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

Effect of endotoxin on ovulation, implantation and early foetal development in rabbits

Salmonella entritidis endotoxin given in a dose of 1 ml/kg [= 20 ug/kg] intravenously to female rabbits five hours after chotionic gonadotropin administration caused significant reduction in the number of ruptured follicles. The simultaneous administration of the same dose of endotoxin with 2 mg/kg indomethacin intra-muscularly did not reverse the effect of endotoxin on ovulatory process. To study the effect of endotoxin on implantation and early foetal development, it was given in a dose of 0.25 ml/kg [= 5 ug/kg] intravenously on day 4 of gestation and this resulted in failure of implantation. On combining endotoxin and indomethacin, the effect of endotoxin on implantation was not reversed. Endotoxin administration on day 8 of gestation produced a lethal effect on most of foetuses and regression of associated placentae. When indomethacin was combined with andotoxin on day 8 of gestation, the immediate lethal action was inhibited as evidenced by presence of most implantations at the time of autopsy on day 14. Nevertheless, most foetuses died after indomethacin treatment. Administration of indomethacin alone on day 4 of pregnancy did not reduce the total number of foetuses, but foetuses and placental tissues were smaller than controls. However indomethacin given on day 8 of pregnancy resulted in a large number of post implantation mortalities. The results are discussed and it was recommended that: First: Women desirous of becoming pregnant or pregnant women early in their gestation should be advised not to use the analgesic agent indomethacin particularly prior to ovulation and during the luteal phase of the menstrual cycle. Second: If a lady is suffering from a disease caused by an endotoxin producing organism she must use a contraception to prevent her from becoming pregnant and if she is already pregnant, gestation must be terminated

Effect of chronic maternal exposure to low carbon monoxide concentrations on the foetus

The effect of maternal exposure to low carbon monoxide concentrations, throughout gestation, was studied in 21 pregnant Buscat rabbits and was compared with seven pregnant controls. Exposure of pregnant rabbits to 100 p.p.m. CO [parts per million by volume] in atmospheric air resulted in a mean maternal carboxyhaemoglobin level of 10.6% and a mean foetal level of 15.4% compared to control values of 1.1 and 1.3% maternal and foetal carboxyhaemoglobin in non-exposed animals. A significant increase in resorption sites and intrauterine foetal deaths and a significant reduction in the litter size and in foetal birth weght was demostrated in carbon monoxide-exposed animals when compared with controls. Neuropathological changes were observed in the foetal brain in 7% of co-exposed foetuses

"Effect of organophosphorus insecticides on pregnant rabbits"

The effect of chronic maternal exposure to the organophosphorus insecticide [Tamaron, Bayer], throughout gestation, was studied in 20 pregnant Buscat rabbits and was compared with 10 pregnant controls. A significant reduction in the litter size and in the foetal birth weight was observed in Tamaron-exposed animals. In pregnant rabbits exposed to the insecticide, 10% of the mothers and 9% of their foetuses showed pathologic changes in the liver in the form of zonal necrosis, associated fatty changes and lymphocytic infiltration

Histopathologic studies of the decidua in induced and spontaneous abortion

Histologic and histopathologic studies of the decidua early in gestation were carried out in 20 cases of induced abortion and 140 cases of spontaneous abortion. Decidual necrosis and vascular changes were demonstrated in cases of spontaneous abortion. The results observed were discussed. It is generally believed that the decidual necrosis observed in cases of spontaneous abortion was secondary to ischaemia resulting from obliterative changes in the decidual blood vessels. These vascular changes are believed to be the result of an antigen antibody reaction and this gives support to the immunological theory of spontaneous abortion. On the other hand, decidual necrosis will interfere with early histotrophic embryonal nutrition

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

Tubal ligation by minilaparotomy: a technique that fasciltates the tubal approach

Female interval sterilisation using a tiny suprapubic incision [minilparotomy], was performed on 185 acceptors. Jayle's vaginal retractor was used to retract the suprapubic wound adges. This facilitated exposure of the tubes even in obese women. We met. with 3.42% overall morbidity in the form of mild infection. The method is simple, rapid, inexpensive and acceptable method for permanent contraception. The operation can be performed by gynaecologists and general surgeons with moderate experiance with minimal complications. It can be advocated as a means of demographic control particularly in developing countries