The role of patient mobilization after embryo transfer in in vitro fertilization programs.
Explore the source record for details and available documents.
Embryo Transfer↗
Biomedical subjects
R Orvieto
Publications and source records attributed to R Orvieto.
The role of the immune system in severe ovarian hyperstimulation syndrome.
The ovarian hyperstimulation syndrome is a serious, and potentially life-threatening, complication of ovulation induction. Hitherto, there has been no reliable test which will predict patients who will subsequently develop ovarian hyperstimulation syndrome. Recently, evidences have accumulated concerning the interaction between the immune and reproductive systems which results from sharing certain lymphohaematopoietic cytokines and their receptors. Furthermore, several cytokines have been implicated in the prediction and pathophysiology of ovarian hyperstimulation syndrome. If this is true, it may be possible to modify the patients' immunological homeostasis by passive immunization with intravenous immunoglobulin (IVIg) and thus to prevent ovarian hyperstimulation syndrome.
Albumins↗
Polycystic ovary syndrome patients as oocyte donors: the effect of ovarian stimulation protocol on the implantation rate of the recipient.
OBJECTIVE: To evaluate the outcome of oocytes donated by women with polycystic ovarian syndrome (PCOS) compared with oocytes donated by women with mechanical infertility. DESIGN: A retrospective study. PATIENTS: The outcome of 159 oocyte donation cycles with oocyte donated by PCOS patients were compared with 69 oocyte donation cycles with oocytes donated by patients with mechanical infertility. We compared the stimulation protocols in the donors to assess if the combination of GnRH analogue (GnRH-a), FSH, and hMG has an advantage over FSH and hMG alone with respect to their effect on fertilization and implantation rates in oocyte donation cycles. RESULTS: When treated with GnRH-a, pregnancy rates in PCOS and mechanical infertility donors were higher than those treated with FSH and hMG alone. The comparison between PCOS and mechanical factor oocyte recipients revealed no significant difference in the pregnancy and abortion rates, but the oocytes of patients with PCOS that were exposed to GnRH-a had a significantly higher implantation rate than those not exposed to GnRH-a. CONCLUSIONS: Oocytes obtained from PCOS patients had a fertilization potential equal to oocytes obtained from mechanical infertility donors. Furthermore, because the oocytes of patients with PCOS exposed to GnRH-a had a significantly higher implantation rate, a detrimental role of high LH on oocyte quality seems probable. However, because PCOS has a high familial prevalence, some reservations may arise due to a possible propagation of the problem in the next generation of oocyte donation programs.
Embryo Implantation↗
A severe case of ovarian hyperstimulation syndrome despite the prophylactic administration of intravenous albumin.
OBJECTIVE: To evaluate the role of the recently suggested IV administration of human albumin solution as an effective preventive measure of severe ovarian hyperstimulation in high-risk patients. CASE: Presented here is, to the best of our knowledge, the first case of early severe ovarian hyperstimulation necessitating early transabdominal aspiration of ascites and intensive fluid and colloid (dextran and albumin) replacement, which developed despite administration of IV human albumin solution in an attempt to prevent severe ovarian hyperstimulation. CONCLUSIONS: Because IV albumin does not prevent severe ovarian hyperstimulation in absolute terms, its use in high-risk patients should not lead one astray. Further research should be directed at investigating the fundamental cause of ovarian hyperstimulation syndrome and developing a reliable predictive test for this complication.
Adult↗
Etiology of ovarian hyperstimulation syndrome?
Explore the source record for details and available documents.
Female↗
Interleukin-2 and ovarian hyperstimulation syndrome: a pilot study.
A prospective case-controlled study was conducted to evaluate the association between the concentrations of interleukin-2 (IL-2) in human follicular fluid obtained at the time of oocyte collection for in-vitro fertilization (IVF) and the development of ovarian hyperstimulation syndrome (OHSS). Follicular fluid was obtained at the time of oocyte collection for IVF consecutively from 40 patients at risk of developing OHSS. Among the 40 patients participating in the study, seven subsequently developed OHSS. Their follicular fluid samples, together with those of an additional seven patients matched by age who did not develop OHSS, were tested for osmolality, total protein content and IL-2 concentrations, and mean serum oestradiol concentrations at the time of human chorionic gonadotrophin (HCG) administration and the mean number of aspirated oocytes were also measured. Follicular fluid IL-2 concentrations were significantly higher (P < 0.002) in the OHSS group as compared to the control group. No significant differences were found between the two groups regarding the mean serum oestradiol concentration on the day of HCG administration, or the mean number of aspirated oocytes, follicular fluid osmolality, or total protein concentrations. This study suggests an association between follicular fluid IL-2 concentration and OHSS. IL-2 is known to cause 'vascular leak syndrome', which resembles OHSS. These observations, together with the established interaction between the immune and the reproductive systems, may suggest a pivotal role of IL-2 in the pathogenesis of OHSS.
Case-Control Studies↗
Effect of uterine leiomyomata on the results of in-vitro fertilization treatment.
The effect of uterine leiomyoma on infertility is subject to controversy. Two main mechanisms associating leiomyomata and infertility have been suggested: the obstruction of gamete transport and impaired implantation. In-vitro fertilization (IVF) is a unique setting for examining the effect of leiomyomata on the implantation rate. This study was designed to determine the impact of uterine leiomyomata on the results of IVF. In a retrospective analysis of IVF cycles, 46 women with documented uterine leiomyoma were compared with a control group with mechanical infertility. The implantation rate and pregnancy outcome in relation to the leiomyoma were observed. Implantation (22.1%/transfer, 6.8%/embryo) and abortion rates (36%) in the study group were similar to the results in the control group with pure mechanical factor. An analysis of IVF results according to the hysteroscopic pretreatment findings revealed that impaired implantation is associated with leiomyoma only where uterine intracavitary abnormalities co-exist. We conclude that implantation rate and pregnancy outcome are impaired in women with uterine leiomyomata only when they cause deformation of the uterine cavity. In patients with leiomyomata associated with an abnormal uterine cavity, surgical treatment should be considered prior to IVF because of the reduced implantation rate.
Abortion, Spontaneous↗
Intravenous albumin and the prevention of severe ovarian hyperstimulation syndrome.
Explore the source record for details and available documents.
Female↗
Laparoscopic removal of an abdominal pregnancy adherent to the appendix after ovulation induction with human menopausal gonadotrophin.
The laparoscopic management of tubal pregnancies has become a standard form of treatment. We present, for the first time, a successful laparoscopic approach in the management of early abdominal pregnancy. Although it is difficult to reach conclusions from such limited published experience, it nevertheless appears that early abdominal pregnancies can be treated via operative laparoscopy. The possible advantages of such a therapeutic approach include lower morbidity and mortality, and a better fertility prognosis.
Adult↗
A severe case of ovarian hyperstimulation syndrome: 65 liters of ascites aspirated in an on-going IVF-ET twin pregnancy.
Ovarian hyperstimulation syndrome (OHSS) is the most serious life-threatening iatrogenic complication of ovulation induction. Presented here is an unusual case where 62 l of intraperitoneal and 3.2 l of intrapleural fluid were aspirated in order to stabilize a severe life-threatening case of OHSS resulting from an on-going IVF-ET twin pregnancy.
Adult↗
Recurrent spontaneous ovarian hyperstimulation syndrome associated with polycystic ovary syndrome.
Ovarian hyperstimulation syndrome (OHSS) is the most serious potentially life-threatening iatrogenic complication of ovulation induction. Presented here is the first reported case of recurrent severe OHSS which developed spontaneously in a women with polycystic ovary syndrome, diagnosed early in her second pregnancy, and necessitated intensive fluid and colloid therapy.
Adult↗
[Toxoplasmosis acquired during pregnancy].
Explore the source record for details and available documents.
Female↗
The role of intrapartum vibroacoustic stimulation in the prediction of neonatal myasthenia gravis.
BACKGROUND: The exact mechanism for the development of neonatal myasthenia gravis is unclear, and the occurrence of neonatal myasthenia gravis cannot be predicted. CASE: A case of normal duration of fetal forearm extention with return to flexion in response to vibroacoustic stimulation, and the pertinent details concerning neonatal myasthenia gravis and vibroacoustic stimulation test are described. CONCLUSIONS: Inasmuch as fetal acoustic stimulation test results in a fetal reaction resembling the startle response of the newborn, we think that it will worthwhile to perform this test antenatally in the next encountered fetuses of myasthenic mothers in order to assess its role in the prediction of neonatal myasthenia gravis.
Acoustic Stimulation↗
The role of cytokines in early detection of preeclampsia.
The signs and symptoms of preeclampsia become apparent at a relatively late stage in pregnancy (third trimester). However, the disorder results from abnormal interaction between fetal and maternal tissue much earlier in pregnancy (first trimester). For this reason, numerous methods have been proposed for the early detection of preeclampsia with considerable disagreement regarding their sensitivity and predictive values. Various reports suggest that preeclampsia is caused by an abnormal maternal immune response to antigenic challenge by the fetoplacental allograft. Moreover, since cytokines are involved in the control of immune response and also have a role in fetal development, their release from the placenta as a consequence of the abnormal maternal immune response, may precede the consequential cascade of pathophysiological reactions shown in preeclampsia. These assumptions may suggest that plasma cytokines' measurements may be used for the early detection of preeclampsia.
Cytokines↗
Low-back pain of pregnancy.
BACKGROUND: Low-back pain (LBP) is a commonly observed symptom during pregnancy. Despite its high frequency the extent of the problem is less well documented and detailed studies concerning related risk factors are scarce. Furthermore, efforts to address the problem are hampered by the inability to predict accurately which pregnancies are at risk. This study was conducted in order to assess the frequency, manifestations and the contribution of various factors to the development of LBP during pregnancy. METHODS: The study included 449 pregnant women who were consecutively referred for an antenatal ultrasonographic examination for various reasons. A simple questionnaire which consisted of several items along with ultrasonographic measurements was devised to evaluate the incidence of and risk factors for LBP during pregnancy. RESULTS: 246 (54.8%) women reported LBP in the present pregnancy. Factors which were found to be significantly associated with an increased risk to develop LBP during pregnancy included low socioeconomic class, existence of LBP before the first pregnancy, during previous pregnancy, and interim pregnancies. Moreover, in nulliparous women, body mass index (BMI) was found to be significantly higher in women suffering from LBP. A tendency was observed between posterior/fundal location of the placenta to the presence of LBP during pregnancy. This tendency was also observed among parous but not among nulliparous women. Among pregnant women with LBP, pain radiation correlated significantly to fetal weight. Moreover, this correlation was also of statistical significance in nulliparous women with anterior placental location. Back care advice given to women suffering from LBP was found to significantly reduce LBP. The age, number of prior pregnancies, gestational age, average maternal height, weight and BMI were not found to be risk factors in LBP. Furthermore, we found no influence of previous abortion/s, instrumental delivery, previous cesarean section, or a history of epidural anesthesia during a previous labor were risks to develop LBP in the subsequent pregnancy. CONCLUSIONS: In the present pregnancy, LBP during pregnancy was associated with a history of LBP various socioanthropometric measures, as well as several ultrasonographic and obstetrical data. Back care advice offered to pregnant women who are prone to develop LBP during pregnancy, as early in their pregnancy as possible, may prevent or result in less 'troublesome' and 'severe' LBP during pregnancy.
Adult↗
The poor-responder patient in an in vitro fertilization-embryo transfer (IVF-ET) program.
The purpose of this article is to review the methods and evaluate the 'avenues' that are open to patients and physicians in their search for improvement of in vitro fertilization-embryo transfer (IVF-ET) treatment results. The option of egg donation, although very important and viable in the treatment of poor responders, is not described here.
Embryo Transfer↗
Lack of association between varicocele and angiokeratoma of the scrotum (Fordyce).
Angiokeratoma of the scrotum is thought to be associated with varicocele. Our study population consisted of young soldiers and adult reservists. The young population was screened during routine medical examination for the existence of varicocele or angiomas on the scrotum, while the adult reservists, who according to their medical records had varicocele, were randomly questioned for the existence of any kind of spots or lesions on their scrota. We found no association between varicocele and angiokeratoma of the scrotum. Since the prevalence of varicocele is high, it is possible that in the reported cases the association of varicocele and angiokeratoma of the scrotum was coincidental.
Adolescent↗
Hyperemesis gravidarum. A review.
Hyperemesis gravidarum is a common entity the cause of which has remained poorly defined. However, it probably is a classic example of the interplay between biologic, psychological and sociological variables. Current data on hyperemesis gravidarum and the pertinent literature for the last two decades are reviewed.
Antiemetics↗