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Biomedical subjects

L Pilka

Publications and source records attributed to L Pilka.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Aspiration of a gestational sac controlled by vaginal ultrasound in multiple pregnancy for the purpose of selective abortion].

A case of an infertile married couple by whom the cause of infertility was oligoasthenospermia of man is described. The couple was treated by intrauterine insemination by capacitated spermatozoa in a cycle stimulated by clomiphene. The ultrasonography revealed a pregnancy of triplets. The patient refused a multiple pregnancy and asked for its interruption. As an alternative we proposed the selective abortion by means of an ultrasound-guided aspiration of two gestational sacs. Description of this method and the result are the theme of our paper.

Abortion, Therapeutic↗
PubMed1990

[Gamete and embryo transfer in conjunction with microsurgical treatment of sterility].

The authors evaluate the results of the programme of transfer of gametes into the oviduct or of embryos into the uterus in conjunction with microsurgery of sterile women. During the period between August 1981 and December 1988 a total of 211 microsurgical operations were made in stimulated cycles. The ovaries were stimulated with clomiphene citrate or in combination with human menopausal gonadotropin. The operation was made 36 hours after administration of human choriogonadotropic hormone. In 146 women at least one oocyte was obtained. A total of 72 gametotransfers into the oviduct were made and in eight, i. e. 11.1%; pregnancy was achieved. Of 43 embryotransfers five pregnancies were achieved, i. e. 11.6%. A total of 13 pregnancies were achieved with four spontaneous deliveries, seven miscarriages and two extrauterine pregnancies. The combination of selected cases of microsurgery of sterility with the IVF programme increases the rate of successful operations without a further burden for the patient, and it extends the possibilities of sterility treatment.

Adult↗
PubMed1990

[The effect of low-dose pre-ovulatory progesterone administration on the outcome of in-vitro fertilization (IVF) and intra-tubal gamete transfer (GIFT)].

The influence of application of low-dose progesterone 4 hours before induction of ovulation by HCG on the outcome of IVF and GIFT was investigated in a bilateral study. The number of patients was 38 from both clinics for IVF and 36 for GIFT. With a pregnancy rate of 35.3% and 17.6% of ongoing pregnancies per transfer the results of the study are much better than before. The rather low number of patients and the low rate of transfers relativate these results. After GIFT an elevated abortion rate leads to only 11.1% ongoing pregnancies following a pregnancy rate of 33.3%. The effect of progesterone supplementation on the LH-peak and the endometrium should be further investigated to find new ways to increase success of IVF and GIFT treatment.

Adult↗
PubMed1989

[Clinical approaches and factors affecting the results of fertilization in vitro in 1987].

In 1987 at the First Gynaecological and Obstetric Clinic in Brno a total of 314 stimulated cycle were monitored as part of the IVF and ET programme. 206 cycles (65.6%) were stimulated by means of clomiphene citrate and 108 cycles (34.4%) by a combination of clomiphene with hMG. Before aspiration 76 cycles (24.2%) were abolished, incl. 60 cycles because of inadequate stimulation. Aspiration of follicular fluid was made in 147 women by the laparoscopic route, in 91 women by transvaginal aspiration, using a vaginal ultrasonic probe. Of 238 aspirations of follicular fluid in 190 women at least one oocyte was obtained, a total of 412 oocytes, i. e. 1.73 +/- 1.4 oocyte per aspiration. A total of 146 oocytes were fertilized, i. e. 35.4% and an embryo transfer was made in 98 instances. In 1987 10 pregnancies were achieved, i. e. 10.2% pregnancies per one embryo transfer. Two preclinical abortions, four clinical abortions and four pregnancies were involved which terminated by the delivery of five healthy infants. The most important factor influencing the number of pregnancies after IVF and ET is the number of transferred embryos. 5.2%, 14.7% and 25% pregnancies per one to three transferred embryos were achieved. In order to make the results of different IVF and ET centres comparable, the authors recommend to classify the achieved pregnancies as the ratio of pregnancies per number of transferred embryos, stating the ratio of different groups. For the lay public the results per aspiration of follicular fluid should be published.

Female↗
PubMed1988

The role of cumulus cell-secreted proteins in the development of human sperm fertilizing ability: implication in IVF.

Cumulus cells surrounding pre-ovulatory human oocytes were found to secrete a variety of proteins which became firmly associated with the cumulus intercellular material. Antibodies raised against human cumuli oophori completely blocked fertilization in vitro by impairing the sperm-zona pellucida interaction. A group of glycoproteins of high mol. wt were identified as the main cumulus cell secretory products. These proteins showed a marked affinity for human spermatozoa and were potent stimulators of the conversion of human and boar proacrosin into acrosin and of human sperm acrosome reaction. Another fraction of proteins of human cumulus intercellular matrix with an apparent mol. wt of approximately 25,000 daltons was also found to stimulate significantly the acrosome reaction of human spermatozoa, although this fraction had no proacrosin-converting activity. These results indicate that proteins secreted by pre-ovulatory human cumulus cells have an indispensable role in the development of human sperm fertilizing ability. This effect seems to be realized by a concerted action of different types of cumulus-derived proteins just prior to and during the sperm-zona pellucida interaction. Disorders of cumulus cell secretory activity may account for some cases of idiopathic infertility and repeated IVF failures.

Antibodies↗
PubMed1988

Zona pellucida resistance to sperm penetration before the completion of human oocyte maturation.

Human oocytes exposed to capacitated spermatozoa in vitro when at metaphase of the 1st meiotic division (metaphase I) were not penetrated, even though some subsequently progressed to metaphase of the 2nd meiotic division (metaphase II). When the non-penetrated oocytes that had reached metaphase II during the incubation with spermatozoa were freed from the zona pellucida and reinseminated, two or more pronuclei developed in most of them. By contrast, no penetration was observed when the oocytes were reinseminated in the zona-intact state. When compared with metaphase II oocytes, metaphase I oocytes had a similar zona-binding capacity for spermatozoa, but fewer spermatozoa were found within the zona. These results indicate that the zona pellucida of human oocytes undergoes important maturational changes during the transition from metaphase I to metaphase II. Ultrastructural and previous histochemical findings suggest that these changes involve secretions from both the oocyte and cumulus cells and that the increased zona resistance at metaphase I may be due to relative insufficiency of cumulus cell-secreted 'softening' factors. If the integrity of the cumulus oophorus is disturbed at this stage, this condition becomes irreversible.

Female↗