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Human endometrium is a very complex system that plays a critical role during implantation process. Several reports focused the attention on the adequate proliferative phase, particularly on mitotic and angiogenetic pathway. The growth factors and angiogenetic factors involved during the different phases of menstrual cycle are discussed and attention is drawn on the interaction between embryo and endometrium through metalloproteinases and integrins during implantation.

Background: An adverse effect of leukocytospermia in seminal fluid on motility and fertilizing power of spermatozoa has been described. This detrimental effect could be mediated by radical oxygen species (ROS). Recently, a direct effect on nuclear DNA of sperm induced by ROS has been described, although the chance of fertilization did not seem altered during ICSI procedure. Aim of this prospective case-control study was to compare the outcome of results in term of fertilization rate and embryo quality in patients with and without idiopathic leukocytospermia during IVF and ICSI cycles., Methods: Seventy-two patients selected for a program of IVF and ICSI were admitted in the study. Fourty-two patients underwent IVF procedure, 14 with idiopathic leukocytospermia and 28 without, and thirty underwent ICSI procedure, 16 with leukocytospermia and 14 without leukocytospermia., Results: Statistical significant differences on cleavage rate of embryos between leukocytospermia and control group in IVF cycles were observed. In ICSI procedure a low fertilization, cleavage rate and percentage of good embyros in the presence of leukocytospermia were evidenced., Conclusions: The presence of a significant number of leukocytes in semen, even in idiopathic condition, could affect the results of IVF and ICSI procedure. An adverse effect of lipoperoxidation process of plasma membrane and damage of nuclear chromatin of sperm, as result of leukocyte contamination could be hypothesized and future studies needed in order to verify the role of ROS on sperm functions.

Background: To assess the results of counselling on sexual behavior and reproductive choices of couples discordant for HIV-1, in South-Eastern Italy., Setting: University Hospital, Apulia region, South-Eastern Italy., Methods: In the period March 1985-December 1995, one hundred and forty-four HIV-1 discordant couples were enrolled. They were followed up for a median period of 39 months (range 12-60 months). Behavioural counselling was performed at each visit of the infected case and the sexual partner was periodically tested for HIV-1 antibodies., Results: Sixty percent of couples pursued in unprotected sex intercourse, 30 new infections being diagnosed during the study period (cumulative incidence rate = 21%). In addition, 49 pregnancies in 38 women were recorded. Termination was very seldom the choice of pregnant women., Conclusions: There is a clear indication for a failure in the counselling process. A change in population characteristics is to be pointed out as the main factor of the results. More appropriate counselling modalities need to be introduced for the different targets of sexual behaviour of our population.

Background: To assess if ultrasonic measurement of the cervical canal has carries, at term of pregnancy, a relationship with the onset of labour. To assess if cervical length identifies women at risk to deliver beyond 42 completed weeks of gestation (287 days)., Methods: Prospective case-control study, carried out between 37 and 40 weeks of gestation in uncomplicated, singleton, cephalic presentation, pregnant women., Setting: outpatient ultrasound Department of a tertiary referral centre, serving > 1000 pregnancies. Weekly measurements of the cervical canal by transvaginal ultrasound probe., Results: Inverse relationship between sonographic measurements and advancing gestational age. At 38 weeks of gestation, significant difference in the ultrasonic recordings between patients delivered before and beyond 41 completed weeks., Conclusions: It is possible to identify as early as 38 weeks of gestation those women that will deliver beyond 41 weeks. There is a subgroup of nulliparous patients that will probably be candidates to induction of labour.