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Biomedical subjects

R Ron-el

Publications and source records attributed to R Ron-el.

At least 19 recordsLinked to original sources
PubMed1999

Birth of a healthy neonate following the intracytoplasmic injection of testicular spermatozoa from a patient with Klinefelter's syndrome.

Klinefelter's syndrome is one of the known causes of azoospermia or cryptoazoospermia, and it may present in non-mosaic (47,XXY) or mosaic (47,XXY/46,XY) form. The likelihood of finding spermatozoa in the ejaculate or testicular tissue of patients with mosaic Klinefelter's syndrome is low, and with the non-mosaic form, even lower. We describe a patient with non-mosaic Klinefelter in whom initially non-motile spermatozoa were derived from searching the ejaculate. Ten mature oocytes were injected, but none was fertilized. Subsequently, testicular biopsy was undertaken in order to collect spermatozoa for oocyte injection. Fifteen motile sperm cells were found and injected. Nine oocytes were fertilized and cleaved; three embryos were transferred into the uterine cavity. The woman conceived and following a normal pregnancy delivered a healthy child. Genetic analysis of the neonate disclosed a normal 46,XY karyotype. Non-motile spermatozoa in the ejaculate did not prove their fertilization potential, but their presence did not exclude finding motile, fertile spermatozoa in the testicular tissue in a non-mosaic Klinefelter patient. This report is further evidence that normal spermatozoa with fertilization potential are produced in the testes of patients with Klinefelter's syndrome.

Adult↗
PubMed1997

Intracytoplasmic injection of fresh and cryopreserved testicular spermatozoa in patients with nonobstructive azoospermia--a comparative study.

OBJECTIVE: To compare the outcome of intracytoplasmic sperm injection (ICSI) with fresh and frozen-thawed testicular spermatozoa in patients with nonobstructive azoospermia. DESIGN: Retrospective analysis of consecutive ICSI cycles. SETTING: In Vitro Fertilization Unit, Assaf Harofeh Medical Center. PATIENT(S): Eighteen with nonobstructive azoospermia in whom testicular sperm was found after testicular sperm extraction. INTERVENTION(S): Testicular sperm retrieval, cryopreservation, and ICSI with fresh or frozen-thawed testicular spermatozoa. MAIN OUTCOME MEASURE(S): Two-pronuclear fertilization; embryo cleavage rates, mean number of embryos transferred per cycle, and their relative quality, embryo implantation, clinical pregnancy, and ongoing pregnancy rates (PRs) per ET. RESULT(S): No statistically significant differences were noted in all parameters examined between ICSI cycles with fresh or cryopreserved testicular spermatozoa from the same nine patients and comparing all ICSI cycles performed; with fresh (25 cycles) and thawed (14 cycles) testicular spermatozoa, respectively: two-pronuclear fertilization, 47% versus 44%; embryo cleavage rates, 94% versus 89%; implantation rates, 9% versus 11%; and clinical PR, 26% versus 27%. The delivery or ongoing PR using fresh sperm was better (21% versus 9%), but the difference did not reach statistical significance. The cumulative clinical PRs and ongoing PRs per testicular sperm extraction procedure were 36% and 24%, respectively. CONCLUSION(S): Testicular sperm cryopreservation using a simple freezing protocol is promising in patients with nonobstructive azoospermia augmenting the overall success achieved after surgical sperm retrieval.

Adult↗
PubMed1996

Intravenous immunoglobulin treatment of pregnant patients with unexplained recurrent abortions.

Intravenous immunoglobulins, first given to recurrent aborters with anti-phospholipid syndrome, have been administered to unexplained aborters since 1986. They probably have immunomodulatory properties beyond supplying blocking antibodies. When pregnancy was confirmed, women were started with a loading dose which was repeated every 3-4 weeks until the second trimester. Dosages were empirical. Pregnancy rates ranged between 50 and 82%. The main maternal complications, i.e. allergic reactions and infections, were rare.

Abortion, Habitual↗
PubMed1995

The effect of pre-treatment with a gonadotrophin-releasing hormone agonist on reproductive functions in mature cycling rats.

In order to investigate the performance of follicles in a rat model in which gonadotrophin-releasing hormone agonist (GnRHa) was used for hypothalamic-pituitary-ovarian axis suppression, three groups of mature cycling rats were studied. One group was treated with buserelin followed by pregnant mare's serum gonadotrophin (PMSG), and the second group was treated with PMSG alone. Both these hormonally treated groups received human chorionic gonadotropin for induction of ovulation. The third group received no hormonal treatment. The average number of ovulated oocytes recovered from rat oviducts pre-treated with GnRHa was significantly higher than that in rats treated with the gonadotrophin alone, in spite of the larger number of pre-ovulatory follicles present in the gonadotrophin-treated group. The morphology of both the pre-ovulatory and the post-ovulatory cumulus-oocyte complexes in the three groups appeared similar. No difference in the capacity of follicles of the three groups to synthesize progesterone in vitro in response to luteinizing hormone could be observed. We conclude that ovarian morphology and function are not impaired by pre-treatment with buserelin.

Animals↗
PubMed1995

Improved techniques for first-trimester fetal reduction using simultaneous abdominal and transvaginal ultrasonographic guidance. Preliminary report.

Simultaneous transabdominal injection of potassium chloride (KCl) assisted by transvaginal ultrasonographic guidance was evaluated in 5 patients who conceived due to various assisted reproductive techniques and ovarian stimulation. All 5 underwent first-trimester fetal reduction for multiplicity of high-order pregnancies. Four sets of triplets were reduced to twin, and 1 twin pregnancy was reduced to a singleton. Less than 2 ml of 2 mEq/ml KCl per fetus was needed for each case. No fetal or maternal complications nor technical failure attributable to the procedure were recorded. All pregnancies were delivered > or = 35 weeks of gestation. Transabdominal fetal reduction using simultaneous transvaginal ultrasonographic guidance for selective feticide combines the benefits of both the transabdominal and transvaginal approaches, mainly in selected cases in which some experts prefer the abdominal route, but find it technically difficult to practice. Further experience is needed to confirm our encouraging preliminary results before drawing any definitive conclusions.

Abdomen↗
PubMed1993

The use of intravenous gammaglobulin, heparin and aspirin in the maintenance of pregnancy of freeze thawed embryo in a patient with lupus-type anticoagulant.

A case of lupus anticoagulant and repeated fetal loss with a successful delivery of a healthy baby after transfer of thawed frozen embryos and intravenous immunoglobulin administration is described. The repeated fetal loss was due to vascular disturbances caused by lupus anticoagulants. Early implantation was not affected. Anticoagulants and/or steroids did not help in further establishing pregnancy. Intravenous immunoglobulin combined with heparin and aspirin led to term pregnancy and the birth of a healthy child.

Adult↗
PubMed1992

Increased fertilization and pregnancy rate in polypronuclear fertilization cycles in in vitro fertilization-embryo transfer.

OBJECTIVE: To compare fertilization and pregnancy rates between cycles with polypronuclear fertilizations and cycles with normal fertilizations. DESIGN: In vitro fertilization-embryo transfer (IVF-ET) cycles in which oocytes were retrieved were divided into two groups according to the nature of fertilization. PATIENTS: All patients were participants of our IVF-ET program. RESULTS: A significantly higher fertilization rate was found in the polypronuclear fertilization cycles (61% versus 36.6%) and also an improved pregnancy rate (47.5% versus 19.6%) and per embryo transfers (53% versus 28.8%). The vast majority of polypronuclear fertilizations occurred in mature oocytes. CONCLUSION: We believe that the increased receptability of the oocytes improves fertilization and conception rates. The polypronuclear fertilization is an extreme expression of such improved receptibility and should be considered as an encouraging sign for conception.

Embryo Transfer↗
PubMed1991

Extremely large number of twists of the umbilical cord causing torsion and intrauterine fetal death.

Extremely large number of twists of the umbilical cord causing torsion of the entire length of the umbilical cord was found in two cases of intrauterine fetal death. It was twisted in one case 35 times and in the other 20 times. No additional pathology, such as stricture or abnormality of the Wharton's jelly, was found. The two mothers complained of decreased fetal movements and both newborns were found later to be growth retarded. A long cord of 120 cm was present in one case and normal length of 70 cm in the other. Close antenatal care in cases with growth retarded fetuses or decreased fetal movements may help in avoiding fetal demise in such rare cases.

Adult↗
PubMed1991

Delayed fertilization and poor embryonic development associated with impaired semen quality.

Delayed fertilization is common in cycles with immature oocytes. This phenomenon was observed in 42 of 423 with mature oocytes. Of the 42 cycles, 16 were excluded because of the presence of sperm autoantibodies. Sperm parameters of the remaining 26 (6.1%) cycles (group A) were compared with those in cycles with no fertilization at all (group B) and those in the control group (group C). The percentage of normal forms was 15% in group B and 24% in group A compared with 51% in group C. Fertilization rates were 32% in group A compared with 81% in group C. The incidence of poor embryonic morphology was 82% in group A compared with 29% in group C. Delayed fertilization and poor embryonic morphology associated with impaired sperm quality is of clinical and prognostic importance.

Blastomeres↗
PubMed1991

The dilemma of the optimal surgical procedure in ectopic pregnancies occurring in in-vitro fertilization.

Ectopic pregnancy remains one of the undesired sequelae of in-vitro fertilization (IVF) treatment. It seems that mechanical infertility increases the risk of this complication in IVF. Thus, the surgeon treating such a case faces the dilemma of the optimal surgical procedure because of the increased risk for repeated ectopic pregnancy in subsequent IVF cycles. Two cases are presented with repeated ectopic pregnancy occurring in IVF. One case underwent salpingectomy on the first occasion and eventually developed a contralateral repeat ectopic gestation ending with salpingectomy. The second case underwent a conservative salpingotomy in the first event and developed a repeated ectopic gestation on the same side, undergoing bilateral salpingectomy. In order to prevent repeated ectopic pregnancies in an IVF programme, a definitive surgical procedure, such as bilateral salpingectomy, should be considered in the first episode in patients referred for IVF because of tubal pathology.

Adult↗
PubMed1990

Fetal outcome following inadvertant administration of long-acting DTRP6 GnRH microcapsules during pregnancy: a case report.

Early follicular use of long-acting analogues of gonadotrophin releasing hormone (GnRH) in IVF programmes has caused some concern with respect to its teratogenic potential. In the case reported here, an injection of DTRP6 GnRH microcapsules was given in the 5th week of a spontaneous unsuspected pregnancy. No deleterious effect or teratogenesis of the embryo could be demonstrated at birth or 18 months later.

Adult↗
PubMed1990

Hormonal changes related to impairment of cervical mucus in cycles stimulated by clomiphene citrate.

The levels of luteinizing hormone (LH), follicular stimulating hormone (FSH), 17-oestradiol (E2), progesterone (P), and testosterone (T) were determined for the early, midfollicular and periovulatory phase of spontaneous and clomiphene citrate (CC) induced cycles in 5 patients who responded with appearance of hostile cervical mucus (Group A) and 5 patients whose cervical mucus remained unchanged during the same treatment (Group B). The patients with hostile mucus were further investigated during a third cycle stimulated by CC and ethinyloestradiol (EE). Patients treated with CC for induction of ovulation who developed hostile cervical mucus showed higher levels of LH and T in the midfollicular phase of the menstrual cycle and significantly higher levels of T in the periovulatory period compared to patients with unchanged mucus. EE treatment induced a drop in the elevated LH and T levels and improved the cervical score. No change in E2 levels was noted. A direct effect of EE on the cervical glands together with the centrally mediated lowering of serum T are suggested to be responsible for improving the cervical mucus.

Cervix Mucus↗
PubMed1989

D-Trp-6-luteinizing hormone-releasing hormone microcapsules in the treatment of uterine leiomyomas.

Long acting D-Trp-6-luteinizing hormone-releasing hormone (LH-RH) microcapsules, 3.2 mg were given monthly, intramuscularly for a period of 6 months to 26 menstruating patients with symptomatic leiomyomas. The patients ages were 22 to 52 years. Five patients (20%) were infertile. Patient evaluation before initiation of treatment included endometrial biopsy, ultrasonic measurements of uterine and tumor volumes, and bone-mineral density. The patients were periodically followed hormonally and ultrasonographically. A statistically significant reduction in uterine and tumor volumes (maximal after 4 months of treatment) was observed in all the patients except one. Two patients discontinued the treatment after 2 months, preferring surgery. A nonsignificant decrease in the mean bone-mineral density was noted after completion of therapy. Minor side effects such as hot flushes, vaginal dryness, backache, vaginal spotting, and nervousness, were encountered frequently, disappearing within 6 weeks after the last injection. A significant increase in uterine and myoma volume was noted in all the patients at 3 months after treatment.

Adult↗
PubMed1989

Low multiple pregnancy rate in combined clomiphene citrate--human menopausal gonadotrophin treatment for ovulation induction or enhancement.

Sixty-five infertile women, 37 with anovulation, eight with ovulatory disturbances and 20 with unexplained infertility were treated by a combination of clomiphene citrate (CC) from cycle day 5 (or 3) and human menopausal gonadotrophin (HMG) begun 3 days later for induction or enhancement of ovulation. Monitoring was carried out by measuring preovulatory 17-beta-oestradiol (E2) and progesterone (P) concentrations in blood samples and by follicle measurements using ultrasound. Forty-seven pregnancies resulted with a multiple pregnancy rate of 7.7% for those completed. This incidence is very low and within the range found for CC induction and might result from the later commencement of stimulation compared with many other protocols. These results were achieved with a low incidence of ovarian hyperstimulation syndrome (2.6% per cycle). The HMG doses given were low in comparison with those found in other forms of induction. The deleterious effects of this combined mode of induction on cervical mucus and the occurrence of premature spontaneous ovulation were much less than in the sequential mode of treatment. These results suggest that combined induction treatment by CC and HMG as described offers a means of achieving low rates of multiple pregnancies a known complication in the induction of ovulation.

Adult↗
PubMed1989

The effect of total abdominal hysterectomy on bladder function in asymptomatic women.

The effect of total abdominal hysterectomy as treatment for benign conditions on the postoperative incidence of urinary symptoms and abnormal urodynamic findings was evaluated in 16 premenopausal women who lacked urinary symptoms preoperatively. The urodynamic evaluation was performed preoperatively, at 4 weeks, and again at 4 months after surgery. No clinical symptoms of frequency, nocturia, urgency, or urge or stress incontinence were found postoperatively. There were no significant differences from the preoperative values for cystometry, uroflometry, and urethral pressure profiles. Urinary dysfunction should not be a consequence of an uncomplicated total abdominal hysterectomy for benign conditions in women who were previously free of urinary symptoms.

Adult↗