The effects of two monophasic oral contraceptives containing 30 mcg of ethinyl estradiol and either 2 mg of chlormadinone acetate or 0.15 mg of desogestrel on lipid, hormone and metabolic parameters.

Background: This study was conducted to compare the effects of two monophasic oral contraceptives (OCs) containing ethinyl estradiol (EE) 30 mcg+either chlormadinone acetate (CMA) 2 mg (Belara) or 0.15 mg desogestrel (Marvelon) on lipid, hormone and other relevant metabolic parameters.

Study Design: Markers of lipid and carbohydrate metabolism, and reproductive hormone levels, were measured in 45 subjects randomly assigned to 6 months of treatment with one of the two OCs.

Autoantibodies to prothrombin and phosphatidylserine/prothrombin-complexes: do they contribute to the serodiagnosis of primary and secondary anti-phospholipid syndrome?

The diagnostic and clinical relevance of Ab to pure and phosphatidylserine-complexed prothrombin for primary and secondary APS was investigated in a total of 357 patients with (n = 169) and without (n = 188) connective tissue diseases. The overall frequency of anti-prothrombin Ab in sAPS, pAPS and patients without APS-related symptoms were found to be 50.0, 37.

Reactivity profiles of autoantibodies to different phospholipids and the phospholipid-binding protein beta2-glycoprotein I in patients with clinical symptoms related to thromboembolic and/or vasculopathic events with or without connective tissue diseases.

To study the antigenic and epitope specificities of anti-phospholipid Ab in detail, we investigated 177 patients without (62 with APS-related systemic clinical symptoms, 115 with microangiopathies) and 164 patients with connective tissue diseases (CTD). Ab associated with primary APS (pAPS) seem to show a restricted specificity (phospholipid/beta2-GPI-complexes), whereas those in secondary APS (sAPS) react additionaly with pure beta2-GPI. Simultaneously, beta2-GPI-independent Ab were also frequently present in both conditions (50% of all Ab-positive sera).

Is the Zona pellucida thickness of metaphase-II oocytes in an IVF/ICSI program influenced by the patient's age?

Zona pellucida (Z.p.) thickness is believed to be considerably influenced by hormonal stimulation.

Chimerism in a fertile woman with 46,XY karyotype and female phenotype.

We report on the unexpected finding of a 46,XY karyotype in a 30 year-old woman with normal ovarian function and a former pregnancy at 17 years of age. Chromosome analysis was performed prior to intracyoplasmic sperm injection (ICSI), due to infertility of her husband. Repeated chromosome analysis in lymphocytes of the female resulted in a normal male karyotype.

[Is there an increase of serum antisperm antibodies following surgery in the cervical transformation zone for cervical intraepithelial neoplasia (CIN)?].

Objective: This prospective controlled study was performed to investigate whether operative procedures of the uterine cervix lead to a change in the titre of humoral antispermatozoal antibodies.

Material And Methods: Humoral antispermatozoal antibodies were measured using an ELISA in 15 patients undergoing cervical scraping, 20 having conisation, 10 having a loop excision before and at least 3 months after surgery as well as in 10 fertile women as a control group.

Results: There were no significant differences in age between groups, in the distribution of initial and final levels of humoral antispermatozoal antibodies (IgG, IgA), and no significant change of the antibody titres (pre- and postoperative) within the individual groups.

A comparative study of the hemostatic effects of two monophasic oral contraceptives containing 30 mu(g) ethinylestradiol and either 2 mg chlormadinone acetate or 150 mu(g) desogestrel.

Objectives: To determine the effect of two low-dose monophasic oral contraceptives containing either 2 mg chlormadinone acetate or 150 microg desogestrel on blood clotting and fibrinolysis.

Methods: In vivo markers of intravascular coagulatory and fibrinolytic activity were measured in 45 volunteers randomly assigned to a 6-month treatment with one of the two study preparations.

Results: During oral contraceptive use, the procoagulatory activity increased (increased prothrombin fragment 1+2), the anticoagulatory capacity changed (increased protein C activity, decreased activated protein C sensitivity, decreased protein S activity and decreased antithrombin III activity) and the fibrinolytic system was activated (increased concentrations of plasmin-antiplasmin complexes and D-dimer as well as total fibrin degradation products).

[Pregnancy and hormone replacement therapy in a patient with resistant ovary syndrome].

We report on the case of a 32-year-old woman with "resistant ovary syndrome". The patient received hormone replacement therapy sequentially with 2 mg estradiol valerate and 2 mg estradiol valerate/0.15 mg levonorgestrel (Klimonorm, Jenapharm, Germany) respectively, because of secondary amenorrhea and premature menopause.

[Persistent anovulation following laparoscopic electrocoagulation of the ovarian surface in a patient with polycystic ovary syndrome (PCOS)].

We report on a 32-year-old woman with polycystic ovarian syndrome (PCOS) who showed no ovarian reaction (oestradiol increase, leading follicle) to clomiphene and gonadotropin stimulation before and after laparoscopic electrocoagulation of the ovarian surface (LEOS) although hormone values (LH-FSH ratio, androstenedione) after LEOS were within normal range. The case is discussed in terms of the literature.

[Cavernous hemangioma of the umbilical cord].

We report the case of a cavernous hemangioma with a recently developed hematoma of the umbilical cord. Because of a threatening intrauterine asphyxia an operative vaginal delivery was performed followed by pulmonary disturbance of adaptation and anemia with transfusion. Possible complications are discussed both in terms of the case-history and literature.

Fertility and pregnancy outcome after myomectomy in sterility patients.

Objectives: To examine total pregnancy rate, pregnancy rate in relation to pretreatment with GnRH-analogues, the frequency of myoma recurrencies and the influence of size, number and localization of removed myomata on pregnancy rate and outcome in infertility patients after myomectomy.

Study Design: A comparative, retrospective non-randomized clinical study involving 67 patients with desire for children and no other recognizable infertility factor. Myomectomy had been performed between 1985 and 1993.

Human follicular fluid levels of endothelins in relation to oocyte maturity status.

The levels of endothelins 1 and 2 (ET-1 and ET-2) have been examined in 415 follicular fluids of 57 women participating in the IVF-ET programme in the University Women's Hospital, Marburg, in relation to the morphological appearance ("maturity") and fertilizability of harvested oocytes as well as to the levels of inhibin, FSH, IGF-1, estradiol and progesterone. Follicular aspiration was done transvaginally in all patients after down regulation with nafareline and ovarian stimulation using urofollitropin and menotropin. Ovulation was induced by hCG.

[Histology and cytology of laparoscopically operated "simple ovarian cysts"].

In a retrospective study the histopathological findings of 127 laparoscopically operated unilocular anechoic smooth-walled ovarian cysts have been correlated with clinical characteristics (age, duration of observation, complaints, hormonal treatment), size by ultrasound, kind and colour of cysts content as well as cytological findings. The age of patients differed from 16-61 years (mean +/- s: 36 +/- 16). The histopathologic findings yielded 15 (11.

[Extrauterine pregnancy after hormonal postcoital contraception].

Postcoital contraception with estrogen-gestagen-combinations is a highly effective emergency measure in cases of unprotected sexual intercourse at midcycle. Pregnancies after hormonal postcoital contraception are rare and ectopic pregnancies are said to be an extreme rarity. At the Department of Obstetrics and Gynecology of the Philipps-University Marburg we could observe two women with ectopic pregnancies after administration of a ethinyestradiol-levonorgestrel combination (Tetragynon, Schering, Berlin).

[Possibilities of endoscopic diagnosis and therapy in reproduction medicine].

Endoscopic minimal invasive procedures have opened new horizons for preventive care and treatment in reproductive medicine. They provide best conditions for careful handling of tissues and preservation of organs. After exclusion of functional sterility factors, the basis of any further treatment is obtained by diagnostic pelviscopy, hysteroscopy and salpingoscopy, respectively falloposcopy, this even more for the endoscopic therapy of tubarian and uterine sterility factors as well as endometriosis.

[The effect of low-dose pre-ovulatory progesterone administration on the outcome of in-vitro fertilization (IVF) and intra-tubal gamete transfer (GIFT)].

The influence of application of low-dose progesterone 4 hours before induction of ovulation by HCG on the outcome of IVF and GIFT was investigated in a bilateral study. The number of patients was 38 from both clinics for IVF and 36 for GIFT. With a pregnancy rate of 35.

[Spermatocyte antibodies in serum and follicular fluid of IVF and GIFT patients].

With a new SPAK-ELISA test system (Seratec GmbH) we determined sperm antibodies in sera of 60 IVF, 11 GIFT patients and their husbands. We evaluated sperm antibodies in sera of 12 IVF (20.0%), 3 GIFT (27%) and 3 males with normozoospermia parameters (4.

[Success rates in in vitro fertilization--a mathematical problem? Comments on the article by M. M. Seibel in Obstet. Gynecol. 72 (1988) 265].

In vitro fertilization, GIFT and related methods have given new perspectives for the treatment of sterility and are applied worldwide. Despite an increasing application of these methods success rates are still relatively low. It may be difficult for sterility patients and their gynecologists to get a clear imagination about the success rates of an IVF-program.

[Problems in treatment of sterility in developing countries--experiences with sterility consultation in Gondar/Ethiopia].

101 women were treated because of sterility in the Gondar College of Medical Sciences, Gondar/Ethiopia, in the years 1987/88. The results revealed some typical difficulties in diagnosis and treatment of sterility in developing countries, arising from limited technological facilities and special characteristics of the group of treated patients. In 61 women a final diagnosis could be made.

[The hormonal micromilieu and oocyte status in the stimulated in vitro fertilization cycle].

FSH, LH, PRL, estradiol-17 beta and progesterone were determined in 651 follicular fluids of 173 patients treated by ovarian stimulation for IVF. The stimulation was performed according to 5 different schemes: clomiphene/HCG, HMG (Pergonal)/HCG, HPG (Anthrogon)/HCG, clomiphene/HPG/HCG, Folistiman (heterologeous pituitary gonadotropin)/HCG. The mean levels of hormones of all follicles of each stimulation scheme were determined and differences between the groups were estimated by Student's t-test and the x-square-test.

[Hormone profile and follicle development in ovarian stimulation treatment for in vitro fertilization. II. Prolactin, estradiol and progesterone profile].

144 patients were treated by 5 different stimulation protocols in the IVF-program of the University Women's Hospital Rostock (Clomiphene/hCG, Clomiphene/Anthrogon/hCG, Pergonal/hCG, Anthrogon/hCG, Folistiman/hCG). Estradiol-17 beta and progesterone were determined during the follicular phase of 172 cycles by RIA. The results were compared between the treatment groups by means of Student's t-test or Mann-Whitney's nonparametric test.

[Developmental trends in reproduction medicine].

In the last few years reproductive medicine has developed into a medical research field of its own. It deals with the theoretical and practical problems of human reproduction and is characterized by close cooperation between medical and scientific specialists both clinically and in research. Far-reaching social effects arise from the application of hitherto unknown research and treatment methods.

[Dynamics of follicle development in stimulated in vitro fertilization cycles--sonographic follow-up and findings following follicle puncture].

Results of ultrasonical folliculometry during treatment by 5 different stimulation protocols were evaluated in 122 cycles of IVF-patients. Additionally, the structure of follicular population was investigated by measurement of follicular volume which was the basis of a follicular hierarchy. - Number of developing, sonographically detectable and punctured follicles increased significantly from stimulation by Clomiphene to stimulation by Folistiman.