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Biomedical subjects

H N Sallam

Publications and source records attributed to H N Sallam.

17 recordsLinked to original sources
PubMed2004

Assisted hatching.

Assisted hatching entails the opening or thinning of the zona pellucida before embryo transfer in order to improve the results of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). The technique can be performed mechanically, chemically or with a laser beam. A piezoelectric method has also been described. Meta-analyses of randomised trials have shown that assisted hatching increases the clinical pregnancy, implantation and on-going pregnancy rates in patients with poor prognosis for IVF and ICSI, particularly those with repeated implantation failure. The technique is not without risks, and has been associated with an increased incidence of monozygotic twinning. Nevertheless, it remains an invaluable tool in assisted reproductive technology.

Embryo Transfer↗
PubMed2002

[The ancient Alexandria school of medicine].

A famous medical school was established in old Alexandria during the third century BC. Although mainly Greek in essence, and following the Hippocratic teachings, it was heavily tainted by the medical practices of ancient Egypt. Anatomy was particularly advanced due to the possibility of dissecting the human body. The most important Alexandrian physicians were Herophilus and Erasistratus. Many graduates of this medical school traveled and practiced throughout the Mediterranean basin. Galen, the famous Roman physician studied in Alexandria before practicing in Rome. His teachings and writings survived well into the sixteenth century and formed the basis of more modern medical practices during the renaissance. These writings were conserved partly by Christian monks and partly by Arab and Jewish scholars of the middle ages. The medical school of Alexandria was still active until late in the 3rd century AD. However, it slipped slowly into oblivion after the fire of 389 AD, which also devastated its famous library.

Anatomy↗
PubMed2002

Ultrasound measurement of the uterocervical angle before embryo transfer: a prospective controlled study.

BACKGROUND: The study aim was to determine whether moulding the embryo transfer catheter according to the uterocervical angle measured by ultrasound could improve pregnancy and implantation rates. METHODS: Patients were alternately allocated to one of two groups. In the ultrasound-guided group (n = 320), the catheter was moulded according to the uterocervical angle measured by abdominal ultrasound. In controls (n = 320), embryo transfer was performed using the "clinical feel" method. RESULTS: Moulding the embryo transfer catheter according to the uterocervical angle significantly increased clinical pregnancy [(OR = 1.57, 95% CI (1.08-2.27)] and implantation rates [(OR = 1.47, 95% CI (1.10-1.96)] compared with the "clinical feel" method. It also significantly reduced difficult transfers [(OR = 0.25, 95% CI (0.16-0.40)] and blood during transfers [OR = 0.71, 95% CI (0.50-0.99)]. Patients with large angles (>60 degrees ) had significantly lower pregnancy rates compared with those with no angle [OR = 0.36, 95% CI (0.16-0.52)]. CONCLUSIONS: Moulding the embryo transfer catheter according to the uterocervical angle measured by ultrasound increases clinical pregnancy and implantation rates and diminishes the incidence of difficult and bloody transfers.

Catheterization↗
PubMed1999

Reference values for the midluteal plasma progesterone concentration: evidence from human menopausal gonadotropin-stimulated pregnancy cycles.

OBJECTIVE: To determine reference values for the midluteal plasma progesterone concentration. DESIGN: Retrospective analysis. SETTING: Infertility clinic at an academic medical center. PATIENT(S): One hundred ninety-two infertile women who became pregnant after induction of ovulation with hMG. INTERVENTION(S): The plasma progesterone level was measured during the midluteal phase of the hMG treatment cycle. MAIN OUTCOME MEASURE(S): The midluteal plasma progesterone concentration was correlated with the outcome of the pregnancy. RESULT(S): In this cohort of 192 women in whom ovulation was induced with hMG and 5,000 IU of hCG, the mean midluteal plasma progesterone concentrations were 29.07 ng/mL, 25.85 ng/mL, 31.49 ng/mL, 41.39 ng/mL, and 28.64 ng/mL in all cycles that resulted in pregnancy, cycles that resulted in full-term singleton pregnancy, cycles that resulted in full-term multiple pregnancy, cycles that resulted in preterm pregnancy, and cycles that ended in miscarriage, respectively. There was no statistically significant difference in the progesterone concentration between the cycles that resulted in full-term pregnancy and those that ended in miscarriage, but there was a statistically significant difference between the cycles that resulted in singleton pregnancy and those that resulted in multiple pregnancy. The minimum value that was compatible with a full-term pregnancy in this cohort of women was 10.83 ng/mL. CONCLUSION(S): In a cohort of 192 women, the minimum plasma progesterone concentration on day 7 in women who attained a full-term pregnancy after induction of ovulation with 5,000 IU of hCG was 10.83 ng/mL.

Abortion, Spontaneous↗
PubMed1999

Mathematical relationships between uterine contractions, cervical dilatation, descent and rotation in spontaneous vertex deliveries.

OBJECTIVE: To determine the mathematical relationships between the strength and duration of the uterine contractions, the descent and rotation of the fetal head and the degree of cervical dilatation in 50 multiparous women with spontaneous vaginal deliveries using a simple device applied to the fetal vertex. METHOD: A simple device for monitoring the progress of labor was applied to the fetal vertex. The device allows the continuous monitoring of descent and rotation of the fetal head. The amount of descent and the degree of rotation were also determined by repeated vaginal examinations as well as the degree of cervical dilatation. The frequency of uterine contractions was also recorded on a partogram. RESULT: A good correlation was found between the amount of descent of the fetal vertex (r = 0.975) and between the degree of rotation of the fetal head (0.83) determined by both methods. Multiple regression analysis was then performed and the degree of cervical dilatation in cm at any given time during the first stage of labor was found to be equal to 2.859 + 0.583 fetal head station in (cm) + 0.1983 internal rotation in degrees -0.0493 (station x internal rotation) + 0.1599 station2 + 0.3622 uterine contractions per 10 min. A nomogram was constructed allowing the calculation of cervical dilatation for a given station of the head, degree of rotation and frequency of uterine contractions. CONCLUSION: There is a defined mathematical relationship between the degree of descent and rotation of the fetal head, the degree of cervical dilatation and the frequency of uterine contractions in multiparous women with vertex presentation. The first three variables can be continuously determined by using the described device. Incorporation of the device into a reusable fetal scalp electrode allows the dual mechanical and electronic monitoring during labor with minimal vaginal examinations.

Cervix Uteri↗
PubMed1991

Construction of a local standard symphysis fundal height curves for monitoring intrauterine fetal growth.

The aim of the present study was to construct standard symphysis fundal height percentile curves to be used as a reference chart in monitoring fetal growth. The construction was based on 1185 observations (symphysis fundal height measured to the nearest 0.5 cm by a malleable elastic tape) obtained from follow up of 105 cases of healthy pregnant women who were: sure of date of their last menstrual period, confirmed by early dating scan "before 20th gestational week", experienced a very strict normal course of pregnancy, giving birth to normal term newborn with appropriate weight for gestational age and sex. The selection of the study sample went through several screening levels starting by 4088 cases and ending by 105 cases. The measurements were taken biweekly from the 18th week of gestation to delivery "37-42 weeks of gestation." Tenth, 25th, 50th, 75th, 90th and 95th percentiles were calculated and represented graphically. Mean, mean-1 SD, mean-2 SD, mean +1 SD, mean + 2 SD were also calculated and represented graphically. The curve of best fit was determined by polynominal regression. The resulted percentile curves and mean values were found to be comparable to those in both developed and developing countries. It was recommended to incorporate the reference charts of symphysis fundal height into the maternity services after using it in routine antenatal examination for large number of cases and establishing its sensitivity and specificity.

Anthropometry↗
PubMed1989

A comparison of 2 methods for monitoring gonadotrophin therapy.

One hundred and seventy nine (179) ovarian cycles from 52 patients treated with human menopausal gonadotrophins were retrospectively analysed. Eighty one (81) cycles were monitored by serial measurements of plasma oestradiol concentrations and 98 cycles were monitored by realtime ultrasound scanning of ovarian follicles. The results suggest that realtime ultrasonography, used alone, is a safe and effective method for monitoring gonadotrophin therapy.

Chorionic Gonadotropin↗
PubMed1983

Blood hormone levels in egyptian women on norethisterone oenanthate.

Ten Egyptian women who were using the injectable contraceptive norethisterone oenanthate (NET-OEN) for at least 6 months were monitored weekly for a period of 12 weeks by measuring 3 pituitary hormones (FSH, LH and prolactin) and 2 ovarian hormones (oestradiol 17-B and progesterone). It was concluded that NET-OEN is a strong ovulation inhibitor, at least after its use for 6 months. Prolactin levels were depressed and this is in contradiction with the findings in rats.

Adult↗
PubMed1982

Real time pelvic ultrasonography during the periovulatory period of patients attending an artificial insemination clinic.

Real time ultrasonography was used to examine the ovaries of 50 patients at the calculated time for artificial insemination with donor semen (AID). Forty-two (84%) had one or more follicles greater than 13 mm in diameter. Both ovaries were monitored daily until the main follicle had ruptured (mean number of examinations, 2.4 per patient; range, 1 to 5). Seven women became pregnant (mean follicular diameter, 21.6 mm; range, 18 to 25 mm). The fecundability rate was 12%, compared with 6% for a corresponding group of 50 patients who were not examined with ultrasound. Seven patients experienced mittelschmerz, and in 39 the leading follicle had ruptured before the rise in basal body temperature (BBT). Ultrasonography may be used to confirm the presence or absence of preovulatory follicle prior to treatment.

Body Temperature↗
PubMed1982

Monitoring gonadotrophin therapy by real-time ultrasonic scanning of ovarian follicles.

Real-time ultrasound scanning of ovarian follicles was performed during 61 cycles in 22 infertile patients being treated with sequential injections of human menopausal gonadotrophin (hMG) and human chorionic gonadotrophin (hCG). Total 24-h urinary oestrogens were estimated (and in 13 cycles plasma oestradiol) but the amount of gonadotrophin given was based mainly on the ultrasound findings. A retrospective analysis of the results showed that there was a poor statistical correlation between the diameter of the largest follicle and the total urinary oestrogens (r=0.39) and with the level of plasma oestradiol (r=0.56), although similar clinical information was obtained by all methods. Ovulation was induced in 58 cycles when the leading follicle had a mean diameter of 20-25 mm (mean 21.3 mm); follicular rupture was observed in 57 cycles and in these cases there was biochemical evidence of luteinization (plasma progesterone greater than 15 nmol/1; total urinary pregnanediol greater than 8 nmol/24h). Three patients (three cycles) were not given hCG; one developed micropolycystic ovaries and two showed evidence of hyperstimulation (one follicle greater than 25 mm diameter, three or more follicles 20-25 mm diameter). Twelve patients became pregnant, all with single fetuses. Subsequently one aborted, one had an ectopic pregnancy, three gave birth to normal babies at term and seven pregnancies are continuing. Real-time ultrasound scanning of ovarian follicles is a simple, practical method for monitoring follicular growth during the administration of hMG and predicting the response to hCG.

Chorionic Gonadotropin↗
PubMedDate not supplied

Minimal requirements for a successful outcome in anovulatory patients treated with human menopausal gonadotropins.

OBJECTIVE: To determine the minimal requirements for achieving a full-term singleton pregnancy in hMG-treated patients. METHODS: One hundred and ninety-two pregnancy cycles resulting from hMG therapy in infertile patients were retrospectively studied to determine the minimal requirements for the occurrence of a pregnancy in those women. The cycles were divided into five groups: pregnancies ending in miscarriage, ectopic pregnancies, pregnancies ending in preterm delivery, full-term singleton pregnancies, and full-term multiple pregnancies. The number of hMG ampules, the number of preovulatory follicles reaching 18 mm or more in diameter, the cervical mucus score (Insler), the number of living spermatozoa per high-power field (HPF) observed in the cervical mucus on the day of hCG administration, and the midluteal plasma progesterone concentration were determined and correlated with the outcome of the pregnancy in the five groups studied. The minimal requirements for the occurrence of a full-term singleton pregnancy were also determined. RESULTS: In this cohort of 192 women, the mean number of hMG ampules administered was 25.38 (1903.5 IU), the mean number of preovulatory follicles reaching 18 mm was 2.1, the mean cervical mucus score (Insler) was 9.48, and the mean number of motile spermatozoa per HPF in the cervical mucus on the day of hCG administration was 19.3. There were no statistically significant differences between the five groups studied regarding these four variables. The mean midluteal plasma progesterone concentration was 29.07 ng/mL and there was no statistically significant difference in midluteal plasma progesterone concentration between the cycles resulting in full-term deliveries and those ending in miscarriage. However, a statistically significant difference in midluteal plasma progesterone concentration was found between the cycles resulting in full-term singleton pregnancies and those resulting in full-term multiple pregnancies. CONCLUSIONS: The minimal requirements for achieving a full-term singleton pregnancy were 9 ampules of hMG (675 IU), one 18-mm follicle, a cervical mucus score (Insler) of 6 on the day of hCG administration, and a midluteal plasma progesterone concentration of 10.83 ng/mL. The presence of motile spermatozoa in the cervical mucus was a reassuring sign in 92.7% of instances but was not an absolute necessity for a successful outcome.

Analysis of Variance↗