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Biomedical subjects

J H Check

Publications and source records attributed to J H Check.

At least 235 records · Page 13Linked to original sources
PubMed1989

Pregnancy in premature ovarian failure after therapy with oral contraceptives despite resistance to previous human menopausal gonadotropin therapy.

We report the case of a 35-year-old woman with premature ovarian failure that was documented at 29 years of age, who wanted to conceive. Although she failed to respond to high doses of menotropin therapy, she ovulated and conceived after she took an oral contraceptive. The oral contraceptive was used to reduce the elevated level of gonadotropins in an effort to restore receptors to the luteinizing hormone and follicle-stimulating hormone, which theoretically may have been down-regulated.

Adult↗
PubMed1989

Ovulation induction and pregnancy with an estrogen-gonadotropin stimulation technique in a menopausal woman with marked hypoplastic ovaries.

A case is described of a woman with ovarian failure and documented atrophic ovaries in whom ovulation was achieved with the use of high-dose estrogen and human menopausal gonadotropins. The proposed mechanism involves a reduction in the elevated gonadotropins, which restored an adequate number of receptors. Thus sensitivity to exogenous menotropins was reestablished.

Adult↗
PubMed1989

Amenorrhea in an ovulatory woman despite a normal uterine cavity: case report.

A 35-year-old nulliparous woman came to us for treatment of amenorrhea. Evaluation demonstrated normal ovulation with appropriate results of sequential endometrial biopsies during the luteal phase. The only abnormality found was an elevated serum level of follicle-stimulating hormone in the early follicular phase, and it is hypothesized that this somehow leads to atrophy of the endometrium without shedding.

Adult↗
PubMed1989

Male sex preselection: swim-up technique and insemination of women after ovulation induction.

Insemination of women with sperm treated by the swim-up technique resulted in 81% male offspring. This was achieved even in women taking ovulation-inducing drugs, in whom the albumin gradient separation technique not only is not effective in male preselection but in which the female sex is favored. Confirmation of these initial data is needed as well as an investigation of the swim-up's efficacy of producing male offspring in women not taking ovulation-inducing drugs.

Clomiphene↗
PubMed1989

Interpretation and misinterpretation of semen parameters.

Semen analysis, which is traditionally used to evaluate male fertility, may be misleading if sample is lost or inadequately mixed. A short or excessive abstinence period may cause a low count or a high count with low motility. Damage from low temperature or delay in evaluation may decrease the reported motility. Computer-assisted semen analysis has eliminated some of the variability and has allowed the evaluation of other sperm motion variables such as sperm velocity, linearity, maximum and mean amplitude lateral head displacement, and beat-cross frequency. These measurements may also occasionally be misleading. Other tests may give a better indication of the function of sperm. The hamster egg penetration test has been used but is technically difficult, and perhaps that is why there is controversy as to the clinical value of the test in predicting subfertile sperm despite normal conventional semen analysis. Some recent data suggest that the hypo-osmotic swelling test, which determines the functional integrity of the sperm membrane, may be the appropriate prognosticator. There is a need for further studies to define the best method to determine whether a male factor is responsible for a couple's infertility.

Diagnosis, Computer-Assisted↗
PubMed1989

Transmission of sexually transmitted diseases by donor semen.

Therapeutic insemination by donor (TID) is being used with increasing frequency. Because many diseases, some of which are lethal, can be transmitted through semen, the American Fertility Society established guidelines for use of donor sperm. They limit TID to cases of male infertility or hereditary/genetic disorders. Donor selection requires good health and absence of genetic abnormalities; criteria for semen including normal sperm motility, concentration, and normal morphology, and blood screening for infectious agents. Human immunodeficiency virus (HIV) testing should be performed initially in donors for fresh semen inseminations. If positive, the assay is verified with a Western blot test; if negative, the donor should be screened at 6-month intervals. Frozen samples should not be used until the 180 day reevaluation of the donor. Many studies show higher pregnancy rates using fresh rather than frozen semen samples for insemination. New methods of cryopreservation minimize the deleterious effects of freezing. If these effects, namely decreased sperm motility and impaired penetration ability, are eliminated, pregnancy rates can be expected to rise. Frozen semen is preferable because it allows time for sexually transmitted diseases to manifest themselves and for specimens from those donors to be rejected prior to use.

Cryopreservation↗
PubMed1989

Semen characteristics and infertility in aging.

A study was initiated to compare the spermiograms according to age in 570 consecutive men with a history of infertility. The semen was evaluated by computer-assisted semen analysis (CSA) and by the hyposmotic swelling test (HOS). A statistical difference was seen between men over 50 years of age compared with younger men, but only for the HOS scores and velocity. No statistical differences were found on any of the other parameters. Since most semen parameters were similar even in the men over age 50, a definite decline in fertility potential with increasing age could not be determined by this study.

Adult↗
PubMed1989

Clinical evaluation of the Pipelle endometrial suction curette for timed endometrial biopsies.

A clinical study was performed to determine the efficacy of the Pipelle in obtaining endometrial samples to be analyzed for luteal function. Patients' tolerance of this instrument and their willingness to undergo subsequent biopsies were also ascertained. An endometrial sample was obtainable from 1,278 women with the Pipelle, whereas 52 required the Novak curette and in 60 the sample could not be obtained with either instrument. Thirteen percent of the patients biopsied with the Pipelle stated that they would not allow a second such procedure to be performed. One percent of the samples were deemed inadequate for hormonal reading. The Pipelle seemed to be a safe, minimally traumatic method of sampling the endometrium for hormonal evaluation.

Biopsy, Needle↗
PubMed1988

The effect of leuprolide acetate in aiding induction of ovulation in hypergonadotropic hypogonadism: a case report.

A 43-year-old woman with a history of 5 years of amenorrhea sought help in achieving a pregnancy. Her gonadotropins were found to be elevated and thus she was diagnosed as having ovarian failure. She was made to ovulate on many occasions by suppressing her gonadotropins first with estrogen, then stimulating her ovaries with hMG. However, she became refractory to this therapy and she was switched from estrogen to LA to suppress gonadotropins. The woman ovulated three times just with leuprolide therapy before any hMG was added. A possible hypothesis is that, on the way down to subnormal levels of LH and FSH, a critical level of gonadotropins was attained where they were still high enough to stimulate the follicles, but low enough to allow restoration of gonadotropin receptors, which previously had been down-regulated by the elevated gonadotropin levels.

Adult↗
PubMed1988

Evaluating glass, polystyrene, and polypropylene containers for semen collection and sperm washing.

The effects of glass, polystyrene, and polypropylene containers on semen parameters as measured by Cell Soft computer-assisted semen analysis and hypoosmotic swelling (HOS) tests were assessed in unwashed specimens and again after sperm washing and swim-up procedures. A superiority in unwashed specimens was observed in glass versus polystyrene concerning velocity, motility percentage, and HOS testing (p less than 0.01). Also, superiority of glass versus polystyrene was demonstrated for linearity and ALH (p less than 0.05). Glass was only superior to polypropylene in categories of motility and HOS testing (p less than 0.05 and p less than 0.01, respectively). There was no category in which plastic was statistically superior to glass in the unwashed specimens. Concerning washed and swim-up specimens, there were no semen parameters in which there was any superiority demonstrated of either glass or plastic. Unless some future proof that the differences in semen parameters demonstrated in this study have no clinical significance, these data suggest that the collection of semen samples for sperm analysis or therapeutic use should be performed in glass containers.

Glass↗
PubMed1988

Correlation of semen analysis and hypoosmotic swelling test with subsequent pregnancies.

The hypoosmotic swelling (HOS) test was evaluated in 40 men whose wives had no apparent fertility factors. Only one of 29 men with normal semen parameters had a surbnormal HOS test, and that couple failed to conceive compared to 27 of 28 with normal HOS test who did conceive. All five couples with husbands with subnormal semen parameters but with normal HOS tests achieved a pregnancy, but none of the three with abnormal HOS tests achieved a pregnancy. The results suggest that the HOS test might be of value in predicting which couples should be more patient despite low semen parameters.

Female↗
PubMed1986

The risk of fetal anomalies as a result of progesterone therapy during pregnancy.

The incidence of congenital anomalies in infants born to 382 women treated with P was noted. Only five anomalies occurred in the infants born to women who had taken P. This study supports the data of Rock et al. by demonstrating a similar low incidence of birth defects in a much larger series of patients who also took a much higher dosage of P. Similarly, because only 1 of 189 patients treated with both P and 17-OHP developed anomalies, the data supports the study by Katz et al., suggesting no increase in anomalies related to 17-OHP therapy.

17-alpha-Hydroxyprogesterone↗
PubMed1986

New approaches to the diagnosis and therapy of the luteinized unruptured follicle syndrome.

Ultrasound has been employed in diagnosing the luteinized unruptured follicle syndrome (LUF). Eighty-nine of 333 infertility patients were found to have LUF. The patients were divided into three groups. Group 1 was on no fertility medication. Twenty-five of 39 of this group released with HCG alone. Ten of the nonreleasers to HCG did release with HMG mixed with HCG. Group 2 patients had been treated with clomiphene and found to have LUF. Thirteen of 16 patients released with HCG and one of the failures released with HMG-HCG. Group 3 patients had been treated with HMG and had failed to release the ova despite HCG. Thirty-one of 33 did release with HMG-HCG. Twenty-six of 89 patients achieved a pregnancy within six months of therapy and 20 of 36 patients with all fertility factors corrected achieved a pregnancy.

Anovulation↗