Effect of prostaglandin alone and in combination with trace minerals on the follicular and luteal dynamics, estrus response and pregnancy in sub-estrus buffaloes (Bubalus bubalis).

Sub-estrus is a condition when buffaloes do not display behavioural estrus signs, despite being in estrus and causes a delay in conception and increases the service period. The present study describes the effect of synthetic prostaglandin (PGF2α) alone and in combination with trace minerals on the follicular and corpus luteum (CL) dynamics, serum estradiol (E2) and progesterone (P4) concentration correlating estrus response and pregnancy outcome in sub-estrus buffaloes during the breeding season. A total of 50 sub-estrus buffaloes, identified through ultrasonography (USG) examination, were randomly allocated into three groups, viz. T1 (Synthetic PGF2α, Inj. Cloprostenol 500 µg, i.m, n = 17), T2 (Synthetic PGF2α + Trace mineral supplementation, Inj. Stimvet 1 mL/100 kg body weight, i.m., n = 17) and control (untreated; n = 16). Following treatment, 100% of sub-estrus buffaloes were induced estrus in the T1 and T2 groups, while only 18.75% were induced in the control. The CL diameter and serum P4 concentration were significantly lower at post-treatment, whereas the pre-ovulatory follicle (POF) size and serum E2 concentration were significantly higher in the T1 and T2 groups as compared to the control (p < .05). The buffaloes of the T2 group had a greater proportion of moderate intensities estrus than those of T1. Moreover, the proportion of buffaloes conceived in the T1 and T2 were 41.2% and 52.95%, respectively. The larger POF diameter and higher serum E2 concentration were associated with intense intensity estrus and higher conception rate (66.7%) in sub-estrus buffaloes. Similarly, CL regression rate, POF size and serum E2 concentration were relatively higher in the buffaloes conceived as compared to those not conceived. It is concluded that synthetic PGF2α in combination with trace minerals induces moderate to intense intensities estrus in a greater proportion of sub-estrus buffaloes and increases the conception rate during the breeding season. Moreover, behavioural estrus attributes correlating follicle and luteal morphometry, serum E2 and P4 concentration could be used to optimise the breeding time for augmenting the conception rate in sub-estrus buffaloes.

Significance of isolating non-tuberculous mycobacterial organisms in infertile women with tubal disease: an observational study.

OBJECTIVES: To explore whether non-tuberculous mycobacteria (NTM) are associated with tubal disease leading to infertility. DESIGN: Prospective observational study. SETTING: Teaching hospital. POPULATION: Women with tubal factor infertility. METHODS: In all, 173 infertile women with tubal disease were investigated for genital tuberculosis, Chlamydia trachomatis and Neisseria gonorrhoeae using polymerase chain reaction, culture and histopathological examination. On culture, NTM were grown in 23.7% of endometrial samples. The mycolic characteristics of these organisms were analysed. MAIN OUTCOME MEASURE: Whether NTM are associated with tubal disease leading to infertility. RESULTS: The organisms identified in association with tubal disease were Mycobacterium tuberculosis in 30%, gonococci in 1.7%, Chlamydia in 7.5% and NTM in 23.7% of cases. Mycobacterium chelonae was the predominant organism identified by high-performance liquid chromatography. In ten women, for whom there was laparoscopic evidence of tubal disease, the only organism that was grown was NTM, and the tests for other organisms were negative. Tests for possible environment (theatre, instruments) contamination was reported negative. CONCLUSION: While evaluating infertile women for tubal disease, culture studies revealed a high prevalence of NTM in the endometrium. In the absence of M. tuberculosis, gonococci and Chlamydia infection, the presence of NTM suggests the possibility that these organisms may be responsible for tubal damage leading to infertility. TWEETABLE ABSTRACT: On evaluating the causes of tubal disease, NTM were associated with tubal disease.

Medical management of male infertility.

The medical management of male infertility has a precise role to play. Inappropriate use of drugs, apart from not promoting fertility, may actually predispose to infertility. Gonadotoxic or gametotoxic drugs should be avoided if possible. If potentially toxic drugs are used for a medical condition, suitable, less or non-toxic alternatives should be used. Where medical management is not possible, instead of wasting time and money on expensive unproven therapies, early recourse to assisted reproduction must be sought.

Mitotic chromosomal anomalies among 1210 infertile men.

Detailed medical and clinical examinations were carried out on 1608 men attending an infertility clinic to determine if any of those exhibiting abnormal semenograms also had any other readily identifiable clinical condition. In all, 1210 men showed abnormal semenograms according to World Health Organization criteria. Karyotyping of the white blood cells in these 1210 men revealed 44 (3.6%) individuals with either autosomal or sex chromosomal aberrations. However, no single characteristic feature of their semenogram or clinical condition was of any diagnostic value to predict the existence of a chromosomal anomaly.

Management of dysfunctional uterine bleeding.

DUB is a common symptom which is mainly due to disorders of ovulation and local endometrial dysfunction. The diagnosis should be made only after excluding organic pelvic disease. Anaemia and other endocrine and systemic causes of DUB must be treated promptly. Spontaneous cure is also possible. However, in patients in whom the symptoms persist, drug treatment with combined oestrogen-progestogen, anti-prostaglandin and anti-fibrinolytic agents is often effective. Hysterectomy and hysteroscopic endometrial ablation are contemplated only in persistent DUB in older and parous women and radiotherapy has no place amongst the modern modalities of management.

Postmolar contraception.

Recent studies on the etiology and the cytogenetics of trophoblastic tumors suggest that hydatidiform mole and choriocarcinoma may be conditions with no causal relationship. With the advent of newer diagnostic methods which aid in the early diagnosis of pregnancy and help to differentiate it from abnormal pregnancy together with the increasing concern over the safety of use of the contraceptive measures following a hydatidiform mole, it is suggested that a period of postmolar contraception may no longer be necessary. The follow-up of these patients should include serial sonography in association with other currently available methods. Pregnancy should also be allowed to occur naturally if the patient so desires.

PIP: The practice of advising a women with hydatidiform mole to use contraception for 1-2 years before planning pregnancy is re-examined in the light of new information on etiology and cytogenetics of mole, risk of developing choriocarcinoma, as well as new technologies for following early pregnancy. The risk of choriocarcinoma after molar pregnancy has been reported at 1-15%, while the risk after all other types of pregnancy varies widely in the literature. Incidence of trophoblastic tumors varies much less in population-based estimates. It is unknown whether the risk of choriocarcinoma is the same for all 3 cytogenetic types of moles, homozygous complete XX, heterozygous complete XY or partial mole. It is likely that a defective ovum is the pathologic basis for mole and choriocarcinoma. The risk of subsequent malignancy is unrelated to the histologic appearance of the mole. The risk of habitual mole ranges from 1:50 to 1:150. As habitual moles recur, the risk of chorionic malignancy falls to extinction. Contraception does not affect the risk of choriocarcinoma: the reason why contraception was advised is that HCG levels due to normal pregnancy could not be distinguished from those due to mole before the advent of quantitative radioimmunoassay and ultrasound. Now normal pregnancy can be documented as early as 1 week after conception by radio receptor assay for HCG, combined with serial ultrasound.