Search PubMed⌕ Search

Biomedical subjects

D L Olive

Publications and source records attributed to D L Olive.

At least 109 records · Page 6Linked to original sources
PubMed1992

Ethiodol oil contrast medium inhibits macrophage phagocytosis and adherence by altering membrane electronegativity and microviscosity.

OBJECTIVE: To examine the effect of Ethiodol oil-soluble contrast medium and Sinografin aqueous-soluble contrast medium on macrophage function. After the observation that Ethiodol alters macrophage phagocytosis and adherence, we sought to determine the mechanism of action by which oil-soluble contrast medium alters the macrophage membrane. DESIGN: The P388D1 cell line was used as a consistent source of macrophages for all experiments. The uptake of 3H-labeled candida albicans was determined in macrophages exposed to 1:100, 1:400, or 1:800 dilutions of Ethiodol, Sinografin (S.R. Squibb, Princeton, NJ) or untreated media. To evaluate the macrophage adherence, 51Cr-labeled macrophages were exposed to the same dilutions of the contrast media. Specific membrane properties, Fc receptor levels, electronegativity, and microviscosity were assessed by flow cytometry after exposure to 1:100 dilutions of Ethiodol or Sinografin. RESULTS: Macrophage phagocytosis was decreased upon exposure to 1:100 and 1:400 dilutions of Ethiodol contrast medium, whereas adherence was reduced at the 1:100 dilution of Ethiodol. There was no effect of any dilution of Sinografin. There was a reduction in membrane electronegativity and microviscosity, but not Fc receptor levels, after exposure to a 1:100 dilution of Ethiodol. CONCLUSIONS: This study establishes a decrease in macrophage phagocytosis and adherence after exposure to Ethiodol oil-soluble contrast medium. We established that this alteration in membrane function is caused by a reduction of membrane negative surface charge and microviscosity. This may suggest a mechanism of action for the therapeutic effect of oil-contrast hysterosalpingograms in women with unexplained infertility.

Animals↗
PubMed1992

Method for the transportation of peritoneal macrophages.

This report outlines a method of PF transport that preserves the viability and activation level of peritoneal macrophages. Collection of macrophages in this manner will allow transport of PF from multiple centers for evaluation of macrophage function in a single laboratory. Such technology will make it possible to intensively study the relationship between peritoneal macrophages and infertility.

Female↗
PubMed1992

Consecutive versus alternating cycles of ovarian stimulation using human menopausal gonadotrophin.

Ovarian stimulation is an effective treatment for patients with ovulatory dysfunction and unexplained infertility. An initial report has suggested that consecutive cycles of ovarian stimulation can be employed without causing a diminished response in the second cycle. However, this observation has neither been confirmed nor has a regimen of consecutive stimulation cycles been compared to one of alternating stimulation cycles. Accordingly, 44 consecutive and 54 alternating cycles of stimulation were evaluated in patients (n = 42) who were treated with human menopausal gonadotrophin (HMG) alone. Human chorionic gonadotrophin (HCG) 10,000 IU was administered i.m. when at least one follicle exceeded 16 mm in mean diameter, and this was followed by either intercourse or intrauterine insemination. Using each patient as her own control, we were unable to demonstrate any differences in mean HMG dose requirements, endocrine parameters or follicular development on the day of HCG administration, or ovulation rates in the second consecutive cycle compared to the second alternating cycle. Clinical pregnancies resulted significantly more often in a consecutive cycle (8/22) than in an alternating cycle (2/27, P = 0.029). We conclude that consecutive cycles of ovarian stimulation with HMG are not detrimental and may, in fact, result in increased cycle fecundity compared to alternating stimulation cycles.

Adult↗
PubMed1992

Endometriosis: advances in understanding and management.

Endometriosis is a commonly encountered disease, yet most aspects of its pathogenesis, pathophysiology, and treatment remain controversial. Recent advances, however, have increased our understanding of this enigmatic disorder. While many theories persist regarding the pathogenesis of endometriosis, the transplantation hypothesis is by far the most widely accepted. Evidence continues to accumulate in support of this theory as the primary mode of generating ectopic endometrium. In addition, recent work has begun to uncover factors critical to the growth and maintenance of such implants. Advances in pathophysiology have strongly suggested a cause-effect relationship between endometriosis and pelvic pain; conversely, such a relationship between implants and infertility is becoming more tenuous. Treatment trials, in both animals and humans, have begun to clarify the role of specific interventions in combating endometriosis. In addition, as new pathophysiologic mechanisms have been proposed, an intriguing array of new modalities have been developed as treatment options.

Animals↗
PubMed1991

Effects of clomiphene citrate and leuprolide acetate on luteal-phase hyperprolactinemia during ovarian stimulation with menopausal gonadotropins.

Hyperprolactinemia, a known modulator of reproductive function, occurs commonly in women undergoing ovarian stimulation with human menopausal gonadotropins (hMG). Clomiphene citrate (CC) and gonadotropin releasing hormone analogues (GnRHa), when administered during the luteal phase, attenuate the hyperprolactinemic response to hMG. We asked whether follicular-phase administration of CC and GnRHa, as employed clinically in women undergoing ovarian stimulation for in vitro fertilization or gamete intrafallopian transfer, would alter the incidence and severity of hMG-induced luteal-phase hyperprolactinemia. Seventy-five percent of all patients had at least one luteal prolactin level greater than 25 ng/ml, and 40% had mean luteal-phase prolactin levels greater than 25 ng/ml. The incidence of hyperprolactinemia was similar in pregnant and nonpregnant cycles. The incidence of hyperprolactinemia was similar for both the GnRH agonist-treated group and those given clomiphene citrate. The increase in mean luteal prolactin levels over the follicular-phase baseline level was significantly greater in the CC-treated group (P = 0.03). This was due to the significant suppression of follicular-phase baseline prolactin levels in patients receiving CC. We conclude that neither CC nor GnRHa administration in the follicular phase prevents luteal-phase hyperprolactinemia in women undergoing ovarian stimulation with hMG.

Clomiphene↗
PubMed1991

Follicular size at the time of human chorionic gonadotropin administration predicts ovulation outcome in human menopausal gonadotropin-stimulated cycles.

OBJECTIVE: The objectives of this study were: (1) to correlate follicle size by transvaginal sonography with ovulation outcome in cycles of controlled ovarian hyperstimulation with human menopausal gonadotropins; (2) to determine if follicular size on the day of human chorionic gonadotropin (hCG) administration predicts the incidence of ovulation; and, if so, (3) to derive a mathematical model that predicts the number of expected ovulations in any given cycle of controlled ovarian hyperstimulation. DESIGN: A retrospective analysis. PARTICIPANTS: Forty-nine consecutive patients undergoing 122 cycles of controlled ovarian hyperstimulation were studied in a tertiary care setting. MAIN OUTCOME MEASURES: Follicular size and evidence of ovulation were determined sonographically. The main outcome measure was the rate of ovulation per follicle size. RESULTS: The percentages of follicles measuring less than or equal to 14 mm, 15 to 16 mm, 17 to 18 mm, 19 to 20 mm, and greater than 20 mm on the day of hCG administration that subsequently ovulated were 0.5%, 37.4%, 72.5%, 81.2%, and 95.5%, respectively. CONCLUSIONS: (1) Follicular size on the day of hCG administration correlates with the incidence of ovulation. (2) The expected number of ovulations in any given controlled ovarian hyperstimulation cycle can be predicted with 95% confidence using the accompanying equation.

Chorionic Gonadotropin↗
PubMed1991

Immediately preovulatory levels of messenger ribonucleic acid for inhibin alpha-subunit are diminished in granulosa cells from successful in-vitro fertilization-embryo transfer.

Inhibin, a gonadal glycoprotein which suppresses pituitary gonadotrophin secretion, preferentially follicle stimulating hormone, has been extensively characterized. It consists of two covalently bound subunits, the alpha- and beta-subunits, encoded by separate genes. In this study, the expression of messenger ribonucleic acid (mRNA) for the inhibin alpha-subunit was studied by Northern blot analysis in granulosa cells of women undergoing in-vitro fertilization/embryo transfer (IVF/ET). Three patient groups were studied: women who failed to become pregnant (n = 11), women who became pregnant but experienced early spontaneous abortion (n = 3) and women who conceived normal ongoing pregnancies (n = 4). Granulosa cells were obtained at the time of follicle aspiration. Levels of alpha-subunit mRNA were 40% lower in patients establishing normal pregnancies than in those who failed to become pregnant or who spontaneously aborted. Thus, a relative diminution of immediately preovulatory levels of mRNA for inhibin alpha-subunit is a marker of success in clinical IVF/ET cycles. This marker of IVF/ET success can be related to previously established markers of success (increased follicular fluid oestradiol and decreased follicular fluid cyclic adenosine monophosphate) by known physiological mechanisms.

Adult↗
PubMed1991

The prevalence and epidemiology of luteal-phase deficiency in normal and infertile women.

The difficulty in determining the prevalence and epidemiology of LPI lies in the ambiguity of diagnosis. To define the abnormal, a complete delineation of normal is first required; this has been disregarded for most diagnostic criteria of this disorder. Once normal is defined, a link between the abnormal state and subfertility is required to demonstrate clinical relevance; this has yet to be shown with any form of LPI criteria. Despite this, some pieces of the puzzle are apparent. In the form of a short luteal phase LPI is present in roughly 5% of ovulatory cycles. The rate also tends to increase at the extremes of reproductive age. The rate of hormonal- or biopsy-diagnosed LPI appears to be in approximately the same range, although the criteria for diagnosis are much more poorly defined, and the rate of "abnormal" is often built into the definition. Finally, ongoing development of more precise and accurate tools for diagnosis promises to produce more and better data in the future to furnish the clinician with greater insight into the rate and overall importance of LPI as a cause of infertility.

Corpus Luteum↗
PubMed1991

Serum progesterone levels predict success of in vitro fertilization/embryo transfer in patients stimulated with leuprolide acetate and human menopausal gonadotropins.

Serum progesterone (P4) levels greater than 2.86 nmol/L (0.9 ng/mL) on the day of hCG administration are reportedly associated with decreased pregnancy rates in in vitro fertilization/embryo transfer (IVF/ET) cycles. To further assess this phenomenon we measured serial serum P4, LH, and estradiol levels in 115 consecutive patients undergoing stimulation for IVF/ET with midluteal leuprolide acetate and human menopausal gonadotropins. IVF/ET cycle outcome was retrospectively correlated with P4 levels on the day of hCG administration. Two critical breakpoints were identified, 1.27 nmol/L (0.4 ng/mL) and 286 nmol/L (0.9 ng/mL). Clinical pregnancies occurred in 9 of 18 patients in group I (P4, less than 1.27 nmol/L) compared to 11 of 81 patients in group II (1.27 less than P4 less than 2.86 nmol/L; P = 0.001) and 0 of 14 patients in group III (P4, less than or equal to 2.86 nmol/L) (P = 0.001). Eleven patients in group III had cryopreservation of embryos during that cycle. Six subsequently underwent frozen embryo transfer, and clinical pregnancies occurred in 2, both of whom have delivered. These findings demonstrate that even modest increases in serum P4 levels (greater than 1.27 nmol/L) are associated with reduced pregnancy rates in IVF/ET cycles. In addition, it appears that the mechanism may not exclusively involve poor oocyte quality.

Antineoplastic Agents↗
PubMed1991

Macrophage-conditioned media enhance endometrial stromal cell proliferation in vitro.

It has been hypothesized that the activated peritoneal macrophages of endometriosis, rather than being a response to ectopic endometrium, may contribute to its pathogenesis. This study attempts to define the effect of macrophage-derived growth factors on endometrial stromal cell growth in vitro, as well as the interaction between estrogen and these growth factors. Mouse endometrial stromal cells were prepared and cultured in either a serum-containing, insulin-free medium or a serum-free, insulin-containing medium, and the effects of adding 10% macrophage-conditioned medium on [3H]thymidine incorporation were assessed. Results indicate that macrophage-conditioned medium will increase incorporation in the presence of insulin but not in insulin-free media. Serum can substitute for macrophage-conditioned medium, but the two together show no additive or synergistic effect. The effect of estrogen on this system was determined, and results indicate that estrogen will perform the function of insulin, with an optimal concentration of 10(-10) to 10(-12) mol/L. Thus macrophage-conditioned medium appears to function as a competence growth factor, and estrogen (in appropriate concentrations) functions as a progression growth factor.

Animals↗
PubMed1991

Surgically induced endometriosis does not alter peritoneal factors in the rabbit model.

OBJECTIVE: It was the purpose of this study to examine the cause and effect relationship between alterations in peritoneal factors and the presence of ectopic endometrium in the rabbit model. DESIGN: Forty rabbits had autologous endometrial or omental (control) tissue surgically implanted. Peritoneal fluid (PF) volume, macrophage number, and macrophage activation, as well as the number of implants with adhesions, were compared with values obtained during the initial surgery. The effect of hormonal treatment on these factors was evaluated at a third laparotomy. RESULTS: There was a significant increase (P less than 0.05) of adhesions in animals with endometrial implants. Peritoneal fluid volume, macrophage number, or macrophage activation were not increased in rabbits with endometrial implants as compared with controls, nor was there a response to hormonal manipulation. CONCLUSIONS: These results demonstrate that PF volume, macrophage number, and macrophage activation are not altered by endometrial implants in the rabbit model. This suggests that the increase in these peritoneal factors in women with endometriosis may not be caused exclusively by the presence of ectopic endometrial tissue.

Analysis of Variance↗
PubMed1990

Ovarian cyst aspiration prior to initiating ovarian hyperstimulation for in vitro fertilization.

Twenty-three consecutive patients presenting for in vitro fertilization were evaluated with transvaginal sonography on cycle day 3, prior to initiating ovarian hyperstimulation. Three of these patients were noted to have large ovarian cysts. All three underwent transvaginal aspiration of the cysts, followed immediately by initiation of ovarian hyperstimulation. Following oocyte retrieval, in vitro fertilization, and embryo transfer, all three women achieved pregnancy. We conclude that cyst aspiration is not contraindicated when an ovarian cyst is encountered in the follicular phase of an in vitro fertilization cycle.

Adult↗
PubMed1990

Effects of gonadotropin-releasing hormone agonist and clomiphene citrate on estrogen/progesterone-induced hyperprolactinemia in monkeys.

The effects of follicular phase clomiphene citrate (CC) and two regimens of leuprolide acetate on estrogen-progesterone-induced hyperprolactinemia in nonhuman primates were studied. All groups received estradiol (E2) benzoate (12.5 micrograms intramuscularly on cycle days 2 to 33) and progesterone (P) (silastic implant for cycle days 14 to 33). A gonadotropin-releasing hormone agonist (GnRH-a) (Lupron 0.5 mg daily, TAP Pharmaceuticals, Chicago, IL) was administered from cycle day 2 to 14 in group II and from day 20 of the previous cycle until cycle day 14 in group III. Oral CC was given on cycle days 3 through 7 in group IV. No significant differences of mean E2 and P concentrations were noted between groups. Neither GnRH-a nor CC had an overall effect on E2/P-induced hyperprolactinemia. However, for the 5-day interval at the onset of the P treatment there was a significant increase in prolactin (PRL) secretion for group II (130.4 +/- 30.6) versus group I (53.9 +/- 3.3), group III (64.4 +/- 11.1), and group IV (68.8 +/- 14.3). This suggests that leuprolide may exert a delayed stimulatory effect on PRL secretion, or that complete suppression of the putative paracrine regulation of PRL stimulation may require more than 13 days of GnRH-a administration.

Animals↗
PubMed1990

Effects of tamoxifen on corpus luteum function and luteal phase length in cynomolgus monkeys.

Previous data in nonhuman primates have demonstrated that tamoxifen prolongs the luteal phase without altering reproductive hormone levels. A small study in humans found no effect on menstrual cycle length, but an increase in luteal ovarian steroid levels. In view of these conflicting results, we studied the effect of tamoxifen on corpus luteum (CL) function in monkeys (n = 20). Blood was obtained daily beginning cycle day 8, and sera assayed for estradiol (E2), progesterone (P), luteinizing hormone, and follicle-stimulating hormone. Four days after the midcycle E2 peak, laparoscopy confirmed CL formation, and the animals were administered (1) lactose (n = 7), (2) tamoxifen, 0.5 mg.kg-1.d-1 (n = 6), or (3) tamoxifen, 3.0 mg.kg-1.d-1 (n = 7) for 12 consecutive days. Serum collection continued until cycle day 50 or menses, whichever came first. Results indicate a biphasic response among tamoxifen-treated animals, with 7 of 13 developing prolonged luteal phases. There was, however, no significant difference in luteal phase length among the three groups, although when the two groups given tamoxifen were combined, the difference in luteal phase length versus controls approached significance. No differences were found among peak P levels, mean luteal phase P levels, or mean luteal phase gonadotropin levels. No variables were found to correlate significantly with luteal phase length. These results suggest that luteal phase administration of the antiestrogen tamoxifen does not alter pituitary gonadotropin secretion or CL function. However, tamoxifen does prolong luteal phase length in a subset of monkeys, perhaps via a direct effect on the endometrium.

Animals↗
PubMed1990

Pregnancy rates following tubal anastomosis: Pomeroy partial salpingectomy versus electrocautery.

Eighty-six tubal anastomosis patients were analyzed for successful outcome. Controlling for tubal length, we analyzed a number of possible confounding variables for their effects on pregnancy, including the type of sterilization performed. Results indicated term pregnancies in 63.9% of all patients, with no significant effect seen due to type of sterilization procedure. Monthly fecundity rates and life table analysis similarly demonstrated no significant differences between the two sterilization groups. With the use of multiple logistic regression, only age proved to be a significant predictor of pregnancy (p = 0.008). Type of sterilization as well as other tested variables had no demonstrable effect. We conclude that with careful initial selection of patients, exclusion of women without an anastomosed tube 4 cm or longer, and meticulous surgical technique, successful pregnancy rates higher than those generally quoted can be achieved.

Adult↗
PubMed1989

Gamete intrafallopian transfer vs superovulation with intrauterine insemination for the treatment of infertility.

Superovulation with intrauterine insemination (SO-IUI) has been suggested as an alternative to gamete intrafallopian transfer (GIFT), despite the absence of controlled or comparative trials. We retrospectively analyzed all GIFT and SO-IUI cycles performed concurrently from January 1985 to August of 1987 at a single university center. Pregnancy rates were significantly better for GIFT than SO-IUI (P less than 0.001), with an odds ratio of 3.25 (P = 0.001). Stepwise multiple logistic regression identified factors that correlate with pregnancy: absence of endometriosis (P = 0.05), infertility less than 3 years' duration (P = 0.002), TMS greater than or equal to 30 X 10(6) (P = 0.005), and treatment with GIFT rather than SO-IUI (P = 0.001). These data give a first approximation of the increased efficacy of GIFT versus SO-IUI and provide valuable insight into significant confounding variables to be considered when planning a randomized, prospective trial to evaluate these techniques.

Adult↗
PubMed1989

Effect of ovarian endometriosis on ovulation in rabbits.

To study the relationship between endometriosis and ovulatory dysfunction, we induced ovarian endometriosis in the rabbit model Adipose tissue was placed in the contralateral ovary as a control. Ovulation was induced with human chorionic gonadotropin, and ovulation points were counted before and after induction of endometriosis. Periovarian adhesions were graded, and ovaries were histologically examined. A significant decrease in the number of ovulation points was observed in ovaries with endometrial tissue (p = 0.001) but not in ovaries that contained adipose tissue (p = 0.095). Periovarian adhesions decreased the number of ovulation points (p less than 0.01) in ovaries that contained adipose or endometrial tissues. Multivariate analysis demonstrated that an increase in adhesion severity was correlated with a decrease in the number of ovulation points (p less than 0.05), but endometrial tissue was not (p = 0.45). We conclude that, in the rabbit model, minimal ovarian endometriosis impairs ovulation primarily through a mechanism related to periovarian adhesions.

Analysis of Variance↗