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K Rezábek

Publications and source records attributed to K Rezábek.

At least 19 recordsLinked to original sources
PubMed2006

[Assisted reproduction in patients with food intake disorders--clinical and ethical aspects].

Fertilization treatment is established therapy of infertility in the cases, where other approaches have failed or were impossible. In eating disorders, majority of fertility problems has been secondary and so fully reversible if appropriately treated. Fertilization treatment should not be used in patients refusing the psychological treatment of the illness. In patients in active phase of the illness fertility treatment at fertility are contra-indicated. Two cases of negative impact of fertility treatment in patients with anorexia nervosa are presented.

Adult↗
PubMed2005

[Delivery of a healthy child from pregnancy after IVF complicated hyperstimulation syndrome, phlebothrombosis and resection of uterine horn. Case report].

OBJECTIVE: To evaluate the negative effect of uterine horn resection for heterotopic pregnancy in the uterine horn in the first trimester on the course of pregnancy and labor. To point out the increased incidence of other complications in pregnancy after IVF+ET (ovarian hyperstimulation syndrome, phlebothrombosis of the pelvic veins). DESIGN: Case study. SETTING: Department of Obstetrics and Gynecology, 1st Faculty of Medicine, Charles University and General Faculty Hospital, Prague. METHODS: In this study, the authors analyze their experience with the course of pregnancy of a patient who had uterine horn resection for a heterotopic uterine horn pregnancy after IVF+ET. The course of pregnancy was associated with further complications such as ovarian hyperstimulation syndrome and the resulting occurence of thrombosis in the 2nd trimester of pregnancy. The pregnancy was terminated by caesarean section for the indication of prior uterine surgery-resection of the uterine horn in the first trimester. A healthy infant was delivered. CONCLUSION: This case study demonstrates the multiple occurrence of serious complications in pregnancy after IVF+ET, which are associated with ovarian hyperstimulation and the transfer of multiple embryos. The pregnancy was terminated with the delivery of a healthy term infant.

Adult↗
PubMed2004

[Thromboembolic complications in patients undergoing in vitro fertilization: retrospective clinical study].

OBJECTIVE: To determine the incidence and the type thromboembolic complications in patients undergoing in vitro fertilization (IVF). To evaluate their clinical course, the influence on reproductive outcomes, and the prevalence of thrombophilia in these women. DESIGN: Retrospective clinical study. SETTING: Assisted Reproduction Center, Department of Obstetrics and Gynecology, 1st Faculty of Medicine and General Faculty Hospital, Charles University, Prague. METHODS: The data, reflecting the diagnosis of thromboembolism (TE), were collected from all patients, who have undergone the IVF cycle in our clinic for the last 7 years. The following data were analyzed in these patients: medical history, type and course of TE, type and effect of ovarian stimulation, clinical pregnancy achievement, occurrence of ovarian hyperstimulation syndrome (OHSS), results of testing for thrombophilia, pregnancy course and outcome. RESULTS: From 2748 IVF cycles 3 cases of TE were found (0.11%). In all cases the unilateral thrombosis of internal jugular vein associated with OHSS, manifesting in 1st trimester of pregnancy and not complicated with pulmonary embolism occurred. At least two thrombophilic markers have been detected in all these women. The clinical course of TE, as well as of the whole gestation was favorable. Prevalence of TE in patients with severe OHSS was 4.1% (2 women from 49). CONCLUSION: The incidence of thromboembolism in women undergoing IVF is low. It appears almost exclusively in association with OHSS and the typical finding is deep venous thrombosis in the neck area. In our opinion, while screening of thrombophilia in all patients from IVF program is not indicated, the routine testing of most common thrombophilic markers in pregnant women with OHSS could decrease the risk of these serious complications.

Adult↗
PubMed2001

[Does bedrest after embryo transfer cause a worse outcome in in vitro fertilization?].

OBJECTIVE: To evaluate the effect of bed rest following embryotransfer (ET) on the results of an in vitro fertilization (IVF) program. DESIGN: A prospective randomized study. SETTING: Gyn.-Obst. Department--Assisted Reproduction Centre, 1st Medical Faculty of Charles University Prague and General Hospital, Prague. METHODS: After randomisation of patients on two groups (N--no bed rest, L--bed rest), embryo transfer (ET) was performed and all patients stand-up 20 minutes later. Group N went home, group L continued bed rest in the hospital overnight. We compared results of IVF in both groups. RESULTS: Both groups (N = 20 patients, L = 18 patients) were comparable in the age, number of previous IVF attempts, stimulation protocol, person performing ET, number of transferred embryos, percentage of ICSI, percentage of diagnosis "tubal infertility" and age of embryos in the day of ET. Results for group N (no bed rest) were in all parameters better than for group L: implantation rate (IR) (22.5% versus 14.5%), IR of high quality embryos (25.8% versus 16.7%), pregnancy rate (50% versus 22.2%, p = 0.08), Take-home baby rate (40% versus 11%, p = 0.07). No of results reached clear statistical significance as the study was finished for ethical reasons (worse results of more difficult therapy in group L). CONCLUSION: The overnight bed rest in the hospital following ET did not ameliorate results of IVF. There is a strong tendency to negative effect of bed rest. Similar results may be found on other authors, but they did not extend the sense of their studies to the question of negative effects of the bed rest after ET, being satisfied with the result of "no worse results after no bed rest".

Adult↗
PubMed2001

[Effect of psychological factors on success of in vitro fertilization].

OBJECTIVE: To examine the influence of psychological factors on outcome of in vitro fertilisation (IVF). DESIGN: Prospective clinical study. SETTING: Department of Gynaecology and Obstetrics, Charles University School of Medicine and General University Hospital Prague. METHODS: Sixty-six couples undergoing IVF treatment were administered psychometric tests: State-Trait Anxiety Inventory, Beck's Depression Inventory, Interpersonal Check List and Dusin Frustration Test. Results of pregnant and non-pregnant group were compared. RESULTS: We found statistically significant differences only in women. Women from the pregnant group had significantly lower scores of trait anxiety then women from the non-pregnant group (P < 0.05). Pregnant women evaluated themselves (P < 0.01) and their partners (P < 0.01) as more hostile then the non-pregnant women in the ICL. In the scores of trait anxiety, depression and frustration were not any differences. In the non-pregnant group were the women significantly more anxious (state anxiety P < 0.02, trait anxiety P < 0.01) and depressed (P < 0.05) then their partners. We didn't find these differences in the pregnant group. CONCLUSION: Women from the pregnant group had significantly lower scores of trait anxiety then women from the non-pregnant group. Those women react in IVF treatment with higher stress and this stress response decreases their chance of conception. They were not any differences between the two groups of man. We found significant differences in the interpersonal interaction. In the non-pregnant group had the women significantly higher scores of depression and both state and trait anxiety. In the ICL evaluated themselves and their partners as more affiliate then the women in the pregnant group. According our opinion adequate hostility protects the women for depression and anxiety and is better coping style.

Adult↗
PubMed2001

[Evaluation of success in assisted reproduction].

OBJECTIVE: Summarize different ways of assisted reproduction performance evaluation. DESIGN: Review. SETTING: Centre for Assisted Reproduction, Department of Gynaecology and Obstetrics, 1st Faculty of Medicine, Charles University, Prague. METHODS: In databases of assisted reproduction centres, in national and international registers we evaluate data concerning in vitro fertilisation and related methods. Target of this evaluation is, first of all, to increase efficiency. RESULTS: Outputs of all the registers inform about absolute numbers of cycles, deliveries, born babies and about relative parameters (implantation rate, pregnancy rate), describing the efficiency of the treatment. CONCLUSION: The output evaluation must consider the influence of the age of female, number of transferred embryos and other factors.

Czech Republic↗
PubMed2000

[Treatment of infertility using oocytes without the zona pellucida].

OBJECTIVE: The study of zona free oocytes fertilization using intracytoplasmic sperm injection (ICSI) with the aim to increase the pregnancy rate in the assisted reproduction. DESIGN: Pilot study. SETTING: Assisted Reproduction Centre, Gynecology Obstetrics Department of the 1st Medical Faculty and General Faculty Hospital, Charles University, Prague. METHODS: Zona free oocytes were fertilized using ICSI and cultured in standard conditions in vitro for 5 days until the blastocyst stage. Blastocysts were cryopreserved using 8% glycerol. RESULTS: The fertilization process of zona free oocyte was physiological, oocytes expulsed the polar body and in standard time, i.e. 18 hour post insemination, two distinct, morphologically normal pronuclei were apparent in cytoplasm. During early cleavage, from the first to the third day of in vitro culture, the dynamics of cell division was normal, the three-dimensional arrangement of cells was more flattened than in normal, zona intact embryo. The fourth and fifth day of culture, the morphological appearance of embryo corresponded to normal development. CONCLUSION: The fertilization of zona free oocytes using ICSI can give morphologically normal zygote and after 5 days culture in vitro these zygotes can develop into blastocyst stage. This method can increase the pregnancy rate in patients with repeatedly low number of oocytes or with defects of zona pellucida.

Adult↗
PubMed2000

[Perinatal outcome of twin pregnancies after fertilization in vitro and after spontaneous conception].

OBJECTIVE: To compare the obstetric outcome of twin pregnancies after IVF with spontaneously conceived twins and thus determine whether IVF twins require greater care. TYPE OF STUDY: A retrospective study. SETTING: The Department of Obstetrics and Gynaecology, 1st Faculty of Medicine of Charles University, Prague. METHODS: Statistical evaluation of obstetric outcome between the group of 46 twin pregnancies after IVF and 85 spontaneously conceived twins. We evaluated the following parameters: signs of abortion and premature delivery, bleeding in pregnancy, premature rupture of membranes, performed cerclage, incidence of praeclampsia, gestational diabetes mellitus and hepatopathy of the mother. Pathological ultrasound findings were also evaluated--disturbances in foetal growth and the amount of amniotic fluid. In these parameters we also evaluated the time of the first signs of their development. Further, we evaluated the type of delivery, the gestational age at delivery, birth weight, birth weight discordance and perinatal mortality. RESULTS: We found statistically significant differences in the method of delivery--more cesarean sections in the IVF group (71.7%) than in spontaneous ones (44.7%). Another difference was the gestational age at which cerclage were performed--earlier in the IVF group (average 22.8 weeks) than in spontaneous ones (average 25.7 weeks). In the other evaluated parameters we did not find any statistically significant differences between the two groups. CONCLUSION: In our retrospective analysis of twin pregnancies, deliveries and neonatal outcome, except for the method of delivery and time of performing cerclage, we did not find any important significant differences between the IVF and spontaneously conceived twins. However, it is necessary to remember the generally worse obstetric outcome of twin compared to singleton pregnancies.

Adult↗
PubMed1999

[Treatment of idiopathic sterility].

In the Centre for Assisted Reproduction of the Second Gynaecological and Obstetric Clinic, First Medical Faculty, Charles University and General Hospital Prague, during the period from 1993-1997, 900 couples were examined on account of sterility. In 8%, i.e. 72 couples the cause was not elucidated. The female patients were divided into groups by age, parity and period of sterility. In these groups the cumulative conception (CCR) was compared as well as the fecundity per cycle after three months without treatment, after three cycles of intrauterine insemination (IUI) and after three cycles of in vitro fertilization (IVF) or intracytoplasmic sperm injection into the oocyte (ICSI). In the group of patients with sterility shorter than three years, the cumulative conception rate after three months without treatment was 34.8%, after the subsequent three cycles of IUI 27.3% and after three cycles of IVF/ICSI 66.7%. In women with sterility extending over more than three years these results were significantly lower: without treatment CCR was 12.5%, when IUI was used it was 16.1% and after IVF/ICSI 40.5%. There were also marked differences in the age groups. Based on these results the authors elaborated an optimal individual therapeutic pattern. Treatment can be postponed by three months in women under 30 years and those where sterility persists for less than three years. If they do not become pregnant, 3-4 IUI cycles should be attempted. Even women where IUI fails have a fair chance to become pregnant by IVF ET. In women above 30 years with sterility lasting more than three years there the chance that they will become pregnant without treatment is only when secondary sterility is involved. IUI increases the probability of pregnancy in this group only slightly. If during stimulation before IUI more than four follicles grow, it is advisable to convert these cycles to IVF. In women above 39 years the authors recommend IVF or ICSI resp. as the method of first choice.

Adult↗
PubMed1999

[Assisted reproduction--present status and perspectives].

OBJECTIVE: To review the current status and new trends in assisted reproduction. DESIGN: The literature on intrauterine insemination, IVF, ICSI, MESA/TESE, preimplantation genetic diagnosis, cryopreservation, in vitro maturation, cloning and stem cells. SETTING: Assisted Reproduction Centre, Ist Medical Faculty of Charles University Prague and General Hospital Prague, Apolinárská 18, 128,00, Prague 2, Czech Republic. RESULTS: IUI, IVF, ICSI also in combination with MESA/TESE are widely used relatively high effective procedures. According to Czech Republic Assisted Reproduction Registry, the pregnancy rate per transfer using IVF, ICSI is 25%, 30% respectively. Cryopreservation of sperm and embryos is a basic part of assisted reproduction, the result with oocytes freezing are still not satisfactory. Preimplantation genetic diagnosis is performed in few countries only due to technical barriers and ethical restrictions. Other methods like cloning, nuclear transfer, embryotherapy or gene manipulation using embryonic stem cells are still only subjects of research. CONCLUSION: During the last ten years, assisted reproduction showed rapid development in a number of treated couples and the spectrum of used methods changed radically.

Czech Republic↗
PubMed1993

[Diagnosis and therapy in fetuses at risk in Rh isoimmunization].

The objective of the work was to evaluate the importance of antenatal examination of amniotic fluid and foetal blood in case of suspected Rh isoimmunization of the foetus. In 1991-1992 in 16 patients with a rise of the titre of anti-D antibodies to > 1:8 between the 24th and 36th week of gestation 32 punctures of the umbilicus by means of a 22 gauge needle were made under continual ultrasonic control. In two instances intraumbilical transfusion was indicated. The authors revealed that with the rising titre of anti-D antibodies in maternal blood the foetal haematocrit value in the umbilical blood declines. With the rising bilirubin level the haematocrit declines. In foetuses with a haematocrit of < 31% severe forms of jaundice are encountered more frequently with the necessity of long-term phototherapy and exchange transfusion. The authors did not find a correlation between the haematocrit of foetal blood and the bilirubinoid concentration in amniotic fluid, assessed by Liley's method. Foetuses with a haematocrit higher than 31% are not threatened by severe forms of jaundice and therefore the authors do not use transfusions in these foetuses. Based on hitherto assembled experience, the authors confirmed that cordocentesis is associated with a comparable risk as amniocentesis but provides more accurate information on the state of the foetus.

Amniocentesis↗
PubMed1990

[Fertility in gonadal dysgenesis].

At the Second Gynaecological and Obstetric Clinic in Prague there are at present 78 phenotypic women with dysgenetic gonads in dispensary care. In 61.5% the main reason for examination in a specialized department was infertility. Based on a comprehensive examination, the authors demonstrate the relationship between chromosomal complement and histology of the gonads on one side and fertility on the other. 31% of women with dysgenetic sclerocystic gonads became pregnant after surgical and hormonal treatment. In 27% of the dispensarized group genital and extragenital tumours were detected.

Female↗
PubMed1990

Reductive effect of lonazolac on lung metastasis formation in mice.

The purpose of this study was to determine the antimetastatic potential of lonazolac. Intravenous inoculation of Lewis lung carcinoma (LLC) or melanoma B-16 (B-16) cells induced macroscopically detectable lung metastases on day 15 after inoculation. After pre- and post-treatment with lonazolac-Ca at oral doses of 1, 25, and 50 mg/kg, the numbers of animals with lung metastases and the score of metastases significantly decreased. Lonazolac-Ca had similar effects also on the formation of spontaneous lung metastases. After treatment with lonazolac-Ca at oral daily doses of 1, 25, and 50 mg/kg during 8 days (LLC) or 10 days (B-16) after inoculation of the tumor cells, the number of animals developing spontaneous lung metastases and the score of metastases also decreased. Intravenous injection of lonazolac natrium was effective in protecting the mice inoculated with 1 X 10(6) melanoma B-16 cells against acute pulmonary embolic death.

Animals↗
PubMed1989

Hindering of tumor lung metastasizing with alpha-(4-cyclohexylphenyl)propionic acid in mice.

Alpha-(4-cyclohexylphenyl)propionic acid, a potent inhibitor of platelet aggregation, has appeared to reduce the quantity and size of Lewis lung carcinoma (LLC) tumor nodules in the lungs. The number of animals developing the tumor colonies in the lungs was decreased by 34% to 49% either when the tumor cells were injected i.v. and alpha-(4-cyclohexylphenyl)propionic acid was administered during 3 days, or when the tumor cells were transplanted i.m. The primary tumor was removed 6 days later and the drug administered during 8 or 21 days.

Animals↗
PubMed1987

Inhibitory action of flurbiprofen and mopidamole on tumor lung metastasis formation in mice.

Flurbiprofen, 0.25 mg/kg, administered to mice orally once daily during 3 days prior to an iv transplantation of Lewis lung carcinoma cells, protected 50%-57% of experimental animals from the formation of lung tumor colonies. With the daily dose of 1.0 mg/kg, this effect was less pronounced. Mopidamole, twice daily 90 mg/kg orally during 3 days, did not have this effect.

Administration, Oral↗
PubMed1986

Antimetastatic effect of flurbiprofen and other platelet aggregation inhibitors.

In the present study, we have examined the antimetastatic effect of flurbiprofen, a nonsteroidal antiinflammatory drug, on spontaneous metastases formation in mice bearing Lewis lung carcinoma and these results were compared with effects of other inhibitors of platelet function (mopidamole, dipyridamole, pentoxifylline). Flurbiprofen decreased significantly spontaneous metastases formation in a dose-depending manner. From the results obtained, it appears that the treatment with flurbiprofen, either on days 1-8 or days 1-21, was similarly effective. In mopidamole treated groups the number of animals with lung metastases was significantly decreased. This effect was not observed after treatment with dipyridamole or pentoxifylline.

Animals↗