Reductive surgery and ovarian function in the human--can reductive ovarian surgery in reproductive age negatively influence fertility and age at onset of menopause?

A statistical study was carried out on a cohort of 165 women, menopausal for at least 2 years, who had undergone reductive ovarian surgery in fertile age, against nonoperated controls. The purpose of the study was to examine possible interference caused by surgery on fertility performance and age at which the natural menopause starts. It was found that fertility in the operated women was reduced when compared to the controls, although the difference was not of statistical significance. However, the difference between the two groups in mean age at menopause onset was significant (P < .001). The study sample was divided into two sub-groups according to age at operation (<30/>30) and a significant difference between them was found for age at menopause onset, the under-thirty group starting earlier. In particular, the onset of menopause was even earlier in women who had undergone bilateral wedge biopsy for polycystic ovarian syndrome (PCO). The anatomical state of the ovary at operation was also found to be relevant: ovariectomized women with intrinsic ovarian pathology (cysts, tumors or PCO) started the menopause earlier than those without intrinsic diseases (i.e., ectopic pregnancy), suggesting that such intrinsic pathology may cause a primary depletion of the follicles.

Folinic acid in the treatment of human male infertility.

OBJECTIVE: To investigate the clinical and histologic effects of folinic acid in the treatment of round cell idiopathic syndrome. DESIGN: Sixty-five males of infertile couples have been treated with folinic acid alone (15 mg one time per day) for a 3-month period. Various sperm parameters (spermatozoa number and motility, round cell number) have been evaluated before and after the therapy. Moreover, to investigate the histologic patterns of the testis induced by the administration of folinic acid, an experimental animal model has been designed on rats previously treated with chemotherapy drugs. RESULTS: All the investigated human seminal parameters presented significant variations after the treatment. An improvement in spermatozoa number and motility and a decrease in round cell number have constantly been noticed; the significance of the changes was particularly impressive in those men whose partners became pregnant later on. A consistent improvement in the histologic structure of the rat tubular epithelium was also detected. CONCLUSION: Folinic acid appears to be a valuable approach for the treatment of round cell idiopathic syndrome.

Zidovudine therapy of HIV-1 infection during pregnancy: assessment of the effect on the newborns.

Zidovudine (ZDV) administration during pregnancy has been suggested for the prevention of mother-to-child HIV-1 transmission. Reliable levels of the drug have been observed in the fetus and in the newborn. Seven HIV-1-infected pregnant women who declined to have abortions and whose immunological status required antiretroviral treatment were administered oral ZDV 18 mg/kg in four daily doses, the initial dose being administered anytime from the 16th to the 30th week of gestation up until the time of delivery. Follow-up of the seven infants from birth with a mean duration of 22 months (range 16-32 months) revealed mild drug-related toxicity: anemia in two infants and macrocytosis in all seven, both conditions resolved by the second month of life. All infants remained HIV-1 seronegative, according to the 1987 CDC classification, and all stayed clinically well. Other virological parameters including virus culture, in vitro antibody production, and polymerase chain reaction, repeatedly performed in the infants, remained negative. Although none of the mothers transmitted HIV-1 infection to the offspring, the size of this study and the relatively low transmission rate (13%) in Europe do not permit us to draw a definite conclusion about treatment efficacy in preventing maternal-fetal transmission. However, the drug caused only limited toxicity among the infants, and its administration to large numbers of mothers in treatment trials should be considered relatively safe for both mother and child.

[Why a gynecological consultation service in a hematology day hospital. Our experience]. / Perché un servizio di consulenza ginecologica presso un day hospital di ematologia. La nostra esperienza.

The paper described the role of a gynaecological advisory service in an hematological day hospital. The main gynaecological problems which arose during anti-cancer and immunosuppressive therapy were classified according to patients' symptoms. The paper stresses the need for close collaboration between hematologists and gynaecologists and underlines the psychological importance of this aspect from the patient's point of view.