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Biomedical subjects

A Reinthaller

Publications and source records attributed to A Reinthaller.

At least 109 records · Page 6Linked to original sources
PubMed1988

Transient hyperprolactinemia during cycle stimulation: influence on the endocrine response and fertilization rate of human oocytes and effects of bromocriptine treatment.

The effect of transient hyperprolactinemia and its treatment during cycle stimulation on the endocrine response and fertilization rate of human oocytes was studied. Fifty stimulated cycles were included in the study and divided into three groups: group I consisted of 18 cycles with serum prolactin (PRL) levels less than or equal to 25 ng/ml; group II contained 15 cycles, where patients developed PRL levels greater than 25 ng/ml; group III consisted of 17 cycles, where patients, who already developed hyperprolactinemia in a previous cycle, were treated by 3.75 mg bromocriptine daily. The serum estradiol (E2), progesterone (P) and PRL levels 1, 2, and 3 days before and at oocyte retrieval were evaluated. The E2 decrease at oocyte retrieval was significantly steeper in groups I and III. Follicular luteinization was more effective in groups I and III. The fertilization rate in groups I and III was significantly higher than in group II. High serum PRL levels seem to interfere in follicular and oocyte development. The treatment of transient hyperprolactinemia improved the patients' endocrine response and the fertilization rate of oocytes.

Adult↗
PubMed1988

Elevated tissue type plasminogen activator in human granulosa cells correlates with fertilizing capacity.

An increased production of plasminogen activators, able to convert plasminogen into plasmin, has been found in experiments in vivo on rat ovarian granulosa cells at the time of ovulation, indicating an involvement in follicular rupture. The granulosa cells of 49 follicles from 20 patients undergoing in-vitro fertilization were obtained by laparoscopy and tested for the content of urokinase-type plasminogen activator (u-PA), tissue-type plasminogen activator (t-PA) and inhibitor of plasminogen activator (PAI). In the respective follicular fluids the concentrations of oestradiol (E2), progesterone (P) and testosterone (T) were determined and the levels of these enzymes and of the follicular steroid content were related to the fertilizing behaviour of the respective oocytes. Follicles containing oocytes which could be fertilized, revealed significantly higher follicular fluid E2 and P levels and significantly lower T levels than follicles with unfertilized oocytes. The respective granulosa cells of fertilized oocytes exhibited higher levels of t-PA compared to their unfertilized counterparts, whereas no significant difference occurred in the levels of u-PA and PAI. These data suggest that successful fertilization of human oocytes is associated with a high content of t-PA in granulosa cells and high E2 and P levels in the follicular fluid.

Adult↗
PubMed1988

Development and application of simple expert systems in obstetrics and gynecology.

Expert systems have become increasingly popular in medicine for the support of medical decisions, e.g. diagnosis or treatment. We describe the development and application of 2 simple rule-based expert systems, one used for cycle stimulation in our in vitro fertilization program and the other for preoperative assessment of urinary incontinence. The programs were written using a commercially available expert system shell, are run on a standard personal computer, and are in actual use in our department. Though it is doubtful that simple expert systems can be superior to a human expert we feel that expert systems are very useful in the standardization of protocols and are a valuable teaching instrument.

Decision Making, Computer-Assisted↗
PubMed1987

[Comparison of vaginosonographic, transabdominal sonographic and laparoscopic follicle puncture for the retrieval of oocytes within the scope of an in vitro fertilization program].

For follicular aspiration and oocyte retrieval for in-vitro-fertilization (IVF) laparoscopy, laparotomy and different ultrasound guided methods like transvesical and transvaginal puncture can be used. Sonographically guided follicular aspiration has become more important because this procedure is less invasive. In this study we compared the results of 28 laparoscopical, 35 transabdominal and 21 transvaginal follicle puncture after successful cycle stimulation. Performing transvaginal puncture 4.7, using laparoscopy 3.4 and performing transvesical puncture 2.0 oocytes per attempt were retrieved. The advantages of transvaginal follicle aspiration were a shorter operation time, a superficial anesthesia and compared to laparoscopy a less invasive and simple technique. Therefore this method is now commonly used for routine IVF procedures in our institution.

Female↗
PubMed1987

Comparison of the results of vaginal and abdominal follicle scans.

The hormonal profile and sonographical assessing of the number and size of the follicles are important in hyperstimulated cycles. Follicular imaging obtained by abdominal scanning may be distorted by echoes from the intestine or by unfavourable location of the ovaries and patients must have a full bladder. We compared the number and size of the follicles at abdominal sonography with the results obtained by vaginal sonography in 37 patients. Vaginal sonography showed more follicles than abdominal sonography because of improved imaging of small follicles on early days of cycle. This might help one to tailor the hyperstimulation to an individual's endocrine response.

Adult↗
PubMed1987

Relationship between the steroid and prolactin concentration in follicular fluid and the maturation and fertilization of human oocytes.

Seventy-eight follicles and their follicular fluid were aspirated from 46 women undergoing in vitro fertilization (IVF) procedures after stimulation of the ovaries with a low-dose human menopausal gonadotropin/human chorionic gonadotropin stimulation regimen. The concentrations of estradiol (E2), progesterone (P), testosterone (T), and prolactin (PRL) were measured in follicular fluid and related to the maturation of the oocyte-corona-cumulus complex (OCCC) and the fertilization of oocytes. Follicles containing mature oocytes had significantly higher follicular fluid E2 and P levels than follicles with intermediate and immature oocytes. A constant decrease in PRL and T values with advancing follicular maturation was observed. Similar results were obtained when the fertilizing ability of the oocytes was examined. The gradual decline in follicular fluid PRL and T levels during follicular development was connected with increasing E2 and P biosynthesis and therefore seems to be an important precondition for normal follicular and oocyte maturation.

Adult↗
PubMed1987

Prostaglandin metabolism in umbilical vessels of smoking and non-smoking mothers.

Arachidonic acid (AA) and its metabolites are responsible for the regulation of the umbilical blood flow. We investigated the prostaglandin (PG) synthesis in umbilical arteries and veins of 16 smoking and 17 non-smoking mothers. AA and PGs were analyzed after extraction of samples by means of thin layer chromatography (TLC). Of all the AA metabolites in umbilical arteries and veins, prostacyclin reached the highest concentration. In non-smoking mothers the conversion rate of AA in arteries and veins was similar. The only exception was PGE2 which showed a significantly lower concentration in umbilical veins of smoking mothers. However, the influence of PGE2 on the blood flow of umbilical arteries and veins seems to be of minor importance compared to other vessels.

Arachidonic Acid↗
PubMed1987

The measurement of amniotic fluid immunoglobulins by laser nephelometry.

Using laser nephelometry IgG, IgA, and IgM levels in amniotic fluid samples from normal pregnancies were measured between 15 and 24 weeks and between 37 and 41 weeks gestation. Not enough samples between 25 and 36 were available for statistical analysis. IgG levels increased until the 20th and 24th weeks of gestation and declined significantly at term. However amniotic fluid IgM and IgA levels rose at term. Five samples of amniotic fluid associated with a fetus of abnormal karyotype were examined. In one case of Down's syndrome excessive IgA and IgM levels were found. In amniotic fluid obtained after intrauterine fetal death at term, very high levels of all three immunoglobulins were found.

Amniotic Fluid↗
PubMed1987

Hormonal parameters in follicular fluid and the fertilization rate of in vitro cultured oocytes.

Oocytes and matched samples of follicular fluid were obtained from 52 preovulatory follicles aspirated laparoscopically for in vitro fertilization (IVF). Follicular fluid concentrations of estradiol (E2), progesterone (P), testosterone (T), prolactin (HPRL), prostaglandin F2 alpha (PGF2 alpha), prostaglandin E (PGE), protein content, and collagenolytic activity were measured and related to the fertilization rate of oocytes cultured in vitro. High concentrations of P and low levels of T and HPRL were associated with mature, fertilizable oocytes. Levels of PGF2 alpha, PGE, and follicular fluid protein concentrations were similar in both groups. Mean collagenolytic activity was increased in the fertilized oocytes, although no significant difference could be observed. Our data demonstrate a close association between follicular fluid steroid and HPRL concentrations and successful fertilization of oocytes.

Dinoprost↗
PubMed1987

Follicular aspiration for in vitro fertilization: sonographically guided transvaginal versus laparoscopic approach.

Laparoscopy is the most commonly used procedure for oocyte retrieval in an in-vitro fertilization (IVF) program. In this study we compared the results of 21 laparoscopic and 21 sonographically guided transvaginal oocyte retrievals using a vaginal probe. Laparoscopically 3.7 and transvaginally 4.8 oocytes per patient were recovered. Overall 6 pregnancies were achieved, giving a pregnancy rate of 14.1% per patient. Vaginal follicular aspiration resulted in a higher oocyte recovery rate. The advantages of the method were a shorter operation time, a superficial anesthesia and, compared to laparoscopy, a less invasive and simpler technique. Therefore this method is now commonly used for routine IVF procedures in our institution.

Adult↗
PubMed1987

[Effect of serum prolactin on cycle stimulation and fertilization of human oocytes].

During cycle stimulation for in-vitro fertilisation (IVF) some patients develop hyperprolactinaemia. Since prolactin (PRL), being an aromatase inhibitor, can interfere with follicular fluid steroid metabolism, we examined the influence of high serum PRL levels on the endocrine response and fertilisation rate of oocytes. 33 consecutive patients stimulated by hMG/hCG for IVF were included in this study. Two groups of patients were established: Group 1 consisting of 18 patients with serum PRL levels less than or equal to 25 ng/ml, and group 2 containing 15 patients, who developed PRL levels greater than 25 ng/ml during cycle stimulation. The serum oestradiol (E2), progesterone (P) and PRL levels 3, 2 and 1 day before and at the day of follicle puncture were evaluated. The decrease of E2 levels at the day of oocyte retrieval was significantly steeper in group 1. The P levels 2 days before oocyte retrieval were significantly higher in group 1 indicating the onset of preovulatory luteinization. Luteinization after the hCG injection was more effective in group 1 resulting in significantly higher P levels. Fertilisation and cleavage rates were significantly higher in patients with normal PRL levels. High serum PRL levels therefore might indicate an interference in follicular and oocyte development leading to oocytes of inferior quality.

Chorionic Gonadotropin↗
PubMed1986

[Intrauterine pregnancy following intratubal gamete transfer--a case report].

Since the beginning of 1986 gamete intrafallopian transfer (GIFT) has been used in the treatment of infertile couples. Only patients in whom tubal patency has been ascertained are included in the programme. After hormonal stimulation of the ovaries and laparoscopic follicular aspiration oocytes and semen are transferred by means of catheterisation into the fallopian tubes. The first pregnancy in our department established by gamete intrafallopian transfer--and the first in Austria to our knowledge--is reported.

Adult↗
PubMed1986

Pregnancy-specific parameters in early pregnancies after in vitro fertilization: prediction of the course of pregnancy.

The plasma concentrations of the beta subunit of human chorionic gonadotropin (beta-hCG), pregnancy-specific glycoprotein, and progesterone were measured in 37 pregnancies after in vitro fertilization. Twenty-one pregnancies ended with delivery, 9 as clinical abortions, and 7 as biochemical abortions. To predict the pregnancy outcome as early as possible, we designed a prediction graph by calculating a "cutoff line" using discriminant analysis and prediction bands up to 95% probability. This prediction graph can help in the estimation of the probability of pregnancy outcome with satisfactory reliability by determination of beta-hCG only.

Abortion, Spontaneous↗
PubMed1986

Factors influencing successful in vitro fertilization and embryo transfer: a matched pair study.

In the present matched-pair study successful and unsuccessful IVF-ET trials in patients with similar preconditions were compared. Sixteen consecutive cases of clinical pregnancies after IVF and ET were included. For each pregnant patient the subsequent patient who fulfilled the matching criteria and who did not conceive was chosen as a control subject. The matching criteria were the stimulation regimen and the number of embryos transferred. Pregnant and nonpregnant patients were compared with regard to their age, the total dosage of hMG, the cycle day at oocyte retrieval, the E2 levels 48 and 24 hours before laparoscopy, the E2 rise, the number of retrieved oocytes, and the cleavage rate. In both groups the investigated variables showed no significant difference between pregnant and nonpregnant patients. In patients with the same cycle stimulation and the same number of embryos transferred, successful implantation was not predictable by the evaluated parameters.

Adult↗
PubMed1985

[Effect of induced abortion on prematurity. Analysis of the period from 1979 to 1984].

Since induced abortion is legalized in Austria the number of patients with induced abortion in their anamnesis is increasing. This factor intensified the discussion about the consequences for following pregnancies, especially the number of preterm deliveries. We investigated the influence of induced abortion on prematurity using the records of primiparae who delivered in our hospital between 1979 and 1984. Previously performed induced abortion did not affect the number of preterm-deliveries, if patients underwent early prenatal care. Patients who had their first check-up after the 18th week of gestation showed a significant increase of preterm delivery.

Abortion, Induced↗
PubMed1985

[Changes in the diagnosis and therapy of extrauterine pregnancy].

In a retrospective study the records of all patients with proven ectopic pregnancy during the years 1971-1973 (n = 41) and 1981-1982 (n = 59) were reviewed with regard to age, symptoms, medical history, diagnostic methods, therapy, and clinical course. Particular attention was given to endocrine diagnostic methods (LH, beta-HCG), ultrasound examinations, and changes in operative therapy. The duration from admission to diagnosis of the ectopic pregnancy decreased from 5.6 to 3.3 days, circulatory shock from 32 to 10%. During 1971-1973 the fallopian tube was removed in 95%, during the years 1981-1982 only in 34%. Our study shows that modern diagnostic methods permit earlier diagnosis of ectopic pregnancy, and that in the majority of cases the removal of the fallopian tube is not necessary.

Abortion, Induced↗