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Biomedical subjects

R Frydman

Publications and source records attributed to R Frydman.

414 records · Page 23Linked to original sources
PubMedDate not supplied

Effect of betamethasone on the fetal heart rate pattern assessed by computerized cardiotocography in normal twin pregnancies.

The effects of corticosteroids, given for enhancement of fetal lung maturation, on fetal heart rate (FHR) are controversial and may decrease its variability. FHR patterns were analyzed by computerized cardiotocography in 46 fetuses from 23 normal dichorionic twin pregnancies on days 0, 1 and 4-7 while the mothers received four intramuscular injections of 3 mg betamethasone sodium and 3 mg betamethasone acetate within 48 h to enhance fetal lung maturation. Compared with pretreatment values, FHR showed a decrease in long- and short-term variations; other parameters, e.g. the number of fetal movements, remained unchanged. However, decreased FHR variation was followed by an increase in the acceleration rate after maternal administration of betamethasone. These modifications were transient and should not lead to unnecessary anxiety or intervention in otherwise normal fetuses.

Betamethasone↗
PubMedDate not supplied

Effect of antenatal betamethasone and dexamethasone administration on fetal heart rate variability in growth-retarded fetuses.

PURPOSE: To study the effect of betamethasone and dexamethasone on fetal heart rate in 55 growth-retarded fetuses. MATERIAL AND METHODS: Fifty-five fetuses with intrauterine growth retardation were exposed in utero to betamethasone (group 1, n = 32) or dexamethasone (group 2; n = 17). Six fetuses received both steroids alternatively at weekly intervals. Computerized cardiotocograms were recorded and analyzed retrospectively. Traces were obtained before, 1 day, 2 days and 4-7 days after treatment was started. RESULTS: One day after treatment was started, both steroids were associated with an initial increase in fetal heart rate variation that was higher with dexamethasone. Short-term variation was significantly decreased during the betamethasone course. All parameters returned to their pretreatment values within a week. CONCLUSION: Dexamethasone and betamethasone had similar effects compatible with a transient damping effect on fetal heart rate variability that reached significance only with betamethasone.

Betamethasone↗
PubMedDate not supplied

[Pharmacokinetics of methotrexate and clinical response associated in the medical treatment of ectopic pregnancies].

Methotrexate (MTX) is used in the medical treatment of unruptured ectopic pregnancy. This drug is administered by intramuscular (IM) or intrasaccular (IS) injection under sonographic control. No data are available concerning the pharmacokinetics of MTX in this new indication. This study compares the two administration routes in 12 patients (21 to 37 years) taken as their own control and presenting with ectopic pregnancy (51 +/- 12 days of amenorrhea). Our aim was to compare the pharmacokinetic profile of MTX for each route to facilitate its use in the future. The initial level of hCG was 4.474 +/- 4.184 mIU/ml. Each patient firstly received 1 mg/kg of MTX intrasaccularly under vaginal sonography. The same dose was injected intramuscularly 48 hours later. The pharmacokinetic profiles of MTX after IS and IM administrations were determined after both injections during 48 hours. MTX serum levels were measured by Fluorescence Polarization Immuno Assay. Data were analyzed by model independent methods and compared by a Wilcoxon T test (p 0.01 was considered as significant). All the unruptured ectopic pregnancy were cured and the hCG serum levels were normalized (10 mIU/ml) in 37 +/- 18 days. After IM administration, AUC0-infinity is significantly (p 0.01) increased i.e., 15.1 +/- 4.1 mumol.h/l versus 11.2 +/- 4.8 after IS injection. T1/2 lambda z and MRT remained unchanged whatever the route is i.e., 11.3 +/- 4.9 h and 8.6 +/- 3.9 h (IS) versus 12.1 +/- 5.9 h and 7.3 +/- 1.8 h (IM). The decrement of AUC0-infinity 8 determined after IS injection might be the consequence of the capture of the MTX by the trophoblastic cells (target cells).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Embryonal and early fetal growth after in vitro fertilization and embryo transfer].

Echographic examination allows correlations between crown-rump length and gestational age. In this study the embryonic and early fetal growth after in vitro fertilization and embryo transfer was evaluated by ultrasound (U.S.) marks. 97 measurements in 54 pregnancies between day 39 and 80 after successful fertilization has been performed. Early fetal growth retardation was detected by U.S. when compared to the Robinson curve for normal pregnancy and confirmed after correction for the instrument error. This delay of 3, 3.5 days disappears around the 13 week of pregnancy and is not related to the baby weight at birth. An implantation delay may explain this difference in growth rate between normal and after F.I.V. and E.T. pregnancies.

Adult↗
PubMedDate not supplied

[The antibacterial activity of amniotic fluid with a correlation between zinc phosphorus concentrations (author's transl)].

Antibacterial activity of 22 amniotic fluids collected at different stage of pregnancy have been tested against different types of staphylococci: 209 P, 2961 and Escherichia Coli OMS and 83. At the same time zinc and phosphorus concentration in these fluids have been measured. 77 p. 100 of those fluids present an antibacterial activity, but no correlation has been found with their concentration in zinc and phosphorus. Probably this activity is multifactorial and further studies need to be done to identify the factor or factors responsible for that antibacterial activity.

Amniotic Fluid↗
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Recent data concerning the use of ovulation inductors during in vitro fertilization programs.

Ovulation inductors within the context of an in vitro fertilization program are mainly used in order to be able to know the exact time of the rupture of the follicle and to recover several mature oocytes. In this paper the Author describes the types of ovulation inductors used at present and underlines the fact that the study of the metabolism of the embryo will be a future aim for a better understanding of the success of in vitro fertilization.

Adult↗
PubMedDate not supplied

[Cytogenetic analysis of human oocytes after sperm microinjection].

After standard in vitro fertilization (IVF) chromosome analysis of uncleaved oocytes has shown that in about 80% of the cases, there was no fertilization at all while in 10% of the cases there was a premature chromosome condensation and a development arrest. After micro-injection our results suggest that both the technique itself and the pathologies which require micro-injection can influence the results. On the other hand about 20-30% of the metaphase II oocytes are cytogenetically abnormal after IVF attempt while ICSI might increase chromosome breakage. Our results suggest that both the technique used and the gamete pathologies can influence the different steps of development arrest.

Chromosome Aberrations↗
PubMedDate not supplied

[Study of sperm-cervical mucus interaction in controlled cycles: feasibility of a new approach].

We report a prospective trial of in vitro sperm-mucus penetration test performed in hormonally controlled environment. To enhance the quality of the cervical mucus (CM), prevent spontaneous ovulation and to eliminate the possibility that results may be biased solely because of CM inadequacy, we conceived a 28-day physiological hormonal replacement regimen. For this women received oral estradiol valerate (E2-V) (4 mg/day) from cycle 1 to 28. CM was collected on days 13 (n = 17), 14 (n = 38) or 15 (n = 16), according to patients' individual preferences. The in vitro sperm-mucus penetration test was performed approximately 30 minutes later. On the same day, measurements of P and E2 levels were done to eliminate the possibility of spontaneous ovulation. Plasma E2 on the day of testing were 220 +/- 100 pg/ml (mean +/- SD). In all patients, except 4, P levels were low (< 1 ng/ml) on the day of the test. Our results indicate that a hormonal preparation with E2/P can be clinically useful for preventing spontaneous ovulation and reliably assuring CM quality when sperm/mucus penetration tests are performed.

Administration, Oral↗
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[Hysteroscopy and sperm infection].

After having shown that rate of pregnancies after IVF was higher without sperm infection, the authors demonstrate that the inflammatory aspects of the endometrium (when observed by hysteroscopy) accompany the failures of IVF. At last it exists a positive correlation between endometrial congestion and positive spermculture. Further prospective studies should examine the rate of implantation of women presenting signs of endometrial congestion.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Luteal phase support after vaginal progesterone: comparative study with micronized oral progesterone].

Two progesterone presentations, a vaginal application of 90 mg progesterone per day (Crinone) or 300 mg progesterone orally administered (Utrogestan) were compared for luteal phase support of patients undergoing an in vitro fertilisation (IVF) procedure. 283 patients were randomly allocated to either treatment. The treatment started within 24 hours after the embryo transfer procedure and continued until day 30 in cases of implantation. Efficacy was assessed using the pregnancy and delivery rates. Safety was assessed through specific symptoms and usual safety monitoring. The pregnancy rate per transfer was not significantly different in the Crinone and Utrogestan groups at day 12 (Crinone: 35.3%, Utrogestan: 29.9%, p = 0.55), at day 30 (Crinone: 28.8%, Utrogestan: 25%, p = 0.61), at day 90 (Crinone: 25.9%, Utrogestan: 22.9%, p = 0.69). No difference in spontaneous abortion rates were seen thereafter. The delivery rate was not significantly different (proportion delivery per patients included, Crinone: 23.0%, Utrogestan: 22.2%, p = 1), as well as the ratio new-born per transferred embryo (Crinone: 11.7%; Utrogestan: 11.1%, p = 0.91). Safety parameters were similar in both groups except for drowsiness, which was more significantly frequent in the oral P group than in the Crinone group at all time points. No serious adverse events were recorded in this study. The fact that Crinone matches the efficacy of the larger doses of progesterone used orally reflects an advantage of the transvaginal route of administration which avoids metabolic inactivation of progesterone during its first liver pass.

Administration, Intravaginal↗
PubMedDate not supplied

[Results of oocyte donation in women with different indications, ages and therapeutic strategies].

PURPOSE: Compare the effectiveness of oocyte donation for various indications, ages and treatments. METHODS: Retrospective analysis of 319 transfers for 184 couples (243 with fresh embryos and 76 with frozen embryos). Transfers are divided into: -7 groups according to indication: premature ovarian failure (POF) with normal caryotype n = 122, surgical POF n = 26, postchemotherapy and postradiation therapy POF n = 23, genetic disease carrier n = 11, IVF failure n = 69, primary amenorrhea n = 58, POF with abnormal caryotype n = 10. -2 groups according to the recipient's age (Group I < or = 40 years, Group II > 40 years); -3 groups according to the dose and the mode of administration of the treatment. Oocytes were donated by volunteer donors of less than 38 years having at last one child. RESULT: According to the recipient's age 31.3% clinical pregnancies (CP) and 24.2% ongoing pregnancies (OP) for group I, versus 19.4% CP and 11.9% OP for group II. The results according to the indication were similar except for postchemotherapy and postradiation therapy POF for which the rate of CP as well as the rate of OP were particularly low. For the treatment groups there is a significant reduction of CP and OP as the treatment dose increases. CONCLUSION: The recipient's age plays an important role for the development of pregnancy and this shows that apparently uterine ageing also plays an undeniable role for the decline of female fertility. Increasing doses of estradiol reduces the rate of CP and OP. Postchemotherapy and postradition therapy POF has much lower results than other indications.

Adult↗
PubMedDate not supplied

[Uterine contractions at the time of embryo transfer: a hindrance to implantation?].

OBJECTIVES: To investigate the hormonal control and the possible consequences of uterine contractions (UC) on IVF-ET outcome. MATERIALS AND METHODS: We studied prospectively 220 controlled ovarian hyperstimulation (COH) cycles for IVF-ET. Just before ET, women underwent 5-minute digital recordings of the uterus using US image analysis software for UC assessment. Plasma progesterone (P) and estradiol were measured. Four groups were defined according to UC frequency: < or = 3.0 (n = 53), 3.1 to 4.0 (n = 50), 4.1 to 5.0 (n = 43), and > 5.0 (n = 74) UC/minute, respectively. RESULTS: Patients, COH and embryology characteristics were comparable in all groups. Notwithstanding estradiol levels were not associated with UC characteristics, plasma P and UC frequency were negatively correlated (r = -0.34, P < 0.001). A stepwise decrease in clinical and ongoing pregnancy as well as implantation rates occurred from the lowest to the highest UC frequency groups (53%, 36%, 21%; 46%, 32%, 20%; 23%, 19%, 10%; and 14%, 11%, 4%; P < 0.001). Direction of UC did not affect ET outcome. CONCLUSIONS: The negative correlation between UC frequency and P levels supports the utero-relaxing properties of P. High frequency UC on the day of ET hinder IVF-ET outcome, possibly by expelling embryos out of the uterine cavity.

Adult↗
PubMedDate not supplied

[Should we apply assisted reproduction technology to women without limitations of age?].

The decline of female fertility with increasing age is due to a physiological diminution of the ovarian reserve of follicles. Hence, a reliable evaluation of the ovarian reserve before performing assisted reproductive technology in aged women provides them and the physician with information about the actual probabilities of pregnancy. Patients aged over 38 years should be accepted in assisted reproduction programs only after confirmation of a healthy ovarian reserve. Patients aged more than 42 years, even in case of a normal ovarian reserve assessment, should be only accepted in selected cases. After 42 years until 46 of age, techniques of in vitro fertilization with oocyte donation may represent an alternative chance of pregnancy to aged women.

Adult↗