Nicolai Holst

Optimization and simplification of culture conditions in human in vitro fertilization (IVF) and preembryo replacement by serum-free media

The results of 220 consecutive IVF treatments are presented, comparing the use of culture media supplemented with either patient serum (Group 1;n=110), or Medi-Cult SSR 2 synthetic serum replacement with pyruvate, and human serum albumin (HSA) (GEA BioTech, Hvidovre, Denmark) (Group 2;n=110). In both groups the Medi-Cult Hybritest was used for routine quality testing. A significantly (P<0.05) increased rate of deliveries/ongoing pregnancies was observed with the Group 2 medium. However, no significant differences in fertilization rate, cleavage rate, or implantation rate were observed. It is concluded that the serum-free culture medium described and the testing for absence of cytotoxicity in a sensitive bioassay (Hybritest) have yielded culture conditions capable of sustaining the development in vitro of human preembryos without impairing the fertilization process or the implantation rate, ultimately resulting in a significantly increased rate of deliverieslongoing pregnancies and an apparently decreased abortion rate. The porential harmful effects of serum and the need for blood sampling and preparation further increase the advantages of replacing serum with the synthetic serum replacement SSR 2 in an IVF program.

Handling of tubal infertility after introduction of in vitro fertilization: changes and consequences

This study aimed at quantifying some important social and economic consequences of the altered handling of tubal infertility after the establishment of IVF treatment. The number of tubal operations was reduced by 50%. This had most important and positive implications on the availability of the operating theater for other elective operations, on the availability of hospital beds for other patient groups, and on the total duration of the certificate of illness. The calculated costs per live birth were

Gut peptides in lactation

17,000 after tubal surgery, compared with

Plasma concentrations of motilin and somatostatin are increased in late pregnancy and postpartum

12,000 after IVF treatment. Life table analyses demonstrated a highly significant increased rate of deliveries after a complete IVF treatment (72.3% per patient) compared with tubal surgery (23.7%, P less than 0.001).

Plasma vasoactive intestinal polypeptide, insulin, gastric inhibitory polypeptide, and blood glucose in late pregnancy and during and after delivery☆

Summary. The circulating levels of prolactin (PRL), vasoactive intestinal polypeptide (VIP), somatostatin (SRIH), cholecystokinin (CCK), pancreatic polypeptide (PP), insulin, motilin and blood glucose were measured in nine nursing women 27–40 days after delivery to establish the possible role of some gastrointestinal regulatory peptides in human breast feeding. During the last 20 min of suckling a significant (P<0·05) increase in serum PRL was observed concomitantly with a significant decrease in plasma SRIH levels (P<0·05 at 20 min and P<0·01 at 30 min). There was a highly significant inverse correlation between mean PRL and SRIH levels during the first 30 min of breast feeding (r= ‐0·996, P<0·00l). Pancreatic polypeptide (PP) also increased significantly (P<0·01) during nursing, while there were no changes in the plasma levels of the other gastrointestinal regulatory peptides studied.

Increased plasma levels of vasoactive intestinal polypeptide in pre-eclampsia.

Objective To examine plasma levels of motilin and somatostatin throughout pregnancy.

Plasma secretin concentrations during normal human pregnancy, delivery, and postpartum

The plasma levels of the gastrointestinal regulatory peptides vasoactive intestinal polypeptide, insulin, and gastric inhibitory polypeptide, as well as blood glucose, were measured in six healthy women before, during, and after normal parturition at term. Plasma levels of vasoactive intestinal polypeptide increased significantly (p less than 0.05) during delivery and remained significantly elevated for 15 minutes post partum. Plasma insulin levels rose significantly (p less than 0.05) within 5 minutes after delivery and stayed three-fold and significantly elevated for 120 minutes post partum. Plasma levels of gastric inhibitory polypeptide decreased significantly (p less than 0.05) between 5 and 30 minutes after delivery. Blood glucose levels were significantly (p less than 0.05) increased during labor, delivery, and the early postpartum period compared to late pregnancy. These findings suggest a mediating role for vasoactive intestinal polypeptide, insulin, and gastric inhibitory polypeptide in the physiologic adaptations to normal pregnancy, delivery, and the postpartum period.

Effects of ovarian stimulation on blood pressure and plasma catecholamine levels

Objective— To investigate the plasma vasoactive peptide (VIP) levels in pregnancies complicated by pre‐eclampsia.

Prolactin response to secretin during the spontaneous menstrual cycle in women.

Plasma concentrations of secretin were measured at 4‐week intervals throughout eight normal pregnancies and again twice postpartum, and in another six women during parturition and the early postpartum period. Comparisons were made with levels in 16 normal non‐pregnant women. Plasma secretin concentrations increased during pregnancy with maximum levels at 36 weeks. The increase was statistically significant from week 28 to 36, compared with non‐pregnant levels. By 5 days after delivery plasma secretin levels were similar to the non‐pregnant levels. No significant changes in plasma secretin were observed during delivery and early postpartum. The altered secretin levels may be of importance for heartburn in pregnancy, calcium metabolism, and the changes in renal haemodynamics.

Characterization of secretin-like immunoreactivity in pregnancy.

Effects of ovarian stimulation for in vitro fertilization on blood pressure and plasma catecholamine levels were studied in 10 women. The examinations were carried out before hormonal treatment with human menopausal gonadotropin (day three of the menstrual cycle, mean serum oestradiol concentration 0.2 nmol l-1, and on the day after ovulation induction with human chorionic gonadotropin (cycle days 10-12, mean serum oestradiol concentration 7.4 nmol l-1). Systolic and diastolic blood pressures (mean +/- SD) decreased 6.7 +/- 8.6 mm Hg, p = 0.049, and 5.3 +/- 4.7 mm Hg, p = 0.009, respectively), and venous plasma noradrenaline increased (42 +/- 44 pg ml-1, p = 0.02) during ovarian stimulation. No significant change was observed in either arterial noradrenaline, arterial adrenaline or venous adrenaline. After stimulation a positive correlation was observed between systolic blood pressure and arterial adrenaline (r = 0.73, p = 0.027), and between systolic blood pressure and the arterial-venous difference for adrenaline (r = 0.81, p = 0.007). The increased venous noradrenaline levels may be a reflex-mediated activation of the sympathetic nervous tone due to a decrease in blood pressure, or may indicate reduced neuronal re-uptake of released noradrenaline. The mechanisms behind the strong correlation between adrenaline and blood pressure are unclear, but may be induced by the supraphysiological oestradiol levels. Thus, adrenaline seems to be more important for blood pressure control in this particular setting.