Successful in-vitro fertilisation and embryo transfer after treatment with recombinant human FSH.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to A Senn.
Explore the source record for details and available documents.
OBJECTIVE: To identify, among patients with idiopathic normogonadotropic oligoasthenozoospermia, those with low bioactive follicle-stimulating hormone (FSH), possibly because of inadequate gonadotropin-releasing hormone (GnRH) pulsatility, whose bioactive FSH and sperm could be improved by GnRH treatment. DESIGN: Randomized, double-blind, placebo-controlled trial with intranasal (IN) GnRH, followed by open GnRH treatment. SETTING: Outpatient endocrinology clinic. PATIENTS: Twenty-eight infertile men with idiopathic normogonadotropic oligoasthenozoospermia. INTERVENTIONS: Gonadotropin-releasing hormone or placebo was self-administered IN every 2 hours. MAIN OUTCOME MEASURES: Serum immunoreactive and bioactive FSH and semen analyses. RESULTS: Ten men showed a low basal FSH bioactive/immunoreactive ratio, which increased in 5 of them under GnRH without parallel sperm modification. Sperm improvements were observed in 10 patients with no parallel evolution of FSH bioactive/immunoreactive ratio. Unpredicted by sperm changes, three pregnancies developed on placebo and 5 on GnRH. CONCLUSIONS: Low bioactive FSH was not the cause of idiopathic normogonadotropic oligoasthenozoospermia in our patients and could not predict response to GnRH. Pulsatile GnRH did not improve sperm beyond random fluctuations.
Using polyclonal antibodies, the distribution of actin, acrosin, dynein, tubulin and hyaluronidase has been examined by indirect immunofluorescence in sperm preparations from fertile donors and in-vitro fertilization (IVF) patients. After recording sperm parameters in native semen, spermatozoa were washed free of seminal plasma using either the swim-up or the Percoll filtration technique. Prior to insemination, aliquots of the washed sperm suspensions were prepared for antibody staining. Spermatozoa from fertile donors were analysed in order to establish the specific fluorescence patterns of each antibody and the threshold scores of normality. Immunofluorescence scores obtained from IVF patients were then analysed with respect to IVF outcome. For each tested protein, the number of normal samples were significantly lower in the group which did not fertilize and fertilization rates were significantly reduced when any of the tested proteins were scored as pathological. Normal fluorescence scores were correlated with morphology, motility, velocity and to a lesser extent with sperm concentration in native semen. On the basis of receiver-operating characteristic curves, likelihood ratios and Cohen's kappa values, the presence of acrosin and tubulin yields the most useful information on sperm functional and structural status and on its fertilizing ability.
Explore the source record for details and available documents.
After a brief historical survey and review of the main Swiss centres engaged in medically assisted procreation, the indications for in vitro fertilization and embryo transfer (IVF-ET) are discussed. This technique offers the sterility specialist a new approach in allowing separate investigation of the two gametes and study of their interactions. This therapeutic approach to infertility is thus supplemented by biological data which may modify or highlight some of the etiologic aspects and promote new treatments. The techniques employed at our centre and the results obtained over the past four years are presented. Analysis of IVF pregnancies shows that the obstetric risks can be associated with the characteristics of the groups treated rather than with the IVF technique.
Different protocols using agonists of GnRH-a have been proposed for the ovarian stimulation in IVF cycles. In case of stimulation failure with the flare-up protocol, we have investigated whether an immediate switch to pituitary blockade by the long-acting analog may avoid the cycle to be canceled. This procedure allows a rescue of cycles among poor responders and does not have any deleterious effect on the recruitment of follicles, oocyte quality, fertilization, and pregnancy rates.
The ovarian hyperstimulation syndrome (SHO) can be defined as an iatrogenic pathology induced by active substances administered for controlling follicular maturation and ovulation. The etiology, the physiopathology, the diagnostic and therapeutic methods available are discussed. A theoretical model, based on clinical data, allows identification of a set of criteria which should help determining prospectively the chances of development of such a pathology.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The treatment of chronic arterial circulatory disorders of the lower extremities depends on the one hand on the presence of a type of occlusive process which can be confirmed angiologically and on the other hand by the degree of severity and thirdly on the availability of operative and conservative methods of treatment. According to the stage of ischemia (Stage III and IV) possibly only surgical measures offer the possibility of preventing amputation. The nearer the stenotic process to the aorta, the greater the possibility of success of a surgical intervention if the general condition does not represent a contraindication to surgery. The questions of indications for operation and the problems of the most suitable procedure (endarterectomy, bypass, prostheses, Dotter's transluminal dilatation) are discussed on the basis of many years' experience.
An epidemiological and genetical study of osteogenesis imperfecta (OI) in Victoria, Australia confirmed that there are at least four distinct syndromes at present called OI. The largest group of patients showed autosomal dominant inheritance of osteoporosis leading to fractures and distinctly blue sclerae. A large proportion of adults had presenile deafness or a family history of presenile conductive hearing loss. A second group, who comprised the majority of newborns with neonatal fractures, all died before or soon after birth. These had characteristic broad, crumpled femora and beaded ribs in skeletal x-rays. Autosomal recessive inheritance was likely for some, if not all, of these cases. A third group, two thirds of whom had fractures at birth, showed severe progressive deformity of limbs and spine. The density of scleral blueness appeared less than that seen in the first group of patients and approximated that seen in normal children and adults. Moreover, the blueness appeared to decrease with age. All patients in this group were sporadic cases. The mode of inheritance was not resolved by the study, but it is likely that the group is heterogeneous with both dominant and recessive genotypes responsible for the syndrome. The fourth group of patients showed dominant inheritance of osteoporosis leading to fractures, with variable deformity of long bones, but normal sclerae.
Extra anatomical cross-over-shunts are feasible even when the lending extremity is itself afflicted by obliterative arterial disease provided that 1. global irrigation of the lending extremity exceeds perfusion of the borrowing extremity, 2. pulse-volume-recording (PVR) corresponds to categories 1--3 as defined by Raines, 3. ankle pressure of the lending extremity is not less than 70 mm of mercury or 4. ankle pressure of the leading extremity corresponds to 60% or more than the systemic blood pressure.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Report on 80 patients with aneurysm of the abdominal aorta seen in this clinic during the period January 1968 to December 1974. They are divided into three groups, viz. asymptomatic, symptomatic and ruptured. The indication for and urgency of surgery are discussed and the results in 62 surgical cases are compared with those in 18 where surgery was not performed. The difficulties encountered in the diagnosis of ruptured aneurysm of the abdominal aorta are outlined. Only in these cases can the prognosis still be decisively improved by early recognition and immediate treatment.
Explore the source record for details and available documents.