[Two years experience of laparoscopic management of the deep posterior vaginal endometriosis]. / Dwuletnie doswiadczenia wlasne w laparoskopowych operacjach endometriozy przegrody odbytniczo-pochwowej.

Our three year experiences of laparoscopic operations recto-vaginal endometriosis is presented here. We treated 15 patients. The main symptom was severe dyspaurenia. Laparoscopic (n = 14) and laparotomic (n = 1) excision of endometriotic nodules resulted in considerable pain relief. The surgical techniques was excision with scissors and bipolar coagulation. In all the procedures the anterior rectum was freed to the loose areolar tissue of the recto-vaginal septum, prior to excising deep fibrotic endometriosis. Operation time was average 135 minutes and intraoperative blood loss was minimal. Postoperative hospital stay was average 4.8 days. Fourteen patients were free from the preoperative symptoms at six month follow-up. Laparoscopic surgery for deep recto-vaginal endometriosis is an effective treatment and offers significant symptom relief.

[Comparison of the efficacy of treatment by two laparoscopic techniques combined with medical treatment of endometriosis stage three and four]. / Porównanie efektywnosci leczenia endometriozy III degrees i IV degrees AFS dwoma technikami laparoskopowymi dodatkowo skojarzonymi z leczeniem farmakologicznym.

20 patients were treated for endometriosis with combined treatment, we have divided prospectively our patients on the 2 groups. One group was operated by laparoscopic marsupialisation of endometrial cyst and coagulation. The second group was operated by stripping of lining. Second-look laparoscopy was performed after six month medical treatment. Two techniques laparoscopic was very efficacy (decrease of AFS score). The difference between them wasn't significant.

[Biophysical characteristics of cervical mucus after stimulation of ovulation by clomiphene citrate and HMG]. / Biofizyczne wlasnosci sluzu szyjkowego po stymulacji owulacji cytrynianem klomifenu i ludzkimi gonadotropinami menopauzalnymi.

OBJECTIVES: Characteristics of cervical mucus during monofollicular stimulation of ovulation by clomiphene citrate and by clomiphene citrate with HMG was evaluated. MATERIALS AND METHODS: 226 women of couples treated for male factor infertility or idiopathic infertility were studied. Favourable parameters of cervical mucus in women treated by clomiphene citrate with HMG were found although they were worse than observed in spontaneous ovulatory cycle. RESULTS AND CONCLUSIONS: The E2/follicle index was used for evaluating efficiency of stimulation. It was the highest during cycles were CC and HMG were used, although they did not reflect the risk of hyperstimulation. Authors discuss the importance of their findings in cases when techniques of ART can not be applied.

[Correlation of pituitary hormones in serum of male patients with fertility problems]. / Wzajemne zaleznosci stezen hormonów przysadkowych w surowicy krwi mezczyzn z zaburzeniami plodnosci.

UNLABELLED: FSH, LH and prolactin serum levels estimations are the part of the most diagnostic procedures in andrology but there is their prediction value under discussion all the time. AIM: To judge the sensitivity of pituitary hormones serum levels estimation as the diagnostic method in male subfertility and to investigate the correlation between FSH, LH and PRL depending on their physiological or pathological ranges. MATERIAL AND METHODS: FSH, LH and PRL serum levels were estimated in 36 males with azoospermia or severe oligozoospermia (density below 5 mln sperm per milliliter) by EIA. The percentage of pathologic values for every hormones was counted. The statistic analyzes (for p. < 0.05) of correlation factor between every couple of hormones were performed in full investigated group and in subgroups which were formed in following way: A-12 men with pathologic FSH serum levels, B-9 men with pathologic LH serum levels and C-24 men with both physiologic gonadotropins serum levels. RESULTS: The percentage of FSH, LH and PRL pathologic values was in all subfertile men: 33%, 25% and 19.4% respectively. The correlation factor for FSH and LH was high in whole group (0.9484), it was the highest in both groups with FSH and LH pathologic levels (almost 1.0). In the group with physiological FSH and LH serum levels this positive correlation was significantly weak but also present (0.4107). The prolactin is completely independent without the correlation with any gonadotropins in any groups. CONCLUSIONS: 1. The sensitivity of the investigations of pituitary hormones during the diagnostic procedures of male fertility disturbances is poor. 2. Gonadotropins and prolactin infertile male serum levels are completely independent. 3. Positive correlation between FSH and LH increases in the pathological range of their values.

[The effect of various methods of luteal phase supplementation on serum progesterone level]. / Wplyw róznych metod suplementacji niedomogi fazy lutealnej na stezenie progesteronu w surowicy krwi pacjentki.

OBJECTIVES: Examined was the effect of luteal phase supplementation on serum progesterone level with the use of two methods: oral administration of 10 mg dydrogesterone twice daily since the detection of corpus luteum till the menstruation and intramuscular HCG administration in the dose 1500 IU every 4 days and 10 mg dydrogesterone twice daily in the same period. DESIGN: A randomized study, controlled by placebo. PATIENTS AND METHODS: 56 infertile women, with luteal phase deficiency assessed on the basis of basal body temperature (decrease shortly after the peak the luteal phase shorter than 11 days) and ovulation determined sonographically. Progesterone was evaluated by an EIA method, on the 3rd, 7th and 11th day since the corpus luteum occurred. RESULTS: The peak of progesterone concentration was assessed in the midluteal phase (7th day) in both supplemented groups, significantly higher than in the placebo group, also in group with dydrogesterone and HCG it was higher than in group with dydrogesterone alone. Progesterone concentration decrease on the 11th day after the ovulation to the values comparable with the placebo group. CONCLUSION: It has been found that both methods increase serum progesterone level in the time of an assumed implantation but they do not affect the premenstrual period if conception is not achieved.