RESUMO
As free stereocilia in semen samples from infertile men could be related to a subclinical chronic infection of the seminal tract, we carried out a retrospective analysis of 14 files of infertile men with stereocilia in semen (group 1) and in two control groups: 30 infertile men from the same study population (group 2) and 40 fertile sperm donors (group 3). Clinical, bacteriological, sonographic and microscopic findings associated with these semen samples were compared. Epididymal cysts were found in two of 14 men in group 1 and in four of 28 in group 2. Positive semen cultures for Chlamydia trachomatis, Mycoplasma hominis or Ureaplasma urealyticum (chi(2) = 8.20; P = 0.002; OR: 7.22) and varicocele (chi(2) = 8.96; P = 0.002; OR: 2.25) were associated to the presence of free stereocilia in semen. These data suggest that a silent chronic infection of the epididymis by C. trachomatis, M. hominis, U. urealyticum and/or inflammation produced by varicocele might be the cause of stereocilia loss in the semen.
Assuntos
Cílios/ultraestrutura , Epididimo/ultraestrutura , Epididimite/patologia , Infertilidade Masculina/patologia , Sêmen/citologia , Adulto , Estudos de Casos e Controles , Infecções por Chlamydia/complicações , Chlamydia trachomatis/isolamento & purificação , Doença Crônica , Epididimo/patologia , Epididimite/etiologia , Epididimite/microbiologia , Humanos , Infertilidade Masculina/etiologia , Masculino , Microscopia Eletrônica de Transmissão , Pessoa de Meia-Idade , Infecções por Mycoplasma/complicações , Mycoplasma hominis/isolamento & purificação , Estudos Retrospectivos , Sêmen/microbiologia , Infecções por Ureaplasma/complicações , Ureaplasma urealyticum/isolamento & purificação , Varicocele/complicaçõesAssuntos
DDT/efeitos adversos , Infertilidade Masculina/etiologia , Inseticidas/efeitos adversos , Malária/prevenção & controle , Adolescente , Adulto , Androgênios/sangue , Carga Corporal (Radioterapia) , DDT/farmacocinética , Humanos , Inseticidas/farmacocinética , Masculino , México , Distribuição TecidualRESUMO
Human papilloma virus (HPV) infections frequently cause cervical lesions of different morphologies. We have previously reported a 53.5% pregnancy rate after treatment in a group of women with infertility associated to HPV infection of the cervix uteri. In that paper it was stated that a controlled study should be conducted in order to confirm this finding. Present work was aimed to find if there is any correlation between HPV infections of the cervix uteri and infertility in a retrospective design using an historical cohort of patients studied between 1991 and 1996 in our clinic. A total of 61 women attending the Infertility Clinic at the Instituto Nacional de Perinatología were included into two group. Group 1 (n = 45) included women with HPV lesions of the cervix and group II (n = 16) was formed by women with other type of cervical lesions who had no evidence of HPV infections on colposcopy. Cervico-vaginal citology, colposcopyc study and biopsy specimens were evaluated in all this medical records and the patients status (pregnant-not pregnant) at one year after treatment was registered. The mean duration time of infertility was 4.86 in group I and 3.5 in group II. Pregnancy rate was 16/45 (35.55%) in group I and 6/16 (37.5%) in group II. Seventy five percent of patients in group I and 66% in group II achieved a spontaneous pregnancy after specific treatment of cervical lesions whereas 25% and 33.3% required only ovarian stimulation with clomiphene or hMG. Pregnancies occurred approximately at 9 months after treatment in group I and at 7 months in group II. An association of cervical lesions and a tuboperitoneal factor (excluding endometriosis) was found on 53.57% of women in group I and on 46.66% of women in group II. Cervico-vaginal cytology was suspicious of HPV infection in less than 25% of cases. Present study emphasizes the need for a colposcopic study for the diagnosis of HPV infection in infertile women with cervical lesions even in cases with a negative cervico-vaginal cytology; because specific treatment of these lesions may yield spontaneous pregnancies. It also demonstrates that around 50% of patients with cervical lesions have an associated tuboperitoneal factor, which indicates that it is mandatory to study the possible participation of viral infections on tubal pathology.
Assuntos
Infertilidade Feminina/terapia , Infecções por Papillomavirus/complicações , Complicações Infecciosas na Gravidez/virologia , Doenças do Colo do Útero/virologia , Adulto , Feminino , Humanos , Infertilidade Feminina/complicações , México/epidemiologia , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/terapia , Infecções por Papillomavirus/virologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/terapia , Doenças do Colo do Útero/epidemiologia , Doenças do Colo do Útero/terapiaRESUMO
OBJECTIVE: To characterize the molecular nature of the chemotactic signal for sperm contained in human follicular fluid (FF). DESIGN: Follicular fluid was fractionated and several procedures were followed to the physicochemical initial characterization of sperm chemotactic compound(s). MAIN OUTCOME MEASURE: Relative chemotactic activity of each fraction was measured in a double chamber device. RESULTS: Sperm chemotaxis was found to be associated with a lipid-like molecule extracted from FF. Several steroids were assayed individually and only P showed sperm chemotactic properties in dose-response curves. CONCLUSIONS: In this paper we present experimental evidence to support the hypothesis that P, the main steroid component of FF, is a mediator of sperm chemoattraction in human beings.
Assuntos
Quimiotaxia , Progesterona/farmacologia , Motilidade dos Espermatozoides/efeitos dos fármacos , Espermatozoides/efeitos dos fármacos , Fatores Quimiotáticos/farmacologia , Relação Dose-Resposta a Droga , Feminino , Líquido Folicular/química , Humanos , Masculino , Progesterona/administração & dosagem , Espermatozoides/fisiologiaRESUMO
Our group has recently described the existence of a chemoattractant factor for spermatozoa contained in the mature follicles fluid. Simultaneously it was possible to develop a new method that permits to evaluate the chemotactic capacity of spermatozoa and that due to its simplicity makes possible the systematic study of CFS features. This study considered CFS molecular characterization from follicular fluid (FF). The FF of women was studied in an Assisted Fertilization Program, that were qualified as mature according to different criteria. The FF were fractioned with different techniques that permitted to separate an active fraction with lipid physicochemical characteristics. The fine layer chromatography showed the presence of different steroids, that were individually assayed for chemotactic activity. Only progesterone showed that activity and its effect showed a dose-response curve within physiological values. Our study permitted to identify progesterone as CFS previously described. This steroid's function is rather new and its action mechanism is being studied in our laboratory.
Assuntos
Quimiotaxia , Fertilização in vitro , Líquido Folicular/efeitos dos fármacos , Progesterona/farmacologia , Espermatozoides/efeitos dos fármacos , Estradiol/farmacologia , Feminino , Humanos , Masculino , Radioimunoensaio , Preservação do Sêmen , Interações Espermatozoide-ÓvuloRESUMO
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
It has been recognized that semen analysis is not a sensible nor a specific tool for detecting infertility in the male. Its predictive value is limited by the subjectivity of manual analysis, a high variability of semen parameters in fertile men and lack of correlation between sperm characteristics and fertility indexes. In this paper we present evidence supporting the concept that calculating an index of potentially fertile cells from data obtained in a regular semen analysis might be useful for predicting fertility in the male.
Assuntos
Fertilidade , Fertilização in vitro , Humanos , Infertilidade Masculina/diagnóstico , Masculino , Oligospermia/diagnóstico , Contagem de Espermatozoides , Motilidade dos EspermatozoidesRESUMO
The spontaneous pregnancy independent of treatment in sterility is a frequently observed event in this group of couples. The spontaneous pregnancy appears up to 61% of women with antecedents of sterility and in selected populations of healthy women; a third of them experience, once in their lives a subfertility episode. The characterization of this event in a population with sterility, will help to define the capacity of different diagnostic methods, as well as therapeutic methods in terms of efficacy. The objective of this study was to identify women with diagnosis of sterility and spontaneous pregnancy; to describe the main characteristics: clinical, of laboratory, of gabinet, and to discuss some implications of biological variability useful in the interpretation of these tests. One hundred and eleven patients with sterility and spontaneous pregnancy, in a descriptive and retrospective design, were analyzed. Operational definitions for the main factors related with sterility, were used, as tuboperitoneal, endocrine-ovarian, cervico-vaginal and masculine. The pregnant patients related to any type of treatment, were excluded. Two study groups were established: Group I (n-46) and Group II (n = 65) with primary sterility and secondary sterility, respectively. Average age for both groups was similar (mean = 29 years old). The time of sterility was 46.52 and 43.52 months, for Group I and II, respectively. The time of pregnancy from the point zero (admission), was, in average 6.21 and 4.9 months for Group I and II. The following factors were identified as abnormal: endocrine-ovarian 28.60 by menstrual pattern, progesterone and endometrial biopsy: tuboperitoneal 12.67% by hysterosalpingography and laparoscopy; masculine 12.67 by direct spermatobioscopy.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Infertilidade Feminina/etiologia , Infertilidade Masculina/etiologia , Gravidez/fisiologia , Biópsia , Estudos de Coortes , Endométrio/patologia , Feminino , Humanos , Infertilidade Feminina/diagnóstico , Infertilidade Masculina/diagnóstico , Masculino , Contagem de Espermatozoides , Motilidade dos EspermatozoidesRESUMO
Intraamniotic infection is a frequent problem in Obstetrics, and is related with an important maternal and fetal impact, being important pre-term delivery and premature rupture of membranes. The "golden" test for this entity is bacteriological culture. Its use is limited in function of time (more than two days) and disponibility. The rapid diagnosis of infection in vital to start antimicrobial management and evaluation of uterine evacuation. Low concentrations of glucose (G) have been used as prognostic of infection in different biological compartments. The objective of this study is to evaluate the usefulness of G as prognostic index of intraamniotic infection (PIIAI) as compared with Gram tincture (GT) and bacteriological culture. Sixty four patients were included. Group I (n = 33) with infection, and group II (n = 31) without infection. Average of G for group I was 19.96 +/- 07.61 ES and 114.46 +/- 20.09 ES for the group II, with p less than 0.001. The sensitivity (S), specificity (Sp), positive predictive value (+PV) and negative (-PV) for a concentration of G in amniotic fluid less than 15 mg/dl was 72, 77, 77 and 72% respectively. The S, Sp +PV and -PV for G minor than 10 mg/dl was 69, 87, 85 and 73%. Gram tinction had a S, Sp +PV and -PV of 57, 83, 79, 65%. If both determinations are put together (G and GT), one sees and S of 88%, Sp 77% +PV 80% and -PV 85%.(ABSTRACT TRUNCATED AT 250 WORDS)