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Biomedical subjects

K Sharif

Publications and source records attributed to K Sharif.

At least 37 records · Page 2Linked to original sources
PubMed2001

Assessment of early cleaving in vitro fertilized human embryos at the 2-cell stage before transfer improves embryo selection.

OBJECTIVE: To determine the most viable embryos for transfer. DESIGN: Study 1: Preselection of early-cleaving 2-cell embryos for transfer. Study 2: Alternating weeks during which preselection was performed and not performed. SETTING: ART program, Birmingham Women's Hospital, Birmingham, United Kingdom. PATIENT(S): Patients undergoing IVF or ICSI cycles with transfer on day 2. INTERVENTION(S): Culture of all fertilized embryos. MAIN OUTCOME MEASURE(S): Number of fertilized embryos cleaving to the 2-cell stage on day 1, embryo quality, implantation rates, and pregnancy rates. RESULT(S): Patients with early-cleaving 2-cell embryos had significantly higher pregnancy and implantation rates (45 of 100 [45.0%] and 58 of 219 [25.5%], respectively) than did patients without early-cleaving 2-cell embryos (31 of 130 [23.8%] and 43 of 290 [14.8%], respectively). In weeks during which preselection was used, the overall pregnancy and implantation rates of the clinic improved. CONCLUSION(S): The presence of early-cleaving 2-cell embryos improves a patient's chance of achieving pregnancy. Use of more stringent embryo selection criteria can improve overall pregnancy rates.

Adult↗
PubMed2001

Blastocyst transfer for patients with multiple assisted reproduction treatment failures: preliminary experience.

This preliminary study reports the results obtained from a patient group in which blastocyst culture and transfer were performed, and discusses the advantages and disadvantages of introducing blastocyst transfer in a clinic. Twenty-six patients who had failed to achieve a pregnancy in previous in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatments were offered the choice of a fresh cycle with culture to the blastocyst stage. Of the 26 patients who elected to attempt blastocyst culture, 11 opted to have transfer on day 2 or day 3 due to low numbers of embryos. Of the 15 patients who proceeded to blastocyst culture, 46.2% of the embryos cultured reached the blastocyst stage or later and eight of the patients achieved a clinical pregnancy. More oocytes were collected in this patient group, hence the chances of obtaining blastocysts were higher. Offering blastocyst culture to patients with a reasonable chance of success who have had previous multiple assisted reproduction failures is an acceptable way of introducing blastocyst culture into practice.

Adult↗
PubMed2001

Should ICSI be the treatment of choice for all cases of in-vitro conception? Considerations of fertilization and embryo development, cost effectiveness and safety.

There is now considerable discussion whether intracytoplasmic sperm injection (ICSI) should be used in all cases of IVF. A critical and balanced view of the current literature is presented. The difficult question is how to identify men with apparently normal semen who are likely to fail to achieve a pregnancy using IVF. In conclusion, from both the safety and scientific viewpoint, ICSI should only be used in cases where success at IVF is regarded as unlikely.

Blastocyst↗
PubMed1999

The baby makers

Explore the source record for details and available documents.

Journal Article↗
PubMed1999

A controlled comparison of ovarian response to controlled stimulation in first generation Asian women compared with white Caucasians undergoing in vitro fertilisation.

OBJECTIVE: To compare ovarian response to controlled stimulation among Asian women from the Indian sub-continent and white Caucasian women undergoing in vitro fertilisation (IVF). DESIGN: Nested case-control study. SETTING: Assisted Conception Unit, Birmingham Women's Hospital. SAMPLE: One hundred and eight first generation Asian patients (born in the Indian sub-continent) and 216 white Caucasian controls, all of whom received IVF treatment in the period 1994 to 1997, were selected for the study. The two groups were matched for age to within one year, early follicular phase follicle stimulating hormone, indication for treatment, gonadotrophin dose and year of treatment. The outcome of treatment was not known when the controls were selected. RESULTS: There was no statistically significant difference between the two groups in the duration of stimulation, egg number, number of embryos produced, fertilisation rate, clinical pregnancy rate, miscarriage rate, cycle cancellation rate and implantation rate. CONCLUSION: Under the same IVF protocol Asian women's response to controlled ovarian stimulation and IVF outcome are comparable to their white Caucasian peers.

Adult↗
PubMed1998

Is bed rest following embryo transfer necessary?

OBJECTIVE: To evaluate the effect of no bed rest following ET on the results of an IVF program. DESIGN: Historical cohort-control study. SETTING: A University-based assisted conception unit. PATIENT(S): One thousand and nineteen (1019) IVF cycles were performed at our unit from June 1994 to August 1996. The historical control consisted of all the 19,697 IVF cycles reported in the United Kingdom national database from April 1994 to March 1995. INTERVENTION: No bed rest following ET in our patients. MAIN OUTCOME MEASURE(S): Pregnancy rate (PR) and clinical PR per cycles started and per ET procedure. RESULT(S): The clinical PR per ET was significantly higher in our patients than in the national data (30% versus 22.9%), as was the clinical PR per cycle (23.5% versus 18.6%). The implantation rate in our patients was 17.2%. CONCLUSION(S): The favorable PR in our patients despite no bed rest following ET suggests the bed rest is not necessary.

Bed Rest↗
PubMed1998

Term delivery in a woman with severe congenital neutropenia, treated with growth colony stimulating factor.

The patient was diagnosed in childhood as having severe congenital neutropenia and had recurrent admissions with severe infections. In 1987, prior to getting married, she was sterilized. She continued to require i.v. antibiotics when she contracted a severe infection. On one occasion, she was treated with growth colony stimulating factor (G-CSF). Her increased neutrophil count was sustained following this treatment. In June 1993, she wished to start a family and underwent in-vitro fertilization (IVF) treatment. G-CSF was given prior to oocyte retrieval. She conceived on her first cycle and an ultrasound scan revealed a singleton pregnancy. Throughout the course of the pregnancy, her white cell count was monitored closely and remained at <1.0x10(9)/l. The pregnancy progressed uneventfully and at 37 weeks gestation she was admitted for G-CSF injections. At 38 weeks she was delivered of a boy weighing 3350 g, by elective Caesarean section. His white cell count was normal. This is the first case of G-CSF being used before conception and during pregnancy in a patient with congenital neutropenia. It shows that advances in cytokine therapy and close interdisciplinary liaison can lead to a successful outcome and help patients, who would otherwise remain childless, to achieve a family.

Adult↗
PubMed1998

Nurses performing embryo transfer: the development and results of the Birmingham experience.

Although in-vitro fertilization treatment is doctor-led, many of its steps are performed by nurses. The embryo transfer step, however, is performed exclusively by doctors in the majority of units. In our unit, doctors performed embryo transfers from June 1994 until December 1995 (period I). From January 1996 until May 1997 (period II) the nurses, after appropriate training, performed the procedure. When they experienced difficulties during the mock transfer performed immediately before the real transfer, or if they were not available to do the procedure, a doctor performed it. In period I, 488 embryo transfers were performed (all by doctors), with a pregnancy rate per transfer of 35% and an implantation rate of 16%. In period II, 522 embryo transfers were performed. Nurses performed 371 (71%) and doctors 151 (29%) of the procedures. The pregnancy rate per nurse-transfer was 40.2% and per doctor-transfer 41%. The corresponding implantation rates were 16.9% and 17%. None of these differences were statistically significant (P > 0.05). These data indicate that, with appropriate training and medical back-up, nurses can perform the majority of embryo transfers with ease and outcome comparable to that of doctor embryo transfer.

Embryo Implantation↗
PubMed1998

Reducing the dose of gonadotrophin-releasing hormone agonist on starting ovarian stimulation: effect on ovarian response and in-vitro fertilization outcome.

The aim of this study was to examine if lowering the dose of gonadotrophin-releasing hormone agonist (GnRHa) on starting ovarian stimulation could be beneficial in in-vitro fertilization (IVF) programmes. A total of 64 normally ovulating patients entering an IVF programme were randomized to receive GnRHa (nafarelin acetate/Synarel) as an intranasal spray commencing in the midluteal phase, either at a dosage of 200 microg three times daily until the day of human chorionic gonadotrophin (HCG) administration, or to be reduced to 200 microg twice daily as ovarian stimulation was initiated. Patients in both groups were below 35 years with a body mass index below 30. All patients received three ampoules of Metrodin HP per day. Blood samples were taken on the day of HCG administration to measure luteinizing hormone (LH), oestradiol, and progesterone. LH and oestradiol were found to be significantly higher in the lower Synarel dose group. Our results show that reducing the GnRHa dose during ovarian stimulation in IVF might be beneficial in terms of significantly more oocytes recovered, and significantly greater number of embryos available for transfer and freezing, with no incidence of premature luteinization.

Adult↗
PubMed1998

Age and basal follicle stimulating hormone as predictors of in vitro fertilisation outcome.

OBJECTIVE: To examine the relative effect of basal follicle stimulating hormone (FSH) concentration and the woman's age on predicting the ovarian response to gonadotrophin stimulation, normal fertilisation rate and pregnancy rate in in vitro fertilisation (IVF) treatment following pituitary desensitisation. DESIGN: Descriptive cohort study. PARTICIPANTS: Three hundred and forty-four women undergoing their first IVF cycle. METHODS: Basal (menstrual-day 3) FSH concentration was measured and the woman's age calculated before she underwent pituitary desensitisation followed by gonadotrophin ovarian stimulation and IVF treatment. MAIN OUTCOME MEASURES: Cancellation rate due to poor ovarian response, total dose of gonadotrophin required to achieve follicular maturity, number of oocytes collected, normal fertilisation rate and pregnancy rate were compared between banded values of the variables studied. RESULTS: Increasing basal FSH concentration was associated significantly with increased cancellation rate, but increasing age was not. Both increasing basal FSH and age were associated significantly with increased total gonadotrophin dose, and reduced number of oocytes collected and pregnancy rate. Analysis of variance showed that the association for basal FSH with the number of oocytes was significant, independent of, and stronger than the effects of age. Logistic regression analysis showed that age, but not basal FSH, was independently associated with pregnancy rate. Neither basal FSH, nor age had significant association with normal fertilisation rate. CONCLUSION: Basal FSH concentration is a better predictor of cancellation rate and of the number of oocytes collected in IVF treatment than age, but age is a stronger predictor of pregnancy rate.

Adult↗
PubMed1997

Regression of myopia induced by pregnancy after photorefractive keratectomy.

BACKGROUND: We evaluated refractive corneal changes that occurred in women who become pregnant after undergoing excimer laser photorefractive keratectomy (PRK) for the treatment of myopia. METHODS: Refractive results of 18 eyes of nine women who underwent PRK and became pregnant during the follow-up period were reviewed. All eyes were followed for a least 12 months after PRK. Subjective refraction, slit-lamp microscopy, and intraocular pressure were measured at each follow-up examination. RESULTS: Twelve of 18 eyes (66%) had myopic regression during the follow-up period. The regression was associated with 1+ to 2+ corneal haze in 10 of these 12 eyes (83.3%). The three women (6 eyes) who had stable refractions after PRK became pregnant at least 5 months postoperatively. The corneal haze and the associated myopic regression improved in 50% of the eyes after delivery. CONCLUSION: Pregnancy seems to induce effects on corneal wound healing following PRK.

Adult↗
PubMed1997

Madelung deformity as a feature of the Leri-Layani-Weill syndrome or dyschondrosteosis.

We report and discuss a case of a Madelung's deformity seen on a wrist roentgenogram of a young girl who is referred for short stature evaluation, which led to the diagnosis of Léri-Weill syndrome or dyschondrosteosis. The authors stress that it is possible to make an accurate diagnosis on a single standard roentgenogram, at low cost, if the different diagnostic criteria are known.

Adolescent↗
PubMed1996

Glomerular epithelial protein 1 and podocalyxin-like protein 1 in inflammatory glomerular disease (crescentic nephritis) in rabbit and man.

The podocyte is the cell responsible in large part for maintaining the glomerular filtration barrier. Glomerular epithelial protein 1 (GLEPP1) is a novel receptor-like transmembrane protein tyrosine phosphatase present on the apical surface of podocyte foot processes. Podocalyxin-like protein 1 (PCLP1) is a transmembrane sialoglycoprotein which is also present on the foot process apical surface as well as on the surface of endothelial cells. GLEPP1 and PCLP1 are thought to play a role in regulating the structure and function of podocyte foot processes. Glomerular injury affecting the podocyte is likely to be reflected by changes in these proteins. GLEPP1 distribution in human renal biopsy with inflammatory glomerular disease and crescent formation was examined by immunocytochemistry. A model of inflammatory glomerular injury induced by guinea pig anti-rabbit basement membrane (anti-GBM) antibody was used to examine the distribution and amount of GLEPP1 and PCLP1 mRNA and protein. A biopsy study was done to determine whether the extent of GLEPP1 depletion from glomeruli at early time points (Day 7) would predict the severity of crescent formation at Day 30. Glomeruli from human renal biopsies with crescentic nephritis showed focal to diffuse disappearance of GLEPP1 protein. No GLEPP1 was present within the cellular crescent. By Day 4 of the rabbit anti-GBM model, before cellular crescents had formed, GLEPP1 protein was reduced from 127 +/- 28 X 10(7) to 30 +/- 5 X 10(7) molecules per glomerulus (p < 0.001), and GLEPP1 mRNA was reduced by 62% (p < 0.05). In contrast, at this time there was no significant reduction of PCLP1 protein from the normal number of 309 X 10(9) molecules per glomerulus and the PCLP1 mRNA level had not decreased. At Day 4, podocyte foot processes were effaced and proteinuria was present. Glomerular culture supernatants from Day 4 rabbits caused a reduction in GLEPP1 but not PCLP1 protein expression by cultured normal glomeruli, showing that a soluble factor was produced at Day 4 which reduced the number of GLEPP1 molecules in glomeruli. There was no detectable proteolysis of GLEPP1 or PCLP1 in glomeruli and no increase in GLEPP1 or PCLP1 excretion in urine. Therefore, the reduction in glomerular GLEPP1 was associated with reduced synthetic capacity. The proportion of glomeruli with reduced GLEPP1 at Day 7 of the model was significantly associated with the percent of glomeruli which had formed crescents at Day 30 (r = 0.86, p < 0.0001). GLEPP1 appears to be a sensitive indicator of glomerular injury during inflammation in man and in the rabbit model. A reduction in amount of GLEPP1 is associated with worse outcome for the glomerulus.

Animals↗
PubMed1996

Transmyometrial embryo transfer after difficult immediate mock transcervical transfer.

OBJECTIVE: To evaluate the place of ultrasound-directed transvaginal transmyometrial ET in a protocol using both the transcervical and transmyometrial routes in a step-wise fashion. DESIGN: A prospective descriptive clinical study. SETTING: A university-based assisted conception unit. PATIENTS: Thirteen patients who had difficult or impossible mock transcervical ET immediately before the real transfer. INTERVENTION: Ultrasound-directed transvaginal transmyometrial ET. MAIN OUTCOME MEASURES: Pregnancy and clinical pregnancy. RESULTS: Four patients became pregnant, including three with clinical pregnancies. CONCLUSIONS: In cases in which transcervical ET isd difficult or impossible, transvaginal transmyometrial ET is a viable option. The use of mock transcervical ET immediately before the real transfer would identify patients needing transmyometrial ET.

Cervix Uteri↗
PubMed1995

Do patients need to remain in bed following embryo transfer? The Birmingham experience of 103 in-vitro fertilization cycles with no bed rest following embryo transfer.

Since the early days of human in-vitro fertilization and embryo transfer, rest in bed for hours immediately following the transfer has been advocated and widely practised. However, there is no scientific validation for this practice which is both time-consuming for the patient and increases space occupancy in the hospital or clinic. We report here on a study of 103 in-vitro fertilization cycles with no bed rest in hospital following the embryo transfer. The mean number of embryos transferred was 2.7 (range 1-3) and the clinical pregnancy rate per embryo transfer procedure was 40%. These results suggest that bed rest is not necessary following embryo transfer.

Adult↗