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Biomedical subjects

Norbert Gleicher

Publications and source records attributed to Norbert Gleicher.

25 records · Page 2Linked to original sources
PubMed2003

Modern obstetrical and infertility care may increase the prevalence of disease: an evolutionary concept.

OBJECTIVE: To explore the hypothesis that the increasing prevalence of some polygenetically inherited conditions, may, to a degree, be the consequence of treatment successes of modern health care that have overcome evolutionary blocks to reproductive success. DESIGN: Hypothesis, based on a selective review of the literature. SETTING: University-affiliated private infertility center. Patient(s)None. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Occurrence of polygenetically inherited diseases. RESULT(S): Successfully treated evolutionary blocks to the inheritance of polygenetically inherited diseases result in an increased prevalence of these diseases in subsequent generations. CONCLUSION(S): Evolutionary processes have erected barriers to successful reproduction for many polygenetically inherited diseases, which are now overcome by successful treatment, leading to an increased prevalence, younger age of occurrence, and greater severity of these diseases in next generation offspring.

Biological Evolution↗
PubMed2003

Bye-bye urinary gonadotrophins? Recombinant FSH: a real progress in ovulation induction and IVF?

Whether recombinant gonadotrophin products do, indeed, represent progress for routine ovulation induction and IVF cycles, in comparison with urinary products, has remained controversial. Here we review published data with regard to respective risks, outcomes and cost for both medication options. Safety considerations favour recombinant products, while overall outcome and cost considerations favour urinary gonadotrophins. Outcome, however, appears to differ, based on age and ovarian function, with younger patients benefiting from the FSH/LH combination offered by urinary products, while older women and young women with ovarian resistance, apparently benefiting from pure FSH stimulation. Young women with poor ovarian reserve may be best stimulated with a pure FSH/antagonist protocol. We conclude that under current pricing structures in the United States, recombinant gonadotrophins do not represent a major progress for the treatments of ovulation induction and IVF. They, however, allow for an improved selectivity of stimulation protocols. The creation of recombinant FSH/LH products and cost adjustments for recombinant products, may affect these conclusions in favour of recombinant products.

Drug Costs↗
PubMed2002

A prospective randomized comparison of the Wallace catheter and the Cook Echo-Tip catheter for ultrasound-guided embryo transfer.

OBJECTIVES: To compare the performance of a new coaxial catheter system with an echo-dense tip (Cook Echo-Tip catheter) with a Wallace catheter during ultrasound-guided ET. DESIGN: Prospective, randomized study. SETTING: Private academically affiliated infertility center. PATIENT(S): Two hundred fifty-one patients undergoing IVF-ET. INTERVENTION(S): The patients underwent ultrasound-guided ET by a single physician with a standardized technique alternately using one of the two catheters. MAIN OUTCOME MEASURE(S): Implantation rates, pregnancy rates, ease of transfer, visualization, and status of catheter tip. RESULT(S): The echo-dense tip of the Cook Echo-Tip catheter was consistently seen with ultrasound guidance, minimizing the need for catheter movement to identify the tip. Implantation rate (30% vs. 35%), clinical pregnancy rate (57% vs. 55%), and ongoing pregnancy rate (49% vs. 47%) were similar in both groups. CONCLUSION(S): The Cook Echo-Tip catheter with its echogenic tip simplifies ultrasound-guided ET, but pregnancy success rates are similar to those obtained when a Wallace catheter is used.

Adult↗
PubMed2002

Some thoughts on the reproductive autoimmune failure syndrome (RAFS) and Th-1 versus Th-2 immune responses.

PROBLEM: The concept of immunologically induced reproductive failure has remained very controversial. Especially the question whether abnormal immune function can cause infertility has recently been subject to strong disagreement. This opinion piece is an attempt to reconcile difference of opinion by integrating clinical data from the human experience with well-established experimental models in animals. METHOD OF STUDY: Review of published literature. RESULTS: Experimental animal data, especially in the mouse, have suggested that normal pregnancy requires a switch to an immune response with T helper (Th)-2 preponderance. Recent data from the human experience suggest that infertility, repeated pregnancy loss and certain complications of pregnancy may be the consequence of abnormal Th-1 preponderance. In analogy, to animal models, immunologic reproductive failure in humans, may therefore not be the consequence of specific autoantibody abnormalities or natural killer (NK)-cell abnormalities, but the reflection of a misdirection of a more broadly based immune response. CONCLUSIONS: Under such a model, both diagnosis and treatment of immunologically induced forms of reproductive failure require re-evaluation. Such a model, however, provides a satisfactory explanation for contradictory findings in the human experience that have led to strong disagreements among investigations.

Animals↗
PubMed2002

The immunological "Wars of the Roses": disagreements amongst reproductive immunologists.

The relevance of abnormal autoimmune function to reproductive function in the female has over recent years become an increasingly controversial and contentious issue. Opposing views have led to a polarization of opinions which, at times, resulted in publications of rather vocal opinions by individuals as well as societal committees. This communication is an attempt to reconcile these, at times diametrically opposing opinions, in a concept of (auto)immune-driven reproduction failure, which could explain and unify these opposing opinions and, thus, hopefully end the ongoing "immunological wars of the roses".

Antibodies, Antiphospholipid↗