About 13% of women may have the wrong method of oocyte insemination when undergoing in vitro fertilization by failure to evaluate the abnormal hypo-osmotic swelling test score.

Purpose: To determine the percentage of males with a low hypoosmotic swelling (HOS) test score in couples having in vitro fertilization-embryo transfer (IVF-ET) where the male partner had normal motile densities and no antisperm antibodies.

Methods: The results were also analyzed according to the percentage of HOS scores < 50% when morphology using strict criteria was < or = 4% or > 4%. A retrospective review was performed.

Microcirculatory dysfunction in sepsis.

Septic shock is a common and deadly disease that traditionally has been diagnosed and treated by evaluation and optimization of global hemodynamic indices. However, microcirculatory dysfunction is a critically important element in the pathophysiology of this disease. New techniques of in vivo video microscopy permit the assessment of microcirculatory function in human subjects.

Progesterone receptor antagonist therapy has therapeutic potential even in cancer restricted to males as evidenced from murine testicular and prostate cancer studies.

Background: Treatment with the progesterone receptor antagonist mifepristone has been shown to improve the length and quality of life in mice with spontaneous leukemia, breast cancer, and lung cancer. The present study evaluated the efficacy of mifepristone therapy in murine tumors restricted to males, i.e.

Idiopathic edema, a condition associated with pelvic pain and other symptoms in women, as a remedial cause of chronic cold induced urticaria.

Purpose: To determine if the treatment of cold induced urticaria refractory to conventional antihistamine-type therapy would respond to treatment with sympathomimetic amines.

Methods: Dextroamphetamine sulfate (15 mg) extended release capsules were prescribed to be taken daily in the morning.

Results: The cold-induced urticaria completely disappeared and antihistamine therapy was discontinued.

A novel highly effective therapy for severe vasomotor symptoms in an estrogen deficient woman--case report.

Purpose: To describe a novel highly effective therapy for vasomotor symptoms associated with diminished oocyte reserve.

Methods: A 58-year-old estrogen deficient woman with severe vasomotor symptoms was treated with 20 mg per day of dextroamphetamine sulfate.

Results: A marked immediate improvement was noted.

Pretreatment of sperm with low hypo-osmotic swelling tests with chymotrypsin prior to intrauterine insemination (IUI) and avoidance of unprotectected intercourse results in pregnancy rates comparable to IUI for other male factor problems.

Purpose: To carry out a retrospectively performed matched controlled study to determine the efficacy of pretreatment of sperm having low hypo-osmotic swelling (HOS) test scores with chymotrypsin galactose prior to intrauterine insemination (IUI) compared to IUI for other types of male factor problems. The women with male partners with low HOS scores were advised not to have unprotected intercourse.

Methods: All cycles having IUI with chymotrypsin treated sperm for low HOS scores were matched with the very next woman having IUI for sperm with other male factor problems but with normal HOS scores.

Length of time of embryo storage does not negatively influence pregnancy rates after thawing and transfer.

Purpose: To determine if longer storage of embryos in a cryopreserved state negatively affects the chance of successful implantation following thawing and transfer.

Methods: A retrospective cohort analysis of frozen-thawed embryos that had been donated to recipients. Four time periods were evaluated.

Effect of fertilization by intracytoplasmic sperm injection versus conventional insemination on embryo cleavage rates.

Purpose: To determine if fertilization by conventional oocyte insemination vs intracytoplasmic sperm injection (ICSI) causes any difference in the maximum number of blastomeres of fresh or frozen thawed embryos transferred.

Methods: Retrospective evaluation of all in vitro fertilization (IVF) cycles over a 10-year period in cycles having a 2 embryos transferred where the semen analysis was normal except for strict morphology which was allowed to be 2-5% normal. The percentage of the maximum number of blastomeres in any transfers was compared according to the method of insemination.

Effect of the length of time that donated embryos are frozen on pregnancy outcome.

Purpose: To determine if the longer length of time that embryos donated to an anonymous couple have been frozen has a negative effect of subsequent successful pregnancy following thawing and transfer to the recipients.

Methods: Retrospective determination of pregnancy rates according to the length of cryopreservation time has on pregnancy outcome following transfer of embryos designated for donation.

Results: Longer time of freezing did not adversely affect subsequent pregnancy rates following frozen embryo transfer.

Evidence that high serum progesterone (P) levels on day of human chorionic gonadotropin (hCG) injection have no adverse effect on the embryo itself as determined by pregnancy outcome following embryo transfer using donated eggs.

Purpose: To determine if too high of a level of progesterone at the time of peak follicular maturation of donors adversely affects pregnancy or implantation rates of recipients.

Methods: A retrospective cohort analysis was performed on donor egg recipients. Pregnancy rates were calculated according to ranges of five serum progesterone (P) levels based on two standard deviations before and above the mean.

Successful treatment of a female with chronic pseudo-intestinal obstruction with sympathomimetic amines and thyroid hormone replacement.

Purpose: To determine if a defect in sympathomimetic amines, which is a common cause of various undiagnosed pain syndromes in women could be the cause of chronic pseudointestinal obstruction. Furthermore to determine if this life-threatening illness may similarly respond to sympathomimetic amines as in other pain syndromes, e.g.

Association of the change in serum estradiol (E2) levels from the day of to the day after human chorionic gonadotropin (hCG) injection and pregnancy outcome following in vitro fertilization-embryo transfer (IVF-ET) in less than average responders.

Purpose: To determine if the change in serum estradiol (E2) from the day of human chorionic gonadotropin (hCG) injection to the day after predicts pregnancy and implantation rates following in vitro fertilization-embryo transfer (IVF-ET) in less than average responders.

Methods: A retrospective cohort analysis was performed in women with less than average follicular response as defined by a peak serum E2 on the day of hCG of < 1500 pg/ml despite a maximum stimulation gonadotropin protocol. Pregnancy and implantation rates were compared in five groups based on standard deviation (SD) below or above the mean.

The effect of endometriosis on pregnancy outcome following in vitro fertilization-embryo transfer (IVF-ET) in women with decreased egg reserve.

Purpose: To determine the effect of the presence of endometriosis on the delivered pregnancy rate following in vitro fertilization-embryo transfer.

Methods: A retrospective cohort analysis of fresh or frozen embryo transfer in women with diminished egg reserve having IVF-ET and who also had had a laparoscopy. The data was analyzed as to whether endometriosis was present or not.

A comparison of pregnancy rates following fresh and frozen embryo transfer according to the use of leuprolide acetate vs ganirelix vs cetrorelix.

Purpose: To determine if controlled ovarian hyperstimulation (COH) regimens using the gonadotropin releasing hormone (GnRH) agonist leuprolide acetate result in higher pregnancy and implantation rates than COH regimens using the GnRH antagonists cetrorelix or ganirelix following fresh and frozen embryo transfer.

Methods: Retrospective analysis was performed evaluating the pregnancy rates with the first fresh and first frozen embryo transfer cycles according to which protocol was used. A haphazard decision was made on which protocol to use.

Cryopreservation of blastocysts using a modification of a simplified freezing protocol with a one step removal of cryoprotectant successfully used previously to freeze 2 pronuclear or multi-cell embryos.

Purpose: To describe a modification of a simplified freezing protocol for the cryopreservation of blastocysts.

Methods: 1.5 M glycerol was substituted as a cryoprotectant instead of propanediol.

A novel method to assess the effect of uterine senescence by comparing pregnancy outcome in younger donors vs older recipients who are sharing a common pool of oocytes.

Purpose: To evaluate uterine senescence by comparing pregnancy rates in older recipients vs their younger donors who were actually trying to conceive themselves.

Methods: A retrospective analysis comparing clinical and delivered pregnancy rates in all infertile donors < or = age 35 sharing their eggs with a recipient age > or = 40 over a 6-year time span. These parameters were also evaluated in the first frozen embryo transfer from these couples (if they had one).

Cervical sonography in pregnant women with a prior cone biopsy or loop electrosurgical excision procedure.

Objectives: To determine if pregnant women with a prior cone biopsy or loop electrosurgical excision procedure (LEEP) have a shorter midtrimester cervical length than do matched controls without a history of cervical surgery.

Methods: Eighty-five pregnant women with a singleton gestation and previous cone biopsy or LEEP and 85 controls matched by age (± 5 years), race, gestational age (± 2 weeks), and number of prior vaginal deliveries underwent a single transvaginal cervical sonographic scan at 15-22 weeks' gestation. No patient had a cerclage in either group.

Fertilization by intracytoplasmic sperm injection with sperm with subnormal morphology using strict criteria results in lower live delivered pregnancy rates following frozen embryo transfer rather than eggs fertilized conventionally.

Purpose: To determine if fertilization by intracytoplasmic sperm injection (ICSI) lowers pregnancy rates following frozen embryo transfer compared to conventional insemination similar to findings with fresh embryo transfer.

Methods: Clinical and live delivered pregnancy and implantation rates were compared according to whether the eggs were fertilized by conventional oocyte insemination vs ICSI over a 10-year period in women whose husbands had normal semen parameters except for having normal strict morphology between 2-5%.

Results: The clinical and live delivered pregnancy rates were 40.

Successful pregnancies following embryo transfer despite very thin late proliferative endometrium.

Purpose: To determine if successful pregnancies are possible following fresh or frozen embryo transfer despite a maximal endometrial thickness of only < or = 5 mm.

Methods: A retrospective review of all fresh and frozen embryo transfers over a seven-year period was performed. The maximum thickness either on the day of human chorionic gonadotropin injection during fresh embryo transfer or the day before the initiation of progesterone in frozen embryo transfer was performed.

Increasing the dosage of progesterone (P) supplemention from the mid-luteal phase in women not attaining a mid-luteal homogeneous hyperechogenic (HH) pattern with sonography improves pregnancy rates (PRS) following frozen embryo transfer (ET).

Purpose: To determine if a mid-luteal phase non-homogeneous hyperechogenic (HH) endometrial echo pattern may lower pregnancy rates following frozen embryo transfer and to determine if raising the dosage of progesterone improves pregnancy outcome.

Methods: Women not attaining an HH pattern at the mid-luteal phase following estrogen-progesterone replacement were randomly given (or not) an increase in progesterone dosage.

Results: Increasing the progesterone dosage in those not attaining an HH pattern significantly improved the pregnancy rate relative to controls not attaining an HH pattern and showed a trend for higher pregnancy rates than those with an HH pattern.

Efficacy of the progesterone receptor antagonist mifepristone for palliative therapy of patients with a variety of advanced cancer types.

Background: Mifepristone has been demonstrated to improve longevity and quality of life in mice with spontaneous murine cancer without progesterone receptors and in human colon cancer. The present study evaluated the palliative effect of mifepristone in a variety of different types of human cancer.

Patients And Methods: Mifepristone was given at 200 mg daily orally with permission from the Food and Drug Administration to people with widely metastatic human cancer no longer responsive to other chemotherapy regimens.

Mifepristone treatment improves length and quality of survival of mice with spontaneous lung cancer.

Background: There are data showing that human leukemia cell lines have mRNA for an immunomodulatory protein found in normal pregnancy that is stimulated by progesterone. One of the functions of this progesterone-induced blocking factor (PIBF) is to suppress natural killer cell activity. Mifepristone has not only been shown to down-regulate PIBF expression by human leukemic cell lines but has also been shown to prolong and improve the length of life of mice with spontaneous leukemia.

A prospective multicenter cohort study of the association between global tissue hypoxia and coagulation abnormalities during early sepsis resuscitation.

Objective: Coagulation activation is an integral part of sepsis pathogenesis. Experimental data suggest that endothelial exposure to hypoxia activates coagulation. We aimed to test the hypothesis that the quantity of exposure to global tissue hypoxia is associated with the degree of coagulation activation during early sepsis resuscitation.

A prospective comparison of in vitro fertilization (IVF) outcome following controlled ovarian hyperstimulation (COH) regimens using follitropin alpha exclusively or with the addition of low dose human chorionic gonadotropin (hCG) and ganirelix.

Purpose: To determine if the addition of luteinizing hormone (LH) activity to a controlled ovarian hyperstimulation regimen for purposes of in vitro fertilization adds any additional benefit to the exclusive use of recombinant (r) FSH in antagonist protocols.

Methods: Women with normal endogenous gonadotropin levels were randomly assigned to receive either follitropin alpha exclusively or have the addition of 25 IU human chorionic gonadotropin (hCG) daily. Ganirelix was used when a 14 mm follicle was attained.

Effect of the degree of fragmentation on embryo survival after freeze-thawing.

Purpose: To determine if the degree of fragmentation of embryos prior to freezing correlate in a negative manner with survival after thawing.

Methods: A retrospective review of frozen embryos thawed for purposes of embryo transfer was done. Survival and transferability rates were determined according to degree of fragmentation.