Seminal plasma hypersensitivity (SPH) is a rare and often misdiagnosed condition characterized by local and/or systemic reactions to seminal plasma proteins following exposure to semen. We aimed to ...summarize key symptomatology, diagnostic features, and management options for SPH.
The databases PubMed, EMBASE, Web of Science, Google Scholar, and Cochrane Review were searched with key words "seminal plasma hypersensitivity" and "seminal fluid allergy" through September 2023. Exclusion criteria included non-English articles, in vitro studies, publication before 1990, duplicates, and articles with no clinical relevance to SPH in women.
The search yielded 53 articles for review. Of these, 60.5% described systemic SPH and 39.5% described localized.
Diagnosis of SPH relies on a thorough patient history and confirmatory skin prick testing. The use of IgE assays is controversial and less accurate for cases of localized SPH. Knowledge of disease immunopathology, systemic versus localized symptom presentation, patient preference, and desire to conceive should guide management options. Artificial insemination has the potential for severe adverse reactions in systemic SPH so necessitates extra procedural precautions. SPH does not appear to impair fertility. Additional research on specific allergens implicated in SPH can aid in the development of more targeted immunotherapy approaches with improved safety and efficacy.
While prolactin is most well known for its role in lactation and suppression of reproduction, its physiological functions are quite diverse. There are many etiologies of hyperprolactinemia, including ...physiologic as well as pathologic causes. Physiologic causes include pregnancy, lactation, sleep-associated, nipple stimulation and sexual orgasm, chest wall stimulation, or trauma. Stress is also an important physiologic cause of hyperprolactinemia, and its clinical significance is still being explored. This review will provide an overview of prolactin physiology, the role of stress in prolactin secretion, as well as the general clinical approach to hyperprolactinemia.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age in the United States and has been associated with several diseases including cardiovascular ...disease, obesity, and glucose intolerance. In this study, systolic blood pressure, diastolic blood pressure, pulse pressure (vascular compliance), large artery elasticity, systemic vascular resistance (SVR), total vascular impedance (TVI), and body mass index (BMI) were measured before and after treatment with spironolactone in 10 women with PCOS. Systolic BP, diastolic BP, and BMI were similar prior to treatment and after treatment. Pulse pressure decreased slightly post‐treatment compared to pretreatment but not to significance (P = 0.07). The results show that after treatment with spironolactone, there was a statistically significant increase in large artery elasticity (P = 0.047), while there was a statistically significant decrease in SVR and TVI (P = 0.0005 and P = 0.03). This study indicates that treatment with spironolactone improves large artery elasticity and reduces systemic vascular resistance without any change in small artery elasticity.
In two identical, double-blind, randomized, 6-month phase 3 trials, elagolix (an oral gonadotropin-releasing hormone antagonist), administered with hormonal add-back therapy (estradiol, 1 mg, and ...norethindrone acetate, 0.5 mg, once daily) was more effective in reducing heavy menstrual bleeding in women with uterine fibroids than placebo. Bone loss was attenuated with add-back therapy, as compared with elagolix alone.
Effects of marijuana on human reproduction Dubovis, Marina; Muneyyirci-Delale, Ozgul
Reproductive toxicology (Elmsford, N.Y.),
June 2020, 2020-06-00, Letnik:
94
Journal Article
Recenzirano
•Δ9-Tetrahydrocannabinol, or THC, is a well-known psychoactive compound in cannabis.•Receptors for THC exist throughout the human reproductive system.•Animal studies suggest exposure to THC disrupts ...important reproductive processes.•Human studies yield conflicting results due to variability in marijuana consumption.•More research is needed as legalization of marijuana continues.
As U.S. states steadily legalize its distribution and the prevalence of its use in people of reproductive age continues to rise, the need to understand the effects of marijuana on human physiology is becoming increasingly urgent. While marijuana is well-known for its psychoactive effects and applications in controlling pain and nausea, little is known about its effects on reproduction. This review includes in vitro studies which consistently demonstrate associations between marijuana consumption and low sperm count, dysregulated menstruation, and abnormal placentation. While many in vivo studies associate maternal marijuana use with stillbirth, neonatal intensive care unit (NICU) admission, and offspring psychosis, significant literature negates these relationships by controlling for poly-substance use and socioeconomic status. Data limited by self-reporting and confounds precludes the drawing of definitive conclusions regarding the effects of marijuana on reproduction. This review serves as a call to action to elucidate these effects and discourage marijuana use in people of reproductive age.
Objective: Adenomyosis’ impact on obstetrical outcomes is investigated with detailed discussion of plausible pathogenesis. Discussion of management strategies to improve outcomes included. Methods of ...study: Terms utilized include ‘adenomyosis’, ‘fertility’, ‘ pregnancy’, ‘obstetrical outcomes’, ‘preeclampsia, ‘fetal growth restriction’, ‘preterm labor’, ‘preterm prelabor rupture of membranes, ‘in vitro fertilization, ‘prelabor rupture of membranes’, ‘ultrasound’, ‘small for gestational age’, ‘cesarean section’ Inclusion criteria are English, between January 1990-January 2023, randomized controlled trials, case controls, cohorts, case series, case reports, systematic reviews, and meta-analyses. Exclusion criteria are studies/articles completed prior to 1990, non-relevant, and non-English. Results: Limited literature exists evaluating the relationship between adenomyosis impact on obstetrical outcomes. However, amongst available literature there exists statistically significant relationship between adenomyosis and adverse obstetrical, neonatal outcomes such as: ectopic pregnancy, placental abruption, pre-eclampsia (PEC), gestational diabetes (GDM), low birth weight (LBW), intra-uterine growth restriction (IUGR), and preterm prelabor rupture of membranes (PPROM). Proposed physiologic mechanisms include disordered anatomic, functional, and immunological environment in the uterus. Proposed management strategies to improve obstetrical outcomes include removal of focal adenomyotic lesions and pre-treatment with GnRH agonists before conception. Conclusion: Adenomyosis has a multifactorial impact on obstetrical outcomes; treatment modalities do exist to improve the chances of conception and retaining a pregnancy. However, more research is required to not only further substantiate treatment modalities relationship to improve pregnancy; but also to clarify adenomyosis impact on infertility
Summary Background Phytoestrogens have been thought to have favorable effects on women's health and perhaps in offsetting cancers. The possible adverse effects of phytoestrogens have not been ...evaluated. Cases Abnormal uterine bleeding with endometrial pathology in three women was found to be related to a high intake of soy products. The first woman had postmenopausal bleeding with uterine polyp, proliferative endometrium and a growing leiomyoma. The second woman presented with severe dysmenorrhea, abnormal uterine bleeding, endometriosis and uterine leiomyoma not responding to treatment. The third woman with severe dysmenorrhea, abnormal uterine bleeding, endometriosis and uterine leiomyomata presented with secondary infertility. All three women improved after withdrawal of soy from their diet. Conclusion Additional information on phytoestrogens is necessary to ascertain their safety before they can be routinely used as supplements.
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