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H Visnová

Publications and source records attributed to H Visnová.

8 recordsLinked to original sources

[Importance of sensitization of insulin receptors in the prevention of ovarian hyperstimulation syndrome].

OBJECTIVE: Aim of our study was to analyze the influence of insulin receptor sensitization on the course of controlled ovarian stimulation in the program of assisted reproduction and to identify the availability of ovarian response improvement due to the reduced production of intraovarian androgens. Further we tried to identify the preventive influence of metformin on development of ovarian hyperstimulation syndrome. DESIGN: Prospective randomized controlled study of 172 patients involved in the assisted reproduction program from May 2000 to December 2001. SETTING: Centre of Assisted Reproduction, Department of Gynecology and Obstetrics, Medical Faculty, Masaryk University and University Hospital, Brno. MATERIAL AND METHODS: Patients undergoing the ovarian stimulation with increased risk of development of ovarian hyperstimulation syndrome due to the polycystic ovarian syndrome were included in the study and randomized to two groups. (1) Women in the first group used the insulin receptor sensitizing drug metformin together with gonadotropins, and (2) women in the second group underwent the classic stimulation protocol alone. The control group (3) consisted of patients with intact ovarian function and different infertility factor. Complex hormonal status was assessed before the treatment initiation and the level of androgens in the follicular fluid was investigated in all patients. RESULTS: Metformin during gonadotropin stimulation has significantly reduced the risk of ovarian hyperstimulation syndrome in women with PCOS. Significantly lower intraovarian androgen levels were documented in comparison to women without metformin and also when compared to patients with intact ovarian function. Metformin had also significantly reduced estradiol blood levels at the day of hCG application without significant influence on the number of obtained oocytes. CONCLUSIONS: The risk of ovarian hyperstimulation syndrome development was significantly decreased in patients with PCOS in consequence to insulin receptors sensitization.

Adult↗

Ascorbic acid and infertility treatment.

AIM OF THE STUDY: To assess the ascorbic acid (AA) in the follicular fluid in women treated by in vitro fertilization and embryonic transfer levels (IVF/ET) and to analyse the influence of vitamin C supplementation on the results of infertility treatment. TYPE OF THE STUDY: Prospective study in women treated by IVF/ET. METHODS: The influence of vitamin C supplementation on the outcome of infertility treatment in the assisted reproduction programme in 76 women (38 of them smokers, 38 non-smokers) was studied. Half the women (19 smokers and 19 non-smokers) were administered vitamin C in daily doses of 500 mg in so-called pellets allowing for gradual release over 8 to 12 hours. The control group consisted of the same number of smokers and non-smokers. In all the women, ascorbic acid levels were determined in two urine samples (prior to supplementation and at follicle retrieval) and in follicular fluid by means of a colorimetric method. Ovarian response to hormonal stimulation with gonadotropins (hMG, FSH) at a dosage of 150-225 IU per day combined with GnRH analogues in the short (buserelin) or long (triptorelin) protocols, and 5,000-10,000 IU of human chorionic gonadotropin was evaluated based on the number of follicles created and number of retrieved oocytes. Fertilisation was assessed, based on the number of successfully fertilised oocytes (fertilisation rate) and based on the number of cultivated embryos. The success of the infertility treatment was evaluated based on the number of pregnancies. RESULTS: Ascorbic acid levels in follicles were significantly higher (p < 0.001) in women with vitamin C supplementation than in the control group (8.98 +/- 5.09 vs. 5.04 +/- 2.85 mg/l). The administration of vitamin C during the period of hormonal stimulation showed a statistically insignificant impact in terms of the higher number of pregnancies (34.2% vs. 23.7%). Vitamin supplementation had a greater impact on the number of pregnancies in the non-smokers' group (57.9% vs. 31.6%). The pregnancy rate was significantly higher (p < 0.01) in non-smoking women than in smokers--44.7% vs. 13.2%, which appears to be a reason for asking women to cease smoking prior to infertility treatment.

Adult↗

[Cryopreservation of sperm before neoplasm therapy--7 years' experience].

OBJECTIVE: To compare sperm count of cancer patients with health men, to analyze possible relation of sperm pathology and diagnosis of malignant disease and present experience of our cryopreservation programme for cancer patients. DESIGN: Retrospective clinical study. SETTING: Department of Obstetrics and Gynecology, Masaryk University, Brno, Czech Republic. METHODS: 215 patients (age 25.4 +/- 5.6 years) were referred to our unit by oncology specialists for semen cryopreservation before cancer treatment during 1995-2001. Sperm samples were analysed according to guidelines of WHO. Richardson's medium and Planer Kryo 10 were used for standard cryopreservation. Sperm count results were compared to control group of 84 men (23.1 +/- 3.6 year) examined as possible sperm donors. Program SPSS version 9 was used for statistical analysis. Standard intracytoplasmic sperm injection (ICSI) using frozen spermatozoa was used for infertility treatment following malignant disease recovery. RESULTS: Testicular cancer was diagnosed in 115 (53.5%) patients, malignant disease of lymphatic and haemopoetic tissue in 75 (34.9%) cases--out of them 35 (16.3%) Hodgkin's lymphoma. Twelve men (5.6%) were treated for osteosarcoma and 13 for other malignant disease. Only 2.8% patients had normospermia. Severe oligospermia < 5 mil/ml was found in 73 men (33.9%) including 22 cases of azoospermia (10.2%) and 12 cases (5.6%) of cryptozoospermia. 138 (64.2%) patients had asthenospermia < 10% of progressive motility, 49 (22.8%) had terratozoospermia < 10% spermatozoa with standard WHO morphology. Sperm concentration, progressive motility and morphology were in cancer patients significantly lower (P < 0.001) than in control group. Men with testicular cancer had significantly higher frequency of severe sperm pathology. Only 4 patients have returned for assisted reproduction treatment. In all cases ICSI was used, 1 pregnancy and delivery was achieved. During more than 4 years after cryopreservation died 16.6% of patients. CONCLUSION: Cancer patients has significantly higher frequency of severe sperm pathologies than healthy men. The most severe sperm pathologies are among men with testicular cancer. Only minority of patients return for fertility treatment. Cryopreserved spermatozoa of cancer patients are able to initiate pregnancy by assisted reproduction techniques.

Adolescent↗

[Present possibilities of prevention of adhesions and their immunologic aspects].

The study reviews recent developments with regard to postsurgical adhesion formation, the role of some cytokines and possible prevention. Interleukin-1 beta (IL-1 beta) levels in peritoneal fluid were assayed during 24 and 48 hours after laparoscopic or laparotomic surgery and the influence of diclofenac was evaluated. IL-1 beta levels in peritoneal fluid were substantially lower after laparoscopic adnexal surgery than after laparotomy. Application of diclofenac after abdominal hysterectomies reduced substantially intraperitoneal IL-1 beta levels.

Adult↗

[The National Register for Assisted Reproduction: results and analysis of complications].

1. Analysis of achieved results of assisted reproduction provides evidence of a steadily increasing success of ART methods in the Czech Republic. 2. Analysis of results and complications makes it possible a) to prove optimal therapeutic procedures in different groups of patients b) to recommend preventive measures to avoid complications c) assess possible side-effects on women and the foetus.

Czech Republic↗