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Empty follicle syndrome
486
Citations from the Literature
Papanicolaou smear history of patients developing cancer: An assessment of screening protocols
cervical
Bearman DM; MacMillan JP; Creasman WT Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA OBSTET. GYNECOL.; 69/2 (151-155) 1987 The American Cancer Society recently has suggested changes in the frequency of Papanicolaou smear screening which, if followed, would alter current practice considerably. This study assessed the impact of the Papanicolaou smear screening interval on the prevention of advanced disease. Between July 1, 1980 and June 30, 1984, 264 women were evaluated and treated for primary epithelial carcinoma of the cervix (64% had stage I disease). Ninety-seven women (37%) had had a normal Papanicolaou smear within three years of diagnosis, including 48 women (18%) whose last normal Papanicolaou smear was within a year of diagnosis. The cytologic history was unavailable for 81 women (31%). Patients with a screening interval of greater than six years were more likely to be older, of lower socioeconomic status, and black, as compared with patients in the more frequently screened groups. Patients with a screening interval of 36 months or less were similar to those with a 37- to 72-month interval with respect to age, racial characteristics, and socioeconomic status. In this similar group of patients, a screening interval of 37-72 months was associated with a significantly larger proportion of advanced stage disease than found in more frequently screened patients. A policy of screening more frequently than every three years may therefore lead to increased survival among women who develop cervical cancer despite cytologic screening.
FERTILITY AND STERILITY Empty follicle syndrome
Coulam CB; Bustillo M; Schulman JD Method& Center for Reproduction and Transplantation Immunology, Indianapolis, IN 46202, USA FERTIL. STERIL.; 4616 (1153-1155) 1986 Four patients who had no oocytes retrieved during an IVF cycle were studied in an attempt to identify predictors of such an occurrence and suggestions for its cause. All 30 follicles aspirated in five cycles in these four women yielded no oocytes. One patient had two cycles that produced no eggs. The empty follicle syndrome may represent a new syndrome and a cause of infertility. Arrest of follicular development in a patient with l’lalphahydroxylase deficiency: Folliculogenesis in association with a lack of estrogen synthesis in the ovaries
Araki S; Chikazawa K; Sekiguchi I; et al Department of Obstetrics and Gynecology, Jichi Medical School, Minamikawachi. Tochigi 329-04, Japan FERTIL. STERIL.; 47/l (169-172) 1987 The degree of follicular development was examined in a patient with 17alpha-hydroxylase deficiency that accounted Int J Gynaecol Obstet 25
for impairment of estrogen and androgen biosynthesis. The ovarian content of P was markedly higher than those of any other steroids requiring 17alpha-hydroxylation for synthesis. The morphologic analysis of the ovaries demonstrated that normal follicles could not develop to more than 2.2 mm in diameter, and most follicles with diameters of 0.1 mm or more yielded to atresia. It is known that estrogen and FSH act synergistically on the growth of the follicles. Our data suggest that the follicles can develop up to the size of 2.2 mm in diameter at most with the sole stimulation of gonadotropin. A monoclonal antibody to a cell surface determinant in human endometrial epithelium: Stage-specific expression in the menstrual cycle
Aplin JD; Seif MW Department of Obstetrics and Gynecology, University of Manchester, St. Mary’s Hospital, Manchester, MI3 OJH, UK AM. J. OBSTET. GYNECOL.; 15611 (250-253) 1987 A monoclonal antibody (CC25) was obtained after immunization of mice with intact glandular epithelial cells from secretory phase endometrium. Here we report a preliminary immunohistologic study in the endometrium of 29 patients in different phases of the menstrual cycle and early pregnancy. In immunofluorescence, CC25 binds to a basolaterally oriented epithelial cell surface antigen that is absent during the proliferative phase and appears suddenly in both glandular and uterine surface locations soon after ovulation. In mid and late secretory phase, the level of expression diminishes slowly. The epitope is absent from glandular epithelial cells in first-trimester decidua. However, it is associated with vascular smooth muscle cells in endometrium and decidua. CC25 promises to be a useful reagent for the analysis of endometrial function during the menstrual cycle. Hirsutism
Rittmaster RS; Loriaux DL Department of Medicine, Dalhousie University, Hahfax, NS, Canada ANN. INTERN. MED.; 106/l (95-107) 1987 Excess body hair, or hirsutism, is usually only a problem in women and can cause considerable psychological distress. The disorder is usually androgen mediated. Because androgens come only from the adrenal glands or gonads or by conversion in peripheral tissues of precursor steroids from these organs, the causes of hirsutism are found in these two organs. Adrenal causes include Cushing’s disease adrenal tumors, and congenital adrenal hyperplasia. Ovarian causes include tumors, polycystic ovarian syndrome, and most cases of idiopathic hirsutism. The clinical evaluation is designed to differentiate between these diagnostic possibilities. When an underlying abnormality can be identified, such as an ovarian tumor, the treatment course is clear. When the diagnosis is idiopathic hirsutism, however, the best treatment is uncertain and several available regimens are possible.
Citations from the Literature
Papanicolaou smear history of patients developing cancer: An assessment of screening protocols
cervical
Bearman DM; MacMillan JP; Creasman WT Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA OBSTET. GYNECOL.; 69/2 (151-155) 1987 The American Cancer Society recently has suggested changes in the frequency of Papanicolaou smear screening which, if followed, would alter current practice considerably. This study assessed the impact of the Papanicolaou smear screening interval on the prevention of advanced disease. Between July 1, 1980 and June 30, 1984, 264 women were evaluated and treated for primary epithelial carcinoma of the cervix (64% had stage I disease). Ninety-seven women (37%) had had a normal Papanicolaou smear within three years of diagnosis, including 48 women (18%) whose last normal Papanicolaou smear was within a year of diagnosis. The cytologic history was unavailable for 81 women (31%). Patients with a screening interval of greater than six years were more likely to be older, of lower socioeconomic status, and black, as compared with patients in the more frequently screened groups. Patients with a screening interval of 36 months or less were similar to those with a 37- to 72-month interval with respect to age, racial characteristics, and socioeconomic status. In this similar group of patients, a screening interval of 37-72 months was associated with a significantly larger proportion of advanced stage disease than found in more frequently screened patients. A policy of screening more frequently than every three years may therefore lead to increased survival among women who develop cervical cancer despite cytologic screening.
FERTILITY AND STERILITY Empty follicle syndrome
Coulam CB; Bustillo M; Schulman JD Method& Center for Reproduction and Transplantation Immunology, Indianapolis, IN 46202, USA FERTIL. STERIL.; 4616 (1153-1155) 1986 Four patients who had no oocytes retrieved during an IVF cycle were studied in an attempt to identify predictors of such an occurrence and suggestions for its cause. All 30 follicles aspirated in five cycles in these four women yielded no oocytes. One patient had two cycles that produced no eggs. The empty follicle syndrome may represent a new syndrome and a cause of infertility. Arrest of follicular development in a patient with l’lalphahydroxylase deficiency: Folliculogenesis in association with a lack of estrogen synthesis in the ovaries
Araki S; Chikazawa K; Sekiguchi I; et al Department of Obstetrics and Gynecology, Jichi Medical School, Minamikawachi. Tochigi 329-04, Japan FERTIL. STERIL.; 47/l (169-172) 1987 The degree of follicular development was examined in a patient with 17alpha-hydroxylase deficiency that accounted Int J Gynaecol Obstet 25
for impairment of estrogen and androgen biosynthesis. The ovarian content of P was markedly higher than those of any other steroids requiring 17alpha-hydroxylation for synthesis. The morphologic analysis of the ovaries demonstrated that normal follicles could not develop to more than 2.2 mm in diameter, and most follicles with diameters of 0.1 mm or more yielded to atresia. It is known that estrogen and FSH act synergistically on the growth of the follicles. Our data suggest that the follicles can develop up to the size of 2.2 mm in diameter at most with the sole stimulation of gonadotropin. A monoclonal antibody to a cell surface determinant in human endometrial epithelium: Stage-specific expression in the menstrual cycle
Aplin JD; Seif MW Department of Obstetrics and Gynecology, University of Manchester, St. Mary’s Hospital, Manchester, MI3 OJH, UK AM. J. OBSTET. GYNECOL.; 15611 (250-253) 1987 A monoclonal antibody (CC25) was obtained after immunization of mice with intact glandular epithelial cells from secretory phase endometrium. Here we report a preliminary immunohistologic study in the endometrium of 29 patients in different phases of the menstrual cycle and early pregnancy. In immunofluorescence, CC25 binds to a basolaterally oriented epithelial cell surface antigen that is absent during the proliferative phase and appears suddenly in both glandular and uterine surface locations soon after ovulation. In mid and late secretory phase, the level of expression diminishes slowly. The epitope is absent from glandular epithelial cells in first-trimester decidua. However, it is associated with vascular smooth muscle cells in endometrium and decidua. CC25 promises to be a useful reagent for the analysis of endometrial function during the menstrual cycle. Hirsutism
Rittmaster RS; Loriaux DL Department of Medicine, Dalhousie University, Hahfax, NS, Canada ANN. INTERN. MED.; 106/l (95-107) 1987 Excess body hair, or hirsutism, is usually only a problem in women and can cause considerable psychological distress. The disorder is usually androgen mediated. Because androgens come only from the adrenal glands or gonads or by conversion in peripheral tissues of precursor steroids from these organs, the causes of hirsutism are found in these two organs. Adrenal causes include Cushing’s disease adrenal tumors, and congenital adrenal hyperplasia. Ovarian causes include tumors, polycystic ovarian syndrome, and most cases of idiopathic hirsutism. The clinical evaluation is designed to differentiate between these diagnostic possibilities. When an underlying abnormality can be identified, such as an ovarian tumor, the treatment course is clear. When the diagnosis is idiopathic hirsutism, however, the best treatment is uncertain and several available regimens are possible.