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Biomedical subjects

P Devroey

Publications and source records attributed to P Devroey.

At least 307 records · Page 17Linked to original sources
PubMed1987

Effects of etomidate on ovarian steroidogenesis.

The present study investigated the influence of two i.v. induction agents, etomidate (0.25 mg/kg) and thiopental (4 mg/kg) followed by isofluorane anaesthesia on the venous blood concentrations of prolactin (PRL), follicle-stimulating hormone (FSH), 17 beta-oestradiol (E2), progesterone (P), 17OH-progesterone (17OH-P) and testosterone (T) in 18 patients during laparoscopy for oocyte aspiration for in-vitro fertilization. A sharp decrease in the plasma concentration of E2 (P less than 0.01), P (P less than 0.01), 17OH-P (P less than 0.01) and T (P less than 0.01) was observed within 10 min after induction of anaesthesia with etomidate, followed by a gradual return to the baseline levels thereafter. No such decrease was noted after the administration of thiopental. These findings suggest that etomidate, which has previously been reported to inhibit adrenocortical steroidogenesis, can also interfere with the endocrine function of the ovary.

17-alpha-Hydroxyprogesterone↗
PubMed1987

Gamete intra-Fallopian transfer: evaluation of 100 consecutive attempts.

The results of 100 gamete intra-Fallopian transfer (GIFT) procedures to treat persistent infertility are reported. Twenty-four pregnancies were achieved, of these six aborted, two were extra-uterine, two stillbirths occurred and nine patients delivered 11 healthy children (two sets of twins) and five pregnancies are progressing well, including two sets of twins. Pregnancy rate in the different groups of patients was: 28% for idiopathic infertility (n = 39), 13% for male infertility (n = 16), 22% for endometriosis (n = 27), and 29% in the presence of antisperm antibodies (n = 7). In our GIFT procedure, we place three oocytes and 50,000 to 100,000 motile spermatozoa per patient into one healthy tube, the remaining oocytes being inseminated and cultured in vitro. Of 502 oocytes recovered, 252 fertilized normally and 178 early embryos were frozen. The replacement of 41 frozen-thawed embryos resulted in five additional, ongoing pregnancies. The combined treatment by gamete intra-Fallopian transfer, in-vitro fertilization and cryopreservation increases the chance of conception.

Adult↗
PubMed1987

Management of failed cycles in an IVF/GIFT programme with the combination of a GnRH analogue and HMG.

The addition of the gonadotropin releasing hormone (GnRH) agonist Buserelin to human menopausal gonadotrophin/human chorionic gonadotropin (HMG/HCG) during ovarian stimulation was evaluated in 23 cycles of 21 women who previously had unsuccessful IVF treatments when stimulated with clomiphene--HMG/HCG. No adverse effects of GnRH-agonist on folliculogenesis were seen. A mean number of 7.2 oocytes per retrieval was collected in 20 treatment cycles. Oocytes quality, fertilization and cleavage parameters were normal. Replacements by gamete intra-Fallopian transfer (GIFT) or IVF took place for 16 patients. Four patients became pregnant in their treatment cycle, one aborted. For 8 patients 18 embryos were cryopreserved, one transfer of a frozen--thawed embryo in a subsequent natural cycle led to a pregnancy. Inadequate luteal phases were constantly observed when supplementation was omitted. Further study is required to confirm that systematic luteal support improves the pregnancy rate.

Adult↗
PubMed1987

Ovarian stimulation, including in vitro fertilisation.

The stimulation regimens and the results of ovulation induction in anovulatory patients and in patients suffering from a Luteinized Unruptured Follicle (LUF) syndrome are discussed as well as the findings concerning superovulation in IVF cycles. The percentage of multiple pregnancies (less than or equal to 20 p. cent) is acceptable, due to the accurate daily performance of hormonal determinations. The pregnancy rate is lower in a LUF population, than in anovulatory patients. This is likely due to the unknown pathophysiology of the LUF syndrome. Compared to natural cycles, the maximum serum LH concentration is reduced in stimulated cycles although multiple oocytes have to mature in superovulated patients. A possible explanation for these reduced LH surges could be an increase in inhibin -like substances. There is still a need for more research to find out the real interaction between the follicle and the hypothalamic-hypophysial axis.

Anovulation↗
PubMed1987

Pregnancies without corpus luteum rescue.

Four beginning pregnancies after cycles with ovarian stimulation are described. Due to a delay of implantation no rescue of the corpus luteum occurred. At first the cycles ended with menstruation, negative serum hCG and normal low serum steroid hormone concentrations. A new stimulation was started and subsequently terminated as soon as the pregnancies were detected. There was no progesterone production in all these four cases during the first 9-13 days of pregnancy. Induced by the renewed stimulation new follicular development was noticed in three patients, followed by ovulation during pregnancy. Two clinical pregnancies were the result, one with good further evolution and delivery, and one aborted at 10 weeks after the first menstrual period. The other two pregnancies ended with preclinical abortions.

Abortion, Incomplete↗
PubMed1986

Evaluation of one-hundred open-ended vasectomies.

Open-ended vasectomy was performed on one-hundred men. Sixty-three of them showed up for follow-up six months later. Spontaneous recanalisation had occurred in two. Sperm granuloma without orchialgia was found in 14 out of 59 men (23.9%). Twenty-one out of the 63 thought their sex life had improved, while 40 thought it was unchanged; only one man mentioned pain during intercourse since vasectomy.

Adult↗
PubMed1986

Recovery of microorganisms in semen and relationship to semen evaluation.

Semen samples from 120 consecutive unselected men attending our fertility clinic were studied to determine the bacterial isolation rate of semen and its influence on semen quality. Each sample was cultured aerobically, anaerobically, and for Ureaplasma urealyticum and Mycoplasma hominis. The following were analyzed for each semen specimen: motility, morphologic features, and number of sperm cells and viscosity of the ejaculate. Four of the 120 samples had negative results; 101 cultures yielded one or more aerobic organisms (the majority with less than 20,000 microorganisms/ml); 26 yielded anaerobic organisms; and 40 yielded U. urealyticum. No single aerobic or anaerobic organism could be related to abnormal semen samples. Only the presence of U. urealyticum correlated significantly with abnormal semen samples (P less than 0.005). The most affected parameters were the number of spermatozoa (P less than 0.005) and motility (P less than 0.05). We conclude that routine aerobic and anaerobic bacterial cultures of semen are not useful in the clinical evaluation of male infertility. The usefulness of routine screenings for U. urealyticum must be investigated further.

Bacteria, Aerobic↗
PubMed1986

Treatment of infertility because of oligoasthenoteratospermia by transcervical intrauterine insemination of motile spermatozoa.

Fifty-three couples with longstanding infertility, the woman being potentially fertile and the man having poor-quality semen, were admitted to a therapeutic trial. A high intrauterine instillation of a washed motile fraction of spermatozoa from the subfertile man was performed in the woman on the day of ovulation. After 130 treatment cycles, 9 of the 53 women had conceived, all within 3 cycles. This simple and painless procedure can be considered an alternative treatment in oligoasthenoteratospermia.

Female↗
PubMed1986

Endocrine profiles in early pregnancies with delayed implantation.

Delayed implantation in cycles with ovarian stimulation and ovulation induction was observed in eight patients. Endocrinological evidence for ovulation during pregnancy is presented in three cases; in one of them the implantation was evidently rescued by a new active corpus luteum. All pregnancies had the following factors in common: (1) A delay in the detection of the first positive serum human chorionic gonadotrophin (HCG) by 4-5 days. (2) The corpus luteum was not rescued initially and menstruation started at low serum concentrations of 17 beta-oestradiol and progesterone between 12 to 18 days (13.8 +/- 1.9 days) after induction of ovulation. (3) Because of the negative HCG, menstrual bloodloss and low steroid hormone concentrations, a new ovarian stimulation was started and continued for some days until pregnancy was detected. On the basis of the endocrine findings, three different forms of delayed implantation could be distinguished. Two of the eight pregnancies had a normal progression until full-term delivery, two developed into echographically-confirmed clinical pregnancies, but aborted at 9 and 11 weeks after the first menstrual period had started. The remaining four ended with a preclinical abortion between 7 and 8 weeks.

Adult↗
PubMed1986

Evaluation of radioimmunoassays using mono- and polyclonal antibodies for the quantitation of human chorionic gonadotropin in early pregnancy.

Five commercial kits for the quantitative determination of human chorionic gonadotropin (hCG) were evaluated for use in an In Vitro Fertilization program. We focused on practicability, precision, sensitivity and the early detection of pregnancy. The IRE method uses purified antiserum against complete hCG and requires overnight incubation. Precision is poor but hCG results agree closely with the other assays. Three other kits use a beta-subunit specific antiserum (Amersham, Becton-Dickinson, Clinical Assays). All these assays have acceptable precision especially in their mid-range. The Amersham assay has the shortest assay time, while the Clinical Assays method requires the least manipulation. The Becton Dickinson assay is precise, less sensitive and has the highest frequency of slightly elevated hCG levels in males and non pregnant females. The Hybritech kit is an immunoradiometric assay based on two monoclonal antibodies. It was tested with a two-step incubation procedure needing a longer assay time than the beta-subunit specific assays but it has the best precision at low hCG levels and is the most sensitive test with the least interference in samples obtained from males and non-pregnant females. For the early detection of pregnancy all assays performed equally well.

Antibodies↗
PubMed1985

Successful in vitro fertilization with sperm cells from a man with immune infertility.

In vitro fertilization and embryo transfer was carried out in a couple that has been infertile for 7 years. High titers of antisperm autoantibodies in the husband's serum are (table, see text) believed to be the main cause of their infertility. Prolonged methylprednisolone treatment of the man combined with artificial insemination remained unsuccessful. In two IVF attempts embryos were obtained and replaced using capacitated sperm of the husband. A pregnancy was established in the second IVF cycle, but a spontaneous abortion followed after 6 weeks of amenorrhea.

Adult↗
PubMed1984

Evaluation of commercially available radioimmunoassays for the determination of luteinizing hormone in serum and urine. Application for the detection of endogenous rise of luteinizing hormone in a in vitro fertilization program.

Three commercially available RIA kits for serum and urinary LH were assessed for their usefulness to detect endogenous LH rise in patients receiving ovarian stimulation as part of an in vitro fertilization treatment for infertility. Prerequisites included a turn-around time of 5 hours for an assay of 100 tubes. The following parameters were evaluated: reproducibility of standard curve, sensitivity, precision profile, within- and between-assay precision, analytical drift, recovery and linearity. The Amerlex LH RIA kit was selected because of superior precision profiles, higher precision and better recovery tests.

Clomiphene↗
PubMedDate not supplied

Impact of ovarian stimulation on corpus luteum function and embryonic implantation.

The luteal phase has been found to be defective in virtually all the stimulation protocols used in in-vitro fertilization (IVF), indicating that common mechanisms might be involved despite the use of different drugs. A normal luteal phase is characterised by a normal hormonal environment, normal progesterone secretion by the corpus luteum and adequate endometrial secretory transformation. Luteinizing hormone supports the corpus luteum and luteal luteinizing hormone (LH) levels have been found to be reduced in human menopausal gonadotrophin (HMG), gonadotrophin-releasing hormone (GnRH)-agonist/HMG and GnRH-antagonist/HMG protocols, probably leading to an insufficient corpus luteum function. Supraphysiological steroid serum concentrations routinely observed in stimulated cycles may adversely affect LH secretion and induce a luteal-phase defect. In turn, these high steroid serum concentrations may advance early luteal-phase endometrial development leading to embryo-endometrial asynchrony and decreased pregnancy rates in IVF cycles.

Chorionic Gonadotropin↗
PubMedDate not supplied

Should requests for donor insemination on social grounds be expanded to transsexuals?

Donor insemination may provide an answer to transsexuals with female partners who have a wish for a child. Although the follow-up on children born in the context of these families is non-existent and the follow-up on transsexuals after sex reassignment surgery (SRS) is limited, fertility centres might consider accepting the requests of transsexuals with a female partner. Between 1997 and 2001, nine couples presented themselves at the Centre for Reproductive Medicine of the Dutch-speaking Brussels Free University, of whom five couples were accepted. Nevertheless, some caution is called for because transsexualism is socially not accepted. Moreover, transsexualism is still considered to be psychiatric condition. The following recommendations should be taken in consideration. Treatment should be limited to female-to-male transsexuals with a female partner. A multidisciplinary team of specialists should carry out the diagnosis for gender identity. Developmental problems of the gender-disordered child might interfere with socio-economic, psychological and emotional stability in adulthood. The period of sex reassignment should be nearly completed.

Adaptation, Psychological↗