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Biomedical subjects

A Reinthaller

Publications and source records attributed to A Reinthaller.

At least 91 records · Page 5Linked to original sources

[Delivery of quadruplets after in vitro fertilization: perinatologic and ethical aspects].

Progress in modern reproductive medicine has brought much success to infertile couples. A side effect of IVF procedure are multiple pregnancies with clinical, ethical, perinatal and social problems. We report about the first case of quadruplets after IVF born in Austria and try to illustrate the perinatal, social and ethical problems. The 34 year old woman was treated in our sterility outpatient clinic because of secondary sterility. In 1988 finally she underwent IVF procedure. Four oocytes were retrieved by means of vaginal follicle puncture. 4 embryos were transferred, and after 3 weeks 4 viable embryos were seen at an ultrasound investigation. Due to placental insufficiency a cesarean section had to be performed in the 31st week of gestation. The weights of the premature infants were 1280 g, 1340 g, 1260 g and 1250 g. Two years after birth two infants show neurologic defects and need permanent care.

Adult↗

[Methods of cryopreservation in animal experiments].

A slow computer-controlled program for cryopreservation of mouse embryos at the 4 to 8 cell stage was compared with various methods of ultrarapid cooling, 104 embryos were frozen by using the slow cooling program, 79% of the embryos developed to blastocysts after thawing, 63 embryos were vitrified and 81% reached the blastocyst stage within 2 days of culture. Using the ultrarapid cooling program A (4-step aequilibration of embryos in cryoprotectant) 62% of embryos survived after freezing and thawing. Only 12% survival rate could be achieved by employing the ultrarapid program B (2-step aequilibration of embryos in cryoprotectant). The significantly higher survival rate of program A compared to program B was due to the longer aequilibration time and therefore presumably higher intracellular concentration of cryoprotectant. In program B the short aequilibration time with the cryoprotectant seemed to result in an inadequate dehydration of blastomeres leading to intracellular ice formation and cell destruction.

Animals↗

The metoclopramid-provocation test for prediction of transient hyperprolactinemia during cycle stimulation.

The predictive value of the metoclopramid-provocation test to detect transient hyperprolactinemia during cycle stimulation was assessed. Patients developing hyperprolactinemia during cycle stimulation showed a significantly higher PRL response to the metoclopramid-provocation test before cycle stimulation. The current study confirms previous reports that hyperprolactinemia during cycle stimulation can interfere with follicular and oocyte maturation. The use of the metoclopramid-test can detect an enhanced responsiveness to PRL stimulators and offers the possibility of treatment during cycle stimulation.

Embryo Transfer↗

In vitro fertilization with spermatozoa from alloplastic spermatocele.

This case report describes successful IVF of oocytes of a 22-year-old female with epididymal spermatozoa aspirated from alloplastic spermatocele of the husband presenting with bilateral congenital absence of the vas deferens. Motile spermatozoa were aspirated from the reservoir 3 months after implantation. Abortion occurred 22 days after embryo replacement.

Abortion, Spontaneous↗

Plasminogen activators, plasminogen activator inhibitor, and fibronectin in human granulosa cells and follicular fluid related to oocyte maturation and intrafollicular gonadotropin levels.

We determined the relative distribution of tissue plasminogen activator (TPA) antigen, urokinase-type PA antigen, PA inhibitor activity, and fibronectin levels in lysates of human granulosa cells (GC) and the respective follicular fluid (FF) in relationship to oocyte-corona-cumulus complex morphology. In addition, FF gonadotropins were measured to investigate a possible relationship of gonadotropins to PA activity. A significant increase of TPA antigen in GC lysates of intermediate and mature oocyte-corona-cumulus complex was found when compared with immature oocyte-corona-cumulus complex. Urokinase-type plasminogen activator levels and PA inhibitor levels did not reveal any significant differences between the different groups. In FF the concentrations of PA and PA inhibitor were significantly lower than in GC lysates and showed no significant difference between the oocyte-corona-cumulus complex groups. The concentration of fibronectin was significantly elevated in GC lysates of mature follicles. The marked increase of TPA in human GC during oocyte maturation showed a positive correlation with the increase of FF follicle-stimulating hormone and beta-human chorionic gonadotropin in the group of mature oocyte-corona-cumulus complex. The data obtained suggest that in man TPA is the predominant PA involved in the process leading to follicular rupture.

Adult↗

Thrombin-antithrombin III complex levels in normal pregnancy with hypertensive disorders and after delivery.

The plasma concentration of the thrombin-antithrombin III-complex (TAT) was investigated during uncomplicated pregnancy in 15 women in the first, 22 in the second and 46 in the third trimester, and in 19 women with hypertensive disorders between 25 and 40 weeks gestation. Eight women at term after a normal pregnancy were studied before the onset of labour and within 60 min and 24 h after delivery. A comparison group of 16 healthy, non-pregnant women was investigated. The mean TAT concentration in normal pregnancies increased significantly in the second and third trimester compared with values in the first trimester and in non-pregnant women. In the group with hypertensive disorders during pregnancy TAT levels were significantly higher than in uncomplicated pregnancies. Within 60 min after delivery a distinct increase of TAT concentrations occurred compared to levels before the onset of labour but the levels had returned to normal by 24 h after delivery. Our findings suggest that an activation of the coagulation system occurs in normal pregnancy. A further activation takes place immediately after delivery. The significantly increased TAT levels in pregnancies with hypertensive disorders suggest a state of chronic disseminated intravascular coagulation leading to an enhanced consumption of and a decreased plasma concentration of antithrombin III.

Adult↗

Placental biopsy for rapid fetal karyotyping in the second and third trimesters of pregnancy.

Rapid chromosomal analysis in the 2nd and 3rd trimester of gestation is desirable in cases of suspected or proven fetal malformation. The presence of any chromosomal aberration of the fetus influences the further prenatal and perinatal management of the pregnancy. Placental biopsy and preparation of trophoblast tissue after short term culture offers the possibility of getting satisfactory results within 2 to 3 days of biopsy. Fifty-seven patients underwent placental biopsy between the 16th and 36th weeks of gestation because of sonographically suspected or proven fetal malformation. In 51 of 57 cases fetal karyotyping was successful and no severe complications after biopsy were seen. Eight pathologic karyotypes were found. In 3 cases the chromosomal analysis yielded unsatisfactory results because of the inadequate quality of metaphases. In another 3 cases not enough chorionic tissue was aspirated in 2 biopsy attempts. In all other cases normal fetal karyotypes were found. Sonographically guided placental biopsy represents a simple method for fetal karyotyping and is a useful tool for the management of pregnancies with suspected or proven fetal malformation in the 2nd and 3rd trimester.

Chorionic Villi Sampling↗

Transvaginal pulsed Doppler measurement of blood flow velocity in the ovarian arteries during cycle stimulation and after follicle puncture.

In experimental studies, an increase of the ovarian blood flow was found during cycle stimulation. In this study, the authors performed transvaginal pulsed Doppler measurements of the ovarian arteries in stimulated cycles before and after follicle puncture. Four days before follicle puncture, high flow velocities in systolis were found compared with diastolis. Toward the day of embryo transfer, a marked increase of the diastolic blood flow velocity was observed. In patients with high endocrine response, the pulsatility index (PI) was significantly lower compared with that of patients with low endocrine response. The technique of transvaginal pulsed Doppler measurements offers the possibility to study the alterations of the ovarian blood flow under physiologic and pathophysiologic conditions.

Adult↗

[Hypophyseal suppression and subsequent cycle stimulation: experiences in an in vitro fertilization program].

Gonadotropin releasing hormone (GnRH) agonists can induce a hypogonadotropic state. We studied the effect of a long acting GnRH agonist on pituitary gonadotropin levels, the pattern of serum steroid levels in subsequent cycle stimulation, and whether such a protocol can improve the results of an in-vitro fertilization (IVF) program. 29 patients with tubal factor from our IVF program received 4 mg Decapeptyl CR intramuscularly and were subsequently stimulated with FSH/HMG/HCG (Group I). 35 patients were stimulated according to our standard protocol with HMG/HCG (Group II). After a single injection of Decapeptyl CR, serum levels of LH, FSH and E2 fell to more than half of pretreatment levels. In the subsequent cycle stimulation the gonadotropin dosage was increased threefold compared with the control group. In group I, progesterone levels were significantly higher. Though more oocytes were retrieved in group I, fertilization rates were significantly lower. After Decapeptyl and the subsequent stimulation, we observed short rises in urinary LH in 22/29 patients. In our experience, a single intramuscular injection of Decapeptyl resulted in sufficient pituitary suppression, however, we could not see an improvement in the results after IVF.

Estradiol↗

Development of mouse embryos following conventional and ultra rapid cryopreservation.

A conventional computer-controlled program for cryopreservation of mouse embryos at the 4 to 8 cell stage was compared with various methods of ultra rapid cooling. 104 embryos were frozen by using the conventional cooling program. 79% of the embryos developed to blastocysts after thawing. Sixty-three embryos were vitrified and 81% reached the blastocyst stage within 2 days of culture. Using the ultra rapid cooling program A (4-step equilibration of embryos in cryoprotectant) 62% of embryos survived after freezing and thawing. Only 12% survival rate could be achieved by employing the ultra rapid program B (2-step equilibration of embryos in cryoprotectant). The significantly higher survival rate of program A compared to program B was due to the longer equilibration time and therefore presumably higher intracellular concentration of cryoprotectant. In program B the short equilibration time with the cryoprotectant seemed to result in an inadequate dehydration of blastomeres leading to intracellular ice formation and cell destruction.

Animals↗