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Biomedical subjects

R Sudik

Publications and source records attributed to R Sudik.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Hormone profile and follicle development in ovarian stimulation treatment for in vitro fertilization. II. Prolactin, estradiol and progesterone profile].

144 patients were treated by 5 different stimulation protocols in the IVF-program of the University Women's Hospital Rostock (Clomiphene/hCG, Clomiphene/Anthrogon/hCG, Pergonal/hCG, Anthrogon/hCG, Folistiman/hCG). Estradiol-17 beta and progesterone were determined during the follicular phase of 172 cycles by RIA. The results were compared between the treatment groups by means of Student's t-test or Mann-Whitney's nonparametric test. Additionally, in 37 cycles prolactin was determined. The levels of estradiol-17 beta in all treated groups were higher as compared with spontaneous cycles. Between the groups statistically significant differences were found in start and velocity of E2-rise, in the average level of E2, and in the level of preovulatory peaks. The latent phase of stimulation was significantly longer in patients treated with pergonal than in Anthrogon treated patients. Moreover, in the Anthrogon group the rate of "high responder" was higher. On average, in patients with a very fast growth rate of estradiol-17 beta (greater than 1.9 nmol/l) during the late follicular phase the percentage of less mature oocytes was increased after follicular puncture. The levels of progesterone started to rise in all groups between day-2 and -1 (day 0: day of LH-peak). On day 0, patients with Pergonal and Anthrogon had the significantly highest level. Levels above the 1s-range occurred in 12 patients during the follicular phase. This elevation of progesterone took place in 3 patients without any rise of basal LH-levels. 80.4% of 37 patients investigated were found to have prolactin levels above 500 mE/l during the late follicular phase. This transient hyperprolactinemia correlated with the rise of estradiol levels and continued during the early and mid luteal phase. Hence preventive administration of bromocryptine appears to be advisable in cycles stimulated with gonadotropins.

Chorionic Gonadotropin↗
PubMed1989

[The hormonal micromilieu and oocyte status in the stimulated in vitro fertilization cycle].

FSH, LH, PRL, estradiol-17 beta and progesterone were determined in 651 follicular fluids of 173 patients treated by ovarian stimulation for IVF. The stimulation was performed according to 5 different schemes: clomiphene/HCG, HMG (Pergonal)/HCG, HPG (Anthrogon)/HCG, clomiphene/HPG/HCG, Folistiman (heterologeous pituitary gonadotropin)/HCG. The mean levels of hormones of all follicles of each stimulation scheme were determined and differences between the groups were estimated by Student's t-test and the x-square-test. Additionally, in a hierarchy of follicles made depending on the follicular fluid volume the hormonal levels were compared between different rank numbers of one stimulation group and between different groups of stimulation. The maturation of oocytes judged by a maturation index and their ability for cleavage in culture after insemination was investigated in relation to the hormonal content of the follicular fluid. Stimulation by gonadotropins (Pergonal, Anthrogon, Folistiman) led to an decreased mean level of follicular steroids. This was related to an increased part of follicles poor in steroids after stimulation by gonadotropins. Within the follicular population follicles stimulated by clomiphene/HCG had a reduction of the levels of estradiol in higher rank numbers, but there were no clear evidences for such a reduction in the other stimulated groups. In all stimulation groups a significant reduction of progesterone levels was observed in higher rank numbers of follicles. Oocytes with a high maturation index mainly derived from follicles rich in progesterone. After insemination, development of oocytes in culture was compatible even with very high or low levels of hormones. There was no relation of the levels in FSH and LH to cumulus expansion and levels of estradiol of the follicular fluid. There was also no clear correlation between the levels of prolactin in follicular fluid and the cleavage rate.

Estradiol↗
PubMed1989

[Problems in treatment of sterility in developing countries--experiences with sterility consultation in Gondar/Ethiopia].

101 women were treated because of sterility in the Gondar College of Medical Sciences, Gondar/Ethiopia, in the years 1987/88. The results revealed some typical difficulties in diagnosis and treatment of sterility in developing countries, arising from limited technological facilities and special characteristics of the group of treated patients. In 61 women a final diagnosis could be made. The main cause of sterility was complete tubal occlusion in 65.6% of the cases due to a high incidence of pelvic inflammatory diseases in the investigated patients. Ovarian causes accounted for only 18%. The importance of the male factor was not evaluable due to a traditionally conservative attitude of most men against sterility investigations. Chromolaparoscopy in combination with endometrial biopsy in the second half of the cycle were well suitable for clearing most of female causes of sterility.

Adolescent↗
PubMed1989

[Success rates in in vitro fertilization--a mathematical problem? Comments on the article by M. M. Seibel in Obstet. Gynecol. 72 (1988) 265].

In vitro fertilization, GIFT and related methods have given new perspectives for the treatment of sterility and are applied worldwide. Despite an increasing application of these methods success rates are still relatively low. It may be difficult for sterility patients and their gynecologists to get a clear imagination about the success rates of an IVF-program. This was mentioned in the "Green Journal" by M.M. Seibel, the article of whom has been taken as a basis for some thoughts about the problem. Unclear statements and different bases for reports of success rates may lead to unrealistic expectations concerning the chance for a successful treatment by IVF. Therefore, in discussion with patients only comprehensible figures should be mentioned, e.g. a rate involving numbers of term pregnancies and oocyte retrievals. Taking this as a crucial point the patient and her partner should be informed about their chances depending on their individual findings and the facilities of the sterility centre.

Adult↗
PubMed1988

[Developmental trends in reproduction medicine].

In the last few years reproductive medicine has developed into a medical research field of its own. It deals with the theoretical and practical problems of human reproduction and is characterized by close cooperation between medical and scientific specialists both clinically and in research. Far-reaching social effects arise from the application of hitherto unknown research and treatment methods. The results of research in reproductive medicine led, due to the development of effective contraceptives, to a reduced connection between sexual intercourse and reproduction, and have made possible reproduction even without sexual intercourse, by means of artificial insemination and in-vitro fertilization. These latest and most exciting developments in reproductive medicine are based on and justified by the right of every couple to a child of their own. In-vitro fertilization and related treatments, eg. gamete intrafallopian transfer, are expected to dominate the treatment of the sterile couple in future. The social effects of the new techniques in reproductive medicine nessecitate the development of ethical standpoints, in which human welfare must predominate. In the GDR, in accordance with the recommendations of the "Ethics in medicine" working group, in-vitro fertilization using gametes of the same couple is ethically accepted, as is also oocyte and embryo donation, provided they aim to fulfil a couple's wish for a child. Surrogate mothers are rejected, however. The combination of in-vitro fertilization and genetic engineering could potentially be used in the treatment of certain types of hereditary disease, but there is also the possibility of misuse.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1987

[Hormone profile and follicle development in ovarian stimulation treatment for in vitro fertilization. 1. FSH and LH profiles].

144 patients were treated by 5 different stimulation protocols in the IVF-program of the University Women's Hospital Rostock (Clomiphene/HCG, Clomiphene/Anthrogon/HCG, Pergonal/HCG, Anthrogon/HCG, Folistiman/HCG). In 172 cycles FSH and LH were measured in serum during the follicular phase by RIA. The results were compared between the treatment groups and a group of normal women by Student's t-test or Mann-Whitney's nonparametric test. Moreover, in each group the number of follicles visible by laparoscopy and number of punctured follicles were estimated. The maturation of collected oocytes were judged by a maturation index. Modus of action and FSH/LH-ratio of used drugs have been shown to influence serum levels of FSH. Every stimulation protocol was characterized by typical profiles of hormones. Especially, immunoreactive levels of FSH were related to development of follicles. Different biological action of various stimulation regimes was demonstrated by a shortage of follicular phase from 13,4 days in the Clomiphene group to 11,0 days in the Folistiman group, an increase of laparoscopically visible follicles from 4,0 to 13,2 and a rise of collected oocytes from 1,6 to 7,3 per laparoscopy. Quality of oocytes has been shown to be related significantly to the modus of stimulation. Anthrogon-protocol was the most effective stimulation regime according to profile of gonadotropins, the number of follicles and the structure of harvested population of oocytes. However, even in this group co-dominant development of follicle was not achieved. Application of pure FSH and an earlier start of stimulation treatment are possibilities for improvements of results in IVF by stimulation.

Chorionic Gonadotropin↗
PubMed1987

[Dynamics of follicle development in stimulated in vitro fertilization cycles--sonographic follow-up and findings following follicle puncture].

Results of ultrasonical folliculometry during treatment by 5 different stimulation protocols were evaluated in 122 cycles of IVF-patients. Additionally, the structure of follicular population was investigated by measurement of follicular volume which was the basis of a follicular hierarchy. - Number of developing, sonographically detectable and punctured follicles increased significantly from stimulation by Clomiphene to stimulation by Folistiman. Only in stimulation by Clomiphene number of sonographical visible follicles was in accordance with laparoscopically punctured follicles. Development of relationship of the follicular classes during treatment supports hypothesis that exogenous gonadotropins do not increase follicular recruitment in the follicular phase but prevent atresia of follicles recruited earlier. Long lasting action of FSH as in stimulation by gonadotropins stimulates a greater number of follicles more intensively as demonstrated by an increased follicular volume in follicles with high rank numbers in gonadotropin treated patients compared with treatment by Clomiphene and Clomiphene/Anthrogon. Very high FSH-levels probably cause a heterogenous population of follicles with an increased number of small follicles at time of follicular puncture.

Chorionic Gonadotropin↗
PubMed1985

[Arginine-GnRH-TRH test in patients with primary hypothalamic amenorrhea].

In 8 patients with hypothalamic primary amenorrhea aged from 16 to 23 years (average age 19,4 years) a sequential stimulations test was performed with 0,5 g arginine hydrochloride per kg body weight, 25 micrograms gonadotropin-releasing hormone (GnRH) and 200 micrograms thyreotropin-releasing hormone (TRH). The response of the lactotropic, gonadotropic, thyreotropic and somatotropic cells of the pituitary was investigated. Serum levels of PRL, LH, FSH, TSH and HGH were determined by RIA. In all women hypoplastic ovaries were found by laparoscopy. In 7 patients tissue biopsies showed primordial follicles or primordial and secondary follicles, respectively. Investigations point to, that in hypothalamic primary amenorrhea at first the function of the gonadotropic and lactotropic cells of the pituitary is injured. The somatotropic cells could not be stimulated in 3 of 8 patients, the function of hypothalamo-pituitary-thyroid-axis in the stimulations test was normal in all women.

Adolescent↗
PubMed1985

[Psychological studies of sterile couples within the scope of an in vitro fertilization program].

The results of a psychological individual and process diagnostic programme at sterility patients undergoing an in-vitro-fertilization and embryo transfer are demonstrated. The women showed an optimistic emotional disposition and negation of conflict or trouble experience during their stay in the hospital. From the day of laparoscopy till embryo transfer a short labilization sets in, i.e. a slight deterioration of the emotional disposition as an expression of a phase of stress compensation. Questions of motivation, partner constellation and special personality characteristics are discussed.

Adaptation, Psychological↗
PubMed1984

[Comparative light- and electron microscopy findings in oocytes obtained by laparoscopy during the cycle period close to ovulation].

Oocytes recovered by diagnostic laparoscopy can be divided in three categories--atretic, non-ovulatory and pre-ovulatory oocytes. Examples for those three categories are demonstrated. The findings from survey sections and from transmission electron microscopy were used for the retrospective characterization of the light micrographs and the description of the surroundings. Methodic experiences allow further research on oocytes and embryos with developmental defects. Two examples were shown. Our experiments yielded, that the examination with light and electron microscopy is suitable for statement in diagnostic laparoscopies and that these examinations were advantageous for the preparation of an in vitro fertilization program.

Female↗
PubMed1984

[In vitro fertilization program in therapy of the sterile marriage. International status and personal experiences].

A review is given about in vitro fertilization (IVF/ET) and embryo transfer in the treatment of sterile couples. Programmes of in vitro fertilization of successful international groups are analysed and discussed, especially the improvements of the method. These international reports were the basis of the programme of in vitro fertilization at women's hospital of the Wilhelm Pieck University at Rostock. The organization of the programme depends on local conditions. Treatment is performed in some so-called IVF-series. The results of the first and second series with 52 patients are reported. The only pregnancy during the second series was an ectopic pregnancy.

Adult↗
PubMed1984

[In vitro fertilization and embryo transfer. Personal experiences in the introduction of laboratory methodology].

Our laboratory technique includes recovery and handling with gametes outside the body, in vitro fertilization, culture of embryos, and finally embryo-transfer. Time-table, culture media and technique of the cultivation as well as laboratory devices are described and than compared with informations about methods from other teams. The necessity of transport of the follicle fluids from operating theatre to laboratory is given caused by local conditions. All dates about number of oocytes (73), quantities of preovulatory oocytes (47) and cleavage rates (55%) are descended from 30 laparoscopic oocyte recoveries of the 2. in vitro fertilization program of the university woman hospital in Rostock, January and February 1984.

Culture Media↗
PubMed1984

[A transportation vehicle for laparoscopically obtained follicular specimens].

Structure, function and first results with a vehicle for transportation were described. This apparatus allows to store laparoscopic harvested follicular fluids for a while in constant temperature and in air condition with 5% CO2 in compressed air. Simultaneously the follicular fluids were transported in this vehicle from operating theatre to the laboratory.

Female↗
PubMed1984

[First experience with an in vitro fertilization program at the Rostock University Clinic of Gynecology and Obstetrics].

In vitro fertilization as an aid in diagnosis and treatment of the sterile couple has been used at the university clinic of gynecology and obstetrics in Rostock since the beginning of 1983. 17 women were treated in the first series of in vitro-fertilization and embryo transfer in September and October 1983. After treatment with clomiphene and HCG in 16 women one or more oocytes were harvested. In 14 women one or more oocytes were fertilized. Embryo transfer was performed in five cases. No pregnancy resulted. The causes of the low cleavage rate and possibilities for improvement of the results are discussed.

Clomiphene↗
PubMed1984

[Problems of ethics in research and practice in reproduction medicine].

The methods in management of infertility with manipulating of gametes require new ethical positions. In GDR artificial donor insemination, in vitro fertilisation and embryo transfer are ethically accepted because they are important possibilities for accomplishment of life in a childless partnership. The problems with egg and embryo donation, surrogate mother and other new methods are discussed.

Embryo Transfer↗
PubMed1984

[Recent findings on follicle and oocyte maturation. 1. Development of follicles and maturation of follicles].

A review is given of the present knowledge of the development of follicles and oocytes, especially in the human. The first report deals with the course of development of follicles from the beginning in the fetal ovary to the mature Graafian follicle in the adult women. Questions of terminology, functional morphology and important aspects of the regulation of follicular growth are discussed. The last part of the paper summarizes the present day possibilities in monitoring growth and maturation of ovarian follicles in clinical practice.

Androstenedione↗
PubMed1984

[Recent knowledge on follicle and oocyte maturation. 2. Oocyte development and maturation].

A review is given about the present knowledge in oocyte development and oocyte maturation. The four parts of the review contain: development of the oocyte in the fetal ovary, morphology and metabolism during meiotic arrest, oocyte maturation, and the relations between oocyte maturation and in vitro-fertilization in the human. The morphological and biochemical changes in the maturation process and present hypotheses about maturation regulation are described especially. The increasing knowledge in this field supports the progress of in vitro-fertilization in the human. On the other hand this technique contributes importantly to new directions in oocyte research.

Cell Differentiation↗