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Biomedical subjects

R E Bernardus

Publications and source records attributed to R E Bernardus.

24 records · Page 2Linked to original sources
PubMed1985

The effect of follicle-stimulating hormone without additional luteinizing hormone on follicular stimulation and oocyte development in normal ovulatory women.

Twelve normally menstruating women were stimulated with (1) human menopausal gonadotropins (hMG) containing follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and (2) FSH only to induce growth of multiple follicles for oocyte retrieval. Maturation of the follicles and presumptively the oocytes was assessed by daily serum estradiol (E2) values, the response of the vaginal epithelium, and cervical mucus. The growth and number of follicles were measured by ultrasound daily. Human chorionic gonadotropin was administered as a surrogate LH surge. The hMG cycles were compared with the FSH-only cycles in relation to serum E2 and oocyte maturation, fertilization, transfer, and pregnancy rates. Five of eight cycles adequately stimulated with FSH only resulted in successful pregnancies. FSH without additional LH can initiate and maintain E2 function and allow oocyte maturation to proceed up to the terminal maturation, which is associated with the LH surge. The effect of LH may be to hasten follicular atresia in the developing cohort of follicles.

Adult↗
PubMed1985

Male factor evaluation in in vitro fertilization: Norfolk experience.

Thirty-three patients from the in vitro fertilization (IVF) program at Norfolk are critically reviewed. A battery of tests was designed and an endocrine investigation was carried out on these patients. The fertilization rate for preovulatory oocytes was lower than in the normal male population (39.6% versus 88.6%). When total concentration of sperm with rapidly progressive motility was less than 6 X 10(5), to fertilize several eggs together the fertilization rate was zero. No fertilization was obtained when the number of sperm with rapidly progressive motility recovered after the separation was less than 1.5 X 10(6). The hamster zona-free oocyte penetration test correlated well with the human IVF system. The other parameters investigated did not show good correlation. When fertilization was achieved, the results of the IVF procedure in the series reviewed rendered a 30.8% pregnancy rate per transfer in 26 transfers. Fifty percent of the pregnancies were normal (either ongoing or delivered). Thirty-seven percent were preclinical miscarriages, and 12.5% were clinical abortions. In the abnormal male population, higher concentrations of sperm per egg should be used for insemination for achievement of optimum fertilization rates. Once fertilization is obtained, the results do not differ substantially from the IVF population at large.

Animals↗
PubMed1984

Torsion of the fallopian tube: some considerations on its etiology.

Macroscopic and histologic findings in 11 patients operated on for isolated tubal torsion suggested a common pathophysiologic process. During laparotomy, tubal torsion appeared to involve the fimbrial end of the fallopian tube, distal to the site of compression by the sterilization procedure, the ovarian ligament, or a dense adhesion. Histologic study of the tube showed signs of vascular disturbances. Similar signs, although to a lesser extent, were present in the fimbrial end of the contralateral tube in sterilized patients. A causative mechanism resulting in tubal torsion is proposed. The present report suggests that tubal torsion can be a late complication caused by some methods of tubal sterilization.

Adult↗
PubMedDate not supplied

The use of pure FSH alone or in combination for ovulation stimulation in in vitro fertilization.

The experience of the Norfolk Program, from the beginning of 1981 until mid 1984, is reviewed. Two groups of patients are compared. The initial experience goes from the very beginning until early 1984 in which knowledge has accumulated; the patients treated afterwards up to mid 1984 where the previous experience was used to monitor them in a more accurate way is reviewed as a separate category. Different protocols, in each group, are compared: concomitant combination of hFSH/hMG (protocol # 1), sequential combination of the two gonadotropins (protocol # 2), and pure FSH administration (protocol # 3). Several parameters were used in the evaluation of the results: 1) day of laparoscopy, 2) volume of the follicles obtained, 3) number of preovulatory oocytes obtained, 4) number of immature oocytes obtained, 5) number of atretic oocytes induced, 6) number of oocytes with abnormal zona pellucida, 7) fertilization rate of preovulatory and immature oocytes, 8) abnormal fertilization rate of preovulatory and immature oocytes, 9) cleavage rate of the normally fertilized preovulatory immature oocytes, 10) transfer rate, single and multiple, 11) follicular and luteal phases as evaluated by estradiol levels in the preovulatory phase and by E2 and progesterone in the post ovulatory phase, 12) pregnancy rate. Pure FSH seems to prolong somewhat the follicular phase. Preovulatory oocytes derived from small follicles may originate pregnancies that may end in abortion. The concomitant combination rendered a larger number of preovulatory oocytes. The number of immature oocytes tend to be higher in the pure FSH stimulated group, but this seems to depend on the way FSH is used. The normal fertilization rate for preovulatory oocytes tends to be similar as the criteria used in the stimulation protocol improved. The abnormal fertilization rate for both types of oocytes decreased in the latest series. The number of embryos transferred was higher in the concomitant combination stimulation. Shortening the hMG/hCG interval in the pure FSH category seems to induce a deficient follicular phase except in cases with rapid high response. When using the hFSH/hMG combination the values of estradiol in the follicular phase tend to be much higher than when the original pure hMG protocol is used. This does not seem to be true when pure FSH stimulation is used. The number of multiple transfers increased substantially in both types of stimulation as experience increased.(ABSTRACT TRUNCATED AT 400 WORDS)

Chorionic Gonadotropin↗