Biomedical subjects

C D Matthews

Publications and source records attributed to C D Matthews.

At least 91 records · Page 5Linked to original sources

PubMed1989

Adjuvant leuprolide in normal, abnormal, and poor responders to controlled ovarian hyperstimulation for in vitro fertilization/gamete intrafallopian transfer.

Fifty patients (normal responders) received either human menopausal gonadotropin (hMG) alone (control group) or leuprolide + hMG (leuprolide group). The use of leuprolide was associated with a reduction of hMG requirements (14.8 versus 17.8 ampules, P = 0.02) and the abolition of spontaneous luteinizing hormone surges (nil versus 3, P = 0.006). The rate of fertilization (87% versus 65%, P = 0.003) was higher in the leuprolide group. Pituitary and ovarian suppression was effected for 16 subjects who had previously shown a poor follicular response and a further 19 subjects who had previously responded abnormally. The poor responders required more hMG (43.9 versus 27.1 ampules, P less than 0.001), achieved a lower estradiol maximum (5.1 versus 12.1 nmol/l, P less than 0.001), and had fewer oocytes recovered (4.1 versus 11.5, P less than 0.001), than the abnormal responders.

Drug Therapy, Combination↗

PubMed1989

Increase in digyny explains polyploidy after in-vitro fertilization of frozen-thawed mouse oocytes.

Fewer frozen-thawed mouse oocytes cleaved to the 2-cell stage compared to fresh control oocytes fertilized in vitro (46% vs 79%). The reduced rate of 2-cell formation was only partly explained by a decreased rate of fertilization (63% vs 85%). However, subsequent development to expanded blastocysts was not different (75% vs 78%). An increased frequency of second polar body retention by fertilized frozen-thawed oocytes compared with controls (11.8% vs 1.3%) was shown to be largely responsible for the higher incidence of polyploidy (16.3% vs 3.7%). The frequency of polyspermic fertilization was not different in the two groups (3.9% vs 2.3%).

Animals↗

PubMed1988

Comparison of zona cutting and zona drilling as techniques for assisted fertilization in the mouse.

Zona cutting and zona drilling of the mouse oocyte significantly increased the fertilization rate (3.8-90%) at low sperm concentrations (less than 200,000/ml) compared with zona-intact controls (0-45%). More oocytes were fertilized after zona drilling. Zona cutting was associated with a low loss of oocytes (less than 1%), no increase in polyspermy and normal development in vitro and in vivo after fertilization. There was a 4% oocyte loss rate after zona drilling, mostly due to extrusion of the oocyte from the zona during the procedure. Hatching of blastocysts occurred about 12 h earlier for zona-drilled than for zona-cut and zona-intact control oocytes. Zona drilling was associated with a higher, but not statistically significant, rate of polyspermy at all sperm concentrations tested. The proportion of zygotes developing to the blastocyst stage was not different between the techniques (zona cut, 77%; zona drilled, 66%; control, 71%). Similarly, no difference was found in the percentage of embryos implanting after blastocyst transfer to the uterine horns of pseudopregnant female mice (zona cut, 67%; zona drilled, 68%; control, 77%). Transmission electron microscopy demonstrated the induced defects in the zona with no damage to the oocyte or oolemma. Parthenogenetic activation was not seen after either of the micromanipulative techniques. Both techniques have promise for application to the human.

Animals↗

PubMed1986

The pH of cervical mucus, quality of semen, and outcome of the post-coital test.

In preliminary experiments, pH measurements were made with pH paper and with a pH electrode on cervical mucus in situ and after aspiration. Paper and electrode gave comparable results with aspirated mucus. Measurements made on mucus in situ and then after aspiration were concordant only when pH paper, but not the pH electrode, was used to measure pH in situ. All spermatozoa were immotile in the post-coital test when the pH of the mucus was below 6. A pH below 6 was found in 38% (23 out of 61) of post-coital tests in which there were fewer than 1% of motile spermatozoa (19% of all tests). The male partners of women who had a mucus pH greater than 6 but had less than 1% of spermatozoa motile in the post-coital test, had slightly poorer quality semen than the partners of women with mucus pH less than 6, or in which there were motile spermatozoa in the mucus.

Cervix Mucus↗

PubMed1984

Improved conception rate after intrauterine insemination of washed spermatozoa from men with poor quality semen.

The efficacy of high intrauterine insemination of a washed motile fraction of spermatozoa from men with poor quality semen on the day after the luteinising hormone (LH) surge was compared with that of natural intercourse based on symptothermal methods and a single act of intercourse timed on the day after the LH surge in the same 35 couples in a controlled and randomised trial of the three types of cycle. Each couple had been trying to conceive for at least 3 years, the woman being potentially fertile and the only detectable defect related to poor semen quality. After 39 intrauterine insemination cycles, 8 women conceived (all in their first insemination cycle); this procedure was significantly more successful than LH-timed intercourse (0/38; p less than 0.05) and natural intercourse timed by symptothermal methods (1/34; p = 0.022). The technique of intrauterine AIH, with a 'Tomcat' catheter, was simple, painless, and uncomplicated.

Clinical Trials as Topic↗

PubMed1984

In vitro fertilization and embryo transfer program, Department of Obstetrics and Gynecology, University of Adelaide at the Queen Elizabeth Hospital, Woodville, South Australia.

A review is presented summarizing the in vitro fertilization experience at the University of Adelaide, Australia. Initial attempts utilizing the normal cycle were unsuccessful in obtaining a pregnancy. Since 1982 the overall ongoing pregnancy rate has been 21% per embryo transfer, 16% per laparoscopy, and 12% per treatment cycle. A detailed description of presently utilized methodology is presented.

Adult↗

PubMed1984

Estimation of fertility and fecundity in women receiving artificial insemination by donor semen and in normal fertile women.

The pregnancy rates after artificial insemination by donor semen (AID) have been compared with pregnancy rates in normal fertile women to assess the efficiency of AID. To do this, the curve y = a(1-(1-b)x) was fitted to life-tabled cumulative pregnancy rates. The equation describes a model in which the parameter a is the proportion of women who are potentially fertile under the conditions of treatment, and in which the parameter b is the pregnancy rate per cycle (or fecundity) of these fertile women. For 259 AID patients with no previous pregnancy a was 65% while for 57 AID patients with a previous pregnancy after AID 'a' was 99.9%. The values of b were similar for the two groups of patients, being 20% and 22% respectively. Women without fertility problems who had become pregnant after discontinuing oral contraception provided the reference group. Since only pregnant women were selected, a was 100% by definition. The values of b for the reference group were 22% for 100 primigravid women and 20% for 100 multigravid women. Only 65% of the AID patients were potentially fertile with AID, but those that were fertile became pregnant at the same rate as normal women who discontinued oral contraception.

Adult↗

PubMed1983

Incidence of multiple pregnancy after in-vitro fertilisation and embryo transfer.

7 multiple pregnancies occurred in a series of 20 pregnancies after oocyte recovery for in-vitro fertilisation and embryo transfer. After ovarian stimulation with clomiphene alone or with human menopausal gonadotropin, 102 laparoscopies were carried out in 62 women and the ongoing pregnancy rate beyond the first trimester was 17/102 laparoscopies (17%), including 5 sets of twins. 1 triplet and 1 twin pregnancy showed evidence of regression of two sacs and one sac, and both are progressing as singleton pregnancies at 16 and 34 weeks, respectively. 3 abortions occurred at 7, 8, and 9 weeks--a spontaneous abortion rate of 15%. The pregnancy and multiple pregnancy rates after stimulation with clomiphene alone or with human menopausal gonadotropin were comparable, but oocyte pickup based on a knowledge of the duration of the endogenous rise in luteinising hormone, rather than 36 h after administration of human chorionic gonadotropin, increased the pregnancy rate. As the quality and number of embryos transferred to the uterus increased, the risk of multiple pregnancy also rose. Consideration should therefore be given to restricting the number of embryos transferred to limit multiple pregnancies to twins.

Adult↗

PubMed1983

Screening of karyotype and semen quality in an artificial insemination program: acceptance and rejection criteria.

Semen quality and karyotype were screened in all men offering to be donors for an artificial insemination (AID) program. The criteria for accepting or rejecting semen have now been set with respect to this sample of the population. There was no evidence of differences between the pregnancy rates of the accepted donors. One of 172 potential donors with a clear medical history had a chromosomal abnormality, 4 had pericentric inversions of chromosome 9, and 14 had other heterochromatic variants. Of the recipients of AID, 5 of 196 women had chromosomal abnormalities, and 12 had heterochromatic variants.

Adult↗

PubMed1983

Special uses of a gas chromatograph-mass spectrometer in endocrinology.

Based on the isotope dilution principle, and using deuterium-labelled steroids as tracers combined with GC-MS analysis, clinically acceptable procedures for the measurement of daily urinary production rates (UPR's) and metabolic clearance rates (MCR's), of hormonal steroids, have been developed. In clinical tests, using progesterone and androstenedione as models the UPR's and MCR's obtained compared favourably with values obtained using radioisotope-labelled tracers. The heavy isotope procedure proved, however, to be superior to the radioisotope methods in accuracy, speed and patient safety.

Androstenedione↗

PubMed1983

The XX male. Clinical and theoretical aspects.

A male patient attending a fertility clinic was recognized as having an XX chromosomal constitution. The clinical and theoretical aspects of the XX male are discussed and note is made of some improvement in the understanding of the condition with the determination of the H-Y status of these individuals.

Adult↗

PubMed1983

Use of imported cryopreserved hamster oocytes in the diagnosis of male infertility.

Frozen hamster oocytes have been imported from England to Australia to establish a test for human sperm fertilizing capacity based on penetration of zona-free hamster oocytes. When examined under similar conditions used for human in vitro fertilization (IVF), high and consistent rates of penetration by human spermatozoa were obtained which were similar whether the spermatozoa had been stored frozen or freshly collected. The availability of a validated test of the capacity of human spermatozoa to fuse with a receptive vitelline membrane should prove useful in combination with other clinical parameters in the evaluation of male infertility.

Animals↗

PubMed1982

The role of testicular biopsy in the investigation of male infertility.

Sixty-five testicular biopsies from infertile men were assessed retrospectively. In 21 patients infertility was attributed to varicoceles. In the remaining cases the testicular histology was classified into 3 major groups. Normal, hypospermatogenesis and germ cell aplasia. These histological categories were correlated with serum gonadotrophic hormone levels and sperm counts. All cases of germ cell aplasia showed azoospermia or severe oligospermia, but sperm counts alone were not reliable indicators of spermatogenesis. Patients with very low sperm counts and raised levels of serum FSH invariably had germ cell aplasia. These patients made up a group in whom testicular biopsies were of limited value in assessment. In all other instances the testicular biopsy was still an important tool in the assessment and prognostication for fertility in the subfertile male.

Biopsy↗

PubMed1982

The outcome of artificial donor insemination compared to the husband's fertility status.

One thousand, three hundred and fifty-seven women were treated by artificial donor insemination (AID) using frozen semen at seven Australian centres. Eight hundred and forty-three of the husbands were azoospermic and five hundred and fifteen had pathological semen. The wives of azoospermic men had a significantly higher rate of success when the two groups were compared by life table analysis. It appears likely that the wives of oligospermic men who require AID are less fertile, and may be a contributory factor in the couple's subfertility.

Australia↗

PubMed1981

Endocrine profiles and fertility status of human menstrual cycles of varying follicular phase length.

Assessment of the relationship between ovarian endocrine function and follicular phase length was made in 48 patients (51 cycles) with spontaneous ovular cycles of varying length. On the basis of follicular phase length when measured from the first day of menstruation to, and including, the day of the luteinizing hormone (LH) peak, cycles were grouped into short (less than 21 days), medium (12 to 16 days), and long (more than 6 days). Daily serum LH, androstenedione, 17 beta-estradiol, progesterone, and 17 alpha-hydroxyprogesterone concentrations were determined in the periovular period. The overall pattern of serum steroid concentrations in medium and long cycles was similar to that previously described for normal women. However, cycles with a short follicular phase had lower mean concentrations of androstenedione and estradiol. In order to assess the fertility potential of cycles with follicular phases of varying length, the prior 265 cycles of 92 consecutive patients who conceived with artificial insemination by donor (AID) were studied. In all cases, insemination occurred on day 0 and day + 1 with respect to the LH peak, and all cycles were assumed to have equal fertility potential. Statistical analysis revealed no significant difference in fertility potential among cycles with follicular phases of differing length.

Adult↗

PubMed1981

Artificial insemination by frozen donor semen: results of multicentre Australian experience.

A total of 5461 insemination cycles with frozen donor semen has been analysed for 8 of the larger AID services in Australia. Cumulative pregnancy rate, calculated by life-table analysis, showed that 50% of all patients are pregnant after 6 cycles of insemination and 64% of all patients are pregnant after 12 cycles of insemination. Pregnancy rate was significantly higher in the first 3 cycles, declined in the next 3 cycles and was further reduced in the last 6 cycles of insemination. An average of 10% of all insemination cycle were anovular, but the proportion of anovular cycles was significantly lower in the first 2 cycles of insemination. There was no significant difference in cumulative pregnancy rates over the first 6 cycles of insemination in clinics using cervical mucus scoring or LH assay for detection of ovulation. An average of 12% of all pregnancies obtained by AID resulted in miscarriage.

Australia↗

PubMed1981

Morphological and functional relations of Graafian follicle growth to ovulation in women using ultrasonic, laparoscopic and biochemical measurements.

The daily growth rates of ovarian follicles were recorded ultrasonically for five days until ovulation in 56 spontaneously ovulating women and related to endocrine and clinical parameters. Over the 5-day period, the average diameter of the follicle destined to ovulate increased from 12 to 23 mm, the second largest follicle from 6 to 12 mm, the third largest follicle from 5 to 9 mm and the fourth largest follicle from 4 to 8 mm. Similar but lesser growth rates occurred in the follicles in the contralateral ovary. Ovulation occurred within 24 hours of the luteinizing hormone (LH) peak, and the mean peak diameter of the ovulating follicle was 23.2 +/- 0.3 (SEM) mm, (range 18-29 mm) before ovulation, and subsequent luteal function was judged to be normal. Follicular growth was most closely correlated with increasing peripheral blood oestrogen levels. In 16 women who had a laparoscopy within 12 hours of the last ultrasound and following the LH peak, the mean diameter of the largest follicle as measured by ultrasound (23.6 +/- 0.4 mm) was similar to that measured at laparoscopy (22.8 +/- 0.04 mm) and estimated from the volume of follicular fluid aspirated (average 5.8 +/- 0.2 ml), 22.5 mm. The follicular fluid levels of progesterone were high on the day of the LH peak and blood progesterone levels had risen significantly indicating that luteinization of the dominant Graafian follicles had already occurred prior to ovulation. This study confirms that ultrasonic monitoring provides a reliable measure of follicular growth and allows studies correlating morphological changes with both normal and abnormal endocrine function of the human ovary.

Adult↗

PubMed1981

Tubal patency testing in a programme of artificial insemination with donor semen.

The value of investigating tubal patency by hysterosalpingography, before artificial insemination with donor semen (AID), was studied retrospectively in 167 patients. The results suggest that unless there is a history of pelvic inflammatory disease preliminary hysterosalpinography is unnecessary. Conception rates were similar in women who had a normal hysterosalpingogram (44%), in those who had an abnormal hysterosalpingogram (46%), and in those who had no preliminary tubal investigation (39%) before AID. Life table analysis of expectancy of conception suggests that tubal patency testing should be delayed until after AID has been unsuccessful for four cycles. Laparoscopy is then the most worthwhile investigation.

Fallopian Tube Patency Tests↗