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Biomedical subjects

F Bonilla-Musoles

Publications and source records attributed to F Bonilla-Musoles.

At least 19 recordsLinked to original sources
PubMed1992

[Abdominal, perineal and vaginal sonographic diagnosis of cervix insufficiency].

In patients with cervical incompetence, the diagnostic efficiency of abdominal, perineal and vaginal sonography was compared. 73 patients, who were divided into three groups, were examined: Group A (n = 50) control group, Group B (n = 11) normal pregnancies, Group C (n = 12) pregnancies with demonstrated cervical incompetence. According to our results, using vaginal sonography, only the incompetent pregnancies showed significant shortening of the cervical length. Characteristic scans were also obtained (membrane herniation) which were useful in diagnosis and control in the performance of cerclage.

Abortion, Habitual↗
PubMed1992

Relativity of the concept 'high responder to gonadotrophins'.

Regression analysis of the proportion of unfertilized oocytes on the number of oocytes retrieved per patient was applied to three different ovarian stimulation protocols in order to establish the relativity of the concept 'high responder to gonadotrophins' for in-vitro fertilization (IVF) patients. After fitting the data to the model: probit(proportion of unfertilized oocytes) + 5 = intercept + B Log10(oocytes retrieved per patient), women with a number of oocytes retrieved greater than or equal to the value necessary to obtain 50% fertilization were defined as high responders. Exogenous gonadotrophin stimulation which was commenced after complete suppression of ovarian activity by a gonadotrophin-releasing hormone analogue (GnRHa) (long protocol) resulted in a significantly higher number of oocytes retrieved (10.15) to obtain 50% fertilization compared to a short protocol (6.84) (exogenous stimulation began 2 days after the GnRHa administration). Women stimulated without use of a GnRHa showed an intermediate response. Implantation, pregnancy and miscarriage rates showed no difference between low-moderate and high responders. These results demonstrate the relativity of the concept 'high responder to gonadotrophins' and indicate that the drawback of low fertilization in high responders could be balanced by the high number of oocytes retrieved per patient (and available embryos for transfer) and the selection of the best embryos for transfer.

Adult↗
PubMed1991

Comparison of implantation and early development of human embryos fertilized in vitro versus in vivo using transvaginal ultrasound.

Several reports in the literature suggest delayed implantation of in vitro-fertilized human embryos compared to in vivo-fertilized eggs. The use of high-frequency transvaginal transducers for early detection of pregnancy has allowed the identification of the gestational sac with very low serum human chorionic gonadotropin (beta-hCG) levels. Thus, the present study evaluated whether retarded implantation can be identified using this novel technology. We studied 13 single pregnancies after in vitro fertilization (IVF) and 14 pregnancies after artificial insemination either by husband (n = 6) or donor (n = 8). In the IVF patients, oocytes were retrieved 35 hours after hCG administration. Embryo transfer occurred approximately 48 hours after retrieval. Artificial insemination was performed 24 and 48 hours after hCG administration. Transvaginal ultrasound scans and serum beta-hCG levels were evaluated every 3 days starting day 12 post-hCG administration. Serum beta-hCG levels rose in parallel when in vitro- and in vivo-fertilized embryos were compared. Similarly, there was no difference between groups in the mean time needed to detect early embryonic structures, such as the embryonic sac, yolk sac, and heartbeats, or the growth rate of the gestational sac. In conclusion, there was no difference in detecting implantation and early embryonic development of human embryos fertilized in vivo versus in vitro as ascertained by ultrasound scans and serum beta-hCG levels. An embryonic sac is detected 23-24 days after hCG administration in pregnancies achieved by assisted reproductive techniques.

Amnion↗
PubMed1991

Failed in vitro fertilization of human oocytes: a cytogenetic analysis.

OBJECTIVE: To investigate possible causes of in vitro fertilization (IVF) failure. DESIGN: A retrospective cytogenetic study of human oocytes divided into four groups or, alternatively, into two groups according to fertilization rates and whether the patients became pregnant or not. Two additional groups included oocytes in which there was no or only partial fertilization. SETTING: Primary treatment of infertility in an institutional practice. PATIENTS, PARTICIPANTS: Two hundred fifty-three inseminated-unfertilized oocytes from 87 women entering the IVF program because of tubal, unknown, and male infertility. Immunological infertility was excluded. INTERVENTIONS: Ultrasound-guided transvaginal follicular aspiration. MAIN OUTCOME MEASURE(S): Planned after data collection. RESULTS: The rate of chromosome anomalies did not show any significant difference among the four groups established according to the fertilization rate and between pregnant and nonpregnant patients. Independently, our data identified male factor as responsible for 41%, chromosome anomalies 19.3%, oocyte immaturity 11.8%, and unknown etiology 41% of fertilization failures (based on analysis of 161 oocytes). CONCLUSIONS: Fertilization rate and pregnancy outcome after IVF are not related to the incidence of oocyte chromosome anomalies.

Analysis of Variance↗
PubMed1990

How accurate is ultrasonography in monitoring IUD placement?

The insertion of two different types of intrauterine devices (Multiload 250 and Silver T) has been monitored in 97 patients through systematic exploration by echography and hysteroscopy. Both techniques seem to be highly reliable in spite of the observation of 9% misplacements of the IUDs not detected by echography. In addition, hysteroscopy enables the diagnosis of frequent associated pathology (endometrial hyperplasia, endometriosis, polyps) difficult to diagnose by echography. The present study demonstrates the fact that the ultrasonography confirmation of IUD localization in the uterus was not always accurate.

Female↗
PubMed1990

Distribution of involucrin in normal and pathological human uterine cervix.

A study was undertaken to determine the potential value of involucrin immunostaining, a protein synthesized by mature squamous epithelial cells, in distinguishing benign from neoplastic lesions in cervical pathology. A total of 146 cervical biopsies were analyzed using an indirect immunoperoxidase method and polyclonal antibody. A suprabasal homogeneous cytoplasmic staining pattern was consistently observed in normal squamous cervical epithelium. In contrast, 43.7% of cervical condylomas showed involucrin at all levels of the epithelium including the basal layer. Variable patterns were seen in cervical intraepithelial neoplasia (CIN), with 46% of full-thickness stainings, although no significant difference was obtained among the different grades of CIN lesions. Distribution of involucrin was correlated (P less than 0.05) with the degree of tumor differentiation in squamous cell carcinomas, being absent in 71.4% of poorly differentiated carcinomas and focally present in 75% of well-differentiated carcinoma. Lesions of endocervical origin, either benign or malignant, were entirely negative for involucrin. It is concluded that involucrin seems unable to establish a reliable differential diagnosis between benign and neoplastic conditions in cervical pathology, and should therefore be considered only a specific marker of squamous differentiation in both normal and pathological human uterine cervix.

Adult↗
PubMed1990

[Pathology of the yolk sac: endosonographic results].

The yolk sac is the first embryonic structure that is observed by vaginal sonography. It shows up between the fourth and fifth week as regular ring inside the gestational sac. In this study the normal growth of the yolk sac is standardised through the measuring of its diameter, perimeter and area from its appearance till the twelfth week. The aim of this work is to discover the alterations in its size and echographic picture, and to study their repercussions in the foetus.

Abortion, Threatened↗
PubMed1990

[Hysterosalpingography: synechiae? Gartner's ducts?].

A linear shadow parallel to the uterus longitudinal axis, was observed in a hysterosalpingography (HSG) and has set up a controversy between synechiae and Gartner's ducts, without reaching a definitive conclusion. A case like this does not seem to have been published previously.

Adult↗
PubMed1989

Abdominal ultrasonography versus transvaginal scanning: accuracy in follicular development evaluation and prediction for oocyte retrieval in stimulated cycles.

Abdominal and vaginal sonographic monitoring were compared in 45 patients undergoing follicular development for the purposes of artificial insemination (N = 22) and in vitro fertilization (IVF; N = 23). Transvaginal sonography recorded a significantly (p less than 0.05) higher number of follicles from cycle day 10 on, compared to the abdominal (sector and linear) approach. Starting on day 8, the size of the dominant follicle was also significantly (p less than 0.05) higher when transvaginal endosonography was used. The number of follicles greater than 15 mm on the day of human chorionic gonadotropin (hCG) administration was correlated with the number of oocytes retrieved in patients undergoing IVF. There was a significant linear correlation when transvaginal (r = 0.86, p less than 0.001) and sector (r = 0.57, p less than 0.05) scans were used.

Female↗
PubMed1989

Distribution of epithelial antigens in the human uterine cervix: a review.

Epithelial antigen immunostaining in the uterine cervix has been claimed to be helpful in the identification and classification of rare lesions, evaluation of basement membrane integrity, study of atypical condylomas, immunodetection of proliferating processes and early diagnosis of malignant transformation. The present review attempts to demonstrate the potential value of immunohistological techniques as a means of identifying normal and abnormal patterns of antigenic expression in cervical epithelium.

Antigens, Neoplasm↗
PubMed1989

Precocious appearance of markers of squamous differentiation in metaplastic cells of human endocervix.

We used immunoperoxidase methods employing antibodies against involucrin and filaggrin, both markers of squamous terminal differentiation, to study squamous metaplastic transformation in the human endocervix. Expression of involucrin and filaggrin was restricted to squamous metaplastic cells whereas columnar epithelial cells were constantly negative. Immature squamous metaplastic epithelium also showed a positive immunostaining. In mature squamous metaplasia a suprabasal homogeneous staining pattern similar to that found in the exocervical epithelium was detected, although with full-thickness filaggrin immunoreactivity in 45% of cases (P less than 0.05). These results support the hypothesis of an epithelial origin of reserve subcolumnar cells, and suggest that precocious squamous differentiation seems to take place in metaplastic cells of the human endocervix.

Adult↗
PubMed1989

[Vaginal endosonography in extrauterine pregnancy].

The real value of vaginal sonography in the early diagnosis of ectopic pregnancy was assessed in 12 cases where ectopic pregnancy was suspected by clinical evolution and levels of B-HCG, and subsequently confirmed by microlaparotomy. The results were compared with those obtained with abdominal sonography and values of B-HCG. Vaginal sonography gave no false negatives and the percentage of false positives was 16.6%. The most typical echographyc images were: 1. Adnexal Mass (50%), 2. Pseudoring (42%), 3. Yolk sac &/or Embryo &/or Heart rate (25%). Values of B-HCG greater than 600 mIU/IS without embryo from 35th day are highly suspicious with regard to ectopic pregnancy.

Adult↗
PubMed1989

Ovarian response and outcome of in-vitro fertilization in patients treated with gonadotrophin-releasing hormone analogues in different phases of the menstrual cycle.

Gonadotrophin-releasing hormone analogues (GnRH-a) are currently used in combination with gonadotrophins in ovarian stimulation for in-vitro fertilization (IVF). The present study evaluates follicular recruitment and outcome of IVF in patients treated with GnRH-a, starting in different phases of the menstrual cycle. Ovarian quiescence was achieved by s.c. injection of a GnRH-a (600 micrograms/day). Three groups of patients were randomly established. Patients in group 1 (n = 14) started GnRH-a treatment 4-7 days after ovulation. Women in group 2 (n = 15) started GnRH-a 8-10 days after ovulation. Patients in group 3 (n = 15) began the analogue 1-3 days after the onset of menses. Multiple follicular development was achieved by a combination of pure follicle-stimulating hormone and human menopausal gonadotrophin. Oocyte collection was performed 35 h after administration of human chorionic gonadotrophin. Luteolysis was successfully induced in 15% of cases in group 1 and 40% in group 2. Ovarian arrest was achieved in a significantly (P less than 0.01) shorter period of time in group 3 in comparison to groups 1 and 2. There was no difference between groups in the dose of gonadotrophins necessary to reach an optimal response. Patients in group 1 showed a significant decrease (P less than 0.05) in the number and size of follicles developed in comparison to groups 2 and 3. Fertilization and cleavage rates were similar in all three groups. The pregnancy rate was 40% in group 3, while it decreased to 14.3 and 13.3% in groups 1 and 2, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Is the retrieval of high numbers of oocytes desirable in patients treated with gonadotrophin-releasing hormone analogues (GnRHa) and gonadotrophins?

Continuous administration of gonadotrophin-releasing hormone analogues (GnRHa) in patients stimulated for the purpose of IVF might have a direct effect on the ovary. We have evaluated the IVF outcome of patients treated with Buserelin and subsequently with a combination of follicle-stimulating hormone (FSH) and human menopausal gonadotrophin (HMG). Patients were divided into three groups according to the number of oocytes obtained by transvaginal ultrasound-guided follicular aspiration: group 1 (n = 35), in which 1-5 oocytes were retrieved; group 2 (n = 30), in whom 6-10 oocytes were obtained; group 3 (n = 32), in whom greater than or equal to 11 oocytes were collected. Only couples with normal semen samples at oocyte retrieval were included in this study. The dose of Buserelin employed was not different between groups. However, the amount of FSH/HMG necessary to reach an optimal response significantly (P less than 0.01) decreased as follicular development increased. The quality of the oocytes obtained was evaluated based on the appearance of the oocyte-corona-cumulus complex, fertilization rate, morphological appearance of the embryos, and implantation rate. The fertilization rate was significantly (P less than 0.01) decreased in group 3 (57.2%) in comparison with groups 1 (77.1%) and 2 (74.2%). There was no significant difference between the groups in the quality of the embryos obtained or the quality of those replaced into the uterus. The implantation rate per embryo transferred was significantly (P less than 0.05) higher in group 1 (16.5%) in comparison with groups 2 (6.6%) and 3 (8.2%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Sonographic diagnosis of holoacardius].

In the 28th week of gestation a normal foetus and a holoacardius were diagnosed via sonography in a biamnotic monochoriatic twin pregnancy. The growth of the foetuses was observed under continuous sonographic control up to the 40th week of pregnancy. The patient delivered a healthy twin by Caesarean section and the acardius was subjected to a postmortem. Macroscopic and histological findings in the foetus, the placenta and the umbilical cords are demonstrated. The pathogenesis of the holoacardius is discussed as being due to chromosomal aberrations and foeto-foetal transfusion syndrome.

Abnormalities, Multiple↗