Jean-René Zorn

Dating biometry during the first trimester: accuracy of an every-day practice

OBJECTIVE The goal of this study was to determine the accuracy of an every-day practice for assessing gestational age by ultrasound measurement of the greatest embryonic length (GEL). DESIGN This retrospective study used measurements taken during the first trimester. SUBJECTS We considered all births in this hospital between 1 January 1992 and 31 December 1994 from pregnancies that began by an in-vitro fertilization procedure (IVF). We examined 143 consecutive files, containing 257 measurements made by 72 different operators. METHODS The precision of seven embryo growth curves was compared. We calculated for each curve its ability to predict (95% prediction interval) the date the pregnancy began, using these dated pregnancies. RESULT For GEL measurements between 3 and 80 mm, which includes most of our population, Robinson and Wisser (2) were the most appropriate curves. The 95% prediction interval was 9.5 and 10.2 days respectively. CONCLUSION Dating pregnancies in every-day practice with GEL is nearly as accurate as prospective studies with only one or two scanners.

The "dysharmonic luteal phase" syndrome: endometrial progesterone receptor and estradiol dehydrogenase.

The dysharmonic luteal phase (DLP) syndrome is defined by delayed endometrial maturation despite normal plasma progesterone (P) values. In ten patients with DLP the actual date of the endometrial biopsy, dated retrospectively, was 24.7 +/- 2.3 days, whereas the histologic date was 20.0 +/- 2.6 days. The concentration of cytosolic P receptor in DLP endometrium tended to be lower, whereas the concentration of nuclear receptor was significantly higher in DLP than in seven matched patients with normal luteal phases. Endometrial estradiol-dehydrogenase activities were identical in both groups. The DLP syndrome cannot be explained by a decreased sensitivity of the endometrium to P and is probably merely functional in nature.

Low dose recombinant FSH treatment may reduce multiple gestations caused by controlled ovarian hyperstimulation and intrauterine insemination

Objective  To evaluate the rate of multiple pregnancies in intrauterine insemination cycles stimulated with a minimal dose of recombinant follicle stimulating hormone (rec‐FSH).

Steroid hormone levels in peritoneal fluid during the periovulatory period

In order to obtain further information on estradiol (E2) and progesterone (P) patterns during the periovulatory period, their levels were determined in peritoneal fluid (PF) and plasma obtained during 22 laparoscopies performed within the 58 hours following the luteinizing hormone surge-initiating rise (LH SIR) determined by plasma LH assays every 6 hours. E2 levels in plasma and PF did not differ before ovulation (n = 13) but differed after ovulation (n = 9, P less than 0.01). P levels were lower in plasma than in PF before ovulation, but there was an overlap of values. After ovulation the difference was significant (P less than 0.01). When plotted as a function of time following LH SIR, E2 levels increases in PF progressively (r = 0.70), whereas the P increase was discontinuous, with a dramatic rise after follicular rupture. These different patterns may be related to respectively divergent and convergent variations of steroid levels in blood and follicular fluid.