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J Dor

Publications and source records attributed to J Dor.

At least 109 records · Page 6Linked to original sources
PubMed1989

Suppression with gonadotropin-releasing hormone analogues prior to stimulation with gonadotropins: comparison of three protocols.

This study compared three groups of patients treated with three different protocols of suppression of the pituitary-ovarian axis prior to and during gonadotropin stimulation for in vitro fertilization with a nonsuppressed control group. Patients treated with daily injections of DTRp6 (Decapeptyl 0.5 mg) or with a single injection of Decapeptyl depot (3.2 mg CR) had a longer folicular phase than patients treated with Buserelin (1.2-1.5 mg daily) and the patients in the control group. The number of human menopausal gonadotropin ampules required to reach adequate stimulation was also significantly higher in the former two groups of patients. The number of oocytes recovered (6-7 per patient), fertilized (45-58%) and cleaved (92-100%) did not differ among the groups. Peak estradiol levels and the pregnancy rate were highest in the group treated with Buserelin. The overall picture would indicate that suppression with Buserelin was the least profound.

Adult↗
PubMed1989

Programmed oocyte retrieval: clinical and biological effects of oral contraceptives administered before in vitro fertilization.

We have prospectively compared two regimens of suppression of the hypothalamic-pituitary-ovarian axis by oral contraceptives (OCs) for 15 or 30 days and two ovarian stimulation protocols. The latent phase, which represents a period of ovarian insensitivity, was prolonged and directly correlated to the duration of suppression. Thirty days' suppression, compared with 15 days', resulted in the cancellation of more cycles and a lower fertilization and pregnancy percentage. No significant increase in either serum progesterone or luteinizing hormone was noted in suppressed cycles. It is concluded that if programming is desired, OCs should be used for the shortest period possible. The variation in the length of the follicular phase indicates that there is a different 'fixed' day for retrieval for each suppression-stimulation protocol and this day should be established prospectively.

Adult↗
PubMed1988

The role of early post-implantation beta-HCG levels in the outcome of pregnancies following in-vitro fertilization.

Daily plasma beta-HCG levels from days 11 to 18 after ovum retrieval (OR) were evaluated in a group of 73 women who became pregnant following in-vitro fertilization and embryo replacement (IVF-ER). The 47 patients who had a normal ongoing pregnancy could be distinguished from the 26 patients with a pathological pregnancy (pre-clinical abortion, clinical abortion and tubal pregnancy) by the mean daily beta-HCG levels, their mean daily increase and the intercept and slope of the beta-HCG regression analysis. The mean daily beta-HCG levels of the normal pregnancies were significantly higher than: (i) pre-clinical abortions on days 12-18 after OR; (ii) clinical abortions on days 12-16; and (iii) tubal pregnancies on days 12-17. Using quadratic discriminant analysis, normal and pathological pregnancies could also be distinguished by their absolute beta-HCG levels on day 13 after OR with 27.6 mIU/ml being the cut-off point. Our results indicate that the outcome of pregnancy following IVF-ER could be predicted with a high degree of probability by monitoring daily beta-HCG levels within the first 2 weeks following OR.

Adult↗
PubMed1988

Protocols for induction of ovulation. The concept of programmed cycles.

Programmed oocyte retrieval which includes suppression of the hypothalamic-pituitary-ovarian axis by oral contraceptives or GnRH analogue and predetermined ("fixed") day for ovum pick-up has been demonstrated to yield a pregnancy rate that is comparable to that achieved by the conventional individualized approach to follicular maturation. We have prospectively compared two regimens of suppression (the pill and GnRH analogue) followed by two ovarian stimulation protocols (clomiphene citrate + human menopausal gonadotropin [CC + hMG] and pure follicle-stimulating hormone + human menopausal gonadotropin [pure FSH + hMG]). Sixteen patients were studied in each group. It was found that the latent phase, which represents a period of ovarian insensitivity, was prolonged and directly correlated to the duration of suppression, and that suppression with the GnRH analogue was associated with a shorter latent phase than that with the pill. Suppression with the pill for 30 days compared with 15 days resulted in a greater cancellation of laparoscopic oocyte retrieval, a lower fertilization rate, and a lower pregnancy rate. The numbers of oocytes recovered, fertilized, and cleaved were similar in both stimulation protocols. The use of the GnRH analogue for 30 days compared with 15 days was associated with a lower pregnancy rate, even though the number of oocytes that were recovered and fertilized were similar. Ovarian stimulation with pure FSH + hMG resulted in a shorter latent phase than did stimulation with CC + hMG, but the results of treatment with both protocols were similar. It is concluded that both the pill and GnRH analogue are acceptable means of manipulating the cycle and the day of oocyte retrieval. However, they should be used for the shortest periods possible because prolonged use is associated with some unwarranted effects. For each suppression-stimulation protocol there seems to be a different fixed day for retrieval that should be established prospectively.

Chorionic Gonadotropin↗
PubMed1986

Periovulatory 17 beta-estradiol changes and embryo morphologic features in conception and nonconceptional cycles after human in vitro fertilization.

Thirty-one patients who became pregnant after in vitro fertilization were compared with a matched control group of 31 patients who underwent embryo transfer but did not conceive. During the follicular phase there was no difference in the mean daily estradiol (E2) levels between the pregnant and control groups. In 95% of the women who conceived, E2 continued to rise or plateau on the day after human chorionic gonadotropin (hCG) administration; this pattern was seen in only 62.5% of the control group. There were significantly more "regular" embryos (i.e., those with symmetric blastomeres and no visible cytoplasmic fragments) replaced in patients who became pregnant, compared with the control subjects (65.6% versus 47.0%, P less than 0.05). Embryo regularity was associated with preovulatory E2 pattern; falling E2 levels on the day after hCG administration were associated with transfer of only 18.8% of regular embryos in the control group, whereas in the conceptional cycles with rising E2 levels, 61.5% of the replaced embryos were morphologically regular (P less than 0.01). These results would indicate that changes in the follicular environment as reflected by peripheral E2 levels might affect the developmental potential of the human embryo.

Chorionic Gonadotropin↗
PubMed1986

Treatment-independent pregnancy after in vitro fertilization and embryo transfer trial.

This study indicates that SP occur in a higher percentage than theoretically expected after IVE-ET treatment, but it is not conclusive as to whether the SP is independent or a result of the treatment or operative laparoscopy. Our results are in agreement with those of previous studies that have shown that SP occur with almost all kinds of infertility. We therefore reject the previous suggestion of Steptoe, who argued that to prevent ectopic pregnancy from complicating embryo replacement, preparatory electrocauterization of diseased tube should be performed. We also suggest that as long as the results of treatment are below the normal monthly spontaneous conception rate, there is justification for a prospective random study that includes all diagnoses other than BTB. Such a study might help make any future selection of patients for treatment more appropriate.

Adult↗
PubMed1986

Ultrastructural characterization of human granulosa cells in stimulated cycles: correlation with oocyte fertilizability.

The fine structure of human granulosa cells (GC) obtained in the course of an in vitro fertilization procedure was correlated with oocyte fertilizability. The investigation was performed by light-microscopic and electron-microscopic examination of ultrathin sections and replicas of freeze-fractured material. GC associated with nonfertilizable oocytes (group I) had significantly smaller cell areas, tended to be tightly packed, and exhibited abundant intercellular gap junctions and adherence junctions. Multiple structural variations of cytoplasmic organelles were observed in comparison to cells associated with fertilizable oocytes (group II). Cells in group II tended to be widely dispersed, frequently contained interiorized gap junctional elements (annular junctions), and showed morphologic correlates of high steroidogenic activity. Structural dissimilarities between groups I and II were not consistently related to follicle size, as determined by volume of aspirated follicular fluid. In view of the sequential ultrastructural changes known to occur during follicular maturation and ovulation, it is concluded that GCs related to nonfertilizable oocytes were lacking structural correlates of luteinizing hormone/human chorionic gonadotropin responsiveness.

Adult↗
PubMed1986

Culture of human granulosa cells from an in vitro fertilization program: effects of extracellular matrix on morphology and cyclic adenosine 3',5' monophosphate production.

Human GCs obtained from patients undergoing an IVF procedure and treated with CC, hMG, and hCG, lack cAMP responsiveness to hCG stimulation in vitro. After 48 hours in culture, recovery of cAMP production was significantly higher in hCG-stimulated cells grown on dishes coated with ECM than in cells grown on uncoated dishes. This difference correlated with a higher degree of morphologic differentiation of cells cultured on ECM. It is concluded that ECM provides superior culture conditions for the recovery of hormone-stimulated cAMP production and the maintenance of morphologic differentiation of preovulatory GCs from stimulated cycles.

Adult↗
PubMed1986

Arachidonic acid metabolism in human granulosa cells: evidence for cyclooxygenase and lipoxygenase activity in vitro.

In view of the studies demonstrating the involvement of eicosanoids (prostaglandins and hydroxyperoxides, including leukotrienes) in ovulation in several mammalian species, we have examined the activity of the two enzyme systems, lipoxygenase and cyclooxygenase in human granulosa cells obtained from women undergoing in-vitro fertilization--embryo transfer. The activity of cyclooxygenase was assessed by radioimmunoassay of prostaglandin E and of 6-keto-prostaglandin F1 alpha, the conversion product of prostacyclin, accumulated in the culture medium of granulosa cells. Lipoxygenase activity was detected by the conversion of [14C]arachidonic acid into its products (hydroxyperoxides and leukotrienes) separated by reversed phase high-performance liquid chromatography. The results confirmed the activity of cyclooxygenase in human granulosa cells, production in vitro of prostaglandin E and prostacyclin and demonstrated the presence of active lipoxygenase enzymes. These results support the possible involvement of eicosanoids in ovulation of the human.

Arachidonic Acids↗
PubMed1985

Penetration of sperm from teratospermic men into zona-free hamster eggs.

The ability of sperm samples from male partners of infertile couples, with isolated teratospermia (ITS), to penetrate zona-free hamster eggs was examined. The ITS patients had a significantly lower proportion of normal spermatozoa than did a control group of men of proven fertility (23.6% and 47.8%, respectively; P less than 0.001), while the mean total sperm count and the % motility did not differ between the two groups. The mean hamster egg penetration rate of sperm from ITS patients was 2.64% compared to 31.1% in the control group. A significant negative correlation was found in the ITS group between the proportion of a) abnormal forms and the ability to penetrate zona-free hamster eggs, and b) pyriform-shaped sperm and the penetration rate. Of the sperm parameters which were examined, only the morphology could be correlated with the rate of penetration.

Adult↗
PubMed1985

The diagnosis of ectopic pregnancies in cases of lower abdominal pain using beta subunit assay of human chorionic gonadotropin.

The role of beta-subunit assay of human chorionic gonadotropin (hCG) in the early and accurate diagnosis and treatment of ectopic pregnancy was evaluated prospectively in a group of 57 women who presented with lower abdominal pains. A flow scheme for diagnosis work-up based primarily on hCG beta-subunit assay resulted in no false negative result. This enabled early and conservative treatment of the condition. Ectopic pregnancy was diagnosed early in more than one third of the patients. As a result conservative treatment was performed in cases were it was required and medically possible (33% of the cases).

Abdomen↗
PubMed1985

Conception rate after gonadotropin therapy in hyperprolactinemia and normoprolactinemia.

The cumulative pregnancy rate after gonadotropin treatment was evaluated in 63 hyperprolactinemic and 242 normoprolactinemic women. All pregnancies in the hyperprolactinemic patients were achieved within four treatment cycles; the cumulative pregnancy was 62% as compared with 29% in normoprolactinemics. The same results were obtained when patients were divided according to endogenous estrogenic activity. These results imply that in bromocriptine failures there is no need to lower prolactin levels to achieve pregnancy with gonadotropins.

Amenorrhea↗
PubMed1984

Chromosome analysis of multipronuclear human oocytes fertilized in vitro.

In an in vitro fertilization and embryo transfer program composed mainly of patients with tubal infertility, the incidence of fertilized oocytes with multiple pronuclei was 4.3%. An attempt was made to fix such oocytes with supernumerary pronuclei in order to assess the chromosome constitution of the gametes. Nine multipronuclear oocytes containing a total of 29 pronuclei were successfully fixed before the first cleavage division, and another oocyte containing 3 pronuclei was fixed before the second cleavage division. On analysis, chromosome counts could be obtained for 28 of the 29 total pronuclei, and 24 gave informative results. Nineteen pronuclei had a normal haploid chromosome count, 2 pronuclei contained one extra chromosome, and 3 pronuclei had one chromosome missing. The presence of a Y chromosome in six pronuclei identified their paternal origin; two of the six sperm pronuclei had a 22,Y,-E chromosome constitution. Only three pronuclei could be conclusively ascertained to be maternal in origin, yet two of these were aneuploid; one pronucleus had a 24,X,+D karyotype and the second had only 22 chromosomes. Multipronuclear oocytes present ideal material for analyzing the chromosome constitution of those human gametes which can undergo fertilization in vitro.

Adult↗
PubMed1984

Successful in vitro fertilization and embryo transfer in a group of patients with tubal infertility.

Thirty-one patients with severe mechanical infertility were treated with clomiphene citrate and human chorionic gonadotropin (HCG) at the start of our in vitro-fertilization and embryo-transfer program. Laparoscopies were performed 34 to 36 h after HCG administration in 32 cases, oocytes were recovered in 29 (91%) and in 19 (59%) at least one oocyte was fertilized. Embryos were transferred to the uterus in 12 cases (38%) and a pregnancy was established in a woman in whom 3 embryos were transferred. This pregnancy terminated at the 39th week of gestation with the delivery of a healthy female baby.

Adult↗
PubMed1983

Abortion rate in pregnancies following ovulation induced by human menopausal gonadotropin/human chorionic gonadotropin.

Despite the high incidence of fetal loss following gonadotropin therapy, the etiologic, factors that contribute to this loss remain unknown. In 203 women who conceived following gonadotropin therapy, the abortion rate was 28.5%. However, in 84 women who conceived a second time, also with gonadotropin treatment, the abortion rate was 11.9%. Second- and third-degree hyperstimulation of the ovary are accompanied by a 50% abortion rate, and the occurrence of abortion is more frequent in the first pregnancy. The contribution of multiple pregnancy, maternal age, and number of gonadotropin treatment cycles are also evaluated and discussed.

Abortion, Spontaneous↗