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C Simón

Publications and source records attributed to C Simón.

At least 127 records · Page 7Linked to original sources
PubMed1995

Exploring the mechanism(s) of endometriosis-related infertility: an analysis of embryo development and implantation in assisted reproduction.

Several retrospective analyses of our in-vitro fertilization (IVF) and oocyte donation programmes have been carried out in an attempt to gain clinical knowledge of the factors implied in the aetiology of endometriosis-associated infertility. In a first approach, a comparison was made of the IVF outcome between 96 cycles in 78 patients with tubal infertility and 96 more cycles in 59 women with endometriosis. The results indicate that endometriosis patients had a poor IVF outcome in terms of a reduced pregnancy rate per cycle (P < 0.0004), a reduced pregnancy rate per transfer (P < 0.002) and a reduced implantation rate per embryo replaced (P < 0.003). In a second study, we addressed the analysis of patients undergoing oocyte donation. The results showed that patients with this disease have the same chances of implantation and embryo development in vivo as other recipients when the oocytes come from donors without known endometriosis. However, when the results of oocyte donation were classified according to the nature of the oocytes donated, patients who received embryos derived from endometriotic ovaries showed a significantly (P < 0.05) reduced ability to implant compared with the remaining groups. In a third approach, we evaluated embryo development in vitro when women with and without endometriosis underwent IVF and embryo replacement 72 h after oocyte retrieval. We observed a significantly (P < 0.04) reduced number of blastomeres in embryos from endometriosis patients compared with controls, as well as an increased (P < 0.05) incidence of arrested embryos in vitro. Taken together, these observations suggest that infertility in endometriosis patients may be related to alterations within the oocyte which, in turn, result in embryos of lower quality, as demonstrated in our IVF programme, and a lower ability to implant, as shown in the oocyte donation model.

Embryo Implantation↗
PubMed1995

Clinical evidence for a detrimental effect on uterine receptivity of high serum oestradiol concentrations in high and normal responder patients.

This study was undertaken to investigate an empirical observation that 'high responder patients have poorer in-vitro fertilization (IVF) outcome than normal responder patients'. The aim of our study was to analyse the effect of high serum oestradiol and progesterone concentrations at the day of human chorionic gonadotrophin (HCG) administration on endometrial receptivity and oocyte-embryo quality in high and normal responder patients. The IVF patients were divided into two groups: 59 high responder patients who voluntarily donated some of their oocytes, and a control group consisting of 105 normal responder patients. Both groups were compared in terms of the number and quality of oocytes retrieved, embryos transferred, fertilization, implantation and gestation rates, serum oestradiol and progesterone concentrations and the oestradiol:progesterone ratio on the day of HCG injection. To ascertain oocyte-embryo quality, a second control group of 96 women undergoing oocyte donation (receiving oocytes from high responder patients) was considered. To assess the impact of steroid concentrations on endometrial receptivity, high responder patients were divided into two subgroups according to oestradiol concentration, above or below the minimal oestradiol and progesterone concentrations (mean--SD) in this group. The normal responder patients were divided into two subgroups according to oestradiol concentration, above or below the maximal oestradiol and progesterone concentrations (mean+SD) in this group. To assess further the relevance of oestradiol concentration on endometrial receptivity, patients were divided into different subgroups according to increasing oestradiol concentration, regardless of whether they were high or normal responders. High responder patients had significantly decreased implantation and pregnancy rates per cycle compared with normal responder patients (33.3 versus 16.3 and 11.1 versus 5.4% respectively; P < 0.05). The results of 108 embryo transfers in 91 recipients who received oocytes from the high responder group showed normal embryo quality. Implantation rates and pregnancies per cycle were significantly lower in high responder patients with serum oestradiol concentrations > 1700 pg/ml compared with those having oestradiol concentrations < or = 1700 pg/ml, as well as in normal responder patients with serum oestradiol concentrations > 2200 pg/ml compared with those having oestradiol concentrations < or = 2200 pg/ml. Considering all the patients together, significant decreases in pregnancy and implantation rates were observed when oestradiol concentrations were > 2500 pg/ml compared with patients having lower oestradiol concentrations. Our clinical results demonstrate that high serum oestradiol concentrations on the day of HCG injection in high and normal responder patients, regardless of the number of oocytes retrieved and the serum progesterone concentration, are detrimental to uterine receptivity without affecting embryo quality.

Chorionic Gonadotropin↗
PubMed1995

Immunohistochemical localization, identification and regulation of the interleukin-1 receptor antagonist in the human endometrium.

There is evidence suggesting the importance of the interleukin-1 receptor type I (IL-1Rtl) and interleukin-1 beta (IL-1 beta) as mediator in local intercellular interactions in endometrial tissue and embryonic implantation. To complete our understanding of the entire endometrial IL-1 system in humans, we have investigated the immunohistochemical distribution of IL-1 receptor antagonist (IL-1ra) in the human endometrium throughout the menstrual cycle. We have also identified the forms of IL-1ra present in human endometrial cells. Immunoreactive IL-1ra was found in both cryostat and paraffin-embedded sections of human endometrium using the alkaline phosphatase-peroxidase (A-P) method with two different IL-1ra antibodies. IL-1ra was present throughout the entire menstrual cycle, located primarily in the endometrial epithelium. However, IL-1ra staining was significantly higher during follicular phase in comparison with early and mid-late luteal phases. Reverse transcriptase polymerase chain reaction of cultured stromal and glandular cells showed that these cells express the intracellular form of IL-1ra mRNA (icIL-1ra). Our results demonstrate the regulated presence of the icIL-1ra in the human endometrium. This finding supports a possible autocrine-paracrine role for the IL-1 system in the human endometrium and embryonic implantation.

Adult↗
PubMed1994

Effects of aging on the human ovary: the secretion of immunoreactive alpha-inhibin and progesterone.

OBJECTIVE: To investigate the changes induced by age in the function and secretory pattern of the human ovary. Immunoreactive alpha-inhibin, E2, and P secretion in vivo and in vitro have been compared in two different populations. DESIGN: Prospective study. Women undergoing IVF-ET were divided into two groups according to age: group 1 (32.0 +/- 0.7 years; mean +/- SEM) and group 2 (40.3 +/- 0.3 years). SETTING: In vitro fertilization program at the Instituto Valenciano de Infertilidad. PATIENTS: A total of 33 infertile women with regular menses, undergoing IVF-ET. INTERVENTIONS: Follicle aspiration performed by transvaginal ultrasound. Four follicles per patient were aspirated in individual plastic tubes. Granulosa-luteal cells isolated with Percoll columns and cultured in vitro up to 4 days in the presence of hCG. MAIN OUTCOME MEASURES: In vitro fertilization parameters, serum levels of E2, immunoreactive alpha-inhibin, and P, as well as the secretion of immunoreactive alpha-inhibin and P by the cultured granulosa-luteal cells. RESULTS: Serum immunoreactive alpha-inhibin levels the day of ovum pick-up were significantly lower in group 2 compared with group 1. Incubation of cells for 96 hours showed a significantly higher ability to accumulate immunoreactive alpha-inhibin in group 1 than 2. Human chorionic gonadotropin stimulated immunoreactive alpha-inhibin production after 96 hours. Cells from younger women displayed a significantly higher ability to secrete P than cells from older women. Human chorionic gonadotropin was able to significantly stimulate P production in group 1. CONCLUSIONS: These results confirm previous observations showing a reduced production of immunoreactive alpha-inhibin and steroids of ovaries from older women and suggest that a reduced cellular function, rather than a decrease in the follicular population, is the main mechanism by which these changes are produced.

Adult↗
PubMed1994

Gene regulation of interleukin-1 beta, interleukin-1 receptor type I, and plasminogen activator inhibitor-1 and -2 in human granulosa-luteal cells.

OBJECTIVE: To investigate the regulation of messenger ribonucleic acid (mRNA) levels of interleukin-1 beta (IL-1 beta), interleukin-1 (IL-1) receptor type 1, and plasminogen activator (PA) inhibitor-1 and -2 in cumulus cells, granulosa-luteal cells, and macrophage-depleted granulosa-luteal cells obtained from human preovulatory follicles. DESIGN: Prospective longitudinal study. SETTING, PATIENTS: Patients undergoing assisted reproductive technologies (ART) in the Department of Gynecology and Obstetrics, Stanford University, Stanford, California. INTERVENTIONS: Cumulus cells and granulosa-luteal cells were collected by ultrasound-guided transvaginal aspiration at the time of ART. MAIN OUTCOME MEASURES: Northern blot analysis of mRNA levels of IL-1 beta, IL-1 receptor type 1, PA inhibitor-1 and -2 in cumulus cells, granulosa-luteal cells and macrophage-depleted granulosa-luteal cells, and indirect immunocytochemical analysis of the IL-1 system and macrophages in granulosa-luteal cell preparations were performed. RESULTS: Interleukin-1 beta mRNA levels in uncultured cumulus cells were less than those of uncultured granulosa-luteal cells with no differences in IL-1 receptor type 1 mRNA levels between these two cell types. Granulosa-luteal cell IL-1 receptor type 1 mRNA levels were expressed constitutively throughout 24 hours of culture with no effect by hCG, whereas IL-1 beta mRNA levels increased within 6 hours, and then remained elevated for 24 hours with no effect by hCG. Interleukin-1 beta significantly increased granulosa-luteal cell mRNA levels of IL-1 beta (over twofold), IL-1 receptor type 1 (over twofold), PA inhibitor-1 (approximately 1.4-fold), and PA inhibitor-2 (approximately 1.6-fold). In contrast, IL-1 beta had no effect on IL-1 beta and IL-1 receptor type 1 mRNA levels in macrophage-depleted granulosa-luteal cells. Granulosa-luteal cells, not macrophages, account for the majority of the immunocytochemical staining for IL-1 beta and IL-1 receptor type 1 in follicular aspirates. CONCLUSIONS: These studies suggest that the IL-1 system is regulated in human granulosa-luteal cells during the periovulatory period. Furthermore, the augmentation of PA inhibitor-1 and -2 mRNA levels by IL-1 beta suggests a potential role for IL-1 beta in remodeling of the human ovary during the periovulatory period.

Adult↗
PubMed1994

Outcome of patients with endometriosis in assisted reproduction: results from in-vitro fertilization and oocyte donation.

A retrospective analysis of our in-vitro fertilization (IVF) and oocyte donation programmes was carried out in order to gain clinical knowledge of the factors involved in the aetiology of the endometriosis-associated infertility. Comparison between the IVF outcomes from 96 cycles in 78 patients with tubal infertility and from 96 cycles in 59 women with endometriosis indicates that endometriosis patients have a poor IVF outcome in terms of reduced pregnancy rate per cycle (P < 0.0004), reduced pregnancy rate per transfer (P < 0.002), and reduced implantation rate (P < 0.003). The analysis of patients undergoing oocyte donation for different reasons, including low response with or without endometriosis, showed that patients with this disease have the same chances of implantation and pregnancy as other recipients when the oocytes came from donors without known endometriosis. However, when the results of oocyte donation were classified according to the origin of the oocytes donated, patients who received embryos derived from endometriotic ovaries showed a significantly (P < 0.05) reduced implantation rate as compared to the remaining groups. Taken together, all these observations suggest that infertility in endometriosis patients may be related to alterations within the oocyte, which in turn result in embryos with decreased ability to implant.

Adult↗
PubMed1994

Immunohistochemical localization of the interleukin-1 system in the mouse ovary during follicular growth, ovulation, and luteinization.

The distribution of immunoreactive interleukin-1 receptor type I (IL-1R tI), IL-1 alpha, and IL-1 beta, and of macrophages, was investigated immunohistochemically in the mouse ovary during follicular growth, ovulation, and luteinization. For this purpose, an indirect immunofluorescence technique, using specific monoclonal antibodies against mouse IL-1R tI, mouse IL-1 alpha, IL-1 beta, and macrophage antigens (CD11b/CD18) was used with sections of paraffin-embedded ovaries from eCG and eCG/hCG-treated 12-wk-old B6C3F-1 female mice. During follicular development, IL-1 alpha, IL-1 beta, and IL-1R tI staining were confined to the theca-interstitial layer of growing follicles with one remarkable exception. Intense IL-1R tI still staining was present in the cytoplasm and plasma membrane of the murine oocyte. During ovulation, IL-1 alpha and IL-1 beta were still confined to the theca layer, but faint IL-1R tI staining was initiated in cumulus cells and in granulosa cells just before follicle rupture. Immediately after follicle rupture, granulosa cells stained positive for IL-1R tI, IL-1 alpha, and IL-1 beta. During luteinization, granulosa-luteal cells of the corpus luteum demonstrated strong IL-1R tI, IL-1 alpha, and IL-1 beta staining. Macrophages were detected in the theca layer and stroma, but never within the follicle before ovulation. Immediately after ovulation, there was a rapid entry of macrophages into the follicle, and macrophages were also present inside the corpus luteum. Our morphological results support a possible autocrine-paracrine role of the mouse ovarian IL-1 system in ovulation and luteinization.

Animals↗
PubMed1994

Interleukin-1 receptor antagonist suppresses human chorionic gonadotropin-induced ovulation in the rat.

Indirect evidence has implicated the interleukin-1 (IL-1) system in ovulation. Thus, the ability of IL-1 beta to induce ovulation in rat and rabbit perfused ovaries has been demonstrated. In the present study, the involvement of the IL-1 system in ovulation was directly tested in vivo, in the rat model. For this purpose, the natural inhibitor of the IL-1 system, interleukin-1 receptor antagonist (IL-1ra), was administered locally by use of an intrabursal injection route. Twenty-six-day-old Sprague-Dawley rats received injections of eCG (10 IU), followed 56 h later by hCG (15 IU). IL-1ra (75 micrograms/bursa) was administered locally into the periovarian sac, 6 h (n = 5), 2 h (n = 11), and 0 h (n = 5) before hCG administration. Control animals (n = 10) received injections of the same volume (50 microliters) of vehicle (PBS). IL-1ra administered locally into the periovarian sac inhibited ovulation from the treated ovary, reaching 40% inhibition (p < 0.05) when injected 2 h prior to hCG, as compared to the untreated contralateral ovary (6 +/- 1.4 ova vs. 10 +/- 1.8 ova) and PBS-injected control ovaries (6 +/- 1.4 ova vs. 8.2 +/- 0.7). Injection of IL-1ra 6 h before or concomitantly with hCG did not affect the ovulation rate. Internucleosomal DNA fragmentation was evaluated by 3' end-labeling and autoradiography for detecting apoptotic changes. No difference in DNA fragmentation was found between treated and untreated ovaries.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Embryonic implantation in mice is blocked by interleukin-1 receptor antagonist.

We have investigated the relevance of interleukin-1 receptor type I (IL-1R tI) in the implantation process in vivo in a murine model. Indirect immunofluorescence experiments demonstrate that IL-1R tI is located in mouse endometrial lumenal epithelium with increased intensity in the periimplantation period, whereas IL-1 beta staining is located in the mouse placenta. PMSG/human CG (hCG)-stimulated and mated 12-week-old B6C3F-1 female mice were randomly allocated to three groups: A, control noninjected; B, buffer-injected animals; and C, animals injected ip with 20 micrograms recombinant human IL-1 receptor antagonist (rhIL-1ra) every 12 h beginning on pregnancy day 3. Injections were continued until day 9, and animals were killed 12 h after the last injection. Pregnancy rates in the three groups were: noninjected, 58.8% (10 of 17); buffer-injected, 73.7% (14 of 19); rhIL-1ra-injected, 6.7% (1 of 15), P = 0.0001155, Fisher exact test. To rule out the possibility that pregnancy failure was due to an embryotoxic effect of rhIL-1ra, 2-cell mouse embryos (n = 276) were flushed from the same group of animals used for in vivo experiments and cultured with increasing concentrations of rhIL-1ra: 0 microgram/ml (n = 91), 1 microgram/ml (n = 36), 50 micrograms/ml (n = 36), 100 micrograms/ml (n = 52), and 200 micrograms/ml (n = 61) rhIL-1ra. The percentages of 2-cell mouse embryos reaching the blastocyst stage after 72 h in culture were 85.7%, 91.6%, 94.4%, 96%, and 85.2%, respectively. We further cultured these blastocysts for 5 days on fibronectin-coated plates with or without 200 micrograms/ml rhIL-1ra. In both groups, hatching, attachment to fibronectin, outgrowth, and migration were documented to be similar. Furthermore, our longitudinal morphological study of embryonic implantation in control and rhIL-1ra-injected mice shows that the blockade of IL-1R tI interferes with the attachment of mouse blastocysts to maternal endometrium in vivo. In summary, we demonstrate that blockade of maternal endometrial IL-1R tI with IL-1ra prevents implantation in the mouse by interfering with embryonic attachment, without adverse effects on blastocyst formation, hatching, fibronectin attachment, outgrowth, and migration in vitro.

Animals↗
PubMed1994

The effect of interleukin-1 beta (IL-1 beta) on the regulation of IL-1 receptor type I messenger ribonucleic acid and protein levels in cultured human endometrial stromal and glandular cells.

Because we hypothesize that the interleukin-1 (IL-1) system may be important in the dialogue between mother and embryo during the implantation process, we have analyzed the effect of IL-1 beta, a secretory product of the human embryo and human endometrium, on the mRNA and protein levels of IL-1 receptor type I (IL-1R tI) in the human endometrium. For this purpose, endometrial epithelial cells (EEC) and stromal cells (ESC) were isolated and cultured with progesterone (3.18 micrograms/mL) and epidermal growth factor (20 ng/mL) for 8 days in the presence or absence of hrIL-1 beta (20 pg/mL). EEC from proliferative and secretory endometrium expressed high levels of IL-1R tI mRNA compared to ESC, and these levels were not modulated by IL-1 beta. However, prostaglandin E2 levels peaked on day 4 in EEC treated with progesterone, epidermal growth factor, and IL-1 beta (208.7 +/- 92 ng/10(7) cells), whereas no prostaglandin E2 was detectable in cells not treated with IL-1 beta, indicating that these cells responded to IL-1 beta. With regard to ESC from secretory endometrium, IL-1 beta increased its own receptor mRNA levels (4 +/- 0.5-fold increase) after 8 days in culture. However, when ESC were isolated from proliferative endometrium, an up-regulation of IL-1R tI (3.5 +/- 0.5-fold increase) was observed on days 6 and 8 of culture regardless of the presence or absence of IL-1 beta. Immunoreactive IL-1R tI was identified in cultured EEC and ESC, and patterns similar to those of mRNA were observed. The constitutive presence of IL-1R tI in EEC, which was not affected by IL-1 beta, and the up-regulation of IL-1R tI mRNA by its ligand IL-1 beta in ESC isolated during the luteal phase suggest a role for the IL-1 system in human implantation.

Endometrium↗
PubMed1994

Interleukin-1 system in the materno-trophoblast unit in human implantation: immunohistochemical evidence for autocrine/paracrine function.

Interleukin-1 receptor type I, IL-1 beta, IL-1 receptor antagonist, and human macrophages were immunohistochemically localized in the villous trophoblast, maternal-trophoblast interphase, and maternal decidua during early human implantation. Immunostaining for IL-1 receptor type I was present in the syncytiotrophoblast and hyperplastic endometrial glands in the maternal decidua. Immunoreactive IL-1 beta was present in the villous cytotrophoblast, syncytiotrophoblast, intermediate trophoblast, and maternal stromal decidual cells. IL-1 receptor antagonist staining was observed in the glandular endometrium of the maternal decidua and in isolated cells located inside the chorionic villi, intervillous space, and maternal decidua. Mature human macrophages, as defined by both CD/68+ and HAM56+, were present in the chorionic villi, maternal blood of intervillous space, and maternal decidua. Co-localization studies demonstrated that macrophages in all of the reported locations also stained for immunoreactive IL-1 beta. Our results show the shared presence in maternal and embryonic tissues of this receptor-agonist-antagonist system during early human implantation. This finding supports an autocrine/paracrine role for the IL-1 system in human implantation.

Chorionic Villi↗
PubMed1994

Cytokines and reproduction.

Cytokines are important in reproduction. Interleukin-1, an established immune mediator, is one of the best-characterized members of the cytokine family. We describe what is known about the interactions between the interleukin-1 system and the hypothalamic-pituitary-gonadal, the hypothalamic pituitary-adrenal, and the hypothalamic-pituitary-thyroid axes. We also review the ovarian role of the interleukin-1 system. This cytokine has an immense and, as yet, imperfectly understood effect on the human reproductive tract. Clearly the immune system has a potential autocrine, paracrine, and endocrine role in regulating human reproductive events such as ovulation, luteinization, and implantation.

Animals↗
PubMed1993

Interleukin-1 type I receptor messenger ribonucleic acid expression in human endometrium throughout the menstrual cycle.

OBJECTIVE: To investigate the messenger ribonucleic acid (mRNA) expression of interleukin-1 (IL-1) type I receptor in the endometrial tissue of normal patients during the menstrual cycle. DESIGN: Prospective longitudinal study. SETTING: Department of Obstetrics and Gynecology, Stanford University Medical Center, Stanford, California. PATIENTS: Twenty fertile women between 19 and 41 years of age underwent hysterectomy for benign reasons (n = 9) and laparoscopy for tubal ligation (n = 11). In all cases, endometriosis was not visualized. INTERVENTIONS: Endometrial biopsy using the Novak curette was obtained at the time of surgery. MAIN OUTCOME MEASURE: Total RNA extracted from unfractioned endometrial tissue was analyzed on Northern blots by using specific complementary deoxyribonucleic acid probes. RESULTS: We found IL-1 type I receptor mRNA expression in endometrial tissue throughout the entire menstrual cycle. However, IL-1 type I receptor mRNA levels were significantly higher during both early and late luteal phases than follicular and midluteal phases. CONCLUSIONS: Our results demonstrate the presence of the IL-1 system in the human endometrium and that the receptor is regulated throughout the menstrual cycle with a 4.1-fold increased expression of the IL-1 receptor gene in the early luteal phase compared with preovulatory endometrium.

Adult↗
PubMed1993

Localization of interleukin-1 type I receptor and interleukin-1 beta in human endometrium throughout the menstrual cycle.

Previous studies in the human suggest that the interleukin-1 (IL-1) system, may be an important paracrine/autocrine mediator in local intercellular interaction in endometrial tissue. In this study we have determined that IL-1 receptor type I (IL-1R tI) is expressed at the messenger RNA (mRNA) and protein levels in glandular cells and its ligand, IL-1 beta has been localized by immunohistochemical methods in endothelial cells and isolated stromal cells in the human endometrium throughout the menstrual cycle. IL-1R tI mRNA was detected in glandular epithelium using both specific complementary DNA and complementary RNA 32P-labeled probes. Human glandular epithelium contains a 5.1-kilobase mRNA transcript throughout the complete menstrual cycle. Quantitative densitometric analysis of slot blot hybridization signals shows an increase of IL-1R tI mRNA in both early and mid-late secretory phases in comparison with the proliferative phase (P < 0.05). IL-1R tI protein was localized in endometrial glandular epithelial cells using both indirect immunofluorescence and avidin-biotin-peroxidase methods. However, more intense staining for IL-1R tI was observed in lumenal epithelial cells compared with the staining present deep in the endometrial glands. Using the same methods, IL-1 beta was detected in endothelial cells of spiral vessels and isolated stromal cells throughout the menstrual cycle, and an increased staining from proliferative to secretory phase was observed. The detection of IL-1R tI in the human endometrial epithelium and its ligand, IL-1 beta, in isolated stromal cells and endothelial cells, is another example of possible communication between the immune and reproductive systems with special relevance to human implantation.

Adult↗
PubMed1992

Glucocorticoid treatment decreases sera embryotoxicity in endometriosis patients.

OBJECTIVE: To investigate the effect of short-term glucocorticoid administration on embryotoxicity of sera from infertile patients with mild to moderate endometriosis. DESIGN: Prospective longitudinal study. SETTING, PATIENTS: Eight infertile patients with mild to moderate endometriosis and a control group of eight infertile patients with tubal infertility were selected on the basis of laparoscopic examination. INTERVENTIONS: Basal (B) serum collection and day 1 (T1), day 3 (T2), day 6 (T3), and day 12 (T4) serum drawn after a 3-day glucocorticoid treatment in endometriosis patients. MAIN OUTCOME MEASURE: Embryotoxicity of endometriosis sera, before and after glucocorticoid treatment, was investigated using a bioassay performed on two-cell mouse embryos. Interleukin 1 alpha (IL-1 alpha) and antismooth muscle, antimitochondrial, and antinuclear autoantibodies were also tested in these sera. RESULTS: At 50% concentration, endometriosis serum is embryotoxic in comparison with control; 0% versus 61% of the embryos reached the blastocyst stage at 72 hours, respectively (basal versus control, P less than 0.001). However, this embryotoxicity significantly decreases 12 days after glucocorticoid treatment in comparison with untreated sera; 32.4% versus 0% of the embryos reached blastocyst stage at 72 hours, respectively (T4 versus basal, P less than 0.001), although they did not reach nontoxic levels (greater than 50%). Interleukin 1 alpha was undetectable in all samples analyzed. In endometriosis sera, antismooth muscle antibody was detected. CONCLUSIONS: At 50% concentration, serum from infertile patients with minimal to moderate endometriosis appears to be embryotoxic to the in vitro development of two-cell mouse embryos. However, this embryotoxicity significantly decreases 12 days after a 3-day treatment with glucocorticoids.

Adult↗
PubMed1991

Müllerian defects in women with normal reproductive outcome.

The incidence of uterine congenital anomalies because of müllerian defects in the normal fertile population is 3.2% (22/679). Twenty (90%) of them are septate uteri, whereas a bicornuate (5%) and a didelphys uterus (5%) have been also found in this population. Based on these findings, we question the usefulness of the septum resection in patients with septate uterus and no previous reproductive failure.

Adult↗
PubMed1989

Ovarian response and outcome of in-vitro fertilization in patients treated with gonadotrophin-releasing hormone analogues in different phases of the menstrual cycle.

Gonadotrophin-releasing hormone analogues (GnRH-a) are currently used in combination with gonadotrophins in ovarian stimulation for in-vitro fertilization (IVF). The present study evaluates follicular recruitment and outcome of IVF in patients treated with GnRH-a, starting in different phases of the menstrual cycle. Ovarian quiescence was achieved by s.c. injection of a GnRH-a (600 micrograms/day). Three groups of patients were randomly established. Patients in group 1 (n = 14) started GnRH-a treatment 4-7 days after ovulation. Women in group 2 (n = 15) started GnRH-a 8-10 days after ovulation. Patients in group 3 (n = 15) began the analogue 1-3 days after the onset of menses. Multiple follicular development was achieved by a combination of pure follicle-stimulating hormone and human menopausal gonadotrophin. Oocyte collection was performed 35 h after administration of human chorionic gonadotrophin. Luteolysis was successfully induced in 15% of cases in group 1 and 40% in group 2. Ovarian arrest was achieved in a significantly (P less than 0.01) shorter period of time in group 3 in comparison to groups 1 and 2. There was no difference between groups in the dose of gonadotrophins necessary to reach an optimal response. Patients in group 1 showed a significant decrease (P less than 0.05) in the number and size of follicles developed in comparison to groups 2 and 3. Fertilization and cleavage rates were similar in all three groups. The pregnancy rate was 40% in group 3, while it decreased to 14.3 and 13.3% in groups 1 and 2, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗