Dirk Vandekerckhove

Ovulation stigma and concentration of progesterone and estradiol in peritoneal fluid: relation with fertility and endometriosis

The relationship between the presence or absence of an ovulation stigma and (1) the fertility status, (2) the incidence of endometriosis, (3) the concentration of progesterone and estradiol in the peritoneal fluid, and (4) the blood levels of luteinizing hormone, follicle-stimulating hormone, progesterone, and estradiol in 21 fertile and 45 infertile patients who underwent a laparoscopy in the early (n = 48) or late luteal phase (n = 18) was investigated. An ovulation stigma was observed in about half of the patients, irrespective of their fertility status (past and subsequent), the presence of endometriosis, or the time of the luteal phase. Progesterone and estradiol concentrations in the peritoneal fluid were highest in the early luteal phase, but they were not correlated with the presence or absence of an ovulation stigma. No significant differences were observed in peripheral hormone levels between women with and those without an ovulation stigma nor between women with high or low concentrations of progesterone in the peritoneal fluid. From the data, it is concluded that hormone assays are of no aid in the diagnosis of the luteinized unruptured follicle syndrome and that the absence of an ovulation stigma on laparoscopic examination cannot be equated with the luteinized unruptured follicle syndrome.

Correlations between follicular fluid steroid analysis and maturity and cytogenetic analysis of human oocytes that remained unfertilized after in vitro fertilization

OBJECTIVE Is there any correlation between follicular fluid (FF) steroid levels and the occurrence of cytogenetic abnormalities in unfertilized human oocytes? DESIGN Cytogenetic analysis was carried out on 397 oocytes, and the steroid content of 104 corresponding FF was analyzed using high-pressure liquid chromatography. Ovarian stimulation was performed by clomiphene citrate and human menopausal gonadotropin (hMG) or by hMG combined with a gonadotropin-releasing hormone agonist (GnRH-a) pretreatment. RESULTS Oocyte maturity was correlated with an increasing FF progestin content and a significant decrease of androstenedione (A) levels. Chromosomal analysis revealed 84 of all oocytes to be abnormal (polyploid or aneuploid and/or prematurely condensed chromosomes present). In this group, A levels and A to estradiol ratios were significantly higher. Although progestin levels were higher in GnRH-a/hMG cycles, the incidence of oocyte normality was not different between the two stimulation schemes. More abnormal oocytes were found in patients with good sperm morphology. CONCLUSIONS Oocyte abnormality correlates with higher A levels in the corresponding FF. Oocyte fertilization is also determined by intrinsic oocytic factors other than maturity.

The medroxyprogfstepone acetate intravaginal silasttc ring as a contraceptive device

Abstract Both the 100 mg and the 200 mg MPA-Silastic rings inserted vaginally on day 5 and worn for 3 weeks suppressed, ovulation in all of the 14 women investigated. A secondary mechanism of action involves interference with the spinnbarkeit of the cervical mucus. Under the experimental conditions, the method was acceptable and the device well tolerated.

The distribution of oestrogen and progesterone receptors in the human endometrial basal and functional layer during the normal menstrual cycle

The distribution of oestrogen and progresterone receptors in the human endometrial basal and functional layer during the normal menstrual cycle was investigated by means of an immunocytochemical technique. A cyclic pattern of receptor distribution was observed. The highest concentration of hormone receptors was observed in the basal layer, in accordance with the idea that this layer is the source of endometrial regeneration.

Structures and concentrations of fifteen different steroid sulfates in human breast cyst fluids

By applying capillary gas chromatography (GC) and gas chromatography mass spectrometry (GC-MS), a simultaneous quantitation of all important steroid sulfates present in a number of breast cyst fluids, has been obtained. The fact that prevailing androgen sulfate structures in the cyst fluids are different from those in blood suggests at least intracystic metabolism of blood-born precursors. Particularly greater amounts of 5 alpha-reduced steroids are found in breast cysts. 5 alpha-Androstane-3 alpha,17 beta-diol is a major androgen sulfate of breast cyst fluids, its concentration being some 2000-fold that of blood. After prolonged topical application of progesterone on the breast, an accumulation of the sulfates of several pregnanediol isomers could be observed.

Follicular fluid steroid levels in relation to oocyte maturity and in vitro fertilization

Steroid levels in follicular fluid (FF) obtained from stimulated ovaries in patients undergoing in vitro fertilization (IVF) were measured by capillary gas chromatography. The correlation between these levels and the maturity of the oocyte, judged from the morphology of the oocyte corona cumulus complex (OCCC) and the fertilizability of the oocytes was analysed. Oocyte maturity was associated with higher FF levels of progesterone, 17-hydroxyprogesterone, 16 alpha-hydroxyprogesterone and 20 alpha-dihydroprogesterone. Follicular fluids containing oocytes that became fertilized had significantly higher levels of 20 alpha-dihydroprogesterone and progesterone and lower levels of androstenedione. Of all the steroids determined, 20 alpha-dihydroprogesterone provides the most significant group differences. Enhanced 20 alpha-dihydrogenation in the presence of decreased 16 alpha- and 17-hydroxylation appears to be an important characteristic of the ultimate ripening stages and early luteinization, at least in stimulated cycles.

Serum HCG and HPL in Twin Pregnancies

Abstract. Serum HCG and HPL levels were determined in 154 samples derived from 39 twin and one triplet pregnancies. Compared with singleton gestations, these levels were respectively 2.5 and 1.5 times higher throughout gestation. Analysis of these data in terms of predictive accuracy for the existence of a twin indicates that neither assay can serve for screening purposes though simultaneous determination of HCG and HPL may provide a fair index of suspicion.

Topographical distribution of oestrogen and progesterone receptors in the human endometrium and Fallopian tube

The topographical distribution of oestrogen and progesterone receptors in the human endometrium and Fallopian tube was investigated by an immunocytochemical technique. A gradient of positively stained cells was observed: the highest oestrogen and progesterone receptor content was noted in the fundal part of the uterine cavity and the ampullar region of the Fallopian tube. The observed gradient is in keeping with biological and pathological events that occur in the human mullerian tract, e.g. fecundation, implantation and carcinogenesis.

Hormonal stimulation for in vitro fertilization: A comparison of fertilization rates and cytogenetic findings in unfertilized oocytes

ObjectiveThe purpose of this study was to compare fertilization and aneuploidy rates after two stimulation protocols in an IVF program.DesignThis was a retrospective study.SettingThe study took place in the IVF laboratory of an Infertility Department.MethodsIn 349 treatment cycles, clomiphene citrate (CC) and human menopausal gonadotropin (hMG) were used in one group (N =233) and hMG after treatment with a gonadotropin-releasing hormone agonist (GnRHa) in two other groups (long protocol): goserelin (N =73) and buserelin (N =43). Cytogenetic analysis was performed on all unfertilized oocytes in both groups.ResultsFertilization rates were significantly higher in the GnRHa/hMG group than in the CC/hMG group, but cleavage rates and embryo quality were not different. Of 736 oocytes prepared for cytogenetic analysis, 256 were karyotyped: 172 were found to be euploid and 84 aneuploid. More oocytes were aneuploid in the GnRHa/hMG group than in the CC/hMG group and this difference was statistically different after analysis of the data using a specially designed mathematical model.ConclusionIf no selection against chromosomally abnormal oocytes takes place at the time of fertilization, more abnormal oocytes are harvested with GnRHa/hMG protocols than with CC/hMG. If, on the other hand, there is a selection against oocytes with some chromosomal imbalance, there is no intrinsic effect of GnRH agonists on the chromosomal complement of the oocyte, and the real aneuploidy frequency in all oocytes, fertilized and unfertilized, is the same in the GnRHa/hMG and in the CC/hMG group.

Chemluminescence immunoassay for estriol in saliva

Estriol is determined in whole saliva of pregnant women by a direct solid-phase chemiluminescence immunoassay. The assay uses a monclonal antibody raised against estriol-6-crboxymethyloxime/bovine serum albumin and the homologous chemiluminescent marker conjugate estriol- 6-carboxymethyloxime/aminopentylethylsiolominol (E3/APEI). The anti-estriol antibody is bound to the wells of a microtitration plate via a second antibody directed against the monoclonal antibody; 50 μl of saliva and 12.5 pg of E3/APEI per well are used. The incubation time is 10 min at room temperature. The calibration graph covers 5–750 pg of estriol and the detection limit is 4.5 pg (0.31 nmol l-1. Mean recovery of added estriol is 98%. Within-assay coefficient of variation is 11.8–5% for 0.21–6.5 nmol l-1 E3, and the between-assay value is 15.7–6.9% for 0.27-3.5 nmol l-1 E3. The correlation of E3 concentration in time-matched samples of saliva and sera from pregnant women was good (r = 0.934). Total assay time including calculation of results is 3 h for 40 saliva samples.