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Biomedical subjects

R T Mansour

Publications and source records attributed to R T Mansour.

At least 37 records · Page 2Linked to original sources
PubMed1996

Successful intracytoplasmic sperm injection without performing cytoplasmic aspiration.

OBJECTIVE: To compare the effect of cytoplasmic aspiration versus no aspiration before intracytoplasmic sperm injection (ICSI) on the rate of oocyte damage, fertilization rate, and embryo quality. DESIGN: A randomized prospective study on sibling oocytes. SETTING: The Egyptian IVF-ET Center, Cairo, Egypt. PARTICIPANTS: Fifty-eight patients who were infertile due to male factor who underwent 60 ICSI cycles. INTERVENTION: Intracytoplasmic sperm injection was performed on randomly allocated metaphase II oocytes with cytoplasmic aspiration in group I and without cytoplasmic aspiration in group II before sperm injection. MAIN OUTCOME MEASURE: Fertilization rate, oocyte damage rate, and embryo quality. RESULTS: Normal fertilization rate per injected oocyte was 61.4% in group I compared with 62.5% in group II. The damage rate per injected oocyte was 16.8% in group I compared with 4.6% in group II. Grade I embryos were 24.5% in group I compared with 48.5% in group II. CONCLUSION: Cytoplasmic aspiration before sperm injection in ICSI is not essential for oocyte activation. It did not improve the rate of normal fertilization. On the other hand, it increased the damaged oocyte rate and the rate of cytoplasmic fragments.

Adult↗
PubMed1995

Ultrasonographically guided transvaginal aspiration of tuboovarian abscesses and pyosalpinges: an optional treatment for acute pelvic inflammatory disease.

OBJECTIVE: Our purpose was to assess the value of ultrasonographically guided transvaginal aspiration of tuboovarian abscesses and pyosalpinges presenting with the clinical picture of acute pelvic inflammatory disease. STUDY DESIGN: Fifteen patients seen for acute pelvic inflammatory disease were treated by ultrasonographically guided transvaginal aspiration of pus from tuboovarian abscesses and pyosalpinges, followed by local and systemic administration of antimicrobal therapy. RESULTS: Improvement of symptoms followed aspiration in all patients. Temperature dropped to normal within 24 to 72 hours, and pain completely disappeared within 3 days. All patients were symptom free during a follow-up period of 6 months after aspiration. CONCLUSION: Ultrasonographically guided transvaginal aspiration of pyosalpinges and tuboovarian abscesses is an effective, simple, and safe treatment. It avoided the need for laparoscopy or laparotomy.

Abscess↗
PubMed1995

The life span of sperm motility and pattern in cumulus coculture.

OBJECTIVE: To study the effect of cumulus cell coculture on human sperm motility, life span, and patterns. DESIGN: Controlled prospective study of 50 normal semen samples. Sperm motility and forward grade was observed in droplets of Ham's F-10 media with cumulus cell coculture and compared with sperm in droplets of Ham's F-10 only. SETTING: The Egyptian IVF-ET Center. MAIN OUTCOME MEASURES: Sperm motility, life span, and forward progressive pattern. RESULTS: The time course of loss of sperm motility in cumulus coculture was significantly slower than without cumulus. Also, the percentage of motile sperm with linear progressive motility of grade 4,3 was significantly higher in cumulus coculture. CONCLUSION: Cumulus cell coculture has a positive effect on prolongation of sperm motility life span and its forward progression.

Cell Communication↗
PubMed1995

The effect of sperm parameters on the outcome of intracytoplasmic sperm injection.

OBJECTIVE: To investigate the influence of sperm parameters on the fertilization and pregnancy rates in intracytoplasmic sperm injection (ICSI). DESIGN: A retrospective analysis of 130 cycles of ICSI performed for the treatment of male factor infertility. SETTING: The Egyptian IVF-ET Center. PARTICIPANTS: One hundred thirty couples with the diagnosis of male factor infertility or with previous failed fertilization in conventional IVF or subzonal sperm injection. INTERVENTION: Ovum pick-up and ICSI. MAIN OUTCOME MEASURE: Fertilization and pregnancy rates in relation to different semen parameters. RESULTS: A total of 1,433 oocytes were retrieved and 1,071 metaphase II oocytes were injected. Normal fertilization occurred in 620 oocytes (58%). Embryo transfer was done for 128 (98.5%) patients, and a total of 46 (35%) clinical pregnancies were achieved. There was no statistically significant difference in the fertilization or pregnancy rates between patients who had previously failed fertilization in conventional IVF, patients with subfertile semen, patients with semen between 1 and 10 x 10(6)/mL, and patients with semen < 1 x 10(6)/mL. There was also no significant difference in the fertilization and pregnancy rates between patients with < 95% or > 95% teratozoospermia. CONCLUSION: In ICSI, the fertilization and pregnancy rates are not affected by different semen parameters as long as morphologically well-shaped live sperms could be used for the injection.

Adult↗
PubMed1995

In vitro fertilization in a spontaneous cycle: a successful simple protocol.

OBJECTIVE: To study the efficacy of a simple protocol of in vitro fertilization in the spontaneous natural cycle. METHOD: A prospective study using in vitro fertilization in a natural cycle for the treatment of infertility due to tubal factor. RESULTS: Fifty-eight patients were monitored by vaginal ultrasound and LH in urine for 229 cycles. In 49.8% of the cycles the pick-up was canceled because of the early LH rise or failure to visualize a dominant follicle. Ovum pick-up was performed in 112 cycles and oocyte retrieval rate was 87.5%. Embryo transfer was performed in 86 cycles, pregnancy rate per pick-up was 10.2%, and there was no pregnancy wastage. CONCLUSION: IVF in a spontaneous cycle is a simple, low cost and safe treatment, which yields reasonable PR, for young regularly menstruating women with tubal factors of infertility.

Adult↗
PubMed1994

Study of the optimum time for human chorionic gonadotropin-ovum pickup interval in in vitro fertilization.

OBJECTIVE: To study the optimum time for ovum pickup after human chorionic gonadotropin (hCG) injection in in vitro fertilization. DESIGN: Prospective randomized study. SETTING: The Egyptian IVF-ET center. PATIENTS: Ninety couples with male factor infertility enrolled for intracytoplasmic sperm injection, divided into three groups. Ovum pickup was performed at 35 hr (group A), 36 hr (group B), and 37 hr (group C) after hCG injection. RESULTS: Number of metaphase II oocytes was significantly higher in group B compared to group A. There was no significant difference between group B and C. Fertilization rate was equal in all groups. The number of fertilized oocytes was significantly higher in group B as compared to group A, and there was no significant difference between groups B and C. CONCLUSION: Oocyte maturity in gonadotropin releasing hormone analogue agonist/human menopausal gonadotropin stimulated cycles is attained 36 hr after hCG injection. Oocyte retrieval should not be performed before 36 hr, and there is no risk of spontaneous ovulation between 36 and 37 hr.

Adult↗
PubMed1994

The prognostic value of successful in-vitro fertilization in subsequent trials.

A retrospective study comparing in-vitro fertilization (IVF) results in patients with previous successful trials versus new IVF patients was designed with the objective of evaluating the prognosis in both groups. Patients were divided into two groups: group A, 22 patients with previous conception in IVF trials; and group B, 235 new IVF patients. All patients had tubal factor as the only cause of infertility and were stimulated by a standard protocol of gonadotrophin-releasing hormone agonist and human menopausal gonadotrophin. The pregnancy rate in group A (64%) was significantly higher than in group B (19%). In group A, 77% of the patients had three or more grade 1 embryos per transfer as compared with 16% in group B. In group A, 95.5% of patients had easy embryo transfer as compared with 61.2% in group B. The results of the study demonstrated that patients with previous IVF pregnancies have a significantly higher pregnancy rate compared with the control group. The improved pregnancy rate is due to the higher quality of embryos and the higher percentage of easy embryo transfers.

Adult↗
PubMed1994

Dummy embryo transfer using methylene blue dye.

The aim of this prospective work was to evaluate different catheters and techniques used for embryo transfer. Studies were performed on 105 IVF patients before the start of treatment cycles. Each patient was used as her own control to study the expulsion of methylene blue (MB) dye after dummy embryo transfer. Group A (n = 35) underwent the test twice, before and after aspiration of the cervical mucus. Group B (n = 30) underwent the test twice with and without the presence of two air bubbles in the embryo transfer catheter. Group C (n = 40) underwent the test twice using two different catheters, the Wallace and the Craft catheters. The results showed that the dye was extruded at the external os in 57% of the cases when the cervical mucus was not aspirated compared to 23% when the mucus was aspirated (P = 0.01). The dye was extruded in 33% of the cases with air bubbles in the catheter as compared to 27% when no air was present (P > 0.05). When the Wallace catheter was used expulsion occurred in 25.5% compared to 77.5% when the Craft catheter was used. We concluded that using soft catheters and complete aspiration of cervical mucus significantly reduced the expulsion of the dye. The presence of air bubbles did not affect rate of expulsion of the dye.

Air↗
PubMed1994

Co-culture of human pronucleate oocytes with their cumulus cells.

The aim of this prospective randomized work was to study the value of co-culturing human pronucleate oocytes with their cumulus cells. A total of 550 fertilized oocytes from 95 in-vitro fertilization patients were randomly divided into two groups on the day after insemination. Group A oocytes (n = 260) were left undisturbed with their attached cumulus cells and group B oocytes (n = 290) were dissected from their cumulus cells. Both groups were incubated and examined daily for 3 days. In group A, 78% (202/260) reached the 4-cell stage 48 h after retrieval compared to 69% (200/290) in group B. At 72 h after retrieval, 70% (141/202) had reached the 8-cell stage in group A compared to 56% (112/200) in group B. The percentages of grade 1 embryos at 48 and 72 h after retrieval were 70% (141/202) and 76% (107/141) in group A compared to 50% (100/200) and 43% (48/112) in group B respectively. We concluded that co-culture of human oocytes with their cumulus cells significantly decreased their fragmentation and increased the number of embryos that reached the 4-cell and 8-cell stages with regular blastomeres. The technique is simple and avoids the use of heterogeneous cells.

Culture Techniques↗
PubMed1993

Ovarian superstimulation and intrauterine insemination for the treatment of unexplained infertility.

OBJECTIVE: To evaluate the efficacy of controlled ovarian hyperstimulation (COH) and IUI in the treatment of unexplained infertility. DESIGN: The pregnancy rate (PR) in patients with unexplained infertility treated by COH and IUI (group A) was compared with a no-treatment control (group B). SETTING: The Egyptian IVF-ET Center. PARTICIPANTS: Four hundred ninety-two patients with the diagnosis of unexplained infertility. INTERVENTION: Controlled ovarian hyperstimulation and IUI. MAIN OUTCOME MEASURES: Cycle fecundity per treatment cycle and PR per patient. RESULTS: In group A cycle fecundity was 20.1% per treatment cycle, and the PR was 34.7% per patient. In group B the PR was 8.9% per patient. Pregnancy rate per patient was significantly higher in group A when compared with the spontaneous PR in group B. CONCLUSION: Controlled ovarian hyperstimulation and IUI significantly increased the PR in patients with unexplained infertility when compared with a no-treatment control group.

Adult↗
PubMed1993

Management of severe ovarian hyperstimulation syndrome by ascitic fluid aspiration and intensive intravenous fluid therapy.

OBJECTIVE: To assess the value of intensive intravenous (IV) fluid therapy and ascitic fluid aspiration in the management of severe ovarian hyperstimulation syndrome. METHODS: Forty-two women with severe ovarian hyperstimulation syndrome were treated by ultrasonically guided transvaginal aspiration of ascitic fluid and IV fluid infusion. Ten women with the same condition treated conservatively constituted a comparison group. The main outcome measures included percentage change in hematocrit, creatinine clearance, and urine output before and after aspiration. The duration of hospital stay was compared between the groups. RESULTS: Marked improvement of symptoms and general condition followed soon after aspiration. Hematocrit readings decreased by 22%, creatinine clearance increased by 79.3%, and urine output increased by 220.7%. The average volume of aspirated fluid was 3900 mL. The average duration of hospital stay was 3.8 days in the treated women. In the comparison group, severe symptoms and electrolyte imbalance continued for an average of 9 days, and the average hospital stay was 11 days. CONCLUSION: Intensive IV fluid therapy and transvaginal aspiration of ascitic fluid are safe and effective in improving symptoms, preventing complications, and shortening the hospital stay in severe ovarian hyperstimulation syndrome.

Ascites↗
PubMed1992

Follicular aspiration does not protect against the development of ovarian hyperstimulation syndrome.

OBJECTIVE: The purpose of this study was to determine the effect of follicular aspiration on the incidence of ovarian hyperstimulation syndrome (OHSS). DESIGN: A retrospective study was done on 219 IVF cycles that proceeded to follicular aspiration (group A) and they were compared with 189 cycles of ovulation induction for non-IVF cycles (group B). We compared the incidence of OHSS in regularly ovulating patients (subgroups A1 and B1) and anovulatory patients (subgroups A2 and B2) in both groups. SETTINGS: The study took place at The Egyptian IVF-ET Center. PARTICIPANTS: Participants were 319 infertility patients. INTERVENTION: Ovulation was induced and follicles were aspirated. MAIN OUTCOME MEASURES: The incidences of moderate and severe OHSS were the main outcome measures. RESULTS: The incidence of OHSS in group B was significantly higher than that in group A (P = 0.016). There was no significant difference in the incidence of OHSS between subgroup A1 and subgroup B1 or between subgroup A2 and subgroup B2. CONCLUSIONS: Follicular aspiration had no effect on the incidence of OHSS. In contrast, the higher incidence of OHSS in group B was related to the higher incidence of anovulatory infertility.

Adult↗