ABSTRACT
Background: Endometriosis affects at least 15 percent of infertile women. The diagnosis is made by direct visualization of implants either at laparoscopy or laparotomy. Elevation of plasma CA-125 levels has been associated with the presence of endometriosis. Aim: To search for a correlation between CA-125 and the presence of endometriosis and its severity, among infertile patients requesting a diagnostic laparoscopy. Patients and methods: A total of 117 women were prospectively enrolled in the study between May 2000 and March 2002. A serum sample for CA-125 was taken immediately before surgery and the value obtained was correlated with the presence or absence of endometriosis and the severity of the disease. Results: Sixty nine patients had endometriosis (59 percent ). Patients with severe endometriosis, or grade IV, showed statistically significant higher levels of CA-125 compared to women without endometriosis or with grades I, II or III of the disease. Discussion: The overall sensibility of CA-125 in detecting patients with endometriosis was low, however, it worked better for patients with advanced disease. Considering the rather low cost and simplicity of the test, we believe that it should be included in the evaluation of infertile couples
Subject(s)
Humans , Adult , Female , Endometriosis , Biomarkers, Tumor , Prospective Studies , Laparoscopy , Infertility, Female , Severity of Illness IndexABSTRACT
El objetivo de este estudio retrospectivo fue evaluar la tasa de embarazos espontáneo después de la repación quirúrgica laparoscópica en 53 pacientes con infertilidad hidrosálpinx. Las cirugías se realizaron entre Mayo de 1994 y Octubre de 1998. Durante la cirugía se clasificó el daño tubario como leve, moderado y severo. Se incluyeron pacientes con al menos una trompa permeable post cirugía, sin fertilización in vitro posterior y con al menos un año de seguimiento. La tasa global de embarazos fue de 33,9 por ciento (18/53), 17 intrauterinos (94,4 por ciento) y sólo un embarazo ectópico (5.6 por ciento). Doce embarazos llegaron a término (22,6 por ciento), presentándose abortos espontáneos 5/18. La tasa de embarazo fue significativamente menor en el grupo de mayor daño tubario. El tiempo promedio hasta el embarazo fue de 5,6 meses. La salpingoneostomía laparoscópica es una alternativa válida para pacientes con infertilidad por hidrosálpinx. Sin embargo, de no obtenerse embarazo en los 18 meses posteriores a la cirugía, debe considerarse otra alternativa terapéutica
Subject(s)
Humans , Adult , Female , Infertility, Female , Salpingitis , Salpingostomy , Laparoscopy , Pregnancy Rate , Prognosis , Retrospective Studies , SalpingitisABSTRACT
Se realiza un estudio para analizar la frecuencia de patología endometrial en mujeres posmenopáusicas sanas con sangrado uterino anormal bajo terapia de remplazo hormonal (TRH). Se estudiaron 104 mujeres posmenopáusicas que presentaron sangrado uterino anormal (irregular o excesivo) durante THR con estrógenos y progesterona en diferentes esquemas (57 por ciento secuencial continuo; 31 por ciento combinado continuo; 12 por ciento secuencial discontinuo). A todas las pacientes se les realizó una biopsia ambulatoria aspirativa de endometrio. El procedimiento fue bien tolerado y no se observaron complicaciones hemorrágicas o infecciosas. Los resultados histológicos fueron los siguientes: endometrio secretor 38.5 por ciento; endometrio proliferativo 25 por ciento; endometrio atrófico 11.5 por ciento; hierplasia endometrial sin atipias 4.8 por ciento; pólipo endometrial benigno 2.9 por ciento; tejido endometrial benigno, inactivo o fragmentos de epitelio 11.5 por ciento; adenocarcinoma de endometrio 1 por ciento y ausencia de tejido endometrial 4.8 por ciento. La biopsia aspirativa de endometrio permitió conocer la situación endometrial en alrededor del 95 por ciento de las pacientes. Muestra insuficiente para diagnóstico se obtuvo en un 5 por ciento de los casos siguriendo atrofía endometrial o patología focal no diagnosticada por el método. La ausencia de lesiones premalignas y la baja incidencia de patología maligna de endometrio en nuestro estudio confirman su baja incidencia en mujeres que reciben esquemas adecuados de terapia de remplazo hormonal
Subject(s)
Humans , Female , Middle Aged , Endometrial Hyperplasia , Endometrial Neoplasms , Estrogen Replacement Therapy/adverse effects , Uterine Hemorrhage , Biopsy , Endometrial Hyperplasia , Endometrial Neoplasms , Endometrium , Postmenopause , Uterine HemorrhageSubject(s)
Humans , Male , Gonadal Steroid Hormones/pharmacology , Hypothalamo-Hypophyseal System/physiology , Testis/physiology , Androgens/deficiency , Penile Erection/physiology , Erectile Dysfunction/drug therapy , Erectile Dysfunction/etiology , Gynecomastia/chemically induced , Gynecomastia/etiology , Hypogonadism/drug therapy , Hypogonadism/etiology , Infertility, Male/etiology , Infertility, Male/therapy , Testosterone/pharmacologyABSTRACT
Background: Estradiol (E2) has a potent antioxidant effect on low density lipoproteins (LDL) in vitro and in vivo, which could be important in explaining the cardioprotective effect of hormone replacement therapy (HRT) in post menopausal women. Estriol (E3), on the other hand, is a weak estrogen with low metabolic effects on different tissues, and at present no cardioprotective effect has been attributed to this steroid. Aim: To study the antioxidant effect of E3 on LDL and to compare it with the potent antioxidant action exhibited by E2. Subjects and methods: After LDL was isolated by ultra centrifugation from plasma of 12 healthy untreated post menopausal women, it was divided into aliquots containing 0.5 mg of LDL protein. Estriol and E2 in doses of 0, 1, 5, 15 and 50 µM were incubated with different aliquots of LDL. CuSO4 15 µM was added to each aliquot to induce an oxidative stress. The aliquots were then incubated during 4 hours at 37 C. Malonaldehyde (MDA) was measured as a marker of LDL oxidation, and expressed as nM/mg protein. Results (mean ñ SD): Estriol induced a dose-dependent decrease in MDA concentration (baseline 62.8 ñ 21.7; 1 µM: 61.5 ñ 23.0; 5 µM: 52.9 ñ 20,3; 15 µM 43.5 ñ 20.1 and 50 µM: 31.0 ñ 17.6 nM/mg protein; F= 92.4; p< 0.0001), reaching a mean decrease of 50.7 percent at the highest dose tested. Estradiol has a similar dose-dependent decrease in MDA concentration (F= 60.2; p< 0.0001), revealing a more potent effect than E3 (p< 0.05), with a mean decrease of 67.4 percent at the highest dose tested. Conclusions: Our results demonstrate that estriol shows an important antioxidant action of LDL in vitro, although its effect is less potent than estradiol. These results raise the possibility that estriol could have a cardioprotective effect in post menopausal women, possibility that has not been yet demonstrated