ABSTRACT
In patients with Hodgkin's disease, the serum IgE concentrations were determined with the PRIST radioimmunoassay before commencing and after ending systemic megavoltage radiotherapy. 57 patients showed mainly raised serum IgE concentrations before radiotherapy. After the end of radiotherapy, 44 patients were investigated, and a highly significant fall of the IgE concentration was shown in the serum following the radiotherapy. The decrease of IgE concentration was most pronounced in the patients in whom large areas of irradiation were necessary or who displayed B symptoms. In a proportion of the patients, the IgE concentration in the serum could be measured once more six and twelve months after the end of radiotherapy. Although the IgE concentrations rose again after radiotherapy, the initial values before the beginning of radiotherapy had not yet been reached again even twelve months after treatment in 21 patients investigated. A long-lasting immunosuppressant effect of radiotherapy on the serum IgE concentration could thus be demonstrated which corresponds to the effect on the serum IgM concentration described earlier.
Subject(s)
Hodgkin Disease/immunology , Immunoglobulin E/analysis , Radiotherapy, High-Energy/methods , Follow-Up Studies , Hodgkin Disease/radiotherapy , Humans , Immunoglobulin E/radiation effects , Lymphatic Irradiation/methods , Time FactorsABSTRACT
This record concerns the statistical registration and analysis of the courses and developments having taken place in 246 pregnancies and births after in-vitro-fertilization. The cases were registered retrospectively, the degree of registration being 77.2% approximately; the scientific evaluation was carried out on the basis of the BPE 1987. It can be shown that there is an increased incidence of the EPH-gestosis, the clinically relevant placenta insufficiency syndrome, the intrauterine death of fetus, the abruptio placentae and prematurity. As predisposing factors must primarily be seen and discussed the ovarian hyperstimulation being--in most cases--connected with IVF and the higher age of the patients; it can be supposed that the method of fertilization in vitro itself is of minor importance. Its importance in the pathogenesis of abruptio placentae, however, cannot be exactly evaluated so far. The frequency of multiple pregnancies represents a special problem. Though the rate is lower in the examined group than in comparable--that is due to the limited number of collected oocytes--it should be aimed at a further lowering of multiple pregnancy rates.
Subject(s)
Embryo Transfer , Fertilization in Vitro , Obstetric Labor Complications/etiology , Pregnancy Complications/etiology , Adult , Extraction, Obstetrical , Female , Fetal Growth Retardation/etiology , Humans , Infant, Newborn , Obstetric Labor, Premature/etiology , Pregnancy , Pregnancy, Multiple , Retrospective Studies , Risk FactorsABSTRACT
Intratubar embryo transfer is a form of sterility treatment, in which the in-vitro-fertilized pre-implantation embryos are transferred into the intact fallopian tube(s). This enables the benefits of in-vitro fertilization (information of the gamete fertilization behavior, specific incubation of dysmature oocytes, reduction of the polyploidy rate, risk of multiple pregnancies) to be combined with those of gamete intrafallopian transfer (GIFT; tubar environment for the further development of the pre-implantation embryos). Intratubar embryo transfer is indicated in cases of sterility that are not due to the fallopian tubes; in addition to idiopathic sterility, particular emphasis is put on a certain form of immunological sterility (antibodies against sperm antigens), which seems to be a special indication for this method. Intratubar embryo transfer demands a two sided approach. It is advisable to collect the oocytes transvaginally, guided by ultrasound, since general anaesthesia maybe dispensed with - if so desired. The embryo transfer itself still requires a pelviscopy, which is only performed once fertilization of the oocyte has been confirmed; which is in contrast to GIFT, in which pelviscopy is an inherent part of each treatment cycle. In spite of this advantage, intratubar embryo transfer is a method, which is associated with a high expenditure. The aim of the study was, to evaluate the success rate when all the alternative, less costly options have been exhausted. Our first results are demonstrating, that intratubar embryo transfer is successful, even as a second line therapy. Therefore the method has a significance in the treatment of sterility, not caused by the tubes and the expenditure, with which it is associated, can be justified.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Embryo Transfer/methods , Fertilization in Vitro/methods , Infertility, Female/therapy , Adult , Embryo Transfer/economics , Embryonic Development , Fallopian Tube Patency Tests , Fallopian Tubes , Female , Follow-Up Studies , Gamete Intrafallopian Transfer/methods , Humans , Pregnancy , Pregnancy, MultipleABSTRACT
The article reports on an ectopic pregnancy after IVF/ET that was characterized by the simultaneous nidation of three of the four transferred pre-implantation embryos in both (heavily damaged) Fallopian tubes. The ectopic nidation not only in one of the Fallopian tubes must be seen as a pointer to the importance of active mechanisms of transport from the cavum into the Fallopian tubes. Therefore it is unlikely that ectopic pregnancies after IVF/ET--even if the technique is satisfactory--can be avoided completely. In view of the fact that several IVF treatments were performed in vain, the nidation of three of the four transferred embryos must be interpreted as supporting the theory that the conditions in the Fallopian tubes are more favourable for the development of the human pre-implantation embryos.
Subject(s)
Embryo Transfer , Fertilization in Vitro , Pregnancy, Multiple , Pregnancy, Tubal/diagnosis , Adult , Fallopian Tubes/pathology , Fallopian Tubes/surgery , Female , Humans , Pregnancy , Pregnancy, Tubal/surgeryABSTRACT
Investigations were continued to study the influence of radiation therapy to immune reactions in man, especially, whether this therapy suppresses humoral immune reactions in patients with Hodgkin's disease. Sera from patients with Hodgkin's disease were collected before, during and after radiation therapy. IgA, IgM and IgG were determined by Mancini technics. 40 patients with Hodgkin's disease showed mostly normal or partly elevated values of immunoglobulins before onset of radiation therapy. Radiation induced a highly significant reduction of IgM and IgA and a significant reduction of IgG, the immunoglobulin values, however, remained mostly within the lower normal range. Investigations during the following months after radiation therapy showed, that IgG returned within two months after the end of therapy to values formerly measured. IgA returned to the basic values about nine months after the end of therapy whereas reduction of IgM continued more than twelve months after the end of therapy.
Subject(s)
Hodgkin Disease/radiotherapy , Immunoglobulins/immunology , Adolescent , Adult , Aged , Combined Modality Therapy , Dose-Response Relationship, Radiation , Female , Follow-Up Studies , Hodgkin Disease/drug therapy , Hodgkin Disease/immunology , Humans , Immunoglobulin A/immunology , Immunoglobulin G/immunology , Immunoglobulin M/immunology , Male , Middle Aged , Radiotherapy Dosage , Radiotherapy, High-Energy/methodsABSTRACT
The method of gamete intrafallopian transfer (GIFT) was first described by Asch and has since the been introduced into the treatment of sterility not caused by the tubes. Standard technique for this method is laparoscopy. We report on the first pregnancy in our hospital when gamete intrafallopian transfer was undertaken hysteroscopically, i.e. combined with a transvaginal ultrasound-guided puncture of follicles for obtaining oocytes. The procedure is described. The important aspects of this technique are discussed briefly and the advantages shown: Shorter duration of intervention, reduced traumatisation of the patient and the possibility of effecting the operation without anaesthesia. The stress resulting from this technique is hardly different from that during intratubal embryo transfer provided this too is effected with sonographically monitored transvaginal follicle puncture.
Subject(s)
Endoscopy/methods , Infertility, Female/therapy , Insemination, Artificial, Homologous/methods , Insemination, Artificial/methods , Polycystic Ovary Syndrome/complications , Adult , Fallopian Tubes , Female , Humans , PregnancyABSTRACT
The intratubar embryotransfer is a variation of the in vitro fertilization, where the procreated preimplantation-embryos are not transferred into the cavum uteri but the tube(s). The intracavitar embryotransfer is the only possibility to treat irreparable tubar sterility in contrary to sterility not caused by the tubes where the transfer can be effected directly into the tubes. Considering the gamete intrafallopian transfer (GIFT) one can assume, that the tubes are the best physiological place for the very young embryo's evolution. In opposition to the GIFT-method the embryotransfer into the tubes will be done only if a fertilization was proved: thereby superfluous operations can be avoided and additional diagnostic hints can be gained. The valuable indications are the following ones: idiopathic sterility, certain cases of andrological subfertility and immunological sterility; probably for some kinds of the last indication from the intratubar embryotransfer there will result a special area of application. It is reported about a viable pregnancy after in vitro fertilization and intratubar embryotransfer. The new method is supposed to be called IVF/IT-ET (i.e. in vitro fertilization and intratubar embryotransfer).
Subject(s)
Embryo Transfer/methods , Fertilization in Vitro/methods , Infertility, Female/therapy , Adult , Combined Modality Therapy , Fallopian Tubes , Female , Follow-Up Studies , Humans , Ovulation Induction/methods , PregnancyABSTRACT
In 48 patients with Hodgkin's disease, the naturally occurring isoagglutinins anti A1, anti A2 and anti B were investigated and their titer determined before commencement of radiotherapy as well as after the end of radiotherapy, and in a proportion of the patients six and twelve months after the end of radiotherapy. Radiotherapy resulted in a highly significant fall in the isoagglutinin titer amounting on average to one titer level compared to the initial value before radiotherapy. After the end of radiotherapy, there was no further fall of the isoagglutinin titers, but a marked reduction of the isoagglutinin titers was still shown six and twelve months later. A long lasting reduction of serum immunoglobulins after radiotherapy in patients with Hodgkin's disease is known from earlier investigations; this applies in particular to IgM. Since the isoagglutinins mainly belong to the IgM fraction, our finding of persistent reduction of isoagglutinin titers after radiotherapy correlates with the known long-lasting reduction of serum IgM concentration.
Subject(s)
Agglutinins/analysis , Hodgkin Disease/immunology , Isoantibodies/analysis , Radiotherapy, High-Energy/methods , ABO Blood-Group System/immunology , Agglutinins/radiation effects , Erythrocytes/immunology , Hodgkin Disease/radiotherapy , Humans , Immunoglobulin M/analysis , Immunoglobulin M/radiation effects , Isoantibodies/radiation effects , Time FactorsABSTRACT
Phytohemagglutinin-stimulated DNA-synthesis of lymphocytes was measured in 35 patients with Hodgkin's disease in continuous remission 1 to 8 years after intensive high-energy radiotherapy. In comparison to a normal control group we found there was no significant difference between the values of patients in complete remission and healthy subjects. We conclude that the extremely suppressed lymphocytic reactivity as measured by DNA-synthesis during irradiation may again reach normal values one or two years after radiotherapy.