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Biomedical subjects

M Wikland

Publications and source records attributed to M Wikland.

At least 91 records · Page 5Linked to original sources
PubMed1987

Fertilization and embryo development of oocytes obtained transvaginally under ultrasound guidance.

The widespread use of ultrasound for follicle development assessment and ovum pickup has raised concerns about the theoretical possibility of adverse effects on oocyte function. Studies in other species do not demonstrate any adverse effects when using sonic energies as those presently used in diagnostic ultrasound. However, no data are available concerning the effects of diagnostic ultrasound on human preovulatory oocytes. This study was conducted to determine whether there were any adverse effects on the reproductive function of oocytes using transvaginal ultrasonography. No effect on fertilization and subsequent cleavage of oocytes was demonstrated. This method can, therefore, be recommended for follicle assessment and as a better alternative to laparoscopy for oocyte retrieval.

Adult↗
PubMed1987

Clinical experience in an in vitro fertilization and embryo replacement program of a new method for analysis of urinary estrogens.

The clinical experience in an IVF/ER program of a newly developed commercial kit (Estradiol enzymatique; BioMerieux) to determine urinary estrogens enzymatically, is reported. The study included 157 cycles, and the main indication for treatment was infertility due to tubal factor. Follicular development was stimulated in most cases by a combination of clomiphene citrate, human menopausal gonadotropin and chorionic gonadotropin. In addition to the previously used method to monitor follicular growth, ultrasound, daily urinary estrogens (estradiol + estrone) levels were assayed. A correlation between the pattern of urinary estrogen and the clinical results was found. In cycles with continuously rising estrogen up to the time of hCG administration a higher rate of in vitro fertilization and clinical pregnancies were obtained as compared to cycles where urinary estrogen declined or levelled off. It is concluded that this enzymatic assay of urinary estrogens is a good alternative to increase the precision of follicle monitoring when radioimmunological assay of serum estradiol levels cannot be obtained on a daily routine basis.

Chorionic Gonadotropin↗
PubMed1987

A self-migration method for preparation of sperm for in-vitro fertilization.

Human sperm samples (n = 211) were prepared for in-vitro fertilization (IVF) and embryo transfer by a self-migration procedure in Earle's medium containing highly purified hyaluronic acid (Hya) (MW 3,000,000) included to increase the viscosity of the medium. The method resulted in the recovery of a significantly higher percentage of motile spermatozoa compared with the traditional centrifugation method, 87.5 +/- 0.9% versus 76.1 +/- 1.3% (P less than 0.001). When comparing media with and without Hya in the self-migration method for preparation of normal sperm samples, the media containing Hya resulted in the recovery of a significantly higher percentage of motile spermatozoa, 89.0 +/- 0.8% versus 73.8 +/- 2.0% (P less than 0.001). In a group of 80 consecutive couples entering our IVF programme, sperm samples from 44 of the men were allocated at random for the self migration method in medium containing Hya and sperm samples from 36 men for preparation by centrifugation and swim-up. Significantly more pregnancies were achieved in the group prepared in medium containing Hya. It is concluded that self-migration of sperm in a medium containing Hya is simple and rapid, and results in a high recovery of motile spermatozoa which can be used for in-vitro insemination of human oocytes with favourable results.

Cell Separation↗
PubMed1987

Oocyte retrieval under the guidance of a vaginal transducer: evaluation of patient acceptance.

Follicle puncture under the guidance of ultrasound has now been used for some years. The most important advantage of the ultrasound-guided technique compared with the laparoscopic technique is that the former can be performed under local anaesthesia. However, both the trans-vesical and the perurethral ultrasound-guided puncturing routes may be quite painful for the patient. For that reason we have developed a trans-vaginal follicle puncture technique using a vaginal transducer. The aim of this study was to evaluate the patients' experience of pain with this new technique. Scanning of follicles was performed using a specially designed vaginal transducer that makes the patients having a full bladder unnecessary. Local anaesthesia was applied as a paracervical block. Follicles were then punctured through the vagina with a needle inserted through a needle guide attached to the transducer. Fifty-one patients answered a questionnaire about their experience of the puncture procedure. Only 10% of the patients found the puncture painful. Ninety-eight per cent of the patients felt no anxiety about going through the procedure again. We therefore conclude that trans-vaginal oocyte pick-up using a vaginal transducer is very well accepted by most women.

Anesthesia, Local↗
PubMed1987

Effect on fertilization of intra-peritoneal exposure of oocytes to carbon dioxide.

Follicular aspiration is generally performed via laparoscopy after creating a pneumoperitoneum with carbon dioxide (CO2). Adverse effects on embryo development may occur following exposure to CO2, which is known to cause a decrease in follicular fluid pH. Such a reduction in pH may affect fertilization and early embryonic development and this study was carried out to study these effects. Oocytes obtained by laparoscopy were compared with those obtained under ultrasonic guidance to determine whether CO2 exposure had any adverse effect. The results suggest that CO2 may affect fertilization, but once this has occurred, there is no effect of CO2 on the rate of cleavage of the embryos.

Carbon Dioxide↗
PubMed1987

Comparison between endovaginal and transabdominal transducers for measuring ovarian volume.

The use of ultrasound for measuring ovarian volume has attracted increasing interest in recent years, as it appears to be a valuable technique for identifying tumors in certain risk groups for ovarian carcinoma. Although in all studies performed to date a transabdominal scanning technique has been used, endovaginal sonography seems more promising for studying the ovaries. The aim of this study is to make a comparison between transabdominal and endovaginal scanning of the ovaries. The study was performed in 17 women with regular menstruation and 11 postmenopausal women. Although no significant difference in ovarian volume was found in comparison of measurements made using an endovaginal and a transabdominal transducer, a much clearer image of the ovaries was obtained with the endovaginal transducer. This scanning technique also seems to be better accepted by the patients since it does not require that the bladder be full. Advantages and disadvantages are discussed.

Female↗
PubMed1987

Role of ultrasound in infertility.

The use of ultrasound technology and its further prospects in an infertility clinic are described. First, the ultrasonic ovarian scanning during the follicular phase of stimulated cycles is discussed. With this technique the number and size of the follicles, and the thickness of the endometrium can be estimated. Second, three different routes for ultrasound guided follicle puncture are described, namely the transvesical, the transvaginal and the perurethral puncture. Finally, the ultrasound guided embryo transfer procedure is explained.

Embryo Transfer↗
PubMed1985

Simplification of the method of in vitro fertilization: sonographic measurements of follicular diameter as the sole index of follicular maturity.

As a simplification of the in vitro fertilization (IVF) procedure, repeated sonographic scanning of follicular diameters in stimulated cycles was performed, until the largest visible follicle reached a mean diameter of at least 20 mm, at which time human chorionic gonadotropin (hCG) was administered. Follicle puncture was performed either guided by sonography or by laparoscopy 34-36 hr after the hCG injection, and following insemination oocytes were cultured for 48-60 hr before embryo transfer (ET). Serum levels of luteinizing hormone (LH), prolactin (PRL), and estradiol-17 beta (E2) at the time of hCG injection as well as follicular fluid levels of follicle stimulating hormone (FSH), LH, and PRL as well as progesterone (P), testosterone (T), and E2 at the time of puncture were determined in retrospect using specific radioimmunoassay (RIA). It was found that the knowledge of a single value of LH or E2 in serum should have been of little additional value for the decision to give hCG in all stimulation models used: clomiphene + hCG, human menopausal gonadotropin (hMG) + hCG, and clomiphene + hMG + hCG. The concentrations of the three steroids measured in follicular fluid were, in a high proportion of the follicles, within a normal range in all stimulation models. The group receiving clomiphene + hMG + hCG appeared promising through its higher proportion of estrogenic follicles. It is concluded that sonographic measurement of follicular diameters may be used as the sole index of follicular maturity in an IVF program.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Relationship between electrical and mechanical activity of the isolated term-pregnant human myometrium.

In order to study the relationship between electrical and mechanical activity of isolated human myometrium in late pregnancy three different techniques were employed: the sucrose gap model, stiff pressure electrodes and flexible suction electrodes. A high degree of concordance was found between the various methods with regard to the pattern of electrical activity. However, the suction electrode technique seemed advantageous from a practical point of view due to its simplicity and high reproducibility. In the human myometrium each contraction was typically adjoined by a single spike potential, although trains of spikes were occasionally observed during the initial phase of the contraction. This contrasted to the bursts of spikes accompanying both the rising phase and the plateau phase of contractions in the myometrial specimens from the pregnant and estrous rat. This indicates a fundamental difference in electro-mechanical coupling mechanisms in the human myometrium when compared to the most widely used animal model for electrophysiological studies.

Adult↗
PubMed1985

Leukotrienes and myometrial activity of the term pregnant uterus.

Biopsies from different segments of the pregnant human uterus were superfused in organ chambers and contractile activity was registered. Leukotriene C4(LTC4) caused inhibition of spontaneous but not noradrenaline induced contractile activity in strips from the cervix. This effect occurred both in early pregnancy and at term. However, the lower and the upper uterine segment of the term pregnant uterus did not respond to LTC4. The results represent a documentation of the segmental differentiation in the uterine response to eicosanoids.

Cervix Uteri↗
PubMed1985

Effect of gonadotrophins on progesterone secretion by cultured granulosa cells obtained from human preovulatory follicles.

Granulosa cells were obtained from human preovulatory follicles in 31 women undergoing in vitro fertilization and embryo transfer due to tubal infertility. Follicular maturation was stimulated and synchronized by treatment with Clomiphene or human menopausal gonadotrophin (hMG), or both, plus human chorionic gonadotrophin (hCG). Follicles were aspirated by ultrasound guided puncture approximately 34-36 h after the hCG injection. The granulosa cells were washed and suspended in modified medium 199 containing 10% foetal bovine serum and cultured as monolayers for 6-8 days in the absence and presence of hormones and reactants. Progesterone formation was analyzed by RIA. In general, the cells underwent morphological luteinization and secreted high amount of progesterone. Under basal conditions the secretion of progesterone was highest during the first 2 days in culture and then gradually declined. Progesterone secretion was stimulated by human LH, hCG and the adenylate cyclase stimulator forskolin, with a maximal effect between days 2-6. The beta-adrenergic agonist isoproterenol in preliminary experiments potentiated the stimulatory effect of hCG but had no own stimulatory effect. No clear differences in progesterone secretion or responsiveness to in vitro stimulation relating to the various in vivo stimulation protocols were found.

Cell Count↗
PubMed1985

The role of prostaglandins for the coordination of myometrial forces during labour.

Systematic studies using a superfusion technique for recording myometrial contractility in vitro have been conducted in our department to explore whether prostaglandins (PG) have a differential action on the different segments of the pregnant uterus and also whether the qualitative and quantitative response undergoes a change during spontaneous labour. Myometrial specimens were excised from the fundal area and from the lower uterine segment at elective caesarean section in the 39th week of pregnancy before commencement of labour and at acute caesarean section during ongoing labour. Before labour PGF2 alpha was without or had a very weak effect on upper segment preparations but was stimulatory on lower segment specimens. PGE2 and PGI2 generally induced a biphasic dose-dependent response (stimulation followed by inhibition). During spontaneous labour PGF2 alpha and PGE2 always stimulated upper segment preparations while the contractile activity of specimens from the lower segment was inhibited by PGE2, PGF2 alpha was generally without effect. PGI2 had the same biphasic action before as during labour. With all reservations for the validity of in vitro experiments, the results favour the hypothesis that initiation of labour in the human involves a qualitative shift in the myometrial reactivity to prostaglandins. These alterations may involve suppression of expulsive forces and perhaps some tightening of the lower uterine segment during pregnancy. Following initiation of labour there is a marked increase in the excitatory action of both PGE2 and PGF2 alpha in the fundal area while the lower uterine segment reacts in a way that favours dilatation.

Dinoprost↗
PubMed1985

Catecholamines and contractility of the human myometrium at term: a possible role for prostaglandins.

The contractile response of small myometrial specimens from the term pregnant human uterus was investigated using a superfusion technique. Adrenaline, noradrenaline and dopamine all had a stimulatory effect on the contractility. It was also demonstrated that this stimulatory effect was alpha-adrenoceptor mediated. If the tissue was pretreated with the prostaglandin synthetase inhibitor indomethacin or the arachidonic acid analogue eicosa-5,8,11,14-tetraenoic acid the effect of catecholamines was significantly reduced. This suggests a specific role of prostaglandins in the mechanism of action of catecholamines on the human myometrium.

Arachidonic Acids↗
PubMed1984

Ultrasound as a diagnostic and operative tool for in vitro fertilization and embryo replacement (IVF/ER) programs.

Diagnostic ultrasound offers unique possibilities to study ovarian morphology, especially follicular growth and development. This makes the technique an important tool for the management of ovulation induction in an in vitro fertilization and embryo replacement (IVF/ER) program. Different general aspects of the use of ultrasound in IVF/ER are discussed in this communication.

Adult↗
PubMed1984

Myometrial response to prostaglandins during labor.

The myometrial response to prostaglandins (PGs) before labor has been studied earlier in this laboratory by the use of a superfusion technique. In the present investigation the same technique was used to explore the contractile effect of PGE2 and PGF2 alpha on myometrial strips obtained during active, spontaneous labor. Both PGE2 and PGF2 alpha had a marked stimulatory effect on strips from the upper uterine segment. The lower segment reacted to PGE2 by inhibition but not at all or slightly stimulatory to PGF2 alpha. Oxytocin constantly induced an excitatory response in both segments. The results support the concept of a prostaglandin-mediated 'fundal dominance' during labor and indicate that PGs contribute to a relaxation of the lower uterine segment. Taken together with previously obtained data the present results provide evidence for a critical change in myometrial responsiveness to prostaglandins by the time of parturition.

Dinoprost↗
PubMed1984

Structural and functional evidence for the denervation of human myometrium during pregnancy.

The neuronal influence of the contractility of the term-pregnant human uterus was studied by pharmacologic and histochemical methods. By the use of adrenergic and cholinergic antagonists or tetrodotoxin it was demonstrated that the contractile response of superfused myometrial strips from the term-pregnant uterus to electrofield stimulation was not influenced by any neuronal factor. Using an indirect immunofluorescence technique with an antiserum to the glial and Schwann cell specific S-100 protein, a marked paucity of nerve fibers was demonstrated in myometrial strips from the term-pregnant uterus as compared with the nonpregnant uterus. It is concluded that the described decrease of nerve fibers within the myometrium of the pregnant uterus may be of importance for the myometrial activity during pregnancy and parturition.

Adult↗