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Biomedical subjects

J Waterstone

Publications and source records attributed to J Waterstone.

9 recordsLinked to original sources
PubMed1992

A prospective randomized study comparing aspiration only with aspiration and flushing for transvaginal ultrasound-directed oocyte recovery.

OBJECTIVE: To compare aspiration only with aspiration and flushing of ovarian follicles during transvaginal ultrasound (US)-directed oocyte recovery. DESIGN: Prospective randomized study. PATIENTS: One hundred patients who were undergoing an in vitro fertilization (IVF) treatment cycle. INTERVENTIONS: All patients underwent pituitary desensitization before the administration of gonadotropins. Monitoring of ovarian stimulation and the criteria for the administration of human chorionic gonadotropin were similar in both groups. In patients in whom aspiration alone was used, each follicle was aspirated until it was empty. The US probe was then rotated until every drop of follicular fluid had been aspirated before the next follicle was aspirated and the procedure repeated. For patients who had aspiration and flushing, each follicle was aspirated and then flushed up to a maximum of six times before moving to the next follicle. In both groups, all follicles greater than 10 mm were aspirated. RESULTS: The indication for IVF and mean age of the patients were comparable in the two groups. There were no significant differences between the aspiration and the aspiration and flushing groups in terms of the number of oocytes retrieved (11 versus 9), the oocyte recovery rates (77.5% versus 77.0%), the fertilization rates (55.6% versus 60.0%), the number of embryos transferred (2 versus 2), or the number of clinical pregnancies (12 versus 13). The time taken for oocyte recovery was significantly shorter (15 versus 30 minutes, P less than 0.00001), and the dose of pethidine required significantly less (50 mg versus 100 mg, P less than 0.00001) in the aspiration only group. CONCLUSIONS: Aspiration alone produces comparable oocyte recovery rates as aspiration and flushing while significantly reducing the length of the procedure and the dose of analgesia required. Aspiration alone suffices for virtually all cases during transvaginal US-directed oocyte recovery.

Adult↗
PubMed1991

The optimum dose and mode of administration of luteinizing hormone releasing hormone analogue in in-vitro fertilization: a comparison of three regimens.

Three regimens for administration of the luteinizing hormone releasing hormone analogue (LHRHa), buserelin, were compared in terms of pituitary down-regulation prior to ovarian stimulation for in-vitro fertilization (IVF). Thirty-three patients who had failed to conceive in previous IVF cycles were randomly divided into three groups. Patients in Group I (n = 11) received intranasal (i.n.) buserelin 200 micrograms four hourly for 21 days; patients in Group II (n = 11) received subcutaneous (s.c.) buserelin 500 micrograms twice a day for 7 days, followed by 500 micrograms daily for 14 days; patients in group III (n = 11) received (s.c.) buserelin 500 micrograms three times a day for 7 days. In all three groups administration of buserelin was continued until serum oestradiol levels were less than 100 pmol/l, at which time human menopausal gonadotrophin (HMG) was commenced. All the patients achieved pituitary down-regulation after seven days of treatment with buserelin, except for four patients who developed ovarian cysts and two with polycystic ovarian disease. The total dose of HMG used and the ongoing pregnancy rate were not significantly different between the three groups. A much higher proportion of patients in Group I developed side-effects and found their treatment disruptive to their life-style. Our results suggest that patient variables (e.g. polycystic ovaries, ovarian cysts) rather than the dose and mode of administration of buserelin, are the major determinant of the length of time needed for pituitary down-regulation. The s.c. route is preferable and the smallest dose of buserelin that will produce pituitary down-regulation should be used.

Adult↗