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Biomedical subjects

D P Levy

Publications and source records attributed to D P Levy.

8 recordsLinked to original sources
PubMed1999

A prospective, randomized comparison of ovulation induction using highly purified follicle-stimulating hormone alone and with recombinant human luteinizing hormone in in-vitro fertilization.

The commercial availability of highly purified, s.c. administered urinary follicle stimulating hormone (FSH) preparations for ovarian stimulation marked the beginning of a new era in the treatment of infertility. As these new formulations contain essentially no luteinizing hormone (LH), supplemental LH may be needed for optimal folliculogenesis. It was the aim of this pilot study to compare fertilization rates, embryo morphology, implantation rates and pregnancy outcomes prospectively in two age-matched patient groups: women who received highly purified FSH (FSH-HP) (n = 17), and women who received FSH-HP plus recombinant human LH (rhLH, n = 14) throughout ovarian stimulation. All patients received mid-luteal pituitary down-regulation with s.c. gonadotrophin-releasing hormone agonist (GnRHa) (leuprolide). Mean implantation rates were 26.9 and 11.9% in the FSH-HP only and FSH-HP + rhLH groups respectively. The mean clinical pregnancy/initiated cycle rate was 64.7 and 35.7% for the FSH-HP only and FSH-HP + rhLH patients respectively. FSH-HP patients and FSH-HP + rhLH patients achieved clinical pregnancy/transfer rates of 68.8 and 45.5% respectively. One patient in the FSH-HP + rhLH group had a spontaneous abortion; no pregnancy losses occurred in the FSH-HP only group. There were more cancellations for poor ovarian response among FSH-HP + rhLH patients (n = 3) than among FSH-HP patients (n = 1). The trend toward better pregnancy outcomes among patients who received FSH-HP without supplemental rhLH did not reach statistical significance. It is postulated that appropriate endogenous LH concentrations exist despite luteal GnRHa pituitary suppression, thereby obviating the need for supplemental LH administration.

Adult↗
PubMed1997

[Average length of spontaneous labor in Chinese primigravidas].

OBJECTIVE: To determine if labor duration is affected by ethnicity, we measured the average length of normal spontaneous labor in recently immigrated Chinese primigravidas and compared our findings to reference primigravida populations of differing ethnicity. MATERIALS AND METHODS: In this descriptive, retrospective study of 1,006 recently immigrated low-risk Chinese primigravidas delivering singleton, vertex, term infants (37-42 weeks gestation, inclusively) without conduction anesthesia or oxytocin, the length of first-, second-, and third-stage labor, maternal age, gestational age, and infant weight was measured and compared to labor lengths previously reported for women of differing ethnicity. RESULTS: Mean first stage labor duration was 326 minutes (SD +/- 185 min, range 25-1640 min), mean second stage labor duration was 52 minutes (SD +/- 42 min, range 2-450 min), and a mean third stage labor duration was 4.6 min (SD +/- 4.5 min, range 1-62 min). Interquartile range (IQR)/median for first-, second-, and third-stage labor was 225 min/300 min, 50 min/40 min, and 3 min/3 min respectively. Weak correlations were observed between first- and second-stage labor lengths, and second- and third-stage labor lengths. Average birth weight was 3250 g (SD +/- 376 g, range 2280-4660 g). Chinese parturients showed a significantly shorter duration of first-stage (P < 0.0001) when compared to parity-matched patients of differing ethnicity. Second-stage labor in Chinese parturients was also shorter, but did not differ significantly (P = 0.185) from previously reported non-Asian controls. CONCLUSION: When compared to previously collected data from non-Chinese women, clinically significant differences in first-stage labor lengths were measured in our study population. While second-stage labor durations were also shorter, the difference was not significant. Labor management should be individualized to account for these differences, and previous reports attempting to show equivalency of labor progress regardless of ethnicity warrant reinterpretation given these findings.

Asian People↗
PubMed1993

Enzymatic cleavage of disaccharide side groups in insoluble synthetic polymers: a new method for specific delivery of drugs to the colon.

A series of water-insoluble acrylic polymers containing disaccharide side groups were synthesized and evaluated in vitro. A cellobiose-derived monomer, 4-O-beta-D-glucopyranosyl-1-methacrylamido-1-deoxy-D-glucitol, was prepared and copolymerized with methacrylic acid. Two different modes of polymerization were used to give two products, P-1 and P-2. A homopolymer, P-3, was also synthesized using the same method as P-2. The degradation of the disaccharide side groups in these polymers and the monomer was evaluated by incubation with beta-glucosidase and measurement of the amount of glucose cleaved. It was found that the degradation rate increased in those polymers possessing lower contents of the disaccharide side groups (i.e. higher content of methacrylic acid). Scanning electron microscopy (SEM) observations of cross-sectioned slabs of P-1 visualized the degradation of the polymer. The enzymatic reaction caused a porous structure to be formed. The increased porosity may be used for the specific release of drugs into organs that contain large amounts of beta-glucosidases, such as the human colon.

Carbohydrate Sequence↗
PubMedDate not supplied

Strategies for ascertaining ovarian reserve among women suspected of subfertility.

"Ovarian reserve" describes the native oocyte endowment and is closely associated with reproductive potential. As a diagnostic entity, ovarian reserve screening developed from clinical experience with the advanced reproductive technologies--particularly in vitro fertilization. Diminished ovarian reserve generally presages a poor response to any fertility treatment, and sharply limits the possibility of successful pregnancy. Screening for ovarian reserve is a fundamental component of the initial infertility evaluation, since it is a key determinant of what, if any, treatment should be offered. Methods of clinical ascertainment of ovarian reserve may be classified in two groups: passive and provocative testing. Both approaches seek to provide information regarding oocyte quality and quantity, which then may be used to direct specific therapeutic interventions. This monograph presents basic elements of ovarian reserve testing as currently practiced, and provides insights into the interpretation and limitations of these assessments.

Female↗