INFERTILITY (MANDUL,SULIT PUNYAANAK) DAN DIET,

PRUDENT DIET :

TREND BARU MENCARI SOLUSI KESULITAN MENCARI KETURUNAN
Key words : sulit mempunyai anak, mandul, pengobatan, diet, endometriosis, myoma,

 

APAKAH DIET BERPENGARUH TERHADAP REPRODUKSI DAN INFERTILITY SESEORANG ?

  • Kemajuan pengetahuan dan tehnologi nutrisi di bidang kedokteran terjadi sangat pesat. Dalam dekade terakhir ini terjadi perubahan pola intervensinya.\
  • Dahulu pengetahuan nutrisi kedokteran selalu mengutamakan pada kebutuhan diet dan nutrisi yang terbaik untuk kelompok usia tertentu misalnya bayi, anak, remaja, dewasa dan lanjut usia. Demikian pula nutrisi yang terbaik untuk penderita penyakit ginjal, penderita penyakit jantung dan sebagainya.
  • Trend terbaru penelitian nutrisi adalah PRUDENT DIET dengan mengembangkan beberapa pendekatan memahami diet yang mengganggu fungsi tubuh kita, misalnya jenis diet yang mengakibatkan penyakit jantung, jenis diet yang mengakibatkan gangguan migraine, gangguan saluran cerna, kelainan kulit, gangguan saluran napas bahkan terakhir banyak diteliti ternyata diet dapat merubah perilaku manusia bahkan dapat membuat manusia menjadi infertil atau mandul alias tidak bisa punya anak
  • Meskipun hal ini masih kontroversi dan belum banyak diperhatikan ternyata terdapat banyak bukti ilmiah baik berupa penelitian dan laporan ilmiah yang mengungkapkan bahwa diet yang salah pada individu tertentu dapat mengakibatkan infertilitas pada seorang manusia.
  • Sampai saat ini tehnologi dan pengetahuan kedokteran sudah sangat pesat kemajuannya, terutama dalam penanganan penyakit. TETAPI SAAT INI BANYAK KASUS MASIH BELUM BANYAK DIKETAHUI KENAPA GANGGUAN DAN PENYAKIT ITU TERJADI. Contohnya : tehnologi kedokteran sudah bisa mengatasi masalah kesulitan mendapatkan keturunan dengan bayi tabung, tetapi MASIH BELUM MENGETAHUI DENGAN JELAS KENAPA GANGGUAN KESULITAN MENDAPATKAN KETURUNAN ITU TERJADI. ARTINYA : BANYAK PENYAKIT SUDAH DIKETAHUI OBATNYA TETAPI MASIH BELUM DIKETAHUI PENYEBABNYA, BILA PENYEBABNYA DIKETAHUI MAKA GANGGUAN TERSEBUT DAPAT DICEGAH.
  • PROGRAM DIET INI BUKAN MEMBERI DIET YANG BERGUNA BAGI SEORANG INFERTIL TETAPI MENCARI DAN MENGETAHUI DIET YANG MENGGANGGU BAGI KESEHATAN REPRODUKSI ATAU DIET SEBAGAI PENYEBAB GANGGUAN INFERTILITAS.
  • Apakah anda pasangan yang punya kecenderungan kesulitan mempunyai keturunan, dan telah melakukan berbagai pengobatan modern maupun alternatif tetapi tidak membuahkan hasil. Maka jalan keluarnya adalah melakukan tehnologi modern dengan tehnologi bayi tabung yang sangat mahal dan tingkat keberhasilannya masih berkisar 20-35%.
  • Sebelum melangkah lebih jauh pada tindakan tersebut tidak ada salahnya anda mencoba mengamati pola diet and selama ini. Apakah pola diet tersebut memicu terjadi proses infertilitas anda dan pasangan anda.
  • BILA ANDA SEORANG WANITA BERMASALAH DENGAN FERTILITAS DAN CERMATI BEBERAPA RIWAYAT KESEHATAN SEPERTI DIBAWAH INI :
  • BILA PASANGAN SUAMI ANDA TIDAK ADA MASALAH DENGAN FUNGSI REPRODUKSI

 

APAKAH ANDA MENGALAMI :

  • ASMA (BATUK LAMA) ATAU PILEK LAMA (SINUSITIS)
  • MEMPUNYAI MASALAH SALURAN CERNA : SULIT BAB, MUDAH DIARE, SERING NYERI PERUT, SERING MUAL, BIBIR KERING, LIDAH PUTIH, MULUT BERBAU, PERUT BERUKURAN BESAR
  • BERAT BADAN SULIT NAIK ATAU BERAT BADAN BERLEBIHAN.
  • PERMASALAHAN KULIT : KULIT KERING, TIMBUL JERAWAT TERUTAMA DI SEKITAR MULUT, SERING GATAL DAN TIMBUL GATAL KEMERAHAN DI KAKI ATAU TANGAN.
  • GANGGUAN NEUROLOGIS : MIGRAIN, SERING SAKIT KEPALA, VERTIGO, BERKACAMATA TEBAL
  • ENDOMETROSIS, MIOMA (KISTA), KEPUTIHAN, GANGGUAN SAAT MENSTRUASI
  • GANGGUAN PSIKOLOGIS RINGAN : DEPRESI, EMOSI SANGAT TINGGI, SULIT KONSENTRASI, GAMPANG PELUPA (short memory loss),
  • BILA ANDA SEORANG WANITA BERMASALAH DENGAN FERTILITAS DAN MEMPUNYAI 3 ATAU LEBIH RIWAYAT KESEHATAN TERSEBUT DI ATAS MAKA SANGAT MUNGKIN DIET ANDA ADA YANG SALAH DAN BERESIKO MENGAKIBATKAN INFERTILITAS,
  • SEBAIKNYA ANDA COBA DAPAT MENGIKUTI PROGRAM DIET KHUSUS SEBELUM MENGIKUTI BERBAGAI PROGRAM TEHNOLOGI KEDOKTERAN YANG CANGGIH YANG MENYITA BANYAK BIAYA.

    The Effects of Diet on Infertility

    Dr Widodo Judarwanto

    · Overwhelmed by studies, research and the constantly changing diet, nutrition and food recommendations? With so many conflicting opinions and studies it’s a full time job trying to keep up with the do’s and don’ts.
    · The presence of allergy seems to be related to a higher rate of infertility.
    · Establish a whole foods based diet that’s easy to incorporate into your busy lifestyle. Include whole vegetables, grains, nuts, seeds, and minimal animal protein. Consider scheduling a consultation with a nutritionist to discover which fresh whole foods you should choose for your body type including quantities, shopping tips and food preparation techniques for maximum health and digestion.
    · Drink plenty of water and avoid sugary liquids. The new high energy, vitamin and natural food drinks on the market may seem like a healthy alternative but they might not be as good for you as you think.
    · Avoid chemicals, additives and preservatives. Get educated on how to read food labels, recognize the artificial sweeteners to stay away from, and get acquainted with some natural sweeteners you may never even have heard about. Start increasing your fertility quotient with powerful dietary and nutritional counseling.
    · Limit your dairy intake. Find out the scary correlation between cow’s milk and reproductive health. Get the latest information on hormones, organics and soy… and how they may be affecting your reproductive health.
    · Curb unhealthy cravings. Here’s a simple solution you can start using tomorrow. Eat breakfast! Skipping breakfast can make cravings worse so start your day right and don’t miss the most important meal of the day. When working with a dietician you’ll learn lots of reasons and cures for unhealthy cravings including other emotional factors that may be keeping your body from conceiving.
    · Proper nutrition is very important from the perspective of reproductive health. A registered nutritionist will provide you with a list of foods and beverages which you should abstain from and a list of foods and beverages which you should partake of. Following these guidelines are important for your health in general and for your reproductive health in particular. She will walk you step by step through your own personalized nutrition and fitness plan and will also give you quick lifestyle and nutritional tips to break free from cravings that can reduce your chances of conceiving.

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    REFERENCE DIET IN INFERTILITY :

    Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Dietary fatty acid intakes and the risk of ovulatory infertility Am J Clin Nutr. 2007 Jan;85(1):231-7
    Department of Nutrition, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA. jchavarr@hsph.harvard.edu
    BACKGROUND: Pharmacologic activation of the peroxisome proliferator-activated receptor gamma (PPAR-gamma) improves ovulatory function in women with polycystic ovary syndrome, and specific dietary fatty acids can affect PPAR-gamma activity. OBJECTIVE: The objective of the study was to assess whether the intakes of total fat, cholesterol, and major types of fatty acids affect the risk of ovulatory infertility. DESIGN: We conducted a prospective cohort study of 18 555 married, premenopausal women without a history of infertility who attempted a pregnancy or became pregnant between 1991 and 1999. Diet was assessed twice during follow-up by using a food-frequency questionnaire. RESULTS: During follow-up, 438 incidents of ovulatory infertility were reported. In logistic regression analyses, intakes of total fat, cholesterol, and most types of fatty acids were not related to ovulatory infertility. Each 2% increase in the intake of energy from trans unsaturated fats, as opposed to that from carbohydrates, was associated with a 73% greater risk of ovulatory infertility after adjustment for known and suspected risk factors for this condition [relative risk (RR) = 1.73; 95% CI: 1.09, 2.73]. Obtaining 2% of energy intake from trans fats rather than from n-6 polyunsaturated fats was associated with a similar increase in the risk of ovulatory infertility (RR = 1.79; 95% CI: 1.11, 2.89). In addition, obtaining 2% of energy from trans fats rather than from monounsaturated fats was associated with a more than doubled risk of ovulatory infertility (RR = 2.31; 95% CI: 1.09, 4.87). CONCLUSION: trans Unsaturated fats may increase the risk of ovulatory infertility when consumed instead of carbohydrates or unsaturated fats commonly found in nonhydrogenated vegetable oils.

    Ferrero S, Pretta S, Bertoldi S, Anserini P, Remorgida V, Del Sette M, Gandolfo C, Ragni N. Increased frequency of migraine among women with endometriosis Hum Reprod. 2004 Dec;19(12):2927-32. Epub 2004 Oct 28
    Department of Obstetrics and Gynaecology, San Martino Hospital, University of Genoa, Largo R. Benzi 1, 16132 Genoa, Italy. simone.ferrero@fastwebnet.it
    BACKGROUND: Our aim is to assess the prevalence and characteristics of headache in patients with endometriosis compared with women without this disease. METHODS: One hundred and thirty-three women with histologically proven endometriosis and 166 controls were interviewed by a neurologist experienced in headache diagnosis; the headache disorders were classified according to the 1988 International Headache Society criteria. RESULTS: The prevalence of migraine was significantly higher among women with endometriosis [n = 51, 38.3%; 95% confidence interval (CI) 30.1-47.2%] than in controls (n = 25, 15.1%; 95% CI 10.0-21.4%) (P < p =” 0.001).” href=”http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Mahadevan%20U%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus”>Mahadevan U, Sandborn WJ, Li DK, Hakimian S, Kane S, Corley DA. Pregnancy outcomes in women with inflammatory bowel disease: a large community-based study from Northern California. Gastroenterology. 2007 Oct;133(4):1106-12. Epub 2007 Jul 25
    BACKGROUND & AIMS: The aim of this study was to determine whether pregnancy outcomes differ between women with and without inflammatory bowel disease (IBD) and to determine what risk factors adversely affect outcomes. METHODS: We conducted a cohort study of all pregnant women within the Northern California Kaiser Permanente membership between the years 1995 and 2002. We abstracted the records of all pregnancies in women with IBD (exposed cohort) and a random sample of pregnancies from age-matched women without IBD (unexposed cohort) and evaluated risk factors for spontaneous abortion, complications of pregnancy, and adverse newborn events. RESULTS: A total of 461 pregnant women with IBD were matched to 493 unexposed pregnant women. Women with IBD were more likely to have an adverse conception outcome (odds ratio, 1.65; 95% confidence interval, 1.09-2.48), an adverse pregnancy outcome (odds ratio, 1.54; 95% confidence interval, 1.00-2.38), or a pregnancy complication (odds ratio, 1.78; 95% confidence interval, 1.13-2.81); however, the difference between the 2 groups in adverse newborn outcomes was not statistically significant (odds ratio, 1.89; 95% confidence interval, 0.98-3.69). Independent predictors of an adverse outcome included a diagnosis of IBD, a history of surgery for IBD, and non-Caucasian ethnicity. Severity of disease and medical treatments were not associated with an adverse outcome. CONCLUSIONS: Women with IBD are more likely to have an adverse outcome related to pregnancy. Disease activity and medical treatment did not predict adverse outcomes in a large, nonreferral population.

    Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Diet and lifestyle in the prevention of ovulatory disorder infertility Obstet Gynecol. 2007 Nov;110(5):1050-8
    Department of Nutrition, Harvard School of Public Health, Boston MA 02115, USA. jchavarr@hsph.harvard.edu
    OBJECTIVE: To evaluate the relation of a dietary pattern and other lifestyle practices to risk of ovulatory disorder infertility. METHODS: We followed a cohort of 17,544 women without a history of infertility for 8 years as they tried to become pregnant or became pregnant. A dietary score based on factors previously related to lower ovulatory disorder infertility (higher consumption of monounsaturated rather than trans fats, vegetable rather than animal protein sources, low glycemic carbohydrates, high fat dairy, multivitamins, and iron from plants and supplements) and other lifestyle information was prospectively related to the incidence of infertility. RESULTS: Increasing adherence to a “fertility diet” pattern was associated with a lower risk of ovulatory disorder infertility. The multivariable-adjusted relative risk of ovulatory disorder infertility comparing women in the highest with women in the lowest quintile of the “fertility diet” pattern score was 0.34 (95% confidence interval 0.23-0.48; P for trend<.001). This inverse relation was similar in subgroups defined by women’s age, parity, and body weight. A combination of five or more low-risk lifestyle factors, including diet, weight control, and physical activity was associated with a 69% lower risk of ovulatory disorder infertility and an estimated population attributable risk of 66% (95% confidence interval 29-86%). CONCLUSION: Following a “fertility diet” pattern may favorably influence fertility in otherwise healthy women. Further, the majority of infertility cases due to ovulation disorders may be preventable through modifications of diet and lifestyle. LEVEL OF EVIDENCE: II. Zac RI, Machado VM, Alberti LR, Petroianu A. Association of allergy, infertility and abortion.] Rev Assoc Med Bras. 2005 May-Jun;51(3):177-80. Epub 2005 Jul 4.
    Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Alfonso Pena 1626, Belo Horizonte, MG, CEP 30130-005, Brazil.
    BACKGROUND: To verify the relation between allergy and abortion or infertility. METHODS: A retrospective study was carried out by interviewing 250 women between 40 and 60 years of age, divided into two groups: Group 1 (n = 162): allergic women and Group 2 (n = 148): women with no record of allergy. Patients were randomly assessed at the Gynecology and Obstetric day care units of the “Hospital das Clínicas-UFMG”. Women in both groups were identified according to their age and skin color. Previous abortion episodes and difficulty to become pregnant were recorded. Doubts related to these replies excluded the woman from this study. Results were compared using the chi-square test. Differences were considered significant for values corresponding to p < href=”http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Cornish%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus”>Cornish J, Tan E, Teare J, Teoh TG, Rai R, Clark SK, Tekkis PP. A meta-analysis on the influence of inflammatory bowel disease on pregnancy. Gut. 2007 Jun;56(6):830-7. Epub 2006 Dec 21.
    Department of Biosurgery and Surgical Technology, St Mary’s Hospital, Imperial College, 10th Floor QEQM Wing, Praed Street, London W2 1NY, UK.
    BACKGROUND: Inflammatory bowel disease (IBD) has a typical onset during the peak reproductive years. Evidence of the risk of adverse pregnancy outcomes in IBD is important for the management of pregnancy to assist in its management. AIM: To provide a clear assessment of risk of adverse outcomes during pregnancy in women with IBD. DESIGN: The Medline literature was searched to identify studies reporting outcomes of pregnancy in patients with IBD. Random-effect meta-analysis was used to compare outcomes between women with IBD and normal controls. Patients and SETTING: A total of 3907 patients with IBD (Crohn’s disease 1952 (63%), ulcerative colitis 1113 (36%)) and 320 531 controls were reported in 12 studies that satisfied the inclusion criteria. RESULTS: For women with IBD, there was a 1.87-fold increase in incidence of prematurity (<37 href=”http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Chavarro%20JE%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus”>Chavarro JE, Rich-Edwards JW, Rosner B, Willett WC. A prospective study of dairy foods intake and anovulatory infertility Hum Reprod. 2007 May;22(5):1340-7. Epub 2007 Feb 28
    Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA. jchavarr@hsph.harvard.edu
    BACKGROUND: Dairy foods and lactose may impair fertility by affecting ovulatory function. Yet, few studies have been conducted in humans and their results are inconsistent. We evaluated whether intake of dairy foods was associated with anovulatory infertility and whether this association differed according to fat content. METHODS: We prospectively followed 18,555 married, premenopausal women without a history of infertility who attempted a pregnancy or became pregnant during an 8-year period. Diet was assessed twice during the study using food-frequency questionnaires. RESULTS: During follow-up, 438 women reported infertility due to an ovulatory disorder. The multivariate-adjusted relative risks (RR) [95% confidence interval (CI); P, trend] of anovulatory infertility comparing women consuming > or = 2 servings per day to women consuming < or =” 1″> or = 1 serving per day of high-fat dairy foods to those consuming < or =” 1″ trend =” 0.05).” href=”http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Sinaii%20N%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus”>Sinaii N, Cleary SD, Ballweg ML, Nieman LK, Stratton P. High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis Hum Reprod. 2002 Oct;17(10):2715-24
    Pediatric and Reproductive Endocrinology Branch, National Institute of Child Health and Human Development, NIH, 10 Center Drive, Building 10, Room 9D42, MSC 1583, Bethesda, MD 20892-1583, USA. sinaiin@mail.nih.gov
    BACKGROUND: Women with endometriosis may also have associated disorders related to autoimmune dysregulation or pain. This study examined whether the prevalence of autoimmune, chronic pain and fatigue and atopic disorders is higher in women with endometriosis than in the general female population. METHODS AND RESULTS: A cross-sectional survey was conducted in 1998 by the Endometriosis Association of 3680 USA members with surgically diagnosed endometriosis. Almost all responders had pain (99%), and many reported infertility (41%). Compared with published rates in the general USA female population, women with endometriosis had higher rates of hypothyroidism (9.6 versus 1.5%, P < p =” 0.001),” href=”http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Ferrero%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus”>Ferrero S, Petrera P, Colombo BM, Navaratnarajah R, Parisi M, Anserini P, Remorgida V, Ragni N. Asthma in women with endometriosis. Hum Reprod. 2005 Dec;20(12):3514-7. Epub 2005 Sep 9
    Department of Obstetrics and Gynaecology, San Martino Hospital and University of Genoa, Largo R.Benzi 1, 16132 Genoa, Italy. simone.ferrero@fastwebnet.it
    INTRODUCTION: This study aimed to investigate asthma prevalence and severity in women with and without endometriosis. METHODS: Before laparoscopy, asthma prevalence was evaluated in 879 women of reproductive age, undergoing surgery because of benign gynaecological conditions. Diagnosis of bronchial asthma was based on the American Thoracic Society criteria; asthma severity was classified in four categories according to the 2002 Global Initiative for Asthma guidelines. Asthmatic patients completed the Living with Asthma Questionnaire (LWAQ). Endometriosis was confirmed histologically and classified according to the revised American Fertility Society criteria. RESULTS: There were no significant differences in age, smoking status, and other demographic and health characteristics between patients with endometriosis (n = 467) and controls (n = 412). Asthma prevalence was similar in women with (23/467, 4.9%; 95% CI, 3.1-7.3) and without (22/412, 5.3%; 95% CI, 3.4-8.0; P = 0.781) endometriosis. Asthma severity was similar in women with and without endometriosis, with 12 (52.2%) women with endometriosis and 13 (59.1%) controls being in the intermittent (mildest) degree of severity. No significant difference was observed between women with and without endometriosis in the LWAQ total score. CONCLUSIONS: Women with endometriosis do not have an increased risk of having asthma.
    See all Related Articles…

    Ciacci C, Cirillo M, Auriemma G, Di Dato G, Sabbatini F, Mazzacca G. Celiac disease and pregnancy outcome Am J Gastroenterol. 1996 Apr;91(4):718-22
    Gastroenterology, Medical School, Naples University “Federico II,” Italy.
    OBJECTIVES: This study investigated the effect of gluten-free diet on pregnancy outcome and lactation in 125 women affected with celiac disease. METHODS: The study has been designed as a case-control study and a before-after study. RESULTS: In the case-control study, comparison of 94 untreated with 31 treated celiac women indicated that the relative risk of abortion was 8.90 times higher (95% confidence limits: 1.19/66.3), the relative risk of low birth weight baby was 5.84 times higher (90% confidence limits: 1.07/31.9), and duration of breast feeding was 2.54 times shorter (p < href=”http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Kinoshita%20T%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus”>Kinoshita T, Ootaka K, Ito M. Delayed-type hypersensitivity reaction to human menopausal gonadotrophin J Obstet Gynaecol Res. 1999 Dec;25(6):437-8.

    Pellicano R, Astegiano M, Bruno M, Fagoonee S, Rizzetto M. Minerva Med. 2007 Jun;98(3):217-9. Women and celiac disease: association with unexplained infertility
    Department of Gastro-Hepatology, Molinette Hospital, Turin, Italy. rinaldo_pellican@hotmail.com
    Celiac disease (CD) is a permanent intolerance to gluten characterized by destructions of the small intestinal villi and malabsorption. The gluten-free diet (GFD) results in healing of the mucosa, resolution of the malabsorpitive states, and reversal of great part of CD effects. Among the extradigestive complications associated with CD, unexplained infertility has been reported since the 70’s. The prevalence of CD among women with unexplained infertility is 2.5-3.5%, higher, although not always significantly, than control population. To date, it is widely accepted that untreated CD represents a risk for abortion, low birth weight babies and short-breast feeding period. These features can be corrected by GFD. Some discrepancies could stem from the heterogeneity of the studies. Regarding a potential pathogenic mechanism, since CD causes malabsorption of folic acid and other nutrients, this pathway has been proposed to explain the unfavourable outcomes of pregnancy. However, this remains a speculation. In conclusion, each woman with unexplained infertility should be screened for CD.

    Biology of Reproduction, Vol 1, 324-329, Copyright © 1969 by Society for the Study of Reproduction
    Egg Yolk Antigens and Their Effect on Fertility in Rabbits
    L. V. SWANSON 1, and A. G. HUNTER 1
    1 Department of Animal Science, University of Minnesota, St. Paul, Minnesota
    Egg yolk citrate, a semen extender consisting of fresh egg yolk suspended in citrate buffer, and Minnesota GO, (Minn. GO), a semen extender consisting of the extract of spray-dried egg yolk in a carbohydrate-containing citrate buffer, were studied to determine their antigenicity and to determine any effect antisera to them might have on fertility. Egg yolk citrate was resolved into three major protein zones by agar-gel electrophoresis while Minn. GO was resolved into four major zones; the faster moving zone in Minn. GO was responsible for the single precipitin unique to Minn. GO. Injection of egg yolk citrate and Minn. GO into rabbits induced antibody formation against egg yolk. Analysis by immunoelectrophoresis and agar gel double diffusion revealed that egg yolk citrate contains eight glycoproteins and one glycolipoprotein. Minn. GO induced antibodies against all egg yolk citrate antigens but formed only seven detectable precipitins with antisera to Minn. GO; of these, six were in common with egg yolk citrate precipitins, but one differed. Study of the antisera by complement fixation showed that egg yolk citrate induced higher titers than Minn. GO. In two replications involving 122 rabbits, the fertility of rabbits inseminated with semen suspended in egg yolk citrate or Minn. GO with antibodies to either extender was equal or better than that of controls inseminated with semen containing normal serum. The antibodies caused clumping of the extender but sperm were not agglutinated or immobilized by these clumps.
    Accepted on March 24, 1969

    Helgstrand S, Andersen AM. Maternal underweight and the risk of spontaneous abortion Acta Obstet Gynecol Scand. 2005 Dec;84(12):1197-201
    Department of Social Medicine, Institute of Public Health, University of Copenhagen, Svanemøllevej 25, DK-2100 Copenhagen N, Denmark.
    BACKGROUND: To evaluate the risk of spontaneous abortion in relation to maternal pre-pregnant underweight. METHODS: The study was designed as a cohort study within the framework of the Danish National Birth Cohort (DNBC). The participants were a total of 23 821 women recruited consecutively to the DNBC from October 1, 1997 to March 31, 1999 and interviewed subsequently. The pregnant women were recruited in first half of pregnancy and interviewed about pre-pregnant body size, obstetric history, exposures in pregnancy, and socio-demographic factors. Pregnancies were followed-up regarding spontaneous abortion. Relative risk of spontaneous abortion was calculated as Hazard Ratios using Cox regression with delayed entry. RESULTS: The outcome measure was spontaneous abortion. The hazard ratio for spontaneous abortion in women with a pre-pregnant body mass index (BMI) below 18.5 was 1.24 (95% confidence limits 0.95-1.63) compared to women with pre-pregnant BMI 18.5-24.9. Women with a BMI of 25 or more had a smaller increase in risk of spontaneous abortion. Adjustment for maternal age, parity, previous miscarriages, and lifestyle factors did not affect the estimates substantially, neither did exclusion of women with metabolic or eating disorders. CONCLUSION: These results indicate that pre-pregnant underweight may affect the risk of spontaneous abortion negatively.

    Tata LJ, Card TR, Logan RF, Hubbard RB, Smith CJ, West J. Fertility and pregnancy-related events in women with celiac disease: a population-based cohort study Gastroenterology. 2005 Apr;128(4):849-55
    Epidemiology and Public Health, University of Nottingham, NG5 1PB Nottingham, UK. laila.tata@nottingham.ac.uk
    BACKGROUND & AIMS: Previous studies have raised concern about reduced fertility and increased adverse pregnancy-related events in women with celiac disease, but none has estimated overall fertility compared with the general female population. METHODS: We compared computerized primary care data for 1521 women with celiac disease with data for 7732 age- and practice-matched women without celiac disease. We estimated population-based rates of fertility and adverse pregnancy outcomes. RESULTS: Crude fertility rates were 48.2 and 47.7 live births per 1000 person-years for women with and without celiac disease, respectively (rate ratio, 1.01; 95% confidence interval, 0.90-1.14). Age-specific fertility rates showed that women with celiac disease had lower fertility when younger but higher fertility when older compared with women without celiac disease. This increase in relative fertility with increasing age held whether women had treated or untreated celiac disease. Risks of cesarean section (odds ratio, 1.33; 95% confidence interval, 1.03-1.70) and miscarriage (rate ratio, 1.31; 95% confidence interval, 1.06-1.61) were moderately higher in women with celiac disease, but risks of assisted birth, breech birth, preeclampsia, postpartum hemorrhage, ectopic pregnancy, stillbirth, and termination were similar. CONCLUSIONS: Overall, women with celiac disease have fertility similar to that of the general female population, but they have their babies at an older age. Although our findings may reflect a disease effect, the age shift in fertility rates and the increase in cesarean section risk is consistent with socioeconomic or educational advantages of women with celiac disease.

    1. Pregnancy outcomes in women with inflammatory bowel disease: a large community-based study from Northern California. [Gastroenterology. 2007]
    2.
    The recurrence risk of adverse outcome in the second pregnancy in women with rheumatic disease1. [Obstet Gynecol. 2002]
    3.
    History of abortion, preterm, term birth, and risk of preeclampsia: a population-based study. [Am J Obstet Gynecol. 2002]
    4.
    Pregnancy outcomes in women with inflammatory bowel disease–a population-based cohort study. [Am J Obstet Gynecol. 1997]
    5.
    Celiac disease and pregnancy outcome. [Am J Gastroenterol. 1996]
    6.
    Macroamylasemia attributable to gluten-related amylase autoantibodies: a case report. [Pediatrics. 2001]
    7.
    Delayed-type hypersensitivity to human gonadotropin: case report. [Fertil Steril. 1995]
    8.
    Human menopausal gonadotropin and recombinant follicle-stimulating hormone for controlled ovarian hyperstimulation in assisted reproductive cycles. [Fertil Steril. 2003]
    9.
    A randomized prospective cross-over study of highly purified follicle-stimulating hormone and human menopausal gonadotrophin for ovarian hyperstimulation in women aged 37-41 years. [J Assist Reprod Genet. 2000]
    10.
    Output and input from the controversy: recombinant FSH versus hMG. [Fertil Steril. 2004]
    11.
    A longitudinal study of the effects of a gluten-free diet on glycemic control and weight gain in subjects with type 1 diabetes and celiac disease. [Diabetes Care. 2002]
    12.
    [Case report: celiac disease] [Med Pregl. 2002]
    13.
    Iron intake and risk of ovulatory infertility. [Obstet Gynecol. 2006]
    14.
    A prospective study of dietary carbohydrate quantity and quality in relation to risk of ovulatory infertility. [Eur J Clin Nutr. 2007]
    15.
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