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T C Li

Publications and source records attributed to T C Li.

At least 145 records · Page 8Linked to original sources
PubMed1991

A morphometric study of the uterine glandular epithelium in women with premature ovarian failure undergoing hormone replacement therapy.

In this study we examined the fine structure of the human glandular epithelium in women with idiopathic ovarian failure in artificial cycles produced by two different types of hormone replacement therapy (oestradiol valerate orally and either intramuscular injection of progesterone or progesterone via vaginal pessary), both of which had been claimed to be capable of supporting successful implantation. Biopsies were performed on day 19 of the artificial cycle. A variety of sterological probes were used to quantify the structural characteristics of these cells and the results obtained were compared with those from normal fertile subjects biopsied on days 2 and 5 after the luteinizing hormone (LH) surge. The glandular epithelial cells from the vaginal group had a less elaborate secretory apparatus when compared with the intramuscular group or with LH + 5 controls. Many of the features of the vaginal group suggested a continued oestrogenic influence, while the intramuscular group seemed to be more advanced than LH + 5.

Cell Nucleus↗
PubMed1991

Endometrial development in the luteal phase of women with various types of infertility: comparison with women of normal fertility.

In this study, the prevalence of retarded endometrial development in the luteal phase of an infertile population (20/142 = 14%) was found to be significantly higher (P less than 0.05) than in that of a control, fertile population (3/68 = 4.4%). However, when the infertile subjects were subdivided into groups of different aetiology, it was found that women with endometriosis and unexplained infertility had a significantly higher prevalence of retarded endometrium (6/21 = 29%, 10/48 = 21% respectively; P less than 0.01 in both cases) than women with normal fertility; whereas the prevalence in women with tubal or male infertility (1/34 = 2.9% and 3/39 = 7.7%, respectively) was not significantly different from that in the fertile subjects. There were no significant differences in the progesterone profiles of the four groups of infertile subjects and the group of fertile subjects. Of the 15 cases of retarded endometrial development with known progesterone profile, two were associated with subnormal progesterone whereas the remaining 13 were associated with normal progesterone, the latter suggesting an abnormal response of the endometrium to a normal amount of progesterone. The findings suggest that further morphological study of the endometrium should be aimed at subjects whose infertility is unexplained or associated with endometriosis, in whom the prevalence of abnormal endometrium is increased.

Adult↗
PubMed1991

Evaluation of the luteal phase.

The values of various methods used to evaluate the luteal phase, including basal body temperature, measurement of progesterone (P), endometrial biopsy, ultrasonographic measurement of endometrial thickness, and measurement of endometrial proteins, are reviewed. Luteal phase defect (LPD) is a controversial entity. The diagnosis of this condition is best based on a histological study of the endometrium. Methods to improve the accuracy of the diagnosis are discussed. LPD is more likely to be a result of an abnormal response of the endometrium to P, than to a subnormal production of P by the corpus luteum. Many methods of treatment for LPD have been proposed but none is based on a properly controlled clinical trial. Treatment designed to improve the response of the endometrium to P may be more rewarding than P supplementation.

Biopsy↗
PubMed1991

Effect of exogenous progesterone administration on the morphology of normally developing endometrium in the pre-implantation period.

The effects on endometrial morphology of a single, intramuscular dose of 100 mg of progesterone administered in the early luteal phase, between days LH + 1 and LH + 6, were studied in a group (n = 8) of normal, fertile subjects by morphometric techniques and transmission electron microscopy. While the dose of progesterone administered consistently resulted in an increase of salivary progesterone concentration to above the upper limit of the reference range, no significant effect on endometrial development was observed; in particular, endometrial development was not advanced.

Embryonic Development↗
PubMed1991

A review of 254 ectopic pregnancies in a teaching hospital in the Trent Region, 1977-1990.

A total of 254 cases of ectopic pregnancy were reviewed in a teaching hospital in Sheffield, in three defined periods: I, 1977-9; II, 1985-7 and III, 1988-90. A previous history of infertility was noted in 37% of cases. Overall, the presenting symptoms, clinical, laboratory, operative as well as histological findings, are in broad agreement with other series. The incidence increased steadily from 8.6 per 1000 total births in period I to 16.5 per 1000 total births in period III. A number of changes noted in recent years include: (1) the diagnosis of ectopic pregnancy was made significantly (P less than 0.05) earlier; (2) a significantly (P less than 0.05) greater proportion of ectopic pregnancies had an association with the following factors: previous tubal surgery, the diagnosis established with ultrasonography, laparotomy preceded by laparoscopy and treatment by conservative surgery; and (3) a significantly (P less than 0.05) smaller proportion of ectopic pregnancies had the diagnosis based on pelvic tenderness or pelvic mass. During the period 1988-90 a total of 126 laparoscopies were performed for suspected ectopic pregnancy, of which 82 (65%) were confirmed to have ectopic pregnancy and 44 (35%) were thought to have no evidence of ectopic pregnancy on laparoscopy. However, two of the latter cases were subsequently found to have an ectopic pregnancy within 2 weeks. The clinical implications of these findings are discussed.

Adolescent↗
PubMed1991

An analysis of factors influencing the outcome of 232 consecutive tubal microsurgery cases.

A consecutive series of 232 tubal microsurgical operations performed at the Jessop Hospital for Women, Sheffield, between 1983 and 1989, was analysed. The various contributory factors to tuboperitoneal damage were reviewed. Eighty patients (35%) conceived, resulting in 66 (29%) live births and 14 (6%) miscarriages. A further 12 (5%) had ectopic pregnancies. The overall cumulative conception rate (CCR) was 40% at the end of 50 months. Microsurgery has been most successful in the adhesiolysis group (n = 78) with a CCR of 46% at the end of 50 months. The terminal salpingostomy group (n = 97) had a CCR of 40% at the end of 36 months. There was a significant reduction in the live birth rate for the group with hydrosalpinx greater than 20 mm in diameter compared with the group with less than 20 mm (P = 0.05). The proximal anastomosis group (n = 27) had a CCR of 33%. No pregnancy was reported following reconstructive surgery for multiple occlusion sites. Overall, the extent of pelvic adhesions had a significant influence on the outcome (P = 0.02). The likelihood of conception was significantly influenced by the duration of infertility (P = 0.02) but not affected by the aetiology of tuboperitoneal damage, parity or age of the patient. In our hands, tubomicrosurgery is more cost-effective than in-vitro-fertilization as a primary treatment of infertility due to tubal diseases.

Abortion, Spontaneous↗
PubMed1991

The variation of endometrial response to a standard hormone replacement therapy in women with premature ovarian failure. An ultrasonographic and histological study.

The endometrial response to a standard hormone replacement therapy in 18 women with premature ovarian failure was examined by serial ultrasonographic measurement of endometrial thickness and histological study of endometrial biopsy taken on day 19 of the cycle. Women with idiopathic ovarian failure (n = 10) had significantly better response than women with Turner's syndrome (n = 4), whereas women with premature ovarian failure associated with previous chemotherapy (n = 4) had an intermediate response. These observations suggest that the endometria of women with Turner's syndrome responded suboptimally to steroid hormones. However, all endometrial biopsies studied revealed secretory changes. Overall, the results of histological dating of endometrial biopsy were found to be positively correlated with endometrial thickness on day 19 of the cycle (r = 0.72, P less than 0.01). The plasma concentration of oestradiol on days 15, 19 and 29 of the artificial cycle were found to be significantly higher than those on the corresponding days of the natural cycle.

Endometrium↗
PubMed1991

The obstetric and neonatal outcome of pregnancy in women with a previous history of infertility: a prospective study.

OBJECTIVE: To compare the frequency of common antenatal problems, the amount of antenatal surveillance and the obstetric and neonatal outcome in women with and without a history of infertility. DESIGN: A prospective cohort study with age and parity matched controls. SETTING: A single consultant unit at the Jessop Hospital for Women, Sheffield, over a 22-month period. SUBJECTS: 114 women with a history of infertility who reached 16 weeks gestation with a singleton live fetus and 114 control women matched for age and parity. MAIN OUTCOME MEASURES: Frequency of antepartum complications, amount of antepartum surveillance, obstetric and neonatal outcome. RESULTS: Common antenatal complications were not increased. In the infertility compared with the control group, the relative risk of requiring an emergency caesarean section was 2.43 (95% CI 1.05-5.63). There was no difference in birthweight. CONCLUSION: Many of the previously observed differences in outcome of pregnancy in women after infertility compared with those without are associated with age and parity but these characteristics do not explain the increased frequency of emergency caesarean section.

Body Height↗
PubMed1991

Beta-adrenergic-induced local angiotensin generation in the rabbit hind limb is dependent on the kidney.

Evidence was sought for beta-adrenergic-induced increase in femoral vascular angiotensin production in sham-operated and nephrectomized rabbits. Systemic blood pressure and right femoral blood flow were monitored in anesthetized rabbits. Arterial and femoral venous plasma angiotensin II (Ang II) and angiotensin I (Ang I) were measured by radioimmunoassay after high-performance liquid chromatography. Isoproterenol, 1 and 10 nmol/min, was infused intrafemoral arterially, reducing femoral vascular resistance by 47 +/- 5% and 60 +/- 6% in the sham-operated group, and by 50 +/- 6% and 63 +/- 4% in the nephrectomized group, respectively. The hemodynamic effect of isoproterenol was blocked by 2 mumol/kg propranolol injected intravenously plus 0.2 mumol/min infused intrafemoral arterially, indicating that the effect was beta-adrenergically mediated. In the sham-operated group, arterial Ang II and Ang I levels were increased, respectively, by 85 +/- 16% and 103 +/- 23% with the low dose of isoproterenol, and by 121 +/- 13% and 563 +/- 126% with the high dose of isoproterenol. The apparent femoral Ang II secretion rate was increased by 3.2-fold and 4.4-fold, and the apparent femoral Ang I secretion rate increased by 4.3-fold and 21.2-fold, with the low and high dose of isoproterenol, respectively. Propranolol abolished or markedly attenuated the increased arterial angiotensin levels and the increased femoral angiotensin secretion rates. Neither the low nor the high dose of isoproterenol caused any increase in plasma levels or the apparent femoral secretion rates of the angiotensins in the nephrectomized group. Low plasma levels of Ang I and Ang II remained in the nephrectomized group, representing some locally generated angiotensins.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Agonists↗
PubMed1991

Lectin binding of endometrium in women with unexplained infertility.

OBJECTIVE: To investigate whether peri-implantation phase endometrium in women with unexplained infertility differs from the endometrium of normal fertile women. DESIGN: Assessment of the function of the endometrium by using endometrial biopsy specimens and lectin histochemistry. SETTING: Infertility Clinic, Jessop Hospital for Women, Sheffield, United Kingdom. PATIENTS: Eighteen normal fertile women (group I) and 18 women with unexplained infertility (group II). INTERVENTIONS: Endometrial biopsies were obtained from both groups at 5, 7, and 9 days after the luteinizing hormone (LH) surge. MAIN OUTCOME MEASURES: Five biotinylated lectins, concanavalin A (ConA), wheat germ agglutinin (WGA), soybean agglutinin, Peanut, and Ulex europaeus I were used as analytical probes to study endometrial glycoconjugates. Histochemical staining was performed using the avidin-biotin peroxidase method. The lectin binding by endometrial glands, surface epithelium, stromal cells, and vessels was assessed. RESULTS: In group I, ConA stained the subnuclear glandular cytoplasm, glandular lumen, stroma cells, and surface epithelium. In group II, ConA binding to glandular or surface epithelium was none or equivocal. In group I, WGA bound to glandular cytoplasm and stroma cells on days LH + 5 and LH + 7. In group II, WGA binding was absent in glands but present in stroma. CONCLUSIONS: Reproductive failure of women with unexplained infertility may be associated with defective biosynthesis and distribution of glycoconjugates that subsequently results in an unfavorable endometrial environment during the peri-implantation phase.

Adult↗
PubMed1990

An endometrial factor in unexplained infertility.

OBJECTIVE: To study a group of women with unexplained infertility to see whether they have a defect that is intrinsic to the endometrium. DESIGN: Evaluation of the functional response of the endometrium by examining endometrial biopsy specimens using immunohistochemical methods in a group of women with unexplained infertility and in a control group of women with normal fertility. PATIENTS: 27 Women with unexplained infertility (average age 33.2); median duration of infertility five years. A control group of 44 women with normal fertility (average age 33.8) who were requesting sterilisation or reversal of sterilisation. SETTING: Infertility clinic, Jessop Hospital for Women, Sheffield. INTERVENTION: Secretory phase endometrial biopsy specimens were taken, with informed consent, as an outpatient procedure. MAIN OUTCOME MEASURES: Immunohistochemistry with monoclonal antibody D9B1, was used to assess the production and secretion of an oligosaccharide epitope produced by endometrial gland cells between two and seven days after the luteinising hormone surge. A reflected light measuring system was used to assess the amount of epitope within the gland cells, and in the gland lumen. RESULTS: In the control group of women, mean reflected light measurements at the cell base and cell apex peaked at three and five days after the luteinising hormone surge respectively, and in the gland lumen the epitope accumulated rapidly from three days, reaching a peak at seven days. In the women with infertility the peaks of epitope at the cell base and cell apex were lower, broader, and delayed in onset, and the build up of epitope in the gland lumen was retarded. The synthesis and secretion of the epitope in the women with infertility was therefore significantly reduced and delayed, even in the presence of normal concentrations of circulating progesterone. CONCLUSIONS: The results suggest that a primary dysfunction of the endometrium might be associated with hitherto unexplained infertility.

Adult↗
PubMed1990

Outpatient endometrial biopsy: clinical, endocrinologic and histologic consequences.

In this prospective study involving 152 outpatient endometrial biopsies (EBs), it was found that 89% had post-EB spotting which ranged from 1 to 5 days with a median of 2 days. Premenstrual spotting which could not be accounted for by post-EB spotting was present in 14% of the subjects, but less than half of them considered such spotting unusual. Outpatient EB resulted in earlier onset of menstruation in 43% of the subjects, but no overall change in the amount of menstrual flow or discomfort. When compared to control cycles in which an EB was not performed, cycles in which an EB was performed, had significant shortening of the luteal phase by an average of 1.0 day (P less than 0.01). However, there was no change in the corpus luteum function as assessed by the measurement of progesterone concentration in saliva samples collected daily throughout the luteal phase. EB did not appear to have any significant effect on histologic development (dating) of the endometrium, although leucocytic infiltration could be increased.

Adult↗
PubMed1990

Delayed abdominal pain after outpatient endometrial biopsy in the luteal phase.

Outpatient endometrial biopsy was followed by delayed abdominal discomfort in 50% of cases. The pain started 2-3 h after the procedure, lasted for about 2 h and was described in most cases as similar to dysmenorrhoea of a moderate degree. Appropriate explanation and the use of a simple analgesic may reduce the discomfort and the anxiety with which it is associated.

Abdominal Pain↗
PubMed1990

Peritoneal sperm recovery can be consistently demonstrated in women with unexplained infertility.

Diligent analysis of PF 10 to 20 hours after midcycle intracervical insemination with husband's semen in couples with unexplained infertility showed that sperm are consistently able to transverse the reproductive tract in this group of patients. However, this finding does not necessarily imply that the sperm were retained at the site of fertilization or that they were competent to achieve oocyte fertilization. Therefore, further experiments obtaining sperm from the tubal isthmus to assess the effects of their sequestration there on their ability to fertilize human oocytes are needed.

Adolescent↗
PubMed1990

Are factors that influence oocyte fertilization also predictive? An assessment of 148 cycles of in vitro fertilization without gonadotropin stimulation.

Fertilization characteristics of 152 consecutively obtained oocytes in an in vitro fertilization (IVF) program employing only natural and clomiphene citrate-induced cycles were retrospectively analyzed. Fertilization occurred significantly more often (1) in women with tubal infertility, (2) in spontaneous cycles, and (3) in cases of secondary infertility. Grade I sperm motility from the original semen sample and the duration of infertility were also significant influencing factors. A similar sperm correlate was not identified on samples after sperm migration. Preovulatory follicular fluid steroids, progesterone (P), estradiol (E2), E2:P ratio, and luteinizing hormone (LH), as well as baseline plasma LH and the magnitude of the LH surge did not correlate with fertilization. However, when the identified factors were used to predict fertilization (discriminant analysis), only 58.3% of oocytes were correctly classified. This data supports the concept of performing IVF as a test in its own right.

Adult↗
PubMed1990

A morphometric study of the human endometrial stroma during the peri-implantation period.

In this study we have examined the human endometrial stromal cell population in well-timed biopsies during the peri-implantation period, using traditional stereological techniques. This paper reports data obtained from 16 women of known fertility who underwent endometrial biopsies at known times after the luteinizing hormone (LH) surge (four each at LH + 2, LH + 4, LH + 6 and LH + 8). The average stromal cell nuclear diameter increased in size throughout the period of study (P less than 0.01), with a significant decrease (P less than 0.05) in the nuclear profile axial ratio. This suggests that the nuclei were increasing in size and becoming more rounded. There was a dramatic increase (P less than 0.01) in the packing density between LH + 2 and LH + 6; this is likely to be due, at least in part, to the glands filling up with secretory products and so compressing the intervening stroma. A substantial decrease (P less than 0.01) was seen in the packing density between LH + 6 and LH + 8. This corresponds to the time when stromal oedema is thought to be maximal.

Adult↗
PubMed1990

A morphometric study of the human endometrial stroma during the peri-implantation period.

In this study we have examined the human endometrial stromal cell population in well-timed biopsies during the peri-implantation period, using traditional stereological techniques. This paper reports data obtained from 16 women of known fertility who underwent endometrial biopsies at known times after the luteinizing hormone (LH) surge (four each at LH + 2, LH + 4, LH + 6 and LH + 8). The average stromal cell nuclear diameter increased in size throughout the period of study (P less than 0.01), with a significant decrease (P less than 0.05) in the nuclear profile axial ratio. This suggests that the nuclei were increasing in size and becoming more rounded. There was a dramatic increase (P less than 0.01) in the rounded. There was a dramatic increase (P less than 0.01) in the packing density between LH + 2 and LH + 6; this is likely to be due, at least in part, to the glands filling up with secretory products and so compressing the intervening stroma. A substantial decrease (P less than 0.01) was seen in the packing density between LH + 6 and LH + 8. This corresponds to the time when stromal oedema is thought to be maximal.

Adult↗