Comparison of fallopian tube intraluminal pathology as assessed by salpingoscopy with pelvic adhesions.

Objective: To correlate the severity and extent of pelvic adhesions, as noted at laparotomy for microsurgery, with the presence and extent of fallopian tube intraluminal pathology, as noted using salpingoscopy.

Design: Prospective clinical study.

Setting: A university teaching hospital.

Computer-assisted measurement of hyperactivation in human spermatozoa: differences between European and American versions of the Hamilton-Thorn motility analyser.

Spermatozoa from healthy donors of proven fertility were analysed for percentage hyperactivation, mean curvilinear velocity (VCL), mean progressive velocity (VSL), amplitude of lateral head displacement (ALH) and percentage linearity (LIN) using two versions of the Hamilton-Thorn motility analyser (HTMA) running at different frame rates. The sort fraction criteria developed using a machine utilizing 30 Hz gave comparable figures for the percentage spermatozoa displaying motility patterns concomitant with hyperactivation when compared to that developed for a machine using a frame rate of 25 Hz. Statistically significant differences were observed when criteria developed using 30 Hz machines were transferred to those using 25 Hz.

The artificial cycle as an effective treatment of persistently retarded endometrium in the luteal phase.

The objective of this study was to examine the results of two hormonal treatment modalities on subjects who had persistently abnormal endometrial development in the luteal phase. A prospective study design was used to investigate 14 women who had persistently retarded endometrium associated with infertility (n = 11) or recurrent miscarriage (n = 3). Treatment A consisted of progesterone supplementation in the form of i.

Placental protein 14 in cycles with normal and retarded endometrial differentiation.

The purpose of this study was to investigate whether endometrium with retarded development differs, functionally, from endometrium with normal 'in-phase' development. Precisely timed endometrial biopsies were obtained from 24 women suffering from unexplained infertility at 4, 7, 10 and 13 days following the luteinizing hormone (LH) surge. Frozen sections were labelled with an anti-placental protein (PP) 14 monoclonal antibody using an avidin-biotin peroxidase technique and semi-quantification of endometrial PP14 was performed using a Quantimet 970 image analyser.

Human oviductal fluid prolongs sperm survival.

Objective: To compare the effect of human oviductal fluid on sperm motility and hyperactivation during 9 hours' incubation in vitro with follicular fluid (FF) and medium controls.

Design: Fertile donor spermatozoa were allowed to penetrate human cervical mucus in vitro and then recovered and incubated in either 30% human oviductal fluid, 20% FF, or medium for up to 9 hours. Sperm motion characteristics were measured using a sperm motility analyzer.

The more accurate timing of insemination with regard to ovulation does not create a significant improvement in pregnancy rates in a donor insemination program.

Objective: To determine if the accurate prediction of ovulation before artificial insemination of frozen donor semen was justified by increased pregnancy rates.

Design: A retrospective study of inseminations, over a 2-year period, administered to women who were enrolled on a donor insemination program and who were monitored using one of four ovulation timing regimens. Also, a study of the significance of follicle status at the time of insemination with relevance to pregnancy was carried out.

Falloposcopic comparison of unilateral and bilateral proximal tubal occlusive disease.

The purpose of this study was to compare the appearance of the entire length of the oviductal canal in women with unilateral versus bilateral proximal tubal occlusion. Eleven women had apparent unilateral disease and 18 had apparent bilateral occlusion. Proximal occlusion was confirmed both by hysterosalpingography and laparoscopy.

The significance of elevated basal follicle stimulating hormone in regularly menstruating infertile women.

Elevated plasma follicle stimulating hormone (FSH) during the reproductive life is an early manifestation of ovarian ageing. The presence of elevated basal FSH in young, regularly menstruating women may represent a stage of menopausal transition consequent on premature ovarian failure. A total of 48 regularly menstruating, infertile women aged < 40 years, with high FSH and aged-matched controls with normal FSH underwent detailed monitoring of endocrine and follicle growth during one complete menstrual cycle.

NEUROSECRETION OF CRUSTACEAN HYPERGLYCEMIC HORMONE EVOKED BY AXONAL STIMULATION OR ELEVATION OF SALINE K+ CONCENTRATION QUANTIFIED BY A SENSITIVE IMMUNOASSAY METHOD.

A sandwich-type enzyme-linked immunosorbent assay (ELISA) was utilized to quantify crustacean hyperglycemic hormone (as Carcinus maenas equivalents) released by single X-organ­sinus gland systems of the crab Cardisoma carnifex during continuous perifusion. Basal rates of secretion (20­60 pg min-1) were stable for at least 4 h. Electrical stimulation (600 stimuli in 5 min) of the axon tract increased secretion two- to threefold, but only if it resulted in neural activity that was propagated to the terminals of the sinus gland.

Prospective study of leukocytes and leukocyte subpopulations in semen suggests they are not a cause of male infertility.

Objective: To determine the effects of leukocytes in semen on sperm quality and the ability to achieve conception.

Design: A prospective analysis of 512 couples attending a regional infertility clinic. Leukocyte subsets were quantified using a monoclonal antibody-based staining procedure.

Sperm numbers and distribution within the human fallopian tube around ovulation.

This study aimed to determine the number and distribution of spermatozoa within the human Fallopian tubes around ovulation. Parous women, undergoing total abdominal hysterectomy for menorrhagia, were inseminated with either partner's semen (3/10) or donor semen (7/10). Approximately 18 h later both Fallopian tubes were ligatured into ampullary, isthmic and intramural regions.

Investigation of impaired ovarian function as a contributing factor to infertility in women with pelvic adhesions.

A prospective study was performed to determine whether a relationship exists between infertility as a result of pelvic adhesions, and raised follicle stimulating hormone (FSH). A total of 66 patients, who had a diagnostic laparoscopy and dye performed as part of their infertility work-up, had an early cycle serum FSH drawn one to two cycles after this procedure. Patients were divided into two groups, one with pelvic adhesions as a result of surgery, infection or endometriosis, and a control group consisting of those with a normal pelvis at laparoscopy or with minimal/mild endometriosis without adhesions.

A study of endometrial morphology in women who failed to conceive in a donor insemination programme.

Objective: To examine the morphology of endometrium in women who failed to conceive after nine or more cycles of donor insemination treatment.

Design: Prospective study.

Setting: Jessop Hospital for Women, Sheffield.

Prognostic significance of computerized motility analysis for in vivo fertility.

Objective: To determine the predictive value of quantitative motility characteristics produced by the Hamilton Thorn Motility (HTM) Analyzer (Hamilton Thorn Research, Beverley, MA) for in vivo conception.

Design: A prospective analysis of 222 couples attending a regional infertility clinic. The measurements were made on a semen sample, and the presence or absence of a treatment-independent conception up to 22 months later was determined.

The acrosome reaction-inducing effect of human follicular and oviductal fluid.

The human sperm acrosome reaction (AR) can be induced in vitro by a variety of naturally occurring and synthetic compounds. The present investigation determined the effect of human natural cycle periovulatory follicular (hFF) and oviductal fluids (hOF) on the human sperm AR in dose-response fashion using the synchronous AR assay. When hFF (30% v/v) or hOF (40% v/v) was added to non-capacitated spermatozoa, no significant (P > 0.

An evaluation of counselling for couples undergoing treatment for in-vitro fertilization.

Fertility difficulties, along with their investigation and treatment, are widely believed to cause significant psychological problems. This study was designed to investigate the efficacy of a non-directive counselling intervention with couples undertaking their first cycle of in-vitro fertilization treatment. Couples were randomly assigned to either a control group, given information about the treatment programme, or to an experimental group, given the same information plus three sessions of counselling before, during and on conclusion of the first treatment cycle.

Beta-1 integrin cell adhesion molecules in the endometrium of fertile and infertile women.

In order to investigate whether the endometrium of women with unexplained infertility differs immunologically from the endometrium of normal fertile women, a panel of six monoclonal antibodies was used to characterize the presence of the beta 1-integrins or very-late-activation antigens (VLA) in the different endometrial compartments. Precisely timed endometrial biopsies at 4, 7, 10 and 13 days following the luteinizing hormone surge were obtained from 24 normal fertile women (group I) and 24 women suffering from unexplained infertility (group II). Frozen sections were labelled using an avidin-biotin peroxidase technique.

Is endometrial development in the peri-implantation period influenced by high concentrations of luteinizing hormone in the follicular phase?

A retrospective study was designed to examine the relationship between luteinizing hormone (LH) concentrations in the follicular phase and endometrial development in the luteal phase of natural and artificial cycles. Two types of cycle were studied: natural cycles (n = 51) in subjects with unexplained infertility were divided into two subgroups, depending on whether LH measurements in the late follicular phase were based on urine (n = 24) or plasma (n = 27) samples; and artificial cycles (n = 17), produced by the administration of a standard hormone replacement therapy, in two subgroups of women, those with premature ovarian failure (n = 10) in whom plasma LH concentrations were high, and those with unexplained infertility (n = 7) who had their hypothalamic pituitary-ovarian axis down-regulated and in whom plasma LH concentrations were low. The correlation between plasma or urine concentrations of LH in the follicular phase and the results of endometrial biopsy obtained in the luteal phase was calculated.

Uterine flushing: a method to recover spermatozoa and leukocytes.

The process of sperm transport from the cervix, where a leukocytic reaction is initiated, through the uterus to gain access to the site of fertilization is very poorly understood. This preliminary study was designed to utilize a uterine flushing technique to determine firstly, the number of spermatozoa that can be recovered from the uterine cavity at 4 h post-insemination, around the time of ovulation, and secondly, to establish whether the spermatozoa initiate a leukocytic response while present. Uterine flushing was carried out in 10 potentially fertile women at 4 h post-insemination with donor semen, 24-36 h after the onset of the luteinizing hormone (LH) surge.

Origin of tonic electrical activity patterns in the diaphragm of the fetal lamb.

The respiratory pattern generator in fetal and postnatal life activates the phrenic nucleus and diaphragm muscle with phasic bursts of activity. In the fetus, diaphragmatic activity is also characterized by tonic activity patterns of unknown origin. We have examined whether such activity is diaphragmatic, or radiated from nearby ribcage muscles, by placing two sets of electrodes side-by-side in the costal portion of the diaphragm in five fetuses.

Concentration of endometrial protein PP14 in uterine flushings throughout the menstrual cycle in normal, fertile women.

Objective: To determine the variation in concentration of endometrial protein PP14 in uterine flushings throughout the menstrual cycle comparing this to concentrations in plasma samples.

Design: Precise timing of all samples by the luteinising hormone surge.

Setting: Jessop Hospital for Women, Sheffield.

Differential recruitment of inspiratory muscles in response to chemical drive.

Changes in the intensity of EMG activity in the costal diaphragm, crural diaphragm and external intercostal muscle during inspiration were assessed in intact, awake lambs following abrupt transitions in the composition of the inspired gases from air to either a hypoxic/hypoxic mixture (10% O2, 90% N2), a hyperoxic/hypercapnic mixture (40% O2, 6% CO2, 54% N2) or a hypoxic/hypercapnic mixture (10% O2, 6% CO2, 84% N2). A regression method was used to compare the dynamic responses of the three muscles over the 10-min period following each transition. The relationship between the dynamic response functions of the costal and crural diaphragm was the same in each of the three experimental conditions, indicating that these separate components of the diaphragm comprise a single functional unit during breathing.