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Biomedical subjects

I Ciuffardi

Publications and source records attributed to I Ciuffardi.

10 recordsLinked to original sources
PubMed1995

The use of progestins for programming assisted reproductive cycles and gonadotropin-releasing hormone agonist flare-up protocols in older patients.

OBJECTIVES: To determine if the use of norethisterone acetate (NET) in the previous cycle affects the ovarian response to GnRH agonist (GnRH-a) in flare-up protocols and controlled ovarian hyperstimulation in older patients. DESIGN: Retrospective analysis of the outcome of the assisted reproductive technology (ART) cycle. PATIENTS: Eighty women > 37 years old undergoing controlled ovarian hyperstimulation (COH) for a ART cycle (GIFT, IVF, zygote intrafallopian transfer). Forty received NET during the luteal phase of the previous cycle for programming the procedure and 40 did not receive NET (control group). Gonadotropin-releasing hormone agonist in follicular phase (flare-up) protocols were administered to all the patients. MAIN OUTCOME MEASURES: Cycle outcome: amount of gonadotropins used, oocyte production and quality, fertilization, and pregnancy rates. Estradiol, FSH, and LH levels the first 3 days of COH in eight patients. RESULTS: There were no differences between both groups in the cycle outcome. Estradiol levels during the first 3 days of COH were higher in the patients that did not receive NET in the previous cycle. Follicle-stimulating hormone and LH levels were similar in both groups. CONCLUSIONS: The administration of NET in the previous cycle in patients > 37 years old does not affect the ovarian response to the combination of follicular phase GnRH-a and gonadotropins for COH.

Adult↗
PubMed1995

Increased capillary permeability induced by human follicular fluid: a hypothesis for an ovarian origin of the hyperstimulation syndrome.

OBJECTIVE: To examine the effect of follicular fluid (FF) and peritoneal fluid (PF) from patients undergoing assisted reproductive technology procedures on endothelial barrier function. This was determined in vitro by measuring the permeability of filter-grown bovine aortic endothelial cell monolayers to a permeability marker. DESIGN: Endothelial cells obtained from bovine thoracic arotas were treated with collagenase solution and plated on millicell filters, on which they formed confluent monolayers. Flux rate was determined at 60 minutes by measuring the radioactive tracer (3H mannitol) permeating from the apical to the basolateral part of the filter. Fifty-eight samples of FF and PF, both from stimulated and natural cycles were analyzed and grouped according to the number of eggs retrieved. Follicular fluid and PF samples from natural cycles were used as controls. RESULTS: There was an augmentation in the permeability rate of both FF and PF from patients undergoing controlled ovarian hyperstimulation (COH) who responded with an increasing number of eggs compared with controls (51% and 39%, respectively). When analyzing samples from patients who responded with a low number of oocytes, no significant increase was observed. CONCLUSIONS: It is known that in OHSS, the increase in capillary permeability is related to the administration of gonadotropins, and is believed to be mediated by a vasoactive substance of ovarian origin. In this study, FF and PF from patients undergoing COH showed a significant increase in the permeability rate through endothelial cells in vitro. Based on these findings, it could be hypothesized that if the same events took place in vivo, the isolation of this factor from ovarian source could be of significant importance to elucidate the pathogenesis of OHSS.

Adult↗
PubMed1995

Hysteroscopy and assisted reproductive technology.

Hysteroscopy is an excellent additional instrument for evaluating the uterine characteristics in infertile women. This article reviews the two main indications for hysteroscopy in infertile patients who are candidates for assisted reproductive techniques: (1) to evaluate the cervix and uterine cavity and (2) rule out any pathology or lesions that could have been missed by hysterosalpingography. Hysteroscopy has been proposed as an alternative method to traditional transabdominal transfer of gamete or embryo to the tube.

Cervix Uteri↗
PubMed1995

[Correlation between plasma progesterone and ultrasonographic detection of corpus luteum in ovulatory cycles].

The ultrasound detection of corpus luteum in the midluteal phase of ovulatory cycles was associated with significantly higher levels of plasma progesterone, opposed to those patients where a corpus luteum could not be identified. The hormone level was directly proportional no the number of corpora lutea seen. However, only 33.3% o patients with no corpus luteum visible were found to have suboptimal plasma progesterone levels (< 10 ng/ml).

Adult↗
PubMed1994

Oocyte donation in humans: a model to study the effect of age on embryo implantation rate.

Although a number of different mechanisms have been suggested to account for the decline of fertility with age, the majority of studies agree that poor oocyte quality and reduced endometrial receptivity are the most important. In fact, the increased incidence of early pregnancy loss and chromosomal abnormalities of oocytes in older women, as well as the ability to reverse decreasing pregnancy rates by using oocyte donation, strongly support the evidence that oocyte ageing is the main factor responsible for decreasing fertility. Conversely, the lack of knowledge of the physiological variables that determine a successful nidation of a human embryo makes the analysis of uterine receptivity much more difficult. In order to evaluate the impact of the age of donors and recipients on pregnancy, implantation and abortion rates, we have retrospectively analysed 258 cycles from our programme of oocyte donation. Results were reviewed according to the following subclasses of age groups: < or = 30, 31-35 and 36-39 years for donors, and < or = 30, 31-35, 36-40, 41-45 and 46-53 years for recipients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Cervical pregnancy. A case report.

Cervical pregnancy is one of the most dangerous forms of ectopic pregnancy. This condition is frequently unsuspected before evaluation of the uterus and it is characterized by massive bleeding during that procedure. We report a case of cervical ectopic pregnancy diagnosed by ultrasound at 11 weeks' gestation and managed by emergency hysterectomy for severe hemorrhage occurring immediately after removal of the placenta.

Abortion, Spontaneous↗
PubMed1992

Early sonographic diagnosis of fetal cystic hygroma colli.

Fetal cystic hygroma colli (FCHC) is a congenital malformation of the lymphatic system which develops as a result of failure of the communication between the jugular lymphatic canal and the internal jugular vein. The diagnosis is usually made by ultrasound in the second trimester of pregnancy by the demonstration of a multiseptate, thin-walled cystic mass appearing posterolaterally in position to the fetal head and neck region. In this report we present two cases of FCHC diagnosed by transabdominal ultrasound in the first trimester of pregnancy. In one case, chorionic villus sampling revealed a 45,X karyotype, the fetus became progressively hydropic and died at 15 1/2 weeks. In the other, the spontaneous resolution of a nonseptated FCHC in a fetus with normal karyotype was documented, resulting in the delivery of a healthy infant a term. Fetal karyotyping, a careful search for other anomalies that may affect fetal survival, and a close sonographic follow-up in cases of FCHC are advocated for an accurate diagnosis and genetic counselling.

Adult↗
PubMed1992

[The tap test in the rapid evaluation of fetal lung maturity].

A new test for the evaluation of fetal lung maturity, called tap test, been recently developed. This rapid, inexpensive, and reliable test is easy to perform and can be used whenever testing for phospholipids are not available. We performed this test in 260 clear samples of amniotic fluid obtained by transabdominal amniocentesis and the results were compared with those of the "shake test". When the "shake test" was positive (n = 156), the tap test was consistent with fetal lung maturity in all cases. When the "shake test" was intermediate or negative (n = 61 and n = 43, respectively), the tap test was consistent with immaturity in only 19.2% of the cases. Fifty-four fetuses were born within 72 hours after the amniocentesis. The "shake test" was positive in 50, intermediate in 3, and negative in 1. In all but one of there cases the tap test was consistent with maturity. The only case of RDS in this series occurred in an infant with immature result. These findings indicate that the tap test is a reliable indicator of fetal pulmonary maturity and probably with a higher specificity than the "shake test".

Amniotic Fluid↗
PubMed1992

[Bilateral renal agenesis: a 10-year experience].

Bilateral renal agenesis (BRA) is an uniformly lethal malformation occurring in 0.1-0.3/1000 births. This condition is associated with severe oligohydramnios, intrauterine growth retardation (IUGR), extra-renal anomalies, and malpresentation. The aim of this study was to present our experience with 10 cases of BRA seen in a 10-year period. In only one case the prenatal diagnosis was made. Therefore, the clinician was faced with a high-risk pregnancy: 70% of cases presented with malpresentation, oligohydramnios, and severe IUGR. This explain the high rate of cesarean section (40%) and the neonatal intensive care offered to these neonates. The principal methods to improve the prenatal diagnosis of this condition are discussed.

Abnormalities, Multiple↗