S Nilsson

Uppsala University, Uppsala, Uppsala, Sweden

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Publications (82)373.83 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Summary Two symphysis-fundus (SF) curves based on ultrasonically dated pregnancies were constructed. One SF curve (A) was constructed using data from all 2255 included women and another SF curve (B) from 1226 women who were selected by almost the same maternal and neonatal criteria as Westin used. The level of both curves is higher than the SF reference curve used today.
    Journal of Obstetrics and Gynaecology 07/2009; 16(4):228-229. DOI:10.3109/01443619609020709 · 0.60 Impact Factor
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    ABSTRACT: To investigate birth rates with two oxygen (O(2)) concentrations in blastocyst culture. Randomized trial. Private in vitro fertilization (IVF) clinic. Six hundred women undergoing IVF. Blastocyst culture in atmospheres with either 6% carbon dioxide (CO(2)) in air, the equivalent to 19% O(2), a two-gas system; or 5% O(2), 6% CO(2), and 90% nitrogen (N(2)), a three-gas system. Birth rate. The inclusion criterion for blastocyst culture (at least five fertilized oocytes) was fulfilled in 396 women, randomized to 197 cultures with the three-gas system and 199 cultures with the two-gas system. The outcome with the three-gas system compared with the two-gas system showed a statistically significantly increased blastocyst rate (47.8% vs. 42.1%), mean number of blastocysts (3.8 vs. 3.3), and number of cryopreserved blastocysts (1.7 vs. 1.1). The mean number of transferred blastocysts was 1.2 versus 1.3. Culture with the three-gas system increased the relative birth rate by 10% compared with the two-gas system (42% vs. 32%, respectively), a statistically significant difference. The overall twin rate was 4.8%. Blastocyst culture with low-oxygen (5%) versus high-oxygen (19%) concentration yielded a better blastocyst outcome and a marked improvement in birth rate. Generation of cytotoxic reactive oxygen species with prolonged embryo culture might deteriorate blastocyst viability.
    Fertility and sterility 07/2008; 91(6):2461-5. DOI:10.1016/j.fertnstert.2008.03.051 · 4.30 Impact Factor
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    M Blennborn, D Hellberg, S Nilsson
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    ABSTRACT: The aim of this study was to evaluate the information and the factors that contribute to the decision to accept and choose single embryo transfer (SET) in females and males. Fifty-four females and males undergoing SET were interviewed separately using a structured questionnaire. The women were significantly more satisfied with the information than the men (odds ratio 3.3), but the decision to accept SET was nevertheless more difficult for women (OR 3.1). Only one-third of both female and males were aware of the increased maternal risks with twin pregnancies. There was a tendency that the women who accepted SET had previous children, shorter duration of infertility, and were younger. Cryopreservation of embryos and a good pregnancy chance were important irrespective of gender. The female needs more support to choose SET. The male needs better information and further involvement in decision-making. The females were more aware of the fetal risks, but the awareness of the increased maternal risks with twin pregnancies was low.
    Journal of Assisted Reproduction and Genetics 09/2007; 24(8):337-42. DOI:10.1007/s10815-007-9132-y · 1.77 Impact Factor
  • Article: IVF and HPV
    Dan Hellberg, Staffan Nilsson
    Fertility and sterility 07/2007; 87(6):1498; author reply 1498. DOI:10.1016/j.fertnstert.2007.01.135 · 4.30 Impact Factor
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    ABSTRACT: To determine risk factors for the appearance of de novo urgency symptoms, and subsequent accompanying problems, after the tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence. A structured preoperative analysis of the incontinence symptoms was made. A mailed questionnaire was distributed to 970 women that underwent the TVT procedure between 1995 and 2001. Average follow-up was 5.2 years (range 2-8 years). The questionnaire included specific questions on current urinary symptoms and incontinence. The disease-specific quality of life instruments IIQ-7 and UDI-6 were used to compare women with, and those without de novo urgency. Seven hundred and sixty women (78.3%) responded and 463 of those were identified as genuine stress incontinence preoperatively. De novo urgency occurred in 67 (14.5%) of the women. The frequency was similar irrespective of duration since the TVT procedure. The women that reported de novo urgency symptoms were compared with those without symptoms. Risk factors for occurrence of de novo urgency symptoms were older age (64.7 years versus 60.9 years; p=0.01), parity (2.6 versus 2.3; p=0.05), history of cesarean section (9.5% versus 2.5%; odds ratio 5.4), and history of recurrent urinary infections (29.7% versus 18.8%; odds ratio 1.6, but non-significant. De novo urgency had a severe impact on quality of life, as compared to the remaining study population. Old age, parity and history of cesarean section were risk factors for de novo urgency after TVT surgery. Postoperative de novo urgency symptoms are as bothersome for the patient as the preoperative stress urinary incontinence.
    European Journal of Obstetrics & Gynecology and Reproductive Biology 06/2007; 132(1):121-5. DOI:10.1016/j.ejogrb.2006.04.012 · 1.63 Impact Factor
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    ABSTRACT: To investigate the outcome of IVF following intracytoplasmic sperm injection (ICSI) from ejaculate, percutaneous epididymal sperm aspiration (PESA) and testicular sperm extraction (TESE), with subsequent blastocyst culture and single blastocyst transfer. Single blastocyst transfer was performed after ejaculate ICSI (oligozoospermia) in 587 patients, TESE/PESA (azoospermia) in 31 patients, and standard IVF in 680 women. There were only minor differences in IVF characteristics between the standard IVF and the PESA-TESE couples. Couples where ejaculate ICSI were performed seemed to represent a slightly poorer prognostic group. A viable fetus after the 12th gestational week, i.e. ongoing pregnancy, was present in 41.4% after ICSI/ET, 51.6% after PESA-TESE/ET and in 40.4% after standard IVF/ET (no significant differences). Single blastocyst transfer after ejaculate ICSI or after PESA/TESE appears to give similar results as conventional IVF blastocyst culture.
    Journal of Assisted Reproduction and Genetics 06/2007; 24(5):167-71. DOI:10.1007/s10815-006-9091-8 · 1.77 Impact Factor
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    ABSTRACT: A mailed questionnaire was sent to 970 consecutive women who underwent a tension-free vaginal tape (TVT) procedure between 1995 and 2001 at the Department of Obstetrics and Gynecology in Falun Hospital. Seven hundred and sixty (78.4%) women responded. The outcome was compared between women older than 75 years (n=113) and younger women, and between women with a body mass index (BMI) above 35 (n=61) and those who had normal weight. Mean follow-up was 5.7 years. Thirty-six elderly women and one of the obese women were deceased at the long-term follow-up. TVT was easy to perform and was a safe procedure for women in all groups. There was a sharp decrease in cure rate of any urinary incontinence problems among women aged 75 years or more (55.7%), as compared to those who were younger (79.7%). The cure rate moderately decreased from BMI groups 19-24 to 30-34. BMI > or =35 seemed to be the best explanatory cutoff level. The overall cure rate in women of normal weight was 81.2%, as compared to 52.1% in the very obese. The cure rate for urinary incontinence with tension-free vaginal tape in women above 75 years of age and in women with a BMI above 35 was acceptable, but lower as compared to the remaining study population.
    International Urogynecology Journal 04/2007; 18(4):423-9. DOI:10.1007/s00192-006-0162-2 · 2.16 Impact Factor
  • S Nilsson, D Hellberg
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    ABSTRACT: A 47-year old man attending at an in vitro fertilization clinic for infertility was diagnosed with congenital idiopathic hypogonadotrophic hypogonadism. No palpable testes and no spermatozoa in the ejaculate were found. Endocrinologically serum FSH, LH and testosterone was undetectable. A retroperitoneal magnetic resonance imaging confirmed the testicular absence. rFSH/hCG treatment was initiated. At four months almond-sized testes had developed and puncture with testicular sperm extraction (TESE) showed occasional immobile spermatozoa. Six months after initiation of treatment occasional mobile spermatozoa in semen were successfully used for intracytoplasmic sperm injection (ICSI) and one oocyte was fertilized and transferred. After 12 months sperm count revealed 10(5) mobile spermatozoa and three oocytes were fertilized. The embryo transfers did not result in a clinical pregnancy. As far as we know, this is the first time that objectively diagnosed testes atrophy could be successfully treated with FSH/hCG.
    Archives of Andrology 03/2006; 52(2):135-8. DOI:10.1080/01485010500315891 · 0.89 Impact Factor
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    ABSTRACT: To undertake a long-term follow-up evaluation of the quality of life (QOL) of women who had undergone a tension-free vaginal tape (TVT) procedure. During the period 1995-2001, 970 women with urinary stress incontinence underwent TVT surgery at the Department of Obstetrics and Gynecology, Falun Hospital. A questionnaire was mailed on average 5.7 years after the TVT procedure. Two incontinence-specific QOL instruments--the Incontinence Impact Questionnaire-7 (IIQ-7) and the Urogenital Distress Inventory-6 (UDI-6)--were administered. An additional questionnaire included general questions and questions about chronic diseases that may be associated with urinary incontinence. The mean age at surgery was 58.7 years (range 29-89 years). Of 913 eligible women, 768 (78.9%) responded. Mean IIQ-7 and IDU-6 scores as estimated by the women improved dramatically at follow-up as compared to preoperative values: from 43.7 to 11.5 for the IIQ-7 and from 54.2 to 24.0 for the UDI-6 on a scale from 0 to 100 (p = 0.0001 for both). There were few differences in mean QOL scores even 8 years after TVT surgery, compared to those determined a shorter time after the operation. Women with diabetes, chronic constipation, chronic bronchitis and preoperative recurrent urinary infections had a relative improvement in QOL of the same magnitude as that of the remaining study population. Advanced age was negatively associated with an improvement in QOL scores. Improvements in measures of QOL after TVT surgery are dramatic and persist for years. Women with concomitant diseases that may be associated with urinary incontinence can be assured that there is a good chance of success with TVT surgery.
    Scandinavian Journal of Urology and Nephrology 02/2006; 40(2):131-7. DOI:10.1080/00365590510031309 · 1.06 Impact Factor
  • Acta Obstetricia Et Gynecologica Scandinavica 02/2006; 85(12):1512; author reply 1513. DOI:10.1080/00016340600969424 · 1.99 Impact Factor
  • Article: P-248
  • Article: P-250
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    ABSTRACT: To compare outcome of the tension-free vaginal tape (TVT) procedure in women with urinary mixed and stress incontinence. A mailed questionnaire was answered by 760 of 970 women who had undergone TVT surgery 2-8 years ago (78% response rate). Seventeen women had unclassified incontinence, and 51 women who developed de novo urgency were excluded, giving 580 (83.8%) with stress incontinence and 112 (16.2%) women with mixed incontinence eligible for analysis. Demographic, reproductive factors, and medical history were obtained. The questionnaire included detailed questions about urinary symptoms. Analysis of outcome was done for cohorts by number of years since the operation. The women with stress incontinence had a persistent cure rate of 85% from 2 to 8 years after the TVT procedure. The women with mixed incontinence had a persistent cure rate of 60% up to 4 years postoperatively, but the cure rate then steadily declined to 30% from 4 to 8 years after surgery. The increased rate of incontinence was due to urgency symptoms. The results of this study indicate that initial good cure rates of TVT for mixed incontinence do not persist after 4 years. III.
    Obstetrics and Gynecology 08/2005; 106(1):38-43. DOI:10.1097/01.AOG.0000167393.95817.dc · 4.37 Impact Factor
  • Urban Waldenström, Dan Hellberg, Staffan Nilsson
    Archives of Gynecology and Obstetrics 08/2005; 272(2):182. DOI:10.1007/s00404-004-0693-z · 1.28 Impact Factor
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    ABSTRACT: Single blastocyst transfer was performed in 306 IVF patients during 2002 to August 2003 in women younger than 39 years of age with at least five fertilized oocytes. Viable pregnancy rate per single blastocyst transfer was 40.7% during 2002 and 47.6% during 2003 (amounting to 35% of all IVF cycles), which in our experience are acceptable results.
    Fertility and sterility 07/2005; 83(6):1849-51. DOI:10.1016/j.fertnstert.2004.11.079 · 4.30 Impact Factor
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    Dan Hellberg, Maria Blennborn, Staffan Nilsson
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    ABSTRACT: The aim of the present study was to identify subsets of women undergoing two-embryo transfer in in vitro fertilization (IVF) who are prone to give birth to twins. During 1990 to 2002 4580 day 2 or day 3 two-embryo transfers were conducted and these constituted the study population. By selecting combinations of factors, some subsets of patients where single-embryo transfer might be conducted would reduce the estimated twin rate by 60%, but requiring single-embryo transfer in only approximately one third of the patients. Examples of such selected groups were patients less than 33 years of age with two top quality embryos, patients less than 39 years of age with two top quality embryos and conducting their first IVF cycle, and patients less than 39 years of age with two top quality embryos and two optimal cleavage cells. By combining factors, subsets of patients with both a high birth and twin rate that could be recommended single embryo transfer were identified.
    Journal of Assisted Reproduction and Genetics 06/2005; 22(5):199-206. DOI:10.1007/s10815-005-4921-7 · 1.77 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the decision-making process and factors that contribute to the decision of IVF participants to choose one or two embryos at transfer. Two hundred and seventy-four IVF patients equally distributed in males and females were personally interviewed using a semi-structured questionnaire which included 82 items. In the whole study population, previous childbirth [odds ratio (OR) 2.1; 95% confidence interval (CI) 1.9-3.6], and spare embryos to freeze (OR 23.6; 95% CI 11.2-54.5) emerged as the most important variables in patients who had one embryo transferred, while previous IVF treatments (OR 0.3; 95% CI 0.1-0.6) and the assumed increased pregnancy chance (OR 0.1; 95% CI 0.05-0.3) were the most important decision-making factors among those who had two embryos. The women were more satisfied with the information (83 versus 71%; P = 0.02), and more aware of the risks with twin pregnancies (77 versus 66%; P = 0.03) than the males. The women were also more concerned about their age. Knowledge about risks of multiple pregnancies was higher in females (77%) than in males (66%, P = 0.03). The results of this study indicate that despite good information about the risks for complications with multiple pregnancies, many patients wish to have two embryos transferred. Spare embryos to freeze, improvement of pregnancy rate in single embryo transfer and young age of the woman are predictive of choosing single embryo transfer. However, the final decision must always be made in agreement with the physician.
    Human Reproduction 06/2005; 20(5):1292-7. DOI:10.1093/humrep/deh785 · 4.59 Impact Factor
  • Dan Hellberg, Urban Waldenström, Staffan Nilsson
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    ABSTRACT: To define “poor responder,” 1699 women with two subsequent IVF cycles (898 of whom had three subsequent IVF cycles) were studied. When one to two oocytes were retrieved in the first cycle the birth rate in the second cycle was less than 10%, and if four or fewer oocytes were retrieved in the second IVF cycle the birth rate in the third cycle was only 7%.
    Fertility and Sterility 09/2004; 82(2):488-90. DOI:10.1016/j.fertnstert.2004.03.025 · 4.30 Impact Factor
  • Urban Waldenström, Dan Hellberg, Staffan Nilsson
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    ABSTRACT: To determine if treatment with low-dose aspirin in a short regimen improves the outcome in a nonselected IVF population as compared with no treatment. Prospective, randomized study where IVF patients were given aspirin or received no treatment. IVF clinic. The study included 1380 consecutive IVF cycles. Women undergoing IVF were randomly assigned to treatment with aspirin 75 mg daily from the day of embryo transfer (ET) until pregnancy test or no treatment in an open study. Birth rate per ET. Background characteristics were similar in the two groups studied except for a minor difference in number of embryos transferred (2.1 vs. 2.0). Birth rate was 27.2% in the aspirin group as compared with 23.2% in the nontreated group, giving an odds ratio, adjusted for number of embryos transferred, of 1.2 (95% confidence interval, 1.0-1.6). The increased birth rate with aspirin compared with no treatment was significant. Given the importance of every birth in IVF, especially when taking into account the limited number of IVF cycles that are normally performed in an individual woman, any treatment to improve birth rate is important.
    Fertility and Sterility 07/2004; 81(6):1560-4. DOI:10.1016/j.fertnstert.2004.02.082 · 4.30 Impact Factor
  • D Hellberg, S Nilsson, P A Mårdh
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    ABSTRACT: In a population of 956 women, attending for contraceptive advice, 131 (13.7%) were found to have BV acording to Amsel's criteria. Clue cells were detected in 200 (20.9%) women, a positive amine ('sniff') test in 191 (20.0%), a vaginal pH > or = 4.7 in 243 (25.4%) and a "characteristic" vaginal discharge in 104 (10.9%) women. Sensitivity, specificity, positive and negative predictive values in relation to BV were calculated for each of these four criteria. The detection of clue cells, an increased pH and a positive sniff test showed excellent sensitivity (86-100%) values, but had a less satisfactory positive predictive value (52-68%). Vaginal discharge was found to be a poor predictor of BV. The vaginal flora in women with clue cells, increased vaginal pH or a positive sniff test was very similar to that of the women with BV, every after excluding concomitant cases of BV and the three respective criteria. Thus, a positive amine test, which is easily performed, strongly suggests BV and a vaginal flora predominated by Gardnerella vaginalis, Mycoplasma hominis, Mobiluncus species and anaerobic species on one hand, and lack of lactobacilli on the other. When there is a clinical suspicion of BV, the sniff test is positive and differential diagnoses are excluded, one can safely treat a woman for bacterial vaginosis.
    Archives of Gynecology and Obstetrics 03/2001; 265(1):11-5. DOI:10.1007/s004040000109 · 1.28 Impact Factor

Publication Stats

2k Citations
373.83 Total Impact Points


  • 1986–2009
    • Uppsala University
      • Department of Women's and Children's Health
      Uppsala, Uppsala, Sweden
  • 1986–1994
    • National Veterinary Institute, Sweden
      Uppsala, Uppsala, Sweden
  • 1992
    • Uppsala University Hospital
      Uppsala, Uppsala, Sweden
  • 1991
    • Akademiska Sjukhuset
      Uppsala, Uppsala, Sweden