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Tarek El-Toukhy

Publications and source records attributed to Tarek El-Toukhy.

12 recordsLinked to original sources
PubMed2006

Over one thousand patients with early stage endometriosis treated with the Helica Thermal Coagulator (HELICA): safety aspects.

STUDY OBJECTIVE: To assess the safety of the Helica Thermal Coagulator in the laparoscopic treatment of early stage endometriosis. DESIGN: Retrospective, observational. SETTINGS: The Princess Royal University Hospital, The Sloane and Chelsfield Park Hospitals, Kent, UK. PATIENTS: One thousand and sixty patients with early stage endometriosis. RESULTS: All patients were treated laparoscopically with the Helica Thermal Coagulator; a new laparoscopic device that combines electrical energy with helium for the treatment of endometriosis. No major bladder, ureteric or bowel injuries occurred. The only complication was a perforated vagina from the cutting probe during dissection of the cul-de-sac in a patient with a vaginal endometriotic nodule. CONCLUSION: The Helica Thermal Coagulator is a safe device for the laparoscopic treatment of endometriosis.

Electrocoagulation↗
PubMed2006

IVF results: optimize not maximize.

The desire to improve in vitro fertilization (IVF) results has led clinicians to replace more than 1 embryo in the uterus. As a result, multiple births have increased over the last 2 decades to epidemic proportions, exposing the field of assisted conception to justified criticism. This review aims to ensure that physicians involved in the field of fertility treatment are aware of the risks and complications related to multiple pregnancies, and to explore possible strategies such as blastocyst culture, preimplantation genetic screening, and embryo cryopreservation, which can help to control and reverse the tide of multiple pregnancies without reducing the good success rate that modern IVF treatment enjoys. A brief overview of the respective UK legislative system is also presented.

Cryopreservation↗
PubMed2006

Towards better quality research in recurrent implantation failure: standardizing its definition is the first step.

Recurrent implantation failure is a frustrating condition for clinicians and patients alike. The number of potential therapies offered to patients in order to overcome this problem is increasing, and more research is needed to establish which of those treatment options is truly beneficial. Improved understanding of their value is more likely if the same definition of recurrent implantation failure is used across future studies. In this article, the inconsistency present in current literature is examined and the case is argued for a standardized definition for the condition.

Animals↗
PubMed2005

Influence of maternal age on the outcome of PGD for aneuploidy screening in patients with recurrent implantation failure.

This study assessed the influence of maternal age on the outcome of aneuploidy screening (AS) cycles for recurrent implantation failure (RIF). One hundred and sixteen couples with a history of RIF underwent 130 cycles of AS. Group A included 78 patients aged < or = 40 years (range 25-40 years) who underwent 86 cycles, while group B included 38 couples aged > or = 41 (range 41-47) who underwent 44 cycles. Fluorescence in-situ hybridization (FISH) analysis of the first and second polar bodies using probes specific for chromosomes 13, 16, 18, 21 and 22 was conducted. Euploid oocytes that cleaved were subsequently tested using the same probes on a single blastomere obtained from day 3 embryos. Chromosomally normal embryos were replaced on day 5 of culture. There was no significant difference between the two groups in the mean numbers of oocytes fertilized normally and oocytes (7.5 +/- 3.2 versus 7.2 +/- 3.6) and embryos tested (4.1 +/- 3 versus 3.4 +/-3). However, the younger age group had a significantly higher proportion of euploid oocytes/embryos, cycles reaching embryo transfer, pregnancy (43 versus 25%), clinical pregnancy (36.1 versus 16.6%) and ongoing delivery (32 versus 12.5%) rates per transfer. Preimplantation genetic diagnosis with AS for recurrent IVF implantation failure using FISH probes is therefore associated with improved outcome in women under 41 years, but has a high cancellation rate and low cycle outcome in older women.

Adult↗
PubMed2003

Vaginal sacrospinous colpopexy and perineorrhaphy for faecal incontinence: preliminary report.

OBJECTIVE: To review our experience with vaginal sacrospinous colpopexy combined with perineorraphy performed for patients with genital prolapse who concomitantly suffered from faecal incontinence (FI). SETTING: Gynaecology Department, Benenden Hospital, Benenden, Kent, UK. SUBJECTS AND METHODS: Between January 1997 and December 2001, 16 patients presented with symptoms of genital prolapse and faecal incontinence. Eleven out of the 16 patients (69%) had anorectal physiological tests and endoanal ultrasound performed before surgery. All patients had sacrospinous colpopexy and perineorraphy. Simultaneous vaginal hysterectomy was performed in two patients and anterior colporrhaphy in six patients. RESULTS: The mean age was 60 years and median parity was 2. The mean operative time was 62 min (range 35-100) and the mean blood loss was 60 ml (range 30-160). The mean follow-up period was 37 months (6-65). Thirteen patients (81%) reported no faecal incontinence after surgery, and two patients (12.5%) reported improvement. One patient (6.5%) had no improvement in her symptom of faecal incontinence after surgery. None of the patients had recurrence of genital prolapse during follow up. CONCLUSION: Sacrospinous colpopexy combined with perineorraphy can help to cure symptoms of faecal incontinence associated with genital prolapse. The possible mechanisms for such a favourable result are discussed.

Fecal Incontinence↗
PubMed2003

Pregnancy after hydrothermal endometrial ablation and laparoscopic sterilisation.

Hydrothermal ablation (HTA) is a newly introduced technique of endometrial ablation. This report describes the first case of pregnancy and miscarriage following successful HTA performed 4 years after laparoscopic tubal sterilisation. The diagnosis of such pregnancies can be difficult and the risk of pregnancy complications is potentially increased.

Abortion, Spontaneous↗
PubMed2003

Effect of blastomere loss on the outcome of frozen embryo replacement cycles.

OBJECTIVE: To assess the impact of survival of cryopreservation and thawing with all blastomeres intact on the outcome of frozen embryo replacement (FER) cycles. DESIGN: Prospective observational study. SETTING: University-affiliated tertiary referral assisted conception unit. PATIENT(S): The number of intact blastomeres before cryopreservation and after thawing was prospectively recorded in 1,687 cleavage-stage embryos thawed in 377 FER cycles. The cycles were categorized into two groups: group A (n = 184) included cycles in which all embryos transferred survived the cryopreservation and thawing process with all their original blastomeres intact; group B (n = 193) included cycles in which embryos transferred included at least one partially damaged embryo that has lost up to 50% of its original blastomere number. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Pregnancy and embryo implantation rates. RESULT(S): Groups A and B were comparable with respect to mean age at cryopreservation, mean number of oocytes retrieved and fertilized normally in the fresh cycle, and mean age at frozen transfer. No significant difference was found between the two groups with regard to mean number of frozen and thawed embryos per cycle and mean endometrial thickness reached before P supplementation. More embryos were transferred per cycle in group B than group A (2.4 +/- 0.6 vs. 2.1 +/- 0.6, respectively). However, the pregnancy and clinical pregnancy rates per cycle were significantly higher in group A than in group B (39.1% and 28.3% vs. 22.8% and 13.5%, respectively). The implantation rate was also higher in group A than in group B (17.3% vs. 8.1%, respectively). CONCLUSION(S): FER cycles in which all embryos transferred remained fully intact at thawing achieve a better outcome than those with at least one partially damaged embryo.

Adult↗
PubMed2002

Sacrospinous cervico-colpopexy with follow-up 2 years after successful pregnancy.

Sacrospinous cervico-colpopexy was performed for marked uterine prolapse in a young woman desirous of childbearing. Follow-up at 2 years following elective cesarean delivery revealed a well-supported cervix and vaginal vault at the level of the ischial spine. Although this represents an appropriate management, more information is still needed before the optimal mode of delivery following successful uterine prolapse repair can be established.

Adult↗
PubMed2002

Increasing the gonadotrophin dose in the course of an in vitro fertilization cycle does not rectify an initial poor response.

OBJECTIVE: To evaluate the value of increasing the gonadotrophin dose after 5 days of controlled ovarian stimulation in IVF patients who show an initial poor response to stimulation. SUBJECTS AND METHODS: We identified all IVF cycles between January 1992 and March 1996 in which ovarian response after 5 days of controlled ovarian hyperstimulation (COH) with 225-300 IU per day of human menopausal gonadotrophins (hMG; Metrodin or Pergonal) was monitored by measurement of serum estradiol concentrations (n=596 patients). According to estradiol concentration, the daily dose of hMG was doubled or increased to 450 IU in 193 patients (group A) or maintained the same in 403 patients (group B). Further cycle monitoring was achieved using serial ultrasound and serum estradiol measurements. RESULTS: The two groups were age-matched. Group A patients experienced a higher cancellation rate despite having a higher mean number of hMG ampoules (59.5 versus 36.2) and a longer duration of stimulation (12.2 versus 10.8 days). They achieved lower levels of serum estradiol on days 9 and 10 of stimulation, produced a lower mean number of oocytes per retrieval (5.8 versus 8.9) and had a lower clinical pregnancy rate per cycle (8.3 versus 23.4%) compared to group B. All differences were statistically significant. CONCLUSION: The poor outcome of cycles with initial low response to COH appears not to be averted by doubling or increasing the hMG dose after 5 days of stimulation.

Adult↗
PubMed2002

Young age does not protect against the adverse effects of reduced ovarian reserve--an eight year study.

BACKGROUND: Ovarian reserve significantly influences IVF outcome. Low response to ovarian stimulation due to reduction of ovarian reserve is occasionally encountered in young women. The aim of this study was to evaluate the outcome of IVF treatment in young patients with reduced ovarian reserve. METHODS AND RESULTS: Between January 1993-2001, 762 consecutive patients satisfied the definition of reduced ovarian reserve (raised early follicular phase FSH or gonadotrophin stimulation cycles where three or fewer oocytes were retrieved after routine FSH stimulation) and were included in the study. They were classified into three age groups: young (< or = 30 years), intermediate (31-38 years) and older (>38 years). The three age groups were similar with respect to basal (day 3) serum FSH and estradiol concentrations, cause of infertility and number of previous treatment cycles. Implantation (13, 9.6 and 9.8%), clinical pregnancy (11.8, 10.2 and 10%) and live birth (7.4, 7.3 and 6.8%) rates were not significantly different in the three age groups respectively (P > 0.05). CONCLUSION: This study shows that younger patients with reduced ovarian reserve have a poor outcome of IVF treatment similar to their older counterparts. Such information may be helpful in counselling these patients who otherwise might anticipate an outcome related to their chronological age.

Adult↗
PubMedDate not supplied

One hundred cases of laparoscopic subtotal hysterectomy using the PK and Lap Loop systems.

STUDY OBJECTIVE: To evaluate the safety and short-term outcomes of laparoscopic subtotal hysterectomy using the PK and Lap Loop systems. DESIGN: Prospective observational study (Canadian Task Force classification II-2). SETTING: Princess Royal University and Chelsfield Park Hospitals, Kent, UK. PATIENTS: One hundred women who underwent laparoscopic subtotal hysterectomy for menorrhagia from February 2003 through July 2004. INTERVENTION: The procedure was performed using the Plasma Kinetic (PK) system to seal the vascular pedicles and the Lap Loop system to separate the uterus at the level of the internal os. The uterus was removed from the abdominal cavity mainly by morcellation or posterior colpotomy. MEASUREMENTS AND MAIN RESULTS: Of 100 patients, 59 were operated on as outpatients. Mean patient age was 44.6 years, median parity was 2, mean body mass index was 26.8, and mean duration of symptoms was 4 years. Clinically, the uterus was enlarged in 70 patients, and preoperative ultrasound scanning suggested the presence of uterine myomas in 42 patients. In addition to hysterectomy, 47 patients had concomitant pelvic surgery. The mean total operating time was 45.5 minutes, and mean estimated blood loss was 114 mL. The overall major complication rate was 2%; two patients required blood transfusion after surgery. There were no bowel or urinary tract injuries, unintended laparotomy, return to operating room, or anesthetic complications. At follow-up, all patients were satisfied with surgery. CONCLUSION: Laparoscopic subtotal hysterectomy using the PK and Lap Loop systems for treatment of therapy-resistant menorrhagia is safe, can be performed as an outpatient procedure, and is associated with reduced operating time and high patient satisfaction.

Adult↗