Por primera vez en Puerto Rico y el Caribe se celebró la vida de los cientos de niños y niñas nacidos gracias a los tratamientos y procedimientos de fertilización en esta Isla, incluyendo el método de Fertilización In Vitro. 

El Encuentro - que tuvo lugar el 16 de mayo del 2004 en el Parque Central de San Juan y fue amadrinado por la telereportera Luz Nereida Vélez- tuvo como propósito el brindar un espacio de confraternización y de orientación para las miles de parejas con distintas condiciones de su sistema reproductivo, y que los lleva a la infertilidad.

El evento contó con un programa variado de actividades, que incluyó música y entretenimiento para niños con la participación del payaso Remi, exhibiciones, clínicas de salud y charlas educativas. 

Desde hace 17 años la doctora Cruz Burgos, quien es la única mujer puertorriqueña dedicada a la endocrinología reproductiva y una de los tres que practica en Puerto Rico, junto al Dr. José R. Cruz Díaz, ofrece los más sofisticados tratamientos de fertilización en los institutos GREFI (Gynecology and Reproduction Endocrinology and Fertility Institute), en San Juan y Ponce. 

Contactos: Militza Suárez Figueroa (787) 243-2918 y Maribella Martínez Bousquet, (787) 598-4405.

Nueva ayuda para la endometriosis

Traducido del inglés: Miércoles, 18 de febrero, 2004

Viernes, 13 de febrero (HealthDayNews) -- El inhibidor de aromatasa letrozole, usado en la actualidad para prevenir la recurrencia de cáncer de seno en mujeres posmenopáusicas, podrían ser eficaz en el tratamiento de endometriosis.

Esto de acuerdo con un estudio en la edición de febrero de Fertility and Sterility.

El estudio del Northwestern Memorial Hospital incluyó 10 mujeres con endometriosis de moderada a severa. Todas recibieron tratamiento quirúrgico y medicamento con pobres resultados. En el estudio, todas las mujeres tomaron letrozole, junto con progestina, durante seis meses. Al final del estudio, la endometriosis o bien desapareció o fue grandemente reducida.

 El estudio también encontró que nueve de cada 10 mujeres tuvo una reducción significativa en el dolor relacionado con la endometriosis.

"Este estudio demuestra el potencial de los inhibidores de aromatasa para reducir rápida y significativamente el dolor y la severidad de la enfermedad, ofreciendo a las mujeres una forma novedosa y más eficaz de suprimir la endometriosis con pocos efectos secundarios", dijo en una declaración el autor del estudio, doctor Serdar Bulun, jefe de la división de investigación de biología reproductiva del Northwestern.

"La endometriosis es ocasionada cuando tejido similar a la pared del útero crece en otras partes del cuerpo, y afecta de 10 a 15 por ciento de las mujeres en edad reproductiva. Esto causa dolor pélvico crónico y contribuye a infertilidad", explicó Bulun.

HealthDay. Derecho de Autor © 2004 ScoutNews, LLC. Todos los derechos reservados.

Laparoscopy can help infertile women avoid months of unnecessary treatments

Women's Health     March 15, 2004

2004 MAR 15 - (NewsRx.com & NewsRx.net) -- Researchers in obstetrics and gynecology and reproductive endocrinology at Cedars-Sinai Medical Center, Los Angeles, California, and the University of Alabama at Birmingham suggest that specialists should consider the routine use of laparoscopic evaluation when women are unable to become pregnant after four cycles of the "fertility pill" clomiphene citrate. They made their recommendation after reviewing 92 cases over an 8-year period.

Some physicians in the past few years have forgone laparoscopy, relying only on a special X-ray image of the fallopian tubes. If the tubes appear to be open, patients then may undergo up to six cycles of additional hormone therapy (gonadotropin injections), followed by in vitro fertilization if pregnancy still has not been achieved.

The X-ray procedure, called a hysterosalpingogram, fills the uterine cavity with a dye that flows into the fallopian tubes unless a blockage is present. The resulting X-rays enable physicians to see abnormalities in the tubes, or areas of polyps, scar tissue, or fibroid tumors in the uterine cavity - some of the conditions that can cause infertility or reduced fertility. These images, however, lack the accuracy and diagnostic specificity available with chromotubation - the injection of a colored fluid - used during a laparoscopic evaluation.

"Laparoscopy is the gold standard for diagnosing intrapelvic adhesions or tubal disease. By taking advantage of this procedure after a four-cycle trial of clomiphene citrate we may diagnose abnormalities earlier rather than later," said Ricardo Azziz, MD, MPH, MBA, chair of Cedars-Sinai's Department of Obstetrics and Gynecology and executive director of the Androgen Excess Society, an international research organization.

"Using the laparoscope, we also often can treat fertility-inhibiting conditions immediately with minimally invasive surgical procedures. In cases when surgical correction is not possible, the laparoscopic findings will guide us to perform in vitro fertilization earlier than later. In either case, the use of laparoscopic techniques can allow many patients to avoid needless cycles of treatments and the related emotional stress and financial burden," said Azziz, who also holds The Helping Hand of Los Angeles Chair in Obstetrics and Gynecology at Cedars-Sinai. Azziz and his colleagues published the results of their review in the journal Fertility and Sterility.

Before any treatment is started, women who seek help because they have been unable to become pregnant due to irregular or absent ovulation typically undergo a pelvic examination and hysterosalpingogram, and the partner's sperm count is analyzed. If there is no obvious abnormality, ovulation induction with clomiphene citrate is often one of the first treatment options used. If pregnancy has not been achieved after four ovulatory cycles, most specialists in reproductive endocrinology have routinely used laparoscopy to search for anatomical abnormalities. Only in recent years have some specialists suggested forgoing this examination.

Of the 92 cases reviewed in this study, 32 patients (34.8%) had a "positive" laparoscopy, defined as findings of advanced stages of endometriosis, a tumor, pelvic adhesions, and/or disorders of the fallopian tubes. Besides these significant abnormalities, more than 29% had stage I or stage II endometriosis, which, according to some studies, also may be associated with reduced fertility and may respond to laparoscopic surgery. Only 35.9% of patients had a completely normal pelvis.

Analyzing patient demographic data, medical histories, and laparoscopic results, the study's authors attempted to determine if certain factors could help predict which patients would be at high risk for pelvic disorders. They found a higher frequency of endometriosis among women who had painful menstrual periods and those who had previously used natural contraception. Pain during intercourse and the previous use of natural contraception were associated with the presence of tumors (endometriomas). Women who had previously been pregnant and those who had used oral contraceptive pills had a reduced number of pelvic adhesions, while those who had never been pregnant and those who had never used oral contraceptives had a higher incidence of pelvic adhesions.

About 91% of the patients in the study had at least one predictor for intrapelvic disease, and almost 40% of those with predictors had a positive laparoscopy, compared with only 12.5% of those without predictors.

Of those experiencing pain during intercourse, nearly 52% had a positive laparoscopy, compared to only 27% of women without pain. Patients with no prior history of using oral contraceptives had a 64.3% likelihood of a positive laparoscopy, compared with 29.5% of women who had used birth control pills. Sixty-four percent of women who had never used contraceptives had positive findings, compared with only 30% of those who had used birth control measures.

While these correlations between clinical features and surgical findings were noted, there were no features that could be used to absolutely predict the presence of significant surgical findings. The investigators concluded that laparoscopy should be used routinely after treatment with four cycles of clomiphene citrate, although the technique may be delayed if there are no identifiable predictors for intrapelvic disease.

"Laparoscopy continues to be a useful tool in the workup of an infertile couple," Azziz said. "Using a set of predictors for intrapelvic disease appears to be a valid approach in developing diagnostic and treatment options, although many women with intrapelvic abnormalities may have no identifiable predictors. Together, these techniques may help many couples avoid months of needless therapies." This article was prepared by Managed Care Weekly Digest editors from staff and other reports. Copyright 2004, Managed Care Weekly Digest via NewsRx.com & NewsRx.net.

©Copyright 2004, OBGYN & Reproduction Week.