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Biomedical subjects

L Pilka

Publications and source records attributed to L Pilka.

At least 19 recordsLinked to original sources
PubMed2005

[Does oocyte retrieval influence the following morphological quality of embryos?].

OBJECTIVE: To verify that the number of retrieved oocytes influence the following morphological quality of transferred embryos and the success of IVF treatment. DESIGN: A retrospective study. SETTING: Clinic of assisted medicine and gynecology, Zlin. METHODS: By observing the collection is composed of 837 IVF cycles with embryotransfer, which were practised between June 2002 and December 2004. To observe the number of retrieved oocytes, following morfological quality of transferred embryos, (number of clinical pregnancies). RESULTS: We found that in cycles with more retrieved oocytes (7 oocytes and more), there were embryos of first morphological quality transferred significantly more frequently (59.2% cycles, p < 0.001) than in cycles with 1-6 retrieved oocytes. Morphologicaly abnormal embryos were found in cycles with more retrieved oocytes (7 oocytes and more) and transferred significantly less frequently (13.1% cycles, p < 0.001) than in cycles with 1-6 retrieved oocytes (34.8% cycles). We have found that on the retrieval of 16-18 oocytes, there were embryos of first morphological quality transferred in 67.4% cycles of treatment (p = 0.002). The number of cycles with transferred morphological abnormal embryos is decreasing in relation with increase of oocyte retrieval (p = 0.002). Most of clinical pregnancies were achieved in IVF cycles with retrieval of 16-18 oocytes (clinical pregnancies was achieved in 50.0% cycles, p < 0.001). CONCLUSION: The results show that the number of retrieved oocytes was influenced following morphological quality of transferred embryos. In IVF cycles with more retrieved oocytes there are transferred embryos of first morphological quality more frequently. These embryos have higher implantation potential. The number and quality retrieved oocytes are possibly more effective with type and dosing of hormonal stimulation, which should be suitable for every patient.

Adult↗
PubMed2003

[Oocyte donation: ethical and practical questions].

AIM OF THE STUDY: This review will summarize the current view on ethical and practical aspects involved in ovum donation. STUDY DESIGN: Literature review. INSTITUTION: Center of Reproductive Medicine, Zlín; Department of Gynecology and Obstetrics, Palacký University, Olomouc. CONCLUSION: Today there are three possible ways of recruiting ovum donors: 1) volunteer ovum donors, 2) related donors (searched by couples in need), 3) in vitro fertilization patients (egg-sharing).

Female↗
PubMed2003

[Pregnancy and delivery after traumatic panhypopituitarism].

OBJECTIVE: We describe a case of 23 years old woman who, with a history of car accident at the age of 11 and severe head injury, attended our Center of Reproductive Medicine complaining of primary infertility. The accident preceded menarche and the development of inner genitalia (uterus 46 mm, cervix:corpus ratio 1:1) as well as secondary sexual development was not fully accomplished. Ovarian failure was accompanied by amenorrhea, if not substituted. Under replacement therapy regular menstruation was established. Basal hormonal levels was extremely low (FSH and LH 0.2-0.3 IU/l, PRL 0.5 ng/ml, estrogens 0.08 nmol/l, PRGE was not detected). With oral administration of micronized estradiol (Check et al., 2001) endometrial thickness of 9 mm was achieved. All of five retrieved oocytes were fertilized with partner sperm (normospermy) and three embryos were transferred. Already the first attempt was successful. Patient suffered with transitional anorexia and vomiting which could be handled conservatively. Hormonals level were normal. Patient substituted with Hydrocortison and Euthyrox. On January 2, 2003 the pregnancy was finished by caesarian section, one week before the delivery term (girl, 2970, Apgar score 10-10-10). DESIGN: Case report. SETTING: Center of Reproductive Medicine, Zlin. CONCLUSION: This care report demonstrates that recent progress in assisted reproduction field enables to manage successfully even exceptional pathological conditions.

Adult↗
PubMed2002

[Legal and ethical problems in assisted reproduction--case report].

OBJECTIVE: The objective of the study is to evaluate legal and ethical aspects of the assisted reproduction in the Czech Republic. These aspects are described in the context of the concrete case. DESIGN: Case report. SETTING: Department of Social Medicine, Medical and Health Care Administration Faculty of the Masaryk University, Brno and Centre of the Reproductive Medicine Zlín. SUBJECT AND METHOD: The description of the concrete case that happened in the Czech Republic. A widow asked for the artificial insemination using the sperm of her deceased husband. CONCLUSION: It was concluded that there is absolutely insufficient legal regulation of the assisted reproduction techniques, it does not respond to the development of the medical knowledge and it responds insufficiently to the ethical dilemmas concerning the assisted reproduction.

Bioethical Issues↗
PubMed1998

A comparison of three preinduction cervical priming methods: prostaglandin E2 gel, Dilapan S rods and Estradiol gel.

The aim of the study was to evaluate the efficacy of three cervical priming methods. From January 1, 1994 to December 31, 1996 247 patients presenting an indication for induction of labor with an unripe cervix were randomly assigned to one of the following preinduction protocols: 0.5 mg of Prostaglandin E2 gel administered intracervically (n = 83), four hygroscopic Dilapan S rods applied intracervically (n = 82), and 150 mg of Estradiol gel administered intravaginally (n = 82). The inclusion criteria were the patient's informed consent, singleton pregnancy of more than 36 weeks, cephalic presentation, Bishop score < 5 points and reactive non-stress test. If the cervical maturation (Bishop score > or = 5, and/or Bishop score augmentation by 2 points) did not occur after 14 hours of priming, the case was considered a failure. In the opposite case the patient was induced by means of extraamniotic PGE2 administration. The mean gain in the Bishop score was 3.7 points in the PGE2 group 3.9 points in the Dilapan S group, and 2.8 points in the Estradiol group. 71 patients (85.5%) were successfully preinduced in the PGE2 group, 73 (89.0%) in the Dilapan S group, and 63 (76.8%) in the Estradiol group. Labor was induced by preinduction only in 23 patients (31.3%) of the PGE2 group in 17 (20.7%) of the Dilapan S group, and in 14 (17.1%) of the Estradiol group. The mean induction to delivery interval was 7 h 27 min in PGE2 group, 7 h 49 min in the Dilapan S group and 9 h 15 min in the Estradiol group. The Caesarean section rate was 24.4% in the PGE2 group, 10.5% in the Dilapan S group, and 24.4% in the Estradiol group. PGE2 gel and Dilapan S rods proved higher efficacy than Estradiol gel. The highest frequency of labor induced by preinduction only was in the PGE2 group. There were shorter induction to delivery intervals in the PGE2, and Dilapan S groups. The lowest Caesarean section rate was in the Dilapan S group. Neither serious side effects nor negative neonatal outcome were noted in either group.

Adult↗
PubMed1998

[The National Register for Assisted Reproduction: results and analysis of complications].

1. Analysis of achieved results of assisted reproduction provides evidence of a steadily increasing success of ART methods in the Czech Republic. 2. Analysis of results and complications makes it possible a) to prove optimal therapeutic procedures in different groups of patients b) to recommend preventive measures to avoid complications c) assess possible side-effects on women and the foetus.

Czech Republic↗
PubMed1997

[Direct and indirect detection of Chlamydia in infertile married couples in the assisted reproduction program].

The authors pay attention to the relationship of pregnancy in women enlisted in the IVF programme and the detection of Chlamydia infection. A group of 74 infertile couples were investigated. A significant relationship was found between confirmed Chlamydia infection in women and men. Moreover a significant relationship was found between Chlamydia infection confirmed by immunofluorescence in men and impregnation in women in the IVF programme. This means that in female partners of men with acute Chlamydia infection the results of IVF are less successful. The authors recommend that all couples enlisted in the IVF programme should be examined for this infection and if it is positive given adequate treatment.

Chlamydia Infections↗
PubMed1997

[Hemostasis using vasopressin analogs during conization of the uterine cervix and minor vaginal operations].

Peroperative haemorrhage is a frequent complication of conization of the portio uteri by surgery-by a "cold knife" scalpel or another method (LEEP, laser, etc.). In a clinical study comprising 41 patients with the diagnosis CIN I-III or laceration of the portio uteri classical conization by means of a scalpel was made with concurrent haemostasis with terlipressin (TLP) by paracervical administration (400 micrograms-REMESTYP 2 amp.). Concurrently the blood loss in ml was followed, the Hb level and other effects of the preparation. From the results ensues that side-effects after local administration of TLP were observed only in 12.2%. Peroperative blood losses were on average under 15 ml. Local paracervical TLP administration appears effective from the clinical aspect with regard to the low frequency of side-effects and the favourable haemostatic effect.

Blood Loss, Surgical↗
PubMed1996

[Induction of cervix ripening with hydrophilic Dilapan rods in pregnancy at term].

During the period between July 1, 1993 and July 31, 1994 the authors preinduced 52 pregnant women in term using the cervical dilatator Dilapan. The group comprised patients with single pregnancies > 38 weeks, vertex presentation, cervical score < 5 and reactive NST. They introduced into the cervical canal 4 Dilapan rods for 12-18 hours and after extraction of the rods, depending on the finding, the patients were induced with Prostaglandin e.a. or oxytocin i.v. The preinduction was successful in 46 patients (88.5 per cent), in 16 patients (30.8 per cent) uterine contractions were induced by Dilapan alone. Forceps delivery was performed 4 times (7.7 per cent) and Caesarean section 12 times (23.1 per cent). Apart from pain in the hypograstrium resembling menstruation pain, no side-effects were recorded. There were no irregularities such as the length of labour stages, blood loss due to injury during labour and the incidence of neonatal hypoxia. Based on the described experience Dilapan can be recommended as a preinduction method for maturation of the portio uteri.

Adult↗