ABSTRACT
Objetivo: Determinar la frecuencia con la que se producen embarazos espontáneos en las pacientes que están en tratamiento con un análogo de la GnRH en un protocolo largo de FIV y su posible repercusión sobre el curso del embarazo (teratogenicidad, aumento de la tasa de abortos). Pacientes y métodos: Entre enero de 1997 y junio de 1998 se realizaron en nuestro centro 690 ciclos de FIV utilizando un protocolo largo. Resultados: En siete pacientes no se produjo la menstruación y la prueba de embarazo fue positiva. Se suspendió el tratamiento con el análogo de la GnRH y se comenzó la administración de progesterona por vía vaginal. Hubo un aborto y el resto de los embarazos tuvieron un curso y un resultado normales. Conclusiones. A pesar de los numerosos datos experimentales que existen en animales, la administración de análogos de la GnRH en humanos no parece que aumente la teratogenicidad ni la tasa de abortos. Queda por aclarar el efecto de la luteólisis inducida por los análogos de la GnRH, así como el papel de la progesterona en las primeras etapas de la gestación (AU)
Subject(s)
Adult , Pregnancy , Female , Humans , Receptors, LHRH/analysis , Luteal Phase , Luteolytic Agents/administration & dosage , Luteolytic Agents/analysis , Progesterone/administration & dosage , Progesterone/therapeutic use , Gonadotropins/analysis , Gonadotropins/therapeutic use , Gonadotropins/administration & dosage , Pregnancy Complications/diagnosis , Clinical Protocols , Abortion/diagnosis , Retrospective Studies , Leuprolide/administration & dosage , Vagina/pathology , Vagina , Ovulation Induction/methodsABSTRACT
OBJECTIVE: To report two cases of monozygotic twinning after IVF-blastocyst transfer. DESIGN: Case report. SETTING: Private practice in an assisted reproductive technology clinic. PATIENT(S): Two women treated with IVF-ET at the blastocyst stage. INTERVENTION(S): Pituitary down-regulation with luteal leuprolide acetate, ovulation induction with gonadotropins, IVF, sequential culture, blastocyst transfer, and P for luteal support. MAIN OUTCOME MEASURE(S): Levels of hCG, pelvic ultrasound examination, amniocentesis, obstetric follow-up, and cesarean section. RESULT(S): Two intrauterine monozygotic twin pregnancies occurred after IVF and blastocyst transfer. One of them was complicated by fetus-to-fetus transfusion syndrome and was delivered preterm by cesarean section; the other woman had a normal pregnancy and vaginal delivery. CONCLUSION(S): Monozygotic multiple gestations may be increased in IVF blastocyst transfers. The potential obstetric complications of this type of pregnancy should be discussed with patients.
Subject(s)
Blastocyst/physiology , Embryo Transfer , Fertilization in Vitro , Twins, Monozygotic , Adult , Female , Humans , PregnancyABSTRACT
In order to analyze the role of 1,25(OH)2 D3 in bone and renal presentation forms of primary hyperparathyroidism (PHP), 61 patients, whose diagnosis had been confirmed surgically, were studied. An increase in serum 1,25(OH)2 D3 levels was found in PHP when compared to normal controls (49.1 +/- 2.8 pg/ml vs 34.1 +/- 1.4 pg/ml) (p less than 0.5). This increase directly correlates with serum alkaline phosphatase and creatinine clearance and inversely correlates with age. When patients were divided into two groups: A (n = 35) and B (n = 26) according to normal or increased 1,25(OH)2 D3 respectively, no difference was found in the clinical presentation forms of PHP. However, higher values of the biochemical parameters and bone remodeling markers were found in group B than in group A. This suggests the role of 1,25(OH)2 D3 as a modulator of metabolic activity in PHP and its possible therapeutic character in the clinical control of asymptomatic forms.
Subject(s)
Bone Diseases, Metabolic/etiology , Calcitriol/blood , Hyperparathyroidism/complications , Kidney Calculi/etiology , Adolescent , Adult , Aged , Bone Diseases, Metabolic/diagnosis , Bone Diseases, Metabolic/metabolism , Female , Humans , Hypercalcemia/diagnosis , Hypercalcemia/etiology , Hypercalcemia/metabolism , Hyperparathyroidism/diagnosis , Hyperparathyroidism/metabolism , Kidney Calculi/diagnosis , Kidney Calculi/metabolism , Male , Middle AgedABSTRACT
We have found a cellular immune defect (low CD4 T lymphocyte count, high CD8 T lymphocyte count and a low CD4/CD8 ratio) in 39 PDB patients. This finding is not correlated with the bone metabolic activity of the disease. There was an improvement in the cellular immune defect in fifteen patients after treatment with elcatonin. These changes could be related to the improvement in the metabolic derangement or else could be the consequence of an effect on altered immunity.
