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Biomedical subjects

P Shrivastav

Publications and source records attributed to P Shrivastav.

16 recordsLinked to original sources
PubMed1999

Comparison of pregnancy outcome of pronuclear- and multicellular-stage frozen-thawed embryo transfers.

PURPOSE: Our purpose was to determine if supernumerary embryos generated by in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) should be frozen (using 1,2-propanediol) at the pronuclear or multicellular stage. METHODS: The study was a retrospective analysis conducted at the Dubai Gynaecology & Fertility Centre of the Department of Health & Medical Services, Dubai, U.A.E. One hundred forty-one women undergoing frozen-thawed embryo replacement cycles with IVF generated embryos and 84 women undergoing the same with ICSI generated embryos. RESULTS: Supernumerary, IVF-generated embryos frozen at the multicellular stage had a significantly higher rate of survival on thawing (73.9%) than embryos frozen at the pronuclear stage (64.4%). The morphological grades of the embryos in the two groups were similar, but a significantly higher pregnancy rate was obtained with embryos frozen at the multicellular stage (22.8%) than with pronuclear-stage embryos (14.8%). Similarly, with ICSI-generated embryos, significantly higher survival was seen with multicellular-stage frozen embryos (74.8%) than pronuclear-stage embryos (64.4%). The morphological grades of the embryos and pregnancy outcomes of the two groups were similar. CONCLUSIONS: Supernumerary embryos generated by IVF and ICSI should be frozen at the multicellular stage so as to allow selection of the best embryos for transfer and embryo freezing of only robust embryos.

Blastocyst↗
PubMed1996

What factors predetermine the risk of having a high-order multiple pregnancy with gamete intra-fallopian transfer?

Limiting the number of oocytes transferred at gamete intra-Fallopian transfer (GIFT) has limited the incidence of high-order pregnancy but at the same time compromised the fertility potential of some patients. A review of 300 patients who have undergone GIFT using a flexible approach as to the number of oocytes transferred identifies the patients at risk of high-order pregnancy as those aged under 30 years in whom more than six oocytes are returned and whose partner's spermatozoa have high progressive motility.

Adult↗
PubMed1994

Percutaneous epididymal sperm aspiration for obstructive azoospermia.

We report the use of percutaneous epididymal sperm aspiration as a simpler and more acceptable alternative to microscopic epididymal sperm aspiration for patients with obstructive azoospermia in whom bypass surgery is not feasible or has not been successful. Some contamination of the aspirate with blood is inevitable, but with careful sperm preparation techniques this can be reduced substantially in the final aliquot used for assisted conception. Spermatozoa with active forward progression may be used for gamete intra-Fallopian transfer treatment, but when this capacity is absent intracytoplasmic sperm injection is recommended. Three pregnancies were obtained in seven couples and a set of twins has been delivered.

Epididymis↗
PubMed1994

Day care management of severe ovarian hyperstimulation syndrome avoids hospitalization and morbidity.

Severe ovarian hyperstimulation syndrome (OHSS) is a dreaded complication of ovulation induction for assisted reproduction treatment. In the past, conservative management has been recommended and this leads to prolonged hospitalization. A total of 18 patients who developed severe OHSS were managed according to two protocols. The first group (n = 8) was managed conservatively with hospitalization, i.v. hydration and supportive therapy. The average duration of hospitalization was 11 days and the patients were uncomfortable throughout. A second group (n = 10) was managed on an out-patient basis with early, ultrasound-guided trans-abdominal paracentesis. While the patient was hydrated intravenously, 1-3 1 of fluid were removed over 2-3 h. The duration of hospitalization was between 6 and 7 h and no in-patient stay was required. Prompt relief of symptoms was reported and none of the patients required re-tapping. Pregnancy was achieved in 68% of all patients. Day care management with easy abdominal paracentesis was found to be simple, safe and effective; patients found it more acceptable as it avoided in-patient hospitalization.

Ambulatory Care↗
PubMed1990

Gamete intrafallopian transfer (GIFT) in women with bicornuate uteri.

Fourteen women with bicornuate uteri underwent a total of 30 gamete intrafallopian transfer procedures. All patients responded adequately to ovarian stimulation. Eight women conceived, two of them twice. Five women delivered at term and three had a premature delivery. There was one spontaneous abortion and an ectopic pregnancy. No neonatal deaths occurred in this series. No increase in the incidence of spontaneous abortion was noted but there appeared to be an increase in the incidence of premature labor. These findings suggest that the prospects of conception for infertile women with bicornuate uteri treated with gamete intrafallopian transfer are similar to those of the rest of the infertile population treated at our center.

Adult↗
PubMed1988

Analysis of 1071 gift procedures--the case for a flexible approach to treatment.

An analysis of the outcome of first gamete intrafallopian transfers for 1071 women indicates that for those aged 40 years or more all the oocytes had to be transferred to obtain a 19.2% pregnancy rate. In this age-group pregnancy rate and multiple pregnancy rate were significantly lower than those for younger women. Success rate, but not multiple pregnancy rate, was significantly higher in the group of women from whom 11 or more oocytes were recovered and transferred after ovulation induction than when only 1-4 oocytes were recovered and transferred. The findings suggest that the number of oocytes transferred should depend on clinical circumstances.

Abortion, Spontaneous↗
PubMed1988

Suppression of puerperal lactation using jasmine flowers (Jasminum sambac).

The efficacy of jasmine flowers (Jasminum Sambac) applied to the breasts to suppress puerperal lactation was compared that of Bromocriptine. Effectiveness of both regimens was monitored by serum prolactin levels, clinical evaluation of the degree of breast engorgement and milk production and the analgesic intake. While both bromocriptine and jasmine flowers brought about a significant reduction in serum prolactin, the decrease was significantly greater with bromocriptine. However, clinical parameters such as breast engorgement, milk production and analgesic intake showed the 2 modes of therapy to be equally effective. The failure rates of the 2 regimens to suppress lactation were similar; however, rebound lactation occurred in a small proportion of women treated with bromocriptine. Jasmine flowers seem to be an effective and inexpensive method of suppressing puerperal lactation and can be used as an alternative in situations where cost and nonavailability restrict the use of bromocriptine.

Bromocriptine↗
PubMed1988

Follicular fluid histamine concentrations in infertile women with pelvic adhesions.

Dense pelvic adhesions can arise as a result of pelvic infection, endometriosis, peritonitis, or pelvic surgery. The burnt-out disease is associated with evidence of a chronic inflammatory response. One of the chemical mediators of inflammation is histamine; and human and animal studies have indicated a role for histamine in the ovulatory process. In women with dense pelvic adhesions we have found significantly elevated concentrations of histamine in the follicular fluid when compared with the follicular fluid obtained from women without adhesions. This may lead to premature ovulation during a normal cycle, resulting in the release of an immature oocyte. It is possible that this may contribute to the lower fertility in women who have pelvic endometriosis but patent fallopian tubes, and in those patients where tubal patency has been restored following tubal surgery.

Female↗
PubMed1988

Secretion of atrial natriuretic peptide and digoxin-like immunoreactive substance during pregnancy.

We investigated the secretion of atrial natriuretic peptide (ANP) and digoxin-like immunoreactive substance (DLIS) during pregnancy, labor, and the puerperium, as measured in maternal and umbilical cord plasma. There were no significant changes in maternal concentrations of ANP during all three periods, and the concentrations were similar to those found in nonpregnant controls and in umbilical cord plasma. Maternal concentrations of DLIS increased significantly in the second half of pregnancy, peaked during labor, then decreased abruptly within 24 h of expulsion of the infant and placenta to values approaching the nonpregnant range. DLIS concentrations in umbilical cord plasma, however, were significantly higher than in maternal plasma during labor. The abrupt fall in DLIS in maternal plasma and the absence of a significant difference in DLIS concentrations between arterial and venous cord plasma suggest that, during pregnancy, the fetus, not the placenta, is the source of DLIS in maternal plasma.

Atrial Natriuretic Factor↗
PubMed1986

Selective screening for cancer of the cervix uteri in South Indian women.

In India, the need exists for a scheme of selective screening for women at high risk of developing cervical carcinoma. In this study, the incidence of abnormal cervical cytology amongst 500 pregnant south Indian women (gravida 3, para 2 or more) who were booked under the Post Partum Programme of the Government of India was compared to that of 200 primi and second gravidas from the same out patient clinic population. Abnormal cytology was detected in 3.6% of the women in the study group which was significantly higher (P less than 0.05) than that in the control (0.5%), indicating that the former are at higher risk of developing cervical cancer. Within the study group, abnormal cytology was not found to correlate with increasing age and gravidity or with any clinical parameter. The study and follow up could be carried out using existing facilities and manpower. Using existing personnel involved in the Post Partum Programme, a follow up rate of 67% could be achieved from among women with abnormal cervical cytology. The cost-effectiveness of this scheme of selective screening is borne out by the extremely modest additional cost incurred.

Adult↗
PubMedDate not supplied

Sperm function and structure and seminal plasma prostanoid concentrations in men with IDDM.

Semen from 18 men with insulin-dependent diabetes mellitus (IDDM) aged 20-40 yr was compared with that from 15 age-matched control subjects. Although semen volume, sperm count, and spermatozoal motility were similar in the two groups, semen from diabetic men had significantly greater numbers of abnormal spermatozoa and significantly lower ability to penetrate hamster eggs. Concentrations of prostaglandins E2, F2 alpha, and I2 and thromboxane A2 were significantly elevated in the seminal plasma from semen of diabetic subjects compared with control subjects. These observations indicate the need for a careful assessment of fertility in diabetic men, the mechanisms underlying the abnormalities in spermatozoa, and the relationship of these abnormalities to the increase in prostanoid concentrations in diabetic men.

6-Ketoprostaglandin F1 alpha↗