1
|
Stepanow C, Naderer A, Alexopoulos J, Walch K, Wenzl R, Leithner K. Sexual health and sexual well-being of women with Mayer-Rokitansky-Kuester-Hauser syndrome after vaginal reconstruction: a qualitative analysis. J Sex Med 2023; 20:57-64. [PMID: 36897238 DOI: 10.1093/jsxmed/qdac011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/29/2022] [Accepted: 10/23/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Contradictory findings on sexual health in women with Mayer-Rokitansky-Kuester-Hauser syndrome (MRKHS) after vaginal reconstruction point toward the need for more profound assessment of this subject, particularly as it is still unclear what constitutes sexual well-being, especially genital self-image or sexual self-esteem, in women with MRKHS and neovagina. AIM The aim of this qualitative study was to assess individual sexual health and sexual well-being in the context of MRKHS after vaginal reconstruction, with an emphasis on genital self-image, sexual self-esteem, sexual satisfaction, and coping with MRKHS. METHODS Qualitative semistructured interviews were conducted with women with MRKHS after vaginal reconstruction (n = 10) with the Wharton-Sheares-George surgical method and a matched control group without MRKHS (n = 20). Women were surveyed about their previous and current sexual activities, perception of and attitudes toward their genitals, disclosure to others, coping with the diagnosis, and perception of surgery. Data were analyzed through qualitative content analysis and compared with the control group. OUTCOMES The primary outcomes of the study were major categories, such as sexual satisfaction, sexual self-esteem, genital self-image, and dealing with MRKHS, as well as subcategories related to the content analysis. RESULTS Although half the women in the present study indicated that they were coping well with their condition and were satisfied with sexual intercourse, most felt insecure about their neovagina, were cognitively distracted during intercourse, and showed low levels of sexual self-esteem. CLINICAL IMPLICATIONS A better understanding of expectations and uncertainties regarding the neovagina might help professionals to support women with MRKHS after vaginal reconstruction to increase sexual well-being. STRENGTHS AND LIMITATIONS This is the first qualitative study focusing on individual aspects of sexual well-being, especially sexual self-esteem and genital self-image, in women with MRKHS and neovagina. The qualitative study indicates good interrater reliability and data saturation. The limitations of this study include the inherent lack of objectivity resulting from the method but also the fact that all the patients had a particular surgical technique, consequently resulting in limited generalizability of these findings. CONCLUSIONS Our data indicate that integrating the neovagina into the genital self-image is a prolonged process that is essential for sexual well-being and should thus be the focus of sexual counseling.
Collapse
Affiliation(s)
- Clara Stepanow
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna A-1090, Austria
| | - Andrea Naderer
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna A-1090, Austria
| | - Johanna Alexopoulos
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna A-1090, Austria
| | - Katharina Walch
- Department of Obstetrics and Gynaecology, Medical University Vienna, Vienna A-1090, Austria
| | - Rene Wenzl
- Department of Obstetrics and Gynaecology, Medical University Vienna, Vienna A-1090, Austria
| | - Katharina Leithner
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna A-1090, Austria
| |
Collapse
|
2
|
Marschalek J, Ott J, Aitzetmueller M, Mayrhofer D, Weghofer A, Nouri K, Walch K. The impact of repetitive oocyte retrieval on the ovarian reserve: a retrospective cohort study. Arch Gynecol Obstet 2019; 299:1495-1500. [PMID: 30790103 PMCID: PMC6475517 DOI: 10.1007/s00404-019-05098-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/07/2019] [Indexed: 01/30/2023]
Abstract
PURPOSE To investigate a possible influence of repetitive micro-traumata on the ovaries in the course of oocyte retrieval during IVF/ICSI treatment on serum anti-Müllerian hormone (AMH) levels. METHODS The study included retrospectively collected data from women who underwent three or more consecutive IVF/ICSI treatments between 2007 and 2017. The primary endpoint of the study was to evaluate changes in serum AMH levels on cycle days 1-3 during the course of repetitive IVF/ICSI treatments. RESULTS A total of 125 patients were included in this study. Median AMH levels before the first, second and third IVF/ICSI cycles were 3.8 ng/mL (IQR 1.8-7.1), 3.3 ng/mL (IQR 1.8-6.1) and 3.0 ng/mL (IQR 1.6-5.3), respectively (p = n.s.). In patients who underwent IVF/ICSI due to polycystic ovary syndrome (PCOS), we found a significant decrease in AMH serum levels between the first [AMH 9.7 ng/mL (IQR 7.4-14.4)] and the third [AMH 5.3 ng/mL (IQR 3.3-10.4)] IVF/ICSI cycles (p = 0.026). When performing a generalized linear model, we found PCOS to be an independent predictor for serum AMH decrease during the course of three oocyte retrievals (p < 0.001). CONCLUSIONS When comparing the indications for IVF/ICSI, we observed a significant decrease in AMH serum levels after repetitive oocyte retrievals only in women with PCOS, while the decrease in AMH was not significant in patients with tubal factor, endometriosis, male factor and unexplained infertility. This finding leads us to hypothesize that repetitive micro-traumata on the ovarian cortex might diminish/normalize functional ovarian reserve in women with PCOS. Further prospective studies are highly warranted to allow firm conclusions.
Collapse
Affiliation(s)
- Julian Marschalek
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Johannes Ott
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Matthias Aitzetmueller
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Daniel Mayrhofer
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Andrea Weghofer
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Kazem Nouri
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Katharina Walch
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| |
Collapse
|
3
|
Heger A, Sator M, Walch K, Pietrowski D. Smoking Decreases Endometrial Thickness in IVF/ICSI Patients. Geburtshilfe Frauenheilkd 2018; 78:78-82. [PMID: 29375149 PMCID: PMC5778194 DOI: 10.1055/s-0043-123762] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 11/15/2017] [Accepted: 11/26/2017] [Indexed: 12/20/2022] Open
Abstract
Introduction
Smoking is a serious problem for the health care system. Many of the compounds identified in cigarette smoke have toxic effects on the fertility of both females and males. The purpose of this study was to determine whether smoking affects clinical factors during IVF/ICSI therapy in a single-center reproductive unit.
Material and Methods
In a retrospective study of 200 IVF/ICSI cycles, endometrial thickness and the outcome of IVF/ICSI therapy were analyzed.
Results
Endometrial thickness was significantly lower in smoking patients than in non-smoking patients (10.4 ± 1.5 mm vs. 11.6 ± 1.8 mm). Age was significantly higher in women who failed to conceive. The total dose of gonadotropins administered was significantly lower in pregnant patients and the highest pregnancy rate was achieved with an rFSH protocol. BMI and number of cigarettes smoked did not influence treatment outcomes in this study.
Conclusion
We showed that smoking has a negative effect on endometrial thickness on the day of embryo transfer. This may help to further explain the detrimental influence of tobacco smoke on implantation and pregnancy rates during assisted reproduction therapy.
Collapse
Affiliation(s)
- Anna Heger
- Psychiatrisches Zentrum Nordbaden, Wiesloch, Germany
| | - Michael Sator
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Katharina Walch
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Detlef Pietrowski
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
4
|
Untersmayr E, Jensen AN, Walch K. Sex hormone allergy: clinical aspects, causes and therapeutic strategies - Update and secondary publication. World Allergy Organ J 2017; 10:45. [PMID: 29308112 PMCID: PMC5745953 DOI: 10.1186/s40413-017-0176-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 12/06/2017] [Indexed: 12/05/2022] Open
Abstract
Sex hormone allergy as a clinical syndrome has been known for almost a century. Due to the diversity of clinical presentation regarding symptoms and disease patterns, the optimal patient care represents an enormous interdisciplinary challenge. Frequently, hypersensitivity reactions affect more than one sex hormone and double positive tests for estrogen and progesterone have been described. Since the menstrual cycle dependent symptoms range from skin afflictions, gynecological problems to non-specific reactions, different pathophysiological mechanisms seem likely. Various desensitization protocols are described as causal treatment options, but are rarely applied in clinical routine. Consequently, major research efforts with a quick translation of therapeutic interventions into clinical practice will be crucial to help affected patients in the future.
Collapse
Affiliation(s)
- E Untersmayr
- Institute for Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - A N Jensen
- AllergyCare - Allergy Diagnosis and Study Center Vienna, Vienna, Austria
| | - K Walch
- Department of Gynecological Endocrinology and Reproductive Medicine, Clinic of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
5
|
Promberger R, Walch K, Seemann R, Pils S, Ott J. A Retrospective Study on the Association between Thyroid Autoantibodies with β2-glycoprotein and Cardiolipin Antibodies in Recurrent Miscarriage. Iran J Allergy Asthma Immunol 2017; 16:72-76. [PMID: 28417627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Accepted: 02/25/2017] [Indexed: 06/07/2023]
Abstract
Etiologic factors for recurrent miscarriage (RM) include autoimmune diseases, the most frequently antiphospholipid syndrome and thyroiditis. Some women who suffer from RM might also have an altered immune system. We aimed to evaluate possible associations between anti-thyroid and anti-phospholipid antibodies in women with RM. In a retrospective case series 1 on 156 women with RM, major outcome parameters were antibodies against cardiolipin, β2-glycoprotein I, thyreoperoxidase (TPO-Ab), and thyroglobulin (TG-Ab). Significant (p<0.05) positive correlations were found between TPO-Ab and TG-Ab (r=0.577), TPO-Ab and IgG anti-cardiolipin antibodies (r=0.284), TPO-Ab and IgG anti- β2-glycoprotein I antibodies (r=0.196), and TG-Ab and IgG anti-cardiolipin antibodies (r=0.193), as well as between all types of anti-phospholipid antibodies. Women with both increased TPO-Ab and TG-Ab levels revealed higher (p<0.001) IgG anti-cardiolipin and IgG anti-β2-glycoprotein I antibodies. Anti-thyroid antibodies were linked to anti-phospholipid antibodies and should be in the focus of future research on RM.
Collapse
Affiliation(s)
- Regina Promberger
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Austria
| | - Katharina Walch
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Austria
| | - Rudolf Seemann
- Deparetment of Craniomaxillofacial and Oral Surgery, Medical University of Vienna, Austria
| | - Sophie Pils
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Austria
| | - Johannes Ott
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Austria
| |
Collapse
|
6
|
Hefler-Frischmuth K, Walch K, Hefler L, Tempfer C, Grimm C. Serologic markers of autoimmunity in women with recurrent pregnancy loss. Am J Reprod Immunol 2017; 77. [PMID: 28132421 DOI: 10.1111/aji.12635] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 01/03/2017] [Indexed: 02/06/2023] Open
Abstract
PROBLEM Various autoimmunologic mechanisms have been shown to be involved in recurrent pregnancy loss (RPL). This study aimed to evaluate whether women with RPL have elevated serum levels of common autoimmunologic parameters. METHOD OF STUDY Serum levels of antinuclear antibodies (ANAs) were measured in 114 women with RPL, and 107 healthy controls using a qualitative immunometric enzyme immunoassay, serum levels of IgG class autoantibodies against histone, IgG class autoantibodies against nucleosomes, and IgG class autoantibodies against double-stranded (ds) DNA were measured by quantitative enzyme immunoassays. RESULTS No differences were ascertained regarding serum levels of ANAs (P=.9), serum levels of antibodies against histones (P=.1), antibodies against nucleosomes (P=.4) and antibodies against dsDNA (P=.6) between women with RPL and healthy controls. No associations were found between serum levels and clinical characteristics of affected women. CONCLUSION Our study shows that serologic parameters of autoimmunity are not elevated in women with RPL and are not associated with clinical characteristics of affected women.
Collapse
Affiliation(s)
| | - Katharina Walch
- Department of General Gynecology and Gynecologic Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Lukas Hefler
- Department of Gynecology, Hospital of the Sisters of Charity Linz, Linz, Austria
| | - Clemens Tempfer
- Department of Obstetrics & Gynecology, Medical University of Bochum, Bochum, Germany
| | - Christoph Grimm
- Department of General Gynecology and Gynecologic Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
7
|
Malutan AM, Drugan C, Walch K, Drugan T, Ciortea R, Mihu D. The association between interleukin-10 (IL-10) −592C/A, −819T/C, −1082G/A promoter polymorphisms and endometriosis. Arch Gynecol Obstet 2016; 295:503-510. [DOI: 10.1007/s00404-016-4269-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 12/09/2016] [Indexed: 01/06/2023]
|
8
|
Nouri K, Walch K, Weghofer A, Imhof M, Egarter C, Ott J. The Impact of a Standardized Oral Multinutrient Supplementation on Embryo Quality in in vitro Fertilization/Intracytoplasmic Sperm Injection: A Prospective Randomized Trial. Gynecol Obstet Invest 2016; 82:8-14. [PMID: 27832646 DOI: 10.1159/000452662] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 10/14/2016] [Indexed: 11/19/2022]
Abstract
The role of micronutrients in fertility has recently gained increased attention. We aimed to test the impact of a standardized, multinutrient supplementation on outcomes after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in a pilot study. One hundred women undergoing IVF/ICSI were prospectively included and randomized to receive either a multinutrient supplementation named PROfertil® female that included folic acid, selenium, vitamin E, catechins, glycyrrhizin, diosgenin, damiana and omega-3-fatty acids (study group; n = 50), or 400 µg folic acid (control group; n = 50). Outcome parameters were embryo quality on day 3 after oocyte retrieval (good quality vs. poor quality) and the clinical pregnancy rate. In an intention-to-treat analyses, a higher rate of women with at least one good quality embryo (with at least 6 cells and a fragmentation rate <20%) were found for the study (29/50, 58.0%) compared to the control group (18/50, 36.0%; p = 0.045 in chi-square test; relative risk 1.611, 95% CI 1.009-2.597). In conclusion, a multinutrient supplementation that includes folic acid, selenium, vitamin E, catechins, glycyrrhizin, diosgenin, damiana and omega-3-fatty acids seems beneficial in terms of embryo quality.
Collapse
Affiliation(s)
- Kazem Nouri
- Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
| | | | | | | | | | | |
Collapse
|
9
|
Nouri K, Ott J, Lenart C, Walch K, Promberger R, Tempfer CB. Predictors of Paracentesis in Women with Severe Ovarian Hyperstimulation Syndrome: A Retrospective Cohort Study. Gynecol Obstet Invest 2016; 81:504-511. [PMID: 27399220 DOI: 10.1159/000443829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 01/05/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND To identify predictors of paracentesis in women with severe ovarian hyperstimulation syndrome (OHSS). METHODS In a retrospective cohort study, we assessed patient characteristics and outcome measures of women with severe OHSS Golan grade II/III from 1996 to 2010 using univariate and multivariate analyses with the number of paracenteses as the main outcome. RESULTS Three hundred ninety four women with OHSS Golan grade II (n = 40) and grade III (n = 354) were included in the study. Paracentesis was performed in 108/394 (27%) of these women. One paracentesis was performed in 63 (16%), 2 paracenteses in 26 (6%), and ≥3 paracenteses 19 (5%) women, respectively. No thrombotic or cerebrovascular morbidity occurred. The mortality of the cohort was 0/394 (0%). In a univariate analysis, late onset OHSS (p = 0.02), pregnancy (p < 0.001), human chorionic gonadotropin use (p = 0.02), ovarian diameter (p = 0.006), and elevated serum levels of alanine aminotransferase (p < 0.001), hematocrit (p < 0.001), leucocytes (p < 0.001), thrombocytes (p < 0.001), and uric acid (p < 0.001) were associated with paracentesis. In a multivariate logistic regression analysis, only alanine aminotransferase (OR 1.006; 95% CI 1.001-1.01) and hematocrit (OR 1.16; 95% CI 1.05-1.27) were independently associated with paracentesis. CONCLUSION Alanine aminotransferase and hematocrit at initial presentation are independent predictors of paracentesis.
Collapse
Affiliation(s)
- Kazem Nouri
- Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | | | | | | | | | | |
Collapse
|
10
|
Pateisky P, Pils D, Kuessel L, Szabo L, Walch K, Obwegeser R, Wenzl R, Yotova I. Die Bestimmung von sCD40L und CXCL-1 im Serum von Endometriosepatientinnen eignet sich nicht als Biomarkertest für Endometriose. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1582180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
11
|
Nouri K, Tempfer CB, Walch K, Promberger R, Dag S, Ott J. Predictive value of the time interval between embryo loading and transfer for IVF/ICSI success: a prospective cohort study. Reprod Biol Endocrinol 2015; 13:51. [PMID: 26022289 PMCID: PMC4455943 DOI: 10.1186/s12958-015-0048-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 05/21/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The influence of embryo loading time (ELT) and the time interval between embryo loading and embryo transfer (TIEL-ET) on the success of IVF/ICSI is unknown. METHODS In a prospective cohort study, we aimed to ascertain the influence of ELT and TIEL-ET on ongoing pregnancy rate (OPR) and life birth rate (LBR). Data from 603 consecutive embryo transfers between January 2008 and December 2013 were collected. A complete data set including the outcomes of interest OPR and LBR was available for 410 women. The primary outcome was IVF/ICSI success, defined as OPR and LBR. RESULTS We used univariate and multivariate logistic regression for analysis. In a multivariate analysis, age (odds ratio [OR] 0.94; 95% confidence interval [CI] 0.89-0.99), catheter type (OR 0.45; 95% CI 0.24-0.84), and uterine length (OR 1.03; 95% CI 1.01-1.06), but not ELT and TIELT-ET were independently associated with OPR. Regarding LBR, age (OR 0.93; 95% CI 0.88-0.98), catheter type (OR 0.41; 95% CI 0.22-0.79), and uterine length (OR 1.03; 95% CI 1.01-1.06), but not ELT and TIELT-ET were independent predictors. CONCLUSION We conclude that speed of embryo transfer is not critical for the success of IVF/ICSI. However, care should be taken to choose catheter types proven to be associated with a high success rate.
Collapse
Affiliation(s)
- Kazem Nouri
- Department of Obstetrics and Gynecology, Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Clemens B Tempfer
- Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany.
- Marienhospital Herne, Hoelkeskampring 40, 44625, Herne, Germany.
| | - Katharina Walch
- Department of Obstetrics and Gynecology, Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Regina Promberger
- Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Sema Dag
- Department of Obstetrics and Gynecology, Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Johannes Ott
- Department of Obstetrics and Gynecology, Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| |
Collapse
|
12
|
Leithner K, Naderer A, Hartung D, Abrahamowicz C, Alexopoulos J, Walch K, Wenzl R, Hilger E. Sexual and Psychosocial Functioning in Women with MRKHS after Neovaginoplasty According to Wharton-Sheares-George: A Case Control Study. PLoS One 2015; 10:e0124604. [PMID: 25901735 PMCID: PMC4406725 DOI: 10.1371/journal.pone.0124604] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 03/04/2015] [Indexed: 11/18/2022] Open
Abstract
Background Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) has a major impact on a woman’s psychological and sexual well-being. In most of the studies that addressed treatment techniques, postoperative sexual function was reported to be satisfactory; however, comparatively few studies have additionally provided an accurate analysis of psychosocial functions in MRKHS patients following different kinds of neovaginal treatment. This study is to evaluate sexual and psychosocial functioning after creation of a neovagina according to Wharton-Sheares-George in women with MRKHS. Methods We performed a case-control-study using multiple measures to assess sexual and psychosocial functioning. Ten MRKHS patients and 20 controls of a University hospital and tertiary center for pediatric and adolescent gynecology were assessed. The follow-up assessment comprised 6 standardized questionnaires (Female Sexuality Function Index, FSFI; Patient Health Questionnaire, PHQ; Brief Symptom Inventory, BSI; World Health Organization Quality of Life Assessment, WHOQoL-BREF; Parental Bonding Instrument, PBI; and a German questionnaire on body image). The main outcome measures were sexual function, psychological status, quality of life, body image, and parental bonding styles. Findings Sexual function, psychological status (including depressive and somatic symptoms), quality of life, and own-body experience were at least as good in operated MRKHS patients as in controls. In some measures (FSFI, PHQ-15, psychological domain of the WHOQoL-BREF, and BSI Positive Symptom Total), patients scored significantly better than controls. The results of the PBI indicated a close and sustainable mother-daughter-relationship in MRKHS patients. Conclusions We found no evidence for an impairment of sexual or psychosocial functioning in patients after neovaginoplasty according to Wharton-Sheares-George. MRKHS may not necessarily compromise sexual and psychological well-being, provided that the syndrome is properly managed by a multidisciplinary team of health professionals.
Collapse
Affiliation(s)
- Katharina Leithner
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria
- * E-mail:
| | - Andrea Naderer
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Dorothee Hartung
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Clara Abrahamowicz
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Johanna Alexopoulos
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Katharina Walch
- Department of Obstetrics and Gynaecology, Divison of Gynaecology and Gynaecological Oncology, Medical University Vienna, Vienna, Austria
| | - René Wenzl
- Department of Obstetrics and Gynaecology, Divison of Gynaecology and Gynaecological Oncology, Medical University Vienna, Vienna, Austria
| | - Eva Hilger
- Department of Neurology, Medical University Vienna, Vienna, Austria
| |
Collapse
|
13
|
Ott J, Mayerhofer K, Nouri K, Walch K, Seemann R, Kurz C. Perioperative androstenedione kinetics in women undergoing laparoscopic ovarian drilling: a prospective study. Endocrine 2014; 47:936-42. [PMID: 24740546 DOI: 10.1007/s12020-014-0267-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 04/02/2014] [Indexed: 01/31/2023]
Abstract
We evaluated perioperative androstenedione levels in laparoscopic ovarian drilling (LOD) for polycystic ovary syndrome (PCOS) and whether an intraoperative androstenedione change was predictive for spontaneous ovulation. In a prospective study, 21 anovulatory women with clomiphene citrate-resistant PCOS who underwent LOD and eight female controls who underwent diagnostic laparoscopy for infertility were included. Perioperatively, blood was drawn one day before surgery, directly before skin incision, ten minutes after surgery, and after two days. Within three months, spontaneous ovulation occurred in 15 women (71.4 %). For both the PCOS and the control group, an androstenedione increase was found from one day before surgery to skin incision (p < 0.05). In PCOS women, there was an intraoperative androstenedione decrease (median 3.5, IQR 2.2-4.8 vs. median 2.6, IQR 1.4-2.6 ng/ml, p = 0.002). In multivariate analysis, only higher preoperative androstenedione (odds ratio, OR 6.53) and luteinizing hormone levels (OR 7.31), as well as secondary infertility (OR 5.40), were associated with higher rates of postoperative spontaneous ovulation (p < 0.001). Androstendione declines significantly during LOD. However, intraoperative kinetics are not useful for the prediction of spontaneous ovulation after LOD, in contrast to preoperative androstenedione and LH levels, as well as a history of previous pregnancies.
Collapse
Affiliation(s)
- Johannes Ott
- Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria,
| | | | | | | | | | | |
Collapse
|
14
|
Nouri K, Huber D, Walch K, Promberger R, Buerkle B, Ott J, Tempfer CB. Fertility awareness among medical and non-medical students: a case-control study. Reprod Biol Endocrinol 2014; 12:94. [PMID: 25260495 PMCID: PMC4182859 DOI: 10.1186/1477-7827-12-94] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 09/13/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To compare the understanding and perceptions of fertility issues among medical and non-medical University students. METHODS In a prospective case-control study, using a 43 item questionnaire with 5 sections and 43 questions regarding personal data (8 questions), lifestyle factors (9 questions), plans on having children (5 questions), age and fertility (5 questions), and lifestyle and fertility (16 questions), knowledge of fertility and influencing factors, desired age at commencement and completion of childbearing, among male and female medical and non-medical students in their first academic year at Vienna University, Vienna, Austria were evaluated. RESULTS 340 students were included. 262/340 (77%) participants planned to have children in the future. Medical students (n = 170) planned to have fewer and later children and had a higher awareness of the impact of age on fertility than non-medical students (n = 170; estimated knowledge probability 0.55 [medical students] vs. 0.47 [non-medical students]; F (1, 336) = 5.18 and p = .024 (η p = .015). Gender did not independently affect estimated knowledge probability (F (1, 336) = 1.50 and p = .221). More female and male medical students had a positive attitude towards Assisted Reproductive Technology in case of infertility than non-medical students (47 and 55% vs. 23 and 29%, respectively; p = <.001). Medical students had a healthier lifestyle than non-medical students. A healthy lifestyle and female gender were associated with higher fertility awareness. CONCLUSIONS Medical students have a higher awareness of fertility issues than non-medical students. Choice of academic study, gender, and personal life style are important factors affecting fertility awareness. These data may be helpful to address knowledge gaps among young non-medical Academics.
Collapse
Affiliation(s)
- Kazem Nouri
- />Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
- />Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Dagmar Huber
- />Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
- />Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Katharina Walch
- />Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
- />Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Regina Promberger
- />Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
- />Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
- />Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Bernd Buerkle
- />Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany
| | - Johannes Ott
- />Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
- />Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Clemens B Tempfer
- />Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
15
|
Nouri K, Tempfer CB, Lenart C, Windischbauer L, Walch K, Promberger R, Ott J. Predictive factors for recovery time in patients suffering from severe OHSS. Reprod Biol Endocrinol 2014; 12:59. [PMID: 24996451 PMCID: PMC4096731 DOI: 10.1186/1477-7827-12-59] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 07/01/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate predictive factors for recovery time from severe ovarian hyperstimulation syndrome (OHSS). METHODS In a retrospective cohort study, 201 women who were hospitalized for severe OHSS were included. Patients with recurrent OHSS were excluded. All the patients received standardized treatment including intravenous hydration, plasma volume expansion, human albumin, furosemid, subcutaneous heparin, and paracentesis if necessary. The main outcome parameter was recovery time from OHSS. Recovery was defined if a morning hematocrit <40%, rebalance of electrolytes, and serum creatinine <1 mg/dL were reached during the standardized therapy and the patient had not suffered from abdominal pain and discomfort at least for one day without any OHSS-specific infusions or medications. RESULTS Pregnant patients (n=80, 39.8%) revealed a longer median duration until recovery than non-pregnant patients (n=121, 60.2%; 10 days, IQR 7-13, vs. 8 days, IQR 6-10, respectively; p=0.001). In a generalized linear model, presence of polycystic ovary syndrome before controlled ovarian hyperstimulation (beta=0.3342 +/- 0.1335, p=0.012) and use of hCG for ovulation induction (beta=0.222 +/- 0.1389, p=0.048) were associated with a longer recovery time in pregnant patients. In non-pregnant patients, none of the tested factors was associated with recovery time. CONCLUSIONS Pregnant patients with severe OHSS needed a significantly longer recovery time than non-pregnant patients. In pregnant patients, presence of polycystic ovary syndrome and ovulation induction with hCG were associated with longer recovery times.
Collapse
Affiliation(s)
- Kazem Nouri
- Department of Obstetrics and Gynecology, Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Clemens B Tempfer
- Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany
| | - Christian Lenart
- Department of Obstetrics and Gynecology, Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Lisa Windischbauer
- Department of Obstetrics and Gynecology, Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Katharina Walch
- Department of Obstetrics and Gynecology, Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Regina Promberger
- Department of Obstetrics and Gynecology, Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
- Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Johannes Ott
- Department of Obstetrics and Gynecology, Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| |
Collapse
|
16
|
Ott J, Walch K, Tempfer CBA, Promberger R, Kurz C, Nouri K. Die schwere Ovarialblutung nach transvaginaler Ovarialpunktion bei IVF: Retrospektive Fallserie und gepoolte Analyse zu Inzidenz, Verlauf und Managment. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1374737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
17
|
Walch K, Kernstock T, Poschalko-Hammerle G, Gleiß A, Staudigl C, Wenzl R. Prevalence and severity of cyclic leg pain in women with endometriosis and in controls - effect of laparoscopic surgery. Eur J Obstet Gynecol Reprod Biol 2014; 179:51-7. [PMID: 24965980 DOI: 10.1016/j.ejogrb.2014.05.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 03/05/2014] [Accepted: 05/23/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE In addition to dysmenorrhea, dyspareunia, and subfertility, pain in the lower extremities has been described to be a further complaint in women affected by endometriosis, and lysis of nerve entrapment was thought to be associated with amelioration of leg pain. Therefore, we aimed to compare the prevalence of cyclic leg pain and pain intensity between women with endometriosis and without endometriosis, and to evaluate the effect of laparoscopic surgery. STUDY DESIGN Forty-four women with endometriosis and 58 controls were included in a prospective, controlled clinical trial at a University hospital/tertiary referral center. Participants were asked to complete questionnaires the day before and six to nine weeks after laparoscopy. The prevalence and intensity of leg pain and improvement after laparoscopic surgery, quantified according to a visual analog scale (VAS) score, were evaluated. We also recorded involvement of dermatomes, the presence and intensity of dysmenorrhea, and correlations between age, stage of endometriosis (rAFS-score), and preoperative VAS scores. RESULTS Before surgery, more women were affected by leg pain in the endometriosis group, compared to the control group (45.5% and 25.9%, respectively). Preoperative VAS scores for leg pain, however, were not significantly different between the two groups. A moderate correlation in the preoperative VAS scores between leg pain and dysmenorrhea was observed. After laparoscopy, we found a significant improvement in leg pain intensity in both groups. The mean difference in the VAS score for pain reduction between the study group and the control group was 0.74 (95% CI: -0.61-2.08), which was not statistically significant. CONCLUSIONS The prevalence of leg pain is increased in endometriosis, while leg pain intensity is not, compared to women without endometriosis. Laparoscopic surgery-even without preparation and decompression of nerve tissue-is associated with an improvement in pain intensity in women with endometriosis, as well as in the group without endometriosis.
Collapse
Affiliation(s)
- Katharina Walch
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
| | - Tamara Kernstock
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - Gunda Poschalko-Hammerle
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - Andreas Gleiß
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Austria
| | - Christine Staudigl
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - René Wenzl
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| |
Collapse
|
18
|
Nouri K, Ott J, Stoegbauer L, Pietrowski D, Frantal S, Walch K. Obstetric and perinatal outcomes in IVF versus ICSI-conceived pregnancies at a tertiary care center--a pilot study. Reprod Biol Endocrinol 2013; 11:84. [PMID: 24004836 PMCID: PMC3844416 DOI: 10.1186/1477-7827-11-84] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 08/28/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although most pregnancies after IVF result in normal healthy outcomes, an increased risk for a number of obstetric and neonatal complications, compared to naturally conceived pregnancies, has been reported. While there are many studies that compare pregnancies after assisted reproductive techniques with spontaneously conceived pregnancies, fewer data are available that evaluate the differences between IVF and ICSI-conceived pregnancies. The aim of our present study was, therefore, to compare obstetric and perinatal outcomes in pregnancies conceived after in vitro fertilization (IVF) versus intracytoplasmatic sperm injection (ICSI). METHODS Three-hundred thirty four women who had become pregnant after an IVF or ICSI procedure resulted in a total of 530 children referred between 2003 und 2009 to the Department of Obstetrics and Gynecology of the Medical University of Vienna, a tertiary care center, and were included in this retrospective cohort study. We assessed maternal and fetal parameters in both groups (IVF and ICSI). The main study outcomes were preterm delivery, the need for neonatal intensive care, and congenital malformations. Moreover, we compared the course of pregnancy between both groups and the occurrence of complications that led to maternal hospitalization during pregnancy. RESULTS There were 80 children conceived via ICSI and 450 children conceived via IVF.Mean gestational age was significantly lower in the ICSI group (p = 0.001). After ICSI, the birth weight (p = 0.008) and the mean APGAR values after 1 minute and after 10 minutes were lower compared to that of the IVF group (p = 0.016 and p = 0.047, respectively). Moreover, ICSI-conceived children had to be hospitalized more often at a neonatal intensive care unit (p = 0.004). There was no difference in pH of the umbilical artery or in major congenital malformations between the two groups. Pregnancy complications (i.e., premature rupture of membranes, cervical insufficiency, and premature uterine contractions) and the need for maternal hospitalization during pregnancy were found significantly more often after IVF (p = 0.0016 and p = 0.0095, respectively), compared to the ICSI group. CONCLUSIONS When comparing IVF versus ICSI-conceived pregnancies at a tertiary care center, we found the course of pregnancy to be more complicated after IVF, whereas the primary fetal outcome seemed to be better in this group than after ICSI treatment.
Collapse
Affiliation(s)
- Kazem Nouri
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Johannes Ott
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Lucia Stoegbauer
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Detlef Pietrowski
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Sophie Frantal
- Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Statistics of the Medical University of Vienna, Vienna, Austria
| | - Katharina Walch
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
19
|
Ott J, Mayerhofer K, Vytiska-Binstorfer E, Walch K, Huber JC, Kurz C. Intraoperative Androstendion-Kinetik bei Laparoskopischer Ovarialstichelung. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1278560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
20
|
Hefler-Frischmuth K, Walch K, Huebl W, Baumuehlner K, Tempfer C, Hefler L. Serologic markers of autoimmunity in women with polycystic ovary syndrome. Fertil Steril 2010; 93:2291-4. [DOI: 10.1016/j.fertnstert.2009.01.056] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2008] [Revised: 01/05/2009] [Accepted: 01/06/2009] [Indexed: 11/17/2022]
|
21
|
Walch K, Hefler L, Nagele F. Oral dydrogesterone treatment during the first trimester of pregnancy: The prevention of miscarriage study (PROMIS). A double-blind, prospectively randomized, placebo-controlled, parallel group trial. J Matern Fetal Neonatal Med 2009; 18:265-9. [PMID: 16318978 DOI: 10.1080/14767050500246243] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE A planned study to test the hypothesis that dydrogesterone given during the first trimester of pregnancy can positively influence the immune system of women suffering from recurrent miscarriages and thereby lead to successful pregnancies. The primary objective is to show whether the administration of dydrogesterone during the first trimester of pregnancy increases the release of progesterone-induced blocking factor (PIBF) and causes a shift from Th-1 cytokines to Th-2 cytokines. Further objectives are an analysis of pregnancy outcome and to investigate the tolerability and safety of dydrogesterone use during pregnancy. METHODS A prospectively randomized, placebo-controlled study of 20 mg dydrogesterone per day during the first trimester of pregnancy in women aged between 18 and 38 and with a history of idiopathic recurrent miscarriage. Start of treatment will be after ovulation. The study will be conducted in a two-stage adaptive design, starting with a sample size of 20 patients per treatment group. The concentrations of Th-1 and Th-2 cytokines in the serum and PIBF in the urine will be measured. Efficacy will be measured primarily by the ratio IFNgamma/IL-10. CONCLUSION The results of this study will contribute to the discussion of a current concept of immunomodulation in pregnancy and potentially provide a treatment option for patients suffering from recurrent miscarriage.
Collapse
Affiliation(s)
- Katharina Walch
- Department of Obstetrics and Gynecology, Division of Gynecological Endocrinology and Reproductive Medicine, University of Vienna School of Medicine, Vienna, Austria.
| | | | | |
Collapse
|
22
|
Walch K, Kolbus A, Hefler-Frischmuth K. Polymorphisms of the endothelial nitric oxide synthase gene in premenopausal women with polycystic ovary syndrome. Maturitas 2008; 61:256-9. [PMID: 18804337 DOI: 10.1016/j.maturitas.2008.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Revised: 08/05/2008] [Accepted: 08/06/2008] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To investigate the association of two common genetic polymorphisms of the gene encoding for endothelial nitric oxide synthase (Nos3), the enzyme catalyzing the production of nitric oxide (NO), with occurrence of the polycystic ovary syndrome (PCOS). METHODS In a prospective case-control study, we analyzed 2 polymorphisms of the Nos3 gene cluster (Nos 3 exon 7 Glu298Asp and 27-base pair repeat in intron 4 of Nos3) in a series of 210 premenopausal Caucasian women with PCOS and 171 healthy controls using pyrosequencing and PCR, respectively. Women completed a detailed questionnaire and underwent a peripheral venous puncture, ultrasonography, and a standardized oral glucose tolerance test (OGTT). RESULTS Genotype frequencies were not significantly different among women with PCOS and controls for the exon 7Nos3 and the intron 4Nos3 polymorphism (p=0.3 and 0.2, respectively). CONCLUSIONS In our series, two common polymorphisms of the Nos3 gene cluster were not associated with occurrence of PCOS.
Collapse
Affiliation(s)
- Katharina Walch
- Elisabeth Vytiska-Binstorfer, Johannes Huber, Konstantin Baumühlner, René Wenzl, Fritz Nagele, Lukas Hefler, Austria.
| | | | | |
Collapse
|
23
|
Walch K, Unfried G, Huber J, Kurz C, Trotsenburg MV, Wenzl R. Behandlungsmöglichkeit der symptomatischen Endometriose mit Implanon®. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-983617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
24
|
Kolbus A, Walch K, Nagele F, Wenzl R, Unfried G, Huber JC. Interleukin-1 alpha but not interleukin-1 beta gene polymorphism is associated with polycystic ovary syndrome. J Reprod Immunol 2006; 73:188-193. [PMID: 16965825 DOI: 10.1016/j.jri.2006.08.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2006] [Revised: 08/03/2006] [Accepted: 08/04/2006] [Indexed: 11/19/2022]
Abstract
Interleukin-1 (IL1) is a multifunctional cytokine and IL1-mediated inflammatory processes have been proposed to influence the processes of ovulation, fertilization and implantation. All these parameters are also affected in women with polycystic ovary syndrome (PCOS). This study investigated the association of common polymorphisms of the interleukin-1 genes (IL1A and IL1B) with the occurrence and clinical characteristics of PCOS. We evaluated one polymorphism of the IL1alpha gene (IL1A C[-889]T) and two of the IL1beta gene (IL1B promoter C[-511]T and IL1B exon 5 position +3953) in 105 Caucasian women with PCOS and 102 healthy Caucasian controls by polymerase chain reaction. For the mutated IL1A allele, allele frequencies in women with PCOS and controls were 60% and 46%, respectively, versus 40% and 54%, respectively, for the wild type allele. Allele frequencies in women with PCOS and controls were 59% (54%) and 61% (41%), respectively, for the mutated IL1B promoter (mutated IL1B exon 5) and 41% (46%) and 39% (59%), respectively, for the wild type alleles. Presence of a polymorphism in the interleukin-1alpha but not the interleukin-1beta gene was found to correlate with the occurrence of PCOS (p=0.04; odds ratio 1.8). The serum level of FSH and subsequent LH/FSH ratio correlated with the polymorphism of IL1A within the PCOS group (p=0.005 and 0.01, respectively). We have shown that a common polymorphism of the interleukin-1alpha but not interleukin-1beta gene is associated with the presence of PCOS and with clinical parameters of women affected by this condition.
Collapse
Affiliation(s)
- Andrea Kolbus
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
| | - Katharina Walch
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Friedrich Nagele
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - René Wenzl
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Gertrud Unfried
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Johannes C Huber
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
25
|
Tempfer CB, Kurz C, Bentz EK, Unfried G, Walch K, Czizek U, Huber JC. A combination treatment of prednisone, aspirin, folate, and progesterone in women with idiopathic recurrent miscarriage: a matched-pair study. Fertil Steril 2006; 86:145-8. [PMID: 16716321 DOI: 10.1016/j.fertnstert.2005.12.035] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2005] [Revised: 12/10/2005] [Accepted: 12/10/2005] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare a combination treatment of prednisone, aspirin, folate, and progesterone with no treatment in women with idiopathic recurrent miscarriage (IRM). DESIGN Matched-pair study. SETTING Academic research institution. SUBJECT(S) Women with a history of IRM, defined as three or more consecutive miscarriages before 20 weeks' gestation without associated anatomic, cytogenetic, hormonal, and infectious pathologies or antiphospholipid syndrome. INTERVENTION(S) Eighty of 210 eligible women consented to participate and were treated with prednisone (20 mg/d) and progesterone (20 mg/d) for the first 12 weeks of gestation, aspirin (100 mg/d) for 38 weeks of gestation, and folate (5 mg every second day) throughout their pregnancies. Fifty of 80 women became pregnant; they were compared with 52 women with IRM (matched for age and number of miscarriages), who became pregnant without treatment during the same observation period. MAIN OUTCOME MEASURE(S) Live birth rate, complications of pregnancy, such as preeclampsia, premature birth, and intrauterine growth restriction, and therapy-related side effects. RESULT(S) The overall live birth rates of the treatment and control groups were 77% (40 of 52) and 35% (18 of 52) (P=.04). The rates of first and second trimester miscarriage among the treatment and control groups were 19% (10 of 52) and 0 (0 of 52), and 63% (33 of 52) and 2% (1 of 52), respectively (P=.09 and P=1.0, respectively). The median gestational age at birth and median birth weight did not differ between the groups. We observed two and three cases of premature birth among the treatment and control groups, respectively (P=.3) and no cases of intrauterine growth restriction and Cushing's disease. Of 80 women who started treatment, one woman had an ectopic pregnancy and one woman terminated her pregnancy due to fetal chromosome aberration (trisomy 18). Three women stopped treatment due to nausea, depression, and tachycardia. CONCLUSION(S) A combination treatment of prednisone, aspirin, folate, and progesterone is associated with a higher live birth rate compared with no treatment in women with IRM.
Collapse
Affiliation(s)
- Clemens B Tempfer
- Department of Gynecologic Endocrinology and Reproductive Medicine, University of Vienna School of Medicine, Vienna, Austria.
| | | | | | | | | | | | | |
Collapse
|
26
|
Kolbus A, Walch K, Szabo L, Huber JC, Nagele F, Unfried G. A polymorphism of the interleukin 1 receptor antagonist is not associated with polycystic ovary syndrome in Caucasian women. Fertil Steril 2006; 85:523-5. [PMID: 16595248 DOI: 10.1016/j.fertnstert.2005.07.1317] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2004] [Revised: 07/26/2005] [Accepted: 07/26/2005] [Indexed: 01/05/2023]
Abstract
In a prospective case-control study we investigated the association of a common polymorphism of the interleukin 1 receptor antagonist gene (IL-1 RA) with the occurrence and the clinical characteristics of polycystic ovary syndrome (PCOS). Allele frequencies did not vary statistically significantly among women with PCOS and healthy controls or within the PCOS group with respect to their clinical characteristics.
Collapse
Affiliation(s)
- Andrea Kolbus
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
| | | | | | | | | | | |
Collapse
|
27
|
Abstract
Oral contraceptives (OCs) have been shown to effectively treat acne. Clinical trials of various doses of ethinyl estradiol (EE) combined with progestins such as levonorgestrel, desogestrel, norgestimate, gestodene, cyproterone acetate and drospirenone in monophasic, triphasic and combiphasic formulations used to treat acne in women are reviewed here. Open-label and comparative studies beginning in the 1980s were the first to demonstrate objective and subjective reductions in the incidence of acne, severity of existing acne and seborrhea. Placebo-controlled trials have corroborated these findings with a trend toward effective acne treatment with declining doses of EE. Significant reductions in total, inflammatory and noninflammatory lesions compared with placebo have been demonstrated with an OC containing the low dose of 20 microg of EE. Collectively, these findings support the use of low-dose OCs for the treatment of acne.
Collapse
Affiliation(s)
- Johannes Huber
- Division of Gynecology and Infertility Treatment, Department of Obstetrics and Gynecology, Medical University Vienna, A-1090 Vienna, Austria.
| | | |
Collapse
|
28
|
Walch K, Grimm C, Nagele F, Huber J, Wölfler M, Vytiska-Binstorfer E, Unfried G, Hefler L. Impaired glucose tolerance is associated with changes in clinical and biochemical parameters in women with polycystic ovary syndrome. Acta Obstet Gynecol Scand 2006; 85:869-73. [PMID: 16817088 DOI: 10.1080/00016340500342938] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND To characterize the phenotype of women with polycystic ovary syndrome with and without impaired glucose tolerance by determining various polycystic ovary syndrome-associated clinical and laboratory parameters. METHODS In a prospective clinical study, we evaluated a series of 102 Caucasian women with polycystic ovary syndrome. Women completed a detailed questionnaire and underwent a standardized oral glucose tolerance test. Various polycystic ovary syndrome-associated laboratory values such as hormonal and metabolic parameters were determined in these women and correlated to clinical data and the presence/absence of impaired glucose tolerance. Furthermore, the insulin resistance was calculated using the homeostasis model assessment index and correlated with clinical and biochemical parameters. RESULTS Eighty-eight (86.3%) and 14 (13.7%) women were diagnosed as having non-impaired glucose tolerance and impaired glucose tolerance, respectively. Presence of impaired glucose tolerance was associated with an increased body mass index, increased body weight, elevated serum levels of bioavailable testosterone, insulin like growth factor-1, insulin, HbA1c, leucocytes, uric acid, alkaline phosphatase, hepatic C-reactive protein, and decreased serum levels of sex-hormone binding globulin. No association was ascertained with subfertility, hirsutism, and menstrual irregularities. We ascertained a positive correlation between the homeostasis model assessment index and body mass index, body weight, alkaline phosphatase, and hepatic C-reactive protein. CONCLUSIONS Impaired glucose tolerance seems to be associated with a specific phenotype within polycystic ovary syndrome. This phenotype is more likely to present with biochemical parameters similar to an inflammatory reaction and a metabolic disorder.
Collapse
Affiliation(s)
- Katharina Walch
- Department of Obstetrics and Gynecology, Division of Gynecological Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria.
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Walch K, Nagele F, Zeillinger R, Vytiska-Binstorfer E, Huber JC, Hefler LA. A polymorphism in the matrix metalloproteinase-1 gene promoter is associated with the presence of polycystic ovary syndrome in Caucasian women. Fertil Steril 2005; 83:1565-7. [PMID: 15866608 DOI: 10.1016/j.fertnstert.2004.11.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2004] [Revised: 11/02/2004] [Accepted: 11/02/2004] [Indexed: 11/20/2022]
Abstract
A common -1607 GG/G polymorphism of the matrix metalloproteinase-1 (MMP1) gene promoter was investigated in a series of Caucasian women with polycystic ovary syndrome (PCOS) and controls, by direct sequencing. In this prospective case-control study, the odds for women with at least one mutant GG allele of the MMP1 promoter to be diagnosed with PCOS was 2.7.
Collapse
Affiliation(s)
- Katharina Walch
- Department of Obstetrics and Gynecology, Medical University Vienna, Vienna, Austria.
| | | | | | | | | | | |
Collapse
|
30
|
Abstract
Thrombophilia has been described to be involved in the pathogenesis of idiopathic recurrent miscarriage (IRM). We investigated the association between IRM and a C-->T polymorphism at nucleotide 46 in the 5'-untranslated region of the coagulation factor XII (FXII) gene. Two hundred and twelve women with a history of IRM and 149 healthy controls were tested by a mutagenically separated polymerase chain reaction assay (MS PCR). Allele and genotype frequencies were not significantly different between the study and the control groups. Our data suggest that the FXII gene is not a candidate gene for this condition.
Collapse
Affiliation(s)
- Katharina Walch
- Department of Gynecologic Endocrinology and Reproductive Medicine, University of Vienna School of Medicine, Vienna, Austria
| | | | | | | | | | | |
Collapse
|
31
|
Walch K, Grimm C, Huber JC, Nagele F, Kolbus A, Hefler LA. A polymorphism of the plasminogen activator inhibitor-1 gene promoter and the polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2005; 123:77-81. [PMID: 16102886 DOI: 10.1016/j.ejogrb.2005.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2005] [Revised: 05/31/2005] [Accepted: 07/04/2005] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the association of a common 5G/4G polymorphism of the plasminogen activator inhibitor-1 gene (PAI1) with occurrence and clinical characteristics of the polycystic ovary syndrome (PCOS). STUDY DESIGN In a case-control study, we evaluated a series of 106 Caucasian women with PCOS and 102 healthy controls. Women completed a detailed questionnaire and underwent a peripheral venous puncture, ultrasonography, and a standardized oral glucose tolerance test (OGTT). The PAI1 gene promoter polymorphism was evaluated using PCR. RESULTS Allele and genotype frequencies were not significantly different among women with PCOS and controls (P=0.3 and 0.6, respectively). In women with PCOS, presence of the 5G/4G polymorphism of PAI1 was not associated with changes in serum hormone levels or with clinical characteristics. CONCLUSIONS The 5G/4G polymorphism of the PAI1 promoter is not associated with occurrence and phenotype of the PCOS.
Collapse
Affiliation(s)
- Katharina Walch
- Department of Obstetrics and Gynecology, Division of Gynecological Endocrinology and Infertility Treatment, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
| | | | | | | | | | | |
Collapse
|
32
|
Grimm C, Tempfer CB, Walch K, Reinthaller A, Tomovski C, Huber JC, Leodolter S, Hefler LA. The influence of a Vitamin D receptor gene polymorphism on the timing of female reproductive functions in humans. Maturitas 2005; 51:135-9. [PMID: 15917153 DOI: 10.1016/j.maturitas.2004.06.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2003] [Revised: 04/28/2004] [Accepted: 06/03/2004] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate the association between a common polymorphism of the Vitamin D receptor gene (VDR) and the timing of female reproductive functions in humans. METHODS One thousand fifty-eight consecutive women were included in this cross-sectional study. We analyzed the intron 8 Bsm I restriction fragment length polymorphism (RFLP) of VDR on chromosome 12q using a microarray-based system. RESULTS The presence of the VDR polymorphism did not influence the timing of menarche and natural menopause and was not associated with the number of spontaneous abortions, full term pregnancies (FTP) as well as the total number of pregnancies. Of note, women with at least one mutant allele of VDR were at a significantly decreased risk for experiencing surgical menopause (odds ratio [OR] 0.65, 95% confidence interval [CI], 0.46-0.92, P = 0.02). Smoking and a body mass index (BMI) > 25 were associated with an earlier natural menopause and an increased risk for surgical menopause, respectively. CONCLUSIONS While no association of a common polymorphism of VDR with the timing of menarche and menopause was ascertained, we found the presence of at least one mutant allele of VDR to be associated with a decreased risk of experiencing surgical menopause, i.e., premenopausal hysterectomy, in a large series of Caucasian women.
Collapse
Affiliation(s)
- Christoph Grimm
- Department of Obstetrics and Gynecology, University of Vienna Medical School, Vienna, Austria
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Worda C, Walch K, Sator M, Eppel W, Tempfer CB, Schneeberger C, Huber JC, Hefler LA. The influence of Nos3 polymorphisms on age at menarche and natural menopause. Maturitas 2004; 49:157-62. [PMID: 15474760 DOI: 10.1016/j.maturitas.2004.01.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2003] [Revised: 12/09/2003] [Accepted: 01/07/2004] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Deficiency of the gene encoding endothelial nitric oxide synthase, i.e. Nos3, has been reported to be associated with late menarche, reduced ovulation rates, fewer deliveries, and earlier onset of menopause in a mouse model. METHODS We assessed the Glu298Asp and the T-786C polymorphisms of Nos3 in 87 consecutive healthy postmenopausal women by pyro- and capillary-sequencing, respectively. Results were correlated with age at menarche and natural menopause, number of miscarriages and live births, as well as body mass index (BMI) and smoking habits. RESULTS Allelic frequencies of the Glu298Asp polymorphism of Nos3 were 121 (69.5%) and 53 (30.5%) for the wild-type G allele and the mutant T allele, respectively. Forty-one women (47.1%) were homozygote wild-type (G/G), 39 (44.9%) were heterozygote (G/T), and 7 (8.0%) were homozygote mutant (T/T). Allelic frequencies of the T-786C polymorphism of Nos3 were 105 (60.6%) and 69 (39.4%) for the wild-type T allele and the mutant C allele, respectively. Thirty-three women (38.0%) were homozygote wild-type (T/T), 39 (45.1%) were heterozygote (T/C), and 15 (16.9%) were homozygote mutant (C/C). Presence of at least one mutant allele of the Glu298Asp or the T-786C polymorphisms of Nos3 were not associated with age at menarche, natural menopause, and number of miscarriages and deliveries. BMI above 27 kg/m2 and smoking were associated with earlier onset of natural menopause (47.8 years versus 50.2 years (P = 0.01) and 46.8 years versus 49.8 years (p = 0.02)). CONCLUSIONS Our data show that smoking and increased BMI, but not Glu298Asp or the T-786C polymorphisms of Nos3, are associated with an early onset of natural menopause.
Collapse
Affiliation(s)
- Christof Worda
- Department of Obstetrics & Gynecology, University of Vienna Medical School, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Walch K, Grimm C, Zeillinger R, Huber JC, Nagele F, Hefler LA. A common interleukin-6 gene promoter polymorphism influences the clinical characteristics of women with polycystic ovary syndrome. Fertil Steril 2004; 81:1638-41. [PMID: 15193488 DOI: 10.1016/j.fertnstert.2004.01.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2003] [Revised: 01/14/2004] [Accepted: 01/14/2004] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the association of a common polymorphism of the interleukin-6 gene (IL6) promoter with the occurence and the clinical characteristics of polycystic ovary syndrome (PCOS). DESIGN Prospective, case-control study. SETTING Academic research institution. PATIENT(S) Sixty-two patients with PCOS and 94 healthy controls. INTERVENTION(S) Peripheral venous puncture, ultrasonography, oral glucose tolerance test (OGTT), questionnaire. MAIN OUTCOME MEASURE(S) Genotype analysis with respect to the common -174 G/C polymorphism of the IL6 gene promoter, analysis of testosterone (T), androstendione, and sex hormone binding globulin serum levels, and evaluation of the OGTT. RESULT(S) Allele frequencies among women with PCOS and controls were 62.9% and 64.4%, respectively, for the wild-type G allele, and 37.1% and 35.6%, respectively, for the mutant C allele. We ascertained a significant association between presence of at least one mutant C allele and the clinical characteristics of affected women: these women were more likely to present with a body mass index >27 kg/m(2), elevated total T serum levels, and a pathological OGTT result. CONCLUSION(S) A common polymorphism of the IL6 promoter, although not associated with the presence of PCOS, is associated with the clinical characteristics of women affected by this condition.
Collapse
Affiliation(s)
- Katharina Walch
- Department of Obstetrics and Gynecology, University of Vienna Medical School, Vienna, Austria.
| | | | | | | | | | | |
Collapse
|
35
|
Gruber CJ, Hengstschläger M, Wieser F, Gruber DM, Walch K, Ferlitsch K, Gruber IM, Maar A, Marton E, Bernaschek G, Huber JC. Absence of microdeletions in the azoospermia-factor region of the Y-chromosome in viennese men seeking assisted reproduction. Wien Klin Wochenschr 2003; 115:831-4. [PMID: 14740346 DOI: 10.1007/bf03041043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The azoospermia-factor region of the Y-chromosome is essential for spermatogenesis in humans. In the literature, a wide range is given for the frequency of microdeletions in this region. The purpose of this study was to evaluate our own population of patients. METHODS During a two-year period at Vienna Medical School, all male patients (n = 383) seeking assisted reproduction were screened for microdeletions. Thirty-three men had azoospermia and 154 severe oligozoospermia. Genomic DNA was prepared from peripheral lymphocytes and polymerase chain reaction analysis of the azoospermia-factor region was performed using the Promega kit. RESULTS No case tested positive for azoospermia-factor microdeletions. In all cases amplification of 18 non-polymorphic sequence tagged sites was obtained. CONCLUSIONS Y-chromosome microdeletions do not seem to be an important factor for male infertility in our patients. This suggests that screening should be restricted to men with azoospermia or severe oligozoospermia only.
Collapse
Affiliation(s)
- Christian J Gruber
- Division of Gynaecologic Endocrinology and Reproductive Medicine, University of Vienna Medical School, Vienna, Austria.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Walch K, Eder R, Schindler A, Feichtinger W. The effect of single-dose oxytocin application on time to ejaculation and seminal parameters in men. J Assist Reprod Genet 2001; 18:655-9. [PMID: 11808847 PMCID: PMC3455247 DOI: 10.1023/a:1013115301159] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To report the effect of a single dose of oxytocin on ejaculation time and seminal parameters. METHODS The prospective randomized clinical study was performed at a private assisted reproduction technology center and included 103 consecutive healthy men (semen donors or husbands of IVF patients). Oxytocin (16 IU) were administered intranasally to 49 subjects, randomly assigned to the study group just before masturbation to ejaculation. The time needed for ejaculation as well as the semen parameters was recorded according to the WHO standards, and compared to the control group of 54 subjects with no prior oxytocin treatment. RESULTS No significant difference was noted between the two groups concerning ejaculation time and semen parameters. CONCLUSIONS Although the administration of oxytocin stimulates sexual behavior and performance in mammalian species, our data indicate that oxytocin has no detectable effect on ejaculation time and seminal parameters after intranasal application in normal, healthy men.
Collapse
Affiliation(s)
- Katharina Walch
- Private Assisted Reproduction Technology Center, Lainzer Strasse 6, Vienna, Austria
| | - Ruth Eder
- Private Assisted Reproduction Technology Center, Lainzer Strasse 6, Vienna, Austria
| | - Andreas Schindler
- Department of Obstetrics and Gynecology, Kaiser Franz Josef Hospital, Vienna, Austria
| | - Wilfried Feichtinger
- Private Assisted Reproduction Technology Center, Lainzer Strasse 6, Vienna, Austria
| |
Collapse
|
37
|
Schlechta B, Kocher AA, Ehrlich M, Ankersmit J, Ploner M, Walch K, Nourani F, Czerny M, Wolner E, Grimm M. Heart retransplantation: institutional results of a series of 31 cases. Transplant Proc 2001; 33:2759-61. [PMID: 11498151 DOI: 10.1016/s0041-1345(01)02182-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- B Schlechta
- Division of Cardiothoracic Surgery, Department of Surgery, University of Vienna, Vienna, Austria
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Schlechta B, Kocher AA, Ehrlich M, Ankersmit J, Ploner M, Walch K, Nourani F, Czerny M, Wolner E, Wollenek G, Grimm M. Outcome of pediatric heart transplantation: an analysis of 27 cases. Transplant Proc 2001; 33:2834-5. [PMID: 11498179 DOI: 10.1016/s0041-1345(01)02210-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- B Schlechta
- Division of Cardiothoracic Surgery, Department of Surgery, University of Vienna, Vienna, Austria
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Abstract
PURPOSE To evaluate the causes of retinal detachment after silicone oil removal, to define possible risk factors and the anatomical and functional prognosis of this complication. METHODS 112 eyes that underwent silicone oil removal were included. The group of eyes with retinal detachment after oil removal (18/112 eyes, 16.1%) was compared with the group with no postoperative retinal detachment. RESULTS The most common cause for retinal detachment after oil removal was anterior PVR (77.8%). Initial PVR detachment, advanced PVR stages, anterior PVR, more preceding operations, aphakia/pseudophakia, myopia and shorter duration of the oil tamponade were significantly more represented in the group of eyes with retinal detachment after oil removal. The prognosis of retinal detachment after oil removal is poor. CONCLUSION Some criteria could be regarded as risk factors for retinal detachment after silicone oil removal. Improvement of the results should be possible by considering these factors and by control of reproliferations.
Collapse
Affiliation(s)
- C Scholda
- Department of Ophthalmology, University of Vienna, Medical School, Allgemeines Krankenhaus, Austria.
| | | | | | | | | | | |
Collapse
|
40
|
Pijnacker LP, Walch K, Ferwerda MA. Behaviour of chromosomes in potato leaf tissue cultured in vitro as studied by BrdC-Giemsa labelling. Theor Appl Genet 1986; 72:833-839. [PMID: 24248209 DOI: 10.1007/bf00266554] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/1986] [Accepted: 05/15/1986] [Indexed: 06/02/2023]
Abstract
Cells of leaf explants of a monohaploid potato (Solanum tuberosum) were stimulated to mitosis on a medium with 5-bromodeoxycytidine during a period of 7 days. The cells cycled with mono- or diplochromosomes which showed differential staining of the sister chromatids and sister chromatid exchanges by the fluorescent plus Giemsa technique after two rounds of BrdC incorporation. Through the staining pattern the course of the first three cell cycles could be traced and the duration of the cycles estimated. Polyploidisation was enhanced by selective stimulation of polyploid cells and by endoreduplication of G2-phase cells. The percentage of polyploid mitoses increased from 10 to 70.
Collapse
Affiliation(s)
- L P Pijnacker
- Department of Genetics, University of Groningen, Centre of Biological Sciences, P.O. Box 14, NL-9750, AA Haaren, The Netherlands
| | | | | |
Collapse
|