Does intraperitoneal insemination in the absence of prior sensitization carry with it a risk of subsequent immunity to sperm?

To evaluate the occurrence of antisperm antibodies in women, with no prior sensitization, 112 couples undergoing intraperitoneal insemination were tested for serum antisperm antibodies with the sperm immobilization test (SIT) and the immunobead test (IBT). A serum sample was taken from each of the 112 patients immediately before the first intraperitoneal insemination. Another sample was taken from 58 patients who underwent a second insemination procedure. In 16 of the 58 patients the IBT results were positive for one or more immunoglobulin classes. Five patients showed positive SITs. In 7 out of these 16 subjects (12%) the antibodies were bound to the head and to the shaft of the sperm tail. Five of the six patients submitted to a third intraperitoneal insemination procedure showed unchanged SIT values and IBT binding percentages. In one subject, SIT (6 months after the third insemination) became negative. Antibody production may be either a transient response to massive antigen stimulation or the first step toward systemic immunity.

Measurement of glucuronometabolites of 17 beta-estradiol and progesterone in early morning urine samples: a promising new method for the evaluation of hormonal responses of Buserelin-hMG treatment in an IVF program.

The success of IVF is related to the number and quality of embryos transferred. In our IVF program we have used two different protocols for superovulation induction. In this study a group of 35 patients was randomized into two groups; the first group (15 patients) was treated with pure FSH and hMG, in the other (20 patients) the normal pituitary function was inhibited with Buserelin before the stimulation with hMG. Ovarian stimulation was monitored by ultrasound examination and endocrine parameters. The RIA determination of 17-beta estradiol (17-E2) plasmatic levels is one of the most widely used techniques in IVF cycle monitoring; however many serious disadvantages are connected with the use of RIA (short half-life of the reagents; hazard of handling radioactive materials; frequent venipunctures for the patients). For these reasons, we propose a chemiluminescence immuno assay (LIA) method for the measurement of glucuronometabolites of 17-E2 and progesterone in early morning urine samples: this technique allows to follow hormonal levels for all the cycle, avoiding patient discomfort. We have found a highly significant correlation between serum and urinary hormonal values. We noted a marked variability in the individual estrogenic response and a significant difference in the response of the two groups. The mean peak on hCG administration day was 6.4 +/- 3.5 micrograms/h for urinary E1-3G and 1270 +/- 678 pg/ml for 17-E2 in Buserelin-hMG group: these hormonal levels appear lower than without ovarian desensitization; (in FSH-hMG group we have, on the same day, 9.7 +/- 3.2 micrograms/h for E1-3G and 1630 +/- 730 pg/ml for serum 17-E2).(ABSTRACT TRUNCATED AT 250 WORDS)

Methylergonovine maleate: a proposal for its more specific use.

Seven hundred cases of spontaneous or operative vaginal delivery were studied at the Department of Obstetrics and Gynecology of the University of Florence. The purpose was to evaluate the frequency of complications such as hemorrhage and/or infections during the immediate post-partum period and the first two weeks after childbirth.

Clinical chemotherapeutic evaluation of fosfomycin plus amoxicillin (co-fosfolactamine): a prospective double-blind clinical trial.

Seventy-three hospitalized patients with urinary tract infections (UTI) were included in a double-blind study and received at random either fosfomycin or fosfomycin plus amoxicillin (CFL) in a pre-fixed combination, in order to evaluate the effectiveness of the CFL. CFL was administered orally to 39 patients at the daily dosage of 1 g every 8 h for 6 days (666 mg of fosfomycin and 334 mg of amoxicillin) while fosfomycin was given orally to 34 patients at the daily dosage of 666 mg every 8 h for 6 days. A bacteriological cure was observed in 97.4% of the patients treated with CFL, while in the fosfomycin group the bacterial eradication was obtained only in 82.3% (P less than 0.05). CFL showed a more rapid bactericidal activity than fosfomycin. In addition, CFL was more effective than fosfomycin against "difficult" Gram-negative bacteria such as Proteus spp. and Pseudomonas aeruginosa. Both antibiotics were well tolerated. Our limited experience revealed that CFL induces a negligible degree of resistant strains, and fewer than fosfomycin. Thus we conclude that CFL seems to be a useful antibiotic combination in the treatment of UTI.

Dynamic fetoplacental unit function test with dehydroepiandrosterone sulfate.

The authors present their experience with the dynamic fetoplacental unit function test using a commercial product containing dehydroepiandrosterone sulfate. The recent literature is cited and the results are discussed. Emphasis is placed on the practicability and applicability of the method in connection with a continuous, reliable evaluation of "at risk" pregnancy.

[Abortion and the man. Psychological and psychopathological manifestations in the face of lost fatherhood]. / L'aborto al maschile. Manifestazioni psicologiche e psico-patologiche in occasione della mancata paternità.

This study examines the psychological and psychopathological reactions that may appear in a man when his partner aborts. The small amount of literature that exists on the subjects was examined, and several men were, interviewed at the time their partners aborted voluntarely. It turns out that in spite of the man's lack of recognition of any reactions (reinforced by current attitudes and by the scant psychological and medical interest in the subject), there is considerable emotional involvement in the lost parenthood, both for the man and the woman. As revealed by the interviews, this involvement may manifest itself in persecutory or depressive anxiety and psychosomatic symptoms. Moreover, but very rarely, real and typical psychopathological symptoms may appear, such as depression and behavioural disorders. The appearance of these reactions is linked to the problems and conflicts aroused by prospective fatherhood, leading to a comparison between the experiences of fuliwed fatherhood and those of fatherhood lost.

PIP: Only recently has any study evaluated the psychological and psychopathological reactions of men whose partners have chosen to have an abortion. Recent studies have shown that fatherhood causes deep personal and social changes and conflicts. It is therefore natural that an interruption of this process, such as through abortion, can inspire feelings of being partially "killed", thus bringing back childhood anxieties and feelings of castration. One study on women who had abortions showed that only 1/6 were accompanied by their partners, and that for those who face abortion as a couple, the future did not seem to hold negative consequences. A study of a number of young men emphasized the frustration of 2 desires: that of becoming a father and, consequently, of becoming a man. Another study of 50 childless young men indicated that the "lack of fatherhood" after the 1st abortion was the origin of frustration and pain that, in some cases, drove unmarried couples to discontinue their relationship. In a 4th study, of 52 women who went to an abortion clinic, 29 were accompanied by their partners. 20 partners agreed to be interviewed. Although none were asked the reason for the abortion, each explained the motivation for it. The observations show "persecution anxieties", especially with regard to the partner, depression anxieties and psychosomatic symptoms. Depression and behavioral disorders, although rarer, may also manifest themselves. The study suggests a comparison between reactions and feelings of potential fatherhood and fatherhood lost.

Estradiol and progestin receptors, 17-beta-hydroxysteroid-dehydrogenase and histopathologic grade in endometrial carcinoma.

The possible correlation between steroid receptor systems, 17-beta-HSD and histopathologic examinations were investigated. The well-differentiated tumors showed higher steroid receptor and 17-beta-HSD values than undifferentiated carcinomas. The steroid receptors did not present a statistically significant correlation with 17-beta-HSD. Nevertheless, some neoplastic endometria (29%) show higher values of progestin receptors and 17-beta-HSD, with a progestin:estrogen receptor ratio greater than one.

A pregnancy in an acromegalic woman during bromocriptine treatment: effects on growth hormone and prolactin in the maternal, fetal, and amniotic compartments.

An unexpected 20-week-old pregnancy was found in a young acromegalic who had been treated with 10 mg bromocriptine/day for 10 months. The drug was continued throughout the period of gestation. No growth of the pituitary adenoma was noticed. The intrauterine development of the fetus was normal. Bromocriptine therapy had no discernible effect on the expected patterns of secretion of placental hormones, but inhibited completely the increase of PRL in the serum of the mother. Maternal plasma GH concentrations were very high in spite of the treatment and progressively declined after delivery. The plasma GH level was normal in the child, but PRL was very low at birth and increased in the following days. The expected high PRL concentration was found in the amniotic fluid. This case study suggests that bromocriptine crosses the human placenta and affects the fetal pituitary, maternal GH does not influence fetal or amniotic GH, and amniotic fluid PRL correlates poorly with either maternal or fetal blood levels and is not affected by bromocriptine.

[Chemotherapy of gestational chorionepithelioma]. / Chemioterapia del gestocorionepitelioma

The department of Gynecology and Obstetrics of Florence University reports the following findings for the chemotherapy of gestational choriocarcinoma during the period 1962-74. Sixteen cases, 11 of which were rated high risk cases, were given chemotherapy with MTX alone or in association with other cytotoxic agents. In the 12 surviving cases that may be considered the incidence of complete remission (from 4 to 13 years) is 67%. Of the 8 cases rated as cured 3 were high risk cases at the beginning of treatment. Intermittent chemotherapy with MTX only was given by slow intravenous injection at doses of 3 to 4 mg/kg for 24-48 h followed from the 48th h by folinic acid treatment for 1-2 days. This schedule is recommended because of its negligible toxicity as a replacemen for intramuscular MTX in 5-day courses, which carries a fairly high risk of toxicity.