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We investigated a possible relationship between the Kobe earthquake (January 17, 1995) and the quality of semen. We assessed sperm concentration and motility of 27 male patients who had a concentration of more than 30 million/ml and >40% sperm motility within 5 months before the earthquake. Twelve male patients from districts with a magnitude of <4 on the Richter scale showed no difference in sperm concentration and motility before and after the earthquake. Of 15 male patients from districts with a magnitude of >6, five patients whose houses received no damage showed no distinct changes in sperm concentration and motility. In contrast, 10 patients whose houses were partially or completely destroyed showed significantly (P < 0.001) lower sperm motility after the earthquake than before, although no significant difference of sperm concentration could be observed. Of these latter 10 patients, seven could be followed. In six patients, sperm motility was restored between 2 and 9 months after the earthquake; the sperm motility in one patient, whose father died a victim of the house crash, has not yet recovered. Thus, the acute stress resulting from such a catastrophic earthquake could be a possible cause of reduced sperm motility.

The aim of this study was to evaluate whether frequency of ovulation and fertility potential of oocytes from the two ovaries differed in regularly menstruating women (1057 cycles of 856 fertile women and 1033 cycles of 258 infertile women). For both fertile and infertile women ovulation from the right ovary occurred more often than from the left ovary (55 versus 45%; P: < 0.005). In infertile women follicular phase length was similar for right- and left-sided ovulation. However, infertile women treated with intrauterine insemination (IUI) or in-vitro fertilization (IVF) showed a pregnancy rate in connection with right-sided ovulation (13%) which was higher than that of left-sided (9%). The ratio of pregnancies deriving from the right ovary per total number of pregnancies was similar in infertile and fertile women (64.6%, 73/113 and 63.4%, 361/569 respectively). The ratio of pregnancies from right-sided ovulation (approximately 64%) per total number of pregnancies was higher than that of right-sided ovulation (approximately 55%) during non-pregnant cycles (P: < 0.0001). The implantation rate in right-sided ovulation seemed to be higher than in left-sided one, since IVF data showed a lower frequency (P: = 0.03) of pre-embryo formation from right-sided ovulation than left-sided. Mid-luteal serum oestradiol and testosterone were higher (P: < 0.05) in right-sided ovulation than left-sided. Taken together, in both fertile and infertile women the fertility potential of oocytes from the right ovary surpasses that of the left ovary.

Thirty-six patients with hypermenorrhea, dysmenorrhea, and/or anemia were examined by transvaginal sonography (TVS) and by transvaginal hysterosonography using an endometrial balloon catheter and saline (TVHS). Those patients who showed distinct intramural myomas by TVS were excluded from this study. Of 36 patients, 22 were diagnosed with submucous myomas, 10 with intramural myomas, and 4 with endometrial polyps by TVS, but 20 patients were diagnosed as having submucous myomas, 12 patients intramural myomas, and 4 patients endometrial polyps by TVHS. The correlation between ultrasound findings and surgery (hysterectomy or hysteroscopy) indicated that there were 13 misdiagnoses (36%) by TVS and only one misdiagnosis (2.8%) by TVHS.

Human ovulation shows characteristics related to age. The interaction between the two ovaries seems to be most pronounced in the younger years, where ovulations jump from one ovary to the other more frequently than later on in life. The C/C+I ratio shows a clear correlation with age and pregnancy rate.

Uterine endometrial movements were observed by transvaginal ultrasound during mid- and late follicular phase and luteal phase in 273 cycles (180 spontaneous cycles in 72 patients; 75 clomiphene citrate cycles in 18 patients; 18 gonadotrophin cycles in 11 patients). The percentage of scans with endometrial movements was 74% in the mid-follicular phase, 96% in the late follicular phase and 72% in the luteal phase. Movements of endometrial cavity echo-free space were observed only in the late follicular phase when the cervical mucus was abundant. The direction of these endometrial cavity movements was objective and therefore distinct. The movements were either vertical (cervix-fundus) or horizontal at the fundus, often to and fro, not unidirectional. The endometrial cavity echo-free space content showed a fern-leaf pattern similar to that of cervical mucus. Thus the content might be cervical mucus plus endometrial secretion, and these fluids might be circulating, flushing or communicating via the cervical canal and the Fallopian tubes through these endometrial cavity movements.

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Ovulation was studied using vaginosonography in a total of 410 natural cycles of 123 women undergoing infertility treatment [267 intrauterine insemination (IUI) cycles of 103 women and 143 in-vitro fertilization (IVF) cycles of 50 women]. None of the women received ovarian stimulation. Each follicle was measured daily from 14 mm in diameter until formation of corpus luteum or oocyte retrieval. Contralateral ovulation as compared with the preceding cycle occurred in 57% of the 410 cycles. Contralateral ovulations occurred in 72% of cycles with a follicular phase < 13 days. In cycles with a follicular phase of > 14 days, ovulations occurred at random. The length of follicular phase in contralateral ovulation cycles (15.2 +/- 3.2 days) was significantly (P < 0.05) shorter than that of ipsilateral ovulation cycles (15.8 +/- 2.8). During the 57% contralateral ovulations in 143 IVF cycles, the rates of oocyte retrieval (89%), fertilization (69%), cleavage (90%) and embryo transfer (56%) were significantly higher than those of ipsilateral ovulations (69, 51, 64 and 23% respectively). The pregnancy rate of contralateral ovulations (9%) was also higher, though not significantly, than that of ipsilateral ovulations (3%), although the pregnancy rates per transfer were similar (16 and 14% respectively). The total pregnancy rate of both IUI and IVF was higher in contralateral than in ipsilateral ovulation cycles (8.1 and 4.0% respectively). The dominant follicles in contralateral ovulation cycles showed significantly higher oestradiol/androstenedione ratio (P < 0.025) and oestradiol/testosterone + androstenedione ratio (P < 0.025) and lower androstenedione (P < 0.05) than those of ipsilateral ovulation cycles. There was no significant difference in oestradiol, progesterone and testosterone. These results indicate that the dominant follicles in contralateral ovulation cycles are healthier than those of ipsilateral ones. Local intra-ovarian factors, e.g. from the corpus luteum, may negatively affect the health of the dominant follicle and the enclosed oocyte. Therefore contralateral selection of the dominant follicle in the succeeding cycle may favour pre-embryo development. The chance of conceiving during a natural cycle may be affected by the site of ovulation in the preceding cycle.