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At least 631 records · Page 35Linked to original sources
PubMed2001

Pregnancy and twinning rates in Thoroughbred mares following the administration of human chorionic gonadotropin (hCG).

AIM: To determine the effect of hCG administration to cycling Thoroughbred mares, on pregnancy and twinning rates and the number of serves in the treated cycle. METHODS: A retrospective case control approach was conducted involving 2119 mare ovulatory cycles, on 1110 mares over a 7-year period. Data were collected by 1 of the authors during routine stud work at 3 commercial Thoroughbred farms in the Waikato region of New Zealand. The hCG (1500 IU) was administered by intravenous injection to selected mares 24 h before the expected time of breeding. Mares were scanned for pregnancy (singleton or twins) 14 days after the onset of dioestrus or detection of ovulation. Multilevel logistic regression analyses were used to identify the risk factors associated with the outcomes of interest while simultaneously controlling for possible confounding factors. RESULTS: Treatment with hCG tended to improve the odds of pregnancy (p=0.06), produced a 3-fold increase in the odds of twins (p<0.001), and increased the odds of a mare having a single serve in the treated ovulatory cycle (p=0.036). The first ovulatory cycle of a season in which a mare was bred was associated with a lower odds of pregnancy (p=0.02), and a lower odds of twins (p=0.003), when compared with subsequent cycles. Lactating mares were less likely to be diagnosed with twins (p=0.005), and were more likely to have a single serve (p<0.001), in any one ovulatory cycle than non-lactating mares. CONCLUSIONS: This report supports the role of hCG as an important therapeutic tool in veterinary management of broodmares for optimal reproductive performance. Mares treated with hCG must be managed in the knowledge that they have an increased likelihood of twins.

Journal Article↗
PubMed2000

Profile and opinions of the female Persona user in The Netherlands.

OBJECTIVES: The primary objective of this study was to investigate the profile of the Dutch Persona user and her opinion about this relatively new way of natural birth control. The results of the study were used to draw conclusions for the suitability for Persona as a contraceptive method. METHOD: Data from 137 users of the device were obtained from structured questionnaires. RESULTS: The 'Persona woman' is typically in a steady relationship, highly educated and has an above-average income. She wants to have a contraceptive method with no side-effects and desires children in the future. She is therefore looking for information about her own cycle. It is remarkable that one in four women uses the system to help in planning a pregnancy instead of avoiding one. CONCLUSIONS: Persona seems to be a welcome alternative for natural family planning and for couples who have no absolute negative attitude towards a(nother) child, but want to postpone their first pregnancy or to space pregnancies. The method is not reliable enough to be used as the only contraceptive method when a couple absolutely wants to prevent a pregnancy. Another conclusion that can be drawn is that the method improves fertility awareness.

Adult↗
PubMed1997

A prospective, randomized, cross-over comparison of two methods of artificial insemination by donor on the incidence of conception: intracervical insemination by straw versus cervical cap.

In a prospective, randomized study of insemination with donor semen, intracervical insemination by straw was compared with insemination using a cervical cap with an intracervical reservoir. A total of 91 patients completed 486 treatment cycles. There were no significant differences in age, parity, indication for insemination by donor, or method of cycle monitoring between women who became pregnant and those who did not conceive with either insemination method. In 236 standard intracervical insemination cycles, 14 patients became pregnant (5.9% per cycle), whereas 38 patients conceived in 250 cervical cap cycles (15.2% per cycle). Both the crude pregnancy rates and the cumulative pregnancy rates calculated by the Kaplan-Meier life-table method were significantly different (chi(2)-test, P < 0.001, and log-rank test, P < 0.005 respectively). Pregnancy rates in artificial insemination with cryopreserved donor semen may be improved by the use of a cervical cap when compared to cervical insemination by straw. The use of the cervical cap may prolong the exposure of the spermatozoa to the cervical mucus and prevent the backflow of semen into the vagina.

Body Temperature↗
PubMed1998

A 3 year retrospective review of intrauterine insemination, using cryopreserved donor spermatozoa and cycle monitoring by urinary or serum luteinizing hormone measurements.

Insemination with donor spermatozoa is an integral part of infertility treatment. For the last 3 years in our unit, intrauterine insemination with donor spermatozoa (IUID) has been used in preference to vaginal insemination. In this retrospective study, patients were offered an initial course of five single intrauterine inseminations with cryopreserved donor spermatozoa and treatment was then reviewed. A total of 389 patients received 1465 inseminations. In all, 1119 cycles were monitored using luteinizing hormone serum analyses and 346 cycles using the urine home test kits. The clinical pregnancy rate per insemination for the cycles monitored by the serum assay was 18.0% (202/1119) compared with the urine cycles (13.7%, 46/346) (P <05). The pregnancy loss rate was not significantly different (14.4%, 29/202 and 21.7%, 10/46) (serum and urine cycles respectively). The viable clinical pregnancy rate was significantly higher (P <03) for the serum cycles than for the cycles using the urinary monitoring (15.5%, 173/1119 and 10.4%, 36/346 respectively). The cycles monitored by serum assay had a significantly higher cumulative viable clinical pregnancy rate (P <0001) of 70.2% after nine inseminations compared with the urine monitored cycles of 54.8%. The majority of patients opted for the serum cycles, with a minority self-selecting the urine cycles mainly for travelling convenience. The explanation for the significant differences between the viable clinical pregnancy rates per insemination and the cumulative viable clinical pregnancy rates may be due to the sensitivity of the urine home test kit or the patients' interpretation of the result.

Cryopreservation↗
PubMed1999

Day-specific probabilities of clinical pregnancy based on two studies with imperfect measures of ovulation.

Two studies have related the timing of sexual intercourse (relative to ovulation) to day-specific fecundability. The first was a study of Catholic couples practising natural family planning in London in the 1950s and 1960s and the second was of North Carolina couples attempting to become pregnant in the early 1980s. The former identified ovulation based on the ovulatory shift in the basal body temperature, while the latter used urinary assays of hormones. We use a statistical model to correct for error in identifying ovulation and to re-estimate the length of the fertile window and day-specific fecundabilities. We estimate the same 6-day fertile interval in both studies after controlling for error. After adjusting for error both data sets showed the highest estimate of the probability of pregnancy on the day prior to ovulation and both fell close to zero after ovulation. Given that the fertile interval is before ovulation, methods that anticipate ovulation by several days (such as the assessment of cervical mucus) would be particularly useful for couples who want to time their intercourse either to avoid or facilitate conception.

Adult↗
PubMed2001

The relationship between cervical secretions and the daily probabilities of pregnancy: effectiveness of the TwoDay Algorithm.

BACKGROUND: The TwoDay Algorithm is a simple method for identifying the fertile window. It classifies a day as fertile if cervical secretions are present on that day or were present on the day before. This approach may be an effective alternative to the ovulation and symptothermal methods for populations and programmes that find current natural family planning methods difficult to implement. METHODS: We used data on secretions from a large multinational European fecundability study to assess the relationship between the days predicted to be potentially fertile by the TwoDay Algorithm and the day-specific probabilities of pregnancy based on intercourse patterns in 434 conception cycles from the study. RESULTS: The days around ovulation that had the highest fecundability were the days most likely to be classified as fertile by the TwoDay Algorithm. In addition, intercourse on a particular day in the fertile interval was twice as likely to result in a pregnancy if cervical secretions were present on that day or the day before. CONCLUSIONS: The TwoDay Algorithm is effective, both in identifying the fertile days of the cycle and in predicting days within the fertile interval that have a high pregnancy rate. Our data provide the first direct evidence that cervical secretions are associated with higher fecundability within the fertile window.

Algorithms↗
PubMed1993

Natural regulation of fertility.

Natural methods play an important part in the overall control of world fertility. Lactational amenorrhoea makes a very large contribution to fertility control in developing countries and recent advances in our understanding of the biology of lactation and fertility have enabled guidelines to be prepared to help nursing mothers who wish to use the natural contraceptive effect of breastfeeding to space their families. Methods to identify more reliably the fertile phase of the menstrual cycle, possibly using home monitoring of hormone levels in the urine, would greatly increase the applicability of NFP methods. If used effectively, natural family planning can have a high effectiveness rate but all methods are extremely unforgiving of risk-taking in the fertile phase. More research is required to identify those factors which could serve to improve the efficacy of NFP methods.

Amenorrhea↗
PubMed1996

Symmetry and ovulation in women.

Women have cryptic ovulation, and self-observation methods of determining the timing of ovulation, such as monitoring cervical mucus symptoms or recording basal body temperature, are not reliable. It has recently become apparent that the symmetry of paired soft tissue traits, such as breast size and digit length, changes across the menstrual cycle. This paper presents evidence that symmetry in four paired soft tissue traits showed a marked increase on the day of ovulation. The difference (i.e. the asymmetry) between the size of the left and right trait in ears, 3rd, 4th and 5th digits was measured. The timing of ovulation was confirmed by real-time pelvic ultrasonography and trait measurements were made without knowledge of scan results. Asymmetry was lowest on the day of ovulation (day 0), decreasing by about 30% from day -1, and significant within-subjects changes occurred from days -2 to day -1, and day -1 to day 0. The practical and evolutionary implications of these findings are discussed.

Adult↗
PubMed1987

One year's experience with programmed oocyte retrieval for IVF.

We have previously described a simplified form of ovulation stimulation for IVF in which the day of presumed oocyte retrieval is determined several weeks in advance. This paper retrospectively analyses this technique in 296 unselected patients over a one year period to assess if the method is suitable for routine use in an IVF programme. Oocyte retrieval was performed on the predetermined day in 70% of patients commencing stimulation. In the remainder, the presumptive day of oocyte retrieval was modified, or the cycle was cancelled. Compared with 356 patients undergoing a comparable classically monitored IVF stimulation during the same period, there was no significant difference in the cancellation rate of cycles prior to oocyte recovery, in the numbers of oocytes or embryos obtained or in the pregnancy rate between the two populations. It is concluded that programmed oocyte retrieval does not have a deleterious effect on the success rate of IVF compared with classical clomiphene citrate/HMG stimulation and it considerably facilitates the administration of an IVF programme.

Clomiphene↗
PubMed1987

Premature luteinization of follicles during ovarian stimulation for in-vitro fertilization.

The structure and growth of developing follicles was monitored using vaginal ultrasound scanning in an outpatient programme of in-vitro fertilization (IVF) and embryo transfer (ET). Patients received either human menopausal gonadotrophin (HMG) alone or clomiphene citrate (CC) + HMG for controlled ovarian stimulation. Ultrasound data were compared with pre-ovulatory oestradiol (E2), luteinizing hormone (LH) and progesterone (P) levels. Hormonal parameters and results were classified according to the main indications of IVF-ET treatment. Twenty-one of the 271 patients in the study showed ultrasonic evidence of premature luteinization (PL) of follicles, thickening of the follicular wall and the appearance of irregular echogenic structures in the follicle. PL was preceded in eight cases by an indisputable LH surge and subsequent P elevation. In the remaining 13 cases PL occurred either due to an abortive LH surge not exceeding by 3-fold the baseline values or as a result of HMG administration. Special attention was paid to the P pattern prior to and after human chorionic gonadotrophin (HCG) administration. PL cycles demonstrated significantly (P less than 0.05) higher P levels before HCG administration and at the time of oocyte retrieval as well. Because implantation was not achieved in these cases, the cancellation of PL cycles is recommended. Vaginal ultrasound scanning seems to be helpful in the evaluation of minor changes in the follicular structure, correlating frequently with hormonal findings.

Clomiphene↗
PubMed1989

Serum levels of pregnancy-associated endometrial alpha 2-globulin (alpha 2-PEG) during normal menstrual and combined oral contraceptive cycles and relationship to immunohistological localization.

Serum levels of pregnancy-associated endometrial alpha 2-globulin (alpha 2-PEG), the major secretory protein of the endometrium during the late luteal phase of the menstrual cycle and early pregnancy, were measured serially during normal menstrual cycles and in women taking various combined oral contraceptives. Pill users were also sampled on an individual basis. Endometrium from women taking the combined oral contraceptive was examined immunohistochemically using a monoclonal antibody to alpha 2-PEG. Levels of alpha 2-PEG in the menstrual cycle sera showed consistent changes following the luteinizing hormone peak, with a greater than three-fold increase between basal levels at mid-cycle and those in the late luteal phase. Serum levels of alpha 2-PEG in the pill users remained at basal levels throughout the cycle, regardless of the progestagen in the formulation. This finding was noted in serial and individual samples from both monophasic and triphasic preparations. However, there was evidence of induction of alpha 2-PEG production at the local endometrial level when immunohistochemical staining was employed at various stages of the pill cycle. This suggests that serum levels of alpha 2-PEG may not necessarily reflect local endometrial production of the protein. These observations are discussed with reference to the proposed value of serum measurement of this protein in assessing relative progestagenic activity upon the endometrium.

Adult↗
PubMed1989

An assessment of the dual-analyte enzyme immunoassay for ovulation timing.

In a search for simpler, more efficient methods of monitoring ovulatory function, either to assist in the investigation of the infertile couple or for contraceptive or fertility control purposes, a number of new methods have been developed. One of these, the OVEIA dual-analyte system is now available for laboratory use. The principle behind the system is the simultaneous measurement of urinary oestrone-glucuronide and pregnanediol-glucuronide. The resultant signal is quantified using an enzymatic photometric endpoint denoted by the relative absorbance (RA%). The application of the OVEIA system to the monitoring of urine samples over the periovulatory period in ovulatory and non-ovulatory cycles from regularly cycling but infertile women is described and the changes in RA% compared with synchronously measured changes in plasma LH and plasma oestradiol concentrations, salivary progesterone profiles and measurements of follicular volume. It is concluded that the OVEIA system is simple and quick to perform and the results obtained compare reasonably well with equivalent direct and indirect indicators of impending ovulation (e.g. increasing plasma oestradiol concentrations or changes in the volume of the follicle). However, as is the case with other endocrine methods, definitive information about the presence or absence of follicular rupture cannot be obtained.

Adult↗
PubMed1989

Results of IVF attempts in patients with unexplained infertility.

From January 1986 to July 1987, 143 patients with unexplained infertility (UI) following 217 IVF attempts were studied and randomly assigned for statistical analysis to be compared with 434 tubal infertility (TI) patients undergoing 748 IVF attempts. The age of patients, previous pregnancy history and stimulation protocols were identical in both groups. In comparison with tubal patients, IVF attempts on the UI group were characterized by the same rates of cycle failure, mean number of oocytes retrieved per cycle, a lower fertilization rate (45.7% UI/59.8% TI) (P less than 0.01) and no difference in cleavage and nidation rates. However, a decrease in the pregnancy rate/attempt (13.8% UI/19.5% TI) tended towards a significant value (P = 0.06). Although the semen parameters were found to be in the normal range during the previous fertility screening in both groups, the incidence of at least one abnormality (count less than 20 X 10(6)/ml, and/or total motility less than 30% and/or abnormal forms greater than 75%) on the day of insemination was found to be significantly higher in UI (20%) than in TI (11%) patients. Moreover, 25% of UI patients did not fertilize any oocytes inseminated, whatever the number of oocytes retrieved. This rate of failed fertilization was significantly lower (9%) in tubal patients. The oestrogen response profiles were similar in both groups, analyzed according to the stimulation protocols.(ABSTRACT TRUNCATED AT 250 WORDS)

Buserelin↗