Reproductive outcome of women with rare Müllerian anomaly: report of 2 cases.

Two patients had a rare uterine anomaly characterized by longitudinal vaginal septum, double cervix, and incomplete septum of the uterus with normal fundus. This report is, to our knowledge, the third in the literature. There are some other works describing a similar anomaly, with a complete uterine septum.

Asymmetrical dimethylarginine, inflammatory and metabolic parameters in women with polycystic ovary syndrome before and after metformin treatment.

Context: Insulin resistance plays a significant role in the pathogenesis of the polycystic ovary syndrome (PCOS) and represents a link to the unfavorable cardiovascular risk profile frequently found in affected patients. The endogenous nitric oxide synthase inhibitor asymmetrical dimethyl-L-arginine (ADMA) is associated with atherosclerosis and represents an independent marker for cardiovascular morbidity and mortality.

Objective: We investigated ADMA levels among other cardiovascular, metabolic, and hormonal parameters in women with PCOS and the effects of metformin treatment on these parameters.

Increased frequency of cystic fibrosis transmembrane conductance regulator gene mutations in infertile males.

Objective: To investigate the frequency of mutations of the cystic fibrosis transmembrane regulator (CFTR) gene in males with reduced sperm quality before intracytoplasmic sperm injection (ICSI).

Design: The nine most frequent cystic-fibrosis-causing mutations in the German population and IVS8T alleles were analyzed.

Setting: University-based centers for reproductive medicine and clinical genetics.

Efficacy and tolerability of vaginal progesterone capsules (Utrogest 200) compared with progesterone gel (Crinone 8%) for luteal phase support during assisted reproduction.

Objective: To demonstrate the comparative efficacy and tolerability of capsules containing 200 mg of P (Utrogest 200) or Crinone 8% gel for luteal phase and early pregnancy support during assisted reproduction techniques (ART).

Design: Prospective, multicenter, randomized, controlled, open, parallel-group Phase III trial.

Setting: Seventeen German IVF centers.

Multi-locus (ML)-FISH is a reliable tool for nondisjunction studies in human oocytes.

In the present study, we developed a fluorescence in situ hybridization (FISH) strategy, which allows a reliable determination of the chromatid number of specific chromosomes in mature human oocytes. 168 unfertilized oocytes were analyzed by dual-color FISH with two direct-labeled locus-specific DNA probes for chromosome 13 and 21. To exclude FISH failures, metaphases with abnormal signal patterns were reanalyzed by multi-locus-FISH (ML-FISH) for chromosome 13 and 21.

Increased pregnancy rates after ultralong postoperative therapy with gonadotropin-releasing hormone analogs in patients with endometriosis.

Objective: To examine whether ultralong GnRH analog (GnRH-a) therapy after surgical treatment of endometriosis and before ART influences the pregnancy rate.

Design: Prospective, randomized, controlled study.

Setting: University clinic for reproductive medicine and gynecologic endocrinology.

[Pharmacokinetic comparison of progesterone capsules with a progesterone gel after vaginal administration].

The transvaginal bioavailability of 200 mg progesterone (CAS 57-83-0) from a vaginal capsule (Utrogest 200) compared to a vaginal gel containing 90 mg progesterone per dose was evaluated in 24 healthy young women using a randomised two-period cross-over design. Both treatments were supposed to release comparable amounts of progesterone. Blood samples were taken over a period of 96 h following single administration.

Long-term GnRH analogue treatment is equivalent to laparoscopic laser diathermy in polycystic ovarian syndrome patients with severe ovarian dysfunction.

This prospective, randomized study included 18 polycystic ovarian syndrome (PCOS) patients with severe ovarian dysfunction, who were evaluated by standard clomiphene and FSH stimulation. In this group of patients, a 6 month down-regulation with gonadotrophin-releasing hormone (GnRH) analogues gave outcomes similar to laparoscopic ovarian laser diathermy with respect to stimulatory outcome and pregnancy rate. Clomiphene stimulation with 50 mg of clomiphene/day and FSH stimulation in a low-dose, step-up protocol with purified FSH did not result in oligofollicular development; thus patients were divided into two subgroups: one subgroup received laparoscopic laser drilling and the other received 6 months of therapy with GnRH analogues plus add-back therapy after diagnostic laparoscopy.

Matrix metalloproteinases and TACE play a role in the pathogenesis of endometriosis.

Endometriosis, a benign gynecologic disorder, occurs in about 10% of women in reproductive age and in up to 50% of women with infertility. The basic etiologic factors causing this disease are unknown as yet. Matrix metalloproteinases (MMP) are involved in degradation of the extracellular matrix (ECM).

Frequency of CFTR gene mutations in males participating in an ICSI programme.

A higher prevalence of cystic fibrosis transmembrane regulator (CFTR) gene mutations has been suggested both in men affected by congenital aplasia of the vas deferens, and in individuals presenting with reduced sperm quality. In this case, an increased risk for offspring being affected by cystic fibrosis (CF) can be expected in couples who are planning to undergo intracytoplasmic sperm injection (ICSI), since most of the male partners suffer from infertility. In order to determine the risk for these couples more precisely, we offered them a test for the most frequent CF mutations prevalent in the German population.

Chlororganic pesticides and polychlorinated biphenyls in breast tissue of women with benign and malignant breast disease.

Persistent chlorinated hydrocarbons assimilated through the diet may, as a result of their carcinogenic, immunotoxic, and, at least in regard to certain of these substances, estrogenic properties, play a role in the etiology of human breast cancer. As a consequence, increased concentrations of these ubiquitous environmental contaminants may be found in breast tissue of women suffering from malignant breast disease. To examine this possibility, surgically removed breast tissue samples from 65 women in Hesse, Germany were examined by capillary gas chromatography for p, p'-dichloro(diphenyl)trichloroethane (p,p'-DDT), p, p'-dichloro(diphenyl)-dichloroethane (p,p'-DDD), p, p'-dichloro(diphenyl)dichloroethene (p,p'-DDE), hexachlorobenzine (HCB), alpha-, beta-, and gamma-hexachlorocyclohexane (HCH) as well as the polychlorinated biphenyls (PCB) no.

Pregnancy and birth after intracytoplasmic sperm injection with spermatozoa from a patient with tail stump syndrome.

Tail stump syndrome, which may be associated with primary ciliary dyskinesia, is also associated with morphological defects of the flagellum resulting in severe asthenozoospermia. Until recently, these morphological anomalies caused definite male infertility. Today, however, new methods such as micromanipulation techniques provide a rational therapy for this patient group.

[Laparoscopic ante-fixation of the uterus--modification of the Menge operation].

Surgical antefixation of the retroflected uterus is today for several reasons a rare event. We report on a forty-year old patient with dyspareunia, dysmenorrhoea and lumbalgia. Elevation of the uterus by means of a Hodge pessary relieved her symptoms.

Acrosin activity of human spermatozoa by means of a simple gelatinolytic technique: a method useful for IVF.

Acrosin activity was determined using a gelatinolysis technique in 100-microliter semen aliquots of 114 patients (normozoospermia, n = 90; asthenozoospermia, n = 12; oligozoospermia, n = 10; polyzoospermia, n = 2) attending an in vitro fertilization (IVF) program. Halo diameter, halo formation rate, and a calculated acrosin activity index correlated significantly with the IVF rates (P = 0.0054, r = 0.

Effect of anesthesia on sperm motility in gamete intrafallopian transfer.

The existence of a motility-inhibiting substance in human peritoneal fluid (hPF) has been demonstrated. The results of this study indicate that this factor from hPF is a heat-resistant, volatile molecule with a very small molecular mass (e.g.

Estrogen induces expression of endometrial epidermal growth factor receptors before implantation.

Problem: Pharmacological doses of 17 beta-estradiol increase epidermal growth factor binding to uterine membranes.

Methods: To determine whether physiological elevated E2 concentrations in the preimplantation phase of rabbits and preovulatory phase of women cause epidermal growth factor (EGF) receptor expression, we performed radioligand binding studies of endometrial membranes with [125I]-EGF.

Results: Unmated rabbits revealed a binding maximum (Bmax) of 514 +/- 197 fmol/mg protein for [125I]-EGF.

Oxygen tension in follicular fluid falls with follicle maturation.

The increase in follicular diameter during maturation is accompanied by an increase in vascular supply. The oxygen tension (PO2) in the follicular fluid of the growing follicle should therefore give an insight whether the oxygen delivery during this pertinent process is sufficient. Follicular fluid of 20 patients subjected to in vitro fertilization and embryo transfer were sampled in heparinized glass capillaries which were placed between the puncturing needle and the collecting reservoir.

[Salpingoscopy--an aid in the diagnosis of sterility].

The condition of the fallopian tubes was assessed in 100 fertile women on whom a caesarean section had been performed and in 100 infertile women who had undergone a diagnostic laparascopy. The 100 infertile women revealed both peritubal adhesions (20% vs 2%) and fimbrial agglutinations (4% vs 0%) in a significantly higher number of cases. When the diagnostic procedure was extended to include the salpingoscopy of 20 women with periampullary and peritubal adhesions, 10% of them were found to be suffering from damage of the endosalphinx.

[Neurologic complication following spinal anesthesia for manual detachment of the placenta].

Long-term paralysis of the lower extremities was observed in a 31-year-old fourth-gravida patient, undergoing a curettage under spinal anaesthesia because of placenta accreta. The patient recovered within three days from her neurological signs and symptoms, consisting of complete paresis of the hip and knee flectors and severe headache. Clinical investigations including a neurological examination, spinal puncture, x-ray pictures of the lumbosacral area and haemograms revealed no evidence for an infection, abscess or haematoma.

Nuclear magnetic resonance imaging of a patient with an ectopic pregnancy.

We attempted to demonstrate the morphological changes of an extrauterine pregnancy by nuclear magnetic resonance imaging. Spin echo mode was used to take images in all three space directions. An enlargement of the uterus with an empty cavity and a hyperplasia of the supporting vasculature were demonstrated as alterations correlating with an extrauterine pregnancy.

The binding sites of the calcium antagonist [3H] PN 200,110 in the human myometrium and myosalpinx.

Calcium antagonists of the dihydropyridine type may prove to be an important adjunct to the therapy of premature labor due to their proven ability to inhibit uterine contractility. Specific binding sites for calcium blockers were concentrated in 45,000 X g membrane preparations of human myometrium and myosalpinx. Scatchard plot analysis of the binding of [3H] PN 200,110, a benzoxadiazole-substituted dihydropyridine derivate, revealed that the binding sites of myometrial membranes numbered between 500 and 700 fmoles/mg protein (Bmax) and had an affinity (KD) of 0.