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Biomedical subjects

P Barg

Publications and source records attributed to P Barg.

9 recordsLinked to original sources
PubMed1996

Abnormal sperm morphology is highly predictive of pregnancy outcome during controlled ovarian hyperstimulation and intrauterine insemination.

PURPOSE: The purpose of this study was to assess the predictive value of a modified form of Kruger's strict criteria for sperm morphology for pregnancy outcomes after intrauterine insemination (IUI) and controlled ovarian hyperstimulation (COH) in the presence of normal sperm concentration and motility. MATERIALS AND METHODS: A retrospective review of 42 couples undergoing COH/IUI was stratified by favorable or unfavorable sperm morphology. End points were pregnancy or failure of treatment as defined by four or more cycles of COH/ IUI without pregnancy. RESULTS: An unfavorable morphology (< 4%) was highly predictive of failure during COH-IUI (94.45%; 17/18). A normal PIF was a sensitive indicator of those patients who became pregnant (93.8%; 15/16) and had a fair specificity for failure to achieve pregnancy after four cycles of treatment (65.4%; 17/26). Couples with a favorable sperm morphology were 28.3 times as likely to achieve a pregnancy within four cycles of treatment as those with unfavorable sperm morphology [95% confidence limits, 3.2 to 250.5; P < 0.001]. CONCLUSIONS: Abnormal strict morphologic assessment is both sensitive and specific for pregnancy outcomes in couples undergoing COH/IUI. Couples with persistently unfavorable sperm morphology should be counseled appropriately and would be better served by more aggressive treatment with in vitro fertilization and embryo transfer.

Adult↗
PubMed1995

Basal serum follicle stimulating hormone (FSH) and estradiol levels as predictors of pregnancy in unstimulated donor insemination cycles.

PURPOSE: The purpose of this study was to evaluate the utility of basal serum follicle stimulating hormone and estradiol levels in predicting pregnancy in women undergoing artificial insemination with donor sperm for severe male factor infertility. METHOD: A retrospective chart review of 48 women who had at least 2 cycles of artificial insemination with donor sperm and who had undergone testing for basal serum follicle stimulating hormone and estradiol levels prior to or during therapy. RESULTS: There was no difference in age or mean basal serum follicle stimulating hormone between women who conceived (clinical pregnancy) and those who did not. Women who conceived had significantly lower mean serum basal estradiol levels (P = 0.02) and significantly fewer numbers of treatment cycles (P = 0.041). The highest pregnancy rate was among those women with normal basal serum follicle stimulating hormone and estradiol levels. Receiver operating characteristic curve analysis revealed basal serum estradiol to be a more reliable predictor of pregnancy than follicle stimulating hormone. CONCLUSIONS: Basal serum follicle stimulating hormone and estradiol levels may be useful in predicting success with artificial insemination with donor sperm. It may be useful to obtain basal serum follicle stimulating hormone and estradiol prior to initiating artificial insemination with donor sperm.

Adult↗
PubMed1990

The use of two-component fibrin sealant for embryo transfer.

This is a report of our preliminary experience using fibrin sealant with a series of 38 patients undergoing IVF and ET. We used a two-component fibrin sealant to create a fibrin plug in the uterine cavity at the time of ET to decrease the possibility of embryo expulsion and also ectopic pregnancy. Our preliminary report proves that it is possible to obtain 26% pregnancies using this two-component biological glue instead of serum or culture medium for uterine embryo replacement. A prospective randomized study will be undertaken to evaluate whether the use of fibrin sealant could significantly improve IVF and ET results.

Culture Media↗
PubMed1988

Gamete intrafallopian tube transfer (GIFT): making laparoscopy more than "diagnostic".

Diagnostic laparoscopy is commonly performed on patients as part of a complete infertility investigation. Recently published protocols have investigated the efficacy of using empiric ovulation induction, intrauterine insemination, or both before beginning in vitro fertilization. Because many patients enrolled in these protocols will be exposed to both ovulation induction and diagnostic laparoscopy, the authors reasoned that it would be more effective to begin ovulation induction at the time of the proposed diagnostic laparoscopy in order to allow gamete intrafallopian tube transfer (GIFT) at the same time. Twenty-five nulliparous patients underwent diagnostic GIFT. There were eight continuing pregnancies in this group (32%). Diagnostic GIFT is a more effective use of the opportunity provided by laparoscopy than diagnostic laparoscopy alone.

Adult↗
PubMed1986

In vitro inhibition with antiestrogens of estradiol effects on prostaglandin F2 alpha production by human endometrium and endometrial epithelial cells.

It has been previously reported that neither an antiestrogen, actinomycin D, nor cycloheximide inhibited estradiol (E2)-stimulated elevations in uterine prostaglandin F2 alpha (PGF2 alpha) production in ovariectomized rats, suggesting that in contrast to other steroid-initiated events, this effect on PGF2 alpha may not involve receptor-mediated transcription-dependent actions of E2. To eliminate indirect influences, the ability of antiestrogens to affect PGF2 alpha output was reevaluated during incubations of human secretory endometrium and in cultures of epithelial cells derived from glands isolated from proliferative and secretory tissues. In these preparations, which respond to E2 with marked elevations in PGF2 alpha output, tamoxifen and its metabolite trans-4-monohydroxytamoxifen acted as virtually pure antagonists, counteracting the E2 effect while failing to influence basal PGF2 alpha output. Consistent with its effects on other estrogen-mediated end points, trans-4-monohydroxytamoxifen was at least 10 times more potent than tamoxifen, eliminating, at a 10(-6) M concentration, almost completely the stimulatory effect of 10(-8) M E2 on PGF2 alpha production by both endometrial fragments and monolayers of epithelial cells.

Cells, Cultured↗
PubMed1985

Prostaglandin F2 alpha output by human endometrium under superfusion and organ culture conditions.

Specimens of proliferative and secretory human endometrium were incubated under organ culture or superfusion conditions and the levels of PGF2 alpha in the medium were measured by radioimmunoassay. Basal rates of PGF2 alpha output during short-term superfusions and long-term (1-2 day) batch incubations, performed on the same tissue specimens, were similar. Basal output of PGF2 alpha by proliferative endometrium (230-280 ng/mg protein X d) was significantly higher than that of secretory tissue under both experimental conditions. Estradiol (10(-8) M) increased PGF2 alpha output significantly (4-fold) only in secretory endometrium under organ culture conditions; Progesterone (10(-7) M) decreased it significantly (to 1/2-1/4 of the basal level) in both types of endometria during long-term incubations and in proliferative endometrium during superfusion. Glands isolated from proliferative and secretory endometrium produced PGF2 alpha during superfusion at a rate comparable to that of endometrial tissue under similar conditions. PGF2 alpha output by glands isolated from secretory endometrium increased significantly (3-fold) when estradiol was added to the superfusion medium.

Dinoprost↗
PubMed1985

In vitro effects of ovarian steroids on prostaglandin F2 alpha output by human endometrium and endometrial epithelial cells.

Correlations of the rise in prostaglandin F2 alpha (PGF2 alpha) levels in human endometrium during the menstrual cycle with changes in plasma concentrations of ovarian steroids have suggested that progesterone (P) priming of the endometrium is necessary for the stimulation of PGF2 alpha production by estradiol (E2). However, despite the absence of significant levels of P in plasma during the follicular phase of the cycle, PGF2 alpha output by epithelial cell cultures derived from proliferative endometrium was stimulated in vitro by 10(-8) M E2 at least as well as PGF2 alpha output from secretory endometrium. In addition, basal PGF2 alpha output by proliferative endometrium under organ culture conditions was significantly greater than that by secretory endometrium. Concurrent addition of P counteracted the effects of E2 in these in vitro systems. P (10(-7) M) plus E2 (10(-8) M) resulted in PGF2 alpha output as low or lower than those of control incubations of secretory and proliferative endometrium. In the epithelial cell cultures, significant net stimulation by 10(-8) M E2 occurred in the presence of 10(-6) M P, a noteworthy finding since the rise in endometrial PGF2 alpha during the luteal phase takes place when the tissue is exposed to both E2 and P. P lowered the basal output of PGF2 alpha by endometrium in organ culture, but not by epithelial cells in monolayer cultures. E2 appears to stimulate PGF2 alpha output by increasing synthesis rather than diminishing metabolism, since exogenous [3H]PGF2 alpha was metabolized to an equivalent extent by fragments of secretory endometrium or glandular epithelial cells regardless of whether E2 was added to the incubation medium. The results from this study confirm that only secretory endometrium responds to E2 in vitro by significantly increasing PGF2 alpha output. The lack of response by proliferative endometrium, when contrasted with the marked responsiveness of epithelial cells derived from this tissue, suggests that an inhibitory influence is removed during the isolation or subsequent culture of endometrial glands.

Cells, Cultured↗
PubMedDate not supplied

Antigenic differences in human sperm samples related to various morphological abnormalities.

Sperm samples were collected from male partners of fertile and infertile couples having unexplained and male factor infertility and analyzed for morphological abnormalities. After a staining procedure, sperm samples of these infertile men showed a variety of abnormalities. The sperm samples were also studied for their binding with the Abs directed against protamine (the nuclear protein), fertilization antigen (FA-1, sperm surface antigen), and the lithium diiodosalicylate- (LIS-) solubilized sperm preparation, and the binding was correlated with the percentage of morphologically abnormal sperm in the sample. Abs used in the present study were raised in female rabbits and had high titers (ELISA titers, 1:4096 to 1:8196), and recognized no band (anti-protamine), one 49,000- +/- 2000-dalton band (anti-FA-1), and at least 8 bands of various molecular identities in the 14,000- to 92,000-dalton range (anti-LIS sperm) on the Western blot of LIS-solubilized human sperm. The affinity-purified Fab' antibodies were iodinated and used in a radioimmunobindingassay for testing their binding with the sperm cells. Anti-protamine Fab's showed minimal binding and the binding activity (cpm bound/10 x 10(6) sperm cells) did not correlate (head defect, r = .12; midpiece defect, r = .07; tail defect, r = .11) significantly with percentage of abnormal cells in the sample. The binding of the anti-FA-1 Fab's also did not show a significant correlation (head defect, r = .29; midpiece defect, r = .48; tail defect, r = .23), though a positive trend (p = .05) was observed with the midpiece defect. In contrast, the binding of anti-LIS sperm Fab's demonstrated a significant correlation with the percentage of abnormal sperm cells in the sample (head defect, r = .51, p = .04; midpiece defect, r = .80, p less than .0001; tail defect, r = .23, p = .039). With an increased percentage of abnormal sperm cells, especially those with midpiece defect, there was an increased binding of anti-LIS sperm Fab's. These results suggest that with an increase in percentage of abnormal sperm, there is a change in antigenicity of the sperm cells. An increase in structural abnormality may enhance antibody binding to an abnormal sperm cell, thus causing a further decrease in its fertilizing capacity.

Antigens↗