1.  Peer Reviewed Title: Oral contraceptive pretreatment in women undergoing controlled ovarian stimulation in ganirelix acetate cycles may, for a subset of patients, be associated with low serum luteinizing hormone levels, reduced ovarian response to gonadotropins, and early pregnancy loss. Author: Meldrum DR; Scott RT Jr; Levy MJ; Alper MM; Noyes N Source: Fertility and Sterility. 2009 May;91(5):1963-5. Abstract: Oral contraceptive pretreatment facilitated scheduling of pure FSH/GnRH antagonist cycles but in a small subset of patients was associated with low serum LH levels, reduced ovarian response, and early pregnancy loss. Supplementation with LH could be examined as a possible way to improve cycle outcome. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | WOMEN | GONADOTROPINS, PITUITARY | IMPLANTATION | ABORTION, SPONTANEOUS | PREGNANCY | ORAL CONTRACEPTIVES | Developed Countries | North America | Americas | Demographic Factors | Population | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Pregnancy, First Trimester | Reproduction | Pregnancy Complications | Diseases | Contraceptive Methods | Contraception | Family Planning Document Number: 341248 |
| 2. Peer Reviewed Title: Mifepristone as an anti-implantation contraceptive drug: roles in regulation of uterine natural killer cells during implantation phase. Author: Zhu HX; Zhang WW; Zhuang YL; Huang LL Source: American Journal of Reproductive Immunology. 2009 Jan;61(1):68-74. Abstract: PROBLEM: To investigate the immunological mechanism of low-dose mifepristone acting as a contraceptive at the level of the endometrium. METHOD OF STUDY: Endometrial explants were cultured in vitro with or without mifepristone treatment for 24 hr. Some tissues were fixed and immunostained for CD56, while other tissues were dissociated and cells analysed by three colour flow cytometry for CD3, CD56 and CD16. RESULTS AND CONCLUSION: Results showed a significant increase in the number of CD56(+) natural killer (NK) cells and the percentages of CD3(-) CD56(+) CD16(-) NK cell subset in the tissue treated with mifepristone, while the percentage of CD3(-) CD56(+) CD16(+) NK cell subset remained unaffected. It shows that low-dose mifepristone increases the number of CD56(+) NK cells and the percentage of CD3(-) CD56(+) CD16(-) NK subset in receptive endometrium and provides new insights into the immunological mechanism of low-dose mifepristone as an anti-implantation contraceptive drug. Language: English Keywords: CHINA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | IMPLANTATION | IMMUNITY, CELLULAR | UTERUS | RU-486 | ORAL CONTRACEPTIVES, LOW-DOSE | ORAL CONTRACEPTIVES, SIDE EFFECTS | IMPLANTATION SUPPRESSION | Asia, Eastern | Asia | Developing Countries | Research Methodology | Economic Development | Economic Factors | Pregnancy, First Trimester | Pregnancy | Reproduction | Immunity | Immune System | Physiology | Biology | Genitalia, Female | Genitalia | Urogenital System | Hormone Antagonists | Hormones | Endocrine System | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Safety | Safety | Public Health | Health | Contraceptive Mode of Action Document Number: 330062 |
| 3. Title: Synthesis and in vivo evaluation of 11-substituted estradiol derivatives as anti-implantation agents. Author: Dwivedy I; Gupta A; Grover A; Srivastava V; Singth MM Source: Bioorganic and Medicinal Chemistry Letters. 2008;:[4] p. Abstract: Synthesis of 11-substituted estradiol derivatives (12-17) has been carried out by the Grignard reaction with alkyl, allyl, and benzyl halides on 17beta-hydroxy-3-methoxy-11-oxo-estra-1,3,5(10),8(9)-tetraene (10). The novel compounds (10 and 12-17) were evaluated for their preliminary post-coital contraceptive (anti-implantation) activity in Sprague-Dawley rats. The tested compounds were administered orally and showed significant anti-implantation activity. Compound 13 is the most potent compound in the series which showed 100% contraceptive efficacy at 1.25 mg kg-1. (author's) Language: English Keywords: GLOBAL | CLINICAL RESEARCH | LABORATORY ANIMALS | ESTROGENS | CONTRACEPTION RESEARCH | IMPLANTATION | Research Methodology | Hormones | Endocrine System | Physiology | Biology | Contraception | Family Planning | Pregnancy, First Trimester | Pregnancy | Reproduction Document Number: 327068 |
| 4. Peer Reviewed Title: The significance of sperm DNA oxidation in embryo development and reproductive outcome in an oocyte donation program: A new model to study a male infertility prognostic factor. Author: Meseguer M; Martinez-Conejero JA; O'Connor JE; Pellicer A; Remohi J Source: Fertility and Sterility. 2008 May;89(5):1191-1199. Abstract: One byproduct resulting from free radical damage is the DNA hydroxylation also known as DNA oxidation. Our aim with this work was to determine the relevance of sperm DNA oxidation on embryo quality in oocyte donation cycles. We prospectively studied pairs of oocyte donation cycles, i.e., the same oocyte donors, donating to two recipients, where the only difference between the two treatments was the use of a different sperm sample. The setting was the University-affiliated private IVF setting. The patient(s) were infertile male partners from couples undergoing oocyte donation cycles (n = 38): 76 semen aliquots analyzed before and after semen processing by swim up. We measured sperm DNA oxidation by flow cytometry using the OxiDNA assay and correlated it with embryo quality parameters, implantation, and pregnancy outcome. A positive correlation was seen between embryo fragmentation and DNA oxidation of capacitated samples at 48 hours and 72 hours after fertilization. However, when we analyzed the differences in the IVF outcome parameters of the couples who shared the oocyte cohort (same donor) with the differences in the OxiDNA values, we observed increased and further relationships with cell embryo division 48 hours after fertilization. A negative association with blastocyst formation was also detected. Oxidative damage in the DNA is clearly increased in samples with lower sperm motility. An association between early and late embryo quality and sperm DNA oxidation supports the relevance of the hydroxylation of 8-oxoguanine as a biomarker of sperm quality reflecting the free radical damage in human sperm. (author's) Language: English Keywords: SPAIN | RESEARCH REPORT | PROSPECTIVE STUDIES | STATISTICAL STUDIES | MEN | INFERTILITY | REPRODUCTIVE TECHNOLOGIES | SPERMATOZOA | IMPLANTATION | SPERM COUNT | ARTIFICIAL INSEMINATION | OXYGEN | LABORATORY PROCEDURES | Europe, Southwestern | Europe | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Reproduction | Germ Cells | Genitalia | Urogenital System | Physiology | Biology | Pregnancy, First Trimester | Pregnancy | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Inorganic Chemicals | Ingredients and Chemicals Document Number: 327227 |
| 5. Peer Reviewed Title: Effects of ovarian high response on implantation and pregnancy outcome during controlled ovarian hyperstimulation (with GnRH agonist and rFSH). Author: Chen QJ; Sun XX; Li L; Gao XH; Wu Y Source: Acta Obstetrica et Gynecologica Scandinavica. 2007;88(7):849-854. Abstract: The study was aimed at investigating the effects of ovarian high response during controlled ovarian hyperstimulation (COH) on implantation and pregnancy outcome in fresh IVF/ICSI cycles, and subsequent frozen-thawed embryo transfer (FET) cycles. An analysis of 1,196 cycles using a long protocol with GnRHa and rFSH was performed. A serum oestrial level (peak E2) was obtained on the day of hCG administration, and patients were grouped by peak E2 percentile distribution into 3 groups. Normal responder was set as cut-off concentrations between percentile (P)25 and P75 (Group A: 1,199-3,047 pg/ml, 595 cycles). Moderate high responders were classified as peak E2 between P75-P90 (Group B: 3,048-4,127 pg/ml, 180 cycles). For the high response group, the E2 cut-off concentration was set as P90 and above (Group C: >/= 4,128 pg/ml, 119 cycles). Oocyte/embryo parameters and clinical outcomes were compared among the 3 groups in fresh cycles and subsequent FET cycles. Comparisons between groups revealed no difference in the quality of oocyte retrieved and in fertilisation rates. Group C showed decreased trends in implantation and pregnancy rates compared with Group A, but statistical significance was reached only for the difference in implantation rates. Implantation and pregnancy rates in FET cycles were similar among the 3 groups. High serum estrogen levels were detrimental to implantation, but not to the quality of oocytes, which may be due to an adverse effect on endometrial receptivity in COH cycles. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | WOMEN | OVULATION | GONADOTROPINS | FOLLICLE STIMULATING HORMONE | ADMINISTRATION AND DOSAGE | IN VITRO | FERTILIZATION | IMPLANTATION | PREGNANCY RATE | PREGNANCY OUTCOMES | Developing Countries | Asia, Eastern | Asia | Demographic Factors | Population | Reproduction | Hormones | Endocrine System | Physiology | Biology | Gonadotropins, Pituitary | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Clinical Research | Research Methodology | Pregnancy, First Trimester | Pregnancy | Fertility Measurements | Fertility | Population Dynamics Document Number: 317961 |
| 6. Peer Reviewed Title: Mifepristone, but not levonorgestrel, inhibits human blastocyst attachment to an in vitro endometrial three-dimensional cell culture model. Author: Lalitkumar PG; Lalitkumar S; Meng CX; Stavreus-Evers A; Hambiliki F Source: Human Reproduction. 2007;22(11):3031-3037. Abstract: The use of fertility regulating drugs is limited among various socio-ethnic groups due to limited knowledge about their mechanism of action. This study investigates the effect of levonorgestrel and mifepristone on attachment of human embryos to an in vitro endometrial construct. Three-dimensional endometrial constructs were established by co-culturing early luteal phase human endometrial stromal and epithelial cells. Expression of endometrial receptivity markers in this construct were examined by immunohistochemistry. Effects of mifepristone and levonorgestrel on viability and attachment of human blastocysts were investigated. Endometrial constructs expressed the factors involved in endometrial receptivity: estrogen receptor, progesterone receptor, vascular endothelial growth factor, leukemia inhibitory factor, interleukin-1, COX-2, MUC-1 and integrin-avbeta3. None of the 15 embryos cultured with mifepristone attached to the endometrial construct (P < 0.01), whereas 10/17 in control, and 6/14 in levonorgestrel, groups attached. The attachment was confirmed by the positive expression of cytokeratin 7 at the attachment site. Mifepristone inhibits blastocyst attachment. Levonorgestrel did not impair the attachment of human embryos to the in vitro endometrial construct. This model could be used to understand endometrial receptivity and embryo-endometrial dialog and to develop new fertility regulating substances. (author's) Language: English Keywords: SWEDEN | RESEARCH REPORT | WOMEN | EMBRYO | FERTILITY | RU-486 | LEVONORGESTREL | ADMINISTRATION AND DOSAGE | HORMONE RECEPTORS | ENDOMETRIAL EFFECTS | IMPLANTATION | Europe, Northern | Europe | Developed Countries | Demographic Factors | Population | Pregnancy | Reproduction | Population Dynamics | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Membrane Proteins | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System | Pregnancy, First Trimester Document Number: 321404 |
| 7. Peer Reviewed Title: Oxytocin antagonists may improve infertility treatment. Author: Pierzynski P; Reinheimer TM; Kuczynski W Source: Fertility and Sterility. 2007 Jul;88(1):213.e19-213.e22. Abstract: The objective was to confirm the improvement of uterine receptivity following administration of oxytocin and vasopressin V1A antagonist atosiban. Design: Case report. Setting: Private reproductive medicine center. A 42-year-old woman with a history of 15 years' infertility and seven failed in vitro fertilization/embryo transfer (IVF-ET) attempts was the patient used for the study. Intervention(s): Atosiban (mixed vasopressin V1A/oxytocin antagonist registered for the treatment of imminent premature birth) was administered on the 14th day of endometrial synchronization for oocyte donation. Main Outcome Measure(s): Uterine contractile activity (component of uterine receptivity) and success of treatment of infertility. Intense spontaneous uterine contractility was visualized by transvaginal sonography. After 1 hour of intravenous infusion of atosiban, a repeated scan showed a significant decrease in contractile activity (11 vs 7 contractions per 4 minutes, respectively). The ET was performed immediately after, and the infusion of atosiban continued for the next 2 hours. The treatment decreased the uterine contractile activity and resulted in successful embryo implantation and a normal twin diamniotic pregnancy. Atosiban may improve uterine receptivity during ET and may increase success rates of advanced infertility treatment procedures. (author's) Language: English Keywords: POLAND | RESEARCH REPORT | WOMEN | INFERTILITY | TREATMENT | OXYTOCIN | HORMONE ANTAGONISTS | ESTRADIOL | PROGESTERONE | ADMINISTRATION AND DOSAGE | IMPLANTATION | PREGNANCY | Developing Countries | Europe, Central | Europe | Demographic Factors | Population | Reproduction | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pituitary Hormones | Hormones | Endocrine System | Physiology | Biology | Estrogens | Progestational Hormones | Drugs | Pregnancy, First Trimester Document Number: 318319 |
| 8. Peer Reviewed Title: Efficiency of changing the embryo transfer time from day 3 to day 2 among women with poor ovarian response: A prospective randomized trial. Author: Bahceci M; Ulug U; Ciray HN; Akman MA; Erden HF Source: Fertility and Sterility. 2006 Jul;86(1):81-85. Abstract: The objective was to compare the outcome of day 2 and day 3 embryo transfers in women demonstrating poor ovarian response. Design: Prospective randomized clinical trial. Setting: Private assisted reproductive technology center. Patient(s): Two hundred eighty-one women demonstrating poor ovarian response to controlled ovarian hyperstimulation. Intervention(s): Women who were poor responders were randomly allocated to day 2 or day 3 embryo transfer following oocyte retrieval. Main Outcome Measure(s): Implantation rates and pregnancy rates per oocyte retrieval and embryo transfer. The clinical pregnancy rates per oocyte retrieval (37.2% vs. 21.4%, respectively; P < .05) and per embryo transfer (38.9% vs. 24.1%, respectively; P < .05) were significantly higher in the day 2 embryo transfer group compared with day 3. On the other hand, implantation rates were not different between groups (23.9% vs. 17.2%, respectively; P = .08). Our results demonstrated that transfering embryos on day 2 could provide an alternative to the management of poor responder patients. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | EMBRYO | EMBRYO TRANSFER | TIME FACTORS | REPRODUCTIVE TECHNOLOGIES | OVARIAN EFFECTS | IMPLANTATION | Developing Countries | Europe, Southeastern | Europe | Studies | Research Methodology | Demographic Factors | Population | Pregnancy | Reproduction | Population Dynamics | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Pregnancy, First Trimester Document Number: 305754 |
| 9. Title: Serum and follicular fluid levels of soluble Fas and soluble Fas ligand in IVF cycles. Author: Onalan G; Selam B; Onalan R; Ceyhan T; Cincik M Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2006 Mar 1;125(1):85-91. Abstract: The objective was to determine follicular fluid (FF) and serum levels of soluble Fas (sFas) and soluble Fas ligand (sFasL) in patients undergoing IVF cycles. A prospective comparative study among patients with endometriosis (n = 12), infertility due to male factor (n = 12) and poor responders (n = 32) undergoing IVF cycles in Centrum IVF Clinic. Individual FF and serum samples were collected from patients during transvaginal ultrasonography-guided follicle aspiration. Patients were classified as poor responder patients undergoing IVF cycles with GnRHa, triptorelin and GnRH antagonist, cetrotide, patients with endometriosis and patients with infertility due to male factor. sFas, sFasL levels in both FF and serum samples and their correlations with clinical outcomes of IVF were measured in each study group. Serum and FF levels of sFas, sFasL were similar in the poor responder and male factor groups. There were no differences between the serum and FF levels of both sFas and sFasL among poor responder patients receiving either GnRH agonist or antagonist therapies. Serum levels of sFas were significantly lower in the endometriosis group compared to the male factor group. Serum and FF levels of sFas, sFasL were similar among patients with or without clinical pregnancy. sFas and sFasL are detected in both serum and follicular fluid samples from IVF cycles, their levels are similar between poor responder and male factor groups as well as between GnRH agonist and antagonist treatment groups. These soluble apoptotic factors may not be predictive for the outcomes of IVF. Decreased serum levels of sFas, suggests increased apoptosis in endometriosis. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | COMPARATIVE STUDIES | CLINICAL RESEARCH | WOMEN | ENDOMETRIOSIS | INFERTILITY | IMPLANTATION | MEASUREMENT | IN VITRO | FERTILIZATION | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Diseases | Reproduction | Pregnancy, First Trimester | Pregnancy Document Number: 297746 |
| 10. Peer Reviewed Title: Ectopic pregnancy with Implanon. Author: Patni S; Ebden P; Kevelighan E; Bibby J Source: Journal of Family Planning and Reproductive Health Care. 2006;32(2):115. Abstract: We report the case of a 27-year-old woman, para 1 + 0, who had a contraceptive implant (Implanon) inserted in January 2004 at a 6-week postnatal check following a spontaneous vaginal delivery. The patient's past gynaecological history was unremarkable, with no history of pelvic inflammatory disease or other risk factors for ectopic pregnancy. Following insertion of the Implanon, the patient had a brownish loss per vaginum on and off and also recalled having a proper period in June 2004. In August 2004, on account of the symptoms of weight gain and erratic vaginal bleeding, the Implanon was removed. A pregnancy test performed at the same time was positive. (excerpt) Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | CASE STUDIES | CLINICAL RESEARCH | PREGNANT WOMEN | PREGNANCY, ECTOPIC | IMPLANTATION | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Pregnancy, First Trimester | Pregnancy | Reproduction Document Number: 298641 |
| 11. Peer Reviewed Title: Pregnancy and contraception in heart disease and pulmonary arterial hypertension. Author: Thorne S; Nelson-Piercy C; MacGregor A; Gibbs S; Crowhurst J Source: Journal of Family Planning and Reproductive Health Care. 2006;32(2):75-81. Abstract: Heart disease is the leading cause of maternal mortality in the UK. There is therefore a need to disseminate amongst the medical profession accurate information about contraception and pre-pregnancy counselling for women with heart disease. The risk of pregnancy depends on the specific disease and the individual patient. For example, the risk of maternal death is up to 50% for those with pulmonary arterial hypertension, but there is no anticipated extra risk for those with mild pulmonary stenosis compared to women without heart disease. Similarly, although certain contraceptive methods are associated with unacceptable increases in risk for specific cardiac conditions, it is not the case that "most structural heart disease" is an absolute contraindication for use of the combined oral contraceptive (COC). (excerpt) Language: English Keywords: UNITED KINGDOM | RECOMMENDATIONS | FOCUS GROUPS | PREGNANT WOMEN | WOMEN | HEART DISEASES | HYPERTENSION | PREGNANCY COMPLICATIONS | ORAL CONTRACEPTIVES, COMBINED | PROGESTERONE | IMPLANTATION | IUD | IUD, COPPER RELEASING | EMERGENCY CONTRACEPTION | Europe, Western | Europe | Developed Countries | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Diseases | Vascular Diseases | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Pregnancy, First Trimester | Pregnancy | Reproduction Document Number: 298634 |
| 12. Peer Reviewed Title: Research hones in on EC mechanism of action. Source: Contraceptive Technology Update. 2005 Jul;:[4] p.. Abstract: The young woman in your examination room has questions about how emergency contraception pills (ECPs) works. How do you explain the method’s mechanism of action? Recent research from members of the New York City-based Population Council’s International Committee for Contraception Research indicates that levonorgestrel-only ECPs (Plan B, Barr Pharmaceuticals, Pomona, NY) appear to work by interfering with ovulation, thus preventing fertilization of the egg. The pills do not appear to disrupt post-fertilization events, such as the implantation of a fertilized egg in the uterus, which has been a point of contention among EC opponents. Further research needs to be done to accrue more indirect evidence to help settle the issue, at least at the technical level, says Horacio Croxatto, MD, a reproductive physiologist at the Chilean Institute for Reproductive Medicine in Santiago, Chile, and co-author of the recent research. This evidence can be obtained when funding for this type of research becomes available, he notes. Plan B now is available at Canadian pharmacies without a prescription following the April 2005 approval by Canadian regulatory authorities. The drug is distributed in Canada by Montreal-based Paladin Labs. EC proponents continue to await word from the Food and Drug Administration regarding the pending U.S. application for over- the-counter (OTC) status of the drug. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | SUMMARY REPORT | WOMEN | EMERGENCY CONTRACEPTION | LEVONORGESTREL | SIDE EFFECTS | OVULATION | FERTILIZATION | IMPLANTATION | ABORTION | North America | Americas | Developed Countries | Demographic Factors | Population | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Treatment | Reproduction | Pregnancy, First Trimester | Pregnancy | Fertility Control, Postconception Document Number: 289411 Notification |
| 13. Peer Reviewed Title: Modulation of estrogen action during preimplantation period and in immature estradiol-primed rat uterus by anti-implantation agent, ormeloxifene. Author: Dwivedi A; Basu R; Chowdhury SR; Goyal N Source: Contraception. 2005;71:458-464. Abstract: Studies were undertaken to evaluate the influence of estrogen antagonist-cum anti-implantation agent, ormeloxifene, on 17 ß-hydroxydsteroid dehydrogenase (17ß-HSD) activity and estrogen action in rat uterus during preimplantation period and to examine its ability to induce progesterone receptor (PR) in immature rat model. A group of female rats received orally a contraceptive dose of 1.25 mg/kg of ormeloxifene on Day 1 postcoitum (pc). Rats were sacrificed on Days 3, 4 and 5 pc, and uterine tissues were processed for enzymatic, estrogen receptor and estradiol (E(-2)) estimations. Immature ovariectomized rats received ormeloxifene, subcutaneously for 3 days at various doses in the absence or presence of estradiol, and uterine PR levels were measured using (3)H-5020 as radioligand. Results revealed that ormeloxifene treatment caued a marked increase in enzyme activity of 17ß-HSD on Days 3, 4 and 5 pc as compared to respective controls. Further, total uterine estrogen receptors as estimated by exchange assay showed a noticeable decrease on Days 4 (35%) and (>80%) pc in ormeloxifene-treated groups. The results correlate well with a decrease in tissue E(-2) levels. In immature rats, ormeloxifene caused a dose-dependent increase in cytosolic PR levels; oreloxifene given along with E2 (0.1 æg) for 3 days caused a significant reduction in concentration of PRs at 10 µg and higher doses. Ormeloxifene also induced (3)H-progesterone ((P)) uptake b immature rat uterus. However, in the presence of E(-2), it significantly reduced (3)H-P uptake. The in vitro competitive binding experiments did not reveal any displacement of (3)H-R5020 either by ormeloxifene or by its hydroxy derivative from PR. The results suggest that in addtion to its competitive antagonism at estrogen receptor level, ormeloxifene enhances the inactivation of intracellular E(-2) to estrone, a biologically less active form, thus declining estrogen receptor pool. Moreover, it causes indirect anti-progestational effects in the uterus b virtue of its anti-estrogenic profile rather than by blocking the PRs. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | EVALUATION | LABORATORY ANIMALS | ESTROGENS | IMPLANTATION | UTERUS | ENZYMATIC EFFECTS | ADMINISTRATION AND DOSAGE | TIME FACTORS | PROGESTERONE | HORMONE RECEPTORS | Developing Countries | Asia, Southern | Asia | Clinical Research | Research Methodology | Hormones | Endocrine System | Physiology | Biology | Pregnancy, First Trimester | Pregnancy | Reproduction | Genitalia, Female | Genitalia | Urogenital System | Enzymes and Enzyme Inhibitors | Drugs | Treatment | Population Dynamics | Demographic Factors | Population | Progestational Hormones | Membrane Proteins Document Number: 286729 |
| 14. Peer Reviewed Title: The acceptability of self-administration of subcutaneous Depo-Provera. Author: Lakha F; Henderson C; Glasier A Source: Contraception. 2005;72:14-18. Abstract: Depo-Provera (depot medroxyprogesterone acetate, or DMPA) is an important contraceptive option for women worldwide. Currently, it is only available in intramuscular form requiring regular quarterly routine attendance at a health facility. A new subcutaneous preparation has been developed. This is self-administrable and could potentially reduce need for routine attendance to an annual visit. In a questionnaire survey of 176 women currently using DMPA, 67% would prefer to self-administer. Of the 33% who did not wish to self-administer, the most common reasons were a fear of needles (62%) and concern regarding incorrect administration (43%). In a second survey of 313 women not currently using DMPA, 64% of women said they would prefer to attend less often for contraceptive supplies. Twenty-six percent of women who had never used DMPA and 40% of ex-users would seriously consider DMPA if self-administration were possible. Our findings would suggest that the advent of subcutaneous self-administrable Depo-Provera with appropriate training and reminder system is likely to be beneficial and popular with many women. (author's) Language: English Keywords: SCOTLAND | RESEARCH REPORT | CLINICAL RESEARCH | KAP SURVEYS | WOMEN | DEPO-PROVERA | ADMINISTRATION AND DOSAGE | SELF CARE | INJECTABLES | IMPLANTATION | ATTITUDES | FEAR | CONTRACEPTIVE SAFETY | COUNSELING | Developed Countries | United Kingdom | Europe, Western | Europe | Research Methodology | Surveys | Sampling Studies | Studies | Demographic Factors | Population | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Drugs | Treatment | Contraceptive Methods | Pregnancy, First Trimester | Pregnancy | Reproduction | Psychological Factors | Behavior | Emotions | Safety | Public Health | Health | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 288295 |
| 15. Peer Reviewed Title: Blastocyst implantation failure in mice due to "nonreceptive endometrium": endometrial alterations by Hibiscus rosa-sinensis leaf extract. Author: Nivsarkar M; Patel M; Padh H; Bapu C; Shrivastava N Source: Contraception. 2005;71:227-230. Abstract: Many plants are known to possess antifertility activity. However, limited attempts have been made to scientifically evaluate these claims. Hibiscus rosa-sinensis flowers have been shown to possess antifertility and abortifacient activity. In this report, antiimplantation activity of water extract of leaves of H. rosa-sinensis was investigated. Pregnant female mice were dosed with extract (100 mg/kg body weight) from days 1 to 6 of pregnancy. No implantation sites were observed in treated animals when they were surgically opened on day 15 of pregnancy. Biochemical and biophysical alterations were observed in the endometrium in treated animals, especially on day 5, at 4:40 a.m., the day of implantation. A sharp increase in superoxide anion radical and a sharp fall in superoxide dismutase (SOD) activity, as seen in the endometrium from control animals, were altered in treated animals. The extract also exhibited antiestrogenic activity, as judged by increase in uterine weight. The physiological alterations induced by water extract of H. rosa-sinensis are discussed. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | LABORATORY ANIMALS | SURGERY | IMPLANTATION | MEDICINAL PLANTS | Asia, Southern | Asia | Developing Countries | Clinical Research | Research Methodology | Treatment | Pregnancy, First Trimester | Pregnancy | Reproduction | Medicine | Health Services | Delivery of Health Care | Health Document Number: 281364 |
| 16. Title: Male hormonal contraception: suppression of spermatogenesis by injectable testosterone undecanoate alone or with levonorgestrel implants in Chinese men. Author: Gui YL; He CH; Amory JK; Bremner WJ; Zheng EX Source: Journal of Andrology. 2004 Sep-Oct;25(5):720-727. Abstract: Monthly injections of testosterone undecanoate (TU) act as a male contraceptive by reversibly suppressing spermatogenesis to azoospermia or severe oligoazoospermia in 95% of Chinese men. In 5% of Chinese men, however, monthly TU administered alone fails to suppress spermatogenesis into contraceptive ranges, or sperm “rebound,” leading to occurrences of pregnancy during treatment. Since combinations of progestins and androgens are associated with greater degrees of sperm suppression in white men, we hypothesized that the combination of TU and the progestin levonorgestrel (LNG) would result in improved spermatogenic suppression in Chinese men. Sixty-two healthy Chinese men were randomly assigned to one of the following 3 regimens: group I (n = 21) received 4 LNG rods (75 mg each), which were followed 4 weeks later by 500 mg of TU by intra-muscular (IM) injection every 8 weeks for 24 weeks; group II (n = 20) received 4 LNG implants, which were followed 4 weeks later by 1000 mg of TU by IM injection every 8 weeks for 24 weeks; and group III (n = 21) received TU 1000 mg by IM injection every 8 weeks for 24 weeks. Sperm counts, serum testosterone (T), luteinizing hormone, follicle-stimulating hormone, and LNG were measured every 2 weeks before, during, and after treatment. During treatment, group II demonstrated a trend toward a greater attainment of azoospermia than groups I and III (90% vs 62% [group I] vs 67% [group III]; P = .09). Attainments of either azoospermia or oligozoospermia (sperm density, <3 x 10(6)/mL) were 95%, 100%, and 86% for groups I, II, and III, respectively (P > .05 for comparisons between groups). Spermatogenesis in all subjects returned to the normal range after the implants were removed. No serious adverse events and no significant changes in serum chemistry occurred during the study. These results demonstrate that the combination of IM injections of high-dose TU every 2 months and LNG implants is associated with marked suppression of spermatogenesis in Chinese men. The combination of high-dose TU every 2 months and LNG implants is a promising candidate for future large-scale efficacy studies of hormonal male contraception in Chinese men. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | MEN | IMPLANTATION | LEVONORGESTREL | TESTOSTERONE | MALE CONTRACEPTION | SPERMATOGENESIS | CONTRACEPTION RESEARCH | Developing Countries | Asia, Eastern | Asia | Demographic Factors | Population | Pregnancy, First Trimester | Pregnancy | Reproduction | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Androgens | Hormones | Endocrine System | Physiology | Biology Document Number: 284867 |
| 17. Title: A trial of a new regimen with clomiphene citrate administration to reduce the antiestrogenic effects on reproductive end organs. Author: Kelekçi S; Saygili-Yilmaz E; Inan I; Eminsoy G Source: European Journal of Obstetrics and Gynecology. 2004;70:54-57. Abstract: The objective was to determine the endocrinological and clinical outcomes of a 3-day clomiphene citrate (CC) regimen and compare it with the classical 5-day clomiphene citrate regimen. 59 patients, diagnosed with Class II ovulatory deficiency according to the criteria defined by WHO, were randomized into two groups. Patients in Group I received 50 mg per day of CC for 3 days starting on the first day of the cycle during 72 cycles. Group II received 50 mg per day of CC for 5 days starting on the fifth day during 64 cycles. The ovulation rate was significantly higher in Group II (78.11%) compared to Group I (63.88%) (P < 0:05). However, the implantation rate was higher in Group I than Group II. We observed that starting CC on the first day of the cycle for 3 days would lead to higher implantation rates compared to the classical 5-day CC therapy. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL TRIALS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | CLOMIPHENE | ESTROGENS | ADMINISTRATION AND DOSAGE | TIME FACTORS | OVULATION | PREGNANCY OUTCOMES | MENSTRUAL REGULATION | IMPLANTATION | Developing Countries | Europe, Southeastern | Europe | Clinical Research | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Fertility Agents | Reproductive Control Agents | Family Planning | Hormones | Endocrine System | Physiology | Biology | Drugs | Treatment | Population Dynamics | Reproduction | Pregnancy | Fertility Control, Postcoital | Pregnancy, First Trimester Document Number: 273597 |
18.  Peer Reviewed Title: Natural killer cells, miscarriage, and infertility. Author: Moffett A; Regan L; Braude P Source: BMJ. British Medical Journal. 2004 Nov 27;329:1283-1285. Abstract: Natural killer (NK) cells have an important role in the early responses to viral infections and have also been linked with failure of pregnancy. Recent reports in the media and the internet have exposed women to a baffling array of conflicting information about tests for NK cells and “cures” for infertility and miscarriage. These are based on the premise that malfunction of NK cells causes these conditions. Increasingly, clinics are offering blood tests to measure the number and activity of circulating NK cells. As a result of these investigations, many women are offered treatments such as steroids, intravenous immunoglobulins, and tumour necrosis factor _ blocking agents. The scientific rationale for these tests and treatments, however, is not supported by our current knowledge of the function of uterine NK cells. (excerpt) Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | STUDIES | PREGNANT WOMEN | IMMUNITY, CELLULAR | INFERTILITY | ABORTION, SPONTANEOUS | DECIDUAL CELL REACTION | IMPLANTATION | TESTING | TREATMENT | Developed Countries | Europe, Western | Europe | Research Methodology | Population Characteristics | Demographic Factors | Population | Immunity | Immune System | Physiology | Biology | Reproduction | Pregnancy Complications | Diseases | Cytologic Effects | Pregnancy, First Trimester | Pregnancy | Measurement Document Number: 278495 |
| 19. Peer Reviewed Title: Endometriosis: epidemiology and aetiological factors. Author: Viganó P; Parazzini F; Somigliana E; Vercellini P Source: Best Practice and Research Clinical Obstetrics and Gynaecology. 2004;18(2):177-200. Abstract: Estimates of the frequency of endometriosis vary widely. Based on the few reliable data, the prevalence of the condition can reasonably be assumed to be around 10%. Although no consistent information is available on the incidence of the disease, temporal trends suggest an increase among women of reproductive age. This could be explained--at least in part --by changing reproductive habits. Numerous epidemiological studies have indicated that nulliparous women and women reporting short and heavy menstrual cycles are at increased risk of developing endometriosis; data on other risk factors are less consistent. These epidemiological findings strongly support the menstrual reflux hypothesis. Additional evidence in favour of this theory includes the demonstration of viable endometrial cells in the menstrual effluent and peritoneal fluid, experimental implantation and growth of endometrium within the peritoneal cavity, observation of some degree of retrograde menstruation in most women undergoing laparoscopy during menses, and an association between obstructed menstrual outflow and endometriosis. (author's) Language: English Keywords: ITALY | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | WOMEN | EPIDEMIOLOGY | ENDOMETRIOSIS | PREVALENCE | RISK FACTORS | MENSTRUAL CYCLE | LAPAROSCOPY | MENSTRUATION DISORDERS | IMPLANTATION | Europe, Southern | Europe | Developed Countries | Research Methodology | Demographic Factors | Population | Public Health | Health | Diseases | Measurement | Biology | Menstruation | Reproduction | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Pregnancy, First Trimester | Pregnancy Document Number: 296921 |
| 20. Title: Interpopulational differences in progesterone levels during conception and implantation in humans. [Diferencias interpoblacionales en el nivel de progesterona durante la concepción y la implantación humanas] Author: Vitzthum VJ; Spielvogel H; Thornburg J Source: PNAS. Proceedings of the National Academy of Sciences. 2004 Feb 10;101(6):1443-1448. Abstract: Clinical studies of women from the United States demonstrate a sensitivity of the ovarian system to energetic stress. Even moderate exercise or caloric restriction can lead to lower progesterone levels and failure to ovulate. Yet women in many non-industrial populations experience as many as a dozen pregnancies in a lifetime despite poor nutritional resources, heavy workloads, and typical progesterone levels only about two-thirds of those of U.S. women. Previous cross-sectional studies of progesterone may, however, suffer from inadvertent selection bias. In a non-contracepting population, the most fecund women, who might be expected to have the highest progesterone, are more likely to be pregnant or breastfeeding and hence unavailable for a crosssectional study of the ovarian cycle. The present longitudinal study was designed to ascertain whether lower progesterone also characterizes conception, implantation, and gestation in women from nonindustrialized populations. We compared rural Bolivian Aymara women (n = 191) to women from Chicago (n = 29) and found that mean-peak-luteal progesterone in the ovulatory cycles of Bolivian women averaged ˜71% that of the women from Chicago. In conception cycles, progesterone levels in Bolivian women during the periovulatory period were ˜63%, and during the peri-implantation period were ˜50%, those of the U.S. women. These observations argue that lower progesterone levels typically characterize the reproductive process in Bolivian women and perhaps others from non-industrialized populations. We discuss the possible proximate and evolutionary explanations for this variation and note the implications for developing suitable hormonal contraceptives and elucidating the etiology of cancers of the breast and reproductive tract. (excerpt) Spanish Abstract: Estudios clínicos de mujeres estadounidenses demuestran una sensibilidad del sistema ovárico al estrés energético. Incluso el ejercicio moderado o la restricción calórica pueden inducir niveles menores de progesterona y anovulación. Sin embargo -aunque no debe descartarse la posibilidad de un sesgo de selección en los estudios transversales previos de progesterona- las mujeres de muchas poblaciones no industriales tienen hasta doce embarazos en el curso de su vida pese a su nutrición deficiente, a su pesada carga laboral y a niveles típicos de progesterona equivalentes a sólo dos tercios de los de sus pares de los EE.UU. En una población que no utiliza métodos anticonceptivos, las mujeres más fértiles, supuestamente poseedoras del máximo nivel de progesterona, son más propensas a quedar embarazadas o a amamantar y, por consiguiente, no pueden participar de un estudio transversal del ciclo ovárico. Este estudio longitudinal se diseñó para establecer si la concepción, la implantación y la gestación en las mujeres de poblaciones no industrializadas también se caracterizaban por un bajo nivel de progesterona. Al comparar un grupo de mujeres Aymará radicadas en el área rural boliviana (n = 191) con mujeres de Chicago (n = 29), se verificó una concentración pico promedio de progesterona en la fase luteínica de los ciclos ovulatorios de las mujeres bolivianas equivalente al 71% de la concentración observada en las mujeres de Chicago. En el ciclo de concepción, los niveles de progesterona de las mujeres bolivianas durante el período periovulatorio fueron del 63%, y durante el período de periimplantación del 50% de los valores para las mujeres estadounidenses. Estas observaciones indican que normalmente el proceso reproductivo en las mujeres bolivianas (y quizá en otras de poblaciones no industrializadas) se caracteriza por niveles más bajos de progesterona. Se analizan los posibles factores inmediatos y evolutivos de esta variación y se consignan las implicaciones para el desarrollo de anticonceptivos hormonales adecuados y la determinación de la etiología de los cánceres de mama y del aparato reproductor. (extracto) Language: English Keywords: UNITED STATES OF AMERICA | BOLIVIA | RESEARCH REPORT | CLINICAL RESEARCH | LONGITUDINAL STUDIES | CROSS-CULTURAL COMPARISONS | PREGNANT WOMEN | WOMEN | IMPLANTATION | PROGESTERONE | MENSTRUAL CYCLE | LUTEINIZING HORMONE | BREAST CANCER | CANCER | CONTRACEPTIVE AGENTS | Developed Countries | North America | Americas | Developing Countries | South America, Central | South America | Latin America | Research Methodology | Studies | Comparative Studies | Population Characteristics | Demographic Factors | Population | Pregnancy, First Trimester | Pregnancy | Reproduction | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Menstruation | Gonadotropins, Pituitary | Gonadotropins | Neoplasms | Diseases | Contraception | Family Planning Document Number: 191142 |
| 21. Title: Delivering the goods. Author: World Health Organization [WHO]. Special Programme of Research, Development and Research Training in Human Reproduction Source: Progress in Reproductive Health Research. 2003;(61):7-8. Abstract: This article discusses issues involved in providing implant services: staff prerequisites, preventing infection, providing client information, and cost-effectiveness of time, personnel and supplies. Language: English Keywords: SUMMARY REPORT | RECOMMENDATIONS | ADULTS | WOMEN | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE SAFETY | CONTRACEPTIVE DISTRIBUTION | FAMILY PLANNING PERSONNEL | IMPLANTATION | TRAINING ACTIVITIES | COST EFFECTIVENESS | Age Factors | Population Characteristics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Safety | Public Health | Health | Distributional Activities | Program Activities | Programs | Organization and Administration | Family Planning Programs | Pregnancy, First Trimester | Pregnancy | Reproduction | Training Programs | Education | Evaluation Indexes | Quantitative Evaluation | Evaluation Document Number: 179541 |
| 22. Title: Mechanisms of action of emergency contraception. [Mecanismos de acción en la anticoncepción de emergencia] Author: Croxatto HB; Ortiz ME; Müller AL Source: Steroids. 2003;68(10-13):1095-1098. Abstract: The use of levonorgestrel (LNG) alone or combined with ethinylestradiol (Yuzpe regimen), for hormonal emergency contraception (HEC) has been approved in several countries whereas in others it is still under debate or has been rejected under the claim that these formulations abort the developmental potential of the embryo. The issue is whether they act by preventing fertilization or by impeding the successful development of the zygote through and beyond implantation. Until now, published work has left this issue largely unresolved, and this paucity of knowledge sustains heated controversies in many settings. A single study indicates that LNG impairs sperm migration in the genital tract of women in ways that could interfere with fertilization. Several studies in women examined the effects of HEC on the outcome of the leading follicle, but lack of precision in the timing of treatment relative to follicular growth, maturation, or rupture confers great variability and inconsistency of results within and between studies. Nonetheless, results indicate that ovulatory dysfunction may account for the prevention of pregnancy in a large proportion of cases. Studies searching for possible alterations of the endometrium at the time implantation would normally take place, found minimal changes of doubtful significance. Recent studies in animals cast serious doubts that LNG prevents pregnancy by interfering with post-fertilization events. Failure to prevent expected pregnancies is close to 25% in women, and this is likely to be accounted for entirely by treatment given too late to prevent fertilization. The exact mode of action of HEC remains undetermined. (author's) Spanish Abstract: En muchos países se ha sido aprobado el uso de levonorgestrel (LNG) sólo o combinado con etinilestradiol (protocolo Yuzpe) para la anticoncepción de emergencia hormonal (HEC, hormonal emergency contraception), mientras que en otros países su uso aún se encuentra bajo debate o ha sido rechazado bajo el alegato que estas formulaciones abortan el potencial desarrollo del embrión. La problemática se centra en si su acción es prevenir la fertilización o impedir el desarrollo del cigoto en el momento de la implantación o luego de ella. Por el momento, las publicaciones no han dado respuesta a este tema y el poco conocimiento que se tiene al respecto provoca encendidas controversias en muchos ámbitos. Sólo un estudio indica que el LNG afecta a la migración de esperma en el tracto genital de la mujer en formas que pueden interferir con la fertilización. En diversos estudios en mujeres se analizaron los efectos de la HEC sobre el folículo principal, pero la falta de precisión en el cronometraje del tratamiento en relación con el crecimiento, la maduración o la ruptura folicular otorga una amplia variabilidad e inconsistencia en los resultados entre los diferentes estudios y dentro de los mismos. Sin embargo, los resultados indican que en una gran proporción de casos el factor que causa la prevención del embarazo sería la disfunción ovulatoria. Estudios para la detección de posibles alteraciones en el endometrio en el momento en que normalmente se produciría la implantación localizaron cambios mínimos de dudosa importancia. Estudios recientes realizados en animales pusieron en duda que el LNG evite el embarazo a través de su interferencia en eventos de posfertilización. Los intentos frustrados para evitar el embarazo alcanzan a casi un 25% de las mujeres y esto probablemente se debe a que el tratamiento fue suministrado demasiado tarde para la prevención de la fertilización. El modo de acción exacto de la HEC sigue aún sin definirse. (del autor) Language: English Keywords: CHILE | RESEARCH REPORT | CLINICAL RESEARCH | LABORATORY ANIMALS | EMERGENCY CONTRACEPTION | ENDOMETRIUM | LEVONORGESTREL | INHIBITION OF FERTILIZATION | IMPLANTATION | South America, Southern | South America | Latin America | Americas | Developing Countries | Research Methodology | Contraception | Family Planning | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Mode of Action | Pregnancy, First Trimester | Pregnancy | Reproduction Document Number: 277762 |
| 23. Title: Effects of mifepristone on endometrial receptivity. Author: Danielsson KG; Marions L; Bygdeman M Source: Steroids. 2003;68:1069-1075. Abstract: At the development of receptivity the endometrium undergoes specific changes. Several factors have been suggested as markers of endometrial receptivity. A common feature for most of these factors is that they are directly, or indirectly, regulated by progesterone. The effect of various doses and regimens of mifepristone on endometrial development and markers of receptivity has been studied. Timed endometrial biopsies were assessed by immunhistochemistry, reverse transcriptase polymerase chain reaction (RT-PCR) and electron microscopy. In addition the contraceptive efficacy of these regimens was investigated. Administration of 200 mg of mifepristone immediately post ovulation has a pronounced effect on endometrial development and on suggested markers of receptivity. This regimen has been shown to be an effective contraceptive method. When 10 mg is given pre or post ovulation, only minor effects on the endometrium are observed. Our studies show that mifepristone, when administered in low doses that do not affect ovulation, significantly affects some of the studied markers of endometrial receptivity and reduces pregnancy rates; however, these activities are more pronounced with the higher dose, which is more effective. Our findings provide insight into the regulation of progesterone receptors of various suggested markers of endometrial receptivity and the possibility of using mifepristone for endometrial contraception. (author's) Language: English Keywords: SWEDEN | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | RU-486 | RESEARCH AND DEVELOPMENT | ENDOMETRIUM | IMPLANTATION | CONTRACEPTION | OVULATION | MENSTRUAL CYCLE | ADMINISTRATION AND DOSAGE | Developed Countries | Europe, Northern | Europe | Demographic Factors | Population | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Technology | Economic Factors | Uterus | Genitalia, Female | Genitalia | Urogenital System | Pregnancy, First Trimester | Pregnancy | Reproduction | Family Planning | Menstruation | Drugs | Treatment Document Number: 285255 |
| 24. Peer Reviewed Title: Ectopic pregnancy and emergency care: ethical and legal issues. Author: Dickens BM; Faundes A; Cook RJ Source: International Journal of Gynecology and Obstetrics. 2003 Jul;82(1):121-126. Abstract: Ectopic or tubal pregnancy presents a medical emergency that requires prompt treatment in order to contain risks of maternal death and morbidity, including loss of future fertility. Medical circumstances involving individual patients and resources of the prevailing health care system will determine the options and means of treatment. Termination of ectopic pregnancy does not constitute or directly implicate abortion. Any practice of deliberately delaying treatment of reliably diagnosed ectopic pregnancy, on non-clinical grounds, until rupture of the fallopian tube has occurred or is imminent, in order to justify termination of the ectopic pregnancy on grounds of saving the patient’s life, is unethical and illegal. Those who undertake or counsel deliberate delay of medically-indicated treatment can be charged with criminal offences and civil (non-criminal) liability, and medical professional misconduct. On reliable diagnosis, prompt treatment to remove ectopic pregnancy is legally justified, and ethically and legally required. (author's) Language: English Keywords: CANADA | PHILOSOPHICAL OVERVIEW | PREGNANT WOMEN | PREGNANCY, ECTOPIC | ABORTION | EMBRYO | IMPLANTATION | MANAGEMENT | EMERGENCY SERVICES | ETHICS | LAPAROSCOPY | METHOTREXATE | Developed Countries | North America, Northern | Americas | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Pregnancy, First Trimester | Organization and Administration | Health Services | Delivery of Health Care | Health | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Drugs | Treatment Document Number: 181737 Notification |
| 25. Title: Paracrine regulation of endometrial function: interaction between progesterone and corticotropin-releasing factor (CRF) and activin A. Author: Florio P; Rossi M; Sigurdardottir M; Ciarmela P; Luisi S Source: Steroids. 2003;68:801-807. Abstract: Under the influence of ovarian steroid hormones, endometrial cells are able to produce a wide variety of growth factors and peptide hormones that are believed to promote: (1) physiological growth and differentiation during the endometrial cycle; (2) decidualization, an essential preparative event for establishment of pregnancy; and (3) pathological growth and differentiation in endometriosis and cancer. Among the local factors produced by the human endometrium, corticotropin-releasing factor (CRF) and activin A have been evaluated in terms of localization and effects. CRF is a neuropeptide expressed by the epithelial and stromal cells of the human endometrium in increasing amounts from the endometrial proliferative to the secretory phase. CRF expression also increases in the pregnant endometrium, from early in the pregnancy until term. CRF-type 1 receptor mRNA is only expressed by stromal cells. Progesterone induces CRF gene expression and release from decidualized cells and CRF decidualizes cultured stromal endometrial cells. Urocortin, a CRF-related peptide, has been identified in endometrial epithelial and stromal cells, and its function is still under investigation. Activin A is a growth factor expressed in increasing amounts throughout endometrial phases by both epithelial and stromal cells. This growth factor is secreted into the uterine cavity with higher levels in the secretory phase. Maternal decidua expresses activin A mRNA in increasing amounts from early pregnancy until term. Human endometrium also expresses activin-A receptors and follistatin, its binding protein. Activin A decidualizes cultured human endometrial stromal cells (an effect reversed by follistatin) and modulates embryonic trophoblast differentiation and adhesion. Activin A is expressed in endometriosis and endometrial adenocarcinoma. (author's) Language: English Keywords: ITALY | LITERATURE REVIEW | WOMEN | PROGESTERONE | ENDOMETRIUM | CANCER | IMPLANTATION | ENDOMETRIOSIS | Europe, Southern | Europe | Developed Countries | Demographic Factors | Population | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Uterus | Genitalia, Female | Genitalia | Urogenital System | Neoplasms | Diseases | Pregnancy, First Trimester | Pregnancy | Reproduction Document Number: 285272 |
| 26. Peer Reviewed Title: Rapid decline in ovarian reserve after repeated ART cycles in a 22-year-old IVF patient. Author: Isikoglu M; Ozgur K Source: Archives of Gynecology and Obstetrics. 2003 Aug;268(3):206-208. Abstract: The objective was to discuss the rapid decline in ovarian reserve due to repeated assisted reproductive technologies (ART) in a 22-year-old patient. This case report presents an infertile couple admitted to our IVF unit with the diagnosis of recurrent implantation failure and congenital uterine anomaly. Main outcome measures were the number of growing follicles and metaphase II oocytes retrieved. After recurrent implantation failure of three in vitro fertilization cycles, the couple underwent three consecutive intracytoplasmic sperm injection cycles in our center. With a high number of oocytes retrieved, first cycle resulted in implantation failure followed by an embryo transfer cancelled cycle. The third cycle was cancelled due to an unexpected poor response even with the highest gonadotrophin dose. Rapid decrease in ovarian reserve should be considered when offering repeated ART cycles even if the woman is very young and has a good ovarian reserve. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN IN DEVELOPMENT | REPRODUCTIVE TECHNOLOGIES | OVARIAN EFFECTS | CONGENITAL ABNORMALITIES | UTERUS | IMPLANTATION | FERTILIZATION | EMBRYO TRANSFER | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Reproduction | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Neonatal Diseases and Abnormalities | Diseases | Pregnancy, First Trimester | Pregnancy Document Number: 298121 |
| 27. Title: Two pathways of progesterone action in the human endometrium: implications for implantation and contraception. Author: Lessey BA Source: Steroids. 2003 Nov;68(10-13):809-815. Abstract: The endometrium is the site of implantation and pregnancy. Preparation for this important biological event relies primarily on progesterone, which takes the estrogen-primed endometrium toward a state of receptivity. As a steroid target tissue, the endometrium is also prone to abnormal growth sometimes leading to the development of hyperplasia or cancer. It is the balance between estrogen and progesterone that maintains the endometrium in a state of health and provides the synchronous timing necessary for a successful implantation to occur. In our efforts to understand the role of progesterone in the endometrium we have focused on the use of specific protein biomarkers. Based on examination of a cell adhesion molecule, the avß3 integrin, and its ligand, osteopontin, we have come to conclude that progesterone action can be direct or indirect. Progesterone acting on the stromal compartment provides paracrine mediators that influence epithelial gene expression. Conversely, acting directly, progesterone may primarily stimulate gene expression of the endometrial epithelium. The complexity of the system is extended since progesterone itself works through two different receptor isoforms. Regulated differential expression of PR-A versus PR-B also appears to fine tune the effect of progesterone on specific genes. Progesterone may also inhibit specific genes that undergo cyclic variation during the menstrual cycle. Together, using in vitro models we have shown that progesterone dynamically regulates gene expression in the endometrium and that imbalances between estrogen and progesterone may have far reaching consequences on normal cycle fecundity and on the balance between health and disease in this hormone-target tissue. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CONTRACEPTION | ENDOMETRIUM | PREGNANCY | IMPLANTATION | PROGESTERONE | OVULATION | HORMONE RECEPTORS | MENSTRUAL CYCLE | Developed Countries | North America | Americas | Family Planning | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Reproduction | Pregnancy, First Trimester | Progestational Hormones | Hormones | Endocrine System | Membrane Proteins | Menstruation Document Number: 277758 |
| 28. Title: Nestorone: clinical applications for contraception and HRT. Author: Sitruk-Ware R; Small M; Kumar N; Tsong YY; Sundaram K Source: Steroids. 2003;68(10-13):907-913. Abstract: The 19-nor derivatives of progesterone are referred to as "pure" progestational molecules as they bind almost exclusively to the progesterone receptor (PR) without interfering with receptors of other steroids. In this category is Nestorone®, which has strong progestational activity and antiovulatory potency with no androgenic or estrogenic activity in vivo. These properties make it highly suitable for use in contraception and hormonal therapy (HT). Due to its high potency, very low doses of Nestorone may be delivered via long-term sustained-release delivery systems. Nestorone, 75 or 100 µg per day, released by vaginal ring has suppressed ovulation in women, with inhibition of follicular maturation. A vaginal ring releasing both 150 µg of Nestorone and 15 µg of ethinyl estradiol per day has effectively suppressed ovulation for 13 consecutive cycles. Nestorone has also been used effectively in a single implant for contraception in breastfeeding women and shows promise for use in transdermal systems as a contraceptive or for HT when combined with estrogen. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CONTRACEPTION | OVULATION SUPPRESSION | HORMONE REPLACEMENT THERAPY | VAGINAL RING | PROGESTERONE | IMPLANTATION | CONTRACEPTIVE MODE OF ACTION | HORMONE RECEPTORS | CONTRACEPTIVE AGENTS, PROGESTIN | Developed Countries | North America | Americas | Family Planning | Treatment | Contraceptive Methods | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Pregnancy, First Trimester | Pregnancy | Reproduction | Membrane Proteins | Contraceptive Agents, Female | Contraceptive Agents Document Number: 277759 |
| 29. Title: Role of posterior stabilisation in the management of tuberculosis of the dorsal and lumbar spine. Author: Sundararaj GD; Behera S; Ravi V; Venkatesh K; Cherian VM Source: Journal of Bone and Joint Surgery. 2003 Jan;85(1):100-106. Abstract: We present a prospective study of patients with tuberculosis of the dorsal, dorsolumbar and lumbar spine after combined anterior (radical debridement and anterior fusion) and posterior (instrumentation and fusion) surgery. The object was to study the progress of interbody union, the extent of correction of the kyphosis and its maintenance with early mobilisation, and the incidence of graft and implant-related problems. The American Spinal Injury Association (ASIA) score was used to assess the neurological status. The mean preoperative vertebral loss was highest (0.96) in the dorsal spine. The maximum correction of the kyphosis in the dorsolumbar spine was 17.8°. Loss of correction was maximal in the lumbosacral spine at 13.7°. All patients had firm anterior fusion at a mean of five months. The incidence of infection was 3.9% and of graft-related problems 6.5%. We conclude that adjuvant posterior stabilisation allows early mobilisation and rehabilitation. Graft-related problems were fewer and the progression and maintenance of correction of the kyphosis were better than with anterior surgery alone. There is no additional risk relating to the use of an implant either posteriorly or anteriorly even when large quantities of pus are present. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | ADULTS | TUBERCULOSIS | SURGERY | IMPLANTATION | SKELETAL EFFECTS | NEUROLOGIC EFFECTS | TREATMENT | Asia, Southern | Asia | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Pregnancy, First Trimester | Pregnancy | Reproduction | Physiology | Biology Document Number: 188158 |
| 30. Peer Reviewed Title: Characterization of morphological and cytoskeletal changes in trophoblast cells induced by insulin-like growth factor-I. Author: Kabir-Salmani M; Shiokawa S; Akimoto Y; Hasan-Nejad H; Sakai K Source: Journal of Clinical Endocrinology and Metabolism. 2002 Dec;87(12):5751-5759. Abstract: IGF-I and IGF-II were appeared to play major roles in the adhesive and migratory events that are considered to be crucial in the implantation process. The purpose of this study was to determine the effects of IGF-I on trophoblast adhesion to extracellular matrix. Trophoblast cells obtained from early gestation at artificial abortion were incubated with the indicated doses of IGF-I at the indicated times. Trophoblast cells were treated with IGF-I in the presence or absence of RGD peptide and an antibody against _-subunit of IGF-I receptor (aIR3). Morphometric and morphological changes were studied using light and electron microscopy. Furthermore, vinculin, actin stress fibers, phosphorylated focal adhesion kinase (FAK), phosphotyrosine, and paxillin were immunolocalized in trophoblast cells after IGF-I treatment in the presence or absence of aIR3. Immunoprecipitation and anti-phosphotyrosine immunoblotting were carried out to detect the phosphorylated FAK and phosphorylated paxillin contents of the IGF-I-treated and untreated trophoblast cells. The results showed that IGF-I promoted trophoblast adhesion to fibronectin substrate in a time- and dose-dependent manner, and addition of RGD peptide and aIR3 monoclonal antibody abolished the effects of IGF-I in these cells. Morphological studies exhibited an increase in the lamellipodia formation upon IGF-I treatment, and confocal images of immunofluorescent staining revealed localization of phosphorylated FAK, paxillin, and vinculin at focal adhesions as well as redistribution of actin microfilaments and formation of actin stress fibers inside the cell. Western blotting, using antiphosphotyrosine demonstrated proteins with molecular masses of 125 kDa (FAK) and 68 kDa (paxillin) present in the IGF-I-treated cells, which were lacking in the control groups. In conclusion, these findings suggest that IGF-I can stimulate lamellipodia formation and promote adhesion of trophoblast cells to extracellular matrix by activating their adhesion molecules that must be activated within the implantation window. (author's) Language: English Keywords: JAPAN | IRAN | RESEARCH REPORT | CLINICAL RESEARCH | IN VITRO | FERTILIZATION | IMPLANTATION | CYTOLOGIC EFFECTS | REPRODUCTIVE TECHNOLOGIES | Developed Countries | Asia, Eastern | Asia | Developing Countries | Middle East | Research Methodology | Reproduction | Pregnancy, First Trimester | Pregnancy | Physiology | Biology Document Number: 296195 |
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