Nulligravid Women Research Articles

A comparison of event rates in nulligravid and nulliparous women using the small Dalkon Shield for intrauterine contraception

The small Dalkon Shield provided intrauterine contraception for 344 nulliparous and 1353 nulligravid women during a two-year study period. In this prospective study, the pregnancy rates for nulligravid and nulliparous patients were 0.9 and 2.2 per hundred woman years, respectively. Significantly different event rates occurred with higher rates in the nulliparous women. The small Shield appeared to perform better in those patients who have not been pregnant.

Metallic copper as an intrauterine contraceptive agent

Some of the biological aspects of copper relevant to reproductive processes are reviewed. Included are cyclic variations in the concentrations of copper in the endometrium, uterine fluid, cervical mucus, and serum as modified by the presence of intrauterine metallic copper and after its removal. Variations in the endometrial enzymes, namely, α-amylase, glycogen synthetase, and phosphorylase, are also considered. The rate of copper loss from the intrauterine copper T in the woman is reviewed, and these data are considered in relation to the duration of effective antifertility action within the uterus. In addition, the theoretical participation of this quantity of copper in the total body metabolic balance of copper is considered. Special reference is made to Wilson's disease. Examples of surface changes in the copper wire which may occur during its intrauterine life are described. The potential implications of copper fragmentation are considered, and relevant experimental data obtained from rhesus monkey studies are presented. The latest clinical data on use-effectiveness of the copper T Models 200 and 300 in nulligravidous, nulliparous, and parous women in the United States and abroad are presented. In addition, a preliminary report is made on a double-blind comparison of the T Cu 200 and the Copper 7 after 9 months of use.

Specific plasma factors blocking human maternal cell-mediated immune reaction to placental antigens.

ONE attractive explanation1 for the apparent lack of maternal immunological reaction to an allogeneic foetus in utero is that the components of the placenta normally act as an immunological barrier effective against both the afferent and efferent arcs of an immune response2,3. We have shown that, in humans, the mother may be specifically sensitized to placental antigens during pregnancy4. When peripheral blood leucocytes from postpartum women were mixed with guinea-pig peritoneal exudative cells, inhibition of cell migration only occurred in the presence of specific placental antigens. Peripheral blood leucocytes from postpartum women were reactive only to the papain-digested membranous antigens prepared from their own placenta and not to antigens prepared from other placentas. Using antigens pooled from five placentas, leucocytes from all of the 41 postpartum women were shown to be reactive, while leucocytes from 12 males and 5 nulligravidous women were not reactive. Mothers with specific cell mediated immunity to foetal tissues may therefore be potentially able to reject their foetuses; failure to do so may be due to blocking or inhibition of the efferent arc. Among the candidates for this role are specific serum or plasma blocking factors such as those interfering with cell mediated immune reactions to foreign embryonic cells5, to allografts in neonatally induced tolerant animals6, to tumour cells7 and to allogeneic cells in tetraparental mice8. We studied the effect of a mother's plasma on the reactivity of her own leucocytes to placental antigens to investigate the presence of such factors.

Opipramol and Chlorthalidone in the Treatment of Premenstrual Tension

Thirty-three patients under the age of 38 suffering from premenstrual tension were admitted to a clinical trial and treated for three cycles. Five received opipramol alone and twenty-eight received a combination of opipramol and chlorthalidone. Slightly better results were obtained with the combination than with opipramol alone, although the number of opipramol patients was too small for valid comparison. There was a progressive improvement over the three cycles. By the third cycle there was a 47.92% improvement in the total score for ten symptoms on opipramol and 59.2% improvement on the combination. As far as the combination was concerned, best results were obtained for the symptoms, swelling of breasts (90%) mastalgia (88.8%), swelling of ankles (83.3%), oliguria (64.2%) and emotional lability (59.2%). The effect of age, marital state and gravidity on the syndrome was examined. No major differences were found in the symptomatology as far as these three factors were concerned. Young, single nulligravid women however, showed a consistently more favourable response to therapy. In terms of individual patient response, twenty-eight patients showed moderate or much improvement by the end of the third cycle.

Phlebographic studies of the leg veins in the first half of pregnancy and during oral contraception.

Phlebography appearances in the legs were studied during the first half of pregnancy in 46 primi‐gravidae and were compared with those in 42 normal nulligravid women. Phlebography was also performed on 34 of the nulligravid women after 6–12 cycles of oral contraceptive therapy. No differences were demonstrated in either study.

POST‐PILL INFERTILITY

One hundred and fifty-one nulligravid women and 63 parous women stopped taking low-dose sequential oral contraceptives in order to become pregnant. During the first post-Pill cycle, 39% of the nulligravid and 54% of the parous women conceived. These figures have been compared with data from the Royal College of General Practitioners survey in England, in which 13% of nulligravid and 17% of parous women conceived in the first cycle after ceasing to take combined oral contraceptives. The percentage of nulligravid women not pregnant six months after withdrawal of low-dose sequential formulations was 19% compared with 32% after withdrawal of combined oral contraceptives. The corresponding figures for parous women were 5% and 21%. Available data suggest that after withdrawal of low-dose sequential oral contraceptives, the incidence of post-Pill infertility is lower than that after withdrawal of combined oral contraceptives. The extent of this difference is 16% three months after withdrawal of the Pill and 10% six months after attempting pregnancy.