Navegando por Palavras-chave "Infertility"

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    Avaliação da contratilidade uterina por ressonância magnética em mulheres submetidas a embolização de miomas uterinos
    (Universidade Federal de São Paulo (UNIFESP), 2018-09-06) Fornazari, Vinicius Adami Vayego [UNIFESP]; Goldman, Suzan Menasce [UNIFESP]; Szejnfeld, Denis; Bonduki, Claudio Emilio; http://lattes.cnpq.br/7384818983129643; http://lattes.cnpq.br/5784659077054234; http://lattes.cnpq.br/4903816455277036; http://lattes.cnpq.br/9458061365748156; http://lattes.cnpq.br/9458061365748156; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To evaluate the impact of uterine fibroid embolization (UFE) on uterine contractility using ultrafast magnetic resonance (cineMR) sequences. Method: This prospective study included 26 patients, aged between 30 and 41 years (mean age: 36 years), with symptomatic uterine fibroids undergoing UFE. Patients underwent cineRM sequences before and 6 months after EMUT. Contractility was classified as absent, ordered or disordered. Patients were divided into three patterns of evolution of contractility after UFE: unchanged (group A), favorable modification (group B) and loss of contractility (group C). The following variables were also evaluated: uterine volume, dominant localization of fibroids, fibroidmyometrial index (predominance of myometrium versus predominance of fibroids) and pattern of necrosis of the dominant myometrial nodule after the procedure. Results: Of the 26 patients, eight (30.7%) had no contractility before the procedure, 18 (69.2%) presented with some type of contractility, 11 (61%) were classified as ordered and seven (39%) as disordered. After UFE, the eight patients without contractility presented with contractions, five ordered and three disordered. Of the 11 patients who initially showed ordered contractility, nine remained ordered and two showed loss of contractility. Of the seven patients who initially presented with disordered contractility, one remained disordered, five began to have ordered contractions and one showed loss of contractility. Regarding the evolution of the contractility pattern, 10 (38%) patients had no change in the pattern (group A), 13 (50%) had a positive change in contractility (group B) and three had loss of contractility (group C). Uterine volume, dominant location of fibroids, fibroidmyometrial index and pattern of myometrial nodule necrosis were not statistically significant when comparing the evolution pattern groups. Conclusion: UFE may be related to an improvement in uterine contractility pattern. Uterine volume, fibroid location, fibroidmyometrial index and pattern of fibroid necrosis do not seem to be related to the evolution of the uterine contractility pattern.
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    Avaliação da resposta de estresse em ratas submetidas ao estresse crônico e a múltiplos ciclos de superovulação
    (Universidade Federal de São Paulo, 2018-03-23) Gonçalves, Bianca Santos Martins [UNIFESP]; Le Sueur-Maluf, Luciana [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    It Is Estimated That Infertility Affects About 10-15% Of Couples Of Childbearing Age Within The World Population, While Annually, 7-10% Of Couples Of Reproductive Age In Brazil Rely On Services Specialized In Fertility Disorders Treatment. From A Psychosocial Perspective, Infertile Individuals Experience Intense Psychological Stress, Related To Emotional Disorders, Which Have Repercussions On Marital And Social Relationships. While The Stress Impact On The Success Of Assisted Reproduction Treatments (Art) Has Been Comprehensively Studied, The Role Of Supraphysiological Concentrations Of Gonadal Hormones (Commonly Experienced By Women In Treatment) On Stress Response, Remains To Be Elucidated. The Aim Of Study Was To Evaluate The Stress Response In Female Rats Submitted To Chronic Stress And Multiple Cycles Of Superovulation Treatment. In Order To Mimic The Context Of Art In Rodents, Female Wistar Rats (10 Weeks Old) With Proven Regular Estrous Cycle, Were Exposed To The Unpredictable Chronic Mild Stress Proto
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    Cadmium-induced testicular injury
    (Elsevier B.V., 2009-08-01) Siu, Erica Rosanna; Mruk, Dolores D.; Porto, Catarina Segreti [UNIFESP]; Cheng, C. Yan; Populat Council; Universidade Federal de São Paulo (UNIFESP)
    Cadmium (Cd) is an environmental toxicant and an endocrine disrupter in humans and rodents. Several organs (e.g., kidney, liver) are affected by Cd and recent studies have illustrated that the testis is exceedingly sensitive to Cd toxicity. More important, Cd and other toxicants, such as heavy metals (e.g., lead, mercury) and estrogenic-based compounds (e.g., bisphenols) may account for the recent declining fertility in men among developed countries by reducing sperm count and testis function. in this review, we critically discuss recent data in the field that have demonstrated the Cd-induced toxicity to the testis is probably the result of interactions of a complex network of causes. This is likely to involve the disruption of the blood-testis barrier (BTB) via specific signal transduction pathways and signaling molecules, such as p38 mitogen-activated protein kinase (MAPK). We also summarize current studies on factors that confer and/or regulate the testis sensitivity to Cd, such as Cd transporters and metallothioneins, the impact of Cd on the testis as an endocrine disruptor and oxidative stress inducer, and how it may disrupt the Zn(2+) and/or Ca(2+) mediated cellular events. While much work is needed before a unified mechanistic pathway of Cd-induced testicular toxicity emerges, recent studies have helped to identify some of the likely mechanisms and/or events that take place during Cd-induced testis injury. Furthermore, some of the recent studies have shed lights on potential therapeutic or preventive approaches that can be developed in future studies by blocking or minimizing the destructive effects of Cd to testicular function in men. (C) 2009 Elsevier Inc. All rights reserved
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    Description and evaluation of experimental models for uterine transplantation in pigs
    (Inst Israelita Ensino & Pesquisa Albert Einstein, 2017) de Oliveira, Emerson; da Silva Tavares, Kelly Alessandra; Vieira Gomes, Mariano Tamura; Salzedas-Netto, Alcides Augusto [UNIFESP]; Ferreira Sartori, Marair Gracio [UNIFESP]; Castro, Rodrigo Aquino [UNIFESP]; Fernandes, Cesar Eduardo; Batista Castello Girao, Manoel Joao [UNIFESP]
    Objective: To evaluate the technique of uterine transplantation and the use of drugs used in the process of immunosuppression. Methods: We included 12 sows, and immunosuppression was performed with minimal doses of cyclosporine, and cross-match was done to exclude the possibility of blood incompatibility. Hysterectomy was performed in the donor under general anesthesia, with the removal of the aorta and inferior vena cava in monobloc, and anastomosis of these vessels was made in the recipient. Results: Six experiments were performed, and on the immediate postoperative period, five animals had good reperfusion. However, on the seventh postoperative day, histological analysis showed rejection in five animals. Conclusion: The experimental model of uterine transplantation is feasible, but monitoring doses of immunosuppressants is pivotal to prevent rejection episodes.
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    Efeito do fluido peritoneal de pacientes inférteis com endometriose e inférteis de causa desconhecida na reação acrossômica de espermatozóides capacitados
    (Universidade Federal de São Paulo (UNIFESP), 1996) Passos, Eduardo Pandolfi [UNIFESP]; Lima, Geraldo Rodrigues de [UNIFESP]
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    O efeito do processamento seminal e a integridade do DNA nuclear do espermatozoide humano
    (Universidade Federal de São Paulo (UNIFESP), 2006) Stevanato, Juliana [UNIFESP]; Cedenho, Agnaldo Pereira [UNIFESP]
    Objetivo: Avaliar o efeito da centrifugacao em gradiente de densidade descontinuo na taxa de fragmentacao em fita dupla do DNA dos espermatozoides. Metodos: Foi realizado um estudo prospectivo e pareado, constituido de 35 amostras seminais antes e depois do processamento seminal em gradiente de densidade descontinuo, provindas de pacientes encaminhados ao Ambulatorio de Reproducao Humana para tratamento de infertilidade conjugal atraves das tecnicas de Reproducao Assistida. As amostras foram colhidas por masturbacao apos um periodo de 2 a 7 dias de abstinencia ejaculatoria e em seguida analisadas de acordo com os criterios da Organizacao Mundial da Saúde (OMS). As amostras foram divididas em duas aliquotas (antes do processamento seminal e depois do processamento seminal) para subsequente avaliacao da motilidade e integridade do DNA espermatico atraves da tecnica do TUNEL, que avalia fragmentacao apoptotica do DNA dos espermatozoides. A integridade do DNA foi avaliada por microscopia optica e expressa em porcentagem de espermatozoides com fragmentacao apoptotica no DNA por amostra. Resultados: A motilidade pos-processamento seminal foi maior do que a motilidade pre¬-processamento (86,6; 17,7 por cento e 60; 14,4 por cento, respectivamente, p <0,0001), no entanto nao foi observada diferenca na fragmentacao apoptotica do DNA dos espermatozoides apos o processamento seminal nas amostras analisadas (antes do processamento seminal: 5; 4,3 por cento e apos 5; 4,5 por cento, p=0,958). Ja as amostras seminais com alteracoes nas variaveis seminais apresentaram maiores porcentagens de celulas com fragmentacao apoptotica do DNA, em relacao as amostras que nao apresentaram alteracoes seminais (Pre-processamento - 8; 4 por cento e 4,5; 3,3 por cento respectivamente, p= 0,011 e pos-processamento - 7,7; 5,1 por cento e 4,4; 3,1 por cento respectivamente, p= 0,027). Mas nao houve melhora na porcentagem de fragmentacao apoptotica do DNA das amostras com e sem variacao seminal apos o processamento (p= 0,929). Conclusao: Nas condicoes deste estudo, o processamento seminal pela centrifugacao em gradiente de densidade descontinuo de duas camadas nao produz efeito na fragmentacao apoptotica do DNA dos espermatozoides, e apesar de pacientes com alteracao seminal apresentarem maior taxa de fragmentacao apoptotica no DNA dos espermatozoides, o processamento seminal nao melhorou os resultados em nenhum dos dois grupos. Portanto atencao especial deve ser dada aos pacientes que apresentam altas taxas de...(au)
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    Efeito protetor do consumo de extrato de castanha do Brasil (Bertholletia excelsa) em parâmteros reprodutivos e de genotoxicidade em ratos Wistar machos expostos aos regimes de injeção única ou repetida de ciclofosfamida
    (Universidade Federal de São Paulo (UNIFESP), 2019-08-20) Nascimento, Leonardo Parreira Silva [UNIFESP]; Aguiar, Odair [UNIFESP]; http://lattes.cnpq.br/0398348332863521; Universidade Federal de São Paulo (UNIFESP)
    Aim: This work proposes to investigate the influence of Brazil nut consumption in combating the potential damage to reproductive and genotoxicity parameters caused by cyclophosphamide administration. Methods: Ninety-six 90-day-old male Wistar rats were divided into 12 groups (Single injection or repeated injection): 1 Control, 2 Cyclophosphamide, 3 Cyclophosphamide + Brazil Nut dose 1, 4 Cyclophosphamide + Brazil Nut dose 2, 5 Brazil nuts dose 1 and 6 Brazil nuts dose 2. Animals received a single intraperitoneal injection every 8 days, containing 100mg / kg cyclophosphamide. Brazil nut extract was offered in lyophilized form (2µ/20g) added to the feed pellet for 28 days from 90 days of age. Biometric and reproductive parameters were evaluated. Results: We observed that single and repeated injection of cyclophosphamide reduced feed intake, mass gain, absolute weight of the testis and epididymis, and caused changes in the morphometry and profile of seminiferous tubules, as well as increased testicular expression of apoptotic markers. The damage was more pronounced in the repeated dose test which caused important changes in sperm counts, besides evidencing the occurrence of testicular oxidative stress. Brazil nuts were effective in reducing changes in tubular diameter, increasing plasma testosterone levels and increasing glutathione peroxidase activity. Additionally, the testis was protected by the germ cell apoptosis nut. Conclusion: Cyclophosphamide has been shown to cause damage in some evaluated parameters, this can be explained by the increased oxidative stress, already discussed in the literature. Thus, the possible protective effect of Brazil nuts is associated with the sinergic antioxidant role of the nutrients.
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    The effects of infertility on the spouses' relationship
    (Univ Sao Paolo, 2012-08-01) Faria, Dieime Elaine Pereira de; Grieco, Silvana Chedid; Barros, Sonia Maria Oliveira de [UNIFESP]; Univ Brussels; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    The present study investigated the effects of infertility on the spouses' relationship, with the objectives to describe the profile of the studied population, and analyze the effects of infertility on their emotional, sexual and marital life. To do this, a cross-sectional and prospective study was performed in a specialist institution. The sample consisted of 50 infertile couples with a mean of six years of infertility. The women manifested negative feelings in view of the infertility, while the men assumed an attitude of support. The effects on the couples' sexual life were more pronounced in women, and the infertility treatment resulted in positive changes for both spouses. No differences were found regarding the effects of infertility between the women who had undergone more than one treatment and those undergoing treatment for the first time; between the men there were differences in the emotional aspect ( frustration and relief) and in the marital relationship ( strengthening and maturing).
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    Estados emocionais de casais submetidos à fertilização in vitro
    (Programa de Pós-Graduação em Psicologia, Pontifícia Universidade Católica de Campinas, 2009-12-01) Montagnini, Helena Maria Loureiro [UNIFESP]; Blay, Sergio Luis [UNIFESP]; Novo, Neil Ferreira [UNIFESP]; Freitas, Vilmon de [UNIFESP]; Cedenho, Agnaldo Pereira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de Santo Amaro Disciplina de Saúde Pública
    Infertility intrudes into the plans in one's personal life and the life of a couple, and causes mental suffering. In vitro fertilization is a new technique in reproductive technology and offers fresh hope of having children, but at the same time, it is considered to be a stressful experience. The aim of this study is to compare the emotional state of men and women undergoing in vitro fertilization and identify a possible relationship between women's emotional state and a successful outcome. Twenty couples in their first cycle of in vitro fertilization were included in this study. Men and women were submitted individually to psychological interviews and tests between 5 and 10 days after the transfer of pre-embryos. Women presented higher levels of anxiety and depression than men. Their self-esteem proved to be lower. Those women (25%) that presented psycho-emotional symptoms, did not get pregnant, however this relationship was not significant. Based on these findings, we conclude that women presented greater anxiety and symptoms of depression than the men and had lower self-esteem. The group of women with psycho-emotional symptoms displayed a tendency not to get pregnant.
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    Fatores que envolvem o alcance da maternidade por meio de material genético de terceiros
    (Universidade Federal de São Paulo (UNIFESP), 2017-04-17) Lozzo, Claudia Ines Aparecida da [UNIFESP]; Villela, Wilza Vieira [UNIFESP]; http://lattes.cnpq.br/1311802831007681; http://lattes.cnpq.br/2421795549401595; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Women who can’t get pregnant or face some difficulties for it, sometimes search for assisted reproduction techniques (AHR). To make the decision to use the Assisted Human Reproduction (AHR) with the donation of oocyte, requires the breaking of paradigms and representations of blood / genetic transmission and the acceptance of the idea that having a child means the experience of pregnancy and birth. Considering AHR a different and controversial contemporary theme, interested women can search for private clinics, hospitals and public information in social medias, blogs and websites that will help them making their decision. Objective: The purpose of this research is to identify some obstacles faced by women who desire the motherhood by using other people’s genetic material. Method: The essay had a focus on available collected testimonies from two selected virtual space aimed at women involved with the AHR process. The participants’ comments were examined and classified considering the obstacles they had about their experience and doubts related to their motherhood projects. Results: The reports analysis permitted the identification of a series of objective and subjective problems faced by women who wanted the motherhood with the donation of genetic material, and appreciating blogs as a place to exchange and share information. The virtual space is important in many situations: encouragement to the process of decision, or not, related to the AHR to get the pregnancy; genetic relationship needs, or not, to build a family; sociocultural development related to blood and family bonds; sympathy before the related experiences; sharing the experiences and knowledge built; support to other women; oocyte donation as a solution to an expensive high technological treatment; facing the prejudice about the use of given gametes; exposing the diagnostic of infertility to do the single parent motherhood; discussion about age and some disorders as restriction factors to motherhood. Conclusion: Blogs have been an important discussion forum where it is possible to share doubts, to know and explain the ambiguity ideas about the theme. Anonymity seems to benefit the experiences exchanged. Information allied to experiences may provide observation about AHR, and help to deconstruct barriers and change values and attitudes about this theme.
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    Frequency of endometriotic lesions in peritoneum samples from asymptomatic fertile women and correlation with CA125 values
    (Associação Paulista de Medicina - APM, 2009-11-01) Barbosa, Caio Parente [UNIFESP]; Souza, Ângela Mara Bentes de; Bianco, Bianca Alves Vieira [UNIFESP]; Christofolini, Denise Maria [UNIFESP]; Bach, Fernanda Abani Mafra; Lima, Geraldo Rodrigues de [UNIFESP]; Faculdade de Medicina do ABC Department of Gynecology and Obstetrics Division of Pathological Gynecology; Universidade Federal de São Paulo (UNIFESP)
    CONTEXT AND OBJECTIVE: Serological testing for CA125 has been widely used to detect endometriosis and to monitor its progression. However, controversy still exists regarding the usefulness of the plasma CA125 assay for diagnosing endometriosis. Furthermore, some authors have described superficial endometriosis as a cyclical and normal phenomenon in women's lives, and have indicated that development and progression of this disease would only occur in some women as a result of immunological changes. This study aimed to determine the frequency of endometriosis and the correlation between serum CA125 levels and the presence of endometriotic lesions in the peritoneum of asymptomatic fertile patients. DESIGN AND SETTING: Cross-sectional study at the Family Planning outpatient clinic of Faculdade de Medicina do ABC. METHODS: Eighty asymptomatic fertile patients who underwent tubal sterilization surgery were studied. Blood and peritoneum samples were collected. CA125 levels were measured from blood samples, and peritoneum biopsies were studied using histopathological tests. RESULTS: Histopathological evaluation of the peritoneum revealed that 16.25% of the patients had minimal or mild endometriosis. There was no statistically significant difference in CA125 levels between patients with and without endometriosis. CONCLUSION: The presence of endometriotic lesions in the peritoneum of fertile patients supports the hypothesis that incidental findings of minimal or mild endometriosis may not be of clinical significance, and that the progression of the disease probably occurs as a result of immunological and genetic abnormalities. Serum CA125 levels did not show any diagnostic significance with regard to detecting the disease.
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    Gravidez ovariana íntegra: tratamento cirúrgico videolaparoscópico
    (Colégio Brasileiro de Cirurgiões, 2007-04-01) Bigolin, Sergio [UNIFESP]; Fagundes, Djalma José [UNIFESP]; Detoni, André Fernando; Rivoire, Henri Chaplin; Universidade Regional Integrada do Alto Uruguai e Missões; Universidade Federal de São Paulo (UNIFESP); Fundação Universidade do Rio Grande Departamento de Cirurgia
    The intact ovarian pregnancy is an extremely rare condition. We report the case of a 34- years old woman case, nuliparus, with no previous clinical history of pelvic disease. An intact right ovarian pregnancy was diagnosed by a transvaginal ultrasonographic exam. A video-laparoscopy surgery was undertaken and only the ectopic tissue was removed. The authors discuss the effectiveness of the diagnostic tools and the surgical approach.
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    Influence of physical activity on male fertility
    (Wiley Online Library, 2022-08) Minas, Aram [UNIFESP]; Fernandes, Ana Carolina Cardillo [UNIFESP]; Maciel Junior, Valter Luiz [UNIFESP]; Adami, Luana [UNIFESP]; Intasqui, Paula [UNIFESP]; Bertolla, Ricardo Pimenta [UNIFESP]; http://lattes.cnpq.br/5188240479960852; http://lattes.cnpq.br/1380195624600283; http://lattes.cnpq.br/9930205833075309; http://lattes.cnpq.br/8306522844493789; http://lattes.cnpq.br/8479803539567479
    Infertility is a worldwide issue impacting 15% of couples' population. Male-related infertility results in almost 50% of these cases. Considering lifestyle factors associated with infertility, here in this literature review article, we aimed to discuss training/sport effects on male-related infertility. Regarding this issue, human and animal model studies related to the subject were gathered and analysed. Exercise is well known as a general improving factor, however, excessive exercise can result in male infertility due to reduced hypothalamus-pituitary-gonadal axis (HPT) function, increased oxidative stress and chronic inflammation. Consequently, these underlying impacts result in a low testosterone production, and reduced semen quality, and can lead to infertility. In contrast, it has been revealed that exercise can improve male fertility status in lifestyle-induced infertility condition such as obesity and diabetes. Indeed, exercise, by increasing testicular antioxidant defence, reducing pro-inflammatory cytokines level and enhancing the steroidogenesis process, leads to improved spermatogenesis and semen quality in lifestyle-induced infertility. In fact, it seems that individual health status as well as exercise volume, intensity and duration are effective-involved co-factors that influence the impact that exercise will promote on male fertility. Regarding these findings, it is important to study exercise different impacts in further clinical trials in order to generate preservative guidelines for exercise and also considering exercise as a treatment option in lifestyle-induced disease management.
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    Investigação do potencial terapêutico da vitamina E contra os danos causados pelo cádmio em parâmetros reprodutivos masculinos em ratos Wistar
    (Universidade Federal de São Paulo, 2022-01-28) Campelo, Lilian Piccolo [UNIFESP]; Aguiar, Odair [UNIFESP]; Nascimento, Leonardo Parreira Silva [UNIFESP]; http://lattes.cnpq.br/7726936511719417; http://lattes.cnpq.br/0398348332863521; http://lattes.cnpq.br/0825512823720535; Universidade Federal de São Paulo (UNIFESP)
    A infertilidade masculina tem se mostrado cada vez mais frequente em casais inférteis, sendo as causas tanto endógenas quanto exógenas. Muitos agentes tóxicos são capazes de atacar o sistema reprodutor masculino, dentre essas substâncias destaca- se o cádmio. Este metal está presente em concentrações importantes nas culturas agrícolas, no cigarro, em solos, na água e em resíduos industriais. O cádmio atua nos testículos causando ação devastadora, mesmo que em pequenas quantidades, sendo capaz de alterar a espermatogênese, e outros parâmetros reprodutivos. Este metal incita alterações importantes no epitélio seminífero e no compartimento intersticial, que levam a desordem na espermatogênese e na produção hormonal, levando à infertilidade. Há pesquisas que comprovam os malefícios gerados pela intoxicação do cádmio que diretamente desencadeia processos oxidativos, levando muitas vezes a morte celular. Inúmeros trabalhos na literatura mostram uma busca incessante por substâncias antioxidantes que possam combater ou proteger contra esses efeitos destrutivos do cádmio. Os danos oxidativos podem ser tratados com agentes antioxidantes, como os ácidos graxos poli-insaturados e as vitaminas. A vitamina E, já é conhecida por ser um poderoso antioxidante, sendo assim um forte protetor celular. Nossos objetivos implicaram em caracterizar o tratamento com a vitamina E, aferindo parâmetros reprodutivos e o status de marcadores antioxidantes testiculares, em animais expostos ao cloreto de cádmio. No presente trabalho, a vitamina E (tocoferol) foi testada em 20 ratos Wistar machos (10 ratos no grupo controle, e em 10 animais no grupo onde administramos aos 90 dias de idade uma única injeção intraperitoneal de cloreto de cádmio). Após 7 dias, foram tratados com vitamina E diluída em óleo de milho, através de gavagem oral diária com dosagem de 100 mg/kg. Após 28 dias, os animais foram eutanasiados. O objetivo deste trabalho foi caracterizar o tratamento com vitamina E, com avaliação dos parâmetros reprodutivos e marcadores da condição testicular, em animais previamente expostos ao cádmio. O cádmio promoveu danos testiculares e no sistema reprodutivo como um todo, e não houve efeito positivo do tratamento de vitamina E na concentração e na forma utilizada neste estudo.
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    Maternal complications and neonatal events associated with multiple pregnancies resulting from assisted reproduction techniques
    (Univ Sao Paolo, 2009-03-01) Graner, Viviane Rodrigues; Oliveira de Barros, Sonia Maria [UNIFESP]; Santa Joana Hosp & Matern; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Israelite Albert Einstein Hosp
    Multiple pregnancy is the most frequent and serious iatrogenic complication of the assisted reproduction techniques. The purpose of this study was to know the maternal complications and neonatal events associated to multiple pregnancies, resulting from assisted reproduction in a reference center in the field of assisted reproduction. This was an observational, cross-section, descriptive and retrospective study performed at Hospital e Maternidade Santa Joana, a reference center in the area of human reproduction in the city of Sao Paulo, Brazil. The studied population consisted of 131 medical records of pregnant women admitted with clinical pathologies and in labor, resulting from multiple pregnancies resulting from assisted reproduction techniques. The predominant maternal complications were: premature labor (65.5%) and premature amniorrhexis (42%), The most frequent neonatal occurrences were respiratory diseases (65.1%), jaundice (38.4%), metabolic disorders (13%) and neurological diseases (9%).
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    Metaplasia óssea endometrial: quadro clínico e seguimento após tratamento
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2010-01-01) Parente, Raphael Câmara Medeiros; Freitas, Vilmon de [UNIFESP]; Moura Neto, Rodrigo Soares de; Oliveira, Marco Aurélio Pinho de; Lasmar, Ricardo Bassil; Patriarca, Marisa Teresinha [UNIFESP]; Canavez, Felipe Simões; Ministério da Saúde; Universidade Federal do Rio de Janeiro; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Rio de Janeiro Instituto de Biologia; Universidade do Estado do Rio de Janeiro Departamento de Ginecologia; Universidade Federal Fluminense Departamento de Ginecologia; Ministério da Saúde Hospital dos Servidores do Estado do Rio de Janeiro
    PURPOSE: to describe the clinical signs and symptoms of patients with bone metaplasia and to assess the risk factors for changes in these symptoms after removal of the bone fragment. METHODS: a cross-sectional study was conducted on 16 patients with a diagnosis of bone fragments in the uterine cavity during the period comprising July 2006 to January 2009. The inclusion criterion was the detection of a bone fragment removed from the uterine cavity. The presence of bone tissue in the endometrial cavity was histologically confirmed in all patients. The data of all patients were obtained before and after removal by means of a questionnaire for the evaluation of the effect of removal on the symptoms and for the search of possible factors related to the onset of the disease. RESULTS: half the patients (8/16) had hemorrhagic symptoms and one third (6/16) were infertile. Removal of the fragments was quite effective in improving the complaints, with the disappearance of symptoms in all cases of hemorrhage and of pelvic pain. CONCLUSION: removal of bone fragments can restore the fertility of selected patients whose infertility is caused by bone metaplasia and is quite effective in leading to improvement in patients with pelvic pain and menorrhage.
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    Peritoneal fluid modulates the sperm acrosomal exocytosis induced by N-acetylglucosaminyl neoglycoprotein
    (Associação Brasileira de Divulgação Científica, 1999-01-01) Passos, Eduardo Pandolfi; Brugnara, L.; Facin, A.C.; Riffel, Alessandro; Lima, Geraldo Rodrigues de [UNIFESP]; Freitas, Vilmon de [UNIFESP]; Brandelli, Adriano; Hospital de Clínicas de Porto Alegre; Universidade Federal de São Paulo (UNIFESP)
    The effect of peritoneal fluid (PF) on the human sperm acrosome reaction (AR) was tested. Sperm was pre-incubated with PF and the AR was induced by calcium ionophore A23187 and a neoglycoprotein bearing N-acetylglycosamine residues (NGP). The AR induced by calcium ionophore was inhibited 40% by PF from controls (PFc) and 50% by PF from the endometriosis (PFe) group, but not by PF from infertile patients without endometriosis (PFi). No significant differences were found in the spontaneous AR. When the AR was induced by NGP, pre-incubation with PFc reduced (60%) the percentage of AR, while PFe and PFi caused no significant differences. The average rates of acrosome reactions obtained in control, NGP- and ionophore-treated sperm showed that NGP-induced exocytosis differed significantly between the PFc (11%) and PFe/PFi groups (17%), and the ionophore-induced AR was higher for PFi (33%) than PFc/PFe (25%). The incidence of the NGP-induced AR was reduced in the first hour of pre-incubation with PFc and remained nearly constant throughout 4 h of incubation. The present data indicate that PF possesses a protective factor which prevents premature AR.
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    The role of the Hoxa10/HOXA10 gene in the etiology of endometriosis and its related infertility: a review
    (Springer, 2010-12-01) Zanatta, Alysson; Rocha, Andre M.; Carvalho, Filomena M.; Pereira, Ricardo M. A.; Taylor, Hugh S.; Motta, Eduardo L. A. [UNIFESP]; Baracat, Edmund C.; Serafini, Paulo C.; Huntington Med Reprod; Universidade de São Paulo (USP); Yale Univ; Universidade Federal de São Paulo (UNIFESP)
    Endometriosis and its associated infertility have been the object of continuous research for over a century. To understand the molecular mechanisms underlying the disease, it has become necessary to determine the aspects of its etiology that are not explained by the retrograde menstruation theory. This could in turn elucidate how various clinical and surgical treatments might affect the evolution and remission of the disease.This review is focused on the most recent clinical and laboratory findings regarding the association of HOXA10 with endometriosis and infertility.The homebox (Hox/HOX) proteins are highly conserved transcription factors that determine segmental body identities in multiple species, including humans. Hoxa10/HOXA10 is directly involved in the embryogenesis of the uterus and embryo implantation via regulation of downstream genes. Cyclical endometrial expression of Hoxa10/HOXA10, with a peak of expression occurring during the window of implantation, is observed in the adult in response to estrogen and progesterone. Women with endometriosis do not demonstrate the expected mid-luteal rise of HOXA10 expression, which might partially explain the infertility observed in many of these patients. Recent studies also demonstrated HOXA10 expression in endometriotic foci outside the Mullerian tract.Multiple lines of evidence suggest that the actions of the homeobox A10 (Hoxa10/HOXA10) gene could account for some aspects of endometriosis.
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    Sperm characteristics in a sample of healthy adolescents in São Paulo, Brazil
    (Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, 2002-04-01) Mori, Marcos Mitsuyoshi [UNIFESP]; Cedenho, Agnaldo Pereira [UNIFESP]; Koifman, Sergio; Srougi, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fundação Oswaldo Cruz Escola Nacional de Saúde Pública Departamento de Epidemiologia e Métodos Quantitativos em Saúde
    The article presents preliminary data from a prospective investigation in a sample of healthy 14-17-year-old students from a technical school in São Paulo, Brazil. Ninety-six Tanner stage 5 and thirty-one Tanner stage 4 adolescents were evaluated: testicular volume was measured using a Prader orchidometer, and semen analysis was performed according to standard procedures. Median testicular volume was 20.0ml among Tanner 5 students and 15.0ml in Tanner 4 students in both the right and left testes. No significant differences were found in sperm volume or motility. Median concentration was 66.0 million/ml for Tanner 5 and 47.0 million/ml for Tanner 4 subjects. Morphological patterns showed abnormal forms in 81.9% of Tanner 5 and 93.6% of Tanner 4 adolescents. Oligospermia (sperm concentration < 5 million/ml) was observed in 7.3% of Tanner stage 5 and 12.9% of Tanner stage 4 individuals. Azoospermia was observed in 3 students (1.8%), with counts less than 1.0 in 8 students (4.8%). The authors discuss the observed results, analyzing the potential implications arising from biological development and potential environmental exposures.
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    Terapia de reposição hormonal no hipopituitarismo
    (Sociedade Brasileira de Endocrinologia e Metabologia, 2003-08-01) Abucham, Julio [UNIFESP]; Vieira, Teresa C. Alfinito [UNIFESP]; Barbosa, Erika Ribeiro [UNIFESP]; Ribeiro, Rogério Silicani [UNIFESP]; Martins, Manoel R. Alves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    This article brings an updated review of hypopituitarism with emphasis in hormone replacement therapy. The physiological basis of hormone replacement therapy and practical aspects of treating hypopituitary patients were both taken into account to provide a rational strategy for treatment. The review is organized by individual pituitary hormone deficiency and covers epidemiology, etiology, clinical presentation, and diagnosis of hypopituitarism, as well as the most relevant hormone preparations currently available for treating each hormone deficiency. Practical guidelines to hormone dosing, routes of administration, side effects and clinical and laboratory monitoring during the entire lifespan are given for each individual hormone replacement therapy: growth hormone in GH-deficient children and adults, thyroid hormone in central hypothyroidism, glucocorticoid in central hypoadrenalism, vasopressin analogs in diabetes insipidus, sex hormones in man and women from puberty to senescence, and gonadotropins for treating infertility. In addition to the literature review, we took into account our own experience of more than two decades in investigating, diagnosing, and treating hypopituitary patients at the Universidade Federal de São Paulo (UNIFESP).