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Biomedical subjects

S Bassil

Publications and source records attributed to S Bassil.

At least 37 records · Page 2Linked to original sources
PubMed1995

Uterine vascularity during stimulation and its correlation with implantation in in-vitro fertilization.

The changes in uterine artery blood flow in women undergoing in-vitro fertilization cycles were studied throughout stimulation after gonadotrophin-releasing hormone (GnRH) desensitization. The data obtained showed that the uterine vascularity was related to hormonal changes. The GnRH agonist effect was seen only after the third week of administration, and the uterine perfusion was significantly (P = 0.002) improved by the oestradiol secretion. Human chorionic gonadotrophins increased the resistance index (RI) significantly (P = 0.0001) for a period of 48 h. Then the progesterone secretion modified the curve with a significant improvement in the uterine blood flow (P = 0.03). Comparison of the RI value 2 days before human menopausal gonadotrophin (HMG) commencement, in patients with and without pregnancy, showed a higher RI in patients who did not conceive but no difference was observed on the day of embryo transfer. The pregnancy rates were similar whatever the range of the RI observed. The data available so far suggest that haemodynamic parameters alone, detected by Doppler sonography, do not provide full information on endometrial receptivity on the day of embryo transfer. A resistance index > 0.79 before HMG commencement seems to indicate poor uterine vascularity and may necessitate an increase in the HMG doses to prevent endometrial immaturity.

Adult↗
PubMed1995

Rectovaginal septum, endometriosis or adenomyosis: laparoscopic management in a series of 231 patients.

A series of 231 cases of deep-infiltrating endometriosis of the rectovaginal septum is presented. Laparoscopic procedures with excision of deep fibrotic endometriotic nodules were performed in all cases. In three cases, the bowel lumen was entered. No other peri-operative complications were observed. Three cases of urinary retention were reported. The nodule resection resulted in considerable pain relief. Histologically, the rectovaginal nodule was similar to an adenomyoma. Indeed it was a circumscribed nodular aggregate of smooth muscle and endometrial glands. This form of disease must be considered as a specific disease which originates from the Mullerian rests present in the rectovaginal septum and we suggest that it be called 'rectovaginal adenomyosis'.

Endometriosis↗
PubMed1995

Micromanipulation of mouse gametes with laser microbeam and optical tweezers.

Micromanipulation of mouse gametes with a commercially available compact laser microbeam system was studied. Both the normal in-vitro fertilization (IVF) group and the laser zona dissection (LZD) group were tested under normal (2 x 10(6) motile spermatozoa/ml) and low (500,000 motile spermatozoa/ml) insemination conditions. Subzonal insemination (SUZI) was also tried in a small group of gametes and the results were compared with those of the low insemination groups. Fertilization rates and blastocyst formation rates for the IVF and the LZD-treated groups were respectively 53 and 60% and 60 and 78%, which were not significantly different. However, under low insemination conditions, the results were significantly better in the LZD-treated group (58% fertilization rate and 83% blastocyst formation rate) compared to the results of the IVF group (33 and 48%) (P < 0.05). The SUZI-treated group showed the lowest fertilization rate (18%). No significant difference between the LZD and the IVF group was observed with respect to parthenogenetic activation. LZD has a beneficial effect on fertilization rates in cases of reduced sperm quality.

Animals↗
PubMed1995

Hysteroscopic myomectomy.

Transhysteroscopic myomectomy has proved to be safe and effective with experienced operators. The use of the continuous flow hysteroscope and preoperative monitoring of intrauterine pressure has contributed to the prevention of fluid intravasion accidents. Effectiveness has been demonstrated in a number of recently published long-term studies.

Female↗
PubMed1995

LASH: laparoscopic supracervical (subtotal) hysterectomy.

From July 1990 to December 1993, 156 laparoscopic supracervical hysterectomies (LASH) were performed. No complications occurred. The technique and the advantages are described. Because of the easy feasibility of this technique, the quick recovery of the patients and the absence of complications this strictly laparoscopic approach must be widely proposed when an hysterectomy is indicated and no risk of remaining cervix cancer is assumed.

Adult↗
PubMed1993

The ovarian hyperstimulation syndrome in in-vitro fertilization: a Belgian multicentric study. II. Multiple discriminant analysis for risk prediction.

The considerable overlap of distributions of values for different parameters between control and ovarian hyperstimulation syndrome (OHSS) populations makes any single variable inefficient for risk prediction. Combinations of variables were studied in a discriminant function in order to increase predictivity and decrease the false negative rate. Such analyses were performed on two groups of in-vitro fertilization (IVF) patients: all OHSS cases (n = 128) (group A) and only severe OHSS cases (n = 92) (group B). Progressive introduction and automated stepwise selection of variables were applied to both groups. The best prediction (78.5%) was obtained in group A under post-oocyte retrieval conditions using log oestradiol, slope of log oestradiol increment, human menopausal gonadotrophin (HMG) dosage, number of oocytes retrieved and ratio of luteinizing hormone/follicle stimulating hormone (LH/FSH), in the formula. The corresponding false negative rate was 18.1%. However, effective prevention of OHSS implies the ability to withhold human chorionic gonadotrophin injection. Therefore a formula for pre-oocyte retrieval conditions was established yielding a prediction rate of 76.1% with a false negative rate of 18.1%. To be validated, such formulae have to be applied to another population of IVF cases used as a 'testing-set'.

Belgium↗
PubMed1992

Second-look laparoscopy after laparoscopic cystectomy of large ovarian endometriomas.

Forty-two patients who underwent a second-look laparoscopy after a unilateral or bilateral intraperitoneal cystectomy for treatment of an ovarian endometrioma of greater than 3 cm were included. At second-look laparoscopy, 92.4% of the adnexae treated for a large endometrioma had no deep ovarian endometriosis. Adhesion de novo formation occurred in 21% of the treated adnexae and in 17% of the contralateral adnexae. Complete or partial recurrence of dense adhesions occurred in 82% of the cases. Laparoscopic cystectomy is effective in treating large endometriomas. However, operative difficulties may be encountered, explaining persistent endometriomas and postoperative adhesions.

Adnexa Uteri↗
PubMed1992

Fertility following laparoscopic management of benign adnexal cysts.

Fertility following laparoscopic treatment of benign adnexal cysts without ovarian suture was studied retrospectively. Patients with endometriomas or who were previously infertile were excluded. Thirty-eight patients treated conservatively were included, 10 after partial resection of functional cysts, 23 after an ovarian cystectomy and six after treatment of a paraovarian cyst. One patient had two cysts. The overall intrauterine pregnancy rate was 92%; one patient had an ectopic pregnancy (2.6%). From these results, we conclude that fertility following laparoscopic treatment of adnexal cysts appears to be normal. Technical guidelines to improve laparoscopic cystectomy are proposed.

Adnexal Diseases↗
PubMed1992

[Technique and preliminary results in second-look laparoscopy in epithelial malignant ovarian tumors].

Second-look laparotomy is the usual mean of intraperitoneal evaluation in patients treated for ovarian carcinoma. We present a preliminary study of 33 second-look. Thirteen of these procedures were performed by laparoscopy. Because of previous surgical history a specific technique is necessary including safety tests, cytologic evaluation after peritoneal washing, and biopsies of any abnormal peritoneal areas, original tumors sites and normal appearing peritoneum. In order to achieve the evaluation of the entire peritoneal cavity a complete bowel adhesiolysis is required. For trained laparoscopists the surgical complication rate is low. In this preliminary study we found that prognosis following negative second-look laparoscopy and second-look laparotomy are similar, suggesting that laparoscopy is a valuable alternative to laparotomy for second-look evaluation in ovarian cancer.

Carcinoma↗
PubMed1992

[Recurrence after conservative celioscopic treatment of a first ectopic pregnancy].

Conservative laparoscopic treatment by salpingotomy was performed on 192 patients who presented with a first ectopic pregnancy (EP). The overall fertility results show that 139 patients (72.4%) obtained an Intra Uterine Pregnancy (IUP), whereas only 18 patients (9.4%) suffered a recurrence. The risk of ipsilateral recurrence is 66.7% (12 cases). For the 14 patients presented with two patent tubes after conservative laparoscopic treatment of a first EP, the ipsilateral recurrence rate is 57.1% (8 cases). The side of the recurrence is directly influenced by the patient's previous history. While 88.9% (8 cases) of recurrence are ipsilateral for patients presenting previous tubal history, this rate is only 44.4% (4 cases) when tubal factors are absent (p less than 0.05). This prompts us to recommend laparoscopic salpingectomy for patients with a serious past tubal history. In these patients recurrence is ipsilateral in more than three out of four cases. On the other hand, for patients with no or few tubal factors the treatment has to be conservative.

Evaluation Studies as Topic↗
PubMed1991

[Ectopic pregnancy. Techniques and results of celioscopic treatment].

As in laparotomy the laparoscopic treatment of ectopic (EP) can be either conservative or radical. After conservative laparoscopic treatment, the risk of failure is comparable to what has been observed after the same treatment by laparotomy and the post-EP fertility results are better than those observed after treatment by laparotomy. These results, associated with the advantages of endoscopy over laparotomy, enable us to say that the laparoscopic treatment is nowdays the best surgical treatment of EP. The post-EP fertility is determined by previous patient's history, whereas the characteristics of the EP do not affect or only slightly affect fertility. A multifactorial analysis enabled us to quantify the pejorative impact on fertility of each of the factors which significantly affect the fertility results. We thus propose a therapeutic scoring system of EP designed to choose the treatment which will better preserve the fertility of the patients who wish to become pregnant.

Female↗
PubMed1991

Advanced heterotopic pregnancy after in-vitro fertilization and embryo transfer, with survival of both the babies and the mother.

A combination of an extra-uterine and an intra-uterine pregnancy is defined as heterotopic pregnancy. An infertile patient, pregnant at her fourth in-vitro fertilization/embryo transfer attempt, was diagnosed at 21 weeks' gestation as having simultaneous abdominal and intra-uterine pregnancy. Expectant management under strict hospitalization was proposed and accepted by the couple, fetal assessment was by serial ultrasound evaluation of growth and amniotic fluid volume and by non-stress tests. Planned operative delivery was accomplished at 34 weeks' gestation. Both the mother and infants are alive and well.

Adult↗
PubMed1991

[The role of anti-inflammatory agents in the treatment of acute salpingitis. A randomized study of 40 patients with celioscopic control].

In a randomised second look laparoscopic study, concomitant antibiotic--anti-inflammatory therapy for the treatment of pelvic inflammatory disease (P.I.D.) was studied. Six weeks after medical treatment results were evaluated during second look laparoscopy based on three parameters: residual inflammation, pelvic adhesions and tubal patency. The combination treatment resulted in decreased pelvic adhesion and tubal occlusion in severe forms of P.I.D. Anti-inflammatory agents combined with anti-biotics are not more beneficial than anti-biotics alone in mild and moderate forms of P.I.D. so combination therapy must be reserved for severe forms of P.I.D.

Administration, Oral↗
PubMedDate not supplied

Indications for cryopreservation of ovarian tissue.

For patients who are planning to have chemotherapy, radiotherapy or to undergo bilateral oophorectomy, loss of ovarian function will result in premature ovarian menopause and loss of fertility. For these women, although there is no successful method for the cryopreservation of human oocytes, ovarian tissue cryobanking is proposed with a view to its autotransplantation at a later date or the isolation and in-vitro maturation of oocytes. Embryo preservation is indeed not an option for single women and even for married women because delaying treatment for at least 2 months of in-vitro fertilization cycles is inappropriate and life-threatening. Following the success of animal experiments, there have been reports of ovarian cryopreservation for women having to receive chemotherapy and/or radiotherapy. We present four case reports of ovarian tissue cryobanking and review the consequences of chemotherapy and radiotherapy on gonadal function, as well as the indications for freezing ovarian tissue.

Adenocarcinoma↗