Hyperbaric oxygen and in vitro fertilisation.
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Adult↗
Biomedical subjects
Ana Mitrović
Publications and source records attributed to Ana Mitrović.
Mean of CA 125 in making therapy decision in adnexal inflammatory tumors.
UNLABELLED: LABORATORY FINDINGS such are white blood count and sedimentation rate are of relative value in inflammations of the upper genital tract and adnexal inflammatory tumors. Antibiotics are administrated in all cases according to the protocol but some of them need operative treatment also. Inflammatory tumors can develop in endometriotic and even in cancer adnexal masses. CA 125 is elevated in great number of patients with advanced ovarian cancer. It can also be elevated in endometriosis, inflammations and in non-gynecological malignancies. Adnexal inflammatory tumor was confirmed in 57 patients. LABORATORY FINDINGS: white blood count and sedimentation rate were in normal levels in 17 patients. CA 125 was elevated in 27 patients. 49 patients were operated and CA 125 decreased in the first 5 days after the operation. Only 8 patients without CA 125 elevation were successfully treated by mean of antibiotics. Even there is no need for routine examining of serum CA 125 in adnexal inflammatory tumors it can be examined in cases with suspected Doppler ultrasonographic findings or unclear clinical findings. Endometriosis brings some risk of malignancy. Inflammatory tumor can develop in endometriotic tumor as well as in necrotic malignant ovary tissue. These could be reasons for making decision to do the operation in cases with inflammatory tumor followed with increased CA 125, hystological assessment and serious interpretation of final results.
Adnexal Diseases↗
Hyperbaric oxygenation as a possible therapy of choice for infertility treatment.
Endometrial sonographic and color doppler features can be used to predict the occurrence of pregnancy in natural or stimulated cycles. Implantation will usually only take place if the endometrium has reach a certain stage of vascularisation and development. The aim of this study was to evaluate endometrial development -- endometrial thickness and reflectivity , subendometrial, endometrial and uterine perfusion, after hyperbaric oxygenation, using transvaginal color doppler. During a three years period 32 women with unexplained infertility were entered into a randomised study. The patients were treated in multiplaced HAUX chamber at pressure of 2.3 ATA during 70 minutes, 7 days consecutively beginning with day 5th of menstrual cycle. The evaluation of effects of hyperbaric oxygen therapy was carried out by transvaginal color doppler sonography which was continuously used starting from 8th day of menstrual cycle until the ovulation in the cycles when the therapy was applied , one month before and one month after the therapy. Folliculometry in the cycles when hyperbaric oxygen therapy at 2.3 ATA was applied, indicated an excellent response of endometrium. Thickness of endometrium at the time of ovulation was 11.0 +/- 2.6 mm. Desirable quality of endometrium was significantly better in the cycle when HBO therapy had been applied (p< 0.001). The doppler flowmetry of the uterine arteries indicated that the uterine blood vessel resistance was slightly higher than expected. Mapping of subendometrial blood vessels in the cycles covered by hyperbaric oxygen therapy showed the intensive capillary network of endometrium with low resistance Ri< 0.45. The oxygen used under higher pressure -- oxygen as a drug , may have an extraordinary significance for better outcome of pregnancy implantation by improving endometrial receptivity. If endometrial receptivity is conditioned by adequate vascularisation and oxygenation, then hyperbaric oxygen therapy is the treatment of choice.
Adult↗
The role of transvaginal colour Doppler sonography in evaluation of abnormal uterine bleeding.
INTRODUCTION: Treatment of abnormal uterine bleeding understands a prompt diagnostic procedure, for the sake of defining the etiological factor of disease. The abnormal uterine bleeding is more common in the perimenopausal than in the postmenopausal women, and it is more frequent sign of an endometrial proliferative or hyperplastic changes. Fewer percentages of women with unexpected and/or acyclic and prolonged bleeding have endometrial cancer. MATERIALS AND METHODS: Seventy-one (71) patients with abnormal uterine bleeding, older than 40 years, of which 10 were in post-menopause, have been tested. Prior to explorative curettage and histopathological analysis, ultrasonographic and hemodynamic studies, at the uterine blood vessels level (uterine artery bilaterally) had been performed by transvaginal colour Doppler method. RESULTS: Histopathological results indicated four types of represented changes, on the basis of how the patients were divided into the groups: I, proliferative endometrium--20 patients; II, endometrial adenocarcinoma--23 patients; III, various forms of endometrial hyperplasia--26 patients, IV, atrophic endometrium--2 patients. Significant statistical difference in the endometrial thickness was established between groups I and II, and endometrial cancer was not found in less than 8 mm thick endometrium. By analysing hemodynamic parameters, significantly lower PI values were obtained in the group of patients with pathologically altered endometrium, compared to other groups. CONCLUSION: Transvaginal colour Doppler has significant role in the diagnostic process for evaluation of abnormal uterine bleeding in perimenopausal and postmenopausal women. Doppler sonography can help in differentiating physiological from malignant endometrial changes and in deciding on the most efficient therapeutical regime.
Adult↗
Relation between body mass and postmenopausal symptoms in surgically castrated women.
INTRODUCTION: Post-menopause androgens are the essential precursors for estrogen synthesis through their conversion in peripheral tissues. The main postmenopausal estrogen is estrone, which is also peripherally converted into estradiol. Concentrations of these two estrogens are directly proportional in circulation. We wanted to establish whether there is a direct correlation between body mass and postmenopausal symptoms in surgically castrated women. MATERIALS AND METHODS: We analyzed 30 patients with artificially induced menopause, 3-12 months after the operation (hysterectomy and bilateral adnexectomy). Prior to being put on hormone substitution therapy the following was obtained from the patients: Body Mass Index--BMI (kg/m(2)), measurement of estradiol (E(2)) by RIA method, and 12 subjective symptoms analyzed according to intensity and frequency. The relationship between BMI, E(2) level and subjective symptoms were assessed. RESULTS: By analyzing the correlation coefficient it was shown that there was statistically significant causal-consequential connection between the E(2) level and BMI (R(2)=0.1647, p<0.05). There is no strong correlation between BMI and symptoms (R(2)=0.004, p<0.05). However, E(2) level correlated with subjective symptoms (R(2)=0.2123, p<0.05). CONCLUSIONS: Estrogen production in postmenopause is dependent on the substrate availability, and thus with adiposity. Therefore, we were surprised by the lack of correlation between BMI and symptoms. This suggests that estrogen metabolism and biological effects are not primarily affected by BMI, and that expression of postmenopausal symptoms does not depend only on estrogen level.
Adult↗
[Magnesium supplementation during pregnancy and lactation].
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Breast Feeding↗
[Correlation analysis of predictive factors of successful implantation in fertilization in vitro].
INTRODUCTION: Endometrial receptivity as isolated predictive factor of successful implantation, with its specifity is determined with numbered factors. PURPOSE: Purpose of this study was to evaluate significance and correlation between relevant factors using appropriate statistical analyses on term of embryo implantation. MATERIAL AND METHODS: Evaluated group contained 85 women whom according different causes of infertility have been determined for assisted reproduction program. Analysed measurements were: endometrial thickness, assessed hyperechogenity in relation with absolute endometrial thickness (HEA relation) and uterine blood flow (pulsatile index-Pi). Simultaneously were analyzed serum estradiol (E2; pg/ml) and progesterone (P; nmol/l) levels. After these evaluations achieved results were processed with standard statistical pack. Beside that were applied parameter and nonparameter tests with aim to test significancy of difference and multiple regressive analyse (Stepwise). RESULTS: Resulted measured parameters have been presented in basic analyse as middle value (Xrs) from all measurements + SD (standard deviation) and significance of difference is tested by mentioned statistical tests (Table 1). Application of Stepwise analyse, "step by step", has used parameter by parameter based on value which has decreased variability and based on achieved correlative coefficient between dependent uneven and complex of independent uneven values. This procedure confirms best correlation between HEA relation and serum progesterone levels and HEA relation in correlation with associated values: P, E2 and endometrial thickness (Table 1). DISCUSSION: Investigation provided till now shows that embryo quality and endometrial receptivity with highest probability determine success of applied assisted reproduction, successful embryonal implantation There is assessed influence of endometrial receptivity represented trough HEA relation using many folded regressive analyse where qualitative endometrial value has been looked with dependency with other parameters gives picture for high determinancy with hormonal activity and with stimulative ovarian activity. This determinancy could be viewed mostly through serum progesterone levels on day of HCG administration. Correlative relation between qualitative endometrial characteristics on day of HCG administration has high value related to progesterone levels. CONCLUSION: Results presented with this research confirm once again complexity characteristic for factors that play final role in embryo implantation in IVF program. There is presented only one aspect related with this problem with aim to contribute quantification importance and assessment rate of mutual influence these factors known till now as relevant.
Blood Flow Velocity↗