Have the Fallopian tubes a vital rôle in promoting fertility?

Diverse lines of evidence suggest that the Fallopian tubes make no overwhelming contribution to human reproduction other than as a conduit for gametes and embryos. Even so, bearing in mind global success rates for in vitro fertilization (IVF) coupled with uterine transplantation of embryos (20% fruitful pregnancies), the Fallopian tubes may make a subtle contribution to reproductive performance. The experimental evidence from monkeys and man arguing against an essential rôle for the tubes -- at least in individual instances -- would include (1) the results of Estes' operation, when ovaries are autotransplanted into the uterine lumen in women with blocked or missing Fallopian tubes and pregnancy ensues; (2) asynchronous embryo transfer when newly fertilized (pronucleate) eggs transplanted to the uterus can generate a pregnancy; (3) the transcervical transfer after IVF of early cleavage stage human embryos into the uterus, with subsequent establishment of pregnancy; (4) the trans-cervical transfer of human spermatozoa and oocytes into the uterus to give pregnancy, indicating that capacitation, fertilization and the earliest stages of embryonic development can be achieved in the uterus. In endeavoring to explain contrasts between these successful procedures in primates and their failure in non-primates, perhaps the simplex uterus in primates compared with a bicornuate or bipartite uterus in laboratory and farm species has relevance: there is lack of a clear-cut distinction between the endometrium and endosalpinx in the intra-mural segment and potential mixing of uterine and tubal fluids. Indeed, the latter may explain in part a susceptibility to tubal ectopic pregnancy, coupled with proliferating endometrial fragments in the Fallopian tube.

Localization of glutathione S-transferases alpha and pi in human embryonic tissues at 8 weeks gestational age

Glutathione S-transferases (GST) are a family of enzymes involved in the detoxification of xenobiotics. In humans, GST are divided into four different classes, alpha, mu, pi and theta, with partly overlapping substrate specificity and a tissue-specific expression pattern. We studied the cellular distribution of GST alpha and pi in a variety of human embryonic organs obtained from an extra-uterine monozygotic twin pregnancy at 8 weeks' gestational age. Tissues were fixed in 4% paraformaldehyde and embedded in paraffin. Three 4 microm thick sections were used, one for routine haematein and eosin staining, the others for immunohistochemical determination using monoclonal and polyclonal antibodies against GST alpha and pi, respectively. Both GST alpha and pi were present in hepatocytes, gastrointestinal epithelium, adrenal gland medulla, and tela chorioidea in the telencephalon. GST pi, but not alpha, was found in the epithelium of pancreatic and pulmonary glands, trachea, nephrons and urinary collecting ducts, as well as in the pia mater of the telencephalon and in developing nerve tissue in the gastrointestinal muscularis mucosae. In summary, we have demonstrated that immunoreactive protein for both GST alpha and pi is expressed in the human embryo at 8 weeks' gestational age. The early expression of GST alpha and pi in the epithelia of the urinary and digestive tracts and the respiratory system supports the importance of GST in the detoxification of potentially toxic or carcinogenic compounds. Our results suggest that the embryo itself is capable of detoxifying noxious compounds that are generated intracellularly or that cross the trophoblastic tissue.

[Heterotopic pregnancy: report of a case and review of the literature]

A case of spontaneous tubal heterotopic pregnancy in primigest patient with survival of intrauterine conception is presented. She was treated in H.G.Z.M.F. No. 8 IMSS in Ciudad Sahagún Hgo. The frequency antecedents, clinical picture, auxiliary methods of diagnosis and therapy are discussed. It is concluded that the heterotopic pregnancy is a rare illness, but it can occur, and is potentially dangerous to the mother and intrauterine conception. The instant detection improves the prognosis.

Is the outcome of in-vitro fertilization and embryo transfer treatment improved by spontaneous or surgical drainage of a hydrosalpinx?

A pilot study was designed to examine whether the outcome of embryo transfer in women with a hydrosalpinx might be improved by surgical drainage of the hydrosalpinx at the time of oocyte collection for in-vitro fertilization treatment. A comparative, controlled but retrospective analysis of the results was performed of all women with infective tubal damage aged <40 years old, who had ovulatory cycles, a normal uterus and a partner with normal spermatozoa. A standardized treatment regimen was used. A maximum of three embryos were transferred. Hydrosalpinx was defined by prior hysterosalpingography and/or laparoscopy with transcervical dye injection. A total of 237 embryo transfer cycles in women with hydrosalpinges (tubal distension not visible in 151, visible but not drained in 30 and drained in 56) were compared with 705 embryo transfer cycles in women with tubal disease but no hydrosalpinx. Results were analysed in the first three cycles but also separately in the first cycle to check for bias. Success rates were higher in the first cycle, but did not significantly influence overall differences. Implantation rates were significantly reduced overall in the hydrosalpinx group (8.0 versus 13.2% for controls; P < 0.001), being 8.3% (P < 0.01) in the subgroup without evident tubal distension and 7.5% (not significant) in the drained hydrosalpinx group. This study shows that tubal damage with distal occlusion is associated with a marked reduction in embryo implantation, even in the absence of obvious fluid distension. Surgical drainage of distended hydrosalpinges appears to offer no benefit.

Fertility after laparoscopic myomectomy: preliminary results

We report the limits, complications, subsequent fertility and outcome of pregnancies after laparoscopic myomectomy. From January 1990 to October 1995, 143 patients underwent a first laparoscopic approach to myomectomy. A total of 41 patients (28.7%) had a laparoconversion (12 cases for a number of myomata >5, 15 cases for myoma diameter >7 cm, 12 cases for peroperative haemorrhage and two cases for adenomyosis). Seventy patients (49%) wished to conceive: 26 had undergone laparoconversion and 44 laparoscopic myomectomy. A total of 19 pregnancies were obtained in 17 patients after laparoscopic myomectomy (38.6%): eight vaginal deliveries, three Caesarean sections, four miscarriages, two abortions, one ectopic pregnancy and one therapeutic abortion. The pregnancy rate in patients with unexplained infertility and with multifactorial infertility was 48.2% and 20% respectively. The mean delay to conception was 11.3 months. No uterine rupture was noted. Pelvic adhesions were found in the four patients who underwent second-look procedure. Our preliminary results indicate that laparoscopic myomectomy is a useful technique.

Unicornuate uterus and rudimentary horn

OBJECTIVE

To evaluate clinical implications of the unicornuate uterus and rudimentary horn.

DESIGN

A retrospective study.

SETTING

A university hospital.

PATIENT(S)

Forty-two women who had a unicornuate uterus with or without rudimentary horn.

INTERVENTION(S)

The rudimentary horn was removed in 21 cases.

MAIN OUTCOME MEASURE(S)

Presence of other anomalies, fertility, and outcome of pregnancies were studied.

RESULT(S)

A right unicornuate uterus with noncommunicating rudimentary horn was the most common type of uterine anomaly. Unilateral renal agenesis was found in 13 (38%) of 34 cases. Six (14%) of the 42 patients had primary infertility. Thirty-four women produced 93 pregnancies; ectopic pregnancy (EP; rudimentary horn, tubal) occurred in 20 of these cases (22%). The pregnant uterine horn ruptured in 3 of 7 cases. Eight (57%) of the 14 women with infertility underwent treatment by IVF-ET; 4 of them conceived, and 2 had term delivery. The fetal survival rate was 61%, prematurity 17%, fetal growth retardation 5%, and the spontaneous intrauterine (IU) abortion rate was 16%. Pregnancy-induced hypertension (PIH) was more common in women lacking a kidney than in those with two kidneys.

CONCLUSION(S)

The high number of EPs indicates removal of rudimentary horn and its tube when diagnosed. The prognosis of IU pregnancy is not impaired in the unicornuate uterus although prematurity threatens. Unilateral renal agenesis is associated with PIH.

[Genetic risk after high dose radioiodine therapy with regard to gonadal dose]

AIM

The genetic risk for the offspring of patients treated with high doses of radioiodine was to be assessed with special regard to the gonadal dose caused by diagnostic and therapeutic procedures.

METHODS

41 young females (aged between 19 and 39 years) and four young males (aged 26 to 36 years) treated with radioiodine because of a thyroid carcinoma were interviewed by use of a questionnaire. The course of pregnancy and birth history could be documented as well as the congenital and developmental conditions of 56 children.

RESULTS

The amount of radioactivity applied for therapy and whole body scans ranged over 4.144 and 35.15 GBq 1-131; the individual gonadal dose was calculated based on the MIRD model and ranged over 0.2 and 2.2 Sv (0.51 Sv at a mean). The period of time between the last radioiodine application and confinement was at least 9 months, not exceeding 14 years. As to the course of pregnancy and birth two early abortions, one extrauterine gravidity and one premature birth due to an insufficiency of the placenta were stated. In one case a chromosomal translocation 7/14 occurred as a genetic defect which lead to an interruption. The children's development was unconspicuous except of two cases of neurodermatitis as well as multiple allergies and an early closure of the anterior fontanelle in one child each.

CONCLUSION

Although the genetic risk is supposed to increase with the gonadal dose achieved (doubling dose 1 Sv) and the increased risk of any congenital anomaly was calculated as about 13% at a mean in our patients, the rate of genetic determined diseases was not elevated (1.8% or 1/57). Thus, no increase of genetic defects or congenital malformations was reported in a total of 408 children described in the literature and in our group.

Genital tuberculosis--a major pelvic factor causing infertility in Indian women

OBJECTIVE

To study the effect of tuberculosis, a common infectious disease in the Indian subcontinent, on the female pelvic factor and its subsequent effect on female fertility.

DESIGN

Retrospective case studies.

SETTING

Department of Infertility Management and Assisted Reproduction, Jaslok Hospital and Research Centre, Bombay, India.

PATIENT(S)

Three hundred women, between the ages of 25 and 35 years, with tubal factor as a cause of their infertile state.

RESULT(S)

One hundred seventeen women with a tubal factor were found to have tuberculosis as the cause of tubal blockage. On laparoscopy, 49.5% were found to have simple tubal blockage, 15.3% showed tubo-ovarian masses, and 23.9% had a frozen pelvis. Seventy-five percent complained of menstrual irregularities, thus indicating endometrial involvement; 25.6% of these women underwent an IVF procedure. The pregnancy rate after IVF-ET was 16.6% per transfer.

CONCLUSION(S)

This study highlights the fact that tuberculosis, a chronic infectious disease, is one of the major etiologic factors of female tubal infertility, especially on the Indian subcontinent.

A case of a neurological complication after transvaginal oocyte retrieval

A patient is described who developed neurological signs of the left leg following transvaginal ultrasound-guided puncture. A hypodense lesion of the obturator space above the lumbosacral plexus was seen on ultrasound which could explain her signs, due to compression by a hematoma. She recovered completely.

Rupture of an heterotopic pregnancy in the 15th week and normal continuation of the intrauterine gestation. Case report

A rare case report of heterotopic pregnancy, ruptured in the 15th week of gestation is presented. The intrauterine pregnancy continued after the laparotomy and removal of the extrauterine fetus and ended with a normal delivery in the 39th week.

Parameters that influence the results of in vitro fertilization/embryo transfer: a study of an egg donation model

A retrospective analysis was carried out after ovulation induction in donors, and treatment outcome in donors and recipients, relating to variables such as: age, protocol of ovarian stimulation, transfer of fresh or cryopreserved embryos, number of embryos transferred including quality and etiology of donor and recipient infertility. The recipients underwent 214 cycles of embryo transfer from 82 different donors. Forty-five (21%) pregnancies were recorded. The age of the recipients significantly affected the conception rate (pregnancy rate of 30% in those aged < 30 years, compared to 9.7% in those aged > 44 years) and the donors were contributed more to pregnancies were also younger. The pregnancy rate was significantly higher when fresh embryos were transferred to recipients (28%, compared to 15% when cryopreserved embryos were transferred). In addition, the number of embryos transferred affected the pregnancy rate if > or = 3 embryos were transferred and, if they were of good quality, the success was significantly higher. Ultimately, when the ovarian stimulation protocol was clomiphene citrate and human menopausal gonadotropin or gonadotropin-releasing hormone agonist/follicle-stimulating hormone/human menopausal gonadotropin, and the etiology of infertility was polycystic ovarian disease in the donors, the success rate was significantly increased in the recipients.

Congenital dislocation of the hip in extrauterine pregnancy

Only two cases have been reported of congenital dislocation of the hip in infants born after extrauterine pregnancies. We report a further two and discuss the management and the variable outcome. These cases seem to confirm that congenital dislocation of the hip is associated with moulding forces rather than being a teratological abnormality.

Selective fallopian tube catheterisation in female infertility: clinical results and absorbed radiation dose

Clinical results of fluoroscopic fallopian tube catheterisation and absorbed radiation doses during the procedure were evaluated in 30 infertility patients with unilateral or bilateral tubal obstruction documented on hysterosalpingography. The staged technique consisted of contrast injection through an intrauterine catheter with a vacuum cup device, ostial salpingography with the wedged catheter, and selective salpingography with a coaxial microcatheter. Of 45 fallopian tubes examined, 35 (78%) were demonstrated by the procedure, and at least one tube was newly demonstrated in 26 patients (87%). Six of these patients conceived spontaneously in the follow-up period of 1-11 months. Four pregnancies were intrauterine and 2 were ectopic. This technique provided accurate and detailed information in the diagnosis and treatment of tubal obstruction in infertility patients. The absorbed radiation dose to the ovary in the average standardised procedure was estimated to be 0.9 cGy. Further improvement in the X-ray equipment and technique is required to reduce the radiation dose.

Heterotopic pregnancy and assisted reproduction--an update

PURPOSE

Heterotopic pregnancy, an extremely rare event in the past, has become a common complication of assisted reproduction techniques.

METHODS AND RESULTS

This serious sequella of IVF/ET or GIFT is probably the result of ovarian hyperstimulation and the transfer of several embryos into the uterus or tubes of a preselected population suffering from mechanical infertility. The techniques and medium used for embryo transfer may also be involved. Delayed diagnosis resulting in rupture, hemorrhage, and emergency intervention with its serious consequences is being reported in nearly half of the cases.

CONCLUSIONS

The prognosis for a viable intrauterine pregnancy, however, is good, and these combined pregnancies have produced a living child in about 70% of cases. A High index of suspicion, repeated ultrasounds, and early intervention are mandatory to salvage the viable intrauterine pregnancy and avoid maternal mortality.

The incidence of major clinical complications in a Dutch transport IVF programme

Four different major clinical complications were identified in a retrospective analysis of 2495 in-vitro fertilization (IVF) cycles resulting in oocyte retrieval. The severe form of ovarian hyperstimulation syndrome (OHSS) occurred in 18 patients, giving a prevalence for this complication of 0.7%. Seven (39%) of these 18 patients had previously been diagnosed as having polycystic ovaries. Eleven patients were admitted with moderate OHSS. Adnexal torsion was diagnosed in two patients. Ovariectomy was considered necessary in both cases. Complications of the transvaginal procedure occurred in seven cases (0.3%): one patient had an acute appendicitis with puncture holes in the appendix, six patients were admitted shortly after oocyte retrieval with a pelvic inflammatory disease. Of the 624 pregnancies obtained, 13 were ectopic, giving an ectopic pregnancy rate of 2.1%. It is concluded that serious clinical complications of IVF treatment are rare. However, patients should be counselled for the occurrence of serious procedure-related complications before entering an IVF programme.

Spontaneous conception and intrauterine pregnancy in a symptomatic missed abortion of ectopic pregnancy conceived in the previous cycle

We encountered a rare case of combined intrauterine and extrauterine pregnancy that occurred following separate spontaneous ovulations. A 33 year old woman visited our hospital with the chief complaint of abdominal pain on April 16, 1993. Her last menstruation was from March 23 for 6 days. However, the urinary human chorionic gonadotrophin (HCG) on April 19 was 1024 IU/l. Pelvic examination and ultrasonography indicated an extrauterine pregnancy, which was confirmed by laparotomy and histological identification of trophoblast cells. The urinary HCG concentration markedly decreased after the operation. However, the HCG level increased again on the fifth post-operative day, and a gestational sac (11 mm) was identified in the uterine cavity on the 11th post-operative day, indicating that this intrauterine pregnancy was established following spontaneous ovulation which occurred before the removal of the extrauterine pregnancy. This case indicates that a combined pregnancy can occur not only after simultaneous multiple ovulations but also after the separate spontaneous ovulations.

[Study of reproductive behavior in Russian and Byelarus populations exposed to ionizing radiation as a consequence of the Chernobyl AES accident]

As a result of the Chernobyl accident the population in Gomel and Mogilev districts of Belorussia as well as in Bryansk district in Russia were exposed to ionizing radiation. The changes in pregnancy outcomes (spontaneous abortions, stillbirths, etc) are the integral indices reflecting the state of the population under post-accident conditions. The data obtained don't allow us to isolate reliably the radiation-induced component in post-accident behavior of the studied populations.

Effect of pelvic inflammatory disease on fertility

Genital infections, in both men and women, may cause permanent functional damage to the reproductive tract resulting in infertility. In men, post-infection infertility is uncommon, whereas in women sequelae after pelvic inflammatory disease (PID) are the most common cause of acquired infertility. In a prospective cohort study of women who all sought pregnancy after laparoscopically verified acute (non-tuberculous) salpingitis, 141/1309 (10.8%) were infertile because of proven post-PID tubal occlusion. In 448 control women, the corresponding figures were 4/448 (0.9%). Of independent and significant importance for post-PID infertility were the numbers of PID episodes (0/1/2 or= 3: RRs 1.0/7.0/16.2/28.3), and in women with only one PID episode, the severity of infection (mild/moderate/severe; RRs 1/1.8/5.6), delayed care (3 days/3 or more days; RR 1/2.8), use of contraceptives (none/pills/IUDs/other; RRs 1/0.3/0.5/0.8). Similar influences of the same variables were also demonstrated for subfertility, i.e. ectopic pregnancy, and time between index laparoscopy and pregnancy in those women who conceived after PID.

Obstetric outcome of 424 pregnancies after intracytoplasmic sperm injection

An evaluation of the outcome of pregnancies resulting from intracytoplasmic sperm injection for severe male factor infertility was conducted by analysing the data obtained from the patients and/or their obstetrician/gynaecologist on standardized questionnaires. The data from 424 pregnancies between April 1991 and September 1994 were analysed. Early pregnancy loss before 16 weeks occurred in 99 cases (23.3%), including 48 clinical abortions (11.3%), 47 subclinical pregnancies (11.1%) and four ectopic pregnancies (0.9%). Vanishing twins and triplets, which could be regarded as early embryonic wastage, were found in 36 cases (8.5%). One pregnancy was interrupted at week 15 of gestation because of anhydramnios, and four pregnancies (0.9%) ended in spontaneous late abortions before 26 weeks. A total of 320 pregnancies (75.5%) resulted in the birth of at least one child; 222 of these (69.3%) were singletons, 93 were twins (29.1%) and five were triplets (1.6%). The problems of prematurity and low birthweight were especially related to the multiplicity of pregnancies. Furthermore, from among the total of 423 babies born, we have observed three cases of stillbirth and five cases of neonatal mortality. The perinatal mortality rate was therefore 18.9 per 1000 births. The results of this study show that the obstetric outcome of these pregnancies was similar to that obtained after conventional in-vitro fertilization and other assisted reproduction techniques.

In-vitro endometrial secretion of human interleukin for DA cells/leukaemia inhibitory factor by explant cultures from fertile and infertile women

Human interleukin for DA cells/leukaemia inhibitory factor (HILDA/LIF) is a cytokine with pleiotropic effects involved in successful murine implantation. We evaluated human uterine HILDA/LIF production by monitoring its in-vitro secretion by endometrial explant cultures obtained from individuals in either normal or pathological conditions. The cytokine secretion was standardized using the day 5:day 1 ratio of HILDA/LIF concentration in supernatants of such cultures, hereby termed HILDA/LIF production index (HLPI). Our results confirmed that HILDA/LIF is secreted by the human endometrium as assessed by secretion at every phase of the cycle in either normal fertile women, or women bearing intrauterine devices. This was also the case for samples obtained from infertile women presenting repeated failures of embryonic implantation or unexplained primary sterility. However, the HLPI were significantly lower in those latter two groups when compared to fertile women. These results suggest an abnormal regulation of HILDA/LIF secretion in such circumstances, and the clinical implication of those data is discussed.

Comparison among different ovarian stimulation regimens for assisted procreation procedures in patients with endometriosis

The objective of our study was to establish the most adequate ovarian stimulation regimen for assisted procreation in endometriotic patients. It consisted of a retrospective analysis comparing the use of the gonadotrophin-releasing hormone analogue (GnRHa) buserelin either for 3 months or for 3 weeks and continued with ovarian stimulation with human menopausal gonadotrophin (HMG), and the use of clomiphene citrate in association with HMG for in-vitro fertilization (IVF) and embryo transfer, gamete intra-Fallopian transfer (GIFT) and zygote intra-Fallopian transfer (ZIFT). A total of 145 patients with endometriosis in 174 cycles were divided into two groups according to the revised American Fertility Society staging of the disease (group A, stages 1 and 2; group B, stages 3 and 4). The use of GnRHa significantly increased the number of oocytes retrieved. GnRH analogues for 3 months gave the highest fertilization rate for groups A and B. The cleavage, pregnancy and delivery rates, although higher in the groups treated with analogues, did not reach statistical significance. A higher number of patients had an embryo transfer in the groups treated with GnRHa (P < 0.05). Treatment with GnRHa for either 3 months or for 3 weeks proved to be more efficient than clomiphene citrate-HMG for assisted procreation procedures in patients with endometriosis.

Hysteroscopic cannulation for proximal tubal obstruction: a change for the better?

OBJECTIVE

To compare overall the results of hysteroscopic tubal cannulations and resection anastomosis for proximal tubal occlusion.

DESIGN

Nonrandomized retrospective analysis of patients operated on by two surgeons.

SETTING

University and large tertiary referral private practice.

PATIENTS

Seventy-four patients over a 10-year period, with bilateral or unilateral proximal occlusion of a single tube.

INTERVENTIONS

Hysteroscopic cannulation, resection anastomosis, or both.

MAIN OUTCOME MEASURES

Intrauterine and ectopic pregnancy rates, long-term tubal patency, and pathology of tubal segments.

RESULTS

In patients with normal distal tubes, intrauterine pregnancy rates were similar (12/21, 57% versus 12/24, 50%) and ectopic pregnancy rates were lower (0/21, 0% versus 7/24, 29.1%) in the cannulation group. One-year patency rates in nonpregnant patients was higher in the anastomosis group (12/15, 80% versus 3/8, 33%).

CONCLUSIONS

Hysteroscopic cannulation should be first choice in the management of proximal tubal obstructions in selected patients. It may be a treatment option for delayed occlusion after successful cannulation or resection anastomosis.

Fetal tissue derived from spontaneous pregnancy losses is insufficient for human transplantation

OBJECTIVE

To determine if sufficient fetal tissue with desirable transplant characteristics can be obtained from spontaneous abortions.

METHODS

A survey of fetal tissues collected from newly diagnosed spontaneous pregnancy losses from three Indianapolis hospitals was conducted from December 1992 to September 1993. Forty-nine of 356 mothers (13.8%) with spontaneous abortions or ectopic pregnancies consented to the evaluation of their products of conception by gross and microscopic pathologic examination, bacterial culture, cytogenetic analysis, cell culture, and maternal serologic tests.

RESULTS

Forty-nine pregnancies (gestational age range 5-30 weeks) provided four identifiable embryos, 12 second-trimester fetuses, and one third-trimester fetus. Nine samples (18.4%) were of excellent or good quality on pathologic grading. Twenty-five of 38 samples tested (66%) grew pathogenic bacteria. Maternal serologic tests were negative for antibodies to human immunodeficiency virus, human T-cell lymphotropic virus, syphilis, and hepatitis B in all cases. One of 43 sera was reactive for hepatitis C, and 33 (77%) were positive for cytomegalovirus. Cytogenetic abnormalities were found in 25% of cultured samples. Five fetal brain samples had cell viabilities of 50% or more. Few viable fetal hepatocytes were found. Only two fetal brain samples (4.1%) were potential candidates for human transplantation.

CONCLUSION

Spontaneous pregnancy losses yield minimal usable tissue for human transplantation because of a lack of embryonic or fetal tissues, delayed collection, decomposition, genetic abnormality, and bacterial contamination.

Different fates await authors after two journal reports declared invalid in UK

Two London gynecologists have left their positions in disgrace amid accusations of fraud connected with two research papers published in a British obstetrics journal. The merger of four medical schools, the first stage of the closure of the eminent St. Bartholomew's Hospital and hospital trust appointments also caught the attention of our London correspondent.

Possible existence of luteinizing hormone/chorionic gonadotropin receptors in human corpora lutea during early pregnancy

In order to evaluate the possible existence of receptors for luteinizing hormone (LH)/chorionic gonadotropin (CG) in human corpora lutea of pregnancy, the specific binding of [125I]hLH to luteal pellets of 6-7 weeks' gestation and the effect of neuraminidase pretreatment on [125I]hLH binding were investigated. A relatively low capacity of hLH binding to luteal tissue of pregnancy was observed. In addition, the specific binding of hLH to luteal pellets significantly increased following neuraminidase pretreatment. The results obtained in this study suggest the possible existence of LH/CG receptors in human corpora lutea of pregnancy.

Suitability of fetal tissues from spontaneous abortions and from ectopic pregnancies for transplantation. Human Fetal Tissue Working Group

OBJECTIVE

To assess the potential availability and utility of fetal tissues obtained from spontaneous abortions and from ectopic pregnancies for human transplantation therapy.

DESIGN

Tissue collection and analysis by personnel skilled in tissue banking.

SETTING

Procurement programs in five tissue banks located in diverse geographical areas that are funded by the National Institutes of Health.

PATIENTS

All women entering obstetric clinics during 1993 who consented to participate in the study.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Evaluation of the products of conception by standard developmental, histological, microbiological, and cytogenetic criteria.

RESULTS

From 22,235 obstetric admissions, 1250 spontaneously aborted embryos and 247 products of ectopic pregnancies were obtained. Of these, seven embryos (0.5%) were potentially useful for human transplantation therapy.

CONCLUSION

Fetal tissues from spontaneous abortions and from ectopic pregnancies are quite limited as feasible sources for human transplantation therapy.