Search PubMed⌕ Search

Biomedical subjects

L Hamberger

Publications and source records attributed to L Hamberger.

At least 55 records · Page 3Linked to original sources
PubMed1996

Ultrasound studies of vascular and morphological changes in the human corpus luteum during the menstrual cycle.

OBJECTIVE: To determine changes in corpus luteum (CL) volume, echogenicity, vascularity, and P production relative to a positive test result for urinary LH and day 1 of next menses. SUBJECTS: Thirteen healthy volunteers (age 23 to 32 years). INTERVENTIONS: All women underwent transvaginal ultrasonography on cycle day 11 and a urinary LH self-test was used daily. The plan was to rescan all women immediately after a positive test result and then at least every 48 hours (until day 6 of the next cycle); samples of peripheral blood were taken for analysis. MAIN OUTCOME MEASURES: The times of follicular rupture, a positive urinary LH test, and the start of menses; CL volume and echogenicity, maximum peak systolic velocity and minimum impedance, the circulating levels of serum P, E2, LH, and FSH. RESULTS: Nine women fulfilled criteria for an ovulatory cycle. There was a good correlation between peak systolic velocity, CL volume, and the concentration of serum P from day 4 to 10 after a positive LH test. Peak systolic velocity reached a maximum value between days 7 and 9 relative to a positive urinary LH test and started to decline from day 1 of menses minus 3, 4 days. CONCLUSION: Changes in peak systolic velocity from the time of a positive urinary LH self-test might be a useful adjunct for monitoring CL function.

Adult↗
PubMed1996

Reinsemination of one-day-old oocytes by use of intracytoplasmic sperm injection.

OBJECTIVE: To evaluate the possible advantages of reinseminating oocytes by use of intracytoplasmic sperm injection (ICSI). DESIGN: Clinical study. SETTING: In vitro fertilization unit with research facilities. PATIENTS: Fifty-seven couples who were part of our regular IVF program. INTERVENTIONS: Nonfertilized oocytes from IVF cycles with no or very low fertilization were microinjected with spermatozoa approximately 25 hours after oocyte pick-up. MAIN OUTCOME MEASURES: Fertilization and pregnancy rates. RESULTS: A mean fertilization rate of 46.5% was obtained when reinseminating the oocytes on day 2 using the ICSI procedure. Of 57 cycles with completely or almost completely failed fertilization, 29 patients received ET after reinsemination by ICSI. Two of these transfers resulted in pregnancies (6.9% per ET) and two healthy babies were born. CONCLUSION: Despite this relative success, considering both the extra work involved and the potential genetic risk, it is doubtful whether ICSI on day 2 should be recommended as a routine procedure. For training and research purposes, however, this approach can be of value.

Cellular Senescence↗
PubMed1995

Fluorescent in situ hybridization analysis of chromosomally normal gametes and abnormal arrested embryos.

OBJECTIVE: The purpose of the present study was to investigate if the arrested embryos from a couple with several previously failed IVF treatments were chromosomally normal. Probes for chromosomes X, Y and 18 were used. RESULTS: A couple had undergone 7 in vitro fertilization treatments over a 2 1/2-year period without achieving a pregnancy. In each cycle, where fertilization was obtained, the development of the embryos was arrested. Fluorescent in situ hybridization probes for chromosomes X and Y (and 18) was carried out on gametes and on embryos in 2 separate cycles. Sperm and oocytes were normally haploid X0 or Y0. The nuclei of the blastomeres were fragmented and mosaic for X or Y, or monosomic X0, despite the fact that 2 pronuclei had been assessed on day 1 following intracytoplasmic sperm injection. CONCLUSION: Chromosomally normal gametes can result in abnormal embryos manifested by arrested development and unexplained infertility.

Adult↗
PubMed1995

Cumulative birth rates following cryopreservation of all embryos in stimulated in vitro fertilization (IVF) cycles.

OBJECTIVE: To cryopreserve all good-quality embryos available after IVF is one way to avoid an impending hyperstimulation and a more attractive alternative to a couple than cancellation of the cycle. At Sahlgrenska University Hospital this method has been practiced since 1991. The aim of this study was to assess the success rate (defined as childbirth per couple) after IVF treatment including one stimulated cycle, resulting in cryopreservation of all good-quality embryos available, followed by replacement of frozen/thawed embryos in one or more natural cycles. DESIGN: A cohort of 32 women undergoing one stimulation for IVF between January 1991 and December 1993 where all good-quality embryos were cryopreserved and transferred in a later spontaneous cycle were studied retrospectively. The cumulative childbirth rate per couple was calculated. RESULTS: A total of 28 women underwent a total of 45 transfers with frozen-thawed embryos. In 4 women no transfer has taken place so far. The clinical pregnancy rate per embryo transfer was 33% (15/45) and per patient 54% (15/28). Three spontaneous abortions occurred giving a cumulative childbirth rate per patient of 39% (11/28). In addition, 6 out of the 28 women still have embryos left in the freezer. CONCLUSION: Cryopreservation of all good-quality embryos available after IVF is a highly effective alternative to cancellation of a cycle when there is impending hyperstimulation. The use of this approach results in a cumulative childbirth rate per couple of at least 39%. Since only one stimulation was performed, it also seems to be cost effective.

Abortion, Spontaneous↗
PubMed1995

Microfertilization techniques--the Swedish experience.

Intracytoplasmic sperm injection (ICSI) has been studied in this animal research programme since 1990. In 1993, the technique was first applied clinically and up to the present time (September 1994), a total of 456 couples have been studied in 538 cycles. The principal indication for the use of ICSI has been severe male sub-fertility as judged by a semen analysis. In addition, men with high titres of antisperm antibodies, blockage of the vas deferens and neurological disorders such as spinal cord lesions have been included in the programme. Men with genetic disorders such as cystic fibrosis and acrosome-deficient spermatozoa have also been treated successfully. The overall fertilization rate using ICSI was 59%, which is similar to the conventional in vitro fertilization (IVF) programme in Göteborg, however, the pregnancy rate per embryo transfer (29%) and the ongoing pregnancy rate per transfer (22%) were slightly lower. The total number of pregnancies was 144 with 111 of the pregnancies either ongoing or already delivered. To date, 36 healthy children have been born following 29 deliveries and no major malformations have been diagnosed. Being the first programme in Scandinavia to perform ICSI, this unit has experienced long waiting lists which indicates that severe male sub-fertility will be one of the major groups for treatment with assisted reproductive technologies in the future.

Cryopreservation↗
PubMed1995

Results from in vitro fertilization and intracytoplasmic sperm injection with purified gonadotrophins (Metrodin HP).

Purified urinary follicle-stimulating hormone (uFSH-HP; Metrodin HP, Serono Ltd.) was compared with a combination of pure FSH and human menopausal gonadotrophin (hMG; Pergonal, Serono Ltd.) in patients undergoing standard in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). In standard IVF, pure FSH gave a significantly higher pregnancy rate per started cycle than did the combination with hMG (35 vs. 18%, p < 0.05). No differences between standard IVF and ICSI were seen which could be associated with hormonal stimulation in an open non-randomized series of patients. In 11 ICSI cycles, the use of recombinant FSH (Gonal F, Serono Ltd.) resulted in 4 ongoing pregnancies.

Cytoplasm↗
PubMed1995

Couples' willingness to pay for IVF/ET.

BACKGROUND: Many politicians and decision-makers in health care consider assisted reproduction an expensive and exclusive treatment despite the results of in vitro fertilization/embryo transfer (IVF/ET) treatments having improved considerably during the last few years. With the improved results the costs in relation to successful outcome are decreasing. AIM AND METHODS: The aim of this study was to evaluate the cost-benefit of IVF/ET treatments in a group of infertile couples. The benefit was measured as willingness to pay (WTP) for IVF/ET treatment and was related to the cost of IVF/ET: For the calculation of costs, data from one private and one public IVF clinic in Sweden during the period from January 1992 to March 1993 were used. RESULTS AND CONCLUSIONS: The cost analysis showed a direct cost for IVF/ET of 3,170 pounds per started treatment and 9,410 pounds per delivery. Including the indirect cost, the total cost was 3,880 pounds per started IVF/ET treatment and 11,490 pounds per delivery. The survey of the WTP showed that the infertile couples gave high economic priority to infertility treatment. A majority of the couples were willing to pay more for a child than the calculated direct cost.

Attitude to Health↗
PubMed1995

Is misoprostol the drug of choice for induced cervical ripening in early pregnancy termination?

BACKGROUND: To study the effectiveness of three different cervical ripening agents in terms of dilatation ability and patient discomfort in connection with legal first trimester abortion. METHODS: Three randomized trials among unselected nulliparous women were performed 1: hygroscopic tent versus gemeprost, 2: misoprostol versus gemeprost and 3: misoprostol administered orally 17 versus 10 hours before vacuum curettage was performed. MAIN OUTCOMES: Dilatation ability, frequent gastrointestinal side effects, severe pain (patients' perception). RESULTS: In Trial 1, there was a tendency of a greater dilatation ability using the hygroscopic tent, while the experience of pain was a greater problem with gemeprost. In Trials 2 and 3, there were no significant differences in the dilatation abilities or gastrointestinal patient discomfort. There was a tendency towards a higher demand for narcotic analgesics in patients treated with gemeprost compared with all other groups. CONCLUSIONS: Gemeprost and misoprostol showed almost identical ability to dilate and caused patient-experienced discomfort to the same degree. The use of misoprostol may be preferred as it has the advantage of being both less expensive and easier to administer.

Abortifacient Agents, Nonsteroidal↗
PubMed1995

The success rate in a Swedish in-vitro fertilization unit: a cohort study.

OBJECTIVE: To evaluate the cumulative childbirth rate after completion of in vitro fertilization (IVF) treatment including three or, in a few cases, four stimulated cycles. DESIGN: A cohort of 398 couples starting their first IVF treatment between January 1990 and December 1992 were followed until completion of their treatment. RESULTS: Of 826 started cycles, embryo transfer was performed in 793 cycles, giving a mean of 2.0 completed cycles per couple. In addition, cryopreserved embryos were transferred in 228 cycles (0.57 cycles per couple). 204 couples completed their treatment with delivery or with an ongoing pregnancy, 95 couples underwent three stimulated cycles without achieving an ongoing pregnancy and 66 couples cancelled their treatment after one or two cycles because of varying reasons. In seven women no transfer took place. Twenty-six women have not yet completed their planned cycles. Of 398 couples, where the vast majority had completed their IVF treatment, 51% (204) delivered as a result of the treatment. CONCLUSION: IVF treatment combined with freezing of surplus embryos, is a highly effective procedure giving a 'take home baby rate' on a cumulative basis of more than 50% within 1 to 3 cycles.

Adult↗
PubMed1995

Monoclonal antibodies against human blastocysts.

A panel of monoclonal antibodies against the implanting mouse blastocyst was tested for cross-reactivity to human blastocysts. The monoclonal antibodies were produced by intrasplenic immunization with living mouse blastocysts or egg-cylinders. Among the 13 anti-mouse blastocyst antibodies checked, 6 ones detected antigen epitopes also in human blastocysts. If the mouse-human cross-reacting antibodies detect similar antigens in blastocysts of the two species, the results imply that anti-mouse blastocyst antibodies with specific properties could be used for studying human blastocysts. This procedure opens for a way to obtain monoclonal antibodies for analysing human blastocysts.

Animals↗
PubMed1994

Transvaginal ultrasound-guided ovarian endoscopy: a novel approach to the assessment of ovarian tumors.

The investigation of ovulatory dysfunction and the characterization of ovarian cystic tumors remain two major problems in gynecology. One of our limitations is the resolution of imaging techniques currently available. We describe the use of a fiberoptic endoscope to inspect the internal appearance of five different ovarian cystic lesions under the guidance of transvaginal ultrasound. The images obtained allow the operator to visualize structures of less than 1.0 mm in diameter, and so introduce the possibility of identifying both the cumulus oophorus in younger women, and very small papillary projections within potentially malignant ovarian cysts.

Journal Article↗
PubMed1994

The use of contraceptive methods among women seeking a legal abortion.

In a simple random sample study of 404 women 20 to 29 years of age, 201 applying for abortion and 203 continuing their pregnancies, all were interviewed personally and requested to complete a questionnaire. The aim of the study was to analyse the use and experience of contraceptives among the abortion applicants in this age group, and to compare their experience with that of women in a matched control group. The most important reasons given for desisting in the use of contraceptives were the experience of side effects, worry about the side effects, and the "human failure" factor involved even with methods of contraception such as pills, which generally are regarded as safe. This study demonstrates that women living alone without any permanent relationship, having a strained economy or having previously had an abortion, need particular and detailed contraceptive advice plus continued close follow-up. To improve the continuation rate, precise contraception counselling focusing on both positive and adverse effects to reduce worry seems essential.

Abortion Applicants↗
PubMed1994

Hydrosalpinx reduces in-vitro fertilization/embryo transfer pregnancy rates.

A retrospective study was designed to examine whether the presence of a hydrosalpinx influenced pregnancy outcome following in-vitro fertilization (IVF) treatment in stimulated cycles. A total of 254 women with tubal lesions were included. Patients with one or two hydrosalpinges were compared with patients having other tubal lesions and pregnancy outcome was analysed. Both pregnancy and delivery rates were significantly higher in the patient group without a hydrosalpinx. The results after frozen embryo transfer showed the same tendency. These findings strongly indicate that a permanent hydrosalpinx has a negative influence on implantation, as well as on pregnancy, and suggest that a more active approach against large hydrosalpinges should be undertaken before IVF treatment, in order to improve the pregnancy rates.

Embryo Transfer↗