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T al-Shawaf

Publications and source records attributed to T al-Shawaf.

At least 19 recordsLinked to original sources
PubMed2000

Does pretreatment with progestogen or oral contraceptive pills in low responders followed by the GnRHa flare protocol improve the outcome of IVF-ET?

PURPOSE: Women undergoing in vitro fertilization with low ovarian reserve and poor response to controlled ovarian hyperstimulation (COH) present a management dilemma. In a retrospective observational study, we compared the pretreatment use of the gestogen medroxyprogesterone acetate (10 mg twice daily from day 15 of the cycle for a minimum of 2 weeks) with an oral contraceptive pill (one tablet daily from day 4 of the cycle for a minimum of 3 weeks). METHODS: The criteria for inclusion in the study included one or more of the following: abandoned cycles due to poor response, fewer than four oocytes retrieved following a standard COH protocol, age > 39 years, and elevated basal serum follicle-stimulating hormone (FSH). Thirty-eight women received pretreatment with gestogen, and a similar number of women received pretreatment with the pill. The flare protocol was used in all treatment cycles combined with an individualized dose of human menopausal gonadotropin (hMG) (4-8 ampoules/day of 75 units FSH/ampoule) depending on previous response, age, and early follicular serum FSH level. Both groups were similar in mean age, duration of infertility, early follicular FSH levels, and the distribution of various aetiologies. RESULTS: Twenty-nine cycles were abandoned before oocyte retrieval, 15 (39.5%) in the pill group and 14 (36.8%) in the gestogen group, because of an inadequate ovarian response. The mean (+/- SD) number of ampoules (75 IU FSH/ampoule) of hMG used per cycle was similar in the pill and gestogen groups (59.7 +/- 19.3 vs. 70.2 +/- 29.4, respectively). There also was no difference seen in the numbers of oocytes retrieved (4.4 +/- 2.3 vs. 4.2 +/- 2.5), total number of embryos (2.5 +/- 2.4 vs. 2.2 +/- 1.1), or the number of embryos transferred (1.8 +/- 1.2 vs. 2.1 +/- 1.0) in the pill and gestogen groups, respectively. One pregnancy in each group resulted following embryo transfer in 22 women in the pill group and in 24 women in the gestogen group. CONCLUSIONS: We conclude that pre-IVF treatment with oral contraceptive pill or gestogen combined with the flare protocol in women at high risk of or with a history of poor ovarian response, as defined in this study, did not appear to result in an improvement in outcome of IVF-embryo transfer.

Adult↗
PubMed1998

Pinworms and postmenopausal bleeding.

The human pinworm Enterobius vermicularis is normally found within the human gastrointestinal tract. Pregnant females migrate out of their host's anus at night to lay their eggs perianally. As a consequence of this nocturnal migration some worms find their way into adjacent orifices, most commonly the female genitourinary tract, producing irritative symptoms such as vulvovaginitis. A case of pinworm infestation of the uterus presented as postmenopausal bleeding.

Aged↗
PubMed1996

Intracytoplasmic sperm injection improving embryo quality: comparison of the sibling oocytes of non-male-factor couples.

OBJECTIVE: Our objective was to investigate whether the quality of embryos developed after intracytoplasmic sperm injection (ICSI) is better than that of conventional IVF embryos. METHODS: Nine couples who previously achieved a normal rate of fertilization following IVF and four couples whose normal rate of fertilization was expected were involved in this study. The oocytes from those couples were randomly divided into two groups, group A by conventional insemination and group B by ICSI. The fertilization rate and quality of embryos were compared. RESULTS: Normal fertilization was achieved in 61% of the oocytes (83/136) after conventional insemination. In group B, 69% of the oocytes (99/144) achieved normal fertilization, although only 127 metaphase II oocytes were injected using the ICSI technique. More grade A embryos were obtained when the ICSI technique was used for fertilization than by conventional IVF (35.4 and 24.3%, respectively; P = 0.028). CONCLUSIONS: A similar fertilization rate can be achieved by ICSI in comparison with conventional IVF, when male factor is not involved. Embryos after ICSI have an improved quality.

Adult↗
PubMed1996

The obstetric outcome of in vitro fertilization and embryo transfer in women with congenital uterine malformation.

OBJECTIVE: Our purpose was to analyze 3 obstetric outcomes according to the various forms of congenital uterine malformation after in vitro fertilization and embryo transfer. STUDY DESIGN: We conducted a retrospective analysis of data from 24 patients with the following types of congenital uterine malformation: 6 unicomuate, 9 bicomuate, 5 septate, and 4 uterus didelphys. All patients underwent in vitro fertilization and embryo transfer at Boum Hall Clinic, a tertiary infertility referral center. RESULTS: Twenty-four patients conceived a total of 19 clinical pregnancies in 51 embryo transfer cycles. The clinical pregnancy rate was 19 of 51 (37.3%) per embryo transfer and 17 of 24 (70.8%) per patient. There were no significant differences in the clinical pregnancy rates when the various forms of uterine malformation were compared. There was a trend for the group with unicomuate uteri and uterus didelphys to have the highest rate of term delivery (6/9, 66.7%) and the lowest rate of first-trimester miscarriages (0/9, 0%) as compared with the group with septate and bicomuate uteri, in whom the term delivery rate was 1 of 10 (10%) and the spontaneous abortion rate was 3 of 10 (30%). The multiple pregnancy rate was 6 of 15 (40%) for women who had three embryos transferred, as compared with 0 in women who had two embryos or one embryo transferred. There was a high rate of preterm delivery (6/13, 46.2%) and cesarean section (10/13, 76.9%). CONCLUSION: In vitro fertilization and embryo transfer in women with congenital uterine malformation is associated with good pregnancy rates, and the patients should be counseled about the risks involved, in particular, the increased rate of preterm delivery and cesarean section.

Adult↗
PubMed1994

Pregnancies after assisted fertilization for "extreme" male factor: report on three cases.

Three cases of extreme male factor infertility, not acceptable for conventional IVF, are presented. In the first case, only 30 sluggishly motile spermatozoa were obtained in two ejaculates but treatment with SUZI resulted in a viable singleton pregnancy. In the second case, a combination of microepididymal sperm aspiration, for vasal obstruction after failure of reversal, with intracytoplasmic sperm injection resulted in a viable singleton pregnancy. In the third case, the husband had a vasal reservoir for distal vasal blockage. Sperm from the reservoir with extremely low motility and high antisperm antibody were microinjected by intracytoplasmic sperm injection and this resulted in a triplet pregnancy.

Adult↗
PubMed1993

Transfer of embryos into the uterus: how much do technical factors affect pregnancy rates?

OBJECTIVE: Our objective was to identify the effect on outcome of (a) ultrasound-assisted embryo transfer, (b) the use of different embryo transfer catheters, and (c) the length of time the patients remain in the supine position after embryo transfer. SETTING: The setting was a private fertility center. SUBJECTS: This was a prospective study of 178 in vitro fertilization and embryo transfers (IVF-ET) and 63 frozen embryo replacements (FER). RESULTS: The pregnancy rate was 28.7% following IVF-ET and 31.8% for FER. Ultrasound-assisted transfer did not affect the outcome (29 vs 30.3%). There was no difference in the performance of the Wallace and Frydman catheters with regard to outcome (30.3 vs 30.7%). Although there was an increase in pregnancy rate as the time interval in the supine position after ET increased, this needs a larger study. CONCLUSION: The parameter studies did not affect the outcome of IVF/ET or FER. Some factors encouraged us to recommend ultrasound-assisted transfer in some cases, and the use of a Frydman catheter for transfer and to encourage the supine position after transfer for longer periods.

Abdomen↗
PubMed1993

Ultrasonic monitoring during replacement of frozen/thawed embryos in natural and hormone replacement cycles.

We evaluated the results of cryopreserved/thawed embryo replacement (FER) to determine if the outcome following transfer in a natural cycle in a defined group was different to that from a hormone replacement cycle, and also to assess vaginal ultrasonographic features that assist in predicting the timing of the transfer. At the London Fertility Centre, 149 consecutive FER cycles were studied retrospectively. Women with proven ovulation and regular cycles were included during natural cycles (n = 77). The hormone replacement cycle group included women with anovulation, irregular cycles and older women (n = 72). In the natural cycle group, transfer was performed following positive urinary luteinizing hormone (LH) surge and confirmation of ovulation by ultrasonography. With the hormone replacement therapy group, gonadotrophin-releasing hormone analogue was used to induce pituitary down-regulation, oestradiol valerate was supplemented followed by regular ultrasound monitoring, and FER 2 days following the initiation of progesterone, which was started once adequate endometrial development was noticed on ultrasonography. The pregnancy and ongoing/delivery rates were analysed in relation to the treatment cycle, age, number and quality of embryos transferred. Ultrasonographic features were examined to evaluate their relationship with the outcome of treatment. The results showed that no difference existed between natural and hormone replacement cycles in pregnancy rates per cycle (26 and 25%), ongoing/delivery rate (20.8% in both groups), and implantation rate (10.3 and 10.6%). Pregnancy rates were not influenced by the number of embryos transferred, stage at which the embryos were cryopreserved, or whether they were extra embryos from in-vitro fertilization/embryo transfer, or gamete intra-Fallopian transfer.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

IVF versus GIFT.

Explore the source record for details and available documents.

Adult↗
PubMed1992

The influence of ovarian response on gamete intra-Fallopian transfer outcome in older women.

Fecundity declines with increasing age in women. The pregnancy rate is lower in in-vitro fertilization/embryo transfer (IVF/ET) in women aged greater than or equal to 40 years. We analysed 349 consecutive gamete intra-Fallopian transfer (GIFT) cycles in women aged greater than or equal to 40 years to identify factors which affected the outcome. A maximum of four oocytes were transferred in GIFT as recommended by the Interim Licensing Authority; 61 women (17.5%) had a positive serum beta-human chorionic gonadotrophin, 35 (10%) had a miscarriage and 26 (7.5%) delivered live infants. The pregnancy rate was lower than with younger women while the conception loss was higher. Pregnancy and delivery rates increased as the number of oocytes retrieved increased but declined again if greater than 10 oocytes were retrieved. If 1-3 oocytes were retrieved, the pregnancy rate was 9.7% and the delivery rate was 3.9%; if 4-10 oocytes were retrieved, the pregnancy rate was 22.1% and the delivery rate was 10.1%, and when greater than 10 oocytes were retrieved, the rates were 17.6 and 5.9% respectively. The highest pregnancy rate was when four oocytes were transformed in GIFT (22.4%) and the delivery rate was 10.0%. An adequate response to long down-regulation with gonadotrophin-releasing hormone agonist was also a factor associated with high delivery rates (13.5%). We conclude that the delivery rate after GIFT in women aged greater than or equal to 40 years is low, but there is a subgroup who have an acceptable delivery rate because of a good ovarian response. In this group, pituitary down-regulation improves the outcome of treatment.

Adult↗
PubMed1992

Prime factors for seeking infertility treatment amongst Iranian patients.

This paper reports a survey of prime factors for seeking infertility treatment amongst 14 Iranian couples and discusses the implications of the findings in relation to issues related to infertility treatment and the need for comparative research on patients from diverse socioeconomic and cultural backgrounds.

Adult↗
PubMed1992

What is stressful about in vitro fertilization?

The present work was designed to explore whether psychological stress is more related to concerns about the actual physical pain or fear of treatment during in vitro fertilization. Analysis of data for 12 middle-class women from Iran showed that the greatest psychological stress during treatment was associated with worries about the outcome of different stages of treatment rather than fear and pain of the actual procedure.

Adult↗