Pelvic adhesions contain sex steroid receptors and produce angiogenesis growth factors.

OBJECTIVE: To evaluate female pelvic adhesion tissue for the presence of estrogen receptor (ER), progesterone receptor (PR), basic fibroblastic growth factor (basic-FGF), and vascular endothelial growth factor (VEGF). DESIGN: Descriptive study. SETTING: Patients at a tertiary medical center. PATIENTS: Female reproductive age patients undergoing gynecologic surgery who were not receiving hormonal therapy. INTERVENTIONS: Female reproductive tract peritoneal adhesion tissue was excised, frozen, and sent for immunohistologic evaluation. MAIN OUTCOME MEASURE: Presence of ER, PR, basic-FGF, and VEGF in adhesion tissue. RESULTS: Nineteen of 19 specimens were positive for PR; 16 of 19 specimens were positive for ER, which was present in a variety of the different cell types constituting adhesion. Vascular endothelial growth factor and basic-FGF were detected in endothelial cells of blood vessels supplying this tissue as well as in mesothelial cells. CONCLUSION: Adhesion tissue contains ER, PR, and growth factors that may be important in the genesis of the permanent fibrovascular bands between pelvic organs. This supports the theoretical possibility of hormonal manipulation of these tissues to negatively influence postoperative pelvic adhesion formation.

Adnexal infarction after conservative surgical management of torsion of a hyperstimulated ovary.

OBJECTIVE: To report a case of postoperative necrosis after conservative management of torsion of a hyperstimulated ovary. DESIGN: Case report and literature review. SETTING: Tertiary care center. PATIENT: Infertility patient undergoing IVF-ET. INTERVENTIONS: Detorsion followed by unilateral salpingo-oophorectomy 2 days later. MAIN OUTCOME MEASURE: Postoperative course. RESULTS: Postoperative necrosis after detorsion. CONCLUSIONS: Postoperative necrosis is an uncommon but serious complication of conservative surgical management of adnexal torsion.

Expression of engineered human 17 beta-estradiol dehydrogenase in a prokaryotic system.

OBJECTIVE: 17 beta estradiol dehydrogenase (17 beta DH) is a model for pyridine-dependent steroid-converting enzymes. To define the structural and functional parameters of 17 beta DH, we created an expression system for production of abundant, homogeneous enzyme. METHODS: A full-length 17 beta DH cDNA clone was engineered into the inducible expression vector pMON 5839. After induction of plasmid-bearing Escherichia coli JM109 cells, the authenticity of the recombinant human placental 17 beta DH (r17 beta DH) was evaluated. RESULTS: Protein electrophoresis and Western blot analysis confirmed the immunologic identity of r17 beta DH with native human placental enzyme. The amino acid sequence, enzyme activity, Vmax, K(m), and kcat of r17 beta DH matched that of the native enzyme. CONCLUSION: Prokaryotic cell lines offer the opportunity to create an unlimited supply of recombinant human placental 17 beta DH without the expense and time commitment of baculoviral or eukaryotic cell lines. We are now able to use r17 beta DH and its mutants to elucidate the mechanisms of action of this class of enzyme.

Long-term follow-up of couples after hamster egg penetration testing.

OBJECTIVE: To determine the clinical usefulness of the zona-free hamster egg penetration test as a long-term prognostic indicator for future pregnancy. SETTING: Division of Reproductive Endocrinology and Infertility at the Washington University Medical Center. PARTICIPANTS: All couples (n = 148) who had a hamster egg penetration assay performed between March 1, 1985 and December 31, 1986 were identified and followed with direct or telephone contact up to 68 months after the initial assay. MAIN OUTCOME MEASURE: The monthly fecundity rates using life table analysis and the 5-year incidence of pregnancy were categorized by the percentage of hamster eggs penetrated and by history of previous urologic surgery. RESULTS: There were no significant differences in the rate nor incidence of pregnancy in couples with hamster egg penetration scores of 0%, > 0% and < or = 10%, > 10% and < or = 20%, or > 20%. Although men with previous urologic surgery tended to have lower scores, there was no significant difference in the 5-year incidence of pregnancy. CONCLUSION: The hamster egg penetration score is not predictive of incidence of pregnancy nor time to conception.