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Biomedical subjects

Jerald S Goldstein

Publications and source records attributed to Jerald S Goldstein.

3 recordsLinked to original sources

A randomized, prospective study comparing laser-assisted hatching and assisted hatching using acidified medium.

OBJECTIVE: To compare the clinical outcomes of patients whose transferred embryos underwent either laser-assisted hatching or hatching with acidified medium. DESIGN: Randomized, prospective, double-blinded study. SETTING: University-based IVF center. PATIENT(S): Clinical outcomes following IVF were compared in 159 patient cycles who randomly had all transferred embryos undergo laser-assisted hatching (Laser; n = 57) or hatching with acidified medium (Acid; n = 54). Patients whose embryos had zonae thickness <13 mum were not hatched (Thin; n = 8) and patients with > or =4 embryos at the 7- to 8-cell stage or higher on Day 3 were transferred on Day 5 (Day 5; n = 40). MAIN OUTCOME MEASURE(S): Implantation rates, clinical pregnancy rates, ongoing pregnancy rates, multiple pregnancy rates. RESULT(S): No significant differences were noted in clinical, ongoing, or multiple pregnancy rates between the four groups. The implantation rate for Day 5 transfers was significantly greater than both the Laser and Acid treatment groups. CONCLUSION: The use of a 1.48-micron infrared diode laser beam provides a safe and rapid method for performing assisted hatching and did not have a negative impact on patient care when compared to outcomes achieved using acidified medium.

Adult↗

Risk of surgery after use of potassium chloride for treatment of tubal heterotopic pregnancy.

BACKGROUND: Spontaneous heterotopic pregnancies are rare, but with assisted reproductive techniques the incidence may approach 1:100. With the widespread use of transvaginal ultrasonography, physicians have attempted treatment of heterotopic pregnancies with minimally invasive procedures such as transvaginal guided potassium chloride (KCl) injection. However, there are few data on the success of this treatment. CASE: A 30-year-old primigravida presented with a desired pregnancy and was found to have a tubal pregnancy in addition to an intrauterine pregnancy. Ultrasound-guided KCl injection into the heterotopic pregnancy was complicated by abdominal pain, surgical abdomen, and hemoperitoneum requiring salpingectomy. CONCLUSION: A review of the literature revealed that 55% of tubal heterotopic pregnancies treated by KCl injection required subsequent salpingectomy. This raises concerns about the advisability of this treatment.

Adult↗

Selective modulation of sex steroids.

Recent evidence suggest that Sex Steroid Therapy involving estrogen while beneficial, may have adverse effects as well. Both of the known estrogen receptors, estrogen receptor-alpha (ER-alpha) and estrogen receptor-beta (ER-beta) have been found in reproductive tissues as well as bone, liver, and brain. These receptors are important targets for endogenous estrogen, estrogen replacement therapy and pharmacological estrogen agonists allowing specific modulation of sex steroids. This article will review the basic mechanisms of sex steroid biosynthesis and detail our current understanding of the action of these hormones on specific hormone responsive tissues. The properties of tibolone, a synthetic steroid will be outlined and its mechanism reviewed.

Estrogen Replacement Therapy↗