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  • 1
    ISSN: 1432-055X
    Keywords: Schlüsselwörter: Allgemeinnarkose – Ketamin – In-vitro-Fertilisations-Embryotransfer (IVF-ET) – Prolaktin –β-Endorphine ; Key words: General anaesthesia – Ketamine – In vitro fertilization-embryo transfer – Prolactin –β-endorphins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract. Different anaesthetic procedures that were used during an in vitro fertilisation and embryo transfer (IVF-ET) program have been analysed in order to determine their influence on plasma levels of estradiol, progesterone, prolactin, and β-endorphin and results of IVF-ET. Methods. Fifty-four patients awaiting transvaginal oocyte aspiration were randomised into three groups: (1) anaesthesia with ketamine as an induction agent and analgesic (n=20); (2) general intubation anaesthesia using thiopentone for induction and enflurane for maintenance (n=18); and (3) no anaesthesia (n=16). Estradiol, progesterone, prolactin, and β-endorphin were measured from day 3 to 14 referring to follicle aspiration. Differences between preoperative hormone levels and their intra- and postoperative peaks were analysed using the Kruskal-Wallis test (P〈0.03). The results were corrected using the Holms method (α=0.05). Results. No differences were observed in estradiol and progesterone levels (Figs. 1, 2). Prolactin levels were 1.4 times higher (P〈0.001) when ketamine was used and 2.2 times higher (P〈0.001) after short general anaesthesia than in the control group (Fig. 3). Similar results were observed with respect to β-endorphin: in comparison with the control group we found significant elevation by a factor of 2.1 when ketamine was used (P〈0.001). The discrepancy became even more marked with general anaesthesia: β-endorphin was 3.9 times higher compared to the controls (P〈0.001) (Fig. 4). Comparing the two groups who were given anaesthetics, prolactin and β-endorphin levels were also significantly different (P〈0.001). The IVF procedure itself did not appear to be affected by different anaesthetic procedures during oocyte aspiration (Table 2). Conclusions. The increased prolactin and β-endorphin plasma levels associated with ketamine and general anaesthesia reflect a significant alteration of the observed hormone levels. When anaesthesia is indicated, we try to avoid general intubation anaesthesia in favor of ketamine.
    Notes: Zusammenfassung. Im Rahmen der in-vitro-Fertilisations-Embryotransfer-(IVF-ET-)Behandlung werden bei der Oozytengewinnung u. a. systemische Kurznarkosen eingesetzt. Ihr Einfluß auf die Östradiol-, Progesteron-, Prolaktin- und β-Endorphin-Plasmaspiegel sowie auf die Ergebnisse der IVF-Verfahren wurde an 54 Patientinnen untersucht. Diese wurden vor einer geplanten transvaginalen Follikelpunktion zwischen einer Narkose mit Ketamin als Einleitungshypnotikum und Analgetikum (n=20), einer "Allgemeinnarkose" mit Thiopental als Einleitungs- und Enfluran als Inhalationsnarkotikum (n=18) und einer Kontrollgruppe ohne Anästhesie (n=16) randomisiert. Die Hormonspiegelbestimmungen erfolgten peri- und intraoperativ zwischen Tag −3 und +14. Die Differenzbeträge zum individuellen Vor- bzw. Nullwert wurden mittels Kruskal-Wallis-Test analysiert (p〈0,03) und nach dem Holm-Verfahren korrigiert (α=0,05). Der Prolaktinspiegel war unter Ketaminanästhesie 1,4fach und Allgemeinanästhesie 2,2fach gegenüber der Kontrollgruppe erhöht (jeweils p〈0,001). Auch die β-Endorphine stiegen um den Faktor 2,1 (p〈0,001) bzw. 3,9 (p〈0,001) signifikant an. Beim Vergleich der Narkoseformen untereinander waren Prolaktin- sowie Endorphinspiegel ebenfalls signifikant unterschiedlich (p〈0,001). Keine Unterschiede ergaben sich bezüglich der Östradiol- und Progesteronspiegel sowie in bezug auf die IVF-Durchführung und die klinischen Ergebnisse nach Embryotransfer. Wenngleich die klinischen Ergebnisse der IVF-Behandlung nicht durch den Einsatz der Narkoseverfahren beeinflußt wurden, sollte dennoch ein Anästhesieverfahren mit einer geringen Beeinflussung der Hormonspiegel gewählt werden. In unserer Untersuchung war dies die Ketaminnarkose ohne endotracheale Intubation.
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  • 2
    ISSN: 1432-0711
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 3
    ISSN: 1432-0711
    Keywords: Ultrastructural of human sperms ; In-vitro fertilization ; Sperm washing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Ultrastructural changes of human sperms after routine preparation for invitro fertilization were examined by scanning electron microscopy. Studies were performed with freshly ejaculated semen of 21 normozoospermic patients. Spermatozoa were analysed at 10000-fold (sperm head with acrosome, postacrosomal border and postnuclear cap) and 2500-fold (midpiece and endpiece of sperm tail) magnification. Compared with untreated specimens, slight membrane damage was found after routine washing and centrifugation procedures in swim-up preparations. However, on the basis of a score system for quantification of morphologic data, no statistically significant differences existed between untreated semen and swim-up preparations. We conclude that, with normozoospermic semen, the rate of ultrastructural damage attributable to sperm-washing procedures is too low to be of clinical consequence.
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  • 4
    ISSN: 1432-0711
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zusammenfassung Die partielle Zona dissection (PZD) stellt eine mikromanipulatorische Methode zur Behandlung männlicher Subfertilität dar, in deren Verlauf die Zona pellucida der Oozyte in einem begrenzten Areal mechanisch geöffnet wird. Hierdurch soll Spermatozoen eingeschränkter Qualität, welche unter normalen Umständen nicht zu penetrieren vermögen, die Fusion mit dem Oolemma und die Fertilisierung der Oozyte erleichtert werden. Die Technik wurde mittlerweile an unserer Klinik etabliert. Wir berichten hier über die erste Schwangerschaft, die mit diesem Verfahren im Rahmen unseres IVF-Programms erzielt wurde.
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  • 5
    ISSN: 1432-0711
    Keywords: Key words: Intracytoplasmic sperm injection ; Fertilization failure ; Oocyte fixation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We report on a couple with complete fertilization failure in three consecutive trials of intracytoplasmic sperm injection. Some of the unfertilized oocytes were fixed and decondensed sperm heads were found in all of them. It is not clear whether specific defects of the oocyte, abnormalities of sperm chromatin, or a combination of factors are responsible for the observed failure to develop pronuclei.
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  • 6
    ISSN: 1432-0711
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zusammenfassung Von 96 Eizellen, die in einem IVF-Programm unbefruchtet bzw. ungeteilt blieben, wiesen 59 den normalen haploiden Satz auf. 24 waren hypohaploid, 2 hyperhaploid, 8 diploid und 3 tetraploid. Der Gesamtanteil aberranter Eizellen betrug 39%. Ein Zusammenhang des Auftretens aberranter Eizellen mit dem Alter der Frauen bzw. mit der Stimulation durch Clomiphen ist aus diesem Material nicht ersichtlich.
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  • 7
    ISSN: 1432-0711
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 8
    ISSN: 1432-0711
    Keywords: Oligozoospermia ; Tamoxifen ; Hormone levels ; Sperm quality ; Semen analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Because of previous contradictory results, we reevaluted the effects of tamoxifen on 29 men presenting with idiopathic oligozoospermia. To determine whether a possible increase in sperm concentration might be correlated with an improvement of sperm quality, the hamster ovum penetration (HOP) test and the hypo-osmotic swelling (HOS) test were included as additional tests of sperm function. Patients were treated with tamoxifen (20 mg/day) for 3 months. From 4 weeks until the end of the study, tamoxifen had a significant effect (P〈0.001) on blood levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), and estradiol (E2). Prolactin (PRL) concentrations were not altered significantly (P〉0.05). There was no significant improvement (P〉0.05) of conventional semen parameters (volume, concentration, motility, morphology), and of HOP and HOS test results. The lack of correlation between a rise in hormone levels and improvement of sperm quality suggests that tamoxifen is of questionable value in men with idiopathic oligozoospermia.
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  • 9
    Electronic Resource
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    Springer
    Archives of gynecology and obstetrics 255 (1994), S. 81-89 
    ISSN: 1432-0711
    Keywords: Human spermatozoa ; Sperm chromosomes ; Cytogenetic anomalies ; Aetiology of aberrations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Human sperm chromosomes can be visualized after their fusion with zona-free hamster eggs. We analyzed a total of 867 metaphases from 33 men that had been classified into three different groups. We present a detailed summary of the kind and frequency of chromosome aberrations we encountered. A comparison of our results with previous studies demonstrates considerable variations in numerical and structural chromosome anomalies in spermatozoa from normal, healthy men. The possible reasons for this are discussed. We reviewed some factors which are supposed to correlate with the occurrence of sperm chromosome aberrations; the effect of paternal age is still uncertain.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Archives of gynecology and obstetrics 255 (1994), S. 81-89 
    ISSN: 1432-0711
    Keywords: Key words: Human spermatozoa – Sperm chromosomes – Cytogenetic anomalies – Aetiology of aberrations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Human sperm chromosomes can be visualized after their fusion with zona-free hamster eggs. We analyzed a total of 867 metaphases from 33 men that had been classified into three different groups. We present a detailed summary of the kind and frequency of chromosome aberrations we encountered. A comparison of our results with previous studies demonstrates considerable variations in numerical and structural chromosome anomalies in spermatozoa from normal, healthy men. The possible reasons for this are discussed. We reviewed some factors which are supposed to correlate with the occurrence of sperm chromosome aberrations; the effect of paternal age is still uncertain.
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