Biomedical subjects

A Kably Ambe

Publications and source records attributed to A Kably Ambe.

At least 19 recordsLinked to original sources

PubMed2001

[Ovarian volume as a predictive factor of ovarian reserve in response to exogenous stimulation with gonadotropins and its correlation with ovum/embryo development in FIVTE/ICSI results].

UNLABELLED: The evaluation of ovarian reserve in regard to the exogenous response elicited by gonadotropines is directly related to the interconnection of diverse intrafollicular factors involved in ovum components, and thus, to a better embryonic development, which will be reflected in the pregnancy ratios of assisted reproduction programs. A series of markers have been proposed in order to dynamically evaluate the ovarian response: hormone determinations (FSH, E2, FSH:LH index), biochemical factors (inhibine-B), intrafolicular (cytokines, leptin), neuromodulators (GNRH test), and so forth. However, none has shown a specific sensitivity in order to accurately determine the best treatment depending on the values they provide. OBJECTIVE: To evaluate the capacity of ovarian response on the basis of ovarian volume determination. Two groups of patients were studied: group 1 (n = 19) with a basal ovarian volume smaller than 3 cm3, and group 2 (n = 21), those with a volume greater than 3 cm3. Patients in group 2 showed a better response to ovarian stimulation, as well as the collection of better quality ovarian, increased fertilization, segmentation and pregnancy ratios and a lower cancellation index as compared to group 1. It can be concluded that patients with an ovarian volume lower than 3 cm3 on the day before the stimulation will present a poor response to exogenous gonadotropins, thus, this variable must be considered as a marker of ovarian follicular response.

Chorionic Gonadotropin↗

PubMed2001

[Gamete laboratory. Determining factors of success in in-vitro fertilization].

The objective was to evaluate the gamete laboratory parameters that can to determine the possibility of achieving pregnancy in in vitro fertilization (IVF). A prospective study was carried in 196 patients undergone to conventional and oocyte donation IVF. After the evaluation of oocytes, embryos and the pregnancies was established that postmature oocytes were more frequently retrieved from patients that did not get pregnant. A good embryo morphology and principally the transfer of 4-cell embryos are common events in IVF. However, there were not significant difference in embryo parameters, number of blastomeres and embryo quality, between pregnant and not pregnant patients. In conclusion, it appear that bad oocyte quality has a negative effect over the possibility of achieving pregnancy. The number of blastomeres and embryo quality were not predictive of the possibility to get pregnant.

Adult↗

PubMed2000

[Effect of intrafollicular interleukin-6 levels on the secretion of estradiol and progesterone in patients treated with in vitro fertilization and embryo transfer].

The objective was to evaluate the relationship between follicular fluid levels of Interleukin-6 (IL-6) and the seric concentrations of estradiol and progesterone during controlled ovarian hyper-stimulation. The levels of IL-6 were measured in follicular fluid of 15 patients undergone to in vitro fertilization and embryo transfer and correlated with the values of seric estradiol and progesterone. There were a negative correlation between follicular levels of IL-6 and either estradiol and progesterone. Four patients achieved pregnancy following embryo transfer (pregnancy rate 26.6%), one of them aborted. As conclusion, the increased levels of IL-6 may be a reaction to controlled ovarian hyper-stimulation and probably a protective response. According to the reduction of estradiol, there may be a subtle reduction in aromatase action by effect of IL-6 and other cytokines.

Adult↗

PubMed2000

[Diagnosis and treatment of the male factor in the age of intracytoplasmic sperm injection].

Currently, we are witnesses of the Assisted Reproductive techniques; advances reproductive goals have been reached with the Intracytoplasmic Sperm Injection (ICSI) in patients with male factor. However, micromanipulation techniques allowed the reproductive solution without an etiologic and/or physiopathologic diagnosis. The andrologic workup of the dynamic and functional sperm characteristics with the endocrine and urologic evaluation should be performed into the infertility management.

Humans↗

PubMed2000

[Changes in preovulatory molecular progesterone/estradiol ratio in patients treated with controlled ovarian hyperstimulation. Can they be used in the assessment of ovarian reserve?].

The objective was to evaluate if the preovulatory molecular ratio between progesterone and estradiol has age-dependent changes in patients undergoing controlled ovarian hyperstimulation. There were 180 cycles of conventional in vitro fertilization which were studied. Patients were divided in three groups: Group 1 (age less than 30 years; n = 40), group 2 (age between 30 and 35 years; n = 82), and group 3 (age between 36 and 40 years; n = 58). Leuprolide acetate was used in all cases. Molecular progesterone/estradiol ratio was calculated with the following formula: [Serum progesterone (ng/mL) x 3180 (Sl x 10(3)) + serum estradiol (pg/mL) x 3.671 (Sl)]. In patients older than 38.5 years there was positive correlation between preovulatory progesterone and estradiol (R = 0.55, R2 = 0.30). There were significant difference in molecular progesterone/estradiol ratio between group 1 compared to group 2 (P less than 0.001), group 1 compared to group 3 (P less than 0.0001), as well as group 1 compared to group 2 plus group 3 (P less than 0.0001). It is concluded that molecular progesterone/estradiol ratio decreases before any endocrine evidence of ovarian aging. The value of this putative test of ovarian reserve is discussed.

Adult↗

PubMed2000

[Changes in preovulatory molecular relationship between estradiol and progesterone in patients undergoing controlled ovarian hyperstimulation. Can they be used for the evaluation of ovarian reserve?].

The objective was to evaluate if the preovulatory molecular ratio between progesterone and estradiol has age-dependent changes in patients undergone controlled ovarian hyperstimulation. Were studied 180 cycles of conventional in vitro fertilization. Patients were divided in three groups: Group 1 (age less than 30 years; n = 40), group 2 (age between 30 and 35 years; n = 82), and group 3 (age between 36 and 40 years; n = 58). Leuprolide acetate was used in all cases. Molecular progesterone/estradiol ratio was calculate with the following formula: [Serum progesterone (ng/mL) x 3180 (SI x 10(3) divided by serum estradiol (pg/mL) x 3.671 (SI)]. In patients with age more than 38.5 years there was positive correlation between preovulatory progesterone and estradiol (R = 0.55, R2 = 0.30). There were significant difference in molecular progesterone/estradiol ratio between group 1 compared to group 2 (P less than 0.001), group 1 compared to group 3 (P less than 0.0001), as soon as group 1 compared to group 2 plus group 3 (P less than 0.0001). It is concluded that molecular progesterone/estradiol ratio decreases before any endocrino evidence of ovarian aging. The value of this putative test of ovarian reserve is discussed.

Adult↗

PubMed2000

[Effect of blood concentrations of preovulatory estradiol on the quality of eggs and pre-embryos in patients treated with fertilization in vitro].

The objective was to investigate if the preovulatory estradiol concentrations obtained during controlled ovarian hyperstimulation (COH) have effect on reproductive outcome. The study included a total of 198 in vitro fertilization (IVF) cycles. Patients were divided into four groups according to serum preovulatory estradiol concentrations. In low responder patients was observed significantly decreased oocyte and preembryo quality compared with normal or high responders (P < 0.01). In this work high response do not have effect on IVF outcome. The clinical results indicate that low estradiol levels the day of hCG administration are apparently correlated with poor oocyte and embryo quality.

Adult↗

PubMed1999

[Clinical use of a quadruple biochemical marker in the prediction of obstetric complications].

The objective was to evaluate the association of an abnormal second trimester prenatal biochemical screening with the subsecuent development of pregnancy complications in women carrying chromosomally normal fetuses. A prospective study of 123 pregnant patients was performed. Specimens were assayed for alpha-fetoprotein, unconjugated estriol, free alpha hCG, and total hCG. The study included the evaluation of the mean and standard desviation as well as multiple of the median. Six women (4.6%) had positive results. The frequency of pregnancy complications in this group was 33.3%, while in the group with negative screening was 11.1%. As conclusion, positive four marker screening is associated with a adverse pregnancy evolution. However the usefulness of four marker screening for to predict pregnancy complications needs more investigations.

Adult↗

PubMed1999

[Osseous metaplasia of the endometrium as a cause of infertility. Hysteroscopic approach].

The osseous metaplasia of the endometrium is very rare cause of infertility. The hysteroscopic approach is a effective method to recover the fertility in most of the cases in a short period. The case of a infertile woman who was previous studied and has indications for laparoscopic and hysteroscopic approach. The infertility workup showed a intracavitary calcification on ultrasonography. During the surgery, the diagnosis of endometriosis and osseous metaplasia of the endometrium were done and treated with histologic confirmation. The patient conceived in her second spontaneous cycle. The hysteroscopy is the first approach in the treatment and should be doing with laparoscopy for the detection of other causes of infertility.

Adult↗

PubMed1999

[Efficacy of simultaneous use of cryopreserved semen, controlled ovarian hyperstimulation and intrauterine insemination in the treatment of sterility caused by hypergonadotropic azoospermia].

The purpose of the present study is to determine the efficacy of an artificial intrauterine insemination program with frozen donor sperm and controlled ovarian hyperstimulation as an alternative therapy for infertility cause by hypergonadotropic azoospermia. Two hundred forty three insemination cycles with frozen donor sperm were analyzed. Clomiphene citrate, pure FSH, recombinant FSH or human menopausal gonadotropins were utilized for ovulation induction; human corionic gonadotropin (hCG), 10,000 IU, was administered when one or more dominant follicles with diameter > or = 16 mm were present; intrauterine insemination was performed 36 hours after the hCG injection. The pregnancy rate per cycle was 19.9%, and the cumulative pregnancy rate was 59.3%. It is concluded that intrauterine insemination with frozen donor sperm and ovulation induction is a good alternative for male factor infertility with no available treatment.

Chorionic Gonadotropin↗

PubMed1999

[Heterotopic pregnancy with intrauterine dizygotic twins following embryo transfer in the blastocyst phase].

Ectopic pregnancy is a common complication of in vitro fertilization and embryo transfer (IVF-ET). On other hand, heterotopic pregnancy complicates 1-2% of all IVF-ET pregnancies. Tubal damage as reason for treatment and multiple embryo transfer might predispose patients to this complication. We present a successful treated case of an infertile patient that developed simultaneous twin intra- and single extra- uterine pregnancy after blastocyst-stage embryo transfer. In IVF-ET patients presence of an intrauterine gestation not exclude the possibility of a concomitant extrauterine pregnancy. Awareness of the possibility of heterotopic pregnancy after IVF-ET plays an important role in the successful treatment of this reproductive complication. Transfer of good quality embryos can be a risk factor to develop heterotopic pregnancy.

Adult↗

PubMed1999

[Clinical evaluation of patients submitted to open vs conventional gynecologic laparoscopy].

The objective was to comparate the clinical evolution and rates of complications for open and conventional gynecological laparoscopy. Were studied the cases of 253 patients divided in two groups: Group 1 (n = 106) patients treated with open laparoscopy, and group 2 (n = 147) patients managed with conventional surgery. The major indication for performing laparoscopy was infertility management. There were not early or I ate complications of trocar insertion or operative laparoscopy in the group 1. However, in group 2 there were four complications (P < 0.05), two related with needle or trocar insertion. As conclusion, in the studied group open laparoscopy can to eliminate the risks of blind insufflation and trocar insertion observed in the classifical technique, is a safe and efficacious method to treat several gynecological pathologies.

Adult↗

PubMed1999

[Spontaneous and assisted reproduction-associated heterotopic pregnancy. The clinical characteristics].

Heterotopic pregnancy is an uncommon obstetric entity with variegated symptomatology. The objective of this report is to describe the clinical findings of the two varieties of heterotopic pregnancy, spontaneous an related with Assisted Reproduction Techniques (ART). Three cases of heterotopic pregnancy are described, two spontaneous and one occurred after in vitro fertilization and embryo transfer (IVF-ET). The two former culminated in miscarriage of intrauterine pregnancy and tubal rupture; and the late obscured for the ovarian hyperstimulation syndrome which prevented accurate ultrasonographic diagnosis. The clinical presentation and key differences are discussed.

Adult↗

PubMed1999

[New concepts in the induction of ovulation. A logarithmic assessment of estradiol production during controlled ovarian hyperstimulation for fertilization in vitro].

The objective was to evaluate the exponential response of serum estradiol to controlled ovarian hyperstimulation (COH) in an in vitro fertilization-embryo transfer (IVF-ET) program through measurement of logarithm of serum estradiol area under the curve (LOG-OUC). One hundred three patients undergone conventional IVF-ET with pituitary suppression were studied. For to calculate the LOG-AUC estradiol, trapezoidal formula and ten-fold logarithm definitions were employed. The estradiol synthesis have notorious logarithmic changes during all COH. There was significant difference between estradiol AUC for initial and final phases of controlled ovarian hyperstimulation. As conclusion LOG-AUC of estradiol can be used for to evaluate the ovarian response to superovulation, its prognostic value for following IVF-ET intent is discussed.

Adult↗

PubMed1999

[From theory to clinical practice: recombinant FSH in daily practice].

The purpose of the present study is to determine the efficacy of induction ovulation with recombinant FSH in patients treated with in vitro fertilization and embryo transfer (IVF-ET) and basic assisted reproductive techniques (ART). One hundred seven cycles were analyzed. The patients were divided in two groups: Group 1, treated with IVF (n = 12) and group 2, treated with basic ART (n = 95). Only recombinant FSH was utilized for ovulation induction; human corionic gonadotropin (hCG), 10,000 IU, were administered when one or more dominant follicles with diameter > or = 18 mm were presents; oocyte retrieval was performed 34 hour, while intrauterine insemination was practiced at 36 hours after the hCG injection. The pregnancy rate per IVF cycle was 25.0%, and 16.4% for basic ART. It is concluded that ovulation induction with recombinant FSH is a good and efficient alternative for both variations of ART.

Female↗

PubMed1998

[Conservative laparoscopic treatment of bilateral ectopic pregnancy. 2 case reports and review of the literature].

Ectopic pregnancy is a frequent clinic entity, with an incidence from 4.5 to 16.8 for 1000 pregnancies. The frequency of ectopic pregnancy has been triplicated in the last years, mainly owed to increase of sexual transmitted diseases, increase in salpinges' surgery and in assisted reproductive medicine. The ectopic pregnancy is also the most frequency cause of maternal death during the first trimester of pregnancy. The frequency of bilateral tubal ectopic pregnancy is extremely rare, it is reported from 1:125 to 1:1580 of all ectopic pregnancies. The first case of bilateral tubal ectopic pregnancy was reported n 1918 by Bledsoe. In Mexico, Molina described the first case in 1993, with conservative laparoscopic treatment. Two clinic cases are presented of bilateral ectopic pregnancy, treated conservatively by laparoscopy. The first one with background of sterility because of anovulation, receiving treatment with menotropins for ovarian hyperstimulation, the other one. In the second case, was a spontaneous pregnancy, in a patient with a history of several pelvic surgeries. In this case a bilateral salpingostomy was realized. In both cases was demonstrated chorionic villi by histopathology. These cases are a model of nature to evaluate the real utility of several diagnostic and therapeutic methods which are available nowadays for the treatment of ectopic pregnancy.

Adult↗

PubMed1998

[Epidemiologic evaluation of the diagnosis and treatment of extrauterine pregnancy at the ABC Hospital].

The objective of this study was to determine the frequency, risk factors, treatment and morbility of the ectopic pregnancy (EP) at the ABC Hospital. EP cases occurring between January 1992 and May 1995 were studied retrospectively analyzing the next variables: Number of live births and EP's, the patients age, obstetric history, previous EP, sterility, previous pelvic surgeries, gestational age at diagnosis, treatment and complications. The results showed that the frequency of EP was 2.06% There was a positive correlation between EP and infertility, nuliparity, and previous tubal surgery secondary to EP. We concluded that even though EP tends to be diagnosed and treated in early stages, the majority of the surgical procedures lower patients fertility.

Female↗

PubMed1998

[Uterine sarcoma. Analytic study of 37 cases].

The lack of uniformity in the nomenclature of the uterine sarcomas, it have contributed to a variety and variability of classifications. Fortunately the sarcomas of uterus are rare. The incidence of this tumor is of 3-5% of all the uterine cancers or of 1.7/100,000 women of 20 years or more. The clinical presentation of these tumors is diverse could come bleed uterine abnormal, abdominal pain, pelvic mass, discharge or cervix prominent mass. Clinical discoveries associated with exist the sarcomas how they are the obesity and high blood pressure in a 30% of the patients it are also observed antecedents of pelvic radiation in a 5-10% of the cases. The genomic alterations that is reported the chromosomes in the literature is associated with 1, 7 11 playing an important paper in the initiation or progression of the sarcomas. We was carried out a retrospective analysis of 37 cases of uterine sarcoma managed in the National Institute of Cancerology at one time of 5 years. Being that the leiomiosarcomas comes in the 51.3% of the cases, followed by the stromal sarcoma, bleed uterine abnormal it was the clinical fact of high importance, detecting these patients in Ia and IIa stadiums predominantly. We observed an increment in the incidence of the uterine sarcoma in patients of 40 years or more. 17 patients were managed exclusively with surgery, 17 patients with surgery and radiotherapy and 5 patients with surgery and chemotherapy (2 patients were managed with surgery + radiotherapy + chemotherapy). The index of failure was from the 45.1% to two years in general form, coming metastasic illness in lung, liver and breast mainly. In conclusion, the adjuvant radiotherapy and chemotherapy to the hysterectomy doesn't increase the index of survivor in the several subtype of uterine sarcomas.

Combined Modality Therapy↗