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Biomedical subjects

T Mantzavinos

Publications and source records attributed to T Mantzavinos.

At least 19 recordsLinked to original sources
PubMed2005

Estradiol and leptin as conditional prognostic IVF markers.

We studied the concentration of serum estradiol and serum and follicular fluid leptin in 200 women undergoing their first in vitro fertilization with embryo transfer (IVF-ET) program at the time of human chorionic gonadotrophin administration and oocyte retrieval, in an attempt to assess their concerted role on embryo quality and the prognosis of IVF outcome. Low serum (46.49 +/- 8.4 ng/ml) and follicular fluid (52 +/- 9.8 ng/ml) leptin levels were associated with a high number of 'good-quality' embryos (73.6%) and high implantation (11.2%) and pregnancy (35.8%) rates and were observed in women with normal peak estradiol levels of between 1000 and 2000 pg/ml. It appears that leptin and estradiol interact coordinately in a concentration-dependent manner to control IVF outcome. Further studies will be required to substantiate and clarify the mechanism of proposed conditional interaction between the two hormonal systems.

Adult↗
PubMed1999

Ureaplasma urealyticum in semen: is there any effect on in vitro fertilization outcome?

OBJECTIVE: To determine the effect of the presence of Ureaplasma urealyticum in semen on IVF outcome (fertilization, pregnancy, and abortion rates). DESIGN: Prospective study. SETTING: Private IVF unit in Athens, Greece. PATIENT(S): One hundred ninety-one asymptomatic men with normal semen parameters whose wives underwent an IVF cycle. INTERVENTION(S): Culture of semen for U. urealYticum on the day of oocyte retrieval. MAIN OUTCOME MEASURE(S): Fertilization, pregnancy, and abortion rates after IVF. RESULT(S): Ninety-six (86%) of the 112 women whose husbands' semen was negative for U. urealyticum and 65 (82%) of the 79 women whose husbands' semen was positive for U. urealyticum underwent ET. The pregnancy rate (PR) was 20% (19/96) in the negative group and 17% (11/65) in the positive group. An increased incidence of abortions (6/11) was observed in the positive group (abortion rate, 54%), compared with 21% (4/19) in the group of women whose husbands' semen was negative for U. urealyticum. CONCLUSION(S): Fertilization rates and PRs may not be affected by the presence of U. urealyticum in semen on the day of oocyte retrieval. It can be presumed that the semen preparation for IVF cleanses the semen of U. urealyticum. On the other hand, the higher abortion rate in the U. urealyticum-positive group might be related to maternal factors, such as an existing U. urealyticum infection or one contracted after conception.

Abortion, Spontaneous↗
PubMed1998

Interleukin-1beta and interleukin-1alpha may affect the implantation rate of patients undergoing in vitro fertilization-embryo transfer.

OBJECTIVE: To investigate whether interleukin-1beta (IL-1beta) and interleukin-1alpha (IL-1alpha) affect the implantation rate of patients undergoing IVF-ET. DESIGN: Follicular fluid and serum were obtained on the day of hCG administration, the day of oocyte retrieval, and the day of embryo transfer. SETTING: Cellular immunology laboratory in a research institute, a high technology IVF unit in a medical center, and a university hospital. PATIENT(S): Thirty-three women who were undergoing IVF-ET. MAIN OUTCOME MEASURE(S): IL-1beta and IL-1alpha were measured by specific ELISA and their levels were correlated with the implantation rate. RESULT(S): Classification of IVF-ET patients according to their implantation rate revealed significantly higher amounts of follicular fluid IL-1beta in the implantation versus nonimplantation cycles (68.5+/-24.6 pg/mL versus 20.5+/-13.4 pg/mL); The difference between the level of IL-1alpha in the two groups was not statistically significant(11.6+/-5.1 pg/mL versus 7.3+/-1.9 pg/mL). In parallel, systemic FSH/hMG-dependent IL-1beta and IL-1alpha production was observed in implantation cycles but not in nonimplantation cycles. Statistically significant IL-1beta and IL-1alpha production was observed after administration of hCG. CONCLUSION(S): Gonadotropins used during IVF-ET induce local and systemic production of IL-1beta and IL-1alpha. In addition, the implantation rate for IVF-ET patients who have detectable serum concentrations of IL-1beta and IL-1beta on the day of hCG administration could be higher than the rate for IVF-ET patients who do not have detectable concentrations of these cytokines.

Adult↗
PubMed1998

Ooplasmic injection of elongating spermatids for the treatment of non-obstructive azoospermia.

We applied the technique of ooplasmic elongating spermatid injection to the treatment of non-obstructive azoospermia. Mature oocytes were injected with elongating spermatids isolated from testicular biopsy material obtained from 13 non-obstructed azoospermic men. Seventy-three oocytes were successfully injected with elongating spermatids and were then cultured for 36 h. At 13 h post-injection 68 oocytes were found to be activated and 52 of them were fertilized. Forty-one 2- to 4-cell stage embryos developed from normally fertilized oocytes were transferred. At least two embryos were transferred to each female partner. Two pregnancies were achieved. Elongating spermatid injection may have a role in the treatment of non-obstructive azoospermia.

Adult↗
PubMed1997

Comparison between steroid hormones and cortisol in serum and follicular fluid in stimulated and unstimulated cycles of in vitro fertilization patients.

The present study was undertaken to evaluate the effects of the concentrations of serum and follicular fluid steroids and cortisol levels on the establishment of pregnancies in in vitro fertilization (IVF). Our study group consisted of 42 women (group A) who received gonadotropins for induction of ovulation for IVF. The control group included 23 women (group B) who underwent in vitro fertilization without stimulation. Serum estradiol and progesterone levels were significantly higher in group A than in group B. Serum and follicular fluid cortisol levels were similar in both groups A and B. There was no significant difference in the fertilization rates of the stimulated or unstimulated cycles. However, there were no pregnancies in group B whereas there was a 28.5% pregnancy rate in group A. There were no correlations between the estradiol, progesterone and cortisol levels when compared to the oocyte maturity and the fertilization rates in both groups of patients.

Adult↗
PubMed1996

Correlation of serum and follicular fluid concentrations of placental protein 14 and CA-125 in in vitro fertilization-embryo transfer patients.

OBJECTIVE: To study serum and follicular fluid (FF) concentrations of placental protein 14 (PP14) and CA-125 in patients participating in an IVF-ET program. DESIGN: Determination in serum and FF on the day of hCG administration, day of oocyte retrieval, and on ET day of PP14 and CA-125. SETTING: Second Department of Obstetrics and Gynecology of the University of Athens; Euromedica IVF Unit; and Hellenic Pasteur Institute. PATIENTS: Thirty-three patients undergoing IVF-ET divided in three groups: 8 with conception, 18 with fertilized oocytes but no conception, and 7 without fertilized oocytes. INTERVENTIONS: All patients underwent an ovarian stimulation with a short protocol of GnRH analogue-pure-FSH-hMG. Three blood probes were collected from each patient, on the day of hCG administration, on retrieval day, and on ET day, respectively, whereas FF was collected on retrieval day. MAIN OUTCOME MEASURES: Determination in serum and FF of CA-125 and PP14. RESULTS: On the day of oocyte retrieval, both mean values of serum PP14 and CA-125 were significantly higher in conceptional than nonconceptional cycles. On the day of ET, the mean values of serum PP14 increased significantly in conceptional cycles whereas CA-125 showed no difference. The mean concentration of PP14 in FF was significantly higher in conceptional cycles whereas there was no significant change in the mean concentration of FF CA-125. CONCLUSIONS: In conceptional cycles after IVF, PP14 increases in serum significantly from hCG day to ET day compared with nonconceptional cycles, whereas CA-125 increases from hCG day to oocyte retrieval day and decreases on ET day. In FF, PP14 was increased in conceptional cycles, whereas CA-125 in FF showed no change.

Adult↗
PubMed1996

Pregnancy results after ovum donation following one to seven embryo transfers.

OBJECTIVE: To determine whether failure to achieve pregnancy after repeated ET after ovum donation was due to an endometrial defect or to the embryo quality. DESIGN: Retrospective data analysis. SETTING: A private infertility center. PATIENT(S): Four hundred sixty-seven donors (513 cycles) undergoing IVF donating oocytes to 266 recipients (423 cycles). INTERVENTION(S): Hormonal endometrial preparation with increasing dosages of valerate E2 (2,4, and 6 mg) and 100 mg of P. MAIN OUTCOME MEASURE(S): Pregnancy rates (PRs) and abortion rates in patients undergoing one to seven ETs after ovum donation. RESULT(S): Pregnancy rates in recipients that had one or two ETs were significantly higher (34.8%) compared with those of recipients having three or more ETs (15.1%). Abortion rates were significantly higher (54.5%) in recipients repeating more than three ETs than in the recipients having one or two ETs (29.1%). CONCLUSION(S): Recipients that had failed to establish a pregnancy after two ETs had a lower PR in successive attempts, possibly because of a defect of their endometrial lining.

Abortion, Spontaneous↗
PubMed1996

Laparoscopic Treatment of Ectopic Pregnancy

During the last 5 years 82 women underwent laparoscopic treatment of ectopic pregnancy, three ovarian and one interstitial. The mean preoperative beta-human chorionic gonadotropin (beta-hCG) value was 1550 mg/ml (range 375-200 mg/ml). The salpinx was ruptured in 12 women. At laparoscopy 35 salpingotomies and 47 salpingectomies were performed. Intraoperative laparotomies were performed in one woman because of interstitial pregnancy and massive intraperitoneal hemorrhage. No patient required further therapy for persistent trophoblastic tissue after salpingotomy.

Journal Article↗
PubMed1996

Serum markers of immune activation in women undergoing in-vitro fertilization and embryo transfer.

We evaluated serum concentrations of two early and sensitive markers of immune activation, interleukin-2 receptor (sIL-2R) and intercellular adhesion molecule-1 (ICAM-1) in two age-matched groups of in-vitro fertilization (IVF)-embryo transfer women, group I (n = 26) without and group II (n = 40) with methylprednisolone (MPD) supplementation of the luteal phase, on the days of oocyte retrieval (sample A) and embryo transfer (B), and second (C) and 13th (D) days post-transfer and in 20 normally cycling women (controls) on the day of luteinizing hormone (LH) peak. No difference in the outcome of the IVF-embryo transfer was observed between groups I and II. In sample A, both immunomarker concentrations showed no significant difference between the two groups of IVF women, while they were significantly higher (P < 0.01) than values in controls. In cycles in which conception occurred, significantly higher immunomarker concentrations were observed in sample A of both groups I and II compared with those in unsuccessful cycles of the same group. A significant decrease of both sIL-2R and ICAM-1 was noticed in sample B only in group II (P < 0.0001 and P < 0.001 respectively; paired t-test) that continued further in the late luteal phase only in the case of conception, independently of MPD supplementation. These data suggest that (i) due to multiple ovulations, IVF-embryo transfer women show elevated concentrations of sIL-2R and ICAM-1 at oocyte retrieval; (ii) since, even at oocyte retrieval stage, high concentrations of immunomarkers are associated with IVF-embryo transfer success, sIL-2R and ICAM-1 could be used as early indicators for conception cycles; (iii) transient suppression of T cell activity by MPD supplementation following IVF-embryo transfer does not improve pregnancy rate.

Embryo Transfer↗
PubMed1996

Triplet pregnancy and fetal reduction counselling.

The aim of this study was to compare the fetal loss between triplet pregnancies that underwent fetal reduction to twins and triplets which continued in spite of reduction being suggested to all of them. During a five year period a total of 3,518 cycles underwent ovarian stimulation with GnRH analogues, HMG, pure-FSH and HCG for the purpose of IVF; 2,918 women underwent ovarian aspiration leading to 2,380 embryotransfers. A total of 560 clinical pregnancies were detected with 24 clinical triplet pregnancies. Fourteen women continued their triplet pregnancy while 10 women underwent fetal reduction to twins. From 42 fetuses (14 triplets) starting the third trimester only 29 survived (total fetal loss 30.9%). From 14 fetuses (7 twins) starting the third trimester all survived. Three twins were lost during the second trimester due to cervix incompetence. Fetal reduction to twins must be proposed to each multifetal pregnancy, considering the very serious high mortality rate.

Female↗
PubMed1996

Heterotopic pregnancies in an in-vitro fertilization program.

During a four-year period in vitro fertilization (IVF) was carried out in 2,356 cycles. The pregnancy rate per transfer was 24% while the incidence of ectopic pregnancies was 7.5% per pregnancy. There were seven cases of heterotopic pregnancies-simultaneous intra- and extrauterine pregnancies (1.5% among all IVF pregnancies). Two of them were diagnosed after tubal rupture of the ectopic pregnancy and five cases were diagnosed by ultrasound at the 7th or 8th week of gestation. Laparotomy and subsequent salpingectomy was carried out in six cases while in one case the ectopic pregnancy was removed by laparoscopy. Three out of the seven heterotopic pregnancies (43%) were successfully continued with normal intrauterine embryo development and delivery.

Adult↗
PubMed1995

Serum and follicular fluid sex hormone-binding globulin in stimulated and unstimulated cycles.

BACKGROUND: It is well-known that sex hormone-binding globulin (SHBG) concentrations in the follicle are relatively low in comparison with the corresponding estradiol (E2) levels, which are extremely high. A direct comparison of these data in stimulated and unstimulated cycles, as well as the relationship of SHBG with testosterone (T) and E2 in serum and follicular fluid (FF), is assessed. METHODS: SHBG was measured in serum and FF in 42 cycles stimulated by GnRH agonists and gonadotropins and in 15 unstimulated cycles. The levels of SHBG were compared to the corresponding total estradiol and total testosterone concentrations. The analyzed FFs of 42 women, 12 of whom conceived, were randomly selected from 90 patients participating in an in vitro fertilization program. Mature oocytes were retrieved from all follicles from which FFs were analyzed. RESULTS: Markedly elevated SHBG was found in both the serum and the FF of stimulated cycles compared to unstimulated cycles. In contrast, serum T and E2 were significantly higher in induced than in unstimulated cycles, while there was no significant difference in FF T or E2 between the two groups of cycles. No correlation was found between serum and FF SHBG in either stimulated or unstimulated cycles. In stimulated cycles, only in FF, SHBG was significantly correlated with both E2 and T. In unstimulated cycles, no correlation was found between SHBG and either one of the corresponding steroids either in serum or in FF. CONCLUSIONS: The fraction of non-SHBG bound, biologically active sex steroids may be lower in the FF of stimulated than that of unstimulated cycles.

Estradiol↗
PubMed1995

The effect of pentoxifylline on sperm motility, oocyte fertilization, embryo quality, and pregnancy outcome in an in vitro fertilization program.

OBJECTIVE: To study the effect of pentoxifylline on sperm motility, oocyte fertilization, embryo cleavage, and quality as well as pregnancy outcome on asthenospermic patients participating in an IVF program. DESIGN: Prospective randomized study. SETTING: Private IVF unit. PATIENTS: Ninety-seven couples, 24 of whom were repeating IVF. Two semen specimens were obtained from each patient and each specimen was divided equally into two parts, nontreated (control semen) and pentoxifylline-treated (treated semen). MAIN OUTCOME MEASURE: Sperm progressive motility, oocyte fertilization. RESULTS: Overall and progressive motility did not differ significantly between the two semen specimens. There was a significant increase in the progressive motality of the pentoxifylline-treated semen compared with control semen. No significant difference was noticed between control and treated semen in fertilization rate, cleavage rate, embryo quality, and pregnancy rate. The percentage of patients who fertilized only with control semen (9.3%) was not significantly different from that of patients who fertilized only with treated semen (10.3%). Couples who were repeating IVF did not show significant difference in fertilization between the present study and previous attempts. CONCLUSION: Our results showed that although the sperm progressive motility is improved after pentoxifylline treatment, it is doubtful whether this effect is of any clinical significance.

Cleavage Stage, Ovum↗
PubMed1994

Immune dysfunction in patients with unexplained repeated abortions.

OBJECTIVES: To examine the immunological profiles by antiphospholipid antibodies IgG, IgM, IgA immunoglobulins ACA, as well as C3, C4 complement component levels. METHODS: A group of 44 women with a history of three or more consecutive pregnancy losses was compared with 34 normal women. RESULTS: Our results showed lower levels of IgG immunoglobulins for the patient group (P < 0.001) while the C3, C4 complement component levels remained unaltered. Anticardiolipin antibodies were positive in ten patients for IgG or IgM isotypes or for both presenting a prevalence of 22.7% while none of the control subjects had ACA positive titers. The lupus anticoagulant was not detected in either group. Ten patients (22.7%) presented positive autoantibody tests as compared with only 3 (8.8%) of the control group. No statistical differences were found between the two groups when the frequency of each autoantibody's positive tests were examined separately. CONCLUSIONS: An inconsistent immune derangement seems to be present in recurrent aborters with the presence of anticardiolipin antibodies as the stronger representative marker of immune alteration.

Abortion, Habitual↗
PubMed1994

Tumour-associated antigens, CEA, CA 125 and SCC in serum and follicular fluid of stimulated and unstimulated cycles.

Serum and follicular fluid levels of CEA, CA 125 and SCC of women participating in an IVF program, in 42 cycles stimulated with GnRH-a and gonadotropins and in 26 unstimulated cycles triggered with HCG, were evaluated and compared with (a) steroid and gonadotropin levels, (b) the results of IVF, and (c) serum values in a control group of women with spontaneous normal ovulatory cycles. In the control group, serum antigens did not vary significantly during the 3 phases of the cycle. In stimulated cycles the median values in serum were 0.7 ng/ml (range, 0.0-2.1) for CEA, 14.0 U/ml (3.3-32.4) for CA 125 and 2.05 ng/ml (1.1-17.8) for SCC, whereas the median values in follicular fluid were 0.6 (0.0-27.9), 21.5 (0-670) and 21.4 (1-360), respectively. In unstimulated cycles the median values and ranges in serum were 0.9 (0.4-3.9), 12.1 (4.8-63.4) and 1.85 (0.7-4.4), respectively, whereas in follicular fluid they were 2.9 (0.4-180.7), 32 (1.7-600) and 231 (10.8-904). Different follicles of the same patients in stimulated cycles showed a wide divergence for all three antigens. In unstimulated cycles all three antigens in follicular fluid were strongly-correlated and a significant inverse correlation was observed between LH and both CA 125 and SCC in serum. In either group of cycles, no significant relationship was found between any serum or follicular fluid antigen and estradiol or testosterone, pregnancy rate, or oocyte quality and fertilization.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗