Pregnancy outcome, health of children, and family adjustment after donor insemination

Article Abstract:

Artificial insemination by donor (AID) is a method of fertilization using donated sperm to achieve pregnancy. There many issues surrounding the procedure, donor screening, insemination timing and the detection of transmissible diseases. Information regarding pregnancy outcome, the health of the children, and the adjustment of the family following AID is limited. The long-term psychological and medical outcome in the cases of 427 women achieving pregnancy by AID over a 12-year period is reviewed. Adequate information was obtained for 594 of the 606 pregnancies; there were 502 live-born children, which included 15 sets of twins. The variables studied included the age of the mother, the cycle of conception, the use of ovulation-inducing drugs, and the use of fresh or frozen sperm. There was no difference in the spontaneous abortion rate (16.5 percent) between fresh and frozen sperm. The incidence of spontaneous abortion was higher in older women and in those whose pregnancies were achieved after a greater number of attempts at AID; these variables may also be related because older women often required more attempts to conceive. Of the 481 children conceived by AID for whom there was complete follow-up, there were 22 major congenital abnormalities and one chromosomal abnormality. Four children had a combination of symptoms suggestive of syndromes, and 38 had minor congenital abnormalities. Learning disabilities were diagnosed in 5.8 percent of the school-age children, and another 10.5 percent were considered intellectually gifted. The rate of congenital abnormalities was similar to the rate in the normally-conceived population. Half of the AID couples did not tell family and friends that they had used the AID procedure. Forty-seven percent are not planning to inform the child of the insemination. The divorce rate was lower among couples having AID pregnancies than in the rest of the population. Only 2.8 percent of the couples sought psychological counseling directly related to the insemination. In conclusion, AID pregnancies involve a risk of birth defects that is similar to that of the general population, and are associated with a lower than average divorce rate. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Statistics, Birth defects, Artificial insemination, Human, Human artificial insemination

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Diagnosis and resection of an oral contraceptive-suppressible Sertoli-Leydig cell tumor with preservation of fertility and a 7-year follow-up

Article Abstract:

A woman with an ovarian tumor (Sertoli-Leydig cell tumor) was examined. She had developed male characteristics (virilism), such as facial and body hair (hirsutism), an enlarged clitoris and acne. After being treated with oral contraceptive drugs (the steroids mestranol and norethindrone), a blood test showed that testosterone and androstenedione (male sex hormones) levels were eliminated. A steroid, dexamethasone, did not suppress the male sex hormones but did suppress dehydroepiandrosterone sulfate, a hormone produced by the adrenal gland which is found in excessive amounts in patients with virilism. One of the patient's uterine tubes and an ovary were removed in order to analyze a portion of the tumor. The tumor was secreting several of the male sex hormones but was not responsible for the presence of dehydroepiandrosterone sulfate. Tests to determine hormonal abnormalities cannot distinguish between adrenal gland tumors and ovarian tumors, both of which cause the development of male sex characteristics. The ability of contraceptive drugs to suppress testosterone secretion does not exclude the possibility of an ovarian tumor. After seven years, a tumor had not recurred, and fertilization had been preserved.

Evaluation, Physiological aspects, Oral contraceptives, Androgens, Contraceptive drugs, Leydig cells

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Virilizing Brenner tumor of the ovary: case report

Article Abstract:

Brenner tumor, an ovarian tumor, caused masculinization (androgenic activity) in a 65-year-old woman. Male and female hormones and the level of milk production were measured before and after the patient was treated with the steroid dexamethasone, which suppresses the hormones, and stimulation treatment with the female hormone hCG. Hormone levels were measured again after the tumor was removed. Male sex hormones were measured in the veins in the ovaries and in surrounding veins. Measurement indicated that the tumor was responsible for the production of the hormones causing the masculinization.

Testosterone, Pituitary hormones

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