Thesis (Ph. D.)--University of Texas at Austin, 1999. / Vita. Includes bibliographical references (leaves 292-308). Available also in a digital version from Dissertation Abstracts.

Thesis (M.A.)--Memorial University of Newfoundland, 2001. / Bibliography: leaves 141-152.

Thesis (Ph. D.)--University of Washington, 1998. / Vita. Includes bibliographical references (leaves [161]-180).

Thesis (M.D.)--Aberdeen University, 2009. / Title from web page (viewed on Dec. 8, 2009). Includes bibliographical references.

Cell adhesion proteins osteopontin, CD44 and integrin alphaVbeta3 interact to form an adhesion complex between the embryo and endometrial surface forming an attachment that can lead to implantation. Whilst receptivity has been investigated extensively, the expression of this adhesion complex has yet to be studied simultaneously in the endometrium. This thesis establishes the expression of the adhesion complex in fertile and infertile endometrium. In addition the regulation of the adhesion complex components by distinct signalling pathways and the key regulators estrogen receptor, nuclear factor kappa B and signal transducer and activator of transcription 1 have been investigated in endometrial cell lines. Objectives: To establish the expression profile of adhesion complex components in samples obtained from fertile and infertile women. To model in vitro hormonal regulation of adhesion complex components to mimic estrogen and progesterone stimulus in the menstrual cycle. To determine if adverse environments common to poly cystic ovarian syndrome and endometriosis affect uterine expression of the adhesion complex via high glucose and pro-inflammatory cytokines. To investigate the direct regulation of Osteopontin and CD44 by estrogen and cytokine signalling through estrogen receptor ?, nuclear factor kappa B and signal transducer and activator of transcription 1. Methodology: Investigation of human biopsies and cell line models by immunohistochemistry, quantitative polymerase chain reaction, chromatin immunoprecipitation and enzyme linked immunosorbent assay. Conclusions: Adverse uterine environments including high glucose and pro-inflammatory cytokines may regulate the expression of the adhesion complex, and contribute to a lack of endometrial receptivity in endometriosis and poly cystic ovarian patients. CD44, ITGAV and ITGB3 levels may be used as markers for loss of receptivity in unexplained infertility.

In chapter one, the existing literature on ovarian ageing and fertility is reviewed. In it I (a) discuss the natural history and the potential causes of ovarian ageing (b) assess available tests of ovarian ageing and their limitations (c) discus the trends in the age of first childbirth, its causes and health service consequences. In chapter two, I explore women’s awareness of issues associated with delayed childbearing, including their social and medical implications and the limitations of available treatment. In chapter three, I surveyed IVF clinics throughout the United Kingdom, to determine (1) proportion of women aged 40 or more in each clinic (2) attitudes of clinicians towards older women and (3) clinicians’ views on an upper age limit for IVF. In chapter four, I investigated trends in the age at which women present to general infertility clinics (a step prior to IVF) in Grampian region. Women were grouped according to their age at first presentation to the infertility clinic (&lt;30, 30-34, 35-39 and ≥40 years). I tested the hypothesis that women of advanced reproductive age have a different diagnostic profile than younger women (&lt;30 years). In particular older women are more likely to be diagnosed with unexplained sub-fertility, probably due to ovarian ageing. This hypothesis was tested based on routinely collected data from a single secondary care centre. In chapter five, a systematic review of currently available dynamic tests of ovarian reserve assesses their power to predict fertility outcomes. In chapter six, I calculated the costs of achieving a live birth in different age groups (< 30, 30-34, 35-39 and ≥40 years) following IVF. In chapter seven, I summarize the results of the studies reported in this thesis and consider how they have improved our understanding of various aspects of delayed childbearing.

Thesis (Ph. D.)--University of Hong Kong, 2010. / Includes bibliographical references (p. 365-392). Also available in print.

When the Y chromosome of a Mus musculus domesticus mouse is placed onto the C57BL/6J (B6) inbred genetic background, the XY (B6.Y TIR) progeny develop only ovaries or ovotestes during fetal life. At puberty, while some of the hermaphroditic males become fertile, none of the XY sex-reversed females produce litters. The objective of my study was to clarify the cause of infertility in B6.YTIR females. We have previously demonstrated that the eggs ovulated from B6.YTIR ovaries undergo fertilization efficiently, but cannot develop beyond the 2-cell stage. In the present study, we collected oocytes directly from XY ovaries, and examined their maturation, fertilization and embryonic development in vitro. The results show that the majority of fertilized eggs fail to reach the blastocyst stage. To determine whether developmental incompetence of XY oocytes can be attributed to defects in the oocytes themselves or the surrounding XY somatic cells, we constructed female mouse chimera composed of B6.YTIR and XX BALB/c cells. All chimeric females produced progeny exclusively derived from XX oocytes. For comparison, most of XX &harr; XX chimeric females produced progeny derived from oocytes of either strain. / The ability of XY oocytes to regulate granulosa cell differentiation and functions was assessed in oocyte-cumulus complexes (OCC) in vitro . Microsurgical removal of oocytes prevented cumulus cell expansion and suppressed estradiol production while it promoted progesterone production. Coculture of the oocytectomized OCC with denuded oocytes from either XX or XY ovaries resumed cumulus expansion and the normal endocrine profile. Morphometric analyses indicated that XY oocytes were significantly smaller and their zona pellucida layer thinner than XX oocytes as early as the preantral stage. Furthermore, XY oocytes were attached with fewer cumulus cells in antral follicles. To determine whether developmental incompetence of the zygotes from XY ovaries resides in the nuclear or cytoplasmic component, we exchanged the pronuclei between the zygotes derived from B6.YTIR oocytes and those from XX oocytes and examined their development in vitro. The results indicate that both compartments are defective in the B6.YTIR oocyte. / In conclusion, the XY oocyte becomes cell-autonomously defective in both nuclear and cytoplasmic components during early oogenesis.

A study to determine the prevalence of infertility in females in a patient population attending a general practice in Katlehong was done over seven weeks in 1985. In this study 40.6% out of a total of 143 patients interviewed were found to be infertile. Contributing factors to infertility included an advanced age of patients and use of intra-uterine contraceptive devices. Pelvic inflammatory diseases, fibroid uteri, fixed retroverted uteri and a poor socio-economic status of patients were also found to be associated with infertility. The above factors associated with infertility in females are discussed and recommendations directed to the reduction of infertility are submitted. / Thesis (M.Med.)-University of Natal, Durban, 1987.

No description available.