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Biomedical subjects

H I Abdalla

Publications and source records attributed to H I Abdalla.

At least 19 recordsLinked to original sources
PubMed2005

Simple enumerations of peripheral blood natural killer (CD56+ NK) cells, B cells and T cells have no predictive value in IVF treatment outcome.

BACKGROUND: To evaluate the association between the absolute counts of the peripheral natural killer (NK) cells (including total CD56(+) NK cells, CD56(dim) NK cells and CD56(bright) NK cells), B cells and T cells on the implantation rate and miscarriage rate after IVF treatment. METHODS: This was a prospective observation study. A total of 138 patients who underwent IVF treatment from December 2002 to July 2003 were recruited to the study. Blood samples were obtained on the day of vaginal oocyte retrieval prior to the procedure. The absolute counts of lymphocytes, NK cells, B cells and T cells were identified by flow cytometry. These absolute counts and their relationships to IVF treatment outcome and miscarriage rate were analysed. RESULTS: There were no significant differences with regard the mean values of absolute lymphocyte count, T cell count, B cell count and NK cell count (including total CD56(+) NK, CD56(dim) NK and CD56(bright) NK cells) between the pregnant and non-pregnant groups and also between the ongoing pregnancy and miscarriage groups. The cause of infertility, duration of infertility, basal FSH levels, number of previous failed IVF treatments, number of previous miscarriages and stimulation characteristics were not significantly different between the pregnant and non-pregnant groups. Previous studies have suggested that women with a history of recurrent miscarriage and those with infertility accompanied by recurrent failed IVF treatments are associated with a peripheral blood NK cell percentage >12%, therefore further analysis of peripheral CD56(+) NK cell levels <12% (group A) and >12% (group B) was performed. There was no significant difference in implantation rate (group A: 17.0%; group B: 23.2%), pregnancy rate (group A: 36.6%; group B: 47.7%) or miscarriage rate (group A: 23.3%; group B: 28.6%). CONCLUSION: There were no significant differences between simple enumerations of peripheral blood NK cells (including total CD56(+) NK, CD56(dim) NK and CD56(bright) NK cells), B cells and T cells with IVF treatment outcome and pregnancy outcome. Women who had a peripheral NK cell level >12% did not have higher number of previous pregnancy losses. Importantly their pregnancy rate was not reduced and their miscarriages were not increased compared to women who had a peripheral NK cells level <12%.

Abortion, Habitual↗
PubMed2004

An increase in the absolute count of CD56dimCD16+CD69+ NK cells in the peripheral blood is associated with a poorer IVF treatment and pregnancy outcome.

BACKGROUND: Our aim was to evaluate the effect of the absolute count of the activation marker (CD69), IgG Fc receptor (CD16) and inhibitor marker (CD94) expression on peripheral blood natural killer (NK) cells on implantation and miscarriage rates after IVF treatment. METHODS: Prospective observational study of 138 randomly selected women who underwent IVF treatment from December 2002 to September 2003. NK cells were identified as CD56(+) (dim + bright) and CD3(-) by flow cytometry. The absolute counts of the CD69(+), CD16(+) and CD94(+)expressing NK cells were recorded and their relation to IVF treatment outcome and miscarriage rate was analysed. RESULTS: The mean (+/-SD) absolute count of the CD56(dim)CD16(+)CD69(+) NK cells for women who had a successful ongoing pregnancy was 0.61 x 10(6)/l (+/-0.31). For those women who failed to achieve a pregnancy, the mean value of the absolute count of CD56(dim)CD16(+)D69(+) NK cells was significantly (P=0.003) higher at 1.66 x 10(6)/l (+/-0.52). The absolute count of CD56(dim)CD16(+)CD94(+) and CD56(dim)CD16(+) NK cells did not show any statistically significant differences between those women with successful and failed IVF treatment. Receiver operating characteristic (ROC) curve analysis was performed to select a CD69 threshold for further statistical analysis. The implantation rate (IR) was significantly lower (13.1%) and miscarriage rate (MR) was significantly higher (66.7%) for women with an absolute CD56(dim)CD16(+)CD69(+) NK cell count of >1.0 x 10(6)/l compared to women with count below this value (IR 28.2% and MR 16.7%). Further analysis of the absolute count of CD56(bright)CD69(+) and CD56(bright)CD94(+) NK cells did not show any significant difference between those women with successful and failed IVF treatment. CONCLUSIONS: An increase in the absolute count of activated NK cells (CD56(dim)CD16(+)CD69(+)) in the peripheral blood is associated with a reduced rate of embryo implantation in IVF treatment. Furthermore, women with high CD56(dim)CD16(+)CD69(+) peripheral blood NK cell absolute count, who are able to achieve pregnancy, have a significantly higher miscarriage rate.

Abortion, Spontaneous↗
PubMed2003

Does egg-sharing compromise the chance of donors or recipients achieving a live birth?

BACKGROUND: To evaluate the effect of egg-sharing and the outcome of assisted reproductive treatment (ART) in standard IVF/ICSI patients, egg-sharing donors and egg-sharing recipients. METHODS: Descriptive cohort study to evaluate 276 egg-sharing cycles involving 192 egg-sharers, 274 recipient cycles receiving eggs from egg-sharers and 1098 non-egg-sharing standard IVF/ICSI cycles from January 1998 to December 2002. Patients were divided into three groups: group A, egg-sharers; group B, non-egg-sharers, age <36 years, FSH <10 IU/l, BMI <30 kg/m(2); and group C, egg-sharing recipients, all ages. Duration and amount of gonadotrophin required to achieve follicular maturity, number of eggs collected and donated, fertilization rate, pregnancy rates and live birth rates were compared between donor, recipient and standard IVF/ICSI patients. The chi(2 )test was used to test for statistical significance (P < 0.05). RESULTS: There was no significant difference in pregnancy rate and live birth rate of egg-sharers, group A (42.0%, 33.0%), non-egg-sharers, group B (40.0%, 30.9%) and recipients, group C (41.4%, 28.6%). The number of oocytes collected, number of mature follicles and amount of gonadotrophin used was not significantly different between the two groups (A and B). The average number of embryos transferred and the mean number of eggs allocated between egg-sharers and recipients was not statistically different. CONCLUSION: Egg-sharing does not compromise the chance of achieving a pregnancy or live birth for the egg-sharer or the recipient as compared to standard IVF/ICSI patients. The egg-sharers were not at a higher potential risk of ovarian stimulation syndrome and there was no imbalance of egg allocation.

Adult↗
PubMed1999

Embryo transfer: ultrasound-guided versus clinical touch.

In this prospective control study, the pregnancy and implantation rates were compared between ultrasound-guided and clinical touch uterine embryo transfers. In addition, a subset of patients was sought that would particularly benefit from embryo transfer under ultrasound guidance. A total of 187 patients (93 ultrasound and 94 clinical touch) was enrolled. Allocation was random and depended on whether their embryo transfers were done during the 1 h each day in which the ultrasound was available. Pregnancy and implantation rates of 37.8 and 20.4% respectively were achieved when ultrasound was used, compared with 28.9 and 16.2% respectively with clinical touch. This difference was not statistically significant. There was no significant difference in the pregnancy rate when the number of embryos transferred was controlled. Older women (>/=37 years old) had an apparently higher pregnancy rate (38.1 versus 20.4%; not significant) with ultrasound guidance during embryo transfer. In the subgroup where the clinician rated the transfer procedure as difficult, there appeared to be a substantial improvement in the pregnancy rate in the group that used ultrasound (54.5 versus 10.0%; not significant). Although our results were not statistically significant, we believe that ultrasound-guided embryo transfers should be used in clinically difficult embryo transfers and in older women, as it appears to improve the pregnancy rate over clinical touch transfers.

Adult↗
PubMed1998

A survey of anonymous oocyte donors: demographics.

This is a questionnaire based study of 501 women enquiring about anonymous oocyte donation at a private in-vitro fertilization (IVF) unit, investigating the demographic characteristics and logistic issues involved in ovum donation. The 501 women were made up of 356 women who did not donate ('non-donors') and 145 women who eventually donated their oocytes ('donors'). Although there was a majority of housewives among the enquirers, women in full-time employment were the majority of actual donors. Logistic factors such as the travel and time commitment involved were major reasons for non-donation as well as concerns about complications. There was a paucity of ethnic donors. Recruitment strategies must focus on retaining potential donors and ensuring a higher proportion become actual donors. These strategies must address the logistic difficulties associated with non-donation including transport problems and social commitments by assisting with childcare provision and travel. Improving donor education and the access to more personal and non-threatening information were other areas that needed attention which were highlighted in the survey.

Adult↗
PubMed1998

Obstetric outcome in 232 ovum donation pregnancies.

OBJECTIVE: To study the obstetric outcome of ovum donation pregnancies. DESIGN: A retrospective analysis of 232 ovum donation pregnancies in the six years from 1988 to 1993. SETTING: Infertility clinic in a private hospital. PARTICIPANTS: All ovum donation recipients that achieved pregnancy in the clinic during the stated time period. MAIN OUTCOME MEASURES: Percentages of live birth and miscarriages and ectopic pregnancies; number of sacs identified in the uterus at early (four weeks after transfer) and later scans; incidence of antepartum and postpartum haemorrhage; incidence of pregnancy-induced hypertension; incidence of preterm, low birthweight and small-for-gestational age babies; and incidence of operative deliveries. RESULTS: Of 232 pregnancies, 151 babies were born (live birth rate of 20%); and 81 were lost (57 before eight weeks, 17 after eight weeks and seven ectopic pregnancies). In nine cases there were no intrauterine sacs at the early scan (two 'chemical pregnancies' and seven ectopic pregnancies). In 169 cases there was initially one intrauterine sac, ending with 102 singleton deliveries (60%); in 47 cases there were initially two intrauterine sacs, ending with 11 singleton deliveries (23%) and 32 twin deliveries (68%); in the seven cases where three sacs were identified initially, there were no singleton deliveries, three twin deliveries (one selective fetal reduction) and three triplet deliveries. Women with premature ovarian failures had a significantly higher pregnancy rate compared with those with functioning ovaries (P < 0.02). However, in the former group, the miscarriage rate was also significantly higher (P < 0.03) so that the number of term births was similar. The incidence of vaginal bleeding was 12% in the first trimester, 1.5% in the second trimester, and 2% in the third trimester. The incidence of postpartum haemorrhage was 12%. Thirty-two women had pregnancy-induced hypertension (23% of all deliveries). This occurred in 22/105 singletons (21%), 7/32 twins (22%) and in all three (100%) of the triplets. In the singleton group 13% of infants were preterm, 18% had a birthweight < 2.5 kg and 15% were < 3rd centile for birthweight at delivery (small-for-gestational age). Ovarian function was found to be the only factor that significantly influenced the incidence of small-for-gestational age babies (odds ratio 8.84; 95% confidence interval 1.1-70.0; P = 0.007). The overall operative delivery rate was 85% with the caesarean section rate being 69%. CONCLUSIONS: Women who become pregnant following oocyte donation should be considered obstetrically as high risk, especially those with ovarian failure because of the increased incidence of small-for-gestational age infants in these pregnancies. They are also at higher risk of pregnancy-induced hypertension and postpartum haemorrhage.

Abortion, Spontaneous↗
PubMed1997

Age of the uterus does not affect pregnancy or implantation rates; a study of egg donation in women of different ages sharing oocytes from the same donor.

The importance of age of the recipient (uterine age) with regards to pregnancy rate, delivery rate and miscarriage rate following oocyte donation was evaluated using retrospective data analysis of cases where two recipients from different age groups shared oocytes from a single donor and had equal numbers of embryos transferred. A total of 104 women (21-52 years of age) underwent a total of 104 cycles of oocyte donation. They were divided into groups according to age (group A: age 39 years or less and group B: age between 40 and 52 years). The minimum age difference between a pair of recipients was five years. Hormone replacement therapy (HRT) was given using oestradiol valerate (6 mg daily) for at least 10 days, followed by a combination of oestradiol with either intramuscular progesterone (100 mg daily), or vaginally administered micronized progesterone (300 microg daily). Women with ovarian function received down-regulation using a luteinizing hormone-releasing hormone (LHRH) analogue before hormone replacement was commenced. A total of 52 transfer cycles was performed in each age group and pregnancy, delivery and miscarriage rates were analysed as outcome measures; 20 pregnancies were achieved in each group (an identical pregnancy rate of 38.5%). In group A seven pregnancies miscarried out of 20 (35%), which was not significantly different from the rate in the older population, group B, where eight out of 20 pregnancies miscarried (40%). The delivery rate in group A was 25% (13 out of 52), again not significantly different from the delivery rate in group B of 23.1% (12 out of 52). In conclusion, using egg donation as a model, the decline in fecundity with age cannot be explained by uterine factors alone.

Adult↗
PubMed1997

Two successful pregnancies in a 46,XY patient.

Two successful pregnancies (singleton followed by twins) following ovum donation/in-vitro fertilization in a 46,XY woman have been studied. Although similar cases have previously been presented: in a pure XY patient and in a 45,X/46,XY patient, this case is one in which a subsequent successful pregnancy has resulted. In such patients, the rate of Caesarean section appears to be increased, and we postulate that the hypoplastic nature of the uterus, although able to respond quite well to both exogenous and endogenous hormones to accept and maintain a pregnancy, may lack the capability to respond fully in labour by dilating appropriately.

Adult↗
PubMed1996

Endometrial thickness: individual and mean growth profiles for different hormone replacement regimens.

Currently, there is a paucity of data describing endometrial growth, with most studies concentrating on endometrial thickness immediately prior to implantation or embryo transfer. This study looked at the individual and combined growth profiles of 67 volunteers receiving three different hormone replacement regimens. Each treatment regimen was in excess of that considered necessary for optimal growth, and all promoted an endometrial thickness that would be considered satisfactory for embryo transfer. Three patterns of growth were identified, but overall there was a decrease in the rate of endometrial growth with duration of treatment. As expected, analysis of variance did not show a significant difference between the mean growth profiles for the three hormone replacement regimens. The correlation (r = 0.45, P < 0.0001) between rank order on day 3 and day 10 of treatment indicates that interim analysis during early treatment cannot accurately predict later thickness, but a doubling of endometrial thickness can be expected in most cases. A relationship between endometrial thickness and either the treatment dose or serum concentrations of oestradiol was not found. These findings suggest that manipulation of endometrial growth is not possible by adjustment of either the treatment dose or serum concentration. The findings indicate that treatment beyond 12 days does not promote either a clinically significant increase in endometrial thickness of an excessive thickness, suggesting that maintenance of an oocyte recipient in a pseudo-follicular phase is unlikely to be disadvantageous to implantation.

Adult↗
PubMed1995

Birth weight: nature or nurture?

OBJECTIVE: To investigate the relative role of environmental and genetic factors in the determination of birth weight following ovum donation. METHODS: Data from 62 cases of ovum donation were used to examine the relative influence of donor and recipient on birth weight. RESULTS: The only discernible factors that significantly influenced birth weight were gestational age and recipient's weight. Donor weight, her own birth weight, and the birth weight of the donor's own children were not significantly correlated with the birth weight of the child following ovum donation. CONCLUSIONS: It is concluded that the environment provided by the human mother is more important than her genetic contribution to birth weight.

Adult↗
PubMed1995

Insulin-related growth factor binding protein-1 levels in ovum donation pregnancies.

The finding that endometrial maturation may be delayed following hormone replacement therapy has suggested that a generalised endometrial dysfunction may exist in ovum recipients. In order to investigate this suggestion further, circulating levels of IGFBP-1 were measured in samples taken throughout pregnancies conceived either spontaneously or following ovum donation. When analysed at two-weekly intervals, the serum levels of IGFBP-1 in ovum donation pregnancies failed to show the expected peak towards the end of the first trimester and were significantly reduced at week ten (U = 364.5, p = 0.0002) and twelve (U = 138.0, p = 0.0047). For the remainder of pregnancy, circulating IGFBP-1 levels were similar in both groups. The birth weight of children born to the ovum donation group was not significantly different from a normal control group, suggesting that circulating levels of IGFBP-1 in early pregnancy do not reflect local function and that IGFBP-1 does not have an essential function (in relation to birth weight) in early pregnancy.

Birth Weight↗
PubMed1995

Serum concentrations of luteinizing hormone and progesterone in ovum recipients: their relationship with pregnancy and miscarriage.

Our objective was to test the hypothesis that the association between elevated luteinizing hormone (LH) concentrations and miscarriage is mediated via an effect of LH on the maternal environment, rather than on the oocyte. The impact of maternal age, ovarian function, previous IVF attempts, therapeutic (buserelin) and hormonal (LH, oestradiol, progesterone) effects occurring on the day of zygote intra-Fallopian transfer (ZIFT) or embryo transfer, and of oocyte or embryo numbers, whether they were fresh or frozen, and their mode of transfer on the occurrence of pregnancy and miscarriage following ovum donation (n = 57) were investigated. The cycles were divided by outcome into non-pregnant (n = 26), miscarriage (n = 19) and normal term pregnancy (n = 12). The circulating concentrations of LH were greater in miscarriage cycles (P = 0.046) and cycles ending in pregnancy (P = 0.04) than in non-pregnant cycles, while the concentrations of progesterone were greater in non-pregnant (P = 0.029) and miscarriage (P = 0.015) cycles than in cycles ending in pregnancy. Frozen embryos were used more frequently in non-pregnant compared to cycles ending in pregnancy (P = 0.016). Multiple regression analysis was used to investigate which factors are associated with miscarriage and identified progesterone concentrations at the time of transfer as being the only significant variable (r = 0.48, F = 8.5, P = 0.007).(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Spontaneous↗
PubMed1994

Endometrial thickness: a predictor of implantation in ovum recipients?

In a retrospective study, the relationship between endometrial thickness and pregnancy rate has been studied in 59 ovum recipient women. Transvaginal ultrasound assessment of endometrial thickness was performed immediately prior to ovum transfer: 19 pregnant recipients had a mean endometrial thickness of 10.24 mm +/- 2.63 SD, 40 nonpregnant recipients had an endometrial thickness of 8.62 mm +/- 3.49 SD (t = 1.805, P = 0.0382). Only two pregnancies occurred in 15 recipients with an endometrial thickness < 7.5 mm, and none when the endometrial thickness was < 5 mm. Our results indicate that endometrial thickness is related to the functional receptivity of the endometrium.

Adult↗
PubMed1993

Age, pregnancy and miscarriage: uterine versus ovarian factors.

This study was performed to evaluate the relative contribution of oocyte and uterine factors to the age-related reduction in fecundity. The pregnancy and miscarriage rates in women receiving donated oocytes were compared to those in women using their own oocytes in in-vitro fertilization (IVF) and gamete intra-Fallopian transfer (GIFT) procedures. Oocyte donation with embryo transfer was performed on 241 women in 371 cycles; 116 of these women became pregnant (48% per patient and 31.5% per cycle) of whom 40 (35%) miscarried, giving a live birth rate of 20.5%. Assisted conception, in the form of IVF/GIFT procedures, was performed on 1331 women using their own oocytes in 2194 cycles; 627 of these women became pregnant (47% per patient and 28.7% per cycle), of whom 228 (36%) miscarried, giving a live birth rate of 18.2%. Neither the age of the donor nor the age of the recipient was related to pregnancy rate. The age of the donor, however, was directly related to the miscarriage rate. On the other hand, the age of patients undergoing IVF/GIFT was inversely related to the pregnancy rate and directly related to the miscarriage rate. In women of 40 years or over, the overall pregnancy and live birth rates were significantly higher and the miscarriage rate was significantly lower in the group receiving donated oocytes compared to the group using their own oocytes. In summary, we suggest that the age-related decline in fecundity is associated with the age of the oocytes rather than the age of the uterus.

Abortion, Spontaneous↗