Intrauterine insemination before transfer of frozen-thawed embryos may improve the pregnancy rate for couples with unexplained infertility: preliminary results of a randomized prospective study.

Objective: To evaluate whether a combination of IUI and frozen-thawed embryo transfer (FT-ET) with ovulation induction would improve the PR in couples with unexplained infertility.

Design: Prospective, randomized study.

Setting: In Vitro Fertilization Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Prednisone and aspirin improve pregnancy rate in patients with reproductive failure and autoimmune antibodies: a prospective study.

Problem: The study was conducted to investigate the efficacy of prednisone and aspirin in autoantibody seropositive patients with repeated in vitro fertilization embryo transfer (IVF ET) failure.

Methods Of Study: The study group comprised 52 consecutive patients seropositive for non-organ-specific autoantibodies, i.e.

Second-trimester multifetal pregnancy reduction facilitates prenatal diagnosis before the procedure.

Objective: To evaluate the pregnancy outcome of selective second-trimester multifetal pregnancy reduction (MFPR) compared to first-trimester MFPR.

Design: Cohort analysis.

Setting: In Vitro Fertilization Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Improvement in the cervical mucus penetration test by using standard sperm control.

The objective of the present experiments was to establish an acceptable standard for the cervical mucus penetration test (CMPT) by determining the minimal progressive motile spermatozoa concentration (PMSC) that will yield the highest score for proven fertile donor sperm specimens. For this purpose, fresh and frozen-thawed samples were used. Semen was obtained from 29 fertile donors and different PMSC (8, 10, and 14 x 10(6)/mL) were prepared for each sample.

Patients with stages III and IV endometriosis have a poorer outcome of in vitro fertilization-embryo transfer than patients with tubal infertility.

Objective: To evaluate the outcome of IVF in patients with stages III and IV endometriosis.

Design: Retrospective study.

Setting: The Sara Racine IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Israel.

Levels of vascular endothelial growth factor are elevated in patients with ectopic pregnancy: is this a novel marker?

Objective: To determine serum levels of vascular endothelial growth factor (VEGF) and evaluate their capacity to serve as a marker for the diagnosis of ectopic pregnancy (EP).

Design: Prospective, case-controlled study.

Setting: A tertiary care center.

Timing of sonohysterography in menstruating women.

A prospective, blind study was carried out on 44 patients to evaluate the most suitable time to perform transvaginal sonohysterography. On the day of arrival at our unit, regardless of their cycle day, the women underwent sonohysterographic evaluation, which was repeated during the first 10 days of the next cycle. Patients with sonohysterographic findings underwent hysteroscopy.

The possible role of antiovary antibodies in repeated in vitro fertilization failures.

Problem: The study was conducted to investigate the possible role of circulating ovarian autoantibodies (ov-ab) in patients with repeated in vitro fertilization embryo transfer (IVF-ET) failure and to evaluate the effectiveness of immunosuppression treatment in these patients.

Method Of Study: The study group comprised 80 IVF patients who had five or more failed treatment cycles (mean 10.2; range 7-22).

Anaerobic glycolysis. The metabolism of the preovulatory human oocyte.

Objectives: The aim of the study was to investigate the process of glycolysis in gonadotropic, hyperstimulated, human ovarian follicles.

Study Design: Follicular fluid (FF) lactate and glucose concentrations were measured in 26 patients with tubal factor infertility undergoing in vitro fertilization treatment.

Results: The mean FF lactate and glucose concentrations were 3.

Pregnancy rate in IVF rescue in high responders to human menopausal gonadotropin.

Purpose: In vitro fertilization had been previously suggested by us as a means of "rescue" for patients with imminent ovarian hyperstimulation syndrome (OHSS) during treatment with human menopausal gonadotropin (hMG). We evaluated the pregnancy rate of rescued IVF cycles.

Methods: During the years 1994-1995, women treated with hMG and at risk of developing OHSS were referred to our IVF unit.

Treatment of severe preeclampsia remote from term: a clinical dilemma.

Unlabelled: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Women with severe preeclampsia are usually delivered without delay. In recent years, a new approach in the treatment of women with severe preeclampsia remote from term has been advocated by several investigators worldwide.

Stress urinary incontinence: prevalence among nulliparous compared with primiparous and grand multiparous premenopausal women.

The study was conducted to assess the prevalence of stress urinary incontinence in premenopausal nulliparae, primiparae, and grand multiparae, and to examine possible obstetric risk factors. Three hundred consecutive nulliparae, primiparae, and grand multiparae, 20 to 43 years of age, were interviewed during the third postpartum day of their consequent delivery about the symptom of stress urinary incontinence. Women were asked whether they had experienced stress urinary incontinence before, during, or after previous pregnancies and how troubled they were by their incontinence.

Prevalence and characteristics of voiding difficulties in women: are subjective symptoms substantiated by objective urodynamic data?

Objectives: To examine the prevalence and characteristics of voiding difficulties in women.

Methods: Two hundred six consecutive female patients who attended a urogynecology clinic were recruited. Patients were interviewed regarding the presence and severity of symptoms that would suggest voiding difficulties (ie, hesitancy, straining to void, weak or prolonged stream, intermittent stream, double voiding, incomplete emptying, reduction, and positional changes to start or complete voiding).

Testicular sperm retrieval and cryopreservation prior to initiating ovarian stimulation as the first line approach in patients with non-obstructive azoospermia.

The potency for fertilization and successful implantation was compared between fresh and cryopreserved testicular spermatozoa obtained from the same patient with non-obstructive azoospermia. Spermatozoa cryopreserved at the outset were also evaluated. Non-obstructive azoospermic men (n = 55) underwent testicular sperm extraction (TESE); mature spermatozoa were found in 33 (60%) of them.

A selective increase in plasma soluble vascular cell adhesion molecule-1 levels in preeclampsia.

Problem: The study was conducted to determine whether altered plasma levels of soluble intercellular adhesion molecule (ICAM)-1 and soluble vascular cell adhesion molecule (VCAM)-1 are involved in the pathogenesis of preeclampsia.

Method Of Study: Maternal plasma samples were collected from 20 patients with preeclampsia, 20 matched normotensive patients with uncomplicated pregnancies. and ten healthy nonpregnant women.

Three-generation evaluation of Y-chromosome microdeletion.

Sperm cells can be retrieved directly from the testis (testicular sperm extraction [TESE] procedure) and used for intracytoplasmic sperm injection (ICSI), circumventing underlying spermatogenetic defects. Thus, it is important that added information be available on the genetic defects in men undergoing TESE for the ICSI procedure and on the transmission of genetic factors associated with infertility to the offspring. We report a three-generation genetic analysis of a family with a case of male factor infertility.

Genetic evaluation of infertile men.

Recently, microdeletions in the azoospermic factor region of the Y chromosome, in addition to chromosomal anomalies, have been detected in men with azoospermia or severe oligozoospermia. In this study we evaluated the molecular and cytogenetic defects of infertile men. The frequency of Y microdeletions among 105 azoospermic, 28 oligozoospermic and 32 fertile men was tested on lymphocyte DNA using a series of 20 sequence-tagged sites.

Antenatal sonographic diagnosis of epignathus at 15 weeks of pregnancy.

Epignathus is a rare, benign, congenital teratoma of the hard palate. Most of these teratomas are unidirectional and protrude through the mouth. Hence, the prognosis depends on the size of the tumor and the degree of face distortion and airway obstruction that it causes.

Anal incontinence: prevalence among female patients attending a urogynecologic clinic.

The present study prospectively surveyed the prevalence of anal incontinence among 283 consecutive female patients attending a urogynecologic outpatient clinic in a maternity hospital. Data concerning bowel habits, laxative use, previous anorectal surgery, and the presence, severity, and frequency of anal incontinence were collected by interviewing the patients. Anal incontinence was reported by 83 women, representing 29% of the study population.

Development of postoperative urinary stress incontinence in clinically continent patients undergoing prophylactic Kelly plication during genitourinary prolapse repair.

The present study was undertaken to evaluate the efficacy of Kelly plication in preventing postoperative urinary stress incontinence in clinically continent patients undergoing surgery for genitourinary prolapse. Thirty clinically continent patients with grade-3 genitourinary prolapse were found to have a positive stress test with repositioning of the prolapse during preoperative urodynamic evaluation. In addition to the genitourinary prolapse repair, these patients underwent a Kelly plication as a preventive measure against possible development of postoperative urinary stress incontinence.

Placing the newborn on the maternal abdomen after delivery increases the volume and CD34 cell content in the umbilical cord blood collected: an old maneuver with new applications.

Objective: Our purpose was to increase the number of the progenitor cells in umbilical cord blood collected for transplantation.

Study Design: We randomly assessed the effect of "upper" and "lower" positions of the newborn on the volume and progenitor cell (CD34(+)) content of the umbilical cord blood collected from 49 healthy, vaginally delivered, term neonates.

Results: Twenty-two collections were performed in the "upper" and 27 in the "lower" position.

Incidence and obstetric risk factors of postpartum anal incontinence.

Background: Anal incontinence in young women may be the result of injury to the pelvic floor during vaginal delivery. This study was conducted to evaluate the relationship between obstetric risk factors and the prevalence of anal incontinence 3 months and 1 year after delivery.

Methods: Three hundred consecutive women who delivered in the obstetric ward of the Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, were prospectively interviewed 3 months postpartum with regard to the symptom of anal incontinence.

Levels of soluble vascular cell adhesion molecule-1 and soluble intercellular adhesion molecule-1 are increased in women with ovarian hyperstimulation syndrome.

Objective: To determine whether plasma and peritoneal fluid levels of soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecule-1 (sICAM-1) are altered in women with ovarian hyperstimulation syndrome (OHSS).

Design: Prospective, case-control study.

Setting: Lis Maternity Hospital and the Sara Racine IVF Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.