Group Of Fertile Women Research Articles

Ovulation patterns affect the offspring sex ratios and change with the women’s age

BackgroundThe aim of this study was to evaluate whether women’s ages at conception and the ratio of male to female infants are associated with various ovulation patterns.MethodsAn observational clinical study was conducted in private OB/GYN clinics. Infertile women with regular menstrual cycles receiving intrauterine insemination (IUI) and/or in-vitro fertilization (IVF) had their ovulation patterns monitored in three consecutive spontaneous cycles receiving infertility treatment in the third cycle. Ovulation patterns were also observed in women with slight ovulation disorders during IUI and/or IVF in clomiphene citrate stimulated cycles. All the pregnant women’s ages at conception and their respective offspring sex ratios were compared to various ovulation patterns. Statistical evaluation was performed using ANOVA, unpaired t test, χ2 test or Fisher’s exact test, heterogeneity χ2 test, odds ratios at 95% confidence intervals and logistic regression.ResultsContralateral ovulation (i.e. ovulation jumping from ovary to the other) was more often observed in relatively younger women, who showed a higher probability of having a boy than after ipsilateral ovulation. There was a significantly higher frequency of boys being conceived following three consecutive ovulations with a left–left–right (LLR) ovulation pattern, while three ovulations from the left ovary (LLL) were associated with a higher frequency of girls. We also found two consecutive menstrual cycles the left–right (LR) ovulation pattern showed a similar significant difference compared to the left-left (LL) ovulation. Both the infertile and infertile + fertile women groups showing right-sided ovulation, regardless of age, showed significantly higher offspring sex ratio compared to left-sided ovulation, which was not observed in the group of fertile women alone.ConclusionsLLR, LR and contralateral ovulation happens more often in younger women and favors male offspring in infertile women. Right-sided ovulation favors male offspring in infertile and infertile + fertile women, which was not observed in the group of fertile women.

Individual and Combined Assessment of Ser680Asn FSH Receptor and FSHβ-211 G>T Gene Polymorphisms in Ovarian Response in IVF/ICSI Program.

Molecular biology tools, such as the detection of Single Nucleotide Polymorphisms (SNPs), have been considered to assist in the management of ovarian stimulation protocols. The aim of this study was to evaluate the impact of two polymorphisms, the Asn680Ser polymorphism of the FSHR gene, and the FSH β subunit (FSHβ) gene polymorphism -211 G>T, in a Greek population of women undergoing IVF/ICSI program in our center. In addition, a control group of fertile women was studied to verify whether there are differences in the genotype distribution between fertile and infertile population for both polymorphisms, as the FSHβ gene polymorphism -211 G>T is studied for the first time in the Greek population. The FSH β-211 G>T polymorphism, studied for the first time in the infertile Greek population, appears to be quite rare. When studying the two polymorphisms separately, statistically significant differences were obtained that concerned the LH levels. According to the combination analysis of the two polymorphisms by the number of alleles, women with 2-3 polymorphic alleles needed more days of stimulation, but there were no differences in pregnancy rates. This molecular genetic study helps to elucidate whether the polygenic combination of the Asn680Ser and FSH β subunit -211 G>T gene polymorphisms is of additive value in the prediction of ovarian response to exogenous gonadotropins.

Health behaviors and quality of life in fertile women using contraception

AbstractIntroduction: Early sexual initiation, the phenomenon of promiscuity, and voluntary childlessness are some reasons behind contraception use by women. Health-related behaviors determine the state of human health and are closely related to quality of life. The aim of the study was to analyze the manifestations of pro-health behaviors and to examine their impact on the quality of life in a group of fertile women using any form of contraception.Materials and methods: Research material was collected from August 2017 to January 2018 in the West Pomeranian Voivod-ship, from 183 women of childbearing age who had been using contraception. The questionnaire consisted of a author’s part and the WHOQOL-BREF questionnaire. Statistical analysis used descriptive and analytical methods, such as the Shapiro–Wilk test and the analysis of variance (ANOVA) test. A structure index containing a percentage was used. The results obtained were statistically analyzed using χ2 test for independent samples. The probability value of p < 0.05 was considered statistically significant.Results: Among pro-health behaviors, 80.9% of the women declared that they performed some physical activity at least once a week, 76% stated that their eating habits were correct, 47% went to a gynecologist once a year, 83.6% claimed they regularly performed preventive examinations. The better the subjective assessment of health, the higher the quality of life in the psychological domain (p < 0.001). The better the nutritional habits were assessed, the better the quality of life in the environment domain (p < 0.05). Not using stimulants had a positive impact on the quality of life in the physical health domain (p < 0.05). A rise in the frequency of follow-up visits to a gynecologist led to a rise in the quality of life in social relationships and physical health domains (p < 0.05).Conclusions: The manifestation of pro-health behaviors in women of childbearing age who use contraception has a positive influence on the quality of their lives in almost all the domains. The overriding purpose of pro-health education is to strengthen the actions of women who display healthy behaviors and, in the case of those exposed to a reduced quality of life due to unhealthy practices, conduct intervention and preventive actions while respecting the woman’s individual biopsychosocial needs.

THE EFFECTS OF CURCUMIN ADMINISTRATION ON EXPRESSION PATTERNS OF VEGF AND COX-2 IN FERTILE ENDOMETRIUM: A RANDOMISED CLINICAL TRIAL

Objective: Curcumin (diferuloylmethane) is a a compound isolated from turmeric with biological activities, including antifertility. Curcumin inhibits COX-2 expression in granulosa cells of ovarian follicles and disrupts vascular endothelial growth factor (VEGF) derived angiogenesis in the endometrium, reducing endometrial receptivity. The purpose of this study was to examine the effects of curcumin on COX-2 and VEGF expression in endometrium of fertile women.
 Methods: A prospective double-blind placebo-controlled clinical trial was conducted in a group of fertile women with regular menstrual cycles, aged between 20-30 y, married, and with children. Subjects were divided into a group receiving daily 800 mg encapsulated curcumin. Curcumin orally for ten days, starting on the third day of the first menstrual day, and a control group. Endometrial biopsy was performed using a microcuret and immunohistochemistry was used to assess VEGF and COX-2 expression. The results were analysed using an independent sample t-test.
 Results: In the curcumin-treated group, VEGF expression was significantly lower than the control group (p<0.05), and COX-2 expression was higher but not significantly so (p>0.05).
 Conclusion: The curcumin causes VEGF expression in endometrium is lower and negatively affects the growth of endometrial stromal cells.

An Emerging Role of Endometrial Inflammasome in Reproduction: New Therapeutic Approaches.

One of the common complications of pregnancy is spontaneous pregnancy loss which occurs in an estimated 5- 15% of pregnancies. Of all women 1%-5% suffer from Recurrent Pregnancy Loss (RPL). Despite the fact that RPL has been associated to various anatomic, hormonal, immune, hematologic, and genetic defects, in 30% of the patients, screening tests included in the RPL workup may have negative results. Recently, we demonstrated a significant increased activation of endometrial NALP-3 inflammasome, and a caspase-1 dependent secretion of IL-18 and IL-1β in the endometrial tissues obtained from RPL women compared with a fertile women group. The inflammasome has emerged as a key player in innate immunity and inflammation. An abnormal inflammasome activation, in absence of detectable infectious causes, might be one of the molecular mechanisms involved in establishing an unreceptive endometrium, potentially leading to early fetal loss. Upon activation, this multiprotein complex makes possible the caspase- 1-mediated proteolytic processing of proinflammatory cytokines generating their respective mature secretory forms. The understanding of molecular modulation of inflammasome associated pathways is critical for drug design, development and delivery. To date many promising inhibitors of inflammasome complex activation have been described, such as MCC950, β-Hydroxybutyrate or Micro RNAs that affect NALP3 expression and activation. Furthermore, several herbal extracts and its bioactive constituents have shown to be effective in inflammatory response mediated by NLRP3 inflammasome activation. Nevertheless all these molecules represent a significant progress toward developing therapies that target IL-18 and IL-1β secretion in a variety of diseases.

Serum magnesium and calcium levels in infertile women during a cycle of reproductive assistance.

Magnesium (Mg) and calcium (Ca) are essential cations for women's preconception health. It is well known that, in blood, the concentration of ionized form of these two cations is temporally altered during menstrual cycle, suggesting a correlation between sex steroid hormones and serum calcium and magnesium levels. Evidence from literature suggests that in assisted reproductive technology increasing estrogens during ovarian hyperstimulation may also modulate serum magnesium and calcium levels. Therefore, we first examined total serum magnesium and calcium levels during follicular phase in a large population of infertile patients who underwent intrauterine insemination (IUI). The results were compared to a group of fertile women. Successively, we studied the total serum magnesium and calcium concentrations in infertile patients before and after ovarian hyperstimulation for in vitro fertilization (IVF). Results highlight that total serum concentration of magnesium and calcium does not seem altered in infertile women. During stimulation with gonadotropins, the values of the two cations do not change significantly in ovarian-stimulated women. However, we found a downward trend in the total magnesium and calcium levels in relation to the rising estrogens.

Mid-menstrual cycle ultrasound evaluation of endometrial thickness of fertile women and women with secondary infertility in Nsukka, Nigeria

BackgroundThe prognostic value of endometrial thickness in achieving conception is still debatable. ObjectiveTo compare the mid menstrual cycle thickness of the endometrium of fertile women and women with unexplained secondary infertility. Materials and methodsA cross-sectional study targeting women of reproductive ages was conducted. The mid menstrual cycle endometrial thickness was measured at sonography in a group of fertile women and in another group of women with secondary infertility. The endometrial thicknesses in the two groups of women were statistically compared. ResultsThere was a preponderance of thickened endometrium among the fertile women. The majority of women with secondary infertility, 21 (30.0%) with a thickness range of 2.0–3.9 mm and 17 (24.29%) with 4.0–5.9 mm had thin endometrium and only a few of them, 8 (11.43%) had endometrium of 12 mm thickness of greater. The median value of mid menstrual cycle endometrial thickness for the fertile group was 10.8 mm (range 7.8–12.4 mm) and the interquartile range was 1.45 mm. For the group with secondary infertility, the median was 5.0 mm (range 2.0–17.0 mm) and the interquartile range 6.0 mm. The endometrium was significantly thinner in subjects with secondary infertility compared to fertile subjects (p < 0.05). ConclusionThe mid menstrual cycle endometrial thickness differs significantly between fertile women and women with secondary infertility. It is thicker in fertile women compared to women with secondary infertility. Therefore, mid menstrual cycle endometrial thickness has potential as a prognostic factor for secondary infertility in the studied population.

Evaluation of the frequency of G-765C polymorphism in the promoter region of the COX-2 gene and its correlation with the expression of this gene in the endometrium of women with endometriosis.

To evaluate the frequency of polymorphism G-765C (rs20417) of the COX-2 gene and the expression of this gene in the endometrium of women with endometriosis. This is a case-control study of 365 women with endometriosis (251 infertile and 114 fertile) submitted to laparoscopy/laparotomy with histological confirmation of endometriosis. The control group was composed of 522 fertile women without endometriosis. Of these, 37 patients from the endometriosis group and 47 from the control group were submitted to biopsy of the endometrium for analysis of the expression of the COX-2 gene. The genotypes were determined using analysis by High-Resolution Melt. Gene expression was measured by qRT-PCR with TaqMan methodology using the GAPDH gene as normalizer of the reactions. The distribution of the genotypes and alleles in the group of fertile women with moderate/severe endometriosis showed a statistically significant difference, demonstrating association of the ancestral allele, -765G, with increased risk of endometriosis (p = 0.028; OR 0.53; CI 0.32-0.90). The mean expression of the COX-2 gene (mRNA PTGS2) in the group of women with endometriosis was statistically higher compared to the control group (3.85 versus 2.84, p = 0.028). The present study identified that in Brazilian women the presence of the ancestral allele, -765G, of the COX-2 gene is associated with an increased risk for development of moderate/severe endometriosis associated with fertility, and that the eutopic endometrium of women with endometriosis showed increased expression of COX-2 when compared to the control group.

Uterine and ovarian arteries blood flow during the mid luteal phase in women with unexplained infertility

Abstract Objective Altered utero-ovarian blood flow has been claimed to be a subtle cause of unexplained infertility. The aim of this study was to compare between the flow velocity indices in the uterine and ovarian arteries during the luteal phase in fertile and unexplained infertility women. Study design Observational, cross section, controlled study done at the departments of Obstetrics and Gynecology, Benha Faculty of Medicine, Egypt, during the period from October 2010 to October 2011. Patients and methods Two groups each of 30 cases and aged 20-25 years were studied. A control group of fertile women who got pregnant within one year of marriage, and a study group of women with unexplained infertility were included. Trans-vaginal pulsed color Doppler ultrasound was done at days 21–23 of the cycle to measure uterine and ovarian arteries resistance and pulsation indices. Outcome measures Mean uterine and ovarian arteries resistance and pulsation indices in both groups and their values in the diagnosis of altered blood flow in unexplained infertility were measured. Results Women with unexplained infertility had significantly higher uterine and ovarian arteries pulsation index ( P Conclusions Unexplained infertility is associated with decreased uterine and ovarian arteries blood flow during the luteal phase. More studies are needed to support this conclusion and to evaluate the possible role of perfusion enhancer drugs in increasing utero-ovarian blood flow and enhancing pregnancy.

Psychological profile of women with infertility: A comparative study.

Background:An endeavour to probe into the psychological profile of infertile women in a comparative stance with the fertile women is not very common. This study is an attempt to explore the possible non-apparent personality factors which contribute to the unexplained pain of infertility.Methods:The main objectives of the present study were (a) to examine whether infertile women are different from fertile women in terms of selected psychological variables- narcissistic components, dimensions of attachment style and uses of defensive manoeuvres; and (b) whether the primary infertile women (n=18) are different from the secondary infertile women (n=12) with respect to those variables. A total of 60 individuals (30 infertile women and 30 matched fertile women) were assessed through Attachment Style Questionnaire (ASQ), Narcissistic Personality Inventory (NPI) and Defense Style Questionnaire (DSQ-40). General Health Questionnaire (GHQ) was administered on to the fertile women to rule out the psychiatric morbidity.Results:Findings revealed that infertile women group differed from fertile women group with respect to narcissism, dimensions of attachment style and uses of defense mechanism. The primary infertile group also showed marked difference from the secondary infertile group with respect to those variables.Conclusions:This study endeavours to enrich the knowledge regarding the personality dynamics of infertile women to design psychotherapeutic programme to aid their well-being, help them to cherish the flavour of parenthood and improve their quality of life.

The Impact of Lifestyle Risk Factors on Female Infertility

ABSTRACT Background: Over 2 million couples in the United States are infertile. The literature reflects a number of potential lifestyle risks that have been associated with the development of this condition; however, few studies have investigated these risks concurrently. With knowledge of the importance of behavioral threats to fertility, women's health care providers will be in a better position to screen and assist women to modify their fertility risks. Objectives: The objectives of this study were (1) to identify lifestyle factors associated with infertility in women by comparing a sample of infertile women with a group of fertile women and (2) to offer recommendations to women's health providers, on counseling women at risk for infertility. Methods: A re-examination of the 1995 National Survey of Family Growth (NSFG) allowed for the investigation of lifestyle factors associated with infertility in women. Using a conceptual model of health behavior to guide the selection of variables, together with multiple logistic regression techniques, an explanatory model of infertility was estimated on a sample of 824 women between the ages of 16 and 45 years. Results: Factors directly related to infertility included increasing age, a history of an ectopic pregnancy, current smoking, obesity, and self reported health status. Protective effects were associated with a history of condom use and having had a Pap smear in the last year. Conclusions and Implications: Routine well-women visits offer an excellent opportunity to begin to address the impact of selected risk factors for infertility. Clinicians can utilize these visits to target appropriate interventions for initiating, repeating, and reinforcing messages on fertility risk.

Vascular endothelial growth factor gene +405 C/G polymorphism is associated with susceptibility to advanced stage endometriosis

Vascular endothelial growth factor (VEGF) is known to play a pivotal role in the development of endometriosis. This study was performed to investigate whether the VEGF gene 5'-untranslated region polymorphism is associated with susceptibility to advanced stage endometriosis. This study comprised 215 women with advanced stage endometriosis, 219 control women without endometriosis, and 70 fertile women. Following extraction of genomic DNA, genotyping of the -460 C/T and +405 C/G polymorphisms of the VEGF gene were performed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis. The distribution of genotypes and allele frequencies of the -460 C/T polymorphism in the endometriosis group did not differ from those in the control group and the fertile women group. However, genotype distribution of the +405 C/G polymorphism was significantly different between patients with and without endometriosis (P = 0.01) and between patients with endometriosis and the fertile women (P = 0.02). Patients with endometriosis showed a higher incidence of the +405 CC genotype compared with the controls and the fertile women (P = 0.007 and 0.016 respectively). These findings suggest that the VEGF +405 C/G polymorphism may be associated with the risk of advanced stage endometriosis in the Korean population.

Age-related changes in ovarian volume ,antral follicle counts and basal follicle stimulating hormone levels: comparison between fertile and infertile women

Our objective was to compare the relationship between age ,basal follicle stimulating hormone (FSH) level and ultrasound-measured mean ovarian volume (MOV) and mean antral follicle counts (MFC) in a groupof infertile and fertile women between the ages of 35 and 45 years. Menstrual cycle day 3 serum FSH ,MOV and MFC were analyzed in 62 infertile and 53 fertile women. Basal FSH and MFC did not differ betweeninfertile and fertile women ,whereas MOV was significantly smaller in infertile women (p < 0.05). In the infertile group ,there was a negative correlation between MOV and age (ρ = -0.389,p < 0.05) ,between MOV and basal FSH (ρ = 0.495 ,p < 0.01) ,and between MFC and age (ρ = -0.553 ,p < 0.01). In the fertile group ,there was a strong negative correlationbetween MOV and basal FSH (ρ = -0.631 ,p < 0.01) ,and between MFC and basal FSH (ρ = -0.710 ,p < 0.01). Mean basal FSH ,MOV and MFC did not differ between subgroups of patientswith different causes of infertility. In the infertile group ,patients with small ovaries of volume less than 1.8 cm3 (mean volume -1 SD) had higher mean basal FSH (p < 0.05) and lowerMFC (p < 0.01) levels than patients with normal ovarian volume. In conclusion ,transvaginal ultrasound (TVU) indices and indirect hormonal parameters of ovarian reserve were similar in infertileand fertile women aged between 35 and 45 years. It is suggested that ,in infertile women above 35 years of age ,TVU rather than hormonal parameters be preferred ,based on our data showing a stronger associationbetween age and TVU indices of ovarian reserve than between age and increase in basal FSH level. Thus ,TVU assessment of ovarian volume and antral follicle counts is a practical and cost-effective ,if notbetter ,technique for ovarian reserve testing.

Low-penetrance genes are associated with increased susceptibility to endometriosis

Objective: To investigate whether genetic polymorphisms of CYP1A1, GSTM1, and GSTT1 are associated with endometriosis. Design: Genetic polymorphism analysis. Setting: University department. Patient(s): A family with four women in two generations who had endometriosis and one member with suspected endometriosis in the third generation were compared with a group of fertile women. Intervention(s): Laparoscopic examination. Main Outcome Measure(s): Blood specimens were obtained from fertile females and available affected female family members. Multiplex polymerase chain reaction (PCR) and restriction fragment length polymorphism PCR was done to determine each participant’s genotype. Result(s): All affected family members had genotype CYP1A1 wt/m1 and GSTM1 null deletion. The frequency of this genotype in 54 fertile women was 13%. A 17-year-old family member with suspected endometriosis had the same genotype. One affected member was also a carrier of a GSTT1 null deletion. This combination was not found in any of the fertile participants. The most frequent genotypes in the sample were CYP1A1 wt/wt, with GSTM1 null deletion and at least one functional allele of GSTT1, and CYP1A1 wt/wt, with at least one functional allele of GSTM1 and GSTT1 (33% and 31%, respectively). Conclusion(s): The combination of CYP1A1 m1 polymorphism and GSTM1 null deletion is closely associated with penetration of the endometriosis phenotype, whereas GSTT1 null deletion may add to the penetration of this trait.

Plasma prealbumin in women with epithelial ovarian carcinoma.

Epithelial ovarian carcinoma produces steroid hormones that may be of prognostic importance. The steroids are mainly bound to plasma albumin and sex hormone-binding globulin. Alterations in plasma protein levels influence hormonal effects. As plasma prealbumin may reflect changes in the patient's clinical status better than do albumin determinations, it is of interest to analyze prealbumin in patients with ovarian cancer. Fifty-one postmenopausal or oophorectomized women with epithelial cancer of the ovary were studied. Plasma prealbumin was analyzed prior to and during chemotherapy. Tumor volumes were evaluated and blood samples were drawn for prealbumin analysis on four occasions at monthly intervals. Plasma levels were compared with one control group of postmenopausal women, one group of fertile women in the follicular phase of the menstrual cycle, and one control group of postmenopausal women with nongynecologic disseminated malignant disease. Prealbumin concentrations are lower in women with carcinoma of the ovary than in postmenopausal controls and the levels correlate inversely to tumor volume. Prealbumin concentrations are decreased in the large tumor group, advanced tumor stage group and in the control group with nongynecologic disseminated malignant disease. During chemotherapy, plasma prealbumin increases concomitantly with the reduction of tumor volume. Initial plasma prealbumin concentration seems to have prognostic importance. Prealbumin may be a sensitive indicator of disturbances in protein metabolism. It may reflect changes in the patient's clinical status better than do albumin determinations. Prealbumin concentration seems to have a prognostic importance in women with epithelial ovarian carcinoma. Prealbumin is studied in women with epithelial ovarian carcinoma prior to and during chemotherapy, and is found to vary inversely with changes in tumor volume.

Vergleich der Resorption von Eisen und Haem-Eisen in Mahlzeiten bei Personen mit und ohne Eisenmangel

The relative intestinal absorption of heme- and non heme-iron in connection with a standardized test meal was studied in a group of fertile women given 16 mg Fe in the form of FeSO4 and 2 mg Fe in the form of hemoglobin. Both in normal subjects and in women with iron deficiency, the heme-iron was significantly better absorbed (16.13% +/- S.D. 8.0 vs 4.59 +/- 3.4, p < 0.01 and 22.03 +/- 8.9 vs 9.45 +/- 7.8, p < 0.05). For targeted prophylaxis of iron deficiency with small, side-effect-free doses, heme-iron is thus a valuable component which increases the absorption by about 40%. Heme-iron does not cause high concentrations in the intestinal lumen of free radical inducing, possibly harmful ferric iron.

Morphometric analysis of the endometrium of infertile patients in relation to peripheral hormone levels

In an attempt to identify factors that may be responsible for reproductive failure, we compared endometrial biopsies taken from infertile patients during the luteal phase of spontaneous cycles (n = 18) with those taken after ovarian stimulation (n = 18). Morphometric analyses were performed and compared with peripheral estradiol (E 2 ) and progesterone levels at the time of supposed implantation. In stimulated cycles the number of glands per square millimeter was positively correlated to the E 2 level. The morphometric data point to a measurable difference between the study groups, indicating an insufficient secretory transformation of the tissue in infertile women when compared with a group of fertile women. The observations suggest that hormonal stimulation occasionally results in impaired development of the endometrial glands.

Within pair differences of human chromosome 9 C-bands associated with reproductive loss.

The size and position of the heterochromatic regions of chromosome 9 were examined in a group of women with histories of recurrent miscarriage and a control group of fertile women. Measurements were made on whole chromosomes (variability between chromosomes was taken to reflect differences in heterochromatin), and corrections for between-cell contraction were made by comparison with chromosome 7. Chromosomes were analysed in pairs and the following results were obtained: (1) The larger of the pairs of chromosomes of the test group were significantly larger than those of the control group: (2) The smaller of the pairs of chromosomes were the same in each group: (3) The differences between the chromosome pairs were significantly greater in the test than the control group: and (4) The sums of the homologous chromosomes were significantly greater in the test than in the control group. Independent assessment also showed that a significantly higher frequency of complete pericentric inversions of chromosome 9 was present in the test than the control group. These results are discussed in the light of two hypotheses: (1) The difference in the size of the homologous chromosomes is critical, and (2) the total heterochromatic content of a chromosome and/or cell is critical. Some evidence is presented to support each hypothesis, but the former is the more favoured by the data.

Sperm Agglutination and Infertility

To the Editor.— I would like to comment on the recent article by Pacheco-Romero et al (224:849, 1973), dealing with the relationship of spermagglutinating activity and female infertility. I fear that this report may cause some confusion, because we may question the reliability of the exact technics that were used, and also because of the logic of the design and the final interpretation concerning antibody importance. Regarding the interpretation, the most urgent point is that the authors did not include a population group of fertile women, although they did study two groups, namely, a group in whom infertility was of the unexplained variety and another group, in whom the infertility was explainable on some organic basis. They found a similar incidence of positive results in these two groups, and they concluded that the presence of spermagglutinins did not play an important role in female infertility. It might have been preferable