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Biomedical subjects

A Nazari

Publications and source records attributed to A Nazari.

At least 37 records · Page 2Linked to original sources
PubMed1996

The effect of assisted hatching on pregnancy rates after frozen embryo transfer.

OBJECTIVE: To compare clinical pregnancy and implantation rates after transfer of frozen-thawed embryos prepared according to an assisted hatching protocol or a nonassisted hatching protocol. DESIGN: A historical cohort study in which a cohort of patients who underwent an assisted hatching protocol was matched for clinical parameters to an external historical cohort treated before assisted hatching was available. SETTING: In vitro fertilization-ET facility of a university-based practice. PATIENTS: Seventy-nine matched pairs. INTERVENTIONS: Nonassisted hatching patients: embryos were thawed, cultured in human tubal fluid + 0.5% bovine serum albumin until 48 hours and transferred. Assisted hatching patients: embryos thawed, cultured in human tubal fluid + 10% synthetic serum substitute until 72 hours, had assisted hatching and transferred. MAIN OUTCOME MEASURES: Clinical pregnancy (gestational sac) and implantation rates. RESULTS: Twelve (15.2%) clinical pregnancies per transfer in nonhatched group versus 24 (30.4%) in hatched group. Nonhatched group: 284 embryos transferred; 15 (5.3%) implanted. Three pregnancies (25.0%) had two sacs. Hatched embryos: 269 were transferred; 37 (13.7%) implanted. Eleven pregnancies (45.8%) were multiple gestations (9 twins, 2 triplets). CONCLUSION: Clinical pregnancy and implantation rates were higher for group having assisted hatching protocol. It is not clear whether the improvement is due to the overall methodology change or to assisted hatching. Assisted hatching using the zona-drilling technique is not detrimental to frozen-thawed human embryos and may be beneficial.

Adult↗
PubMed1996

Relationship of early follicular phase sera follicle stimulating hormone and luteinizing hormone levels as measured by a radioimmunoassay and an enzyme-linked immunosorbent assay to number of oocytes retrieved.

A study was performed to see if the level of serum follicle stimulating hormone (FSH) or luteinizing hormone (LH) obtained in the early follicular phase could predict the number of oocytes retrieved following in vitro fertilization (IVF). For each patient the sera FSH and LH were measured by both an enzyme-linked immunosorbent assay (ELISA) and a radioimmunoassay (RIA) method. With the ELISA method when early follicular phase serum FSH was < or = to the group median (9.0 mIU/mL) 16.5 oocytes were retrieved vs 6.7 when FSH was greater than the median. Comparable values using the median of the RIA assay were 17.5 vs 8.1 oocytes. Similar analysis for serum LH failed to show any relationship between baseline LH and the number of oocytes retrieved. This study thus demonstrates that at least one non-isotopic method is equal to a specific RIA method in distinguishing good from average or poor responders.

Adult↗
PubMed1995

Pregnancy after zona drilling of cryopreserved thawed embryos: case report.

OBJECTIVE: To confirm successful implantation of IVF, cryopreserved human embryos after assisted hatching with acidic Tyrode's solution. DESIGN: Case report. SETTING: In vitro fertilization-ET facility of a university-based practice. PATIENT: A 28-year-old female with nonoperable bilateral tubal occlusion and > 1 1/2 years of primary infertility. INTERVENTIONS: The patient was stimulated for egg retrieval after an hMG-controlled ovarian hyperstimulation regime. Luteal phase leuprolide acetate (1 mg) was administered SC for 10 days. The dose was then reduced to 0.5 mg, and she was given hMG and FSH IM twice daily until two lead follicles reached 20 mm average diameter. The patient was administered 10,000 IU hCG 36 hours before retrieval. MAIN OUTCOME MEASURES: Viable pregnancy documented by ultrasound (US). RESULTS: After the transfer of five cryopreserved-thawed human embryos that were subjected to assisted hatching using acidic Tyrode's solution, the patient established a triplet gestation as documented by US. CONCLUSION: This case report demonstrates that zona drilling can be successfully applied to frozen-thawed pronuclear stage embryos that were cultured to 72 hours without damaging them, as evidenced by continued cleavage and resulting implantation.

Adult↗
PubMed1995

Comparison of efficacy of high-dose pure follicle-stimulating hormone versus human menopausal gonadotropins for in vitro fertilization.

The advent of recombinant DNA technology will soon produce for the market a product that has pure follicle-stimulating hormone (pFSH) but no luteinizing hormone. A prospective randomized study was performed to see if pFSH (Metrodin) was able to stimulate the same in vitro fertilization parameters as human menopausal gonadotropin when preceded by gonadotropin suppression by leuprolide acetate. The results showed similar parameters between the two drugs, i.e., number of oocytes, number of embryos, endometrial thickness at time of human chorionic gonadotropin, fertilization rates and pregnancy rates in a protocol purposely designed to stimulate as many follicles as safely as possible because of a shared oocyte and successful cryopreservation program.

Adult↗
PubMed1995

Comparison of androgen levels in conception vs. non-conception cycles following controlled ovarian stimulation using the luteal phase gonadotropin-releasing hormone agonist protocol.

Serum concentrations of androstenedione, testosterone and dehypdroepiandrosterone sulfate (DHEAS) as well as estradiol and progesterone were measured throughout the in vitro fertilization (IVF) cycle and compared by conception outcome to try to determine if differing levels of androgens could help elucidate the endocrine environment conducive to successful IVF cycles. The luteal phase gonadotropin-releasing hormone agonist (GnRH-a) protocol was used for ovarian stimulation. of the 46 women enrolled in the study, 11 conceived and 35 did not conceive. Throughout the follicular phase, levels of androstenedione and DHEAS were found to rise but the same pattern of increase was found in both conception and non-conception cycles. The pattern of testosterone increase in non-conception cycles was faster than that in conception cycles. Differences in mean levels of androstenedione, testosterone, estradiol and progesterone by conception outcome in the late luteal phase can be attributed to secretion by the corpus luteum. It is possible that those women having multiple failed cycles with rapidly rising serum testosterone levels should be considered for longer use of the GnRH-a. Differences in the pattern of testosterone rise should be monitored.

Adult↗
PubMed1993

The efficacy of short-term gonadotrophin-releasing hormone agonists versus human chorionic gonadotrophin to enable oocyte release in gonadotrophin stimulated cycles.

One of the reasons for failure to conceive following human menopausal gonadotrophin (HMG) therapy may be due to non-release of oocytes from the follicles. We hypothesized that by using a gonadotrophin-releasing hormone agonist (GnRHa) for a short duration, endogenous release of luteinizing hormone and follicle stimulating hormone may enable oocyte release to occur, similar or superior to the effect of human chorionic gonadotrophin (HCG). This study attempted to compare the efficacy of HCG versus the GnRHa leuprolide acetate to release oocytes and achieve pregnancies and to compare the effectiveness of leuprolide acetate versus a combination of HCG with HMG to release oocytes. Unfortunately due to lack of prior data, many patients preferred to reject leuprolide acetate in favour of HCG, resulting in three times as many patients being treated with HCG in cycle 1; 78.2% of oocytes were released following leuprolide acetate versus only 55.7% with HCG. Interestingly, 87.5% of those females in whom oocyte release failed in cycle 1 with HCG did indeed release with leuprolide acetate in cycle 2, but none of these previous failures released with HCG in cycle 2. Pregnancy rates were equal in those women releasing oocytes, whether treated with HCG or leuprolide acetate. These preliminary data justify a larger randomized study.

Chorionic Gonadotropin↗
PubMed1993

Embryo transfer technique as a cause of ectopic pregnancy in in vitro fertilization.

A randomized prospective study was performed to compare the effects of a midfundal versus a deep fundal transfer technique on subsequent intrauterine and ectopic PRs after IVF. The clinical intra-uterine PR after the deep fundal transfer was 12.4% per cycle with a 1.5% ectopic PR (which represented 12.2% of the pregnancies) versus 14.2% IUPs per cycle with a 0.4% ectopic rate (representing 3% of pregnancies) after midfundal transfers. The midfundal technique appears superior to deep fundal procedures because of a lower percentage of EPs without any sacrifice of the intrauterine PR after midfundal transfers.

Embryo Transfer↗
PubMed1992

Comparison of pregnancy rates following in vitro fertilization-embryo transfer between the donors and the recipients in a donor oocyte program.

Our in vitro fertilization (IVF) program provides a unique opportunity to evaluate influences of hormonal milieu on pregnancy outcome, by using a shared pool of oocytes obtained by donors (in exchange for financial assistance). The study presented herein evaluated 38 retrieval cycles (28 oocyte donors/22 recipients). No difference in mean number of embryos transferred was seen (2.7 in the donors vs 2.8 in the recipients). However, a statistically significant difference was seen in the pregnancy rates per retrieval (10.5% donors vs 29% recipients) and per transfer (4/35, 11.1%, vs 11/34, 32.3%). Abortion rates were similar (25% donor, 27.2% recipients). These data suggest that other reports of higher pregnancy rates from donor oocyte programs may not be due exclusively to better-quality oocytes. Possibly a negative effect of hyperstimulation or adverse endometrial environment of the donor (possible chronic endometritis) may explain these data.

Abortion, Spontaneous↗
PubMed1991

Relationship of small-for-dates sac size to crown-rump length and spontaneous abortion in patients with a known date of ovulation.

Spontaneous abortion after established sonographic viability is rare. This study prospectively evaluated 39 late first-trimester abortions after fetal viability was established by ultrasound. The average crown-rump length measurement and mean sac diameter in this group were determined and compared with predicted values based on known conception dates, and the discrepancy between actual and predicted measurements was noted. The same calculations were then made on 39 prospectively matched non-aborting controls. We also determined the difference between sac size and crown-rump length in both groups. Significant differences were found for all three measures. Small-for-dates sac size and small-for-dates crown-rump length were defined as having a discrepancy score greater than 1 standard deviation (SD) above normal. Small-for-dates sac/crown-rump length was defined as having a discrepancy score less than 1 SD below normal. A high percentage of aborters was correctly predicted by a mean sac diameter (82%) or crown-rump length (77%) that was greater than +1 SD, with few false positives (12.8 and 5.1%, respectively). The cutoff for differences of sac minus crown-rump length measurements (10.1 mm) was less sensitive (56%), but just as specific (82%). When both the mean sac diameter and crown-rump length were smaller than expected (according to known date of ovulation), the ability to predict abortion was 71% with few false positives (3.5%).

Abortion, Spontaneous↗
PubMed1990

Ovulation induction and pregnancies in 100 consecutive women with hypergonadotropic amenorrhea.

The efficacy of a technique of gonadotropin suppression and human menopausal gonadotropins (hMG) to induce ovulation in women with hypergonadotropic amenorrhea was evaluated in 100 consecutive women. Ovulation was achieved in 19% of cycles (68/361), the pregnancy rate per cycle was 5.2% (19/361), and the viable pregnancy rate was 2.2% (8/361). In the majority of the successful cases, estrogen was used to decrease the elevated luteinizing hormone and follicle-stimulating hormone levels, especially where the ethinyl estradiol therapy alone induced a rise in endogenous 17 beta-estradiol levels with hMG used to boost the follicle to maturation. Although the success rate is low, this technique can result in some successes in otherwise almost hopeless cases.

Adult↗
PubMed1990

Correlation of computerized semen analysis with successful fertilization of oocytes in an in vitro fertilization program.

Sixty-nine couples enrolled in 123 in vitro fertilization-embryo transfer cycles were categorized by percentage fertilization; the results of categorization were compared with those of computerized semen analysis carried out with the CellSoft semen analyzer. Four groups were established: group 1 had 75% fertilization or greater; group 2 had 34% to 74% fertilization; group 3 had 1% to 33% fertilization; and group 4 had 0% fertilization. Statistical differences in certain semen parameters (motility, linearity, and straight-line velocity) were found comparing groups 1 and 3 using the initial ejaculate. A significant number of patients in group 1 had all normal semen parameters, but no statistical difference could be found in group 3 or 4 because of variations in specific abnormal parameters in the groups. When the straight-line velocity-motile density (SLVMD) calculation was used, a significant difference was seen between group 1 and group 3 and between group 1 and group 4 (p less than 0.01); 65% of group 3 and 76% of group 4 had an abnormal SLVMD. SLVMD is a useful calculation to predict fertilization rates in vitro from the initial ejaculate.

Computers↗
PubMed1989

Amenorrhea in an ovulatory woman despite a normal uterine cavity: case report.

A 35-year-old nulliparous woman came to us for treatment of amenorrhea. Evaluation demonstrated normal ovulation with appropriate results of sequential endometrial biopsies during the luteal phase. The only abnormality found was an elevated serum level of follicle-stimulating hormone in the early follicular phase, and it is hypothesized that this somehow leads to atrophy of the endometrium without shedding.

Adult↗