Download the Free Unbound MEDLINE PubMed App to your smartphone or tablet.
Available for iPhone, iPad, iPod touch, and Android.
Infertility female [keywords]
- Early referral makes the decision-making about fertility preservation easier: a pilot survey study of young female cancer survivors. [JOURNAL ARTICLE]
- Support Care Cancer 2014 Nov 26.
The purpose of the study was to investigate the association between patients' decision-making about fertility preservation (FP) and time between cancer diagnosis and FP consultation in young female cancer survivors.This is a pilot survey study of women aged 18-43 years seen for FP consultation between April 2009 and December 2010.Among 52 women who completed the survey, 15 (29 %) had their FP consultation more than 2 weeks after their cancer diagnosis (late referral group) and 37 (71 %) were within 2 weeks of their cancer diagnosis (early referral group). In univariate analysis, the only difference between the late referral and early referral groups was a higher decisional conflict scale (DCS) in late referral group (p = 0.04). In multivariable analysis, late referral group was more likely to have high DCS (>35) compared to early referral group (odds ratio 4.8, 95 % confidence interval 1.5, 21.6) after adjusting for age, center, and type of cancer.Early referral to a fertility specialist can help patients make better decision about FP. This is the first study to suggest that early referral is important in patients' decision-making process about FP treatment. Our finding supports the benefit of early referral in patients who are interested in FP which is consistent with prior studies about FP referral patterns.
- Utility of antioxidants during assisted reproductive techniques: an evidence based review. [JOURNAL ARTICLE]
- Reprod Biol Endocrinol 2014 Nov 24; 12(1):112.
Assisted reproduction technology (ART) is a common treatment of choice for many couples facing infertility issues, be it due to male or female factor, or idiopathic. Employment of ART techniques, however, come with its own challenges as the in vitro environment is not nearly as ideal as the in vivo environment, where reactive oxygen species (ROS) build-up leading to oxidative stress is kept in check by the endogenous antioxidants system. While physiological amounts of ROS are necessary for normal reproductive function in vivo, in vitro manipulation of gametes and embryos exposes these cells to excessive ROS production either by endogenous or exogenous environmental factors. In this review, we discuss the sources of ROS in an in vitro clinical setting and the influence of oxidative stress on gamete/embryo quality and the outcome of IVF/ICSI. Sources of ROS and different strategies of overcoming the excessive generation of ROS in vitro are also highlighted. Endogenously, the gametes and the developing embryo become sources of ROS. Multiple exogenous factors act as potential sources of ROS, including exposure to visible light, composition of culture media, pH and temperature, oxygen concentration, centrifugation during spermatozoa preparation, ART technique involving handling of gamete / embryo and cryopreservation technique (freeze/thawing process). Finally, the use of antioxidants as agents to minimize ROS generation in the in vitro environment and as oral therapy is highlighted. Both enzymatic and non-enzymatic antioxidants are discussed and the outcome of studies using these antioxidants as oral therapy in the male or female or its use in vitro in media is presented. While results of studies using certain antioxidant agents are promising, the current body of evidence as a whole suggests the need for further well-designed and larger scale randomized controlled studies, as well as research to minimize oxidative stress conditions in the clinical ART setting.
- Retrospective comparison of cabergoline and bromocriptine effects in hyperprolactinemia: a single center experience. [JOURNAL ARTICLE]
- J Endocrinol Invest 2014 Nov 25.
Patients with hyperprolactinemia who require medical therapy are typically treated with dopamine agonists (DAs). In most cases, DAs normalize prolactin levels, control symptoms, and substantially decrease tumor size. Here, we aimed to compare the efficacy of cabergoline (CAB) and bromocriptine (BRC) in patients with hyperprolactinemia at a single center.Retrospective analysis of the clinical records of 498 patients with hyperprolactinemia [mean age 33.3 ± 10.8 years (range 16-66), 450 women, and 48 men] who had received either CAB (n = 450) or BRC (n = 48) was performed.The mean age, gender distribution, and treatment duration were similar between the CAB and BRC groups (33.2 ± 11 vs. 34.1 ± 9.6 years, male/female 44/406 vs. 4/44, 18.7 ± 12.1 vs. 17.8 ± 6.0 months, respectively; p > 0.05 for all). Mean dosage was 1.5 ± 1.6 mg/week for CAB and 3.8 ± 2.7 mg/day for BRC. Baseline prolactin levels, frequency of galactorrhea, amenorrhea, oligomenorrhea, erectile dysfunction, infertility, and visual impairment were similar between the two groups, whereas the baseline tumor volume was higher in the CAB group. The prolactin normalization rate (87.4 vs. 41.4 %, p = 0.029) and tumor volume shrinkage (79.8 ± 39.1 vs. 54.1 ± 55.3 %, p = 0.015) were significantly higher in the CAB-treated patients than in the BRC-treated patients, while the tumor cure rates were similar. Symptom relief was higher in the CAB group than in the BRC group. More side effects were recorded in patients who took BRC (29.1 vs. 5.3 %, p < 0.001).Our data revealed that CAB was more effective than BRC in controlling symptoms associated with hormone excess, normalizing serum prolactin levels, and shrinking prolactinomas.
- Infertility evaluation via laparoscopy and hysteroscopy after conservative treatment for tubal pregnancy. [JOURNAL ARTICLE]
- Int J Clin Exp Med 2014; 7(10):3556-3561.
Evaluate the cause of infertility and impairment of tubal reproductive functions in infertility patients, who suffered tubal pregnancy after conservative treatment, using laparoscopy, hysteroscopic tubal catheterization, and hydrotubation.Seventy-five infertility patients treated for tubal pregnancies were divided into two groups based on past treatment methods of their tubal pregnancies, conservative-medical group and conservative-surgical group. The severity of pelvic adhesions, tubal morphology, tubal fimbria, and other infertility factors were observed via laparoscopy. Additionally, hysteroscopic tubal catheterization and hydrotubation was used to diagnose tubal patency and evaluate the intrauterine cavity.There were one or more factors associated with infertility in the 75 patients, among which abnormal tubal was an absolutely important factor. In conservative-medical group, 92.11% (35/38) of the patients were with bilateral or unilateral oviduct exceptions, such as adhesion around or distorted tubal, closure or adhesion in umbrella end, lumen block. In conservative-surgical group, all of the patients were with bilateral or unilateral fallopian tube lesions. As two fallopian tubes per patient, 80.26% (61/76) of the tubes in conservative-medical group was damaged, 95.95% (71/74) in conservative-surgical group. The differences between the two groups was significant (P < 0.05). However, differences between these two groups in morphology of damaged tubes, anomaly of umbrella end and occlusion of lumen were not significant (P > 0.05). Incidence of pelvic adhesions in conservative-medical group was 76.32% (29/38), which was lower than 100% (37/37) of conservative-surgical group. The difference was significant (P < 0.05), which suggested that conservative-medical treatment was more effective than surgical treatment in preventing pelvic adhesion.Factors associated with tubal infertility affect patients who accepted conservative treatment for tubal pregnancy. In patients with a history of a tubal pregnancy, it may be less likely to compromise future reproductive function for conservative-medical treated patients than that for conservative-surgery treated patients.
- Masturbation Frequency and Sexual Function Domains Are Associated With Serum Reproductive Hormone Levels Across the Menopausal Transition. [JOURNAL ARTICLE]
- J Clin Endocrinol Metab 2014 Nov 20.:jc20141725.
Objective: To determine whether reproductive hormones are related to sexual function during the menopausal transition. Design: The Study of Women's Health Across the Nation (SWAN) is a multiethnic cohort study of the menopausal transition located at seven US sites. At baseline, the 3302 community-based participants, aged 42-52, had an intact uterus and at least one ovary and were not using exogenous hormones. Participants self-identified as White, Black, Hispanic, Chinese, or Japanese. At baseline and at each of the 10 follow-up visits, sexual function was assessed by self-administered questionnaires, and blood was drawn to assay serum levels of T, estradiol, FSH, SHBG, and dehydroepiandrosterone sulfate. Main Outcome Measures: Self-reported frequency of masturbation, sexual desire, sexual arousal, orgasm, and pain during intercourse. Results: Masturbation, sexual desire, and arousal were positively associated with T. Masturbation, arousal, and orgasm were negatively associated with FSH. Associations were modest. Estradiol was not related to any measured sexual function domain. Pain with intercourse was not associated with any hormone. Conclusions: Reproductive hormones were associated with sexual function in midlife women. T was positively associated, supporting the role of androgens in female sexual function. FSH was negatively associated, supporting the role of menopausal status in female sexual function. The modest associations in this large study suggest that the relationships are subtle and may be of limited clinical significance.
- [Birth rate and fertility: knowledge and expectations analysis of 3585 university students]. [English Abstract, Journal Article]
- Acta Med Port 2014 Sep-Oct; 27(5):601-8.
Nowadays, Portuguese birth rate is insufficient to ensure renewal of generations. Women high education levels and labor market integration and increased economic difficulties are some of multiple factors leading to a delay in average parenting age and an increase of infertility; also subject to others such as obesity, smoking and alcohol consumption.Transversal epidemiological study, analytical, uncontrolled, from self-filled online questionnaires, promoted by students' university unions. A sample of 3585 university students was considered and a global and by gender statistic analysis was done through SPSS, Excel was used to build graphics and tables and ArcMap to represent maps.Mainly students from the Health Sciences (40.6%), Universidade de Lisboa (59.4%), female (76.9%), median age of 22; intention to marry/ union 71.0%, parenthood 85.7%. A total of 18.4% smoke, 22.3% consume alcohol and obesity 15.4%; employment (47.4%) and the partner's will (39.9%) were important determinants for parenthood decision as well as having financial stability to provide a good education (33.6%) and healthcare (38.6%); A total of 53.6% have considered the hypothesis of infertility and highlight above 35 year old maternal age (18.7%), obesity (18%) and female smoking (19.0) as factors. Higher and more significant values for smoking (p = 0.001) and alcohol consumption (p = 0.000) in males were found.The sample seems representative, well distributed among different areas of study, with more female respondents than the university portuguese ratio. There are more students with parenting projects than marriage/cohabitation, in accordance with Portuguese data. Nevertheless, the same students identify the family as a priority in comparison with employment and career. Parenting decisions are tied by social-economic situation but an important factor is the low fertility due to the maternal age delay of the first pregnancy.University student unions are an excellent instrument to access them; a high number of respondents consider having children but delay the decision; there is a lack of information about the consequences of delaying parenting age and about infertility factors. The negative trend of fertility must be seen as a necessity to develop specific policies.
- Evaluation of embryo quality after concurrent use of ovarian stimulating hormones and gamma irradiation. [JOURNAL ARTICLE]
- Iran J Reprod Med 2014 Aug; 12(8):573-580.
Background: Radiotherapy has many side effects on fertilization in young women. Radiation can lead to ovarian failure in women who underwent abdomen or pelvic radiotherapy. Objective: This study helps us to investigate ovarian response of NMRI female mice to ovarian stimulating hormones (PMSG, HCG) after whole-body gamma irradiation. Materials and Methods: 45 pregnant mice were divided into two groups of control and experimental. The experimental group was classified into three sub-groups: Irradiation group (2 or 4Gy),Superovulation group (10 or 15IU),and superovulation and gamma-radiation group (2Gy & 10IU, 2Gy & 15IU, 4Gy & 10IU,4Gy & 15IU). Female mice were killed and embryos were removed from oviduct .The number of embryos cells counted and the quality of them was evaluated in each group. Kruskal-Wallis test and Mann-Whitney test were used to analyze the data. Results: There was a significant difference in the number of 2-4 cells grade D embryos in 2Gy & 15IU group compared with control and 2Gy groups (p=0.01), and the number of embryos in 4Gy group was more than in 10IU and 15IU (p=0.03) and 2Gy & 15IU groups (p=0.01). It was more significantly embryos in 4Gy & 15IU group compared to 2Gy & 15IU group (p=0.01).In addition There were no significant differences in the number of 2-4 cells grades A, B and C embryos and also number of 4-8 cells grades A, B and C, D embryos in groups. Conclusion: The concurrent use of ovulation stimulating hormones and gamma rays ameliorates this problem of drastic decrease in number of living embryos due to whole-body irradiation.
- A population-based study on infertility and its influencing factors in four selected provinces in Iran (2008-2010). [JOURNAL ARTICLE]
- Iran J Reprod Med 2014 Aug; 12(8):561-566.
Background: Infertility has a varied impact on multiple dimensions of health and functioning of women. Objective: We aimed to identify the burden of infertility and its influencing factors based on a population based study conducted in four provinces of Iran. Materials and Methods: A sample of 1126 women, aged 18-45 years, was selected using the multi stage, stratified probability sampling procedure; those met the eligibility criteria were invited for further comprehensive interview. This study used the definition of infertility proposed by World Health Organization "the woman has never conceived despite cohabitation and exposure to pregnancy for a period of 1 year". Results : The overall prevalence of lifetime infertility and current primary infertility were 21.1% (95% CI: 18.4- 23.8) and 6.4% (95% CI: 4.8-8) respectively. The probability of first pregnancy at the end of 2 years of marriage was 94% for all ever-married women. Infertility were observed as significantly higher among women age 31-35 (OR: 4.6; 95% CI: 1.9-11.5; p=0.001) and women with more than 9 years of education (OR: 2.8; 95% CI: 1.5-3.3; p<0.0001). Conclusion: The necessities of modern living have compelled many women to postpone childbearing to their late reproductive years; however they must be informed of being at risk of infertility with ageing.
- Comparison of two dimensional and live three dimensional ultrasounds for the diagnosis of septated uterus. [JOURNAL ARTICLE]
- Iran J Reprod Med 2014 Aug; 12(8):547-554.
Background: Traditionally, septate uterus was diagnosed with invasive method like hysterosalpingography and hysteroscopy. Nowadays transvaginal ultrasonography was reported to be a sensitive tool for detection of septate uterus too. Objective: The objective of the present study was to evaluate the application of two dimensional ultrasound (2-DUS) and real time three dimensional ultrasound (3-DUS) in differentiating various type of septated uterus. Hysteroscopy confirmation was assigned as the gold standard. Materials and Methods: This retrospective study was performed among 215 infertile women with suspected septate uterus from October 2008 to July 2012. An inclusion criterion was septated uterus based on HSG or experiencing abortion, preterm labor, or recurrent IVF failure. Fusion anomalies were excluded from the study (unicornuate, bicornuate and didelphys anomalies). The results of 3D and 2D sonographies were compared, while they were confirmed by hysteroscopy result in detection of septated uterus. Kappa index for agreement between 2DUS and hysteroscopy, as well as 3-DUS and hysteroscopy in detection of septate uterus was carried out. By receiver operating characteristic (ROC) curve, cut off points for predicting the kind of anomalies were proposed. Results: The women were evaluated by 2-DUS (n=89) and (II) 3-DUS (n=126). All women underwent hysteroscopy, following 2-DUS and 3-DUS at the same or subsequent cycle. The results of kappa (K) index were 0.575 and 0.291 for 3-DUS and hysteroscopy, as well as 2-DUS and hysteroscopy, respectively. Also, the cutoff points were 27% for arcuate and subseptate, and 35% for differentiating septate and subseptate. Conclusion: Real time 3-DUS has better ability for visualization both uterine cavity and the fundal uterine, so it has higher agreement in detection of septate uterus than 2-DUS.
- Sexual dysfunction in patients with polycystic ovary syndrome and its affected domains. [JOURNAL ARTICLE]
- Iran J Reprod Med 2014 Aug; 12(8):539-546.
Background: Polycystic Ovary Syndrome (PCOS) is presented with characteristic complications such as chronic an ovulation, obesity, and hyperandrogenism which can affect sexual function in women of reproductive age. Objective: Herein we evaluated the frequency and predisposing factors of sexual dysfunction in infertile PCOS patients. Materials and Methods: In this cross-sectional study, 130 married women with a definite diagnosis of PCOS who were referred due to infertility were recruited. They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index (FSFI) questionnaire. Results: The frequency of sexual dysfunction was verified 57.7% in PCOS patients with the domains of desire and arousal being commonly affected in 99.2% and 98.5%of cases respectively. BMI had a significant effect on sexual desire and arousal (p=0.02) while the effect of hirsutism was significant on all domains (p<0.001 for total FSFI score) except for dyspareunia. Conclusion: PCOS patients markedly suffer from sexual dysfunction as comorbidity. It seems appropriate to screen all PCOS patients for sexual function with a simple short questionnaire such as FSFI. Targeted interventions could be considered to help improve their quality of life along with other treatments.