phagocytic activity of neutrophils and the oral hormonal contraceptives

The phagocytic activity of neutrophils from OCs users was assayed by the method of Leight et al. [1977] using the yeast "Candida albicans". Significant diminution of the phagocytic activity was observed when the assay was performed with the neutrophils in its own serum. However, when the assay was performed with the neutrophils suspended in pooled serum, no significant difference was observed in comparison to the controls. It is concluded that sera from OCs suers may contain factor[s] that depress the phagocytic activity of neutrophils. The possible responsible factor[s] and the significarce of such diminished phagocytic activity were discussed

Effect of oral hormonal contraceptives and intrauterine devices on peripheral lymphocytes subpopulation

Subpopulations of peripheral lymphocytes were studied in 40 women taking oral hormonal contraceptives [OC's], in 50 women using intrauterine contraceptive devices [IUD's] and in 20 age matched control group of women who had never taken oral hormonal contraceptive pills not used intrauterine devices. The group taking oral hormonal contraceptive demonstrated significant depression of their T lymphocyte count when compared to the control group. While, the group using IUS's showed significant rise of their T lymphocytes count. On the other hand no significant quantitative difference in subpopulation of the peripheral lymphocytes "B cells" with IgG, IgA and IgM markers was observed between the three studied groups. These findings suggest that the use of oral hormonal contraceptives induces a state of immunological abnormality, affecting mainly the cellular limb of the immune system. While in IUD's users the increase in the T lymphocytes suggest that the ID's mode of action might partly be immunologically mediated

Effect of medrogestone on endometrial histology and histochemistry in patients with luteal phase defects

Fifty infertile patients with luteal phase defects were the subject of this study. Progestrone in oil, [12.5 and 25 mg] and medrogestone, [5 and 10 mg] were administered daily, starting 3 days after the probable day of ovulation for 2 consecutive cycles. Endometrial biopsies were subjected to histlogical and histochemical examinations. Secretory endometrial patterns that were in phase were observed in all cases after progestrone therapy. Also, the same patterns were observed in 90% and 70% of case after Medrogestone in 5 mg and 10 mg dosage respectively. Undatable endometrial patterns with early glandular exhaustion and sometimes pseudodecidual reaction were observed with medrogestone therapy. These were detected in 10% and 30% of cases with the 5 mg and 10 mg dosage respectively. Also weak activity of the glandular succinic dehydrogenase was observed on histochemical examination of the undatable endometrial patterns. No Histologic or histochemical differences were noted, when both drugs produce secretory endometrium that was in-phase or 1 day out of phase of the cycle day. It is concluded that oral medrogestone is liable to produce early glandular exhaustion when given to patients with inadequte luteal phase. Such asynchronous maturation may interfer with blastocyst nidation. It can also be concluded that progestrone therapy, albeit inconvinent when administered intramuscularly, is the drug of choice in the treatment of luteal phase defects

Further laparoscopic evaluation of the pelvic organs in bilharzial patients

The laparoscopic findings in 205 bilharzial infertile patients were compared to those of 203 infertile patients free from bilharziasis. The incidence of Bilharziasis of the upper genital tract [except that of the endometrium] is not such low as previously reported. Bilharzial nodules were visualized on the surface of the corpus uteri. Fallopian tubes, broad ligaments and pelvic peritoneum. Periuterine adhesions were significantly increased in the bilharzial group. Peritubal adhesions, fimbrial phimosis and tubal occlusion were not significantly different in the bilharzial and non-bilharzial cases. Periovarian adhesions and ovarian elargment were significantly increased in the bilharzial group. During laparoscopy, the presence of nodules on the suface of the pelvic organs with patent Fallopian tubes in patients with urinary and /or intestinal bilharziasis is fairly diagonstic of bilharzial infestation of the upper genital organs

Histopathological and histochemical observations on the endometrium in bilharzial patients

The endometrium of 40 patients with genital and/or extragenital bilharziasis and that obtained from 40 healthy women of comparable age and parity were examined histologically and histochemically for glycogen and enzymes. Bilharzial patients showed no bilharzial endometrial affection. However, in 7.5% of these subjects, there was persistent anovulation while all healthy women were ovulating. Luteal phase defects, evaluated by his-tological dating of endometrial biopsies, were present in 12.5% of bilharzial patients compared with 5% incidence in healthy women. Histochemical alterations in glycogen and the enzymes [succinic dehydrogenase, non-specific esterase, alkaline phosphatase and acid phosphatase] were observed in these women with corpus luteum insufficiency. It is believed that the increased incidence of anovulation and of corpus luteum insufficiency, with endometrial histochemical alterations, are partly resposible for the higher incidence of female infertility among the bilharzial population, reported by some authors; and observed in the present investigation

Long term effects of oral hormonal contraceptives on the urinary tract

One Hundred healthy women in the childbearing period and a similar number of pill users for more than three years were investigated. Significant bacteriuria was demonstrated in 36% of pill users compared with 16% in healthy controls. Dilatation of the lower ureter was encountered in 24% of pill users and in 8% of controls. Grade I vesicoureteric reflux was demonstrated in 15 women on oral hormonal contraceptives compared with 4% in controls. Hypotonicity of the urinary tract musculature, as well as other factors, are believed to be responsible for these changes. Periodic urologic investigations are suggested for these who use pills for prolonged time. Structural changes demonstrated in the urinary tract during normal pregnancy have been attributed at least in part to the presence of placental steroid hormones [Youssef, 1956 : Fainstat, 1963]. The effects of oral hormonal contraceptives on the upper urinary tract had been studied with contradictory results. Marshall et al., [1966] observed dilatation of the ureters and renal pelvis in women using oral hormonal con-pills were discontinued. However felding [1966] who followed a small group of women taking Anovlar I for 3-9 months, found no radiologic evidence of ureteral dilatation. Descending urograms were normal in 10 patients on oestrogen-progestagen combination studied by Marchant [1972]. Couriere et al., [1970] observed no urologic changes in women after year of pill use. Recently, Youssef et al., [1975] demonstrated bladder hypotonia and increased capacity durign the use of oral hormonal contraceptive which was more manifest during the second year. Aaso, Zahran et al., [1976] observed bladder trabeculations in pill users. However, the susceptibility of the urinary system to infection after servical years of pill use is not clear. In most of the reports, the duration of pill use was in the range of 1-3 years [Courriere et al., 1970 and Zahran et al., 1976]. This stimulated us to study women on oral hormonal contraceptives for more than three years