摘要:

We report herein a technique for direct intraendometrial transfer (DIET) of human embryos. In this study we evaluated whether 2-day embryos injected into the endometrial stroma can develop normally into viable pregnancies. After in vitro fertilization the embryos were injected into the endometrium of 14 women under direct visualization using a CO2-pulsed flexible hysteroscope. A total of 44 embryos were transferred, resulting in 2 clinical (14.3% per cycle) and 2 chemical pregnancies. In 1 patient, amniocentesis revealed monosomy X and the pregnancy was terminated at 18 weeks. The 2nd patient had an uneventful pregnancy and delivered a healthy baby. The results from the present study, demonstrating a low implantation rate after DIET of 2-day embryos, suggest that the endometrial stroma does not provide an optimal environment for early embryonic development. The acidifying effect of CO2 used for insufflation may also explain the low pregnancy rate after DIET. We conclude that it is possible to achieve pregnancy by DIET in humans, but presently this procedure can be considered only in cases where the implantation site needs to be precisely determined.

ISSN:0378-7346    

DOI:10.1159/000291824

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Purpose: To analyze the effects and potential benefits of a single midcycle dose of follicle-stimulating hormone (FSH) prior to human chorionic gonadotropin (hCG) administration during unstimulated in vitro fertilization (IVF) cycles. Methods: Twenty-five cycles from 20 patients receiving 150 IU of FSH 42–44 h and 10,000 IU of hCG 34–36 h prior to follicle aspiration were compared to 110 cycles triggered with hCG alone. Results: Serum E2 levels were significantly lower on the day of hCG treatment in the FSH-treated group (266 vs. 297 pg/ml). On the day after hCG administration, serum E2 was similar in both groups. Maximum follicular diameters the day of and the day after hCG treatment were similar as were the number of oocytes aspirated and embryos transferred, and clinical pregnancy rates in both groups. The number of cycles dropped due to premature luteinizing-hormone (LH) surge was 8% in the FSH group compared to 20% in the group treated with hCG alone. Conclusions: A midcycle FSH boost does not increase pregnancy success of unstimulated IVF cycles but does enhance the increase in serum E2 levels after hCG, thereby potentially allowing earlier hCG administration while incurring decreased cycle cancellation rates due to premature LH surges.

ISSN:0378-7346    

DOI:10.1159/000291825

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

A computerized Medline search was conducted, to assess the prognostic value of hysterosalpingography (HSG) and the probability of pregnancy after normal versus abnormal HSG findings. A total of 13 studies turned out to be eligible, reporting on 3,277 women. 15% of women with an abnormal HSG and 32% of women with a normal HSG achieved pregnancy. Sensitivities and specificities of the studies were heterogeneous. The pooled odds ratio was 3 (95% CI: 2.3–3.4). Its ROC Curve shows that, at the operating point yielding the lowest number of misclassifications, a sensitivity of 63% and a specificity of 62% is achieved. Seven studies reported unilateral and bilateral obstruction. Odds ratios were 2 (95% CI: 1.5–2.6) and 19 (95% CI: 7.5–46.5) respectively. So, overall, HSG has a low prognostic value, the outcome of HSG adds little to predicting the occurrence of pregnancy. However, when HSG shows bilateral obstruction, the chance of getting pregnant is only minimal.

ISSN:0378-7346    

DOI:10.1159/000291826

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Controversy still surrounds abortion and abortion care in many countries. Information for women who seek abortion is not always as objective and complete as desired. In Italy abortion has been legal for the last decades. The overall purpose of this study was to investigate general information needs among patients in a hospital in Rome. A questionnaire concerning information needs, opinions on information to include in a booklet, and methods of information was distributed among 212 women in a public hospital in Rome. Women answered the questionnaire very differently, and general information needs were not shown to be as essential as expected; their present needs seemed especially underestimated. However, a booklet with information as objective and complete as possible is suggested as a way of giving information to abortion patients.

ISSN:0378-7346    

DOI:10.1159/000291827

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The spiral arteries of the human uterus are considerably remodeled structurally during pregnancy to facilitate an increase in blood flow. An immunohisto-chemical study was undertaken to determine whether the spiral arteries were innervated and, if so, whether they were denervated in the process of the physiologic vascular changes of normal pregnancy or, conversely, remained innervated in the absence of physiologic changes in abnormal pregnancy. Uterine tissues from nonpregnant nulliparous women, from normal early pregnancy, from normal late pregnancy, from abnormal early pregnancy (i.e. spontaneous abortions), and from abnormal late pregnancy (i.e. preeclampsia and intra-uterine growth retardation) were subjected to immunohistochemistry using a panel of neuron-associated antibodies (neurofilament, neuron-specific enolase, S100 protein, protein gene product 9.5). All sections of the nonpregnant uterus showed an abundance of nerves deep in the myometrium, some of which were associated with radial and arcuate arteries. Very few nerves were demonstrated at the endomyometrial junction and no nerves were seen accompanying the intramyometrial spiral arteries. In both normal and abnormal pregnancy, nerves were not detected in the decidua or accompanying intradecidual spiral arteries, whether they were physiologically altered or not. Nerves were seen in the myometrium in 7 of 10 normal and in 1 of the 8 third-trimester abnormal placental beds, but none were seen accompanying intramyometrial spiral arteries, whether showing physiological changes or not. The lack of innervation of the spiral arteries in the nonpregnant state as well as in normal and abnormal pregnancy suggests that nonneurogenic mechanisms control blood flow at the spiral-arterial level.

ISSN:0378-7346    

DOI:10.1159/000291828

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Cord blood thyrotrophin (TSH) levels of 134 patients with singleton pregnancies and breech presentation at delivery were compared with those of cephalic-presenting controls matched for mode of delivery, the presence of labour, parity, and the date of delivery. Infants delivered by vaginal breech delivery were found to have a higher incidence of elevated cord blood TSH level than either cephalic-presenting infants or breech-presenting infants delivered by Caesarean section. We conclude that vaginal breech delivery can be associated with false positive congenital hypothyroidism screening.

ISSN:0378-7346    

DOI:10.1159/000291829

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000292227

出版商:S. Karger AG    

年代:1916

数据来源: Karger

摘要:

This study was undertaken to test the accuracy of formulas we recently developed for the sonographic estimation of the weight of very preterm fetuses. The formulas were used to determine estimated weights from prenatal sonographic data for 62 premature infants born at 23–29 weeks of gestation, weight < 1,400 g. The mean absolute deviation of the actual birth weight from the estimated weight was 75.8 ± (SD) 68.5 g, the mean percent deviation +0.60% and the absolute mean percent deviation 8.1 ± (SD) 5.6%; 90.3% of the birth weights lay within 15% of the estimated weight. The model described represents an accurate method for prenatal estimation of the weight of very preterm fetuses.

ISSN:0378-7346    

DOI:10.1159/000291830

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

A variable white blood cell count without clinical signs of sepsis or hematological disorders is often observed in newborns. The intention of this study was to investigate the effect of mode of delivery on hematologic measurements, especially white blood cell count in the umbilical vein. 121 term newborns were investigated prospectively. They were subdivided into three groups: spontaneous births (n = 83), vacuum extraction (n = 19) and cesarean sections (n = 19). The mode of delivery influenced the leukocyte count and the precursor cells. The mean leukocyte counts after spontaneous birth (14.6 ± 4.0 leukocytes/nl) and after vacuum extraction (16.6 ± 7.4 leukocytes/nl) were significantly higher than after cesarean section (12.1 ± 4.4 leukocytes/nl; p < 0.05). The precursors of leukocytes were also significantly higher in infants with vacuum extraction (1.06 ± 0.83 cells/nl) than in spontaneously delivered infants (0.54 ± 0.47 cells/nl). An inverse relationship between the number of leukocytes and the arterial cord blood pH was observed (p < 0.05). No significant differences were observed in the effect of mode of delivery on erythrocyte and platelet counts.

ISSN:0378-7346    

DOI:10.1159/000291831

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000291832

出版商:S. Karger AG    

年代:1997

数据来源: Karger