PubMed Health⌕ Search

Biomedical subjects

Maritta Hippeläinen

Publications and source records attributed to Maritta Hippeläinen.

10 recordsLinked to original sources
PubMed2006

Assessment of attitudes towards assisted reproduction: a survey among medical students and parous women.

BACKGROUND: The present paper explores attitudes towards different aspects of assisted reproductive technologies among parous women and future doctors (third- and fourth-year medical students). METHODS: We anonymously surveyed 200 parous women who had at least three infants and had given birth at Kuopio University Hospital, and 200 medical students of Kuopio University. RESULTS: The overall response rate was 45%. Most of the medical students were childless (95.7%), unmarried (63.8%), and younger (24 vs. 35 years) compared with the parous women (p < 0.001). Medical students were liberal in questions of who has the right to get infertility treatment: 49% of them would allow the possibility to lesbian couples, 43% to homosexual couples and over 50% to single women. Over 40% of medical students would allow the use of a surrogate mother for lesbian and homosexual couples; the number was under 20% in the group of parous women. Their setting of priorities within the field of reproductive health also showed differences in prostate cancer screening, doctor's appointments for contraception, abortion and menopausal hormone replacement therapy. CONCLUSIONS: Medical students take a rather liberal stance on reproductive issues. On the other hand, baseline attitudes among medical students reveal some degree of subjectivism when it comes to allocation of scarce healthcare resources within the field of reproductive health. Medical education faces a challenge in ensuring that future physicians are able to set priorities and balance resources between preventive medicine and management of specific medical conditions, and to base their attitudes on evidence.

Adult↗
PubMed2005

Effect of endometriosis on IVF/ICSI outcome: stage III/IV endometriosis worsens cumulative pregnancy and live-born rates.

BACKGROUND: Women with endometriosis often need IVF to conceive-most women need several cycles of treatment. METHODS: To evaluate the impact of moderate to severe endometriosis on cumulative IVF outcome, we carried out an observational study on 98 consecutive women who underwent IVF or ICSI treatment and had endometriosis diagnosed by laparoscopy or laparotomy and classified as minimal to mild endometriosis (American Society for Reproductive Medicine I/II) (n = 31) or moderate to severe endometriosis (American Society for Reproductive Medicine III/IV) (n = 67). The reference group consisted of 87 consecutive women with tubal infertility. The main outcome measures were cumulative pregnancy and live birth rates. RESULTS: There was a significantly lower pregnancy rate per fresh embryo transfer after pooled cycles (1-4) among women with stage III/IV endometriosis (22.6%) compared to stage I/II group (40.0%) or tubal infertility (36.6%). After 1-4 IVF/ICSI treatments, including frozen embryo transfer, 56.7% of the women with stage III/IV endometriosis were pregnant and 40.3% gave birth. The corresponding values were 67.7/55.8% when endometriosis was stage I/II and 81.6/43.7% in the controls respectively. CONCLUSION: Stage III/IV endometriosis means a worse prognosis for IVF/ICSI treatments compared to milder stages or tubal factors. Lower implantation and multiple pregnancy rates offer some support to our practice to continue two embryo transfers in this group.

Adult↗
PubMed2005

Androgen receptor gene CAG length polymorphism in women with polycystic ovary syndrome.

OBJECTIVE: To determine whether the CAG repeat length of the androgen receptor (AR) gene contributes to individual differences in the susceptibility to the development of polycystic ovary syndrome (PCOS). DESIGN: Retrospective case-control study. SETTING: University-based clinic. PATIENT(S): One hundred six nondiabetic women with PCOS and 112 nonhirsute fertile controls. INTERVENTION(S): Androgen receptor gene CAG repeat length was analyzed in women with PCOS and their controls. MAIN OUTCOME MEASURE(S): Androgen receptor gene CAG repeat length in both groups. RESULT(S): The mean CAGn was 21.5 repeats in both groups (NS; t-test). Furthermore, when the CAGn lengths were divided into three categories (CAGn < or =18, 19-24, > or =25), the distribution was similar in both groups (NS; chi2 test). However, all five women carrying < or =15 CAG repeats belonged to the PCOS group. In the PCOS group, CAGn did not correlate with body mass index or serum testosterone concentration. CONCLUSION(S): Androgen receptor CAGn is not a major determinant of PCOS. However, it may be a significant modulator of androgen-related diseases in some individuals.

Adenine↗
PubMed2005

Associations between two single nucleotide polymorphisms in the adiponectin gene and polycystic ovary syndrome.

In the present study we determined whether genetic variability in the gene encoding adiponectin is associated with polycystic ovary syndrome (PCOS). Altogether 143 Caucasian women with PCOS and 245 healthy controls were genotyped for two single nucleotide polymorphisms (SNPs) in exon 2 and intron 2 in the adiponectin gene. Single-point analysis was expanded to pair-of-loci haplotype analysis to examine the estimated haplotype frequencies of the two SNPs, of unknown phase, in the PCOS and control groups. Estimated haplotype frequencies were assessed using the maximum-likelihood method, employing an expectation-maximization algorithm. A significantly different allele distribution in intron 2 SNP was observed between the groups, with the T allele being significantly reduced in the PCOS group (25.9%) compared with the control group (32.7%) ( p = 0.047), at an odds ratio of 0.72 (95% confidence interval 0.52-0.99). Otherwise, the allele and genotype distributions in either SNP were not statistically different between the groups. In haplotype estimation analysis, there was a lower frequency of the haplotype T-T in the PCOS group (25.9%) than in the control group (32.7%) ( p = 0.058). We conclude that polymorphisms of the adiponectin gene may be implicated in individual susceptibility to PCOS.

Adiponectin↗
PubMed2004

A survey of the attitudes of infertile and parous women towards the availability of assisted reproductive technology.

OBJECTIVE: The aim of the study was to assess differences in attitudes towards aspects of assisted reproduction technology between infertile and parous women. DESIGN: Case-control study. SETTING: University-based tertiary care clinic. POPULATION/SAMPLE: Three hundred and ninety-two women with fertility problems and 200 parous controls. METHODS: A questionnaire was sent out to 392 the members of Childless Support Association and 200 parous women who had at least three infants and had given birth at Kuopio University Hospital. The questionnaire consisted of 46 questions: demographic information, fertility history, different aspects of assisted reproduction technology and prioritisation issues. MAIN OUTCOME MEASURES: Attitudes towards assisted reproduction technology. RESULTS: The overall response rate was 46%. Infertile women were highly educated (P < 0.01) and had lower parity (mean 0.83 vs 4.76, P < 0.01) than parous women. We recorded four major differences in attitudes between the two groups (OR >2 or <0.5) including provision of infertility treatment to lesbian (46.9% vs 16.7%) and homosexual couples (28.4% vs 11.4%), the opportunity for homosexual couples to use surrogate mothers (30.6% vs 15.2%) and limitations in the number of infertility treatment cycles (28.4% vs 61.4%). For 11 questions, we recorded minor, but statistically significant, differences. In the prioritisation questions, the women set the order according to their own interests, probably because the women were at fertile age and they had or would like to have a child. Maternity services and screening for cancer in women (Papanicolaou's test and mammography) were at the top of the list. CONCLUSION: These results reflect a split attitude that was influenced by the wish of infertile women to help childless couples and to be able to recruit suitable sperm/oocyte donors. Parous women were motivated by their concern for children's rights.

Adult↗
PubMed2003

The androgenic sex hormone profile is an essential feature of metabolic syndrome in premenopausal women: a controlled community-based study.

OBJECTIVE: To evaluate sex hormones in premenopausal white women with metabolic syndrome (MBS). DESIGN: Cross-sectional controlled community-based study. SETTING: Pieksämäki District Health Center, Pieksämäki, Finland. PATIENT(S): Five hundred forty-three women, aged 34 to 54 years, were screened according to National Cholesterol Education Program criteria: waist >88 cm, hypertension >/=130/>/=85 mm Hg, hypertriglyceridemia >/=1.7 mmol/L, high-density lipoprotein (HDL)-cholesterol <1.3 mmol/L, and fasting glucose >/=6.1 mmol/L. Sixty-three women fulfilled at least three of the above-mentioned criteria and were enrolled. Eighty-eight age-matched women without MBS served as controls. INTERVENTION(S): None. MAIN OUTCOME MEASURES: Sex steroid levels in relation to insulin sensitivity and body composition. RESULT(S): A markedly lower insulin sensitivity index and higher free androgen index were detected in the women with MBS than in the controls. Abdominal obesity and increased diastolic blood pressure were significantly associated with high free androgen index in multiple regression analysis. CONCLUSION(S): A hyperandrogenic hormone profile appeared to be a typical feature of premenopausal female MBS even without polycystic ovary syndrome (PCOS).

Adult↗
PubMed2003

Two exonic single nucleotide polymorphisms in the microsomal epoxide hydrolase gene are associated with polycystic ovary syndrome.

OBJECTIVE: To determine whether genetic variability in the gene encoding microsomal epoxide hydrolase (EPHX) contributes to individual differences in susceptibility to the development of polycystic ovary syndrome (PCOS). DESIGN: Retrospective case-control study. SETTING: University-based clinic. PATIENT(S): One hundred twelve white women with PCOS and 115 healthy controls. INTERVENTION(S): None. MAIN OUTCOME MEASURES: The presence of two single nucleotide polymorphisms (SNPs), T-->C (Tyr113His) in exon 3 and A-->G (His139Arg) in exon 4, in the EPHX gene. Single point analysis was expanded to pair of loci haplotype analysis to examine the estimated haplotype frequencies of the two SNPs, of unknown phase, in the PCOS and control groups. Estimated haplotype frequencies were assessed using the maximum-likelihood method, using an expectation-maximization algorithm. RESULT(S): Single point allele and genotype distributions in exon 3 and exon 4 of the EPHX gene were not statistically different between the groups. However, according to the haplotype estimation analysis, we observed a significantly elevated frequency of haplotype C-G (His113-Arg139) in the PCOS group versus the control group. The odds ratio for PCOS associated with the low activity haplotype C-G (His113-Arg139) was 2.28 (95% confidence interval 1.1-4.8). CONCLUSION(S): The use of two intragenic single nucleotide polymorphisms jointly in haplotype analysis of association demonstrated that the genetically determined low activity haplotype C-G (His113-Arg139) was significantly associated with PCOS.

Case-Control Studies↗
PubMed2002

Experience of in vitro fertilization surrogacy in Finland.

BACKGROUND: In vitro fertilization (IVF) surrogacy makes it possible for women who do not have a functional uterus to have their own genetic offspring. We describe here our experience of IVF surrogacy in Finland over a 10-year period. METHODS: This retrospective study included 17 women who underwent ovarian stimulation in connection with surrogacy in 1991-2001 at four clinics. The surrogate mothers were unpaid volunteers: six sisters, three mothers, one husband's sister, one cousin, four friends and three other volunteers. Thorough counseling was given to the commissioning couples and to the surrogate mothers and their partners. The commissioning couples were prepared to adopt their biological children. RESULTS: Twenty-eight surrogate IVF cycles were started in 17 women. One couple received donated oocytes. Trans-vaginal oocyte retrieval was feasible in every case, including those five women with congenital absence of the vagina and uterus. An average of 1.8 embryos was transferred at a time, and 11 pregnancies were achieved [50% per fresh embryo transfer (ET) and 16% per frozen-thawed ET]. Nine healthy singletons and one set of twins were born. One pregnancy ended in miscarriage. The mean birth weight of singleton infants was 3498 g (2270-4650 g). The birth weights of the twins were 2900 and 2400 g. In all cases the genetic parents took care of the infant immediately after birth. Two surrogate mothers had postpartum depression. CONCLUSIONS: Altruistic IVF surrogacy works well, but careful counseling of all parties involved is essential.

Adult↗