- Email: [email protected]
Inflamatory diseases of the cervix as a cause of infertility
THURSDAY,
SEPTEMBER
7
primary and 3(12%) secondary sterility. 4(16%) of them had primary, 13(52%) secondary amenorea and 8(32%) of them had neat menstrual cycle. With the help of the radioimunity method, we have determined the harmonic values and the corelation between PRL, FSH and LH. At the same time we discovered that out of 25 women with HiPRL, 8(32%) had lower FSH values and 10(40%) lower LH values. Galactorea was present in 12(48%) cases and a pathological tomographic finding of the heat in 3(12%) cases. According to the ophtalmologic finding only 2 women had slight pathological changes in the widerness of the eye field and the eye bottom. Results: After the applied therapy with Bromcriptin in the case of 22(88%) women we have found lower values of PRL, in 11(64,78%) cases the women restored their normal menstrual cycle and in the case of 10(40%) women it resulted with pregnancy. Conclusion: The low HiPRL results in shortened luteal phase and the high HiPRL inhibites the ovulation.
P4.13.08 IDENTIFICATION OF THE HUMAN SPERM PROTEIN INTERACTING WITH ANTISPERM ANTIBODY IN SERA OF INFERTILE WOMEN M. Kamada’, S. Yamamoto’, M. Takikawa’, K. Kunimi’, M. Maegawa’, S. Futak?, Y. 0hmoto3, T. Aono’, S. S. Koide“, ‘Dept. OBIGYN, ‘Pharmacol., Univ. of Tokushima; ‘Otsuka Pharmacol., Tokushima. Japan; “Pop. Council, New York, USA Objectives: To identify the target antigen of naturally occurring antisperm antibodies present in the circulation of infertile women. Study Methods: Twenty-nine infertile women with sperm immobilizing antibodies, 22 infertile women with other etiologies and 20 fertile women. Titers of antibodies to rSMP-B were determined by ELISA using as substrate the synthetic peptide segment (rSMP-230) corresponding to the hydrophilic domain of rSMP-B. Polyclonal antibody to rSMP-230 was assessed for the same biological activities as sperm immobilizing antibodies. Namely, tests for sperm immobilization and zona penetration were performed using the in vitro human fertilization system. Results: Anti-rSMP-230 antibodies were detected in 10 out of 29 (34%) sera obtained from immunologic infertile women; whereas only one serum sample (2%) among women whose sera contain no sperm immobilizing activity had a low titer of anti-rSMP-230 antibody. Polyclonal anti-rSMP-230 antibody completely immobilized human sperm in the presence of complement and blocked sperm penetration across human zona pellucida. Conclusions: The human sperm protein, rSMP-B, is probably the target antigen of sperm immobilizing antibodies.
P4.13.09 INDUCTION OF OVULATlON BY EXTENDED CLOMIPHENE CITRATE AND (PREDNISONE OR BROMOCRImINE) IN CLOMIPHENE CITRATE NONRESPONDERS. A. Beini, F Zarrinkoub, Dept. OBIGYN, Arash Maternity Hospital, Tehran University of Medical Sciences, Tehran, Iran. Objectives: To evaluate effectiveness of these alternative therapies for clomiphene citrate resistant patients. Study Methods: In a retrospective study in Arash maternity hospital, Tehran University of medical sciences from Mar 1997 to Jo1 1999. 46 anovulatory patients who failed to ovulate after clomiphene cirtate 150mg daily for 5 days were identified. Treatment consist of clomiphene citrate given on cycle days through 9 at a dose of 150mg daily but 34 patients of this group addition ally were given prednisone 5mg orally each night throughout the cycle, and 12 rest patients were given bromocriptine 2.5mg daily. Results: A total of 34 patients who received cloimiphene citrate plus prednisone completed 88 cycles of treatment. 26 (76%) of 34 patients became ovulatory and 62 (70%) of 88 treatment cycles resulted in ovulation, 15 of 34 patients (447)D conceived with this therapy. A total of 12 patients who received clomiphene citrate plus bromocriptine completed32 cycles of treatment, 8 (66%) of 12 patients became ovulatory and 21 (65%) of 32 treatment cycles resulted in ovulation. 5 of 12 patients (41%) conceived.
129
Conclusions: Administration of extended clomiphene citrate plus prednisone or bromocriptine in clomiphene resistant patients is associated with high rate of ovulation and pregnancy and is a good alternative therapy before gonadotropin stimulation or surgery.
P4.13.10 INFERTILITY IN THE CASES WITH ENDOMETRIOSIS V. Omandziski, L. Jovcevska, P. Kokormanov, G. Mirkovska, Specialistic health organization for OB/GYN “Dr. Vance Organdziski” Stip, Republic of Macedonia Objectives: The aim of this study is to evaluate the cases with endometriosis treated for infertility, in our society in the last 10 years (1990.1999). We were mostly interested in the relationship between the minor asymtomatic endometrial implant in unexplained infertility and the comparative results gained by conservative surgery and the hormonal therapy in different stages of this illness. Study Methods: 86 cases were analysed; 32 (37,2%) in weak form, 41 (47,7%) in medium form and 13 (15,1%) in advanced form of endometriosis. In all cases histerosalpingographical (HSG) examination were performed for indirect radiological evaluation of tubal ovarial or peritoneal endometriosis, Ultrasound examination, by what the selection of patients was allowed for early laparoscopy and treatment for infertility. The diagnosis was confirmed by laparoscopy and histopsthological method. Our experience, as well the experience of the other authors, assert that the therapy with Danazol amp. Zoladex and progestagene before the conservative surgical treatment improved the state of endometrical implant and allowed using less radical operation. In the cases where there were only andometrical cistae, the success of the treatment was twice bigger than in the cases of athesia. Results: Out of all patients treated with hormonal therapy, 18(20,9%) got pregnant. These are the patients with asymptomatic weak endometriosis. By conservative surgery 18(20,9%) patients were treated and 5(5,8%) got pregnant. On the whole, 25(29,1%) women got pregnant. According to the literature 6.15% of the infertile women had endometriosis as the only cause for infertility. Conclusion: The way in which the endometriosis affects the fertility is unknown yet. Most probably it works through the ovarial disfunction or worstenes the transport of the ovulum because of the disturbed tubal mobility. Most of the pregnancies appeared one year after the diagnosis was given, and treatment was undertaken. Our practise has shown Danazol amp. Zolodex and Progestagenes to be a very effective mean in supression of endometriosis.
P4.13.11 INFLAMATORY DISEASES OF THE CERVIX AS A CAUSE OF INFERTILITY G. Mirkovska, V. Organdziski, L. Jovcevska, P. Kokormanov, Specialist Health Organization for OB/GYN “Dr. Vance Organdziski” Stip, Republic of Macedonia Objectives: This work has its emphasis on the inflammatory type of cervical secretion, as a reason of infertility in the cases of organic healthy woman with normal hormonal status. Study methods: A group of 40 female patients, in the cases of which there was a reasonable doubt that the cause of infertility was in the cervix, were submitted to various investigation processes. Through the tests we have found out that all of the patients have regular ovulations and HSG picture, and the male patients, that their husbands are all fertile. In the series order all of them were submitted to an endocervical smear in, to examin the bacteriological research and the antibiogram. The chart 1 shows the kind and number of the bacteriological research and antibiogram. d_
co,,
N”_n 16
*PC cot
5
9
BhS
8
c 3
Mb vag Mb Ph T,a Iha 5 I II 10 I II
The patients were from 19 to 42 years old. Twenty four (24) of them had a primar sterility and sixteen (16) had a secondary one. Their treatment has consisted of use of antibiotics, hemotherapies and local antiseptic therapy.
3
130
THURSDAY,
Results: During the first year of treatment of the cervix 28 (70%) of the patients had become pregnant. Three (3) of them (10,7%) had an spontaneous abortion, two (2) of them (7,14%) gave a premature birth, and the rest of them 23 (82,1%) gave a birth of a healthy and live children. The remaining number of patients that didn’t become pregnant 12 (30%) are qualified as one with the unknown etiology which requires additional researches and treatment. Conclusion: There are two major groups of inflammatory type: Specific, and non-specific. Their relationship has a relevant influence on the quality of the cervical mucus and the fertility of spermatozoa, which go through it. On their way they get infected and cause infertility or spread the infection to the embryo membranes and can cause miscarriage.
P4.13.12 INTRACYTOPLASMIC INJECTION USING SPERM ASPIRATED BY PERCUTANEOUS EPIDIDYMIS IN TREATMENT FOR OBSTRUCTIVE AZOOSPERMIA Menn Xiannne, Li Yuan Qiu Yi Fan Yun-jing Zhang Mei-xin Shandong Insititute for Family Planning, Jinan, Shandong P.R. China 250002 Percutaneous epididymal sperm aspiration (PESA) and intracytoplasmic sperm injection (ICSI) were used in patients with congenital bilateral absence of the vas deferens (CBAVD, n=16) and failing vasovasotomy (n=7). ICSI was carried out in 23 cycles. Sperm retrieved by PESA was 2-82_106/mL with l-80% motility and 20.95% abnormal forms. A total of 179 eggs were collected and 199 subsequently were microinjected. Normal fertilization occurred in 145 oocytes, fertilization rate was 81.0% (1451179). 23 subjects underwent ET in which ten conceived(pregnancy rate 56.52% per transfer). Six of them gave birth to normal babies. Our result reveals that PESA-ICSI is an effective method for infertile patients with obstructive azoospermia.
P4.13.13 IUI WITH SHORT-LIVED SPERMATOZOA 1. OBIGYN, Nutech Mediworld (Ferti.Clinic), G-1511, Malviya Nagar, New Delhi-110017, India. 2. Vera Hingorani, Retired from AIIMS & Batra Hospital MRC, New Delhi, India Objectives: To improve upon the seccess rate of Intra Uterine Insemination (IUI), especially when the male partner has very shortlived or too few spermatozoa. Twenty five women, one cycle each, undertook IUI procedure with ejaculates containing very short-lived spermatozoa some times it was as low as about half an hour. The IUI was performed with 0.5 ml. of the ejaculates within 10 minutes of taking the sample. It was used in: i) Unwashed condition ; ii) but was timed with the availability of the ovum in the Ampulla of the Fallopian Tube i.e. about 18 hours after the rupture of the foilicle seen by Ultrasound scan. Results: Out of the 25 women who had undergone the IUI procedure, 16 became pregnant and nine did not conceive in the first cycle. Thus it raised the success ratae of IUI of 64% from 10.15% world wide. Conclusions: Infertility caused by very short-lived/Low count sperms, in couples with otherwise normal fertility parameters, IUI could overcome it to a great extent by fast use of unwashed ejaculates and synchronizing the procedure with the availability of the ovum in the Ampulla of the Fallopian tube.
P4.13.14 PEmIDE-M INDUCED EFFECTS ON THE CHANGE SPERM QUALITY M Radovic’ S Arsenijevi?, A Zivanovi?, S Petkovic’, -> Kadija’, S. Pantovic’, V. Milenkovic’. Institute for Gynecology and Obstetrics, Clinical Center Belgrade, Yugoslavia Clinic for Gynecology and Obstetrics, KBC Kragujevac,
OF HUMAN Lj. Mirkovic’, S. of Serbia, Yugoslavia
Objectives: The motility of spermatozoa is of crucial importance for the penetration through the cervical mucus as well as zone free hamster egg penetration test in vitro. It is possibly decisive for the penetration through the envelope of the oocyte in v&o, too. The aim of this study was to evaluate the efects of met-enkephalin Peptid-M on function of hyman spermatosoa.
SEPTEMBER
Study Methods: Twenty two asthenozoospermic men, volunteers from infertile couples, served us as study group. These patients were daily i.m. administered 5 mg Peptide-M during 7 days. Normal parameters for the evaluation of the sperm quality were measured. Results: Data obtained in this study indicate that the thymic preparation Peptide-M excerts a significant influence on the progressive motility (PM%), motility (M%), and agglutination of the spermatozoa. Progressive motility has been significantly increased after the therapy (P=O.O03; P
P4.13.15 PROSPECTIVE, BLINDED EVALUATION OF THE UTERINE CAVITY AND THE FALLOPIAN TUBES USING THREE DIMENSIONAL CONTRAST SONOGRAPHY R.S. Sankual (l), E. Confino (2) (1) Dept. Post Partum, Nowrosjee Wadia Maternity Hospital, Parel, India. (2) Section of Reproductive Endocrinology, Northwestern University Medical School, Chicago, Illinois, USA. Hysterosalpingography is routinely performed on all infertility patients. This procedure provides anatomical information on the uterine cavity and the fallopian tubes. Since hysterosalpingogram results in a minimal amount of radiation delivered to the patient, there is a need to develop a comparable procedure that does not require radiation. Previous attempts to perform contrast sonography of the uterus and fallopian tubes demonstrated that this procedure provides valuable information about the uterine cavity. Contrast sonography of the fallopian tube has provided limited information on tubal anatomy and limited information on unilateral or bilateral tubal spillage of contrast material into the abdominal cavity. The introduction of three dimensional ultrasound may result in better resolution and imaging of the fallopian tubes. This equipment is currently available for clinical use. The purpose of this study is to compare patients’ hysterosalpingogram to contrast sonography of the uterus and fallopian tubes performed with three dimensional ultrasound. The performer of the ultrasound will be blinded to the results of the previously performed hysterosalpingogram.
P4.13.16 RELATIONSHIP BETWEEN PLASMA LEVELS OF INSULIN AND LEPTIN, AND SYMPATHETIC ACTIVITY IN WOMEN WITH POLYCYSTIC OVARY SYNDROME Elsv Velazauez, G. Arata de Bellabarba, V. Villarroel, Z. Molina. Universidad de Los Andes, ULA, Apartado 42, Merida 5101, Venezuela. Objectives: This study was planned to evaluate the relationship between insulin and leptin plasma levels with sympathetic activity in women with polycystic ovary syndrome (PCOS). Study Methods: d 19 non-obese women with PCOS were studied. Twelve healthy non-obese women served as controls. An oral glucose tolerance test (OGTIJ was performed and blood samples were taken before and at 30,60, and 120 min. after glucose load. Glucose, insulin, leptin, and .&4androstenedione were measured before the OGTT. Supine blood pressure and plasma norepinephrine (NE), and response to upright posture was performed. Results: Basal and post-glucose insulin levels and A4androstenedione were higher in PCOS patients. There were not significant differences in supine NE levels between groups but the response to upright posture was significantly (p< 0.05) higher only in obese women. In this group,
7
SEPTEMBER
7
primary and 3(12%) secondary sterility. 4(16%) of them had primary, 13(52%) secondary amenorea and 8(32%) of them had neat menstrual cycle. With the help of the radioimunity method, we have determined the harmonic values and the corelation between PRL, FSH and LH. At the same time we discovered that out of 25 women with HiPRL, 8(32%) had lower FSH values and 10(40%) lower LH values. Galactorea was present in 12(48%) cases and a pathological tomographic finding of the heat in 3(12%) cases. According to the ophtalmologic finding only 2 women had slight pathological changes in the widerness of the eye field and the eye bottom. Results: After the applied therapy with Bromcriptin in the case of 22(88%) women we have found lower values of PRL, in 11(64,78%) cases the women restored their normal menstrual cycle and in the case of 10(40%) women it resulted with pregnancy. Conclusion: The low HiPRL results in shortened luteal phase and the high HiPRL inhibites the ovulation.
P4.13.08 IDENTIFICATION OF THE HUMAN SPERM PROTEIN INTERACTING WITH ANTISPERM ANTIBODY IN SERA OF INFERTILE WOMEN M. Kamada’, S. Yamamoto’, M. Takikawa’, K. Kunimi’, M. Maegawa’, S. Futak?, Y. 0hmoto3, T. Aono’, S. S. Koide“, ‘Dept. OBIGYN, ‘Pharmacol., Univ. of Tokushima; ‘Otsuka Pharmacol., Tokushima. Japan; “Pop. Council, New York, USA Objectives: To identify the target antigen of naturally occurring antisperm antibodies present in the circulation of infertile women. Study Methods: Twenty-nine infertile women with sperm immobilizing antibodies, 22 infertile women with other etiologies and 20 fertile women. Titers of antibodies to rSMP-B were determined by ELISA using as substrate the synthetic peptide segment (rSMP-230) corresponding to the hydrophilic domain of rSMP-B. Polyclonal antibody to rSMP-230 was assessed for the same biological activities as sperm immobilizing antibodies. Namely, tests for sperm immobilization and zona penetration were performed using the in vitro human fertilization system. Results: Anti-rSMP-230 antibodies were detected in 10 out of 29 (34%) sera obtained from immunologic infertile women; whereas only one serum sample (2%) among women whose sera contain no sperm immobilizing activity had a low titer of anti-rSMP-230 antibody. Polyclonal anti-rSMP-230 antibody completely immobilized human sperm in the presence of complement and blocked sperm penetration across human zona pellucida. Conclusions: The human sperm protein, rSMP-B, is probably the target antigen of sperm immobilizing antibodies.
P4.13.09 INDUCTION OF OVULATlON BY EXTENDED CLOMIPHENE CITRATE AND (PREDNISONE OR BROMOCRImINE) IN CLOMIPHENE CITRATE NONRESPONDERS. A. Beini, F Zarrinkoub, Dept. OBIGYN, Arash Maternity Hospital, Tehran University of Medical Sciences, Tehran, Iran. Objectives: To evaluate effectiveness of these alternative therapies for clomiphene citrate resistant patients. Study Methods: In a retrospective study in Arash maternity hospital, Tehran University of medical sciences from Mar 1997 to Jo1 1999. 46 anovulatory patients who failed to ovulate after clomiphene cirtate 150mg daily for 5 days were identified. Treatment consist of clomiphene citrate given on cycle days through 9 at a dose of 150mg daily but 34 patients of this group addition ally were given prednisone 5mg orally each night throughout the cycle, and 12 rest patients were given bromocriptine 2.5mg daily. Results: A total of 34 patients who received cloimiphene citrate plus prednisone completed 88 cycles of treatment. 26 (76%) of 34 patients became ovulatory and 62 (70%) of 88 treatment cycles resulted in ovulation, 15 of 34 patients (447)D conceived with this therapy. A total of 12 patients who received clomiphene citrate plus bromocriptine completed32 cycles of treatment, 8 (66%) of 12 patients became ovulatory and 21 (65%) of 32 treatment cycles resulted in ovulation. 5 of 12 patients (41%) conceived.
129
Conclusions: Administration of extended clomiphene citrate plus prednisone or bromocriptine in clomiphene resistant patients is associated with high rate of ovulation and pregnancy and is a good alternative therapy before gonadotropin stimulation or surgery.
P4.13.10 INFERTILITY IN THE CASES WITH ENDOMETRIOSIS V. Omandziski, L. Jovcevska, P. Kokormanov, G. Mirkovska, Specialistic health organization for OB/GYN “Dr. Vance Organdziski” Stip, Republic of Macedonia Objectives: The aim of this study is to evaluate the cases with endometriosis treated for infertility, in our society in the last 10 years (1990.1999). We were mostly interested in the relationship between the minor asymtomatic endometrial implant in unexplained infertility and the comparative results gained by conservative surgery and the hormonal therapy in different stages of this illness. Study Methods: 86 cases were analysed; 32 (37,2%) in weak form, 41 (47,7%) in medium form and 13 (15,1%) in advanced form of endometriosis. In all cases histerosalpingographical (HSG) examination were performed for indirect radiological evaluation of tubal ovarial or peritoneal endometriosis, Ultrasound examination, by what the selection of patients was allowed for early laparoscopy and treatment for infertility. The diagnosis was confirmed by laparoscopy and histopsthological method. Our experience, as well the experience of the other authors, assert that the therapy with Danazol amp. Zoladex and progestagene before the conservative surgical treatment improved the state of endometrical implant and allowed using less radical operation. In the cases where there were only andometrical cistae, the success of the treatment was twice bigger than in the cases of athesia. Results: Out of all patients treated with hormonal therapy, 18(20,9%) got pregnant. These are the patients with asymptomatic weak endometriosis. By conservative surgery 18(20,9%) patients were treated and 5(5,8%) got pregnant. On the whole, 25(29,1%) women got pregnant. According to the literature 6.15% of the infertile women had endometriosis as the only cause for infertility. Conclusion: The way in which the endometriosis affects the fertility is unknown yet. Most probably it works through the ovarial disfunction or worstenes the transport of the ovulum because of the disturbed tubal mobility. Most of the pregnancies appeared one year after the diagnosis was given, and treatment was undertaken. Our practise has shown Danazol amp. Zolodex and Progestagenes to be a very effective mean in supression of endometriosis.
P4.13.11 INFLAMATORY DISEASES OF THE CERVIX AS A CAUSE OF INFERTILITY G. Mirkovska, V. Organdziski, L. Jovcevska, P. Kokormanov, Specialist Health Organization for OB/GYN “Dr. Vance Organdziski” Stip, Republic of Macedonia Objectives: This work has its emphasis on the inflammatory type of cervical secretion, as a reason of infertility in the cases of organic healthy woman with normal hormonal status. Study methods: A group of 40 female patients, in the cases of which there was a reasonable doubt that the cause of infertility was in the cervix, were submitted to various investigation processes. Through the tests we have found out that all of the patients have regular ovulations and HSG picture, and the male patients, that their husbands are all fertile. In the series order all of them were submitted to an endocervical smear in, to examin the bacteriological research and the antibiogram. The chart 1 shows the kind and number of the bacteriological research and antibiogram. d_
co,,
N”_n 16
*PC cot
5
9
BhS
8
c 3
Mb vag Mb Ph T,a Iha 5 I II 10 I II
The patients were from 19 to 42 years old. Twenty four (24) of them had a primar sterility and sixteen (16) had a secondary one. Their treatment has consisted of use of antibiotics, hemotherapies and local antiseptic therapy.
3
130
THURSDAY,
Results: During the first year of treatment of the cervix 28 (70%) of the patients had become pregnant. Three (3) of them (10,7%) had an spontaneous abortion, two (2) of them (7,14%) gave a premature birth, and the rest of them 23 (82,1%) gave a birth of a healthy and live children. The remaining number of patients that didn’t become pregnant 12 (30%) are qualified as one with the unknown etiology which requires additional researches and treatment. Conclusion: There are two major groups of inflammatory type: Specific, and non-specific. Their relationship has a relevant influence on the quality of the cervical mucus and the fertility of spermatozoa, which go through it. On their way they get infected and cause infertility or spread the infection to the embryo membranes and can cause miscarriage.
P4.13.12 INTRACYTOPLASMIC INJECTION USING SPERM ASPIRATED BY PERCUTANEOUS EPIDIDYMIS IN TREATMENT FOR OBSTRUCTIVE AZOOSPERMIA Menn Xiannne, Li Yuan Qiu Yi Fan Yun-jing Zhang Mei-xin Shandong Insititute for Family Planning, Jinan, Shandong P.R. China 250002 Percutaneous epididymal sperm aspiration (PESA) and intracytoplasmic sperm injection (ICSI) were used in patients with congenital bilateral absence of the vas deferens (CBAVD, n=16) and failing vasovasotomy (n=7). ICSI was carried out in 23 cycles. Sperm retrieved by PESA was 2-82_106/mL with l-80% motility and 20.95% abnormal forms. A total of 179 eggs were collected and 199 subsequently were microinjected. Normal fertilization occurred in 145 oocytes, fertilization rate was 81.0% (1451179). 23 subjects underwent ET in which ten conceived(pregnancy rate 56.52% per transfer). Six of them gave birth to normal babies. Our result reveals that PESA-ICSI is an effective method for infertile patients with obstructive azoospermia.
P4.13.13 IUI WITH SHORT-LIVED SPERMATOZOA 1. OBIGYN, Nutech Mediworld (Ferti.Clinic), G-1511, Malviya Nagar, New Delhi-110017, India. 2. Vera Hingorani, Retired from AIIMS & Batra Hospital MRC, New Delhi, India Objectives: To improve upon the seccess rate of Intra Uterine Insemination (IUI), especially when the male partner has very shortlived or too few spermatozoa. Twenty five women, one cycle each, undertook IUI procedure with ejaculates containing very short-lived spermatozoa some times it was as low as about half an hour. The IUI was performed with 0.5 ml. of the ejaculates within 10 minutes of taking the sample. It was used in: i) Unwashed condition ; ii) but was timed with the availability of the ovum in the Ampulla of the Fallopian Tube i.e. about 18 hours after the rupture of the foilicle seen by Ultrasound scan. Results: Out of the 25 women who had undergone the IUI procedure, 16 became pregnant and nine did not conceive in the first cycle. Thus it raised the success ratae of IUI of 64% from 10.15% world wide. Conclusions: Infertility caused by very short-lived/Low count sperms, in couples with otherwise normal fertility parameters, IUI could overcome it to a great extent by fast use of unwashed ejaculates and synchronizing the procedure with the availability of the ovum in the Ampulla of the Fallopian tube.
P4.13.14 PEmIDE-M INDUCED EFFECTS ON THE CHANGE SPERM QUALITY M Radovic’ S Arsenijevi?, A Zivanovi?, S Petkovic’, -> Kadija’, S. Pantovic’, V. Milenkovic’. Institute for Gynecology and Obstetrics, Clinical Center Belgrade, Yugoslavia Clinic for Gynecology and Obstetrics, KBC Kragujevac,
OF HUMAN Lj. Mirkovic’, S. of Serbia, Yugoslavia
Objectives: The motility of spermatozoa is of crucial importance for the penetration through the cervical mucus as well as zone free hamster egg penetration test in vitro. It is possibly decisive for the penetration through the envelope of the oocyte in v&o, too. The aim of this study was to evaluate the efects of met-enkephalin Peptid-M on function of hyman spermatosoa.
SEPTEMBER
Study Methods: Twenty two asthenozoospermic men, volunteers from infertile couples, served us as study group. These patients were daily i.m. administered 5 mg Peptide-M during 7 days. Normal parameters for the evaluation of the sperm quality were measured. Results: Data obtained in this study indicate that the thymic preparation Peptide-M excerts a significant influence on the progressive motility (PM%), motility (M%), and agglutination of the spermatozoa. Progressive motility has been significantly increased after the therapy (P=O.O03; P
P4.13.15 PROSPECTIVE, BLINDED EVALUATION OF THE UTERINE CAVITY AND THE FALLOPIAN TUBES USING THREE DIMENSIONAL CONTRAST SONOGRAPHY R.S. Sankual (l), E. Confino (2) (1) Dept. Post Partum, Nowrosjee Wadia Maternity Hospital, Parel, India. (2) Section of Reproductive Endocrinology, Northwestern University Medical School, Chicago, Illinois, USA. Hysterosalpingography is routinely performed on all infertility patients. This procedure provides anatomical information on the uterine cavity and the fallopian tubes. Since hysterosalpingogram results in a minimal amount of radiation delivered to the patient, there is a need to develop a comparable procedure that does not require radiation. Previous attempts to perform contrast sonography of the uterus and fallopian tubes demonstrated that this procedure provides valuable information about the uterine cavity. Contrast sonography of the fallopian tube has provided limited information on tubal anatomy and limited information on unilateral or bilateral tubal spillage of contrast material into the abdominal cavity. The introduction of three dimensional ultrasound may result in better resolution and imaging of the fallopian tubes. This equipment is currently available for clinical use. The purpose of this study is to compare patients’ hysterosalpingogram to contrast sonography of the uterus and fallopian tubes performed with three dimensional ultrasound. The performer of the ultrasound will be blinded to the results of the previously performed hysterosalpingogram.
P4.13.16 RELATIONSHIP BETWEEN PLASMA LEVELS OF INSULIN AND LEPTIN, AND SYMPATHETIC ACTIVITY IN WOMEN WITH POLYCYSTIC OVARY SYNDROME Elsv Velazauez, G. Arata de Bellabarba, V. Villarroel, Z. Molina. Universidad de Los Andes, ULA, Apartado 42, Merida 5101, Venezuela. Objectives: This study was planned to evaluate the relationship between insulin and leptin plasma levels with sympathetic activity in women with polycystic ovary syndrome (PCOS). Study Methods: d 19 non-obese women with PCOS were studied. Twelve healthy non-obese women served as controls. An oral glucose tolerance test (OGTIJ was performed and blood samples were taken before and at 30,60, and 120 min. after glucose load. Glucose, insulin, leptin, and .&4androstenedione were measured before the OGTT. Supine blood pressure and plasma norepinephrine (NE), and response to upright posture was performed. Results: Basal and post-glucose insulin levels and A4androstenedione were higher in PCOS patients. There were not significant differences in supine NE levels between groups but the response to upright posture was significantly (p< 0.05) higher only in obese women. In this group,
7