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1.
Artículo en Inglés | MEDLINE | ID: mdl-31404406

RESUMEN

Objectives: Surveys of the general population regarding sex selection using pre-implantation genetic diagnosis are limited and were mainly conducted in the United States and Northern Europe. In those Western societies, surveys have shown that people's interest in using sex selection techniques is encouraged by the desire for a sexually balanced family. It is important to determine attitudes to sex selection in a wider range of countries especially that cultural differences exist among countries. Study design: A questionnaire-based cross-sectional study regarding attitudes towards sex selection for non-medical reasons was designed. One thousand five hundred participants of the reproductive age group presenting to the Women s Health Center at the American University of Beirut Medical Center were offered to complete the survey. The questionnaire included demographic details, obstetric and infertility history, opinions regarding sex selection, personal interest in expanding the family, and personal interest in choosing the sex of a future child. Results: The response rate was 86.6%. Nineteen per cent of the respondents considered it strictly prohibited, 38.8% considered the technique acceptable only if medically indicated while 33.4% believed that it should be available to all those who request it. Multivariate logistic regression on the predictors of the variable affecting the attitudes towards sex selection showed that the educational level, religious disapproval and the desire of the opposite sex of the already existing children were the only significant predictors. Conclusion: The middle-eastern multi-religious population studied has a negative attitude towards sex selection through pre-implantation genetic diagnosis. Religion, educational status and desire of children of both genders were identified as the significant predictors of the decision whether to accept sex selection or not.

2.
AJP Rep ; 3(2): 103-4, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24147245

RESUMEN

Objectives Data on fetal effects following accidental electric shock during pregnancy are scarce. We report on a case of accidental maternal electric shock associated with benign fetal arrhythmia in a woman at 28 weeks' gestation. Study Design Case report. Results Although electrocution involving low-voltage, low-frequency current has been associated with fatal cardiac arrhythmias and conduction abnormalities, two protective parameters in the present case likely reduced the fetal injury: the dry skin at the site of current entry and the hand-to-hand pathway of current flow. Conclusion Because the pathophysiology of electric injury is altered during pregnancy, assessment of fetal well-being should be prompted no matter how trivial an incident may appear.

3.
Int J Hyperthermia ; 28(8): 742-6, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-23072616

RESUMEN

PURPOSE: This study aims to evaluate the effects of fever on follicular development in women undergoing controlled ovarian stimulation during in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) cycles. MATERIALS AND METHODS: This was a retrospective observational self-controlled study at a tertiary-care fertility centre. Six gonadotropin stimulation cycles characterised by poor ovarian response in which women reported the occurrence of a febrile illness, were considered for evaluation. Fever-exposed cycles were compared to the next stimulation cycle in the same women. Primary outcome measures were final number of pre-ovulatory follicles (≥ 16 mm) and final peak serum estradiol levels (pg/mL). Other outcome measures were final number of medium-sized follicles (12-15 mm), final mean estradiol serum level per follicle ≥ 12 mm (pg/mL), total days of stimulation and total gonadotropin ampoules utilised. RESULTS: Fever-exposed cycles were associated with significantly lower number of pre-ovulatory follicles (0.7 ± 0.8), significantly higher number of medium-size follicles (21.0 ± 4.5), and significantly reduced serum estradiol per follicle ≥12 mm (50.7 ± 11.7 pg/mL). They also required a significantly longer duration of ovarian stimulation (15.7 ± 3.3 days) and a significantly increased number of gonadotropin ampoules (47.2 ± 10.9). Four women had polycystic ovary syndrome and one hypothalamic hypogonadism. CONCLUSION: This preliminary report suggests a possible negative effect of fever on follicular development and ovarian estradiol production in some women undergoing controlled ovarian stimulation.


Asunto(s)
Fiebre/fisiopatología , Folículo Ovárico/fisiopatología , Inducción de la Ovulación , Adulto , Estradiol/sangre , Femenino , Fertilización In Vitro , Humanos , Inyecciones de Esperma Intracitoplasmáticas
4.
Acta Obstet Gynecol Scand ; 91(11): 1273-8, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22994379

RESUMEN

OBJECTIVE: To assess the psychological impact (Hospital Anxiety and Depression Scale) of an investigational ovarian stimulation protocol in women with premature ovarian failure (POF). DESIGN: Prospective longitudinal study. POPULATION: Ten women with POF. METHODS: Women with idiopathic POF were placed on three consecutive treatment cycles consisting of gonadotropin ovarian stimulation after estrogen priming, gonadotropin-releasing hormone agonist pituitary desensitization, and corticosteroid immune suppression. RESULTS: Median anxiety and depression scores increased significantly from baseline following three consecutive treatment cycles from 4.0 (range 2.0-8.0) to 11.0 (range 10.0-14.0) (p-value 0.041) and from 1.5 (range 0-6.0) to 9.0 (range 7.0-10.0) (p-value 0.039), respectively. There were nine "probable" anxiety (90%) and three "probable" depression (30%) cases on the final treatment cycle compared with none (0%) on baseline (p-value 0.004 and 0.250, respectively). CONCLUSIONS: The use of investigational ovarian stimulation protocols in women with idiopathic POF was associated with excessive psychological strain. Women with POF should be cautioned against the potentially harmful aspect of similar treatments of unproven benefit.


Asunto(s)
Infertilidad Femenina/terapia , Inducción de la Ovulación , Insuficiencia Ovárica Primaria/psicología , Adolescente , Adulto , Ansiedad/etiología , Buserelina/uso terapéutico , Gonadotropina Coriónica/uso terapéutico , Depresión/etiología , Estrógenos/uso terapéutico , Estrógenos Conjugados (USP)/uso terapéutico , Femenino , Glucocorticoides/uso terapéutico , Humanos , Infertilidad Femenina/etiología , Infertilidad Femenina/psicología , Inseminación Artificial , Estudios Longitudinales , Acetato de Medroxiprogesterona/uso terapéutico , Menotropinas/uso terapéutico , Ovario/diagnóstico por imagen , Prednisona/uso terapéutico , Insuficiencia Ovárica Primaria/complicaciones , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Sustancias para el Control de la Reproducción/uso terapéutico , Ultrasonografía , Adulto Joven
5.
Acta Obstet Gynecol Scand ; 91(1): 117-21, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21615358

RESUMEN

OBJECTIVE: To compare maternal and neonatal outcomes of twin gestations in nulliparous and multiparous women. DESIGN: Retrospective analysis of maternal and neonatal records. SETTING: American University of Beirut Medical Center, a referral university-affiliated hospital. POPULATION: Pregnant women who delivered twin gestations beyond 24 weeks from 1990 to 2004. METHODS: The data collected were analyzed using Student's paired t-test or χ(2) test. Logistic regression analysis was used to study the effect of multiple variables on preterm delivery. MAIN OUTCOME MEASURE: Preterm birth rate. RESULTS: Nulliparas (n=333) were more likely to be younger (28.1±5.4 vs. 30.0±5.2 years; p<0.001) and the pregnancy a product of assisted reproductive technology (23.1 vs. 4.5%; p<0.001) compared with multiparas (n=508). They were at significantly increased risk of preterm delivery (54.4 vs. 45.1%; p=0.009) at lower gestational age (35.6±3.2 vs. 36.2±3.0 weeks; p=0.004). They had longer first and second stages of labor and a higher cesarean delivery rate (61.3 vs. 44.9%; p<0.001). Except for a higher intensive care nursery admission rate and longer nursery stay for twins of nulliparas, all neonatal morbidities were comparable. On multiple logistic regression analysis, multiparity (relative risk 0.70, 95% confidence interval 0.51-0.97) and growth restriction (relative risk 0.16, 95% confidence interval 0.12-0.22) were protective, while discordance (relative risk 2.24, 95% confidence interval 1.40-3.60) was a predictor of preterm delivery. CONCLUSIONS: Nulliparous women with twin gestations are at significantly higher risk for preterm delivery and cesarean delivery compared with multiparous women. Although this was not translated into higher perinatal mortality, these women should be monitored closely and counseled regarding these risks and their attendant morbidity.


Asunto(s)
Paridad , Resultado del Embarazo , Embarazo Gemelar , Nacimiento Prematuro/etiología , Adulto , Cesárea/estadística & datos numéricos , Femenino , Edad Gestacional , Humanos , Unidades de Cuidado Intensivo Neonatal , Trabajo de Parto , Modelos Logísticos , Embarazo , Complicaciones del Embarazo/etiología , Estudios Retrospectivos
6.
J Matern Fetal Neonatal Med ; 24(6): 867-9, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21534855

RESUMEN

A case of ectopia cordis (EC) with gastroschisis in a 27-year-old primigravida was diagnosed at 10(3/7) weeks of gestation. The pregnancy was terminated by suction dilatation and curettage. With the increasing use of first trimester ultrasonography, early detection of fetal abnormalities is becoming more frequent. We review other published cases of EC detected in the first trimester and discuss the possible advantages of early diagnosis including options of termination at earlier gestational ages which might decrease the physical and psychological trauma on some patients.


Asunto(s)
Ectopía Cordis/diagnóstico por imagen , Primer Trimestre del Embarazo , Anomalías Múltiples/diagnóstico por imagen , Aborto Eugénico , Adulto , Ectopía Cordis/complicaciones , Femenino , Gastrosquisis/complicaciones , Gastrosquisis/diagnóstico por imagen , Humanos , Embarazo , Ultrasonografía Prenatal
7.
J Voice ; 25(4): 501-4, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-20537860

RESUMEN

PURPOSE: The purpose of this study is to look at the prevalence of vocal symptoms and acoustic changes in patients with polycystic ovary syndrome (PCOS). MATERIALS AND METHOD: A total of 17 patients with PCOS diagnosed on the basis of three criteria: the presence of irregular menstrual cycles, hirsutism, and polycystic ovaries were included in the study. Twenty-one normal females' frequencies matched on age with the cases were used as controls. The following vocal symptoms were investigated: throat clearing, deepening of the voice, loss of voice, lump in the throat, and difficulty being heard. Acoustic analysis and laryngeal videostroboscopy were performed. RESULTS: The age range was between 19 and 38 years with a mean age of 26 years. The most common prevailing symptom was throat clearing present in 76.5% versus 4.8% in the controls, followed by loss of voice (47.6%), lump in the throat (41.2%), and deepening of voice (35.3%). The differences in the prevalence of throat clearing, deepening of voice, lump in the throat, and difficulty being heard were statistically significant compared with controls (P value<0.05). There was no statistically significant difference in the acoustic parameters except for an increase in the relative average perturbation (P value=0.035) and a decrease in maximum phonation time (P value=0.001) in patients with PCOS. In the PCOS group, three patients had evidence of mild vocal fold edema and one patient had vocal fold nodules. In the control group, one subject had vocal fold edema and one subject had vocal fold nodules. CONCLUSION: Patients with PCOS seem to have more vocal symptoms compared with controls. Physicians should be aware of vocal changes in hirsute subjects with PCOS.


Asunto(s)
Síndrome del Ovario Poliquístico/fisiopatología , Acústica del Lenguaje , Voz , Adolescente , Adulto , Femenino , Humanos , Hiperandrogenismo/fisiopatología , Laringoscopía , Adulto Joven
8.
Breast Cancer Res Treat ; 124(1): 13-26, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20809361

RESUMEN

The risk of breast cancer has been associated with reproductive history. The purpose of this study was to determine the relationship between fertility drugs used in assisted reproductive procedures and the risk of breast cancer. We performed a literature search using the MEDLINE, the COCHRANE Library, and Scopus to identify studies linking breast cancer to fertility drugs. We excluded case series, case reports, and review articles from our analysis. The study populations included women who were treated for infertility with clomiphene, gonadotropins, gonadotropin-releasing hormones, or other unspecified fertility agents. We extracted information on study design, sample size, type of fertility drugs and number of treatment cycles, breast cancer incidence, and follow-up time from these studies. Eight case-control studies and fifteen cohort studies were included in the quantitative analyses. The Newcastle-Ottawa Quality Assessment Scales were used. Two investigators independently extracted study methods, sources of bias, and outcomes. We found that the risk of breast cancer was not significantly associated with fertility drug treatment. The follow-up periods were short in some of the studies analyzed in our study; however, we proceeded to test the trend in risk estimates across different durations of follow-up and found a trend for association using the nonparametric test; this was interpreted with caution in view of the lack of adjustment with other confounding factors. The current published data do not suggest higher risk of breast cancer in women who receive fertility treatment, but the lack of long-term follow up and the inherent weaknesses in some of the published studies have to be cautiously taken into account.


Asunto(s)
Neoplasias de la Mama/inducido químicamente , Fármacos para la Fertilidad Femenina/efectos adversos , Técnicas Reproductivas Asistidas/efectos adversos , Adulto , Anciano , Medicina Basada en la Evidencia , Femenino , Humanos , Persona de Mediana Edad , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo
9.
Eur J Obstet Gynecol Reprod Biol ; 150(2): 171-4, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20223580

RESUMEN

OBJECTIVE: Smoking is a significant health hazard that has been associated with poor reproductive outcome and reduced fertility in reproductive age women. The aim of this study was to assess the effect of nargile smoking on intra-cytoplasmic sperm injection (ICSI) outcome. STUDY DESIGN: A prospective analysis of the outcomes of 297 women who underwent ICSI treatment at the ART Unit at the American University of Beirut Medical Center between January 1, and December 31, 2006 was done. The patients were divided into 3 groups based on their smoking status: cigarette smokers (n=42), nargile smokers (n=51) and non-smokers (n=204). RESULTS: The mean age of nargile smokers was significantly lower than the other groups; however, the 3 groups were similar with respect to the cause of infertility, total dose of follicular stimulating hormone (FSH), number of oocytes and embryos obtained, and number and quality of embryos transferred. There was no significant difference in the clinical pregnancy rate between nargile smokers and non-smokers (51.0% vs 43.6%). However, cigarette smokers had a significantly lower clinical pregnancy rate compared to non-smokers (23.8% vs 43.6%, p=0.0238). On multiple logistic regression analysis, factors that decreased the clinical pregnancy rates were cigarette smoking and maternal age. CONCLUSION: Although this study did not find a deleterious effect of nargile smoking on ICSI outcome, the results need to be confirmed in prospective studies that would include larger number of women with more objective measures of nargile smoke exposure.


Asunto(s)
Fertilización In Vitro , Infertilidad/terapia , Fumar , Adulto , Femenino , Humanos , Edad Materna , Oocitos , Inducción de la Ovulación , Embarazo , Resultado del Embarazo , Índice de Embarazo , Estudios Prospectivos , Estadísticas no Paramétricas , Resultado del Tratamiento
11.
Reprod Biomed Online ; 20(3): 328-34, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20093086

RESUMEN

Apoptosis is implicated in the fragmentation of preimplantation mammalian embryos, yet the extent of this association remains controversial. The aim of this study was to assess the ability of sphingosine-1-phosphate (S1P), a known anti-apoptotic substance, to reduce the fragmentation rate of human preimplantation embryos when added to their culture microenvironment. Mature human oocytes were inseminated using intracytoplasmic sperm injection, incubated for 3 days and evaluated for embryo quality and fragmentation by the same embryologist. Oocytes in the study group were manipulated and cultured in culture medium supplemented with S1P to a 20 micromol/l concentration. A total of 46 patients donated 177 mature oocytes for the study group and 546 oocytes for the control group. The fertilization rate was significantly lower in the S1P-supplemented group (52.4% versus 67.3%; P=0.002) and the proportion of grade I embryos with less than 15% fragmentation was significantly higher in the same group (79.5% versus 53.9%; P<0.0001). Sphingosine-1-phosphate added to the culture medium of human preimplantation embryos is associated with a significantly lower fragmentation rate and hence better quality embryos. The clinical significance of these findings on reproductive outcome remains highly speculative awaiting further studies to translate this improvement in embryo quality into better pregnancy rates.


Asunto(s)
Apoptosis/efectos de los fármacos , Blastocisto/efectos de los fármacos , Embrión de Mamíferos/efectos de los fármacos , Lisofosfolípidos/farmacología , Oocitos/efectos de los fármacos , Esfingosina/análogos & derivados , Adulto , Medios de Cultivo , Transferencia de Embrión , Femenino , Fertilización In Vitro/efectos de los fármacos , Humanos , Oocitos/citología , Embarazo , Inyecciones de Esperma Intracitoplasmáticas , Esfingosina/farmacología
12.
Prenat Diagn ; 30(3): 241-6, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20087923

RESUMEN

BACKGROUND: Factors that influence a pregnant woman's decision to accept or decline genetic tests are largely undefined. The objective of this study was to determine the acceptance rate of prenatal diagnostic testing in Lebanon according to religion. METHODS: Prenatal charts were reviewed to obtain information about prenatal genetic testing. Women were divided according to their religion and were compared regarding the acceptance of triple screen test (TST) or amniocentesis (AMN) and reasons for declining such tests. Differences between groups were examined using the student's t-test, chi(2)-test and multivariate analysis (age >or= 35 years, religion, education and class). RESULTS: The religious distribution was 73.8% Moslems, 14.0% Christians and 11.2% Druze. Utilization of TST, AMN, and either (TST/AMN) was 61.2%, 7.6% and 67.0%, respectively. Uptake of TST/AMN was highest in Christians and lowest in Moslems and that of AMN higher in Christians >or= 35 years compared with Moslems. On multivariate analysis, none of the factors studied significantly affected the utilization of TST or TST/AMN except for age >or= 35 years which was associated with a borderline decrease in the utilization of TST Odds Ratio (OR) 0.485 (95% CI 0.21-1.12). The utilization of AMN significantly increased with age >or= 35 years OR 7.19 (95% CI 2.65-19.56) and lower education. CONCLUSION: Religion does not seem to affect utilization of prenatal diagnostic tests in Lebanon.


Asunto(s)
Amniocentesis/psicología , Actitud Frente a la Salud , Pruebas Genéticas/psicología , Religión y Psicología , Adulto , Amniocentesis/ética , Amniocentesis/estadística & datos numéricos , Toma de Decisiones/ética , Femenino , Pruebas Genéticas/ética , Pruebas Genéticas/estadística & datos numéricos , Humanos , Oportunidad Relativa , Paridad , Embarazo
13.
J Assist Reprod Genet ; 26(1): 25-7, 2009 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-19107590

RESUMEN

PURPOSE: To assess the effect of wearing powdered gloves during embryo transfer as compared to un-powdered gloves on the pregnancy outcome of IVF cycles. METHODS: Patients, undergoing embryo transfer procedures, were prospectively randomized into two groups: In the first (group A, n=356) group embryo transfer was performed while wearing powdered gloves; in the second (group B, n=356) group embryo transfer was performed while wearing un-powdered gloves. The primary end point of the study was the clinical pregnancy rate. RESULTS: The two groups were comparable with respect to the mean age, mean number of grade one embryos obtained, and the mean number of embryos transferred. The clinical pregnancy rates of the two groups were not different. CONCLUSIONS: Powdered gloves, worn during embryo transfer, have no adverse effect on the pregnancy outcome of IVF cycles.


Asunto(s)
Transferencia de Embrión/métodos , Fertilización In Vitro , Guantes Quirúrgicos/efectos adversos , Infertilidad/terapia , Polvos/efectos adversos , Resultado del Embarazo , Adulto , Factores de Edad , Femenino , Humanos , Masculino , Embarazo , Índice de Embarazo
14.
Int J Microbiol ; 2009: 796512, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-20148175

RESUMEN

The antimicrobial susceptibility profiles of 76 Streptococcus agalactiae (Group B Streptococci [GBS]) isolates from vaginal specimens of pregnant women near term were correlated to their genotypes generated by Random Amplified Polymorphic DNA analysis and their virulence factors encoding genes cylE, lmb, scpB, rib, and bca by PCR. Based on the distribution of the susceptibility patterns, six profiles were generated. RAPD analysis detected 7 clusters of genotypes. The cylE gene was present in 99% of the isolates, the lmb in 96%, scpB in 94.7%, rib in 33%, and bca in 56.5% of isolates. The isolates demonstrated a significant correlation between antimicrobial resistance and genotype clusters denoting the distribution of particular clones with different antimicrobial resistance profiles, entailing the practice of caution in therapeutic options. All virulence factors encoding genes were detected in all seven genotypic clusters with rib and bca not coexisting in the same genome.

15.
Gynecol Obstet Invest ; 66(4): 274-8, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18799887

RESUMEN

OBJECTIVE: The objective of this study is to assess the effect of two methods of vaginal scrubbing before egg retrieval on the outcome of in vitro fertilization-embryo transfer (IVF-ET) cycles. METHOD: 721 consecutive cycles of IVF-ET, at the American University Hospital of Beirut, were randomized prospectively into one of two groups. In the study group the betadine used to scrub the vagina, prior to egg retrieval, was not washed out, whereas in the control group this betadine was cleansed by saline irrigation. The two groups were compared as to the outcome of their IVF-ET cycles. RESULT: Both groups were similar in age, mean dose of FSH received, the number of oocytes and embryos obtained, the number of grade 1 embryos obtained, and the fertilization rate. There was no difference in the total pregnancy, clinical pregnancy, missed abortion, and multiple pregnancy rates between the two groups. However, the chemical pregnancy rate was higher in the study group as compared to controls. CONCLUSION: Vaginal preparation by betadine does not seem to affect the results of IVF. However, because it is associated with an increase in the rate of chemical pregnancy, it is advisable to cleanse before oocyte aspiration.


Asunto(s)
Antiinfecciosos Locales/administración & dosificación , Fertilización In Vitro/métodos , Recuperación del Oocito/métodos , Povidona Yodada/administración & dosificación , Vagina/efectos de los fármacos , Adulto , Femenino , Humanos , Masculino , Embarazo , Estudios Prospectivos
16.
Reprod Biomed Online ; 17 Suppl 1: 21-4, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18644219

RESUMEN

Sex ratio is a subject of scientific interest but little is known about the factors that affect the sex ratio of humans. The aim of this study was to assess the effect of the Lebanese civil war on sex ratio. Data on all live births delivered at a large university hospital for the years 1977-2005 were used in this study. Study periods were defined as wartime (1977-1992) and post-war (1993-2005). The sex ratio in the study time period was calculated as the male proportion, i.e. males/males + females in live-born infants. Sex ratio during the war was compared with that of the post-war period. The sex ratio was similar in the war and post-war period (0.515 versus 0.513; OR = 1.007; 95% CI 0.98-1.04). The annual variation in the sex ratio during the study period did not show any significant change in any of the years. In conclusion, the Lebanese civil war did not cause a detectable change in sex ratio at birth. Factors that might have affected the sex ratio include the nature of the study population (civilians), the variable intensity of war in different periods, and the effect of stress and environmental toxins.


Asunto(s)
Parto , Razón de Masculinidad , Estrés Psicológico/fisiopatología , Guerra , Femenino , Humanos , Recién Nacido , Líbano , Masculino , Embarazo , Sistema de Registros/estadística & datos numéricos , Factores de Riesgo
17.
Reprod Biomed Online ; 17 Suppl 1: 43-53, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18644222

RESUMEN

The aim of this study was to review the existing literature on the effect of war on female and male fertility. A MEDLINE search for studies that included participants defined as infertile because they were unsuccessful in achieving a pregnancy after a year and studies that assessed the effect of war on semen parameters and menstrual dysfunction were performed. Twenty articles were included in this review. For female fertility, studies showed that women who were prisoners of war or who were living in areas exposed to bombardment had increased risk of menstrual abnormalities. For male fertility, the results were conflicting. The Vietnam War was not associated with difficulty in conception although one study revealed a decrease in sperm characteristics. Studies of male US and Danish 1990/91 Gulf war veterans showed no evidence of reduced fertility; however, studies of UK and Australian veterans reported increased risk of infertility. The Lebanese and Slovenian civil wars were associated with a decrease in sperm parameters. Exposure to mustard gas was also associated with abnormal semen parameters; however, exposure to depleted uranium had no effect on semen characteristics. Most of the studies examined had major limitations including recall bias and small number of cases included.


Asunto(s)
Infertilidad Femenina/epidemiología , Infertilidad Masculina/epidemiología , Personal Militar/estadística & datos numéricos , Guerra , Exposición a Riesgos Ambientales , Femenino , Fertilidad , Humanos , Masculino , Embarazo , Prisioneros , Riesgo , Semen , Recuento de Espermatozoides , Veteranos/estadística & datos numéricos
18.
Curr Opin Obstet Gynecol ; 20(3): 313-9, 2008 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-18460948

RESUMEN

PURPOSE OF REVIEW: Worldwide 50-80 million people suffer from infertility. Assisted reproductive technology has provided a way of overcoming infertility and childlessness. The current article will focus on data linking infertility and its treatment to ovarian cancer. RECENT FINDINGS: Ovarian cancer risks associated with fertility drug treatment are encouraging, but not decisive. In view of the limited ability to evaluate drug effects on borderline tumors, given their rare occurrence, studies involving patient reports of prior drug exposures have noted an elevated risk of borderline tumors associated with fertility drugs. Nevertheless, the risk of invasive ovarian cancer appears to be restricted to those women who remain childless despite the infertility treatment. SUMMARY: As long as doubt persists, it might be advisable to reflect on a few clinical recommendations: identify high-risk infertile patients for ovarian cancer, investigate preexisting cancer before fertility treatment, inform patients regarding potential risks, obtain an informed consent, avoid exposure to long periods of ovulation induction cycles that are given before patients are referred for in-vitro fertilization and embryo transfer for women at greater risk and monitor women who have been treated with these drugs, especially those who failed to conceive, regularly and thoroughly.


Asunto(s)
Fármacos para la Fertilidad Femenina/efectos adversos , Neoplasias Ováricas/inducido químicamente , Femenino , Humanos , Estudios Retrospectivos , Riesgo
19.
Fertil Steril ; 89(5): 1098-102, 2008 May.
Artículo en Inglés | MEDLINE | ID: mdl-17658525

RESUMEN

OBJECTIVE: To assess the effect of 17alpha-hydroxyprogesterone caproate (17-HPC) given before embryo transfer on the pregnancy outcome of IVF-embryo transfer (ET) cycles. DESIGN: Randomized controlled study. SETTING: A university-based hospital IVF unit. PATIENT(S): One hundred twenty-five consecutive patients undergoing IVF-ET were randomly assigned into treatment and control groups. INTERVENTION(S): In the treatment group, 63 patients received 17-HPC (250 mg, i.m.), 1 day before ET. The control group consisted of 62 patients who did not receive any injections. MAIN OUTCOME MEASURE(S): Pregnancy and multiple-pregnancy rates. RESULT(S): The two groups were similar with respect to the age of patients, total dose of FSH, number of oocytes and embryos obtained, and number and quality of embryos transferred. There was no significant difference in the pregnancy rate (34.9% vs. 38.7%) or in the rate of multiple gestation (15.9% vs. 9.7%) between cases and controls, respectively. CONCLUSION(S): The use of 17-HPC before ET does not appear to affect the outcome of IVF-ET.


Asunto(s)
Transferencia de Embrión/métodos , Fertilización In Vitro/métodos , Hidroxiprogesteronas/farmacología , Resultado del Embarazo , Progestinas/farmacología , Caproato de 17 alfa-Hidroxiprogesterona , Adulto , Femenino , Humanos , Persona de Mediana Edad , Músculo Liso/efectos de los fármacos , Embarazo , Índice de Embarazo , Útero/efectos de los fármacos
20.
Fertil Steril ; 90(2): 340-5, 2008 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-17919611

RESUMEN

OBJECTIVE: To investigate the long-term impacts of the 15-year Lebanese civil war on male infertility. DESIGN: Clinic-based, case-control study, using reproductive history and risk factor interview data and laboratory-based semen analysis. SETTING: Two IVF clinics in Beirut, Lebanon, during an 8-month period (January-August 2003). PATIENT(S): One hundred twenty infertile male cases and 100 fertile male controls, distinguished by semen analysis and reproductive history. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Standard clinical semen analysis. RESULT(S): Infertile male cases were more likely than fertile controls to have lived through the Lebanese civil war and to have experienced war-related trauma (residence in bombing areas, participation in combat, injuries, kidnapping, and displacement from home). Cases had a 57% increase in their odds of exposure to civil war-related trauma. CONCLUSION(S): This case-control study demonstrates an association between the Lebanese civil war and male infertility. Wartime and postwar exposure to a number of potential reproductive risk factors-including toxins, injuries, and stress-is believed to be the main factor leading to this finding.


Asunto(s)
Infertilidad Masculina/etiología , Guerra , Adulto , Estudios de Casos y Controles , Humanos , Líbano , Masculino , Semen/fisiología , Trastornos por Estrés Postraumático/complicaciones
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