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L Klentzeris

Publications and source records attributed to L Klentzeris.

6 recordsLinked to original sources
PubMed1999

A case of failed oocyte maturation in vivo and in vitro.

OBJECTIVE: To study a couple for whom all oocytes failed to mature during three attempts at IVF/ICSI treatment. Our aims were (a) to promote oocyte maturation in vitro and (b) to identify the stage of maturation arrest. DESIGN: Case report. SETTING: Infertility treatment center with academic research links. PATIENT(S): Couple with unexplained infertility. INTERVENTION(S): Exogenous gonadotropin stimulation culminating in the retrieval of eight oocyte-cumulus complexes that were exposed to gonadotropins for 24 hours in vitro. MAIN OUTCOME MEASURE(S): Observation of oocyte cumulus complexes, measurements of oocyte diameter, oocyte chromatin staining with Hoechst 33258. RESULT(S): The cumulus complexes varied in appearance and expanded in vitro, but yielded immature oocytes. Germinal vesicle breakdown occurred in all oocytes and chromatin was consistent with arrest at entry into M-phase. The oocytes were of a size normally competent to mature. CONCLUSION(S): Infertility in this couple was attributed to the failure of oocytes to enter M-phase. This was not overcome by exposure to gonadotropins in vitro nor associated with incompetence due to small oocyte size.

Adult↗
PubMed1995

Computer image sperm selection as a novel approach to subzonal insemination in the human.

Utilizing real-time computer image analysis, individual spermatozoa were selected using microaspiration. Selection criteria were based on potential hyperactivation motility characteristics; the amplitude of lateral head displacement > 7.5 microns, curvilinear velocity > 70 microns/s and linearity of < 30%. For this pilot study, 16 patients (eight in each group) were recruited. Using subzonal insemination (SUZI), up to five (mean = 4.4 +/- 0.3) spermatozoa selected using computer-image sperm selection (CISS) were micro-injected, or up to 15 (mean = 12.8 +/- 1.3 SD) unselected spermatozoa. In the group which utilized CISS, 28 out of 49 (57%) oocytes were fertilized compared with 13 out of 52 (25%) utilizing conventional SUZI (P < 0.04); polyspermy was 20% (n = 10) and 2% (n = 1) respectively. CISS with SUZI showed increased efficiency in achieving fertilization and is a novel approach to studying individual sperm function in a sperm egg bioassay where gamete ratios are close to unity.

Adult↗
PubMed1993

A study of endometrial morphology in women who failed to conceive in a donor insemination programme.

OBJECTIVE: To examine the morphology of endometrium in women who failed to conceive after nine or more cycles of donor insemination treatment. DESIGN: Prospective study. SETTING: Jessop Hospital for Women, Sheffield. SUBJECTS: Two groups: twenty-six infertile women and a control group of eight fertile women. INTERVENTION: Endometrial biopsy specimens were obtained in the mid-luteal phase, timed precisely by the luteinising hormone surge. MAIN OUTCOME MEASURE: Morphological study of endometrial biopsy specimens by the use of traditional dating criteria and established morphometric techniques. RESULTS: Twelve biopsy specimens (42%) were found to be retarded. In addition, morphometric analysis revealed significant differences in the glandular component of the endometrium between the infertile and fertile groups. CONCLUSION: Endometrial defect leading to implantation failure may be an important underlying cause of failure to conceive after repeated attempts at donor insemination. The endometrium should be investigated in this group of women, and further attempts at donor insemination treatment should be offered only in conjunction with attempts to restore the normality of the endometrium.

Adult↗
PubMed1992

How well does ultrasonographic measurement of endometrial thickness predict the results of histological dating?

In this study, transabdominal ultrasonographic measurement of endometrial thickness was performed prior to sampling of the endometrium for histological examination in regularly cycling women. In the natural cycles, the results of ultrasonography and histological dating were significantly correlated (r = 0.76, P less than 0.0001, n = 63). Endometrial histology was likely to be proliferative if the thickness was less than 8 mm, and likely to be secretory if the thickness was greater than 9 mm. However, for a given endometrial thickness, the stage of endometrial development appeared to vary widely, suggesting that ultrasonographic measurement of endometrial thickness cannot accurately predict the results of histological dating. In the second part of the study, endometrial thickness at a defined stage of histological development (results of histological dating between days LH + 4 and LH + 6) was compared in three types of cycles: natural (n = 13), clomiphene-stimulated (n = 12) and artificial (n = 22) cycles. The endometrial thickness (mean +/- standard deviation) in artificial cycles (9.9 +/- 1.3 mm) was significantly smaller than that in natural (11.3 +/- 1.4 mm) or clomiphene-stimulated (11.2 +/- 1.3 mm) cycles, but there was no difference in endometrial thickness between the latter two types of cycle. Our observations suggest that it is unlikely that ultrasonographic measurement of endometrial thickness can replace histological examination of the endometrium in the evaluation of the luteal phase.

Adult↗
PubMed1991

The variation of endometrial response to a standard hormone replacement therapy in women with premature ovarian failure. An ultrasonographic and histological study.

The endometrial response to a standard hormone replacement therapy in 18 women with premature ovarian failure was examined by serial ultrasonographic measurement of endometrial thickness and histological study of endometrial biopsy taken on day 19 of the cycle. Women with idiopathic ovarian failure (n = 10) had significantly better response than women with Turner's syndrome (n = 4), whereas women with premature ovarian failure associated with previous chemotherapy (n = 4) had an intermediate response. These observations suggest that the endometria of women with Turner's syndrome responded suboptimally to steroid hormones. However, all endometrial biopsies studied revealed secretory changes. Overall, the results of histological dating of endometrial biopsy were found to be positively correlated with endometrial thickness on day 19 of the cycle (r = 0.72, P less than 0.01). The plasma concentration of oestradiol on days 15, 19 and 29 of the artificial cycle were found to be significantly higher than those on the corresponding days of the natural cycle.

Endometrium↗