Subclinical Abortion Research Articles

Prevalence of subclinical abortions in cows due to mycotoxicosis

The article presents data on the distribution and seasonal dynamics of subclinical abortions in cows with mycotoxin poisoning, particularly zearalenone. Subclinical abortion is a common phenomenon among cows in dairy farms and causes significant economic losses due to multiple unsuccessful inseminations, reduced animal productivity, and premature culling. The research aimed to study the seasonal fluctuations of hidden abortions in cows and the influence of the method of keeping in the conditions of feed contamination with microscopic fungi and their toxins. To diagnose hidden abortions, cows were diagnosed with the pregnancy on the 32nd day after insemination. When pregnancy was confirmed, the animals were examined for 92 days. At the same time, if the pregnancy was not confirmed, it was considered that an abortion had occurred. Seasonal fluctuations of subclinical abortions were established - the most significant number (up to 13.6 %) was diagnosed at the end of spring, associated with many animals entering the hunt after the transit period. It is also important that at that time, the number of mycotoxins in feed reached record values, which led to abortions due to toxic effects on the organs of the reproductive system in particular and the body in general. A large number of abortions (11.2 %) in the summer season was also confirmed. At the same time, animals kept free all year received a similar diet containing mycotoxins. At the same time, a concomitant negative factor was temperature shock at this time of year. This whole complex of reasons led to subclinical abortions followed by the resorption of the fetus. Sonographically, areas of reduced echogenicity of the uterus in cows after abortions were detected, which is evidence of the development of subclinical endometritis, confirmed by the uterus's heterogeneous echogenicity. In infertile animals, the presence of follicles with cavities and small yellow bodies that did not extend beyond the surface of the ovary was established sonographically. This indicates a hypofunctional state and impaired folliculogenesis and luteogenesis.

The role of obstetrical diseases in the development of subclinical metritis

The results of the dependence of obstetric diseases of cows in the occurrence of subclinical abortions against the background of the development of metritis under the influence of mycotoxins are given. Subclinical metritis is a fairly common phenomenon in cows, which causes significant economic losses. At the same time, the number of subclinical metritis in cows correlates with the number of obstetric pathology. Due to the negative impact of mycotoxins, in particular zearalenone, the balance of sex hormones is disturbed, which creates conditions for the development of saprophytic microflora in the organs of the reproductive system of cows. At the same time, deoxynivalenol helps to reduce the resistance of the cow's body in general and mucous membranes, in particular, which contributes to the development of inflammatory processes in the uterus. These processes are often subclinical. The aim of the work was to find out the role of obstetric diseases in the development of subclinical metritis and to develop clinical and prognostic tests for the occurrence of metritis and the basis for the analysis of obstetric pathology. The spread of obstetric pathology was established depending on the way cows are kept. Thus, in farms where cows were kept on tethers, the number of obstetric pathologies was 15.5 times higher. However, the number of inflammatory processes in the organs of the reproductive system in such farms was lower by 12 %. A decrease in the level of T- and B-lymphocytes in the blood and suppression of their functional activity was established, which is manifested by a decrease in the level of immunoglobulin G and has a significant effect on the increase in the frequency of subclinical abortions. The dependence of the reproductive capacity of cows on the frequency of subclinical and chronic inflammatory processes of the reproductive organs, which occur against the background of mycotoxicosis, was established. The influence of mycotoxins on the functioning of the ovaries and uterus was studied, and an increase in the number of such cases was established in farms with tethered cows. The correlation between the contamination of cow feed and the reduction of fertilization in cows was found. An increase in the number of subclinical abortions under the influence of zearalenone, which is found in large quantities in feed, has been established. The dependence of ovarian disorders on increasing productivity in cows was investigated.

Pregnancy outcomes following different protocols of controlled ovarian hyperstimulation in couples undergoing intrauterine insemination.

Clomiphene citrate (CC), letrozole and cetrorelix acetate are frequently used agents in controlled ovarian hyperstimulation (COH). However, these three agents have not yet been compared to one another regarding their pregnancy outcomes. The present study was designed to retrospectively compare pregnancy outcomes among the three aforementioned agents. This study involved infertile couples with an infertility duration of at least 2 years, ages 18 to 42years and who were referred to have their first intrauterine insemination (IUI) treatment cycle. All patients underwent COH with recombinant follicle-stimulating hormone (rFSH) plus CC (n=118), letrozole (n=81), or cetrorelix acetate (n=62), followed by IUI. Using the one-way multivariate analysis of covariance to control female patients' ages, patients stimulated with cetrorelix acetate/rFSH or CC/rFSH had higher numbers of preovulatory follicles than women stimulated with letrozole/rFSH (P<.02), whereas women stimulated with cetrorelix acetate/rFSH had a thicker endometrium than women stimulated with CC/rFSH (P<.0005). Biochemical pregnancy rates were similar among the three protocols of COH. However, women stimulated with letrozole/rFSH showed clinical pregnancy rates higher than those stimulated with CC/rFSH (P=.003) or cetrorelix acetate/rFSH (P=.03) and subclinical abortion rates lower than those stimulated with CC/rFSH or cetrorelix acetate/rFSH (P=.009). Of the different protocols of COH, the odds of having a clinical pregnancy was 3.1 times greater for women stimulated with letrozole/rFSH than women stimulated with CC/rFSH (P=.004) and 2.8 times greater for women stimulated with letrozole/rFSH than women stimulated with cetrorelix acetate/rFSH (P=.03). Our observations show that increased numbers of preovulatory follicles or endometrium thickness do not necessarily improve pregnancy outcomes, because pregnancy outcomes are also subjected to the type of COH used agent. In this regard, letrozole produced fewer preovulatory follicles and did not significantly increase endometrium thickness, but significantly improved pregnancy outcomes in comparison to CC and cetrorelix acetate.

47,XXX/45,X/46,XX mosaicism in a patient with Turner phenotype and spontaneous puberal development

To describe a patient with infertility and phenotypic combination of Turner and triple-X syndrome related to mos 47,XXX/45X/46,XX karyotype. Case report. División de Genética, Centro de Investigación Biomédica de Occidente and Hospital de Ginecología y Obstetricia, CMNO, Instituto Mexicano del Seguro Social. The 24-year-old patient presented a phenotypic combination of Turner syndrome and X polysomy. She showed wide and short neck, low posterior hairline, cubitus valgus, bilateral shortening of the fourth and fifth metacarpals, multiple nevi, and müllerian anomalies but had spontaneous pubarche, thelarche, and menarche. Laboratory evaluations, imaging studies, ovarian biopsy, G-banding karyotype, and in situ fluorescence hybridization. Clinical and laboratory findings. A karyotype: mos 47,XXX/45X/46,XX was found in the cytogenetic studies, a bicornuate uterus in the ultrasonographic scan, and a normal ovarian profile in the laboratory tests. The infertility in the present case can be related to either bicornuate uterus or subclinical abortions due to aneuploid ova. Cytogenetic assessment provides important information regarding infertile patients with uterine factors and short stature.

The Value of a Single Sensitive Urine Pregnancy Test in Prediction of Pregnancy Outcome

A simple and reliable indicator for pregnancy outcome will be valuable clinically for patient management and for counselling women whose pregnancies are results of subfertility treatment. This study aimed at evaluating the ICON II test, a simple semiquantitative sensitive urine pregnancy test, in predicting pregnancy outcome in women who conceived after various forms of subfertility treatment. The ICON II test was performed on day 20 after the ovulating dose of hCG administration or spontaneous LH surge. One hundred and forty-five consecutive pregnancies were studied, 99 being viable and 46 nonviable which included subclinical abortion, clinical abortion and ectopic pregnancies. There was a significant difference in the luteal serum progesterone and hCG levels between viable and nonviable pregnancies. There was also a significant difference in the ICON II test result, i.e. either weakly positive (hCG of 25-50 IU/l) and positive (hCG > 50 IU/l) and the pregnancy outcome (p < 0.0001). The specificity of a weakly positive ICON II test in predicting poor pregnancy outcome was 98.8% whereas the sensitivity was 28.6%. In conclusion, a weakly positive ICON II test is useful in predicting poor pregnancy outcome.

Sonographic assessment of ovarian and endometrial changes during long-term Norplant use and their correlation with hormonal levels

To study the probability of ovulation and subclinical abortion during long-term use of Norplant and to assess the concomitant endometrial development. This was a prospective nonrandomized comparative study. The ovaries and endometrium were assessed daily by ultrasonography during 59 menstrual cycles in 50 women who were using Norplant for > 1 year. Serum concentrations of E2, P, FSH, LH, pregnancy specific beta 1 glycoprotein (Sp1), and hCG were also daily measured. The findings were compared with those in 35 ovulatory cycles in normal fertile women not using contraception. Clients of the Family Planning Clinic of Assiut University Hospital (Norplant users) and the hospital women staff (controls). Sonographic and hormonal evidence of ovulation were observed in one third of Norplant users; two of them resulted in conception. However, the majority of these ovulatory cycles showed low midcycle peaks of E2, FSH, and LH and evidence of luteal phase defect (LPD). Excessive follicular enlargement was observed in 46% of the cycles. Norplant users had significantly thinner endometrium that did not exhibit the normal phasic changes in sonographic texture. Apart from conceptive cycles, no rise in Sp1 or hCG was observed. Norplant acts mainly by inhibiting ovulation, but when this occurs, it is associated with LPD and subnormal endometrial development. Subclinical abortion does not contribute to the contraceptive effect.

Placental proteins in the diagnosis and evaluation of the "elusive" early pregnancy.

For many many years much time and effort has been invested to identify, purify, and quantify markers of significant reproductive events. The search for such markers has been recently intensified with the widespread acceptance of IVF and ET as a treatment regimen for the management of certain causes of infertility. Now it is possible to monitor ovarian folliculogenesis and time of ovulation, successful fertilization, and subsequent nidation and the ensuing pregnancy. Following successful fertilization and zygote development, EPF, a protein complex which suppresses in vitro lymphocyte rosette formation can be detected within 24 hours. Shortly after implantation hCG can be measured in the maternal circulation. The developing trophoblastic tissue continues to synthesize and secrete into the maternal circulation many varied proteins including SP1, PAPP-A, and PP5. To date hCG is the mainstay of rapid and early pregnancy diagnosis and is an accepted biochemical marker of successful implantation and trophoblastic activity. Combination of hCG and EPF measurement offers the clinician new insight into his infertile patient for now it is possible to monitor successful fertilization and implantation as separate independent events. Such diagnostic assays should also provide new insight into early embryo mortality rate at the pre- and postimplantation stage and hence indicate the selection pressures acting on an embryo. It is the application of these assays which has led to the definition of subclinical abortions and to the description of biochemical pregnancies. The value of these proteins for the management of compromised early pregnancies has to be more fully examined. Although the differentiation between a normal and abnormal pregnancy is more readily ascertained by serial sampling and analysis of the time taken for circulating levels to double (3). Preliminary data suggest the potential of EPF and PAPP-A measurement in such clinical conditions is enormous. Our studies suggest that PAPP-A, at present, is the only biochemical marker which can predict pregnancy abortion, even in the presence of normal ultrasound scans, many weeks prior to the event, thus implying a vital biological role for PAPP-A in normal pregnancy (52). Despite the need for more intensive evaluation of these early pregnancy indicators the search for that "demmed elusive" marker has more than "Those Frenchies" earnestly looking for him here and there.

Subclinical abortions in patients treated with clomiphene citrate

Using radioimmunoassay for human chorionic gonadotrophin beta-subunit, 39 treatment cycles of clomiphene citrate therapy were studied prospectively for incidence of subclinical abortions. Eight treatment cycles resulted in clinically recognizable pregnancies and three other treatment cycles ended up with subclinical abortions. The plasma progesterone levels in patients with subclinical abortions at the 13th day after ovulation were lower than those in patients with normal pregnancies.

Trophoblastic markers in women using intrauterine contraception.

Serum levels of human chorionic gonadotropin (hCG) and pregnancy-specific beta 1-glycoprotein (PSBG) were measured in 214 women using Copper-T200 intrauterine devices (CIUDs). In a cross-sectional study the samples were taken between the 25th and 35th cycle days, 1 sample per cycle. Either trophoblastic marker was detectable in 8 women (3.7%), hCG in 3 (1.4%), PSBG in 7 (3.3%), and both markers together in (0.9%). Normal menstruation-like bleeding ensued in all but 1 woman whose bleeding was delayed by 5 days. Our results suggest that the intrauterine contraceptive device (IUD) prevents pregnancy mainly before significant amounts of trophoblastic products are secreted. Still, the incidence of subclinical abortion based on the demonstration of trophoblastic markers in serum was 7 to 10 times higher than that of established pregnancy in women using a CIUD.