There was a significant degree of agreement between hysterosalpingo-contrast sonography with a saline-air device and hysterosalpingography when the fallopian tube was patent but not when it was occluded. In the absence of patency, further evaluations with hysterosalpingography may be indicated to avoid false-positive results. Although the procedure time and degree of pain appear to be greater, avoidance of radiation exposure by using hysterosalpingo-contrast sonography with a saline-air device may outweigh the drawbacks.
Bisphenol A (BPA) is an endocrine disruptor associated with poor pregnancy outcomes in human and rodents. The effects of butterfat diets on embryo implantation and whether it modifies BPA's actions are currently unknown. We aimed to determine the effects of butterfat diet on embryo implantation success in female rats exposed to an environmentally relevant dose of BPA. Female Sprague-Dawley rats were exposed to dietary butterfat (10% or 39% kcal/kg body weight [BW]) in the presence or absence of BPA (250 μg/kg BW) or ethinylestradiol (0.1 μg/kg BW) shortly before and during pregnancy to assess embryo implantation potentials by preimplantation development and transport, in vitro blastulation, outgrowth, and implantation. On gestational day (GD) 4.5, rats treated with BPA alone had higher serum total BPA level (2.3-3.7 ng/ml). They had more late-stage preimplantation embryos, whereas those receiving high butterfat (HBF) diet had the most advanced-stage embryos; dams cotreated with HBF and BPA had the most number of advanced embryos. BPA markedly delayed embryo transport to the uterus, but neither amount of butterfat had modifying effects. An in vitro implantation assay showed HBF doubled the outgrowth area, with BPA having no effect. In vivo, BPA reduced the number of implanted embryos on GD8, and cotreatment with HBF eliminated this adverse effect. HBF diet overall resulted in more and larger GD8 embryos. This study reveals the implantation disruptive effects of maternal exposure to an environmentally relevant dose of BPA and identifies HBF diet as a modifier of BPA in promoting early embryonic health.
Objective-HSG is the accepted standard to diagnose tubal patency. In contrast to bilateral tubal occlusion where therapy is directed towards laparoscopic correction or IVF, treatment of unilateral tubal occlusion (UTO) is less clear, including conservative OI and IUI directed towards the patent tube. We assessed the value of conservative OI-IUI and pregnancy outcomes in those with UTO. Methods: We evaluated patients diagnosed on HSG with UTO (n=24) (proximal [n=7] and mid-distal or distal occlusion [n=17]). Inclusion included women <38 years; regular menstrual cycles; normal sperm parameters; and normal spill from 1 fallopian tube on HSG. Controls underwent donor insemination (n=87 in 275 cycles) with bilateral tubal spill. Treatment included LH testing and time intercourse (n=5) or OI-IUI with Clomiphene Citrate or Letrazole (n=19 in 36 cycles). All treatment cycles were monitored by ultrasound; hCG was given when lead follicle size reached >18mm (unless recruited follicle on obstructed side); and IUI was performed 24-36 hours later. The primary outcome measured was clinical pregnancy (CP). Results: Baseline demographics including age (32.2±4[±SD] vs 33.4±2 yrs, p-NS) and BMI (27.9±7 vs 28.2±8 kg/m 2 , p-NS) were similar between UTO and control groups. Between HSG and treatment, spontaneous pregnancy occurred in 5 (21%) women with UTO (1 proximal, 4 distal). In those undergoing OI-IUI treatment, CP rates/patient (32%, n=6/19 and 24%, n=21/87, p=0.56) and CP/cycle (17%, 6/36 and 8%, 21/275, p=0.10) were similar for UTO and control groups. Overall, CP occurred in 2 (29%) and 9 (53%) patients with proximal and mid-distal or distal UTO, p=0.005, respectively. Twenty-nine (81%) cycles recruited a dominant follicle on the patent side (19% CP/cycle), in contrast no pregnancies occurred (0%, 0/7) if recruitment occurred on the side of UTO, p=0.3. Conclusions: Pregnancy rates are not compromised in women with UTO and conservative treatment with OI-IUI appears justified as a first line approach, obviating more aggressive therapies including laparoscopy and IVF.
As cancer survival has continued to improve, cancer patients and their sexually intimate partner (SIP) are confronted with a number of issues including sexual function and overall sexual health. Our study objective was to assess changes in sexual function in women undergoing cancer treatment and their SIP, and attempt to identify areas of needed support and improvement. In this questionnaire-based observational study, females (n = 11) completed a Female Sexual Function Index (FSFI) and for SIP's (n = 11), a Brief Sexual Function Inventory (BSFI). Level of satisfaction prior to and within 3 months following treatment with surgery, chemotherapy and/or radiation was compared. Mean pre-and post-treatment total (30.7 ± 2.7 vs. 23.2 ± 3.7, p < 0.001) and individual FSFI domains were significantly different for desire (4.
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