Simultaneous intrauterine and cervical pregnancies after in vitro fertilization and embryo transfer in a patient with a history of a previous cervical pregnancy. Case report.
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Adult↗
Biomedical subjects
G M Masson
Publications and source records attributed to G M Masson.
Size distribution of luteal cells from pregnant and non-pregnant marmoset monkeys and a comparison of the morphology of marmoset luteal cells with those from the human corpus luteum.
The size distribution of marmoset luteal cells was determined on Days 6, 14 and 20 after ovulation in non-pregnant cycles and in early pregnancy. Image analysis was used to estimate the cell diameter of dispersed cells prepared from the marmoset corpus luteum (CL). Steroidogenic cells showed a size distribution consistent with one population of cells. There was a significant increase in mean cell diameter (P less than 0.05) from Day 6 to Day 14 in pregnant and non-pregnant animals with no further increase on Day 20. Micrographs of marmoset luteal tissue showed cells of greater than 10 micron containing the organelles typical of steroid-producing cells, and smaller non-steroidogenic cells surrounding the steroid-producing cells. On the basis of microscopy, there were no areas within the CL where cell composition was noticeably different. In contrast, micrographs of human luteal tissue showed two types of steroidogenic cell; most cells were similar to those in the marmoset CL but a smaller population of smaller cells could be distinguished around the periphery and along vascular septa. It is likely that these smaller and larger types of steroidogenic cells are of theca and granulosa cell origin respectively, the two cell populations differing in the degree of electron density and amount of rough endoplasmic reticulum. A distinguishing feature between marmoset and human luteal cells was the shape of the mitochondrian which were considerably rounder in marmoset luteal cells. The origin of steroidogenic cells in the marmoset CL is unclear, although in marmosets and man the luteal cell types display morphological characteristics distinct from the large and small luteal cells described for CL of the domestic ungulates.
Animals↗
Trial of support treatment with human chorionic gonadotrophin in the luteal phase after treatment with buserelin and human menopausal gonadotrophin in women taking part in an in vitro fertilisation programme.
OBJECTIVE: To evaluate the effect of support with human chorionic gonadotrophin in the luteal phase in women taking part in an in vitro fertilisation programme after buserelin and human menopausal gonadotrophin were used to hyperstimulate their ovaries. DESIGN: Controlled group comparison. SETTING: Outpatient department of a private hospital. PATIENTS: 115 Women with indications for in vitro fertilisation, all of whom had at least one embryo transferred. INTERVENTIONS: After suppression of the pituitary with buserelin the ovaries of all the women were stimulated with human menopausal gonadotrophin on day 4 of the luteal phase. Human chorionic gonadotrophin (10,000 IU) was given to induce ovulation, and oocytes were recovered 34 hours later. Embryos were transferred 46 to 48 hours after insemination. Women who had received the 10,000 IU of human chorionic gonadotrophin on a date that was an uneven number (n = 61) were allocated to receive support doses of 2500 IU human chorionic gonadotrophin three and six days after that date. The remaining 54 women did not receive hormonal support. END POINT: Determination of the rates of pregnancy. MEASUREMENTS and main results--Support with human chorionic gonadotrophin did not significantly alter the progesterone or oestradiol concentrations in the early or mid-luteal phase. The mean (range) progesterone concentrations in the late luteal phase in women who did not become pregnant were, however, significantly higher in those who received support (16(9-110) nmol/l nu 8(4-46) nmol/l), and the luteal phase was significantly longer in this group (14 days nu 12 days). The rate of pregnancy was significantly higher in the women who received support than in those who did not (25/61 nu 8/54). CONCLUSIONS: When buserelin and human menopausal gonadotrophin are used to hyperstimulate ovaries support with human chorionic gonadotrophin in the luteal phase has a beneficial effect on in vitro fertilisation.
Adult↗
Augmentation by epidermal growth factor of basal and stimulated progesterone production by human luteinized granulosa cells.
Human granulosa cells were prepared from follicular aspirates obtained during oocyte collection for in vitro fertilization. Following several days in culture, cells were washed and then progesterone output was measured in 2-h incubations. After culture for 3 days, incubated cells responded well to human chorionic gonadotrophin (hCG) and prostaglandin (PG) E2 with similar levels of maximum response. Exposure of cultured cells to epidermal growth factor (EGF) for 2 days (days 3-5) led to substantial increases both in basal production and in responses to hCG and PGE2 during subsequent incubations. These effects of EGF were not accompanied by measurable increases in DNA levels in cultures over this time. Results may point to a possible paracrine role for EGF-like factors modulating the activity of cells forming the early corpus luteum.
Cells, Cultured↗
The OVEIA assay, a simultaneous measurement of oestrone and pregnanediol glucuronides, for studying the treatment of infertility patients.
A new simple assay developed for establishing the limits of the fertile period was evaluated in infertility patients. This assay is a colorimetric method for measuring the oestrone glucuronide/pregnanediol glucuronide ratio. Steroid levels were assayed simultaneously and an index of their ratio was obtained in this dual analyte assay (DAA). Twenty subfertile women, receiving clomiphene citrate for ovulation induction, were monitored for the DAA index using early morning urine samples. Ten of these women were also monitored in a pretreatment cycle. A further 10 patients on an in-vitro fertilization (IVF) programme were assessed with the same assay. DAA ratios were found to correlated with follicular phase serum oestradiol levels. Peak DAA ratios dropped dramatically when significant rises in urinary luteinizing hormone concentrations occurred prior to ovulation. An association between high DAA ratios and adequate luteal phase activity was also established. In addition, the total volume of the three largest ovarian follicles, as measured by ultrasound, in IVF patients was found to correlate with DAA measurements.
Adult↗
Iodination of a long-acting analogue of luteinizing hormone releasing hormone: separation of reaction products by column liquid chromatography and measurement of biological activity.
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Amino Acids↗
Early conceptual loss in subfertile patients.
The incidence of early conceptual loss was studied in 27 subfertile women by measuring their serum and urine hCG levels in the luteal phase. Eleven patients eventually had clinically confirmed pregnancies, nine of whom had had significant hCG elevations in previous menstrual cycles. In the remaining 16 patients, who have so far failed to achieve a clinical pregnancy, only three had had elevated hCG results. Thus 'apparent' early conceptual loss in non-pregnancy cycles was found to be more often associated with the fertile group of patients.
Abortion, Spontaneous↗
Incarceration of the retroverted gravid uterus at term. Case report.
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Adult↗
Serum chorionic gonadotrophin (hCG), schwangerschaftsprotein 1 (SP1), progesterone and oestradiol levels in patients with nausea and vomiting in early pregnancy.
Serum concentrations of human chorionic gonadotrophin (hCG), schwangerschaftsprotein 1(SP1), progesterone and oestradiol were measured in 116 pregnant women experiencing varying degrees of nausea and vomiting or no nausea at all at between 9 and 16 weeks gestation. The patients were categorized into four groups, namely asymptomatic, nausea alone, nausea and vomiting and hyperemesis gravidarum. The distribution of levels for each group were examined in relation to the calculated normal ranges. Statistically higher hCG levels were found in out-patients with nausea alone or nausea and vomiting than in the asymptomatic women. No significant differences were found between the groups for any of the other measured variables, including the progesterone/oestradiol concentration ratio.
Chorionic Gonadotropin↗
Lack of direct inhibitory action of oxytocin on progesterone production by dispersed cells from human corpus luteum.
Suspensions of luteal cells were prepared from samples of human corpora lutea obtained during the luteal phase of menstrual cycles. Addition of oxytocin (1 mumol/l) to the various cell preparations had no effect on either basal production of progesterone or on steroidogenic responses to a range of concentrations of gonadotrophin.
Adult↗
Pregnancy-specific-beta 1-glycoprotein: effect on lymphocyte proliferation in vitro.
The effects of three different preparations of pregnancy-specific-beta 1-glycoprotein (SP1) were investigated in parallel with progesterone, oestradiol and human chorionic gonadotrophin (hCG) on the proliferative response of lymphocytes in the mixed lymphocyte reaction (MLR), and to the mitogens phytohaemagglutinin (PHA) and pokeweed mitogen (PWM). A dose-related inhibition of the MLR was obtained with SP1 at 2.5-10 mg/l. SP1 also inhibited the PHA response at 10 mg/l, but had no effect on the PWM response at these concentrations. Progesterone and oestradiol inhibited all systems at 10-20 mg/l while hCG inhibited all systems at 1500-3000 IU/ml. The observations suggest that SP1 selectively inhibits the proliferative responses of T lymphocytes at the concentrations studied.
Chorionic Gonadotropin↗
Effects of a long-acting analogue of LH releasing hormone on human and rat corpora lutea.
Dispersed luteal cells were prepared both from samples of human corpora lutea obtained during normal menstrual cycles and from luteinized rat ovaries of animals pretreated with pregnant mare's serum gonadotrophin and human chorionic gonadotrophin (hCG). Addition of the long-acting analogue, D-Ala6-des-Gly10-LH releasing hormone ethylamide (D-Ala6-LHRH), to rat luteal cells caused a small but significant increase in progesterone production. An inhibitory action of the analogue on hCG-stimulated steroidogenesis by rat luteal cells was confirmed. Addition of D-Ala6-LHRH to suspensions of human luteal cells had no effect on either basal or hCG-stimulated progesterone production. Studies on the interaction of 125I-labelled D-Ala6-LHRH with the dispersed cell preparations, while confirming the presence of displaceable binding to rat luteal cells, failed to detect any equivalent binding to human luteal cells. Low levels of displaceable binding observed using homogenates of human corpora lutea are interpreted as being of doubtful physiological significance in view of the negative findings obtained with the intact cell system.
Animals↗
Inhibitory action of chemically deglycosylated human chorionic gonadotrophin on hormone-induced steroid production by dispersed cells from human corpus luteum.
The biological activity of deglycosylated human chorionic gonadotrophin (hCG) prepared by treatment of the native hormone with anhydrous hydrogen fluoride was evaluated using suspensions of dispersed cells from biopsies of human corpus luteum obtained during the luteal phase of normal menstrual cycles. A reproducible pattern of response to hCG in terms of progesterone production by luteal cells was established for a range of luteal ages. Deglycosylation of hCG led to a diminished level of maximum response to the hormone. Co-incubation of luteal cells with a level of hCG just sufficient to elicit a maximum response and increasing concentrations of deglycosylated hCG led to a progressive inhibition of the hormonal response; at a concentration of 10(3) ng deglycosylated hCG/ml (a tenfold excess of deglycosylated hCG over the native hormone), hCG-induced progesterone production was reduced by about 50%. Deglycosylated hCG therefore acts as a partial antagonist for the action of hCG on human luteal cells.
Chorionic Gonadotropin↗
Value of Schwangerschaftsprotein 1 (SP1) and pregnancy-associated plasma protein-A (PAPP-A) in the clinical management of threatened abortion.
Pregnancy-associated plasma protein-A (PAPP-A) and Schwangerschaftsprotein 1 (SP1) levels were measured in single serum samples from 60 patients admitted with vaginal bleeding in the first 14 weeks of pregnancy. When based on ultrasound diagnoses the prediction of non-viability (the predictive value) was 97% for SP1 and 84% for PAPP-A. Whereas the prediction of viability (above -2SD of the normal range) with SP1 was 88% the value with PAPP-A was only 57%; the poorer result obtained with PAPP-A probably reflects its longer half-life. Pregnancy outcome is not related to the duration of bleeding.
Abortion, Threatened↗
Development of a radioimmunoassay for pregnancy-associated plasma protein A and establishment of normal levels in the first trimester of pregnancy.
An accelerated double antibody method has been developed for the radioimmunoassay of pregnancy-associated plasma protein A (PAPP-A) in serum. The workable range for the assay was 0.04-1.8 mg/l of serum. PAPP-A levels were determined in single serum samples from 110 women with prospective normal pregnancies of between 7 and 14 weeks' gestation. The level of pregnancy specific beta 1 glycoprotein (SP1) was also measured in these samples and normal ranges for PAPP-A and SP1 were constructed from the results obtained.
Female↗
Comparison of serum and urine hCG levels with SP1 and PAPP-A levels in patients with first-trimester vaginal bleeding.
Serum levels of human chorionic gonadotropin (hCG) in patients with threatened abortion are compared to the values in normal pregnancy. The predictive value was 93%, the sensitivity was 84%, and the prediction of gestational viability was 81% for the threatened group. These results compare favorably with urinary pregnancy testing and are similar to those obtained with the assay of Schwangerschaftsprotein I. Human chorionic gonadotropin was, however, a much better predictor of pregnancy outcome than pregnancy-associated plasma protein-A.
Abortion, Threatened↗
Improved separation of motile sperm in asthenospermia and its application to artificial insemination homologous (AIH).
A method is described for the separation of motile sperm from semen by "migration' into a diluent, providing a large area of interface between the semen and the diluent and resulting in a good yield of motile sperm (58%), with a mean percentage of motility of 95%. The method provides a specimen free of seminal plasma and debris and suitable for intrauterine insemination in less than two hours. The motile fraction was used for AIH treatment of 20 couples with a mean of 4 years' infertility, where the female factor had been excluded and the male was asthenospermic. After a mean of six cycles, three pregnancies were achieved. Improvement of the percentage of motility alone did not, in this study, give a significant improvement in conception rates when compared with accepted cycles with the placebo.
Adult↗
Stimulation by human chorionic gonadotrophin of oestradiol production by dispersed cells from human corpus luteum: comparison with progesterone production; utilization of exogenous testosterone.
Cell suspensions were prepared from tissue samples of human corpora lutea obtained during the mid- and late-luteal phase of the menstrual cycle. Both oestradiol and progesterone production by dispersed cells were stimulated by similar concentrations of human chorionic gonadotrophin (hCG). As the degree of stimulation of production by hCG was greater for progesterone than for oestradiol (five- to tenfold compared two- to threefold higher than basal production), the ratio of progesterone to oestradiol produced varied according to the level of trophic stimulation. A comparison of cell suspensions prepared form mid- to late-luteal phase corpora lutea, exposed to the same concentration of hCG (10 i.u./ml) in vitro, did not reveal a shift to oestradiol production in the late-luteal phase. Provision of additional testosterone during incubation raised the level of oestradiol production by dispersed luteal cells. At an optimum concentration of testosterone (l mumol/l), oestradiol synthesis was not raised further in the presence of hCG or N6, O2'-dibutyryl cyclic AMP, suggesting a lack of induction or activation of the aromatase system by gonadotrophin in short-term cultures. Basal and stimulated levels of progesterone production were not significantly impaired in the presence of testosterone.
Chorionic Gonadotropin↗