[Psychosomatic sterility. Search for a hypothesis for personaity structure using Moretti's graphology method]. / Sterilità psicosomatica. Ricerca per una ipotesi di struttura di personalità con la metodologia grafologica morettiana.

Over the past three years the authors have performed a random clinical study on couples who came to the aim of identifying the possible presence, in those cases in which it was not possible to pinpoint an organic or functional etiological factor, of a relationship between personality structure and so-called "sterility sine cause" which according to the recent studies by Pancheri and Zichella on reproductive emotionality, is thought to caused by a factor of psychosomatic origin, The substantiality of the concept of reproductive emotionality, otherwise referred to as sexual instinct, was put forward in 1962 by Padre Gerolamo Moretti, a leading figure of Italian graphology. Research to date, carried out using traditional methods of clinical psychology, interview and tests, in an attempt to determine a particular personality profile, has not produced completely satisfactory results. From the literature it does not appear that graphological analysis has been applied in research of this nature. Graphology, if used by competent and appropriately trained persons, is certainly a powerful and refined diagnostic method which enables an idiographic, holistic and integrated personality profile (intelligence and temperament) tp be obtained for the subject in question. Moretti's temperament classification was used to define the personality structure of patients: assault, resistance, assignment and expectation. Research using graphological techniques has revealed that it is possible to define a personality structure within which suspected "sine cause" patients may be classified. In comparison to the control group, there was a prevalent attitude expressing a tendency to reserve, introversion, diffidence, anxiety, excessive and sometimes unmotivated concern regarding persons and things, attachment to one's own ideas, inflexibility of one's own position, scarce capacity to make oneself available, excessive attention to formal aspects. A number of practical considerations also emerged from the research: the good level of acceptance and compliance with the diagnostic instrument used and the fact that the patient in question does not necessarily have to be present. Due to the ease of obtaining an example of the patient's handwriting, graphological analysis could be outinely requested as the first approach in suspected cases of sterility due to psychosomatic causes.

Chromosome heteromorphisms and early recurrent abortions.

In order to identify the role played by heterochromatic polymorphisms in miscarriage, an analysis was carried out on 257 couples, 137 of them with two or more abortions and 120 serving as a control. All couples were taken from two Italian populations: 77 cases and 70 controls came from an exogamic population whilst 60 cases and 50 controls came from an almost endogamic one. Out of the 137 cases, six couples in the exogamic and five in the endogamic groups were excluded because at least one partner had balanced chromosomal aberrations. Four controls from the exogamic group were also excluded for the same reason. The remaining 126 cases were analysed to detect the presence of chromosomal heteromorphism in one or both partners. The results suggested that chromosomal heteromorphism does not induce miscarriage. In fact, only one heteromorphism, inv(9)(p11q12), seems to be marginally related to recurrent abortion and only in the exogamic population. In addition no differences were found in the distribution of chromosomal heteromorphism in the couples analysed in relation to the number of abortions, i.e. two or more than two.

Immunochemical and biological characteristics of a human autoantibody to human chorionic gonadotropin and luteinizing hormone.

Anti-hCG/LH autoantibodies were found in the serum of an infertile woman a few days after an abortion which occurred after 46 days of amenorrhea. The antibody titer increased for approximately 4 more weeks, and then declined to low levels during a 14-month anovulatory period, after which regular menses resumed. Immunoglobulins isolated from a pool of serum obtained during the postabortion period neutralized the activity of both hCG and LH in an in vivo bioassay, and the binding affinity of the antibodies toward both hormones was high. When menses were resumed, there was a considerable reduction of the affinity toward LH. The variations in antibody titers and/or affinities can explain the sequence of fertilization, abortion, anovulatory period, and normalization of menses.

Chlamydia trachomatis infection monitoring with cytomorphology, direct immunofluorescence and "in vitro" growth method.

The increased occurrence of genital infections from Chlamydia trachomatis (Ct) suggested the need for a simple, rapid, sensitive method for detection of Ct. The purpose of the present study was to select symptomatic or asymptomatic women through two fast screenings: Pap-test and direct immunofluorescence (IF) test with monoclonal antibody. From 1,816 cervical cytology samples, 32 (1.76%) were selected for intracytoplasmic inclusions pathognomonic of Ct infection. Only 19 women underwent a check-up. The direct IF gave positive results in ten cases out of 19 (52.63%), and culture in eleven (57.89%). A correlation was made between the direct IF test and culture and also between cytologic and colposcipc findings. We thus conclude that direct IF, for its specificity, sensitivity, easy execution and low cost, could be currently utilized when clinical signs or Pap smears are suggestive of Ct infections.

Intrauterine death: an approach to the analysis of genetic heterogeneity.

A study of survival time of zygotes in utero and the relationship with parental phenotype of a series of genetic polymorphisms was carried out in 41 couples with habitual abortion. Variability of intrauterine survival time was found to be much higher between families than within families suggesting that several genetic entities contribute to the condition clinically defined as habitual abortion. Significant differences of survival time were found in relation to the length of the paternal Y chromosome and to the maternal phenotypes of PGM1 and Ss. These observations are in line with previous data suggesting intrauterine selection in these polymorphisms. Further studies of the timing of intrauterine death in relation to 'normal' genetic polymorphisms may help to clarify the aetiology of spontaneous fetal loss.

Genetic polymorphisms and human reproduction: a study of phosphoglucomutase in spontaneous abortion.

Theoretical arguments suggest that variation of metabolic parameters due to genetically determined enzyme polymorphisms may exert important effects on implantation and zygote development. The polymorphic enzyme phosphoglucomutase controlled by locus 1 (PGM1) is a phosphotransferase which plays a key role in carbohydrate metabolism and it is present in high concentrations in placental tissue. The enzyme has been studied in 47 couples with habitual abortion, in 36 women with single episodes of spontaneous abortion, in 48 women with induced abortion, and in control samples of normal individuals from the same population. Among couples with habitual abortion a significant increase of mean survival time of fetuses was observed in PGM1-heterozygote mothers as compared to homozygotes. An increased proportion of couples which may produce the hypothetical PGM1-null phenotype was also observed in habitual abortion, which suggests that homozygosity for PGM10 allele may contribute to fetal loss. Investigations on polymorphic enzymes involved in placental and fetal metabolism may contribute significantly to the problem of genetic etiology of spontaneous abortion.

Blood groups and histocompatibility antigens in habitual abortion.

Forty-six couples with at least two consecutive abortions were examined. The morphological and the functional clinical check-ups were constantly negative. In all the couples a karyotype analysis was carried out including an investigation of C and/or G bands. The phenotypes of ABO, Rh, MNSs and HLA-systems were also determined. No significant difference was observed in the distribution of ABO phenotypes between males and females, or between subjects with abortions and controls. Regarding the Rh system, the most important findings are the absence of phenotypes with the E allele in double dose, the reduction of the frequency of the CCDee phenotype and the increase in the frequency of the ccDEe phenotype. Concerning MNSs system, an increase in the frequency of the phenotypes with the S allele in double dose is observed. Females with habitual abortions show a higher incidence of Bw35 as compared both to males and to the controls. No significant differences were observed for other antigens. The persistence of a genetic disequilibrium both in the Rh and the MNSs systems suggests that the selection might act against certain antigenic combinations, independently from the state of materno-foetal compatibility. Though preliminary, our data seem to give some support to this hypothesis. They also suggest that Bw35 antigen may be important in human reproduction.