RESUMO
The systematic analysis of immunity status in the peritoneum of women with endometriosis, is presented. Twenty five patients were studied, distributed as follows: A. Endometriosis, B. Sterility of non identified cause. In all the patients, peritoneal fluid was obtained (PF) during diagnostic laparoscopy, and a sample of peripheral blood was taken simultaneously. Both samples were processed analysis of lymphocytes subpopulations (ALS) by flux cytometry using monoclonal antibodies with reactivity to lymphocytes T total (CD+), lymphocytes B (CD19+), auxiliatory/inductory (CD3+CD4+), suppressor/cytotoxic (CD3+CD8+) and NK (CD3+CD16+ + 56+). The peritoneal ALS of both groups were characterized by a clear lymphocyte B diminution, moderate diminution of activators; a considerable increase of suppressors; altered CD4+/CD8+ relation in favour of suppression and NK diminution when comparing with its own blood compartment. All of these values were identical for both groups, and the only significant difference was found when comparing activated lymphocytes T subpopulation that was lesser in PF of women with endometriosis. This is the only fact that backs up the existence of altered immunity in the peritoneum of these patients, that affects the expression of activated lymphocytes. However, taking as a criterium the rest of subpopulations, in endometriosis as well as in ECNI the microenvironment goes for suppression and they are not distinguishable among them. On other side, it started signal characterization that conditions suppression induction for lymphocytes activation in peritoneal environment of women with endometriosis. Ten samples of PF of patients using peripheral purified lymphocytes by density gradient of voluntary donnors, normal, fertile, were analyzed. Cells were cultivated and stimulated in vitro with concanavaline A in presence of timidine 3H. In experimental holes PF was added at dose-response concentration, and it was evaluated as the difference in synthesis of radioactive ADN against the incubated cells in absence of PF. It was possible to demonstrate the presence of associated factors in PF of patients with endometriosis that inhibit proliferation of lymphocytes stimulated by Con A, and not so in samples of ECNI. With these factors one supposes the presence of soluble signals that condition local immunological suppression.
Assuntos
Endometriose/imunologia , Peritônio/imunologia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Subpopulações de Linfócitos , Estudos ProspectivosRESUMO
Assisted Human Reproduction (AHR) has been one of the most important advances in Ginecology and Obstetrics technology, it has contributed to improve understanding on deeper biological mechanisms of human reproduction. Since Louise Brown's birth, in 1978, in vitro fertilization and Human Embryos Transference (HET) developed by Steptoe and Edwards, became the basis for new AHR methods. Later, writen information has increased, so, it is easy to find a lot of scientific reports in national and international specialized journals. These reports contents not only technological advances, but a lot of ethical thoughts which had showed the necessity for a worldwide legislation.
Assuntos
Transferência Embrionária , Fertilização in vitro/legislação & jurisprudência , Inseminação Artificial/métodos , Criopreservação , Ética Médica , Feminino , Humanos , Legislação Médica , Masculino , México , Bancos de EspermaRESUMO
Uterine leiomyomatosis shows a frequency from 25 to 30% in reproductive age women. Traditional treatment is hysterectomy or myomectomy independently from fertility wishes of the woman. Its growth has been associated to estrogenic activity. Because of this, several substances have been used to diminish tumour size, pre-operatively. The use of analogues of liberating hormone of hypophysiary gonadotropins (GnRH), given to favor surgical technique, to diminish trans-operative bleeding and to avoid blood transfusions. Clinical efficiency of the use of nafarelin acetate in women with uterine leyomiomatosis, pre-operatively during three months, was studied in this paper. The study was prospective, comparative, blind and with longitudinal measurements. Twenty eight women were included. Group I (n = 13) and Group II (n = 15) control without treatment. Observation units included FSH, LH, E2, BHC, HCT, USG basal, 30, 60, 90 days. Results showed a diminution of more than 80% of the initial uterine volume, and of 30% of the myomas independently measured. Side effects, tolerance and efficacy of the used compound, are mentioned.
Assuntos
Hormônio Liberador de Gonadotropina/análogos & derivados , Leiomioma/cirurgia , Nafarelina/administração & dosagem , Neoplasias Uterinas/cirurgia , Adulto , Fatores Etários , Método Duplo-Cego , Feminino , Hormônio Liberador de Gonadotropina/administração & dosagem , Humanos , Consentimento Livre e Esclarecido , Leiomioma/diagnóstico por imagem , Leiomioma/tratamento farmacológico , Estudos Longitudinais , Cuidados Pré-Operatórios , Estudos Prospectivos , Ultrassonografia , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Uterinas/tratamento farmacológicoRESUMO
Due to lack of evidence of infection in patients for ovarian punction for ovular capture, the hypothesis of possible antibacterial action that could exist in follicular fluid, was evaluated. One hundred and ten samples of such fluid, were taken for antibacterial analysis, 37 of which, were studied, as they were the clearest ones and not contaminated. Such samples were obtained from hyperstimulated patients, ready for ovular capture through vagina by ultrasonographic guide. A bacterial inoculum, was prepared, in order to evaluate antimicrobial activity of follicular fluid against E. coli, P. aeruginosa, S. agalactiae, L. monocytogenes and C. albicans. Counting of bacterial colonies, at 2, 4, 6, 12 and 24 hours. Results summary shows bacteriostatic activity in all studied colonies, and E. coli and S. agalactiae seem to be the most sensitive, followed by P. aeruginosa, S. aureus and L. monocytogenes; and still present in C. albicans. It is concluded that follicular fluid has an antibacterial action, probably selective; and that keeping this research line will confirm this finding, and possibly will determine the concerned factors.
Assuntos
Bactérias , Líquido Folicular/fisiologia , Candida albicans , Escherichia coli , Feminino , Fertilização in vitro , Líquido Folicular/imunologia , Transferência Intrafalopiana de Gameta , Humanos , Listeria monocytogenes , Técnicas Microbiológicas , Pseudomonas aeruginosa , Pesquisa , Staphylococcus aureus , Streptococcus agalactiae , Fatores de TempoRESUMO
Patient with primary sterility; antecedent of tubal surgery and damaged tuboperitoneal factor; she was programmed for in vitro fertilization with embryo transference. She had ovarian hyperstimulation with pure FSH and menotropins; follicular aspiration, via vagina with ultrasonographic guidelines. Seven days after, she presented with colic pain at left iliac region a hard, painful mass was found at left iliac region. Uterus deviated to the right, painful to movement; left vaginal cul de sac increased in volume and left adnexal tumor, without limits; left pararectal tumor. Exploratory laparoscopy was done, with pelvic abscess drainage, 10 to 12 cm, and left oophorectomy; the diagnosis was left pyo-ovary. Normal evolution.
Assuntos
Abscesso/etiologia , Transferência Embrionária , Fertilização in vitro , Doenças Ovarianas/etiologia , Folículo Ovariano , Adulto , Feminino , Humanos , Laparoscopia , Doenças Ovarianas/diagnóstico , Doenças Ovarianas/cirurgia , Ovariectomia , Ultrassonografia , Vagina/diagnóstico por imagemRESUMO
The factuality and diagnostic accuracy of aspiration endometrial biopsy with Karman's cannula, as compared with the curetted sample with Novak's cannula, were evaluated. Two hundred and thirty endometrial biopsies, were taken, as part of the study in women with fertility problems, at the Assisted Reproduction Clinic and Sterility Clinic, Instituto Nacional de Perinatología. The samples taken with Karman's cannula, Group I (n = 115); and with Novak's cannula, Group II (n = 115), were compared: procedure's time, pain intensity, quantity and quality of samples, macro and microscopically. In 92.2% of group I, tissue adequate for diagnosis, was obtained, as compared with 84.4% in Group II; likewise, the sample was better quantitatively and qualitatively, in Group I; and required time was less than one minute in 90% in Group I, an 83% in Group II. With the use of Karman's cannula, 20% of the patients had no pain, and 0.9% with the use of Novak's cannula. So, it can be concluded that endometrial aspiration with Karman's is reasonable and reliable in the functional histological diagnosis; it permits the obtention of adequate samples, in quantity and quality, and offering as advantages less pain and more security for the patients.
Assuntos
Biópsia por Agulha , Endométrio/patologia , Adulto , Biópsia por Agulha/efeitos adversos , Biópsia por Agulha/métodos , Diagnóstico Diferencial , Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/patologia , Endometrite/diagnóstico , Endometrite/patologia , Feminino , Humanos , Hiperplasia , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/etiologia , Pólipos/patologiaRESUMO
One hundred and twenty women were studied which had primary or secondary sterility, and underwent into the GIFT or IVF-ET program at the INPer. They were divided in two groups. Group I had 96 women in which only was taken in account the follicular development measured by vaginal ultrasound to decide continuation or cancellation, in this group estradiol serum levels determination was done, but it was not used for decision making; group II had 24 women in which estradiol was taken in account in addition with ultrasound. There were no differences in the number of follicles seen by ultrasound neither in the estradiol serum levels between the groups. Correlation coefficients between follicles seen by ultrasound and retrieved oocytes and mature oocytes, thus partial correlation coefficients for follicles seen by ultrasound plus estradiol serum levels and retrieved oocytes and captured oocytes were higher in group I in all days with the exception of day 10 in which they were similar. By the aforementioned in can be concluded that in this group of patients the ultrasound was the most reliable variable to give a quantitative and qualitative prognostic of oocyte retrieval.
Assuntos
Estradiol/sangue , Oócitos/citologia , Oócitos/crescimento & desenvolvimento , Ovário/diagnóstico por imagem , Adolescente , Adulto , Método Duplo-Cego , Estudos de Avaliação como Assunto , Feminino , Fertilização in vitro , Transferência Intrafalopiana de Gameta , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/diagnóstico por imagem , Infertilidade Feminina/terapia , Prognóstico , UltrassonografiaRESUMO
Male infertility study requires systematization of clinical and paraclinical diagnostic procedures and the knowledge of frontier techniques to analyze functional capacity of human spermatozoon. The application of the various methods of assisted reproduction in male infertility treatment, should be judged with a good criterion in order to offer maximal benefit and least risk. New methods to handle gametes and standardization of existing ones, could, in the future, offer better alternatives in male infertility treatment.
Assuntos
Infertilidade Masculina/diagnóstico , Humanos , Infertilidade Masculina/etiologia , Infertilidade Masculina/terapia , Masculino , Anamnese , Exame Físico , Técnicas Reprodutivas , Sêmen/química , Espermatozoides/fisiologiaRESUMO
39 patients which underwent an IVF-ET procedure at the INPer were divided in two groups. To one of them, progesterone was administered since the day of oocyte retrieval (group I), whereas the other group received progesterone 48 hours before hCG administration (group II). There were no statistical differences between the groups in the parameters analysed before the oocyte retrieval. There were statistical differences between the groups in progesterone levels in the day of oocyte retrieval in favour of group II, and in fertilization rate and transfer rate for group I. There were no valuable differences between the groups in pregnancy rate.
Assuntos
Fertilização in vitro , Fertilização/efeitos dos fármacos , Ovulação/efeitos dos fármacos , Gravidez/efeitos dos fármacos , Progesterona/administração & dosagem , Adolescente , Adulto , Gonadotropina Coriônica/administração & dosagem , Avaliação de Medicamentos , Feminino , Humanos , México , Indução da Ovulação , Fatores de TempoRESUMO
There were analyzed in a retrospective way the results of pre-retrieval hormonal levels as well as the number of retrieved oocytes, mature oocytes and transferred embryos in three groups of patients (2 GIFT, 1 IVF-ET) which achieved a pregnancy, and were matched with groups with no pregnancy. There were no statistically significant differences in most of the analyzed parameters, by the aforementioned we can suppose that pregnancy depends of endometrial quality and in this moment we are not able to modify it satisfactorily.