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Biomedical subjects

K Nowroozi

Publications and source records attributed to K Nowroozi.

At least 37 records · Page 2Linked to original sources
PubMed1990

Ovulation induction and pregnancies in 100 consecutive women with hypergonadotropic amenorrhea.

The efficacy of a technique of gonadotropin suppression and human menopausal gonadotropins (hMG) to induce ovulation in women with hypergonadotropic amenorrhea was evaluated in 100 consecutive women. Ovulation was achieved in 19% of cycles (68/361), the pregnancy rate per cycle was 5.2% (19/361), and the viable pregnancy rate was 2.2% (8/361). In the majority of the successful cases, estrogen was used to decrease the elevated luteinizing hormone and follicle-stimulating hormone levels, especially where the ethinyl estradiol therapy alone induced a rise in endogenous 17 beta-estradiol levels with hMG used to boost the follicle to maturation. Although the success rate is low, this technique can result in some successes in otherwise almost hopeless cases.

Adult↗
PubMed1990

Correlation of computerized semen analysis with successful fertilization of oocytes in an in vitro fertilization program.

Sixty-nine couples enrolled in 123 in vitro fertilization-embryo transfer cycles were categorized by percentage fertilization; the results of categorization were compared with those of computerized semen analysis carried out with the CellSoft semen analyzer. Four groups were established: group 1 had 75% fertilization or greater; group 2 had 34% to 74% fertilization; group 3 had 1% to 33% fertilization; and group 4 had 0% fertilization. Statistical differences in certain semen parameters (motility, linearity, and straight-line velocity) were found comparing groups 1 and 3 using the initial ejaculate. A significant number of patients in group 1 had all normal semen parameters, but no statistical difference could be found in group 3 or 4 because of variations in specific abnormal parameters in the groups. When the straight-line velocity-motile density (SLVMD) calculation was used, a significant difference was seen between group 1 and group 3 and between group 1 and group 4 (p less than 0.01); 65% of group 3 and 76% of group 4 had an abnormal SLVMD. SLVMD is a useful calculation to predict fertilization rates in vitro from the initial ejaculate.

Computers↗
PubMed1990

Evaluation and treatment of a male factor component to unexplained infertility.

The standard semen analysis frequently fails to identify subfertile males even when findings are normal and conversely often fails to identify fertile males with subnormal semen analyses. This has created the need to produce other tests of sperm physiology that will better distinguish a fertile from a subfertile specimen. Understanding more about the nature of the sperm defect should lead to the establishment of more specific and effective therapies. Until that time, it would still be reasonable to try some of the available empirical therapies even though they may work merely by a placebo mechanism.

Ascorbic Acid↗
PubMed1990

Serum CA 125 levels in early pregnancy and subsequent spontaneous abortion.

CA 125 has been found in high concentrations in human amniotic fluid throughout gestation, with significant quantities seen in the decidua and chorion. Because disruption of the epithelial basement membrane of the fetal membrane or the decidua could theoretically lead to a rise in maternal CA 125 levels, this increase may be a predictor of subsequent spontaneous abortion of the fetus. A study was initiated to investigate whether a sudden rise in the serum CA 125 level might predict spontaneous first-trimester abortions. CA 125 levels of 101 pregnant women were evaluated 18-22 days from conception and 6 weeks from conception (a frequent time for spontaneous abortion) to determine whether there is a sudden increase (from baseline or early trimester levels) during the middle or late first trimester immediately before or at the time of abortion. The results indicated that although there was a definite correlation found between elevation of CA 125 and spontaneous abortion, the higher levels occurred early in the first trimester whereas the majority of abortions did not occur until much later, after fetal viability was established. Six of ten women with CA 125 levels of 150 U/mL or greater aborted, compared with four of 92 women with CA 125 levels less than 150 U/mL. One of 11 women pregnant after in vitro fertilization had a CA 125 level above 150 U/mL, and she aborted.

Abortion, Spontaneous↗
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

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↗
PubMedDate not supplied

Comparison of various therapies for the luteinized unruptured follicle syndrome.

A study was initiated to evaluate the prevalence of the luteinized unruptured follicle (LUF) syndrome in a group of 355 women with infertility. The diagnosis was established by carefully observing daily sonograms along with measuring estradiol, progesterone, and luteinizing hormone (LH) levels. Two distinct types of LUF syndrome were identified: mature follicle LUF, in which release of an ovum was not demonstrated after a follicle attained maturity (serum estradiol reached 200 pg/mL while serum progesterone remained less than 2.5 ng/mL), versus premature luteinization LUF, where the serum progesterone increased above 2.5 ng/mL before follicular maturation was attained. The use of either hCG alone or hCG in combination with hMG in a single injection at the time of follicular maturation successfully corrected mature follicle LUF in 21 of 46 patients (46%), whereas ovulation-inducing drugs plus hCG or hCG and hMG corrected LUF in 24 of 25 patients (96%). Clomiphene citrate proved inferior to hMG in that it corrected LUF in 3 of 25 patients (12%) versus 12 of 22 patients (95%) who had undergone hMG therapy. Thus, hMG-hCG therapy is the most efficacious for mature follicle LUF, but because release can occur spontaneously on occasion by an appropriately timed single gonadotropin injection, one could offer the less costly options first. For premature luteinization, speeding up follicular maturation with gonadotropin therapy is effective. Upon failure of this technique, the more costly endogenous gonadotropin suppression followed by hMG can be employed.

Adult↗
PubMedDate not supplied

Evidence that difference in size of fraternal twins may originate during early gestation: a case report.

We describe a woman who conceived by in vitro fertilization (IVF) and embryo transfer (ET). Transvaginal ultrasound demonstrated at least 1 week's difference in size of twin gestations from 1 month post-transfer of embryos to delivery. Differences in sac size, crown-rump length, and gestational growth are discussed, as are implications of ultrasound in early pregnancy.

Adult↗
PubMedDate not supplied

Late luteal phase progestogen-dependent endometrial protein levels in women with in-phase biopsies--can low levels predict a subfertile group?

A group of infertile women who had luteal phase defects (LPD), but in whom follicular maturation was deemed normal, were treated with progesterone until the endometrial biopsy was corrected. At the time the corrected biopsy was obtained, serum was taken and the progestogen-dependent endometrial protein (PEP) concentration was determined. Serum PEP concentration in patients who successfully conceived was 102.5 +/- 62.6% units/mL, while PEP concentrations in patients who failed to conceive were 57.9 +/- 34.4% (P = .003). In patients whose PEP value was more than two standard deviations below the corresponding mean control PEP, pregnancy was achieved in 6/17 (35.3%). The conception rate was significantly greater (25/35, 71.4%) in patients with values higher than this. Thus, the PEP concentration in serum may identify a group of patients with persistent LPD despite apparent normalization of the morphology of late secretory phase endometrium, which might explain some cases of cryptic, unexplained infertility.

Biopsy↗
PubMedDate not supplied

An in vivo technique for screening immunologic factors in the etiology of the unexplained poor postcoital test.

A study was designed to determine the incidence and etiology of the unexplained poor postcoital test. An in vivo comparison of sperm penetration by husband's versus donor sperm in the wife's estrogen-stimulated mucus was performed. The 8 of 30 women showing improvement of husband's penetration in mucus (group 1) were treated with high-dose estrogen (HDE) and hMG, and 4/8 conceived. Anti-sperm antibodies (ASA) were insignificant in this group. In group 2, in which donor sperm penetrated but husband's sperm did not, 8 men of 17 were found to have an ASA level over 50% on the sperm surface; 6/8 treated with high-dose methylprednisolone (MP) had an improved postcoital test, and 5 achieved a pregnancy. Two patients with levels under 50% were still treated with MP, and one achieved a pregnancy. In five group-3 couples, positive ASA were found in the cervical mucus of two women; and one woman improved on the postcoital test and conceived following MP therapy. The 30 unexplained poor postcoital tests occurred in 5,000 couples evaluated. In general, those patients considered to have significant clinical antibody had levels over 50%. Because side effects of MP may be severe, and positive ASA may be found in normal donors, it is important to use a comparison penetration test to help determine if treatment with corticosteroids seems reasonable.

Cervix Mucus↗