Thesis (doctoral)--Katholieke Universiteit te Nijmegen.

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Includes bibliographical references and index.

Further studies were conducted to define an indispensable role of uterine bicarbonate secretion at pre-implantation for the success of blastocyst implantation. The in vitro implantation experiments showed that only when cultured in bicarbonate-containing medium, the blastocysts exhibited normal rate of attachment and outgrowth level. The forskolin-induced endometrial bicarbonate secretion measured by the Isc on pregnant day 4 was almost abolished by CA inhibitor acetazolamide. The efflux of intracellular bicarbonate, measured by intracellular pH-sensitive dye, was blocked by CFTR inhibitor, NPPB, and SLC26a6 inhibitor, DIDS, indicating their involvement in mediating uterine bicarbonate secretion. / In conclusion, the present findings have demonstrated an important role of CFTR in formation of optimal uterine fluid, in terms of both volume and composition, which is crucial for various reproductive events occurring in the uterus. Deviation from the normal uterine fluid composition and volume due to defects in CFTR function or abnormal regulation under pathological conditions, such as CF and genital bacteria infection, probably leads to infertility. The information obtained may provide insight into regulatory mechanism underlying fertility and infertility, as well as the rationale for development of treatment methods for female infertility and new strategies for female contraception. (Abstract shortened by UMI.) / The last part of the study was to demonstrate possible cause of infertility by disturbance of uterine fluid dynamic due to abnormal expression of CFTR using a model of uterine Chlamydia (C.) trachomatis infection, the most common infection-related sterility with the underlying cause unexplained. Uterine C. trachomatis infection induced up-regulated expression of CFTR with enhanced electrolyte and fluid transport as demonstrated by the increase in the cAMP-dependent Isc and uterine wet weight with obvious fluid accumulation in the lumen at diestrus stage, during which the endometrium normally undergoes a series of changes preparing for blastocyst implantation with minimum CFTR expression and uterine fluid volume. The abnormal uterine fluid accumulation upon uterine C. trachomatis infection significantly reduced implantation rate in uterine C. trachomatis infection mouse model. / The present study was aimed to elucidate the cellular and molecular mechanisms underlying the CFTR-related reproductive events in physiological and pathological conditions by using a variety of techniques, including RT-PCR, Western blot, intracellular and extracellular pH measurements, and the short-circuit current (Isc) measurement, in conjunction with mouse primary culture of endometrial cells and blastocyst, as well as several animal models including CF mouse, mouse uterine infectious model and overyectomized (OVX) mouse, etc. / We first examined dynamic changes in uterine bicarbonate secretion, as indicated by bicarbonate-dependent forskolin-induced Isc and epithelial surface pH measurement, and the expression profile of candidate genes and proteins known to be involved in bicarbonate secretion throughout the estrous cycle in mouse uterus. The results showed that the maximum mRNA and protein levels of CFTR, SLC26a6, carbonic anhydrase (CA)2 and CA12 were observed at proestrus stage and/or estrus stages. Luminal surface pH measured by 5-N-hexadecanoyl-aminofluorescein (HAF) showed that the basal endometrial epithelial surface pH at estrus stage was significantly higher than that in diestrus, which could be reduced significantly by CFTR inhibitor DPC, SLC26a6 inhibitor 4',4'-Diisothiocyanostilbene-2',2' Disulfonic Acid (DIDS) and CA suppressor acetazolamide. In the ovariectimized (OVX) mice and primary culture of endometrial cells, estrogen could induce up-regulation of CFTR, SLC26a6, CA2 and CA12 expression with corresponding increase in the bicarbonate-dependent Isc, suggesting a novel role of estrogen in regulating uterine bicarbonate secretion. / He, Qiong. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3247. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 163-176). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

<p>As a consequence of positioning women within the dominant gender role of motherhood, the inability to have a child has exposed women, and more notably women in Africa, to extreme social consequences that often violate their human rights and lead to socio-economic disempowerment. The aim of this study was to consider prevailing discursive construction that position women within dominant ideologies that engender motherhood for women, and to explore how women make sense of and construct meaning regarding their experience when they desire but are not able to have a child.</p>

Ajonuma Louis Chukwuemeka. / "March 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 215-238). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

<p>As a consequence of positioning women within the dominant gender role of motherhood, the inability to have a child has exposed women, and more notably women in Africa, to extreme social consequences that often violate their human rights and lead to socio-economic disempowerment. The aim of this study was to consider prevailing discursive construction that position women within dominant ideologies that engender motherhood for women, and to explore how women make sense of and construct meaning regarding their experience when they desire but are not able to have a child.</p>

D.Litt. et Phil. / Endometriosis is among the most common gynaecological maladies affecting women's reproductive health and is also known to be associated with infertility. The pathogenesis of endometriosis is however not well understood. Altered immunity has been indicated in the pathophysiology of this puzzling disease. Over the last decade or more the research evidence suggesting that stress might play a role in the pathogenesis of various illnesses has grown significantly. According to certain tenets of psychoneuroimmunology, behaviour and cognitive therapy, by changing an individual's reaction to stress and increasing the ability to cope with stress, thereby altering immune function, may have an effect on the proliferation of a specific illness, in the case of this study, endometriosis. Various behaviour patterns used by individuals to deal with personal and environmental stressors, have been identified. The incessant struggle to overcome real and imagined obstacles imposed by events, time and the actions of other people typifies the Type A behaviour pattern. The aims of this study were to detemine, whether there were, in a randomly chosen group of patients with endometriosis, persons with high indices of Type A behaviour; to determine whether the modification of Type A behaviour in these patients had a positive effect on their biopsychosocial functioning and finally, whether the modification of Type A behaviour had a positive effect on these patients' endometriosis-related infertility. Endometriosis patients being treated at an infertility clinic were invited to participate in the study. Forty-two subjects were recruited. A psychometric test battery was administered to all the participants. Based on the results of the Videotaped Structured Interview, the subjects were equally divided into three groups: a low index Type A group, a high index Type A group and a middle group. Experimental groups 1 and 2 received counseling aimed at reducing Type A behaviour, using the revised version of the SARCPP, which was originally used with coronary heart disease patients. The test battery was again administered after the intervention. It was found that a subset of endometriosis patients did show higher indices of Type A behaviour. Furthermore an intervention that was found to be successful in reducing the Type A behaviour intensity and frequency in subjects with coronary heart disease was also found to be similarly successful in a subset of women with endometriosis. The most significant finding was the increase in pregnancies among the group of subjects who had been exposed to the treatment. Type A behaviour modification was indeed found to be effective in the treatment of infertility in couples where the female experienced endometriosis-related infertility.

published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

Eighteen women were interviewed using focused ethnography to discover what it meant to be infertile women of Mexican descent. Some women reported that the infertility experience and the physical diagnostic procedures and treatments for infertility resulted in physical and psychological suffering (sufrimiento). Other women believed that infertility was a punishment from God and this created spiritual suffering for them. Profound suffering came from the realization that perhaps a dream--giving birth to their biological child and experiencing parenting--would never occur. The infertility experience had eroded their identities as women; in a sense, it was destroying them. Infertility had given these women a sense of abnormality, of being personal failures as women. Infertility implied not only the personal loss of hopes and dreams for the future of a sole individual, the woman, but it also implied the loss of hopes and dreams for the future of her family group, her partner's family group, not excluding the society which the couple was part of as well. Some women withdrew from their families, their friends and other people to avoid the painful and often embarrassing interrogative remarks from others. However, it was this social isolation which also created great suffering for these women since the isolation led to a loss of interaction with friends, family, and other people at a time when these women needed most the support. Fifty-five percent of the women feared that their inability to have a baby would eventually result in future abandonment by their partners. Some women saw their husbands as unsupportive because some men were unwilling to participate in diagnostic infertility evaluations and because some men also refused infertility treatments. The women maintained an attitude of fighting (luchando) which contradicted the stereotypical view of women of Mexican descent as being submissive, passive, and undecisive about handling crucial problems in their lives. Fifty percent of the women had used a combination of medical infertility treatments and folk medicine. Their persistent faith in God, in the Virgen de Guadalupe, and other religious saints had made it possible for these women to tolerate their enormous suffering.