[Immunologically conditioned fertility disorders in men--experience of the immunobiological department of the Institute for Maternal and Child Care].

Objective: To provide an overview of the results obtained from the more than ten-year systematic monitoring of the contribution of immunopathological mechanisms to the ethiopathogenesis of fertility disorders in men.

Design: A summarising retrospective study.

Setting: Mother and Child Care Institute, Prague.

[Prediction of pregnancy-induced hypertension in women with risk factors].

Unlabelled: The objective of the presented work was to find possible predictive factors of pregnancy-induced hypertension (PIH) in women with the risk of gestational diabetes (GDM) during pregnancy. A group of women with the risk of development of gestational diabetes was selected because it is known that in women with GDM a hypertension is encountered 2-4 times more frequently than in women without disorders of glucose tolerance during pregnancy. The patients were divided into four groups with regard to the risk of development of hypertension.

[The effect of diazepam and flumazenil on pulsatile secretion of prolactin and LH in women].

The authors examined the effect of diazepam and flumazenil on prolactin and LH secretion in women. The experiment lasted 12 hours during which specimens of venous blood were collected for assessment of LH and prolactin after 10-minute intervals. After 5 hours to a group of 8 women (4 in the luteal and 4 in the follicular stage of the cycle) flumazenil was administered--3 x 10 mg i.

[Cryopreservation of embryos in the IVF/ET program at the Maternal and Child Care Institute in Prague].

Two methods for embryo cryopreservation using 1,2-propanediol were compared--ultra-rapid vitrification and controlled freezing. No significant differences were found in the pregnancy and implantation rates although better results were achieved by the controlled freezing method. Significantly better results both in pregnancy and implantation rates were obtained when the embryos were frozen in the pronuclear stage compared to cleaved stage embryos.

[Factors affecting the results of in vitro fertilization. V. Co-culture of embryos].

Pronuclear stage embryos were divided into two groups and cultivated in i) M-199 or in ii) M-199 on a monolayer of Vero cells for 48, 60 or 72 hours respectively. Under the standard conditions (i) no significant differences in pregnancy rate (PR) were found (48 and 60 h; PR 20.14% and 20.

[Risk of diabetes mellitus, variations in glucose tolerance, insulin secretion and lipid parameters in offspring of diabetic mothers].

Background: Children of diabetic mothers are a relatively new population group which started its existence due to revolutionary changes in the treatment of insulin-dependent diabetes during pregnancy. In the Institute for the Care of Mother and Child since the fifties comprehensive care of diabetic mothers was concentrated and thus it became possible to follow-up a relatively large group of their children to adult age.

Methods And Results: The authors investigated 176 children of diabetic mothers (CDM) aged 20.

[Factors affecting the results of in vitro fertilization--IV. Importance of the stimulation protocols combining GnRH analogs and HMG in women with unsuccessful stimulation with combinations of clomiphene citrate-HMG].

Poor responders, whose cycles were cancelled after CC-hMG stimulation because of inadequate response, were stimulated with GnRH analogues (Suprefact nasal spray) and hMG in short protocol. In this highly negative selected group the cancellation rate was significantly lower (16.2%) than in the "normal" IVF population stimulated with clomiphene citrate and hMG (24.

[Factors affecting the results of in vitro fertilization--III. The effect of the height and properties of the endometrium in the ultrasound image on the probability of implantation].

Ultrasound examination of endometrium thickness and texture (triple-line, homogenous, hyperechogenic) did not help us to predict the implantation after embryo transfer. However, in patients stimulated with GnRH analogues and hMG the endometrium was significantly higher than in patients stimulated with clomiphene citrate and hMG. Triple-line endometrium was more common in women stimulated with GnRH analogues and hMG than in those stimulated with clomiphene citrate and hMG.

[Complications in insulin-dependent diabetic mothers during pregnancy and the long-term prognosis for their children].

The authors investigated whether vascular complications of insulin-dependent diabetic pregnant women can influence on a long-term basis their children in adult life. In a group of 169 children of diabetic mothers (CDM) 12 developed diabetes during childhood and adolescence; in the remaining 157, age 20.75 +/- 0.

[The early androgen syndrome--effect on the hormonal and immune system].

Administration of 1 mg testosterone propionate to neonate mice of both sexes on the 4th day after birth causes marked and prolonged changes in some parameters of the immune and hormonal system. At the age of one month the oestradiol level in males and females is markedly elevated, but not the testosterone level. There is a marked increase in the metabolic activity of peritoneal macrophages stimulated by zymosan and at the same time also in the percentage of cells phagocytizing inert HEMA particles.

[Changes in hypophyseal-ovarian axis hormone levels in the first days after central nervous system surgery].

The authors examined the FSH, LH, prolactin, oestradiol and progesterone levels during the perioperative period in 14 women, mean age 35.7 years, who were subjected to intracranial operations. They found that during the first postoperative days the FSH level (p < or = 0.

[Cryopreservation of embryos in the in vitro fertilization/embryo transfer program].

An ultra-rapid method for cryopreservation of human embryos, using 1,2-propane-diol, was developed. 280 spare embryos obtained in the IVF program were frozen by this method. 91 embryos were thawed and 68 of them (74.

[Selective reduction of multiple pregnancy in the 1st trimester: results and experience in 10 cases].

Ten patients with multiple gestations, all resulting from in vitro fertilization, underwent multifoetal pregnancy reduction. In four cases transvaginal puncture was performed, six patients underwent transabdominal pregnancy reduction. Seven women delivered, all three pregnancy losses occurred in the transvaginal punction group--there was one early loss after the procedure and two abortions in the late second trimester.

[Use of modern methods in prenatal diagnosis of congenital adrenal hyperplasia--examination protocol].

The prenatal diagnosis of congenital adrenal hyperplasia (CAH) in the second trimester of gestation (as done so far in this country) is late and unsuitable with regard to possible interruption of pregnancy. Modern methods of early prenatal diagnosis are based on examination of material from chorionic villi (6th-10th week of gestation) or early amniocentesis (10th-12th week of gestation). The authors present their decision taking scheme, examination protocol and their own experience with the use of molecular genetic analysis and assessment of 17-hydroxyprogesterone from early amniocentesis in the prenatal diagnosis of CAH.

[Multiple pregnancies in the IVF and ET programs at the Institute for Maternal and Child Care].

Of the 71 clinical pregnancies achieved in the IVF and ET programme at the Institute for the Care of Mother and Child between January 1989 and June 1991 22 were multiple (30.9%). In seven cases (31.

The correlation of serum prolactin level and psychic stress in women undergoing a chronic hemodialysis programme.

Altogether eight women undergoing a chronic hemodialysis treatment were studied for five months. Four of them were in the premenopause and four in the postmenopause. Once a month levels of prolactin, FSH, LH, estradiol and progesterone were measured, Lüscher colour test was performed, from which the screamer index as an indicator of psychic stress was calculated and the levels of urea, creatinine and hematocrite were assessed to inform us of the adequacy of dialysis.

[FSH, LH, prolactin, estradiol and progesterone after burn injuries in premenopausal and postmenopausal women].

The authors examined 49 women who suffered severe burns and had to be hospitalized. Thirteen of these women were postmenopausal, 35 premenopausal and in one women, incipient pregnancy was revealed. In 14 women repeatedly FSH, LH oestradiol, progesterone and prolactin were assessed in serum by RIA.

[Alpha-fetoprotein in umbilical cord blood and hyperbilirubinemia in normal neonates].

In a group of 154 mature normal neonates the authors recorded significantly higher mean alpha-fetoprotein values in children with hyperbilirubinaemia (higher than 205 mumol/l) than in other neonates. The differences were observed also in children of equal gestation age. Development of hyperbilirubinaemia is more probable and indication for phototherapy is significantly higher in neonates with alpha-fetoprotein levels in umbilical blood above 100 mg/l and these infants must be carefully observed.

[Disorders of the menstrual cycle in women after entering military training. IV. FSH, LH, prolactin, estradiol, progesterone and cortisol in the first week after beginning training].

The authors investigated the hormonal levels of FSH, LH, oestradiol, cortisol and progesterone in women after entering a military training contre. The specimens were collected on the fourth day after admission to the Centre and the results correlated with later "separation" disorders of the menstrual cycle in these women. The authors did not find differences in the mean levels of any hormone in normally regularly menstruating women and in women with disorders of the cycle.

[Transurethral transvesicular follicle aspiration in the IVF and ET program].

Fifty eight ultrasound-guided transurethral aspirations for in vitro fertilization were performed from October 1987 to June 1988. At that time twenty two laparoscopic oocyte retrievals were done, mostly in patients in our gamete intrafallopian transfer (GIFT) program. All procedures were performed by the same ovarian stimulation protocol under general anesthesia.

Gamete intrafallopian transfer (GIFT) as a complement to the tubal microsurgery.

We accomplished a transfer of at least one oocyte and sperms in 26 microsurgically operated patients. Two patients were stimulated by clomiphene citrate only, 24 women by a combination of a clomiphene citrate and human menopausal gonadotrophin. The operation was timed 34-36 hours after application of 6,000 IU hCG i.