Research Interests:
Research Interests:
Research Interests:
The present study describes a new modification for testicular sperm extraction (TESE) with an intraoperative surgical loop, coupled with stereomicroscopic dissection in the laboratory, to identify sperm-containing tubules. The study... more
The present study describes a new modification for testicular sperm extraction (TESE) with an intraoperative surgical loop, coupled with stereomicroscopic dissection in the laboratory, to identify sperm-containing tubules. The study included 116 consecutive patients with nonobstructive azoospermia (NOA) undergoing TESE and intracytoplasmic sperm injection. After dissection of tes-ticular tissue under the stereomicroscope, patients were separated into 2 groups according to tubular diameter. In the first group (n 72), all tubules were of the same diameter. In the second group (n 44), tubules with variable diameters could be identified. In such cases, 1–2 of the most distended and opaque seminiferous tubules were selected and minced alone, then examined for the presence of spermatozoa. The rest of the testicular tissue suspension was minced and examined separately. In 11 (25%) cases, retrieved sper-matozoa were found in the isolated distended tubules only. In 21 (47.7%) cases, spermatozoa were found in both the isolated distended tubules and the rest of the specimen. In 2 cases, sperma-tozoa were found only in the whole sample, not in the isolated tu-bules. In the remaining 10 cases, spermatozoa were not found in either the whole sample or the isolated tubules. The sperm recovery rate in the isolated tubules was significantly higher than that of the rest of the specimen (72.7% vs 52%, 2 3.93, P .05), and larger numbers of spermatozoa could be easily retrieved in a shorter period of time. In conclusion, the selection and isolation of the most dilated and opaque seminiferous tubules by using the surgical loop, coupled with laboratory stereoscopic dissection, improves sperm retrieval for men with NOA. It is possible that surgical-loops TESE coupled with stereomicroscope may offer superior sperm retrieval when compared with conventional TESE and may also offer reduced operative time when compared with microdissection TESE.
Research Interests:
Research Interests:
Research Interests:
Research Interests: Cryopreservation, Human, Pregnancy, Humans, Female, and 18 moreMale, Premature Ejaculation, tESTIS, Middle Aged, Fertility Rate, Human reproduction, Late onset hypogonadism, Adult, Birth Rate, Spermatozoa, Semen Preservation, Gonadotropins, Pregnancy Rate, Cumulant, Ejaculation, Reoperation, Oligospermia, and hypogonadism
Research Interests:
Forty-two women with peritubal and periovarian adhesions as the only cause of infertility were superstimulated with clomiphene citrate and human menopausal gonadotropin in 103 cycles. Superstimulation resulted in considerable increase in... more
Forty-two women with peritubal and periovarian adhesions as the only cause of infertility were superstimulated with clomiphene citrate and human menopausal gonadotropin in 103 cycles. Superstimulation resulted in considerable increase in ovarian size, and change in the tubo-ovarian relationship. Twenty-two patients became pregnant, achieving a pregnancy rate of 21% per cycle and an overall rate of 52%. Hyperstimulation syndrome occurred in 85 cycles (82.5%). Four cases of tubal pregnancy were reported (3.8%). This line of treatment could be tried before resorting to microsurgery or in vitro fertilization and embryo transfer in patients with peritubal and periovarian adhesions with at least one patent tube.
Research Interests:
Transvaginal aspiration of pelvic cystic inflammatory masses guided by a real time ultrasound vaginal transducer is described. The technique was successfully used in 32 patients to aspirate these masses before ovulation induction for in... more
Transvaginal aspiration of pelvic cystic inflammatory masses guided by a real time ultrasound vaginal transducer is described. The technique was successfully used in 32 patients to aspirate these masses before ovulation induction for in vitro fertilization (IVF). It is a safe and simple procedure that resulted in significantly higher ovarian response to stimulation for IVF, easier ultrasonic follow-up of the follicles, significant increase in the average number of oocytes per pick-up, and significant increase in the number of embryos per transfer when compared with the control group.
Research Interests:
This study included 11 cases of severe OHSS that were treated by transvaginal aspiration of the ascitic fluid guided by ultrasound. Immediate improvement of the symptoms and general condition as well as a significantly shorter hospital... more
This study included 11 cases of severe OHSS that were treated by transvaginal aspiration of the ascitic fluid guided by ultrasound. Immediate improvement of the symptoms and general condition as well as a significantly shorter hospital stay was noticed when compared with the control group. It is a safe and simple procedure that does not require anesthesia.
Research Interests:
Transvaginal ultrasonically guided aspiration of pelvic endometriotic cysts was performed on 21 patients with recurrent endometriosis after previous surgical treatment. Their main complaint was pelvic pain and infertility. Further... more
Transvaginal ultrasonically guided aspiration of pelvic endometriotic cysts was performed on 21 patients with recurrent endometriosis after previous surgical treatment. Their main complaint was pelvic pain and infertility. Further conservative surgery was considered a contraindication. The symptoms improved markedly following aspiration. During a 12 month follow-up, reaccumulation occurred in only six cases (28.5%) and the improvement in symptoms persisted in the majority of cases. The technique is simple, safe and effective in the treatment of selected cases of endometriosis.
Research Interests: Surgery, Treatment, Humans, Female, Ultrasonics, and 7 moreTechnique, Follow-up studies, Vagina, Human reproduction, Adult, Endometriosis, and Suction
Thirty-one women with hypothalamic primary or protracted secondary amenorrhoea were treated with human menopausal gonadotrophin (HMG) in 89 cycles, but adequate follicular growth failed to occur. They were then treated with a... more
Thirty-one women with hypothalamic primary or protracted secondary amenorrhoea were treated with human menopausal gonadotrophin (HMG) in 89 cycles, but adequate follicular growth failed to occur. They were then treated with a gonadotrophin releasing hormone analogue (GnRHa) and HMG in 91 cycles. An adequate ovarian response occurred in 68 cycles (74.7%) and pregnancy occurred in 26 cycles (28.6%). GnRHa and HMG produced an adequate ovarian response in hypothalamic amenorrhoeic patients who failed to respond to HMG alone. The strong initial agonistic effect of GnRHa produced sudden high levels of FSH that might possibly have initiated folliculogenesis which was continued by HMG.
Research Interests:
A case of ectopic pregnancy with a gestational sac in the right tube of 25 mm diameter and beating fetal heart was treated conservatively by transvaginal, ultrasonically guided injection of potassium chloride and methotrexate. Serum... more
A case of ectopic pregnancy with a gestational sac in the right tube of 25 mm diameter and beating fetal heart was treated conservatively by transvaginal, ultrasonically guided injection of potassium chloride and methotrexate. Serum levels of beta-human chorionic gonadotrophin returned to normal in 42 days and the tubal mass collapsed gradually and resolved in 7 weeks.
Research Interests:
Three hundred thirty-five patients selected for in vitro fertilization (IVF) were randomly divided into two groups. Group A (n = 167) was subjected to dummy embryo transfer (ET) before the start of IVF treatment to choose the most... more
Three hundred thirty-five patients selected for in vitro fertilization (IVF) were randomly divided into two groups. Group A (n = 167) was subjected to dummy embryo transfer (ET) before the start of IVF treatment to choose the most suitable catheter for each patient. Group B (n = 168) started their IVF treatment without dummy ET. Embryo transfer technique was difficult in 50 cases (29.8%) in group B, whereas no difficulty was met in group A. Pregnancy rate and implantation rate (22.8%, 7.2%) in group A were significantly higher than in group B (13.1%, 4.3%). The lower pregnancy rate in group B is due to the very low pregnancy rate (4%) in difficult ET cases. Dummy ET is a simple procedure that determines the most suitable ET catheter for each patient and avoids unexpected difficult and failed ET.
Research Interests:
... Lisa C. Grossman BA a , b , Konstantinos G. Michalakis MD b , Hyacinth Browne MD b , Mark D. Payson MD c and James H ... compartment syndrome; PAP = peak airway pressure; CPP = cerebral perfusion pressure; DO 2 I = oxygen delivery... more
... Lisa C. Grossman BA a , b , Konstantinos G. Michalakis MD b , Hyacinth Browne MD b , Mark D. Payson MD c and James H ... compartment syndrome; PAP = peak airway pressure; CPP = cerebral perfusion pressure; DO 2 I = oxygen delivery index (mL O 2 /min/m 2 ); SVR ...
Research Interests:
Three cases of severe OHSS were treated by transvaginal aspiration of the ascitic fluid and autotransfusion of the aspirated fluid. Marked improvement of the symptoms, general condition, and urine output followed the aspiration shortly.... more
Three cases of severe OHSS were treated by transvaginal aspiration of the ascitic fluid and autotransfusion of the aspirated fluid. Marked improvement of the symptoms, general condition, and urine output followed the aspiration shortly. No reactions were noticed during or after the autotransfusion. The blood parameters were corrected, and the general condition and urine output continued to improve. The procedure is simple, safe, and straightforward that showed a striking physiological success in correcting the maldistribution of fluid and proteins without the use of heterogeneous biological material.
Research Interests:
To evaluate the efficacy of controlled ovarian hyperstimulation (COH) and IUI in the treatment of unexplained infertility. The pregnancy rate (PR) in patients with unexplained infertility treated by COH and IUI (group A) was compared with... more
To evaluate the efficacy of controlled ovarian hyperstimulation (COH) and IUI in the treatment of unexplained infertility. The pregnancy rate (PR) in patients with unexplained infertility treated by COH and IUI (group A) was compared with a no-treatment control (group B). The Egyptian IVF-ET Center. Four hundred ninety-two patients with the diagnosis of unexplained infertility. Controlled ovarian hyperstimulation and IUI. Cycle fecundity per treatment cycle and PR per patient. In group A cycle fecundity was 20.1% per treatment cycle, and the PR was 34.7% per patient. In group B the PR was 8.9% per patient. Pregnancy rate per patient was significantly higher in group A when compared with the spontaneous PR in group B. Controlled ovarian hyperstimulation and IUI significantly increased the PR in patients with unexplained infertility when compared with a no-treatment control group.
Research Interests:
Research Interests:
To report a case of IVF with apparently normal female and male gametes that resulted in the development of only multipronuclear oocytes (instead of oocytes containing two pronuclei) and was successfully treated with ICSI. Case report. A... more
To report a case of IVF with apparently normal female and male gametes that resulted in the development of only multipronuclear oocytes (instead of oocytes containing two pronuclei) and was successfully treated with ICSI. Case report. A university hospital. A 35-year-old woman with unexplained infertility and her partner, a 38-year-old man with normozoospermia. Intracytoplasmic sperm injection. Oocyte fertilization and pregnancy. Normal fertilization and an ongoing pregnancy occurred after transfer of two embryos. Although the usual indication for ICSI is male subfertility, it can also be used to successfully treat oocyte defects.
Research Interests: Cell Cycle, Prospective studies, Pregnancy, Humans, Fertility and Sterility, and 15 moreFemale, Intracytoplasmic Sperm Injection, In Vitro Fertilization, Male, Male Infertility, Clinical Sciences, Fertilization, Adult, Public health systems and services research, Fertilization in Vitro, Spermatozoa, Suction, Oocytes, Female Infertility, and Cytoplasm
The aim of this prospective randomized work was to study the value of co-culturing human pronucleate oocytes with their cumulus cells. A total of 550 fertilized oocytes from 95 in-vitro fertilization patients were randomly divided into... more
The aim of this prospective randomized work was to study the value of co-culturing human pronucleate oocytes with their cumulus cells. A total of 550 fertilized oocytes from 95 in-vitro fertilization patients were randomly divided into two groups on the day after insemination. Group A oocytes (n = 260) were left undisturbed with their attached cumulus cells and group B oocytes (n = 290) were dissected from their cumulus cells. Both groups were incubated and examined daily for 3 days. In group A, 78% (202/260) reached the 4-cell stage 48 h after retrieval compared to 69% (200/290) in group B. At 72 h after retrieval, 70% (141/202) had reached the 8-cell stage in group A compared to 56% (112/200) in group B. The percentages of grade 1 embryos at 48 and 72 h after retrieval were 70% (141/202) and 76% (107/141) in group A compared to 50% (100/200) and 43% (48/112) in group B respectively. We concluded that co-culture of human oocytes with their cumulus cells significantly decreased their fragmentation and increased the number of embryos that reached the 4-cell and 8-cell stages with regular blastomeres. The technique is simple and avoids the use of heterogeneous cells.
Research Interests:
A retrospective study comparing in-vitro fertilization (IVF) results in patients with previous successful trials versus new IVF patients was designed with the objective of evaluating the prognosis in both groups. Patients were divided... more
A retrospective study comparing in-vitro fertilization (IVF) results in patients with previous successful trials versus new IVF patients was designed with the objective of evaluating the prognosis in both groups. Patients were divided into two groups: group A, 22 patients with previous conception in IVF trials; and group B, 235 new IVF patients. All patients had tubal factor as the only cause of infertility and were stimulated by a standard protocol of gonadotrophin-releasing hormone agonist and human menopausal gonadotrophin. The pregnancy rate in group A (64%) was significantly higher than in group B (19%). In group A, 77% of the patients had three or more grade 1 embryos per transfer as compared with 16% in group B. In group A, 95.5% of patients had easy embryo transfer as compared with 61.2% in group B. The results of the study demonstrated that patients with previous IVF pregnancies have a significantly higher pregnancy rate compared with the control group. The improved pregnancy rate is due to the higher quality of embryos and the higher percentage of easy embryo transfers.
Research Interests:
To compare the results of IVF and intracytoplasmic sperm injection (ICSI) in tubal factor infertility with normal semen parameters. A prospective randomized study. The Egyptian IVF-ET Center. One hundred sixteen patients infertile due to... more
To compare the results of IVF and intracytoplasmic sperm injection (ICSI) in tubal factor infertility with normal semen parameters. A prospective randomized study. The Egyptian IVF-ET Center. One hundred sixteen patients infertile due to tubal factor were divided randomly into two groups. Group A(n = 58) was treated with IVF and group B(m = 58) was treated with ICSI. In vitro fertilization and ICSI. Pregnancy rate. In group A, 736 oocytes were retrieved and normal (two pronuclear [2pN] fertilization occurred in 477 oocytes (64.8%). In group B, 748 oocytes were retrieved, 572 metaphase II oocytes were injected, and 2PN fertilization occurred in 400 oocytes (70% per injected oocyte and 53.5% per retrieved oocyte). Clinical pregnancy was diagnosed in 18 patients in group A (31%) and 19 patients in group B (32.8%). There was no significant difference in the pregnancy rate between the two groups. The fertilization rate per retrieved oocytes was significantly higher in group A. Intracytoplasmic sperm injection does not offer a higher pregnancy rate as compared with IVF in the treatment of tubal factor infertility with normal semen.
Research Interests:
Research Interests:
... Redgment, CJ, Yang, D., Tsirigotis, M., Yazdani, N., Al Shawaf, T. and Craft, IL (1994) Experience with assisted fertilization in severe male ... Clark, RV and Sherins, RJ (1986) Use of semen analysis in the evaluation of the... more
... Redgment, CJ, Yang, D., Tsirigotis, M., Yazdani, N., Al Shawaf, T. and Craft, IL (1994) Experience with assisted fertilization in severe male ... Clark, RV and Sherins, RJ (1986) Use of semen analysis in the evaluation of the infertile couple. ... Cohen, J., Edwards, R., Fehilly, C. et al. ...
Research Interests:
Research Interests:
The effect of salpingectomy for unilateral hydrosalpinx with a contralateral normal tube was evaluated in two infertile patients in which unilateral hydrosalpinx, visualized by vaginal ultrasound, was treated by unilateral salpingectomy... more
The effect of salpingectomy for unilateral hydrosalpinx with a contralateral normal tube was evaluated in two infertile patients in which unilateral hydrosalpinx, visualized by vaginal ultrasound, was treated by unilateral salpingectomy as a preparatory step before IVF. Spontaneous pregnancy occurred in both patients while waiting to be enrolled in an IVF trial. In conclusion, unilateral salpingectomy for hydrosalpinx in the presence of a contralateral healthy tube could result in spontaneous pregnancy.
Research Interests:
ABSTRACT
Research Interests:
Objective: To evaluate the effect of fibroids on outcome of IVF and study value of myomectomy prior to IVF. Design: Prospective controlled study. Setting: Private IVF center, The Egyptian IVF ET Center, Maadi, Cairo. Materials and... more
Objective: To evaluate the effect of fibroids on outcome of IVF and study value of myomectomy prior to IVF. Design: Prospective controlled study. Setting: Private IVF center, The Egyptian IVF ET Center, Maadi, Cairo. Materials and methods: One hundred and ...
To assess the value of treating idiopathic male infertility by intrauterine insemination (IUI) of the occasionally improved cryopreserved semen. Two groups of idiopathic oligospermic patients were chosen at random and treated by IUI using... more
To assess the value of treating idiopathic male infertility by intrauterine insemination (IUI) of the occasionally improved cryopreserved semen. Two groups of idiopathic oligospermic patients were chosen at random and treated by IUI using processed fresh semen in group A and the best available cryopreserved semen samples pooled with fresh samples in group B. Egyptian IVF-ET Centre, Maadi, CAiro, Egypt. One hundred fifty infertile couples because of idiopathic oligoasthenospermia. Intrauterine insemination. The pregnancy rate was evaluated after an average of three treatment cycles. The pregnancy rate (PR) was significantly higher in group B when compared with group A. The improvement in the PR was highly significant in the subgroup of patients for whom reasonable semen samples could be collected and cryopreserved. Our study indicates that IUI with fresh semen pooled with cryopreserved occasionally improved semen samples for the treatment of oligoasthenospermia results in an improved...
Research Interests:
The purpose of this study was to determine the effect of follicular aspiration on the incidence of ovarian hyperstimulation syndrome (OHSS). A retrospective study was done on 219 IVF cycles that proceeded to follicular aspiration (group... more
The purpose of this study was to determine the effect of follicular aspiration on the incidence of ovarian hyperstimulation syndrome (OHSS). A retrospective study was done on 219 IVF cycles that proceeded to follicular aspiration (group A) and they were compared with 189 cycles of ovulation induction for non-IVF cycles (group B). We compared the incidence of OHSS in regularly ovulating patients (subgroups A1 and B1) and anovulatory patients (subgroups A2 and B2) in both groups. The study took place at The Egyptian IVF-ET Center. Participants were 319 infertility patients. Ovulation was induced and follicles were aspirated. The incidences of moderate and severe OHSS were the main outcome measures. The incidence of OHSS in group B was significantly higher than that in group A (P = 0.016). There was no significant difference in the incidence of OHSS between subgroup A1 and subgroup B1 or between subgroup A2 and subgroup B2. Follicular aspiration had no effect on the incidence of OHSS. ...
Research Interests:
Research Interests:
Unexplained infertility constitutes around 15% of patients presenting with infertility. A lack of agreement exists among infertility specialists with regard to the diagnostic tests to be performed and their prognostic value as well as... more
Unexplained infertility constitutes around 15% of patients presenting with infertility. A lack of agreement exists among infertility specialists with regard to the diagnostic tests to be performed and their prognostic value as well as criteria of normality. It seems that serum progesterone for detection of ovulation, hysterosalpingography and or laparoscopy for tubal patency and semen analysis are the basic tests for diagnosis of unexplained infertility. Expectant treatment is the option of choice for young patients with short period of infertility. The spontaneous pregnancy rate is very high in this group of patients. The world literature have shown that controlled ovarian hyperstimulation and intrauterine insemination (COH and IUI) is an effective treatment of unexplained infertility. According to the available data, this procedure could be limited to three trials. There is evidence that both COH and IUI are important independent positive factors in achieving better pregnancy rate...
Research Interests: Physiology, Reproduction, Biology, Treatment, Fertility, and 19 moreDeveloping Countries, Population Dynamics, Health, Medicine, Pregnancy, Population, Progesterone, Humans, Female, Ovulation Induction, Hormones, Semen Analysis, Artificial insemination, The Endocrine System Function, Diagnostic Test, Female Infertility, Pregnancy Rate, Pregnancy Outcome, and Intrauterine Insemination
... Infertility: a health problem in the Muslim world. Serour GI, El Ghar M, Mansour RT. ... These results demonstrate that prevention of infertility is preferable to treatment particularly in developing countries such as Egypt.... more
... Infertility: a health problem in the Muslim world. Serour GI, El Ghar M, Mansour RT. ... These results demonstrate that prevention of infertility is preferable to treatment particularly in developing countries such as Egypt. Islam's view of infertility and family is also addressed. ...
Research Interests: Religion, Physiology, Demography, Economics, Africa, and 40 moreReproduction, Biology, Fertility, Developing Countries, Population Dynamics, Egypt, Preventive medicine, Health, Islam, Public Health, Public sector, Research, Infertility, Medicine, Endoscopy, Middle East, Methods, Therapeutics, Population, Spermatogenesis, Health Services, Ovulation, Disease, Diagnosis, Infection, Longitudinal Studies, Artificial insemination, Birth Rate, Private Sector, Genitalia, Physical examination, Government Programs, Pelvic Inflammatory Disease, Uterus, Laparoscopy, Endometrium, Pregnancy Rate, Urogenital System, Family Characteristics, and Delivery of Health Care
Research Interests:
To assess the value of intensive intravenous (IV) fluid therapy and ascitic fluid aspiration in the management of severe ovarian hyperstimulation syndrome. Forty-two women with severe ovarian hyperstimulation syndrome were treated by... more
To assess the value of intensive intravenous (IV) fluid therapy and ascitic fluid aspiration in the management of severe ovarian hyperstimulation syndrome. Forty-two women with severe ovarian hyperstimulation syndrome were treated by ultrasonically guided transvaginal aspiration of ascitic fluid and IV fluid infusion. Ten women with the same condition treated conservatively constituted a comparison group. The main outcome measures included percentage change in hematocrit, creatinine clearance, and urine output before and after aspiration. The duration of hospital stay was compared between the groups. Marked improvement of symptoms and general condition followed soon after aspiration. Hematocrit readings decreased by 22%, creatinine clearance increased by 79.3%, and urine output increased by 220.7%. The average volume of aspirated fluid was 3900 mL. The average duration of hospital stay was 3.8 days in the treated women. In the comparison group, severe symptoms and electrolyte imbala...
Research Interests:
To study the effect of cumulus cell coculture on human sperm motility, life span, and patterns. Controlled prospective study of 50 normal semen samples. Sperm motility and forward grade was observed in droplets of Ham's F-10 media... more
To study the effect of cumulus cell coculture on human sperm motility, life span, and patterns. Controlled prospective study of 50 normal semen samples. Sperm motility and forward grade was observed in droplets of Ham's F-10 media with cumulus cell coculture and compared with sperm in droplets of Ham's F-10 only. The Egyptian IVF-ET Center. Sperm motility, life span, and forward progressive pattern. The time course of loss of sperm motility in cumulus coculture was significantly slower than without cumulus. Also, the percentage of motile sperm with linear progressive motility of grade 4,3 was significantly higher in cumulus coculture. Cumulus cell coculture has a positive effect on prolongation of sperm motility life span and its forward progression.
Research Interests:
One hundred and fourteen couples with long standing infertility due to male factor, cervical factor and unexplained infertility were admitted for therapeutic trials with intrauterine insemination of washed, capacitated husband's sperm... more
One hundred and fourteen couples with long standing infertility due to male factor, cervical factor and unexplained infertility were admitted for therapeutic trials with intrauterine insemination of washed, capacitated husband's sperm cells between May 1986 to October 1987 at The Egyptian IVF-ET Center, Cairo, Egypt. Three hundred and sixty-four trials were done (an average of 3.19 trial per patient). Fifty-eight patients got pregnant (16% pregnancy rate per trial). This simple and noninvasive procedure can be considered as an alternative treatment for infertility due to male factor, cervical factor, and unexplained infertility.