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M Dorta

Publications and source records attributed to M Dorta.

30 records · Page 2Linked to original sources
PubMed1989

Enhanced preovulatory progesterone levels in clomiphene citrate-induced cycles.

We measured basal body temperature, cervical mucus, follicular diameter, and serum LH, FSH, 17 beta-estradiol, and progesterone daily in 40 spontaneous ovulatory cycles in 27 infertile women and in 40 clomiphene citrate-induced ovulatory cycles in 31 women. The cervical score was significantly lower and the serum FSH, LH, and 17 beta-estradiol levels were significantly higher during the follicular phase in induced compared with spontaneous cycles. Serum progesterone was significantly higher on the 3 days preceding ovulation and the day of ovulation in the induced cycles. These increased preovulatory serum progesterone levels could contribute to the lower cervical mucus score in the induced compared with spontaneous cycle, whereas their effect on the endometrium is still unclear.

Adult↗
PubMed1989

Pregnancies in septate uteri: outcome in relation to site of uterine implantation as determined by sonography.

Sonography was used to study the site of uterine implantation of 12 pregnancies in eight patients with complete septation of the uterus. The purpose was to determine the incidence of septal implantation in these patients and its relation to the outcome of the pregnancies. The live-birth rate in the 12 pregnancies was 33%. Three pregnancies (25%) went to term and ended in live neonates. One (8%) resulted in a premature delivery and the neonate survived. Eight (67%) ended in abortion. Sonograms showed that in all four pregnancies that were not aborted, implantation was in the lateral wall of the uterus. In comparison, in the eight pregnancies that terminated in abortion, implantation was septal in six, mixed in one, and undetermined in one. Our experience with this small group of patients suggests that pregnancies in septate uteri have a poor prognosis and that abortion is related to septal implantation.

Adult↗
PubMed1989

Magnetic resonance evaluation of double uteri.

A total of 18 infertile patients with hysterosalpingographic diagnosis of bifid uterus underwent magnetic resonance imaging (MRI) and subsequent laparoscopy or laparotomy to evaluate the capability of MRI to differentiate among the various classes of the malformation. Magnetic resonance imaging identified both bicornuate uteri correctly, both didelphic uteri, nine of the 12 partial septate uteri, and both complete septate uteri. The method demonstrated a sensitivity of 100% and a specificity of 78.6% in demonstrating cervical prolongation of the spur. Compared with laparoscopy, MRI is less expensive and less invasive, and can also be performed in patients with extensive adhesions. However, it has the disadvantage of not providing information on tubal conditions or on the presence of minimal and mild endometriosis.

Evaluation Studies as Topic↗
PubMed1988

Prediction and self-prediction of ovulation in clomiphene citrate-treated patients.

We studied 15 infertile patients for a total of 25 cycles in order to compare the predictive value of the following parameters in timing ovulation: basal body temperature (BBT), cervical mucus, serum E2 and LH, follicular growth as shown by ultrasonography, and urinary LH. The patients themselves tested urinary LH at home using Clearplan kits. BBT had low value as a predictive test for the time of ovulation, whereas ultrasonography had a predictive value of 9%, serum E2 50%, cervical mucus 59%, serum LH 63.6% and Clearplan kits 63.6%. The best predictive reliability in timing ovulation was obtained by considering both serum LH and E2 measurements. The Clearplan kits were as reliable as serum LH measurements and have greater practical advantages.

Adult↗
PubMed1988

Ultrasonography in the differential diagnosis of "double" uteri.

A total of 43 infertile patients with hysterosalpingographic diagnosis of bifid uterus underwent sonography and subsequent laparoscopy/hysteroscopy to evaluate the capacity of ultrasound to demonstrate the peritoneal profile of the malformed uteri correctly. Sonographic visualization was adequate in 39 cases (90.7%) and the following were identified correctly: 1 of 2 didelphic uteri, all of 11 bicornuate uteri, all of 4 complete septate uteri, and all of 22 partial septate uteri. The sensitivity of ultrasound in detecting the presence of a perimetrial fundal notch was 92.3% and its specificity 100%. Thus, a precise differential diagnosis of "double" uteri was possible with this technique, which may in some clinical situations provide an alternative to laparoscopy.

Endoscopy↗
PubMed1988

Structural and ultrastructural patterns of the human preovulatory endometrium following clomiphene citrate treatment.

To investigate ultrastructural modifications in the endometrium of women receiving clomiphene citrate (CC) treatment, we performed endometrial biopsies in the preovulatory phase in 17 patients with anovulatory infertility and 16 normo-ovulating women with tubal or male sterility. Histology, scanning and transmission electron microscopy (SEM and TEM) revealed midproliferative phase aspects in 11.7% of the treated group and 6% of the controls, late proliferative aspects in 76.4% and 82%, and postovulation days 1-3 characteristics in 11.7% and 12% respectively. No significant differences were observed between the patients and controls; our data indicate that CC taken in a dose not exceeding 100 mg/day from day 3 of the cycle can induce endometrial maturation that is almost identical with that of a spontaneous preovulatory phase. This type of endometrium should therefore allow implantation of a fertilized egg and maintain unmodified the complex biohumoral relations with the embryo.

Clomiphene↗
PubMed1988

Ultrasound in the diagnosis of subclasses of unicornuate uterus.

Fourteen infertile women with hysterographic diagnoses of unicornuate uterus underwent pelvic ultrasonography and, subsequently, laparoscopy to evaluate the ability of ultrasound to diagnose the subclasses of this malformation. Seven women underwent laparotomy to remove a rudimentary horn. Ultrasound demonstrated a sensitivity of 85.7% and a specificity of 100% in diagnosing the presence of a rudimentary horn, and a sensitivity of 80% and a specificity of 100% in diagnosing the presence of a cavity in the rudimentary horn. Urography confirmed the supplementary information on the urinary tract provided by ultrasound. Ultrasound appears to have a role in the clinical management of women with unicornuate uterus.

Female↗
PubMed1987

Reproductive performance of women with unicornuate uterus.

The reproductive history of 19 women with a diagnosis of unicornuate uterus confirmed by laparoscopy or laparotomy is analyzed. The patients were followed for 2 to 10 years. One patient had a cavitary communicating rudimentary horn, four a cavitary noncommunicating rudimentary horn, seven a noncavitary rudimentary horn, and seven no rudimentary horn. Six of the patients presented with primary infertility. The other 13 women had a total of 29 pregnancies, 1 (3.4%) in a rudimentary horn determining rupture; abortions occurred in 17 (58.6%), premature labor in 3 (10.3%), and term births in 8 (27.6%), with a live birth rate of 38%. Of the 11 births, 6 (54.5%) were breech presentations, and 9 (81.8%) were cesarean sections. In five cases the rudimentary horn was removed, with associated salpingooophorectomy in three patients. Cervical cerclage was not performed in any of the patients.

Abortion, Spontaneous↗
PubMedDate not supplied

Simultaneous intra- and extrauterine pregnancy after multiple ovulation induction.

Superovulation was induced by combined treatment with a GnRH analog, hMG and hCG in a 31 years old nulligravida with a diagnosis of unexplained infertility. She developed a mild hyperstimulation syndrome for which she received conservative treatment in hospital, and she was discharged only after we demonstrated a gestation sac in utero with evident fetal heart beat and beta hCG assays were positive. One week later the patient was readmitted urgently with acute abdominal pain. Laparoscopy revealed a left tubal pregnancy with corpus luteum on the right ovary and free blood in the pouch of Douglas. Salpingotomy was therefore performed with dilatation and curettage of the uterine cavity. Histological examination confirmed the presence of contemporary intra- and extrauterine pregnancy. Based on this first communication, a high index of clinical suspicion for an extrauterine pregnancy is warranted in all patients undergoing superovulation even after a pregnancy in utero has been demonstrated.

Adult↗
PubMedDate not supplied

Effects of clomiphene citrate on cervical mucus: analysis of some influencing factors.

A multicenter study was performed to investigate the effects of a standard dose of clomiphene citrate (100 mg/day from day 5 of the cycle for five days) on the quality of cervical mucus. A total of 82 cervical mucus samples from 60 infertile patients (15 with secondary amenorrhea, 16 with delayed ovulation, 15 with anovulatory cycles, 14 with oligomenorrhea) was examined on the day of maximum follicular diameter. As a control we studied 54 cervical mucus samples from 47 patients with documented tubal sterility or infertile partners, who had spontaneous cycles with normal rhythm. Cervical mucus was unfavorable in 59% of the treatment cycles compared with 11% of the control cycles. Clomiphene citrate's antiestrogenic effect on cervical mucus was found to be related to the length of time between the last drug administration and the day of maximum follicular diameter (delta days), since cervical mucus was favorable in 64% of the cycles with a delta days more than 6 and in only 16% of the cycles with a delta days of 6 or less. Clomiphene citrate thus seems able to decrease cervical mucus quality. This could be one of the causes of the discrepancy between the rates of ovulation and pregnancy reported in patients treated with this drug.

Adult↗
PubMedDate not supplied

Sonographic evaluation of uterine morphology: a new scanning technique.

Through sonographic sections with mid-empty bladder it is possible to evaluate all uterine biometric data. This technique was evaluated in thirty-four cases of uterine malformations and satisfactory results were obtained in thirty-two of them. If further studies on randomized patients confirm the specificity of this technique, it could become a basic non invasive investigation for the screening of uterine malformations.

Diagnosis, Differential↗