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E Geva

Publications and source records attributed to E Geva.

At least 55 records · Page 3Linked to original sources
PubMed1997

Autoimmunity and reproduction.

OBJECTIVE: To review the association between autoimmunity and reproductive failure. DESIGN: A MEDLINE search done from 1965 to 1996. More than 300 original and review articles were evaluated, from which the most relevant were selected. RESULT(S): Autoimmune processes now are accepted widely as one of the possible mechanisms of many human diseases. The presence of autoimmune disorders has been associated repeatedly with reproductive failure. On the other hand, reproductive failure may be the first manifestation of autoimmune disorders. CONCLUSION(S): When abnormal autoantibody levels are present in women with reproductive failure, the reproductive failure alone should be considered as one of the possible clinical expressions of autoimmune disorders. Two relevant questions of whether these patients should be treated for autoimmunity remain unsolved. A prospective, placebo-controlled trial is necessary to evaluate the importance of any treatment.

Abortion, Habitual↗
PubMed1997

Elevated levels of interleukin-6 in the follicular fluid at the time of oocyte retrieval for in vitro fertilization may predict the development of early-form ovarian hyperstimulation syndrome.

OBJECTIVE: To determine the possible predictive role of interleukin-2 (IL-2), IL-6, and tumor necrosis factor (TNF-alpha) in the development of early-form ovarian hyperstimulation syndrome (OHSS). DESIGN: Nested, case-control study. SETTING: An IVF unit, university-based program. PATIENT(S): Follicular fluid (FF) was obtained from 322 high responders. The study group and control group comprised 10 patients who developed early, severe OHSS and 10 who did not develop OHSS, respectively. An additional control group included 10 low-responder patients who did not develop OHSS. INTERVENTION(S): Ovulation induction with hMG combined with GnRH analogue. MAIN OUTCOME MEASURE(S): All FF samples were tested for IL-2, IL-6, and TNF-alpha. The patient's serum was tested for mean E2 and P concentrations. RESULT(S): Interleukin-6 levels in the FF were significantly higher in the OHSS group than in the two control groups, whereas no differences were found in IL-2 and TNF-alpha. No correlation was found between the FF concentrations of IL-2, IL-6, and TNF-alpha and the mean serum E2 levels or the number of oocytes retrieved. CONCLUSION(S): Elevated levels of IL-6 in the preovulatory FF at the time of oocyte retrieval for IVF may predict the development of early-form OHSS in high responders.

Adult↗
PubMed1997

The presence of antithyroid antibodies in euthyroid patients with unexplained infertility and tubal obstruction.

PROBLEM: The presence of antithyroid antibodies in euthyroid patients with unexplained infertility and tubal obstruction. METHOD: The presence of antithyroid autoantibodies (microsomal and thyroglobulin) was measured in 40 patients with unexplained infertility, and 40 patients with tubal obstruction infertility, and compared to 40 healthy nulligravidae. RESULTS: Eight patients (20%) in the unexplained infertility study group, seven (17.5%) in the tubal obstruction group and two (5%) in the healthy nulligravida group, were positive for antithyroid autoantibodies: five (12.5%) were positive for antimicrosomal antibodies, two (5%) were positive for antithyroglobulin antibodies, and one patient (2.5%) was positive for both. The tubal obstruction group comprised seven (17.5%) patients positive for antithyroid autoantibodies: four (10%) for antimicrosomal antibodies, two (5%) for antithyroglobulin antibodies, and one patient (2.5%) was positive for both. In the healthy nulligravidae group only two patients (5%) were positive for antithyroid antibodies: one for antimicrosomal and one for antithyroglobulin. No significant differences were found in the presence of antithyroid antibodies between patients with unexplained infertility and those with tubal obstruction infertility. Both groups differed significantly from the healthy controls with regard to the presence of antithyroid antibodies (P < 0.05). CONCLUSION: Subclinical presence of antithyroid autoantibodies is characteristic of both unexplained and mechanical infertility, as opposed to healthy controls. Further investigation of larger groups is needed to determine the prevalence of antithyroid antibodies in the unique population of infertile women.

Adult↗
PubMed1997

Interleukin-10 in preovulatory follicular fluid of patients undergoing in-vitro fertilization and embryo transfer.

PROBLEM: The present study aimed at investigating the presence of Interleukin-10 (IL-10) in preovulatory follicular fluid (FF) and its possible correlation with 17-beta-estradiol (E2) and progesterone (P) levels, and treatment outcome in patients undergoing in-vitro fertilization-embryo transfer (IVF-ET). METHODS: Twenty consecutive patients with tubal factor infertility who underwent oocyte retrieval for IVF-ET were assayed for pooled, preovulatory FF levels of IL-10, E2, and P. RESULTS: The mean FF levels of IL-10, E2, and P were 78.7 +/- 104.7 pg/ml, 2,787.0 +/- 726.1 pg/ml, and 1.5 +/- 0.8 ng/ml, respectively. No correlation was found between preovulatory FF concentration of IL-10, E2, oocyte number, oocyte fertilization rate, embryo quality, and pregnancy rate. The levels of IL-10 were found to be negatively correlated with P concentration, although not significantly (P = 0.057). CONCLUSION: Interleukin-10 exists in the preovulatory FF. Further investigations are needed to determine the role of IL-10 in the folliculogenesis.

Adult↗
PubMed1996

The effect of antioxidant treatment on human spermatozoa and fertilization rate in an in vitro fertilization program.

OBJECTIVE: To study the possible influence of antioxidant treatment on human spermatozoa and the fertilization rate in an IVF program. DESIGN: Prospective study. SETTING: In Vitro Fertilization Unit, Serlin Maternity Hospital, and the Laboratory of Male Fertility, Bar-Ilan University, Ramat-Gan, Israel. PATIENTS: Fifteen fertile normospermic male volunteers who had low fertilization rates in their previous IVF cycles. INTERVENTIONS: Vitamin E (alpha-tocopherol) 200 mg daily by mouth for 3 months. MAIN OUTCOME MEASURES: Lipid peroxidation potential (amount of malondialdehyde [MDA]), quantitative ultramorphologic analysis of spermatozoa, and fertilization rate per cycle. RESULTS: The high MDA levels significantly decreased from 12.6 +/- 9.4 nmol/10(8) spermatozoa to normal levels of 7.8 +/- 4.2 nmol/10(8) spermatozoa after 1 month of treatment. The fertilization rate per cycle increased significantly from 19.3 +/- 23.3 to 29.1 +/- 22.2 after 1 month of treatment. No additional effects on MDA levels and fertilization rate were observed after completion of treatment. With regard to the quantitative ultramorphologic analysis, none of the sperm cell subcellular organelles were affected significantly by vitamin E treatment. CONCLUSION: Vitamin E may improve the fertilization rate of fertile normospermic males with low fertilization rates after 1 month of treatment, possibly by reducing the lipid peroxidation potential, and with no change of the quantitative ultramorphologic analysis of subcellular organelles.

Administration, Oral↗
PubMed1996

Organ-specific autoantibodies are possible markers for reproductive failure: a prospective study in an in-vitro fertilization-embryo transfer programme.

This study was conducted to investigate the usefulness of organ-specific autoantibodies as possible markers for reproductive failure. Antithyroid and antiovarian autoantibody concentrations were measured in 78 patients with mechanical or unexplained infertility that were enrolled in an in-vitro fertilization (IVF)/embryo transfer programme with follow-up of the outcome. In all, 16 patients (20.5%) were positive for antithyroid antibodies, nine (11.5%) were positive for antiovarian autoantibodies and two (2.6%) were positive for both autoantibodies. All 23 patients who were positive for either antithyroid or antiovarian autoantibodies, or both, were defined as the study group, and 55 who were negative for autoantibodies were considered as the control group. No statistical difference in the incidence of autoantibodies was found between the patients with mechanical infertility and those with unexplained infertility. No differences were found in the mean number of oocytes retrieved, fertilization rates or mean numbers of transferred embryos between the study and the control groups. The pregnancy rate per cycle was 10.8% (7/65) in the study group, compared with 25.0% (24/96) in the control group (P < 0.05). We conclude that organ-specific autoantibodies such as antithyroid and antiovarian antibodies may serve as possible markers for reproductive failure. Further investigation is required to understand the possible immunopathological mechanism for reproduction failure in patients with organ-specific autoantibodies.

Adult↗
PubMed1995

Autoimmune disorders: another possible cause for in-vitro fertilization and embryo transfer failure.

This study was undertaken to investigate the role of autoantibodies in association with in-vitro fertilization (IVF) and embryo transfer failure. Anticardiolipin, lupus anticoagulant, anti-deoxyribonucleic acid and antinuclear antibody, rheumatoid factor and antithyroid antibody concentrations were measured. The study group comprised 50 IVF patients with three or more previously failed cycles after embryo transfer. The control group comprised 80 computer-matched women: 40 who had conceived and delivered following three or less IVF and embryo transfer cycles, and 40 who were healthy nulligravidas. The incidence of autoantibodies in the study group was 22.0%, compared with 2.5% in the IVF control group (P < 0.05) and 7.5% in the nulligravida group (P < 0.05). In the study group, no statistical difference was found between the patients with unexplained infertility and those with mechanical infertility (23.0 and 20.8% respectively). The high occurrence of autoantibodies found in patients who failed at least three IVF and embryo transfer cycles could imply that these autoantibodies may be one of the possible causes of IVF failure in either mechanical or unexplained infertility. Further investigations are required to indicate the autoantibody profile as part of the work-up after three or more failed IVF and embryo transfer attempts.

Adult↗
PubMed1994

Circulating autoimmune antibodies may be responsible for implantation failure in in vitro fertilization.

OBJECTIVE: To investigate the role of autoimmune factors as a possible cause for implantation failure as manifested by chemical pregnancy after IVF and ET. DESIGN: Anticardiolipin, anti-double-stranded DNA (dsDNA), antinuclear antibody, lupus anticoagulant, and rheumatoid factor serum levels were examined in patients with chemical pregnancies and in matched controls. SETTING: An IVF unit, university-based IVF program. PATIENTS: The study group included 21 patients who had one or more chemical pregnancies and no deliveries. The control group consisted of 21 patients who had conceived and delivered after IVF-ET treatment, without any history of fetal wastage, matched for age, type and duration of infertility, and number of previous IVF cycles. RESULTS: The incidence of circulating autoimmune antibodies in the study group was 33.3% (7/21). Three patients (14.2%) were positive for anticardiolipin, two (9.5%) were positive for antidsDNA, one (4.7%) for antinuclear factor, and one (4.7%) for rheumatoid factor. Autoimmune antibodies were not detected in any of the control group. CONCLUSION: Autoimmunity may play a role in implantation failure in IVF-ET. Circulating autoimmune antibody screening is therefore recommended after chemical pregnancy.

Adult↗
PubMed1994

Analysis of the fourth to eighth in-vitro fertilization treatments after three previously failed attempts.

The fourth to eighth in-vitro fertilization cycles of patients who had previously reached the stage of embryo transfer without conceiving were evaluated. A total of 426 cycles were received in women ranging in age from 25 to 46 years. The patients underwent from four (169 women) to eight (27 women) treatment cycles, using four established protocols for induction of ovulation. There was no statistical difference in the age, aetiology, duration of infertility and distribution of the various protocols among the analysed groups. The pregnancy rates in cycles 4-8 were 19.5, 15.4, 10.8, 16.7 and 11.8% respectively (mean 16.2% per cycle) and were not statistically different. There was no trend of reduced success when the number of attempts increased. The overall live birth rate was 12.4%. The pregnancy rate was comparable between age groups. No protocol proved to be significantly superior to others when pregnancy rate per embryo transfer was assessed. We concluded that the pregnancy rate in cycles 4-8 was stable, including those of patients up to 42 years of age. Continuous efforts are therefore advised for at least up to this age and number of attempts. A change of an induction protocol in subsequent cycles, after repeated failure, is not statistically justified.

Adult↗
PubMed1993

[Comparison of ovulation induction protocols for in vitro fertilization].

In a retrospective study we evaluated 4 controlled ovarian hyperstimulation (COH) protocols for in vitro fertilization (IVF) treatment. Treatment cycles 4 through 8 were analyzed in patients, who in 3 previous attempts reached the stage of embryo transfer (ET) but did not conceive. The 426 recorded cycles included all indications for IVF, but not the male factor. The age range was 25-46 years. Patients underwent from 4 cycles (169 women) to 8 cycles (27 women). The COH protocols used included established combinations of menotropins, clomiphene citrate/hMG, and short and long protocols of GnRH analogs followed by hMG. There were no statistically significant differences in patient age, etiology and duration of infertility, or distribution of the various COH protocols among the groups of patients. No single protocol was significantly superior to any other when the pregnancy rate per cycle was assessed. The results did not justify changing a COH protocol which had lead to ET but not to pregnancy, for another protocol.

Adolescent↗
PubMedDate not supplied

Issues in the assessment of reading disabilities in L2 children--beliefs and research evidence.

In bilingual and multilingual settings one is constantly challenged by the difficulty of teasing apart phenomena associated with normal second language (L2) reading acquisition from authentic warning signs of reading failure. The bulk of this paper focuses on a critical discussion of a cluster of beliefs that pertain to the issues concerning the diagnosis of reading disability in multilingual and bilingual settings among school children. Findings from available research on reading acquisition among bilingual children and research focusing specifically on the assessment of English-as-a-second language (ESL) children who might be at risk for reading disability are used to evaluate the validity of these beliefs. While some beliefs are supported by research, others are not. In particular, the research suggests that reliable diagnosis of dyslexia among ESL children can be achieved by examining within-language differences on various indices of basic reading skills such as phonological processing, and by noting a significant gap between oral and reading comprehension.

Adolescent↗
PubMedDate not supplied

The possible association between in vitro fertilization treatments and cancer development.

The objective of this paper is to assess whether ovarian hyperstimulation and in vitro fertilization (IVF) are associated with increased risk of cancer development, using an historical cohort analysis of infertile women who attended the IVF unit, Lis Maternity Hospital Tel Aviv Medical Center, Tel Aviv, Israel. One thousand and 82 women participated in the IVF treatment program between 1984 and 1992. Cancer incidence rates were determined through the National Cancer Registry and were compared to the expected rates with respect to appropriate age and continent of birth. Twenty-one cases of cancer were observed as compared to 11 that were expected (SIR 1.91; 95% CI 1.18-2.91). When cancer cases that were diagnosed within one year of the IVF treatment were excluded from the analysis (SIR = 1.46; 95% CI 0.83-2.36), no significant excess risk of cancer was noted. We conclude that in this cohort of infertile women, the higher than expected cancer rate could not be attributed to IVF treatments. Special attention should be made to women who may be diagnosed with cancer during or shortly after IVF treatment.

Adult↗
PubMedDate not supplied

Evaluation of fetal echogenic bowel in the second trimester.

Previous studies cite different possible etiologies for fetal echogenic bowel (FEB). The purpose of this study was to evaluate the possible etiologies for second-trimester FEB, and to provide clinical guidelines for evaluation of this finding. The study included 79 patients diagnosed with FEB in the second trimester. Fifteen cases (19%) were associated with maternal vaginal bleeding. Of these, 12 patients underwent amniocentesis, 9 of which had visible blood products in the amniotic fluid. Seven cases (8.9%) had associated severe malformation. Seven other cases (8.9%) were noted in multifetal pregnancies. Five fetuses (6.3%) had evidence of bowel obstruction or perforation not associated with cystic fibrosis (CF). Chromosomal aberrations were found in 5 fetuses (6.3%). Intrauterine infection with cytomegalovirus, herpes simplex virus, varicella-zoster virus, or parvovirus B-19 was documented in 5 patients (6.3%). Three cases (3.8%) were associated with subsequent unexplained stillbirth. Two fetuses (2.5%) were found to be affected by CF. Finally, in 30 cases (38%), no obvious reason for FEB was found. We conclude that the evaluation of second-trimester FEB should include targeted ultrasound for associated malformations, infectious studies, DNA analysis for CF mutations, amniocentesis for chromosomal analysis and evaluation of the amniotic fluid for degraded blood products, and an autopsy in cases of stillbirth. Even when no apparent reason is found, pregnancies should be considered at high risk for poor outcome.

Chromosome Aberrations↗
PubMedDate not supplied

Intracardiac echogenic focus: no apparent association with structural cardiac abnormality.

OBJECTIVE: The aim of our study was to evaluate whether intracardiac echogenic foci (ICEFs) may be associated with increased risk for structural cardiac anomalies in the low-risk population. METHODS: During a 24-month period, 3,744 low-risk patients were prospectively screened for ICEFs by prenatal sonography. The study group was composed of 138 fetuses (3.7%) with ICEF. The control group was composed of 167 fetuses without ICEF. In all fetuses a complete echocardiographic evaluation was performed. RESULTS: Among the 138 fetuses in the study group, 108 (78%) ICEFs were found in the left ventricle, 25 (18%) were found in the right ventricle, and 5 (4%) were found to be bilateral. No statistically significant difference was found between the study and the control group regarding the presence of cardiac anomalies. Only 1 case (0.7%) of pulmonic stenosis was found in the study group, compared to 1 case (0.6%) of bicuspid aortic valve in the control group. CONCLUSIONS: We conclude that ICEFs found in low-risk patients are not associated with a significant increase in the risk of cardiac anomalies.

Adult↗