Análisis de la infertilidad femenina en la población camagüeyana / Analysis of female infertility in population from Camaguey

Fundamento: es necesario considerar la infertilidad como un problema de salud global.Objetivo: analizar las características clínico-etiológicas de la infertilidad femenina.Métodos: se realizó un estudio observacional analítico transversal en el Servicio de Reproducción Asistida de Camagüey desde enero de 2015 hasta junio de 2016 con un universo de 173 pacientes. Los datos se obtuvieron de las historias clínicas. Se empleó estadística descriptiva e inferencial.Resultados: la media de edad fue de 29,73 años. La mitad de las mujeres tenían infertilidad secundaria y 91 eran sobrepeso u obesas. La duración media de la infertilidad involuntaria fue de 5,03 años, el mayor número tenían trastornos de la ovulación y presentaban un cociente LH/FSH>3, mientras que otras mostraban morfología de ovarios poliquísticos.Conclusiones: las mujeres con edades de 22-28 años tenían dos veces más posibilidad de tener una infertilidad primaria, mientras que las mujeres del grupo de > 35 años tenían casi cinco veces más probabilidad de presentar una infertilidad secundaria. La duración de la infertilidad está en proporción directa a la edad(AU)

Background: it is necessary to consider infertility as a world health problem.Objective: to analyze clinical-etiological characteristics of female infertility at Assisted Reproduction Center in Camaguey from January 2015 to June 2016.Methods: an analytic cross-sectional study was carried out. The universe was composed by 173 infertile females. The data were obtained from medical records and they were processed by descriptive and inferential statistics.Results: the average age was 29,73 years. Half of the women had secondary infertility and 91 were overweight or obese. The average duration of involuntary infertility was 5,03 years, the largest number had ovulation disorders and had a LH / FSH ratio> 3, while others showed polycystic ovarian morphology.Conclusions: females with ages between 22-28 years old had twice more probability to suffer from primary infertility, meanwhile female higher than 35 years old had five times more probability to suffer from secondary infertility. Duration of involuntary infertility is on direct relation to females ages(AU)

Use of gonadotropins in infertile patients.

A new era in the history of gonadotropins.

Microsurgical principles and postoperative adhesions: lessons from the past.

"Microsurgery" is a set of principles developed to improve fertility surgery outcomes. These principles were developed progressively based on common sense and available evidence, under control of clinical feedback obtained with the use of second-look laparoscopy. Fertility outcome was the end point; significant improvement in fertility rates validated the concept clinically. Postoperative adhesion formation being a major cause of failure in fertility surgery, the concept of microsurgery predominantly addresses prevention of postoperative adhesions. In this concept, magnification with a microscope or laparoscope plays a minor role as technical facilitator. Not surprisingly, the principles to prevent adhesion formation are strikingly similar to our actual understanding: gentle tissue handling, avoiding desiccation, irrigation at room temperature, shielding abdominal contents from ambient air, meticulous hemostasis and lavage, avoiding foreign body contamination and infection, administration of dexamethasone postoperatively, and even the concept of keeping denuded areas separated by temporary adnexal or ovarian suspension. The actual concepts of peritoneal conditioning during surgery and use of dexamethasone and a barrier at the end of surgery thus confirm without exception the tenets of microsurgery. Although recent research helped to clarify the pathophysiology of adhesion formation, refined its prevention and the relative importance of each factor, the clinical end point of improvement of fertility rates remains demonstrated for only the microsurgical tenets as a whole. In conclusion, the principles of microsurgery remain fully valid as the cornerstones of reproductive microsurgery, whether performed by means of open access or laparoscopy.

Ovarian stimulation, insemination, and contraception.

We have come a long way in achieving, and preventing, pregnancy since 1966.

Barrenness vanquished: the legacy of Lesley Brown.

Prior to 1978, the therapeutic offerings available to couples afflicted with infertility were painfully limited. Indeed, there was precious little one could offer Lesley and John Brown in their desperation. Anovulatory infertility was managed with ovulation induction using Clomiphene Citrate and Human Menopausal Gonadotropins. Anatomic infertility was addressed by increasingly sophisticated if marginally effective microsurgical approaches. The therapy of male infertility, still in its infancy, was commonly handled through cervical or intrauterine insemination including the use of donor sperm. The road traveled by Mrs. Brown radically altered this hope-limited landscape. A trailblazer to the millions who followed, Mrs. Brown played a key role in the abolition of the scourge of infertility. In this communication we trace in some detail the singular story of Mrs. Lesley Brown and the all-important legacy thereof. In doing so, we wish to pay tribute to this remarkable individual and her contributions to one of the most compelling scientific and medical breakthroughs of the 20th century.

[On warrior virgins, effeminate men, and infertility among ancient Scythians]. / Om krigeriske piger, kvindelige maend og infertilitet hos antikkens skythere. Hippokrates som kulturetnograf.

The Hippocratic text 'On the winds, waters and places' contains a fairly long description of an ancient Scythian tribe, the nomadic Sauromats. In this tribe the gender roles appear to have been inverted to some degree. The virgin women fight from horseback with swords, bows and arrows, and are not allowed to marry before they have killed three enemies. The married women are often infertile. The Hippocratic author ascribes this to the pronounced fatness of these women. Many men suffer from impotence and as a consequence dress as women, talk like them and carry out feminine household work. The Hippocratic author emphasises that the male impotence and the female infertility stem from the cold, damp climate and the Scythians' way of living, particularly the men spending most of their time riding. In contrast Herodotus states that the male impotence is Aphrodite's revenge because the Scythians ravaged her temple in Ascalon many years earlier. The difference between the Hippocratic emphasis on natural explanations for all natural phenomena, including health and disease and the occasional divine intervention promoted by Herodotus is underlined. There seems to be no plausible modern explanation for the impotence and infertility as described by the Hippocratic author.

Fertility preservation: definition, history, and prospect.

Exposure to gonadotoxic agents for treating cancer and other diseases or postponement of maternity jeopardize the prospects of genetic parenthood and are major factors driving the development of fertility preservation technologies. Although its mainstays, cryopreservation and vitrification, have been adopted from infertility medicine for fertility preservation purposes, there is a need for additional specialized procedures, protocols, and biomedical devices. As its multidisciplinary character and aims diverge compared with other branches of reproductive medicine, we are witnessing the emergence of a field in its own right.

The "infertility" of Catherine de Medici and its influence on 16th century France.

OBJECTIVE: Catherine de Medici, queen consort of King Henry II of France, was a powerful woman at a time when power for her sex was determined by fecundity. A decade long history of infertility might have placed her at risk for condemnation, but her husband's known urologic abnormalities played in her favor. This presentation will address the penile deformity of her husband, Henry II, and how this likely played a crucial role in her eventual rise to power, the interventions undertaken with regard to her purported infertility, and the historical ramifications when Catherine de Medici went on to have children. MATERIAL AND METHODS: A review of the literature of the lives of Catherine de Medici, King Henry II, and their children was completed. RESULTS: The inability to conceive an heir in the first decade of Catherine de Medici's marriage was attributed to Henry II, who was born with hypospadias and chordee. Through the intervention of Doctor Jean Fernel, the royal couple went on to have 10 children. When Henry II died in 1559 Catherine de Medici went on to rule France in the name of her sons for the next 3 decades, until her death in 1589. CONCLUSION: Henry II was born with hypospadias and chordee, and this contributed to the inability of Catherine de Medici to conceive a child for the first 10 years of their marriage. The cure of "her" infertility changed the course of history, as she subsequently ruled in the name of her sons following the death of Henry II.

Etiology of sperm immunity in women.

Sperm immunity in females can reduce the likelihood of natural conception, and sperm antibodies from female sera have been shown to inhibit IVF in humans and in several animal models. The etiology of sperm immunity in human females is unknown, but several possible mechanisms have been proposed, including cross-reactivity with microbial antigens and interferon gamma-mediated potentiation of the antisperm immune response in women whose male partners have sperm autoantibodies in their semen. This article reviews these ideas and postulates a novel hypothesis based on the potential for the generation of anti-idiotype antibodies in women whose partners have sperm antibodies in their semen.

Consideraciones sobre embarazo ectópico: experiencia en el Instituto Autónomo Hospital Universitario de Los Andes: años 2000-2006 / Considerations on ectopic pregnancy: experience at the Hospital Universitario de Los Andes: years 2000-2006

Determinar factores de riesgo y modalidades diagnóstico-terapéuticas del Embarazo Ectópico (EE). Estudio descriptivo, analítico de 353 casos de EE. Período 2000-2006. Servicio de Gineco-obstetricia de IAHULA, Estado Mérida, Venezuela. 353 historias con diagnóstico de EE. Grupo predominante: 19-34 años (75,1 por ciento). Nuliparidad (25,5 por ciento). Antecedentes Gineco-obstétricos (27,2 por ciento); Anticonceptivos (45,3 por ciento); ITS (23, 2 por ciento); DIU (10,8 por ciento); Cirugía Ginecológica y/o Abdominal anterior (33,4 por ciento). ß-hCG positivas 94,3 por ciento; Culdocentesis positivas 78,16 por ciento. Hallazgo Ultrasonográfico: 88,33 por ciento, Hallazgo Quirúrgico: 310 casos; localización Tubarica (97,09 por ciento); Salpingectomía total: 84,1 por ciento. El EE es una emergencia obstétrica frecuente, pone en riesgo la vida de la paciente con patogénesis multifactorial.

The use of controlled ovarian hyperstimulation (COH) in clinical in vitro fertilization: the role of Georgeanna Seegar Jones.

The use of controlled ovarian hyperstimulation (COH) to recruit multiple oocytes is now common practice worldwide in most clinical programs of in vitro fertilization (IVF). It was not always so. This is the story of the first successful use of exogenous gonadotropins in a clinical program of IVF.