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S Bjercke

Publications and source records attributed to S Bjercke.

At least 19 recordsLinked to original sources
PubMed2005

IVF/ICSI outcome and serum LH concentration on day 1 of ovarian stimulation with recombinant FSH under pituitary suppression.

BACKGROUND: Down-regulation with GnRH agonist has been suggested to result in a profound suppression of LH bioactivity, reduced estradiol synthesis, and thus impaired IVF and pregnancy outcome. The aims of this study were: (i) to assess the usefulness of serum LH measurement on stimulation day 1 as a predictor of ovarian response, conception and pregnancy outcome in patients treated with long-term down-regulation with GnRH agonist and recombinant FSH, and (ii) to define the best threshold LH value, if any, to discriminate between women with different outcomes of IVF. METHODS: Records of 2625 cycles in 1652 infertile women undergoing IVF (n = 1856) and/or ICSI (n = 769) treatment were reviewed. RESULTS: The range of LH concentrations on stimulation day 1 overlapped among non-conception cycles, conception cycles, ongoing pregnancies and early pregnancy losses. Receiver operating characteristic (ROC) analysis showed that serum LH concentrations on stimulation day 1 were unable to discriminate between conception and non-conception cycles (AUC(ROC) = 0.51; 95% CI: 0.49-0.54) or ongoing pregnancies versus early pregnancy loss groups (AUC(ROC) = 0.52; 95% CI: 0.47-0.57). Stratification for various low serum levels of LH did not reveal significant differences with respect to conception or pregnancy outcome among different LH levels on stimulation day 1. CONCLUSIONS: Serum LH concentration on stimulation day 1 cannot predict ovarian response, conception and pregnancy outcome in women receiving long-term down-regulation during assisted reproduction treatment.

Adult↗
PubMed2004

The impact of insulin resistance on the outcome of laparoscopic ovarian electrocautery in infertile women with the polycystic ovary syndrome.

In this study we assessed how insulin resistance affects pregnancy rates in infertile women with the polycystic ovary syndrome (PCOS) treated with laparoscopic ovarian electrocautery. Sixty-four PCOS women were included in the study in a consecutive fashion. Following the CIGMA (continuous infusion of glucose with model assessment) test, 28 women were classified as insulin resistant and 36 women as non-insulin resistant. After the ovarian electrocautery patients were observed for 12-18 months. If pregnancy did not ensue, they were referred for one or more cycles of in vitro fertilization (IVF). Following ovarian electrocautery the non-insulin-resistant women more frequently achieved a regular menstrual cycle and ovulation than the insulin-resistant PCOS women. Consequently 18 (50%) of the non-insulin-resistant PCOS women achieved a pregnancy versus only five (18%) of women in the insulin-resistant PCOS group. Following treatment with both ovarian electrocautery and IVF, 27 (75%) of the non-insulin resistant PCOS women achieved a successful pregnancy, while 13 (46%) of the insulin-resistant PCOS group achieved this. In conclusion, insulin resistance may be an important marker of a poor outcome of treatment in PCOS infertility. Further studies are needed to evaluate the possible effect of treatment alternatives to alleviate the unfavorable influences of insulin resistance and hyperinsulinemia on ovulation induction in PCOS women.

Adult↗
PubMed2003

Cycle characteristics of day 3 embryo transfers with 4-cell embryos only.

PURPOSE: Patient and cycle characteristics of day 3 transfers with developmentally lagging 4-cell embryos only were analyzed and related to the outcome of a live birth. METHODS: Day 3 transfers with either 4-cell embryos only (study group; n = 138) or 8-cell embryos only (control group; n = 282) were compared retrospectively. RESULTS: The total dose of FSH per treatment was higher, while the number of oocytes, zygotes, and transferred embryos was lower in the study group cycles compared to controls. The implantation, pregnancy, and live birth rates were dramatically lower in the study group compared to the control group. In the study group, the few cycles resulting in a live birth were characterized by a normal ovarian response to stimulation, similar to that of control group cycles with- or without a live birth. CONCLUSIONS: In cycles characterized by intensive ovarian stimulation, but poor response, the chance for a live birth is extremely low after day 3 transfer of 4-cell embryos.

Adult↗
PubMed2000

Comparison between two hCG-to-oocyte aspiration intervals on the outcome of in vitro fertilization.

PURPOSE: To determine whether there was any difference in the outcome of in vitro fertilization when retrieval of oocytes was done 34 hr (group A) or 38 hr (group B) after hCG injection. METHODS: A total of 170 patients with tubal failure were randomized into either group A (83 patients) or group B (87 patients). They underwent in vitro fertilization according to described protocols and were compared with regard to the frequency of spontaneous ovulation, number of oocytes retrieved, oocyte cumulus complex quality, embryo quality, and implantation and pregnancy rates. RESULTS: There was no significant difference for any of the parameters tested for in group A and group B. CONCLUSIONS: HCG can be administered at any time within the time interval of 34 to 38 hr before retrieval of oocytes without affecting the results of in vitro fertilization.

Adult↗
PubMed1999

[Normal implantation is important in order to avoid pregnancy complications and diseases later in life].

Normal placentation is important to avoid complications in pregnancy and diseases later in life. Infertility, spontaneous abortions, intrauterine growth retardation and preeclampsia may be a spectrum of disorders all caused by poor placentation. The aetiology may in all instances be due to decreased interaction between the trophoblasts and the endometrium/decidua, although in different degrees. Implantation is to a large extent controlled by a complex interplay between surface molecules on trophoblasts and cells in the uterus. Different cytokines, enzymes, receptors and adhesion molecules play an essential role. Defect placentation may lead to "programming", whereby an insult suffered at a critical period of development results in a permanent effect on the structure or function of the organ or tissue. Poor growth in utero is associated with diseases like hypertension and diabetes later in life. Over-invasion of trophoblasts may result in placenta accreta/pancreata and uterine rupture. Under-invasion may lead to preecklampsia, growth retardation and spontaneous abortion. Therefore, the balance between trophoblast invasion and maternal defence must be maintained in order to obtain successful pregnancy outcomes. Unravelling how this is done remains a major challenge in reproductive biology.

Cell Differentiation↗
PubMed1999

Human chorionic gonadotrophin concentrations in early pregnancy after in-vitro fertilization.

There is increased risk of early pregnancy loss after assisted reproduction. In this study the use of serum human chorionic gonadotrophin (HCG) concentrations on day 12 after in-vitro fertilization (IVF) and embryo transfer was evaluated to predict pregnancy outcome. A total of 417 IVF pregnancies were included. Early pregnancy loss was defined as biochemical pregnancies, ectopic pregnancies and first trimester abortions. Vital pregnancies were defined as delivered singletons, multiple pregnancies and second trimester abortions. On the post embryo transfer day 12, the mean HCG concentration of the vital pregnancy group was significantly higher than in early pregnancy loss outcomes (P < 0.00001). Receiver operating characteristic (ROC) curve analysis was performed to evaluate the cut-off value of HCG giving maximal sensitivity and specificity in order to discriminate early pregnancy losses from vital pregnancies. A patient with a HCG value higher than the calculated cut-off value (55 IU/l) had a 90% chance of having a vital pregnancy after IVF and embryo transfer. It can be concluded that a discriminatory HCG value on day 12 after IVF and embryo transfer cycles may be useful in predicting pregnancy outcome and may guide clinicians in identifying those pregnancies at risk for adverse outcomes and instituting more intensive surveillance in this population.

Abortion, Spontaneous↗
PubMed1998

[Intracytoplasmic sperm injection].

The first results of intracytoplasmic sperm injection (ICSI) in Norway are presented. Acceptable fertilization rates were obtained for all indications; severe male infertility, as well as moderately reduced sperm quality where in vitro fertilization (IVF) and embryo transfer had previously failed. Furthermore, in cases where IVF had failed despite normal sperm quality, fertilization rates of 50-60% were achieved. The overall pregnancy rate was 24.9% per embryo transfer, and the live pregnancy rate per started cycle was 13.4%. As expected, the results improved with experience. The results were greatly influenced by the age of the female. In the age group 34 years or less, the total pregnancy rate per cycle was 32.4%, with a miscarriage rate of 24.2%. In the age group 35 years or more, (42% of the study group), the total pregnancy rate per embryo transfer was 15.2%, with a miscarriage rate of 75%. The corresponding implantation rates were 17.4% and 7.9% respectively. 23 children have been born so far, none with major malformations or chromosome abnormality symptoms.

Adult↗
PubMed1994

Recurrent abortions and lymphocyte transfusions.

Normal pregnancies depend on successful implantation of the placenta in the uterus. The trophoblast which forms the ultimate interface between the fetal and maternal tissue seems to lack the foreign (allo) antigens (namely HLA/TLX) required to induce immunological rejection reactions in the mother. It was previously believed that the trophoblast expressed paternal allo antigens and that successful pregnancies were dependent on so called 'kind' (non-cytotoxic or non-complement binding) blocking antibodies in order to protect the fetal unit from maternal cytotoxic T-cells and -antibodies. Blocking antibodies attached to paternal antigens on the trophoblast were assumed to prevent maternal cytotoxic T cell and cytotoxic antibodies from recognising the trophoblast as foreign tissue. On this assumption it was reasoned that transfusions of paternal HLA-expressing lymphocytes would increase maternal antipaternal HLA (TLX) blocking antibodies and thus be beneficial to women who experienced multiple miscarriages. There is, however, no scientific evidence for a specific immune response after lymphocyte transfusions that fulfil this function. Immunological tests, as for example mixed lymphocyte culture (MLC), on peripheral blood lymphocytes do not seem to reflect the local immune state in the uterus, either in the pregnant or the non-pregnant state. Since the trophoblast forms the ultimate interface between fetal and maternal tissue, its structure, secretions, and interaction with the decidua must be of definite importance for implantation of the blastocyst and growth of the embryo.

Abortion, Habitual↗
PubMed1993

Characteristics of women under fertility investigation with IgA/IgG seropositivity for Chlamydia trachomatis.

Chlamydial serology was performed in a group of 100 consecutive women and their partners under fertility investigation. Over one-quarter of the women had evidence of an ongoing, asymptomatic chlamydial infection. A significantly higher incidence of IgA-positivity was associated with women with evidence of tubal pathology, verified by hysterosalpingography and/or laparoscopy and with previous users of intrauterine devices. The male partners of IgA-positive women had a significantly higher incidence of IgA-positivity than the other men. However, this was not associated with an increase in sperm pathology relative to the controls. The study indicates that chlamydial serology should be integrated into the routine screening of women under fertility investigation regardless of previous history and that IgA serology provides more information about tubal pathology than IgG serology.

Antibodies, Bacterial↗
PubMed1993

Glandular distribution of immunoglobulins, J chain, secretory component, and HLA-DR in the human endometrium throughout the menstrual cycle.

Two-colour immunofluorescence was used to study components of the secretory immune system in the endometrium. Tissue sampling was performed in the follicular, ovulatory and luteal menstrual phase from women admitted for laparoscopic sterilization. The specimens were prepared for immunohistochemistry by a method that removes most extracellular immunoglobulin (Ig). The stroma contained only a few Ig-producing immunocytes, but was rich in HLA-DR positive cells. Most of the IgA- and IgM-producing immunocytes also expressed J chain, which is necessary for the generation of polymeric Ig (poly-Ig) with affinity for epithelial secretory component (SC or poly-Ig receptor). Throughout the menstrual cycle there was increasing accumulation of Ig within the endometrial glands, with preferential apical and intraluminal occurrence of IgA and IgM, usually along with J chain and SC. It is likely that some monomeric IgA (without J chain) and IgG enter the endometrial glands by passive diffusion from the stroma, but there is clearly an additional active external poly-Ig transport. Some of the glands stained for HLA-DR irrespective of the menstrual phase or degree of SC expression. Our findings suggest that active SC-mediated external transport of serum-derived (and to some extent locally produced) poly-Ig is enhanced in the luteal phase, and that SC and HLA class II molecules are differently regulated in the endometrial glands.

Adult↗
PubMed1992

Chlamydial serology in the investigation of infertility.

Almost one-quarter of 100 asymptomatic men under fertility investigation had significant titres of IgA antibodies (greater than 1:8) specific for Chlamydia trachomatis in seminal plasma. No clear association was evident between the presence of these antibodies and sperm quality. In a second study, the female partners of men with consistently high serum or seminal plasma levels of chlamydia-specific IgA also exhibited a positive IgA reaction in serum without any clinical indications of the presence of an infection. In one group of men and women, antibiotic treatment for 4 weeks resulted in the disappearance of the IgA from the serum after a variable period of less than or equal to 12 weeks. The study indicates that chronic asymptomatic infections with Chlamydia trachomatis may be responsible for a large number of cases of infertility. It also implies that all men and women under investigation for infertility should be routinely screened with chlamydial serology regardless of previous history and clinical findings.

Anti-Bacterial Agents↗
PubMed1991

[Surface molecules on the trophoblast cells].

Normal pregnancies depend on successful implantation of the placenta in the uterus. The trophoblast forms the ultimate interface between foetal and maternal tissue. It seems to lack the foreign antigens required to induce immunological rejection reactions in the mother. Therefore a successful pregnancy probably does not depend on the production of blocking antibodies to protect the foetus from maternal cytotoxic T-cells. Non-MHC-molecules may play a role in placentation. Trophoblast cells and cancer cells have several properties in common.

Agammaglobulinemia↗
PubMed1989

Increased relative frequency of suppressor monocytes in peripheral blood in early pregnancy.

The adherent cell fraction (AdC) of human peripheral blood mononuclear cells (PBM) contains two cell types of opposing function in vitro. Dendritic cells (DC) act as antigen presenting cells (APC) in vitro, while monocytes (Mo) have a suppressive effect on antigen activation of T cells. In this report we show that pregnant women (PW) during the first trimester have a significantly increased relative frequency of suppressor Mo compared with nonpregnant healthy controls. The T cell response to PPD (purified protein derivative of tuberculin) was significantly lower in the PW, but after removal of Mo by adherence the T cell response was about the same in the two groups. These observations indicate the PW during the first trimester have the same number of T cells reactive to PPD and normal functioning DC. The relative suppression expressed on a per Mo basis was the same in both groups, which indicates that the increased suppression in the PW was caused by an increased number of Mo, and not by changes in their activation state.

Adolescent↗