Biomedical subjects

V Unfer

Publications and source records attributed to V Unfer.

11 recordsLinked to original sources

PubMed2001

A prospective randomized study comparing intramuscular progesterone and 17alpha-hydroxyprogesterone caproate in patients undergoing in vitro fertilization-embryo transfer cycles.

OBJECTIVE: To compare the effectiveness of i.m. P and 17alpha-hydroxyprogesterone caproate (17-HPC) for luteal phase support, in patients undergoing IVF-ET cycles. DESIGN: Prospective, randomized study. SETTING: Patients undergoing IVF-ET in our Centers. PATIENT(S): The inclusion criteria were the use of GnRH down-regulation and aged <40 years. INTERVENTION(S): A total of 300 cycles were randomly treated with either 17-HPC (341 mg every 3 days) or P (50 mg daily). MAIN OUTCOME MEASURE(S): The outcomes of IVF in both study groups were evaluated for biochemical pregnancy, miscarriage, clinical pregnancy, and ongoing pregnancy. RESULT(S): No difference was found in the main outcome parameters considered. CONCLUSION(S): Although the results of the study encourage the use of 17-HPC for luteal phase support in patients undergoing IVF-ET program, more studies are necessary to support the hypothesis that it can replace i.m. P-in-oil.

17 alpha-Hydroxyprogesterone Caproate↗

PubMed2001

Low dose of ethinyl estradiol can reverse the antiestrogenic effects of clomiphene citrate on endometrium.

Fifty healthy, voluntary patients aged between 20 and 30 years with regular menstruation and plasmatic progesterone level >10 ng/ml at the midluteal phase have been enrolled in this study. They were randomly treated with clomiphene citrate (CC; group A) or CC + ethinyl estradiol (0.05 mg group B, or 0.02 mg group C). We estimated the difference in uterine artery pulsatily index, endometrial thickness and histological dating and morphometric analysis of endometrium. No significant differences in Pulsatility Index values and in the number of preovulatory follicles were noted. The difference between endometrial thickness, histological dating and morphometric analysis of the endometrium were statistically different between groups B and C vs. A. Our study shows that CC has a deleterious effect on endometrium maturity and that adding ethinyl-E(2) produces a favorable endometrial response even with very low doses.

Adult↗

PubMed2000

Use of ethinyl estradiol to reverse the antiestrogenic effects of clomiphene citrate in patients undergoing intrauterine insemination: a comparative, randomized study.

OBJECTIVE: To compare the effectiveness of clomiphene citrate used alone and in combination with ethinyl E2 for the induction of ovulation in patients undergoing IUI. DESIGN: Randomized, double-blind study. SETTING: Four infertility treatment centers. PATIENT(S): Women aged 25-35 years with infertility of at least 2 years' duration and oligomenorrhea or amenorrhea associated with a positive menstrual response to an IM progesterone challenge. INTERVENTION(S): A total of 64 patients were randomized to treatment with CC (100 mg daily for 5 days) or CC (100 mg daily for 5 days) plus ethinyl E2 (0.05 mg daily for 5 days). MAIN OUTCOME MEASURE(S): The uterine artery pulsatility index, number of preovulatory follicles, endometrial thickness, and pregnancy rate. RESULT(S): Both treatment regimens increased FSH, LH, and 17beta-E2 levels, with no statistically significant differences. There was a statistically significant difference in endometrial thickness between the two treatment groups. No statistically significant differences were noted in pulsatility index values or in the number of preovulatory follicles. CONCLUSION(S): Ethinyl E2 can reverse the deleterious effects of CC on endometrial thickness, which may contribute to higher pregnancy rates.

Adult↗

PubMed2000

Use of intramuscular progesterone versus intravenous albumin for the prevention of ovarian hyperstimulation syndrome.

This study was designed to compare the effectiveness of intramuscular progesterone with that of intravenous albumin in the prevention of ovarian hyperstimulation syndrome (OHSS). Ninety-six patients at high risk to develop OHSS (estradiol concentration >9, 000 pmol/l on the day of hCG administration and over 20 follicles of a diameter larger than 14 mm observed by transvaginal ultrasonography) and undergoing in vitro fertilization-embryo transfer were enrolled. They were randomly treated with intramuscular progesterone (200 mg/day) or 100 ml of 20% intravenous albumin in order to estimate the difference in the incidence of OHSS. A significant difference in the incidence of moderate OHSS and no cases of severe OHSS were observed between the groups. Our data show the effectiveness in preventing OHSS with high doses of progesterone.

Adult↗

PubMed1999

Luteal phase support with 17alpha-hydroxyprogesterone versus unsupported cycles in in vitro fertilization: a comparative randomized study.

This study was designed to determine the efficacy of 17alpha-hydroxyprogesterone caproate (17-OHPc) for luteal phase support in in vitro fertilization (IVF). For this purpose, a total of 86 IVF patients undergoing embryo transfer were randomly allocated to two groups as follows: (1) group A, including 43 patients who received the support of luteal phase through the intramuscular administration of 17-OHPc at a dosage of 341 mg every 3 days, and (2) group B, including 43 patients who received the intramuscular administration of a saline solution as placebo every 3 days. In both groups, the treatment was started within 24 h after embryo transfer until beta-HCG evaluation. In case of positive beta-HCG, it was extended until 12 weeks. Efficacy was assessed using the pregnancy rates, which was, per transfer, statistically significantly higher in group A than in group B (32.5 vs. 18.3% respectively). On the basis of our results, we emphasize the use of 17-OHPc for luteal phase support after IVF and embryo transfer.

17-alpha-Hydroxyprogesterone↗

PubMed1996

A comparison of the shake test, optical density, L/S ratio (planimetric and stechiometric) and PG for the assessment of fetal lung maturity.

Our aim was to determine the diagnostic accuracy and reliability of four tests for the assessment of fetal lung maturity (FLM): shake test, optical density at 650 nm (OD650), lecithin to sphingomyelin ratio (L/S) by planimetry and stechiometry, and presence of phosphatydylglycerol. Amniotic fluid was obtained from 74 patients at various gestational ages. The shake test and the OD650 were performed according to published methods L/S was determined by TLC (thin-layer chromatography) and the ratio assessed by planimetry and stechiometrically by measurement of organic phosphorus from the chromatographic spots. PG was assessed similarly by TLC. When correlated with gestational age at amniocentesis, all tests correlated positively: shake test (r = 0.46, p < 0.005); OD650 (r = 0.31, p < 0.005); planimetric L/S (r = 0.77, p < 0.005); stechiometric L/S (r = 0.52, p < 0.005) and PG (r = 0.54, p < 0.005). The diagnostic accuracy of each test was as follows: the shake test and the OD650 had a sensitivity of 50%, while the steciometric L/S had a sensitivity of 75%, the planimetric L/S and the presence of PG were 100%. All four tests demonstrated a specificity greater than 64%, the highest for the PG presence being (83%) and the shake test (86%). Predictive negative values for lung maturity were > 93% for all tests, with the highest for the planimetric L/S and presence of PG being (100%). The study confirms that the determination of L/S ratio is still superior to other tests in terms of overall diagnostic accuracy. In addition, it was found that presence of PG was highly associated with the absence of respiratory complications in the newborn.

Adult↗

PubMed1996

Nausea, vomiting and thyroid function before and after induced abortion in normal pregnancy.

Thyroid function in early pregnancy has been reported to be slightly different from that in second or third trimester. We assessed thyroid function before and after induced abortion in normal pregnant women. A significant increase in serum Free T4 and a decrease in serum TSH were observed before abortion and these changes, apart from the contemporary significance of serum hCG-beta, were especially marked in pregnant women with nausea and vomiting. On the other hand, an increased level of Free T4 and a reduced level of TSH returned to the normal ranges 7-10 days after induced abortion. Furthermore, serum hCG-beta was significantly reduced. These results suggest that, in normal early pregnancy, thyroid function may be related to serum hCG-beta concentration and its increased level, which induces gestational emesis.

Abortion, Induced↗

PubMed1996

An obstetric and neonatal study on unplanned deliveries before arrival at hospital.

OBJECTIVE: To establish the prevalence of unplanned deliveries before arrival at a big metropolitan hospital and to determine the demographic characteristics of the group of women at risk of delivering before arrival. DESIGN: A random case control study. Each baby born before arrival and its mother were compared to the next baby born in the same Department. SUBJECTS: All babies born before arrival at the Department of Obstetrics and Gynecology, University "La Sapienza" in a 10 yr. period (Jan 1983-Dec 1993). RESULTS: Of 27,274 consecutive deliveries in the study period, 22 (0.8%) babies were born before arrival at hospital. Of the 22 women who delivered before arrival, 16 were Italian, 5 were considered nomad (no fixed address) and one was a Polish tourist. No statistical difference was found between groups regarding maternal age, parity, gestational age, birth weight and immediate delivery complications. No mortality cases were observed in the study or control group. Neonatal stay in the neonatal ward was longer in the study group (6.5 vs 3.5 days, P < 0.001). Hypothermia was the highest morbidity (P < 0.001) and neonatal complications were more prevalent in babies delivered before arrival than in-born babies (P < 0.001). CONCLUSIONS: Delivery before arrival to hospital does not seem to carry a higher neonatal mortality risk. However, the prevalence of complications was higher in such babies, with hypothermia being the highest morbidity.

Academic Medical Centers↗

PubMed1996

The influence of obesity in the sexual life of women in menopause. A case control study.

It seemed important to us to investigate sexuality during the post-menopausal and senile period to evaluate whether changes in sexual behaviour are related with endocrine-functional alterations brought on by menopause, or whether social-economic and environmental factors represent the principal cause. Thus 1,500 questionnaires were distributed to women aged from 50 to 87. Of the 1,500 questionnaires distributed, only 713 (47.53%) were returned completely filled-in. All women had been classified for age, civil status and life environment. Our statistic analysis does not seem to have singled out those factors that influence sexual activity in women of advanced age but shows only how age, indifferently from civil status and life environment, represents the most important factor. At the same age other factors, probably attached to psychological features and way of life and thus difficult to define and even less qualifiable, may be of influence, explaining a further percentage of control of those answers not explainable by age.

Age Factors↗

PubMed1995

An Italian survey on how information campaigns about AIDS have changed contraception in young couples. A sectional study and a comparison with the literature.

The purpose of the present investigation was to ascertain whether adolescent had been sensitized by the campaign against AIDS and if their behaviour regarding the use of contraception had changed accordingly. To this end 2,000 questionnaires (of which 1,554 were returned) were distributed to a population aged 13-20 years, recruited from high schools or sporting centers. The results of our survey, which started in 1992 and lasted 15 months, indicate that after the informative campaigns of 1986, contraceptive habits have changed, and at present, the method predominantly used by teenagers (60.6%) at their first sexual intercourse is the condom. The results of the present study have been compared with those of the literature regarding the years previous to our study. In our investigation, only 18.9% of the interviewed used oral contraception vs. 43.3% and 34.50% of those reported in 1980-85 and 1986-89, respectively. Particularly significant is the fact that 11.6% of teenagers used the condom in addition to oral contraception at their first sexual intercourse. In conclusion, we can assert that AIDS campaigns conducted in Italy, starting from 1986, has resulted in an increase of the use of condoms with respect to other methods of contraception.

Acquired Immunodeficiency Syndrome↗

PubMed1995

Pregnancy in adolescents. A case-control study.

OBJECTIVE: to investigate pregnancy outcome and incidence of pregnancy-related disorders in the adolescent. DESIGN: a matched control retrospective study. SUBJECTS: pregnant adolescents aged 14 to 19 years admitted to the Departments of Obstetrics and Gynecology--Policlinico Umberto I, between the years 1984 and 1993; a comparable number of pregnancies aged 20 to 24 years was considered as a control group. RESULTS: In the 10 yrs. period a total of 304 pregnancies in adolescents were considered. Preterm deliveries were 9.5% in the adolescent group vs 5.9% in control (P > 0.05). A higher incidence was found in number of cesarean section (P < 0.001), spontaneous abortion (P = 0.003), intrauterine growth retardation (P = 0.04) and fetal distress (P = 0.04) in the adolescent group vs matched controls. Also mean birth weight was significantly lower in the adolescent group when compared with normal group (P < 0.001). CONCLUSION: we found a higher incidence of obstetric complications, such as IUGR, acute fetal distress in labor and lower birth weight, in the adolescent group, resulting in a higher number of cesarean sections. We hypothesise that the relative state of "hypoarterialisation" characteristic of the adolescent uterus may be involved in the afore-mentioned complications.

Adolescent↗