Human placental lactogen (HPL), alpha-fetoprotein, prolactin and growth hormones were assayed simultaneously twice weekly in 21 women from 4--16 weeks' gestation. Mean levels were established from 15 of the women for comparison with one woman with a twin pregnancy, two who aborted and three who received progestogen supplements. There was wide interpatient variation in all hormone levels excepting HPL. The mean levels of all except growth hormone showed an upward trend. Mean growth hormone levels were higher initially but remained within a 2--4 ng/ml range throughout. In the twin pregnancy, only HPL and alpha-fetoprotein levels were significantly raised. HPL was detected in one of the two women who aborted, whereas growth hormone was initially extremely high, falling precipitously prior to abortion in both women. Treatment with progestogen supplements did not appear to influence any of the hormones measured. This study suggests that serial estimations of HPL appear to be the most cost-effective guide to early fetal well-being of the four hormones measured.

Abortion, Spontaneous↗

PubMedDate not supplied

Essential pre-conceptual measures for the female partner before commencing an in vitro fertilisation programme.

Two hundred and eighty-one women were checked for the presence of specific pre-conceptual data and their medico-legal implications prior to commencing an in vitro fertilisation (IVF) programme. In only 9.6 per cent were the results of a recent rubella test available in the patients referral notes. Fifty-four per cent were then tested in the unit. Two per cent were found to be not immune. Thirty-six per cent of women needed a cervical smear prior to commencing therapy. No such test had been undertaken previously in 6.7 per cent and 12.7 per cent had abnormal test results. Pre-conceptual intake of folic acid is considered an important preventative measure. The patient uptake rose from 15 per cent to 97 per cent following specific advice.

Adult↗

PubMedDate not supplied

Establishing an intracytoplasmic sperm injection (ICSI) programme for the treatment of male factor infertility in Ireland.

This paper chronicles the introduction and initial experiences of Intra Cytoplasmic Sperm Injection (ICSI) as a treatment for severe male factor infertility in Ireland. Following initial development of the technique using a bovine model, therapy was offered clinically from September 1995. Up to March 1996 a total of 60 couples underwent the procedure. Fertilisation and embryo transfers were achieved in 50 of these (83.3 percent). Fourteen (23 percent) became clinically pregnant per cycle commenced, 28 percent per embryo transfer. Despite a drop in the total number of oocytes available, fertilisation rates rose over the 6 months of the study from 22 percent to 54 percent. There were 2 miscarriages (14.2 percent) and the multiple pregnancy rate was 28.5 percent. Eight singletons, 2 twins and 2 triplet sets have been successfully delivered. Provided there is proper patient selection, ICSI should prove a valuable addition to treatment options available to infertile couples in Ireland.

Adult↗

PubMedDate not supplied

The assessment of fetal maturity in utero by amniocentesis.

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Amniocentesis↗

PubMedDate not supplied

The provision of a semen cryopreservation service for male cancer sufferers in the Republic of Ireland.

BACKGROUND: Chemotherapy, radiotherapy and surgery for cancer all carry risks of sterility. Semen cryopreservation would allow procreational ability to be preserved. METHODS: A human-assisted reproduction unit was set up in the Rotunda Hospital where semen was cryopreserved and stored for use. RESULTS: Semen was frozen for procreational potential during 1998 from 58 males about to have oncology therapy likely to render them sterile. The planning for this service and the modus operandi now in place are described. While cryopreservation was not unsuccessful in any case, substandard samples were obtained from 14 men. Pre-freeze viral tests tested positive for CMV in six patients. One pregnancy is already on-going utilising IVF with thawed semen. One patient's death has been notified and the frozen semen disposed of. CONCLUSION: The service is, at present, outside public purse provision. It is hoped that in the near future this will change, as the deficit between charges and costs cannot be sustained in-house forever.

Cryopreservation↗

PubMedDate not supplied

Initial experiences of a testicular sperm extraction programme for assisted reproduction in Ireland.

BACKGROUND: The technique aspirating spermatozoa from the testis is a new development in male infertility treatment. It is appropriate for infertile couples where the male has azoospermia but is still producing live motile spermatozoa in the testes. AIM: To describe the initial experiences of a testicular sperm extraction programme (TESE) coupled with intracytoplasmic sperm injection (ICSI) in 18 men during 1998. METHODS: Spermatozoa were obtained by direct aspiration from the testes using a 16 gauge needle with cannula and negative suction under local anaesthetic. All samples obtained were to be cryopreserved for use in a subsequent ICSI cycle. RESULTS: All five men with congenital bilateral absence of the vas deferens to be carriers of cystic fibrosis gene mutations. No gene deletions were found in their wives. No other cyto or molecular genetic abnormalities were otherwise found. Twenty one procedures were carried out. The mean number of aspirations was 1.72. Eleven samples from 10 men had sperm suitable for ICSI post-freeze. Post-procedure pain was the universal side-effect. Eight couples had a single attempt at ICSI, two couples two each. Fertilisation rate was 71.4%. Two pregnancies were achieved. CONCLUSION: TESE may give hope in selected cases of azoospermia of fathering a child without the involvement of a third party.

Adult↗

PubMedDate not supplied

Fibrillary glomerulonephritis and pulmonary haemorrhage in a Woolly monkey (Lagothrix lagotricha).

Fibrillar deposits, distinct from amyloid deposits, were demonstrated by electron microscopy in the glomeruli and lung of an Amazonian Woolly monkey (Lagothrix lagotricha) which had died with extensive pulmonary haemorrhage. The renal lesions were typical of fibrillary glomerulonephritis in man, and IgG deposition was also demonstrated in the kidney. The association of renal and pulmonary lesions has been reported previously in man, but this is the first report of fibrillary glomerulonephritis, and a pulmonary-renal syndrome, in non-human animals.

Actin Cytoskeleton↗

PubMedDate not supplied

Bone density changes during two years treatment with tibolone or conjugated estrogens and norgestrel, compared with untreated controls in postmenopausal women.

OBJECTIVE: To quantify and compare the effect of two different hormone replacement therapy regimens on bone mineral density (BMD) and serum alkaline phosphate levels against a group of no treatment control volunteers. METHODS: An open 104-week comparative study of 113 early postmenopausal women. Fifty volunteered for the no treatment arm; the remainder were randomized to tibolone (T) (n = 32) or conjugated estrogens plus sequential norgestrel (CEEP) (n = 31). BMD was measured at baseline and after 48 and 96 weeks by dual photon absorptiometry. RESULTS: Baseline BMD was lower in nontherapy controls and with women assigned to CEEP compared with the T group. Statistical significance was not reached. By 96 weeks, increased BMD was observed with both therapies at all sites, whereas controls had lost bone compared with baseline. Changes from baseline with both preparations were significantly different (p < 0.05) from changes in controls for all sites, except femoral neck where the change was significant only with CEEP (p < 0.05). Alkaline phosphatase was significantly reduced in both treatment groups compared with controls (p < 0.05) at 48 and 96 weeks. CONCLUSIONS: The significant increases in BMD with T and CEEP confirm both regimens are effective in preventing osteoporosis. Without treatment, BMD declines postmenopausally.

Alkaline Phosphatase↗

PubMedDate not supplied

Observations on the motility, ultrastructure and elemental composition of human spermatozoa incubated with caffeine.

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Adult↗

PubMedDate not supplied

Variations in elemental distribution in human spermatozoa.

Morphologically normal spermatozoa from groups of men attending the infertility clinic with normal density and motility had subcellular elemental composition measurements from various parts of the spermatozoa compared with anatomically similar spermatozoa from semen with marked oligo- or asthenozoospermia. In the two groups of semen the mean % value of the elements was similar in the acrosome, nucleus, mid-piece and tail regions excepting sodium and potassium which were significantly lower in the abnormal semen. Although a similar elemental distribution was found in each group the observed trend towards higher total values in the abnormal semen did not reach significance. Highest levels were found in the nuclear and mid-pieces of all spermatozoa suggesting future diagnostic possibilities for such measurements in determining spermatozoal procreative potential.

Elements↗