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Biomedical subjects

J Smitz

Publications and source records attributed to J Smitz.

At least 145 records · Page 8Linked to original sources
PubMed1988

Embryo donation in patients with primary ovarian failure.

Thirty-six infertile patients with primary ovarian failure, who were referred for oocyte (embryo) donation are reported. After substitution therapy with oestradiol valerate (per os) and progesterone (i.m. or per os), endometrial tissue was made receptive for embryonic implantation, although the endometrial biopsies on day 21 demonstrated a certain delay in development (of 1.6-2.4 days). Six patients became pregnant, three of them delivered four healthy babies, one pregnancy is progressing normally and two ended in an early clinical abortion.

Chromosome Aberrations↗
PubMed1988

In-vitro fertilization with husband and donor sperm in patients with previous fertilization failures using husband sperm.

When previous attempts at in-vitro fertilization using semen from the husband failed, a subsequent IVF attempt was performed using husband and donor sperm in order to compare fertilization and embryo formation after insemination with husband and donor sperm of the same oocyte population. Significantly more eggs were fertilized in patients suffering from andrological and idiopathic infertility when donor sperm were used. No differences were seen in patients with tubal infertility. In the andrological group, the embryos fertilized by the husband showed significantly more fragmentation. No pregnancies were established when husband-fertilized oocytes (embryos) were replaced in the andrological and idiopathic infertility group. This study suggested that an IVF trial using husband and donor sperm might be indicated in couples suffering from andrological or idiopathic infertility in whom no fertilization occurred in a previous cycle using sperm from the husband.

Adult↗
PubMed1988

The luteal phase after in-vitro fertilization and related procedures.

To evaluate any beneficial effect of progesterone supplementation during the luteal phase of GIFT or IVF cycles stimulated by clomiphene citrate and HMG, two random prospective studies were performed. In the first study, a group of patients received a luteal phase supplement of 50 mg natural progesterone i.m. daily from the day of oocyte retrieval onwards. Initial results on 168 patients indicated that the pregnancy rate was similar in patients with or without progesterone supplements. No differences were found between the two groups in an analysis of pregnant and failed cycles. In a second study two different protocols of luteal phase supplementation after Buserelin-HMG stimulation were compared: natural progesterone in combination with oestradiol valerate (50 patients) or HCG supplements (41 patients). A 32% pregnancy rate per cycle was encountered in both groups. Endometrial biopsies, taken during the luteal phase from patients who did not undergo embryo replacement, revealed retarded endometrial development in most of the biopsies.

Buserelin↗
PubMed1988

The luteal phase and early pregnancy after combined GnRH-agonist/HMG treatment for superovulation in IVF or GIFT.

Endometrial biopsies showing inadequate development were observed after ovarian stimulation with the GnRH agonist Buserelin and HMG for IVF or GIFT when luteal supplementation was omitted. Ninety-one patients were randomly allocated to two luteal supplementation regimens: in 41 women HCG and in 50 women progesterone and oestradiol valerate. The pregnancy patients treated with a combination of the GnRH agonist and HMG a delay of implantation of 1.3 days was observed compared to pregnancies after clomiphene citrate-HMG stimulation. This delay was not due to slower preimplantation embryo development after GnRH agonist-HMG treatment. Temporarily defective function of the corpus luteum was evidenced by measuring serum progesterone, 17 beta-oestradiol and 17-hydroxyprogesterone in the patients receiving progesterone and oestradiol valerate. This inadequate corpus luteum function could be related to the prolonged blockage of pituitary gonadotrophic function after arrest of the GnRH agonist.

Buserelin↗
PubMed1988

Congenital hypothyroid goiter and amiodarone.

Amiodarone is an anti-arrhythmic drug with a content of 39% Iodine. No adverse effects on fetal thyroid function have previously been observed with maternal ingestion of Amiodarone during pregnancy. A case of severe congenital hypothyroidism with goiter, associated with maternal ingestion of 200 mg Amiodarone daily from the 13th week of pregnancy, is described here. No other environmental causes of goiter, nor a congenital organic thyroid disorder could be demonstrated.

Adult↗
PubMed1987

Rhabdomyolysis in hypokalaemic periodic paralysis: a clue to the mechanism that terminates the paralytic attack?

The changes in serum levels of myoglobin (Mb) and creatine kinase (CK) during a spontaneous attack of hypokalaemic periodic paralysis were studied. During paralysis, serum Mb and CK were normal. A rise in plasma potassium, resulting in clinical recovery, was associated with a simultaneous rise in serum Mb, and followed by a rise in serum CK. It is postulated that hypokalaemia might cause muscle ischaemia, which would result in an accumulation of free fatty acids (FFA) within the muscle cells. High concentrations of FFA may induce molecular changes and increase the permeability of the sarcolemma. This might be the mechanism by which potassium is released from muscle cells into the circulation and muscle membrane excitability is restored.

Adult↗
PubMed1987

Gamete intra-Fallopian transfer: evaluation of 100 consecutive attempts.

The results of 100 gamete intra-Fallopian transfer (GIFT) procedures to treat persistent infertility are reported. Twenty-four pregnancies were achieved, of these six aborted, two were extra-uterine, two stillbirths occurred and nine patients delivered 11 healthy children (two sets of twins) and five pregnancies are progressing well, including two sets of twins. Pregnancy rate in the different groups of patients was: 28% for idiopathic infertility (n = 39), 13% for male infertility (n = 16), 22% for endometriosis (n = 27), and 29% in the presence of antisperm antibodies (n = 7). In our GIFT procedure, we place three oocytes and 50,000 to 100,000 motile spermatozoa per patient into one healthy tube, the remaining oocytes being inseminated and cultured in vitro. Of 502 oocytes recovered, 252 fertilized normally and 178 early embryos were frozen. The replacement of 41 frozen-thawed embryos resulted in five additional, ongoing pregnancies. The combined treatment by gamete intra-Fallopian transfer, in-vitro fertilization and cryopreservation increases the chance of conception.

Adult↗
PubMed1987

Management of failed cycles in an IVF/GIFT programme with the combination of a GnRH analogue and HMG.

The addition of the gonadotropin releasing hormone (GnRH) agonist Buserelin to human menopausal gonadotrophin/human chorionic gonadotropin (HMG/HCG) during ovarian stimulation was evaluated in 23 cycles of 21 women who previously had unsuccessful IVF treatments when stimulated with clomiphene--HMG/HCG. No adverse effects of GnRH-agonist on folliculogenesis were seen. A mean number of 7.2 oocytes per retrieval was collected in 20 treatment cycles. Oocytes quality, fertilization and cleavage parameters were normal. Replacements by gamete intra-Fallopian transfer (GIFT) or IVF took place for 16 patients. Four patients became pregnant in their treatment cycle, one aborted. For 8 patients 18 embryos were cryopreserved, one transfer of a frozen--thawed embryo in a subsequent natural cycle led to a pregnancy. Inadequate luteal phases were constantly observed when supplementation was omitted. Further study is required to confirm that systematic luteal support improves the pregnancy rate.

Adult↗
PubMed1987

Cryopreservation of human embryos obtained after gamete intra-Fallopian transfer and/or in-vitro fertilization.

During a one-year period 636 excess embryos obtained after in-vitro fertilization and gamete intra-Fallopian transfer combined with in-vitro fertilization were cryopreserved using two different protocols. For early stage embryos including the pronucleate stage, 1,2-propanediol was used as cryoprotectant (procedure A, adapted from Renard) and for later stage embryos dimethylsulphoxide was used in protocol B, adapted from Trounson and Mohr. After thawing 288 embryos, half of them were of sufficient quality to be replaced. After cryopreservation, procedure A gave the best survival in embryos having less than or equal to 2 blastomeres; for later stage embryos best survival was obtained using the dimethylsulphoxide protocol. Survival after cryopreservation was also clearly related to the quality of the embryos prior to freezing. Embryos were replaced during endocrinologically monitored natural cycles and were transferred in synchrony between endometrial and embryonic age. After replacement of 126 embryos in 110 patients, 20 pregnancies occurred. So far six healthy children have been born, two patients aborted and 12 pregnancies are ongoing. In this series no statistical difference was observed between the implantation rate of embryos cryopreserved by procedure A or B. Six pregnancies occurred in patients from the oocyte and embryo donation programme. An adequate cryopreservation programme circumvents the difficult problem of synchronizing the ovarian cycles of donor and acceptor patients.

Embryo Transfer↗
PubMed1987

Hormonal changes during a spontaneous attack of hypokalemic periodic paralysis.

We studied the hormonal changes during a spontaneous attack of hypokalemic periodic paralysis in a 20-year-old man, before and after treatment with potassium chloride. During paralysis, we observed high circulating levels of insulin, epinephrine, norepinephrine, growth hormone, ACTH and cortisol, most likely reflecting a condition of stress. Normalization of all these hormones occurred with recovery. Plasma aldosterone concentrations were normal. The increased plasma levels of insulin, but also of catecholamines and growth hormone, created a condition promoting potassium uptake in muscle cells. We suggest that stress may play a role in the pathophysiology of the paralytic attacks in this disorder.

Adrenocorticotropic Hormone↗
PubMed1987

Thyroid hormone reserve in asymptomatic autoimmune thyroiditis.

Basal (B) and peak (P) serum levels of thyroxine (T4), free thyroxine (FT4), triiodothyronine (T3), free triiodothyronine (FT3), and TSH were measured before and after oral TRH (40 mg) administration in 79 subjects affected with asymptomatic autoimmune thyroiditis (AAT) and in 69 normal subjects. The area under the curve (AUC) and peak values of T4, FT4, T3 and FT3 were considered as parameters of thyroid hormone reserve. Intrathyroidal iodine (ITI) was measured by the X-ray fluorescence method. The AAT subjects were divided into three groups on the basis of their basal and peak TSH values. In group I, these parameters were similar to those in the normal controls; in group II, basal TSH remained normal but peak TSH was significantly increased, and in group III both values were significantly increased. Group I differed from the controls by a decrease in P FT4 and AUC FT4, whereas in groups II and III B FT4 was also significantly lowered. T3 levels were similar in all groups except in group III, in whom they dropped. ITI was already lower in group I than in the controls. Its decline went further in groups II and III. An inverse correlation with significant r values was evidenced between log B and P TSH on one hand and log B FT4, P FT4 and AUC FT4 on the other. When group III was excluded, log P TSH was positively correlated with log B T3, P T3, AUC T3, and AUC F T3.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Heterophyle antibodies causing false positive radio-immunoassay results. A case report.

A case report of falsely elevated serum hormone values measured by radio-immunoassay (RIA) is described. The radio-immunoassays concerned have a first antibody raised in rabbits and mostly a separation technique based on a second antibody-solid phase system. The presence of heterophyle (anti-rabbit) antibodies in patients' serum is proved.

Adrenocorticotropic Hormone↗
PubMed1987

Ovarian stimulation, including in vitro fertilisation.

The stimulation regimens and the results of ovulation induction in anovulatory patients and in patients suffering from a Luteinized Unruptured Follicle (LUF) syndrome are discussed as well as the findings concerning superovulation in IVF cycles. The percentage of multiple pregnancies (less than or equal to 20 p. cent) is acceptable, due to the accurate daily performance of hormonal determinations. The pregnancy rate is lower in a LUF population, than in anovulatory patients. This is likely due to the unknown pathophysiology of the LUF syndrome. Compared to natural cycles, the maximum serum LH concentration is reduced in stimulated cycles although multiple oocytes have to mature in superovulated patients. A possible explanation for these reduced LH surges could be an increase in inhibin -like substances. There is still a need for more research to find out the real interaction between the follicle and the hypothalamic-hypophysial axis.

Anovulation↗
PubMed1987

Evaluation of five commercially available direct radio-immunoassays for the determination of 17 beta-estradiol in serum for the hormonal monitoring of ovarian stimulation.

Five direct radio-immunoassay kits for the dosage of 17 beta-estradiol were assessed for their usefulness to monitor the serum values of 17 beta-estradiol in stimulated and natural ovarian cycles. Prerequisites included a turn-around time of 4 hours for an assay of 100 tubes and a range extended to at least 2,000 ng/l. The following parameters were evaluated: characteristics of the standard curve, sensitivity, precision profile, within- and between-assay precision, analytical drift and linearity. We found that the five tested methods are technically suitable to monitor serum 17 beta-estradiol in stimulated cycles but they all lack precision for low 17 beta-estradiol levels as seen in the early follicular phase of natural cycles.

Estradiol↗