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M Bloechle

Publications and source records attributed to M Bloechle.

13 recordsLinked to original sources
PubMed2007

Fertilisation failure after intracytoplasmic sperm injection is not associated with sperm aneuploidy of a globozoospermic patient.

The objective of this study was to determine the aneuploidy rate in spermatozoa from a globozoospermic patient who underwent three unsuccessful intracytoplasmic sperm injection (ICSI) treatment cycles together with his wife. The aneuploidy rates of chromosomes 13, 18, 21, X and Y as well as the diploidy rate in the spermatozoa of this man were evaluated by fluorescence in situ hybridisation to clarify if chromosomal aneuploidy could be a cause for the low fertilisation rate observed in this case. In the spermatozoa of our patient no increase in aneuploidy rates was found for the tested chromosomes (0.0% disomies of chromosomes 13, 18 and 21 with a diploidy rate of 0.6%; X/Y missegregation: 0.6%) indicating that the ICSI outcome of the couple was not impaired by sperm aneuploidy of the globozoospermic man.

Adult↗
PubMed2006

Interphase M-FISH applications using commercial probes in prenatal and PGD diagnostics.

Early, rapid and reliable diagnosis is of first priority in prenatal medicine. The combination of specific sonographic markers (e.g. nuchal translucency) and biochemical parameters in maternal serum (e.g. free beta-human chorionic gonadotropin, pregnancy-associated plasma protein A), has already dramatically improved the sensitivity of non-invasive first trimester risk screening in pregnancy. In invasive prenatal diagnosis, in addition to well-established chorionic villi short-term culture, interphase multi-colour-fluorescence in situ hybridisation (M-FISH) on uncultured amnion cells has become a reliable tool for the rapid detection of fetal aneuploidies. Interphase M-FISH applications have enabled the diagnosis of selected chromosomal abnormalities in single cells and, therefore, have also become an important diagnostic tool for preimplantation diagnosis (PGD). The development of commercially available probe sets, in particular, has led to a broad use of interphase M-FISH in prenatal and PGD diagnosis.

Amniocentesis↗
PubMed1998

Septate uterus.

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Female↗
PubMed1997

Recurrence of hydrosalpinges after transvaginal aspiration of tubal fluid in an IVF cycle with development of a serometra.

The presence of hydrosalpinges has been shown to be deleterious in infertility treatment. Pregnancy rates after in-vitro fertilization (IVF) with embryo transfer decline considerably. This study concerns a patient who developed bilateral hydrosalpinges during controlled ovarian stimulation in preparation for IVF treatment. Transvaginal aspiration of the tubal fluid was unsuccessful as the tubes refilled within 2 days. Additionally, on the day of embryo transfer a serometra developed which could not be seen on the day of oocyte retrieval. The uterine cavity was evacuated via an embryo transfer catheter and three embryos were transferred. The serometra reappeared 3 days after embryo transfer. A pregnancy could not be achieved. The accumulation of fluid in the uterine cavity during an IVF/embryo transfer cycle is a rare complication of hydrosalpinges. However, the retrograde flow of tubal fluid may disturb intrauterine embryo development. This study suggests that the aspiration of hydrosalpinges and intrauterine fluid accumulation during an IVF cycle is not beneficial, as the underlying pathology is not cured. Cancellation of the treatment cycle or cryopreservation of oocytes in the pronucleate stage and transfer of the cryopreserved oocytes after surgical correction of the tubes may be better options.

Exudates and Transudates↗
PubMed1997

Colour Doppler assessment of ascendent uterine artery perfusion in an in-vitro fertilization-embryo transfer programme after pituitary desensitization and ovarian stimulation with human recombinant follicle stimulating hormone.

The purpose of the present study was to evaluate the use of colour Doppler sonography of ascendent uterine artery perfusion in 91 patients undergoing in-vitro fertilization (IVF)-embryo transfer treatment after ovarian stimulation with a depot formulation of goserelin and recombinant human follicle stimulating hormone according to the long protocol. Resistance index (RI), pulsatility index (PI), maximum peak velocity (Vmax) and minimum diastolic velocity (Vmin) were assessed for the left and right ascending uterine artery on day 1 of ovarian stimulation, on day -2 [the day of human chorionic gonadotrophin (HCG) application] and on day +14 (12 days after embryo transfer). The data of 75 patients who had at least two cleaved preimplantation embryos available for transfer were analysed: 21 patients became pregnant resulting in a pregnancy rate of 28% (21/75). After exclusion of biochemical, ectopic and abortive pregnancies (n = 5), the data from 54 non-pregnant patients and 16 pregnant patients were analysed. No differences with respect to patient age, current cycle number, indication for IVF treatment, endometrial thickness at day -2 and serum oestradiol and serum progesterone concentrations at day -2 were found between the pregnant and non-pregnant groups. Compared to the non-pregnant patients the ascendent uterine artery flow of the pregnant patients showed significantly lower RI (P < 0.009) and PI (P < 0.03) values at the beginning of ovarian stimulation. Vmax and Vmin did not differ between the two groups. On day -2 no differences in RI, PI, Vmax and Vmin were found between pregnant and non-pregnant patients. On day +14 the flow in the ascendent uterine arteries of the pregnant patients showed significantly lower RI (P < 0.008) and PI (P < 0.03) values and significantly higher Vmax (P < 0.003) and Vmin (P < 0.0001) values. RI (P < 0.009) and PI (P < 0.003) values had decreased significantly and Vmax (P < 0.0002) and Vmin (P < 0.0001) had increased significantly on day +14 compared to the previous observation times in both the pregnant and non-pregnant groups. A significant correlation between the increase of serum progesterone concentrations and the decrease of RI (r = 0.68, P < 0.009), and the increase of Vmin (r = 0.67, P < 0.01) was only detected in the pregnant group. In conclusion, the differences found in RI and PI values at the beginning of ovarian stimulation were not clinically helpful as there was a wide overlap between non-pregnant and pregnant patients. The parameters currently used in colour Doppler assessment of uterine artery perfusion are not clinically helpful in discriminating prospectively which patients will and will not become pregnant in an IVF programme. In pregnant patients, increasing progesterone concentration is correlated with a significant decrease in impedance to uterine perfusion in the late luteal phase.

Adult↗
PubMed1996

Neuroectodermal cyst may be a rare differential diagnosis of fetal sacrococcygeal teratoma: first case report of a prenatally observed neuroectodermal cyst.

In spite of the fact that most anomalies can be accurately diagnosed prenatally, one may be confronted with an extremely rare fetal abnormality that has never been described before. We report a case of a neuroectodermal cyst arising from the posterior neuropore. After 21 weeks of gestation a fetal anechoic intra- and extra-abdominal tumor was detected. The mass grew to 75 x 41 x 33 mm at 35 weeks. Initially it was believed to be a sacrococcygeal teratoma. Serial scans and Doppler ultrasound examinations were performed, which demonstrated fetal well-being. Color Doppler imaging failed to demonstrate increased tumoral perfusion. After elective Cesarean section, the tumor was excised. The postoperative course was complicated by recurrent infections of the urinary tract due to neurological damage to the bladder. There was also impaired function of the anal sphincter. The histological finding of a monolayer of neuroepithelial cells and melanocytes led to the diagnosis of a neuroectodermal cyst.

Adult↗
PubMed1996

[Highly purified FSH for stimulation of down regulated cycles in the in vitro fertilization program].

Highly purified FSH (Fertinorm HP) was used for follicle stimulation during one cycle of IVF in each of 112 women. In all cases, stimulation was begun with 150 IU FSH per day s.c. after pituitary down-regulation with a GnRH analogue in a Long protocol. Sixteen (14.3%) of the 112 treatment cycles started were stopped before follicle aspiration. The reasons for stopping stimulation were elevated progesterone values with premature luteinisation in 9 (8.0%) patients, inadequate follicle stimulation in 4 (3.6%) cases and threatened overstimulation in 3 (2.7%) cases. The mean duration of stimulation was 11.8 days with 7.8 oocytes obtained per aspiration by the transvaginal rute. Embryo transfer was possible in 77 (68.7%) patients, with a mean of 2.3 embryos per transfer. A total of 23 clinical pregnancies resulted, with a pregnancy rate of 20.5% and 29.9% per cycle and embryo transfer, respectively. There were three cases of multiple pregnancy (13.0%), two (8.7%) miscarriages occurred and one patient (4.3%) had a tubal pregnancy. The rate of successful pregnancies was thus 17.9% per cycle. Five patients (5.2%) required treatment for overstimulation. There were not other treatment complications. These results show that highly purified FSH can also be used successfully in IVF after pituitary down-regulation. The remaining endogenous LH activity in these cases may be regarded as sufficient for follicular development and steroid synthesis. Highly purified FSH can therefore be used for all stimulation protocols in patients with normal gonadotrophin levels. The relatively low rate of miscarriages with this treatment is noteworthy.

Adult↗
PubMed1996

Comparison between hysterosalpingo-contrast sonography and sonographically controlled selective tubal catheterization.

Hysterosalpingo-contrast sonography was compared with sonographically controlled selective tubal catheterization (STC) in 26 infertile women who complained of infertility. Both procedures were carried out on a single examination date. A group of 10 patients first underwent hysterosalpingo-contrast sonography followed by STC, while 16 first had STC followed by hysterosalpingo-contrast sonography. The main outcome measure was tubal patency. A total of 52 Fallopian tubes was assessed. Hysterosalpingo-contrast sonography showed 39 tubes (75%) and STC 46 (89%) to be patent, 13 tubes (25%) and six tubes (12%) were diagnosed to be proximally occluded, by means of hysterosalpingo-contrast sonography and STC respectively. Concordant diagnosis with both methods was made in 43 of 52 tubes (83%). When hysterosalpingo-contrast sonography was followed by STC, the concordance rate was 85%. When STC was followed by hysterosalpingo-contrast sonography, the concordance rate was 81%. In one patient the diagnosis of proximal occlusion of one tube as determined by hysterosalpingo-contrast sonography and STC had to be correlated in laparoscopy. In a patient, who after hysterosalpingo-contrast sonography and STC, was suspected to have bilateral proximal occlusion of the tubes, considerable bilateral proximal stenosis and distal occlusion was documented at laparoscopy. In conclusion, sonographically controlled STC may correct a misdiagnosis in cases where hysterosalpingo-contrast sonography leads to the finding of proximal tubal obstruction. The combination of hysterosalpingo-contrast sonography and STC as an out-patient investigation method for tubal patency assessment in infertile women avoids anaesthesia and radiation. For this reason we recommend the combination of sonographically controlled STC with hysterosalpingo-contrast sonography, at least in cases where proximal tubal occlusion is suspected after hysterosalpingo-contrast sonography. The influence of the order in which the two methods are used on the results of both should be investigated in a randomized study.

Adult↗
PubMed1996

[Vaginal reconstruction in vaginal aplasia by a Vecchietti modified laparoscopic operation--further simplification of the method].

We describe on a case of a patient with Mayer-v. Rokitansky-Küster-syndrome the formation of a vagina by a laparoscopic modification of the Vecchietti-procedure. A further simplification of this procedure is the use of a laparoscopic needle-holder to tense the strings above the abdominal wall. We even abandoned the use of a prothesis after finishing the tension phase. Instead, we allowed early intercourse on the third day of extraction of the vaginal phantom.

Adolescent↗
PubMed1994

[Vaginal ultrasound cervix imaging in pregnancy--predictive value of suspicious findings on the subsequent course of pregnancy].

To evaluate the use of serial measurement of cervical length and width of internal os by means of vaginal ultrasound 144 pregnant women were examined prospectively. We hypothesized, that cervical length and width of the internal os would be significantly different in normal patients and those with preterm labor or cervical incompetence. Predictive validity of suspicious findings indicating the occurrence of preterm labour and cervical incompetence in further course of pregnancy should be assessed. Anamnestic, sonographic and outcome data were analysed. To assess sensitivity, specifity, positive and negative predictive values, different values of cervical length and width of internal os between 20 and 27 weeks were analysed. Significant differences of cervical length and width of internal os in normal and pathologic pregnancies could be documented early in pregnancy course. By further investigation early suspicious findings indicating the developing pathology were found only for the subgroup with cervical incompetence. Sensitivity of vaginal ultrasound examination between 20 and 27 weeks indicating the whole pathologic collective was only 30%, whereas up to 55.5% of pregnancies complicated by cervical incompetence were detected. Specifity (up to 95%) and negative predictive value (90%) were high. The results show that cervical examination by vaginal ultrasound allows early detection of developing cervical incompetence. The high specifity and the high negative predictive value may be useful to exclude cervical incompetence in clinically unclear cases thus helping to avoid unnecessary therapeutical interventions.

Adult↗
PubMed1992

[Fetal teratoma--diagnosis and management].

Fetal and neonatal teratoma is rare, but it is the most common tumor of the fetus and meonate. We report seven cases with fetal sacrococcygeal teratoma and two cases with craniocervical teratoma. The diagnosis, further management of pregnancy and birth are described and compared with recent literature. While craniocervical teratoma is associated with very poor prognosis, there are sacrococcygeal teratoma with good survival rate and postoperative good functional results. Very important is prolongation of pregnancy near to term.

Coccyx↗
PubMedDate not supplied

[Pregnancy in Takayasu arteritis].

We report the course of pregnancy in a patient with Takayasu's arteritis type I and describe the diagnostical and therapeutical management with repeated Doppler-sonography. Immunosuppressive therapy was reduced in pregnancy and could be maintained on a low level even after delivery. In the third trimester arterial blood pressure raised up to 190/60 mm Hg and was sufficiently lowered by prescription of verapamil. Repeated Doppler-sonographic investigation beginning with 20 weeks of gestation revealed indices in the normal range during the whole pregnancy. After 37 weeks of gestation a healthy infant was delivered vaginally. The post partum course was uneventful.

Adult↗