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Biomedical subjects

R S Bots

Publications and source records attributed to R S Bots.

14 recordsLinked to original sources

Successful induction of ovulation in normogonadotrophic clomiphene resistant anovulatory women by combined naltrexone and clomiphene citrate treatment.

Patients suffering from normogonadotrophic anovulation and infertility are initially treated with clomiphene citrate. Those who do not respond to clomiphene citrate usually receive gonadotrophin treatment which is labour-intensive, expensive, and associated with an increased risk of multiple pregnancies and ovarian hyperstimulation syndrome. We treated 22 patients with clomiphene resistant normogonadotrophic anovulation with naltrexone (an opioid receptor blocker) alone or naltrexone in combination with an antioestrogen. In 19 patients ovulation and resumption of a regular menstrual cycle was achieved and in 12 out of 19 a singleton pregnancy was observed. In conclusion, ovulation can be induced successfully using naltrexone alone or naltrexone in combination with an anti-oestrogen in clomiphene citrate resistant anovulatory patients. Compared to gonadotrophin induction of ovulation, this method is safe, simple and inexpensive.

Administration, Oral↗

Direct intraperitoneal insemination compared to intrauterine insemination in superovulated cycles: a randomized cross-over study.

The aim of this randomized cross-over study was to determine whether direct intraperitoneal insemination (DIPI) is superior to intrauterine insemination (IUI) in hyperstimulated cycles. The treatment cycles were stimulated with either clomiphene citrate and human menopausal gonadotrophins, or buserelin and human menopausal gonadotrophins. 207 subfertile couples with a cervical factor, a male factor, a combined cervical and male factor, or an unexplained subfertility were randomly assigned to the first treatment cycle. IUI and DIPI were performed in alternate cycles to a maximum of 6 cycles per couple. Every treatment cycle was followed by a nontreatment cycle. The pregnancy rate per completed cycle was 24% for IUI and 16% for DIPI (p = 0.018), whereas the cumulative pregnancy rates for IUI and DIPI were 53 and 40%, respectively (p = 0.002). There were no significant differences between pregnancy rates for IUI and DIPI in the different categories of subfertility. We conclude that DIPI does not offer better pregnancy chances than IUI in superovulated cycles.

Adult↗

Intravenous pulsatile administration of gonadotrophins in an in-vitro fertilization programme.

A group of 70 patients with 181 previously failed cycles of in-vitro fertilization (IVF) (including intra-muscular administration of gonadotrophins) achieved ongoing pregnancy rates of 29.3% per started cycle when gonadotrophins were administered intravenously in a pulsatile fashion, during suppression with a gonadotrophin releasing hormone analogue. The ongoing pregnancy rates of 175 patients treated with gonadotrophins intramuscularly and who also had at least one previous failed IVF cycle and who were treated during the same period in the same IVF programme was 15.6% per started cycle. This rate was significantly lower than that in the group treated intravenously.

Adult↗

Delayed interval delivery in a triplet pregnancy; a case report.

A case report is presented in which a triplet pregnancy ended in an immature delivery of triplet A at 20 weeks gestation, followed by a successful delay in delivery of 49 days of triplets B and C by means of a cervical cerclage and tocolysis. This is the first reported case in which two living infants could be vaginally delivered after a preceding vaginal delivery of the third infant in a triplet pregnancy.

Adult↗

Influence of occupation and living habits on semen quality in men (scrotal insulation and semen quality).

Fifty-six males from infertile couples were categorised into two different groups and their semen quality examined. Patients in which there was no evidence of interference with normal testicular thermoregulation either during the day or the night were classified as 'cool workers' and 'cool sleepers' (Group I, n = 26). In the other group (II), 'warm workers'/'warm sleepers' (n = 30), there was evidence for scrotal insulation. The number of good moving spermatozoa per ejaculate as well as this number per ml was greater in 'cool workers'/'cool sleepers' than in 'warm workers'/'warm sleepers' (p less than 0.001). These results emphasize the need for comprehensive patient history when evaluating infertility problems. Similarly, living habits may play a role in human male infertility and treatment.

Adult↗

The rhythmicity of fetal breathing varies with behavioural state in the human fetus.

The rhythmicity of human fetal breathing movements was studied during two different behavioural states (1F and 2F, respectively), using real-time B-scan-directed M-mode ultrasound recordings. The mean breath-to-breath interval durations and the standard deviations (SD), and the standard deviations of the interval differences (SDDSI) were calculated. The mean breath-to-breath interval duration was not significantly shorter during 1F than during 2F. SD and SDDSI, however, showed significantly lower values during 1F, demonstrating that the fetal breathing rhythm is more regular during state 1F than during state 2F epochs. Regular fetal breathing is thus a concomitant of state 1F.

Female↗

Are there behavioural states in the human fetus?

The aim of this study was to search for the existence of behavioural states in the human fetus and to describe their developmental course. In a longitudinal study, 14 low-risk fetuses were studied at 2-week intervals from 32 weeks of gestation onward. Fetal body movements as well as fetal eye movements, visualized by means of real-time ultrasonic imaging, and fetal heart rate patterns, recorded by means of a cardiotocograph, were used as state variables. At 38 and 40 weeks, four distinct behavioural states, named states 1F through 4F and corresponding respectively to states 1 through 4 of the neonate, could be identified. That these constellations of parameters represented true behavioural states was demonstrated by the stability of association of parameters for prolonged periods and by the simultaneity of change of parameters at state transitions. There is evidence for episodes of wakefulness in the fetus. Before 36 weeks, cycles were present in each of the state variables and combinations of parameters typical of particular states were observed. However, the relatively short durations of these combinations and the lack of simultaneity of change in the three state variables support the conclusion that these periods of coincidence occurred by chance and did not represent organized behavioural states.

Activity Cycles↗

Human fetal eye movements: detection in utero by ultrasonography.

Eye movements of the human fetus were detected in utero by means of real-time B-scan and M-mode ultrasonography. In 14 low-risk fetuses studied between 32 weeks menstrual age and term either rapid or slow eye movements or a mixture of both types were detected in 60 +/- 10% (mean +/- SD) of 558 2 min scoring epochs. A comparison of direct echoscopic detection of eye movements in a 3-day-old neonate confirmed that the movements observed in the orbital region with the real-time scanner corresponded well with eye movements seen directly. Thus eye movements can be added to the list of phenomena which can be observed noninvasively for the study of human fetal behaviour.

Age Factors↗

Maternal morbidity due to beta-adrenergic therapy. Pre-existing cardiomyopathy aggravated by fenoterol.

In the 32nd wk, fenoterol was administered to a patient during her first pregnancy because of premature rupture of the membranes and uterine contractions after 2 wk of medication. At 8 microgram/min of fenoterol, total irregularity of the maternal pulse occurred. In the 35th wk, cesarean section had to be performed because of fetal asphyxia at 5 cm of cervical dilatation. Intensive care treatment of the mother was necessary during the postoperative phase. The diagnosis of pre-existing congestive cardiomyopathy was made. Non-invasive examination of the heart is advised before beta-adrenergic drugs are given.

Adult↗

Fetal breathing movements in the normal and growth-retarded human fetus: a multiscan/M-mode echofetographic study.

52 women were examined, between the 25th and 40th wk of pregnancy, during the day-time, by the echographic multiscan/M-mode technique. Definitions of normal fetal breathing movements and singultus fetalis movements were determined. In normal pregnancies fetal breathing movements occurred during 12-19% of the total observation time before the 39th wk of pregnancy but only during 6-9% of the observation time in the 39th or 40th wk. In low birth weight pregnancies fetal breathing movements occurred during 8-13% of the total observation time, and the incidence was the same before and after the 39th wk. Singultus fetalis movements occurred in normal and low birth weight pregnancies.

Female↗