Laser irradiation pretreatment improves endometrial preparation of frozen-thawed embryo transfer in recurrent implantation failure patients

Recurrent implantation failure (RIF) remains a clinical dilemma. Helium-Neon (He-Ne) laser irradiation has recently become more popular under certain clinical conditions. Given the unique therapeutic effects, we were interested in determining whether pretreatment with He-Ne laser irradiation prior to frozen-thawed embryo transfer (FET) would improve the microcirculation and cause the release of growth factors and cytokines, thus improving endometrial receptivity and the clinical pregnancy rates. Patients chose for themselves whether to proceed with (n = 29) or without (n = 31) pretreatment with He-Ne laser irradiation prior to FET. The clinical pregnancy rate (37.9%) and implantation rate (20.3%) were higher in the laser-treatment group than in the control group (35.5% and 15.9%, respectively, p = .844 and .518, respectively). The live birth rate was higher in the laser-treatment group (27.6% vs. 25.8%, respectively, p = .876) and the miscarriage rate was lower in the laser-treatment group (18.2% and 27.3%, respectively, p = .611). No side effects or complications from laser irradiation were encountered in patients who received the laser treatment. We concluded that pretreatment with He-Ne laser prior to FET may be an alternative choice for RIF-affected women; however, additional well-designed prospective studies are necessary to determine the precise clinical value of this treatment.

[Application of low-intensity laser radiation and endotoxin-binding preparations to the treatment of female infertility]

A total of 38 women of reproductive age (from 20 to 45 years) with chronic inflammatory gynecological diseases including 7 with primary and 9 with secondary infertility were examined by standard clinical, instrumental, and laboratory methods. In addition, variations of such important characteristics as serum endotoxin level and activity of antiendotoxin immunity were measured. The study has demonstrated participation of chronic aggression of endotoxins (of intestinal origin) in pathogenesis of the disorders of interest. Inclusion of the "antiendotoxic component" in the combined therapy allowed the efficacy of the treatment of chronic inflammation and female infertility to be greatly enhanced. It suggests the important (if not decisive) role of bacterial lipopolysacchardides in the pathogenetic mechanism underlying the problems considered in this study.

[Electromagnetic radiation of extra high frequency as a method of rehabilitation after surgical treatment of tubal-peritoneal infertility]

Seventy four patients entered the placebo-controlled study of rehabilitation EHF therapy 1 month after surgical laparoscopy for tubal-peritoneal infertility. It was found that early EHF therapy corrects hemodynamics in small pelvis vasculature characteristic for chronic inflammation of the uterine appendages thus raising the rate of impregnation.

Cancer risk following radiotherapy for infertility or menstrual disorders

A cohort of 968 Israeli women treated with radiotherapy for infertility was followed up for cancer incidence. The majority of the subjects were irradiated to both the ovaries and the pituitary gland. Mean doses to the brain, colon, ovary and bone marrow were 0. 8, 0.6, 1.0 and 0.4 Gy, respectively. More than 10 years after radiation treatment, 60 cancers were observed compared with 74.5 expected based on national cancer incidence rates (standardized incidence ratio 0.81, 95% confidence interval 0.61-1.04). No statistically significant excess or deficit was seen for any individual type of cancer; however, a non-significant 60% increased risk of colon cancer was observed. Risk of colon cancer was higher among women with 2 or more treatments and increased with length of follow-up. A decreased risk of breast cancer was suggested. Neither age at exposure nor attained age modified subsequent cancer risk. No clear excess of any cancer site was observed among women at organ doses above the median compared with subjects at doses below the median, except a slight increase in colon cancer. No significant excess incidence of cancer was demonstrated in this small cohort of patients treated with radiotherapy for infertility. Our results are consistent with those from an earlier study of cancer mortality among women receiving radiotherapy for infertility conducted in New York City. Int. J. Cancer 82:795-798, 1999. Published 1999 Wiley-Liss, Inc.

Mortality following radiation treatment for infertility of hormonal origin or amenorrhoea

BACKGROUND

Between 1920 and 1965, radiation treatment to the ovaries and/or pituitary gland was used for refractory hormonal infertility and amenorrhoea. The potential carcinogenic effects of hormonal infertility, as well as exposure to relatively low doses of ovarian and pituitary radiation can be studied among patients receiving these treatments.

METHODS

A cohort of 816 patients treated between 1925 and 1961 was identified from the medical records of a New York City radiologist. The mortality experience for 84% of these women was determined and radiation doses for individual patients were estimated. Doses were, on average, 87, 64, 54, and 29 cGy to the ovary, brain, colon, and active bone marrow, respectively.

RESULTS

Compared with mortality rates in the US population, the risk of death was less than expected (standardized mortality ratio [SMR] = 0.87; 95% confidence interval [CI]: 0.75-1.00). Deaths due to circulatory and digestive diseases were significantly below expectation. Cancer mortality was about 10% higher than that expected based on New York City mortality rates. Based on a small number of cases, no increase was found for cancers of the ovary or brain, or leukaemia, sites for which direct radiation exposure occurred, but significant excesses of colon cancer and non-Hodgkin's lymphoma were observed. A deficit in mortality from female genital cancers was surprising, since nulliparity has been a consistently reported risk factor for cancers of the endometrium and ovary. Breast cancer mortality was close to expectation.

CONCLUSIONS

Overall, this study provided little evidence that either infertility or its treatment with radiation increased the risk of total or cancer mortality.

[Hemodynamics in the organs of small pelvis during complex treatment using electromagnetic fields in patients with tubal infertility of inflammatory etiology]

Hydrotubation treatment of uterine tube impotency of an inflammatory origin results in many cases in stubborn hemodynamic disorders in the small pelvis organs, that may be normalized after exposure to a permanent magnetic field (magnetophores). Multiple-modality treatment results in recovery of the uterine tube patency in 50% of cases and in pregnancy coming within a year in 22.6% of cases.

The influence of radiation on fertility in man

Increasing numbers of young people are now being cured of certain neoplasms by radiotherapy and chemotherapy. Such people will naturally wish to lead a normal life and possibly to have children. Therefore the question of the effect of radiation and cytotoxic drugs on the reproductive capacity of these patients has become important. The purpose of this report is to review the information available on the effect of radiation on fertility in man. Direct information on radiation effects on human fertility is available from reports on therapeutic exposure and deliberate experimental exposure. Although the total number of cases involved is small, a number of general principles emerge. In males, fractionated irradiation of the testes may be more harmful than acute, at least up to total doses of about 600 cGy (rad). Fractionated doses greater than 35 cGy cause aspermia, the time taken for recovery increasing with dose, and after more than 200 cGy aspermia may be permanent. In females, response varies with age as well as dose. For example, 400 cGy may cause a 30% incidence of sterility in young women, but in women aged above 40 years it results in 100% sterility. However, individuals of either sex show a degree of variation in their response to irradiation.