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Biomedical subjects

A Templeton

Publications and source records attributed to A Templeton.

At least 163 records · Page 9Linked to original sources
PubMed1987

Luteal phase after ovarian hyperstimulation.

The luteal phase was investigated in 17 women with normal menstrual cycles and tubal infertility who were superovulated with clomiphene (9 cycles), clomiphene plus pulsatile human menopausal gonadotrophin (hMG) (12 cycles) and clomiphene plus pulsatile follicle stimulating hormone (FSH) (11 cycles) during an in-vitro fertilization programme. Follicles were aspirated 34-36 h after the onset of the endogenous LH surge. Urinary total oestrogen levels during the first 6 days of the luteal phase were significantly higher, the duration of the luteal phase was significantly shorter and the luteal levels of urinary pregnanediol were significantly lower in the two combination treatment cycles than in the clomiphene only cycles. When the three treatment groups were combined the mid-luteal peak pregnanediol levels and the duration of the luteal phase showed significant negative correlations with plasma or urinary oestrogen levels during the follicular and the luteal phase. It is suggested that the luteal function in cycles superovulated with clomiphene/hMG or clomiphene/FSH is disrupted and this is related to the high amounts of circulating oestrogen.

Clomiphene↗
PubMed1986

Characteristics of ovarian follicles in spontaneous and stimulated cycles in which there was an endogenous luteinizing hormone surge.

The growth of ovarian follicles was assessed with the use of ultrasound in spontaneous cycles and in cycles stimulated with clomiphene citrate (CC) alone, CC plus pulsatile human menopausal gonadotropin, and CC plus pulsatile follicle-stimulating hormone (FSH). At the time of the onset of the luteinizing hormone surge (LH), the size of the leading follicle did not differ significantly between the spontaneous and the stimulated cycles, although it was larger in the CC/FSH cycles. During the two days before the LH surge onset, the growth rate was faster in the stimulated than the spontaneous cycles. It is suggested that despite the provocation of extremely high plasma-estradiol levels and multiple follicular development, the leading follicle in stimulated cycles ovulated at a size equal to or greater than that in spontaneous cycles. The reason for the higher follicle size in the CC/FSH cycles is, as yet, unclear.

Clomiphene↗
PubMed1986

Endogenous luteinizing hormone surge in women during induction of multiple follicular development with pulsatile follicle stimulating hormone.

In this study nine consecutive normally cycling women undergoing in-vitro fertilization (IVF) were superovulated with clomiphene citrate followed by pulsatile 'pure' FSH injected s.c. via a pump (28 IU every 3 h). All women displayed an endogenous LH surge, which was markedly attenuated in most of the cases (peak value 44.5 +/- 5.9 U/l, duration 29.2 +/- 1.2 h, mean +/- SEM) as compared to spontaneous cycles. An increase in serum progesterone levels before the onset of the LH surge was seen in only one woman at a time when the LH values were low. During the LH surge serum progesterone levels increased significantly in all patients (12.7 +/- 1.90 nmol/l vs 4.74 +/- 1.57 nmol/l at the onset of the surge, mean +/- SEM, P less than 0.05) indicating follicular luteinization. Very high oestradiol levels in serum were found at the onset of the LH surge (7504 +/- 898 pmol/l, mean +/- SEM). Preovulatory oocytes were recovered from all women through a laparoscope 34-36 h after the beginning of the LH surge and embryos were replaced to them after IVF. One ongoing clinical pregnancy occurred. In contrast to results in monkeys, these results demonstrate for the first time that normally cycling women superovulated with clomiphene pulsatile 'pure' FSH will display an endogenous LH surge. Although the surge is attenuated implantation can occur.

Clomiphene↗
PubMed1986

Relationships between the characteristics of endogenous luteinizing hormone surge and the degree of ovarian hyperstimulation during superovulation induction in women.

Ovarian hyperstimulation was induced in 17 normally cycling women undergoing in-vitro fertilization (IVF) and embryo transfer with clomiphene (9 cycles), clomiphene followed by pulsatile hMG (12 cycles) or clomiphene followed by pulsatile FSH (11 cycles). Hyperstimulation was greater with the combined treatments than with clomiphene alone. In all 32 cycles an endogenous LH surge occurred. The peak values and the duration of the LH surge showed significant negative correlations with the plasma oestradiol levels, the number of the follicles and the total follicular fluid volume aspirated at laparoscopy. We suggest that during superovulation induction for IVF, the endogenous LH surge is attenuated by factors which are related to the degree of ovarian hyperstimulation.

Clomiphene↗
PubMed1986

The effect of pulsatile follicle stimulating hormone on the endogenous luteinizing hormone surge in women.

The effect of pulsatile administration of 'pure' FSH on the endogenous LH surge was investigated in 10 infertile but otherwise normal women. In each woman the LH surge in the spontaneous cycle preceding the treatment cycle was characterized in blood samples taken every 6 h. FSH was injected s.c. via a pump (28 IU every 3 h) starting on cycle day 2. Only five of the FSH-treated women displayed an endogenous LH surge, and this was markedly attenuated in four of them. The LH surge occurred significantly earlier in the FSH-treated than in the corresponding spontaneous cycle (cycle day 10.2 +/- 0.5 vs 13.6 +/- 0.8 mean- +/- SEM, P less than 0.05), although it tended to occur later in the FSH-treated cycles with a higher total follicular fluid volume of follicles 12-15 mm in diameter. This volume was even greater in the FSH-treated cycles without an endogenous LH surge. Serum progesterone levels increased significantly in all five FSH-treated cycles after the onset of the LH surge and ovulation was confirmed by ultrasound in four of them. These results suggest that the LH surge during superovulation induction with pulsatile FSH in normally cycling women is a variable event. We postulate that unknown inhibitory substances secreted be small growing follicles antagonize the positive feedback effect of E2 on LH secretion.

Animals↗
PubMed1986

A comparison of fixed regimens for obtaining human cleaving oocytes for research purposes.

A fixed schedule for ovarian stimulation and follicular aspiration, previously used in our department for research purposes, was modified in an attempt to increase the recovery and cleavage rates of the oocytes. Three different clomiphene regimens were used to stimulate the ovaries of normal volunteer women requesting laparoscopic sterilization (50 mg and 150 mg daily for 5 days, and 50 mg daily for 10 days). Oocytes were recovered from 83% of the aspirated follicles, i.e. 1.6 oocytes/patient: 65% of the oocytes cleaved after in-vitro fertilization and, on average, 1.0 cleaving egg was obtained per patient. There were no differences in the recovery and cleavage rates between the three clomiphene regimens. It is concluded that a sufficient number of cleaving embryos for research purposes can be generated with the present fixed regimen, which offers little inconvenience to the volunteers as the day of egg recovery can be predicted some time in advance.

Adult↗
PubMed1986

Urinary oestrogen levels and follicle ultrasound measurements in clomiphene induced cycles with an endogenous luteinizing hormone surge.

Total oestrogen in urine and the ultrasonic size of the follicles were measured in relation to the onset of the endogenous luteinizing hormone (LH) surge (day 0) in 18 cycles induced with clomiphene citrate in an in-vitro fertilization programme. Oestrogen values in urine (microgram/24 h) increased progressively during the late follicular phase up to the day of the onset of the surge. The mean maximum follicle diameter (22.3, SD 4.7 mm) estimated by ultrasound was measured on day 0. At the onset of the LH surge, the values of urinary total oestrogen showed a better relation with the total volume of the first three follicles in order estimated by ultrasound (r = 0.71) than with the mean ultrasonic diameter of the leading follicle (r = 0.56). A wide range of individual values for both urinary oestrogen and follicle size was found. In another group of 32 women treated with clomiphene for recovery of oocytes used for research purposes, a good correlation was found between the mean ultrasonic follicle diameter 16 h before the laparoscopy and the follicle diameter calculated from the fluid volume at aspiration (r = 0.80). These results suggest that the decision when to give human chorionic gonadotrophin (hCG) in an in-vitro fertilization programme remains arbitrary in many individual cases. Apart from the oestrogen levels, the calculation of the size of all follicles, instead of only the leading one, may give further help in timing the hCG.

Clomiphene↗
PubMed1985

Endogenous luteinizing hormone surge during superovulation induction with sequential use of clomiphene citrate and pulsatile human menopausal gonadotropin.

There is dispute as to whether an endogenous LH surge occurs in women during follicle stimulation with human menopausal gonadotropin (hMG) for in vitro fertilization (IVF). In this study, 12 consecutive normally cycling women with tubal infertility were treated with clomiphene citrate and hMG for ovulation induction and subsequent IVF. Beginning on the fifth day of clomiphene administration (150 mg daily for 5 days), 225 IU hMG were given daily sc in a pulsatile manner (28 IU/3 h). All women had an endogenous LH surge which started on the seventh to ninth day of hMG administration. The mean duration [25.5 +/- 1.0 (+/- sem) h] and the mean peak value (38.9 +/- 4.7 U/liter) of the LH surge were less than those in spontaneous cycles. However, luteinization of at least some of the follicles occurred, based on findings of supraphysiological levels of serum progesterone during the surge and subsequent increase in urinary pregnanediol levels (luteal phase). Preovulatory oocytes were recovered via laparoscopy 34-35 h after the onset of the surge, and these oocytes cleaved after IVF. One pregnancy was achieved after embryo transfer, which resulted in abortion. These results represent the first demonstration that an attenuated LH surge is obtained in normally cycling women during superovulation induction with sequential clomiphene/pulsatile hMG treatment.

Clomiphene↗
PubMed1984

The recovery of pre-ovulatory oocytes using a fixed schedule of ovulation induction and follicle aspiration.

Thirty-two volunteer women, scheduled for laparoscopy, were subjected to a fixed regimen of ovulation induction and ovarian follicle aspiration, following manipulation of the previous menstrual cycle with oral contraceptive pills or norethisterone. This allowed the time of oocyte recovery to be planned several weeks in advance. The recovery rate of mature oocytes (loosely dispersed cumulus) in the patients who had their cycles adjusted with norethisterone was comparable to that in a group of women treated in an embryo-transfer programme who were being individually monitored, although there was evidence from cleavage rates and concentration of sex steroids in follicular fluid that further follicular maturation could have occurred. It is suggested that a modification of this schedule could provide an acceptable recovery rate of pre-ovulatory oocytes for research purposes, and possibly by simplifying the monitoring technique could be applicable to a wider range of patients seeking embryo transfer.

Androgens↗
PubMed1982

Sperm function in patients with unexplained infertility.

Sperm function was studied in 27 patients with hitherto unexplained infertility. The ability of spermatozoa to reach the site of fertilization was assessed by laparoscopic sperm recovery from the peritoneal fluid and fimbrial rinsings and sperm fertilizing capacity with the zona-free hamster egg penetration in vitro test. The ability of spermatozoa to reach the site of fertilization correlated significantly with their fertilizing capacity in vitro, but was totally unrelated to any of the conventional criteria of semen quality, including the postcapacitation movement characteristics of the spermatozoa. Among patients with unexplained infertility, there are individuals with defects of sperm function which cannot be identified by conventional clinical techniques.

Female↗
PubMed1982

An analysis of semen quality and sperm function in cases of oligozoospermia.

This study is based upon an analysis of 27 severely oligozoospermic men, in whom defects in sperm motility and morphologic defects were also evident, and 35 control subjects of proven fertility. Semen samples recovered from these men were assessed by conventional criteria, time-exposure photomicrography, and the zona-free hamster egg penetration test. Evidence of severely defective sperm function was obtained for the oligozoospermic group, which gave a mean +/- standard error (SE) fertilization rate of 2.8% +/- 1.5, compared with 44.0% +/- 3.4 for the normal fertile control subjects. Multivariate discriminant analysis was used for selection of those parameters of semen quality that could most accurately identify the 70% of oligozoospermic samples that failed to exhibit any fertilizing potential in the hamster egg assay. This analysis correctly identified 89% of such samples, on the basis of seven discriminating variables, of which the most significant were percentage of motile sperm, the log of sperm density, and a log transformation of the concentration of progressive spermatozoa.

Fertilization↗
PubMed1980

The effect of social selection on the population dynamics of Huntington's disease.

Wallace (1976) postulated the importance of social selection on the frequency of Huntington's disease. This effect of social selection was studied with respect to the population dynamics of Huntington's disease genes. It is shown that social selection operates mainly through heterozygotes. Existing data indicate that the frequency of Huntington's disease in the population is determined by its social effects.

Gene Frequency↗
PubMed1978

Characteristics of patients requesting reversal of sterilization.

With the increased number of female patients seeking sterilization and the good chance of successful reversal using modern microsurgical techniques, it can be anticipated there will be a rise in the number of patients requesting reversal of sterilization. We have studied the characteristics of 36 patients who requested reversal of sterilization at the Royal Infirmary, Edinburgh, in the last five years. The majority of patients requested reversal on the basis of a new relationship. Other reasons included sexual problems and child death. Eighteen of the patients had clear evidence of marital disharmony at the time of sterilization. Seven of the patients had been admitted to hospital with a drug overdose since being sterilized.

Adult↗