Pituitary suppression by long-acting D-Trp6-LH-RH and concomitant hMG ovarian stimulation for in vitro fertilization and embryo transfer (ET) has been used in 19 patients who previously failed to conceive, following ovarian stimulation by clomiphene citrate and hMG. When available, up to five embryos were transferred. Compared with the previous CC/hMG cycles, D-Trp6-LH-RH/hMG cycles were associated with significantly more embryos (P less than .002), lower follicular-phase basal LH levels (P less than .05), and a higher early luteal progesterone level (P less than .05). Following D-Trp6-LH-RH/hMG cycles, 11 patients had a clinical pregnancy. The multiple pregnancy rate was 18% and the abortion rate, 18%. Thirty percent of the cycles (6/20) were associated with the ovarian hyperstimulation syndrome. These promising results warrant a further trial of D-Trp6-LH-RH-hMG stimulation.

Adult↗

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The effect of amniotic fluid on intraperitoneal adhesion formation--an experimental study.

In an attempt to investigate the relative paucity of intraperitoneal adhesions after cesarean sections, we tested the effect of amniotic fluid on adhesion formation in rat model. Trauma was induced to the uterine serosa in 40 rats. Amniotic fluid was intraperitoneally instilled in 20 rats and saline in another 20 rats acting as controls. No inhibitory effect of the amniotic fluid could be demonstrated. The effect of the amniotic fluid and the saline solutions on fibroblastic proliferation was examined in vitro using fibroblastic cell cultures. No direct effect on fibroblast proliferation was found. It is concluded that it is not the direct effect of the spilled amniotic fluid that inhibits adhesion formation after the performance of cesarean sections.

Amniotic Fluid↗

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Cervical cerclage--its role in the pregnant anomalous uterus.

Twenty-nine cases of cervical incompetence were found among 98 women diagnosed as having a congenital uterine anomaly on hysterosalpingography, a high incidence of 30%. The highest incidence was found in the bicornuate uterus group--38%. The incidence of premature delivery and late abortion was higher in this group than in the rest of the patients with uterine anomalies (55% and 68%, vs. 45% and 32%). An obvious improvement in obstetrical performance was noted after cerclage. In the cervical incompetence group, term deliveries increased from 26% to 63%. Premature deliveries and late abortions dropped from 74% to 37%. Even in the patients with anomalous uterus without proven diagnosis of cervical incompetence, term deliveries increased from 64% to 96%, and pregnancies terminating prematurely dropped from 35.6% to 4%, following cerclage. No doubt exists as to the need for cerclage in cases of cervical incompetence. We also believe it should be performed prophylactically in cases of bicornuate uterus. The concept of routine prophylactic cerclage in all cases of uterine anomalies should be considered.

Abortion, Spontaneous↗

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Experimental endometriosis and fertility: compared effects of an antigonadotropin (danazol) and an antiprostaglandin (indomethacin).

The possible role of prostaglandins in infertility associated with endometriosis is not fully understood. We therefore compared the efficacy of danazol, the drug chosen for treating this disease with that of indomethacin, an anti-prostaglandin, in rats affected with experimentally produced endometriosis. Endometriosis was induced in two groups of ten rats. The rats in group A were given danazol orally and those in group B were given peritoneal injections of indomethacin. The resulting fertility rates were very good in group B and less so in group A. Group A showed better anatomical findings, but group B gave improved results regarding adhesions.

Administration, Oral↗

PubMedDate not supplied

Strain gauge transducer for neuromuscular blockade monitoring.

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Anesthesia↗

PubMedDate not supplied

Manual removal of the placenta--its role in intrauterine adhesion formation.

OBJECTIVE: To determine the role of postpartum intrauterine manipulation of the uterine cavity in the formation of intrauterine adhesions. PATIENTS AND METHODS: Diagnostic hysteroscopy was performed following manual removal of the placenta in 48 patients. RESULTS: Intrauterine adhesions were observed in only one case (2%), and an incomplete uterine septum was found in seven cases (15%). CONCLUSIONS: Manual removal of the placenta does not seem to predispose to the formation of uterine adhesions. Incomplete uterine septum may be involved in some of the cases of retained placenta.

Adult↗