The validity of the postcoital test

Article Abstract:

The postcoital test is performed after sexual intercourse to diagnose infertility. The test involves examining the characteristics of cervical mucus and the number and motility of the sperm after sexual intercourse. Although the postcoital test is frequently performed, its validity in assessing fertility has been questioned. The validity of the test for predicting infertility was evaluated by determining the likelihood that someone with the condition will be detected (sensitivity), the likelihood that someone has that condition rather than some other (specificity), and the likelihood that a correct diagnosis both positive and negative will be made (the predictive value). The sensitivity of the test ranged from 0.09 to 0.71, indicating 9 to 71 percent of the infertile couples were detected. The specificity of the test ranged from 0.62 to 1.00, indicating a positive postcoital test result detected from 62 percent to 100 percent of the couples who were actually infertile. The positive predictive value was 0.56 to 1.00, indicating that 56 to 100 percent of infertile couples were identified. The negative predictive value was 0.25 to 0.75, indicating 75 to 25 percent of tested couples who were not infertile could be identified. Since an insufficient number of infertile couples were correctly diagnosed, the validity of the postcoital test is poor. The lack of normal standards and the difficulty in reproducing results may contribute to the poor validity of the postcoital test. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Diagnosis, Testing, Medical examination, Semen, Infertility, Cervix mucus

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An epidemic of antiabortion violence in the United States

Article Abstract:

From the time abortion was legalized in the early 1970s in the US, providers of abortion services have been targets of protest and intimidation. In the past few years, these providers have increasingly been subjected to violence by antiabortion supporters. This study sought to characterize the growing violence faced by providers of abortion services. Data on such violent acts occurring between January 1, 1977 and December 31, 1988 was analyzed. There were 110 cases of violent acts, such as arson or bombing, during this period, with the largest number (29) occurring in 1984. The violent acts were directed against health care providers in 108 of the 110 cases. No hospitals were attacked. Of the 80 health facilities attacked, 16 were attacked more than once, with one facility being attacked five times. The largest number of attacks occurred in Ohio, with 16 attacks, followed by California with 10 attacks and Texas with nine. By population, the highest number of attacks occurred in the District of Columbia, followed by Vermont, Oregon, and Minnesota. There was no relation between proportion of abortion providers attacked and abortion rates during the period. Many of the attacks occurred in clusters. Arson was the most frequent type of violent act, followed by bombing. Fires and firebombings caused the most extensive monetary damages. The number of attacks appeared to drop after 1984 as perpetrators have for the most part been vigorously prosecuted. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, Crimes against, Ethical aspects, Crime, Pro-life movement, Abortion, Abortion services, Right to life

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Primary prevention of gynecologic cancers

Article Abstract:

Measures can be taken to prevent cervical, endometrial, and ovarian cancer, and women should be told how they can reduce their risk. A review of the literature found substantial evidence supporting several prevention strategies. Avoidance of smoking, a diet rich in vitamin C, and the use of barrier methods of contraception and spermicides all reduce the risk of cervical cancer. The use of oral contraceptives increases it. Both the use of estrogen-progestin oral contraceptives and avoidance of obesity reduce the risk of endometrial cancer. The use of combination oral contraceptives, breastfeeding, and tubal ligation all reduce the risk of ovarian cancer. Any adverse effect of oral contraceptives on the occurrence of cervical cancer are more than offset by the reduction of risk in endometrial and ovarian cancer. Pap smears reliably screen for cervical cancer, but there are no reliable screening tests for the other two cancers.

Women, Prevention, Diseases, Cancer, Cancer prevention

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