Identification of novel candidate genes associated with meiotic aneuploidy in human embryos by whole-exome sequencing.

PURPOSE: To identify novel genetic variants responsible for meiotic embryonic aneuploidy. METHODS: A prospective observational cohort study that included 29 couples who underwent trophectoderm biopsies from 127 embryos and performed whole-exome sequencing (WES) between November 2019 and March 2022. Patients were divided into two groups according to the expected embryo aneuploidy rate based on maternal age. RESULTS: After variant filtering in the WES analysis of 58 patients/donors, five heterozygous variants were identified in female partners from the study group that had an impact on embryo aneuploidy. Additionally, a slowdown in embryo development and a decrease in the number of blastocysts available for biopsy were observed in the study group embryos. CONCLUSION: This study has identified new candidate genes and variants not previously associated with meiotic embryo aneuploidy, but which are involved in important biological processes related to cell division and chromosome segregation. WES may be an efficient tool to identify patients with a higher-than-expected risk of embryo aneuploidy based on maternal age and allow for individualized genetic counselling prior to treatment.

Comprehensive mitochondrial DNA analysis and IVF outcome.

STUDY QUESTION: Do mitochondrial DNA (mtDNA) copy number and heteroplasmy in human embryos affect the ongoing pregnancy rate? SUMMARY ANSWER: Our study suggests that mtDNA copy number above a specific threshold is associated with the ongoing pregnancy rate. WHAT IS KNOWN ALREADY: Mitochondria play a vital role in cell function. Recently, there has been increasing research on mtDNA as a biomarker of embryo implantation. Although reports showed that high levels of mtDNA in the blastocyst are associated with low implantation potential, other publications were unable to confirm this. Confounding factors may influence the mtDNA copy number in euploid embryos. On the other hand it has been speculated that both mtDNA heteroplasmy and copy number contribute to mitochondrial function. Next generation sequencing (NGS) allows us to study in depth mtDNA heteroplasmy and copy number simultaneously. STUDY DESIGN SIZE DURATION: A prospective non-selection study was performed. We included 159 blastocyst biopsies from 142 couples who attended our clinic for preimplantation genetic testing for aneuploidies (PGT-A), from January 2017 to December 2017. All embryos were biopsied on Day 5 or Day 6. The aneuploid testing was performed by NGS. All blastocysts were diagnosed as euploid non-mosaic and were transferred. The mtDNA analysis was performed once the embryo diagnosis was known. PARTICIPANTS/MATERIALS SETTING METHODS: Sequencing reads mapping to the mtDNA genome were extracted from indexed bam files to identify copy number and heteroplasmy. The relative measure of mtDNA copy number was calculated by dividing the mtDNA reads by the nuclear DNA value to normalize for technical variants and the number of cells collected at the biopsy. All the results were subjected to a mathematical correction factor according to the embryo genome. Heteroplasmy was assigned by MitoSeek. MAIN RESULTS AND THE ROLE OF CHANCE: The mean average copy number and SD of mtDNA per genome was 0.0016 ± 0.0012. Regarding heteroplasmy, 40 embryos were heteroplasmy carriers (26.32%). MtDNA variants were detected in coding and non-coding regions and the highest number of variants in an embryo was eight. With respect to IVF outcome for mtDNA copy number analysis, we set a threshold of 0.003 for the following analysis. The vast majority of the embryos were below the threshold (142/159, 89.31%) and 17 embryos were classified as having higher mtDNA levels. We showed a reduction in ongoing pregnancy rate associated with elevated mtDNA copy number (42.96% versus 17.65%, P < 0.05). This result was independent of maternal age and day of the biopsy: these factors were included as confounding factors because mtDNA copy number was negatively correlated with female age (25 -30 y: 0.0017 ± 0.0011, 30 -35 y: 0.0012 ± 0.0007, 35 -40 y: 0.0016 ± 0.0009, over 40 y: 0.0024 + 0.0017, P < 0.05). Embryos biopsied on Day 5 were more likely to have higher quantities of mtDNA compared with those biopsied on Day 6 (0.0017 versus 0.0009, P < 0.001). According to IVF outcome and heteroplasmy, a lower ongoing pregnancy rate was reported for embryos that carried more than two variants. However, this did not reach statistical significance when we compared embryos with a number of variants lower or higher than two (39.15 versus 20.0, P = 0.188). Finally, a clear positive association between the mtDNA variants and copy number was reported when we compare embryos with or without heteroplasmy (0.0013 ± 0.0009 versus 0.0025 ± 0.0014, P < 0.001) and among different numbers of variants (0:0.0013 ± 0.0009, 1-2:0.0023 ± 0.0012, >2:0.0043 ± 0.0014, P < 0.05). LIMITATIONS REASONS FOR CAUTION: A limitation may be the size of the sample and the high-throughput sequencing technology that might not have detected heteroplasmy levels below 2% which requires high sequence depth A clinical randomized trial comparing the clinical outcome after the transfer of embryos selected according to mtDNA levels or only by morphological evaluation will be necessary. More research into the impact of mtDNA heteroplasmy and copy number on IVF outcome is needed. WIDER IMPLICATIONS OF THE FINDINGS: Our results demonstrate that embryos with elevated mtDNA copy number have a lower chance of producing an ongoing pregnancy. MtDNA copy number is higher in older women and is dependent upon the number of cell divisions that preceded biopsy. Moreover, our data suggest that mitochondrial activity could be a balance between functional capacity and relative mtDNA copy number. STUDY FUNDING/COMPETING INTERESTS: There are no conflicts of interest or sources of funding to declare. TRIAL REGISTRATION NUMBER: Not applicable.

Widespread divergence between incipient Anopheles gambiae species revealed by whole genome sequences.

The Afrotropical mosquito Anopheles gambiae sensu stricto, a major vector of malaria, is currently undergoing speciation into the M and S molecular forms. These forms have diverged in larval ecology and reproductive behavior through unknown genetic mechanisms, despite considerable levels of hybridization. Previous genome-wide scans using gene-based microarrays uncovered divergence between M and S that was largely confined to gene-poor pericentromeric regions, prompting a speciation-with-ongoing-gene-flow model that implicated only about 3% of the genome near centromeres in the speciation process. Here, based on the complete M and S genome sequences, we report widespread and heterogeneous genomic divergence inconsistent with appreciable levels of interform gene flow, suggesting a more advanced speciation process and greater challenges to identify genes critical to initiating that process.

Análisis retrospectivo de las complicaciones asociadas a los dispositivos implantables intravasculares / Retrospective analysis of complications associated with implantable intravascular devices

Objetivos: Presentar nuestra serie de pacientes a los que se ha implantado un reservorio subcutáneo permanente, el sistema elegido, la técnica y las complicaciones. Material y métodos: Entre el 1 de enero de 2005 y el 31 de diciembre de 2006, se colocaron 66 dispositivos. Los pacientes provenían desde los servicios de oncología médica y hematología. La colocación del reservorio se hizo en quirófano, bajo estrictas medidas de asepsia. Se canalizó la vena subclavia por vía infraclavicular, según la técnica de Seldinger. Una vez canalizada la vena, se realizó una incisión a unos 5 cm del punto de punción para permitir a un tunelizador guiar el catéter hasta el lugar donde se colocaría el reservorio de titanio. Posteriormente, se disecó el tejido celular subcutáneo en la zona infraclavicular hasta crear un lecho donde se deposita un pequeño depósito con una membrana de silicona que permite las inyecciones, perfusiones y extracciones sanguíneas. Se fijó el depósito y se cerraron las incisiones por planos anatómicos. Se diseñó un protocolo para la recogida de datos y seguimiento que incluía: datos de filiación, diagnóstico, indicación, tipo de catéter, vía de acceso venoso, profilaxis antibiótica, complicaciones tempranas y tardías, eventual retirada del catéter y motivo, y días de uso sin complicaciones. El seguimiento de los pacientes de realizó de forma retrospectiva hasta cierre del estudio (junio de 2007). El análisis estadístico se realizó con el programa SPSS 11.0. Resultados: La indicación fue la administración de quimioterapia; la patología predominante fue el carcinoma de mama. Los catéteres utilizados fueron del tipo Celsite ST201.La vía de acceso elegida mayoritariamente fue la vena subclavia derecha (60,6%). Aparecieron complicaciones tempranas (menos de un mes de la colocación) en 2 (3%) pacientes, consistentes en funcionamiento anómalo del catéter y un neumotórax, que se resolvió con medidas conservadoras (...) (AU)

Objectives: To present our series of patients with a permanent subcutaneous reservoir and describe the system chosen, the technique used, and complications. Material and methods: Between January 1, 2005 and December 31, 2006, 66 devices were placed in patients from the Medical Oncology and Hematology Services. There servoir was placed in the operating room, under strict aseptic conditions. The subclavian vein was canalized through the infraclavicular route, following Seldinger’s technique. After the vein was canalized, an incision was made approximately 5 cm from the puncture point to allow a tunneler to guide the catheter to the area where the titanium reservoir would be placed. Subsequently, the subcutaneous cellular tissue of the infraclavicular area was dissected to create a bed where a small deposit was placed with a silicone membrane to allow injections, perfusions and blood extraction. The deposit was fixed and the incisions were closed by anatomical planes. A protocol was designed for data collection and follow-up, which included the following: affiliation, diagnosis, indication, catheter type, route of venous access, antibiotic prophylaxis, early and late complications, eventual catheter withdrawal and reason, days of use without complications. Patient follow-up was performed retrospectively until the end of the study (June 2007). The statistical analysis was performed with the SPSS 11.0 statistical package. Results: The indication was chemotherapy administration and the main disease was breast carcinoma. The type of catheter used was Celsite ST201. The most frequently chosen route of access was the right subclavian vein (60.6%). Early complications (less than 1month after placement) occurred in two patients (3%) and consisted of catheter malfunction and pneumothorax, which were resolved with conservative measures. Late complications occurred in 12 patients (18.2%) (…) (AU)

Regression of papilloma high-grade lesions (CIN 2 and CIN 3) is stimulated by therapeutic vaccination with MVA E2 recombinant vaccine.

Human papillomavirus (HPV) is the etiologic agent for cervical cancer. In Mexico, a women dies every 2 h, and since 1990 the statistics have shown that the numbers of deaths are increasing. We conducted a phase II clinical trial to evaluate the potential use of the MVA E2 recombinant vaccinia virus in treating high-grade lesions (CIN 2 and CIN 3) associated with oncogenic papillomavirus. Fifty-four female patients with high degree lesions were treated either with an MVA E2 therapeutic vaccine or with conization. Thirty-four women received the therapeutic vaccine, at a total of 10(7) virus particles per dose injected directly into the uterus once every week over a 6-week period. Twenty control patients were treated with conization. By colposcopy, 19 patients out of 34 showed no lesion, in three patients the lesions were reduced by 85-90%, in eight other lesions had reduced by 60%, and in four more patients, they were reduced by 25%. Histological analysis showed total elimination of high-grade lesions in 20 out of 34 patients after treatment with MVA E2. Eleven patients had a 50% reduction in lesion size. In two other patients, the lesion was reduced to CIN 2 and in one more patient the lesion was reduced to low grade (CIN 1). All patients developed antibodies against the MVA E2 vaccine, and generated a specific cytotoxic response against papilloma-transformed cells. DNA viral load was significantly reduced in MVA E2-treated patients. Conization eliminated the lesions in 80% of the patients, but patients did not develop cytotoxic activity specific against cancer cells and did not eliminate the papillomavirus. In addition, three patients treated with conization had recurrence of lesions 1 year later. These results show that therapeutic vaccination with MVA E2 proved to be very effective in stimulating the immune system against papillomavirus, and in generating regression of high-grade lesion.

Anestesia y analgesia epidurales en un paciente con enfermedad de Wilson cerebral / Epidural anaesthesia and analgesia in a patient with cerebral manifestations of Wilson’s disease

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[Cesarean delivery and exeresis of a pheochromocytoma performed under epidural and general anesthesia]. / Cesárea y exéresis de un feocromocitoma bajo anestesia combinada epidural y general.

A 33-year-old pregnant woman with episodes of nocturnal tachycardia and anxiety diagnosed with extra-renal pheochromocytoma in her 28th month of gestation was admitted in her 38th week for an alpha-adrenergic block prior to elective cesarean section and tumor exeresis. The cesarean section was performed with the patient given an epidural lumbar block, and immediately after delivery of the fetus total intravenous anesthesia (with propofol, remifentanil, and rocuronium) was administered in addition to the continuous epidural analgesia used during tumor resection and postoperatively. No complications developed during surgery or recovery and the clinical courses were satisfactory for both mother and child. The use of propofol and remifentanil in combination with epidural anesthesia is not common in our clinical context. We point out that the multimodal technique affords good hemodynamic stability, guarantees satisfactory analgesia, and reduces the need for vasoactive drugs.

PFA, a novel mollusk agglutinin, is structurally related to the ribosome-inactivating protein superfamily.

The structural organization of PFA, a novel beta-galactose-specific agglutinin from the snail Pomacea flagellata, was partially characterized. Using mass spectrometry, the molecular weight of this glycoprotein was determined as 32,444 Da (7.4% carbohydrate). The agglutinin was found to form very large aggregates in solution, which were dissociated to monodisperse native-like dimers upon addition of polyethyleneglycol. The identity of the first 38 and the last 11 residues of the polypeptide chain was determined. It was found that PFA and the N-glycosidase subunit of ricin, a heterodimeric cytotoxin isolated from castor bean seeds, are homologous to each other in the N-terminal region. Furthermore, the far-UV circular dichroism spectra of these proteins were found to be nearly superimposable, evidencing that they share common general features in their secondary and tertiary structures. On the basis of these similarities, it can be concluded that PFA is structurally related to the ribosome-inactivating protein superfamily.

Stereochemical metrics of lectin-carbohydrate interactions: comparison with protein-protein interfaces.

A global census of stereochemical metrics including interface size, hydropathy, amino acid propensities, packing and hydrogen bonding was carried out on 32 x-ray-elucidated structures of lectin-carbohydrate complexes covering eight different lectin families. It is shown that the interactions at primary binding subsites are more efficient than at other subsites. Another salient behavior found for primary subsites was a marked negative correlation between the interface size and the polar surface content. It is noteworthy that this demographic rule is delineated by lectins with unrelated phylogenetic origin, indicating that independent interface architectures have evolved through common optimization paths. The structural properties of lectin-carbohydrate interfaces were compared with those characterizing a set of 32 protein homodimers. Overall, the analysis shows that the stereochemical bases of lectin-carbohydrate and protein-protein interfaces differ drastically from each other. In comparison with protein-protein complexes, lectin-carbohydrate interfaces have superior packing efficiency, better hydrogen bonding stereochemistry, and higher interaction cooperativity. A similar conclusion holds in the comparison with protein-protein heterocomplexes. We propose that the energetic consequence of this better interaction geometry is a larger decrease in free energy per unit of area buried, feature that enables lectins and carbohydrates to form stable complexes with relatively small interface areas. These observations lend support to the emerging notion that systems differing from each other in their stereochemical metrics may rely on different energetic bases.

[Causes for accepting or not accepting contraceptive methods in the immediate postabortion]. / Causas de aceptación y no aceptación de métodos anticonceptivos en el postaborto inmediato.

OBJECTIVE: To determine the causes that motivate acceptance or not-acceptance of contraceptiva methods in the immediate post abortion period. Material and methods. 191 questionnaires were applied to immediate post abortion patients, in the "Luis Castelazo Ayala" Gynecology and Obstetrics Hospital of the Instituto mexicano del Seguro Social. Patients were divided by two groups: acceptants (n = 75) and not-acceptants (n = 116). Both groups were compared with Student's t test and contrast of proportions. RESULTS: There were not significant differences in the general characteristics of both groups like age, age at menarche, beginning of sexual intercourse, age of marriage or free union, school grade, age at first pregnancy, number of pregnancies, gestational age of the last pregnancy that ended in abortion, previous use of contraceptiva methods and previous experience with them and whether or not they wanted a new pregnancy. The contraceptive method was offered to all patients in the acceptant group. Information was given to 45.33% of them and was considered satisfactory in 75.00%. In contrast, not-acceptants that received information were only 26.72% (p < 0.05) and all of them (100.00%) considered it inadequate (p < 0.05). In 20.68% of the women the method was not offered (p < 0.05). Medical contraindications were present in only 6.03%. The accepted methods were intrauterino device (64.00%), parentheral methods (16.00%), oral contraceptives (13.33%), surgical sterilization (5.33%) and condoms (1.33%). The contraceptive coverage of post abortion patients was 39.27% in this period. CONCLUSIONS: The use of contraceptive methods in post abortion patients can be increased if it is offered systematically to all patients who have had an abortion. Information given to patients must be understandable and sufficient to dissipate fears and ciarify doubts regarding the contraceptive method; contraceptive options must be offered according to the reproductive expectancies and using the informed consent to reinforce the acceptance of the chosen method.

Structural bases of lectin-carbohydrate affinities: comparison with protein-folding energetics.

We have made a comparative structure based analysis of the thermodynamics of lectin-carbohydrate (L-C) binding and protein folding. Examination of the total change in accessible surface area in those processes revealed a much larger decrease in free energy per unit of area buried in the case of L-C associations. According to our analysis, this larger stabilization of L-C interactions arises from a more favorable enthalpy of burying a unit of polar surface area, and from higher proportions of polar areas. Hydrogen bonds present at 14 L-C interfaces were identified, and their overall characteristics were compared to those reported before for hydrogen bonds in protein structures. Three major factors might explain why polar-polar interactions are stronger in L-C binding than in protein folding: (1) higher surface density of hydrogen bonds; (2) better hydrogen-bonding geometry; (3) larger proportion of hydrogen bonds involving charged groups. Theoretically, the binding entropy can be partitioned into three main contributions: entropy changes due to surface desolvation, entropy losses arising from freezing rotatable bonds, and entropic effects that result from restricting translation and overall rotation motions. These contributions were estimated from structural information and added up to give calculated binding entropies. Good correlation between experimental and calculated values was observed when solvation effects were treated according to a parametrization developed by other authors from protein folding studies. Finally, our structural parametrization gave calculated free energies that deviate from experimental values by 1.1 kcal/mol on the average; this amounts to an uncertainty of one order of magnitude in the binding constant.

Spectroscopic and thermodynamic evidence for a complex denaturation mechanism of bovine beta-lactoglobulin A.

We present a spectroscopic and calorimetric study on the thermal denaturation of bovine beta-lactoglobulin (beta-lg) variant A. Spectroscopic data allowed detection of a stable intermediate emerging from structural modifications restricted to local regions of the native molecule. It is suggested that this kind of intermediate could be a common property of lipocalins. Using the same set of parameters that has successfully related thermodynamics and structural properties of other proteins, it is shown that the thermally denatured state of beta-lg retains a significant amount of buried hydrophobic surface area. Thus, despite being a small protein composed of a single structural domain, beta-lg exhibits a complex unfolding mechanism, comprising at least two other species different from the native and completely unfolded states.

Effect of clomiphene citrate on ovulation after treatment withdrawal.

The effect of clomiphene citrate (CC) on ovarian function in cycles subsequent to treatment withdrawal was studied. Thirty two out of 45 patients with anovulation due to polycystic ovarian syndrome (PCOS) and with no other factor affecting fertility who got pregnant were included. All patients received CC to induce ovulation. Pregnancies in CC treated cycles and after treatment were recorded. Twenty pregnancies were achieved during CC treated cycles and 12 in the cycles after it was withdrawn. In the latter group, eight pregnancies were achieved in the cycle following CC therapy, and four in the second subsequent cycle. In relation to pregnancy complications no significant statistical differences were found between the group of patients who became pregnant during the stimulation cycles and in the cycles after CC.

[Nursing in the movies: its image during the Spanish Civil War]. / La enfermería en el cine. Imagen durante la Guerra Civil Española.

INTRODUCTION: The cinema had carried out a determining role in the development of stereotypes and in a wide gamut of models related to real life situations. The objective of this analysis is to determine the influence cinema had on the image of nurses during the Spanish Civil War from 1936-1939. These are the initial hypotheses: the role of Spanish nurses during the civil war was reflected by both sides in their respective movie productions; and the image of nurses shown in these films, on both sides, presents a conflicting role concept for women in society. METHODS AND MATERIALS: Following strategies developed by specialists in film analysis (Bondwell 1995, Uneso 1995, Carmona 1991) a total of 453 movie productions, 360 on the republican side and 93 on the national side, were reviewed. These films were listed in the Spanish National Films Library records. RESULTS: After analyzing the Spanish cinema productions during the Spanish Civil War, data relating to 453 films were identified. The genre included documents, news programs and fiction movies. 77 were produced in 1936, 235 in 1937, 102 in 1938 and 39 in 1939. A tremendous difference exists between the republican productions, 79% of the total, and the national productions. By genres, the types produced on the republican side were: in 1936, 53 documentals, 4 news programs and 9 fiction films; in 1937, 186 documentals, 5 news programs and 19 fiction films; in 1938, 72 documentals, 1 news programs and 2 fiction films; in 1939, 2 documentals and 2 fiction films. On the national side, their productions were: in 1936, 10 documentals and 1 fiction film; in 1937, 22 documentals, 2 news programs and 1 fiction film; in 1938, 19 documentals and 3 news programs; in 1939, 29 documentals and 6 fiction films. CONCLUSIONS: During the Spanish Civil War, movies produced by both sides made an effort to reflect their ideal woman as a stereotypical ideal nurse. This ideal nurse showed the values, ideas, aesthetics and prejudices each side held in the war.

New insights into the molecular basis of lectin-carbohydrate interactions: a calorimetric and structural study of the association of hevein to oligomers of N-acetylglucosamine.

Isothermal titration calorimetry was used to characterize thermodynamically the association of hevein, a lectin from the rubber tree latex, with the dimer and trimer of N-acetylglucosamine (GlcNAc). Considering the changes in polar and apolar accessible surface areas due to complex formation, we found that the experimental binding heat capacities can be reproduced adequately by means of parameters used in protein-unfolding studies. The same conclusion applies to the association of the lectin concanavalin A with methyl-alpha-mannopyranoside. When reduced by the polar area change, binding enthalpy values show a minimal dispersion around 100 degrees C. These findings resemble the convergence observed in protein-folding events; however, the average of reduced enthalpies for lectin-carbohydrate associations is largely higher than that for the folding of proteins. Analysis of hydrogen bonds present at lectin-carbohydrate interfaces revealed geometries closer to ideal values than those observed in protein structures. Thus, the formation of more energetic hydrogen bonds might well explain the high association enthalpies of lectin-carbohydrate systems. We also have calculated the energy associated with the desolvation of the contact zones in the binding molecules and from it the binding enthalpy in vacuum. This latter resulted 20% larger than the interaction energy derived from the use of potential energy functions.

[Correlation of histopathologic findings with ultrasonography variables of the endometrium according to body weight and adipose tissue distribution in postmenopause]. / Correlación de los hallozgos histopatológicos con las variables ultrasonográficas del endometrio conforme al peso corporal y distribucióndel tejido adiposo en la posmenopausia.

The purpose of this work was to correlate the histologic findings and ultrasonographic variables of the endometrium in relation to corporal weight and body fat distribution, in two groups of women: one with posmenopausal uterine bleeding and other under hormonal replacement therapy (HRT). Thirty one posmenopausal women were studied and divided into two groups: I. women with posmenopausal uterine bleeding (n = 19) and II women with HRT (conjugated estrogens and chlormadinone) (n = 12). In both groups transvaginal ultrasound was accomplished the same day previous to the endometrial biopsy (EB). The EB was taken in the group I the day they attended the hospital referring transvaginal bleeding and in group I a statistical significant correlation was found among the corporal weight and histologic findings and among the endometrial refringence and the histologic findings. In group II there was a statistical significant correlation among the body fat distribution and endometrial refringence and among the endometrial thickness and histologic findings. It can be concluded that in women with posmenopausal bleeding the corporal weight influences the histologic findings and the refringence is related with histologic findings, while those under HRT is more important the body fat distribution over endometrial refringence and the endometrial thickness is related with histologic findings.

The relation of the gonadotrophin response to chlormadinone according to body weight in patients with amenorrhea due to polycystic ovarian syndrome.

OBJECTIVE: To analyze the influence of weight on gonadotrophin response after chlormadinone (hydroxyprogesterone derivative) induced uterine bleeding in women with amenorrhea due to polycystic ovarian syndrome (PCOS). DESIGN: A comparative study. METHODS: Thirty-six patients with PCOS were classified according to body mass index into three weight groups, normal, overweight and obese. Luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels were measured during amenorrhea and between days 3-5 after a chlormadinone (2 mg/day for 5 days) induced uterine bleed. Statistical analysis was performed with Wilcox-on test for paired groups and Mann-Whitney U-test for independent groups. RESULTS: Overall LH, FSH levels and the LH/FSH ratio fell significantly (P < 0.001, P < 0.01 and P < 0.001, respectively) after chlormadinone administration. The LH levels decreased in all three weight groups, the LH/FSH ratio only fell in those normal and overweight subjects, and FSH did not change in any group. When comparing the group with normal weight and those with overweight and obesity no hormonal differences were found. CONCLUSION: These results show that chlormadinone has an inhibitory effect predominantly over LH secretion which reduces the LH/FSH ratio, but this is independent of body weight.

Prognosis for fertility analyzing different variables in men and women.

A cohort of 123 infertile couples was studied by life tables over a 30-month follow-up period to determine the influence on reproductive prognosis of clinical features, namely the women's age, previous gestational events, evolution time, and a number of conditioning infertility factors. The cumulative pregnancy rate (CPR) was 60% at 30 months. Women aged 32 years or less had a CPR of 65% and those over 32 years had a CPR of 31%. Couples with previous pregnancy had a CPR of 88%, while those with primary infertility had a CPR of 45% (marginal statistical difference). The group with infertility evolution of 36 months or less had a CPR of 75% and those with greater than 36 months infertility evolution had a CPR of 43% (p < .05). With one conditioning infertility factor a CPR of 75% was found, and with multiple factors a CPR of 47% (p < .05) was found. With these results a grading chart was created using all the analyzed criteria, determining the proportion of pregnancies per number of negative points obtained; at greater grades the proportion of pregnancy was reduced (p < .01). This report establishes the prognostic value of different variables observed in the evaluation of infertile men and women, and a simple procedure to calculate the probability to achieve pregnancy is proposed.

Estradiol and progesterone endometrial receptors and body fat distribution in obese women.

The content of endometrial receptors for estradiol (ER) and progesterone (PR) was determined in three groups (10 women each) classified with respect to body fat distribution: (1) normal, nonobese; (2) lower body segment obesity and (3) upper body segment obesity. The ER in group 3 were significantly (p < 0.05) higher than those of group 1. As regards PR, no statistical differences were found among the three groups. These findings demonstrate different endometrial ER concentrations in obese women according to body fat distribution, greater in upper segment obesity. Probably the lack of progesterone as well as other factors in the endocrine milieu of these patients may determine the differences found; therefore, future research on this matter should be carried out.