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32. Long term effects of micro-surgical testicular sperm extraction on androgen status in patients with non obstructive azoospermia

Author

Comhaire Frank, De Sutter Petra, Van der Elst Josiane, Dhont Marc, Dekuyper Peter, Kerckhaert Wim, De Croo Ilse, Everaert Karel, Mahmoud Ahmed, and Lumen Nicolaas

Subjects
Diseases of the genitourinary system. Urology, RC870-923
Abstract

Abstract Background The aim of our study was to review the results of microsurgically performed testicular sperm extraction (TESE) and to evaluate its possible long term effects on serum testosterone (T). Methods We operated on 48 men (35 +/- 8 years) with non-obstructive azoospermia (NOA). If no spermatozoa were found following a micro epididymal sperm extraction (Silber et al., 1994) and testicular biopsy, testicular microdissection was performed or multiple microsurgical testicular biopsies were taken. The mean follow-up of the serum T was 2.4 +/- 1.1 years. Results Sperm was retrieved in 17/48 (35%) of the men. The per couple take home baby rate if sperm was retrieved was 4/17 (24%). Serum T decreased significantly at follow-up (p < 0.05) and 5/31 (16%) de novo androgen deficiencies developed Conclusion In patients with non-obstructive azoospermia in whom no spermatozoa were found following a micro epididymal sperm aspiration and a simple testicular biopsy, we were able to retrieve spermatozoa in 35% of the men. The take home baby rate was 24% among couples with spermatozoa present upon TESE. De novo androgen deficiency occurred in 16% of the male patients following TESE indicating that, in men with NOA, long term hormonal follow up is recommended after TESE.

Published
2006
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35. Clinical benefit of metaphase I oocytes

Author

Van der Elst Josiane, De Sutter Petra, Vanhoutte Leen, and Dhont Marc

Subjects
Gynecology and obstetrics, RG1-991, Reproduction, QH471-489
Abstract

Abstract Background We studied the benefit of using in vitro matured metaphase I (MI) oocytes for ICSI in patients with a maximum of 6 mature metaphase II (MII) oocytes at retrieval. Methods In 2004, 187 ICSI cycles were selected in which maximum 6 MII oocytes and at least one MI oocyte were retrieved. MI oocytes were put in culture to mature until the moment of ICSI, which was performed between 2 to 11 hours after oocyte retrieval (day 0). In exceptional cases, when the patient did not have any mature oocyte at the scheduled time of ICSI, MI oocytes were left to mature overnight and were injected between 19 to 26 hours after retrieval (day 1). Embryos from MI oocytes were chosen for transfer only when no other good quality embryos from MII oocytes were available. Outcome parameters were time period of in vitro maturation (IVM), IVM and fertilization rates, embryo development, clinical pregnancy rates, implantation rates and total MI oocyte utilization rate. Results The overall IVM rate was 43%. IVM oocytes had lower fertilization rates compared to in vivo matured sibling oocytes (52% versus 68%, P < 0.05). The proportion of poor quality embryos was significantly higher in IVM derived oocytes. One pregnancy and live birth was obtained out of 13 transfers of embryos exclusively derived from IVM oocytes. This baby originated from an oocyte that was injected after 22 hrs of IVM. Conclusion Fertilization of in vitro matured MI oocytes can result in normal embryos and pregnancy, making IVM worthwhile, particularly when few MII oocytes are obtained at retrieval.

Published
2005
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36. Tubal Hydatidiform Mole

Author

Depypere, Herman T., Dhont, Marc, Verschraegen-Spae, Marie R., and Coppens, Mieke

Published
1993

37. Predictive value of early embryonic cardiac activity for pregnancy outcome

Author

Merchiers, Erik H., Dhont, Marc, De Sutter, Paul A., Beghin, Cathy J., and Vanderkerckhove, Dirk A.

Subjects
Fetal heart rate -- Abnormalities, Fetal heart rate monitoring, Pregnancy, Complications of -- Diagnosis, Health
Abstract

Detection of a heartbeat in a fetus is an early indication of a viable pregnancy. Recent advances have improved the ability to detect and measure fetal heartbeats at even sooner. It has been reported that fetal heart rates normally are around 100 beats per minute at five weeks which gradually increases with time. On the other hand, abnormally slow rates have been associated with fetal death. Fetal heart rates were monitored between the fifth and 12th week of pregnancy in 170 pregnancies to establish normal development and to see if abnormally slow heart rates correlated with adverse outcomes of pregnancy. Results showed that 29 of the pregnancies ended in a miscarriage before the 12th week. Heartbeats were detected as early as five weeks three days of pregnancy and were always detected by the first day of the seventh week in normal pregnancies. In all instances where a heartbeat was not detected by six weeks one day, the pregnancy ended in miscarriage. In the normal pregnancies fetal heart rate increased from an average of 82 beats per minute during the fifth week to 156 beats per minute the ninth week. In cases where miscarriage occurred, but a heart rate was detected at some point, the rates never exceeded 100 beats per minute and a gradual decline in heart rate was detected in 10 cases. In fact, a gradual decline in heart rate was always indicative of miscarriage. A single measurement of abnormally low fetal heart rate was not a good predictor of outcome. These results suggest that fetal heart rates in normal pregnancies increase significantly between the fifth and ninth week of pregnancy and are always detectable by the beginning of the seventh week. A single observation of an abnormally slow heart rate does indicate a higher likelihood of adverse outcome, but is not a useful indicator for screening purposes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

41. Non-contraceptive benefits of oral contraceptives

Author

Dhont, Marc

Subjects
Open Access Journal of Contraception
Abstract

Marc Dhont Department of Obstetrics and Gynecology, Ghent University Hospital, Ghent, Belgium Abstract: The health benefits of the oral contraceptive (OC) pill are numerous and outweigh the risks of OC use. There are unintended but useful preventive side effects and potential therapeutic uses of OCs apart from contraception itself. Unequivocal evidence for the protective influence of combined OCs against ovarian and endometrial cancers, and colon cancer to a lesser extent, has been found. The pill also reduces the incidence of benign breast disease, functional ovarian cysts, pelvic inflammatory disease requiring hospitalization, ectopic pregnancy, and iron-deficiency anemia. The pill can be used for the treatment of several gynecologic disorders such as dysmenorrhea, irregular or excessive bleeding, acne, hirsutism, and endometriosis-associated pain, whether prescribed solely to treat these symptoms or prescribed to treat them in addition to providing contraception. These health benefits are often underestimated, as they get too little attention from the mass media. Keywords: the pill, estrogens, progestogens, safety, contraception

Published
2011

49. Comparison of outcome of pregnancy after intrauterine insemination (IUI) and in vitro fertilization (IVF)

Author

De Sutter, Petra, Veldeman, Liv, Kok, P., Szymczak, Nathalie, Van Der Elst, Josiane, Dhont, Marc, and Department of Embryology and Genetics

Subjects
intra-uterine insemination, perinatal outcome, IVF, pregnancy, female genital diseases and pregnancy complications, reproductive and urinary physiology
Abstract

INTRODUCTION: Pregnancy outcome after IVF has been shown to be worse than after spontaneous conception. There is discussion as to whether this results from the technique itself or the patient characteristics. This study compares pregnancy outcome after IVF and intra-uterine inemination (IUI) in a matched patient group. METHODS: Data were obtained from our IVF and IUI databases (1997-2001). Matching was performed for maternal age, parity and plurality, and 126 IUI pregnancies were compared with 126 IVF pregnancies. Outcome variables were pregnancy duration, birth weight, Caesarean section rates, preterm contraction rates, neonatal intensive care unit admission, Apgar score, blood loss rates and maternal hypertension. RESULTS: None of the analysed parameters was statistically different between the groups. CONCLUSION: This matched case-control study does not show different pregnancy outcomes after IVF and IUI. Since there is no reason to believe that the IUI technique in itself leads to an increased obstetric orneonatal risk, this study suggests that the worse pregnancy outcome after IVF as compared with spontaneous conceptions is due to the specific patient characteristics, rather than to the use of IVF itself.

Published
2005

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