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Biomedical subjects

T Bergh

Publications and source records attributed to T Bergh.

At least 37 records · Page 2Linked to original sources
PubMed1994

Ultrasonographical and hormonal description of the normal ovulatory menstrual cycle.

OBJECTIVE: To describe the changes in uterine volume, endometrial thickness and follicular size during the normal menstrual cycle by use of transvaginal ultrasonography and to correlate these changes with the endocrine events in the same cycle. METHODS: A group of 23 healthy women with normal body mass index and with a history of regular menstruations were monitored with repeated hormonal and vaginal ultrasonographical investigations during the menstrual cycle. RESULTS: Sixteen of the women fulfilled the hormonal criteria for ovulation. The mean length of the cycles was 28 days (range 25-30 days) with a mean length of the follicular and the luteal phases of 14.4 days (range 12-17 days) and 13.5 days (range 12-16 days), respectively. The estradiol level in serum the day before the peak of the luteinizing hormone varied between 490 and 1710 pmol/l (mean 1087 pmol/l). Ultrasonographically, the most clinically relevant changes were the increase in diameter of the dominant follicle and the growth of the endometrium. At ovulation the dominant follicle had a mean diameter of 21.4 mm (range 17.4-27.0), whereas the endometrium had a mean thickness of 12.8 mm (range 10.0-15.9). When analysed over the entire follicular phase, the serum estradiol concentration correlated both with the diameter of the dominant follicle (r = 0.93, p = 0.0001) and with the thickness of the endometrium (r = 0.79, p = 0.0001). However, no such correlations were found when only the last part of the follicular phase was analysed. In the luteal phase there was no correlation between the size of the corpus luteum and the serum concentration of progesterone. CONCLUSIONS: Vaginal ultrasonography is a practical and reliable method to monitor structural changes in the ovaries and the uterus during the menstrual cycle. The results are of clinical importance for a better understanding of the physiological changes and helpful when monitoring induction of ovulation in assisted reproduction.

Adult↗
PubMed1993

Transvaginal sonographic evaluation of endometrial growth and texture in spontaneous ovulatory cycles--a descriptive study.

Repeated transvaginal ultrasonographic examinations were performed during spontaneous ovulatory cycles to follow the texture and growth pattern of the endometrium in 23 healthy volunteers. The serum concentrations of oestradiol, progesterone and luteinizing hormone (LH) were measured regularly. The day of the LH peak was designated as day 0. On ultrasound only one thin echogenic line was seen from menstruation to day -7. From days -6 to -1 a change from one to three thin lines was observed together with an increasing hypoechogenic texture between the lines. These changes corresponded to the increasing serum concentration of oestradiol and increasing thickness of the endometrium. At ovulation there was maximum hypoechogenic texture between the lines which had become thicker. At ovulation the endometrium had a mean thickness (both layers) of 12 mm. From days +1 to +6 an increasing blurring of the three lines became apparent and the previously hypoechogenic layers gradually displayed a more echogenic texture. From day +7 to menstruation the lines were indistinguishable due to the appearance of a general hyperechogenic texture of the endometrium. In the luteal phase the growth of the endometrium plateaued. The results indicate that ultrasound assessment of endometrial growth and texture may be an important tool to evaluate normal ovulatory endometrial development. It can also be useful in monitoring stimulated cycles in different treatment modalities of assisted reproduction.

Adult↗
PubMed1993

A prospective randomized trial of artificial insemination versus intercourse in cycles stimulated with human menopausal gonadotropin or clomiphene citrate.

OBJECTIVE: To determine the relative efficacy of intrauterine insemination (IUI), direct intraperitoneal insemination, and intercourse in cycles stimulated with clomiphene citrate (CC) or human menopausal gonadotropins (hMG). DESIGN: A prospective randomized trial with a 2(3) factorial design with eight different treatment alternatives. Only one cycle per couple was performed. SETTINGS: The Departments of Obstetrics and Gynecology, Central Hospital, Västerås and Akademiska Hospital, Uppsala University, Uppsala, Sweden. PATIENTS: Of 157 randomized couples with unexplained infertility including 51 cases with minimal or mild endometriosis, 148 were selected for comparison. MAIN OUTCOME MEASURE: Pregnancy rate (PR). RESULTS: Follicular stimulation with hMG gave a higher PR than with CC in the insemination cycles, 19% (10/52) and 4% (2/49), respectively, but the PRs in intercourse cycles were not significantly different for hMG and CC, 13% (3/24) and 17% (4/23), respectively. Insemination cycles and intercourse cycles had a similar overall PR, 12% (12/101) and 13% (7/47), respectively. Furthermore, IUI and direct intraperitoneal insemination did not differ in efficacy. CONCLUSION: Follicular stimulation with hMG is more effective than CC in insemination cycles, but insemination as such seems to have no beneficial effect on the PR in stimulated cycles for treatment of unexplained infertility.

Adult↗
PubMed1992

Clinical complications during in-vitro fertilization treatment.

A questionnaire was sent to 12 large in-vitro fertilization (IVF) clinics in Nordic countries, asking about the number of clinical complications in connection with IVF treatment. The total number of cycles included was 10,125, with 7331 embryo transfers performed. Clinical complications were rare, although hyperstimulation syndrome was reported in 0.7% of the cycles started and follicle puncture complications in 0.5% of cycles. Post-operative infections were reported in 0.3% of embryo transfers.

Female↗
PubMed1992

Hormone and ultrasound parameters in ovarian stimulation cycles for direct intraperitoneal insemination.

To determine hormonal and ultrasound parameters associated with pregnancies, 115 women with unexplained infertility (n = 82), endometriosis (n = 22) or cervical factor (n = 11) were treated with direct intraperitoneal insemination (DIPI) after ovarian stimulation with clomiphene citrate and human menopausal gonadotrophins (HMG). Twenty women conceived and were compared with the remaining 95 non-pregnant women during one treatment cycle. Women with basal FSH levels less than or equal to 1.25 micrograms/l responded with higher oestradiol levels (P less than 0.0001), with the development of more follicles (P less than 0.05) and higher progesterone levels (P less than 0.05) than women with basal FSH levels greater than 1.25 micrograms/l, but the conception rates were similar. Women with miscarriages or biochemical pregnancies had a higher basal FSH value than both the women with term pregnancies and the non-pregnant women. Women with at least 3 preovulatory follicles greater than or equal to 15 mm had a higher pregnancy rate than those with fewer follicles, but a further increase was not observed above that number. The endometrium was thicker on the day of ovulation induction in cycles leading to a term pregnancy than in cycles without conception or with a biochemical pregnancy. No term pregnancy was observed when the endometrium was thinner than 8 mm. Women with a short luteal phase (less than 12 days) had a higher ratio of oestradiol/progesterone in the midluteal phase than women with a luteal phase of greater than or equal to 12 days and pregnant women.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Intrauterine insemination and comparison of two methods of sperm preparation.

In a study of intrauterine inseminations (IUI) after clomiphene stimulation, a randomized comparison was made between a new method of sperm preparation, self migration in sodium hyaluronate (SH), and a traditional method, centrifugation and swim up (CS). After two IUI cycles with either SH or CS, the sperm preparation method was swapped and the patients received another two IUI cycles. Interjacent cycles of natural intercourse after clomiphene treatment served as the control. The SH method resulted in a significantly higher percentage recovery of progressive motile spermatozoa than the CS method, 17.7% versus 8.6% (P less than 0.01). The sperm samples were prepared by SH in 68 cycles and by CS in 57 cycles, resulting in six and five pregnancies, respectively. Pregnancies were obtained in 11 of 125 IUI cycles (8.8%) and in 3 of 124 control cycles (2.4%) (P less than 0.05). The pregnancy rate following IUI was highest in the patients with cervical factor (35%) and asthenozoospermia (23%), while none became pregnant in the group with oligozoospermia. In the unexplained infertility group, no difference between the pregnancy rates in IUI cycles and control cycles was seen. SH is a simple and rapid method of sperm preparation and it appears to give a high recovery of motile spermatozoa and a number of pregnancies which is comparable to that of CS. Treatment with IUI in cycles with a simple stimulation protocol seems to be valuable in cases involving either a cervical factor or asthenozoospermia.

Adult↗
PubMed1991

Clinical response and prolactin concentration in hyperprolactinemic women during and after treatment for 24 months with the new dopamine agonist, CV 205-502.

Twenty-four hyperprolactinemic women of whom 23 previously had been given bromocriptine, were treated between 6 and 24 months with a new non-ergot dopamine agonist, CV 205-502 (quinagolide; Norprolac, Sandoz Ltd, Basle Switzerland). Twenty-four weeks of treatment resulted in normalization of prolactin secretion in 16 of the 24 women. All of these women as well as 4 of those who remained hyperprolactinemic had regular menstrual bleedings. Fifteen of the 24 women were treated for 24 months and all had normalized prolactin levels in serum at the end of this period. Regular menstrual bleedings were observed in 13 women. Mild to moderate galactorrhea was recorded at baseline in 14 of the 15 women. After 24 months of treatment, mild galactorrhea was still present in 3 women. All 15 women had been treated with bromocriptine or other dopamine agonists before they entered the study. In 9 of the women the tolerability had been judged to be fair (N = 4) or poor (N = 5). Five of the 15 women had previously discontinued bromocriptine treatment because of adverse effects but had few problems tolerating CV 205-502. Prolactin in serum increased in all the patients after discontinuation of the medication. The results confirm that CV 205-502 seems to be a valuable compound in the management of patients with hyperprolactinemia.

Adult↗
PubMed1991

Nordic in vitro fertilization embryo transfer (IVF/ET) treatment outcomes 1982-1989.

In the four Nordic countries, Denmark, Finland, Norway and Sweden, data were compiled from altogether 30 in vitro fertilization (IVF) clinics regarding their treatment outcomes. Two small, recently established IVF clinics in Finland did not respond to the postal inquiry used for data collection. For each clinic, data were collected from the time they commenced activities until June 1989. Preliminary data for the latter half of 1989 was also gathered. The first IVF-baby in this data set was born in Gothenburg in 1982. Seven years later, in December 1989, altogether 35 clinics in the four countries were in operation and 1,290 children had been born. The largest number of clinics, 12, was to be found in Sweden but the number of treatment cycles in relation to the population was highest in Norway with about 340 treatments per million inhabitants annually during 1988-89, with Sweden in second place: 190 treatments per million inhabitants. The ratio of private to public clinics was highest in Finland, where four out of ten clinics were privately run. A mean clinical pregnancy rate per embryo transfer of 20% was recorded and 85% were singleton pregnancies. Spontaneous abortions occurred in 25% and the ectopic pregnancy rate was 7% of all clinical pregnancies. The 'take home baby rate' for 1988-89 was 13% per embryo transfer. There were no major differences between the four countries.

Embryo Transfer↗
PubMed1991

Direct intraperitoneal insemination--clinical results and comparison between two methods of sperm preparation.

OBJECTIVE: To compare sperm preparation with a new self-migration method in sodium hyaluronate and a centrifugation/swim-up method and to study the efficiency of direct intraperitoneal (IP) insemination. STUDY DESIGN: Sodium hyaluronate and centrifugation/swim-up were used randomly for direct IP insemination in alternating cycles. Treatments were given with an interval of at least one untreated cycle. When ovulation occurred on weekends, the patients received only controlled ovarian hyperstimulation. SETTINGS: Department of Obstetrics and Gynecology University Hospital, Uppsala, Sweden. PATIENTS: Seventy-nine couples with unexplained infertility (n = 53), endometriosis (n = 17), and cervical factor (n = 9). INTERVENTIONS: Controlled ovarian hyperstimulation was accomplished by clomiphene citrate and gonadotropins. MAIN OUTCOME MEASURES: Sperm parameters and pregnancy rates. RESULTS: Sodium hyaluronate and centrifugation/swim-up resulted in similar conception rates, but sodium hyaluronate recovered more motile spermatozoa than centrifugation/swim-up (P less than 0.0001). The number of patients who became pregnant after direct IP insemination or controlled ovarian hyperstimulation only was significantly higher than that observed after untreated cycles (P = 0.00001 and P = 0.008, respectively). CONCLUSIONS: Sperm preparation with sodium hyaluronate can be used as an alternative to centrifugation/swim-up. Direct IP insemination appears to increase the cycle fecundity, but whether direct IP insemination/controlled ovarian hyperstimulation is more effective than controlled ovarian hyperstimulation alone has yet to be proven.

Adult↗
PubMed1990

The occurrence of macroscopical pituitary calcifications in prolactinomas.

Radiographs of the sella turcica from 73 hyperprolactinaemic women, were followed-up for 5 to 13 years. Six women (8%) were found to harbour granular calcific deposits in the anterior part of the sella turcica visible on the plain radiographs. In three women the calcification increased in size during follow-up. This was accompanied by signs of regression of other features of pituitary tumour on the radiographs in two women. Pituitary calcifications associated with hyperprolactinaemia seem to represent a benign and regressive process.

Bromocriptine↗
PubMed1990

Long-term radiographic follow-up of the sella turcica in hyperprolactinaemic women.

Seventy-three hyperprolactinaemic women were followed up with radiographic examinations (lateral and posteroanterior coned down views) of the sella turcica for 5 to 13 years during which time all but one had received treatment with bromocriptine. Progression of the sellar asymmetry occurred in 25 women (7 during pregnancy), 14 had regression of their changes in the pituitary fossa while 34 did not show any changes in the configuration of the sella turcica. Prolactin levels in serum, duration of bromocriptine therapy or sellar configuration could not predict later radiographic progressive or regressive changes of the sella turcica. The clinical course was benign in the majority of the women with signs of prolactin-producing adenomas. The risk of serious tumour enlargement seems to be very small. We were not able to demonstrate any parameter which could predict the growth or shrinkage of the tumour. Routinely repeated radiographic sellar examinations are unnecessary in the vast majority of hyperprolactinaemic women.

Adult↗
PubMed1988

The importance of human chorionic gonadotropin support of the corpus luteum during human gonadotropin therapy in women with anovulatory infertility.

One hundred ten women with anovulatory infertility (World Health Organization [WHO] group I n = 50, WHO group II n = 60) were given 341 treatment courses with human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG). Additional hCG was given as single or repeated injections during the luteal phase in 205 ovulatory cycles. In WHO group I, the incidence of luteal phase defects was lower and the pregnancy rate higher in cycles with extra hCG administration during the luteal phase than in cycles with no extra hCG. In WHO group II, there was no such difference after supplemental hCG. The abortion rate was the same after cycles with or without extra hCG administration. It is suggested that during ovulation induction with hMG/hCG in anovulatory women with no evidence of endogenous estrogen activity, the luteal phase should be supplemented with additional hCG.

Adult↗
PubMed1988

Long-term treatment with a new non-ergot long-acting dopamine agonist, CV 205-502, in women with hyperprolactinaemia.

Twenty-four hyperprolactinaemic women were treated for 6 months with the new, non-ergot, long-acting dopamine agonist, CV 205-502. The treatment resulted in normalization of PRL secretion in 17 of the 24 women at once-daily doses of 0.05 to 0.15 mg of the drug. Sixteen of these women as well as 4 of those who remained hyperprolactinaemic had regular menstrual bleeding. Five of the patients had previously discontinued bromocriptine therapy because of adverse effects but had no problems tolerating CV 205-502. Of three bromocriptine-resistant women, two responded partially while one also remained unresponsive to CV 205-502 treatment. Mild to moderate galactorrhoea was recorded at baseline in 19 of the 24 women. After 6 months' treatment mild galactorrhoea was still present in six patients, four of whom had attained normal PRL levels. Side-effects were mild and transient. CV 205-502 seems to be a valuable compound in the management of patients with hyperprolactinaemia.

Adult↗
PubMed1987

Prolactin secretion and menstrual function after long-term bromocriptine treatment.

Long-term bromocriptine treatment was discontinued in 75 hyperprolactinemic women. Bromocriptine had been given for up to 65 months (median, 24 months). Treatment was reinstituted in 42 women (56%) after 1 to 3 months, mainly because of increasing prolactin levels. Thirty-three women (44%) were followed up for 6 months or more without treatment. Menstrual bleeding occurred in 19 of the 33 women (58%) after 6 months without treatment. The mean prolactin concentration in this group had decreased more than 60% compared with pretherapy concentrations. In 18 of the 42 women who had bromocriptine therapy again, treatment was discontinued a second time. Six of these patients have regular menstrual bleeding. Long-term bromocriptine treatment seems to induce long-standing normalization of prolactin secretion in patients with hyperprolactinemia.

Adolescent↗
PubMed1987

CV 205-502: a new long-acting drug for inhibition of prolactin hypersecretion.

CV 205-502, an octahydrobenzo(g)quinoline, is a new non-ergot long-acting prolactin inhibitor. The substance was given to 24 hyperprolactinaemic women for 7 d. The women were randomized to one of three dose regimens, 0.01 mg, 0.03 mg or 0.06 mg daily. Two patients in each group were given placebo. Frequent blood samples were obtained during days 1, 7 and 8. The prolactin levels in serum were depressed dose-dependently in all patients given active substance. In group 1 (0.01 mg) the dose was insufficient to induce normal serum prolactin levels except in one woman, while two women in group 2 (0.03 mg) and four in group 3 (0.06 mg) became normoprolactinaemic. The depressant effect on prolactin secretion lasted for 24 h in group 2 and 3. Side-effects were mild and transient. No change in blood pressure was observed. CV 205-502 was an effective and long-acting drug for treatment of patients with hyperprolactinaemia in this short-term study and this new drug deserves investigation of its usefulness in long-term treatment.

Adolescent↗
PubMed1987

Metabolic profile in obese women with the polycystic ovary syndrome.

Nine obese women with oligo- or ameno-rrhoea, all with clinical and endocrinological signs of polycystic ovary syndrome (PCO) were submitted to metabolic studies. Their mean weight was 96 kg and their mean plasma testosterone concentration was 3.5 nmol/l. A group of nine obese, regularly menstruating women of similar age and degree of obesity (mean body weight 102 kg) served as controls. Their mean testosterone concentration was 1.9 nmol/l. The high-density lipoprotein (HDL) cholesterol and apolipoprotein (apo) A-I concentrations in plasma were significantly lower in women with PCO than in control women. Furthermore, in the whole group the testosterone level showed significant inverse relationships to HDL-cholesterol (r = -0.64; P less than 0.01) and apo A-I (r = -0.59; P less than 0.01). The lipoprotein lipase activity (LPLA) in adipose tissue was lower in the women with PCO than in the control group with levels similar to those found in adipose tissue in men. There was an inverse relationship between the testosterone concentration in plasma and LPLA in adipose tissue (r = -0.51; P less than 0.05). The fat cells were of similar size at different regions in the women with PCO but showed marked differences in the control subjects who had much larger cells at the femoral than the abdominal site. The results show that the hyperandrogenism in PCO affects adipose tissue LPLA which could explain the lower HDL cholesterol values in women with PCO.

Adipose Tissue↗