Biomedical subjects
Publications and source records attributed to K Sterzik.
Transabdominal, transvesical aspiration of oocytes was performed in 58 infertility patients under ultrasound guidance. In contrast to other groups, no particular guiding instruments were used. Wider bore needles and general anesthesia improved the oocyte recovery rate from 44% to 80%, thus approaching the one achieved by laparoscopy.
Patients under study in a programme of in-vitro-fertilisation and regarded as "normocyclic" were divided into 3 groups, depending on prior therapy: Patients in group I received clomiphene for follicle stimulation, and for ovulation HCG. Those in group II received in addition HMG for follicle maturation. Those in group III received HMG and HCG. When sonographs revealed a mature follicle about to rupture and the serum oestradiol increased, the follicle was aspirated to collect the ova. In 34 patients either no ova could be obtained, or the ova collected could not be fertilised, or because the oestradiol levels fell, no follicle was aspirated. In these 34 patients a biopsy of the endometrium was obtained some time between the 11th to 21st day of the cycle and studied histologically. Only ten of the 34 patients had a normally functioning endometrium suitable for implantation. The remaining patients revealed functional disturbances ranging from insufficient secretion to deficient proliferation to atrophy. Six biopsies could not be evaluated (advanced atrophy?). The women in group III showed the best results. The poor results obtained in group I and II were related in part to the anti-oestrogenic effect of clomiphene. Aspiration of the follicle seemed to have no deleterious effect on the endometrium. Five of the male partners of the 10 patients with a normal endometrial histology had a pathologic spermiogram. As compared to the endocrinological parameters, the histological studies revealed a high rate of pathologic endometria.(ABSTRACT TRUNCATED AT 250 WORDS)
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beta-1-Glycoprotein (SP1) concentration of 170 women with undisturbed pregnancy under 18th week were taken as reference. SP1 levels of 72 patients with threatening abortion but favorable outcome were compared with those of 70 patients with threatening abortion and subsequent miscarriage. Decreased SP1 levels were determined in most (88%) patients who aborted, whereas 88.8% of patients with favorable outcome had SP1 levels within normal range. The predictive value of SP1 determination in early pregnancies is emphasized.
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In 69 patients with normal pregnancy the estimated day of confinement (EDC) was determined by three different methods (last menstrual period = LMP, ultrasound, and determination of Schwangerschaftsprotein-1 (SP-1) serum concentration). Ultrasound and LMP were shown to predict the EDC with approximately the same accuracy. While data obtained by LMP were scattered a little bit more around the mean value, data obtained by ultrasound tended to underestimate the EDC slightly. Determination of SP-1 serum concentration had the lowest predictive value in assessing the EDC. Accordingly, we don't consider routine SP-1 determinations to be a useful test in antenatal care.
Human menopausal gonadotropin (hMG) was administered to 10 patients with polycystic ovarian disease (PCOD) who had failed to ovulate in response to clomiphene citrate. Five patients (group 1) were treated with intramuscular hMG injections daily, on an individually adjusted regimen. Five others (group 2) were stimulated with subcutaneous hMG in a pulsatile fashion by means of a portable infusion minipump. The pulse doses ranged between 3.5 and 7.7 IU FSH per pulse at a constant frequency of 90 minutes. Sixteen of 18 treatment cycles were ovulatory, 9 under intramuscular, and 7 under subcutaneous treatment. A total of two patients conceived with singleton pregnancies, one in each treatment group. Neither ovarian hyperstimulation nor complications of injections were noted. The amount of subcutaneous hMG required to achieve ovulation was significantly less (46.5%; P less than .001) than that needed with intramuscular administration. However, there were no differences in the duration of stimulation periods, the lengths of luteal phases, or serum E2 and gonadotropin levels between the groups. In conclusion, pulsatile subcutaneous hMG administration may be an alternative delivery mode for patients with PCOD.
We investigated the effect of follicle-stimulating hormone (FSH) administration on the ultrastructure of spermatozoa in order to evaluate the potential of FSH therapy for improving sperm quality. Forty-six patients exhibiting idiopathic oligoasthenoterato-zoospermia who attended the intrauterine insemination (IU), in vitro fertilization (IVF), or intracytoplasmic sperm injection (ICSI) program at our clinic received FSH in daily dosages of 150 IU over a period of 12 weeks. Using transmission electron microscopy, the ultrastructural analysis of spermatozoa was performed prior to the start of FSH therapy, after the treatment had been finished, and 6 weeks posttherapy. Applying a mathematical formula based on submicroscopic characteristics, we calculated the number of morphologically normal spermatozoa. After the FSH treatment, the examined subcellular organelles achieved a higher percentage of integrity. Follicle-stimulating hormone treatment leads to a higher number of morphologically normal spermatozoa. The electron microscopic findings indicate that treatment with pure FSH may be an effective way to improve sperm quality in cases with oligoasthenoterato-zoospermia. Applying the mathematical analysis based on the whole complex of the selected sperm characteristics, we obtained a way to evaluate the success of therapy for the first time.