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Biomedical subjects

P Riss

Publications and source records attributed to P Riss.

At least 55 records · Page 3Linked to original sources

Hormonal parameters in follicular fluid and the fertilization rate of in vitro cultured oocytes.

Oocytes and matched samples of follicular fluid were obtained from 52 preovulatory follicles aspirated laparoscopically for in vitro fertilization (IVF). Follicular fluid concentrations of estradiol (E2), progesterone (P), testosterone (T), prolactin (HPRL), prostaglandin F2 alpha (PGF2 alpha), prostaglandin E (PGE), protein content, and collagenolytic activity were measured and related to the fertilization rate of oocytes cultured in vitro. High concentrations of P and low levels of T and HPRL were associated with mature, fertilizable oocytes. Levels of PGF2 alpha, PGE, and follicular fluid protein concentrations were similar in both groups. Mean collagenolytic activity was increased in the fertilized oocytes, although no significant difference could be observed. Our data demonstrate a close association between follicular fluid steroid and HPRL concentrations and successful fertilization of oocytes.

Dinoprost↗

Follicular aspiration for in vitro fertilization: sonographically guided transvaginal versus laparoscopic approach.

Laparoscopy is the most commonly used procedure for oocyte retrieval in an in-vitro fertilization (IVF) program. In this study we compared the results of 21 laparoscopic and 21 sonographically guided transvaginal oocyte retrievals using a vaginal probe. Laparoscopically 3.7 and transvaginally 4.8 oocytes per patient were recovered. Overall 6 pregnancies were achieved, giving a pregnancy rate of 14.1% per patient. Vaginal follicular aspiration resulted in a higher oocyte recovery rate. The advantages of the method were a shorter operation time, a superficial anesthesia and, compared to laparoscopy, a less invasive and simpler technique. Therefore this method is now commonly used for routine IVF procedures in our institution.

Adult↗

[Effect of serum prolactin on cycle stimulation and fertilization of human oocytes].

During cycle stimulation for in-vitro fertilisation (IVF) some patients develop hyperprolactinaemia. Since prolactin (PRL), being an aromatase inhibitor, can interfere with follicular fluid steroid metabolism, we examined the influence of high serum PRL levels on the endocrine response and fertilisation rate of oocytes. 33 consecutive patients stimulated by hMG/hCG for IVF were included in this study. Two groups of patients were established: Group 1 consisting of 18 patients with serum PRL levels less than or equal to 25 ng/ml, and group 2 containing 15 patients, who developed PRL levels greater than 25 ng/ml during cycle stimulation. The serum oestradiol (E2), progesterone (P) and PRL levels 3, 2 and 1 day before and at the day of follicle puncture were evaluated. The decrease of E2 levels at the day of oocyte retrieval was significantly steeper in group 1. The P levels 2 days before oocyte retrieval were significantly higher in group 1 indicating the onset of preovulatory luteinization. Luteinization after the hCG injection was more effective in group 1 resulting in significantly higher P levels. Fertilisation and cleavage rates were significantly higher in patients with normal PRL levels. High serum PRL levels therefore might indicate an interference in follicular and oocyte development leading to oocytes of inferior quality.

Chorionic Gonadotropin↗

[Intrauterine pregnancy following intratubal gamete transfer--a case report].

Since the beginning of 1986 gamete intrafallopian transfer (GIFT) has been used in the treatment of infertile couples. Only patients in whom tubal patency has been ascertained are included in the programme. After hormonal stimulation of the ovaries and laparoscopic follicular aspiration oocytes and semen are transferred by means of catheterisation into the fallopian tubes. The first pregnancy in our department established by gamete intrafallopian transfer--and the first in Austria to our knowledge--is reported.

Adult↗

[Value of anamnesis and the clinical stress test in the diagnosis of incontinence before gynecologic operations].

In a study comprising 471 patients the clinical value of a standardized questionnaire (Gaudenz questionnaire) and the standing clinical stress test were determined in the diagnosis of urinary incontinence. The sensitivity, specificity and predictive value of the positive and negative test of both methods were ascertained. As opposed to the final urodynamic result the clinical stress test alone showed a sensitivity of 48% (specificity 70%) in the diagnosis of genuine stress incontinence. 82% of all patients with stress incontinence were ascertained by the questionnaire, but only 54% were classified correctly as negative. The specificity of both methods combined was 94% and the predictive value 89%. On the other hand the questionnaire's predictive value in the diagnosis of urge incontinence was 9% (specificity 58%). However, the predictive value of both questionnaire and standing clinical stress test, combined, rose to 15%. Our results statistically demonstrate that the use of both methods together provides more significant information than the use of either separately.

Female↗

Pregnancy-specific parameters in early pregnancies after in vitro fertilization: prediction of the course of pregnancy.

The plasma concentrations of the beta subunit of human chorionic gonadotropin (beta-hCG), pregnancy-specific glycoprotein, and progesterone were measured in 37 pregnancies after in vitro fertilization. Twenty-one pregnancies ended with delivery, 9 as clinical abortions, and 7 as biochemical abortions. To predict the pregnancy outcome as early as possible, we designed a prediction graph by calculating a "cutoff line" using discriminant analysis and prediction bands up to 95% probability. This prediction graph can help in the estimation of the probability of pregnancy outcome with satisfactory reliability by determination of beta-hCG only.

Abortion, Spontaneous↗

Factors influencing successful in vitro fertilization and embryo transfer: a matched pair study.

In the present matched-pair study successful and unsuccessful IVF-ET trials in patients with similar preconditions were compared. Sixteen consecutive cases of clinical pregnancies after IVF and ET were included. For each pregnant patient the subsequent patient who fulfilled the matching criteria and who did not conceive was chosen as a control subject. The matching criteria were the stimulation regimen and the number of embryos transferred. Pregnant and nonpregnant patients were compared with regard to their age, the total dosage of hMG, the cycle day at oocyte retrieval, the E2 levels 48 and 24 hours before laparoscopy, the E2 rise, the number of retrieved oocytes, and the cleavage rate. In both groups the investigated variables showed no significant difference between pregnant and nonpregnant patients. In patients with the same cycle stimulation and the same number of embryos transferred, successful implantation was not predictable by the evaluated parameters.

Adult↗

[Morphologic changes in anterior levatorplasty].

In a follow-up study 3-12 months after a modified anterior repair we examined 36 patients clinically, urodynamically and by means of plastic moulds of the vagina. Though 30/36 patients said they were improved by the operation problems at intercourse were frequent: more than a third of the patients complained about stenosis of the vagina. On the vaginal moulds the diameter of the impression of the levator muscle was 0.5 cm smaller after modified anterior repair as compared to colporrhaphy. 33/36 patients developed a descent of the posterior vaginal wall. We conclude that a satisfactory correction of a descent of the vagina can be achieved by the modified anterior repair; however a large number of patients develop rectocele and stenosis of the vagina with subsequent difficulty at sexual intercourse.

Adult↗

[Anterior levatorplasty in prolapse and incontinence: a clinical and urodynamic study].

In this follow-up study we demonstrate the clinical and urodynamic results in 46 patients who underwent modified anterior repair because of vaginal prolapse or incontinence. Besides frequent inflammations of the lower urinary tract (70%), dehiscence of the anterior vaginal wall was quite common (30%). Considering the patient pre- and postoperative anamnestic data, we found a significant increase in continent patients (4 preoperative-18 postoperative). The urodynamic parameters showed a change in the first urge to void at significant higher bladder volumes, and a significant increase of the functional length of the urethra. After surgery a negative stress profile and a positive clinical stress test were seen less often.

Adult↗

[Effect of induced abortion on prematurity. Analysis of the period from 1979 to 1984].

Since induced abortion is legalized in Austria the number of patients with induced abortion in their anamnesis is increasing. This factor intensified the discussion about the consequences for following pregnancies, especially the number of preterm deliveries. We investigated the influence of induced abortion on prematurity using the records of primiparae who delivered in our hospital between 1979 and 1984. Previously performed induced abortion did not affect the number of preterm-deliveries, if patients underwent early prenatal care. Patients who had their first check-up after the 18th week of gestation showed a significant increase of preterm delivery.

Abortion, Induced↗

[Changes in the diagnosis and therapy of extrauterine pregnancy].

In a retrospective study the records of all patients with proven ectopic pregnancy during the years 1971-1973 (n = 41) and 1981-1982 (n = 59) were reviewed with regard to age, symptoms, medical history, diagnostic methods, therapy, and clinical course. Particular attention was given to endocrine diagnostic methods (LH, beta-HCG), ultrasound examinations, and changes in operative therapy. The duration from admission to diagnosis of the ectopic pregnancy decreased from 5.6 to 3.3 days, circulatory shock from 32 to 10%. During 1971-1973 the fallopian tube was removed in 95%, during the years 1981-1982 only in 34%. Our study shows that modern diagnostic methods permit earlier diagnosis of ectopic pregnancy, and that in the majority of cases the removal of the fallopian tube is not necessary.

Abortion, Induced↗

The prevalence of ureaplasma, mycoplasma and antibodies against chlamydia group antigen in gynecological outpatients.

177 women with an average age of 30 years were investigated for ureaplasma, mycoplasma and for antibodies against the chlamydia group antigen. Specimen of endocervical mucus and catheter specimens of urine were cultured and the ELISA ("enzyme-linked immunosorbent assay") technique applied. In addition the purity class (I to III) of gram-stained vaginal smears was determined. Ureaplasma were isolated from 45.8 and 26.0%, mycoplasma from 9.0 and 7.9% of cervical and urine specimens respectively. The patients were divided into 5 clinical groups. Patients in the first three groups (I-III, inflammatory disorders, bleeding anomalies, benign and malignant neoplasms of the genital tract) showed a significantly (p less than or equal to 0.05) higher colony count of ureaplasma in their urine than patients in the other two groups (IV and V, who had attended the hospital for reproductive problems or for routine examination). There was a clear correlation between the isolation rates of ureaplasma and mycoplasma and the purity classes of the vaginal smears. The rate of isolation increased progressively with class II and III smears. Antibodies against the chlamydia group antigen were detected in about 40% of all sera tested. A very high titer of antibodies reflecting a recent chlamydial infection was found in 11% of the sera tested.

Adolescent↗

Studies on the fibrinolytic activity of the human female genital tract.

The success of a fibrin glue depends on the correct admixture of fibrinogen, thrombin, and the proteinase inhibitor aprotinin. Using a modification of Astrups method we measured the fibrinolytic activity of surgical specimens of human fallopian tube and uterus. Increasing concentrations of aprotinin were added until there was complete inhibition of fibrinolysis. The fallopian tube and the uterus had higher intrinsic fibrinolytic activity than peripheral nerve tissue. At concentrations of between 10 and 20 KIU of aprotinin, fibrinolysis was blocked in all tissues studied.

Aprotinin↗

[Effect of late motility on the fertilization of ova in the IVF program].

In the course of the IVF programme at our department we made the observation that even with primarily normal sperm counts late motility often varies widely. The impression that late sperm motility might be related to successful fertilisation caused us to study the influence of late sperm motility on fertilisation rates in a series of 80 patients. Sperm was capacitated with B2 medium (Menezo INRA). Even in the presence of an originally normal sperm count, reduced late motility was associated with lower fertilisation and embryo transfer rates. It seems that late sperm motility will have to be considered as an important parameter in evaluating the prognosis for successful IVF and ET.

Adult↗

Investigation of beta-endorphin and adrenocorticotropic hormone in placenta, amniotic membrane and umbilical cord using an immunoperoxidase technique.

The identification of immunoreactive beta-endorphin, beta-lipotropin and ACTH from extracts of human placentas by radioimmunoassay suggests a probable synthesis of these peptides in the placenta. In this study we investigated the presence of beta-endorphin and ACTH in placenta, amniotic membranes and umbilical cord using a peroxidase-antiperoxidase staining technique. Tissues were obtained immediately after delivery, fixed in formalin and embedded in paraffin. As control tissues autopsy specimens of pituitary glands from adults and newborns were used. All sections of pituitary glands showed a positive reaction; negative results were observed in sections of placentas, umbilical cords and amniotic membranes. We conclude that no intracellular storage of beta-endorphin and ACTH takes place in the examined tissues.

Adrenocorticotropic Hormone↗