Transvaginal salpingo-sonography (TSSG) in the evaluation of tubal patency.

Transvaginal sonography was used in 78 patients to evaluate tubal patency as a control in infertility workup. The cervix was fitted with a Semm cervix-adapter (Wisap); air and saline were injected through it. Careful scanning of the uterine angles and of the tubes permitted to demonstrate bilateral passage of the contrast medium in 52 of the 55 patients and monolateral passage in 3. 21 patients had also other conventional evaluations of tubal patency. Two patients were excluded from protocol. Total agreement with hysterosalpingography (HSG) was found in 69.2% of the cases, partial agreement in 23%. Total agreement with laparoscopy (LPS) was found in 83.3% of the cases. In conclusion transvaginal sonosalpingography (TSSG) can be used as a first ambulatorial evaluation of tubal patency in infertility work-up.

[Significance and problems of psychological consultation for infertility. Personal experience]. / Significato e problemi della consulenza psicologica per infecondità. Una esperienza.

A sample group of 200 couples attending the Centre for the Diagnosis and Treatment of Sterility in the Couple were studied. All patients had one or more conversations with a psychologist in order to analyze the real desire for pregnancy and to encourage a better relationship between the medical team and the patients. The study throws light on many conflictual situations relating to both the individual's and the couple's desire to achieve pregnancy with the help of science. Nevertheless, it was not possible to utilise all the information gathered by the psychologist from the conversations to improve the relationship between the medical team and the patients.

[Ultrasonic evaluation of spontaneous and drug-induced cycles in a sterile population]. / Valutazione ultrasonografica in cicli spontanei ed indotti farmacologicamente in una popolazione sterile.

The scope of this study was to correlate the size and number of growing follicles contemporeaneously in 106 spontaneous cycles and in 126 cycles induced by the administration of clomiphene, gonadotropins and LH-RH microinfusers, in a total of 149 sterile patients with a mean age of 30.2 years. The results have shown that maximum follicular diameter is significantly larger in drug-induced cycles in comparison to spontaneous cycles (p less than 0.05). Nonetheless, ultrasound examination alone is not sufficient to establish follicular development and the time for administering HCG in order to diminish the percentage of hyperstimulation syndromes. Additional biochemical and biological (E2) tests should therefore be performed, as well as a careful study of the endometrial response to induction therapy.

[Correlation of positivity for serum anti-chlamydia antibodies and tubal damage as a cause of infertility. Preliminary study]. / Correlazioni tra positività per anticorpi anti-chlamydia sierici e fattore tubarico come causa di infertilità. Studio preliminare.

Chlamydia Trachomatis is one of the most frequently bound aetiological agents in acute salpingitis. Chlamydia infection often runs asymptomatically or with slight symptomatology, so patients do not call in their doctor. This hypothesis is backed by the observation that serum antibody positivity for Chlamydia and tubal infertility are often found together. The purpose of the present study was to determine the positivity of serum antibodies for Chlamydia in infertile women observed at this Centre and compare it with a control group of non-sterile patients. Further, in those patients in whom antibody positivity exists, it was also proposed to seek tubal lesions at hysterosalpingography or coelioscopy. The antibody titre in infertile women is compared with that of the control group. The study was carried out in 30 sterile women and in 30 patients in the definitely fertile control group. The "Ipazyme" (Sorin) immunoperoxidase test was used to seek IgG and IgA anti-Chlamydia antibodies. The geometric mean of the antibody titre was calculated in those women with a titre equal to or greater than 64 for IgG antibodies and equal to or greater than 16 for IgA antibodies. It is now intended to study whether the titre is higher in infertile women compared to the control group and if positivity is more significant in these patients.