Pertubation with lidocaine--a non-hormonal, long-term treatment of dysmenorrhea due to endometriosis.

The major symptoms of endometriosis are dysmenorrhea and infertility. Pertubations with lidocaine have been shown to reduce dysmenorrhea and have an enhancing effect on fertility. Different concentrations of lidocaine were evaluated in a randomized, double-blind study of pre-ovulatory pertubations with lidocaine solutions in women with dysmenorrhea. The patients had laparoscopically diagnosed endometriosis and normal fallopian tubes. Ninety pertubations were carried out without complications on 26 patients during up to six cycles. The effect was evaluated by means of questionnaires where a clinically significant reduction of dysmenorrhea was reported. Pertubation with lidocaine can be a non-hormonal treatment option for dysmenorrhea.

Helping parents to tell their children about the use of donor insemination (DI) and determining their opinions about open-identity sperm donors.

OBJECTIVE: To look at the level of compliance with Swedish law whether or not parents intend to tell their child about donor insemination. We also wanted to look at the parents' attitudes towards open-identity sperm donors and at relationships within the family. METHOD: All parents who were treated and gave birth to a child through donor insemination from 1997 to 2003 were included in the study. Sixteen of 20 couples (80%) were willing to take part in an interview, where the men and women were interviewed separately. The children of these couples had an average age of 2.9 years. RESULTS: Three of the 16 couples had told their child about donor insemination and 9 couples intended to tell the child when he/she was older. Thus 12 couples (75%) had disclosed or planned to inform their child in the future. Fourteen of 16 couples had told others about the donor insemination. The majority (21 of 31 individuals) had a positive attitude towards open-identity for sperm donors and 16 of 31 would have chosen an open-identity sperm donor if they had had the choice between that and an anonymous donor. All the parents felt they had an equal relationship with their child. CONCLUSION: Couples who conceived a child through donor insemination are open about the donor insemination, both to other people in their surroundings and in their intention to tell the child. These families seem to be functioning well with relaxed attitudes towards the donor insemination process.

Knowledge of reproduction in teenagers and young adults in Sweden.

OBJECTIVE: To investigate the knowledge of reproductive physiology and anatomy among adolescents and young adults in Sweden, and to evaluate the education obtained on these issues. METHODS: Two hundred and nine study specific questionnaires were distributed, of which 206 were answered by students in primary school, upper secondary school and at first year of university. A total knowledge score based on 21 out of the 35 questions in the questionnaire was calculated. As only 44 of the 206 respondents answered all the questions a revised score was also calculated, in which partial dropouts were interpreted as wrong answers. RESULTS: The mean of the total knowledge score was 28.7 out of 54 among the 44 respondents answering all questions, and the revised knowledge score was 24.0. The level of knowledge tended to be higher in older age groups, among women, as well as among respondents who had visited a Youth clinic. The time of ovulation was known by 21.4% of men compared to 63.4% of women. Almost 50% of the students knew one mechanism whereby oral contraceptives act to protect against pregnancy. Of the respondents, 77.2% knew of Chlamydia trachomatis but the knowledge of other STIs, like condyloma, was poorer (16.5%). Reasons for infertility were relatively well known among the respondents. Of the respondents, 57.5% stated that they had not received enough information on reproductive issues. CONCLUSIONS: The students have not achieved sufficient knowledge concerning sexual and reproductive matters that they, according to the national curriculum, should have attained by the end of the 9th grade. An improvement of the quality of the education, adapted to the students' age and pre-existing knowledge, and a review of the contents of the education is therefore needed.

Relationships in couples after failed IVF treatment: a prospective follow-up study.

BACKGROUND: There are few studies of couples that analyse satisfaction with treatment, adoption plans and relationships in couples after unsuccessful IVF. METHODS: ENRICH marital inventory was used to describe marital dynamics and to gain information about treatment and adoption plans. A specially designed questionnaire was used. Of the 51 couples without previous children who were asked to participate after their first failed IVF cycle, 45 participated. The next stage of the study was carried out when the couples had reached the 6 months point after the first IVF cycle, and the last stage after the couples had been through one to three treatments, 1(1/2) years after the last treatment. RESULTS: The couples displayed a stable relationship from the start as well as 1 year after the last IVF cycle. The vast majority of the couples had decided to go through with an adoption. Seventy-three per cent of the women were interested in more IVF treatment compared to 33% of the men. CONCLUSION: The stresses associated with IVF treatment did not have a negative impact on the couples' appreciation of their relationships during and after the treatment period. After treatment had been completed, the couples seemed to have reoriented themselves toward other solutions to childlessness.

Relationships and parenthood in couples after assisted reproduction and in spontaneous primiparous couples: a prospective long-term follow-up study.

BACKGROUND: The aim of this study was to analyse relationships and parenthood in primiparous IVF couples and spontaneous primiparous couples. METHOD: In total, 110 consecutive IVF couples were studied. The control group was matched for women's age and selected out of the total spontaneous pregnant population in the study area. Questionnaires and semi-structured telephone interviews were used to gain information about sociodemographic data, couples' relationships, and the children's health, temperament and behaviour. Obstetrical variables concerning the course and outcome of pregnancy and delivery as well as the health status of the new-borns were obtained from standardized antenatal care and delivery files. RESULTS: There were no differences concerning gestational age, mode of delivery or neonatal health between the two groups. The IVF couples were more stable over time-from pregnancy until the child was 1 year old-in their relationship, while the control group experienced a decrease in marital satisfaction. The children in the IVF group were assessed by their parents as being more regular/habitual, sensitive and manageable than the control children. CONCLUSION: The differences present between the groups were in favour of the IVF families, and the effects of the infertility crisis were not notable when the children were 1 year old.

T and B lymphocyte subsets in patients with unexplained recurrent spontaneous abortion: IVIG versus placebo treatment.

PROBLEM: To investigate circulating lymphocyte subsets in women with recurrent spontaneous abortion (RSA) in relation to pregnancy outcome and to treatment with intravenous immunoglobulin (IVIG). METHOD OF STUDY: Forty-one women with a history of unexplained RSA were examined during first trimester of pregnancy before IVIG or placebo treatment and after pregnancy. The results were compared with five healthy, non-pregnant women and five women in the first trimester of normal pregnancy. Circulating lymphocyte subsets with focus on T-cell subpopulations were determined by flow cytometry. RESULTS: The proportions of human leukocyte antigen (HLA)-DR positive T cells (CD3+ HLA-DR+), T-killer/effector cells (CD8+ S6F1+) and B cells (CD19+) were increased, whereas the proportion of T-suppressor/inducer cells (CD4+ CD45RA+) was decreased during first trimester pregnancy of RSA women compared with pregnant normal controls. T and B lymphocyte subsets did not correlate with pregnancy outcome on either IVIG or placebo group. CONCLUSIONS: In RSA patients, the immune system seems to be activated in contrast to the suppression noted in normal pregnancy.