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Biomedical subjects

F M Graham

Publications and source records attributed to F M Graham.

18 recordsLinked to original sources
PubMed1992

Identifiable semen donors--attitudes of donors and recipient couples.

Fifty-three couples embarking on donor insemination (DI) replied to an anonymous questionnaire asking what they wanted to know about the donor should they become pregnant. Fifty-one percent were definitely and 32% probably going to tell a child of its donor origins. Items most frequently listed for themselves and on behalf of a child were--interests/sports (57%), physical attributes (41%), occupation (37%) and family background (26%). Forty-two percent of the women and 28% of the men thought the child should have access to the identity of the donor eventually. Thirty-eight donors were surveyed by a questionnaire; 68% were agreeable to their identity being available to a donor insemination child when the child reached maturity. When the category of identifiable donor was created, 20 of 36 (56%) new donors and donors still donating chose this option.

Adult↗
PubMed1990

Prevalence of chlamydial antibodies in women with tubal disease: impact of Chlamydia trachomatis on the demand for in vitro fertilisation.

Serum IgG and IgA antibodies to Chlamydia trachomatis were measured in 102 in vitro fertilisation (IVF) patients with tubal disease and in 102 infertility patients without tubal disease to assess the impact of chlamydial infection on the demand for IVF treatment in New Zealand. Sixty-five percent of the IVF patients had IgG titres greater than or equal to 1:64, compared to 24% of the controls; 29% of the IVF patients had IgA titres greater than or equal to 1:32 compared to 0% of the controls. The proportion of IVF patients with IgG antibodies increased from 39% for those from socioeconomic group 1 to 79% of those from groups 4 to 6. The difference in prevalence of IgG antibodies between the tubal and nontubal patients suggests that about 40% of the tubal infertility currently being treated by IVF has chlamydia as a causal agent. The presence of IgG or IgA antibodies did not seem to affect the chance of pregnancy in the IVF programme, nor the chance of subsequent miscarriage.

Antibodies, Bacterial↗
PubMed1987

Social and reproductive characteristics of the first 100 couples treated by in vitro fertilisation programme at National Women's Hospital, Auckland.

Reproductive and social histories of the first 100 patients attending the in vitro fertilisation (IVF) programme at National Women's Hospital, Auckland, have been studied. The average age at first treatment was 31.6 (SD 3.9) for women, and 34.2 (4.6) for men. The couples had been married 7.6 (3.3) years and had experienced 6.7 (3.2) years infertility. It was a second marriage for 16. The husbands had on average a higher social classing than the population (class: number [population]--1:16 (7%), 2:18 (14%), 3:42 (28%), 4:19 (29%), 5:4 (14%), 6:1 (8%); but this bias diminished in the next 159 couples. Nine couples withdrew before their quota of cycles, 7 from stress. Tubal disease was the cause of infertility in 93, but in 69 its origin was untraceable. In 22 it could be attributed to pelvic inflammatory disease (eight associated with IUCDs and 2 with sexually transmitted disease) and in two to sterilisation. Although 59 women had a history of having conceived, only 34 were parous, and only 11 had a child of the current union.

Adult↗
PubMed1987

Levels of oxytocin-like activity and progesterone in follicular fluid from in vitro fertilization cycles.

Oxytocin-like immunoreactivity, estradiol, and progesterone were measured in follicular fluid collected during oocyte collection in an in vitro fertilization program in which clomiphene citrate was used to stimulate follicular development. Follicles which yielded morphologically normal embryos after fertilization of the oocyte had oxytocin concentrations ranging from less than 10 to 600 ng/liter. Oxytocin concentrations did not differ between follicles from 12 pregnancy cycles (median, 169; N = 21) and follicles from 12 nonpregnancy cycles (median, 110; N = 18). Oxytocin concentrations were correlated negatively with progesterone concentrations (Spearman's rank correlation coefficient r = -0.50; P = 0.001). In cycles with some follicles having progesterone concentrations less than 10 and some greater than 10 mumol/liter, oxytocin concentrations were higher in the less progestogenic follicles in 15 of 16 cases.

Body Fluids↗
PubMed1985

The development of a programme for in vitro fertilisation in New Zealand.

The first seven months experience of a programme for in vitro fertilisation at National Women's Hospital in Auckland is described. Following a five month period of technique development, 36 women with tubal infertility were admitted to the programme from July 1983 to February 1984. A clinical pregnancy rate of 15% (6/41 laparoscopies) was achieved during this period.

Abortion, Spontaneous↗
PubMed1985

Ultrasonic preovulatory follicular appearances as an indicator of the outcome of an in vitro fertilization cycle.

Twenty-four consecutive patients in an in vitro fertilization program were scanned within 1 hour of laparoscopic follicular aspiration. Twelve patients had follicles with intrafollicular echoes (group 1), and 12 patients had follicles with no changes (group 2). All women in group 1, but only four in group 2, had mature oocytes that after fertilization had cleavage rates compatible with pregnancy. Six clinical pregnancies occurred in group 1, and none occurred in group 2. The presence of intrafollicular echoes may indicate follicular maturation and may be a useful predictor of a cycle likely to produce a pregnancy.

Female↗
PubMed1984

Insulin resistance with acanthosis nigricans and acral hypertrophy.

Two patients are described with obesity, acanthosis nigricans, acral hypertrophy, basal hyperinsulinism and exaggerated insulin responses to oral glucose. One patient, a diabetic female showed features of virilisation due to polycystic ovarian disease and underwent gonadectomy with some resolution of her androgenisation and acanthosis nigricans. Binding of labelled insulin to erythrocytes was significantly decreased in both patients compared with normal or obese control subjects. In contrast, the receptor concentration in adipose tissue obtained from the patient undergoing gonadectomy was higher than seen in obese control subjects. Thus, somatic growth may be stimulated by insulin in some tissues in these hyperinsulinaemic patients due to relative preservation of receptor numbers.

Acanthosis Nigricans↗
PubMed1984

A prospective study of the preselection of the sex of offspring by timing intercourse relative to ovulation.

The relationship between the sex of offspring and the time interval between coitus and ovulation/fertilization has been prospectively investigated in 33 pregnancies using the rise in luteinizing hormone in the early morning urine, the peak cervical mucus symptom, and the shift in basal body temperature as indicators for ovulation. Reference to the peak cervical mucus symptom showed a significant association of conception of a male child with longer intervals (greater than 2 days) between coitus and fertilization (P less than 0.03). However, while a similar trend for male conceptions was evident when the duration of sperm survival was determined by reference to each of the other two indicators of ovulation, the relationship was not significant. The results clearly refute the theory that intercourse close to ovulation favors male conceptions. While the findings are consistent with the contrary theory, it may be premature to conclude that a male child is more likely to be conceived if coitus takes place several days before ovulation.

Adult↗
PubMed1984

Clinical and biochemical evaluation of patients with hirsutism.

Patients with moderate to severe hirsutism presenting over an 18-month period to an endocrine clinic were assessed by clinical evaluation and hormone measurements. Hair growth rate was estimated by a photographic technique and the severity of hirsutism graded using an objective scale. Of 43 patients, 9 had polycystic ovaries and the remainder were considered to have idiopathic hirsutism. The most severely affected group had significantly increased hair growth rates compared with less clinically affected subjects, and 47% of this group showed objective features of virilization. However, apart from a significantly higher 24-hr urine 17-ketosteroid excretion all other hormonal patterns were not significantly different between severely and mildly affected patients. Serum levels of testosterone (T), sex hormone-binding globulin (SHBG), free T (calculated from T and SHBG values), and androstenedione (A) were abnormal in 44%, 51%, 60% and 60% of patients respectively, whereas plasma levels of the specific adrenal androgen DHAS were increased in 40% of patients. There was an overlap between patients with elevated hormone levels, although isolated elevation of T, A or DHAS were seen in 9%, 19% and 3% of patients respectively. In 19% of patients all serum androgen measurements were normal. Gonadotrophin levels were significantly lower in the more severely affected group. Thus androgen levels in patients with idiopathic hirsutism or polycystic ovaries, show considerable overlap with measurements in normal subjects, and elevated plasma androgens may be of adrenal (DHAS) or combined adrenal/ovarian (T, A) origin.

17-Ketosteroids↗
PubMed1983

An evaluation of teaching cervical mucus symptoms to ovulating infertile women.

Women (n = 113) with ovulatory menstrual cycles but complaining of infertility were instructed in the observation and charting of cervical mucus symptoms. At the completion of 3 teaching cycles, 80 subjects (70.8%) had successfully charted at least one cycle with an ovulatory mucus pattern (10 subjects became pregnant). Sixty-two (54.9%) of the women continued for a further 3 cycles of investigation during which, around the time of ovulation, an assessment was made of the mucus at the cervix. On the basis of this assessment subjects were classified as either Group 1: charting ovulatory mucus symptoms with 'fertile type' mucus observed at the cervix - 48 subjects (10 became pregnant); Group 2A: charting uninterpretable mucus symptoms but 'fertile type' mucus observed at the cervix - 8 subjects; or, Group 2B: charting uninterpretable mucus symptoms and mucus of poor quality observed at the cervix - 6 subjects. The study shows that infertile ovulating women can be taught to observe and chart their mucus symptoms. Such charting is useful in identifying the fertile period of the cycle for timing of intercourse and for timing of postcoital tests and cervical assessment. It is also useful in identifying the small number of women (5.3%) with an apparent deficiency in mucus production. Whether the 20 subjects (17.7%) who became pregnant were assisted in this objective by their charting of symptoms is unclear.

Body Temperature↗
PubMed1980

Thyrotrophin displacement activity of serum immunoglobulins in health and disease.

A radioreceptor assay for TSH displacement activity (TDA) was employed as an index of thyroid stimulating immunoglobulins (TSlg) in serum from patients with autoimmune thyroid disease. TDA was less than or equal to 20 in normal subjects (37/37), patients without thyroid disease (36/38), non-toxic goitre (18/19) and toxic nodular goitre (16/17) and was significantly lower in Nepalese subjects with severe endemic goitre. TDA was greater than 20 in 84% of patients with untreated hyperthyroid Graves' disease (70/83), in Hashimoto's thyroiditis (3/17) and following subtotal thyroidectomy (8/14) or 131I therapy (7/11), but was less than or equal to 20 in euthyroid patients treated with carbimazole (58/59) and during spontaneous remission (18/19). Serial TDA measurements during antithyroid drug therapy suggested that carbimazole has a direct effect in reducing TSlg concentration but that TDA is not a useful prognostic indicator of short term relapse or remission.

Autoimmune Diseases↗
PubMed1979

Investigation and management of symptomatic hyperprolactinaemia.

Fifteen patients with infertility and hyperprolactinaemia have been investigated using tests of prolactin and LH secretion, and treated by prolactin suppression. In addition, 4 patients with hyperprolactinaemia not desiring fertility were also investigated. Of the total group, 16 had galactorrhoea and 15 had amenorrhoea. Pituitary tumours were present in 6 patients and 4 had pituitary microadenomas. Prolactin levels measured by both radioimmunoassay and radioreceptor assay were elevated before treatment and fell during therapy with bromoergocryptine (7.5 mg daily). Tests of prolactin release with TRH and chlorpromazine before treatment did not distinguish patients with functional hyperprolactinaemia from those with pituitary tumours. Basal plasma gonadotrophin concentrations were not elevated despite subnormal urinary oestrogen levels. The serum LH response to LRH was normal during hyperprolactinaemia, but LH release in response to oestrogen provocation was impaired in 14 of 17 patients. During prolactin suppression, mean oestrogen excretion rose significantly and the oestrogen provocation test became normal in all except 2 patients. Pregnancy occurred in all of the 15 patients desiring fertility. Abortion has occurred in 4 patients, all of whom are currently pregnant again. Nine pregnancies have reached term, with no complications from pituitary expansion. It appears that during hyperprolactinaemia there are defects in both positive and negative feedback of oestrogen on LH secretion, and that prolactin suppression in such patients is highly effective in restoring fertility.

Adenoma↗
PubMedDate not supplied

Characteristics of natural conceptual cycles occurring in a prospective study of sex preselection: fertility awareness symptoms, hormone levels, sperm survival, and pregnancy outcome.

A prospective study of sex preselection provided the opportunity to characterize the fertile menstrual cycle. We describe from 91 natural conceptual cycles, or sub-groups thereof, cervical mucus symptoms, basal body temperature (BBT) changes, hormonal characteristics, and the outcome of pregnancy. The cervical mucus symptoms defined a potential fertile period of 10 days' average length, with the "peak" mucus symptom occurring at a mean of day 15.5 of the cycle. A fertile period of 9 to 10 days was also indicated by pregnancies resulting from single acts of intercourse between -6 and +3 days from ovulation. The BBT chart was biphasic in 73 of 76 cycles. The duration of the LH surge as observed in early morning urine samples averaged five days, with the peak occurring 1.4 days after the onset. Considerable inter-subject variability was seen in the LH excretion levels. Hormone measurements of peripheral plasma during the luteal phase showed the first detectable presence of hCG between day 7 and day 13 after conception. Progesterone concentrations in the midluteal phase exceeded 20 nmol/L and tended to be higher than in a comparison group of nonfertile cycles, whereas the estradiol concentrations were similar in fertile and nonfertile cycles. The birth sex ratio favored males when intercourse preceded ovulation/fertilization by two days or longer. While this association was statistically significant, the number of pregnancies involved is too small to conclude that the relationship is real.

Adult↗