Relationship of within-patient semen variability to outcome of intrauterine insemination.

To define the subpopulation of infertility patients who would benefit from intrauterine insemination (IUI) with swim-up homologous sperm, the relationship of within-patient semen variability to outcome of IUI was studied. The 61 women in the study had negative workups. Men had at least one semen sample with greater than or equal to 20 x 10(6) sperm/ml.

Proximal tubal occlusion: microsurgery versus IVF--a review.

The success of IVF has established it as a viable alternative to microsurgery in the treatment of infertility associated with certain types of tubal occlusion. The authors have recently reported on the success rates of microsurgery versus IVF in cases of distal tubal occlusion. The present study summarizes the results reported in the world literature for microsurgery in cases of proximal tubal occlusion secondary to surgical sterilization, previous infection, or endometriosis, and compares them with the results reported for IVF.

Hematometra-hematocolpos: a late complication of successful separation of conjoined twins.

A late complication of separation of conjoined twins, hematometra-hematocolpos, may appear with sexual maturation. An obstructed genital outflow tract can cause significant urologic and reproductive tract morbidity.

Distal tubal occlusion: microsurgery versus in vitro fertilization--a review.

The success of in vitro fertilization (IVF) has established it as a viable alternative in the treatment of infertility associated with distal tubal occlusion (DTO). In an attempt to adequately counsel patients with DTO as to whether their primary treatment should be microsurgery or IVF, the authors have performed a comprehensive world-wide literature review. Based on what has been published to date, it would appear that patients with mild to moderate tubal disease should be offered salpingoneostomy as their first treatment modality.

The effect of preimplantation culture conditions on murine embryo implantation and fetal development.

Ham's F-10 medium (Gibco, Grand Island, NY) and medium T6 with and without 15% fetal calf serum (FCS) were compared for their ability to support development of murine blastocysts with the capacity to implant and produce normal fetuses when transferred to pseudopregnant females. All media supported equal rates of blastocyst development from 2-cell embryos. In addition, there were no differences in the rates of blastocyst implantation.

Raynaud's phenomenon in infertile women treated with bromocriptine.

Two cases are reported of infertile women who developed cold-induced digital vasospasm (Raynaud's phenomenon) on low-dose Parlodel (5.0 to 7.5 mg/day).

Semen quality before and after processing by a swim-up method: relationship to outcome of intrauterine insemination.

Twenty-five couples with normal semen analyses and postcoital tests of less than or equal to 3 motile sperm/high-power field were treated by intrauterine insemination (IUI) with sperm prepared by a swim-up method. Eight women conceived (32%). Influence of semen parameters both before and after swim-up, patient age, and duration of infertility on outcome of IUI was assessed with logistic discriminant analysis.

Symptomatic endosalpingosis in a postmenopausal woman.

The presence of ectopic fallopian tube epithelium (endosalpingosis) in postmenopausal women is rare and usually asymptomatic. A case is presented of symptomatic endosalpingosis in a postmenopausal woman who had none of the previously described predisposing factors.

Declining serum concentrations of the beta-subunit of human chorionic gonadotropin and ruptured ectopic pregnancy.

Declining values of the beta-subunit of human chorionic gonadotropin may be associated with ectopic pregnancy or missed abortion. Sonography may not always establish a definitive diagnosis. A case is presented where expectant management of declining levels resulted in rupture of an ectopic pregnancy.

Intracervical versus intrauterine insemination: correlation of outcome with antecedent postcoital testing.

Thirty-four infertile women alternated cycles of intracervical insemination (ICI) with whole ejaculate homologous semen (mean, 3.2 cycles/patient) versus intrauterine insemination (IUI) with washed sperm (mean, 3.4 cycles/patient).

Uterine arteriovenous malformation successfully embolized with a liquid polymer, isobutyl 2-cyanoacrylate.

A uterine arteriovenous malformation was diagnosed angiographically in a 27-year-old woman presenting with recurrent menometrorrhagia. Bilateral hypogastric artery embolization with a liquid polymer, isobutyl 2-cyanoacrylate (Bucrylate), resulted in subsequent normal menses. Bucrylate offers a number of advantages over other agents previously used to embolize uterine arteriovenous malformations.

Inaccuracy of basal body temperature charts in predicting urinary luteinizing hormone surges.

Sixty basal body temperature (BBT) charts were reviewed by three reproductive endocrinologists in an attempt retrospectively to predict the urinary luteinizing hormone (LH) surge. LH surges had been previously detected in all cycles with the use of a commercially available monoclonal antibody kit, Ovustick (Monoclonal Antibodies, Inc., Mountain View, CA).

Isolated endometriosis in an inguinal hernia.

Presented is the case of a patient with inguinal endometriosis adjacent to a hernia sac in whom laparoscopy revealed no evidence of pelvic endometriosis.

Maternal virilization in pregnancy due to an unclassified sex-cord stromal neoplasm.

Virilization in pregnancy has been reported with various ovarian neoplasms. Presented is a case of maternal virilization resulting from an unclassified sex-cord stromal neoplasm.

Hyperprolactinemia and associated pituitary prolactinomas.

The association between serum prolactin (PRL) and the presence of pituitary tumors as determined by third generation computed tomography scan was studied in hyperprolactinemic patients. Patient charts from a four-year period were reviewed to identify those patients with elevated PRL (greater than or equal to 25 ng/mL). All patients with hyperprolactinemia underwent computed tomography scan evaluation of the pituitary gland.

Relaxin in normal and pathogenic pregnancies.

Serum relaxin concentrations were quantitated throughout pregnancy. Relaxin levels were higher in the first than in either succeeding trimester of pregnancy. Relaxin concentrations in third-trimester twin pregnancies were not significantly different from those in singleton pregnancies.

Accessory cervix: an unusual congenital malformation.

A woman with a septate vagina and two cervices was observed. One of the cervices ended blindly. The other cervix communicated with a normal corpus and two normally positioned patent fallopian tubes.

Induction of relaxin secretion in nonpregnant women by human chorionic gonadotropin.

Five normal women using barrier forms of contraception has serum samples drawn every 2 days during control menstrual cycles. Relaxin was not detectable in their serum. All five subjects then received 2500 IU hCG im every 2 days beginning 8--10 days after presumed ovulation.

Serial relaxin concentrations in human pregnancy.

Relaxin is a peptide hormone produced by the corpus luteum during pregnancy in human beings. There are no extraluteal sites of production of relaxin in women. By means of a heterologous porcine radioimmunoassay, serial serum relaxin concentrations were determined in three women throughout pregnancy and into labor.

Clomiphene citrate in the management of infertility associated with shortened luteal phases.

Repetitively short luteal phases were found in eight infertile women. The short luteal phase was defined as 10 days or less from the presumed time of ovulation (as assessed by basal body temperature recording) to the onset of menses. Clomiphene citrate (Clomid) therapy resulted in pregnancy in two patients and lengthened the luteal phase in the other six.