[Echography in assisted reproduction techniques]. / L'ecografia nelle tecniche di riproduzione assistita.

The Authors describe the A.R.T. echoguided techniques, that can be routinely used in IVF/ET programs. All these techniques are simple and have replaced the previous ones. The echoguided oocyte recovery is now widely accepted instead of the laparoscopic way: the gamete intrafalloppian transfer can be easily performed under local anesthesia; the selective fetal reduction in cases of multiple pregnancies can be easily carried out on an outpatient basis.

Varicocele and puberty. A transversal and longitudinal survey.

The interest for varicocele in the determination of male infertility has increased during the last decades. Most researchers consider varicocele as the primary cause of male infertility, but recently another group of authors give it a secondary role in the alteration of spermatogenesis. We think that the major part of the controversy depends on an absence of a systematic approach to the problem. We give a primary importance to an accurate epidemiological evaluation which consists in a transversal and longitudinal survey of male subjects in puberal age. Our data show that left varicocele is practically inexsistent before the onset of puberty; the percentage incidence of this alteration increases progressively with puberal maturity and the tends to decrease slightly when maturity is complete. By correlating this pathology with puberty we can obtain more precise informations than when it is correlated to the regestrated age. The young patients who result suffering from varicocele, must be controlled carefully and periodically for the evaluation of the period and the opportunity of a therapeutic treatment.

Urogenital inflammations: aetiology, diagnosis and their correlation with varicocele and male infertility.

The urogenital inflammations may be considered as "apparatus pathology". We analyze only inflammatory diseases of the prostate gland, because it may be extensible to the entire male genital apparatus. Among aethiological agents of infections an important role belongs to Chlamydia and Mycoplasma; we describe various methods for diagnosis of the Chlamydia and Mycoplasma infections. When objective clinical findings are poor or absent (such in prostatosis and prostatodynia) the transrectal ultrasonography demonstrates characteristic pictures useful for diagnosis and follow-up. Our clinical data and anatomo-pathological remarks suggest a real correlation between varicocele and genital inflammations (26%). This association doesn't represent the only cause of infertility, but frequently reduces the probability of male fertility.

Prolactin (PRL) inhibiting substance in seminal plasma of infertile patients. Preliminary results.

The role of PRL in the control of the mechanisms of regulation of testicular function is still unclear. Indeed, hyperprolactinemia is usually associated with male hypofertility. Several studies have demonstrated that human seminal plasma (HSP) contains radioimmunoassayble PRL and than testis and prostate possess membrane receptors for PRL (Charreau et al. 1977; Aragona et al. 1977). Recently Demoulin and Franchimont have observed, in HSP, the presence of a substance capable of inhibiting PRL secretion by isolated rat pituitary cells (Demoulin et al. 1978). They abbreviated it SPIF (seminal plasma PRL inhibiting factor). The inhibition of PRL secretion was significant for concentrations equal to or higher than 4.2 l of HSP/ml of culture medium. This non steroidal substance is thermostable and trypsin resistant; the molecular weight is less than 10,000 Daltons. In this work, we have compared the SPIF activity with basal levels of LH, FSH, PRL, Testosterone and, after stimulation, in the serum of patients affected with various fertility problems.