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Biomedical subjects

I D Cooke

Publications and source records attributed to I D Cooke.

At least 163 records · Page 9Linked to original sources
PubMed1990

A quantitative study of endometrial development in the luteal phase: comparison between women with unexplained infertility and normal fertility.

This study compared endometrial development in the luteal phase of women with unexplained infertility (n = 30) with that in women with normal fertility (n = 70) by the use of quantitative histological techniques (morphometric analysis) on endometrial specimens which were precisely timed from the luteinizing hormone surge. When overall endometrial development (histological dating) was considered, the proportion of women with unexplained infertility who had retarded endometrial development (20%) was found to be significantly higher than for women with normal fertility (3%) (P less than 0.01). When individual histological features were considered, women with unexplained infertility were found to have significant deviation from the normal range established from fertile women in only five of the 14 histological features measured. All of these five features related to the glandular but not to the stromal component of the endometrium; four of these five features are related to glandular secretory activity.

Adult↗
PubMed1990

The interaction of parameters of male and female fertility in couples with previously unexplained infertility.

A prospective study was undertaken of the relationship between semen variables, serial endocrine and follicular ultrasound measurements in one complete menstrual cycle, and the treatment-independent chance of conception for couples who were referred with unexplained infertility. For the 91 couples studied, the mean length of infertility was 70 months. A 100% follow-up rate was achieved. When a stepwise analysis was performed examining semen variables and ultrasonographic and endocrine variables, the mean ratio of salivary progesterone/plasma estradiol between days +1 and +3, with respect to the luteinizing hormone surge and the Grade 2 motile sperm density, were the only variables that achieved the 5% level of significance. There was a highly significant relationship between the product of these two variables and the chance of conception. This study clearly demonstrates an interaction between parameters of male and female fertility.

Estradiol↗
PubMed1989

The clinical value of conventional semen analysis.

The objectives of this study were, firstly, to relate semen variables to treatment independent conception rates by life-table analysis after having accounted for known female factors; secondly, to assess the relationship between the length of involuntary infertility before investigation and the predictive value of semen parameters; and thirdly, to examine the relationship between the type of progressive spermatozoal motility and fertility outcome. Laboratory error in the assessment of semen variables was minimized by using one consistent observer. Seven hundred thirty-nine subjects were recruited to the study over a 34-month period, and a 96.5% follow-up rate was achieved. Where the female partner had regular spontaneous ovulation, no pelvic pathology, and more than 48 months' preceding infertility, the Grade 2 motile sperm density (the concentration of spermatozoa exhibiting slow or sluggish linear or nonlinear motility) was the variable that best predicted fertility outcome (X1(2) = 20.24, P less than 0.0001). Where the Grade 2 motile sperm density was below 5 X 10(6)/ml in the latter group (19%), no conceptions were reported at 32 months' follow-up. Semen variables were not of predictive value where there were fewer than 48 months' infertility before investigation, or where the female partner had ovulatory dysfunction or pelvic pathology.

Cell Survival↗
PubMed1989

How precise is histologic dating of endometrium using the standard dating criteria?

Sixty-three endometrial biopsies were dated histologically by using the standard criteria on two separate occasions by the same observer. Overall, it was found that exact agreement occurred in 15 (24%), but disagreement of more than 2 days occurred in 6 (10%). The proportion of exact agreement in the first half of the luteal phase (32%) was found to be significantly higher (P less than 0.05) than that in the second half of the luteal phase (9%). In a separate part of the study, 27 women had two endometrial biopsies, each performed in a separate cycle. The within-subject between-cycle variation of the results of endometrial dating (exact agreement: 4%, disagreement of more than 2 days: 41%) was found to be significantly different from intraobserver variation (P less than 0.01 for both). The amount of intraobserver variation suggests that the traditional dating criteria are not precise enough to quantify corpus luteum function in the second half of the luteal phase, whereas the amount of within-subject between-cycle variation implies that the result of endometrial dating in one cycle cannot be used reliably to predict that of another cycle.

Adult↗
PubMed1989

Differences in the fertility of donor insemination recipients--a study to provide prognostic guidelines as to its success and outcome.

Data on 207 couples attending for donor insemination (DI) were analyzed to determine the differences in fertility of insemination recipients and to provide prognostic guidelines as to its success. This study has shown that DI recipients with no infertility factors whose partners were azoospermic had the highest fecundability (0.178), whereas those with no infertility factors whose partners were subfertile had the lowest fecundability (0.036). Donor insemination recipients with treated endometriosis and ovulatory dysfunction have significantly higher fecundability (0.093 and 0.091, respectively) than those with other infertility factors (0.021) such as fibroids, tubal disease, or a combination of infertility factors. This study provides prognostic guidelines for DI recipients as to its success.

Adult↗
PubMed1989

Screening for cytomegalovirus antibody in a donor insemination program: difficulties in implementing The American Fertility Society guidelines.

With the recommendations of The American Fertility Society that all donors and recipients in a donor insemination programme should be screened for CMV antibody, we have documented the prevalence of CMV antibody in donors, recipients, and their partners in our clinic. Forty percent of our donors were CMV-positive, and in only 35% of the couples were both partners negative. The implications of using exclusively CMV-negative donors are examined. The necessity for further research on the detection and the transmission of various strains of CMV and the effects of cryopreservation on them is emphasized.

Antibodies, Viral↗
PubMed1989

A prospective randomized controlled trial comparing urinary luteinizing hormone dipsticks and basal body temperature charts with time donor insemination.

Especially now with the almost exclusive use of frozen semen, accurate timing of donor inseminations is an important point to address if a successful donor insemination program is to be established. To examine whether the timing of donor inseminations using urinary luteinizing hormone (LH) dipsticks (group 2) was significantly better than using basal body temperature (BBT) charts (group 1) we performed a prospective randomized controlled trial. There was no significant difference between the cumulative pregnancy rates at 6 months (0.23 versus 0.31 for groups 1 and 2, respectively) or the monthly fecundability (0.04 versus 0.07 for groups 1 and 2, respectively). Using these monthly fecundabilities we have calculated that approximately 378 patients in each arm of the trial would be needed to demonstrate a significant difference between the two groups. We therefore conclude that timing donor inseminations using urinary LH dipsticks does not significantly improve the conception rates.

Body Temperature↗
PubMed1989

Is routine examination of the male partner of any prognostic value in the routine assessment of couples who complain of involuntary infertility?

The purpose of this study was to determine whether routine examination of the male partner is of value in assessing couples complaining of involuntary infertility. The relationship between male age, a previous paternity, male physical characteristics, and fertility outcome was examined. Life table analysis was performed after accounting for known female factors. Five hundred forty-four couples were recruited to the study. All conceptions were independent of treatment to either partner in which the female partner was found to be "normal" on investigation. Although male age and several physical characteristics were related to fertility outcome when all couples were examined, this was, by virtue of these variables, being related to female age and the length of involuntary infertility before investigation. When only those couples were examined in which the female partner was normal on investigation (n = 250), past paternity (x1(2) = 4.21, P = 0.040, RR = 1.81) was the only variable that retained a significant relationship to fertility outcome. It was concluded that routine examination of the male partner is of no prognostic value for couples complaining of involuntary infertility.

Adult↗
PubMed1989

The endometrial cycle: the expression of a secretory component correlated with the luteinizing hormone peak.

This paper reports the pattern of production and secretion of a secretory phase epitope in the endometrium of 44 normal fertile women. Peroxidase immunochemistry was used to detect the monoclonal antibody D9B1, which binds to a peptide-associated sialylated oligosaccharide, in endometrial biopsies all chronologically dated from the luteinizing hormone (LH) peak. During the proliferative phase, the epitope was shown to be absent from tissue sections. It first made its appearance within gland cells 2 days after the LH peak. By LH+3 a rapid accumulation of the D9B1 epitope was noted in the base of the cell, below the nucleus. On subsequent days, increasing amounts of the antigen were detected in the apical cytoplasm, apparently in a more concentrated form than in the basal cell zone. On day LH+6, around the time of implantation, secretory vesicles in the cell apex were discharged into the gland lumen where the glycoconjugate finally accumulated. This immunohistochemical approach introduces a new parameter for evaluation of endometrial function and could be used to improve the accuracy of histological assessment of the endometrial cycle.

Adolescent↗
PubMed1989

The hypo-osmotic swelling test and the sperm mucus penetration test in determining fertilization of the human oocyte.

The usefulness of the hypo-osmotic swelling (HOS) test and the sperm mucus penetration (SMP) test as sperm function tests for in-vitro fertilization was analysed in 56 couples. Using logistic regression analysis only the SMP test was independently related to fertilization (P = 0.004), no false negative results were obtained, i.e. no fertilization if sperm from the ejaculate failed to penetrate mucus. The HOS test was of no predictive value. The results justify a further examination of the SMP test in other IVF centres.

Cervix Mucus↗
PubMed1989

Female age, the length of involuntary infertility prior to investigation and fertility outcome.

The objectives of this study were two-fold: firstly to determine whether female age exerts an influence on the fertility outcome of couples attending an infertility clinic, independent of demographic and clinical details; and secondly to examine the relationship between the length of involuntary infertility prior to investigation and the subsequent chance of conception. Seven-hundred-and-thirty-one subjects whose partner did not have azoospermia were recruited to the study. Female age ranged from 20 to 46 (mean = 31.1). The range of involuntary infertility prior to investigation was 12-216 (mean = 62) months. One-hundred-and-twenty-four women conceived. The following variables achieved the 5% level of significance when a stepwise analysis was performed on all cases; the concentration of spermatozoa exhibiting slow or sluggish linear or non-linear motility (chi 2(1) = 17.57, P less than 0.0001, RR = 1.67 per 50 x 10(6)), female age (chi 2(1) = 12.44, P = 0.0004, RR = 0.92 per annum), tubal status (chi 2(1) = 12.22, P = 0.0005, RR = 2.15), length of infertility before investigation (chi 2(1) = 11.22, P = 0.0008, RR = 0.87 per annum) and past paternity (chi 2(1) = 8.43, P = 0.0037, RR = 1.81). Female age was found to be positively correlated with the incidence and severity of ovulatory dysfunction, tubal occlusive disease, pelvic adhesions and endometriosis. Where the female partner was 'normal' on investigation, all conceptions were independent of treatment to either partner.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1989

Antisperm antibodies are more prevalent in men with low sperm motility.

Fifty-six men with low sperm motility (less than or equal to 40% of sperm with forward progression) who attended our infertility clinic were tested for antisperm antibodies (IgG and IgA) using the indirect immunobead test. Nineteen (34%) of these men were found to be positive (greater than 10% binding). This was significantly higher (P less than 0.01) than the incidence (5%) of antibodies in men who attended our infertility clinic with high sperm motility (greater than 40% of sperm with forward progression). It is concluded that significantly more men with low sperm motility have antisperm antibodies. The functional significance of these antibodies warrants further investigation.

Autoantibodies↗
PubMed1989

Suppression of gonadotrophin secretion does not reverse premature ovarian failure.

The effect of prolonged inhibition of gonadotrophin secretion was studied in 12 women with premature ovarian failure. All the patients had plasma concentrations of follicle-stimulating hormone (FSH) greater than 20 i.u./l, and in six, primordial follicles had been seen on ovarian biopsy. Goserelin (Zoladex, ICI), a depot synthetic analogue of luteinizing hormone-releasing hormone (LHRH) was administered by three consecutive 4-weekly injections. Plasma concentrations of luteinizing hormone (LH) fell from 34 (SD 11) i.u./l to 2.4 (SD 1.9) i.u./l, and plasma concentrations of FSH fell from 106 (SD 29) i.u./l to 4.5 (SD 2.6) i.u./l 4 weeks after the first injection. Plasma concentrations of gonadotrophins returned to pretreatment values in every patient within 9 weeks of the final injection of goserelin. Regular ultrasonography during the period following the final injection failed to demonstrate the development of ovarian follicles in any patient, and plasma concentrations of oestradiol remained below 100 pmol/l. This study has failed to show that suppression of gonadotrophin secretion reverses premature ovarian failure.

Adult↗