[Gestrinone in the therapy of sterility due to endometriosis]. / Gestrinon v terapii sterility pri endometrióze.

Thirty-two infertile women with laparoscopic diagnosis of asymptomatic pelvic endometriosis were treated with gestrinone 2.5 mg twice weekly for 6 months. Subsequently, a second-look laparoscopy was performed in all of them. All of the patients were followed for at least 12 months after the end of treatment, during which time they attempted to conceive. Ten (31.25%) from all 32 treated women became pregnant. The highest incidence of pregnancy was in the stage I (12.5%) and II (12.5%) (rAFS) of endometriosis, a half of them in stage III (6.25%) and no pregnancy was recorded in the stage IV found prior to the beginning of therapy. There was no statistically significant (chi 2-test) relationship between the reduction of laparoscopic findings (defined as a visual extermination or as a decrease in staging of endometriosis) and pregnancy. In 19 (59.4%) from 32 treated women the stage of endometriosis remained unchanged, in 9 (28.3%) it was reduced by one up to three stages and in 4 (12.5%) the endometriosis was visually eliminated. In no case the staging of endometriosis was worsened during therapy. Gestrinone was well tolerated. In no one of patients it was necessary to interrupt the treatment untimely.

[Peritoneal macrophages and their activity in sterile patients with endometriosis]. / Peritoneální makrofágy a jejich aktivita u sterilních pacientek s endometriózou.

The authors analyzed the peritoneal fluid (PF) during laparoscopic examination in 50 sterile women, incl. 27 where endometriosis was found. The control group was formed by 23 sterile women without signs of endometriosis. In both groups the volume of PF, concentration and absolute number of peritoneal macrophages and their phagocytic activity were evaluated. In the group of sterile women with endometriosis there was significantly increased volume of PF, higher concentration and absolute number of macrophages than in the group of patients without endometriosis. The phagocytic activity of peritoneal macrophages did not differ significantly in the control group and in patients with endometriosis.

Gamete intrafallopian transfer (GIFT) as a complement to the tubal microsurgery.

We accomplished a transfer of at least one oocyte and sperms in 26 microsurgically operated patients. Two patients were stimulated by clomiphene citrate only, 24 women by a combination of a clomiphene citrate and human menopausal gonadotrophin. The operation was timed 34-36 hours after application of 6,000 IU hCG i.m. After finishing the surgery we transferred maximally two oocytes and 200,000 sperms to each patent tube. Using this procedure three pregnancies occurred (11.5%). However, there was one ongoing pregnancy only. The extrauterine pregnancy was successfully treated with methotrexat and the third pregnancy was biochemical. The number of clinical pregnancies in this modification doesn't reach the referred success rate of a standard gamete intrafallopian transfer.