Success Rate Of Injection Research Articles

The effect of insemination/injection time on the results of IVF and ICSI.

The aim of this study was to investigate whether a pre-incubation time between oocyte retrieval and insemination or injection had any effect on the success rate of IVF or intracytoplasmic sperm injection (ICSI). Based on previously published data, many laboratories retain a time interval of several hours between oocyte retrieval and insemination/injection. In our setting, insemination and injection times are dependent only on the laboratory workload. Totals of 881 IVF and 432 ICSI cycles performed between 1997 and 1999 were analysed retrospectively. Oocyte retrieval occurred 36 h after human chorionic gonadotrophin administration, and insemination or injection took place 1--7 or 0.5--8 h after oocyte retrieval respectively. No statistically significant differences were found between these time periods and outcome of IVF and ICSI with respect to fertilization rate, embryo quality, implantation rate, abortion and ongoing pregnancy rates, except for the abortion rate after IVF. As this finding may be due to chance and no differences were found in the ongoing pregnancy rates, this finding was considered to be of less importance. If laboratory control and efficiency demands early insemination or injection, it could be performed without reservation.

COLLAGEN INJECTION FOR TREATMENT OF URINARY INCONTINENCE IN CHILDREN

We assess the success rate of periurethral collagen injection in children with neurogenic bladder dysfunction secondary to myelomeningocele. From 1992 to 1998, 15 male and 5 female patients with spina bifida (age 13.3 +/- 3.8 years) underwent endoscopic collagen injection for the treatment of urinary incontinence secondary to sphincter deficiency. Mean followup was 4.2 years. Pretreatment urodynamic study showed a stable compliant bladder with an average leak point pressure of 52 cm. H2O (range 23 to 100). Concurrent medical management included anticholinergics in 15 cases, agonists in 3, and clean intermittent catheterization in 16. Five patients had undergone previous ileocystoplasty. Collagen injections were given with the patient under general anesthesia. The number of injections was 1 in 5 cases, 2 in 11, 3 in 3, and 4 in 1. Average collagen volume injected per treatment was 6.6 cc (range 2 to 13). All patients were evaluated on a subjective continence scale of no change (wet), improved or completely dry at the time of assessment. Of the 20 patients, 16 had no change, 3 showed improvement and 1 was dry. Initial improvement in the first 2 months after injection deteriorated thereafter in 16 cases. The previously reported high success rate of collagen injection is not supported by this study. With long-term followup collagen injection is rarely effective for treating urinary incontinence in children with neurogenic sphincter deficiency.

Laparoscopic methotrexate instillation in unruptured tubal pregnancyis it worthwhile?

This study documents the success rate and risks of laparoscopic local injection of methotrexate in the unruptured tubal pregnancy. This was a prospective study conducted in two centres, King Abdulaziz University Hospital and Dr Erfan & Bagedo Hospital, Jeddah, Saudi Arabia. Twenty-one patients with an intact tubal pregnancy were selected for laparoscopic local treatment with the use of a single injection of 12·5 mg of methotrexate into the ectopic site at the time of diagnostic laparoscopy. In 80·9% (17 patients), serum g -hCG level decreased to the nonpregnant level with no further intervention and the patients recovered without any serious side effect. In 19·9% (four patients) mini-laparotomy was indicated because of a rising g -hCG. Local methotrexate therapy in an early intact tubal ectopic at the time of laparoscopy is a possible alternative to surgery in selected cases. It also has some advantage over systemic (intramuscular) methotrexate as it avoids potentially serious side effects.

A Device for Simultaneous Application of Sclerotherapy and Endoscopic Ligation for Management of Esophageal Varices

Abstract:A device developed for simultaneous application of sclerotherapy and endoscopic variceal ligation to treat esophageal varices is described. This device took less than 14 sec to attach to the endoscope, compared to 71 sec using the conventional device. The success rate of intravariceal injection using a 3‐cm or 4‐cm long hemostatic balloon or a conventional balloon was not significantly different. This device had the added advantage that simultaneous sclerotherapy and ligation were possible without changing the endoscope.

Oocyte morphology predicts outcome of intracytoplasmic sperm injection.

To examine the influence of cytoplasmic morphology on the success rate of intracytoplasmic sperm injection (ICSI), the morphology of 837 metaphase II oocytes was assessed after cumulus stripping. The main abnormalities detected were excessive granularity, cytoplasmic inclusions such as vacuoles, smooth endoplasmic reticulum clustering and refractile bodies. Microinjection was performed in 538 oocytes with normal cytoplasm, 142 out of 161 with excessive granularity and 112 out of 138 with cytoplasmic inclusions. Very poor oocytes were not injected. No difference was found in fertilization rate. The embryos achieved cleaved normally and a similar number of good quality embryos among the three groups was noted. The outcome of transfer of embryos derived solely from normal oocytes (group A: 72 patients, 183 embryos) was compared with those from oocytes with cytoplasmic abnormalities (group B: 34 patients, 85 embryos). In group A, 17 clinical pregnancies (24% per patient, implantation rate 10%) were established. In group B, only one clinical pregnancy (3% per patient, implantation rate 1%) was established, from the transfer of embryos derived from oocytes with homogeneous granularity of the cytoplasm. No pregnancy resulted following the transfer of embryos from eggs with cytoplasmic inclusions. The difference was statistically significant. The outcome of ICSI is dependent on the quality of the oocytes retrieved. Normal fertilization and early embryo development were achieved in oocytes with abnormal cytoplasm morphology, but the resulting embryos failed to demonstrate the same implantation potential as those derived from oocytes with normal cytoplasm.

Failure to Obtain Durable Results with Collagen Implantation in Children with Urinary Incontinence

Purpose We studied the efficacy and durability of injection of glutaraldehyde cross-linked bovine collagen for treating urinary incontinence in children. Materials and Methods From April 1994 to July 1995, 12 boys and 8 girls 4 to 18 years old (mean age 9.5) underwent endoscopically directed collagen injections into the bladder neck. Followup ranged from 9 to 23 months (mean 15.2). The etiology of incontinence included myelodysplasia in 12 patients, exstrophy/epispadias in 4, and epidural abscess, sacral agenesis, imperforate anus and posterior urethral valves in 1 each. Results Collagen was injected once in 9 patients, twice in 10 and 3 times in 1. Injected volume ranged from 3 to 18 cc (mean 7.3). Followup urodynamic studies were available for 10 patients. Leak point pressure increased from 28.7 to 34.9 cm. water. One patient (5%) was dry, 5 (25%) had improvement, 10 (50%) had transient improvement for 2 to 90 days (mean 52) and 4 (20%) remained incontinent. Five children underwent bladder neck sling procedures. In 1 patient transient sciatic nerve irritation developed due to gluteal hematoma. Conclusions The previously reported high success rate of collagen injection for urinary incontinence in children is unsupported by this study. Improvement in continence was temporary or inadequate in the majority of patients. Collagen therapy may only delay the need for surgery for managing organic urinary incontinence in children.

Surgical Versus Endoscopic Correction of Vesicoureteral Reflux in Children with Neurogenic Bladder Dysfunction

Purpose We attempted to compare the efficacy of subureteral polytetrafluoroethylene injection and ureteral reimplantation for treating vesicoureteral reflux in children with neurogenic bladder dysfunction. Materials and Methods We retrospectively studied the records of all children with neurogenic bladder dysfunction and reflux into single collecting systems treated with cross-trigonal ureteroneocystostomy or subureteral polytetrafluoroethylene injection. Followup cystography was performed 2 months postoperatively and ultrasound was done twice yearly thereafter. Urodynamic data were evaluated when available. Success was defined as complete eradication of reflux. Data were stratified by procedure, patient sex, grade and laterality of reflux, and the presence of unilateral or bilateral reflux, and then compared using chi-square analysis. Results Of 85 patients (118 ureters) identified followup data were available in 95%. Subureteral polytetrafluoroethylene injection and ureteroneocystostomy were done on 60 and 47 ureters, respectively. Both groups were similar in mean patient age, followup and preoperative degree of reflux. Success rates after ureteroneocystostomy and a single injection were 84.3 versus 56.7%. The cumulative success rate of subureteral polytetrafluoroethylene injection was 61% after a second injection. The success rate of ureteroneocystostomy was significantly greater than that of injection (p = 0.02). Reflux resolved in all patients in whom injection failed and who underwent secondary reimplantation. Successful ureteroneocystostomy was unrelated to patient sex, reflux grade or laterality, or bilateral versus unilateral reflux. Subureteral polytetrafluoroethylene injection was more likely to fail in higher grades of reflux (p = 0.03) but success was otherwise unrelated to other parameters. Failure to correct reflux was unrelated to urodynamic findings. Conclusions Primary open ureteral reimplantation is more effective than subureteral polytetrafluoroethylene injection for correcting reflux in children with neurogenic bladder dysfunction. Despite controversy related to the appropriate injectable substance, the relative technical simplicity, outpatient nature, rapid recovery and potential for successful secondary reimplantation support a role for subureteral polytetrafluoroethylene injection in managing reflux in these difficult cases.

OK‐432 Therapy for Recalcitrant Warts

Twelve patients with warts recalcitrant to various treatment, including cryotherapy, were treated with OK-432 injection therapy. Six patients received only subcutaneous injection, three received only intralesional injection, and the other three received both subcutaneous and intralesional injections. Complete clearing of the warts occurred in nine (75%) of 12 patients, while the other three patients were not cured. Grouping the patients by the method of injection, the success rate of subcutaneous injection was 5/9 (55.6%), and that of intralesional injection was 4/6 (66.7%). Although five patients complained of mild fever and malaise, these side effects gradually disappeared during the repeated injections. OK-432 injection is considered as a hopeful therapy for recalcitrant warts.