Asian Pacific Journal of Reproduction

Pages 253-257

Authors: Ibrahim A. Abdelazim, Mohannad Lutfi Abu faza

Objective To compare the cervical length measured by TVS with modified Bishop's score for cervical assessment before induction of labor. Methods One hundred and twenty women in their first pregnancy were admitted for induction of labor. Digital vaginal examination was done to record the modified Bishop's score, followed by TVS to detect the cervical length. The method of induction of labor was decided after the initial vaginal examination, when the modified Bishop's score was evaluated. Dinoprostone pessary was used for labor induction if the Bishop score was < 5 (unfavourable cervix), and amniotomy was usually performed when the cervix was 3 cm dilated, and the presenting part was low (0 station). Results The cervical length measured by TVS was significantly shorter in the patients delivered vaginally, compared with the patients delivered by cesarean section (24.7±6.9) versus (26.5±8.2) mm; respectively. A total of 72 (78.3%) of the patients delivered vaginally, and 10 (35.7%) of the patients delivered by cesarean section had cervical length < 25 mm. The modified Bishop's score was significantly high in the patients delivered vaginally, compared with the patients delivered by cesarean section (6.0±2.7) versus (5.9±8.7) respectively. Moreover, 77 (83.7%) of the patients delivered vaginally, and 11 (39.3%) of the patients delivered by cesarean section had modified Bishop's score > 5. Conclusions Both Methods of cervical assessment (cervical length measured by TVS, and modified Bishop's score) were significantly associated with successful induction. Keywords Sonographic assessment; Cervical length; Induction of labor

Pages 262-264

Authors: Yoshitomo Kobori, Hiroaki Aoki, Koujiro Nishio, Ryo Sato, Yoshio Ashizawa, Hiroshi Yagi, Shigehiro So, Gaku Arai, Hiroshi Okada

Objective To overcome intravaginal ejaculation disorder with the help of a masturbation aid (TENGA®). Methods A total of 10 patients with intravaginal ejaculation disorder underwent rehabilitation using TENGA. Patients' satisfaction, achievement of intravaginal ejaculation and pregnancy were evaluated through a questionnaire. Results Seven of the patients (70%) achieved ejaculation in the masturbation aid (TENGA) of which two patients (20%) succeeded in ejaculation within a partner's vagina after rehabilitation. One case achieved spontaneous pregnancy. Conclusions The use of a masturbation aid (TENGA) has shown to be a useful tool in correcting the Methods of masturbation and achieve normal intravaginal ejaculation, and could be an effective option for the treatment of intravaginal ejaculation disorder. Keywords Ejaculation,; Masturbation; Male infertility

Pages 269-276

Authors: Paula C. Mota, Renata S. Tavares, Marília Cordeiro, Susana P. Pereira, Stephen J. Publicover, Paulo J. Oliveira, João Ramalho-Santos

Objective The goal of this study was to verify if 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) could have any effect on male germ cells mitochondria and in this way add new insights in how male reproductive alterations observed in other studies occur. Methods In vivo and in vitro approaches using rat testis and human sperm as models were employed to evaluate TCDD effects on testicular and sperm mitochondria after 24 h of exposure. Results Testicular mitochondria from TCDD-treated rats presented no differences in the bioenergetic parameters monitored except for a significantly higher electric membrane potential in the presence of ADP, corroborated when TCDD was directly added to testicular mitochondria from untreated rats. Nevertheless, sperm mitochondrial membrane potential, motility, viability, capacitation and acrosomal integrity did not change after TCDD treatment. Moreover, only few sperm cells exposed to TCDD increased their intracellular Ca2+ concentration. Conlusions TCDD can interact directly with rat testicular mitochondria inducing small changes. This effect, however, does not seem to occur in human sperm or it may be insufficient to induce significant alterations as observed by the maintenance of sperm function. Keywords 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD); Mitochondria; Rat testis; Human sperm; Male fertility

Pages 283-286

Authors: Luis Humberto Sordia-Hernandez, Julio Herrero, Arturo Morales Martinez, Jose María Gris, Donato Saldivar Rodriguez, Oscar Vidal Gutierrez, Celina Castro

Objective To determine if a relationship exists between the histopathological diagnosis of adenomyosis and the clinical conditions and pathologies that are more commonly related to it in patients undergoing hysterectomy. Methods Retrospective, comparative, case-control study was conducted. With previous approval by ethics committee, we included 794 patients undergoing hysterectomy at a University Hospital. The Medical records and pathology reports of patients undergoing hysterectomy over a two-year period were reviwed. Clinical conditions and associated pathologies, in patients with and without adenomyosis, were reviewed and compared. Statistical analysis was done using the Chi-square test. Results Adenomyosis was reported in 140 out of 794 patients, 17.6% (95% CI: 15.1–20.4). No differences in adenomyosis prevalence were found among patients with or without uterine fibroids, 20.2% (75/371) vs. 15.5% (65/423); endometrial polyps, 9.7% (6/62) vs. 18.3% (134/732); and the presence or lack of endometrial hyperplasia 13.9% (5/36) vs. 17.4% (135/758). The prevalence of adenomyosis among patients with endometriosis was 40.7% (11/27), and among those without this diagnosis, 16.8% (129/767). This difference was significant (P=0.001). A history of two or more curettages was also positively related to adenomyosis. Conclusions There was a statistically significant difference in the prevalence of adenomyosis in women with endometriosis when compared to women without endometriosis. A higher incidence of adenomyosis was found in patients with a history of two or more curettages. Trauma to the endometrium could explain the higher incidence of adenomyosis in both conditions

Pages 293-299

Authors: Stanimir Yotov, Anatoli Atanasov, Yordanka Ilieva

Objective The aim of the present study was to assess therapeutical effect of modified Ovsynch and PRID estrus synchronization protocols in Bulgarian Murrah buffalo with inactive ovaries during the low-breeding season. Methods The study was carried out in 46 Bulgarian Murrah buffaloes with small inactive ovaries established by two consecutive transrectal ultrasonographies on Day 40 and 50 postpartum. At the start of the therapy the buffaloes were randomly divided into three groups. Group I (n=18) was treated by PRID-based protocol; Group II (n=18) was treated by Ovsynch based protocol and Group III (control; n=10) was injected intramuscular with saline at the same days as in the first two groups and fertile bull was introduced after that. The animals in the different groups were submitted to ultrasound examination at day of artificial insemination or bull introduction. Ovulation was determined 7 days post insemination by ultrasound. The pregnancy diagnosis was done 30 days after insemination. Mean diameter of the largest follicles at the start of therapy and the day of AI was registered. In the hormonal treated buffaloes estrus clinical sings, ovulation rate and pregnancy rate after AI were determined. In the control group pregnancy rate after spontaneous estrus was established. The mean diameter of the largest follicles determined on Days 40 and 50 after calving was not over 9 mm for all buffaloes. Results At day of AI the average diameters of the preo-vulatory follicles in PRID and Ovsynch treated buffaloes were significantly (P<0.01) greater than these on Day 0. The cases of a clear uterine mucus discharge during the induced estrus were significant more (P<0.05) for Group I (94.4%) than Group II (66.7%). The pregnancy rate after AI (56.6% and 38.8%) in PRID and Ovsynch program was significant higher (P<0.05) than pregnancy rate after spontaneous estrus (10%) in the control group. Conclusions the treatment of buffalo ovarian inactivity could start on Day 50 postpartum. The PRID and Ovsynch estrus synchronization protocols by substitution of the second GnRH with hCG, could be successfully used for therapy of Bulgarian Murrah buffaloes with inactive ovaries during the low-breeding season.

Pages 303-307

Authors: Danielle Barbosa Morais, Tarcizio Antônio Rêgo de Paula, Karine Moura de Freitas, Sérgio Luis Pinto da Matta

Objective To describe the seminiferous epithelium cycle (SEC) by tubular morphology method, and the acrosomal development of individualizing spermatids, and to explore the distinction of the stages between two generations of spermatids. Methods Testicular fragments were fixed in Karnovsky, embedded in glycol methacrylate and examined under light microscopy and transmission electron microscopy. Sections in 3 μm thickness were stained with toluidine blue for the characterization of the stages of the SEC by the tubular morphology method, or submitted to the PAS reaction for the visualization of the acrosomal formation. Additional details on the acrosomal formation were observed under transmission electron microscopy. Results Through the eight stages described by tubular morphology method, 10 steps of acrosomal formation were observed in the spermatid development, called acrosomal steps. As the spermatids were produced in stage V of the tubular morphology method, it was at this stage from which began the steps of acrosomal development. Conclusions We propose association of the acrosomal steps for the first time, with the different stages by tubular morphology method. This method presents an alternative to the existent Methods, allowing interspecific comparisons of the SEC, not only among different species of bats, but also among the other mammals.

Pages 312-314

Authors: Hikmet Hassa, Engin Korkmazer, V Yavuz Tokgöz, Tufan Öge

Objective To study the role of diabetes, hypertension and obesity in etiology of endometrial polyps. Methods A total of 250 patients with endometrial polyp and 256 patients normal endometrial cavity were included, who applied to our outpatient clinic. We recorded the age, fertility state, body mass index, number of polyps, hypertension and diabetes status of the patients by using SPSS Windows 16.0. All patients in polyp group were verified by post-operative pathology report. Results No significant difference was found in patients with diabetes and obesity, but hypertension was a significant factor in patients who had endometrial polyp comparing to total patient population (n=526). Conclusions This finding may alert the physician to consider the endometrial cavity in hypertensive patients who applied with abnormal uterine bleeding.

Pages 318-319

Authors: Gokhan Tulunay, Isin Ureyen, Alper Karalok, Taner Turan, Nurettin Boran

Anomalies of major retroperitoneal vascular structures have been showed up in many reports so far. Here, a group of vascular anomalies of retroperitoneum were reported, all of which were encountered during the staging surgery of a 65-year-old woman with endometrium carcinoma. There was no vascular injury during the surgery associated with these vascular abnormalities. Since they are met quite frequently, it is important for surgeons dealing with retroperitoneum to be aware of the possible anomalies of vascular and renal structures in this region.

Pages 323-325

Authors: Babita Panda, Sasmita Das, Lita Mohapatra, Mahesh C. Sahu, Rabindra N. Padhy

Success in pregnancy of a 42-years old woman with a history of unexplained recurrent miscarriages is described. She had a sub-septate uterus with free spillage bilaterally, based on hysterosalpingogram, and it was corrected by hysteroscopy in October 2009, which was followed by transcervical septal resection (TCRS). Clomiphene citrate was given ovulation. She was treated with folic acid supplementation, aspirin 75 mg, micronized progesterone 400 mg/d, and low molecular heparin 2500 IU/d, from the diagnosis of pregnancy at 5 weeks, until the delivery. However, at 28 weeks glucose tolerance test with 100 g glucose revealed mild derangement in first (159 mg/dL) and second (164 mg/dL) hour values; metformin was given for the control of sugar. Heparin injections were given to the patient continuously during the antenatal period. No major bleeding episode was noted during pregnancy or delivery. A male child weighing 3.2 kg with a good APGAR score was delivered at the end of the term. Both anatomical abnormality and advanced maternal age had determinative role in pregnancy loss, but TCRS and antithrombotic heparin and aspirin treatment had the blithesome effect.

Pages 330-336

Authors: Prashant Tiwari, Rajnikant Panik, Arin Bhattacharya, Dheeraj Ahirwar, Anish Chandy

The premise that chronic neuroleptic treatment may induce decline in some schizophrenic patients has received considerable attention. This effect, typically called super sensitivity psychosis, has been accredited to neuroleptic induced changes in mesolimbic or mesocortical dopaminergic receptors. Both typical and atypical antipsychotics generations of medication tend to block receptors in the brain's dopamine pathways which offers a number of harmful and undesired (adverse) effects including lowered life expectancy, extrapyramidal effects on motor control including akathisia (an inability to sit still), trembling, and muscle weakness weight gain, decrease in brain volume, enlarged breasts e.g. gynecomastia in men and milk discharge in men and women (galactorrhea due to hyperprolactinaemia), lowered white blood cell count (agranulocytosis), involuntary repetitive body movements (tardive dyskinesia), diabetes, and sexual dysfunction. In evaluating the risk of neuroleptic medication, the occurrence of its common side effects and uneasiness connected with these side effects should be determined. However, research has not established that neuroleptics cause the projected effect, and considerations of mechanism have not been alienated from those of causation. The focus of research in this area should be the concern or repudiation of a causal relationship between chronic neuroleptic use and psychotic relapse, even though at hand article would eradicate to researchers to find out a compiled revision on probable side effects of neuroleptic drugs.