Http Dx Doi Org 10 1080 09513590802630120, Apr 1, 2009
Human menopausal gonadotropin (hMG) was demonstrated to be superior to recombinant FSH (rFSH) reg... more Human menopausal gonadotropin (hMG) was demonstrated to be superior to recombinant FSH (rFSH) regarding clinical outcomes. It is not clear whether this change in the evidence was due to the introduction of highly purified (HP) hMG. Systematic review of properly randomised trials comparing HP-hMG vs. rFSH in women undergoing in vitro fertilisation (IVF) and/or intracytoplasmic sperm injection (ICSI). A meticulous search was performed using electronic databases and hand searches of the literature. Six trials (2371 participants) were included. Pooling of the trials demonstrated that the probability of clinical pregnancy following HP-hMG administration was higher than rFSH and reached borderline significance (odd ratio (O.R) = 1.21, 95% confidence interval (CI) = 1.00 to 1.45), but the ongoing pregnancy/live-birth rate was not statistically different between the two drugs, although it showed strong trends towards improvement with HP-hMG (O.R = 1.19, 95% CI = 0.98 to 1.44). Subgroup analysis comparing both drugs in IVF cycles demonstrated a statistically significant better ongoing pregnancy/live-birth rate in favour of HP-hMG (O.R = 1.31, 95% CI = 1.02 to 1.68). On the other hand, there was almost an equal ongoing pregnancy/live-birth rate in ICSI cycles (OR = 0.98, 95% CI = 0.7 to 1.36). HP-hMG should be preferred over rFSH in women undergoing assisted reproduction, especially if IVF is the intended method of fertilisation.
In a prospective study, 140 patients with infertility because of ovulatory factors (group A) were... more In a prospective study, 140 patients with infertility because of ovulatory factors (group A) were followed up for 6 months after failure to achieve pregnancy using human menopausal gonadotropin (hMG) therapy. They included cases of oligomenorrhea, polycystic ovarian disease (PCOD), and hypogonadotropic amenorrhea. They were treated with hMG alone or in combination with clomiphene citrate or gonadotropin-releasing hormone agonist analog. The control group (B) included 83 infertile patients because of similar ovulatory factors. They were followed up for 6 months not preceded by ovulation induction. The overall pregnancy rate (PR) in group A (20.7%) was significantly higher than group B (7.2%). The PR was significantly higher in oligomenorrhea and PCOD patients when compared with the control group. There was no significant difference in the hypogonadotropic group.
Elevated levels of interleukin-2, soluble interleukin-2 receptor alpha, interleukin-6, soluble in... more Elevated levels of interleukin-2, soluble interleukin-2 receptor alpha, interleukin-6, soluble interleukin-6 receptor and vascular endothelial growth factor in serum and ascitic fluid of patients with severe ovarian hyperstimulation syndrome
The aim of this prospective work was to evaluate different catheters and techniques used for embr... more The aim of this prospective work was to evaluate different catheters and techniques used for embryo transfer. Studies were performed on 105 IVF patients before the start of treatment cycles. Each patient was used as her own control to study the expulsion of methylene blue (MB) dye after dummy embryo transfer. Group A (n = 35) underwent the test twice, before and after aspiration of the cervical mucus. Group B (n = 30) underwent the test twice with and without the presence of two air bubbles in the embryo transfer catheter. Group C (n = 40) underwent the test twice using two different catheters, the Wallace and the Craft catheters. The results showed that the dye was extruded at the external os in 57% of the cases when the cervical mucus was not aspirated compared to 23% when the mucus was aspirated (P = 0.01). The dye was extruded in 33% of the cases with air bubbles in the catheter as compared to 27% when no air was present (P > 0.05). When the Wallace catheter was used expulsion occurred in 25.5% compared to 77.5% when the Craft catheter was used. We concluded that using soft catheters and complete aspiration of cervical mucus significantly reduced the expulsion of the dye. The presence of air bubbles did not affect rate of expulsion of the dye.
BACKGROUND: The aims of this study were to find an ultrasonically echogenic material to study the... more BACKGROUND: The aims of this study were to find an ultrasonically echogenic material to study the uterine activity, and to test whether closing the vaginal speculum on the cervix prevents the displacement of the injected material. METHODS: A concentrated sperm suspension was used as an ultrasonically visible material. Forty-five women undergoing intrauterine insemination were randomized into: open speculum group (n
... Ahmed Kamal, MD Ibrahim Fahmy, MD Ragaa Mansour, MD, Ph.D. Ahmed Abou-Setta, MD Gamal Serour,... more ... Ahmed Kamal, MD Ibrahim Fahmy, MD Ragaa Mansour, MD, Ph.D. Ahmed Abou-Setta, MD Gamal Serour, MD Mohamed Aboulghar, MD ... Hum Reprod 1998;13(12):3390-3. 9. Fahmy I, Mansour R, Aboulghar M, Serour G, Kamal A, Tawab NA, et al. ...
International Journal of Gynecology & Obstetrics, 1992
Study Objective: To develop mathematical models using kinematic parameters from Computer-Aided Sp... more Study Objective: To develop mathematical models using kinematic parameters from Computer-Aided Sperm Analysis (CASA) that predict the fertilization rate of sperm recovered from the caput epididymidis and to test the hypothesis that fertilization was enhanced by the presence of specific sperm subpopulations in the inseminate. Setting: In vitro fertilization (IVF) program. Patients: Thirteen patients with congenital absence of the vas deferens provided epididymal sperm for IVF as well as for CASA. Results: The mathematical model that was most predictive of fertilization rates included kinematic parameters of the epididymal aspirate (percent motility), the inseminate used for IVF (curvilinear velocity (VCL)) and the change in sperm movement after in vitro processing by the mini-Percoll technique (difference in amplitude of lateral head displacement (ALH)). Multivariate cluster analysis revealed that inseminates that resulted in higher fertilization rates had subpopulations of sperm that were characterized by high VCL and high mean angular displacement, as well as a greater change in ALH after processing. Conclusions: In vitro fertilization with epididymal sperm was more likely to succeed when the sperm population that was initially aspirated had a higher proportion of motile cells and when these sperm were capable of capacitation in vitro as indicated by the appearance of sperm subpopulations with motility that resembled hyperactivation. Cryopreservntion of the 0eeasiomBy improved semen samples for intrPaterine hseminetion: A ww approach in the treatment of idio@ic m8le infertility EGY FERTIL STERIL 1991 56/6 (1151-1155) Objective: To assess the value of treating idiopathic male infertility by intrauterine insemination (IUI) of the occasionally improved cryopreserved semen. Design: Two groups of idiopathic oligospetmic 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. Setting: Egyptian IVF-ET Centre, Maadi, Cairo, Egypt. Patients, Participants: One hundred tifty infertile couples because of idiopathic oligoasthenospermia. Intervention: Intrauterine insemination. Main Outcome Measure: The pregnancy rate was evaluated after an average of three treatment cycles. Results: 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. Conclusions: Our study indicates that IUI with fresh semen pooled with cryopreserved occasionally improved semen samples for the treatment of oligoasthenospermia results in an improved PR. ANN INTERN MED 1991 115110 (827-829) The AIDS epidemic has now entered the second decade. Numerous changes have occurred during first 10 years, including definition of the causative agent and development of many therapies for both the primary disease and its complications. The populations at risk have also changed, and women now represent a major group, the gender-specific issues of whom need to be addressed. This demographic change may require the consideration of changes in diagnostic criteria and the involvement of women in clinical trials. Large multidisciplinary, longitudinal studies of women infected with HIV must be done.
Unexplained infertility constitutes around 15% of patients presenting with infertility. A lack of... 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...
The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 1998
There are currently groups of women using high-dose estrogen contraceptive pills, especially in t... more There are currently groups of women using high-dose estrogen contraceptive pills, especially in the developing countries. The aim of this study was to determine the correlation between the duration of contraceptive pill intake, the dose of steroid contained in the contraceptive pills and the incidence and degree of serum prolactin level elevation in those women. This study was conducted in 100 contraceptive pill users. Women were randomly selected for this study with an age range from 19 to 35 years and duration of contraceptive pill intake from 6 to 120 months. Cases were classified into two groups. The first group (50 cases) were taking high-dose estrogen pills (50 micrograms) and the second group (50 cases) were taking low-dose estrogen pills (30 micrograms). The results of the present study showed that there was a significant elevation in serum prolactin level in both groups, with a more significant elevation in the high-dose pill users. There is a positive relationship between ...
The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 1997
The advances and wide availability of assisted reproductive techniques represent the dramatic cha... more The advances and wide availability of assisted reproductive techniques represent the dramatic changes that have occurred in infertility treatment and in attitudes towards the different options faced by both physicians and patients. It is a human right that individuals can freely choose reproductive options. Though reproductive choice is basically a personal decision, yet it is not totally so. Islam is a comprehensive system that regulates the spiritual as well as civil aspects of individual and communal life. It aims to develop the unique personality of the individual and a distinct culture for the community based on Islamic ideals and values. The basic concept of Islam is to avoid mixing genes as Islam enjoins the purity of genes and heredity.
Http Dx Doi Org 10 1080 09513590802630120, Apr 1, 2009
Human menopausal gonadotropin (hMG) was demonstrated to be superior to recombinant FSH (rFSH) reg... more Human menopausal gonadotropin (hMG) was demonstrated to be superior to recombinant FSH (rFSH) regarding clinical outcomes. It is not clear whether this change in the evidence was due to the introduction of highly purified (HP) hMG. Systematic review of properly randomised trials comparing HP-hMG vs. rFSH in women undergoing in vitro fertilisation (IVF) and/or intracytoplasmic sperm injection (ICSI). A meticulous search was performed using electronic databases and hand searches of the literature. Six trials (2371 participants) were included. Pooling of the trials demonstrated that the probability of clinical pregnancy following HP-hMG administration was higher than rFSH and reached borderline significance (odd ratio (O.R) = 1.21, 95% confidence interval (CI) = 1.00 to 1.45), but the ongoing pregnancy/live-birth rate was not statistically different between the two drugs, although it showed strong trends towards improvement with HP-hMG (O.R = 1.19, 95% CI = 0.98 to 1.44). Subgroup analysis comparing both drugs in IVF cycles demonstrated a statistically significant better ongoing pregnancy/live-birth rate in favour of HP-hMG (O.R = 1.31, 95% CI = 1.02 to 1.68). On the other hand, there was almost an equal ongoing pregnancy/live-birth rate in ICSI cycles (OR = 0.98, 95% CI = 0.7 to 1.36). HP-hMG should be preferred over rFSH in women undergoing assisted reproduction, especially if IVF is the intended method of fertilisation.
In a prospective study, 140 patients with infertility because of ovulatory factors (group A) were... more In a prospective study, 140 patients with infertility because of ovulatory factors (group A) were followed up for 6 months after failure to achieve pregnancy using human menopausal gonadotropin (hMG) therapy. They included cases of oligomenorrhea, polycystic ovarian disease (PCOD), and hypogonadotropic amenorrhea. They were treated with hMG alone or in combination with clomiphene citrate or gonadotropin-releasing hormone agonist analog. The control group (B) included 83 infertile patients because of similar ovulatory factors. They were followed up for 6 months not preceded by ovulation induction. The overall pregnancy rate (PR) in group A (20.7%) was significantly higher than group B (7.2%). The PR was significantly higher in oligomenorrhea and PCOD patients when compared with the control group. There was no significant difference in the hypogonadotropic group.
Elevated levels of interleukin-2, soluble interleukin-2 receptor alpha, interleukin-6, soluble in... more Elevated levels of interleukin-2, soluble interleukin-2 receptor alpha, interleukin-6, soluble interleukin-6 receptor and vascular endothelial growth factor in serum and ascitic fluid of patients with severe ovarian hyperstimulation syndrome
The aim of this prospective work was to evaluate different catheters and techniques used for embr... more The aim of this prospective work was to evaluate different catheters and techniques used for embryo transfer. Studies were performed on 105 IVF patients before the start of treatment cycles. Each patient was used as her own control to study the expulsion of methylene blue (MB) dye after dummy embryo transfer. Group A (n = 35) underwent the test twice, before and after aspiration of the cervical mucus. Group B (n = 30) underwent the test twice with and without the presence of two air bubbles in the embryo transfer catheter. Group C (n = 40) underwent the test twice using two different catheters, the Wallace and the Craft catheters. The results showed that the dye was extruded at the external os in 57% of the cases when the cervical mucus was not aspirated compared to 23% when the mucus was aspirated (P = 0.01). The dye was extruded in 33% of the cases with air bubbles in the catheter as compared to 27% when no air was present (P > 0.05). When the Wallace catheter was used expulsion occurred in 25.5% compared to 77.5% when the Craft catheter was used. We concluded that using soft catheters and complete aspiration of cervical mucus significantly reduced the expulsion of the dye. The presence of air bubbles did not affect rate of expulsion of the dye.
BACKGROUND: The aims of this study were to find an ultrasonically echogenic material to study the... more BACKGROUND: The aims of this study were to find an ultrasonically echogenic material to study the uterine activity, and to test whether closing the vaginal speculum on the cervix prevents the displacement of the injected material. METHODS: A concentrated sperm suspension was used as an ultrasonically visible material. Forty-five women undergoing intrauterine insemination were randomized into: open speculum group (n
... Ahmed Kamal, MD Ibrahim Fahmy, MD Ragaa Mansour, MD, Ph.D. Ahmed Abou-Setta, MD Gamal Serour,... more ... Ahmed Kamal, MD Ibrahim Fahmy, MD Ragaa Mansour, MD, Ph.D. Ahmed Abou-Setta, MD Gamal Serour, MD Mohamed Aboulghar, MD ... Hum Reprod 1998;13(12):3390-3. 9. Fahmy I, Mansour R, Aboulghar M, Serour G, Kamal A, Tawab NA, et al. ...
International Journal of Gynecology & Obstetrics, 1992
Study Objective: To develop mathematical models using kinematic parameters from Computer-Aided Sp... more Study Objective: To develop mathematical models using kinematic parameters from Computer-Aided Sperm Analysis (CASA) that predict the fertilization rate of sperm recovered from the caput epididymidis and to test the hypothesis that fertilization was enhanced by the presence of specific sperm subpopulations in the inseminate. Setting: In vitro fertilization (IVF) program. Patients: Thirteen patients with congenital absence of the vas deferens provided epididymal sperm for IVF as well as for CASA. Results: The mathematical model that was most predictive of fertilization rates included kinematic parameters of the epididymal aspirate (percent motility), the inseminate used for IVF (curvilinear velocity (VCL)) and the change in sperm movement after in vitro processing by the mini-Percoll technique (difference in amplitude of lateral head displacement (ALH)). Multivariate cluster analysis revealed that inseminates that resulted in higher fertilization rates had subpopulations of sperm that were characterized by high VCL and high mean angular displacement, as well as a greater change in ALH after processing. Conclusions: In vitro fertilization with epididymal sperm was more likely to succeed when the sperm population that was initially aspirated had a higher proportion of motile cells and when these sperm were capable of capacitation in vitro as indicated by the appearance of sperm subpopulations with motility that resembled hyperactivation. Cryopreservntion of the 0eeasiomBy improved semen samples for intrPaterine hseminetion: A ww approach in the treatment of idio@ic m8le infertility EGY FERTIL STERIL 1991 56/6 (1151-1155) Objective: To assess the value of treating idiopathic male infertility by intrauterine insemination (IUI) of the occasionally improved cryopreserved semen. Design: Two groups of idiopathic oligospetmic 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. Setting: Egyptian IVF-ET Centre, Maadi, Cairo, Egypt. Patients, Participants: One hundred tifty infertile couples because of idiopathic oligoasthenospermia. Intervention: Intrauterine insemination. Main Outcome Measure: The pregnancy rate was evaluated after an average of three treatment cycles. Results: 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. Conclusions: Our study indicates that IUI with fresh semen pooled with cryopreserved occasionally improved semen samples for the treatment of oligoasthenospermia results in an improved PR. ANN INTERN MED 1991 115110 (827-829) The AIDS epidemic has now entered the second decade. Numerous changes have occurred during first 10 years, including definition of the causative agent and development of many therapies for both the primary disease and its complications. The populations at risk have also changed, and women now represent a major group, the gender-specific issues of whom need to be addressed. This demographic change may require the consideration of changes in diagnostic criteria and the involvement of women in clinical trials. Large multidisciplinary, longitudinal studies of women infected with HIV must be done.
Unexplained infertility constitutes around 15% of patients presenting with infertility. A lack of... 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...
The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 1998
There are currently groups of women using high-dose estrogen contraceptive pills, especially in t... more There are currently groups of women using high-dose estrogen contraceptive pills, especially in the developing countries. The aim of this study was to determine the correlation between the duration of contraceptive pill intake, the dose of steroid contained in the contraceptive pills and the incidence and degree of serum prolactin level elevation in those women. This study was conducted in 100 contraceptive pill users. Women were randomly selected for this study with an age range from 19 to 35 years and duration of contraceptive pill intake from 6 to 120 months. Cases were classified into two groups. The first group (50 cases) were taking high-dose estrogen pills (50 micrograms) and the second group (50 cases) were taking low-dose estrogen pills (30 micrograms). The results of the present study showed that there was a significant elevation in serum prolactin level in both groups, with a more significant elevation in the high-dose pill users. There is a positive relationship between ...
The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 1997
The advances and wide availability of assisted reproductive techniques represent the dramatic cha... more The advances and wide availability of assisted reproductive techniques represent the dramatic changes that have occurred in infertility treatment and in attitudes towards the different options faced by both physicians and patients. It is a human right that individuals can freely choose reproductive options. Though reproductive choice is basically a personal decision, yet it is not totally so. Islam is a comprehensive system that regulates the spiritual as well as civil aspects of individual and communal life. It aims to develop the unique personality of the individual and a distinct culture for the community based on Islamic ideals and values. The basic concept of Islam is to avoid mixing genes as Islam enjoins the purity of genes and heredity.
Uploads
Papers by Gamal Serour