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Biomedical subjects

S Fishel

Publications and source records attributed to S Fishel.

61 records · Page 4Linked to original sources
PubMed1987

General anesthesia for intrauterine placement of human conceptuses after in vitro fertilization.

General anesthesia has been used for the replacement of human conceptuses after in vitro fertilization (IVF). Two adjuvants, enflurane and halothane, have been compared. Halothane significantly reduced the incidence of implantation compared to enflurane. In 356 replacements, the incidence of implantation for enflurane and halothane was 34 and 17%, respectively (P = 0.005). Sixty-four percent of all replacements had three conceptuses; the incidence of implantation for enflurane and halothane in this group was 43 and 19%, respectively (P = 0.002). The incidence of multiple pregnancy was similar for both anesthetic agents (20%) and the demise of implantation sacs 5 weeks postovulation was 11% for enflurane and 12% for halothane.

Adult↗
PubMed1985

In vitro fertilization: a treatment for male infertility.

Three-quarters of 41 women whose husbands were the cause of infertility in the couple had one or more embryos replaced after in vitro fertilization. One-third became pregnant despite their long history of infertility; the incidence of pregnancy was 45% after one or more replacements of embryos. In a group of 61 couples where both partners were infertile, 26% became pregnant. These data indicate that the lower chance of fertilization with poor semen is balanced by a higher chance of pregnancy in women with a normally functioning reproductive system. Oligospermia, asthenospermia, teratospermia, and autoimmunity are among the many forms of male infertility which can now be successfully treated by in vitro fertilization. Overall, 57% of the oocytes were fertilized, and almost 50% of men with very low numbers of active spermatozoa (less than or equal to 0.5 X 10(6)/ml motile spermatozoa) were successful in establishing pregnancy. Two semen parameters impaired fertilization most: seminal inflammatory cells and low progressive activity. The collection of split ejaculates and the careful preparation of spermatozoa, by sedimentation and layering methods, proved to be beneficial, improving sperm motility and raising the chance of fertilization.

Embryo Transfer↗
PubMedDate not supplied

Use of recombinant LH in a group of unselected IVF patients.

The aim of this study was to evaluate the use of recombinant luteinizing hormone (rLH) supplementation in an unselected group of IVF patients undergoing follicular stimulation with recombinant follicle stimulating hormone (rFSH) after pituitary down-regulation. Group A comprised 122 cycles administered rFSH and rLH while group B included 331 cycles using rFSH only during the same period of treatment. There was no significant difference in any of the endocrine, embryological and outcome parameters measured. The implantation rate of 14.2% for group A compared with 9.8% for group B showed a positive trend (P = 0.055), but for patients in whom LH concentration was <1.0 IU/l at down-regulation or required excessive FSH stimulation, there was an increased incidence of implantation if rLH was supplemented. It was concluded that the addition of exogenous rLH to an unselected group of 'down-regulated' patients stimulated with rFSH appears to offer little benefit, but in the event of profound LH down-regulation or requirement for excessive exogenous FSH (>2500 IU), the rate of implantation might be improved.

Adult↗
PubMedDate not supplied

Can we justify spermatid microinjection for severe male factor infertility?

During 1995 and 1996 the first spermatid pregnancies were announced with both round spermatid (ROSI) and elongated spermatid (ELSI) injections. These publications were flanked by live births from ROSI in a number of animal species, with resulting offspring appearing normal, healthy and fertile. However, the live births in humans heralded a scientific and ethical debate on the clinical use of this technology; and in a number of countries nationwide moratoria prohibiting spermatid microinjection were enjoined. Concerns surrounded the biological condition of spermatids and clinical implications of utilizing an immature spermatozoon for conception. Nevertheless, case reports and a few scientific studies on human spermatid conception have been published in recent years, and further polemic on testicular histopathology and prognosis has ensued. This paper reviews the current arguments on the clinical use of ROSI and ELSI, and evaluates the biology of the main contributory components of a spermatozoon to the subsequent embryo, namely the genetic material, the microtubular organizing complex and the putative oocyte activating factor. We also consider the relevant testicular histopathology and likely outcome in the context of the current birth rate from ROSI and ICSI. We conclude by considering the way forward for infertile men who require this technology to become genetic fathers, and whether the time is now appropriate to consider clinical trials.

Clinical Trials as Topic↗