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T Mardesić

Publications and source records attributed to T Mardesić.

At least 19 recordsLinked to original sources
PubMed2005

[Threatening uterine rupture in pregnancy after previous laparoscopic myoma enucleation. Case report].

OBJECTIVE: To evaluate the negative effect of uterine myoma enucleation forcompact structure of the uterus. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, 1st Faculty of Medicine, Charles University and General Faculty Hospital, Prague, Pronatal Sanatoruim, Prague METHODS: In this study, the authors analyze their experience of the course of pregnancy in a patient who had uterine myoma enucleation with penetration to the uterine cavity and large coagulation. The pregnancy was terminated by caesarean section for the indication of prior uterine surgery and the risk of uterine rupture in 38 week of pregnancy. CONCLUSION: This case report demonstrates the risk of uterine rupture in pregnancy after laparoscopy myoma enucleation.

Adult↗
PubMed2004

[The first pregnancy and birth after cryopreservation of oocytes in the Czech Republic--importance of the method for reproductive medicine].

OBJECTIVE: The purpose of this work was to develop methods for successful cryopreservation of human oocytes. DESIGN: Case-controlled study and case report. SETTING: Sanatorium Pronatal, Prague. METHODS: Propanediol (PrOH)-sucrose was used as cryoprotectant medium for cumulus-free oocytes and stepwise dilution of cryoprotectant post-thaw. RESULTS: The method was used in three patients (38 denuded oocytes) and yielded excellent survival and fertilization rates (89.5% and 73.5% respectively). In all patients embryo-transfer was possible, one patient got pregnant and delivered a healthy baby. CONCLUSION: Our data show that cryopreservation may ensure that the integrity of the human oocyte is adequate for normal fertilization and embryo development.

Adult↗
PubMed2004

[Condition of children after assisted reproduction in the Czech Republic in the period of 1995-1999].

INTRODUCTION AND PROBLEM: Since the introduction of in vitro fertilization (IVF) there has been continuing discussion on possible genetic defects and malformations in children in connection with the technique of assisted reproduction. These data have not been so far analyzed in the all-state scale of the Czech Republic and our contribution thereby contributes by present complex analysis of the data to the knowledge of this problem in this country. MATERIAL AND METHODS: The paper analyzes data of children from IVF Registry for the years 1995-1998 and compares the results obtained with those of children born after spontaneous pregnancy in the Czech Republic in the period of 1995-1999. The incidence of inborn defects in children born after IVF methods has been confronted with data from the VV Registry after spontaneous conception. It is a retrospective analysis of individual anonymous data. RESULTS: In the period of 1995-1998 there were 3,782 successful pregnancies after IVF, which ended by successful delivery of the children. In the period of 1995-1999, 367,735 children were born in the Czech Republic on the whole. In the total number of 3,782 successful pregnancies, 5,126 children were born, 5,108 being born alive and were stillborn. The frequency of children having been delivered with an inborn defect were 2.98% in the IVF children and 2.77% in other born children, the difference not being statistically significant. CONCLUSION: The analysis of our cohort of IVF children has not revealed increased rate of inborn defects in comparison with children born after spontaneously conception.

Congenital Abnormalities↗
PubMed2004

[Condition of the children born after assisted reproduction in Czech Republic].

OBJECTIVE: A retrospective study of data, with an analysis of bio-social factors and the incidence of birth defects in the children born out of pregnancy resulting from assisted reproduction in the Czech Republic in the period from 1995 to 2002. Also, the objective was to analyse these factors in comparison with a group of children born during the same period after spontaneous conception. DATA SOURCE AND METHODS: The data were obtained from the National Health Registers, the administration of which has been entrusted to the Institute of Health Information and Statistics of the Czech Republic (IHIS CR). Specifically, the National Register of Birth Defects and the National Register of Neonates were used. Groups of children born after spontaneous conception and after assisted reproduction were analysed. We analysed the frequency of pregnancy, the gestation week at birth and birth weight, the incidence of immaturity at birth, hypotrophy, hypertrophy, the incidence of birth defects in prenatally and postnatally diagnosed cases and the mortality rate during the 1st year of life. RESULTS: In the period 1995-2002, a total of 731,617 children were born in the Czech Republic. During the same period, a total of 14,243 children were born after assisted reproduction. A statistically significant higher (p<0.0001) proportion of the children born out of multiple pregnancies (40% in the assisted reproduction group as compared with 1.7% in the spontaneous conception group) was identified. The overall mortality rates (early neonatal mortality and infant mortality) are significantly influenced by the number of children within a pregnancy, and as a consequence of the unfavourable distribution in the assisted reproduction group (statistically significant higher representation of children from multiple pregnancies), the rates are higher in the assisted reproduction group. CONCLUSION: The frequencies of children born with a birth defect in the assisted reproduction group and in the group of other born children were not statistically significant. The differences in mortality rates, birth weights and the gestation week are caused by the unfavourable demographic distribution in the assisted reproduction group.

Birth Weight↗
PubMed2002

[Protection of reproductive functions in patients with tumors].

BACKGROUND: Survival from cancer continues to improve. Antimitotic therapy can induce failure of spermatogenesis and oogenesis, gonadal disturbances and infertility. Recent advances in reproductive medicine have opened opportunities for the preservation of reproductive potential of patients with cancer. The aim of our study was to analyse by a multidisciplinary team the contemporary state of art and proposal of the Czech model of fertility preservation starting in childhood and continuing through the whole reproductive period. METHODS: This paper highlights the problems associated with gonadal failure as a consequence of therapy for malignancy in childhood, adolescence and adulthood. Analysis of these problems served as a principle for the management strategy for fertility preservation. CONCLUSIONS: Patients undergoing treatment for malignancy are at the high risk of gonadal damage and infertility. Therefore, alternative treatments with less gonadal toxicity and different treatment protocols were evaluated. Fertility can be preserved with the freezing and banking of spermatozoa, embryos, and oocytes obtained prior to the cancer treatment. In female patients (starting in puberty) pharmacological preservation of gonads with gonadoliberin analogues is also possible. Chance for the future fertility preservation for children offers freezing and thawing of primordial follicles and spermatozoa obtained during the gonadal biopsies. Long-term follow-up study by a multidisciplinary medical team is necessary.

Adult↗
PubMed2002

[Reproductive risks in aging males].

OBJECTIVE: To review the literature on the association between male age and semen quality, fertility status and reproductive risks. DESIGN: Review. SETTING: Centre for infertility diagnosis and treatment Sanatorium Pronatal, Prague. METHODS: Review of English language-published research over the last 20 years using MEDLINE. RESULTS: The modification of gamete production in aging males is more qualitative than quantitative. However, aging of testes not only influences the individual, but through the gametes also offspring with increased risk of chromosomal, gene and behavioral abnormalities. CONCLUSION: It seems reasonable and consistent to recommend that both men and women complete their family before age 40 if possible.

Aging↗
PubMed2001

[Turner syndrome: overview of problems, present status, proposals for care and a protocol for monitoring in childhood, adolescence and adulthood].

BACKGROUND: Girls and adolescents with Turner syndrome (TS) usually receive intensive medical care in a multidisciplinary team, coordinated by paediatric endocrinologist. Majority of them are discharged from specialist clinics following the induction of puberty and attainment of final height. Patients with Turner syndrome have a reduced life expectancy, they are known to have multi-system impairments in addition to the short stature and to the absence of sexual development. Aim of this study is to propos a continuous follow-up by multidisciplinary team of physicians starting in childhood and following the discharge from the paediatric care. METHODS AND RESULTS: This paper highlights the medical and psychosocial problems associated with Turner syndrome in childhood, adolescence and in adulthood. Analysis of these problems served as a background to management strategy. CONCLUSIONS: Women with Turner syndrome are at risk of number of medical problems. Quality of their life and the life expectancy can be improved with increasing awareness to comorbities associated with Turner syndrome. Assisted reproduction technologies has recently offered a chance for pregnancy and delivery of a healthy child also to women with Turner syndrome. Therefore, long-term follow-up by multidisciplinary team of physicians knowledgeable about these medical problems is necessary. Introduction of a centralised system of systematic multidisciplinary approach to patients with Turner syndrome from childhood and adolescence to adulthood seems to be very important.

Adolescent↗
PubMed2001

[Reproductive medicine from childhood to adulthood].

Modern era brought new diagnostic and therapeutic methods to endocrinology and changed the approach to many diseases and developmental disorders. Explosion of new findings brought about the possibility of examinations on subcellular level. Possibility to study structure and function of various genes is not any more the futurology. However, still in medicine romain a roas which are considered as less important. It is usually assumed that questions of fertility will be dealt by the specialist for adults. We suppose that the given problems should be well advised by an interdisciplinary co-operating team in the paediatric patients already. However, it should be recognised that some reproduction disorders have their origin in the early age. The aim of this paper is to give an overview on endocrine disorders in relation to reproduction impairments and to outline possibilities of co-operation between different specialist treating patients from childhood trough adulthood.

Adult↗
PubMed2001

[Effect of salpingectomy on the results of IVF in women with tubal sterility--prospective study].

OBJECTIVE: To compare the IVF results after salpingectomy of hydrosalpinges visible on ultrasound with IVF results in women with tubal infertility but without hydrosalpinx. DESIGN: Prospective study. SETTING: Sanatorium Pronatal, Na Dlouhé mezi 4/12, 147 00, Praha 4. METHODS: 101 women with tubal factor infertility were evaluated. In a prospective study we compared the results of first IVF cycle after salpingectomy of hydrosalpinges visible on ultrasound performed in 51 women (study group) with IVF results of 50 women with tubal infertility (confirmed by HSG and laparoscopy) but without hydrosalpinges and without salpingectomy. RESULTS: The maternal age in both groups (32.4 +/- 3.9 in salpingectomy group and 33.0 +/- 4.1 in control group), maximum estradiol levels (1392.6 +/- 675.8 pg/ml in salpingectomy group vers. 1624.7 +/- 909.7 pg/ml in control group), number of oocytes (11.3 +/- 5.8 after salpingectomy vers. 11.0 +/- 6.1 in controls), number of embryos generated (7.1 +/- 4.6 vers. 7.9 +/- 4.7) and number of embryos transferred were not statistically different. In their first IVF cycle after salpingectomy has been performed 30 women out of 51 became clinically pregnant (58.8%), while in control group a clinical pregnancy could be verified in 16 women (32.0%). Implantation rate in women after salpingectomy was 28.2% vers. 12.3% in control group. Both implantation rate and pregnancy rate were statistically different at 5% level of significance. CONCLUSION: After salpingectomy of hydrosalpinges visible on ultrasound the implantation rate and clinical pregnancy rate are significantly better when compared to IVF patients with tubal infertility without the presence of hydrosalpinges and without salpingectomy. Salpingectomy should be offered to all patients with hydrosalpinges visible on ultrasound. Moreover, this radical approach should be considered even in women with highly damaged tubes but without the presence of hydrosalpinges.

Adult↗
PubMed2000

[Does reduction in multifetal pregnancy increase the risk of poor outcome in twin pregnancy?].

OBJECTIVE: To compare perinatal results for multi-foetal pregnancies where the reduction was performed with pregnancies where the reduction was not performed. SETTING: Sanatorium Pronatal, Na Dlouhé mezi 4/12, 147 00, Praha 4--Hodkovicky. METHODS: We have analyzed results of pregnancies, after delivery, for women with twin pregnancy which originated in our sanatorium, as a result of treatment with assisted reproduction methods, in the period of time from January 1st 1996 to December 31st 1998. In the group being monitored there were 122 twin pregnancies originated as a result of reduction of triple and more-foetal pregnancies. We evaluated the percentage of miscarriages, length of pregnancies, weight of the newborns and the manner of termination of the delivery. These results were compared with our control group consisting of 180 cases of twin pregnancies which were not a result of reduction. RESULTS: Analysis was performed for those mothers only where complete data were available. At a 5% level of statistical significance, it was not proved that both groups differed in average term of pregnancy or average weight of the twins. Average age of the mothers differed at 5% level of significance (average age values were 30.16 for the group with reduction and 31.73 for the group without reduction). Fisher test on 5% significance level did not ascertain any significant difference in the probability of miscarriage between the group with reduction (5.26%) and the group without reduction (12.84%). At 5% level of statistical significance, no significant difference in probability of perinatal death of the foetus or delivery of a stillborn foetus was ascertained. However, it is necessary to point out a low frequency of these phenomena in our group. The percentage of cesarean sections did not differ significantly in both groups (86.24% in the group monitored vs 87.24% in the group of twins without reduction). CONCLUSION: The analysis of both groups proves that reduction of multi-foetal pregnancies does not worsen perinatal results in comparison to pregnancies where reduction was not performed.

Adult↗
PubMed2000

[Polycystic ovary syndrome as a multisystemic endocrinopathy].

OBJECTIVE: To review the recent progress in the diagnosis, pathophysiology and treatment of polycystic ovary disease (PCOD). DESIGN: A review describing the progress in understanding of the dysregulation of ovarian androgen biosynthesis in polycystic ovary disease (PCOD). SETTING: The Institute for the Care of Mother and Child, Podolské nábr. 157, 147 10 Prague 4, Sanatorium Pronatal, Na Dlouhé mezi 4/12, 147 00 Praha 4-Hodkovicky. CONCLUSION: It is proposed, that although this syndrome is very heterogeneous, the final common pathway involves a dysregulation of enzymes responsible for ovarian androgen biosynthesis, possibly induced/influenced by extraovarian factors--especially insulin resistance, hyperinsulinaemie, growth factors, luteinizing hormone and their biochemical sequelae. It's probably extraovarian factors that determine endocrinological and clinical expression of the disease.

Female↗
PubMed1990

Conservative nonsurgical treatment of early detected tubal pregnancies with intra-amniotic methotrexate.

Four cases of early detected tubal pregnancies were managed conservatively by aspiration and administration of 20 mg methotrexate into the amniotic sac during laparoscopy. All three women for whom hysterosalpingograms are available had patent tubes on the side of the former ectopic pregnancy six months after treatment. Spontaneous menstruation occurred within six weeks after methotrexate application in all cases.

Amnion↗