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At least 1,009 records · Page 56Linked to original sources
PubMed1989

[Risks of medical complications inherent in technics of assisted procreation (excluding legal incidences)].

Although in France the law is still relatively poor in matters concerning complaints against medical people for accidents and incidents in connection with assisted reproduction, it appeared to the authors that it would be interesting to examine the subjects. There is some French and Anglo-saxon literature about the matter so that the circumstances that can be dangerous for the patients as well as well as for the doctors carrying out the processes can be listed in connection with the medico-legal field. When the legal cases in connection with the manipulation of gametes and of embryos have been excluded, there only remain the risks linked to the complications of the various techniques of assisted reproduction. These include those in connection with induction of ovulation and ovarian hyperstimulation. After having made a list of the risks in connection with In-Vitro Fertilization, with G.I.F.T. and with the various technique similar to it, such as artificial insemination donor, the authors suggest the steps that can be taken to prevent these medical complications and their eventual medico-legal repercussions. These consist of good organisation and improving the facilities dealing with assisted reproduction. The personnel should be well trained, as much information as possible should be given to the patients so that they give informed consent, whether exploratory procedures are being carried out or they are being treated with hormones, or having such manipulations as are necessary to obtain the desired pregnancy for them.

Female↗
PubMed1987

Abnormalities of ejaculation.

The normal physiologic processes of emission and ejaculation require coordination of neurophysiologic, anatomic, and, in certain cases, psychological phenomena. Disruption of any component, from the embryologic development of the müllerian duct through the medications used for nonrelated systemic disease, can alter the efficient function of ejaculation. Evaluation of the urologic patient who has any of a number of abnormal ejaculatory states requires an understanding of the many possible mechanisms of failure. The majority of these men need evaluation because of a possible male-factor infertile marriage. The potential for improvement is significant, given the development of improved techniques to stimulate ejaculation and the promise shown by extracorporeal fertilization techniques such as in vitro fertilization and gamete intrafallopian tube transfer. These patients deserve complete assessment and optimization of any factors that will enable them to achieve their goal of procreation.

Adolescent↗
PubMed1993

Serial transvaginal ultrasound scans and beta-human chorionic gonadotropin levels in early singleton and multiple pregnancies.

OBJECTIVE: To determine if serum beta-hCG levels are higher in multiple gestation than in singleton pregnancy at the time of intrauterine sac visualization and the first appearance of fetal heart activity as documented by serial transvaginal ultrasound (US). DESIGN: Prospective analysis of serial transvaginal US findings in 19 pregnancies correlated with serum hCG levels during early gestation. SETTING: Reproductive endocrinology division of the University of Arkansas for Medical Sciences, Little Rock, Arkansas. PATIENTS: Nineteen infertility patients were studied after conceiving. Thirteen underwent IVF or GIFT, 4 received hMG therapy, 1 was treated with clomiphene citrate, and 1 pregnancy followed spontaneous ovulation. INTERVENTIONS: Transvaginal US and hCG levels were obtained every Monday, Wednesday, and Friday from 20 to 22 days after ovulation until the appearance of fetal heart activity. RESULTS: Initial sac visualization occurred at lower serum hCG levels in singleton versus multiple pregnancies (2,180 +/- 1,170 versus 7,028 +/- 4,280 mIU/mL, mean +/- SD). Sacs were always seen when the serum hCG level (mIU/mL) was > or = 1,161 in singleton, 1,556 in twin, 3,372 in triplet, and 9,399 in quadruplet pregnancies. CONCLUSION: Failure to observe an intrauterine sac by transvaginal US in the presence of serum hCG levels in the 1,000 to 2,000 mIU/mL range is not pathognomonic for an ectopic gestation. Clinical symptomatology, risk of multiple pregnancies, and gestational age must also be considered.

Analysis of Variance↗
PubMed1995

[Evidence of antimicrobial activity of the follicular fluid: an evaluation and analytical study of samples obtained in an assisted reproduction program].

Due to lack of evidence of infection in patients for ovarian punction for ovular capture, the hypothesis of possible antibacterial action that could exist in follicular fluid, was evaluated. One hundred and ten samples of such fluid, were taken for antibacterial analysis, 37 of which, were studied, as they were the clearest ones and not contaminated. Such samples were obtained from hyperstimulated patients, ready for ovular capture through vagina by ultrasonographic guide. A bacterial inoculum, was prepared, in order to evaluate antimicrobial activity of follicular fluid against E. coli, P. aeruginosa, S. agalactiae, L. monocytogenes and C. albicans. Counting of bacterial colonies, at 2, 4, 6, 12 and 24 hours. Results summary shows bacteriostatic activity in all studied colonies, and E. coli and S. agalactiae seem to be the most sensitive, followed by P. aeruginosa, S. aureus and L. monocytogenes; and still present in C. albicans. It is concluded that follicular fluid has an antibacterial action, probably selective; and that keeping this research line will confirm this finding, and possibly will determine the concerned factors.

Bacteria↗
PubMed1995

Profound luteinizing hormone suppression after stopping the gonadotropin-releasing hormone-agonist leuprolide acetate.

OBJECTIVE: To compare levels of serum LH during continued use of leuprolide acetate (LA) with levels during the first week after discontinuing LA. DESIGN: Prospective controlled study. SETTING: Clinical assisted conception program. PATIENTS: Women undergoing controlled ovarian stimulation for assisted conception were randomized to receive LA according to "short" or "ultrashort" protocols. The alternative protocol was used then in a second cycle. Each patient was thus her own control. MAIN OUTCOME MEASURES: Serum LH over time. RESULTS: When LA was stopped after 5 days of administration, LH levels fell profoundly when compared with levels when LA was continued. CONCLUSION: Loss of LH after stopping LA is likely to be clinically important in ovarian stimulation regimens that use pure FSH with LA in ultrashort protocols. The fall in LH lasts at least 1 week and may be explainable by persistent suppression of endogenous GnRH by LA during this time.

Estradiol↗
PubMed1995

Safety of a freestanding surgical unit for the assisted reproductive technologies.

OBJECTIVE: To determine the safety of a freestanding surgical unit for assisted reproductive technology (ART), using the rate of unplanned admissions to a hospital within 24 hours of surgery. DESIGN: Prospective. SETTING: A freestanding surgical unit within a medical office building. PATIENTS: A mixture of private and university-referred patients undergoing 6,776 ART surgical procedures. MAIN OUTCOME MEASURES: Patients admitted during the first 24 hours of surgery were recorded and hospital progress was monitored for invasive procedures, treatments, time of discharge, and residual complications. Variables tabulated included age, fertility diagnosis, ART procedure, E2 level, number of follicles by ultrasound, previous surgery, and type of anesthesia. RESULTS: There were 11 hospital admissions (0.16%). Four patients required surgery: one laparoscopy and three laparotomies. Admissions after vaginal oocyte retrieval were no different from those after GIFT via laparoscopy, 0.16% versus 0.18%, respectively. The number of admissions after monitored anesthesia care was higher than expected compared with general anesthesia. Profiles of hospitalized patients showed no apparent differences from the nonhospitalized patients. CONCLUSIONS: Surgical procedures for ART performed in a freestanding surgical unit can be performed safely with a low hospitalization rate and minimal morbidity.

Female↗
PubMed1993

[Non-stimulated cycles and GIFT].

Authors, following a 19 natural cycle survey, used a simplified protocol for GIFT. 13 oocytes recoveries were followed by GIFT and two pregnancies occurred for a 15.4% success per attempt. We considered this technique as successful if having regard to the patients clinical situation, and the use of GIFT without ovarian stimulation should therefore be considered as a alternative to stimulate cycle.

Adult↗