| 1. |
- Saldeen, Pia, et al.
(författare)
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Omega-3 Fatty acids: structure, function, and relation to the metabolic syndrome, infertility, and pregnancy.
- 2006
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Ingår i: Metabolic syndrome and related disorders. - : Mary Ann Liebert Inc. - 1557-8518 .- 1540-4196. ; 4:2, s. 138-148
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Tidskriftsartikel (refereegranskat)abstract
- Omega-3s are found in oily fish. We have drastically reduced our intake of fish during the last century. Many of us therefore suffer from a deficiency of omega-3s, which has consequences for health. In this review, we focus on structure-functional relationships and the relation of omega-3s to the metabolic syndrome, infertility, and pregnancy.
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| 2. |
- Saldeen, Pia, et al.
(författare)
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Women and omega-3 fatty acids
- 2004
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Ingår i: Obstetrical and Gynecological Survey. - 0029-7828. ; 59:10, s. 722-730
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Forskningsöversikt (refereegranskat)abstract
- Omega-3 fatty acids (omega-3 FA) are constituents of the membranes of all cells in the body and are precursors of locally produced hormones, eicosanoids, which are important in the prevention and treatment of various diseases, especially in women. Omega-3 FA are of interest in some of the most common conditions affecting women. One mechanism underlying dysmenorrhea is a disturbed balance between antiinflammatory, vasodilator eicosanoids derived from omega-3 FA and proinflammatory, vasoconstrictor eicosanoids derived from omega-6 FA. Increased intake of omega-3 FA can reverse the symptoms in this condition by decreasing the amount of omega-6 FA in cell membranes. An increased prostacyclin/thromboxane ratio induced by omega-3 FA can facilitate pregnancy in women with infertility problems by increasing uterine blood flow. Supplementation with omega-3 FA during pregnancy lowers the risk of premature birth and can increase the length of pregnancy and birth weight by altering the balance of eicosanoids involved in labor and promote fetal growth by improving placental blood flow. Intake of omega-3 FA during pregnancy and breast feeding may facilitate the child's brain development. There is also some evidence that supplementation with omega-3 FA might help to prevent preeclampsia, postpartum depression, menopausal problems, postmenopausal osteoporosis, and breast cancer. Furthermore, because elevated triglyceride levels are associated with cardiovascular disease, especially in women; and because omega-3 FA have powerful effects on triglycerides, women in particular gain from an increased intake of these fatty acids. This is especially important in women receiving hormone therapy, which can increase triglyceride levels. The quality of the omega-3 FA preparation is important. It should have an appropriate antioxidant content not to induce lipid peroxidation, and its content of dioxin and polychlorinated biphenyls (PCBs) should be well below the established safe limit. Target Audience: Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this article, the reader should be able to describe the function and actions of omega-3 and omega-6 fatty acids, to outline the potential advantages of omega-3 fatty acid supplementation, and to list the potential sources of omega-3 fatty acids.
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| 3. |
- Persson, Jan, et al.
(författare)
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Histopathology indicates lymphatic spread of a pelvic retroperitoneal ectopic pregnancy removed by robot-assisted laparoscopy with temporary occlusion of the blood supply.
- 2010
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; APR 8, s. 835-839
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Retroperitoneal ectopic pregnancies are extremely rare and a diagnostic and therapeutic challenge as an early diagnosis is difficult and all treatments entail a risk for severe bleeding. We present a case of a live completely retroperitoneal ectopic pregnancy in the right obturator fossa. Following 3D color Doppler vaginal ultrasonography to evaluate the relation to larger blood vessels the pregnancy was completely removed by robot-assisted laparoscopic surgery. The hypogastric artery was temporarily occluded by removable vessel clips. Time for surgery was 126 minutes, no bleeding occurred. The postoperative course was uneventful and s-betahCG normalized in five weeks. Histopathology of the intact specimen showed trophoblast surrounded by lymphatic tissue. We believe robot-assisted laparoscopic surgery is a feasible and safe technique for surgery of retroperitoneal ectopic pregnancies with similar or other locations allowing occlusion of the main supplying artery. Lymphatic spread may explain retroperitoneal ectopic pregnancies.
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| 4. |
- Saldeen, Pia, et al.
(författare)
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A prospective randomized controlled trial comparing two embryo transfer catheters in an ART program.
- 2008
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Ingår i: Fertility and Sterility. - : Elsevier BV. - 1556-5653 .- 0015-0282. ; 90:3, s. 599-603
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the performance of the Cook Sydney IVF (SIVF) embryo transfer (ET) catheter and the Edwards-Wallace (EW) ET catheter. DESIGN: Prospective randomized controlled clinical trial with an intention-to-treat analysis. SETTING: Two-center study. PATIENT(S): Four hundred consecutive women <40 years undergoing ET with two fresh embryos. INTERVENTION(S): Women were randomly allocated to undergo ET with either the EW or the SIVF catheter, with possible catheter change in case of insertion difficulties. MAIN OUTCOME MEASURE(S): Live birth and clinical pregnancy rates. RESULT(S): Two hundred two women were allocated to the SIVF catheter and 198 to the EW catheter. No significant differences in the clinical pregnancy rates (odds ratio [OR] 0.99, 95% confidence interval [CI] 0.66-1.47) and live-birth rates (OR 1.09, 95% CI 0.72-1.65) were found. The EW catheter had to be changed more often than the SIVF catheter (OR 9.5, 95% CI 3.3-27.5) because of catheter insertion problems. CONCLUSION(S): The pregnancy and live birth rates were not significantly different with the two catheters, but catheter insertion failure was significantly more common with the EW catheter than with the SIVF catheter.
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| 5. |
- Saldeen, Pia, et al.
(författare)
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Structural, functional and circulatory placental changes associated with impaired glucose metabolism.
- 2002
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 105:2, s. 136-142
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate associations between structural, functional and circulatory placental changes in pregnancies complicated by impaired glucose metabolism. DESIGN: Umbilical artery (UA) blood flow resistance was measured by Doppler velocimetry in 21 gravidae with diabetes/impaired glucose tolerance (IGT) and 10 healthy gravidae. Umbilical and placental vessel segments were incubated for determination of prostacyclin and thromboxane synthesis, and tissues histologically examined. Non-parametric statistical tests at a two-tailed P<0.05 were used. RESULTS: Placental lesions were more common in diabetes/IGT and, although not being an uniform finding, in general associated with a higher vascular synthesis of thromboxane and/or lower prostacyclin/thromboxane synthesis ratio. As an exception, ischemic villitis was associated with a higher ratio and higher UA flow resistance. CONCLUSIONS: Placental lesions are associated with an altered vascular prostanoid synthesis in diabetes/IGT, but not until structural signs of ischemia develop is a rise of UA blood flow resistance detected.
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| 6. |
- Saldeen, Pia
(författare)
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Studies on Prostanoid Production in the Umbilicoplacental Circulation
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The fetoplacental circulation is a low pressure system with a high vascular prostacyclin to thromboxane (Pc/Tx)synthesis ratio. In intrauterin growth restriction (IUGR) and diabetes the prostanoid balance may be altered. AIMS: To investigate relationships between umbilicoplacental vascular prostanoid synthesis (by incubation of vessel samples), circulatory changes (by Doppler velocimetry of umbilical cord blood flows), structural placental changes (by histomorphology), lipid peroxidation (by cord plasma malondialdehyde) and platelet activation (by cord plasma Tx). RESULTS: IUGR-study: 1) Umbilical cord vascular prostanoid synthesis was lower in growth restricted than in normally grown neonates; 2) No correlation between cord prostanoid synthesis and umbilical artery vascular flow resistance was found. Diabetes studies: 1) The Pc/Tx vascular synthesis ratios were generally lower in diabetes compared with controls; 2) A positive correlation between flow resistance and Pc/Tx ratio was found in the umbilical artery; 3) In the umilicoplacental arterial tree, the vascular production of Px decreased and that of Tx increased towards the periphery; 4) Placental histomorphological lesion were in general associated with a higher vascular Tx synthesis and/or lower Pc/Tx synthesis ratio; 5) In contrast, ischemic villitis was associated with a higher Pc/Tx ratio; 6)Signs of platelet activation, but not lipid peroxidation, were found in fetal plasma of diabetics; 7) A defect vascular prostanoid synthesis capacity was found among diabetics. CONCLUSION: In IUGR the vascular prostanoid synthesis was generally low but not associated with abnormal umbilical cord blood flows. Impaired maternal glucose metabolism was associated with disturbances in the prostanoid equilibrium in fetal blood and umbilicoplacental vessels. These finding indicate endothelial cell pathology and disturbed vessel wall function.
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| 7. |
- Saldeen, Pia, et al.
(författare)
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The probability of successful IVF outcome after poor ovarian response
- 2007
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 86:4, s. 457-461
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Tidskriftsartikel (refereegranskat)abstract
- Background. To evaluate the relationship between age and poor ovarian response to pregnancy and cancellation rate after IVF stimulation. Methods. Poor ovarian response was defined as <= 5 follicles at ovum pick up (OPU). Out of 1,706 consecutive OPUs performed during 2003/2004, 290 poor responders were identified. This cohort of poor responders was divided into two groups, 'older' and 'younger', with a cut-off at the median age of 37 years. The pregnancy and cancellation rates after OPU were analysed. Results. Women aged > 37 years, who were poor responders, had a significantly lower pregnancy rate per OPU (3.0%) compared to normal to high responders in the same age group (22.1%, p < 0.05). Also, 43.6% of women > 37 years, who were classified as poor responders, did not receive an embryo transfer ( ET), compared to 13.2% of normal to high responders in this age group ( p < 0.05). Poor responders who were 5/37 years had a significantly lower pregnancy rate/OPU compared to normal to high responders who were <= 37 years (14.0 versus 34.5%, p < 0.05) and a higher cancellation rate (40.1 versus 10.5%). Logistic regression analyses showed strong correlations between treatment outcome and the number of oocytes, age, and the mean and cumulative FSH dose given. The variable with the strongest impact on negative outcome was an interactive term between mean age and mean-FSH dose ( p = 5.0 x 10(-5)), indicating that women > 37 years, who receive high doses of FSH have a significantly poorer treatment outcome than can be explained by either age or FSH dose alone. Conclusions. Poor ovarian response after IVF stimulation requires thorough counselling prior to OPU, regardless of the woman's age. In poor responders > 37 years of age, especially those who require high FSH doses, we suggest that the decision whether or not to proceed to OPU should include the couple after thorough counselling, even though the chance of successful outcome is extremely low.
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| 8. |
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| 9. |
- Sundström, Per, et al.
(författare)
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Cumulative delivery rate in an in vitro fertilization program with a single embryo transfer policy.
- 2009
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 88:6, s. 700-706
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the cumulative delivery rate for women completing three fresh embryo transfer cycles or giving birth after the first or second transfer cycle in an in vitro fertilization program with a single embryo transfer (SET) policy. SETTING: Privately run infertility clinic in southern Sweden (Skåne region). POPULATION: Four hundred fifty-three consecutive, unselected public patients beginning an ovum pick-up cycle between July 2002 and June 2004. METHOD: Retrospective, observational study. MAIN OUTCOME MEASURE: Cumulative delivery rates. RESULTS: Of 370 women who completed the study with up to three fresh ET cycles (90% SETs), 244 women (66%) progressed to delivery. Among the deliveries were three sets of twins (1%), one dizygotic. Cumulative delivery rates showed significant differences relative to age <36 (71%) and >or=36 years (47%), and delivery rates relative to rank of ET cycle (first and second vs. third ET cycle - 35, 34, and 21% delivery rates, respectively). CONCLUSIONS: The 66% cumulative delivery rate is in accordance with rates in similar observational studies and in estimation studies, in which predominantly two embryos were used for transfer. The multiple delivery rate was low. We suggest that repeated SET cycles can be implemented on a large scale even in a primarily unselected patient population without compromising the outcome.
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| 10. |
- von Wowern, Emma, et al.
(författare)
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Arterial stiffness during controlled ovarian hyperstimulation and early pregnancy in women exposed to assisted reproduction
- 2018
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Ingår i: Hypertension in Pregnancy. - : Informa UK Limited. - 1064-1955 .- 1525-6065. ; 37:4, s. 182-191
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Female sex hormones have vasorelaxing effects in non-pregnant and pregnant women. We aimed to investigate the effect of controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF), and early pregnancy, on arterial stiffness as assessed by digital pulse wave analysis (DPA), hypothesizing reduced arterial stiffness as an effect of increased estrogen levels.MATERIAL AND METHODS: A total of 68 women undergoing IVF were examined with DPA before conception and during IVF treatment with COH and embryo transfer (ET), and in gestational week seven in 19 women who became pregnant. Heart rate (HR), mean arterial pressure (MAP) and the DPA variables cardiac ejection elasticity index (EEI), b/a, dicrotic index (DI), d/a and aging index (AI) were measured.RESULTS: HR was significantly increased at all measuring points (p ≤ 0.003) but MAP only at ET (p 0.007). DPA variables representing large arteries (EEI, b/a) and peripheral arteries (DI, but not d/a), and the global variable AI, indicated increased arterial stiffness at ET compared with baseline (p ≤ 0.035). No DPA variable was significantly changed at pregnancy measurements compared to baseline.CONCLUSION: During COH for IVF treatment, DPA showed no changes in arterial stiffness during the follicular phase or in early pregnancy, but increased arterial stiffness in central and peripheral arteries in the early luteal phase. The result suggests a hormonal hemodynamic activation counteracting the effects of estrogen.
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| 11. |
- Wennberg, Anna Lena, 1968, et al.
(författare)
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Egen äggbank fbör att skydda fertiliteten mot åldrande. : Private egg bank to protect fertility against aging
- 2014
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Ingår i: Läkartidningen. - 0023-7205. ; 111:18-19, s. 793-5
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Tidskriftsartikel (refereegranskat)abstract
- Förglasning (vitrifiering) är en ny metod för att frysa obefruktade äggceller med resultat jämförbara med konventionell IVF. Äggfrysning i fertilitetsbevarande syfte kan göras av medicinska skäl men också för att skydda fertiliteten mot åldrande. Statens medicinsk-etiska råd (Smer) anser att äggfrysning bör kunna erbjudas kvinnor av såväl medicinska som sociala skäl. Äggfrysning av sociala skäl bekostas av individen. Arbete pågår med att fastställa nationella riktlinjer för nedfrysning av ägg. Vår erfarenhet är att kvinnor som fryser ägg av sociala skäl har en stark barnönskan men saknar möjlighet till graviditet i sin aktuella sociala situation.
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