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Unlabelled: The aim of the study was to compare frequency of four gynecological operations: myomectomy, tubal surgery, cystectomy and operative management of ectopic pregnancy, performed by laparotomy or laparoscopy, by the same team of surgeons. In the years 1994-1997 in Division of Reproduction Poznań University Medical School 647 cystectomies, 208 myomectomies, 68 tuboplasties and 50 surgical treatments of ectopic pregnancy were done. Among 973 operations--684 (70.3%) were performed by laparoscopy. There was a gradual tendency in increasing endoscopic procedures. Comparing the year 1994 and 1997 percentage of operations performed by laparoscopy significantly changed: In tuboplasty from 83% to 95%, cystectomy from 35.9% to 80.3%, ectopic pregnancy from 61.5% to 91.7% and myomectomy from 52.7% to 61.5%. Patient hospital stay decreased significantly after laparoscopic procedures (from 5.1 days to 3.25 days). During the study period open surgery followed laparoscopy only in 8 cases (1.1%) because of complications or technical difficulties., Conclusion: 1. Operative laparoscopy is a safe and effective procedure, in many cases replacing open surgery. 2. Shortening of hospital stay and recovery period after laparoscopy is one of the main advantages of this method of treatment.

The authors measured efficiency of the determination of bacterial infection from the semen of infertile men. They compared the correlation of counts of bacteria with white blood cells (peroxidase method) and round cells in ejaculate. Seminal white blood cells counts (more than 1 x 10(5)/ml) correlated well with bacteriospermia (more than 1000 cells/ml), R = 0.4741, p = 0.0007. Determination of round cells in semen has no clinical value in prediction of seminal infection, R = 0.0153, p = 0.6022.

Nine different cryoprotectant buffers were tested to measure their protective ability towards main sperm seminological parameters. These were: maintained sperm motility, progressive motility and sperm viability. Out of the nine tested buffers, medium E (TES-Tris without glycerol) and H (glycerol only) showed significantly lower (P < 0.001) values than the rest of the studied buffers in respect to all tested seminological features. The other media did not differ significantly in their cryoprotective abilities to sperm. Richardson's medium (A) preserved sperm viability significantly better (P < 0.001) than the other tested buffers, reaching 63.1% of viable spermatozoa in proportion to the fresh sperm sample before freezing. Three cryoprotectants, A (with egg yolk, no TEST buffer system), D (neither egg yolk nor TEST buffer system), F (TEST-egg yolk buffer system) were further studied for their ability to preserve sperm function in sperm-cervical mucus penetration (Penetrak) and sperm penetration assay (SPA). In our hands, neither supplementation of the buffer with egg yolk nor TEST-egg yolk buffer system promoted sperm capacity in functional tests. A,D,F buffers did not significantly differ among each other in applied functional assays, however, they all diminished (P < 0.001) sperm penetration ratios when compared with fresh sperm samples. Therefore enhancement of sperm capacity to fertilize after equilibration with TEST-egg yolk buffer system should be contested.

The first results of laser therapy in treatment of condylomata acuminata of male reproductive organs are reported. Between November 1991 and December 1993 in Department of Reproduction, Institute of Gynecology and Obstetrics, Karol Marcinkowski University School of Medical Sciences, Poznań in nine patients with condylomatous changes of reproductive organs CO2-laser therapy under colposcopic control was done. In 7 of them the healing was achieved. In two patients second laser therapy was done. All patients are still under control in Department of Reproduction and there was no recurrence diagnosed.

The first results of treatment of condylomata acuminata of anogenital region in 11 pregnant women were presented. The analysis were made in Department of Reproduction, Institute of Gynecology and Obstetrics, Academy of Medicine, Poznań. All patients were treated between 28 and 35 week of pregnancy. After first laser-therapy the healing achieved in 9 women. The second lasertherapy was required in 2 patients. It was done after 3 weeks. Complete destruction of pathological changes was obtained. All women had vaginal delivery and no complications (connected with HPV infection) in their newborns were found. The authors said that CO2-lasertherapy under colposcopic control is a reliable method for treatment of condylomata acuminata in pregnant women.

The study showed the treatment of superficial endometriosis of the uterine cervix in 54 women between November 1991 and January 1994. After first vaporisation 43 patients were cured successfully. In 8 cases vaporisation should be repeated and in 3 women the operation should be performed for the third time. All patients are still under control in our department and there is no recurrence observed.

The authors presented use of carbon dioxide laser in treatment of dysplasia of the uterine cervix in women with malreproduction. Between November 1991 and September 1993 in the Department of Reproduction, Institute of Gynecology and Obstetrics, Academy of Medicine, Poznań the CO2-laser vaporisation in 21 women was done. In 19 patients the healing was achieved. In two of 21 women in control examination CIN was diagnosed. They were treated with electroconisation. In control examination no signs of dysplasia in all women were observed. The patients are still under control in our department.

The authors described the results of treatment of erosions of the uterine cervix in 78 women with primary sterility with CO2-laser vaporisation in Department of Reproduction, Institute of Gynecology and Obstetrics, Academy of Medicine, Poznań. The results were estimated through clinical, cytological and colposcopical examinations in the term of 6 weeks and 3 months after therapy. The Insler's cervical mucus test was done in all women after 3 months. In all women the healing was achieved and five of them were needed for second laser therapy because of superficial endometriosis. The authors think that CO2-laser vaporisation (under colposcopical control) of erosions of the uterine cervix in women with primary sterility is the reliable method. The wound's healing after laser therapy is quick and without any complications. Laser therapy causes no trauma of the cervix structure and does not disturb in excretion of mucus by cervical glands.

The authors showed the case of 23 years old multipara treated in Department of Reproduction, Institute of Gynecology and Obstetrics, Academy of Medicine, Poznań because of hydatidiform mole using the exhaustion of uteri. After 8 weeks the hysteroscopy was done in order to explain the reasons of elevated serum beta hCG levels. During the hysteroscopy the polypoid lesion was recognized and removed using the electric resectoscope. After this endoscopic operation the normalization of serum beta hCG levels was achieved.

Among 3,734 women, hospitalized for giving birth, 58.9% had a positive Toxoplasma serological test (DA). No clinical expression of congenital toxoplasmosis was observed in 4,311 newborns; seven had a false positive ISAGA test with cord blood. Only 24% of the women were aware of congenital toxoplasmosis and only 3% were serologically examined before. Health education should be intensified and serological tests more commonly performed especially in the risk groups.

We tried to define a potential ability of human spermatozoa for fertilization after 3 month preservation of samples in a liquid nitrogen. The functional test were applied: penetration of sperm to cervical mucus ("Penetrak") and sperm penetration to hamster zona-free oocytes. We would like to emphasize that presented way of cryo-preservation in 3 selected media with fast cooling of samples allow to maintain fertilizing ability of spermatozoa and subsequent insemination.

We attempted to find the optimal way of cryopreservation of male gametes. We have been tested 9 cryoprotectants currently existing in the world literature. These fluids have been so far separately investigated in different centers of infertility treatment. In this study we compared the effectivity of these fluids in preservation of viable sperm. Basic seminological parameters and two variants of freezing were tested. There were noted significant differences between fast and slow cooling of sperm samples. Nevertheless after fast cooling we found a marked decrease of seminological parameters in preserved sperm when compared to fresh samples.

The hysteroscopic evaluation of uterine openings in 23 sterile women was described. The attention was paid to morphological features of obliterated uterine openings. The hysteroscopic examination of structural changes located in uterine openings seems to be a reliable method for evaluation of potency of oviducts. This procedure may help in choosing the proper way of therapy--microsurgery or IVF.

A 27-year-old female patient was admitted to the Reproductive Function Clinic, Institute of Gynaecology and Obstetrics in Poznań, for periodically occurring painful symptoms in the left iliac fossa. Gynaecological examination found at the site of left adnexa a solid mass with smooth surface, preliminarily diagnosed as adnexal tumour. Ultrasonography found ectopic kidney in pelvic presentation which was confirmed by urography.

Authors have presented long-term results of microsurgical treatment of female infertility. Operations of the abdominal ostium were successful in 28% (home taken baby), what is similar to the results presented in the literature. Poor outcome of the other types of the microsurgical operations was analysed. Comparison of the microsurgery with the different methods of the assisted medical procreation was performed (e.g. IVF-ET and GIFT), showing the advantages of the latest.

Endoscopic examination was made in 20 sterile women. Particular attention was drawn to the mechanism of uterine openings of the oviductus, viewed by hysteroscopy. Clinical condition end the flux of contrast via abdominal part of oviductus evaluated using laparoscopic technique. The hysteroscopic picture of valvular mechanisms is reliable element for evaluation of potency of oviductus. Combined laparoscopy and hysteroscopy brings a lot of information concerning the structure and function of oviductus.

154 pregnant women with dysplasia and cervical carcinoma of the uterus treated in the Institute in years 1953-1990 underwent investigation. We notice that only 50 pathologies were diagnosed in I trimester of pregnancy and 85% constituted precancerous and early forms of carcinoma of the uterine cervix. Authors presented the model of management and care of pregnancy, labour and puerperium in these patients. Due to this procedure we obtained 90% compatibility of preliminary and final diagnosis.

The aim of this study was evaluation of uterine factors in sterility and infertility using hysterosalpingographic and hysteroscopic techniques. Sixty five women ranged in age from 22 to 40 years were included in this study. The results of performed hysterosalpingographies and hysteroscopies were compared. Intrauterine changes found during diagnostic procedures were removed in operative hysteroscopy and the effectiveness of this treatment was estimated by pregnancy rate. The most frequent changes found within cervical canal and uterine cavity were adhesions and endometrial polyps. The rate of uterine septa and submucous myomas were considerable lower. Hysteroscopy was found the best diagnostic method in evaluation of intrauterine conditions for fertility and considerably increased the range of information about the type and location of uterine abnormalities. The removal of those changes during operative hysteroscopy increased the fertility rate in women treated with this procedure.

Value of the laparoscopy in diagnostic process and treatment of the polycystic ovaries was analysed. Authors have presented changes in the procedure which occurred after developing new technologies. The first results of the operative laparoscopy, with use of monopolar cauterization are described.

Authors have presented 45 clinical situations where laparoscopy was followed by laparotomy. Pre- and intraoperative diagnosis was analyzed. Dense adhesions were the most common indication to perform laparotomy (43%).

Clinical study in 98 women with genital endometriosis was performed. In 33 patient endometriosis was treated by operative laparoscopy-electrocauterization of foci in 20 women, ovarian cyst resection in 9 and cyst extrication in 4. In 10 cases laparoscopy was followed by laparotomy. Very high correlation between endometriosis and infertility was found (71.4%). Very few patients conceived till now (28.57%). Searching in the time of laparoscopy very subtle foci of endometriosis was stressed.

In this a rabbit immunological serum against human trophoblast was obtained after triple intramuscular superficial villi extract injection from chorion of 6--7 week pregnancy with Freund's adjuvant. In immunofluorescent indirect reaction to this serum made on chorion and placenta sections some most intense specific fluorescence was obtained in cytoplasm of primordial cyto- and synytiotrophoblast. Some favourable influence of antigenic differences between ovum and mother especially implantation has been suggested.