Psychosomatic aspects of vulvodynia. Comparison with the chronic pelvic pain syndrome.

OBJECTIVE: To examine psychosomatic aspects of vulvodynia (VD) in comparison with the chronic pelvic pain syndrome (CPPS). STUDY DESIGN: Sixty-seven VD patients and 97 CPPS patients were examined with psychological tests (Freiburg Personality Inventory, Giessen Test) and compared with a control group of 34 healthy women. Sociodemographic data and psychoanalytic diagnoses were collected for 36 VD patients and 106 CPPS patients (inpatients). Descriptive statistics, chi 2 test and multivariant analyses were used. RESULTS: CPPS patients had significantly higher somatization than VD patients (P < .004). Both CPPS and VD patients, as inpatients, were significantly more depressive than the control group. In milder forms of VD, the patients (outpatients) exhibited no depression. The incidences of sexual abuse and severe psychological disturbances were significantly higher in the CPPS group (P < .01). CONCLUSION: VD and CPPS are two, distinct psychosomatic gynecologic syndromes and indicate psychosomatically oriented therapy.

Epidermal growth factor and leukemia inhibitory factor levels in follicular fluid. Association with in vitro fertilization outcome.

OBJECTIVE: To determine the levels of epidermal growth factor (EGF) and leukemia inhibitory factor (LIF) in follicular fluid, if any, and to assess the association of these cytokines with the outcome of in vitro fertilization (IVF). STUDY DESIGN: EGF and LIF levels determined by enzyme-linked immunosorbent assay in 60 preovulatory follicular fluids were compared with 25 IVF outcomes. RESULTS: Immunoreactive EGF and LIF could be detected in human follicular fluid. Levels of these cytokines were similar in FF obtained from follicles that resulted in fertilized oocytes and those that did not. EGF levels were significantly lower in patients establishing a pregnancy as compared to patients achieving no pregnancy (P < .007). LIF levels were similar in both groups of patients. CONCLUSION: EGF appears to be associated with IVF outcome.

Increased recovery of viable spermatozoa through oscillating centrifugation.

OBJECTIVE: To compare the number and quality of spermatozoa recovered following the standard centrifugation method with those recovered following oscillation of the relative centrifugal field during the centrifugation method. DESIGN: Prospectively controlled in vitro study. SETTING: Private andrology laboratory. PATIENT(S): Seventeen healthy sperm donors. INTERVENTION(S): Equal halves of the same semen sample were evaluated following the standard centrifugation or following oscillation of the relative centrifugal field during centrifugation. MAIN OUTCOME MEASURE(S): Number of sperm, sperm motility, progressive sperm motility at 0 hours and after 3-hour of incubation at 5 degrees C in TES and Tris (buffer) (TEST)-yolk. RESULT(S): The number of sperm, sperm motility, progressive sperm motility at 0 hours and after 3-hour of incubation at 5 degrees C in TEST-yolk were significantly higher for the sperm recovered following oscillating centrifugation compared with standard centrifugation. CONCLUSION(S): Oscillating the relative centrifugal field during centrifugation yields higher number of viable spermatozoa.

Interferon-gamma production by the human preimplantation embryo.

PROBLEM: This study demonstrated that the human embryo produces interferon-gamma (IFNgamma). It is important to know whether IFNgamma can be produced before implantation. Therefore the aim of this study was to evaluate the profile of IFNgamma production between days 2 and 5 after in vitro fertilization. METHOD: Twenty embryos were cultured from day 2 to 5 after fertilization. The embryo stages were checked each day and the media refreshed. IFNgamma levels were estimated by an enzyme-linked immunosorbent assay. RESULTS: All embryos produced measurable IFNgamma at least for 1 day. Yields of IFNgamma were: 0.46 +/- 0.45 (n = 4) on day 2, 0.69 +/- 0.52 (n = 19) on day 3, 0.73 +/- 0.52 (n = 15) on day 4, 0.55 +/- 0.32 (n = 11) IU/ml on day 5, respectively. There was no significant difference in the IFNgamma production between in vitro culture days or between the developmental stages of embryos. CONCLUSION: IFNgamma is produced by all the embryos and seems to peak between days 3 and 4, which is just before implantation.

The effect of antigamete antibodies on the success of assisted reproduction.

The aim of the study was to investigate the presence of antigamente antibodies in unexplained infertility patients and to prove the efficiency of IUI and IVF-ET treatments for these patients. The study includes 46 unexplained infertility patients and as controls, a group of 21 tubal infertility patients. Serum, follicular fluid and cervical mucus samples were collected from each patient and antibodies were measured with commercial ELISA kits. Twenty-two of the 46 unexplained infertility patients produced at least one of the antibodies against sperm or ovary. Fertilization rates were lower in immunological and unexplained infertility patients than in tubal infertility patients, being statistically significant. Pregnancy rates were lower in immunological and unexplained infertility patients than in tubal infertility patients after IVF-ET, but this was not statistically significant. Pregnancy rates after IUI treatment were equal in both immunological and unexplained infertility groups. AGA (antigamete antibodies) were found in 45% of unexplained infertility patients and therefore may be a possible cause of infertility. IUI and IVF-ET are successful choices for treatment of these patients.

Interferon gamma and interleukin 10 levels in preimplantation embryo culture media.

PURPOSE: The aim of our study is to elucidate whether human oocytes/embryos secrete IFN gamma and/or IL-10 and whether the fertilization process depends on the balance between these cytokines. METHODS: A total of 142 embryo culture media from 24 patients were collected and the cytokine levels were tested with ELISA. RESULTS: IFN gamma and IL-10 were detectable in 40.1% and 29.6% of culture media respectively. The difference of IFN gamma and IL-10 levels in media from fertilized oocytes between day 1 and day 2 are significant (0.46 vs. 1.47 and 34.2 vs. 12.7, respectively). However there was no significant difference between the IFN gamma levels of the media from fertilized and nonfertilized oocytes 0.46 vs. 0.85 at day 1 and 1.47 vs 1.49 at day 2, as well as IL-10 levels 34.2 vs. 30.9 at day 1 and 12.7 vs. 9.58 at day 2 respectively. CONCLUSIONS: Human preimplantation embryos secrete the cytokines IFN gamma and IL-10. No effect of these cytokines on fertilization process could be shown.