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Query: KEGG:D06457 (HCG)
 2,659 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors analyse the effectiveness of ectopic pregnancy diagnosis in women with clinical history and high psychological motivation for treatment. The effectiveness of the diagnostic algorithm was studied in 21 women with previous history of infertility treatment (including 15 who had undergone tube surgery). The diagnostic process was begun between 20th and 25th days after the suspected conception. The only clinical symptom that the patients complained of was spotting (7 cases). The algorithm used serum HCG determination (EIA); in cases of HCG ranging between 2 mIU/ml and 1500 mIU/ml (or clinical uncertainty)-transvaginal sonography (with colour Doppler) was used. If ectopic pregnancy was suspected, laparoscopy was done. It was found that in 15 cases laparoscopic images agreed with diagnostic results; in 5 cases, the image obtained was false negative; in 1 case it was false positive. The diagnostic efficiency of sonography alone was higher than if it was correlated with HCG, but it, too, did not secure against false positive and false negative results. The conclusion was drawn that despite very high sensitivity (70%) and specificity (93%) of the diagnostic procedures used, in high-risk patients the diagnosis should be verified by laparoscopy.
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PMID:Ectopic pregnancy diagnosis in very high risk patients. 981 Apr 17

A survey in 1996 of our female patients suggest that the three commonest causes of infertility were endometriosis, anovulation and idiopathic which comprises of about 70% of all the patients. In the male patients, sperm morphology evaluation by critical criteria showed that abnormal morphology was present in 71% while 87% of all the semen analysis were abnormal. The objective of this study was to assess the status of IUI before proceeding to formulate patient protocols for IVF in a tertiary infertility referral unit. A retrospective study of patients data was done from Jan 1995 to Dec 1996. Ovarian stimulation by clomiphene for anovulatory and idiopathic patients was performed on couples with at least one patent fallopian tube. Ovulation induction was by an intramuscular injection of 5000 i.u of HCG after follicular maturation. IUI was performed approximately 36-40 hours later. A total of 74 couples received 114 treatment cycles producing a total of 9 conceptions. The conception rate of IUI was therefore 7.89% per cycle and 12.16% per couple with the cumulative pregnancy rate of 28.21%. Associated success features of IUI found in this study were the age of the woman and the semen parameters of the husband.
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PMID:Assessing the status of intrauterine insemination before forming a medically assisted conception unit. 1097 7

The purpose of this study was to evaluate the effectiveness of combined approach on the prevention of severe ovarian hyperstimulation syndrome (OHSS) in high risk patients undergoing controlled ovarian hyperstimulation for IVF. The combined approach consisted of: (1) step-down administration of gonadotropins; (2) lowering the dose of human chorionic gonadotropin; (3) intravenous albumin infusion at the time of oocyte retrieval and (4) progesterone use for luteal support. Total of 87 high risk patients with a serum estradiol level >11,010 pmol/l or 3000 pg/ml on HCG day were managed by this combined approach and their results were compared with 274 low risk patients. In all high risk patients, the gonadotrophin dose were decreased starting as early as on day 4 of ovarian stimulation as necessary, ovulation was triggered by a decreased HCG dose of 5000-7000 IU according to the level of estradiol, intravenous infusion of 20% human albumin, 50-100ml were given just 1h before the oocyte retrieval and luteal support was provided either by 50mg progesterone in oil, IM or 600 mg micronized progesterone orally or vaginally until the day of beta-HCG determination. All patients were followed by serial ultrasonographic examinations and complete blood count analysis after embryo transfer to detect the early signs of OHSS and to allow early intervention. Age and duration of infertility were similar in both groups. Although the number of gonadotrophin ampoules used (22.7 +/- 4.7 versus 27.8+/-3.7; P<0.05) was significantly lower, estradiol levels (16,764 +/- 6936 pmol/l versus 8870 +/- 2456 pmol/l; P<0.05) and mean number of oocytes (18.3 +/- 5.9 versus 10.6+/-5.4; P<0.05) were significantly higher in study group. There was no significant difference between groups in terms of the mean number of transferred embryos (3.2 +/- 1.1 versus 3.4+/-1.1) and rate of pregnancies (50.5% versus 40.1%). There was only one moderate and no severe OHSS case in the high risk group, while five moderate and one severe OHSS cases developed in the control group consisting of low risk patients. In conclusion, intravenous albumin combined with low dose HCG, early step-down administration of gonadotropins and progesterone use for luteal support, so called combined approach, proved to be effective in the prevention of severe ovarian hyperstimulation syndrome in documented high risk patients.
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PMID:Combined approach as an effective method in the prevention of severe ovarian hyperstimulation syndrome. 1145 50

The aim of the study is to evaluate the cases of abortions in women after infertility treatment. The study group consists of 77 women with abortions, who were compared with 200 pregnant women (control group) comparable as to duration of pregnancy and time of hospitalization. All women conceived after successful infertility treatment. Martial history, methods of medical therapy as well as oxytocinase and isooxytocinase blood levels, urine HCG levels, cervical smear and ultrasonographic evaluation were studied during hospitalization. The results show the concordance between biochemical and biophysical pregnancy monitoring with data regarding high risk pregnancies. The medical history review shows no clinically useful differences which may be the background of the prognosis. Each pregnancy after successful infertility treatment should be regarded as a high risk one therefore its monitoring is more important than methods of treatment applied before pregnancy. The differences in ovulation induction methods are statistically significant, however in individual cases are not pathognomonic.
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PMID:Threatened and recurrent abortions after treatment of infertility. 1175 9

The presence of HCG (human chorionic gonadotropin) in the blood and urine of women with IUDs during the luteal phase of the menstrual cycle has been reported and suggests that IUDs have a post-implantation abortifacient action (the embryo produces HCG after implantation). This study examines the validity of this hypothesis. 8 randomly selected Lippes Loop wearers aged 21 to 35 years (mean age, 29 years) participated in the study. IUD use ranged from 7 to 38 months (means, 23 months). Mean length of menstrual cycle was 30.5 days. The women were asked to have sexual intercourse regularly at least every 2 days, beginning from the 12th day of the menstrual cycle. 57 blood samples were collected every 2nd day, starting day 18 of the menstrual cycle until the onset of subsequent menses. Radioimmunoassay (RIA) for HCG beta subunit, luteinizing hormone (LH) and progesterone was done. Ovulation occured in all women as shown by serum progesterone levels above 3 mg/ml. HCG could not be detected in any sample, including samples with high levels of LH, suggesting that there is no cross-reactivity of the anti-HCG beta subunit antibody with LH. This study did not confirm studies of others which found HCG in the blood/urine samples of IUD wearers. The disparity in findings may be attributed to either non-specific interference, or of a cross-reaction between the anti-serum used for the beta HCG RIA and LH. The true mechanism of IUD remains unknown. Either the IUD prevents the embryo from reaching the HCG-secreting stage, or the IUD interferes with fertilization itself.
Infertility 1980
PMID:Chorionic gonadotropin in women fitted with intrauterine device. 1226 38

Between November 1980-August 1989, physicians in Cairo, Egypt followed 1488 infertile couples. The study reported the extent of infertility, its etiology, and problems related to its management. Primary and secondary infertility affected 70.7% and 29.3% of the couples, respectively. Length of infertility ranged from 1 to 23 years (mean = 7.18 for primary infertility and 6.05 for secondary infertility). 306 husbands (20.6% of the couples) had either an insufficient sperm count (20 X 1 million), insufficient sperm motility (40%), or 40% abnormal sperm. Both the husband and wife of 181 couples (12.2%) suffered from infertility. The physicians could not identify the cause of infertility in 49 couples (3.3%). 952 wives (64% of the couples) were infertile. Tubal problems were mainly responsible for female infertility (42%) followed by ovulatory disorders (25.3%), multiple factors (23.4%), pelvic endometriosis (5.6%), and cervical effects (4.2). Various treatments included laparoscopic adhesiolysis in 30 patients, tubal microsurgery in 523 patients, induction of ovulation and monitoring (e.g., clomid and HCG) in 224 patients, in vitro fertilization (IVF) and embryo transfer (ET) in 256 patients, artificial insemination with husband's capacitated sperm along with ovulation induction in 114 couples, intrauterine synechia and septa via hysteroscopy in 17 patients, and abdominal myomectomy in 57 patients. The follow-up pregnancy rate for 523 microsurgery patients was 55.2% and 38% went full term. Only 51-63% of the couples could afford to pay for IVF and ET, induction/monitoring of ovulation, or artificial insemination with husband's sperm all of which only the private sector provided. Patients had to wait for laparoscopy and microsurgery which were also available through government hospitals. These results demonstrate that prevention of infertility is preferable to treatment particularly in developing countries such as Egypt. Islam's view of infertility and family is also addressed.
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PMID:Infertility: a health problem in the Muslim world. 1228 61

Assisted reproductive techniques have become a routine treatment for infertility. The extended use of gonadotrophin-releasing hormone analogues in assisted reproductive techniques has made luteal phase support mandatory, as it has been clearly demonstrated that they alter luteal LH pulsatility. For luteal support, HCG administration, though effective, has a high risk of ovarian hyperstimulation syndrome. Progesterone continues to be the gold standard for supplementation. Vaginal progesterone represents a highly effective alternative to painful intramuscular injections. The vaginal route is mainly characterized by direct delivery of the progesterone to the endometrium, thus producing high levels at the target tissue and a very low incidence of side effects.
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PMID:Luteal phase support. 1251 63

The aim of this study was to determine the relationship between the ovarian stimulation protocol (with HMG or FSH) after down-regulation with GnRH anologa and protein (total protein and albumin) as well as bilirubin and urea in serum. Furthermore, it was intended to find out the effect of these parameters on IVF/ICSI outcome. 50 patients were included in this study. All patients underwent controlled ovarian hyperstimulation for assisted reproduction therapy either with FSH (Gonal-F) or HMG (Menogon). Ovulation induction was induced by human chorionic gonadotrophine (HCG, Predalon) 10 000 IU i. m. The protein concentration (total protein, albumin) as well as bilirubin and urea concentrations were determined before down-regulation with GnRHa, at the beginning of ovarian stimulation with FSH or HMG, on the day of ovulation induction with HCG, during oocyte retrieval and fourteen days after embryo transfer. The age, body mass index and etiology of infertility showed no significant difference between patients stimulated with HMG or FSH. Total protein and albumin concentration decreased significantly (p=0.001) from 77.45 +/- 5.90 g/L and 47.02 +/- 3.41 g/L to 74.60 +/- 4.6 g/L and 45.04 +/- 2.39 g/L, respectively at the time of oocyte retrieval. Whereas, no significant change with bilirubin and urea concentration was observed. However, the mean concentration of total protein, albumin, bilirubin of patients who become pregnant was higher of those who did not. In conclusion, this study shows that total protein and albumin concentration in plasma decreased during the follicular phase significantly with the application of exogenous gonadotrophins and steroid hormones in comparison to the value before down-regulation. The mean value of total protein, albumin, bilirubin of patients who become pregnant was higher (but not significant) of those who did not. However, the high individual variation in the present results shows that these parameters are not useful as a predictor of IVF/ICSI outcome.
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PMID:[Association between ovarian stimulation regime and protein metabolism of patients undergoing IVF/ICSI therapy]. 1455 96

A couple with unexplained infertility was referred for routine IVF and ICSI treatment. Ovulation was induced by the GnRH analogue protocol combined with HMG and HCG. Preparation of denuded oocytes revealed a major disorder of the zona pellucida and abnormal oocytes. During preparation of ova for ICSI, 15 retrieved oocytes were denuded, 14 of which underwent ICSI treatment. Four of the oocytes collapsed and the remaining 10 appeared to have irregular, fragile zona pellucida. Nevertheless, following ICSI, seven low-quality embryos developed, three of which were transferred into the uterus. Two implantations were achieved, but only one embryo resulted in an uneventful pregnancy and delivery by Caesarean section of a normal female neonate with an Apgar score of 10. It is hypothesized that infertility was due to the abnormal oocyte structure and abnormal zona pellucida, which prevented natural conception. This condition was successfully resolved by the ICSI procedure.
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PMID:Case report: pregnancy outcome following ICSI of oocytes with abnormal cytoplasm and zona pellucida. 1499 56

Radiotherapy is generally considered as the standard treatment for most testicular seminomas. However, there have been substantial changes in the management of these tumours over the past few years. In early seminoma, there is a trend towards a decrease in treatment intensity or even towards therapeutic abstention (i.e. surveillance); whereas in advanced cases, combination chemotherapy is taking over from radiotherapy. In stage I, where cure rates are almost 100%, the limiting of the lymph node area to be irradiated and decrease of the dose to 20-25 Gy was followed by very low long-term toxicity rates, and a very small risk of infertility, without compromising the overall prognosis. Surveillance is an acceptable alternative to postoperative radiotherapy. However, the risk of nodal relapse is around 18-20%. With surveillance, the frequency and duration of follow-up is increased in comparison to the same with postoperative radiotherapy, with higher cost. In stage IIa, radiotherapy remains the standard but recent studies have shown that limiting the nodal volume to the paraortic area is justified as in stage I. In stage IIb and higher, combination chemotherapy is almost always given. However, the association between carboplatin and radiotherapy represents an efficient and well-tolerated alternative. Late tissue damage and the risk of decrease in fertility are minimized with novel radiotherapeutic approaches. However, the occurrence of second cancers in the long term is a matter of concern. It is possible though, that patients with seminoma have a tendency per se to develop second cancers. The prognosis of cryptorchid seminoma and of HCG-producing seminoma has been the subject of controversy but recent large studies have demonstrated that stage for stage, the cure rates are similar to those of other seminomas.
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PMID:[Radiotherapy of testicular seminoma: changes over the past 10 years]. 1512 47


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