reproductive endocrinologists.

  15. Gastrointestinal events and association with initiation of treatment for osteoporosis

    Directory of Open Access Journals (Sweden)

    Modi A

    2015-11-01

    Full Text Available Ankita Modi,1 Ethel S Siris,2 Jackson Tang,3 Shiva Sajjan,1 Shuvayu S Sen1 1Center for Observational and Real-World Evidence, Merck & Co., Inc, Kenilworth, NJ, 2Toni Stabile Osteoporosis Center, Columbia University Medical Center, NY Presbyterian Hospital, New York, NY, 3Asclepius Analytics Ltd, Brooklyn, NY, USA Background: Preexisting gastrointestinal (GI events may deter the use of pharmacologic treatment in patients diagnosed with osteoporosis (OP. The objective of this study was to examine the association between preexisting GI events and OP pharmacotherapy initiation among women diagnosed with OP. Methods: The study utilized claims data from a large US managed care database to identify women aged ≥55 years with a diagnosis code for OP (index date during 2002–2009. Patients with a claim for pharmacologic OP treatment in the 12-month pre-index period (baseline were excluded. OP treatment initiation in the post-index period was defined as a claim for bisphosphonates (alendronate, ibandronate, risedronate, zoledronic acid, calcitonin, raloxifene, or teriparatide. During the post-index period (up to 12 months, GI events were identified before treatment initiation. A time-dependent Cox regression model was used to investigate the likelihood of initiating any OP treatment. Among patients initiating OP treatment, a discrete choice model was utilized to assess the relationship between post-index GI events and likelihood of initiating with a bisphosphonate versus a non-bisphosphonate. Results: In total, 65,344 patients (mean age 66 years were included; 23.7% had a GI event post diagnosis and before treatment initiation. Post-index GI events were associated with a 75% lower likelihood of any treatment initiation (hazard ratio 0.25; 95% confidence interval 0.24–0.26. Among treated patients (n=23,311, those with post-index GI events were 39% less likely to receive a bisphosphonate versus a non-bisphosphonate (odds ratio 0.61; 95% confidence

  16. Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility.

    Science.gov (United States)

    Murto, Tiina; Bjuresten, Kerstin; Landgren, Britt-Marie; Stavreus-Evers, Anneli

    2013-07-11

    Infertile women might get pregnant sometime after fertility treatment, but today, there is no prediction model on who will eventually have children. The objective of the present study was to characterize hormone levels in an arbitrary menstrual cycle in women with unexplained infertility and male infertility, and to determine the predictive value for long-term possibility of live birth. In this cross-sectional study, with 71 infertile women with diagnosis unexplained infertility and male infertility, blood samples were obtained during the proliferative and secretory phases of an arbitrary menstrual cycle. Serum concentrations of FSH, LH, AMH, inhibin B, estradiol, progesterone, PRL and TSH were determined. The predictive value of ovulation and hormonal analysis was determined by identifying the proportion of women with at least one live birth. Mann Whitney U test, chi2 test and Spearman's correlation were used for statistical analysis. A value of p hormone values and live birth rates between women with unexplained infertility and male infertility. The best sole predictors of live birth were age of the women, followed by ovulatory cycle, defined as serum progesterone concentration of greater than or equal to 32 nmol/L, and a serum TSH concentration of less than or equal to 2.5 mIU/L. Combining the age with the ovulatory cycle and serum TSH less than or equal to 2.5 mIU/L or serum AMH greater than or equal to 10 pmol/L the predictive value was close to 90%. Age in combination with the presence of an ovulatory cycle and serum TSH or serum AMH is predictive for long-term live birth. The advantage of serum AMH compared with serum TSH is the very little variation throughout the menstrual cycle, which makes it a useful tool in infertility diagnosis.

  17. [Treatment's initiation in chronic inflammatory demyelinating polyradiculopathy (CIDP)].

    Science.gov (United States)

    Uzenot, D; Azulay, J-P; Pouget, J

    2007-09-01

    Treatment's initiation in chronic inflammatory demyelinating polyradiculopathy (CIDP) remains a difficult medical decision. Only plasma exchanges, intravenous immunoglobulins (IVIg) and corticosteroids are proven effective treatments. Immunosuppressors are actually not first-line treatments in CIDP. Particular CIDP forms are associated with different response to treatments: pure motor CIDP should be treated by IVIg, and corticosteroids should only carefully be used in Lewis-Sumner syndrome. Otherwise, IVIg are first-line treatment in diabetic patients. Patients must be informed of side's effects and expected clinical effects. Early treatment was actually not proved to prevent axonal damages in CIDP patients, and waiting seems to be the best therapeutic option in poorly symptomatic patients. Recently, clinical guidelines were proposed to help clinician in this treatment choice, but there is no consensus about the best dose, duration or administration way to CIDP treatments. Further studies should be performed to clarify these points and to determine immunosuppressor agents place in treatment strategy.

  18. [Orchitis and male infertility].

    Science.gov (United States)

    Schuppe, H-C; Pilatz, A; Hossain, H; Meinhardt, A; Bergmann, M; Haidl, G; Weidner, W

    2010-05-01

    Infections and inflammations of the genital tract are considered the most frequent causes of reduced male fertility, but conclusive epidemiological data are not available. In view of the exposure of germ cells to pathogenic components as well as the cells and mediators involved in the inflammatory processes, irreversible damage to spermatogenesis and corresponding decline of ejaculate quality are to be expected, particularly in cases of chronic orchitis. While the consequences of orchitis and epididymo-orchitis that exhibit clinical symptoms due to systemic or local infections are well known, including testicular atrophy and complete loss of fertility, those cases of inflammatory reactions of the testicles that manifest an asymptomatic or subclinical course, or are not even due to an infection, have received little attention until now. However, systematic histopathological analyses have shown a high prevalence of asymptomatic inflammatory reactions in testicular biopsies from infertile men. The mostly focal lymphocytic infiltrates correlate with the degree of damage to spermatogenesis and corresponding clinical and endocrinological parameters of testicular function. Noninvasive diagnostic techniques are not yet available so that chronic asymptomatic inflammations of the testicles as the primary cause or cofactor of male fertility disorders are underestimated. Except for administration of pathogen-specific antibiotics, treatment recommendations are to a large extent still lacking.

  19. More attention paid to the drug treatment of male infertility -whether to use testosterone or not%应关注男性不育的药物治疗:睾酮,用还是不用

    Institute of Scientific and Technical Information of China (English)

    李宏军

    2014-01-01

    Whethertousetestosteroneornotinthetreatmentofmaleinfertilityisabigproblem.The2013 guidelines on male infertility of European Association of Urology (EAU)point out that testosterone replacement is strictly contraindicated in the treatment of male infertility,which has brought extensive concerns.Although absence of well performed and controlled clinical trials for drugs treatment of male infertility at present,the opportunity to prove the effectiveness of such drugs should not be deprived.Exploration on drug treatment should be encouraged and strengthened rather than forbidden simply.No matter from the perspective of basic medical principles or devel-opment of medicine or medical research status or humanity medicine,empirical drug treatment (including testoster-one)of male infertility should be the first-line option or basic option.Therefore,I believe that the conclusion from EAU guidelines on male infertility is poorly conceived and major reasons for application of testosterone in the treat-ment of male infertility are discussed in this article.%在治疗男性不育症中是否使用睾酮是一个大问题。2013年欧洲泌尿外科学会(EAU)的《男性不育指南》指出:雄激素补充治疗被严格禁止用于男性不育的治疗,这种观点引起强烈关注和质疑。尽管一些临床研究的证据目前还没有支持用于男性不育的药物治疗,但不应该妨碍证明这些药物有效的机会,药物治疗的广泛探索应该被鼓励和加强,而不是简单地禁止。无论是从医学基本原则、促进医学发展、医学研究现状以及人文医学角度,男性不育的经验性药物治疗(包括睾酮)应该成为一线选择或基础选择。因此,笔者认为EAU《指南》的上述结论考虑不周,故对在治疗男性不育症中应用睾酮的主要理由进行了论述。

  20. Living with infertility : Experiences among urban slum populations in Bangladesh

    NARCIS (Netherlands)

    Papreen, N; Sabin, K; Begum, L; Ahsan, SK; Baqui, AH

    2000-01-01

    This paper explores the perceived causes of infertility, treatment-seeking for infertility and the consequences of childlessness, particularly for women, among a predominantly Muslim population in urban slums of Dhaka in Bangladesh. In-depth interviews were conducted with 60 women and GO men randoml

  1. Living with infertility : Experiences among urban slum populations in Bangladesh

    NARCIS (Netherlands)

    Papreen, N; Sabin, K; Begum, L; Ahsan, SK; Baqui, AH

    This paper explores the perceived causes of infertility, treatment-seeking for infertility and the consequences of childlessness, particularly for women, among a predominantly Muslim population in urban slums of Dhaka in Bangladesh. In-depth interviews were conducted with 60 women and GO men

  2. The Sexual Impact of Infertility Among Women Seeking Fertility Care

    Directory of Open Access Journals (Sweden)

    William D. Winkelman, MD

    2016-09-01

    Conclusion: In women seeking fertility treatment, younger age and female factor infertility were associated with increased sexual impact and thus these women are potentially at higher risk of sexual dysfunction. Providers should consider the role young age and an infertility diagnosis plays in a women’s sexual well-being.

  3. Periodontal status in infertile women attending in vitro fertilization clinics

    Directory of Open Access Journals (Sweden)

    Godavarthi Lalasa

    2014-01-01

    Conclusion: Within the limits of this study, it can be concluded that altered hormonal levels in infertile women undergoing assisted reproductive therapy and infertile women not undergoing this treatment can lead to increased attachment loss, suggesting that these women may require constant periodontal monitoring.

  4. The Pregnancy in Polycystic Ovary Syndrome II (PPCOS II) trial: rationale and design of a double-blind randomized trial of clomiphene citrate and letrozole for the treatment of infertility in women with polycystic ovary syndrome.

    Science.gov (United States)

    Legro, Richard S; Kunselman, Allen R; Brzyski, Robert G; Casson, Peter R; Diamond, Michael P; Schlaff, William D; Christman, Gregory M; Coutifaris, Christos; Taylor, Hugh S; Eisenberg, Esther; Santoro, Nanette; Zhang, Heping

    2012-05-01

    Polycystic Ovary Syndrome (PCOS) is a common cause of female infertility and first line treatment is currently oral clomiphene citrate, a selective estrogen receptor modulator, which results in both a high nonresponse rate and multiple pregnancy rate. Aromatase inhibitors such as letrozole may have more favorable ovarian and endometrial effects. The goal of the Pregnancy in Polycystic Ovary Syndrome II (PPCOSII) study is to determine the safety and efficacy of clomiphene citrate (CC) compared to letrozole, in achieving live birth in infertile women with PCOS. The population will consist of 750 infertile women with PCOS. Additionally, the couple will have no other major infertility factor. This will be a multi-center, prospective, double-blind clinical trial of CC vs. letrozole for 5 treatment cycles (or approximately up to 25 weeks). The randomization scheme will be coordinated through the central data coordinating center (DCC) and the randomization is stratified by each participating site. After progestin withdrawal as needed, 750 women will be equally randomized to two different treatment arms: A) CC 50mg every day for 5 days (days 3-7 of cycle), or B) letrozole 2.5mg every day for 5 days (days 3-7 of cycle), for a total of 5 cycles or 25 weeks. The dose will be increased in subsequent cycles in both treatment groups for non-response or poor ovulatory response up to a maximum of 150 mg of CC a day (×5 days) or 7.5mg of letrozole a day (×5 days). The primary analysis will use an intent-to-treat approach to examine differences in the live birth rate in the two treatment arms.

  5. Infertility and assisted reproductive technology (ART) - with emphasis on In Vitro Fertilisation (IVF)

    OpenAIRE

    Danielsson, David André

    2004-01-01

    Infertility and assisted reproductive technology (ART) - with emphasis on In Vitro Fertilisation (IVF). A literary study reviewing the epidemiology, pathology, investigation and treatment (with complications) of both male and female infertility. Causes of infertility in women include hostile cervical mucus, sexually transmitted diseases such as Chlamydia, pelvic inflammatory disease, endometriosis, tubal dysfunction, problems with ovulation, polycystic ovary syndrome, hormonal imbalance ...

  6. Epidemiology of infertility: social problems of the infertile couples

    African Journals Online (AJOL)

    Epidemiology of infertility: social problems of the infertile couples. Margaret .... imbalance in the power relations between men and women to such an .... India in 1993, the African Academy of Sciences issued a dissent- ..... York: Plenum Press.

  7. Certain Less Invasive Infertility Treatments Associated with Different Levels of Pregnancy-Related Anxiety in Pregnancies Conceived via In Vitro Fertilization

    Science.gov (United States)

    Stevenson, Eleanor Lowndes; Sloane, Richard

    2017-01-01

    Background: Research supports that in vitro fertilization causes anxiety and that anxiety can continue into the resulting pregnancy. Most women who have IVF will have a less invasive treatment for infertility prior to IVF; however, it is unclear if specific less invasive treatment cycles impact anxiety that is experienced in the pregnancy resulting from IVF. Methods: A prospective study was conducted for women who became pregnant via IVF, and data was collected about reported previous non-IVF treatment cycles as well as Pregnancy Related Anxiety Measure. Latent Class Analysis was conducted A p-value of ≤0.05 was considered significant. Results: 144 subjects participated and were highly educated, affluent, married, and primarily white. The LCA process yielded two groups that on average had similar levels on most items except for use of intra uterine insemination and/or ovarian stimulation. This information was used to generate four exhaustive and mutually exclusive groups: Stimulation Only (stim-only), Stimulation and Intra uterine Insemination (stim-IUI), Intra uterine Insemination only (IUI only), or No Treatment (No Tx). ANOVA found that those in the Stim Only group had statistically significantly higher PRAM scores than the Stim IUI (p=0.0036), the IUI only group (p=0.05), and the No Tx group (p=0.0013). Conclusion: Women who become pregnant via IVF and had a history of non-in vitro fertilization cycles that only involved ovarian stimulation experienced more pregnancy-specific anxiety in the pregnancy that results from in vitro fertilization.

  8. Epigenetics of reproductive infertility.

    Science.gov (United States)

    Das, Laxmidhar; Parbin, Sabnam; Pradhan, Nibedita; Kausar, Chahat; Patra, Samir K

    2017-06-01

    Infertility is a complex pathophysiological condition. It may caused by specific or multiple physical and physiological factors, including abnormalities in homeostasis, hormonal imbalances and genetic alterations. In recent times various studies implicated that, aberrant epigenetic mechanisms are associated with reproductive infertility. There might be transgenerational effects associated with epigenetic modifications of gametes and studies suggest the importance of alterations in epigenetic modification at early and late stages of gametogenesis. To determine the causes of infertility it is necessary to understand the altered epigenetic modifications of associated gene and mechanisms involved therein. This review is devoted to elucidate the recent mechanistic advances in regulation of genes by epigenetic modification and emphasizes their possible role related to reproductive infertility. It includes environmental, nutritional, hormonal and physiological factors and influence of internal structural architecture of chromatin nucleosomes affecting DNA and histone modifications in both male and female gametes, early embryogenesis and offspring. Finally, we would like to emphasize that research on human infertility by gene knock out of epigenetic modifiers genes must be relied upon animal models.

  9. Infertility and uterine fibroids.

    Science.gov (United States)

    Zepiridis, Leonidas I; Grimbizis, Grigoris F; Tarlatzis, Basil C

    2016-07-01

    Uterine fibroids are the most common tumors in women and their prevalence is higher in patients with infertility. At present, they are classified according to their anatomical location, as no classification system includes additional parameters such as their size or number. There is a general agreement that submucosal fibroids negatively affect fertility, when compared to women without fibroids. Intramural fibroids above a certain size (>4 cm), even without cavity distortion, may also negatively influence fertility. However, the presence of subserosal myomas has little or no effect on fertility. Many possible theories have been proposed to explain how fibroids impair fertility: mechanisms involving alteration of local anatomical location, others involving functional changes of the myometrium and endometrium, and finally endocrine and paracrine molecular mechanisms. Nevertheless, any of the above mentioned mechanisms can cause reduced reproductive potential, thereby leading to impaired gamete transport, reduced ability for embryo implantation, and creation of a hostile environment. The published experience defines the best practice strategy, as not many large, well-designed, and properly powered studies are available. Myomectomy appears to have an effect in fertility improvement in certain cases. Excision of submucosal myomas seems to restore fertility with pregnancy rates after surgery similar to normal controls. Removal of intramural myomas affecting pregnancy outcome seems to be associated with higher pregnancy rates when compared to non-operated controls, although evidence is still nοt sufficient. Treatment of subserosal myomas of reasonable size is not necessary for fertility reasons. The results of endoscopic and open myomectomy are similar; thus, endoscopic treatment is the recommended approach due to its advantages in patient's postoperative course.

  10. Tratamento da infertilidade em mulheres com síndrome dos ovários policísticos Treatment of infertility in women with polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Laura Ferreira Santana

    2008-04-01

    Full Text Available A síndrome dos ovários policísticos (SOP é a principal endocrinopatia ginecológica na idade reprodutiva, com incidência de 6 a 10% das mulheres no menacme. A resistência insulínica e a hiperinsulinemia compensatória permanecem como os elementos mais importantes na etiopatogenia da SOP. Esta revisão teve como objetivo discutir as controvérsias no tratamento de mulheres com SOP nos diferentes contextos da infertilidade feminina e gestação, à luz das evidências atuais, com ênfase no consenso de 2008 proposto pelas sociedades européia (European Society of Human Reproduction and Embryology, ESHRE e americana (American Society for Reproductive Medicine, ASRM de reprodução.Polycystic ovary syndrome (PCOS occurs in 6 to 10% of women during the reproductive age. Insulin resistance and compensatory hyperinsulinemia are currently two of the main factors involved in the etiopathogenesis of PCOS. The objective of the present review was to discuss the controversies related to the treatment of infertile women with PCOS and during their pregnancy, focusing on the European Society of Human Reproduction and Embryology (ESHRE and the American Society for Reproductive Medicine (ASRM current consensus.

  11. Risk of diabetes according to male factor infertility

    DEFF Research Database (Denmark)

    Glazer, Clara Helene; Bonde, Jens Peter; Giwercman, Aleksander

    2017-01-01

    STUDY QUESTION: Is male factor infertility associated with an increased risk of developing diabetes? SUMMARY ANSWER: The study provides evidence that male factor infertility may predict later occurrence of diabetes mellitus with the risk being related to the severity of the underlying fertility...... problem. WHAT IS KNOWN ALREADY: Previous cross-sectional studies have shown an increased prevalence of comorbidities among infertile men when compared to controls. STUDY DESIGN, SIZE, DURATION: In this prospective cohort study, 39 516 men who had since 1994 undergone fertility treatment with their female...... partner were identified from the Danish national IVF register, which includes data on assumed cause of couple infertility (male/female factor, mixed and unexplained infertility) and type of fertility treatment. With a median follow-up time of 5.6 years, each man was followed for diabetes occurrence from...

  12. Effects of using a nursing crisis intervention program on psychosocial responses and coping strategies of infertile women during in vitro fertilization.

    Science.gov (United States)

    Shu-Hsin, Lee

    2003-09-01

    Infertility and its treatment may cause life crises in infertile women. The purpose of this study is to evaluate the effects of a crisis intervention program on improving psychosocial responses and enhancing coping strategies for infertile women attending different stages of an In-Vitro Fertilization V Embryo Transfer (IVF-ET) treatment program. Using an experimental study design, infertile women attending an IVF-ET treatment program were randomly assigned to experimental and control groups. In the experimental group, infertile women completed and answered a questionnaire and received nursing crisis intervention at the initial stage of treatment (day 3). This included (1). viewing a video explaining the therapeutic process of IVF-ET, (2). self-hypnosis and muscle relaxation training, and (3). provision of cognitive-behavioral counseling. The same questionnaire was used again for subjects at the stage of embryo transfer and before taking a pregnancy test. The women in the control group were only interviewed using the same questionnaire and at the same times as the experimental group. Analysis by repeated measurement ANOVA demonstrated that there was a reduction in psychosocial response in terms of interpersonal relationships, and there was an interaction between intervention effects and stage of treatment. However, there was no statistically significant difference in the level of psychosocial responses between the experimental and control groups although some meaningful findings were made. However, in terms of state of anxiety, confrontational problems, and isolated mind/body relaxation, there were significant differences between the two groups of infertile women at some stages of IVF-ET treatment. The women in the experimental group perceived a positive effect of the nursing intervention in relieving their psychosocial responses. The results of this nursing crisis intervention could be helpful in nursing practice when dealing with infertile women attending IVF

  13. Endometriosis: Does It Cause Infertility?

    Science.gov (United States)

    ... Society for Reproductive Medicine Endometriosis: Does It Cause Infertility? This fact sheet was developed in collaboration with ... a surgical procedure called laparoscopy. Does endometriosis cause infertility? If you have endometriosis, it may be more ...

  14. A Naval Postgraduate Dental School Analysis Of Initial Endodontic Treatment

    Science.gov (United States)

    2016-06-30

    initial treatment. J Endod 2004;30:302-9. Fouad AF, Burleson J. The effect of diabetes mellitus on endodontic treatment outcome. J Am Dent Assoc 2003;134...Hemoglobin Levels and Prevalence of Apical Periodontitis in Type 2 Diabetic Patients. J Endod 2015;41:601-6. Santos SM, Soares JA, Costa GM, Brito...Chen SC, Feng YC, Hsiao CK, Chiang CP. Impact of diabetes mellitus , hypertension, and coronaiy aitery disease on tooth extraction after nonsurgical

  15. Systematic Review of Premenstrual, Postmenstrual and Infertility Disorders of Vitex Agnus Castus

    Science.gov (United States)

    Rafieian-Kopaei, Mahmoud; Movahedi, Mino

    2017-01-01

    Introduction Vitex agnus-castus, also called vitex is aboriginal to the Mediterranean region, with long leaves, tender stem, flowers and ripening seeds. The aim of this study was to overview premenstrual, postmenstrual and infertility disorder of Vitex agnus-castus. Methods This review article was carried out by searching studies in PubMed, Medline, Web of Science, and IranMedex databases. The initial search strategy identified about 87 references. In this study, 43 studies were accepted for further screening, and met all our inclusion criteria (in English, full text, therapeutic effects of Vitex agnus-castus and dated mainly from the year 2009 to 2016). The search terms were Vitex agnus-castus, premenstrual, postmenstrual, infertility disorder properties and pharmacological effects. Result Vitex agnus-castus was shown to contribute to the treatment of premenstrual syndrome (PMS). Moreover, the result of the present study showed that this valuable plant is helpful in alleviation of pain resulting from postmenstrual disease. Furthermore, it was found that Vitex agnus-castus is beneficial in infertility disorder. Conclusion Vitex agnus-castus (AC) is a phytopharmaceutical compound and is shown to be widely used to treat PMS and PMDD. In addition, it was shown to be beneficial in post-menstrual cases and it can also contribute to treatment of infertility cases in both men and women. Dopaminergic compounds available in this plant help to treat premenstrual mastodynia as well as other symptoms of the premenstrual syndrome. PMID:28243425

  16. Oxidative stress & male infertility.

    Science.gov (United States)

    Makker, Kartikeya; Agarwal, Ashok; Sharma, Rakesh

    2009-04-01

    The male factor is considered a major contributory factor to infertility. Apart from the conventional causes for male infertility such as varicocoele, cryptorchidism, infections, obstructive lesions, cystic fibrosis, trauma, and tumours, a new and important cause has been identified: oxidative stress. Oxidative stress is a result of the imbalance between reactive oxygen species (ROS) and antioxidants in the body. It is a powerful mechanism that can lead to sperm damage, deformity and eventually, male infertility. This review discusses the physiological need for ROS and their role in normal sperm function. It also highlights the mechanism of production and the pathophysiology of ROS in relation to the male reproductive system and enumerate the benefits of incorporating antioxidants in clinical and experimental settings.

  17. Procreative sex in infertile couples: the decay of pleasure?

    Directory of Open Access Journals (Sweden)

    Marci Roberto

    2012-11-01

    Full Text Available Abstract Background Infertility represents a major challenge to the emotional balance and sexual life of couples, with long-lasting and gender-specific effects. The objective of this study is to explore personality features of infertile patients and detect possible sexual disorders in couples undergoing infertility treatment. Materials and methods In this prospective study 60 infertile couples and 52 fertile control couples were asked to complete standardized and validated questionnaires: the Adjective Check List (ACL to enquire about personality features and the Female Sexual Function Index (FSFI or the International Index of Erectile Function (IIEF to assess sexual functioning of female and male partners. The study population was divided into 3 groups: Group A (N = 30, recently diagnosed infertile couples Group B (N = 30, infertile couples already undergoing Intrauterine Insemination and Group C (N = 52, fertile control group. Results Infertile patients did not display any distinguishing personality features. Regarding sexual function, men of all the three groups scored higher in both questionnaires (sexual satisfaction, desire and orgasm than their female partners. Comparing results between groups, Group A male partners obtained lower scores in all the subscales. Women belonging to Group A and Group B showed an impairment of sexual arousal, satisfaction, lubrification and orgasm when compared to fertile controls. Conclusions Even if at the very first stages of infertility treatment no personality disturbances can be detected, the couples’ sexual life is already impaired with different sexual disorders according to gender.

  18. A Naval Postgraduate Dental School Analysis of Initial Endodontic Treatment

    Science.gov (United States)

    2013-06-01

    Vertucci FJ. Root canal anatomy of the human permanent teeth . Oral Surg Oral Med Oral Pathol 1984;58:589-99. 5. Yesilsoy C, Gordon W, Porras O...1 A NAVAL POSTGRADUATE DENTAL SCHOOL ANALYSIS OF INITIAL ENDODONTIC TREATMENT by Rodney V. Scott LCDR, DC, USN...A thesis submitted to the Faculty of the Endodontics Graduate Program Naval Postgraduate Dental School Uniformed Services

  19. Imaging female infertility.

    Science.gov (United States)

    Sadow, Cheryl A; Sahni, V Anik

    2014-02-01

    The purpose of this pictorial review is to discuss causes of female infertility, in particular, those etiologies in which imaging plays a key role in detection. Included are disorders of cervical, ovarian, fallopian tube, and uterine origin. We also discuss the role of various imaging modalities including hysterosalpingography, pelvic ultrasonography, hysterosonography, and pelvic MR imaging in elucidating the cause of female infertility. Radiologists need to know the conditions to be aware of when these patients are sent for diagnostic imaging, as well as how to direct further management, if necessary, should an abnormality be detected.

  20. Male infertility microsurgical training

    Institute of Scientific and Technical Information of China (English)

    Akanksha Mehta; Philip S Li

    2013-01-01

    Microsurgical training is imperative for urologists and clinical andrologists specializing in male infertility.Success in male infertility microsurgery is heavily dependent on the surgeon's microsurgical skills.Laboratory-based practice to enhance microsurgical skills improves the surgeon's confidence,and reduces stress and operating time,benefiting both the patient and the surgeon.This review provides guidelines for setting up a microsurgical laboratory to develop and enhance microsurgical skills using synthetic and animal models.The role of emerging techniques,such as robotic-assisted microsurgery,is also discussed.

  1. Overtreatment in couples with unexplained infertility.

    Science.gov (United States)

    Kersten, F A M; Hermens, R P G M; Braat, D D M; Hoek, A; Mol, B W J; Goddijn, M; Nelen, W L D M

    2015-01-01

    What is the percentage of overtreatment, i.e. fertility treatment started too early, in couples with unexplained infertility who were eligible for tailored expectant management? Overtreatment occurred in 36% of couples with unexplained infertility who were eligible for an expectant management of at least 6 months. Prognostic models in reproductive medicine can help to identify infertile couples that would benefit from fertility treatment. In couples with unexplained infertility with a good chance of natural conception within 1 year, based on the Hunault prediction model, an expectant management of 6-12 months, as recommended in international fertility guidelines, prevents unnecessary treatment. A retrospective cohort study in 25 participating clinics, with follow-up of all couples who were seen for infertility in 2011-2012. In all, 9818 couples were seen for infertility in the participating clinics. Couples were eligible to participate if they were diagnosed with unexplained infertility and had a good prognosis of natural conception (>30%) within 1 year based on the Hunault prediction model. Data to assess overtreatment were collected from medical records. Multilevel regression analyses were performed to investigate associations of overtreatment with patient and clinic characteristics. Five hundred and forty-four couples eligible for expectant management were included in this study. Among these, overtreatment, i.e. starting medically assisted reproduction within 6 months, occurred in 36%. The underlying quality indicators showed that in 34% no prognosis was calculated and that in 42% expectant management was not recommended. Finally, 16% of the couples for whom a correct recommendation of expectant management for at least 6 months was made, started treatment within 6 months anyway. Overtreatment was associated with childlessness, higher female age and a longer duration of infertility. No associations between overtreatment and clinic characteristics were found. The

  2. Infertility: Medical and Social Choices.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Office of Technology Assessment.

    This report illustrates a range of options for Congressional action in nine principal areas of public policy related to infertility: (1) collecting data on reproductive health; (2) preventing infertility; (3) information to inform and protect consumers; (4) providing access to infertility services; (5) reproductive health of veterans; (6) transfer…

  3. Is There a Relationship between Ovarian Epithelial Dysplasia and Infertility?

    Directory of Open Access Journals (Sweden)

    Gautier Chene

    2012-01-01

    Full Text Available Aim. Ovarian epithelial dysplasia was initially described in material from prophylactic oophorectomies performed in patients at genetic risk of ovarian cancer. Similar histopathological abnormalities have been revealed after ovulation stimulation. Since infertility is also a risk factor for ovarian neoplasia, the aim of this study was to study the relationship between infertility and ovarian dysplasia. Methods. We blindly reviewed 127 histopathological slides of adnexectomies or ovarian cystectomies according to three groups—an exposed group to ovulation induction (n = 30, an infertile group without stimulation (n = 35, and a spontaneously fertile control group (n = 62—in order to design an eleven histopathological criteria scoring system. Results. The ovarian dysplasia score was significantly higher in exposed group whereas dysplasia score was low in infertile and control groups (resp., 8.21 in exposed group, 3.69 for infertile patients, and 3.62 for the controls. In the subgroup with refractory infertility there was a trend towards a more severe dysplasia score (8.53 in ovulation induction group and 5.1 in infertile group. Conclusion. These results raise questions as to the responsibility of drugs used to induce ovulation and/or infertility itself in the genesis of ovarian epithelial dysplasia.

  4. Benzodiazepines and adequacy of initial antidepressant treatment for depression.

    Science.gov (United States)

    Pfeiffer, Paul N; Ganoczy, Dara; Zivin, Kara; Valenstein, Marcia

    2011-06-01

    In short-term efficacy studies, coprescription of a benzodiazepine improves first-month adherence and response to antidepressant treatment. We used Veterans Health Administration data to examine the impact of coprescribed benzodiazepines on initial antidepressant adherence in routine clinical practice and the risks of long-term benzodiazepine use, abuse, and dependence. Our study population was 43,915 Veterans Health Administration patients diagnosed with depression and started on an antidepressant between October 2006 and September 2007. Using logistic regression, adjusting for demographic and clinical covariates, we predicted the likelihood that patients received antidepressant treatment for an adequate duration (90 days), with our primary independent variable of interest being receipt of a benzodiazepine on the same day as the start of the antidepressant. We also assessed the frequency and characteristics of patients whose benzodiazepine use persisted for 1 year or who were diagnosed with anxiolytic abuse or dependence after receiving combined treatment. The adjusted probability of receiving antidepressant treatment of adequate duration was 42.4% for patients who received a benzodiazepine with their initial antidepressant compared with 39.3% for patients initially treated with an antidepressant alone (P benzodiazepines for at least 1 year, and 0.7% were diagnosed with anxiolytic abuse or dependence. Anxiolytic abuse or dependence, but not long-term benzodiazepine use, was associated with other substance use disorders. These findings should be considered by clinicians when assessing the individual risks and benefits of combining a benzodiazepine with antidepressant treatment.

  5. Ethical issues in the initiation and termination of treatment.

    Science.gov (United States)

    Kilner, J F

    1990-03-01

    This report addresses the ethical issues involved in decisions to initiate and terminate treatment. A general framework is constructed and then two illustrative cases are discussed. The framework is developed in three stages. First, the issue of guiding ethical principles is examined, with a multiple-principle approach being adopted. Second, common models of the care-giver/patient relationship (warrior, parental, contractual, covenantal) are identified, and their varying impacts on treatment decisions are explained and assessed. Third, specific criteria for determining when to initiate and terminate treatment are introduced. Two criteria (willingness and medical benefit) are commended in the context of initiating treatment, while three distinctions (willing v unwilling, passive v active, and terminal v nonterminal) are found to be particularly helpful when deciding if treatment should be terminated. Two illustrative cases involve end-stage renal disease (ESRD). The first describes a noncompliant and abusive intravenous (IV) drug user on hemodialysis who wants to continue on dialysis and eventually receive a living-related donor kidney transplant. The second describes a patient's decisions to refuse feeding gastrostomy and jejunostomy, any further surgical or diagnostic intervention, and eventually dialysis-though only after a period of time when he wants dialysis alone to continue.

  6. Initial application of digital tomosynthesis to improve brachytherapy treatment planning

    Science.gov (United States)

    Baydush, Alan H.; Mirzaei McKee, Mahta; King, June; Godfrey, Devon J.

    2007-03-01

    We present preliminary investigations that examine the feasibility of incorporating volumetric images generated using digital tomosynthesis into brachytherapy treatment planning. The Integrated Brachytherapy Unit (IBU) at our facility consists of an L-arm, C-arm isocentric motion system with an x-ray tube and fluoroscopic imager attached. Clinically, this unit is used to generate oblique, anterior-posterior, and lateral images for simple treatment planning and dose prescriptions. Oncologists would strongly prefer to have volumetric data to better determine three dimensional dose distributions (dose-volume histograms) to the target area and organs at risk. Moving the patient back and forth to CT causes undo stress on the patient, allows extensive motion of organs and treatment applicators, and adds additional time to patient treatment. We propose to use the IBU imaging system with digital tomosynthesis to generate volumetric patient data, which can be used for improving treatment planning and overall reducing treatment time. Initial image data sets will be acquired over a limited arc of a human-like phantom composed of real bones and tissue equivalent material. A brachytherapy applicator will be incorporated into one of the phantoms for visualization purposes. Digital tomosynthesis will be used to generate a volumetric image of this phantom setup. This volumetric image set will be visually inspected to determine the feasibility of future incorporation of these types of images into brachytherapy treatment planning. We conclude that initial images using the tomosynthesis reconstruction technique show much promise and bode well for future work.

  7. Registering initial defaulters and reporting on their treatment outcomes.

    Science.gov (United States)

    Harries, A D; Rusen, I D; Chiang, C-Y; Hinderaker, S G; Enarson, D A

    2009-07-01

    This Unresolved Issues article highlights three original articles that appeared last year in the Journal discussing the phenomenon of initial defaulters. There are three important challenges with patients that appear in the laboratory sputum register but are not recorded in the tuberculosis (TB) patient register: the first is how to identify these patients, trace them and get them on to treatment as soon as possible; the second is how to register and report on these cases as part of the case-finding component of TB control; and the third is whether to include these initial default patients in the cohort analysis of treatment outcomes. We recommend a step-wise approach to these challenges and advocate that these patients be included, wherever possible, in the TB patient register and in the cohort analysis of treatment outcomes.

  8. ICSI treatment of severe male infertility can achieve prospective embryo quality compared with IVF of fertile donor sperm on sibling oocytes

    Directory of Open Access Journals (Sweden)

    Ju-Fen Zheng

    2015-01-01

    Full Text Available Azoospermia, cryptozoospermia and necrospermia can markedly decrease the ability of males to achieve pregnancy in fertile females. However, patients with these severe conditions still have the option to be treated by intracytoplasmic sperm injection (ICSI to become biological fathers. This study analyzed the fertilization ability and the developmental viabilities of the derived embryos after ICSI treatment of the sperm from these patients compared with in vitro fertilization (IVF treatment of the proven-fertile donor sperm on sibling oocytes as a control. On the day of oocyte retrieval, the number of sperm suitable for ICSI collected from two ejaculates or testicular sperm extraction was lower than the oocytes, and therefore, excess sibling oocytes were treated by IVF with donor sperm. From 72 couples (73 cycles, 1117 metaphase II oocytes were divided into 512 for ICSI and 605 for IVF. Compared with the control, husbands′ sperm produced a lower fertilization rate in nonobstructive azoospermia (65.4% vs 83.2%; P< 0.001, crytozoospermia (68.8% vs 75.5%; P< 0.05 and necrospermia (65.0% vs 85.2%; P< 0.05. The zygotes derived in nonobstructive azoospermia had a lower cleavage rate (96.4% vs 99.4%; P< 0.05, but the rate of resultant good-quality embryos was not different. Analysis of the rates of cleaved and good-quality embryos in crytozoospermia and necrospermia did not exhibit a significant difference from the control. In conclusion, although the sperm from severe male infertility reduced the fertilization ability, the derived embryos had potential developmental viabilities that might be predictive for the expected clinical outcomes.

  9. ICSI treatment of severe male infertility can achieve prospective embryo quality compared with IVF of fertile donor sperm on sibling oocytes.

    Science.gov (United States)

    Zheng, Ju-Fen; Chen, Xiao-Bao; Zhao, Lei-Wen; Gao, Min-Zhi; Peng, Jie; Qu, Xian-Qin; Shi, Hui-Juan; Jin, Xing-Liang

    2015-01-01

    Azoospermia, cryptozoospermia and necrospermia can markedly decrease the ability of males to achieve pregnancy in fertile females. However, patients with these severe conditions still have the option to be treated by intracytoplasmic sperm injection (ICSI) to become biological fathers. This study analyzed the fertilization ability and the developmental viabilities of the derived embryos after ICSI treatment of the sperm from these patients compared with in vitro fertilization (IVF) treatment of the proven-fertile donor sperm on sibling oocytes as a control. On the day of oocyte retrieval, the number of sperm suitable for ICSI collected from two ejaculates or testicular sperm extraction was lower than the oocytes, and therefore, excess sibling oocytes were treated by IVF with donor sperm. From 72 couples (73 cycles), 1117 metaphase II oocytes were divided into 512 for ICSI and 605 for IVF. Compared with the control, husbands' sperm produced a lower fertilization rate in nonobstructive azoospermia (65.4% vs 83.2%; P< 0.001), crytozoospermia (68.8% vs 75.5%; P< 0.05) and necrospermia (65.0% vs 85.2%; P< 0.05). The zygotes derived in nonobstructive azoospermia had a lower cleavage rate (96.4% vs 99.4%; P< 0.05), but the rate of resultant good-quality embryos was not different. Analysis of the rates of cleaved and good-quality embryos in crytozoospermia and necrospermia did not exhibit a significant difference from the control. In conclusion, although the sperm from severe male infertility reduced the fertilization ability, the derived embryos had potential developmental viabilities that might be predictive for the expected clinical outcomes.

  10. Infertility: Ongoing Global challenge of new millennium

    Directory of Open Access Journals (Sweden)

    Kantibhai Naranbhai Sonaliya

    2016-06-01

    Full Text Available Background: Infertility tends to be the global challenge even in the second decade of the new millennium. Especially in developing countries like India, it is still one the most lethal social evil responsible for a big proportion of cases of psychological disturbances including suicide. Again, recently, few conditions other than communicable or Non-communicable diseases are given place among the categories of significant public health problems like Road Traffic Accidents, Burns, Poisoning, drowning and few more. But, for developing countries like India, the list is incomplete without inclusion of Infertility (there may be several others also. In public health, tuberculosis, leprosy and some other diseases are considered social diseases which produce social stigma for the patients and/or his family members.1 In same manner, Infertility is an important cause of social stigmatization since centuries for a couple suffering from, especially for woman involved. During a transitory phase of industrialization and socio-economic development, the situation is changed a minute smidgen at urban areas of India but at rural parts, sub-urban or even at urban slums (mainly among pockets of recent migrants the situation is as same as a few hundred years ago. A female of no religion, caste, social status or higher level of education are barred from some stringent mores related to infertility. Infertile females are still not allowed to take part in so many religious or social ceremonies; on the contrary, they have to face more harassment including domestic violence than their counterparts, who have given birth to the child. Due to social, psychological, economic disturbances, they are forced to take multiple sorts of treatments including religious quacks. So many infertile women are exploited physically and economically also in such weird ways of treatment to gain a pregnancy.

  11. Are repeated assisted reproductive technology treatments and an unsuccessful outcome risk factors for unipolar depression in infertile women?

    DEFF Research Database (Denmark)

    Sejbaek, Camilla S; Pinborg, Anja; Hageman, Ida

    2015-01-01

    INTRODUCTION: Previous studies have shown conflicting results whether unsuccessful medically assisted reproduction is a risk factor for depression among women. This study therefore investigated if women with no live birth after assisted reproductive technology (ART) treatment had a higher risk...... of unipolar depression compared with women with a live birth after ART treatment. MATERIAL AND METHODS: The Danish National ART-Couple (DANAC) Cohort is a national register-based cohort study that consists of women who received ART treatment from 1 January 1994 to 30 September 2009, in Denmark (n = 41 050......). Information on unipolar depression was obtained from the Danish Psychiatric Central Research Register. The analyses were conducted in Cox regression analysis. RESULTS: During the 308 494 person-years of follow up, 552 women were diagnosed with unipolar depression. A Cox proportional hazards model showed...

  12. Parenting after Infertility

    Science.gov (United States)

    Olshansky, Ellen

    2009-01-01

    Becoming a parent after experiencing infertility can pose unique challenges to early parenthood. Parents may struggle with the normal anxiety and fatigue, as well as possible depression, that accompany new parenthood, but with added guilt or shame because of how much they wanted a child and how hard they worked to become parents. These feelings…

  13. Fertility and Infertility.

    Science.gov (United States)

    Orgebin-Crist, Marie-Claire; And Others

    In this report, emphasis is placed on major research developments in the reproductive sciences, their impact on the health of individuals as well as on that of society, and on current trends that may provide new opportunities for future research in fertility and infertility. In the first section, major developments in the reproductive sciences are…

  14. Fertility and Infertility.

    Science.gov (United States)

    Orgebin-Crist, Marie-Claire; And Others

    In this report, emphasis is placed on major research developments in the reproductive sciences, their impact on the health of individuals as well as on that of society, and on current trends that may provide new opportunities for future research in fertility and infertility. In the first section, major developments in the reproductive sciences are…

  15. Parenting after Infertility

    Science.gov (United States)

    Olshansky, Ellen

    2009-01-01

    Becoming a parent after experiencing infertility can pose unique challenges to early parenthood. Parents may struggle with the normal anxiety and fatigue, as well as possible depression, that accompany new parenthood, but with added guilt or shame because of how much they wanted a child and how hard they worked to become parents. These feelings…

  16. A Study of Couple Burnout in Infertile Couples

    Science.gov (United States)

    Ghavi, Fatemeh; Jamale, Safieh; Mosalanejad, Leili; Mosallanezhad, Zahra

    2016-01-01

    Introduction: Infertility is a major crisis that can cause psychological problems and emotionally distressing experiences, and eventually affect a couples’ relationship. The objective of this study is to investigate couple burnout in infertile couples who were undergoing treatmentat the Infertility Clinic of Yazd, Iran. Method: The present study is a cross-sectional descriptive one on 98 infertile couples referringto the Infertility Centerof Yazd, Iran, who were chosen on a simple random sampling basis. The measuring tools consisted of the Couple Burnout Measure (CBM) and a demographic questionnaire. The collected data were analyzed using SPSS 16 and the statistical tests of ANOVA and t-test. P-values less than 0.05 were considered as significant. Results: The results show that infertile women experience higher levels of couple burnout than their husbands (pburnout—psychological burnout (pburnout (pburnout (p<0.001)—between wives and husbands show that women are at greater risk. Conclusion: Infertile couples’ emotional, mental, and sexual problems need to be addressed as part of the infertility treatment programs, and psychotherapists should be included in the medical team. PMID:26573033

  17. Characterization of fertility related antisperm antibodies-a step towards causal treatment of immunological infertility and immuno-contraception

    Institute of Scientific and Technical Information of China (English)

    Gerhard Haidl

    2010-01-01

    @@ Antisperm antibodies (ASA)occur in men and women and may significantly impair fertility. The identification of functionally rele-vant antigens of ASA is important for establishing causal treatment options on the one hand and may,on the other hand, enhance the de-velopment of tools for immunocon-traception. One candidate protein is addressed in an article of Wang et al. [1] published in Asian Journal of Andrology.

  18. 中药妇通汤治疗输卵管阻塞性不孕症的临床疗效观察%Clinical Efficacy Observation of Chinese Futong Decotion Treatment of Tubal Obstruction Infertility

    Institute of Scientific and Technical Information of China (English)

    许红英; 李万斌

    2014-01-01

    Objective: To investigate the traditional Chinese medicine gynecology and through Decoction in the treatment of oviduct obstructive infertility clinical curative ef ect. Methods: the infertility patients in our hospital in 2004 December -2012 year selection during December, were randomly divided into study group, the recanalization of fal opian tube pil control group through liquid treatment, after 3 months of treatment with hysterosalpingography to judge the curative ef ect. Results:comparing the two groups of patients after treatment, the study group patency in 26 cases, the patency rate was 35.62%, 6 cases of control group was smooth, the patency rate was 16.67%, after treatment has the curative ef ect dif erence between the two groups was significant (P<0.05). Conclusion:Traditional Chinese medicine gynecology and through Decoction in treatment of Tubal Obstructive infertility.%目的:探讨中药妇通汤治疗输卵管阻塞性不孕症的临床疗效。方法选择2004年12月~2012年12月在我院就诊的不孕症患者,随机分为复通丸研究组、输卵管通液治疗对照组,治疗3个月后采用子宫输卵管碘油造影判定疗效。结果两组患者治疗后对比,研究组通畅26例,通畅率35.62%,对照组通畅6例,通畅率16.67%,治疗后两组间疗效差异均有显著性(P<0.05)。结论中药妇通汤可治疗输卵管阻塞性不孕症。

  19. Male infertility in Nigeria: A neglected reproductive health issue ...

    African Journals Online (AJOL)

    Male infertility in Nigeria: A neglected reproductive health issue requiring attention. ... in Nigeria are sexually transmitted infections and hormonal abnormalities. ... a proper diagnosis, and adequate treatment given where causes are treatable.

  20. Study on Treatment of Polycystic Ovarian Syndrome with Infertility by Combined Therapy of Chinese Herbal Medicine and Compound Cyproterone Acetate

    Institute of Scientific and Technical Information of China (English)

    TAO Li-li (陶莉莉); CHEN Xiao-ping (陈小平); GU Zheng-tian (顾正田)

    2003-01-01

    Objective: To evaluate the effect of combined therapy of Chinese herbal medicine and compound cyproterone acetate (CPA) in treating non-obesity polycystic ovarian syndrome (PCOS) and to explore its mechanism in improving withdrawal ovulation. Methods:Eighty-six patients of non-obesity PCOS, typed as Shen-deficiency with blood stasis Syndrome or Shen-deficiency with Phlegm-Dampness Syndrome by Syndrome Differentiation in traditional Chines medicine, were randomly divided into three groups: (1) The TCM group (n=26) was treated with Chinese drugs for 6 menstrual cycles; (2) The western medicine (WM) group (n=30) was treated with 1 tablet of CPA for 21 days, with the treatment beginning from the 5th day of menstruation. The treatment was given for 3 menstrual cycles by repetitious medication, which stopped and restarted on the 5th day of withdrawal bleeding. Then the ovulation promoting therapy was applied by using clomifene citrate and human chorionic gonadotropin (CC/Hcg) for 3 menstrual cycles; (3) The TCM-WM group (n=30) was treated with the medications used for the above two groups. The menstrual cycle, the volume and duration of the menstruation, as well as the improvement of acne and pilosis [Ferriman-Gallway (F-G) scoring]were observed after 3 cycles ended. Moreover, condition of ovulation was monitored by B-ultrasonography at the 4th-6th cycle and status of pregnancy was observed. Results: Compared with before treatment, the blood level of luteinizing hormone (LH) and testosterone (T) in all 3 groups after treatment significantly decreased (P<0.05), with its ratio to follicle-stimulating hormone (LH/FSH) recovered to normal, but without markedly change in levels of FSH, estradiol (E2) and prolactin (PRL). The menstrual cycle in most patients got regular and acne significantly alleviated (P<0.05), and the improvement of infrequent menstruation and acne was better in the WM group and the TCM-WM group than that in the TCM group, but pilosis showed no significant

  1. Diagnosis of septic arthritis and initial antibiotic treatment

    OpenAIRE

    Bombaci, Hasan; Canbora, Kerem; Onur, Gokhan; Gorgec, Mucahit; Dosoglu, Nilgun

    2004-01-01

    Objectives: This study was designed to determine the similarities and differences in clinical, laboratory and radiographic presentation of septic arthritis in childhood and at adult ages, to find out its etiological profile, and to establish an antibiotic treatment protocol for the initial period and for patients in whom the causative agent could not be identified. Methods: Thirty-four patients (age range 15 months to 85 years) who underwent surgery with a diagnosis of septic arthritis wer...

  2. Infertility Care Among OEF/OIF/OND Women Veterans in the Department of Veterans Affairs

    Science.gov (United States)

    Mattocks, Kristin; Kroll-Desrosiers, Aimee; Zephyrin, Laurie; Katon, Jodie; Weitlauf, Julie; Bastian, Lori; Haskell, Sally; Brandt, Cynthia

    2015-01-01

    Background An increasing number of young women Veterans seek reproductive health care through the VA, yet little is known regarding the provision of infertility care for this population. The VA provides a range of infertility services for Veterans including artificial insemination, but does not provide in vitro fertilization. This study will be the first to characterize infertility care among OEF/OIF/OND women Veterans using VA care. Methods We analyzed data from the OEF/OIF/OND roster file from the Defense Manpower Data Center (DMDC)—Contingency Tracking System Deployment file of military discharges from October 1, 2001–December 30, 2010, which includes 68,442 women Veterans between the ages of 18 and 45 who utilized VA health care after separating from military service. We examined the receipt of infertility diagnoses and care using ICD-9 and CPT codes. Results Less than 2% (n = 1323) of OEF/OIF/OND women Veterans received an infertility diagnosis during the study period. Compared with women VA users without infertility diagnosis, those with infertility diagnosis were younger, obese, black, or Hispanic, have a service-connected disability rating, a positive screen for military sexual trauma, and a mental health diagnosis. Overall, 22% of women with an infertility diagnosis received an infertility assessment or treatment. Thirty-nine percent of women Veterans receiving infertility assessment or treatment received this care from non-VA providers. Conclusions Overall, a small proportion of OEF/OIF/OND women Veterans received infertility diagnoses from the VA during the study period, and an even smaller proportion received infertility treatment. Nearly 40% of those who received infertility treatments received these treatments from non-VA providers, indicating that the VA may need to examine the training and resources needed to provide this care within the VA. Understanding women’s use of VA infertility services is an important component of understanding VA

  3. STUDY OF GENITAL TUBERCULOSIS IN INFERTILE WOMEN

    Directory of Open Access Journals (Sweden)

    Shrikant

    2016-06-01

    Full Text Available AIM To determine the incidence of female Genital Tuberculosis (GTB and to analyse clinicopathological features for GTB and comparison of Polymerase Chain Reaction (PCR, Acid Fast Bacillus (AFB staining and Histopathology (HPR. STUDY SETTING A prospective study conducted on 50 infertile patients in the Department of Obstetrics and Gynaecology at Krishna Hospital, Karad, for a period of 2 years between December 2013 and December 2015. METHODS Patients were investigated for the presence of Mycobacterium Tuberculosis (MTB on samples collected by endometrial curettage by PCR, AFB and HPR. Additional tests like Hysterosalpingography (HSG Laparoscopic chromopertubation and hysteroscopy were performed if not done earlier. RESULT PCR demonstrated MTB DNA in 9 patients, and 2 were positive with AFB and HPR. Within positive patients HSG findings were suggestive of TB in 3 cases and laparoscopy in 5 cases and hysteroscopy in 4 cases. Two MTB PCR positive patients conceived spontaneously after 6 months of anti-tubercular treatment. CONCLUSION Genital tuberculosis is a diagnostic challenge if untreated it is chronic, progressive and destructive disease. Early diagnosis is crucial because once the infection damages the tubes, reverting tubal patency is very difficult. Molecular tests like DNA PCR have enabled us to detect the organism in its latent stage and initiation of treatment early in the disease can prevent many irreversible changes in the female genital tract.

  4. Effect observation of drug treatment for infertility of polycystic ovary syndrome%药物治疗多囊卵巢综合症不孕的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张宝爱

    2015-01-01

    ObjectiveOf infertility caused by polycystic ovary syndrome, by symptomatic treatment. MethodsWill 66 cases caused by polycystic ovarian infertility after treatment of drug Diane-35 in different periods, were given at the same time metformin, bromocriptine fertility treatment.ResultsThe effect of oral Diane -35 combined with metformin, bromocriptine on sex hormone levels. Before and after the treatment, the differences were not statistically significant (P>0.05)ConclusionOf polycystic ovary syndrome (PCOS) application of Diane - 35 for, while giving the compound Xuanju capsule as an adjuvant drug therapy and effect in the treatment of infertility.%目的:探讨多囊卵巢综合症引起的不孕,通过对症药物治疗的方法。方法将66例多囊卵巢引起的不孕症经过药物达英-35不同周期的治疗,同时分别给予二甲双胍、溴隐亭治疗助孕。结果口服达英-35联合二甲双胍、溴隐亭对性激素水平的影响。治疗前后比较差异均无统计学意义(P>0.05)结论多囊卵巢综合症应用达英-35治疗,同时给予复方玄驹胶囊做辅助药物治疗,治疗不孕症的疗效明显。

  5. [CHROMOSOMAL ABNORMALITIES IN PATIENTS WITH INFERTILITY].

    Science.gov (United States)

    Pylyp, L Y; Spinenko, L O; Verhoglyad, N V; Kashevarova, O O; Zukin, V D

    2015-01-01

    To assess the frequency and structure of chromosomal abnormalities in patients with infertility, a retrospective analysis of cytogenetic studies of 3414 patients (1741 females and 1673 males), referred to the Clinic of reproductive medicine "Nadiya" from 2007 to 2012, was performed. Chromosomal abnormalities were detected in 2.37% patients: 2.79% in males and 1.95% in females. Balanced structural chromosomal abnormalities prevailed over numerical abnormalities and corresponded to 80.2% of all chromosomal abnormalities detected in the studied group. Sex chromosome abnormalities made up 23.5% of chromosomal pathology (19/81) and included gonosomal aneuploidies in 84% of cases (16/19) and structural abnormalities of chromosome Y in 16% of cases (3/19). The low level sex chromosome mosaicism was detected with the frequency of 0.55%. Our results highlight the importance of cytogenetic studies in patients seeking infertility treatment by assisted reproductive technologies, since an abnormal finding not only provide a firm diagnosis to couples with infertility, but also influences significantly the approach to infertility treatment in such patients.

  6. The "Everything About the Existence" Experiences of Turkish Women With Infertility: Solicited Diaries in Qualitative Research.

    Science.gov (United States)

    Boz, İlkay; Okumuş, Hülya

    2017-08-01

    Infertility as a gynecological illness causes many psychological problems. In Turkey, only a limited number of studies have used qualitative methods to explore the experiences of infertile women. The aims of this study are to investigate the infertility experiences of women using Watson's Theory of Human Caring as a guide and to sensitize healthcare professionals to the importance of the personal stories of these women. A phenomenological approach was used to guide our exploration of the stories of infertile women during their treatment for infertility. This study involved 18 infertile women in Turkey. Data were collected using solicited diaries and were evaluated using thematic analysis. The findings identified the following themes: (a) losing control of everything, (b) facing up to the angst, (c) living with the unknown, (d) alienation from the fertile world, (e) existential faith and hope, and (f) nonhealing environment. This study identified "existentialist philosophy" as the most important aspect of the infertility experience. Participant experiences highlighted that they lived with a despair that was brought about by losses resulting from the infertility diagnosis and its treatment. Nurses should help infertile women reorganize the meaning of infertility to reach a healthy interpretation of infertility.

  7. Clinical Research on Combined Traditional Chinese and Western Medicine Treatment of Infertility with Polycystic Ovary Syndrome%中西医结合治疗多囊卵巢综合征致不孕临床研究

    Institute of Scientific and Technical Information of China (English)

    周燕霞

    2014-01-01

    To study the clinical curative effect of combination of traditional Chinese and western medicine treatment of infer-tility with polycystic ovary syndrome. Methods:50 patients with polycystic ovary syndrome infertility were randomly divided into two groups. The control group of 25 cases was given western medicine treatment,and the observation group of 25 cases was treated with com-bined traditional Chinese and western medicine treatment. The treatment results of two groups of patients were analyzed and compared. Results:After treatment,the effective rate of observation group was 82% ,the control group was 60% ;the clinical curative effect of ob-servation group was better than that of the control group(P 0. 05),and there was signifi-cant difference between two groups of patients of pregnancies in statistical analysis(P 0.05),两组患者的妊娠情况经过统计学分析,有显著的差异(P <0.05)。结论:中西医结合治疗多囊卵巢综合征致不孕的临床疗效显著。

  8. Polycystic ovaries and infertility: Our experience

    OpenAIRE

    Lavanya Rajashekar; Deepika Krishna; Madhuri Patil

    2008-01-01

    Background: Polycystic ovary syndrome (PCOS) is one of the most common (15-20%) endocrine disorders in women of childbearing age. Although it is a major cause of infertility, its etiology remains unknown and its treatment difficult. Aim: To evaluate the incidence, treatment and outcome of patients with PCOS. DESIGN: Retrospective analysis. Materials and Methods: PCOS patients (914 of the 1057) attending the outpatient department (OPD) from June 2003 to February 2008 were evaluated for this ...

  9. Tarlov cyst and infertility.

    Science.gov (United States)

    Singh, Pankaj Kumar; Singh, Vinay Kumar; Azam, Amir; Gupta, Sanjeev

    2009-01-01

    Tarlov cysts or spinal perineurial cysts are uncommon lesions. These are mostly incidental findings on magnetic resonance imaging or myelograms. The objectives of this study were to describe Tarlov cysts of the sacral region as a potential cause for retrograde ejaculations and review available management options. Case report and literature review. A 28-year-old man presented with back pain and retrograde ejaculations resulting in infertility. After microsurgical excision of large perineurial cysts, back pain resolved, but semen quality showed only marginal improvement. Later, the couple successfully conceived by intrauterine insemination. To the best of our knowledge, this is the first reported case of Tarlov cyst associated with retrograde ejaculation and infertility. Despite being mostly asymptomatic and an incidental finding, Tarlov cyst is an important clinical entity because of its tendency to increase in size with time. Tarlov cysts of the sacral and cauda equina region may be a rare underlying cause in otherwise unexplained retrograde ejaculations and infertility. Microsurgical excision may be a good option in a select group of patients.

  10. Biomedical infertility care in sub-Saharan Africa: a social science-- review of current practices, experiences and view points.

    Science.gov (United States)

    Gerrits, T; Shaw, M

    2010-01-01

    Some sort of infertility treatments, including the use of advanced reproductive technologies (ARTs), is nowadays provided at several places in sub-Saharan Africa. Yet, to date only a few studies have actually looked into the way these treatments are offered, used and experienced. In this review article the authors present and discuss empirical study findings that give insight into the way biomedical infertility care is provided, considered, experienced and/or used in sub-Saharan African countries. They concentrate on four themes that were often referred to in the reviewed studies and underline the importance of taking into account the local sociocultural context and notions when developing and implementing infertility care, namely: counselling, male involvement, acceptability of ARTs and the use of donor material (semen and embryos). In the conclusion the authors emphasize the importance of preventing infertility as part of integrated reproductive health programs and the need to improve the quality of (low tech) infertility care in the public health sector by means of standardized guidelines, training of health staff and improved counselling. In addition, from a reproductive rights perspective, they support initiatives to introduce low cost ARTs to treat tubal factor related infertility. They also point to potential unintended side effects of the introduction of ARTs and the use of donor material in the sub-Saharan African context, affecting gender inequity and inequity between citizens from different social classes, and argue that such effects should be acknowledged and avoided by all possible means. Finally, they present an agenda for future social science research on this topic in sub-Saharan Africa.

  11. Osteoporosis in the Women's Health Initiative: Another Treatment Gap?

    Science.gov (United States)

    Sattari, Maryam; Cauley, Jane A; Garvan, Cynthia; Johnson, Karen C; LaMonte, Michael J; Li, Wenjun; Limacher, Marian; Manini, Todd; Sarto, Gloria E; Sullivan, Shannon D; Wactawski-Wende, Jean; Beyth, Rebecca J

    2017-08-01

    Osteoporotic fractures are associated with high morbidity, mortality, and cost. We performed a post hoc analysis of the Women's Health Initiative (WHI) clinical trials data to assess osteoporosis treatment and identify participant characteristics associated with utilization of osteoporosis medication(s) after new diagnoses of osteoporosis or fracture. Information from visits prior to and immediately subsequent to the first fracture event or osteoporosis diagnosis were evaluated for medication use. A full logistic regression model was used to identify factors predictive of osteoporosis medication use after a fracture or a diagnosis of osteoporosis. The median length of follow-up from enrollment to the last WHI clinic visit for the study cohort was 13.9 years. Among the 13,990 women who reported new diagnoses of osteoporosis or fracture between enrollment and their final WHI visit, and also had medication data available, 21.6% reported taking an osteoporosis medication other than estrogen. Higher daily calcium intake, diagnosis of osteoporosis alone or both osteoporosis and fracture (compared with diagnosis of fracture alone), Asian or Pacific Islander race/ethnicity (compared with White/Caucasian), higher income, and hormone therapy use (past or present) were associated with significantly higher likelihood of osteoporosis pharmacotherapy. Women with Black/African American race/ethnicity (compared with White/Caucasian), body mass index ≥30 (compared with body mass index of 18.5-24.9), current tobacco use (compared with past use or lifetime nonusers), and history of arthritis were less likely to use osteoporosis treatment. Despite well-established treatment guidelines in postmenopausal women with osteoporosis or history of fractures, pharmacotherapy use was suboptimal in this study. Initiation of osteoporosis treatment after fragility fracture may represent an opportunity to improve later outcomes in these high-risk women. Specific attention needs to be paid to

  12. Initial treatment of descemetocele with hydrophilic contact lenses.

    Science.gov (United States)

    Leibowitz, H M; Berrospi, A R

    1975-09-01

    A hydrophilic contact lens was used as the initial mode of therapy in 5 cases of descemetocele. The lens was left in place over the descemetocele continuously for periods ranging from 2 to 15 months. Corneal perforation did not occur, and the anterior chamber remained formed in all cases. The device seemingly provides sufficient structural reinforcement to Descemet's membrane to prevent its distension by the intraocular pressure. It also maintains Descemet's membrane in a moist state and protects the descemetocele from the trauma of the lid margins during blinking. This series of cases indicates that a hydrophilic contact lens can be a very effective temporizing measure for the treatment of descemetocele, enabling the surgeon initially to cope with an ocular emergency in a very simple manner, and to convert the ultimate surgical repair to a scheduled, carefully planned procedure with a much greater potential for success.

  13. Fertility prognosis for infertile couples

    DEFF Research Database (Denmark)

    Bostofte, E; Bagger, P; Michael, A

    1993-01-01

    OBJECTIVE: To develop a fertility prognosis model for infertile couples. DESIGN: Prospective follow-up study. PARTICIPANTS: In the period November 30, 1977 to June 1, 1985, 321 consecutive couples were investigated for infertility at Hvidovre University Hospital. Investigation of the female...... MEASURE: The Cox regression model was used to predict the time required to conceive based on informations provided by fertility investigations. RESULTS: Three of 16 prognostic variables (the period of infertility, the female infertility factor, and the P-test) possess significant prognostic information....... The period of infertility and the P-test are best scored as continuous variables, whereas the female infertility factor are best categorized in four classes, i.e., normal, ovulation or cervical disorder, anatomic disorder, or a combination of disorders. CONCLUSIONS: The three prognostic variables...

  14. The role of intrauterine insemination in male infertility.

    Science.gov (United States)

    Akanji Tijani, Hammed; Bhattacharya, Siladitya

    2010-12-01

    Male infertility is a common condition and intrauterine insemination (IUI) is used to treat the mild to moderate forms. Male subfertility determination is usually based on routine semen analysis but recent publications have questioned its diagnostic and prognostic accuracy as well as the effectiveness of IUI itself, as a treatment modality. We carried out a structured review of the literature to assess the current evidence regarding the diagnosis of male infertility, the effectiveness and cost effectiveness of IUI in male infertility and factors that affect the outcome of IUI. There is still uncertainty regarding the criteria for diagnosing male infertility and predicting treatment outcome based on standard semen parameters. The presence of seminal defects compromises the outcome of IUI in comparison with unexplained infertility. The total motile sperm count (TMSC) appears to have a consistent, direct relationship with treatment outcome, but there is no definite predictive threshold for success. However, it is reasonable to offer IUI as first-line treatment if TMSC is greater than 10 million when balancing the risk and cost of alternate treatments, such as in vitro fertilization (IVF). Sperm DNA studies and sperm preparation techniques warrant further studies in order to establish their clinical relevance. There are limited data on the clinical and cost-effectiveness of IUI in male infertility and large high-quality randomized controlled trials are warranted. However the difficulties in organizing such a study, at the present time, are a matter for discussion.

  15. Importance of proper initial treatment of moderate and major burns

    Directory of Open Access Journals (Sweden)

    Vulović Dejan

    2008-01-01

    Full Text Available Background/Aim. Burns are common injuries with frequency depending on human factors, development of protection, industry and traffic, eventual wars. Organized treatment of major burn injuries has tremendous medical, social and economic importance. The aim of this study was to analyze initial treatment of major and moderate burns, to compare it with the current recommendations and to signify the importance of organized management of burns. Methods. In a prospective study 547 adult patients with major burns were analyzed, covering a period of eight years, with the emphasis on the initial hospital admission and emergency care for burns greater than 10% of total body surface area (TBSA. Results. In the different groups of major burns, the percentage of hospital admission was: 81.5 in burns greater than 10% TBSA, 37.7 in burns of the functional areas, 54.5 in the III degree burns, 81.6 in electrical burns, 55.9 in chemical burns, 61.9 in inhalation injury, 41.0 in burns in patients with the greater risk and 100 in burns with a concomitant trauma. In the group of 145 patients with burns greater than 10% TBSA, intravenous fluids were given in 87 patients, analgesics in 45, corticosteroids in 29, antibiotics in 23 and oxygen administration in 14. In the same group, wound irrigation was done in 14.4%, removing of the clothing and shoes in 29.6%, elevation of the legs in 8.9% and prevention of hypothermia in 7.6% of the victims. There were no initial estimations of burn extent (percentage of a burn, notes about the patient and injury and tetanus immunizations. Conclusion. Based on these findings, it is concluded that there should be much more initial hospital admissions of major burns, and also, necessary steps in the emergency care of burns greater than 10% TBSA should be taken more frequently. On the other side, unnecessary or wrong steps should be avoided in the initial burn treatment.

  16. Markers of genital tuberculosis in infertility.

    Science.gov (United States)

    Khanna, A; Agrawal, A

    2011-12-01

    Although genital tuberculosis is a condition that is prevalent worldwide, it is still a diagnostic dilemma. This study aimed to find an effective diagnostic modality for the condition. A total of 100 infertile women were clinically evaluated with haemoglobin estimation, total and differential count, Mantoux test, tubercle bacilli enzyme-linked immunosorbent assay (TB ELISA), hysterosalpingography, pelvic ultrasonography, laparohysteroscopy, premenstrual endometrial biopsy for histopathology, culture and tubercle bacilli polymerase chain reaction (TBPCR). The womens' Day 2 hormonal profile (luteinising, follicle-stimulating, prolactin and thyroidstimulating hormones) and their husbands' semen analysis were also conducted. A total of 58 women had primary infertility and 42 had secondary infertility. Female factor infertility was present in 63 percent of the cases (mostly tubal; 45.97 percent). 26 women tested positive for endometrial TBPCR. Erythrocyte sedimentation rate, Mantoux test, TB ELISA and hysterosalpingography were found to have high negative predictive value (greater than 80 percent), while the positive predictive value was 35-45 percent. Laparoscopy findings were suggestive of tuberculosis in 13 percent of the women, out of which 83.3 percent were positive for endometrial TBPCR. Hysteroscopy revealed intrauterine adhesions in 34.8 percent of the women, with 68.8 percent being positive for tubercular bacilli. Our study established that in cases of genital tuberculosis, the use of expensive endometrial TBPCR tests may be avoided with a detailed workup, which would also help in the institution of anti-tubercular treatment in early disease, thus enhancing the chance of pregnancy.

  17. Germ cell transplantation in infertility mouse

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    This work investigated the spermatogenesis in an infertility BALB/c-nu mouse model by reinfusing germline stem cells into seminiferous tubules.Donor germ cells were isolated from male FVB/NJ-GFP transgenic mice.Seminiferous tubule microiniection was applied to achieve intratubular germ cell transfer.The germ cells were injected into exposed testes of the infertility mice.We used green fluorescence and DNA analysis of donor cells from GFP transgenic mice as genetic marker.The natural mating and Southern blot methods were applied to analyze the effect of sperm cell transplantation and the sperm function after seminiferous tubule microinjecUon.The spermatogenesis was morphologically observed from the seminiferous tubules in 41/60(68.33%)of the injected recipient mice using allogeneic donor cells.In the colonized testes,matured spermatozoa were seen in the lumen of the seminiferous tubules.In this research,BALB/c-nu infertility mouse model,the recipient animal,was used to avoid immunological rejection of donor cells,and germ cell transplantation was applied to overcome infertility caused by busulfan treatment.These results demonstrate that this technique of germ cell transplantation is of great use.Germ cell transplantation could be potentially valuable to oncological patients.

  18. 继发性不孕症治疗方法的选择及妊娠结局分析%Choice of Different Treatment of Secondary Infertility and Analysis of Pregnancy Outcome

    Institute of Scientific and Technical Information of China (English)

    毕芳芳; 杨清; 李景溪; 王睿聪

    2013-01-01

    目的:探讨各种治疗方法在继发性不孕症中的治疗作用.方法:对我院2007-2009年诊治的955例继发性不孕症患者的资料进行归纳整理,分析各种治疗方案的可行性和妊娠结局.结果:①多囊卵巢综合征患者中,应用促排卵药物治疗65例,妊娠率为47.69%;腹腔镜下卵巢开窗治疗29例,妊娠率为65.52%;行体外受精-胚胎移植(IVF-ET)14例,妊娠率为57.14%.②输卵管因素导致的不孕症中,行输卵管通液治疗95例,妊娠率为33.68%;宫、腹腔镜联合下输卵管整形患者81例,妊娠率为60.49%;行IVF-ET 319例,妊娠率为39.81%.③子宫因素导致的不孕症中,月经失调行人工周期疗法94例,妊娠率为60.63%;行宫腔镜、腹腔镜或开腹手术168例,妊娠率为61.31%;行IVF-ET患者67例,妊娠率为26.87%.④不明原因继发性不孕者,23例患者行IVF-ET,妊娠率为21.74%.在所有行IVF-ET的患者中,总妊娠率为37.35%.结论:针对不同病因导致的继发性不孕症,选择合适的治疗方法,有利于妊娠率的提高.%Objective:To investigate the effect of various methods in the treatment of infertility. Methods:Summarize 955 cases of secondary infertility diagnosed in our hospital from 2007 to 2009, and analyze the various treatment methods and pregnancy outcome. Results:① In ovulation disorders patients, 65 cases undergo ovulation induction therapy and the pregnancy rate was 47.69% jlaparoscopic fenestration of 29 cases and the pregnancy rate was 65.52%; 14 cases of in vitro fertilization and embryo transfer(IVF-ET) and the pregnancy rate was 57.14%. ② 95 cases with tubal-line treatment and the pregnancy rate was 33.68%; 81 cases of tubal plastic surgery under laparoscope and the pregnancy rate was 60.49% in tubal factor infertility. ③ 94 cases with artificial cycle therapy and the pregnancy rate was 60.63%; 168 cases with surgery treatment and the pregnancy rate was 61.31% ;67 cases of IVF-ET and the

  19. Infertility and assisted reproduction in Denmark. Epidemiology and psychosocial consequences.

    Science.gov (United States)

    Schmidt, Lone

    2006-11-01

    Clinically a couple is considered to be infertile after at least one year without contraception and without pregnancy. There was scant knowledge about the prevalences of infertility, involuntary childlessness and the seeking of fertility treatment and only few longitudinal studies about the psychosocial consequences of infertility and its treatment. This thesis is about the epidemiological aspects of infertility; the conceptualization and measurement of important psychosocial aspects of infertility; and a medical sociological analysis of the associations between these psychosocial variables among Danish women and men in fertility treatment. The thesis is based on nine papers. The three main purposes were: (i) to review critically, population based studies of infertility and medical care seeking in industrialised countries. Further, to examine these prevalences and subsequent motherhood among women in former assisted reproduction in a Danish population. (ii) To develop measures of psychosocial consequences of infertility: fertility problem stress, marital benefit, communication, coping strategies, attitudes to and evaluation of fertility treatment. (iii) To examine these phenomena and to analyse their interrelations among Danish women and men in fertility treatment. The thesis is based on four empirical studies: (i) The Women and Health Survey, a cross-sectional population-based study among 15-44 year old women (n=907, 25-44 year old) in Copenhagen County, 1989. (ii) The Psychosocial Infertility Interview Study, a qualitative interview study among 16 couples (n=2 participants) infertility treatment at The Fertility Clinic, Herlev University Hospital,1992. (iii) The Infertility Cohort, a longitudinal cohort study consecutively including all couples (n=250 participants) beginning anew fertility treatment period at one of four public (Braedstrup, Herlev, Odense, Rigshospitalet) and one private fertility clinic (Trianglen),2000-2002. (iv) The Communication and Stress

  20. Dermatoglyphic pattern in male infertility.

    Science.gov (United States)

    Sontakke, B R; Talhar, S; Ingole, I V; Shende, M R; Pal, A K; Bhattacharaya, T

    2013-06-01

    Dermatoglyphics in infertile male patients were studied and compared with that of age matched controls to see whether any specific dermatoglyphic pattern exists in infertile male patients. Infertile male patients with abnormal semen profile were referred to Cytogenetic Laboratory for karyotyping. We selected twenty-four infertile male patients with abnormal semen profile. Out of twenty-four infertile male patients, nineteen were with normal Karyotype and five patients were with abnormal Karyotype. Loop was the commonest pattern observed in the infertile male patients. All these fingertip and palmar dermatoglyphic findings were compared with that of result on finger and palmar dermatoglyphics of equal number of age matched controls. Statistical evaluation was done with software "EPI- info, version-6.04 d". Infertile males had reduced number of loops as compared to that of controls which was statistically significant. Total whorls were increased in infertile male patients as compared to that of controls which was statistically insignificant. Percentage of true palmar pattern in I 3 and I 4 areas was reduced in infertile male patients as compared to that of controls which was statistically insignificant.

  1. Genetics Home Reference: Y chromosome infertility

    Science.gov (United States)

    ... Home Health Conditions Y chromosome infertility Y chromosome infertility Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Y chromosome infertility is a condition that affects the production of ...

  2. Clinical application of female hormone determination in infertility treatment%激素检测在女性不孕症诊治中的临床应用

    Institute of Scientific and Technical Information of China (English)

    张春燕; 潘柏申

    2015-01-01

    Laboratory determination for female hormones plays a large part in infertility treatment , especially during in vitro fertilization(IVF) cycle.The hormones contain follicle stimulating hormone (FSH), estradiol(E2), anti-Müllerian hormone(AMH), inhibin B(Inh B), progesterone and luteinizing hormone (LH).Serum FSH, E2 and AMH levels are commonly determined for women as a part of ovarian reserve testing .E2 levels are also frequently evaluated in a controlled-ovarian-hyperstimulation ( COH ) setting to monitor follicular development . In addition to its role in evaluating ovarian reserve , researchers have studied AMH as a predictor of response to gonadotropin stimulation during ovulation induction .Inh B levels are not regarded as a reliable assessment index of ovarian reserve .Poorer responders to gonadotropin generally have lower Inh B levels .Progesterone is a simple determination for ovarian function .The role of progesterone and LH levels in evaluating the success of IVF cycle has been the subject of debate for many years .%女性激素水平的实验室检测在不孕症的诊治中,特别是在体外受精( IVF)的周期中起着重要作用。这些激素包括卵泡刺激素(FSH)、雌二醇(E2)、抗苗勒氏管激素(AMH)、抑制素B(Inh B)、孕酮和黄体生成素( LH)。血清FSH、E2和AMH通常作为评估女性卵巢储备功能的检测项目。 E2通常也被用于监测控制性超排卵( COH)中的卵泡发育。除了用于评估卵巢储备功能以外,AMH还可在诱导排卵过程中作为对促性腺激素反应的预测因子。 Inh B不能被视为一个评估卵巢储备功能的可靠标志物。促性腺激素反应不良的患者Inh B水平一般较低。孕酮是一个检测卵巢功能的简单指标。孕酮和LH在预测IVF是否成功方面的价值存在争论。

  3. Surgical techniques for the management of male infertility

    Institute of Scientific and Technical Information of China (English)

    Natalya A Lopushnyan; Thomas J Walsh

    2012-01-01

    Evaluation and surgical treatment of male infertility has evolved and expanded,now leading to more precise diagnoses and tailored treatments with diminished morbidity and greater success.Surgeries for male infertility are divided into four major categories:(i)diagnostic surgery; (ii) surgery to improve sperm production; (iii) surgery to improve sperm delivery; and (iv) surgery to retrieve sperm for use with in vitrofertilization and intracytoplasmic sperm injection (IVF-ICSI).While today we are more successful than ever in treating male infertility,pregnancy is still not always achieved likely due to factors that remain poorly understood.Clinicians treating infertility should advocate for couple-based therapy,and require that both partners have a thorough evaluation and an informed discussion before undergoing specific surgical therapies.

  4. Prerequisite Testing for Infertility Treatment

    Science.gov (United States)

    ... Party Reproduction A Patient's Guide to Assisted Reproductive Technology Frequently Asked Questions History of IVF PROFESSIONALS & PROVIDERS Join SART Research Publications The SART Executive Council ASRM Ethics Reports ASRM Practice Guidelines Career Opportunities IVF SUCCESS ...

  5. Progress of Integrative Chinese and Western Medicine in Treating Polycystic Ovarian Syndrome Caused Infertility

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Polycystic ovarian syndrome (PCOS) is one of the most popular diseases that cause menstrual dysfunction and infertility in women. The present paper is a brief retrospection on the progress in treatment of PCOS caused infertility with integrative Chinese and Western medicine (ICWM). It can be seen from these materials that using traditional Chinese medicine (TCM) recipes formulated by Sheh-replenishing herbs or acupuncture to reinforce Gan-Shen, regulate Chong-Ren Channels in treating PCOS, stable clinical efficacy could be obtained, with less adverse reaction, though the effect initiated somewhat late. Whereas, when Shen-replenishing recipe and acupuncture are combined with hormone or ovulation promoting drugs of Western medicine, the above-mentioned shortcomings would be overcome. So, this combined therapy is frequently used in clinical practice.

  6. Progress of integrative Chinese and Western medicine in treating polycystic ovarian syndrome caused infertility.

    Science.gov (United States)

    Song, Juan-juan; Yan, Miao-e; Wu, Xiao-ke; Hou, Li-hui

    2006-12-01

    Polycystic ovarian syndrome (PCOS) is one of the most popular diseases that cause menstrual dysfunction and infertility in women. The present paper is a brief retrospection on the progress in treatment of PCOS caused infertility with integrative Chinese and Western medicine (ICWM). It can be seen from these materials that using traditional Chinese medicine (TCM) recipes formulated by Shen-replenishing herbs or acupuncture to reinforce Gan-Shen, regulate Chong-Ren Channels in treating PCOS, stable clinical efficacy could be obtained, with less adverse reaction, though the effect initiated somewhat late. Whereas, when Shen-replenishing recipe and acupuncture are combined with hormone or ovulation promoting drugs of Western medicine, the above-mentioned shortcomings would be overcome. So, this combined therapy is frequently used in clinical practice.

  7. Evidence-Based Care for Couples With Infertility.

    Science.gov (United States)

    Stevenson, Eleanor L; Hershberger, Patricia E; Bergh, Paul A

    2016-01-01

    When couples cannot achieve pregnancy, they often seek health care from medical and nursing specialists. The care the couple receives begins with a thorough assessment to determine the possible cause of infertility and to plan appropriate care to ensure the best chance for the couple to have a biological child. In this article, we provide an overview of the etiology and evaluation of infertility, the various treatment options available, and the appropriate clinical implications.

  8. Who goes to treatment? Predictors of treatment initiation among gambling help-line callers.

    Science.gov (United States)

    Ledgerwood, David M; Arfken, Cynthia L; Wiedemann, Ashley; Bates, Kendrich E; Holmes, Donald; Jones, LaNeice

    2013-01-01

    Although the consequences of problem gambling can be severe, few ever seek treatment for this disorder. Problem gambling help-lines represent a crucial point of entry into the treatment system. Through brief telephone counseling, help-lines have the potential of enhancing callers' motivations to engage in longer-term treatment. We prospectively examined treatment initiation and its predictors among individuals calling a state help-line. Participants (n = 143) were assessed shortly after their initial call and re-contacted at least two months later. Overall 67% of the re-contacted help-line callers had attended at least one treatment session at the time of the follow-up interview (92.7% formal treatment and 28.1% peer-support meetings). Multivariate analysis revealed that gambling-related financial difficulties and past treatment for problem gambling (but not for mental health or substance abuse) predicted treatment initiation. Enhanced counseling focusing on motivational factors may result in better treatment engagement for some problem gamblers. Copyright © American Academy of Addiction Psychiatry.

  9. Male Infertility: MedlinePlus Health Topic

    Science.gov (United States)

    ... Retrograde ejaculation Semen analysis Sperm release pathway Testicular biopsy Related Health Topics Assisted Reproductive Technology Female Infertility Infertility National Institutes of Health The ...

  10. 探讨多囊卵巢综合症不孕症的治疗方法及妊娠结果%Treatment of Polycystic Ovary Syndrome Infertility and Pregnancy Outcome

    Institute of Scientific and Technical Information of China (English)

    赵虎; 张凌; 蔡一玲; 赖繁

    2013-01-01

      目的探讨多囊卵巢综合症不孕症的临床治疗方法,以及使用该方法对妊娠结果的影响情况。方法对我院收治的69例多囊卵巢综合症不孕症患者进行治疗,本着就症治疗恢复生育的目的进行,方案采用二甲双胍联合克罗米芬治疗,疗程为12周,对比治疗前后 LH、T、FINS 和 FBG 水平变化,以及最终妊娠的情况。结果治疗后 T、LH 与FINS 的含量比治疗前下降较显著(P<0.05),符合统计学意义,FBG 水平在治疗前后差异不显著(P>0.05),经过治疗后,42例(60.87%)有排卵现象,最终有29例(42.03%)成功妊娠。结论采用二甲双胍联合克罗米芬治疗多囊卵巢综合症不孕症的临床效果较好,排卵率高,且增加了妊娠的几率,无副作用,较安全。%  Objective Clinical study on treatment of polycystic ovary syndrome infertility, and using the method of influence on pregnancy outcome. Methods The hospital treated 69 cases of polycystic ovary syndrome with infertility treatment, were in on the treatment to restore fertility purpose, scheme using metformin combined with clomiphene therapy, treatment for 12 weeks, changes of LH, T, FINS and FBG levels before and after treatment were compared, and the end of pregnancy. Results After treatment, T, LH and FINS content decreased significantly than that before treatment (P0.05 ), after treatment, 42 cases (60.87%) have oviposit phenomenon, final y 29 cases (42.03%)of successful pregnancy. Conclusion Objective to evaluate the clinical effect of using metformin combined with clomiphene in treatment of polycystic ovarian syndrome infertility,ovulation rate is high, and increased the probability of pregnancy, no side effects, safe.

  11. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra

    2014-01-01

    Objective. To examine the costs to the public health care system of couples in medically assisted reproduction. Design. Longitudinal cohort study of infertile couples initiating medically assisted reproduction treatment. Setting. Specialized public fertility clinics in Denmark. Sample. Seven hund...

  12. Infertility and incident endometrial cancer risk: a pooled analysis from the epidemiology of endometrial cancer consortium (E2C2)

    Science.gov (United States)

    Yang, H P; Cook, L S; Weiderpass, E; Adami, H-O; Anderson, K E; Cai, H; Cerhan, J R; Clendenen, T V; Felix, A S; Friedenreich, C M; Garcia-Closas, M; Goodman, M T; Liang, X; Lissowska, J; Lu, L; Magliocco, A M; McCann, S E; Moysich, K B; Olson, S H; Petruzella, S; Pike, M C; Polidoro, S; Ricceri, F; Risch, H A; Sacerdote, C; Setiawan, V W; Shu, X O; Spurdle, A B; Trabert, B; Webb, P M; Wentzensen, N; Xiang, Y-B; Xu, Y; Yu, H; Zeleniuch-Jacquotte, A; Brinton, L A

    2015-01-01

    Background: Nulliparity is an endometrial cancer risk factor, but whether or not this association is due to infertility is unclear. Although there are many underlying infertility causes, few studies have assessed risk relations by specific causes. Methods: We conducted a pooled analysis of 8153 cases and 11 713 controls from 2 cohort and 12 case-control studies. All studies provided self-reported infertility and its causes, except for one study that relied on data from national registries. Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI). Results: Nulliparous women had an elevated endometrial cancer risk compared with parous women, even after adjusting for infertility (OR=1.76; 95% CI: 1.59–1.94). Women who reported infertility had an increased risk compared with those without infertility concerns, even after adjusting for nulliparity (OR=1.22; 95% CI: 1.13–1.33). Among women who reported infertility, none of the individual infertility causes were substantially related to endometrial cancer. Conclusions: Based on mainly self-reported infertility data that used study-specific definitions of infertility, nulliparity and infertility appeared to independently contribute to endometrial cancer risk. Understanding residual endometrial cancer risk related to infertility, its causes and its treatments may benefit from large studies involving detailed data on various infertility parameters. PMID:25688738

  13. Folic acid supplementation and IVF pregnancy outcome in women with unexplained infertility.

    Science.gov (United States)

    Murto, T; Skoog Svanberg, A; Yngve, A; Nilsson, T K; Altmäe, S; Wånggren, K; Salumets, A; Stavreus-Evers, A

    2014-06-01

    Folic acid supplements are commonly used by infertile women which leads to a positive folate status. However, the effect of folic acid supplements on pregnancy outcome in women with unexplained infertility has not been well investigated. This study evaluated folic acid supplement use and folate status in women with unexplained infertility in relation to IVF pregnancy outcome. In addition, use of folic acid supplements and folate status were compared between women with unexplained infertility and fertile, nonpregnant control women. Women with unexplained infertility used significantly more folic acid supplements and had higher median total folic acid intake from supplements compared with fertile control women (both P folic acid supplementation or folate status were not related to pregnancy outcome in women with unexplained infertility. In conclusion, folic acid supplementation or good folate status did not have a positive effect on pregnancy outcome following infertility treatment in women with unexplained infertility. Folate is one of the B vitamins which has been suggested to be related to infertility. Folic acid is an artificial form of folate which is commonly used in dietary supplements. Folic acid supplementation has been shown to increase folate concentrations and decrease concentrations of the amino acid homocysteine in the blood. Folic acid supplementation is commonly used by infertile women, but the effect on pregnancy outcome in women with a diagnosis of unexplained infertility has not been thoroughly investigated. In the present study, folic acid supplement use and folate status (concentrations of folate and homocysteine) in women with unexplained infertility were evaluated in relation to pregnancy outcome. In addition, the use of folic acid supplements and folate status were compared between women with unexplained infertility and fertile control women. Our results showed that women with unexplained infertility used considerably more folic acid

  14. Bridging waitlist delays with Interim Buprenorphine Treatment: Initial feasibility

    Science.gov (United States)

    Sigmon, Stacey C.; Meyer, Andrew; Hruska, Bryce; Ochalek, Taylor; Rose, Gail; Badger, Gary J.; Brooklyn, John R.; Heil, Sarah H.; Higgins, Stephen T.; Moore, Brent A.; Schwartz, Robert P.

    2015-01-01

    Despite the effectiveness of agonist maintenance for opioid dependence, individuals can remain on waitlists for months, during which they are at significant risk for morbidity and mortality. Interim dosing, consisting of daily medication without counseling, can reduce these risks. In this pilot study, we examined the initial feasibility of a novel technology-assisted interim buprenorphine treatment for waitlisted opioid-dependent adults. Following buprenorphine induction during Week 1, participants (n=10) visited the clinic at Weeks 2, 4, 6, 8, 10 and 12 to ingest their medication under staff observation, provide a urine specimen and receive their remaining doses via a computerized Med-O-Wheel Secure device. They also received daily monitoring via an Interactive Voice Response (IVR) platform, as well as random call-backs for urinalysis and medication adherence checks. The primary outcome was percent of participants negative for illicit opioids at each 2-week visit, with secondary outcomes of past-month drug use, adherence and acceptability. Participants achieved high levels of illicit opioid abstinence, with 90% abstinent at the Week 2 and 4 visits and 60% at Week 12. Significant reductions were observed in self-reported past-month illicit opioid use (p<.001), opioid withdrawal (p<.001), opioid craving (p<.001) and ASI Drug composite score (p=.008). Finally, adherence with buprenorphine administration (99%), daily IVR calls (97%) and random call-backs (82%) was high. Interim buprenorphine treatment shows promise for reducing patient and societal risks during delays to conventional treatment. A larger-scale, randomized clinical trial is underway to more rigorously examine the efficacy of this treatment approach. PMID:26256469

  15. Dasatinib and Doxorubicin Treatment of Sarcoma Initiating Cells

    DEFF Research Database (Denmark)

    Aggerholm-Pedersen, Ninna; Demuth, Christina; Safwat, Akmal;

    2016-01-01

    ) treatment with or without doxorubicin was assessed by MTS assay. Results. Initial results showed that the hMSC-TERT4 was more doxorubicin-sensitive while hMSC-TERT20-CE8 was less doxorubicin-sensitive evidenced by monitoring cell viability in the presence of doxorubicin at different doses. The epidermal......) stem cell line hMSC-TERT4 and a transformed cell line hMSC-TERT20-CE8, known to form sarcoma-like tumours when implanted in immune-deficient mice, were used as models. Receptor tyrosine kinase (RTK) activation was analysed by RTK arrays and cellular viability after tyrosine kinases inhibitor (TKI...... growth factor receptor (EGFR) was activated in both cell lines. However hMSC-TERT20-CE8 exhibited significantly higher expression of the EGFR ligands. EGFR inhibitors such as erlotinib and afatinib alone or in combination with doxorubicin failed to further decrease cell viability of hMSC-TERT20-CE8...

  16. Initial experience with ocriplasmin in the treatment of vitreomacular traction

    Directory of Open Access Journals (Sweden)

    José Maurício Botto de Barros Garcia

    2016-04-01

    Full Text Available ABSTRACT This study aimed to report the clinical and structural outcomes of intravitreal ocriplasmin in the treatment of vitreomacular interface disorders in two tertiary centers in Brazil. A retrospective study was performed by reviewing medical records and spectral domain optical coherence tomography (SD-OCT findings of seven patients who were treated with a single ocriplasmin injection. A total of 57.14% of patients achieved resolution of vitreomacular traction as evidenced by SD-OCT. Regarding our functional results, 87.71% maintained or improved visual acuity after follow-up. To the best of our knowledge, this is the first study reporting initial results of ocriplasmin therapy in Brazil.

  17. 探讨多囊卵巢综合征不孕患者治疗方式%To Investigate the Treatment of Infertility in Patients With Polycystic Ovary Syndrome

    Institute of Scientific and Technical Information of China (English)

    张春许

    2015-01-01

    Objective Explore effective methods for treating infertility polycystic ovary syndrome. Methods 54 cases of polycystic ovary syndrome infertility patients were selected from January 2012 to December 2013 in our hospital, all patients were given medicine treatment of artificial cycle. Results This group of patients were treated with 37 cases, effective in 11 cases, invalid in 6 cases, effective rate was 88.9%, the curative effect was satisfactory. Conclusion Artificial periodic therapy for polycystic ovary syndrome infertility, can adjust the menstrual cycle, improve clinical symptoms, improve pregnancy rate, the exact effect.%目的:探讨有效的治疗多囊卵巢综合征不孕的方法。方法选择我院2012年1月~2013年12月收治的54例多囊卵巢综合征不孕患者的临床资料,全部患者均给予中药人工周期法治疗。结果本组患者经治疗37例,有效11例,无效6例,有效率88.9%,疗效较为满意。结论采用中医人工周期疗法治疗多囊卵巢综合征不孕,可调整月经周期,改善临床症状,提高妊娠率,疗效确切。

  18. Thyroid dysfunction in infertile women

    Directory of Open Access Journals (Sweden)

    S G Perminova

    2011-12-01

    Full Text Available Objective. To study the rate and structure of thyroid diseases in infertile women and to asses their reproductive system depending upon the thyroid pathology. Subjects and methods. The study was based on the results of screening of T status of 496 women with infertility (main group and 80 fertile women (control group. Traditional methods of diagnosis of infertility were used along with special methods of investigation including assessment of function and structure of T (TTH, fT4, fT3, AT-TPO, AT-rTTH, ultrasound examination of T, thin-niddle aspirational biopsy, scintigraphy of T. A complex evaluation of the reproductive system status in infertile women was done depending on the type of T pathology. Results. Infertile women were found to suffer from thyroid dysfunction 3.8 times as more often as fertile ones (48% and 12.5%, p <0.05. Its structure included mainly AT-TPO carrier phenomenon in combination with ultrasound markers of thyroid autoimmunity (24%, hypothyroidism following thyroid autoimmunity (9.4% demonstrating itself as clinical (0.8%, subclinical (8.6%, and euthyroid (7.8% goiters. The portion of women with infertility and hyperthyroidism was small (0.6%. An association of thyroid autoimmunity with idiopathic infertility, endometriosis, endocrine infertility was found. Conclusion. It is necessary to perform a screening assessment of the function and structure of T in infertile women within diagnostic search for the reasons of infertility and in-time correction of the revealed thyroid dysfunction.

  19. Infertility and preterm delivery, birthweight, and Caesarean section: a study within the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Basso, Olga; Baird, Donna D.

    2003-01-01

    BACKGROUND: More than 10% of babies are born to couples taking >1 year to conceive (a common definition of infertility). Some evidence indicates that such pregnancies are at increased risk of preterm delivery and other adverse birth outcomes, but the problem has rarely been addressed in large....... Among couples with a TTP >1 year, infertility treatment was associated with added risk only among multiparas. CONCLUSION: Infertile women are at higher risk of adverse birth outcomes even if they conceive without treatment. With >10% of babies born to infertile couples, it is important to consider...

  20. Medical management of male infertility in the absence of a specific etiology.

    Science.gov (United States)

    Gudeloglu, Ahmet; Brahmbhatt, Jamin V; Parekattil, Sijo J

    2014-07-01

    Idiopathic male infertility can be diagnosis in approximately one-third of infertile males. The empirical medical treatment with or without assisted reproductive techniques appears common in male infertility practice. This type of management can be classified as hormonal treatment including gonadotropins, antiestrogens, and aromatase inhibitors and support with antioxidant supplements such as carnitine, lycopene, glutathione, and vitamin E. This review investigates the evidence of commonly used empirical medical management of male infertility when there is no demonstrable diagnosis. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  1. Quality and quantity of infertility care in Bangladesh.

    Science.gov (United States)

    Fatima, P; Ishrat, S; Rahman, D; Banu, J; Deeba, F; Begum, N; Anwary, S A; Hossain, H B

    2015-01-01

    Infertility is an important health issue which has been neglected in the developing countries. First test-tube babies (triplet) in Bangladesh were born on 30th May, 2001. Although there is no tertiary level infertility center in the public sector, several private centers have come up with the facilities. The objective of the study was to find i) the quality and quantity of infertility care in Bangladesh and ii) the cause of infertility in the attending patients iii) the treatment seeking behaviors iv) and the reasons for not taking treatment among the attending patients. There are now 10 tertiary level Infertility centers in Bangladesh. The information was collected in a preformed datasheet about the facilities and the profile of the patients and the treatment seeking behavior of the attending patients. Out of the ten centers two centers refused to respond and did not disclose their data. Around 16700 new patients are enrolled in a year in the responsive clinics. Five percent (5%) of the patients underwent ART, 7% of the patients gave only one visit, 84% of the patients completed their evaluation, 76% of the patients took treatment. Causes of infertility in the patients taking treatment were male factor in 36.4%, bilateral tubal block in 20.2%, PCOS and anovulation in 31.7%, endometriosis in 19.6%, unexplained in 10.95, combined in 3.5%, ovarian failure in 1.4%, testicular failure in 0.33%, congenital anomaly in 0.3%. The main reason for not taking treatment was financial constrainment. The quality and quantity of infertility care is dependent on the available resources and on the use of the resources by the patients. In developing countries the resources are merging and confined to specified areas which cannot meet the demand of their population. The study gives us the idea of the need and the demand of the services in the country.

  2. Metabolomics: a state-of-the-art technology for better understanding of male infertility.

    Science.gov (United States)

    Minai-Tehrani, A; Jafarzadeh, N; Gilany, K

    2016-08-01

    Male factor infertility affects approximately half of the infertile couples, in spite of many years of research on male infertility treatment and diagnosis; several outstanding questions remain to be addressed. In this regard, metabolomics as a novel field of omics has been suggested to be applied for male infertility problems. A variety of terms associated with metabolite quantity and quality have been established to demonstrate mixtures of metabolites. Despite metabolomics and metabolite analyses have been around more than decades, a limited number of studies concerning male infertility have been carried out. In this review, we summarised the latest finding in metabolomics techniques and metabolomics biomarkers correlated with male infertility. The rapid progress of a variety of metabolomics platforms, such as nonoptical and optical spectroscopy, could ease separation, recognition, classification and quantification of several metabolites and their metabolic pathways. Here, we recommend that the novel biomarkers determined in the course of metabolomics analysis may stand for potential application of treatment and future clinical practice.

  3. Clinical management and therapeutic outcome of infertile couples in southeast Nigeria

    Directory of Open Access Journals (Sweden)

    Menuba IE

    2014-10-01

    Full Text Available Ifeanyi E Menuba,1 Emmanuel O Ugwu,1 Samuel N Obi,1 Lucky O Lawani,2 Chidinma I Onwuka11Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku Ozalla Enugu, Enugu State, Nigeria; 2School of Postgraduate Studies, Department of Community Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu State, NigeriaBackground: Infertility is highly prevalent in Nigeria and most infertile couples in southeast Nigeria are offered conventional forms of treatment, which consist mainly of ovulation induction and tubal surgery, due to limited availability and high cost of endoscopic and assisted reproductive technologies like laparoscopy and in vitro fertilization. The aim of this study was to determine the prevalence of infertility, outcome of infertility investigation, and the treatment outcome of infertile couples following therapeutic interventions in southeast Nigeria over a 12-month period.Methods: This was a prospective cross-sectional study of 218 consecutive infertile couples presenting for infertility management at the infertility clinics of two tertiary health institutions in Enugu, southeast Nigeria. Infertility investigations were carried out on these couples using the available conventional diagnostic facilities. Following the results of the investigations/diagnosis, conventional treatment was offered to the couples as appropriate. Data analysis was both descriptive and inferential at 95% confidence level.Results: The mean age of the women was 33.5±4.62 (range: 15–49 years. Most (58.3% [n=127] were nulliparous. The prevalence of infertility was 12.1%. Infertility was primary in 28.4% (n=62 and secondary in 71.6% (n=156. Female etiologic factors were responsible in 32.1% (n=70, male factors in 26.1% (n=57, and a combination of male/female factors in 29.4% (n=64. The etiology was unknown in 12.4% (n=27. Tubal factors 23.8 % (n=52 and ovulation failures 26.1% (n=57 are common female factors implicated

  4. Investigation and Countermeasure on Prevention and Treatment of Infertility for Community Residents%社区居民不孕不育防治知识现况调查及对策

    Institute of Scientific and Technical Information of China (English)

    陆丽娜

    2012-01-01

    Objective To explore the grasping situation of the knowledge of prevention and treatment of infertility and to analyze the countermeasures. Methods Using the stratified sampling method, 500 community residents in seven communities in Zhoushan were enrolled in the research. They were investigated with a self-designed grasping situation scale of the knowledge for prevention and treatment of infertility ,with a statistical analysis of the survey results. Results On basic knowledge,the most (90. 48%) and the least (49. 07%) correct answers lay in the optimal fertile age and the symptoms of infertility,respectively. On preventive knowledge, the most (71. 01%) and the least(37. 68%) correct answers lay in the impacts of sex life and pedestrian and the influence of drugs, respectively. On therapeutic knowledge, the most (55. 69%) and the least (14. 91%) correct answers lay in how to choose the doctors and hospitals and whether habitual abortor should prevent miscarriage,respectively. Conclusion It is necessary to carry out the health education about prevention and treatment of infertility in community. To improve the awareness of prevention and treatment of infertility, the medical staff should strengthen and promote the health education to the weak links.%目的 调查社区居民不孕不育防治知识的掌握情况,探讨相应的对策.方法 采用分层抽样法选取舟山市7个社区中的500名居民为调查对象,采用自制的社区居民不孕不育防治知识现况调查表对其进行调查并对结果进行统计描述.结果 基础知识中答对人数最多的为"最佳受孕年龄",占90.48%;答对人数最少的为"不孕不育的症状",占49.07%.预防知识中答对人数最多的为"性生活及人流影响",占71.01%;答对人数最少的为"药物影响",占37.68%.治疗知识中答对人数最多的为"如何选择医生、医院",占55.69%;答对最少的为"习惯流产者是否应尽力保胎",占14.91%.结论 在社区广泛开展不

  5. Management of female infertility from hormonal causes.

    Science.gov (United States)

    Luciano, Antony A; Lanzone, Antonio; Goverde, Angelique J

    2013-12-01

    Hormonal causes of female infertility involve ovulatory dysfunctions that may result from dysfunction of the hypothalamic-pituitary-ovarian axis, peripheral endocrine glands, nonendocrine organs, or metabolic disorders. It is important to think of anovulation not as a diagnosis but as a symptom of a metabolic or endocrine disorder that requires a thorough diagnostic evaluation to identify the specific cause and to implement effective therapies that assure the best possible pregnancy outcome and avoid long-term adverse health consequences. In most instances, the medical history points to the underlying dysfunction, which can usually be confirmed with laboratory or imaging tests. For more challenging cases, more extensive evaluations may be needed, including perturbation studies. Nevertheless, the management of anovulatory infertility is gratifying because its causes are often manifest and the treatment usually results in resumption of ovulatory cycles, restoration of fertility, and healthy offspring through natural conception without requiring expensive and intrusive assisted reproductive technologies. © 2013.

  6. Isolated adrenocorticotropin deficiency presenting as primary infertility.

    Science.gov (United States)

    Atkin, S L; Masson, E A; White, M C

    1995-06-01

    A 31 year old female presented with primary infertility and gave a two year history of amenorrhea without symptoms or signs of endocrine dysfunction. Examination was normal and investigation showed low oestradiol and progesterone levels with decreased LH pulsatility. The cortisol responses were impaired following hypoglycaemic stress and a short synacthen test, but the cortisol response to a prolonged synacthen test was normal. An inadequate ACTH response to CRF testing confirmed the diagnosis of isolated ACTH deficiency. Hydrocortisone therapy was followed by an ovulatory menstrual cycle. Amenorrhea again ensued following the reduction of the steroid dose and normal menses resumed on normal steroid replacement therapy. Six hourly gonadotrophin pulsatility showed a significant increase in both pulse amplitude and mean LH and FSH levels following steroid treatment. Isolated ACTH deficiency is a rare but treatable cause of hypogonadism and infertility, and this case gives further insight on the role of cortisol on the hypothalamo-pituitary gonadal axis.

  7. Pathogenic mechanisms in endometriosis-associated infertility.

    Science.gov (United States)

    Gupta, Sajal; Goldberg, Jeffrey M; Aziz, Nabil; Goldberg, Eric; Krajcir, Natalie; Agarwal, Ashok

    2008-08-01

    To review the mechanisms by which endometriosis may affect reproductive function. Review of the English literature from 1986 to 2007 after searching Medline, EMBASE, Cochrane, and BIOSIS, as well as relevant meeting abstracts. Fertility research center and obstetrics and gynecology department in a tertiary care hospital. There is compelling evidence in the literature that endometriosis has detrimental effects on ovarian and tubal function and uterine receptivity, resulting in female infertility. The mechanisms of infertility associated with endometriosis remain controversial and include abnormal folliculogenesis, elevated oxidative stress, altered immune function, and hormonal milieu in the follicular and peritoneal environments, and reduced endometrial receptivity. These factors lead to poor oocyte quality, impaired fertilization, and implantation. Through unraveling the mechanisms by which endometriosis leads to infertility, researchers are sure to find a nonsurgical means to diagnose endometriosis, most likely through serum and peritoneal markers. Cytokines, interleukins, oxidative stress markers, and soluble cellular adhesion molecules all show potential to be used as a reliable marker for diagnosing endometriosis. After analyzing the pathogenic mechanisms of endometriosis, it seems that the future treatment of this entity may include cyclo-oxygenase-2 inhibitors, immunomodulators, or hormonal suppressive therapy to eliminate the need for surgical treatment of endometriosis.

  8. A STUDY ON THE ROLE OF ELEVATED SERUM PROLACTIN IN PRIMARY FEMALE INFERTILITY

    Directory of Open Access Journals (Sweden)

    Ritu Saloi

    2017-07-01

    Full Text Available BACKGROUND Infertility affects large number of couples both globally as well as in India. Primary infertility is a common, preventable, but neglected reproductive health problem in developing countries like India. The present study was undertaken in an attempt to find out the role of hyperprolactinaemia or elevated prolactin level in the development of primary infertility in female and analyse its effect in folliculogenesis. MATERIALS AND METHODS In this study, 52 female subjects with the complaint of primary infertility in the child bearing age group who have attended Obstetrics and Gynaecology, Outpatient Department, Gauhati Medical College and Hospital, Guwahati, for treatment were taken as the cases. RESULTS The incidence of hyperprolactinaemia, i.e. serum prolactin levels >25 ng/mL in the infertile women was 42.31%, whereas in the control group of fertile females, the incidence of hyperprolactinaemia was 13.46%. Anovulatory cycles were detected in 51.92% of the infertile group, whereas in the control group, it was detected in 7.69%. Galactorrhea was present in 9.62% of the infertile women. Menstrual disorders observed in the infertile and control groups were 61.54% and 17.31%, respectively. The results of the study were statistically analysed. CONCLUSION There is a high incidence of hyperprolactinaemia in infertile women. Percentage of anovulatory/delayed ovulatory cycles were also found to be higher in the infertile group than the fertile females.

  9. The Impact of Emotionally Focused Therapy on Emotional Distress in Infertile Couples

    Directory of Open Access Journals (Sweden)

    Marzieh Soltani

    2014-01-01

    Full Text Available Background: The present study investigated the effect of emotionally focused therapy (EFT on factors contributing to emotional distress among infertile couples. Materials and Methods: In this semi-experimental study, the subjects consisted of 12 Iranian couples: six infertile men and six infertile women. They were assessed as depressed, anxious and stressful individuals using depression, anxiety and stress scale (DASS. The subjects were randomly divided into control and experimental groups. The experimental group with six couples (i.e. three infertile men and three infertile women received EFT, while the control group with similar number of couples (i.e. three infertile men and three infertile women was deprived of the treatment. Results: There were no significant differences between the two groups regarding job, educational level, income, age, marriage and infertility duration. The pre- and post-test comparisons of DASS subscales showed that level of depression, anxiety and stress among couples with EFT instruction was significantly less than those without such instructions (p<0.0001. Conclusion: Emotionally focused therapy could reduce the rate of depression, anxiety and stress in infertile couples, regardless of the man or woman as the cause of infertility.

  10. Empirical medical therapy in idiopathic male infertility: Promise or panacea?

    Science.gov (United States)

    Jung, Jae Hung; Seo, Ju Tae

    2014-09-01

    Male factors account for 20%-50% of cases of infertility and in 25% of cases, the etiology of male infertility is unknown. Effective treatments are well-established for hypogonadotropic hypogonadism, male accessory gland infection, retrograde ejaculation, and positive antisperm antibody. However, the appropriate treatment for idiopathic male infertility is unclear. Empirical medical treatment (EMT) has been used in men with idiopathic infertility and can be divided into two categories based on the mode of action: hormonal treatment and antioxidant supplementation. Hormonal medications consist of gonadotropins, androgens, estrogen receptor blockers, and aromatase inhibitors. Antioxidants such as vitamins, zinc, and carnitines have also been widely used to reduce oxidative stress-induced spermatozoa damage. Although scientifically acceptable evidence of EMT is limited because of the lack of large, randomized, controlled studies, recent systematic reviews with meta-analyses have shown that the administration of gonadotropins, anti-estrogens, and oral antioxidants results in a significant increase in the live birth rate compared with control treatments. Therefore, all physicians who treat infertility should bear in mind that EMT can improve semen parameters and subsequent fertility potential through natural intercourse.

  11. Infertility in men with inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Takeshi Shin; Hiroshi Okada

    2016-01-01

    Inflammatory bowel disease(IBD) predominantly affects young adults. Fertility-related issues are therefore im-portant in the m-anagem-ent of patients with IBD. However, relatively m-odest attention has been paid to reproductive issues faced by m-en with IBD. To investigate the effects of IBD and its treatm-ent on m-ale fertility, we reviewed the current literature using a system-atic search for published studies. A PubM ed search were perform-ed using the m-ain search term-s "IBD AND m-ale infertility", "Crohn’s disease AND m-ale infertility", "ulcerative colitis AND m-ale infertility". References in review articles were used if relevant. We noted that active inflammation, poor nutrition, alcohol use, sm-oking, m-edications, and surgery m-ay cause infertility in m-en with IBD. In surgery such as proctocolectom-y with ileal pouch-anal anastom-osis, rectal incision seem-s to be associated with sexual dysfunction. Of the m-edications used for IBD, sulfasalazine reversibly reduces m-ale fertility. No other m-edications appear to affect m-ale fertility significantly, although sm-all studies suggested som-e adverse effects. There are lim-ited data on the effects of drugs for IBD on m-ale fertility and pregnancy outcom-es; however, patients should be inform-ed of the possible effects of paternal drug exposure. This review provides inform-ation on fertility-related issues in m-en with IBD and discusses treatm-ent options.

  12. Laparoscopic operation in treatment of tubal infertility: clinical analysis of 86 cases%腹腔镜手术治疗输卵管性不孕症86例临床分析

    Institute of Scientific and Technical Information of China (English)

    郝莉娜; 李光

    2012-01-01

    目的 探讨腹腔镜手术对输卵管性不孕症的治疗价值.方法 腹腔镜下对碘油子宫输卵管造影确诊为输卵管性病变的86例不孕症患者,腹腔镜进行输卵管伞端成形术、输卵管造口术、输卵管吻合术、粘连松解术及病灶清除等手术.术后随访观察患者的妊娠情况.结果 造成输卵管性不孕症的主要病因是输卵管周围粘连40例,占46.51%;其次为输卵管积水18例,占20.93%.手术后通畅效果较好的为输卵管周围粘连、输卵管积水、输卵管积脓.不同病因输卵管疏通率不同,经比较有显著性差异(χ2=31.48,P<0.01).共计77条输卵管经治疗被疏通,总有效率为89.53%;术后随访2年共有48例患者妊娠,其中异位妊娠2例,宫内妊娠46例,宫内妊娠率为53.49%;25例在半年内受孕,占29.07%;14例在1年内受孕,占16.28%.结论 腹腔镜手术在输卵管性不孕症治疗方面有较高的临床价值.%Objective To explore the treatment value of laparoscopic operation in treatment of tubal infertility. Methods Eighty-six cases of tubal infertility patients, who were diagnosed with tubal infertility by lipiodol hysterosalpingography, underwent laparoscopic tubal fimbria angioplasty, tubal ostomy, tubal anastomosis, lysis of adhesions and focal cleaning. The pregnant status of them was followed up postoperatively. Results The peritubal adhesion was a major cause of tubal infertility ( 40 cases ), occupying 46. 51% ; followed by hydrosalpinx (18 cases ), accounting for 20. 93% . Operation effect was better for peritubal adhesion, hydrosalpinx and pyosalpinx. The dredging rates of different etiologies were different, and there were significant differences (x2=31.48,P<0.0l). A total of 77 fallopian tubes were dredged, and the total effective rate was 89. 53% . There were 48 cases with postoperative pregnancy during 2-year follow-up. Among these, there were 2 cases of ectopic pregnancy and 46 cases of intrauterine pregnancy, with

  13. Hysterosalpingographic findings in infertility

    Energy Technology Data Exchange (ETDEWEB)

    Park, M. S.; Kim, K. S.; Kim, J. S.; Bai, B. C. [Seoul Red Cross Hospital, Seoul (Korea, Republic of)

    1981-12-15

    Four hundred and fifty four cases of H.S.G. in infertility were analyzed and following brief results were obtained. 1. Most frequent age group was 25-29 year old, and those number of patient were 188 (41.4%). 2. Most frequent abnormal uterine findings was intravasation (113 cases), and malposition (119), irregular margin (104), filling defect (37), and diverticulum (6) in decreasing order. 3. Most frequent abnormal tubal finding was obstruction (199 cases), and hydrosalpinx (99), diverticulosis (22), intravasation (17), peritubal adhesion (13), and beaded tube (10) in decreasing order. 4. Nagative findings was seen in 155 cases (34.1%) of uterus and in 227 cases (50.0%) of fallopian tubes. 5. Nagative findings in both uterus and fallopian tubes was seen only 87 cases (19.2%)

  14. Spontaneous pregnancy after pessary placement in a patient with infertility and advanced pelvic organ prolapse

    Directory of Open Access Journals (Sweden)

    Tsia-Shu Lo

    2016-02-01

    Full Text Available To highlight possible association of advanced pelvic organ prolapse with infertility and its successful outcome following conservative management. We report herein a 38-year-old para 1, non-overweight woman who presented with secondary infertility without any factors for infertility except for an advanced POP. She had intrauterine insemination (IUI performed twice at a local clinic and in vitro fertilization-embryo transfer (IVF-ET program twice in our institute unsuccessfully. She conceived spontaneously after vaginal pessary placement and delivered, vaginally, a healthy female baby weighing 3,365 g at the 38th week of gestation. Advanced POP appears to be an important risk factor for infertility. After completing an infertility workup, pessary application can be the first-line treatment modality for women with unexplained infertility due to advanced POP.

  15. Maternal stress before and during pregnancy and subsequent infertility in daughters

    DEFF Research Database (Denmark)

    Plana-Ripoll, Oleguer; Li, Jiong; Kesmodel, Ulrik Schiøler

    2016-01-01

    STUDY QUESTION: Is maternal stress following the death of a close relative before or during pregnancy associated with the risk of infertility in daughters? SUMMARY ANSWER: Compared with unexposed women, women whose mothers had experienced bereavement stress during, or in the year before, pregnancy...... had a similar risk of infertility overall, but those exposed to maternal bereavement during the first trimester had a higher risk of infertility. WHAT IS KNOWN ALREADY: Animal studies have shown that prenatal maternal stress results in reduced offspring fertility. In humans, there is evidence......, or a sibling during pregnancy or in the year before conception. Infertility was defined as any record of infertility treatment or diagnosis of female infertility. We considered the date of onset as the date of the first appearance of any such record. The association between exposure and outcome was examined...

  16. Two-year treatment patterns and costs in glaucoma patients initiating treatment with prostaglandin analogs

    Directory of Open Access Journals (Sweden)

    Jordana K Schmier

    2010-09-01

    Full Text Available Jordana K Schmier1, Edmund C Lau2, David W Covert31Exponent, Alexandria, VI, USA; 2Exponent, Menlo Park, CA, USA; 3Alcon Research Ltd, Fort Worth, TX, USAObjective: To determine treatment patterns and costs over a two-year period among new initiators of topical prostaglandin analogs in a managed care population by retrospective cohort analysis of an insurance claims database.Methods: Patients who initiated therapy with a prostaglandin analog between September 2006 and March 2007 were identified. The use of monotherapy and adjunctive therapies were compared by index prostaglandin. Days to initiation of adjunctive therapy and rates of glaucoma surgical procedures were also calculated. Medical costs (antiglaucoma medications and ophthalmic visits over the two-year period were estimated.Results: The analysis identified 5018 patients with at least one prostaglandin analog prescription (bimatoprost, n = 747; latanoprost, n = 1651; benzalkonium chloride (BAK-free travoprost, n = 203. The majority (51%–54% had repeat prescriptions. Among those with repeat prescriptions, 52% were female (not significant and mean age was 64 years (P < 0.01. Rates of adjunctive therapy use varied across groups (bimatoprost 51%, latanoprost 37%, and BAK-free travoprost 35%, P < 0.0001. Median and mean days to initiation of adjunctive therapy were 83 and 140 for bimatoprost, 101 and 181 for latanoprost, and 113 and 221 for BAK-free travoprost. Two-year medical costs were $3147, $2843, and $2557 for patients initiating treatment with bimatoprost, latanoprost, and BAK-free travoprost, respectively. Use of glaucoma surgical procedures across the treatment groups was similar over the two-year period.Conclusions: Over a two-year period, the rate and time to initiation of adjunctive therapy use, as well as medical costs, varied between index prostaglandins. However, the rate of glaucoma surgical interventions did not vary significantly across index medications.Keywords: costs

  17. Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility

    National Research Council Canada - National Science Library

    Murto, Tiina; Bjuresten, Kerstin; Landgren, Britt-Marie; Stavreus-Evers, Anneli

    2013-01-01

    ... for long-term possibility of live birth. In this cross-sectional study, with 71 infertile women with diagnosis unexplained infertility and male infertility, blood samples were obtained during the proliferative and secretory phases...

  18. COOK guide wire treatment of tubal infertility by hysteroscope combined with laparoscope%宫腹腔镜联合cook导丝治疗输卵管性不孕症

    Institute of Scientific and Technical Information of China (English)

    赵玲; 江道龙

    2012-01-01

    [ Objective ] To investigate the clinical value of COOK guide wire treatment of tubal infertility by hysteroscope combined with laparoscope. [Methods] 96 tubal infertility cases with COOK guide wire were treated under hysteroscope combined with laparoscope. [Results] ① 136 tubal complete obstruction and 56 incomplete obstruction, while 120 proximal obstruction and 72 distal obstruction. ② Total recanalization rate was 90.6%; Complete obstruction and incomplete obstruction of recanalization rates were 89.6% and 91.9%; proximal and distal obstruction recanalization rates were 95% and 83.3%. ③ Total pregnancy rate was 55.2% within two years; Proximal obstruction in pregnancy rate was greater than the distal obstruction, and the pregnancy rate of complete obstruction and incomplete obstruction postoperative was not significantly different. [Conclusions] COOK guide wire treatment of tubal infertility by hysteroscope combined with laparoscope has good clinical effect, especially for the proximal tubal occlusion with the optimal treatment outcome.%目的 探讨宫腹腔镜联合cook导丝治疗输卵管性不孕症的临床价值.方法 对96例输卵管性不孕症患者行宫腹腔镜联合cook导丝介入术疏通输卵管,观察术中梗阻情况、术后复通率和妊娠率.结果 ①192条输卵管中136条完全梗阻,56条不完全梗阻;120条近端梗阻,72条远端梗阻;②总复通率为90.6%;完全梗阻和不完全梗阻的复通率分别为89.6%和91.9%;近端和远端梗阻复通率分别为95.0%和83.3%;③2年内总妊娠率为55.2%,近端梗阻的妊娠率大于远端梗阻,完全梗阻和不完全梗阻的术后妊娠率差异无显著性.结论 宫腹腔镜联合cook导丝手术治疗输卵管性不孕症具有良好的临床效果,尤其对于近端输卵管阻塞的治疗效果最佳.

  19. Y chromosome microdeletions in Turkish infertile men

    Directory of Open Access Journals (Sweden)

    Zamani Ayse

    2006-01-01

    Full Text Available AIMS: To detect the frequency and types of both chromosomal abnormalities and Y chromosome microdeletions in infertile men attending to our university intracytoplasmic sperm injection ICSI/IVF centre and fertile control subjects in our patient population. SETTINGS AND DESIGN: A total of 50 infertile men who were referred to IVF center of Meram medical faculty were selected for the molecular azospermia factor (AZF screening program. MATERIALS AND METHODS: Karyotype analysis and polymerase chain reaction amplification using 15 Y-specific sequence-tagged sites of AZF region were done. RESULTS: The total prevalence of chromosomal abnormalities was found to be 10% (5/50, including 4 patients with numerical and 1 patient with structural abnormalities. Overall, 4 of the 50 patients tested (8% exhibited deletions of the Y chromosome, 3 of them being azospermic and 1 of them oligospermic men. The frequency of the microdeletions in subgroups with azospermia and oligozoospermia was found to be 10.7% (3/29 and 4.7% (1/21 respectively. Microdeletions of AZFb and AZFc regions were detected in all of the 4 patients. Neither AZFa nor AZFd microdeletions were indicated. CONCLUSIONS: Our findings suggest that one must know whether there is a genetic cause for male infertility before patients can be subjected to ISCI or testicular sperm extraction (TESE/ISCI treatment.

  20. Infertility Counseling and Support: When and Where to Find It

    Science.gov (United States)

    ... Home FAQs Frequently Asked Questions Quick Facts About Infertility FAQs About Infertility FAQs About the Psychological Component of Infertility FAQs About Cloning and Stem Cell Research SART's ...

  1. [Stress and distress in infertility among women].

    Science.gov (United States)

    Damti, Osnat Bloch; Sarid, Orly; Sheiner, Eyal; Zilberstein, Tali; Cwikel, Julie

    2008-03-01

    In the industrialized world, approximately 12% of couples suffer from infertility. As a result of its collective political and historical experience, Israel boasts one of the world's most progressive fertility policies ranging from hormonal treatment to In Vitro Fertilization (IVF). Approximately 40% of the causes of infertility are attributed to the woman. Among the factors contributing to reduced fertility are endocrine factors, immune factors and mechanical factors. Studies have accumulated information regarding the contribution of psychological factors to infertility in women. Among the identified risk factors are depression, anxiety and stress-dependent changes like altered heart rate and increased blood cortisol levels. The hypothalamic-pituitary-adrenal axis (HPA) has been shown to be an important mediator of infertility, involved in the excretion of CRH, ACTH and cortisol, respectively. Data gathered in the literature suggests the involvement of the HPA axis on the hypothalamic-pituitary-gonadotropic axis (HPG). Specifically, changes in diurnal excretion patterns of cortisol have been shown to accompany mental stress and to mediate the down-regulation of the HPG axis. This impact could possibly involve inhibitory mechanisms at the pituitary level, by reducing the release of FSH and LH by GnRH. Furthermore, research has shown that the effect of cortisol on the HPG axis is dependent on the endocrine status of the ovary in its different stages within the menstrual cycle. From the studies presented in this review it can be hypothesized that stress can induce altered cortisol-excretion patterns along the menstrual cycle, which ultimately affect the hormonal profile in critical stages of the fertilization process.

  2. Assisted reproductive technology in the treatment of male infertility: Potential risks and tactics%男性不育的辅助生殖技术处理:潜在风险与思考

    Institute of Scientific and Technical Information of China (English)

    戴继灿

    2011-01-01

    辅助生殖技术是上世纪末出现的治疗男性不育的重要手段,它在男性不育的治疗中有着不可替代的作用,但有关男性不育的辅助生殖技术处理也存在潜在风险,在男性不育的诊疗中如何规避这些潜在风险值得男性生殖健康领域的工作者思考.本文对辅助生殖技术潜在风险进行总结,同时,为提高男性不育的治疗效果,尽量减少辅助生殖技术带来的风险,提出了包括患者的评估、健康教育以及治疗等男性不育规范化处理方面的一些建议,并强调病因处理和抗氧化治疗在男性不育治疗中的重要作用.%Assisted reproductive technology ( ART), developed in the end of last century, has been playing an irreplaceable role in the treatment of male infertility, though it does have its potential risks, including the induction of monozygotic twins, premature delivery, high incidence of birth defects, etc. How to avoid these risks has posed a challenge and demands earnest attention from andrologists. This article summarizes the main potential risks of ART and proposes some tactics concerning patient evaluation, health education and treatment standardization, so as to optimize the outcomes and minimize the risks. Meanwhile, emphasis is placed on the importance of etiological and anti-oxidant strategies in the treatment of male infertility.

  3. 坤泰胶囊治疗不孕症100例疗效分析%Analysis of the mechanism of kuntai in treatment of 100 cases with infertility

    Institute of Scientific and Technical Information of China (English)

    梁莹

    2014-01-01

    Objective:To investigate the clinical effect and the mechanism of kuntai capsule in treatment of infertility patients,in order to find out an effective methods to improve the chance of pregnancy for infertility patients.Methods:100 cases with infertility were selected from January 2010 to January 2013.All cases were began to oral kuntai capsule at the fifth day of third menstrual cycle.We observed the endometrial thickness and morphology,uterine blood flow parameters of endometrial spiral artery pulsatili-ty index(PI) and resistance index(RI) in patients before and after treatment.Results:Comparied the changes of endometrial thick-ness,PI value,RI value before and after the treatment,the result were t=8.3481(P=0.0000),t=8.2067(P=0.0000),t=19.2055(P=0.0000) respectively.Comparison result of type endometrium before and after treatment was χ 2=13.2667(P=0.0003).The differ-ence was statistically significant.Conclusion:Kuntai capsule can effectively improve uterine receptivity,and helpful for embryo implantation,so it can improve the chance of pregnancy,and also safety and effectivly in treatment of infertility,so it is worth to be widely used in clinical.%目的:探究坤泰胶囊治疗不孕症患者的临床用药机制及疗效,为提高不孕患者的受孕几率寻求有效的治疗方法。方法:2010年1月-2013年1月收治不孕症患者100例,所有患者均于第3个月经周期的第5天开始口服坤泰胶囊。观察治疗前后患者的子宫内膜厚度及形态,子宫内膜螺旋动脉血流参数搏动指数(PI)及阻力指数(RI)。结果:患者经治疗后子宫内膜厚度、PI 值、RI 值变化相比治疗前分别为 t=8.3481(P=0.0000)、t=8.2067(P=0.0000)、t=19.2055(P=0.0000);治疗后A型内膜相比治疗前χ2=13.2667(P=0.0003),差异具有统计学意义。结论:坤泰胶囊能有效改善患者的子宫内膜容受性,利于患者进行胚胎着床,从而提高患者的受孕几率,治疗不孕安全有效,值得临床推广使用。

  4. Chromosomal disorders and male infertility

    Institute of Scientific and Technical Information of China (English)

    Gary L Harton; Helen G Tempest

    2012-01-01

    infertility in humans is surprisingly common occurring in approximately 15% of the population wishing to start a family.Despite this,the molecular and genetic factors underlying the cause of infertility remain largely undiscovered.Nevertheless,more and more genetic factors associated with infertility are being identified.This review will focus on our current understanding of the chromosomal basis of male infertility specifically:chromosomal aneuploidy,structural and numerical karyotype abnormalities and Y chromosomal microdeletions.Chromosomal aneuploidy is the leading cause of pregnancy loss and developmental disabilities in humans.Aneuploidy is predominantly maternal in origin,but concerns have been raised regarding the safety of intracytoplasmic sperm injection as infertile men have significantly higher levels of sperm aneuploidy compared to their fertile counterparts.Males with numerical or structural karyotype abnormalities are also at an increased risk of producing aneuploid sperm.Our current understanding of how sperm aneuploidy translates to embryo aneuploidy will be reviewed,as well as the application of preimplantation genetic diagnosis (PGD) in such cases.Clinical recommendations where possible will be made,as well as discussion of the use of emerging array technology in PGD and its potential applications in male infertility.

  5. Chromosomal disorders and male infertility.

    Science.gov (United States)

    Harton, Gary L; Tempest, Helen G

    2012-01-01

    Infertility in humans is surprisingly common occurring in approximately 15% of the population wishing to start a family. Despite this, the molecular and genetic factors underlying the cause of infertility remain largely undiscovered. Nevertheless, more and more genetic factors associated with infertility are being identified. This review will focus on our current understanding of the chromosomal basis of male infertility specifically: chromosomal aneuploidy, structural and numerical karyotype abnormalities and Y chromosomal microdeletions. Chromosomal aneuploidy is the leading cause of pregnancy loss and developmental disabilities in humans. Aneuploidy is predominantly maternal in origin, but concerns have been raised regarding the safety of intracytoplasmic sperm injection as infertile men have significantly higher levels of sperm aneuploidy compared to their fertile counterparts. Males with numerical or structural karyotype abnormalities are also at an increased risk of producing aneuploid sperm. Our current understanding of how sperm aneuploidy translates to embryo aneuploidy will be reviewed, as well as the application of preimplantation genetic diagnosis (PGD) in such cases. Clinical recommendations where possible will be made, as well as discussion of the use of emerging array technology in PGD and its potential applications in male infertility.

  6. Nursing Intervention of Laparoscopy in Diagnosis and Treatment Before and After of Infertility%宫腹腔镜诊治不孕症的术前及术后的护理干预

    Institute of Scientific and Technical Information of China (English)

    杨芝兰; 滕树艳

    2015-01-01

    Objective:To explore the methods of nursing care in the treatment of infertility by hysteroscopy combined with laparoscopy.Method:80 cases were diagnosed as infertile patients, the diagnosis and treatment of hysteroscopy combined with laparoscopy operation.The patients were randomly divided into two groups,the intervention group and control group,40 cases in each group.The intervention group was trested perfect operation during in hospital preparation, careful postoperative nursing and the whole psychological support;the control group was treated conventional nursing.Result:The intervention group 28 cases of successful pregnancy, included 9 cases of primary infertility and 19 cases of secondary infertility, pregnancy of the shortest time was 2 months after the operation, with the longest up to 23 months after operation; 28 cases of successful pregnancy in patients with 4 cases of successful pregnancy after assisted reproductive technology, the rest were the natural pregnancy; abortion 1 cases, the other 27 cases were belong to full-term normal neonates.The control group 18 cases of successful pregnancy, included 5 cases of primary infertility and secondary infertility in 13 cases, the pregnancy time is the shortest 2.5 months postoperatively, the longest for 24 months after operation; 18 cases of successful pregnancy in patients with 6 cases of successful pregnancy after assisted reproductive technology, the rest were natural pregnancy; 2 cases of ectopic pregnancy, abortion 3 cases, the other 13 cases were belong to full-term normal neonates.two sets of ectopic pregnancy after statistics processing,the rate and abortion rate had no statistical significance.Conclusion:Hysteroscopy combined with laparoscopy for treatment of infertility can improve the effectiveness of diagnosis and treatment, psychological support of nurses nursing and full preoperative and postoperative therapy are the key to success.%目的:探讨宫腔镜联合腹腔镜在不孕症诊治中的

  7. Coenzyme Q10 and male infertility.

    Science.gov (United States)

    Balercia, G; Mancini, A; Paggi, F; Tiano, L; Pontecorvi, A; Boscaro, M; Lenzi, A; Littarru, G P

    2009-07-01

    We had previously demonstrated that Coenzyme Q10 [(CoQ10) also commonly called ubiquinone] is present in well-measurable levels in human seminal fluid, where it probably exerts important metabolic and antioxidant functions; seminal CoQ10 concentrations show a direct correlation with seminal parameters (count and motility). Alterations of CoQ10 content were also shown in conditions associated with male infertility, such as asthenozoospermia and varicocele (VAR). The physiological role of this molecule was further clarified by inquiring into its variations in concentrations induced by different medical or surgical procedures used in male infertility treatment. We therefore evaluated CoQ10 concentration and distribution between seminal plasma and spermatozoa in VAR, before and after surgical treatment, and in infertile patients after recombinant human FSH therapy. The effect of CoQ10 on sperm motility and function had been addressed only through some in vitro experiments. In two distinct studies conducted by our group, 22 and 60 patients affected by idiopathic asthenozoospermia were enrolled, respectively. CoQ10 and its reduced form, ubiquinol, increased significantly both in seminal plasma and sperm cells after treatment, as well as spermatozoa motility. A weak linear dependence among the relative variations, at baseline and after treatment, of seminal plasma or intracellular CoQ10, ubiquinol levels and kinetic parameters was found in the treated group. Patients with lower baseline value of motility and CoQ10 levels had a statistically significant higher probability to be responders to the treatment. In conclusion, the exogenous administration of CoQ10 increases both ubiquinone and ubiquinol levels in semen and can be effective in improving sperm kinetic features in patients affected by idiopathic asthenozoospermia.

  8. Women with polycystic ovary syndrome and treatment strategies of infertility patients%多囊卵巢综合征合并不孕患者治疗策略的研究

    Institute of Scientific and Technical Information of China (English)

    谭伟涛

    2013-01-01

    目的:探讨多囊卵巢综合征合并不孕患者治疗方法的选择及影响因素。方法选取2009年7月至2012年6月收治的多囊卵巢综合征合并不孕患者82例,分为研究组患者42例采用二甲双胍、炔雌醇环丙孕酮(达英-35)联合来曲唑治疗;对照组患者40例单纯采用来曲唑促排卵治疗。治疗时间为3~6个月,两组患者比较排卵率、妊娠率及妊娠后流产率。结果研究组患者正常排卵率为72.7%,对照组患者正常排卵率为62.3%(P >0.05),差异无统计学意义。研究组妊娠18例、流产2例;对照组妊娠8例、流产3例,两组比较差异具有统计学意义(P <0.05)。结论多囊卵巢综合征合并不孕症患者在接受促排卵治疗前先行二甲双胍、达英-35治疗可明显提高患者的妊娠率,降低流产率。对治疗患者不孕症疗效显著。%Objective The choice and influence factors combined infertility treatment of women with polycystic ovary syndrome. Methods From 2009 July to 2012 polycystic ovarian syndrome admitted from June 82 cases with infertility patients, divided into 42 cases of study group were treated with metformin, ethinylestradiol and cyproterone acetate (with 35) combined with letrozole therapy; the control group of 40 patients treated with letrozole induced ovulation treatment. The treatment time was 3 - 6 months, the abortion rate between two groups of ovulation rate, pregnancy rate and pregnancy. Results The patients in study group with normal ovulation rate was 72.7%, the control group with normal ovulation rate was 62.3% (P > 0.05), no significant difference. 2 cases of study group 18 cases of pregnancy, abortion; control group of 8 cases of pregnancy, abortion 3 cases, statistically significant differences between the two groups (P < 0.05). Conclusion Polycystic ovarian syndrome complicated with infertility patients undergoing ovulation induction therapy before metformin, Diane-35 35

  9. Clinical value of serum immune antibody detection in infertile patients and treatment experiment%不孕症患者血清免疫性抗体检测的临床价值与治疗体会

    Institute of Scientific and Technical Information of China (English)

    姜玉娟

    2016-01-01

    目的:研究不孕症患者血清免疫性抗体检测的临床价值。方法选取吉林省人口生命科学技术研究院2013~2014年收治的不孕症患者150例为观察组,正常生育妇女150例为对照组,观察组患者给予肾上腺皮质激素类和隔绝疗法进行治疗。比较两组治疗前抗精子抗体( Antisperm antibody,AsAb)、抗子宫内膜抗体(Endometrial antibody,EMAb)、抗卵巢抗体(antiovary antibody,AoAb)、抗透明带抗体(Anti zona pellucida antibodies,AzpAb)阳性比例的差异和观察组治疗前后的变化情况,并评价疗效。结果观察组治疗前AsAb阳性、EMAb 阳性、AoAb 阳性、AzpAb 阳性的例数(34、17、11、10)均高于对照组(2、1、1、1)( P <0.05);观察组治疗后AsAb阳性、EMAb阳性、AoAb阳性、AzpAb阳性的例数(19、7、3、3)低于治疗前(34、17、11、10)(P<0.05)。观察组治疗后自然受孕和人工受孕的例数高于治疗前的例数(8 vs 0,16 vs 0)(P <0.05)。结论免疫抑制治疗不孕有良好的效果,通过检测和分析自身免疫抗体的变化诊断和治疗不孕症具有可行性,值得临床推广应用。%Objective To study the clinical value of serum immune antibody detection in infertile patients. Methods 150 infertile patients who were treated in population life science and technology institute of Jilin province from March 2013 to March 2015 were selected as observation group, and 150 normal reproductive women were selected as control group. The observation group was treated with adrenal cortical hormone and isolated therapy. The differences of positive rate of AsAb, EMAb, AoAb and AzpAb of two groups before treatment were compared, and in order to investigate the effect of treatment, a contrast observation of AsAb, EMAb, AoAb and AzpAb of oberservation group was made. Results The rates of AsAb positive, EMAb positive, AoAb positive and AzpAb positive of observation group were higher than those of the control group(P<0. 05). The

  10. Biomedical infertility care in Sub-Saharan Africa: what is going on?

    NARCIS (Netherlands)

    Gerrits, G.J.E.; Slager, E.

    2011-01-01

    Infertility treatments, including the use of advanced reproductive technologies (ARTs), are nowadays provided at several places in sub-Saharan Africa. This article, which is based on a review of (scarce) social science studies, gives insight into the way biomedical infertility care is provided,

  11. Viewpoint: medical infertility care in low income countries: the case for concern in policy and practice

    NARCIS (Netherlands)

    van Zandvoort, H.; de Koning, K.; Gerrits, T.

    2001-01-01

    Based on published, 'grey' and anecdotal information, this paper explores some aspects of infertility, its medical treatment and their burden in poor countries. Many cases of infertility result from sexually transmitted infections (STI) and unsafe abortion and there is no doubt that their prevention

  12. Infertility and preterm delivery, birthweight, and Caesarean section: a study within the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Basso, Olga; Baird, Donna D.

    2003-01-01

    BACKGROUND: More than 10% of babies are born to couples taking >1 year to conceive (a common definition of infertility). Some evidence indicates that such pregnancies are at increased risk of preterm delivery and other adverse birth outcomes, but the problem has rarely been addressed in large......, longitudinal studies enrolling couples irrespective of infertility treatment. METHODS: We used data from the Danish National Birth Cohort: 55 906 singleton live births from women who reported their waiting time to pregnancy (TTP) and other covariates in an interview during the 2nd trimester of pregnancy....... Among couples with a TTP >1 year, infertility treatment was associated with added risk only among multiparas. CONCLUSION: Infertile women are at higher risk of adverse birth outcomes even if they conceive without treatment. With >10% of babies born to infertile couples, it is important to consider...

  13. Evaluation of the melatonin and oxidative stress markers level in serum of fertile and infertile women

    Directory of Open Access Journals (Sweden)

    Sara Soleimani Rad

    2015-07-01

    Full Text Available Background: Infertility is defined as the inability to achieve the pregnancy within a year of unprotected intercourse. Infertility is a complex issue and different factors such as stress oxidative can be involved in this problem. So, any attempt to neutralize oxidative stress would be helpful in the treatment of infertility. Melatonin is a known scavenger of free radicals. Objective: The aim of our study was to evaluate the level of melatonin and its correlation with oxidative biomarkers in fertile and infertile women. Materials and Methods: The participants including fertile and infertile women were divided into two groups of 30 people. Blood sampling was performed and sera were collected. The level of Malondialdehyde (MDA, total antioxidant capacity (TAC and melatonin were detected. Data were analyzed using T-test and their correlation was assessed using Spearman test. Results: Serum melatonin from fertile women was higher than infertile women but the difference was not significant (p= 0.46. MDA level in fertile women was significantly lower than infertile women (p<0.001 and the level of TAC in fertile women was significantly higher than infertile women (p<0.001. Spearman test revealed a significant and direct correlation between melatonin and TAC in fertile and infertile women and a significant but reverse correlation between melatonin and MDA in infertile and fertile women. Conclusion: Differences in the level of oxidative stress biomarkers in fertile and infertile individuals have been reported. This study revealed a significant correlation between melatonin and oxidative stress biomarkers, concluding that melatonin level could be involved in infertility.

  14. Evolution of psychology and counseling in infertility.

    Science.gov (United States)

    Boivin, Jacky; Gameiro, Sofia

    2015-08-01

    Five key paradigm shifts are described to illustrate the evolution of psychology and counseling in infertility. The first paradigm shift was in the 1930s when psychosomatic concepts were introduced in obstetrics and gynecology as causal factors to explain why some couples could not conceive despite the absence of organic pathology. In the second shift, the nurse advocacy movement of the 1970s stimulated the investigation of the psychosocial consequences of infertility and promoted counseling to help couples grieve childlessness when medical treatments often could not help them conceive. The third shift occurred with the advent of IVF, which created a demand for mental health professionals in fertility clinics. Mental health professionals assessed the ability of couples to withstand the demands of this new high technology treatment as well as their suitability as potential parents. The fourth shift, in the 1990s, saw reproductive medicine embrace the principles of evidence-based medicine, which introduced a much more rigorous approach to medical practice (effectiveness and safety) that extended to psychosocial interventions. The most recent paradigm shift, in the new millennium, occurred with the realization that compliance with protracted fertility treatment depended on the adoption of an integrated approach to fertility care. An integrated approach could reduce treatment burden arising from multiple sources (i.e., patient, clinic, and treatment). This review describes these paradigm shifts and reflects on future clinical and research directions for mental health professionals.

  15. Prevalence of Genital Tuberculosis among Infertile Women: A Systematic Review and Meta-analysis

    Directory of Open Access Journals (Sweden)

    Kefayat Chaman-Ara

    2016-04-01

    Full Text Available Genital tuberculosis is a kind of infectious diseases with a relatively high prevalence in developing countries. The aim of this study was to investigate the prevalence of genital tuberculosis among infertile women. A PubMed, Science Direct, Scopus, Google Scholar, SID, Magiran and Cochrane databases (from 1980 to the present, date of last search March 2016 was carried out using the search keywords tuberculosis, genital tuberculosis, female genital, genital tract, genital system, female infertility, endometrial tuberculosis, anti-tubercular therapy, bacteriological, tuberculin antigen, histological, infertility, fallopian tube diseases, prevalence, rate, percent in order to find the studies which have reported the prevalence of genital tuberculosis among infertile women. Data were extracted from retrieved studies and a meta-analysis was done. 23 studies were found. In these studies a total of 4361 infertile women have been studied. The prevalence of genital tuberculosis among infertile women with 95% confidence interval was 24.2% (18.5-29.99. The prevalence of genital tuberculosis among infertile women is high. It seems that exact planning and action for the prevention and treatment of genital tuberculosis can reduce the infertility prevalence and prevent the negative consequences of infertility

  16. Anatomical causes of female infertility and their management.

    Science.gov (United States)

    Abrao, Mauricio S; Muzii, Ludovico; Marana, Riccardo

    2013-12-01

    The main female anatomical causes of infertility include post-infectious tubal damage, endometriosis, and congenital/acquired uterine anomalies. Congenital (septate uterus) and acquired (myomas and synechiae) diseases of the uterus may lead to infertility, pregnancy loss, and other obstetric complications. Pelvic inflammatory disease represents the most common cause of tubal damage. Surgery still remains an important option for tubal factor infertility, with results in terms of reproductive outcome that compare favorably with those of in vitro fertilization. Endometriosis is a common gynecologic condition affecting women of reproductive age, which can cause pain and infertility. The cause of infertility associated with endometriosis remains elusive, suggesting a multifactorial mechanism involving immunologic, genetic, and environmental factors. Despite the high prevalence of endometriosis, the exact mechanisms of its pathogenesis are unknown. Specific combinations of medical, surgical, and psychological treatments can ameliorate the quality of life of women with endometriosis. In the majority of cases, surgical treatment of endometriosis has promoted significant increases in fertilization rates. There are obvious associations between endometriosis and the immune system, and future strategies to treat endometriosis might be based on immunologic concepts.

  17. Quality of life and its related factors in infertile couples.

    Science.gov (United States)

    Keramat, Afsaneh; Masoomi, Seyyedeh Zahra; Mousavi, Seyed Abbas; Poorolajal, Jalal; Shobeiri, Fatemeh; Hazavhei, Seyyed Mohammad Mehdi

    2014-01-01

    Health related quality of life (QoL) has now been considered as a main tool for outcome measurement in infertility. The present study aimed to determine the association between general and specified QoL with different psychological aspects of self-esteem, social support, sexual satisfaction, and marital satisfaction in a sample of Iranian infertile couples. This cross-sectional study was conducted on 385 infertile couples referred to the Fatemieh Hospital in Hamadan City, western Iran in 2012.To measure the self-esteem, the Iseng test was used. The social support scaling developed by Cassidy and Long was used for assessment of social support. The sexual satisfaction was also assessed by the Lindaberg questionnaire. For assessing the general QoL state, the WHO-QoL-BREF and FertiQoL tools were employed. Self-esteem scores were lower in the couples with longer infertility duration. The social support mean score was lower in low income couples. Those with higher educational level, shorter infertility duration, and higher income were more satisfied from their marital relationships. Besides, we revealed that the previous failed efforts for treatment of infertility were adversely associated with the lower social support and sexual satisfaction. The higher educational level, higher monthly income, living in urban area, shorter duration of marriage and infertility, and male gender were associated with better. QoL status in the most components.Associations between QoL and self-esteem, social support, sexual satisfaction, and marital satisfaction were significant (Pself-esteem, social support, sexual satisfaction, and marital satisfaction.

  18. 中西医结合治疗高催乳素血症不孕症临床分析%Clinical Analysis of Traditional Chinese and Western Medicine Treatment on Infertility Patients with Hyperprolactinemia

    Institute of Scientific and Technical Information of China (English)

    徐碧红; 李茂清

    2012-01-01

    目的:观察中西医治疗高催乳素血症不孕症患者43例的的临床疗效.方法:将86例高催乳素不孕症患者,随机分为对照组、治疗组两组.对照组43例患者给予溴隐亭治疗,治疗组加服自拟疏肝补肾汤,连服3个月.观察两组患者的临床疗效、性激素[包括催乳素(PRL)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、孕酮(P)、睾酮(T)]水平,临床症状积分及妊娠情况等.结果:治疗组、对照组的临床疗效95.3%、79.1%;治疗后两组均可降低PRL水平,提高E2、P水平(P>0.05);但治疗组在临床症状改善方面明显优于对照组(P<0.05);治疗组妊娠率显著高于对照组(P<0.05).结论:中西医治疗高催乳素血症不孕症具有良好的疗效,可改善患者临床症状,提高妊娠率,减少溴隐亭的不良反应,值得临床推广应用.%Objective: To observe the effect of traditional Chinese and western medicine treatment on 43 infertility patients with hyperprolactinemia. Methods;S6 patients of infertility with high prolaetin were randomly divided into control group and treatment group. 43 patients in the control group were given bromocriptine,the treatment group also took liver -soothing and kidney - nourishing decoction for 3 months. The clinical efficacy, sex hormones (including PRL,LH,FSH, E2, P, T) levels, clinical symptom score and pregnancy rate were observed. Results: The clinical efficacy of treatment group and control group were 95. 3% and 79. 1 % ;after treatment the two groups could reduce PRL levels effectively and improve E2,P levels( P >0. 05 ) ;but in the treatment groups clinical symptoms improvement were better than that in the control group( P <0.05) ;the pregnancy rate of treatment group was significantly higher than that of the control group( P <0.05). Conclusion: Traditional Chinese and western medicine treatment has good curative effect on infertility patients with hyperprolactinemia and can improve clinical

  19. Does infertility history affect the emotional adjustment of couples undergoing assisted reproduction? the mediating role of the importance of parenthood.

    Science.gov (United States)

    Moura-Ramos, Mariana; Gameiro, Sofia; Canavarro, Maria Cristina; Soares, Isabel; Almeida-Santos, Teresa

    2016-05-01

    The emotional adjustment of couples undergoing assisted reproductive technology (ART) treatments has been widely studied; however, it remains unclear whether infertility history contributes to couples' adjustment. This study examined the impact of infertility history (duration of infertility and number of previous ART treatment cycles) on the emotional adjustment of couples undergoing an ART cycle and the mediating effect of importance of parenthood on that association. In this cross-sectional study, 70 infertile couples (70 women and 70 men) completed self-report questionnaires assessing emotional adjustment and infertility stress during the hormonal stimulation phase of an ART cycle. Path models accounting for the dyadic nature of the data examined the direct and indirect effects (by affecting representations about parenthood and childlessness) of infertility history on emotional adjustment. The number of previous cycles affected men's, but not women's, emotional adjustment by affecting the representations on the importance of parenthood and of childlessness. Duration of infertility had the opposite effect, as couples with longer infertility reported heightened importance of parenthood, which negatively affected their emotional adjustment. Infertility history was associated with emotional adjustment in men and women, although these associations were complex. The results suggest that progression through treatment is harder for those men and women who attribute higher importance to being parents, which is aggravated by longer infertility. What is already known about the subject? Infertility is an unexpected and stressful life event Assisted reproductive treatments (ART) are emotionally demanding What does this study add? The influence of infertility history on adjustment is mediated by the importance of parenthood Men and women are affected by their past history of infertility differently. © 2015 The Authors. British Journal of Health Psychology published by John

  20. Dasatinib and Doxorubicin Treatment of Sarcoma Initiating Cells: A Possible New Treatment Strategy

    Directory of Open Access Journals (Sweden)

    Ninna Aggerholm-Pedersen

    2016-01-01

    Full Text Available Background. One of the major challenges affecting sarcoma treatment outcome, particularly that of metastatic disease, is resistance to chemotherapy. Cancer-initiating cells are considered a major contributor to this resistance. Methods. An immortalised nontransformed human stromal (mesenchymal stem cell line hMSC-TERT4 and a transformed cell line hMSC-TERT20-CE8, known to form sarcoma-like tumours when implanted in immune-deficient mice, were used as models. Receptor tyrosine kinase (RTK activation was analysed by RTK arrays and cellular viability after tyrosine kinases inhibitor (TKI treatment with or without doxorubicin was assessed by MTS assay. Results. Initial results showed that the hMSC-TERT4 was more doxorubicin-sensitive while hMSC-TERT20-CE8 was less doxorubicin-sensitive evidenced by monitoring cell viability in the presence of doxorubicin at different doses. The epidermal growth factor receptor (EGFR was activated in both cell lines. However hMSC-TERT20-CE8 exhibited significantly higher expression of the EGFR ligands. EGFR inhibitors such as erlotinib and afatinib alone or in combination with doxorubicin failed to further decrease cell viability of hMSC-TERT20-CE8. However, inhibition with the TKI dasatinib in combination with doxorubicin decreased cell viability of the hMSC-TERT20-CE8 cell line. Conclusion. Our results demonstrate that dasatinib, but not EGFR-directed treatment, can decrease cell viability of stromal cancer stem cells less sensitive to doxorubicin.

  1. Rationale for combination therapy as initial treatment for hypertension.

    Science.gov (United States)

    Giles, Thomas D

    2003-01-01

    Recent hypertension guidelines recommend initiating antihypertensive therapy with a combination of two or more agents in patients whose blood pressure exceeds their appropriate blood pressure goal by 20/10 mm Hg. This recommendation is based on the knowledge that the majority of patients with blood pressures of this magnitude will not achieve sufficient blood pressure reduction with monotherapy. Further, compared with high-dose monotherapy, combination therapy is often associated with fewer adverse effects and, for this reason, may improve patient adherence. Bringing patients to blood pressure goal quickly is likely to improve clinical outcomes. This article discusses the rationale for using combination antihypertensive therapy as initial therapy for high blood pressure in selected patients and reviews data from a study of 364 high-risk patients with Stage 2 hypertension in which a fixed-dose combination product (amlodipine besylate/benazepril HCl) proved more successful as initial therapy than high-dose monotherapy (amlodipine besylate) in reducing blood pressure.

  2. Estimates of lifetime infertility from three states: the behavioral risk factor surveillance system.

    Science.gov (United States)

    Crawford, Sara; Fussman, Chris; Bailey, Marie; Bernson, Dana; Jamieson, Denise J; Murray-Jordan, Melissa; Kissin, Dmitry M

    2015-07-01

    Knowledge of state-specific infertility is limited. The objectives of this study were to explore state-specific estimates of lifetime prevalence of having ever experienced infertility, sought treatment for infertility, types of treatments sought, and treatment outcomes. Male and female adult residents aged 18-50 years from three states involved in the States Monitoring Assisted Reproductive Technology Collaborative (Florida, Massachusetts, and Michigan) were asked state-added infertility questions as part of the 2012 Behavioral Risk Factor Surveillance System, a state-based, health-related telephone survey. Analysis involved estimation of lifetime prevalence of infertility. The estimated lifetime prevalence of infertility among 1,285 adults in Florida, 1,302 in Massachusetts, and 3,360 in Michigan was 9.7%, 6.0%, and 4.2%, respectively. Among 736 adults in Florida, 1,246 in Massachusetts, and 2,742 in Michigan that have ever tried to get pregnant, the lifetime infertility prevalence was 25.3% in Florida, 9.9% in Massachusetts, and 5.8% in Michigan. Among those with a history of infertility, over half sought treatment (60.7% in Florida, 70.6% in Massachusetts, and 51.6% in Michigan), the most common being non-assisted reproductive technology fertility treatments (61.3% in Florida, 66.0% in Massachusetts, and 75.9% in Michigan). State-specific estimates of lifetime infertility prevalence in Florida, Massachusetts, and Michigan varied. Variations across states are difficult to interpret, as they likely reflect both true differences in prevalence and differences in data collection questionnaires. State-specific estimates are needed for the prevention, detection, and management of infertility, but estimates should be based on a common set of questions appropriate for these goals.

  3. [L-arginine and male infertility].

    Science.gov (United States)

    Scibona, M; Meschini, P; Capparelli, S; Pecori, C; Rossi, P; Menchini Fabris, G F

    1994-12-01

    The clinical efficacy and acceptance of L-arginina HCL was tested in 40 infertile men. All of these men had a normal number of spermatozoa (> 20 million/ml), but a decreased motility; this decreased motility was not due to infection or to immunological disorders. The treatment consisted of 80 ml of 10% L-arginine HCL administered daily per os for 6 months. L-arginine HCL showed to be able to improve the motility of spermatozoa without any side-effects.

  4. Subclinical Pelvic Inflammatory Disease and Infertility

    National Research Council Canada - National Science Library

    Wiesenfeld, Harold C; Hillier, Sharon L; Meyn, Leslie A; Amortegui, Antonio J; Sweet, Richard L

    2012-01-01

    OBJECTIVE:The reported incidence of acute pelvic inflammatory disease (PID) has decreased but rates of tubal infertility have not, suggesting that a large proportion of PID leading to infertility may be undetected...

  5. Increases in body mass index following initiation of methadone treatment.

    Science.gov (United States)

    Fenn, Jennifer M; Laurent, Jennifer S; Sigmon, Stacey C

    2015-04-01

    Despite the clear efficacy of methadone for opioid dependence, one less desirable phenomenon associated with methadone may be weight gain. We examined changes in body mass index (BMI) among patients entering methadone treatment. A retrospective chart review was conducted for 96 patients enrolled in an outpatient methadone clinic for ≥ 6 months. The primary outcome of BMI was assessed at intake and a subsequent physical examination approximately 1.8 ± 0.95 years later. Demographic, drug use and treatment characteristics were also examined. There was a significant increase in BMI following intake (pmethadone treatment enrollment was associated with clinically significant weight gain, particularly among female patients. This study highlights the importance of efforts to help patients mitigate weight gain during treatment, particularly considering the significant health and economic consequences of obesity for individuals and society more generally.

  6. Enhanced Fertility after Diagnostic Hysterosalpingography in Unexplained Infertility

    Directory of Open Access Journals (Sweden)

    M Fallah- Tafti

    2009-07-01

    Full Text Available Introduction: Infertility is a common complication present in 10-15% of the population. It causes serious problems for the family. There are different methods for evaluation and treatment of infertility. One of the routine tests is hysterosalpingography that was first used in1922 and with changes in types of contrast media and its techniques, it is the primary test for simultaneous evaluation of tube, uterus body and cervix. Methods: This descriptive clinical outcome study was carried out on the base of a case series study. The study was performed on 117 patients who referred for HSG procedure and were followed for 2 years for detection of pregnancy. Data was analyzed by SPSS.14, and statistical tests included student’s t-test, chi-square and Fisher exact test. Results: The mean age of patients was 26±4.7 years. Duration of infertility was 6 years. Of the total, 98(83.8% cases had one or both patent tubes on HSG. They didn’t have any established causes of infertility after scrutiny of other findings and 51(43.6% cases became pregnant during 2 years (CI=95%,34.6-52.6%. Notable point was that 86.3% of pregnancies occurred in the first 6-months after HSG procedure. Conclusion: HSG plays a significant role in infertility diagnosis and treatment in spite of the new techniques and methods for infertility diagnosis and treatment; so follow up and control of patient for 6 months after HSG is recommended. If HSG fails, other procedures such as laparoscopy can be done.

  7. Immune Aspects of Female Infertility

    Directory of Open Access Journals (Sweden)

    Andrea Brazdova

    2016-05-01

    Full Text Available Immune infertility, in terms of reproductive failure, has become a serious health issue involving approximately 1 out of 5 couples at reproductive age. Semen that is defined as a complex fluid containing sperm, cellular vesicles and other cells and components, could sensitize the female genital tract. The immune rejection of male semen in the female reproductive tract is explained as the failure of natural tolerance leading to local and/or systemic immune response. Present active immune mechanism may induce high levels of anti-seminal/sperm antibodies. It has already been proven that iso-immunization is associated with infertility. Comprehensive studies with regards to the identification of antibody-targets and the determination of specific antibody class contribute to the development of effective immuno-therapy and, on the other hand, potential immuno-contraception, and then of course to complex patient diagnosis. This review summarizes the aspects of female immune infertility.

  8. Evaluation on Sperm Acrosome Integrity of Infertile Men with Varicocele

    Institute of Scientific and Technical Information of China (English)

    P.Tzvetkova; Wei-jie ZHU; Jing LI; D.Tzvetkov

    2007-01-01

    Objective To determine the sperm acrosome integrity of samples from infertile men with varicocele.Methods Forty-nine infertile men with varicocele were divided into three groups according to the grade of varicocele. Group A (grade Ⅰ), B (grade Ⅱ), and C (grade Ⅲ) consisted of 15, 18, and 16 cases, respectively. Besides, 15 semen samples from normospermic donors were used as the control. The acrosome integrity of sperm was examined with fluorescein-labeled Pisum sativum agglutinin. Acrosomal ultrastructure was observed with transmission electron microscopy.Results In three varicocele groups, most samples had high sperm abnormal morphology rates. There were significant differences in acrosome integrity rates between each varicocele group and the control (P<0.01). Group C had the lowest acrosome integrity rate among the three groups. Ultrastructural observation showed that acrosome malformations revealed acrosomal membranes defects, swelling, hypoplasia, and dissolution of the matrix.Conclusions Infertile men with varicocele had low level of acrosome integrity. Severe varicocele for infertile men might be associated with severe acrosomal defects. Evaluating sperm acrosome should aid the understanding of the sperm structural state and benefit the treatment for infertile men.

  9. Seminal biomarkers for the evaluation of male infertility

    Directory of Open Access Journals (Sweden)

    Jared M Bieniek

    2016-01-01

    Full Text Available For men struggling to conceive with their partners, diagnostic tools are limited and often consist of only a standard semen analysis. This baseline test serves as a crude estimation of male fertility, leaving patients and clinicians in need of additional diagnostic biomarkers. Seminal fluid contains the highest concentration of molecules from the male reproductive glands, therefore, this review focuses on current and novel seminal biomarkers in certain male infertility scenarios, including natural fertility, differentiating azoospermia etiologies, and predicting assisted reproductive technique success. Currently available tests include antisperm antibody assays, DNA fragmentation index, sperm fluorescence in situ hybridization, and other historical sperm functional tests. The poor diagnostic ability of current assays has led to continued efforts to find more predictive biomarkers. Emerging research in the fields of genomics, epigenetics, proteomics, transcriptomics, and metabolomics holds promise for the development of novel male infertility biomarkers. Seminal protein-based assays of TEX101, ECM1, and ACRV1 are already available or under final development for clinical use. Additional panels of DNA, RNA, proteins, or metabolites are being explored as we attempt to understand the pathophysiologic processes of male infertility. Future ventures will need to continue data integration and validation for the development of clinically useful infertility biomarkers to aid in male infertility diagnosis, treatment, and counseling.

  10. Biochemical infertility among females attending University of Ilorin Teaching Hospital, Nigeria.

    Science.gov (United States)

    Akande, A A; Idowu, A A; Jimoh, A K

    2009-03-01

    Biochemical laboratory investigations potentially contribute to the diagnosis of over 50-75% of couples being investigated for infertility. Both hormonal and anti-hormonal treatments have achieved great successes in the treatment of infertility. Our aim therefore was to investigate the pattern of biochemical abnormalities in females diagnosed as infertile form anovulation. One hundred and twenty women diagnosed clinically as primary or secondary infertility from anovulation referred from the gynecological clinic of UITH and private hospitals in Ilorin were investigated by routine fertility test profile. The age ranged between 20-40 years (mean = 32.9, sd +/- 4.7) for the primary infertility and 23-47 years (mean = 34.4, sd +/- 5.4) for the secondary infertility groups respectively. Ninety six (80%) subjects were found to have hormonal abnormalities. Pattern of biochemical diagnosis amongst the 33 (34.4%) primary infertility subjects included hypergonadotrophic hypogonadism 21 (63.6%), hypogonadotrophic hypogonadism 9 (27.3%), and hyperprolactinemia 3 (9.1%). Among the 63 (65.6%) cases of secondary infertility, there were 31 (49.2%) cases of hypergonadotrophic hypogonadism, 30 (47.6%) hypogonadotrophic hypogonadism, and 2 (3.2%) hyperprolactinemia. There was no statistical difference in the mean values in the various biochemical parameters. Hormonal profile should be a goal standard in the diagnosis of anovulation.

  11. Polycystic ovaries and infertility: Our experience

    Directory of Open Access Journals (Sweden)

    Lavanya Rajashekar

    2008-01-01

    Full Text Available Background: Polycystic ovary syndrome (PCOS is one of the most common (15-20% endocrine disorders in women of childbearing age. Although it is a major cause of infertility, its etiology remains unknown and its treatment difficult. Aim: To evaluate the incidence, treatment and outcome of patients with PCOS. DESIGN: Retrospective analysis. Materials and Methods: PCOS patients (914 of the 1057 attending the outpatient department (OPD from June 2003 to February 2008 were evaluated for this study. Of the 914 patients investigated, 814 came for treatment and these patients were studied for hormonal disturbances and their response to various modalities of treatment. Results: Of the 2270 infertility patients, 46.50% (1057 had PCOS, out of these, 86.47% (914 were investigated and 77% (814 came for treatment. Our overall pregnancy rate was 48.40% (394/814. The pregnancy rate per cycle with timed intercourse (TI was 44.77% (47/105, 17.09% (286/1673 with intrauterine insemination (IUI, 29.82% (51/171 with in vitro fertilization (IVF and 22.22% (10/45 with frozen embryo transfer (FET. The maximum number of pregnancies (85.29%, 284/333 were achieved in the first three treatment cycles. The abortion rate was 19.01% (73/384 and the incidence of ectopic pregnancy was 5.47% (21/384. Complications seen were in the form of ovarian hyperstimulation (OHSS, retention cyst on day two and multiple pregnancies in 11.71% (228/1946 of the total treatment cycles. Conclusion: Most PCOS symptoms could be adequately controlled or eliminated with proper diagnosis and treatment. Thus, ovulation induction (OI protocols and treatment modalities must be balanced for optimal results.

  12. Diabetes Care and Treatment Project: A Joslin Telemedicine Initiative

    Science.gov (United States)

    2005-10-01

    in the development of microvascular complications of diabetic retinopathy and nephropathy or mitigation of the progression of these complications, d...follow-up eye care based on findings of their baseline examination. Those patients whose initial diagnosis suggests no significant diabetic retinopathy...Determine the level of agreement in retinopathy diagnosis comparing retinal images taken using the new JVN portable retinal imager and the clinical gold

  13. Is fixed combination therapy appropriate for initial hypertension treatment?

    Science.gov (United States)

    Elliott, William J

    2002-08-01

    Recent clinical trials in hypertension prove how seldom single drug therapy achieves target blood pressure (BP) and reduces cardiovascular morbidity and mortality. A natural response is the testing and marketing of fixed-dose combination products for hypertension, of which 14 have been approved in the United States since 1993. Currently, only five products are indicated by the Food and Drug Administration for initial therapy of hypertension; all include a diuretic. To achieve such an indication, studies must show not only safety and efficacy of the combination, but also BP lowering that is at least additive compared with the two agents given separately, as well as a "synergy" not present when each agent is given alone. Some advantages to initial combination therapy include greater BP reduction, improved adherence to pill taking, fewer side effects, and lower cost. The most likely candidates for initial combination therapy are patients with initial BP higher than 160/100 mm Hg, or those with a BP goal lower than the customary 140/90 mm Hg. These include patients with target organ damage, clinical cardiovascular disease, proteinuria, renal impairment, or diabetes mellitus. In many of these circumstances, an angiotensin converting enzyme inhibitor or angiotensin II receptor antagonist is frequently recommended; adding a diuretic or calcium antagonist to it is much more likely to result in achievement of the BP goal. More research is being done to explore the combination of not only two representatives from classes of conventional agents, but also other drugs that may help address the multiple manifestations of the "metabolic syndrome" that often accompanies hypertension.

  14. Mendelian genetics of male infertility

    Science.gov (United States)

    Hwang, Kathleen; Yatsenko, Alexander N.; Jorgez, Carolina J.; Mukherjee, Sarmistha; Nalam, Roopa Lata; Matzuk, Martin M.; Lamb, Dolores J.

    2013-01-01

    Infertility is defined as the inability of a couple to conceive despite trying for a year, and it affects approximately 15% of the reproductive-age population. It is considered a genetically lethal factor, as the family lineage stops at that individual with no progeny produced. A genetic defect associated with an infertile individual cannot be transmitted to the offspring, ensuring the maintenance of reproductive fitness of the species. However, with the advent of assisted reproductive techniques (ART), we are now able to overcome sterility and bypass nature’s protective mechanisms that developed through evolution to prevent fertilization by defective or deficient sperm. PMID:21382200

  15. Analysis of prognosis of TCRM in the treatment of uterine fibroid complicated with infertility%TCRM 治疗子宫肌瘤伴不孕生殖预后分析

    Institute of Scientific and Technical Information of China (English)

    刘喻; 王明波; 李琼

    2015-01-01

    Objective To analyze pregnancy outcome by transcervical resection of myoma (TCRM) in the treatment of uterine fibroid complicated with infertility, in order to provide reference for optimal surgical plan. Methods There were 86 patients undergoing trans-laparoscopy myomectomy (TLM) as TLM group, and 72 patients undergoing TCRM for main treatment of uterine fibroid as TCRM+TLM group. All patients received follow-up for 6~36 months, and their postoperative pregnancy rate, and spontaneous abortion rate before and after operation were observed. Results The difference of cumulative pregnancy times and spontaneous abortion rate between the two groups had no statistical significance before operation (P>0.05). The difference of spontaneous abortion rate between the two groups before operation had statistical significance (P0.05). Conclusion TCRM in treating uterine fibroid complicated with infertility provides little uterine damage, with increased pregnancy rate and decreased spontaneous abortion rate. Its combination with TLM can provide assessment and treatment for pelvic cavity, and that is much better than single TLM treatment.%目的:分析宫腔镜子宫肌瘤电切术(TCRM)治疗子宫肌瘤伴不孕患者的妊娠结局,为制定最佳手术方案提供参考。方法86例采用腹腔镜子宫肌瘤剔除术(TLM)的患者作为 TLM 组,72例采用TCRM 治疗为主的子宫肌瘤伴不孕患者,设为 TCRM+TLM 组,所有患者均随访6~36个月,观察两组患者术后妊娠率、手术前后自然流产率。结果手术前两组累计妊娠次数与自然流产率比较,差异无统计学意义(P>0.05)。手术前后各组自然流产率比较,差异具有统计学意义(P0.05)。结论TCRM 治疗子宫肌瘤伴不孕对子宫的损伤较小,可明显增加妊娠率,降低自然流产率,与 TLM 共同进行可同时对盆腔情况予评估及治疗,明显优于单纯 TLM 治疗。

  16. Infertility and Life Satisfaction among Women

    Science.gov (United States)

    McQuillan, Julia; Stone, Rosalie A. Torres; Greil, Arthur L.

    2007-01-01

    Using data from a random sample of 580 midwestern women, the authors explore the association between lifetime infertility and life satisfaction. Past research shows lower life satisfaction among those seeking help for infertility. The authors find no direct effects of lifetime infertility, regardless of perception of a problem, on life…

  17. Is hyperprolactinemia the main cause of infertility?

    Directory of Open Access Journals (Sweden)

    Mikaily J

    1999-06-01

    Full Text Available Hyperprolactinemia probably is one of infertility causes. Its incidence is 20% in infertile patients. In this study importance of hyperprolactinema was studied. Importance of hyperprolactinemia as a primary factor of infertility, is uncertain. We studied 500 infertile women in infertility center of Shariati hospital. Prevalence of hyperprolactinemia was 19%. Hyperprolactinemia as a sole cause of infertility was found in only 0.8%. There was a good correlation between galactorrhea and hyperprolactinemia (P=0.00007. Galactorrhea is not a screening test for hyperprolactinemia (sensivity=25%, but its specifity is high (91%. If we omit prolactin assay for patients without galactorrhea, we will miss primary cause of infertility in probably 0.1% of patients, so we find that performing prolactin assay for patients without galactorrhea is under question. Subpopulation of infertile patients with hyperprolactinemia are not different with infertile population in mean age (P=0.09, mean duration of infertility (P=0.28 and type of infertility. We suggest that hyperprolactinemia is not a primary or sole factor of infertility

  18. Factor structure of the General Health Questionnaire-28 (GHQ-28 from infertile women attending the Yazd Research and Clinical Center for Infertility

    Directory of Open Access Journals (Sweden)

    Zahra Shayan

    2015-12-01

    Full Text Available Background: Nowadays, infertility problems have become a social concern, and are associated with multiple psychological and social problems. Also, it affects the interpersonal communication between the individual, familial, and social characteristics. Since women are exposed to stressors of physical, mental, social factors, and treatment of infertility, providing a psychometric screening tool is necessary for disorders of this group. Objective: The aim of this study was to determine the factor structure of the general health questionnaire-28 to discover mental disorders in infertile women. Materials and Methods: In this study, 220 infertile women undergoing treatment of infertility were selected from the Yazd Research and Clinical Center for Infertility with convenience sampling in 2011. After completing the general health questionnaire by the project manager, validity and, reliability of the questionnaire were calculated by confirmatory factor structure and Cronbach's alpha, respectively. Results: Four factors, including anxiety and insomnia, social dysfunction, depression, and physical symptoms were extracted from the factor structure. 50.12% of the total variance was explained by four factors. The reliability coefficient of the questionnaire was obtained 0.90. Conclusion: Analysis of the factor structure and reliability of General Health Questionnaire-28 showed that it is suitable as a screening instrument for assessing general health of infertile women.

  19. Effect of Palm Pollen on Sperm Parameters of Infertile Man.

    Science.gov (United States)

    Rasekh, Athar; Jashni, Hojjatollah Karimi; Rahmanian, Karamatollah; Jahromi, Abdolreza Sotoodeh

    2015-04-01

    There is a rapidly growing trend in the consumption of herbal remedies in the developing countries. The aim of this study was to determine the effects of orally administered Date Palm Pollen (DPP) on the results of semen analysis in adult infertile men. Forty infertile men participated in our study. They were treated by Pollen powder 120 mg kg(-1) in gelatinous capsules every other day, for two months. Before and at the end of therapy, the semen was collected after masturbation and sperm numbers, motility and morphology were determined. Our findings revealed that consumption of DPP improved the sperm count. The treatment was significantly increased sperm motility, morphology and forward progressive motility. Date palm pollen seems to cure male infertility by improving the quality of sperm parameters.

  20. In vitro fertilization for endometriosis-associated infertility.

    Science.gov (United States)

    Polat, Mehtap; Yaralı, İrem; Boynukalın, Kübra; Yaralı, Hakan

    2015-08-01

    Endometriosis is an enigmatic disease affecting 10-15% of reproductive aged women and is encountered in 25-35% of women suffering from infertility. IVF is an effective tool to overcome endometriosis-associated infertility when expectant management or surgery fails. Direct IVF should be envisioned if the female age is greater than 38 year and infertility is long lasting. Likewise, semen characteristics or tubal status that is incompatible with natural conception mandates going straight to IVF. IVF, not only bypasses the distortion of pelvic anatomy associated with advanced stage endometriosis, but also removes gametes from a hostile peritoneal environment. In this article, we address the impact, if any, of endometriosis and endometriomason IVF outcome, whether surgical treatment of early-stage disease, endometriomas or deep infiltrating endometriosis would enhance pregnancy rates in IVF, which protocol to employ for controlled ovarian hyperstimulation for IVF and finally the impact, if any, of controlled ovarian hyperstimulation for IVF on progression of endometriosis.

  1. Is infertility after surgery for cryptorchidism congenital or acquired?

    DEFF Research Database (Denmark)

    Cortes, Dina; Thorup, J M; Visfeldt, J

    1998-01-01

    We evaluated whether deletions of the DAZ (deleted in azoospermia) gene, abnormal karyotypes or hypogonadotropic hypogonadism (HH) were demonstrable in infertile men who had undergone surgery in childhood for cryptorchidism with a simultaneous testicular biopsy that demonstrated no or almost...... no germ cells. In six men with infertility after surgery for cryptorchidism, the adult karyotype and analyses for the DAZ gene, serum follicle-stimulating hormone, luteinizing hormone, and testosterone were performed from a peripheral blood sample. Testicular volume was also measured. All patients...... exhibited a 46,XY karyotype. There were no deletions of the DAZ-gene, no HH and no testicular atrophy. The infertility was thus not proved to be congenital, and consequently, surgical treatment is indicated before the germ cells disappear from undescended testes. This appears to be before 15 months of age....

  2. A Review: Role of oxidative stress in male infertility

    Directory of Open Access Journals (Sweden)

    Hamed Fanaei

    2013-09-01

    Full Text Available Recent studies have shown that reactive oxygen species (ROS have a very important role in the intracellular signaling process in physiological conditions. On the other hand, during the recent decade it has been indicated that ROS play a role in various types of male infertility and it is due to the overproduction of ROS or decrease in the antioxidant defense system in the reproductive system and sperm. In pathological conditions, ROS via interferences in the spermatogenesis process, sperm function, and sperm structure (motility, viability, acrosome reaction, sperm-oocyte fusion, and damage to DNA and cell membrane as well as reduction in fertilization and implantation can lead to infertility. Knowledge of how ROS affect the physiological process of the reproductive system is crucial in the treatment of infertility. Thus, in this review article we will discuss experimental and clinical findings related to the effects of ROS on male fertility.

  3. [Triage and initial treatment of house fire victims].

    Science.gov (United States)

    Gremion, C; Wicky, R; Niquille, M

    2005-08-10

    Medical teams are often confronted to the numerous victims due to house fires. The time course of these disasters is difficult to predict and requires an excellent rescue organization as well as good cooperation with the fire brigades and appropriate matching and raising of means to the magnitude of the disaster. Victims usually present with three types of injuries: thermal, traumatic and toxic. In order to avoid an overflow of patients in surrounding hospitals, adequate triage and treatment are required on the field. Triage is best relized by history and physical examination and the main treatment remains maximal oxygen therapy. In case of severe monoxide intoxication, cyanide poisoning should be highly suspected.

  4. Arthrocentesis as initial treatment for temporomandibular joint arthropathy : A randomized controlled trial

    NARCIS (Netherlands)

    Vos, L. M.; Huddleston Slater, J. J. R.; Stegenga, B.

    2014-01-01

    Objective: To determine the effectiveness of arthrocentesis compared to conservative treatment as initial treatment with regard to temporomandibular joint pain and mandibular movement. Patients and methods: In this randomized controlled trial, 80 patients with arthralgia of the TMJ (classified accor

  5. Genomic markers to tailor treatments: waiting or initiating?

    NARCIS (Netherlands)

    P. Tajik; P.M. Bossuyt

    2011-01-01

    The decade since the publication of the Human Genome Project draft has ended with the discovery of hundreds of genomic markers related to diseases and phenotypes. However, the project has not yet delivered on its promise to tailor treatments for individuals. The number of genomic markers in clinical

  6. In situ chitosan gelation initiated by atmospheric plasma treatment.

    Science.gov (United States)

    Molina, R; Jovancic, P; Vilchez, S; Tzanov, T; Solans, C

    2014-03-15

    This work reports on the feasibility of atmospheric dielectric barrier discharge (DBD) plasma as a novel synthetic pathway for the liquid phase gelation of chitosan. The DBD plasma chitosan gelation process did not significantly alter the chemical structure of the biopolymer as confirmed by FTIR study. However, the oxidation processes and local heating effect associated with the solvent evaporation during the plasma treatment could provoke both reaction of chitosan degradation and the cleavage of β-1-4-glycosidic linkages with the concomitant generation of aldehyde groups able to crosslink via Schiff-base with amino groups from other chitosan molecules. Shear viscosity measurements suggested the formation of chitosan fragments of lower molecular weight after the plasma treatment of 1% (w/v) chitosan and fragments of higher molecular weight after the plasma treatment of 2% (w/v) chitosan. The crosslinking density of hydrogels generated during the in situ DBD plasma chitosan gelation process increased as a function of the treatment time and concentration of chitosan. As of consequence of the increase of the cross-linking density, the equilibrium swelling ratio and water content decreased significantly.

  7. Approaches to improve the diagnosis and management of infertility

    NARCIS (Netherlands)

    Devroey, P.; Fauser, B. C. J. M.; Diedrich, K.

    2009-01-01

    Recent advances in our understanding of the causes of infertility and of assisted reproductive technology (ART) have led to the development of complex diagnostic tools, prognostic models and treatment options. The Third Evian Annual Reproduction (EVAR) Workshop Meeting was held on 26-27 April 2008 t

  8. Role of diagnostic laparoscopy in the management of female infertility

    Directory of Open Access Journals (Sweden)

    Rajshree Dayanand Katke

    2016-08-01

    Conclusions: We concluded that Laparoscopy has important role in the diagnosis and treatment of unexplained infertility. It also helps in Prediction and improvement of success rate of assisted reproductive technologies like IUI and IVF. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2592-2595

  9. Cultural Considerations in Counseling Couples Who Experience Infertility

    Science.gov (United States)

    Burnett, Judith A.

    2009-01-01

    Infertility creates challenges affecting various aspects of couples' intimate lives. Practices regarding reproduction are often shaped by cultural messages. Culturally sensitive treatment methods help counselors provide effective therapy to couples with fertility problems. This article describes cultural influences, challenges, and counseling…

  10. Cultural Considerations in Counseling Couples Who Experience Infertility

    Science.gov (United States)

    Burnett, Judith A.

    2009-01-01

    Infertility creates challenges affecting various aspects of couples' intimate lives. Practices regarding reproduction are often shaped by cultural messages. Culturally sensitive treatment methods help counselors provide effective therapy to couples with fertility problems. This article describes cultural influences, challenges, and counseling…

  11. Comparison of hysteroscopy combined with laparoscopy or laparoscopy alone in treatment of infertility%腹腔镜单用与宫腹腔镜联合应用在治疗不孕症中的对比分析

    Institute of Scientific and Technical Information of China (English)

    罗克燕; 徐敏; 孙贵红

    2013-01-01

    目的 探讨宫腹腔镜联合应用在诊治女性不孕症中的价值和治疗后卵巢储备功能变化情况,并与腹腔镜单用诊治进行比较.方法 收集该科2010年1月~2011年12月治疗的238例不孕症患者的临床资料,分为宫腹腔镜联合治疗组(观察组)和腹腔镜单用治疗组(对照组),观察对比两组病因构成,并对患者治疗后妊娠情况及卵巢储备功能进行随访.结果 两组患者都以输卵管病变和盆腔病变为多见,观察组宫腔粘连、子宫肌瘤、纵隔子宫、子宫内膜息肉的检查阳性率明显高于对照组,两者比较差异有显著性(P<0.05).治疗后通过随访,观察组妊娠88例,妊娠率达61.54%,对照组妊娠46例,妊娠率为48.42%,两组比较差异有显著性(P<0.05).各组患者血清FSH、LH和E2水平在治疗后1个月较治疗前和治疗后其他时间结果差异有显著性(P<0.05),两组间血清FSH、LH和E2水平差异无显著性(P>0.05);两组间治疗前后卵巢截面积、PSV和EDV比较差异无显著性(P>0.05),各组治疗后1个月的卵巢截面积、EDV和PSV参数较治疗前和治疗后其他时间结果差异有显著性(P<0.05).结论 联合应用宫腹腔镜是诊治女性不孕症的有效方法,能够直观、准确、全面地对盆腔及宫腔进行检查,根据病因采取有针对性的治疗,能够提高妊娠率,具有临床推广应用价值.%[Objective] To investigate the value of combined use of hysteroscopy and laparoscopy in diagnosis and treatment of female infertility and evaluate the ovarian reserve function change after the laparoscopic operation.[Methods] 238 female infertile patients who underwent laparoscopic operation in our hospital during Jan.2010 and Dec.2011 were randomly divided into observation group and control group.The pregnancy rate and ovarian reserve function changes were followed up.[Results] Uterine tube and pelvic diseases were the factors that led to infertility.The positive

  12. Barriers to and Reasons for Treatment Initiation Among Gambling Help-line Callers.

    Science.gov (United States)

    Khayyat-Abuaita, Ula; Ostojic, Dragana; Wiedemann, Ashley; Arfken, Cynthia L; Ledgerwood, David M

    2015-08-01

    Identifying barriers to seeking treatment is essential for increasing problem gambler treatment initiation in the community, given that as few as 1 in 10 problem gamblers ever seek treatment. Further, many problem gamblers who take the initial step of contacting problem gambling help-lines do not subsequently go on to attend face-to-face treatment. There is limited research examining reasons for attending treatment among this population. This study addressed these gaps in the literature by examining barriers and attractions to treatment among callers to the State of Michigan Problem Gambling Help-line. In total, 143 callers (n = 86 women) completed the Barriers to Treatment for Problem Gambling (BTPG) questionnaire and responded to open-ended questions regarding barriers to and reasons for treatment initiation, as part of a telephone interview. Greater endorsement of barriers to treatment was associated with a lower likelihood of initiating treatment, especially perceived absence of problem and treatment unavailability. Correspondingly, problem gamblers who identified more reasons to attend treatment were more likely to attend, with positive treatment perceptions being the most influential. These findings can help get people into treatment by addressing barriers and fostering reasons for attending treatment, as well as reminding clinicians of the importance of identifying and addressing individual treatment barriers among patients with problem gambling.

  13. [Goodpasture syndrome: treatment initiation with plasmapheresis before histologic diagnostic verification].

    Science.gov (United States)

    Gartenschläger, M; Lenci, G; Schinzel, H; Schweden, F; Dienes, H P; Weilemann, L S

    1996-11-01

    A 28 years old male patient presented, after a history of previous recurrent hemoptysis, with diffuse bilateral air space consolidation at chest radiography (CXR). Within 48 hours, partial respiratory insufficiency developed and required intubation. On a clinical and roentgenographic basis, the diagnosis of a Goodpasture syndrome was suspected. Plasmapheresis and immunosuppressive therapy with prednisone and cyclophosphamide were started immediately. Three days after admission, macrohematuria developed and serum creatinine began to rise to a maximum of 3.9 mg/dl. Totally, 13 plasmaphereses were performed within 27 days. Clinical, laboratory and radiological findings improved markedly. 30 days after admission, the patient was discharged and followed on an outpatient basis. Serum creatinine eventually decreased to 1.1 mg/dl. Initially, circulating antibodies against glomerular basement membrane (GBM) were positive, controls remained negative. Renal biopsy was performed after the acute phase and showed glomerulonephritis and linear immunoglobulin deposition along the GBM. Radiologic findings at CXR and high resolution computed tomography are demonstrated.

  14. Cigarette smoking and male infertility

    Directory of Open Access Journals (Sweden)

    Taymour Mostafa

    2010-07-01

    Full Text Available Numerous studies have identified specific body systems affected by the hazardous effects of the cigarette smoking particularly the respiratory and cardiovascular systems. The effect of smoking on male reproduction has also been studied where semen quality was investigated in different cross-sectional studies including infertile patients with conflicting results. This article aimed to assess the relationship between smoking and male infertility. A review of published articles was carried out, using PubMed, medical subject heading (MSH databases and Scopus engine excluding the effects of smoking outside male infertility. Key words used to assess exposure, outcome, and estimates for the concerned associations were: smoking, semen, male infertility, sperm, humans, and fertility. Most of the reports showed that smoking reduces sperm production, sperm motility, sperm normal forms and sperm fertilising capacity through increased seminal oxidative stress and DNA damage. Few papers reported nonsignificant differences in semen parameters between smokers or non-smokers. It is concluded that although some smokers may not experience reduced fertility, men with marginal semen quality can benefit from quitting smoking.

  15. Cost effectiveness of arthrocentesis as initial treatment for temporomandibular joint arthralgia: A randomized controlled trial

    NARCIS (Netherlands)

    Vos, L.M.; Stant, A.D.; Quik, E.H.; Huddleston Slater, J.J.R.; Stegenga, B.

    2013-01-01

    Objective: To determine the cost effectiveness of arthrocentesis as initial treatment compared to care as usual (CAU) for temporomandibular joint (TMJ) arthralgia. Materials and methods: 80 patients were randomly allocated to arthrocentesis as initial treatment (n = 40) or CAU (n = 40). Arthrocentes

  16. Impact of asymptomatic urogenital tract infections on ejaculate parameters in infertile men with varicocele

    Directory of Open Access Journals (Sweden)

    L. F. Kurilo

    2016-01-01

    Full Text Available Varicocele, a pathology developing in 15 % males, is associated with 30 % male infertility cases. The role of urogenital infections coinciding with varicocele in infertile men has not been studied in sufficient detail.Objective: to examine the effects of bacterial and viral infections on ejaculate parameters in infertile patients with varicocele. The study included 49 patients with infertility and varicocele and 26 healthy males undergoing prophylactic medical examination. Highlevel infection was recorded after examination of ejaculates and urethral scrapes of 49 patients: bacterial (30.6 % and viral (14.3 % pathogens. Quantitative analysis of viral DNA showed high contamination of ejaculates with herpes viruses (> 3 lg10/ml. Detailed analysis of spermatograms demonstrated a decrease in all basic parameters in patients with varicocele and infertility compared with those in healthy subjects. The presence of infectious agents had a statistically significant negative effect on ejaculate parameters. Spermiological examination revealed high level of sperm abnormalities (astenozoospermia, oligoteratozoospermia, and oligoastenoteratozoospermia in patients with infertility, varicocele and bacterioviral infection of urogenital tract compared with uninfected infertile patients with varicocele. Laboratory tests for bacterial and viral infections should be recommended in infertility associated with varicocele even in the absence of clinical signs of these infections. Quantitative analysis of urogenital pathogens allows one to determine the necessity of etiotherapy of hidden infection and to monitor the effectiveness of treatment.

  17. Causes of infertility in view of Iranian traditional medicine: A review

    Directory of Open Access Journals (Sweden)

    Seyed Kazem Kazemeini

    2017-08-01

    Full Text Available Infertility is one of the most important reproductive health concerns in the conventional medicine. Iranian traditional medicine presents different viewpoints in this regard which they could be of benefit and a good guide for the society of medicine. This study sought to provide the comprehensive investigation on the causes of infertility according to Iranian traditional medicine for understanding of old sages' ideas and categorizing of the causes of infertility. In this narrative review, we searched causes of infertility in traditional medicine books and available articles in this field. Iranian traditional physicians have investigated the causes of infertility in couples and attributed them to male and female causes. They have divided the main causes of infertility in both sexes into structural and functional abnormalities, that both traditional medicine and conventional medicine have a lot of participations, but the traditional medicine believes holistic approach in the treatment of diseases and the involvement of all parts of the body particularly specialty board members (heart, liver, brain, ovary, and testicles in the proper conduct activities in different parts of the body such as reproduction system. There is also special attention to temperament Mizaj disorders. Given the numerous commonalities existing between traditional and conventional medicine in categorizing the causes of infertility, Iranian traditional medicine methods can be applied as a complementary solution in infertility. It could be also subject to further research and investigation due to its opposition to modern medicine in some regards.

  18. Causes of infertility in view of Iranian traditional medicine: A review

    Science.gov (United States)

    Kazemeini, Seyed Kazem; Emtiazy, Majid; Owlia, Fatemeh; Khani, Parisa

    2017-01-01

    Infertility is one of the most important reproductive health concerns in the conventional medicine. Iranian traditional medicine presents different viewpoints in this regard which they could be of benefit and a good guide for the society of medicine. This study sought to provide the comprehensive investigation on the causes of infertility according to Iranian traditional medicine for understanding of old sages' ideas and categorizing of the causes of infertility. In this narrative review, we searched causes of infertility in traditional medicine books and available articles in this field. Iranian traditional physicians have investigated the causes of infertility in couples and attributed them to male and female causes. They have divided the main causes of infertility in both sexes into structural and functional abnormalities, that both traditional medicine and conventional medicine have a lot of participations, but the traditional medicine believes holistic approach in the treatment of diseases and the involvement of all parts of the body particularly specialty board members (heart, liver, brain, ovary, and testicles) in the proper conduct activities in different parts of the body such as reproduction system. There is also special attention to temperament Mizaj disorders. Given the numerous commonalities existing between traditional and conventional medicine in categorizing the causes of infertility, Iranian traditional medicine methods can be applied as a complementary solution in infertility. It could be also subject to further research and investigation due to its opposition to modern medicine in some regards. PMID:28835934

  19. Chromosomal abnormalities and Y chromosome microdeletions in infertile men from Morocco.

    Science.gov (United States)

    Naasse, Yassine; Charoute, Hicham; El Houate, Brahim; Elbekkay, Chadli; Razoki, Lunda; Malki, Abderrahim; Barakat, Abdelhamid; Rouba, Hassan

    2015-09-18

    Male infertility is responsible for 50% of infertile couples. Thirty percent of male infertility is due to cytogenetic and genetic abnormalities. In Arab and North African populations, several studies have shown the association of these chromosomal abnormalities with male infertility. Our objective is to evaluate the frequency of chromosomal abnormalities and Y chromosome microdeletions in infertile men from Morocco. A total of 573 Moroccan infertile men (444 azoospermic and 129 oligozoospermic men) referred for cytogenetic analysis to the Department of Cytogenetics of the Pasteur Institute of Morocco, were screened for the presence of chromosomal abnormalities and Y chromosome microdeletions. Chromosomal abnormalities accounted for approximately 10.5% (60/573). Fifty six cases among them have sex chromosome abnormalities (93.34%), including Klinefelter's syndrome in 41 patients (68.34%). Autosomal chromosome abnormalities (6.66%) were observed in 4 patients. Chromosomal abnormalities were more prevalent in azoospermic men (13.06%) than in oligospermic men (1.55%). Y microdeletions were detected in 16 of 85 patients (AZFc: 14.12%, AZFbc: 4.70%), most of them where azoospermic men with no chromosomal abnormality. These results highlighted the need for efficient molecular genetic testing in male infertility diagnosis. In addition, a genetic screening should be performed in infertile men before starting assisted reproductive treatments.

  20. Clinical diagnostic testing for the cytogenetic and molecular causes of male infertility: the Mayo Clinic experience.

    Science.gov (United States)

    Hofherr, Sean E; Wiktor, Anne E; Kipp, Benjamin R; Dawson, D Brian; Van Dyke, Daniel L

    2011-11-01

    Approximately 8% of couples attempting to conceive are infertile and male infertility accounts for approximately 50% of infertility among couples. Up to 25% of males with non-obstructive infertility have chromosomal abnormalities and/or microdeletions of the long arm of the Y-chromosome. These are detected by conventional chromosome and Y-microdeletion analysis. In this study, we reviewed the results of testing performed in the Mayo Clinic Cytogenetics and Molecular Genetics Laboratories and compared our findings with previously published reports. This study includes 2,242 chromosome studies from males ≥18 years of age referred for infertility between 1989 and 2000 and 2,749 Y-deletion molecular studies performed between 2002 and 2009. 14.3% of infertile males tested by karyotyping had abnormalities identified. These include: (258) 47,XXY and variants consistent with Klinefelter syndrome, (3) combined 47,XXY and balanced autosomal rearrangements, (9) 47,XYY, (9) Y-deletions, (7) 46,XX males, (32) balanced rearrangements, and (1) unbalanced rearrangement. 3.6% of males tested for Y-microdeletion analysis had abnormalities identified, 90% of which included a deletion of the AZFc region. This study highlights the need of males suffering from non-obstructive infertility to have laboratory genetic testing performed. An abnormal finding can have significant consequences to assisted reproductive techniques and fertility treatment, and provide a firm diagnosis to couples with longstanding infertility.

  1. Chromosomal aberrations, Yq microdeletion, and sperm DNA fragmentation in infertile men opting for assisted reproduction.

    Science.gov (United States)

    Shamsi, Monis B; Kumar, Rajeev; Malhotra, Neena; Singh, Nita; Mittal, Suneeta; Upadhyay, Ashish D; Dada, Rima

    2012-09-01

    Male infertility is a multi-factorial disorder, and identification of its etiology in an individual is critical for treatment. Systematically elucidating the underlying genetic causes (chromosomal and Yq microdeletion) and factors, such as reactive oxygen species (ROS) levels and total antioxidant capacity (TAC), which contribute to sperm DNA damage, may help to reduce the number of men with idiopathic infertility and provide them with the most suitable therapeutics and counseling. This study was done to comprehensively investigate genetic and oxidative stress factors that might be the etiology of a large percentage of men with idiopathic infertility. One hundred twelve infertile men and 76 fertile controls were screened for chromosomal aberrations and Yq microdeletions. ROS, TAC, and sperm DNA damage were assessed in cytogenetically normal, non-azoospermic men with intact Y chromosome (n = 93). ROS was assessed in neat and washed semen by chemiluminescence; seminal TAC with a commercially available kit; and sperm DNA damage by the comet assay. Two men had cytogenetic abnormalities and seven men harbored Yq microdeletions. ROS levels in neat and washed semen of infertile men were significantly higher (P fragmentation in infertile men was significantly higher (P < 0.01) than controls. Genetic factors and oxidative stress cumulatively account for large number of idiopathic infertile cases. Unlike, genetic causes, which cannot be cured, timely identification and management of oxidative stress may help to reverse/reduce the effects on induced DNA damage, and improve the outcomes for infertile males.

  2. HIV Care and Treatment Beliefs among Patients Initiating Antiretroviral Treatment (ART) in Oromia, Ethiopia.

    Science.gov (United States)

    Tymejczyk, Olga; Hoffman, Susie; Kulkarni, Sarah Gorrell; Gadisa, Tsigereda; Lahuerta, Maria; Remien, Robert H; Elul, Batya; El-Sadr, Wafaa; Melaku, Zenebe; Nash, Denis

    2016-05-01

    To better understand patient beliefs, which may influence adherence to HIV care and treatment, we examined three dimensions of beliefs among Ethiopian adults (n = 1177) initiating antiretroviral therapy (ART). Beliefs about benefits of ART/HIV clinical care were largely accurate, but few patients believed in the ability of ART to prevent sexual transmission and many thought Holy Water could cure HIV. Factors associated with lower odds of accurate beliefs included advanced HIV, lack of formal education, and Muslim religion (benefits of ART/clinical care); secondary or university education and more clinic visits (ART to prevent sexual transmission); and pregnancy and Orthodox Christian religion (Holy Water). Assessment of patient beliefs may help providers identify areas needing reinforcement. In this setting, counselors also need to stress the benefits of ART as prevention and that Holy Water should not be used to the exclusion of HIV care and ART.

  3. Infertility in resource-constrained settings: moving towards amelioration.

    Science.gov (United States)

    Hammarberg, Karin; Kirkman, Maggie

    2013-02-01

    It is often presumed that infertility is not a problem in resource-poor areas where fertility rates are high. This is challenged by consistent evidence that the consequences of childlessness are very severe in low-income countries, particularly for women. In these settings, childless women are frequently stigmatized, isolated, ostracized, disinherited and neglected by the family and local community. This may result in physical and psychological abuse, polygamy and even suicide. Attitudes among people in high-income countries towards provision of infertility care in low-income countries have mostly been either dismissive or indifferent as it is argued that scarce healthcare resources should be directed towards reducing fertility and restricting population growth. However, recognition of the plight of infertile couples in low-income settings is growing. One of the United Nation's Millennium Development Goals was for universal access to reproductive health care by 2015, and WHO has recommended that infertility be considered a global health problem and stated the need for adaptation of assisted reproductive technology in low-resource countries. This paper challenges the construct that infertility is not a serious problem in resource-constrained settings and argues that there is a need for infertility care, including affordable assisted reproduction treatment, in these settings. It is often presumed that infertility is not a problem in densely populated, resource-poor areas where fertility rates are high. This presumption is challenged by consistent evidence that the consequences of childlessness are very severe in low-income countries, particularly for women. In these settings, childless women are frequently stigmatized, isolated, ostracized, disinherited and neglected by the family and local community. This may result in physical and psychological abuse, polygamy and even suicide. Because many families in low-income countries depend on children for economic survival

  4. Unexplained infertility: association with inherited thrombophilia.

    Science.gov (United States)

    Fatini, Cinzia; Conti, Lucia; Turillazzi, Valentina; Sticchi, Elena; Romagnuolo, Ilaria; Milanini, Maria Novella; Cozzi, Cinzia; Abbate, Rosanna; Noci, Ivo

    2012-05-01

    Unexplained infertility represents one of the most common diagnoses in fertility care. Attention is being paid to the association between inherited thrombophilia and infertility causes. In this study we investigated the prevalence of inherited thrombophilia according to infertility causes. We studied Prothrombin gene G20210A mutation, Factor V Leiden, deficiencies in protein S and C and antithrombin in 930 Caucasian infertile women referred to Fertility Center of the Department of Sciences for Woman and Child's Health, University of Florence, of whom 230 with unexplained, 195 female and 283 male infertility, and in 240 women who have conceived naturally without hormonal stimulation therapy. A significant relationship between inherited thrombophilia [OR 95%CI 1.97 (1.05-3.68), p = 0.03] and unexplained infertility was observed, whereas no association between thrombophilia and female and male infertility was found. Significantly higher prevalence of prothrombin gene mutation in unexplained infertile women in comparison to that observed in fertile women was observed (5.7% vs 2.1% p = 0.04); the prevalence of the other thrombophilia determinants was higher, even if not significantly, in the unexplained infertile group. This study demonstrates the relationship between inherited thrombophilia and unexplained infertility, thus suggesting the contribution of genetic components in modulating unexplained infertility, behind anovulation, male and tubal factor. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Don't Give Up! A Cyber-ethnography and Discourse Analysis of an Online Infertility Patient Forum.

    Science.gov (United States)

    Lee, Mihan

    2017-01-06

    Infertility affects women across the socioeconomic spectrum; however, it is by no means egalitarian in its distribution, nor uniform in its lived experience. Evidence shows striking disparities by income, race, and education in infertility prevalence, access to infertility services, and success rates after receiving infertility treatments. However, few studies so far have investigated disparities in patients' access to psychological support during the infertility journey. This paper undertakes a cyber-ethnography of the online patient forum, "Finding a Resolution for Infertility," hosted by RESOLVE: The National Infertility Association. It also draws from interviews with 54 infertility patients recruited from the forum. Our aim was to examine how social support operates within this virtual realm, by examining how the forum's language, norms, and values create and enforce categories of deserving and belonging among site users. We find that the forum's discourse privileges an infertility narrative we term the "persistent patient," in which a patient exhaustively researches treatment options, undergoes multiple cycles of treatment despite repeated failures, and ultimately achieves success (a healthy baby). Meanwhile, there is little to no discursive space for discussion of the financial and social resources necessary to act in accordance with this script. Thus, women without such resources can be alienated, silenced, and denied mental health support by this online community.

  6. Dasatinib and Doxorubicin Treatment of Sarcoma Initiating Cells

    DEFF Research Database (Denmark)

    Aggerholm-Pedersen, Ninna; Demuth, Christina; Safwat, Akmal;

    2016-01-01

    growth factor receptor (EGFR) was activated in both cell lines. However hMSC-TERT20-CE8 exhibited significantly higher expression of the EGFR ligands. EGFR inhibitors such as erlotinib and afatinib alone or in combination with doxorubicin failed to further decrease cell viability of hMSC-TERT20-CE8......) stem cell line hMSC-TERT4 and a transformed cell line hMSC-TERT20-CE8, known to form sarcoma-like tumours when implanted in immune-deficient mice, were used as models. Receptor tyrosine kinase (RTK) activation was analysed by RTK arrays and cellular viability after tyrosine kinases inhibitor (TKI....... However, inhibition with the TKI dasatinib in combination with doxorubicin decreased cell viability of the hMSC-TERT20-CE8 cell line. Conclusion. Our results demonstrate that dasatinib, but not EGFR-directed treatment, can decrease cell viability of stromal cancer stem cells less sensitive to doxorubicin....

  7. 多囊卵巢综合征导致不孕的危险因素及治疗方案探讨%Exploring the risk factors causing infertility in women with polycystic ovary syndrome and its treatment programs

    Institute of Scientific and Technical Information of China (English)

    张建伟; 何泓

    2014-01-01

    目的:探讨多囊卵巢综合征(PCOS)导致不孕的危险因素,并评估不同的药物治疗方案的疗效。方法以152例PCOS患者为病例组,以正常分娩的152例孕产妇为对照组,回顾分析两组的基本特征、相关疾病家族史等指标与PCOS不孕的关联性及关联强度。采用单纯促排卵剂(单纯用药组,76例)和排卵剂联合炔雌醇环丙孕酮、二甲双胍(联合用药组,76例)对152例PCOS患者进行治疗,并评价两组的治疗效果。结果经单因素Logistic回归分析,BMI、肥胖、多毛、痤疮、糖尿病家族史、秃顶家族史、月经紊乱家族史是PCOS导致不孕的危险因素(P<0.05),危险度分别上升1.486倍、4.317倍、28.505倍、12.963倍、3.492倍、4.970倍、15.202倍;多因素Logistic回归分析,肥胖、有糖尿病家族史、有月经紊乱家族史是发生PCOS导致不孕的独立危险因素(P<0.05);经4个月经周期的治疗后,联合用药组的流产率(10.53%)明显低于单纯用药组(25.00%),联合用药组妊娠率(46.05%)明显高于单纯用药组(15.79%,P<0.05)。结论肥胖、有糖尿病家族史、有月经紊乱家族史,是PCOS导致不孕的独立危险因素;治疗时,患者在服用促排卵剂前,最好先服用二甲双胍、炔雌醇环丙孕酮治疗,以提高自然受孕率。%Objective To explore the risk factors causing infertility in women with polycystic ovary syn-drome (PCOS) and its treatment programs. Methods A retrospective study was carried out with 152 PCOS patients and 152 normal puerperal women. The risk factors associated with infertility in PCOS were analyzed. The PCOS pa-tients were divided into twp groups of 76 cases, stimulate ovulation agent only group and combined medication group (a combination of stimulate ovulation agent, ethinyl estradio-cyproterone and metformin). Results By univariate lo-gistic regression analysis, it was turned out that BMI, obesity, hirsutism, acne

  8. A CLINICO-EPIDEMIOLOGICAL STUDY OF INFERTILE COUPLES AMONG THE SUBURBAN/RURAL POPULATION OF BOKAKHAT, ASSAM

    Directory of Open Access Journals (Sweden)

    Pranabika

    2016-03-01

    Full Text Available Infertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse (WHO-ICMART. Infertility is the inability of a sexually active, non-contraception couple to achieve pregnancy in one year. Infertility affects relatively large number of couples, both globally as well as in India. There are sparse data on the prevalence of infertility in India. This study describes the correlates and prevalence of infertility among couples in Bokakhat, Assam, India. MATERIALS AND METHODS This study is a cross-sectional study done in the suburban/rural field practice area of Bokakhat Subdivisional Civil Hospital, during August 2008 to July 2009. Couples having infertility were identified using WHO definition by house to house survey and interviewed to know various epidemiological correlates including demographic characteristics, aetiology and treatment if taken for the same. RESULTS There were total of 1755 eligible couples and 167 were found to be having primary or secondary infertility. The study showed that among eligible couple’s prevalence of primary infertility was 6.4%, while secondary infertility was 3.01%. Among couples with primary infertility, male factors were responsible in 18 (15.78%, female factors in 32 (28.07%, both partners were accountable in 27 (23.68%, while 37 (32.45% couple’s cause of infertility was unexplained. CONCLUSION It was concluded that this study has provided significant information concerning the prevalence of infertility in our area and also provided information about different demographical and aetiological factors associated with infertility.

  9. The Role of Infertility Etiology in Success Rate of Intrauterine Insemination Cycles: An Evaluation of Predictive Factors for Pregnancy Rate

    Science.gov (United States)

    Ashrafi, Mahnaz; Rashidi, Mandana; Ghasemi, Afsaneh; Arabipoor, Arezoo; Daghighi, Sara; Pourasghari, Parisa; Zolfaghari, Zahra

    2013-01-01

    Background: The objective of this study was to identify the prognostic factors that influence the outcome of ovarian stimulation with intrauterine insemination (IUI) cycles in couples with different infertility etiology. Materials and Methods: This retrospective study was performed in data of 1348 IUI cycles with ovarian stimulation by clomiphene citrate (CC) and/or gonadotropins in 632 women with five different infertility etiology subgroups at Akbarabbadi Hospital, Tehran, Iran. Results: The pregnancy rate (PR)/ cycle was highest (19.9%) among couples with unexplained infertility and lowest (10.6%) in couples with multiple factors infertility. In cases of unexplained infertility, the best PRs were seen after CC plus gonadotropins stimulation (26.3%) and with inseminated motile sperm count>30×106 (21.9%), but the tendency didn’t reach statistical significant. In the ovarian factor group, the best PRs were observed in women aged between 30 and 34 years (20.8%), with 2-3 preovulatory follicles (37.8%) and infertility duration between 1and 3 years (20.8%), while only infertility duration (p=0.03) and number of preovulatory follicles (p=0.01) were statistically significant. Multiple logistic regression analysis determined that number of preovulatory follicles (p=0.02), duration of infertility (p=0.015), age (p=0.019), infertility etiology (p=0.05) and stimulation regimen (p=0.01) were significant independent factors in order to predict overall clinical PR. Conclusion: The etiology of infertility is important to achieve remarkable IUI success. It is worth mentioning that within different etiologies of infertility, the demographic and cycles characteristics of couples did not show the same effect. Favorable variables for treatment success are as follows: age infertility ≤5 years and a cause of infertility except of multiple factors. PMID:24520471

  10. Breast Cancer-Initiating Cells: Insights into Novel Treatment Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Santilli, Guido; Binda, Mara; Zaffaroni, Nadia; Daidone, Maria Grazia, E-mail: mariagrazia.daidone@istitutotumori.mi.it [Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS-Istituto Nazionale dei Tumori, Via Amadeo 42, Milan 20133 (Italy)

    2011-03-16

    There is accumulating evidence that breast cancer may arise from mutated mammary stem/progenitor cells which have been termed breast cancer-initiating cells (BCIC). BCIC identified in clinical specimens based on membrane phenotype (CD44{sup +}/CD24{sup −/low} and/or CD133{sup +} expression) or enzymatic activity of aldehyde dehydrogenase 1 (ALDH1{sup +}), have been demonstrated to have stem/progenitor cell properties, and are tumorigenic when injected in immunocompromized mice at very low concentrations. BCIC have also been isolated and in vitro propagated as non-adherent spheres of undifferentiated cells, and stem cell patterns have been recognized even in cancer cell lines. Recent findings indicate that aberrant regulation of self renewal is central to cancer stem cell biology. Alterations in genes involved in self-renewal pathways, such as Wnt, Notch, sonic hedgehog, PTEN and BMI, proved to play a role in breast cancer progression. Hence, targeting key elements mediating the self renewal of BCIC represents an attractive option, with a solid rationale, clearly identifiable molecular targets, and adequate knowledge of the involved pathways. Possible concerns are related to the poor knowledge of tolerance and efficacy of inhibiting self-renewal mechanisms, because the latter are key pathways for a variety of biological functions and it is unknown whether their interference would kill BCIC or simply temporarily stop them. Thus, efforts to develop BCIC-targeted therapies should not only be focused on interfering on self-renewal, but could seek to identify additional molecular targets, like those involved in regulating EMT-related pathways, in reversing the MDR phenotype, in inducing differentiation and controlling cell survival pathways.

  11. Breast Cancer-Initiating Cells: Insights into Novel Treatment Strategies

    Directory of Open Access Journals (Sweden)

    Maria Grazia Daidone

    2011-03-01

    Full Text Available There is accumulating evidence that breast cancer may arise from mutated mammary stem/progenitor cells which have been termed breast cancer-initiating cells (BCIC. BCIC identified in clinical specimens based on membrane phenotype (CD44+/CD24−/low and/or CD133+ expression or enzymatic activity of aldehyde dehydrogenase 1 (ALDH1+, have been demonstrated to have stem/progenitor cell properties, and are tumorigenic when injected in immunocompromized mice at very low concentrations. BCIC have also been isolated and in vitro propagated as non-adherent spheres of undifferentiated cells, and stem cell patterns have been recognized even in cancer cell lines. Recent findings indicate that aberrant regulation of self renewal is central to cancer stem cell biology. Alterations in genes involved in self-renewal pathways, such as Wnt, Notch, sonic hedgehog, PTEN and BMI, proved to play a role in breast cancer progression. Hence, targeting key elements mediating the self renewal of BCIC represents an attractive option, with a solid rationale, clearly identifiable molecular targets, and adequate knowledge of the involved pathways. Possible concerns are related to the poor knowledge of tolerance and efficacy of inhibiting self-renewal mechanisms, because the latter are key pathways for a variety of biological functions and it is unknown whether their interference would kill BCIC or simply temporarily stop them. Thus, efforts to develop BCIC-targeted therapies should not only be focused on interfering on self-renewal, but could seek to identify additional molecular targets, like those involved in regulating EMT-related pathways, in reversing the MDR phenotype, in inducing differentiation and controlling cell survival pathways.

  12. The role of clinical pathologists in the management of male infertility ...

    African Journals Online (AJOL)

    The role of clinical pathologists in the management of male infertility. ... selection of required tests so as to ensure optimum diagnosis and treatment efficiency. ... for further tests which include hormonal assays, tissue studies and karyotyping.

  13. Infertility among women working in horticulture. A follow-up study in the Danish Occupational Hospitalization Register

    DEFF Research Database (Denmark)

    Hougaard, Karin Sørig; Hannerz, Harald; Feveile, Helene

    2009-01-01

    The possible association between employment in horticulture with potential exposure to pesticides and female infertility was examined by identification of women with hospital contact due to infertility and working in horticulture through the Danish Occupational Hospitalization Register. This follow......-up study gave a standardized incidence ratio of 1.06 (95% confidence interval: 0.84-1.32) for treatment of infertility in women working in horticulture compared with the standard population and did not confirm that women working in the horticultural industry are at increased risk for infertility....

  14. Infertility among women working in horticulture. A follow-up study in the Danish Occupational Hospitalization Register.

    Science.gov (United States)

    Hougaard, Karin Sørig; Hannerz, Harald; Feveile, Helene; Bonde, Jens Peter; Burr, Hermann

    2009-04-01

    The possible association between employment in horticulture with potential exposure to pesticides and female infertility was examined by identification of women with hospital contact due to infertility and working in horticulture through the Danish Occupational Hospitalization Register. This follow-up study gave a standardized incidence ratio of 1.06 (95% confidence interval: 0.84-1.32) for treatment of infertility in women working in horticulture compared with the standard population and did not confirm that women working in the horticultural industry are at increased risk for infertility.

  15. STDs and Infertility

    Science.gov (United States)

    ... are often unaware of, and do not seek treatment for, their infections and because screening for chlamydia is still not routine in many clinical settings. STDs Home Page Bacterial Vaginosis (BV) Chlamydia Gonorrhea Genital Herpes HIV/AIDS & STDs ...

  16. The Potential Use of Intrauterine Insemination as a Basic Option for Infertility: A Review for Technology-Limited Medical Settings

    Directory of Open Access Journals (Sweden)

    Abdelrahman M. Abdelkader

    2009-01-01

    Full Text Available Objective. There is an asymmetric allocation of technology and other resources for infertility services. Intrauterine insemination (IUI is a process of placing washed spermatozoa transcervically into the uterine cavity for treatment of infertility. This is a review of literature for the potential use of IUI as a basic infertility treatment in technology-limited settings. Study design. Review of articles on treatment of infertility using IUI. Results. Aspects regarding the use of IUI are reviewed, including ovarian stimulation, semen parameters associated with good outcomes, methods of sperm preparation, timing of IUI, and number of inseminations. Implications of the finding in light of the needs of low-technology medical settings are summarized. Conclusion. The reviewed evidence suggests that IUI is less expensive, less invasive, and comparably effective for selected patients as a first-line treatment for couples with unexplained or male factor infertility. Those couples may be offered three to six IUI cycles in technology-limited settings.

  17. The Clinical Effects of Laparoscopy for Tubal Obstruction Infertility Diagnosis and Treatment%腹腔镜用于输卵管梗阻不孕症的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    韩焕梅

    2013-01-01

    Objective: To investigate clinical effect of laparoscopy for diagnosis and treatment of tubal obstruction infertility. Method: 90 cases of tubal obstruction infertility patients which were received and treated from January of 2009 to December of 2010 in our hospital were chosen, and through the laparoscope, every part in the abdominal and pelvic cavity of these patients was explored, Then according to the different prevalence of patients, different operation were choosed, including tubal ostomy, fallopian tube dilation, resection of peritubal adhesion etc. The fluent ability of oviducts were observated and the condition of intrauter-ine pregnancy were followed-up by telephone. Result: The fallopian tube patency rate was 71. 11% after surgery was significantly higher than 41.11% which is the rate of pre-operative ( P 0. 05 ), the difference was not statistically significance. Conclusion: Laparoscope was used in tubal obstruction infertility has advantages, such as small incision, good vision, high precisional surgery, recovery quickly, fewer complications. And it can significantly improve intrauterine pregnancy rate, the effect was confirmed, deserves widespread recommendation.%目的:探讨腹腔镜用于输卵管梗阻不孕症诊治的临床效果.方法:选择我院于2009年1月至2010年12月收治的90例输卵管梗阻不孕症患者,在腹腔镜下,对患者腹、盆腔内各部位情况进行探查,然后根据患者不同的患病情况,选择采取不同手术,包括输卵管造口术、输卵管伞部扩张术、输卵管周围粘连松解术等.观察患者术后输卵管的通畅情况,并通过电话随访跟踪患者术后宫内妊娠情况.结果:手术后输卵管的通畅率71.11%显著高于手术前输卵管的通畅率41.11,且P0.05,差异无统计学意义.结论:腹腔镜应用于输卵管梗阻不孕症,具有切口小、视野良好、手术精度高、恢复快、并发症少且能显著提高宫内妊娠率的优点,效果显著,值得在临床中推广.

  18. Immunoregulation of follicular renewal, selection, POF, and menopause in vivo, vs. neo-oogenesis in vitro, POF and ovarian infertility treatment, and a clinical trial

    Directory of Open Access Journals (Sweden)

    Bukovsky Antonin

    2012-11-01

    advancing age, due to degenerative changes of the immune system. This causes cessation of oocyte and follicular renewal at 38 +/-2 years of age due to the lack of formation of new granulosa cells. Oocytes in primordial follicles persisting after the end of the prime reproductive period accumulate genetic alterations resulting in an exponentially growing incidence of fetal trisomies and other genetic abnormalities with advanced maternal age. The secondary germ cells also develop in the OSC cultures derived from POF and aging ovaries. In vitro conditions are free of immune mechanisms, which prevent neo-oogenesis in vivo. Such germ cells are capable of differentiating in vitro into functional oocytes. This may provide fresh oocytes and genetically related children to women lacking the ability to produce their own follicular oocytes. Further study of "immune physiology" may help us to better understand ovarian physiology and pathology, including ovarian infertility caused by POF or by a lack of ovarian follicles with functional oocytes in aging ovaries. The observations indicating involvement of immunoregulation in physiological neo-oogenesis and follicular renewal from OSC during the fetal and prime reproductive periods are reviewed as well as immune system and age-independent neo-oogenesis and oocyte maturation in OSC cultures, perimenopausal alteration of homeostasis causing disorders of many tissues, and the first OSC culture clinical trial.

  19. Immunoregulation of follicular renewal, selection, POF, and menopause in vivo, vs. neo-oogenesis in vitro, POF and ovarian infertility treatment, and a clinical trial.

    Science.gov (United States)

    Bukovsky, Antonin; Caudle, Michael R

    2012-11-23

    degenerative changes of the immune system. This causes cessation of oocyte and follicular renewal at 38 +/-2 years of age due to the lack of formation of new granulosa cells. Oocytes in primordial follicles persisting after the end of the prime reproductive period accumulate genetic alterations resulting in an exponentially growing incidence of fetal trisomies and other genetic abnormalities with advanced maternal age. The secondary germ cells also develop in the OSC cultures derived from POF and aging ovaries. In vitro conditions are free of immune mechanisms, which prevent neo-oogenesis in vivo. Such germ cells are capable of differentiating in vitro into functional oocytes. This may provide fresh oocytes and genetically related children to women lacking the ability to produce their own follicular oocytes. Further study of "immune physiology" may help us to better understand ovarian physiology and pathology, including ovarian infertility caused by POF or by a lack of ovarian follicles with functional oocytes in aging ovaries. The observations indicating involvement of immunoregulation in physiological neo-oogenesis and follicular renewal from OSC during the fetal and prime reproductive periods are reviewed as well as immune system and age-independent neo-oogenesis and oocyte maturation in OSC cultures, perimenopausal alteration of homeostasis causing disorders of many tissues, and the first OSC culture clinical trial.

  20. Is initial (24 hours) lavage necessary in treatment of CAPD peritonitis?

    DEFF Research Database (Denmark)

    Ejlersen, E; Brandi, L; Løkkegaard, H

    1991-01-01

    A randomized trial was conducted to examine the influence of initial lavage on treatment of CAPD peritonitis. Patients with hypotension and shock were excluded from the trial. Thirty-six CAPD patients with acute peritonitis were randomized to treatment with intraperitoneal antibiotics including...... benefit in treatment of CAPD peritonitis in patients without profound hypotension and shock....

  1. Genome instability in AZFc region on Y chromosome in leukocytes of fertile and infertile individuals following exposure to gamma radiation.

    Science.gov (United States)

    Moghbeli-Nejad, Sahar; Mozdarani, Hossein; Behmanesh, Mehrdad; Rezaiean, Zahra; Fallahi, Parvin

    2012-01-01

    Men are exposed to various doses of ionizing radiation due to living in regions with high natural background radiation, accidentally, occupationally or for cancer treatment. To study genomic instability of AZFc region to gamma radiation, blood samples from normal, oligozoospermia, and azoospermia individuals were irradiated by a Co-60 source. Irradiated cells were kept for 48 h in order to repair initial DNA damages. Real time PCR was performed for three markers (SY 1206, SY 1197, SY 579) for testing copy number variation before and after irradiation. Copy number variations were compared by calculation of cycle threshold comparative method. Copy number variations of studied markers in AZFc region (microdeletion and duplication) in all samples after exposure to radiation increased with a dose dependent fashion. The frequency of instability was significantly higher in samples from infertile men in comparison with fertile ones (p  0.05). This observation might be a possible explanation for induction of azoospermia and oligozoospermia after radiotherapy. Increased frequency of induced microdeletion and duplication in infertile men compared with normal might be attributed to the deficiency in repair systems and the genetic factors involved in incomplete spermatogenesis of infertile men.

  2. Preliminary Screening of Infertility by Evidence-Based Medicine%不孕症循证初筛病因

    Institute of Scientific and Technical Information of China (English)

    冯帆

    2011-01-01

    不孕症是一类集医疗、社会心理及经济层面的复杂社会问题.本研究通过对不孕症初筛临床路径循证依据进行综述,提出与妊娠结局直接与不直接相关的检查项目,旨在指导临床医师对不孕症患者进行科学、规范的初步筛查,遏制在不孕症诊治中的过度检查、高额成本,让患者花最小的代价,即可获得满意疗效.%Infertility is a complex disorder with significant medical, psychosocial, and economic aspects. The study reviewed the initial screening evaluation of infertility which based on evidence-based medicine. This review questioned some tests which directly or indirectly related to pregnancy outcomes, which can guide clinicians to check patients by a scientific and standardized way and stop excessive examination, so that infertility couple will get a satisfied treatment at the minimum cost.

  3. A Survey on Infertility in Royan Institute

    Directory of Open Access Journals (Sweden)

    Mohammad Kamali

    2007-01-01

    Full Text Available Background: Infertility is defined as failure in pregnancy after one year of unprotected intercourse.Several centers have reported different causes of infertility. The most common causes of infertility are:male factor such as sperm disturbance, female factor such as ovulation dysfunction and tubal factor,both male and female factor, and unexplained infertility .The aim of this study was to survey theepidemiology of infertility in Royan institute.Material and Methods: In this descriptive retrospective study, 2492 infertile couples were studied.These couples were selected by systematic sampling among couples referred to Royan institutebetween 1995 and 2001.All existing demographic data and diagnostic methods were recorded inquestionnaires .Results were analyzed using SPSS version 11.5.Results: In this study, the frequency of primary and secondary infertility was 90.1% and 9.9%,respectively. Among 2492 couples, 50.5% had male factor, 28.6% had female factor, 11.6% had bothmale and female factors and in 9.3% of couples, the cause of infertility was unknown .Results showedthat 32.3% of men had normal spermogram, 23.6% of couples had azoospermia, and 40.3% had spermdisturbance including oligospermia, asthenospermia, oligoasthenospermia and teratospermia .3.8%were not able to collect sample for semen analysis. Among women, different infertility factors included:ovarian factor (20.36%, tubal factor (12.64%, uterine factor (4.13%, endometriosis (1.28% andrecurrent abortion (0.68%. 50.48% of women were normal.Conclusion: Although male factor was the most common cause of infertility in Royan institute, we cannot conclude that this factor is the most common cause of infertility in Iran since this center isconsidered referral especially for male infertility. We suggest performance of similar researches inother centers to evaluate the most common causes of infertility in Iran.

  4. Genetic causes of male infertility.

    Science.gov (United States)

    Stouffs, Katrien; Seneca, Sara; Lissens, Willy

    2014-05-01

    Male infertility, affecting around half of the couples with a problem to get pregnant, is a very heterogeneous condition. Part of patients are having a defect in spermatogenesis of which the underlying causes (including genetic ones) remain largely unknown. The only genetic tests routinely used in the diagnosis of male infertility are the analyses for the presence of Yq microdeletions and/or chromosomal abnormalities. Various other single gene or polygenic defects have been proposed to be involved in male fertility. Yet, their causative effect often remains to be proven. The recent evolution in the development of whole genome-based techniques may help in clarifying the role of genes and other genetic factors involved in spermatogenesis and spermatogenesis defects. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. Value of hysteroscopy in management of unexplained infertility

    Directory of Open Access Journals (Sweden)

    Aisha M. Elbareg

    2014-12-01

    Conclusion: As a cause of unexplained infertility, subtle uterine abnormalities are diagnosed only during hysteroscopy and they are relatively common in infertility women. Although the presence of these abnormalities is not detected by the basic investigations for infertility, their correction seems to be necessary when infertility is desired and other infertility causes are excluded.

  6. Research progress of treatment of infertility resulted from PCOS with TCM%中药治疗多囊卵巢综合征所致不孕的研究进展

    Institute of Scientific and Technical Information of China (English)

    王秀霞; 宋玉林

    2012-01-01

    The infertility resulted from the polycystic ovary syndrome ( PCOS ) is one of the major reasons why PCOS patients seek clinical diagnosis and treatment. The kidney deficiency is deemed the basic pathology thereof in TCM, supervening with the blood stasis, phlegm-damp, phlegm-stasis and liver depression and etc. TCM treatment can improve the partial ovarian environment, as well as the endocrine function of the body tissues. The combined application of TCM and western medicine will raise notably the pregnancy rate. The common TCM cures comprise the dialectical syndrome, periodical treatment and TCM prescriptions featuring the noticeable clinical effects. However, we have such serious problems with the clinical research as: lacking unified standards with effect evaluation and standardized TCM syndrome types as well as the imprecise research structure and etc.%多囊卵巢综合征所致不孕是多囊卵巢综合征患者求诊的最主要原因之一.中医学认为肾虚是其基本病机,兼见血瘀、痰湿、痰瘀互结、肝郁等.中药治疗能够改善卵巢局部微环境,改善机体的内分泌功能.尤其是与西药的联合应用能够显著提高患者的成功受孕率.中医常用治疗方法包括分型辨证、调期治疗、单方验方等,中西医结合疗效更为显著.但目前临床研究存在疗效评价缺乏统一标准,辨证论治方案不规范,科研设计不严谨等问题.

  7. Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility

    National Research Council Canada - National Science Library

    Murto, Tiina; Bjuresten, Kerstin; Landgren, Britt-Marie; Stavreus-Evers, Anneli

    2013-01-01

    .... The objective of the present study was to characterize hormone levels in an arbitrary menstrual cycle in women with unexplained infertility and male infertility, and to determine the predictive value...

  8. ROLE OF LAPAROSCOPY IN INVESTIGATION OF FEMALE INFERTILITY: A RETROSPECTIVE STUDY OF 50 CASES

    Directory of Open Access Journals (Sweden)

    Sailatha

    2014-07-01

    Full Text Available : Infertility is not only a medical, but a serious social problem as well, especially in our country. Use of diagnostic and therapeutic laparoscopy in infertility has been a focus of attention in recent years and is found to be very effective method in evaluating these cases. Traditional way to assess the uterine cavity, tubal structures and tubal patency was hysterosalpingography, but it has now largely been superseded by hysteroscopy and laparoscopy. It is concluded that laparoscopy is useful in diagnosing cases with endometriosis, tubal factor infertility and exclusion of bilateral anatomical tubal pathology by diagnostic laparoscopy could avoid IVF treatment in these cases.

  9. Insight into the diagnosis and management of subclinical genital tuberculosis in women with infertility

    Directory of Open Access Journals (Sweden)

    Nalini Mahajan

    2016-01-01

    Full Text Available Genital tuberculosis (GTB is an important cause of infertility in India. Lack of an accurate diagnostic test has led to an indiscriminate use of antitubercular treatment in infertile women. Apart from concerns of drug toxicity, this may be a contributing factor in the increasing incidence of multidrug-resistant TB reported in India. We conducted a study to analyze whether a combination of tests could help improve diagnostic accuracy. An algorithm for the management of GTB in infertile women based on the use of multiple tests is presented.

  10. [Hysteroscopic evaluation in patients with infertility].

    Science.gov (United States)

    Lasmar, Ricardo Bassil; Barrozo, Paulo Roberto Mussel; Parente, Raphael Câmara Medeiros; Lasmar, Bernardo Portugal; da Rosa, Daniela Baltar; Penna, Ivan Araujo; Dias, Rogério

    2010-08-01

    to describe hysteroscopy findings in infertile patients. this was a retrospective series of 953 patients with diagnosis of infertility evaluated by hysteroscopy. A total of 957 patients investigated for infertility were subjected to hysteroscopy, preferentially during the first phase of the menstrual cycle. When necessary, directed biopsies (under direct visualization during the exam) or guided biopsies were obtained using a Novak curette after defining the site to be biopsied during the hysteroscopic examination. Outcome frequencies were determined as percentages, and the χ2 test was used for the correlations. The statistical software EpiInfo 2000 (CDC) was used for data analysis. a normal uterine cavity was detected in 436 cases (45.8%). This was the most frequent diagnosis for women with primary infertility and for women with one or no abortion (pinfertility. Patients with a history of abortion and infertility should be submitted to hysteroscopy in order to rule out intrauterine synechiae as a possible cause of infertility.

  11. EFFECT OF ELECTROACUPUNCTURE ON ANTISPERM ANTIBODIES IN MALE INFERTILITY PATIENTS

    Institute of Scientific and Technical Information of China (English)

    伦新; 荣莉

    2003-01-01

    Aims: To explore the therapeutic effect of electroacupuncture (EA) for treatment of male immune-infertility patients and to observe the effect of EA on antisperm antibody (AsAb) positive reaction. Methods: A total of 100 male infertility AsAb-positive patients were randomized into EA group (n = 50, BL- 15, BL- 17, -18, -23, etc. ) and medication group (n=50, oral administration of prednisone, 5 mg/time, t. i. d. ). Serum and sperm AsAb were determined with enzyme immunoassay technique. Results: Following 4 months' treatment, the cure rates and the total effective rates of EA and medication groups were 40.4% (20 cases/50 cases) and 92.0% (45/50), 10.0% (5/50) and 64.0% (32/50) respectively. The cure rate of EA group was significantly superior to that of medication group (P<0.01). But, no significant difference was found between two groups in the total effective rate (P >0.05). After treatment, AsAb positive rates of both groups particularly that of EA group decreased significantly compared with pre-treatment of each group (P<0.05-0.01). Conclusion: EA treatment can work well in the treatment of some immune-mediated male infertility patients and possesses a favorable regulation action on AsAb reaction.

  12. Comparison of uterine and tubal pathology identified by transvaginal sonography, hysterosalpingography, and hysteroscopy in female patients with infertility.

    Science.gov (United States)

    Phillips, Catherine H; Benson, Carol B; Ginsburg, Elizabeth S; Frates, Mary C

    2015-01-01

    The causes of female infertility are multifactorial and necessitate comprehensive evaluation including physical examination, hormonal testing, and imaging. Given the associated psychological and financial stress that imaging can cause, infertility patients benefit from a structured and streamlined evaluation. The goal of such a work up is to evaluate the uterus, endometrium, and fallopian tubes for anomalies or abnormalities potentially preventing normal conception. To date, the standard method for assessing these structures typically involves some combination of transvaginal sonography (TVS), hysterosalpingography (HSG), and hysteroscopy (HSC). The goal of this review is to compare the diagnostic accuracy of TVS, HSG, and HSC for diagnosing abnormalities in infertility patients to determine if all studies are necessary for pre-treatment evaluation. We identified infertility patients prior to initiation of assisted reproductive technology who had baseline TVS, HSG, and HSC within 180 days of each other. From medical record review, we compared frequencies of each finding between modalities. Of the 1274 patients who received a baseline TVS over 2 years, 327 had TVS and HSG within 180 days and 55 patients had TVS, HSG and HSC. Of the 327, TVS detected fibroids more often than HSG (74 vs. 5, p < .0001), and adenomyosis more often than HSG (7 vs. 2, p = .02). HSG detected tubal obstruction more often than TVS (56 vs. 8, p = .002). Four (1.2 %) patients had endometrial polyps on both HSG and TVS. In the 55 patients with HSG, TVS, and HSC, HSC identified endometrial polyps more often than TVS (10 vs. 1, p = .0001) and HSG (10 vs. 2, p = .0007). TVS detected more fibroids than HSC (17 vs. 5, p < .0001). Tubal obstruction was identified more often by HSG than HSC (19 vs. 5, p < .0001). TVS is superior for evaluation of myometrial pathology. HSG is superior for evaluation of tubal pathologies. Endometrial pathologies are best identified with

  13. Somatic chromosomal abnormalities in infertile men and women.

    Science.gov (United States)

    Mau-Holzmann, U A

    2005-01-01

    Infertility--the inability to achieve conception or sustain a pregnancy through to live birth--is very common and affects about 15% of couples. While chromosomal or genetic abnormalities associated with azoospermia, severe oligozoospermia or primary ovarian failure were of no importance for reproduction prior to the era of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), advances in assisted reproductive techniques (ART) now enable many infertile couples to have children. These developments have raised the question of the genetic consequences of ICSI: concerns of the potential harm of the invasive procedure and concerns about the genetic risk. The infertile male and female definitely have an increased risk to carry a chromosomal abnormality. Detection of such an abnormality is of fundamental importance for the diagnosis of infertility, the following treatment, the evaluation of the risk for the future child and the appropriate management of the pregnancy to be obtained. Therefore, cytogenetic screening of both partners is mandatory prior to any type of ART. The present review is based on several surveys on male and female infertility and analyzes the types and frequencies of the different reported chromosome abnormalities according to the type of impairment of spermatogenesis and the type of treatment planned or performed. With regard to assisted reproductive techniques (especially ICSI) the main types of chromosomal abnormalities are discussed and their potential risks for ICSI. If available, reported cases of performed ICSI and its outcome are presented. The detection of an abnormal karyotype should lead to comprehensive genetic counselling, which should include all well-known information about the individual type of anomaly, its clinical relevance, its possible inheritance, the genetic risk of unbalanced offspring, and the possibilities of prenatal diagnosis. Only this proceeding allows at-risk couples to make an informed decision

  14. Spermatozoal protein profiles in male infertility with asthenozoospermia

    Institute of Scientific and Technical Information of China (English)

    LI Hong-jun; YU Ning; ZHANG Xin-yu; JIN Wei; LI Han-zhong

    2010-01-01

    Background Infertility is a major medical and social problem, and elementary research on the spermatozoal proteins and their functions are relatively scarce and there are very few confirmed and effective options for the treatment of male infertility. Thus, it is essential to find candidate proteins that affect male infertility. This study was designed to detect the proteins with differential expression in sperm from infertile patients and normal donors.Methods Semen samples from patients with idiopathic asthenozoospermia (n=114) and from fertile men with normal spermiograms (n=37) were collected. Semen sample analysis, sperm protein extraction, SDS-PAGE electrophoresis and Western blotting analysis were performed. Results were analyzed by SPSS 16.0 statistical software.Results Western blotting analysis of spermatic proteins displayed a major differentially expressed protein in spermatozoa from fertile and idiopathic asthenozoospermia patients. Densities and volumes of the identified protein in the patients were significantly decreased compared to normal donors (P=0.034 and P=0.036, respectively). The protein was identified as DEAD-box protein 4 (DDX4, VASA). The expression and correction value (CV) of DDX4/VASA in the patients was reduced significantly compared to normal donors (P=0.037 and P=0.031, respectively).Conclusions The expression of spermatic protein DDX4/VASA associates with spermatic motility, implying that DDX4NASA may be a candidate marker for evaluation of spermatic motility.

  15. Screening for chromosomal abnormalities in 2650 infertile couples undergoing ICSI.

    Science.gov (United States)

    Kayed, Hesham F; Mansour, Ragaa T; Aboulghar, Mohamed A; Serour, Gamal I; Amer, Alaa E; Abdrazik, Ashraf

    2006-03-01

    Chromosomal abnormalities are the major contributor to the genetic risks of infertility treatment associated with intracytoplasmic sperm injection (ICSI). The study objective was to assess prospectively the frequency of chromosomal aberrations in couples undergoing ICSI. A total of 2650 infertile couples (5300 patients) underwent chromosome analysis before undergoing ICSI in the Egyptian IVF-ET Centre. Heparinized blood samples were cultured, harvested and banded according to standard methods. Overall, 96.94% of the patients studied (5138/5300) had a normal karyotype, while the remaining 162 patients (3.06%) had an abnormal karyotype. Male patients constituted the majority of abnormalities; 138 males (85.19%) and 24 females (14.81%). These chromosomal aberrations included 117 cases (2.2%) of sex chromosome abnormalities; 113 males and four females. Forty-five patients (0.85%) had autosomal aberrations; 25 of them were males and 20 were females. The current data show that chromosomal abnormalities affect 3.06% of infertile patients, and occur in both sexes, but more predominantly in males undergoing ICSI for male factor infertility. It is recommended that chromosomal analysis be performed before undergoing ICSI, to identify patients who can be offered preimplantation genetic diagnosis.

  16. Domestic violence in Iranian infertile women

    OpenAIRE

    Sheikhan, Zohre; Ozgoli, Giti; Azar, Mahyar; AlaviMajd, Hamid

    2014-01-01

    Background: Millions of men and women suffer from infertility worldwide. In many cultures, infertile women are at risk of social and emotional problems. Infertility may affect the public health in many countries. Domestic violence is the intentional use of physical force, power or threat against oneself, another person or another group or community which leads to injury, death, mental harm, lack of development or deprivation. This study aimed to assess the prevalence of domestic violence agai...

  17. Role of Ultrasound in Male Infertility

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Min Hoan; Sung, Chang Kyu [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    US evaluation is the mainstay of diagnostic imaging of infertile men. In this editorial, we review the spectrum of diseases responsible for male infertility, discuss the way in which US imaging studies can be used for evaluation of male infertility, and illustrate characteristic US imaging features that allow for specific diagnosis. The discussion will be divided into three main categories: obstruction in sperm passage, impairment of sperm function, and defect in sperm genesis.

  18. Risk factors for secondary infertility among women in Karachi, Pakistan.

    Directory of Open Access Journals (Sweden)

    Neelofar Sami

    Full Text Available BACKGROUND: Secondary infertility in developing countries is mostly attributable to blockage of the fallopian tubes due to adhesions caused by reproductive tract infections. There is a dearth of information on the prevalence and causes of secondary infertility from Pakistan. This paper presents results on factors associated with secondary infertility among married women in Karachi, Pakistan. METHODS: A matched case-control study was conducted. Cases were women aged 15-35 years with history of at least one previous conception and currently seeking treatment for secondary infertility. Controls were women residing in the neighborhood of cases with at least one live birth and not taking treatment for secondary infertility. The age of controls was matched by ±5 years to that of cases. Data was collected from June to August 2003. Conditional logistic regression was used to determine crude and adjusted odds ratios (OR with corresponding 95% confidence intervals (CI for factors associated with secondary infertility. RESULTS: The final multivariate logistic regression model revealed that after adjusting for age, cases were more likely to be the housewives (AOR = 2.6, 95% CI:1.5-4.4, had used inappropriate material to absorb blood during menstruation (AOR = 9.0, 95% CI: 5.0-16.4, and at their last delivery, had a birth attendant who did not wash hands with soap and water (AOR = 3.0, 95% CI: 1.4-5.7. Moreover, women with secondary infertility were more likely to report current or past history of having STI symptoms (AOR = 3.6, 95% CI: 2.4-5.6 and use of intra-vaginal indigenous medicines during their last post-partum period (AOR = 3.1, 95% CI: 1.6-5.7. CONCLUSION: We recommend health education and awareness messages for safe practices during menstruation, delivery, and the postpartum period for women in general. Additionally, sanitary napkins should be made available at an affordable cost, and safe delivery kits should contain

  19. Association of gastrointestinal events and osteoporosis treatment initiation in newly diagnosed osteoporotic Israeli women

    OpenAIRE

    J. Yu; Goldshtein, I.; Shalev, V.; Chodick, G.; Ish‐Shalom, S.; Sharon, O.; A. Modi

    2015-01-01

    Summary Background The objective was to examine the association of gastrointestinal (GI) events and osteoporosis treatment initiation patterns among postmenopausal women following an osteoporosis diagnosis from an Israeli health plan. Methods This retrospective analysis of claims records included women aged ≥ 55 years with ≥ 1 osteoporosis diagnosis (date of first diagnosis was index date). Osteoporosis treatment initiation was defined as use of osteoporosis therapy (oral bisphosphonates or o...

  20. Improving Question-Asking Initiations in Young Children with Autism Using Pivotal Response Treatment

    Science.gov (United States)

    Koegel, Robert L.; Bradshaw, Jessica L.; Ashbaugh, Kristen; Koegel, Lynn Kern

    2014-01-01

    Social initiations make up a core deficit for children with autism spectrum disorder (ASD). In particular, initiated questions during social interactions are often minimal or absent in this population. In the context of a multiple baseline design, the efficacy of using the motivational procedures of Pivotal Response Treatment to increase social…