W. Ombelet - Academia.edu (original) (raw)
Papers by W. Ombelet
There is limited literature on the influence of smoking and BMI on success rates after intrauteri... more There is limited literature on the influence of smoking and BMI on success rates after intrauterine insemination (IUI). As a result of a prospective cohort study we could investigate data from 1401 IUI cycles with partner semen and 1264 IUI cycles with donor semen, primary outcome being clinical pregnancy rate (CPR). Univariate statistical analysis showed significant influence of female BMI on clinical pregnancy in the partner insemination group (CPR of 6,5%, 8%, 16,3% and 9,4% for a female BMI < 20, 20-24.9, 25-29.9 and 3 30, p=0.032), while in the donor group this in uence was not signi cant (CPR respectively 11.1% (BMI< 20), 18.5% (20-24.9), 18.0% (25-29.9) and 14.7% for BMI 3 30). Multivariate analysis through generalized estimating equations (GEE) could not confirm this significant influence of female BMI on fecundity in the partner semen group. For smoking, univariate statistical analysis revealed male smoking to be a negative influence for the clinical pregnancy rate in...
10 years of Facts Views & Vision in Obgyn: Chief editor's report
It’s always nice to look back and try to summarize what we achieved during these last 10 years of... more It’s always nice to look back and try to summarize what we achieved during these last 10 years of FV&V. We observed a broad input from all different fields including obstetrics, perinatal medicine, gynaecology and reproductive health. It was fascinating that many papers showed a lot of interest in the global perspective of our specialty. Structured reviews, strong opinion and viewpoint papers, excellent historical reviews, exactly what we were looking for from the very beginning.
Human Reproduction
pre-menopausal women (follicular phase), group 2 = premenopausal women (luteal phase), group 3 = ... more pre-menopausal women (follicular phase), group 2 = premenopausal women (luteal phase), group 3 = post-menopausal women. The strips were treated with five different stimulus concentrations of ETI (10-1°, 10-9 , 10-8 , 10-7 , and 10-6 M). The experiment is two-factorial with unequal number of replications and was analysed using generalized linear modelling. The response variable is the ratio of the curve peak when a strip is treated with ETI + KCI (80 mM) relative to the curve peak when it is treated with KCI alone.
Magnetic Resonance Imaging
Purpose: To evaluate the perfusion parameters of inner and outer myometrium in healthy nulliparou... more Purpose: To evaluate the perfusion parameters of inner and outer myometrium in healthy nulliparous and primiparous women who are and who are not currently using hormonal contraceptives by means of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Material and methods: We performed pelvic 1.5T DCE-MRI on 98 women: 18 nulliparous non-users, 30 nulliparous users, 12 primiparous non-users and 38 primiparous users of hormonal contraception (mean age respectively 26.4, 25.8, 30.23 and 28.18 years). The nulliparous non-users underwent DCE-MRI investigations during their follicular, ovulatory and luteal phase. Perfusion parameters (iAUC/volume, K trans , K ep and Ve) were assessed in the anterior and posterior wall of the junctional zone (JZ) and outer myometrium. Results: In nulliparous non-users, the mean K trans and iAUC/volume showed a decrease from follicular to luteal phase (0.82 vs 0.55 min-1 for K trans , p = 0/027 and 1.28 vs 0.68 for iAUC/volume, p < 0.001). The anterior JZ demonstrated lower K trans (p = 0.050) and higher K ep (p = 0.012) in nulliparous non-users, lower K trans in nulliparous users (p < 0.001) and lower Ve in primiparous users (p = 0.012) than the anterior outer myometrium. K trans in the anterior and posterior JZ wall in nulliparous users was lower than in non-users (p = 0.001 and p = 0.013) and Ve at the anterior JZ wall in primiparous users was lower than in non-users (p = 0.044). Conclusion: This study provides data on normal perfusion parameters of inner and outer myometrium, which may be potentially useful in assisted reproductive therapy.
ESHRE Monographs, 2008
Although the consequences of the problem of childlessness are more pronounced in developing count... more Although the consequences of the problem of childlessness are more pronounced in developing countries when compared with Western societies, local health care providers and international organizations pay little attention on this issue. The limited budgets for reproductive health care are mostly restricted to family planning and mother care. The most common misunderstanding is the 'overpopulation-issue'. It is generally believed that the expected growth of the world population puts a real burden on the issue of infertility treatment in resource-poor countries, although recent UN reports clearly show that in most developing countries the fertility rate is dropping significantly and will fall below the threshold of 2.0 by 2050. It seems that the expected population growth in developing countries in the next decades is rather due to population ageing and not to high fertility rates. Another important issue surrounding infertility in developing countries is the so-called 'limited resources argument'. Because the problem of childlessness is a major health problem in most developing countries, a rearrangement of the global reproductive health care budget should be requested from local governments and international organizations taking into account the urgent need for a go-together of more successful family-planning policies and affordable simplified ART methods.
Facts, views & vision in ObGyn, 2014
Magnetic Resonant Imaging (MRI) has demonstrated that we can differentiate the uterus in 3 import... more Magnetic Resonant Imaging (MRI) has demonstrated that we can differentiate the uterus in 3 important functional areas. Exploration of the uterus in the infertile patient should implement the evaluation of the endometrium, the Junctional zone myometrium (JZ), the outer myometrium and the cervical canal. Especially the JZ myometrium should receive our close attention in the exploration and treatment of the infertile patient. MRI cannot be implemented as a screening examination but also limiting the imaging of the womb to a 2 or 3 D ultrasound exam only does not meet the scientific requirements of sensitivity and specificity. Modern ambulatory uterine diagnosis in a one-stop approach includes transvaginal ultrasound, fluid mini Hysteroscopy, contrast sonography and endomyometrial tissue sampling. Transvaginal Ultrasound being the gold standard for global uterine screening has a cardinal importance for diagnosis of myometrial disorders and uterine congenital malformations whereas hyster...
Fertility Awareness-Based Methods' and subfertility: a systema-tic review
Facts, views & vision in ObGyn, 2014
Fertility awareness based methods (FABMs) can be used to ameliorate the likelihood to conceive. A... more Fertility awareness based methods (FABMs) can be used to ameliorate the likelihood to conceive. A literature search was performed to evaluate the relationship of cervical mucus monitoring (CMM) and the day-specific -pregnancy rate, in case of subfertility. A MEDLINE search revealed a total of 3331 articles. After excluding articles based on their relevance, 10 studies and were selected. The observed studies demonstrated that the cervical mucus monitoring (CMM) can identify the days with the highest pregnancy rate. According to the literature, the quality of the vaginal discharge correlates well with the cycle-specific probability of pregnancy in normally fertile couples but less in subfertile couples. The results indicate an urgent need for more prospective randomised trials and -prospective cohort studies on CMM in a subfertile population to evaluate the effectiveness of CMM in the subfertile couple.
Facts, views & vision in ObGyn, 2014
Infertility care is one of the most neglected health care issues in developing countries (DC), af... more Infertility care is one of the most neglected health care issues in developing countries (DC), affecting more than 50 million couples. The social stigma of childlessness still leads to isolation and abandonment. Bilateral tubal occlusion due to sexually transmitted diseases and pregnancy-related infections is the most common cause of infertility in DC. Consequently most cases of infertility are only treatable by using assisted reproductive technologies which are either unavailable or too costly. Lowering the laboratory costs associated with IVF is a crucial step to make IVF affordable for a larger part of the world population. We recently developed and described a new simplified method of IVF culturing, called the (t)WE lab method. Our initial results in fresh IVF cycles showed that IVF methodology can be significantly simplified and result in successful outcomes at levels that compare favourably to those obtained in high resource programs. We report three pregnancies and four live ...
Facts, views & vision in ObGyn, 2011
The involvement of DNA strand breaks and Topoisomerase II in sperm chromatin condensation during spermatogenesis in the human
is the coordinator of the Special Task Force on 'Developing countries and infertility' of the Eur... more is the coordinator of the Special Task Force on 'Developing countries and infertility' of the European Society of Human Reproduction and Embryology (ESHRE).
Interlobar Venous Flow Is Different between Left and Right Kidney in Uncomplicated Third Trimester Pregnancy
Gynecologic and Obstetric Investigation - GYNECOL OBSTET INVEST, 2008
Aim: To investigate Doppler flow patterns of renal interlobar veins (RIV) in left (L) and right (... more Aim: To investigate Doppler flow patterns of renal interlobar veins (RIV) in left (L) and right (R) kidney in relation to gestational age and to intrarenal pyelocalyceal diameters (PCD). Methods: Cross-sectional study involving 6 groups of women: (1) non-pregnant women, women pregnant between weeks (2) 11–14, (3) 18–23, (4) 28–33, (5) 37–40 and (6) women <5 days post delivery. During standardized renal duplex ultrasound scan, PCD (mm) was measured and venous impedance index (VI = [peak flow (PV) – presystolic flow]/PV) of RIV was defined. Comparison between L and R kidney was performed by repeated-measures analysis of variance for VI and by t tests for PCD. Results: A total of 150 women were examined, 25 in each group. In the early third trimester of pregnancy, L VI was significantly higher than R VI (0.38 ± 0.01 vs. 0.33 ± 0.01, p < 0.0001) and L PCD was significantly lower than R PCD (3.90 ± 3.68 vs. 6.25 ± 4.03, p = 0.03). Conclusion: RIV Doppler flow is different between l...
Treatment of Male Infertility Due to Sperm Surface Antibodies
The Journal of Urology, 1998
International Journal of Gynecology & Obstetrics, 2009
We conducted a retrospective analysis to examine the frequency of chromosomal abnormalities in pr... more We conducted a retrospective analysis to examine the frequency of chromosomal abnormalities in products of conception from patients with recurrent miscarriages in relation to the number of previous miscarriages. Material and Methods: We studied 1309 pregnancies with a history of 2-20 consecutive first-trimester abortions in Nagoya City University Medical Hospital. The frequencies of abnormal and normal embryonic karyotypes for each number of previous abortions were studied. The subsequent pregnancy outcome of patients whose previous miscarriages were karyotyped were studied along with the predictive value of karyotyping of previous miscarriages for subsequent miscarriages. Chromosomal analysis was performed on products of conception using a standard G-banding technique. Results: The miscarriage rate increased with the number of previous spontaneous abortions. The frequency of abnormal embryonic karyotypes significantly decreased and that of normal embryonic karyotypes significantly increased with the number of previous abortions. 44 of 71 patients whose karyotypes were normal aborted subsequently and 23 of 60 patients whose karyotypes were abnormal aborted subsequently. Patients with a previous normal embryonic karyotype aborted more frequently than those with an abnormal karyotype. Conclusions: The frequency of normal embryonic karyotypes significantly increases with the number of previous abortions and a normal karyotype in a previous pregnancy is a predictor of subsequent miscarriage.
Doppler Measurement of Renal Interlobar Vein Impedance Index in Uncomplicated and Preeclamptic Pregnancies
Hypertension in Pregnancy, 2009
To define normal values of Renal interlobar vein impedance index (RIVI) throughout gestation, as ... more To define normal values of Renal interlobar vein impedance index (RIVI) throughout gestation, as a reference to RIVI in preeclampsia (PE). Longitudinal evaluation of 20 uncomplicated pregnancies (UP) by standard renal duplex scan, every 4 weeks during pregnancy and postpartum. Comparison of RIVI between 40 PE and UP, and plotting of PE values against the normal reference range at corresponding gestation. In PE, RIVI is significantly higher than in UP, the difference being larger at the left side and in cases of preeclampsia remote from term. Increase of RIVI in women with PE is gestation-dependant.
Reflections on the way to conduct an investigation of subfertility
Human Reproduction, 1995
Infertility is a worldwide issue in reproductive health. In view of the World Health Organization... more Infertility is a worldwide issue in reproductive health. In view of the World Health Organization's definition of health, the psychological and social consequences of infertility simply cannot be ignored. Prevention of infertility is difficult and does not help the couple seeking medical advice for infertility, whereas efficient treatment for infertility is time consuming, expensive and often unsuccessful. This article reflects on a shortened, yet full investigation of both partners' fertility before any treatment whatsoever, which is indispensable once the decision to help the couple medically has been made. By optimizing the use of modern gynaecological endoscopy within the woman's cycle, an exhaustive infertility investigation can be conducted within the span of two couple-physician contacts, thereby responding to the couple's concern, avoiding loss of time and energy due to inappropriate therapies, and directing the subfertility treatment correctly from the start. Trained gynaecologists can easily conduct this investigation in fertility centres in developed countries, as well as in centres for family planning in developing countries. The investigation can be employed either with an emphasis on diagnosis alone (and then even under local anaesthesia) or, if the necessary infrastructure is available, in combination with operative endoscopy under general anaesthesia where indicated.
Fertility and Sterility, 2007
The proportion of twins resulting from multifetal pregnancy reduction of higher-order multiples i... more The proportion of twins resulting from multifetal pregnancy reduction of higher-order multiples is increased in pregnancies resulting from hormone stimulation when compared with twins following in vitro fertilization/intracytoplasmic sperm injection treatment. These reduced twin pregnancies may carry a higher perinatal risk compared with other twin pregnancies, which should be taken into account when assessing the perinatal outcome of twin pregnancies after assisted reproduction.
Human Reproduction …, 2001
The aim of the study was to conduct a structured review of the literature published on the use of... more The aim of the study was to conduct a structured review of the literature published on the use of normal sperm morphology, as an indicator of male fertility potential in intrauterine insemination (IUI) programmes. Published literature in which normal sperm morphology was used to ...
Andrologia, 2011
Preservation of spermatozoa is an important aspect of assisted reproductive medicine. The aim of ... more Preservation of spermatozoa is an important aspect of assisted reproductive medicine. The aim of this study was to investigate the efficacy and use of a recently developed liquid nitrogen and cryogen-free controlled rate freezer and this compared with the classical liquid nitrogen vapour freezing method for the cryopreservation of human spermatozoa. Ten patients entering the IVF programme donated semen samples for the study. Samples were analysed according to the World Health Organization guidelines. No significant difference in total sperm motility after freeze-thawing between the new technique and classical technique was demonstrated. The advantage of the new freezing technique is that it uses no liquid nitrogen during the freezing process, hence being safer to use and clean room compatible. Investment costs are higher for the apparatus but running costs are only 1% in comparison with classical liquid nitrogen freezing. In conclusion, post-thaw motility of samples frozen with the classical liquid nitrogen vapour technique was comparable with samples frozen with the new nitrogenfree freezing technique. This latter technique can thus be a very useful asset to the sperm cryopreservation laboratory.
Oral communication abstracts Objectives: To determine fetal and neonatal outcome in referrals wit... more Oral communication abstracts Objectives: To determine fetal and neonatal outcome in referrals with isolated abdominal fetal calcifications. Methods: We report 24 cases of prenatally diagnosis isolated abdominal calcifications referred to our centre over the period 1997-2007. The management included detailed fetal ultrasound imaging, maternal TORCH analysis, parental and fetal cystic fibrosis mutations analysis, fetal karyotype, and infectious investigations in amniotic fluid. Neonatal examination and postnatal ultrasound findings were collected and follow-up was obtained. Results: In 16 cases, abdominal calcifications were limited to one single organ (7 into the liver, 1 into the bowel, 1 into the spleen, 6 cases close to stomach and 1 behind the liver). In 2 cases, TORCH screening was abnormal (1 case of CMV and 1 toxoplasmosis) and in 1 case ureplasma urealyticum was found in amniotic fluid. Calcifications size remained stable during pregnancy for all cases excepted one with spontaneous antenatal resolution. In 8 cases, multiple abdominal calcifications were present. CMV infection was found in 2 cases and in 1 case Ureaplasma urealyticum was found in amniotic fluid. Postnatal outcome was complicated by neonatal peritonitis for one newborn and by chorioamnionitis ureaplasma for another one. For the others, postnatal outcome was uneventful and abdominal isolated calcifications were confirmed in postnatal US examination. No abnormal karyotype and no genetic abnormality of parental and fetal CF screen was evidenced. Conclusions: Abdominal isolated calcifications are frequently found at the 2 nd trimester US. Our experience shows that when they are isolated to one single organ, neonatal outcome is uneventful but when they are present in multiple localisations, there is an increased risk of neonatal complications, as meconial peritonitis or chorioamniotitis. The prenatal management should include maternal TORCH screen and US Follow-up and amniotic fluid sampling should be discussed OC162 Presence of acoustic streaming in different types of adnexal masses
There is limited literature on the influence of smoking and BMI on success rates after intrauteri... more There is limited literature on the influence of smoking and BMI on success rates after intrauterine insemination (IUI). As a result of a prospective cohort study we could investigate data from 1401 IUI cycles with partner semen and 1264 IUI cycles with donor semen, primary outcome being clinical pregnancy rate (CPR). Univariate statistical analysis showed significant influence of female BMI on clinical pregnancy in the partner insemination group (CPR of 6,5%, 8%, 16,3% and 9,4% for a female BMI < 20, 20-24.9, 25-29.9 and 3 30, p=0.032), while in the donor group this in uence was not signi cant (CPR respectively 11.1% (BMI< 20), 18.5% (20-24.9), 18.0% (25-29.9) and 14.7% for BMI 3 30). Multivariate analysis through generalized estimating equations (GEE) could not confirm this significant influence of female BMI on fecundity in the partner semen group. For smoking, univariate statistical analysis revealed male smoking to be a negative influence for the clinical pregnancy rate in...
10 years of Facts Views & Vision in Obgyn: Chief editor's report
It’s always nice to look back and try to summarize what we achieved during these last 10 years of... more It’s always nice to look back and try to summarize what we achieved during these last 10 years of FV&V. We observed a broad input from all different fields including obstetrics, perinatal medicine, gynaecology and reproductive health. It was fascinating that many papers showed a lot of interest in the global perspective of our specialty. Structured reviews, strong opinion and viewpoint papers, excellent historical reviews, exactly what we were looking for from the very beginning.
Human Reproduction
pre-menopausal women (follicular phase), group 2 = premenopausal women (luteal phase), group 3 = ... more pre-menopausal women (follicular phase), group 2 = premenopausal women (luteal phase), group 3 = post-menopausal women. The strips were treated with five different stimulus concentrations of ETI (10-1°, 10-9 , 10-8 , 10-7 , and 10-6 M). The experiment is two-factorial with unequal number of replications and was analysed using generalized linear modelling. The response variable is the ratio of the curve peak when a strip is treated with ETI + KCI (80 mM) relative to the curve peak when it is treated with KCI alone.
Magnetic Resonance Imaging
Purpose: To evaluate the perfusion parameters of inner and outer myometrium in healthy nulliparou... more Purpose: To evaluate the perfusion parameters of inner and outer myometrium in healthy nulliparous and primiparous women who are and who are not currently using hormonal contraceptives by means of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Material and methods: We performed pelvic 1.5T DCE-MRI on 98 women: 18 nulliparous non-users, 30 nulliparous users, 12 primiparous non-users and 38 primiparous users of hormonal contraception (mean age respectively 26.4, 25.8, 30.23 and 28.18 years). The nulliparous non-users underwent DCE-MRI investigations during their follicular, ovulatory and luteal phase. Perfusion parameters (iAUC/volume, K trans , K ep and Ve) were assessed in the anterior and posterior wall of the junctional zone (JZ) and outer myometrium. Results: In nulliparous non-users, the mean K trans and iAUC/volume showed a decrease from follicular to luteal phase (0.82 vs 0.55 min-1 for K trans , p = 0/027 and 1.28 vs 0.68 for iAUC/volume, p < 0.001). The anterior JZ demonstrated lower K trans (p = 0.050) and higher K ep (p = 0.012) in nulliparous non-users, lower K trans in nulliparous users (p < 0.001) and lower Ve in primiparous users (p = 0.012) than the anterior outer myometrium. K trans in the anterior and posterior JZ wall in nulliparous users was lower than in non-users (p = 0.001 and p = 0.013) and Ve at the anterior JZ wall in primiparous users was lower than in non-users (p = 0.044). Conclusion: This study provides data on normal perfusion parameters of inner and outer myometrium, which may be potentially useful in assisted reproductive therapy.
ESHRE Monographs, 2008
Although the consequences of the problem of childlessness are more pronounced in developing count... more Although the consequences of the problem of childlessness are more pronounced in developing countries when compared with Western societies, local health care providers and international organizations pay little attention on this issue. The limited budgets for reproductive health care are mostly restricted to family planning and mother care. The most common misunderstanding is the 'overpopulation-issue'. It is generally believed that the expected growth of the world population puts a real burden on the issue of infertility treatment in resource-poor countries, although recent UN reports clearly show that in most developing countries the fertility rate is dropping significantly and will fall below the threshold of 2.0 by 2050. It seems that the expected population growth in developing countries in the next decades is rather due to population ageing and not to high fertility rates. Another important issue surrounding infertility in developing countries is the so-called 'limited resources argument'. Because the problem of childlessness is a major health problem in most developing countries, a rearrangement of the global reproductive health care budget should be requested from local governments and international organizations taking into account the urgent need for a go-together of more successful family-planning policies and affordable simplified ART methods.
Facts, views & vision in ObGyn, 2014
Magnetic Resonant Imaging (MRI) has demonstrated that we can differentiate the uterus in 3 import... more Magnetic Resonant Imaging (MRI) has demonstrated that we can differentiate the uterus in 3 important functional areas. Exploration of the uterus in the infertile patient should implement the evaluation of the endometrium, the Junctional zone myometrium (JZ), the outer myometrium and the cervical canal. Especially the JZ myometrium should receive our close attention in the exploration and treatment of the infertile patient. MRI cannot be implemented as a screening examination but also limiting the imaging of the womb to a 2 or 3 D ultrasound exam only does not meet the scientific requirements of sensitivity and specificity. Modern ambulatory uterine diagnosis in a one-stop approach includes transvaginal ultrasound, fluid mini Hysteroscopy, contrast sonography and endomyometrial tissue sampling. Transvaginal Ultrasound being the gold standard for global uterine screening has a cardinal importance for diagnosis of myometrial disorders and uterine congenital malformations whereas hyster...
Fertility Awareness-Based Methods' and subfertility: a systema-tic review
Facts, views & vision in ObGyn, 2014
Fertility awareness based methods (FABMs) can be used to ameliorate the likelihood to conceive. A... more Fertility awareness based methods (FABMs) can be used to ameliorate the likelihood to conceive. A literature search was performed to evaluate the relationship of cervical mucus monitoring (CMM) and the day-specific -pregnancy rate, in case of subfertility. A MEDLINE search revealed a total of 3331 articles. After excluding articles based on their relevance, 10 studies and were selected. The observed studies demonstrated that the cervical mucus monitoring (CMM) can identify the days with the highest pregnancy rate. According to the literature, the quality of the vaginal discharge correlates well with the cycle-specific probability of pregnancy in normally fertile couples but less in subfertile couples. The results indicate an urgent need for more prospective randomised trials and -prospective cohort studies on CMM in a subfertile population to evaluate the effectiveness of CMM in the subfertile couple.
Facts, views & vision in ObGyn, 2014
Infertility care is one of the most neglected health care issues in developing countries (DC), af... more Infertility care is one of the most neglected health care issues in developing countries (DC), affecting more than 50 million couples. The social stigma of childlessness still leads to isolation and abandonment. Bilateral tubal occlusion due to sexually transmitted diseases and pregnancy-related infections is the most common cause of infertility in DC. Consequently most cases of infertility are only treatable by using assisted reproductive technologies which are either unavailable or too costly. Lowering the laboratory costs associated with IVF is a crucial step to make IVF affordable for a larger part of the world population. We recently developed and described a new simplified method of IVF culturing, called the (t)WE lab method. Our initial results in fresh IVF cycles showed that IVF methodology can be significantly simplified and result in successful outcomes at levels that compare favourably to those obtained in high resource programs. We report three pregnancies and four live ...
Facts, views & vision in ObGyn, 2011
The involvement of DNA strand breaks and Topoisomerase II in sperm chromatin condensation during spermatogenesis in the human
is the coordinator of the Special Task Force on 'Developing countries and infertility' of the Eur... more is the coordinator of the Special Task Force on 'Developing countries and infertility' of the European Society of Human Reproduction and Embryology (ESHRE).
Interlobar Venous Flow Is Different between Left and Right Kidney in Uncomplicated Third Trimester Pregnancy
Gynecologic and Obstetric Investigation - GYNECOL OBSTET INVEST, 2008
Aim: To investigate Doppler flow patterns of renal interlobar veins (RIV) in left (L) and right (... more Aim: To investigate Doppler flow patterns of renal interlobar veins (RIV) in left (L) and right (R) kidney in relation to gestational age and to intrarenal pyelocalyceal diameters (PCD). Methods: Cross-sectional study involving 6 groups of women: (1) non-pregnant women, women pregnant between weeks (2) 11–14, (3) 18–23, (4) 28–33, (5) 37–40 and (6) women <5 days post delivery. During standardized renal duplex ultrasound scan, PCD (mm) was measured and venous impedance index (VI = [peak flow (PV) – presystolic flow]/PV) of RIV was defined. Comparison between L and R kidney was performed by repeated-measures analysis of variance for VI and by t tests for PCD. Results: A total of 150 women were examined, 25 in each group. In the early third trimester of pregnancy, L VI was significantly higher than R VI (0.38 ± 0.01 vs. 0.33 ± 0.01, p < 0.0001) and L PCD was significantly lower than R PCD (3.90 ± 3.68 vs. 6.25 ± 4.03, p = 0.03). Conclusion: RIV Doppler flow is different between l...
Treatment of Male Infertility Due to Sperm Surface Antibodies
The Journal of Urology, 1998
International Journal of Gynecology & Obstetrics, 2009
We conducted a retrospective analysis to examine the frequency of chromosomal abnormalities in pr... more We conducted a retrospective analysis to examine the frequency of chromosomal abnormalities in products of conception from patients with recurrent miscarriages in relation to the number of previous miscarriages. Material and Methods: We studied 1309 pregnancies with a history of 2-20 consecutive first-trimester abortions in Nagoya City University Medical Hospital. The frequencies of abnormal and normal embryonic karyotypes for each number of previous abortions were studied. The subsequent pregnancy outcome of patients whose previous miscarriages were karyotyped were studied along with the predictive value of karyotyping of previous miscarriages for subsequent miscarriages. Chromosomal analysis was performed on products of conception using a standard G-banding technique. Results: The miscarriage rate increased with the number of previous spontaneous abortions. The frequency of abnormal embryonic karyotypes significantly decreased and that of normal embryonic karyotypes significantly increased with the number of previous abortions. 44 of 71 patients whose karyotypes were normal aborted subsequently and 23 of 60 patients whose karyotypes were abnormal aborted subsequently. Patients with a previous normal embryonic karyotype aborted more frequently than those with an abnormal karyotype. Conclusions: The frequency of normal embryonic karyotypes significantly increases with the number of previous abortions and a normal karyotype in a previous pregnancy is a predictor of subsequent miscarriage.
Doppler Measurement of Renal Interlobar Vein Impedance Index in Uncomplicated and Preeclamptic Pregnancies
Hypertension in Pregnancy, 2009
To define normal values of Renal interlobar vein impedance index (RIVI) throughout gestation, as ... more To define normal values of Renal interlobar vein impedance index (RIVI) throughout gestation, as a reference to RIVI in preeclampsia (PE). Longitudinal evaluation of 20 uncomplicated pregnancies (UP) by standard renal duplex scan, every 4 weeks during pregnancy and postpartum. Comparison of RIVI between 40 PE and UP, and plotting of PE values against the normal reference range at corresponding gestation. In PE, RIVI is significantly higher than in UP, the difference being larger at the left side and in cases of preeclampsia remote from term. Increase of RIVI in women with PE is gestation-dependant.
Reflections on the way to conduct an investigation of subfertility
Human Reproduction, 1995
Infertility is a worldwide issue in reproductive health. In view of the World Health Organization... more Infertility is a worldwide issue in reproductive health. In view of the World Health Organization's definition of health, the psychological and social consequences of infertility simply cannot be ignored. Prevention of infertility is difficult and does not help the couple seeking medical advice for infertility, whereas efficient treatment for infertility is time consuming, expensive and often unsuccessful. This article reflects on a shortened, yet full investigation of both partners' fertility before any treatment whatsoever, which is indispensable once the decision to help the couple medically has been made. By optimizing the use of modern gynaecological endoscopy within the woman's cycle, an exhaustive infertility investigation can be conducted within the span of two couple-physician contacts, thereby responding to the couple's concern, avoiding loss of time and energy due to inappropriate therapies, and directing the subfertility treatment correctly from the start. Trained gynaecologists can easily conduct this investigation in fertility centres in developed countries, as well as in centres for family planning in developing countries. The investigation can be employed either with an emphasis on diagnosis alone (and then even under local anaesthesia) or, if the necessary infrastructure is available, in combination with operative endoscopy under general anaesthesia where indicated.
Fertility and Sterility, 2007
The proportion of twins resulting from multifetal pregnancy reduction of higher-order multiples i... more The proportion of twins resulting from multifetal pregnancy reduction of higher-order multiples is increased in pregnancies resulting from hormone stimulation when compared with twins following in vitro fertilization/intracytoplasmic sperm injection treatment. These reduced twin pregnancies may carry a higher perinatal risk compared with other twin pregnancies, which should be taken into account when assessing the perinatal outcome of twin pregnancies after assisted reproduction.
Human Reproduction …, 2001
The aim of the study was to conduct a structured review of the literature published on the use of... more The aim of the study was to conduct a structured review of the literature published on the use of normal sperm morphology, as an indicator of male fertility potential in intrauterine insemination (IUI) programmes. Published literature in which normal sperm morphology was used to ...
Andrologia, 2011
Preservation of spermatozoa is an important aspect of assisted reproductive medicine. The aim of ... more Preservation of spermatozoa is an important aspect of assisted reproductive medicine. The aim of this study was to investigate the efficacy and use of a recently developed liquid nitrogen and cryogen-free controlled rate freezer and this compared with the classical liquid nitrogen vapour freezing method for the cryopreservation of human spermatozoa. Ten patients entering the IVF programme donated semen samples for the study. Samples were analysed according to the World Health Organization guidelines. No significant difference in total sperm motility after freeze-thawing between the new technique and classical technique was demonstrated. The advantage of the new freezing technique is that it uses no liquid nitrogen during the freezing process, hence being safer to use and clean room compatible. Investment costs are higher for the apparatus but running costs are only 1% in comparison with classical liquid nitrogen freezing. In conclusion, post-thaw motility of samples frozen with the classical liquid nitrogen vapour technique was comparable with samples frozen with the new nitrogenfree freezing technique. This latter technique can thus be a very useful asset to the sperm cryopreservation laboratory.
Oral communication abstracts Objectives: To determine fetal and neonatal outcome in referrals wit... more Oral communication abstracts Objectives: To determine fetal and neonatal outcome in referrals with isolated abdominal fetal calcifications. Methods: We report 24 cases of prenatally diagnosis isolated abdominal calcifications referred to our centre over the period 1997-2007. The management included detailed fetal ultrasound imaging, maternal TORCH analysis, parental and fetal cystic fibrosis mutations analysis, fetal karyotype, and infectious investigations in amniotic fluid. Neonatal examination and postnatal ultrasound findings were collected and follow-up was obtained. Results: In 16 cases, abdominal calcifications were limited to one single organ (7 into the liver, 1 into the bowel, 1 into the spleen, 6 cases close to stomach and 1 behind the liver). In 2 cases, TORCH screening was abnormal (1 case of CMV and 1 toxoplasmosis) and in 1 case ureplasma urealyticum was found in amniotic fluid. Calcifications size remained stable during pregnancy for all cases excepted one with spontaneous antenatal resolution. In 8 cases, multiple abdominal calcifications were present. CMV infection was found in 2 cases and in 1 case Ureaplasma urealyticum was found in amniotic fluid. Postnatal outcome was complicated by neonatal peritonitis for one newborn and by chorioamnionitis ureaplasma for another one. For the others, postnatal outcome was uneventful and abdominal isolated calcifications were confirmed in postnatal US examination. No abnormal karyotype and no genetic abnormality of parental and fetal CF screen was evidenced. Conclusions: Abdominal isolated calcifications are frequently found at the 2 nd trimester US. Our experience shows that when they are isolated to one single organ, neonatal outcome is uneventful but when they are present in multiple localisations, there is an increased risk of neonatal complications, as meconial peritonitis or chorioamniotitis. The prenatal management should include maternal TORCH screen and US Follow-up and amniotic fluid sampling should be discussed OC162 Presence of acoustic streaming in different types of adnexal masses