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Biomedical subjects

M L Taymor

Publications and source records attributed to M L Taymor.

At least 37 records · Page 2Linked to original sources
PubMed1984

Bromocriptine response in normoprolactinemic patients with polycystic ovary disease: a preliminary report.

Recent work has suggested that a central deficiency or defect of dopamine may contribute significantly to the inappropriate gonadotropin secretion commonly associated with polycystic ovary disease. To evaluate this hypothesis, 2.5 to 5 mg of the dopamine agonist bromocriptine was administered daily to patients with polycystic ovary disease. Prolactin (PRL) levels were normal in all cases and there was no evidence of galactorrhea. All patients had failed to conceive while on clomiphene citrate. Seven patients were treated for a total of nine cycles. Ovulation occurred in four cycles, and two of these patients conceived. In five cycles, no ovulation occurred. Among ovulatory cycles, PRL levels declined, but not to undetectable levels. There was also a periovulatory drop in dehydroepiandrosterone sulfate. Levels of luteinizing hormones rose initially and then dropped to below baseline postovulation. Among anovulatory cycles, PRL fell to undetectable levels and dehydroepiandrosterone sulfate was unaffected. Luteinizing hormone levels rose initially and then dropped slightly. In both ovulatory and anovulatory cycles, follicle-stimulating hormone (FSH) levels remained low. These preliminary data suggest: 1) bromocriptine appears capable of altering gonadotropin secretion in polycystic ovary disease, and 2) variable results on ovulation in polycystic ovary disease may reflect the diverse etiology of the pathophysiology of polycystic ovary disease and/or choosing inappropriate dosages of bromocriptine.

Adult↗
PubMed1983

Induction of ovulation monitored by ultrasound.

Eighty menstrual cycles were induced by the administration of human menopausal gonadotropin (hMG), and the induction of ovulation was evaluated by serial ultrasound scanning. Ovulation occurred in 57 of these cycles, and pregnancy occurred in 17 patients. No pregnancy occurred if the follicle size was below 15 mm at the time that human chorionic gonadotropin (hCG) was administered. A 15-mm follicle size is, therefore, regarded as a minimum size for a mature ovum. Multiple follicles were present in seven of the cycles where pregnancy occurred, but only two patients had multiple pregnancies. Ovarian hyperstimulation (OHS), which is characterized by cystic ovarian enlargement of greater than 5 cm after ovulation, was present in 25 cycles. This is a considerably higher incidence than previously documented, but since it is not possible to predict reliably its occurrence, and in no patients were the symptoms severe, it is considered an acceptable and inevitable sequela of ovulation induction. The present role of ultrasound is to establish whether the ovary responds to gonadotropin stimulation, to ensure that the follicle has reached a minimum size, to determine the number of preovulatory follicles to inform better the patient about the possibilities of multiple pregnancies, to establish that ovulation has occurred after administration of hCG, and to document the presence or absence of OHS.

Estrogens↗
PubMed1983

Recurrent anaphylactic reaction to intraperitoneal dextran 75 used for prevention of postsurgical adhesions.

The use of intraperitoneal dextran at the conclusion of a gynecologic surgical procedure to prevent postoperative adhesions has increased recently. Although anaphylactic reaction to dextran administered intravenously is well documented, the authors report such a reaction after intraperitoneal administration. The delayed appearance and the continuation of the undesirable reaction until the intraperitoneal reservoir of dextran was removed by means of a culdocentesis are noteworthy. Physicians should be alerted to this potential complication.

Adult↗
PubMed1983

Disappearance of human chorionic gonadotropin following removal of ectopic pregnancy.

A study was undertaken to determine the length of time serum beta-subunit of human chorionic gonadotropin (beta-hCG) could be detected following removal of ectopic pregnancy. Seven patients underwent complete removal of trophoblastic tissue by either salpingectomy or partial resection of the involved fallopian tube. Nine other patients had conservative surgical treatment by either linear salpingostomy or fimbrial expression of the fallopian tube. Serum beta-hCG levels were determined serially in all these patients. The results demonstrate that the initial titer of hCG is a significant factor in determining the length of time that it can be detected in the serum postoperatively. In addition, decreasing titers, conforming to the disappearance curve of hCG, as constructed in this study, are a helpful aid in avoiding further surgery in the group of patients who had a conservative removal of the trophoblastic tissue. Finally, the serum clearance of hCG by radioimmunoassay may take at least up to 24 days after surgery.

Chorionic Gonadotropin↗
PubMed1983

Ovulation timing by luteinizing hormone assay and follicle puncture.

Follicle puncture with oocyte harvest or ovarian inspection for an early corpus luteum was carried out in 13 patients undergoing laparoscopy during routine infertility workup. Laparoscopies were carried out 28 to 38.5 hours after the onset of the luteinizing hormone surge so that there would be a concentration of data around the expected time of ovulation. A rapid luteinizing hormone assay was used. All the corpora lutea were found 38 hours or more after the onset of the luteinizing hormone surge. Between 28 and 38 hours after the onset of the surge, intact follicles containing oocytes in various stages of maturation were found.

Corpus Luteum↗
PubMed1982

The temporal relationship between the luteinizing hormone surge and human oocyte maturation.

The temporal relationship of oocyte maturation to endogenous luteinizing hormone (LH) in vivo throughout the preovulatory period has not been previously reported. In order to study in vivo oocyte maturation follicular aspiration was carried out from 4 to 38 hours after the onset of the LH surge. Oocytes were obtained in 72% of cases. If oocytes were harvested more than 18 hours after the onset of the LH surge, resumption of meiosis had occurred. Twenty-eight to thirty-eight hours after the onset of the LH surge preovulatory oocytes in metaphase II were obtained. A corpus luteum was found 38 hours after the onset of the LH surge.

Female↗
PubMed1982

Reversal of persistent anovulation in polycystic ovarian disease by administration of chronic low-dose follicle-stimulating hormone.

Low doses of follicle-stimulating hormone (FSH) were administered once daily to two consecutive patients with polycystic ovarian disease (PCOD) for therapy of infertility. Serial blood samples were obtained for gonadotropins and ovarian steroid determinations during the period of FSH administration. Exogenous FSH resulted in an initial and concomitant decrease in serum androstenedione (A), estrone (E1), and luteinizing hormone (LH), with an increase in estradiol (E2) and FSH. Subsequent changes in the above-mentioned hormonal levels were typical of a normal ovulatory cycle, with the exception of FSH, which continued to rise in the second half of the follicular phase. This was attributed to the exogenous administration of FSH. Both patients became pregnant in their first induced ovulatory cycle by administration of chronic low-dose FSH. These preliminary data demonstrate (1) a correction of the biochemical imbalance characteristic of PCOD, (2) successful ovulation induction, and (3) restoration of fertility in PCOD treated with chronic low-dose FSH.

Adult↗
PubMed1982

The effectivenss of danazol on subsequent fertility in minimal endometriosis.

Sixty-five patients with minimal endometriosis were studied for the purpose of prospectively comparing conservative medical management in the form of danazol with no therapy in the treatment of this disease. After completion of the basic infertility evaluation and correction of additional factors affecting fertility, a diagnostic laparoscopy, dilatation and curettage (D and C), and tubal lavage were performed. A randomly selected cord determined whether the patient received no treatment for 6 months or danazol for 6 months followed by no treatment for 6 months. The dosage of danazol was 800 mg daily for the first 2 months, 600 mg daily for the next 2 months, and 400 mg daily for the final 2 months. The mean age of both the danazol-treated group and the group that received no danazol was 31 years. Conception occurred in 30% of the danazol-treated patients and 50% of the untreated patients. These results suggest that infertile patients with minimal endometriosis should be given an opportunity to conceive after laparoscopy, D and C, and tubal lavage. This would seem particularly true in older patients where a 6-month delay in permitting attempts at conception represents a significant interval of time.

Adult↗
PubMed1981

A rapid radioimmunoassay method for serum luteinizing hormone utilizing polyethylene glycol and a double-antibody method of separation.

A method is described utilizing polyethylene glycol (PEG) combined with a double antibody for separation for rapid radioimmunoassay (RIA) of human luteinizing hormone(hLH). The total assay time is 3 hours with a 1-hour incubation period. Reliable comparisons with the 3-day assay have been shown. The average between-assay coefficient of variation was 11%, whereas the average within-assay coefficient of variation was 6%. The sensitivity of the assay was 7.5 mIU/ml. It is suggested that this reliable and rapid RIA for hLH will prove to be a valuable adjunct in the treatment of patients when timing of ovulation is imperative, such as for artificial insemination and harvesting of maturing human oocytes.

Animals↗
PubMed1981

The role of ultrasound in ovulation induction: a critical appraisal.

Twenty-five cycles induced by human menopausal gonadotropin (hMG) were serially studied by ultrasound. The developing follicles were observed up to and beyond human chorionic gonadotropin (hCG) administration. Ovulation as determined by subsequent pregnancy or a sustained elevation of basal temperature was seen in 18 of these cycles. Among these patients the follicular size ranged between 24 and 13 millimeters. No pregnancies occurred where the follicular size was below 15 mm. A shortened luteal phase was noted in three cycles where the follicular size was either 13 or 14 mm. Multiple follicles greater than 10 mm were observed in 14 of the ovulating cycles, but in no case did a multiple pregnancy occur. Fifteen millimeters is therefore suggested as a minimum size for satisfactory ovulation, but it does not appear that an optimum size exists. We conclude that ultrasound can play an important role in the monitoring of ovulation induction but does not replace the present methods.

Anovulation↗
PubMed1981

Ovarian pathology associated with insulin resistance and acanthosis nigricans.

Insulin resistance and the skin lesions of acanthosis nigricans are not commonly seen by the gynecologist, but the ovarian pathology that can be associated with insulin resistance and acanthosis nigricans is well known. The clinical course of disease in a patient with virilization-amenorrhea associated with insulin resistance and acanthosis nigricans is presented to illustrate the association. Hyperthecosis was the ovarian pathology demonstrated; testosterone levels were in excess of 400 ng/gl. Postoperative testosterone levels were normal at 62 ng/dl. Additional ovarian pathology reported in association with insulin resistance and acanthosis nigricans includes polycystic ovary disease alone, in association with stromal luteomas, or with bilateral dermoid cysts. Furthermore, masculinizing ovarian neoplasms such as hilar cell tumors have been reported in association with ovarian hyperthecosis. When evaluating patients with androgen excess, it would be worthwhile to keep in mind the association with abnormal carbohydrate metabolism and acanthosis nigricans.

Acanthosis Nigricans↗
PubMed1980

Elemental composition of fluid in the human Fallopian tube.

Relatively undisturbed samples of human oviduct fluid were obtained by aspiration into a Silastic catheter inserted through the fimbriated end of the oviduct during surgical laparotomy. The concentrations of Na, Cl, K, Ca, Mg, S and P were determined in picolitre aliquots of this fluid using X-ray spectrometry by electron probe excitation. Human tubal fluid has a unique elemental composition characterized by high concentrations of K and Cl, but low concentrations of Ca, relative to the range of normal human serum values. Na and Mg concentrations in oviduct fluid are similar to serum levels.

Adult↗
PubMed1980

Luteal phase deficiency and infertility: difficulties encountered in diagnosis and treatment.

Uncertainty concerning the importance of luteal phase defects as a cause of female infertility is closely related to problems of diagnosis. A study was undertaken of the consistency of the parameters used in daignosing luteal phase deficiency in 14 patients; results of randomized treatment regimens were also compared. Specific diagnostic criteria utilizing the basal body temperature (BBT) chart, endometrial biopsy, and progesterone levels were used. Prolactin and luteinizing hormone levels were measured at the time of progesterone determinations. Of the 29 cycles studied, only one third showed consistent abnormalities in BBT chart, endometrial biopsy, and progesterone levels. Discrepancy between the endometrial biopsy and the progesterone level occurred in at least 50% of all cycles studied. Prolactin levels were elevated in only 1 patient, suggesting a minor role for altered prolactin metabolism in luteal phase deficiency. Randomized treatment with progesterone vaginal suppositories, clomiphene citrate, and no treatment resulted in pregnancy in 5 of 14 patients (36%).

Adult↗
PubMed1979

The role of counseling in infertility.

Sixty-two couples with infertility received infertility counseling along with the infertility investigation and treatment. At the end of the study a questionnaire was sent to all patients in order to evaluate the incidence of psychologic symptoms associated with their infertility and their response to counseling. The study confirmed the presence of a high incidence of emotional symptomatology in the self-selected patients. It showed that male partners are also affected, but less so. Finally, it has demonstrated that infertility counseling serves to enhance the quality of life in many patients who have become the victims of their "infertility crises."

Anger↗