Three years experience with local hydrocortisone treatment in women with immunological cause of infertility.

Two high selected groups of infertile women with proved cervical spermagglutinating antibodies by ficin, sucrose gradient ultracentrifugation, ELISA and microagglutinating test, by indirect MAR-test had been chosen for local hydrocortisone treatment. In the first group being composed of 20 infertile women we registered 16 decreasing or total disappearance of antisperm activity in cervical ovulatory mucus. Ten of them delivered healthy child. New 27 selected patients have treated in their immunological failure of reproduction by local hydrocortisone application, too, two of them are pregnant now. During the local hydrocortisone immunosuppression no side effects were registered. Hydrocortisone treatment seems to be a very perspective method in regulation of cervical immunological cause of infertility.

[Diagnostic reliability of pre-biopsy methods (colposcopy and cytology) in predicting the histological basis of cervical lesions]. / Diagnostická spolehlivost prebioptických metod (kolposkopie a cytologie) pri predpovedi histologického podkladu cervikální léze.

The more frequent incidence of cancer of the uterine cervix and thus of precanceroses in younger age groups, the introduction of new therapeutic methods (cryotherapy, CO2 laser, modernized diathermocoagulation) call for an estimate of the histological basis of the cervical lesion and in precanceroses assessment of its grade. These data must be provided by prebioptic methods (cytology and colposcopy). This diagnosis is essential to provide optimum therapy under the given circumstances. During the two-year period of 1985-1986 at the Gynaecological Clinic in Plzen 308 women detected by cytological screening were examined who were subsequently operated on account of a cervical lesion. In the investigated group a prebioptic predicition of high reliability was made. A concordant finding was recorded in 286 women, i.e. 92.9%. False negative, i.e. so-called risk errors were made in 9 women, i.e. 2.9%. False positive errors without risk, where the only consequence was unnecessarily radical treatment, were made in 13, i.e. in 4.2% women.

Local hydrocortisone treatment of sperm-agglutinating antibodies in infertile women.

Local sperm-agglutinating antibodies (LSAA) in the cervical ovulatory mucus may be a cause of primary infertility. A group of 17 infertile women with LSAA treated without effect with artificial insemination and then condom therapy were studied. After hydrocortisone application to the ectocervix for up to four cycles, LSAA disappeared totally in 13 patients; six of them have given birth to babies. No side effects of treatment were observed. Hydrocortisone for local immunosuppression may become a new method of therapy in cervical immunological infertility.