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Biomedical subjects

H C van Os

Publications and source records attributed to H C van Os.

13 recordsLinked to original sources
PubMed1998

A prospective randomized clinical trial comparing recombinant follicle stimulating hormone (Puregon) and human menopausal gonadotrophins (Humegon) in non-down-regulated in-vitro fertilization patients.

A randomized clinical trial was performed comparing recombinant follicle stimulating hormone (rFSH, Puregon, n = 54) and human menopausal gonadotrophin (HMG, Humegon, n = 35) in infertile women undergoing in-vitro fertilization without the use of a gonadotrophin-releasing hormone (GnRH) agonist. Most patients had a tubal or idiopathic infertility, the latter always longer than 4 years' duration. Patients with sperm abnormalities were excluded. None of the between-group differences in treatment outcome was statistically significant. In the rFSH group, a mean number of 11.2 oocytes was retrieved compared with 8.3 in the HMG group. Ongoing pregnancy rates per started cycle were higher in the rFSH group (22.2%) than in the HMG group (17.1%). Implantation rates were 27.5% in the rFSH group in comparison with 16.7% in the HMG group. In the rFSH group, a mean total dose of 1410 IU during 6.2 days was administered compared with 1365 IU in 6.0 days in the HMG group. Oestradiol concentrations on the day of human chorionic gonadotrophin administration were 3889 pmol/l in the rFSH group and 3145 pmol/l in the HMG group. In 15 subjects (rFSH: n = 9, 16.7%; HMG: n = 6, 17.1%) luteinizing hormone concentrations higher than 10 IU/l were seen during stimulation. In two of them, both from the rFSH group, ongoing pregnancies were achieved. The results indicate that rFSH (Puregon) is at least as efficacious as HMG and that acceptable pregnancy rates can be achieved without the use of a GnRH agonist.

Adult↗
PubMed1994

Absence of hepatitis B virus (HBV) DNA in children born after exposure of their mothers to HBV during in vitro fertilization.

During in vitro fertilization, 22 human embryos were exposed to hepatitis B virus (HBV) in contaminated human serum present in the culture medium. All mothers experienced hepatitis B during the first trimester of pregnancy, and two had hepatitis B surface antigen and HBV DNA, as determined by PCR, at the time of delivery. No HBV DNA was found in serum or lymphocytes from the exposed 22 infants. HBV DNA was also absent from one infant at autopsy.

Culture Media↗
PubMed1993

Immune response to hepatitis B vaccine in pregnant women receiving post-exposure prophylaxis.

Hepatitis B immunoglobulin and vaccine were given as post-exposure prophylaxis to 73 women after an outbreak of hepatitis B due to in vitro fertilization treatment. The immunization schedule consisted of 5 ml of hepatitis B immunoglobulin (125 IU/ml) at months 0 and 1 and recombinant hepatitis B vaccine (10 micrograms of HBvaxDNA) at months 0, 1, 2 and 6. The safety and immunogenicity of hepatitis B vaccine were studied in 16 women who became pregnant after in vitro fertilization; 57 non-pregnant women receiving the same treatment served as controls. Blood samples were drawn at 0, 1, 2, 6 and 7 months. One patient had a clinical abortion 2 days after initial immunization; other side effects of vaccination were not found in vaccinees or in their offspring. All vaccinees exhibited antibodies against hepatitis B surface antigen after vaccination but relatively low peak geometric mean titers of 258 IU/l and 684 IU/l were attained in pregnant and non-pregnant women, respectively. There were no significant differences in seroconversion rates and geometric mean titers between the two groups although the immune response to hepatitis B vaccine was slower and lower in pregnant women at all times. Our results suggest that when post-exposure prophylaxis for hepatitis B infection is indicated, passive active immunization can be started safely during pregnancy. The relative weak response to the vaccine calls for monitoring of the anti-HBs 1 month after the initial series of vaccinations.

Abortion, Spontaneous↗
PubMed1992

Vaginal disinfection with povidon iodine and the outcome of in-vitro fertilization.

In a prospective randomized study, the influence was assessed of vaginal disinfection with a 1% solution of povidon iodine (Betadine), before performing a transvaginal ultrasound-guided oocyte retrieval, on fertilization, cleavage rate and pregnancy rate. The outcome of 334 oocyte retrievals was studied. In 160 cases, Betadine was used and in the remaining 174 cases, normal saline was used. No differences in the fertilization and cleavage rates were found (fertilization 45.5% versus 47.8%, cleavage 49.8% versus 52.1% in the Betadine and normal saline groups respectively). However the pregnancy rate was significantly higher in the normal saline group (17.2% versus 30.3% clinical pregnancies per embryo transfer). No increase in infection risk occurred in the saline group.

Disinfection↗
PubMed1991

The influence of contamination of culture medium with hepatitis B virus on the outcome of in vitro fertilization pregnancies.

Heat-inactivated human serum is added to the culture medium used for in vitro fertilization and other forms of assisted conception. Because one batch of pooled serum contained hepatitis B virus, an epidemic occurred among women participating in the treatment program. Seventy-nine women had serologic proof of hepatitis B infection. This incident gave the opportunity to study the effect of hepatitis B virus on pregnancy outcome and the newborn. The situation is unique because the preimplantation embryo was exposed to hepatitis B virus or the pregnancy was complicated by a (sub)clinical infection. Twenty-four women were or became pregnant while having an acute hepatitis B infection. Five pregnancies ended in abortion. The remaining 19 pregnancies ended in the birth of 24 children. No evidence for any harmful effect of exposure to hepatitis B virus in the embryonic or fetal period on the newborn could be found.

Adult↗
PubMed1989

The influence of the interval between in vitro fertilization and embryo transfer and some other variables on treatment outcome.

This prospectively randomized study compares the outcome of 434 ETs 48 to 52 hours after insemination (day 2) and 324 ETs 72 to 76 hours after insemination (day 3). The influence of the interval between insemination and ET was assessed, as well as that of the number of embryos transferred, embryo quality, and the presence of supernumerary embryos. The mean number of embryos transferred after 2 and 3 days was equal (2.9 embryos/ET). The pregnancy rates per ET were not significantly different (21.9% versus 23.5%), but a higher percentage of viable pregnancies was observed after ET on day 3 (88.2% against 69.5% following ET on day 2). Treatment outcome was positively correlated with the number of embryos transferred and the presence of supernumerary embryos.

Abortion, Spontaneous↗
PubMed1989

Value and limitations of vaginal ultrasonography--a review.

Vaginal ultrasonography has become an indispensable method in infertility and early pregnancy investigations, in spite of its comparatively recent introduction. Initially this technique was introduced as an alternative for abdominal ultrasonography in in-vitro fertilization treatment for monitoring follicle growth and harvesting oocytes. In due course, the technique was used in many other fields of gynaecology and obstetrics, e.g. ovulation induction, early detection of (ectopic) pregnancy, oncology and placenta localization. The value and limitations of vaginal ultrasonography are discussed as well as patients' acceptance.

Female↗
PubMed1988

The value and role of plasma 17 beta-oestradiol measurements during ovarian hyperstimulation for in-vitro fertilization.

Follicular aspiration was performed in 464 hyperstimulated IVF treatment cycles in patients with severe tubal damage as the sole cause of their infertility. In 413 cycles, one to four embryos could be replaced, resulting in 102 clinical pregnancies. In 458 treatment cycles, data on plasma E2 levels were available on days -3 and -2, in 322 cycles also on days -1 and 0, day 0 being the day of follicular puncture. Although the distribution of cycles leading to clinical pregnancy within the 5-95th centile for plasma E2 levels differed from that observed outside this range, these differences were of no statistical significance. These results indicate that IVF pregnancies occur in the presence of a wide range of E2 levels, during the 3-day period preceding follicular aspiration. The importance of plasma E2 measurements for treatment policy must, therefore, be reconsidered.

Clomiphene↗
PubMed1988

Factors influencing the outcome of successive IVF treatment cycles in attaining a follicular puncture.

An analysis has been made on data from 576 cycles in 300 patients regarding the chances of various superovulation protocols attaining a puncture in successive cycles. The cumulative proportion of patients with at least one successful stimulation increased from 77% at the first attempt, to 98% at the fifth attempt. Of the 576 stimulations, 440 (76%) resulted in a puncture. Age, the number of ovaries and the reaction to superovulation induction contribute to the outcome of a cycle, the chances being lowest for older individuals with one ovary and an inadequate reaction in the first treatment cycle. Changing the treatment protocol did not improve the outcome in subsequent gonadotrophin-induced cycles, even if combined with clomiphene citrate. Reasons for cancellation did not tend to recur, although the incidence of dominance and premature stimulation was significantly higher in patients aged greater than 35 years. Age-dependent chances of success were calculated.

Adult↗
PubMed1986

Volumetric behaviour and survival of mouse zygotes and embryos in hyperosmotic media.

Volume changes and survival of mouse zygotes and pre-implantation embryos were studied after their exposure to hyperosmotic media. Transfer of zygotes from culture medium to medium containing 1.5 M DMSO led to a rapid volume reduction to 60% of control values. After 10 min the volume was normal again, illustrating the rapid penetration of DMSO at room temperature. Re-transfer of zygotes equilibrated in 1.5 M DMSO to culture medium in one step doubled the volume. Twelve minutes later normal diameters were observed again. Volume changes were also recorded after transfer to media rendered hypertonic by the addition of NaCl or sucrose. A proportional decrease in volume was noticed up to 1500 mOsmol. A further increase in measured osmolarity up to 3100 mOsmol led only to limited further shrinkage of the zygotes (minimal volume observed was 27% of control volume). Addition of 1.5 M DMSO or 1.5 M propanediol had no influence on the final volume reaction to NaCl and sucrose. Exposure to media with a measured osmotic value of 3200 mOsmol (NaCl added) during 10 min did not prevent further development of the embryos to the hatched blastocyst stage. A solution of 4000 mOsmol proved lethal to nearly all embryos. Addition of 1.5 M DMSO to this medium did not have a protective effect against the osmotic stress at room temperature.

Animals↗