PubMed Health⌕ Search

Biomedical subjects

J H Check

Publications and source records attributed to J H Check.

At least 37 records · Page 2Linked to original sources
PubMed1991

Influence of endometrial thickness and echo patterns on pregnancy rates during in vitro fertilization.

Previous data has suggested that improved PRs were seen in women with increased endometrial thickness as determined by sonography before oocyte retrieval. The hyperstimulation protocol used was CC-hMG. The study presented herein was initiated to evaluate if a similar trend was evident in women whose hyperstimulation protocol included the long LA-hMG therapy. We also demonstrated an improved PR in women with greater endometrial thickness, but in general, the endometrium was thicker in the pregnant women treated with the gonadotropin-releasing hormone agonist than in those treated with CC.

Embryo Transfer↗
PubMed1991

Premature luteinization: treatment and incidence in natural cycles.

The incidence of premature luteinization was evaluated in 400 women with a history of infertility (greater than or equal to 18 months). After its diagnosis, this condition was treated with ovulation-inducing drugs in the early follicular phase in an attempt to accelerate follicular maturation before the luteinizing hormone (LH) surge. Premature luteinization was diagnosed if serum progesterone levels greater than 1.5 ng/ml were associated with an LH surge before the serum oestradiol level reached 200 pg/ml and before the follicle was mature. Fifty-two of 400 (13%) women demonstrated premature luteinization in two consecutive cycles. Fourteen of 52 (27%) women corrected the problem with a clomiphene citrate regimen, as compared with 32 of 38 (75%) treated with HMG and HCG; conception rates were 83 and 50%, respectively, for the patients who responded to the two regimens. Overall, regimens utilized in this study resulted in a 58% pregnancy rate in 6 months.

Female↗
PubMed1991

Correlation of serum progestagen-associated endometrial protein levels with endometrial biopsies serum steroid levels and therapy for luteal phase defects.

The progestagen-associated endometrial protein (PEP) level rises from the early to the late luteal phase. A study was performed in infertile women where late luteal phase endometrial biopsies and serum PEP levels were obtained. The objective of the study was to evaluate the correlation between the PEP levels and the endometrial biopsies and to determine if subnormal PEP levels could be improved by the same therapies used to correct endometrial defects. There was a poor correlation between PEP levels and endometrial biopsies (r = 0.17). Similarly, there was no significant correlation between PEP levels and levels of the following hormones: mid- and late-luteal phase progesterone (P) (r = 0.186 and 0.282 respectively), mid-luteal phase 17-hydroxyprogesterone (17-OHP) (r = 0.139) and mid-luteal phase oestradiol (r = 0.135). Furthermore, there was no correlation between PEP levels and the dosage of progesterone used in therapy (r = 0.07). There were no statistically significant differences in PEP values (U/ml) depending on whether any fertility drug was taken. Thus our data suggest that progesterone may only have a permissive role, with some other factor(s) controlling the actual rise and fall of PEP.

17-alpha-Hydroxyprogesterone↗
PubMed1991

Ipsilateral versus contralateral ovary selection of dominant follicle in succeeding cycle.

There is still confusion as to whether ovulation in a succeeding cycle is a random event or is more likely to occur at the ipsilateral or contralateral ovary. Both histologic and sonographic data support alternating ovulation. Some ultrasound studies have suggested that ipsilateral ovulation is more likely in succeeding cycles, and another found right-sided ovulation to be more common. Because many of the studies are based upon small numbers, we initiated a large study to determine the more likely side of ovulation. Furthermore, the present investigation attempted to confirm biochemically the true existence of the dominant follicle by demonstrating appropriate serum estradiol levels. Evaluation of natural cycles (286 pairs) demonstrated 52.4% ipsilateral ovulation and 47.6% contralateral ovulation. Right-sided ovulation occurred in 54.5% of cycles. Our data suggest that the side of ovulation in successive cycles is not influenced by the side of ovulation in the preceding cycle.

Female↗
PubMed1991

Extreme elevation of serum CA-125 in two women with severe endometriosis: case report.

Two women with elevated preoperative serum CA-125 levels were found to have extensive endometriosis - one, the highest level related to endometriosis ever reported in the English literature. Endometriosis was found to be etiologic as seen by the prompt reduction in serum CA-125 levels following surgical treatment limited to endometriosis. Thus, a very high CA-125 level does not necessarily forebode ovarian malignancy.

Acute Disease↗
PubMed1991

Relationship of small-for-dates sac size to crown-rump length and spontaneous abortion in patients with a known date of ovulation.

Spontaneous abortion after established sonographic viability is rare. This study prospectively evaluated 39 late first-trimester abortions after fetal viability was established by ultrasound. The average crown-rump length measurement and mean sac diameter in this group were determined and compared with predicted values based on known conception dates, and the discrepancy between actual and predicted measurements was noted. The same calculations were then made on 39 prospectively matched non-aborting controls. We also determined the difference between sac size and crown-rump length in both groups. Significant differences were found for all three measures. Small-for-dates sac size and small-for-dates crown-rump length were defined as having a discrepancy score greater than 1 standard deviation (SD) above normal. Small-for-dates sac/crown-rump length was defined as having a discrepancy score less than 1 SD below normal. A high percentage of aborters was correctly predicted by a mean sac diameter (82%) or crown-rump length (77%) that was greater than +1 SD, with few false positives (12.8 and 5.1%, respectively). The cutoff for differences of sac minus crown-rump length measurements (10.1 mm) was less sensitive (56%), but just as specific (82%). When both the mean sac diameter and crown-rump length were smaller than expected (according to known date of ovulation), the ability to predict abortion was 71% with few false positives (3.5%).

Abortion, Spontaneous↗
PubMed1990

Serum progestagen-associated endometrial protein (PEP) levels in conception versus nonconception cycles following in vitro fertilization-embryo transfer.

The human endometrium synthesizes a specific protein known as the progestagen-dependent endometrium protein (PEP) which rises from early to late luteal phase. The PEP levels follow the pattern of the endometrial biopsy more than the serum progesterone (P) levels (4). Late luteal-phase serum PEP levels were evaluated as well as serum P in mid-luteal phase in patients undergoing IVF-ET. Comparisons were made between conceivers and nonconceivers and between aborters and nonaborters. Both serum PEP and late luteal P levels were significantly higher in pregnant patients but no differences in mid luteal P levels were seen. No difference was seen in aborters vs nonaborters. It is still inconclusive whether the higher late luteal PEP levels contribute to the greater likelihood of pregnancy or are a result of the pregnancy.

Abortion, Spontaneous↗
PubMed1990

Ovulation and successful pregnancy in a woman with ovarian failure after hypophysectomy and gonadotropin therapy.

A 38-year-old woman ovulated and conceived after administration of human menopausal gonadotropins despite a previous diagnosis of ovarian failure at age 18. Possible explanations include restoration of down-regulated gonadotropin receptors by development of a prolactinoma, spontaneous remission of autoimmune oophoritis, or prior tumor secretion of biologically inert gonadotropins.

Adenoma↗
PubMed1990

Ovulation induction and pregnancies in 100 consecutive women with hypergonadotropic amenorrhea.

The efficacy of a technique of gonadotropin suppression and human menopausal gonadotropins (hMG) to induce ovulation in women with hypergonadotropic amenorrhea was evaluated in 100 consecutive women. Ovulation was achieved in 19% of cycles (68/361), the pregnancy rate per cycle was 5.2% (19/361), and the viable pregnancy rate was 2.2% (8/361). In the majority of the successful cases, estrogen was used to decrease the elevated luteinizing hormone and follicle-stimulating hormone levels, especially where the ethinyl estradiol therapy alone induced a rise in endogenous 17 beta-estradiol levels with hMG used to boost the follicle to maturation. Although the success rate is low, this technique can result in some successes in otherwise almost hopeless cases.

Adult↗
PubMed1990

Pelvic sonography can predict ovum release in gonadotrophin-treated patients as determined by pregnancy rate.

Ultrasonographic monitoring of ovum release was performed in two consecutive cycles in each of 220 patients treated with gonadotrophin. Definite release occurred in 69% of cycles, indeterminate in 24% and non-release in 7%. Support for the accuracy of sonography in diagnosing the luteinized unruptured follicle (LUF) was demonstrated by a much higher pregnancy rate in those patients showing ovum release. There was a definite tendency for non-release to recur in the next cycle. Thus, the data support the routine use of sonography 2-3 days after human chorionic gonadotrophin (HCG) injection to monitor ovum release in gonadotrophin-treated patients (HMG).

Chorionic Gonadotropin↗