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Biomedical subjects

P Ventruba

Publications and source records attributed to P Ventruba.

At least 19 recordsLinked to original sources
PubMed2006

[Antibodies against the chlamydial heat shock protein in women with periadnexal adhesions].

OBJECTIVE: To compare and analyze IgG antibodies against chlamydial heat shock protein (cHSP60) in the blood serum of women with or without periadnexal adhesions in small pelvis. DESIGN: Retrospective study. SETTING: Department of Gynaecology and Obstetrics, Masaryk University, Brno, Veterinary Research Institute, Brno, Department of Clinical Microbiology, Faculty Hospital Brno. METHODS: IgG antibodies against cHSP60 in the blood serum were detected by means of recombinant enzyme immunoanalysis ("cHSP60 - IgG - rELISA medac"). The presence of antibodies was expressed as +, ++ or +++ pozitive. Laparoscopy according to a standard procedure was performed in 76 women (age 28 +/- 43 years) from couples with fertility disorders treated in the Centre of Reproductive Medicine, Department of Gynaecology and Obstetrics. Chí-square test (programme Statcalc - EpiInfo 6) and calculation of OR value were used for statistical analysis. RESULTS: Twenty-four women (31.6%) had normal finding in small pelvis. Periadnexal adhesions were detected in 43 (56.6%) patients, hydrosalpinx in 13 cases (17.1%), endometriosis in 27 (35.5%) patients and uterine myomas in 11 (145%) women. In the group of 33 women without periadnexal adhesions cHSP-60 antibodies were pozitive in 3 women (9.1%), in 43 women with periadnexal adhesions were pozitive in 17 cases (39.5%). In 13 patients with hydrosalpinx cHSP-60 antibodies were pozitive in 61.5%. In patients with periadnexal adhesions semiquantitative pozitivity +++ was detected in 8 cases (18.6%), 4 of them with hydrosalpinx (30.8%). Statistical analysis found significantly higher presence of cHSP-60 antibodies in women with periadnexal adhesions (OR = 654, CI interval = 1.59 - 37.81, chi-square: p = 0.0028) CONCLUSION: Women with periadnexal adhesions have more frequent and stronger pozitivity of IgG antibodies against chlamydial heat shock protein cHSP60.

Adnexal Diseases↗
PubMed2004

[Posthumous sperm procurement and use--ethical and legal dilemmas].

OBJECTIVE: To present a review of bioethical discussion and recommendations concerning posthumous sperm procurement and postmortem parenthood. DESIGN: Review article. SETTING: Department of Obstetrics and Gynecology, Masaryk University, Brno, Department of Obstetrics and Gynecology, Palacky University, Olomouc. SUBJECT AND METHOD: Literature search in Database of Abstracts of Reviews of the Evidence (DARE) and MEDLINEplus. Posthumous sperm procurement and cryopreservation must be performed within 36 hours after death. To established appropriate medical practice, it is important to consider all stakeholders in the decision-making process: the deceased, the requesting party, the child, the physician and the society. There are only few legislative measures concerning postmortem parenthood and posthumous sperm procurement. The essential elements for postmortem reproduction are: judicial order, ethics committee approval, bereavement period of at least 6 month before use. CONCLUSION: Posthumous sperm procurement is fraught with ethical and legal implications. All stakeholder should be considered. Society for reproductive medicine should prepare acceptable standard protocol.

Cryopreservation↗
PubMed2003

[Importance of sensitization of insulin receptors in the prevention of ovarian hyperstimulation syndrome].

OBJECTIVE: Aim of our study was to analyze the influence of insulin receptor sensitization on the course of controlled ovarian stimulation in the program of assisted reproduction and to identify the availability of ovarian response improvement due to the reduced production of intraovarian androgens. Further we tried to identify the preventive influence of metformin on development of ovarian hyperstimulation syndrome. DESIGN: Prospective randomized controlled study of 172 patients involved in the assisted reproduction program from May 2000 to December 2001. SETTING: Centre of Assisted Reproduction, Department of Gynecology and Obstetrics, Medical Faculty, Masaryk University and University Hospital, Brno. MATERIAL AND METHODS: Patients undergoing the ovarian stimulation with increased risk of development of ovarian hyperstimulation syndrome due to the polycystic ovarian syndrome were included in the study and randomized to two groups. (1) Women in the first group used the insulin receptor sensitizing drug metformin together with gonadotropins, and (2) women in the second group underwent the classic stimulation protocol alone. The control group (3) consisted of patients with intact ovarian function and different infertility factor. Complex hormonal status was assessed before the treatment initiation and the level of androgens in the follicular fluid was investigated in all patients. RESULTS: Metformin during gonadotropin stimulation has significantly reduced the risk of ovarian hyperstimulation syndrome in women with PCOS. Significantly lower intraovarian androgen levels were documented in comparison to women without metformin and also when compared to patients with intact ovarian function. Metformin had also significantly reduced estradiol blood levels at the day of hCG application without significant influence on the number of obtained oocytes. CONCLUSIONS: The risk of ovarian hyperstimulation syndrome development was significantly decreased in patients with PCOS in consequence to insulin receptors sensitization.

Adult↗
PubMed2003

Ascorbic acid and infertility treatment.

AIM OF THE STUDY: To assess the ascorbic acid (AA) in the follicular fluid in women treated by in vitro fertilization and embryonic transfer levels (IVF/ET) and to analyse the influence of vitamin C supplementation on the results of infertility treatment. TYPE OF THE STUDY: Prospective study in women treated by IVF/ET. METHODS: The influence of vitamin C supplementation on the outcome of infertility treatment in the assisted reproduction programme in 76 women (38 of them smokers, 38 non-smokers) was studied. Half the women (19 smokers and 19 non-smokers) were administered vitamin C in daily doses of 500 mg in so-called pellets allowing for gradual release over 8 to 12 hours. The control group consisted of the same number of smokers and non-smokers. In all the women, ascorbic acid levels were determined in two urine samples (prior to supplementation and at follicle retrieval) and in follicular fluid by means of a colorimetric method. Ovarian response to hormonal stimulation with gonadotropins (hMG, FSH) at a dosage of 150-225 IU per day combined with GnRH analogues in the short (buserelin) or long (triptorelin) protocols, and 5,000-10,000 IU of human chorionic gonadotropin was evaluated based on the number of follicles created and number of retrieved oocytes. Fertilisation was assessed, based on the number of successfully fertilised oocytes (fertilisation rate) and based on the number of cultivated embryos. The success of the infertility treatment was evaluated based on the number of pregnancies. RESULTS: Ascorbic acid levels in follicles were significantly higher (p < 0.001) in women with vitamin C supplementation than in the control group (8.98 +/- 5.09 vs. 5.04 +/- 2.85 mg/l). The administration of vitamin C during the period of hormonal stimulation showed a statistically insignificant impact in terms of the higher number of pregnancies (34.2% vs. 23.7%). Vitamin supplementation had a greater impact on the number of pregnancies in the non-smokers' group (57.9% vs. 31.6%). The pregnancy rate was significantly higher (p < 0.01) in non-smoking women than in smokers--44.7% vs. 13.2%, which appears to be a reason for asking women to cease smoking prior to infertility treatment.

Adult↗
PubMed2002

[Cryopreservation of sperm before neoplasm therapy--7 years' experience].

OBJECTIVE: To compare sperm count of cancer patients with health men, to analyze possible relation of sperm pathology and diagnosis of malignant disease and present experience of our cryopreservation programme for cancer patients. DESIGN: Retrospective clinical study. SETTING: Department of Obstetrics and Gynecology, Masaryk University, Brno, Czech Republic. METHODS: 215 patients (age 25.4 +/- 5.6 years) were referred to our unit by oncology specialists for semen cryopreservation before cancer treatment during 1995-2001. Sperm samples were analysed according to guidelines of WHO. Richardson's medium and Planer Kryo 10 were used for standard cryopreservation. Sperm count results were compared to control group of 84 men (23.1 +/- 3.6 year) examined as possible sperm donors. Program SPSS version 9 was used for statistical analysis. Standard intracytoplasmic sperm injection (ICSI) using frozen spermatozoa was used for infertility treatment following malignant disease recovery. RESULTS: Testicular cancer was diagnosed in 115 (53.5%) patients, malignant disease of lymphatic and haemopoetic tissue in 75 (34.9%) cases--out of them 35 (16.3%) Hodgkin's lymphoma. Twelve men (5.6%) were treated for osteosarcoma and 13 for other malignant disease. Only 2.8% patients had normospermia. Severe oligospermia < 5 mil/ml was found in 73 men (33.9%) including 22 cases of azoospermia (10.2%) and 12 cases (5.6%) of cryptozoospermia. 138 (64.2%) patients had asthenospermia < 10% of progressive motility, 49 (22.8%) had terratozoospermia < 10% spermatozoa with standard WHO morphology. Sperm concentration, progressive motility and morphology were in cancer patients significantly lower (P < 0.001) than in control group. Men with testicular cancer had significantly higher frequency of severe sperm pathology. Only 4 patients have returned for assisted reproduction treatment. In all cases ICSI was used, 1 pregnancy and delivery was achieved. During more than 4 years after cryopreservation died 16.6% of patients. CONCLUSION: Cancer patients has significantly higher frequency of severe sperm pathologies than healthy men. The most severe sperm pathologies are among men with testicular cancer. Only minority of patients return for fertility treatment. Cryopreserved spermatozoa of cancer patients are able to initiate pregnancy by assisted reproduction techniques.

Adolescent↗
PubMed2001

The outcome of infertility treatment by in-vitro fertilisation in smoking and non-smoking women.

The former and current smoking habits of 159 patients treated for infertility by means of IVF/ET technique were observed. The data were verified by a cotinine examination in urine. The basal levels of gonadotropines before treatment, the process and outcome of ovarian stimulation, oocyte fertilisation and incidence of pregnancy were observed. There were no differences between smokers and non-smokers in terms of their age and professional risks; smoking correlated with a lower level of education. The overall response of active smokers to hormonal stimulation was worse than that of non-smokers: a lower number of mature follicles (12.3 vs. 16.2) and a lower number of oocytes were gained (7.3 vs. 10.9). There was a correlation between the age of the smokers and the higher consumption of FSH needed for stimulation and lower levels of 17 beta-estradiole. The number of fertilised oocytes in smokers was significantly lower (p < 0.01; 68.2% vs. 47.8%). A negative correlation between the duration of exposure to cigarette smoke and fertilisation rate was shown (p < 0.05). There were fewer embryos in smokers as compared with non-smokers (3.3 vs. 4.7). A total of 35 women became pregnant (i.e. 22.1%), of which 28.8% were non-smokers, 12.5% were occasional smokers, and none were regular smokers. The OR value in non-smokers was 1.48, and in occasional smokers 0.57. In this study, the negative influence of smoking on the outcome of treatment by IVF/ET technique was proved. The phasing out of smoking should be an integral part of human infertility treatment.

Adult↗
PubMed2001

[Analysis of factors affecting the results of assisted reproduction using a system for information mining of the SHLUK database].

OBJECTIVE: To retrospective explorating computer analysis of data about therapeutic cycles in assisted reproduction technology (ART) to confirm applicability of system for data mining SHLUK in partial analysis of fertilisation phase of therapeutic cycle. Relations between parameters of sperm count analysis and outcome of in vitro fertilisation were analyzed. DESIGN: Retrospective analysis. SETTING: 1st Depart of Obstet. and Gynaecol., Masaryk University, Brno; FEI, VSB, Ostrava. METHODS AND MATERIAL: Conditions of successful therapy in single phases of ART therapeutic cycles, were analysed using system SHLUK, which included a lot of methods for data mining. Analysis of relation between reasons and results in ART therapeutic cycles was done through method IMPL and method of group implication GRIMPL. Analysed file included data about 8516 therapeutic cycles ART in 4470 patients and data about 666 clinical pregnancies stored in electronical form in clinical data register. The model analysis of fertilisation tested relations between parameters of sperm analysis and outcome of in vitro fertilisation. Fertilisation rate (FR)--ratio of fertilized oocytes/obtained oocytes was evaluated as fertilisation stage outcome. RESULTS: Significantly higher FR--60.9% was in the group with sperm concentration before preparation 41-60 mil/ml. When sperm concentration before preparation was under 10 mil/ml--FR was significantly lower--42.2%. Motility of sperm before preparation under 10%--FR was significantly lower--45.3%. Motility of sperm before preparation 41-50%--FR was significantly higher--56.9%. Significantly higher FR--minimal 56.0% was in group of examinations with sperm after preparation was 41-90%, then FR was significantly higher--53.5%. In sperm survival test, where more than 30% of sperm survive 24 hours of cocultivation with oocytes FR was significantly higher--minimal 55.9%. CONCLUSION: Applicability of system for data mining SHLUK in the analysis of factors with influence on assisted reproduction outcome was proved. System for data mining SHLUK makes possible to define statistically significant relations between attributes of fertilisation stage of ART cycles and it is able to postulate basic hypothesis about existing reasons and results in therapeutic cycles of ART.

Data Interpretation, Statistical↗
PubMed2001

[Polymorphism of angiotensin converting enzyme (ACE) and TNF-beta genes in men with disorders of spermatogenesis--pilot study].

INTRODUCTION: The presence of components of the renin angiotensin system and tumour necrosis factor in a male reproductive tract supports the hypothesis that these substances may influence reproductive functions. It was proved that angiotensin II as a product of ACE has influence on sperm capacitation and motility. TNF-beta is released from T-lymphocytes and has the regulatory effect on steroidogenesis and spermatogenesis. Aberrations of these agents can result in infertility. OBJECTIVE: The aim of this study was to determine the allele frequency of ACE and TNF-beta genes in men with pathological sperm count and men with normal fertility. We examined the insertion/deletion (I/D) ACE and B1/B2 TNF-beta gene polymorphic alleles and analyzed their frequency in patients and fertile men. DESIGN: A pilot study. SETTING: 1st Clinic of Gynaecology and Obstetrics and Institute of Pathologic Physiology, Masaryk University, Brno, CR. MATERIAL AND METHODS: The genomic DNA was isolated from peripheral blood leukocytes by a standard method according to Sambrook in a group of 46 patients (33.4 +/- 7.2 years) with pathological sperm count (9 azoospermia, 21 severe oligoasthenospermia, 16 moderate oligoasthenospermia) and in a control group of 88 healthy men (31.2 +/- 9.3 years) with normal fertility. Polymerase chain reaction (PCR) was used for genom analysis. The method according to Rigat was used for the I/D ACE polymorphism. B1/B2 TNF-beta genotype of each patient was determined after Nco I digestion of the amplified product and subsequent agrose gel electrophoresis. Fisher's exact test and chi square test were used for statistical analysis. RESULTS: In the study we found these differences of allel frequency and their combination: 1. Combinations of the genotype II (ACE) + B1B2 (TNF-beta) and genotype II (ACE) + B2B2 (TNF-beta) were less frequent in patients (8.7%) than in fertile men (28.4%), this difference was statistically significant (p = 0.021). 2. Allele B1 (TNF-beta) was more frequent among patients (40.2%) than in the control group (29.5%), this difference was near to the point of statistical significance (p = 0.05). 3. Allele D (ACE) frequency was higher in men with pathological sperm count (52.2%) than in fertile men (44.9%), this difference was not statistically significant (p = 0.15). CONCLUSION: The study has found different allele frequency of I/D ACE and B1/B2 TNF-beta genes polymorphism in men with pathological sperm count compared to men with normal fertility. These results could contribute to elucidate the genetic background of a male infertility.

Adult↗
PubMed2000

Familial cryptic translocation with del 4q34-->qter and dup 12pter-->p13 in sibs with tracheal stenosis: clinical, classical and molecular cytogenetic studies and CGH analyses from archival placental tissues evidencing tertiary trisomy 4 in one abortion specimen.

We report on two retarded half-sibs of different sex and seemingly normal karyotype who had the same syndrome of minor anomalies, heart defect and a distal tracheal stenosis, and who shared a healthy mother. These findings raised suspicions of a cryptic chromosome translocation. A translocation t(4;12)(q34;p13), balanced in the mother and unbalanced in the sibs with loss of terminal 4q and gain of terminal 12p regions, was verified by FISH using whole chromosome painting, subtelomeric and YAC probes. Clinical features could be explained by partial monosomy 4q and partial trisomy 12p. Tracheal stenosis was interpreted as a consequence of the same developmental disturbance leading to esophageal atresia and tracheo-esophageal fistula. It was attributed to the 4q deletion in which esophageal atresia as also respiratory difficulties and airway obstructions had been described. Paraffin-embedded placental tissues were available from three of the five abortions of the mother allowing DNA extraction and comparative genome hybridization (CGH). Two of the abortion specimens had the same der(4)t(4;12)(q34;p13) unbalanced translocation as identified in the sibs. In the third abortion specimen, suspicious of triploidy because of partial hydatidiform mole, CGH uncovered a tertiary trisomy 4 resulting from a 3:1 segregation of the translocation chromosomes and their homologs during maternal meiosis I. Differences in CGH results using DNA generated directly or after DOP-PCR were explained by DNA fragmentation in paraffin-embedded tissues and unequal amplification. Am. J. Med. Genet. 94:271-280, 2000.

Adult↗
PubMed2000

[Continuous monitoring of fetal oxygen saturation (FSpO2) using intrapartum fetal pulse oximetry (IFPO) in the diagnosis of acute fetal hypoxia].

OBJECTIVE: The aim of the study was to evaluate the possibility of lowering the Caesarean Section rate in patients presenting the signs of intrauterine hypoxia on CTG tracing by evaluating the foetal oxygen saturation (FSpO2) by means of intrapartum foetal pulse oximetry (IFPO). DESIGN: Open prospective study. SETTING: 1st Department of Gynecology and Obstetrics, Medical Faculty of Masaryk University, Brno. METHODS: From January 1, 1999 to December, 1999 68 patients were enrolled in the study. For the application of the IFPO sensor the patient had to meet the following criteria: patient's informed consensus, pregnancy > or = 36 weeks, regular uterine contractions, rupture of membranes, cervical dilatation of > or = 2 cm, singleton pregnancy, cephalic occiput presentation, no sings of vaginal infection, acute foetal hypoxia on CTG tracing: (baseline heart rate < 100 beats/min of different patterns. Progressive bradycardia: baseline heart rate gradually decreases between contractions (DIP II, DIP 0). Persisting bradycardia, baseline < 80 beats/min. Baseline tachycardia (> 150 beats/min) with reduced variability and/or severe variable (DIP 0) and late decelerations (DIP II). The IFPO used--Nellcor N-400. In all patients that fulfilled the above mentioned criteria during the first stage of labor the sensor was applied preferably on the posterior cheek of the foetus and the FSpO2 values were continuously monitored up to the complete dilatation. The threshold of the intrapartum foetal hypoxia (FSpO2 values) was considered < 30% for more than 10 minutes. In cases of normal FSpO2 values the delivery was conducted vaginally even if the CTG tracing continued to signalise++ intrauterine hypoxia. In case of pathologic FSpO2 values, Caesarean Section was performed. RESULTS: IFPO is an easy feasible method and in all cases the values of FSpO2 were obtained. The method has no serious side effects neither in the mother nor in the foetus. Nevertheless the presence of the sensor in the uterine cavity provokes often unpleasant feelings and limits the mother in free movements. In all suspicious CTG tracings (17) no Caesarean Sections were performed after the verification of the foetal hypoxia by means of FSpO2 evaluation. In 51 patients a pathologic CTG tracing indicating the performance of Caesarean Section was present. After FSpO2 evaluation the Caesarean Section was performed only in 11 (21.6%) patients. The remaining 40 (78.4%) delivered vaginally. Between these two groups there was statistical difference in the values of FSpO2 and postpartum cord pH. The state of newborns evaluated according to the Apgar score did not significantly differ in the two groups. CONCLUSION: These preliminary results indicate that taking in an account foetal SpO2 evaluated by IFPO in the 1st stage of labor in cases of pathologic CTG tracing (late and variable deceleration) indicating Caesarean Section, > 50% of these may be saved with identical perinatal outcome (Apgar scores, cord pH).

Acute Disease↗
PubMed2000

[Effect of maternal O2 inhalation on oxygen saturation in the parturient (SpO2) and the fetus (FSpO2)].

OBJECTIVE: The aim of the study was to evaluate the impact of different concentrations of inspirated O2 on the SpO2 values of the foetus and the mother during the 1st and 2nd stages of labor. DESIGN: Prospective study. SETTING: 1st Department of Gynecology and Obstetrics, Medical Faculty of Masaryk University, Brno. METHODS: 17 non-risk patients were enrolled in the study. The SpO2 levels of the mother and the foetus were monitored simultaneously in 10 min intervals with the room air inspiration entrainment O2 mask and the inflatable face mask during 1st and 2nd stages of labor. RESULTS: No changes in maternal SpO2 values were revealed in the three different O2 inspiration regimens neither in the 1st, nor in the 2nd stages of labor. The mean value was 98% +/- 1.6 SD. As for the foetus the SpO2 values were increased by 6% (+/- 7.9 SD) after 40% concentration of O2 and 7.7% (+/- 8.8 SD) after 98% O2 inspiration during the 1st stage of labour. These values have decreased promptly after the cessation of the O2 inspiration. The mean SpO2 values at room O2 concentration were 46.3% +/- 7.9 SD for the 1st stage of labor and 43.7% +/- 4.8 SD for the 2nd stage of labor. CONCLUSION: The O2 inspiration during the labor has no impact on the maternal SpO2 values but increases the SpO2 values of the foetus during the 1st stage of labor. We were not able to evaluate the impact of the O2 inspiration on foetal SpO2 values during the 2nd stage of labor.

Adult↗