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PubMedDate not supplied

[A new technique for measuring 17beta-estradiol using Kryptor (Cis Bio International): utilization to monitor ovulation stimulation].

We studied the performances of the 17b-estradiol determination with the Kryptor System (Cis Bio international), in assisted medical procreation cycles. The detection is based on Trace technology. We compared this method with Estradiol-6 method on ACS-180 (Bayer Diagnostics). The Kryptor method is sensitive, has a good precision and accuracy. Comparison with ACS-180 showed a good correlation but results were much higher. Patients under stimulation for assisted procreation were followed by the two methods. The results were close to those obtained with ACS-180 but significantly higher. Thus it was necessary to define the levels which have to be reached before ovulation induction.

Automation↗

PubMed1992

The effect of prenatal diagnosis on the incidence of Down syndrome livebirths in the Singapore General Hospital.

During a 3-year-period between January 1988 and December 1990, there were 12 Down Syndrome (DS) livebirths out of 13,794 livebirths at the Department of Obstetrics and Gynaecology, Singapore General Hospital, giving an incidence of 1 in 1,150 livebirths or 0.87 per thousand. There were 1569 mothers who were 35 years or older at the expected date of delivery (EDD) and 5 of these 12 DS livebirths were from these older mothers. Although only 11.5% of all mothers were 35 years or more, as a group, these older mothers contributed to 42% of the DS livebirths. There were 5 DS fetuses diagnosed prenatally and 4 were aborted electively. The fifth DS fetus which was diagnosed prenatally was allowed to continue to term because of the mother's religious objection to an induced abortion. The failure to offer prenatal diagnosis and selective procreation to all mothers 35 years or older had resulted in 4 unnecessary DS births, reducing our DS detection rate by a factor of 33%. All these 4 cases were booked late for antenatal care.

Adult↗

PubMed1989

[When should donor artificial insemination be considered?].

DAI (artificial insemination with donor) is a method used in male infertility. If azoospermia represents the standard medical indication of DAI, moderate sperm insufficiencies may, on the contrary, benefit from other medically assisted procreation techniques. The place of artificial insemination with spouse or fertilization in vitro as opposed to DAI, is discussed in the presence of male hypofertility. The DAI must be used as a last resort after failure of all other treatments.

Female↗

PubMed2005

A proposed stem cell research policy.

The aspirations of scientists and patients for human embryonic stem cell (hESC) research in the U.S. motivate attention to the nitty-gritty of law and regulation and its confluence with such moral consensus as lies within our reach. Federal law and regulation form a tangle. Analysis yields several conclusions not widely appreciated. A legislative enactment is the rate-limiting step of federally funded research, the restriction of research imposed by the previous administration's policy as reprised in current proposals fails to achieve its objective of avoiding complicity in embryo sacrifice, the current administration's policy is another failed noncomplicity scheme under which research cannot be expanded without demolishing its putative justification, and the Food and Drug Administration has already effectively interdicted procreative cloning. While it is not plausible to deny complicity in embryo sacrifice when performing or funding hESC research, one can justify sacrifice of some embryos by an argument whose premises are consistent with a wide range of moral and religious views. This paper proposes a rule of public policy providing for the use of donated embryos barred from the womb. This rule would optimize research while manifesting its moral justification. The rule is suitable for implementation by any government that funds hESC research. The rule's justification provides a cogent argument for such incremental steps toward its implementation as become politically feasible from time to time.

Complicity↗

PubMed1986

Growth and development of children born to patients after cancer therapy.

Eighteen children born to parents who had previously received chemotherapy or radiotherapy were examined for physical health, growth, and development. The immunologic and the hematologic status of these children was also evaluated. Their ages ranged from birth to 15 years. The children had a careful history and physical examination to detect any abnormal symptoms or signs, and the parent's previous treatment was carefully documented. Four sets of parents had children while one of the parents was on active treatment (2 male and 2 female). Of the male patients, one patient's wife had a baby that was "small for gestational age" at birth and had transient failure to thrive; the other child was normal. Of the female patients, one offspring was small for gestational age at birth and the other was normal, but both continued to have failure to thrive for up to 17 months and 26 months, respectively. Ten parents procreated after being treated with chemotherapy and/or radiotherapy, to whom 14 children were born. One child was a stillbirth with multiple congenital abnormalities, and another child had trisomy 13-15 and died 6 months later. The other 12 children were normal at birth, but one child is under the 5th percentile for growth at twelve months of age. In all children studied, immune function test, complete blood count, and viral titers were considered normal for age. In our study, we found that three out of four children born to parents who were on chemotherapy had failure to thrive. Of the 14 children born to parents who conceived after being off chemotherapy, 11 were found to be normal in growth and development. These results imply that there is a high risk of complications in children born to parents who procreated while receiving chemotherapy. Further studies are needed to develop better guidelines for counseling cancer patients who want to have children.

Abnormalities, Multiple↗

PubMed1988

[The electrodynamics of biological processes].

The relations between field-physics and biology are systematically and continuously being inspected. In this paper, the electromagnetic field is taken into consideration, too. An objective point for a biological system of equations corresponding with MAXWELL-equations is given. Therefore processes of the growth and procreation are to be regarded as a unit. A new natural constant called b can be predetermined from field-biology. A triplet of natural constants--c, h, and b--enables a solid connection between physics and biology.

Animals↗

PubMed2004

Interaction of the glucocorticoid receptor and the chicken ovalbumin upstream promoter-transcription factor II (COUP-TFII): implications for the actions of glucocorticoids on glucose, lipoprotein, and xenobiotic metabolism.

Glucocorticoids exert their extremely diverse effects on numerous biologic activities of humans via only one protein module, the glucocorticoid receptor (GR). The GR binds to the glucocorticoid response elements located in the promoter region of target genes and regulates their transcriptional activity. In addition, GR associates with other transcription factors through direct protein-protein interactions and mutually represses or stimulates each other's transcriptional activities. The latter activity of GR may be more important than the former one, granted that mice harboring a mutant GR, which is active in terms of protein-protein interactions but inactive in terms of transactivation via DNA, survive and procreate, in contrast to mice with a deletion of the entire GR gene that die immediately after birth. We recently found that GR physically interacts with the chicken ovalbumin upstream promoter-transcription factor II (COUP-TFII), which plays a critical role in the metabolism of glucose, cholesterol, and xenobiotics, as well as in the development of the central nervous system in fetus. GR stimulates COUP-TFII-induced transactivation by attracting cofactors via its activation function-1, while COUP-TFII represses the GR-governed transcriptional activity by tethering corepressors, such as the silencing mediator for retinoid and thyroid hormone receptors (SMRT) and the nuclear receptor corepressors (NCoRs) via its C-terminal domain. Their mutual interaction may play an important role in gluconeogenesis, lipoprotein metabolism, and enzymatic clearance of clinically important compounds and bioactive chemicals, by regulating their rate-limiting enzymes and molecules, including the phosphoenolpyruvate carboxykinase (PEPCK), the cytochrome P450 CYP3A and CYP7A, and several apolipoproteins. It appears that glucocorticoids exert their intermediary effects partly via physical interaction with COUP-TFII.

Animals↗

PubMed2006

Case of progressive intrauterine twin pregnancy after surgical treatment of cornual pregnancy.

OBJECTIVE: To report on a case of heterotopic triplet pregnancy after in utero transfer of three embryos obtained by in vitro fertilization (IVF), with progression of the intrauterine twin pregnancy after resection of the cornual pregnancy. DESIGN: Technique and instrumentation. SETTING: Département de Médecine de la Reproduction, Hôpital Edouard Herriot, Lyon, France. PATIENTS: A 32-year-old woman, nulliparous with primary infertility for the previous 12 years due to mixed causes (tubal and male infertility). INTERVENTIONS: Diagnosis by ultrasound scan and per-laparoscopic confirmation, followed by resection of the cornual pregnancy by laparotomy. MAIN OUTCOME MEASURES: Ultrasound diagnosis and follow-up of the pregnancy. Delivery. RESULTS: Complete ablation of the cornual pregnancy. Progression of the intrauterine twin pregnancy without difficulties until 31 weeks of gestation. Cesarean upon onset of labor. Birth of two living infants. The scar of the uterine horn, examined during the caesarean, was thick and solid. CONCLUSIONS: The early diagnosis and surgical treatment of an ectopic pregnancy permitted the development of the intrauterine pregnancy. The risk of heterotopic pregnancy is increased by medical techniques that facilitate procreation. This risk is directly related to the number of embryos transferred. In the case of heterotopic pregnancy, the rate of progressive intrauterine pregnancy after treatment of the ectopic pregnancy is encouraging.

Adult↗

PubMed1989

Legal and ethical issues in the use of antiandrogens in treating sex offenders.

Antiandrogen treatment of sexual offenders raises serious legal and ethical considerations in both the medical profession and in the courts. Discussion is offered on the use of antiandrogens in both an involuntary and voluntary context. The potential negative impact of this treatment modality on such constitutional issues as privacy interests, right to procreative freedom, freedom of speech and communication, and freedom from cruel and unusual punishment is explored and notable, germane court cases are presented. The need for clear ethical guidelines for the administration of this treatment is stressed.

Androgen Antagonists↗

PubMed1990

[Contribution of applied cytogenetics to medically assisted procreation].

The cytogenetic studies of gametes and embryos reveal the incidence of chromosomic abnormalities in medically assisted pregnancies. When extended to natural fecundation, these data enable a better comprehension of the place and the role of the selection in the quality of the conceptus.

Abortion, Spontaneous↗

PubMed1976

A computer analysis of the Schreber Memoirs.

With the aid of a computerized system for content analysis, WORDS, the complete Schreber Memoirs was subjected to various multivariate reduction techniques in order to investigate the major content themes of this document. The findings included the prevalence of somatic concerns throughout the Memoirs, clear references to persecutory ideas and to Schreber's assumption of a redemptive role, complex encapsulated concerns about Schreber's relationship with God, a lack of any close relationship between sexuality and sexual transformation either to themes of castration or procreation, and the fact that neither sun, God, nor Flechsig was significantly associated with clusters concerning gender, sexuality, or castration. These findings are discussed in relation to psychodynamic interpretations furnished by prior investigators who employed different research methods.

Austria↗

PubMed1993

Japanese attitudes toward assisted procreation.

CONCLUSION: Based on the present results, the following points are suggested: First, there are significant attitudinal differences [in Japan] on new reproductive technologies between infertile couples and married laypersons; laypersons' attitudes were not so affirmative as those of infertile couples. Second, among the group of infertile couples, male respondents showed more affirmative attitudes toward assisted procreation than female respondents. Third, the main reason for approving of new reproductive technologies was that "it is a treatment for infertility," while the main reasoning of those who disapproved of them was that "it conflicts with the way of nature."

Attitude↗

PubMed2002

[The gynecology-obstetrics department].

The scientific and clinical activities of the Department of Obstetrics and Gynaecology have involved the three main subdivisions: the gynecological surgery, the obstetrics and fetal medicine, the endocrinology and the reproductive medicine. Minimal invasive surgery including laser assisted laparoscopy or robotic assisted surgery has been particularly developed. Endometriosis, a frequent and sometimes particularly invasive disease, and oncologic surgeries have been developed in collaboration with the digestive surgery department. The department has also contributed to the comprehension and treatment of prenatal pathologies such as premature labor and deliveries or the gestational diabetes. The department has supported the development of techniques to study the fetal well-being in utero: the prenatal echography, the chorionic villous sampling, the amniotic puncture or the cordocentesis for prenatal genetic diagnosis or fetal infectious contaminations, the CMV transmission more specifically. In endocrinology and reproductive medicine, the department has mainly developed the in vitro fertilization techniques. The prolonged embryo culture, the study of preimplantation embryo metabolism, the preimplantation genetic diagnosis and the cryopreservation of ovarian fragments to preserve fertility in women undergoing oncologic treatments represent the more recent developed topics. Finally, the security of viral transmission in assisted procreation and the treatment of these patients with chronic viral diseases (Hepatitis C or HIV) are another domain with important scientific activity.

Belgium↗

PubMed1997

[Diagnostic and therapeutic approach to male sterility].

The new techniques of medically assisted procreation allow to approach most of the male infertilities. Their complexity and cost call for a precise diagnosis prior to treatment initiation and a multidisciplinary investigation of the sterile couple is mandatory. We demonstrate the urological side of these investigations.

Diagnosis, Differential↗

PubMedDate not supplied

Unmanaged care: the need to regulate new reproductive technologies in the United States.

In the aftermath of allegations of the misuse of human eggs in the United States, questions are being raised about whether profitable reproductive services should continue to function in a free market under the aegis of physicians or should be regulated. Other countries in which reproductive technologies are employed to a significant degree have developed regulations governing their use, many as a result of recommendations made by inter-disciplinary commissions that solicited public input. Policy makers in the United States have been reluctant to regulate reproductive technologies, however, because their use is politically controversial, they want to whittle down government, some do not consider infertility an illness, and some believe regulation would interfere with the right to reproduce. Yet the unfettered use of reproductive technologies can create such harms as lack of informed consent, providing procedures not medically indicated for financial gain, practice by unqualified personnel, injury to patients and donors, failure to screen donated gametes, and inadequate medical record keeping. Americans place special value on the welfare of children and those who bring them into the world. Such values can outweigh individual procreative liberty when new reproductive technologies are at issue. Although the optimal course would be to establish a regulatory body to govern reproductive technologies, this is not politically feasible now. The newly established National Bioethics Advisory Commission provides a forum in which issues surrounding reproductive technologies should be addressed at this time in the United States.

Advisory Committees↗

PubMed1998

Abortion, revised: participants in the U.S. clinical trials evaluate mifepristone.

This paper centers on the questions: How do non-surgical abortion methods affect private experiences of abortions? How might they influence public conceptions of abortion? Drawing on interviews with clients who participated in the 1994-95 U.S. clinical trials of mifepristone at one trial site (conducted during the trials), and focus group interviews conducted with health care workers at all 17 trial sites (after the trials were completed), we examine participants' evaluations of this method of abortion. Surgical abortion functioned as the reference point by which research participants assessed medical abortion. They discussed mifepristone abortion in terms of nature and invasion, privacy and bodily integrity, denial and agency. Clients frequently portrayed mifepristone abortion as a better moral choice than surgical abortion--in some cases even depicting it as not-really-an-abortion but rather as a miscarriage. Clients felt that mifepristone offered them a greater measure of control over their abortion experiences. Health care providers offered critical analysis of their clients' perceptions, yet affirmed the potential of medical abortion to offer women greater variety and latitude in procreative decision-making, and perhaps even to depoliticize the issue of abortion in the U.S. by thwarting the efforts of anti-abortionists to target providers and aborting women.

Abortifacient Agents, Steroidal↗

PubMed1999

[Management of multiple pregnancies at the Befelatanana Antananarivo University Hospital Center (Madagascar): report of 143 cases].

Multiple pregnancies (MP) outcomes are often complicated. They deliver premature infants and provoke high blood pressure. A retrospective study was carried out in 1998 at the Maternity Hospital of Befelatanana, Antananarivo in order to assess MP frequency and to specify the most important favourising factors and difficulties during labor and the quality of the labor management. All pregnancies with a MP were included in this survey. 143 MP were registered: 142 twin pregnancies and 1 triplet pregnancy. 2.0 per cent of cases were recurrent MP. The average age of pregnancies was 26 years old. Among these 143 MP, 48.0 per cent were primiparas. Poor quality of prenatal visits is frequently encountered. As antecedents there are abortion, hormonal contraceptive taking, preterm delivery, gravidic toxemia, cicatricial uterus, ectopic pregnancy. 6.3 per cent of the first twin had breech presentation, 2.0 per cent transversal labor presentation. As events during labor 40.0 per cent dynamic dystocia, 26.0 per cent acute fetal suffering, 27.0 per cent hyperthermia, 23.0 per cent high blood pressure, some of them as eclampsia or pre-eclampsia were noted. 60.0 per cent of the first twin delivery were easy. Whatever his labor presentation, version by internal manipulations following by breech extraction was performed on the second twin (67.0 per cent of cases). 18.2 per cent of parturient women had cesaretomy. 11 maternal deaths were noted. Infant perinatal mortality rate was of 35.7 per cent. Infant morbidity and mortality are essentially due to infections. The authors conclude that complications prevention will be obtained by improvement of standard of living of all female able to procreate. It needs also correct cares at prenatal visits and during labor. Health education must be focalized on strict and correct surveillance of pregnancies and intergenesic periods by the reinforcement of planning family.

Adolescent↗

PubMed1993

The management of granulosa-cell tumors of the ovary based on long-term follow up.

The results of treatment in 130 cases of GCT of the ovary treated in the Institute of Oncology in Warsaw and followed up from 5 to 40 years were analysed with respect to the methods of therapy and age of the patients. The highest 5-year survival rate (86%) was obtained by combination of radical surgery with external irradiation. Such treatment also resulted in the lowest percentage of early and late failures of the treatment (17%). Conservative surgery, applied in the Ist stage of GCT resulted in 69% of 5-year survivals and gave young women a chance of procreation; however, the majority (69%) of patients who underwent this treatment sooner or later developed a recurrence leading, in consequence, to death.

Adolescent↗