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Biomedical subjects

S Milingos

Publications and source records attributed to S Milingos.

At least 55 records · Page 3Linked to original sources
PubMed1996

The value of semen characteristics and tests of sperm function in selecting couples for intra-uterine insemination.

In order to improve the selection of couples for intrauterine insemination (IUI) because of longstanding primary infertility of alleged male origin, we have performed a prospective study measuring conventional and advanced analysis of sperm characteristics, the hypoosmotic swelling test, the Shorr stain, the acidified aniline blue stain and alpha-glucosidase activity in seminal plasma, of 89 couples with no demonstrable abnormality of the female partner. Twenty-four couples attained spontaneous conception, 23 were successful within six cycles of IUI, and 42 remained without conception in spite of IUI during six unstimulated cycles. The proportion and concentration of spermatozoa with progressive motility was significantly lower (P < 0.01) in the successful IUI cases than in the couples attaining spontaneous conception, and the lower quartile value was lower in the former than in the latter. There were less pregnancies among IUI treated couples when sperm concentration and motility were within the range of normal fertile men, or when the concentration of white blood cells was elevated. More pregnancies occurred when markers of epididymal function, namely the result of the Shorr stain and alpha-glucosidase measurement, were normal. Total progressive motility and the result of the Shorr stain were the only independent variables selected by logistic regression to discriminate between successful and failed IUI cases. It is concluded that only a limited group of couples may benefit from IUI.

Adult↗
PubMed1996

Oocyte donation to women over 40 years of age: pregnancy complications.

Recently, oocyte donation to women of advanced age has led to a considerable number of conceptions, thus increasing the age limit for becoming pregnant. A main consideration encountered by physicians, though, is the potential medical and obstetric complications of a pregnancy at an advanced age. In this study, the obstetric complications, as well as the perinatal outcome, of pregnancies of aged recipients (above 40) are presented and compared to those of younger recipients. A significantly higher incidence of gestational diabetes (P < 0.001), an increased incidence of pre-eclampsia (at the 10% level of significance) and an increased risk for thrombophlebitis (again at the 10% level) was observed in the older patients, but a careful follow-up during their pregnancy led to a highly satisfactory obstetric and perinatal outcome. A rigorous precycle medical screening (especially for cardiovascular diseases and diabetes) and a careful follow-up during pregnancy is, therefore, imperative so that oocyte donation to older women is not withheld and continues to provide fertility possibilities to otherwise sterile patients.

Adult↗
PubMed1996

Effect of follicle stimulating hormone or human chorionic gonadotrophin treatment on the production of gonadotrophin surge attenuating factor (GnSAF) during the luteal phase of the human menstrual cycle.

OBJECTIVE: Although there is much in-vivo evidence for the existence of a gonadotrophin surge attenuating factor (GnSAF), its source and identity remain unknown. We have studied the control of GnSAF production by FSH and hCG during the luteal phase of the cycle. DESIGN: Normally cycling women were investigated in three cycle. Starting on day 5 after the midcycle LH peak, the women received i.m. injections of placebo (1st cycle control), hCG at a dose of 750 IU per day (2nd cycle) and FSH at a dose of 225 IU per day (3rd cycle) for five consecutive days. The response of LH to a single i.v. dose of 10 microg GnRH (GnSAF bioactivity) was investigated several times during the experimental period. PATIENTS: Six normally ovulating women with long-standing unexplained infertility were studied. The women were used as their own controls during the cycle treated with placebo. MEASUREMENTS: Pituitary response to GnRH was calculated as the net increase in LH at 30 minutes (deltaLH) above the basal value. RESULTS: Serum concentrations of FSH and hCG increased significantly during the second and 3rd cycles respectively. Compared with the control cycles, deltaLH was significantly attenuated as early as 12 hours from the onset of FSH injections. In contrast, basal concentrations of oestradiol (E2) and immunoreactive inhibin started to increase 48 hours after the first injection of FSH, while progesterone values remained similar to those in the controls. During treatment with hCG, no attenuation was seen in deltaLH values, while those of E2, progesterone and inhibin showed a significant increase. CONCLUSIONS: These results demonstrate that during the luteal phase of the human menstrual cycle, FSH, but not LH, stimulates the production of gonadotrophin surge attenuating factor. It is suggested that the source of gonadotrophin surge attenuating factor at that stage of the cycle is a cohort of small follicles rather than the corpus luteum.

Adult↗
PubMed1996

A flexible protocol for the induction of recipient endometrial cycles in an oocyte donation programme.

Synchronization of the availability of good quality oocytes from donors and adequate endometrial maturation of recipients are very important for the success of an oocyte donation programme. A flexible protocol for the endometrial preparation of recipients is important in timing embryo transfer between days 17 and 19 of the cycle ('window of receptivity'). The purpose of this study was to evaluate the effect of the length of oestradiol administration to recipients on pregnancy outcome. Oestrogen administration was 8 mg/day, but its length varied prospectively from 6 to 27 days, followed by the addition of progesterone (100 mg daily i.m.) for 2-4 days according to the availability of good quality oocytes. Pregnancy outcome was evaluated regardless of age, indication for oocyte donation or number of embryos transferred per patient. The pregnancy rate per cycle was comparable when oestradiol was administered from 6 to 11 days before progesterone addition, while it dropped significantly thereafter. The variation in progesterone administration did not affect pregnancy outcome. These findings provide us with a greater flexibility by allowing us to vary oestradiol administration to recipients from 6 to 11 days prior to progesterone, reducing considerably, therefore, the need to cancel embryo transfer because of oocyte unavailability. Thus we can arrange to transfer embryos between days 17 and 19 of the recipient's cycle so as to obtain the best possible clinical outcome.

Adult↗
PubMed1996

Changes in pituitary response to gonadotropin-releasing hormone following bilateral ovariectomy in women treated with follicle-stimulating hormone.

Superovulation- induction in women attenuates the pituitary response to gonadotropin-releasing hormone (GnRH). The aim of this study was to assess the duration of the suppressing activity of the ovaries on the pituitary. Eighteen normally ovulating women received treatment with follicle-stimulating hormone (FSH, 225 IU/day) on cycle days 2, 3 and 4. On cycle day 4, six women underwent hysterectomy plus bilateral ovariectomy (group A), another six women underwent hysterectomy without ovariectomy (group B) and the remaining six women underwent no operation (group C). The women of group C were also investigated during a preceding untreated spontaneous cycle (group D). The response of luteinizing hormone (LH) to an intravenous injection of 10 micrograms GnRH was investigated on cycle days 2, 3, 4 (2 and 12 h after clamping of the infundibulopelvic and/or round ligaments), 5, 6 and 7 in all four groups. The response of LH to GnRH at 30 min (delta LH) was significantly attenuated as early as 12 h from the onset of FSH treatment (groups A, B and C), while estradiol and inhibin concentrations started to increase later (group C). In group C (no operation), the attenuation of delta LH values continued throughout the study period, while in groups A and B the initial attenuation was followed by a marked increase in delta LH values within 2 h from the operation. The increase in group A was twice the value in group B. Following this, delta LH values in group B were attenuated again within the next 24 h, while in group A they remained for the rest of the postoperative period significantly higher than in group B. In conclusion, it was found that the factor that mediates the suppressing effect of superovulated ovaries on the pituitary has a short-lasting (< 2 h) attenuating activity in the circulation.

Adult↗
PubMed1995

Intrauterine insemination in male subfertility: a comparative study of sperm preparation using a commercial Percoll kit and conventional sperm wash.

In order to evaluate the possible benefit of sperm preparation using a commercially available, ready-to-use Percoll gradient kit (PerWash, FertiPro, Belgium) for intrauterine insemination (IUI), a two-centre study was performed comparing this method with conventional sperm preparation by means of centrifugation-resuspension. In the Percoll group, 25 couples out of 52 (48%) achieved pregnancy requiring 136 cycles of insemination, with a per cycle success rate of 18.4%. This result was significantly better (P < 0.01) than the per cycle pregnancy rate of 8.9%, which is 23 pregnancies out of 65 cases treated during 259 cycles of insemination with conventionally prepared semen. Also, the 10th percentile of sperm characteristics among successful cases was lower for sperm concentration, proportion and concentration of grade (a) motile spermatozoa in the Percoll group as compared to couples inseminated with conventionally prepared semen. In contrast, cases with elevated proportion of grade (a) motility (> 22%) were significantly less likely (P < 0.001) to obtain pregnancy with IUI, using either sperm preparation method. It is concluded that sperm preparation for intrauterine insemination using the Percoll gradient kit gives a better success rate and can be applied in cases with more severe sperm deficiency.

Adult↗
PubMed1995

Does treatment with testosterone undecanoate improve the in-vitro fertilizing capacity of spermatozoa in patients with idiopathic testicular failure? (results of a double blind study).

Seventy-seven couples in whom conventional in-vitro fertilization (IVF) had remained unsuccessful because of low fertilization rate and abnormal sperm characteristics were given either testosterone undecanoate 120 mg/day, or placebo during 3 months, after which a new IVF treatment was applied under identical technical conditions. There were no significant changes in sperm characteristics among the treated and placebo couples and the fertilization rate showed a similar increase after treatment in both groups. No significant difference in pregnancies occurred, with 32% pregnancies in the placebo controls and 17% among couples treated with testosterone undecanoate. It is concluded that testosterone undecanoate intake does not improve sperm characteristics, or the in-vitro fertilizing potential, or pregnancy rate over those observed in the placebo controls in cases with primary idiopathic testicular failure.

Adult↗
PubMed1995

A preliminary study of the effect of growth hormone on mouse preimplantation embryo development in vitro.

The role of growth hormone (GH) in follicular development, ovulation and embryo development is currently under reconsideration. In this study, we have tried to investigate the effect of GH on preimplantation development of mouse embryos in vitro. Zygotes and two-cell mouse embryos were cultured without (control) or with GH. For zygotes, the addition of 0.2 micrograms/ml of GH resulted in 77 +/- 1% of blastocysts formed and 66 +/- 3% rate of hatching (control 64 +/- 4 and 31 +/- 3%, p < 0.05 and p < 0.01, respectively). For two-cell embryos, the addition of 0.2 micrograms/ml of GH resulted in 87 +/- 2% of blastocysts formed and 60 +/- 4% hatching rate (control 76 +/- 4 and 47 +/- 5%, p < 0.05 for both). This positive effect of GH addition implies that the latter can support mouse preimplantation development in vitro and it suggests, along with its local action on the ovary and its possible effects, via the insulin-like growth factor system, on the tubal and uterine epithelium, a continuous role of this hormone in reproductive physiology from follicular maturation to embryonic development and, possibly, implantation.

Animals↗
PubMed1994

Effect of follicle stimulating hormone treatment on the pituitary response to luteinizing hormone-releasing hormone in post-menopausal women.

To study the role of exogenous follicle stimulating hormone (FSH) in the attenuation of luteinizing hormone (LH) response to luteinizing hormone-releasing hormone (LHRH) during ovulation induction in women, 10 healthy post-menopausal women were treated with FSH (225 IU/day) for 5 days and normal saline (2 ml/day) for another 5 days. The two regimens were given consecutively in a 10 day experiment. The regimen for the first 5 days was randomly chosen and was given to the women in an alternate way. The response of LH to an i.v. injection of 10 micrograms LHRH was investigated twice on day 1 (i.e. before the onset of treatment and 12 h later) and once on days 2, 5 and 10 of the experiment (0900 h). Basal FSH and LH values before the onset of treatment on day 1 were similar in the five women who started with the saline and the five who started with the FSH regimen. Basal FSH values increased significantly during treatment with FSH, while LH and oestradiol values remained unchanged throughout the whole experiment. LH increment 30 min post-LHRH did not change significantly either during the first 24 h or during the whole experiment regardless of the starting regimen. These results demonstrate that in post-menopausal women the response of LH to LHRH is not affected by exogenous administration of FSH. It is suggested that exogenous FSH does not show activities on gonadotrophin secretion similar to those ascribed to a gonadotrophin surge attenuating factor.

Female↗
PubMed1993

Changes in pituitary response to GnRH during the luteal-follicular transition of the human menstrual cycle.

OBJECTIVE: We studied changes in pituitary response to GnRH during the luteal-follicular transition of the human menstrual cycle. DESIGN: Normally cycling women were investigated during two consecutive menstrual cycles. In each woman, GnRH tests were performed during the two LH surges and several times during the luteal-follicular transition. Data for analysis were available in all women on days -8, -6, -4, -2, -1, 1, 2, 3, 4, 5 and 7 in relation to the onset of second menstruation (day 1). PATIENTS: Five normally ovulating parous women were studied. MEASUREMENTS: Pituitary response to GnRH was calculated as the net increase in LH and FSH at 30 minutes (delta LH and delta FSH) above the basal value. RESULTS: delta LH and delta FSH showed a similar pattern of significant changes during the luteal-follicular transition. They decreased progressively from days -8 to 1 and increased on day 2. delta LH and delta FSH then decreased on days 3 and 4 and showed a further increase on days 5 and 7. In contrast to these changes, basal FSH levels increased from days -2 to 1 and remained high up to day 5, while basal LH levels showed a trend to increase only after the onset of menses. CONCLUSIONS: These results demonstrate that the increase in basal FSH secretion during the luteal-follicular transition is GnRH independent. It is suggested that LH and FSH release under the stimulation by GnRH is regulated by a common mechanism.

Adult↗
PubMed1983

Treatment of chronic prostatitis by consecutive per os administration of doxycycline, sulfamethoxazole/trimethoprim, and cephalexin.

Fifty men with cytologically confirmed chronic prostatitis were treated for 3 months by consecutive p.o. administration of doxycycline, sulfamethoxazole/trimethoprim, and cephalexin. The subjective symptoms, palpatory findings, secretory capacity of the accessory genital glands (values of acid phosphatase and fructose in the seminal plasma) were evaluated. The cytologic findings from the expressed prostatic fluid and semen analysis before and after the treatment were also studied. Approximately 60% of the patients were cured of the subjective symptoms. The palpatory findings disappeared in 50% of the cases. The cytologic findings became normal in 70% of the patients (inflammatory cells less than 25/HPF). The secretory function of the prostate and the seminal vesicles was improved in 50% and 25%, respectively, of the patients, and the quantitative and qualitative motility and viability of the spermatozoa after treatment were significantly enhanced.

Administration, Oral↗
PubMed1981

Clindamycin phosphate in the treatment of endometritis due to anaerobic bacteria.

Treatment of endometritis due to anaerobic pathogens demands early isolation and identification of the offending pathogen by the appropriate culture and optimum use of antibiotics according to the sensitivity test. Clindamycin phosphate has been used as a highly active antibiotic against both gram-positive and gram-negative anaerobic pathogens, including bacteroides fragilis. The concentration of clindamycin phosphate in blood from the uterus was tested in 30 women after administration of one single dose (600 mg) intramuscularly. The levels of clindamycin in the above-mentioned tests state how samples were compared with the minimal inhibitory concentration of the offending anaerobic pathogens in cases of endometritis.

Anaerobiosis↗
PubMed1980

Carcinoembryonic antigen (CEA) in normal and pre-eclamptic pregnancies (values in maternal blood, amniotic fluid and umbilical cord blood).

Values of carcinoembryonic antigen (CEA) were measured by radioimmunoassay in 100 pregnant women divided into 4 groups. In group 1 (49 normal pregnancies) and 2 (17 pre-eclamptic pregnancies), the estimation of CEA was done in maternal vein blood, umbilical cord blood and in amniotic fluid. In group 3 (20 normal pregnancies) CEA was measured separately in blood of the two umbilical vessels as well as in maternal vein blood. In group 4 (14 pregnancies with small-for-date infants) CEA was estimated in umbilical cord blood. The values in amniotic fluid of normal and pre-eclamptic pregnancies were more than 20 times higher than in the other two compartments. A significant correlation was found between the amniotic fluid and umbilical cord blood values (r = 0.500; P < 0.05), as well as between the values in umbilical artery and vein (r = 0.792; P < 0.001). Thus, it is thought that CEA is transferred from the amniotic cavity to the umbilical cord while a part of CEA perhaps is produced by the placenta. Umbilical cord blood values of small-for-date fetuses do not differ significantly from the normal. On the contrary, significantly lower values were obtained in umbilical cord blood and in amniotic fluid of pre-eclamptic women as compared to the normal, but this finding is not useful clinically because of the large standard deviation.

Amniotic Fluid↗
PubMedDate not supplied

The effective cumulative pregnancy rate of different modes of treatment of male infertility.

The clinical efficacy of conventional and advanced methods of treatment was assessed in 814 couples with infertility due to a male factor. The monthly and effective cumulative rate of ongoing or term pregnancies was calculated during 4712 couple-months. Treatment of varicocele by transcatheter embolization, resulting in 3.9% pregnancies per cycle and an effective cumulative pregnancy rate of 41% after 1 year, is more effective than counselling and timed intercourse (9% pregnancies after 12 months). Intrauterine insemination (IUI) of washed spermatozoa produced 17% pregnancies in the initial 4 months, but the success rate of the subsequent cycles (1.7% per cycle) was not different from that of the controls. In vitro fertilization (IVF) resulted in 16% pregnancies per attempt, but the effective cumulative pregnancy rate was only 31% in 12 months due to the long interval between treatment attempts and the high drop-out rate. With subzonal microinjection of sperm, the fertilization rate was higher (71%) than with regular IVF (29%) but both the pregnancy rate per attempt (9%) and the effective cumulative pregnancy rate (17% after 12 months) were low. The 10th percentile of sperm characteristics (cut-off values) of successful cases showed intrauterine insemination to be advantageous in cases with a lower percentage of spermatozoa with progressive motility (9%) than in the controls (15%). The cut-off value of sperm morphology in IVF (4%) is lower than that of IUI (8%) and of the controls (9%), but higher than that of subzonal insemination (1%). Treatment strategy must be defined selecting or combining conventional and assisted reproductive technology for each individual couple with male factor infertility.

Female↗