Does large loop excision of the transformation zone of the cervix predispose to the development of antisperm antibodies in women?

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those stratified by age were 0.13 (age < 22 years) and 0.39 (age ~22 years). Potential confounders included in regression models did not diminish the associations. Conclusions. Smoking is associatedwith lowered semen quality. IslfbeDmoIrmmkIagwrertBBylnwemenarteudmgMlnvBro fe-rtilhtiooprogram Sterxik K.; Strehler E.; De Santo M.; Trumpp N.; Abt M.; Rosenbusch B.; Schneider A. DEU

FERTIL STERIL 19966514(810-814) Objective. To investigate the influence of cigarette smoking of women on the fertilization and pregnancy rates obtained by in vitro fertilization (IVF) treatment. Patients. One hundred ninety-seveninfertile, otherwise healthy women who entered an IVF program for the first time. Setting. Fertility Unit at the Women’s University Hospital of the University of Ulm, Germany. Interventions. The study population consisted of 197 women (23-39 years oId) who were divided into the following groups: non-smokers(n = 68), passive smokers (n = 26) and active smokers (n = 103)according to the cotinine concentration measuredin follicular fluid. The reasonfor infertility was strictly a tubal factor with apparently normal ovulatory cycles. To guarantee an objective recording of tobacco smoke exposure, the smoking habit was not determined by questionnaires, but by cotinine, the principal metabolite of nicotine. Results. There were no signilicant differences in fertilization and pregnancy rates between the different groups. The E2 serum levels were decreasedsignificantly in women who smoked when compared with the results obtained from non-smokers and passive smokers. Overall, a strong negative correlation of the cotinine and E, levels was observed (r = -0.65). Conclusions. The results suggestthat there is no clinically detectable impairment of fertilization potential due to female smoking and that there is a greater influence on the outcome of IVF by other factors. Doeshrgelaopexcisiaaoftktrxnsformatimzolleoftbecenix pdhpoee to tbe devebpmeot of amtispem antibodks in women? Nicholson S.C.; Robinson J.N.; Sargent I.L.; Hallam N.F.; Chamock F.M.L.; Barlow D.H. GBR

FERTIL STERIL 19966514(871-873) Objective. To determine whether large loop excision of the transformation zone of the uterine cervix for cervical intraepithelial neoplasia predisposes to the development of female isoimmunity to human spermatozoa. Design. A prospective, controlled study. Setting. Colposcopy and Andrology Units at the John Radclife and Churchill Hospitals, Oxford, UK. Interventions. Serum samples were collected from 33 women before large loop excision of the transformation zone of the cervix and repeated at a minimum time interval of 4 months after the procedure. Women were questioned regarding the procedure and subsequentreproductive function. A control population of 30 women not undergoing cervical surgery also underwent serial serum screening for antisperm antibodies. Main outcome measure(s).The detection of serum antisperm antibodies by flow cytometry. Results. None of the serum samples before large loop excision of the cervical transformation

of Gynecology

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zone had clinically significant levels of antisperm antibodies. There was, however, a significant rise in antisperm antibody levels in women following large loop excision of the transformation zone. Apparent risk factors for the development of antisperm antibodies included a short duration of sexual abstinence and the use of non-barrier contraception after surgery. There was no rise in antisperm antibody levels in the control population. Conclusions. Large loop excision of the transformation zone of the cervix is a risk factor for the development of antisperm antibodies in women. Women should be advised to use barrier contraception or avoid sexual intercourse until complete healing of the cervix has occurred. latrafoukulfu bemodylmmicsbefore the administration of bumaIl dnwionk gn~~I~lvopio ia WOIIIOII at risk of the marim byperstImaIatiollayndNme Oyesanya O.A.; Parsons J.H.; Collins W.P.; Campbell S. GBR

FERTIL STERIL 19966514(874-876) Objective. To test the hypothesis that alteration of intrafollicular hemodynamicsprecedesthe ovarian hyperstimulation syndrome (OHSS). Design. A prospective study. Setting. The IVF Unit and the Doppler Imaging Laboratory of King’s College Hospital, London, UK. Patients. Twenty-four women undergoing in vitro fertilization and considered to have an exaggerated responseto ovarian stimulation and hence at risk of OHSS. Interventions. Transvaginal Doppler imaging of the intrafollicular blood flow was performed before human chorionic gonadotropin (hCC) administration to determine the indexes of intrafollicular hemodynamics. Main outcome measures. Moderate or severe OHSS. Results. There was no statistically significant difference in mean age (32.63 f 1.77 vs. 31.48 * 3.87). duration of infertility (6.00 f 2.19 vs. 5.29 t 2.73). maximum peak systolic velocity (0.25 f 0.16 vs. 0.26 f 0.21 m/s), mean of six maximal peak systolic velocity (0.15 f 0.04 vs. 0.21 t 0.10). minimum pulsatility index (0.76 i 0.26 vs. 0.59 i 0.23), mean of six minimal pulsatility indexes (0.89 t 0.30 vs. 0.79 i 0.14). minimum resistance index (0.47 f 0.06 vs. 0.41 f 0.10) and mean of six minimal resistanceindexes (0.56 f 0.05 vs. 0.53 t 0.06) of intrafollicular blood flow between the women who developed moderate or severe OHSS and matched controls. Conclusions. Measurement of intrafollicular hemodynamics before hCG administration does not predict the development of OHSS. Hated interloveIsla the ovarian bypedmdxtioa sy~+ dromrcovarim immmafIbItfocaIhtin0 of ill&.*

6NH Loret De Mola J.R.; Flores J.P.; Baumgardner G.P.; Goldfarb J.M.; Gindlesperger V.; Friedlander MA. USA OBSTET GYNECOL 1996 8714(581-587) Objective. To examine the production and immunolocalixation of interleukin-6 (H-6) in patients with the ovarian hyperstimulation syndrome. Method. The study group consisted of patients with ovarian hyperstimulation syndrome (n = 9) from whom serum and ascites samples were obtained. The control samples used were serum (n = IO), peritoneal (n = 16) and