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Contracept Technol Update. 1986 Feb;7(2):15-7.
Smoking may be linked to primary tubal infertility.
[No authors listed]
PIP: A recent case-control study conducted in King County, Washington, has implicated cigarette smoking in primary tubal infertility. Both cases and controls were questioned about their reproductive, medical, contraceptive, and sexual histories as well as on personal hygiene, demographic characteristics, and tobacco and alcohol use. Adjustments were made for the confounding effects of IUD use, number of sexual partners, and family income. Study results indicated that women who smoked at the time they started trying to become pregnant were 2.7 times more likely to have primary tubal infertility than nonsmokers. The magnitude of risk was influenced by the age at which the woman began smoking, the number of years she smoked and the average number of cigarettes smoked/day. The relative risk for women who began smoking before age 16 years and for those who smoked for more than 5 years was 4 times that of nomsmokers. On the other land, women who had qit smoking before trying to conceive had virtually no increased risk of tubal infertility. Women who had used the Dalkon Shield and smoked at the time they tried to conceive were 6.7 times more likely to have primary tubal infertility than women who had never smoked or used an IUD. However, women who had used a copper IUD were at little or no increased risk. Current smokers who had had more than 5 sexual partners were more than 5 times at risk of primary tubal infertility than nonsmokers with 4 or fewer sexual partners. These findings have led to speculation that smoking may have some relationship to infection with sexually transmitted diseases. Specifically, it has been suggested that smoking may exert a direct effect on the immune system, making it easier for sexually transmitted pathogens to enter the system. It is urged that women who plan to have children should be advised not to smoke, especially if they use a noncopper IUD or have many sexual partners.
online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12340521&dopt=Abstract
New Afr. 1987 Apr;:16.
Africa not interested in EEC help on AIDS.
Misser F, Brisset C.
PIP: African countries have rejected attempts by the European Commission and the World Health Organization (WHO) to promote a program to halt the spread of acquired immunodeficiency syndrome (AIDS) in Africa. To date, WHO has been notified of 2324 AIDS cases in Africa; however, this represents only a small fraction of the actual number of cases on the African continent. Africa's stance in part reflects objection to a European Commission proposal that all students from African countries should be screened for AIDS before being awarded scholarships to study in Europe. It has also been proposed that foreigners seeking residence permits obtain certificates showing they are not carrying the AIDS virus. There is a new concern that AIDS can be spread by vaccination programs for other diseases as a result of unsterilized needles. The vaccines themselves could prove fatal to children who are already harboring the AIDS virus since they would have no immunity to the vaccine. Moreover, vaccination of any type stimulates the immune system to develop change and could precipitate the onset of AIDS in infected but asymptomatic children. At present, however, mass immunization programs in developing countries will continue since present estimates indicate the risk of a child dying of 1 of the 6 major diseases covered by large-scale immunization programs is far greater than the risk of the child dying of AIDS.
online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12341823&dopt=Abstract
IPPF Med Bull. 1988 Jun;22(3):1-3.
Problems of HIV infection for women in Africa.
Goethel W.
PIP: Increasingly large numbers of babies in sub-Saharan African are born with congenital human immunodeficiency virus (HIV). Attention is directed to the risk of vertical transmission, breast feeding and transmission of HIV infection, the risk of progression of HIV-related disease during pregnancy, contraception and HIV infection, counseling, congenital HIV infection, and management. In Africa, heterosexual sex is the primary route of spread of HIV, meaning the virus affects both sexes equally. Further, most HIV-seropositive women are in the sexually active and reproductive age group. The effect of HIV on the immature fetal immune system can be such that the infant does not make antibodies to HIV. Consequently, an infected infant can have negative HIV antibody tests. Viral antigen tests now are helpful in the diagnosis of congenital HIV infection but are costly and not widely available. This difficulty in serological diagnosis means that the frequency of transmission from HIV-infected mothers in their infants remains unknown. There have been 5 reports of apparent spread of HIV through breast feeding, yet it seems unlikely that breastfeeding plays a significant role in the spread of HIV infection. The claim that pregnancy triggers progression of disease in HIV positive women is based on only a series of case reports of Acquired Immune Deficiency Syndrome (AIDS) in pregnancy and an apparently high incidence of AIDS in women who had previously delivered an affected infant. The personal experience of HIV-infected women in sub-Saharan Africa, followed for an average of 2 years after delivery, suggests that pregnancy does not commonly accelerate progression of HIV-related disease, since most remain asymptomatic. Those infected with HIV need good contraceptive advice, and whatever contraceptive a woman chooses, it also should be recommended that condoms are used too whenever there is a risk of sexual spread of HIV infection. Women need current information about their condition, but counseling requires more than factual information. Affected women need and deserve advice and support from their doctor or health worker. Most infants with congenital HIV infection present before age 1. In many cases HIV infection is diagnosed in the 2nd year of life. HIV-infected children present with a wide variety of problems the most common of which are pneumonia and failure to thrive. Mothers need to be reassured that problems arising from HIV infection, such as rashes, dehydration, and chest infections can be treated even though there is no cure as yet for their child's underlying weakness.
online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12342059&dopt=Abstract
Adv Contracept Deliv Syst. 1988;4(4):295-327.
Sperm/macrophage interactions: fertility, infertility, and the IUD.
Olive DL, Schlaff WD.
PIP: Research shows that the immune system affects the physiologic and pathophysiologic processes of reproduction. Even though normal barriers to sperm autoimmunity in the male exist, they can be altered by trauma, infections, biopsy, and most often, vasectomy. Under normal circumstances, seminal plasma suppresses lymphocyte stimulation and transformation induced by a variety of activators. On the other hand, the greatest reduction of sperm antigen load in the female reproductive system occurs at the cervix which serves as a filter to remove seminal plasma, leukocytes, and bacteria. The likelihood of sperm antibody development in the female reproductive tract, however, is low primarily because of inherent properties of sperm and seminal plasma and secondarily to elimination by local cellular activity. Most scientists agree that macrophages remove excess sperm from the male and female reproductive tracts. In females, ovarian cyclicity controls, in part, this response. Further, recent research shows that the only characteristic required for phagocytosis of sperm is an intact plasmalemma which suggests that sperm have a surface molecule critical to binding and uptake by the macrophage. Often this natural response to remove excess sperm from the body is altered causing reproductive failure. 3 drugs (methyldopa, danazol, and ethiodol) have demonstrated an ability to depress the response when it leads to reproductive failure. The most promising drug is ethiodol. 1 reason IUDs are an effective contraceptive is because they cause the formation of inflammatory cells in the endometrial cavity, thereby attracting macrophages to the uterus. Researchers demonstrated that, in those women with an IUD who had recently been inseminated and had a subsequent salpingectomy, no sperm were present in the oviducts.
online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12342244&dopt=Abstract
Contracept Technol Update. 1989 Oct;10(10):140-2.
Female contraceptive vaccine possible, but not for years.
[No authors listed]
PIP: Researchers are presently testing 2 types of contraceptive vaccines in animal models. One of these is the sperm antigen vaccine which would cause immunity to sperm within the female reproductive tract. The other works against the zona pellucida (the extracellular membrane surrounding the ovum) which the sperm must bind to and penetrate for fertilization to take place. At this time, researchers do not yet know what vaccine is the best route. The sperm antigen vaccine would inhibit capacitation--that stage where they become capable of fertilizing the ovum. The researchers foresee certain problems with this vaccine, however. For example, it will be difficult to get a vaccine to work properly within just the reproductive tract since most antigen vaccines work within the entire immune system. Further, all the areas of the reproductive tract are biologically different. In addition, researchers must find a vaccine potent enough to affect the millions of sperm that enter the uterus. A potential problem with the zona pellucida vaccine is that it could create ovarian dysfunction permanently. Therefore, researchers realize the importance of finding a zona pellucida vaccine that will induce fertilization but not destroy the ovaries. WHO is in the early stages of working on a vaccine against human chorionic gonadotropin to prevent implantation, but this and any postfertilization vaccine will probably not be produced for the US market because of the present antiabortion sentiment. Additional barriers to production of a contraceptive vaccine is that pharmaceutical companies fear liability in marketing a new contraceptive and their profit margin will be low. Nevertheless, the earliest a contraceptive vaccine would become available in 1999.
online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12342587&dopt=Abstract
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