T. Cordes

Universitätsklinikum Schleswig - Holstein, Kiel, Schleswig-Holstein, Germany

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Publications (56)65.71 Total impact

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    ABSTRACT: Zusammenfassung Die Frage, ob eine ovarielle hormonelle Stimulation mit einem erhöhten Krebsrisiko für gynäkologische Karzinome einhergeht, stellt nach wie vor eine Kontroverse dar. Es gibt Hinweise in Studien, dass Risikofaktoren im Kollektiv infertiler Frauen existieren, die zu einem erhöhten Erkrankungsrisiko für bestimmte Malignome führen. Zu diesen zählen Nulligravidität, lange Stimulationsbehandlungen von Patientinnen mit einer langen Nachbeobachtungszeit sowie häufig durchgeführte Clomifenstimulationen. Außerdem scheint eine leichte Erhöhung von Borderline-Tumorinzidenzen während ovarieller Stimulation vorzuliegen. Die Daten zum Mammakarzinom werden in den einzelnen Untersuchungen sehr heterogen angegeben, während neuere Studien zum Endometriumkarzinom bei Clomifenstimulation durchaus Hinweise auf ein erhöhtes Erkrankungsrisiko zeigen. Die Ergebnisse der einzelnen Studien müssen weiterverfolgt werden, insbesondere, da die Patientinnen, die eine ovarielle Stimulation erhalten haben, erst jetzt den malignomspezifischen Altersgipfel der Karzinomerkrankung erreichen. Es müssen weitere epidemiologische Untersuchungen durchgeführt und die Daten längerer Nachbeobachtungszeiten in laufenden Studien abgewartet werden, um hinsichtlich dieser Fragestellung eindeutigere Aussagen machen zu können.
    No preview · Article · Sep 2014 · Gynäkologische Endokrinologie
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    ABSTRACT: Purpose: In the GnRH-antagonist protocol, ovarian stimulation with gonadotropins typically commences on cycle day 2 or 3. Initiation of ovarian stimulation with a spontaneously occurring menstruation, however, poses significant organizational challenges for treatment centres and patients alike. It has previously been demonstrated in the context of fertility preservation that initiation of stimulation in the luteal phase is feasible in terms of retrieval of mature oocytes for cryopreservation. Herein, we report the extension of this concept to a routine IVF setting with the aim of establishing an ovarian stimulation protocol, which can be utilized independent of menstruation. Because of asynchrony of endometrium and embryo in such a setting, all fertilized oocytes have to be cryopreserved for a later transfer. Methods: This was a prospective, case-control study (trial registration: NCT00795041) on the feasibility of starting ovarian stimulation in a GnRH-antagonist protocol in the luteal phase. Inclusion criteria were: IVF or ICSI; 18-36 years; ≤3 previous IVF/ICSI attempts; BMI 20-30 kg/m(2); regular cycle (28-35 days); luteal phase progesterone >7 ng/ml at initiation of stimulation. Exclusion criteria were: PCOS, endometriosis ≥AFS III°, unilateral ovary, expected poor response. Stimulation was performed with highly purified uFSH (Bravelle®) 300 IU/day and 0.25 mg/day GnRH-antagonist starting on cycle day 19-21 of a spontaneous menstrual cycle and commencing until hCG administration when three follicles ≥17 mm were present. All 2PN stage oocytes were vitrified for later transfers in programmed cycles. Feasibility was defined as the achievement of ongoing pregnancies progressing beyond the 12th gestational week in at least 2/10 study subjects (primary outcome). Secondary outcomes were gonadotropin consumption per oocyte obtained, stimulation duration, and fertilization rates. Study subjects were matched in a 1:3 ratio with concomitantly treated control cases of similar age, BMI, and duration of infertility who were treated in a conventional GnRH-antagonist protocol with 150-225 rFSH or HP-HMG/day. Results: The study group consisted of ten subjects, mean age 31.4 years, BMI 25.4 kg/m(2), of which one had fertilization failure. Mean stimulation duration was 11.7 (SD 1.6) vs. 9.1 (SD 1.3) days, mean cumulative FSH dose was 3,495.0 (SD 447.5) vs. 2,040.5 (SD 576.2) IU, and mean number of oocytes was 8.8 (SD 5.0) vs. 10.0 (SD 5.4) in study vs. control group, respectively. Per follicle ≥10 mm, the cumulative FSH dose was 274.5 (SD 130.8) IU vs. 245.2 (SD 232.3) IU in study and control groups, respectively. Cumulative ongoing pregnancy rates were 1/10 (10 %) and 6/30 (20.0 %) in study and control group, respectively (difference: 10 %, 95 % confidence interval of the difference: -29.2-22.2 %, p = 0.47). Fertilization rate was similar between groups, with 63.5 % (SD 32.9) in the study and 61.3 % (SD 26.7) in the control group, respectively. Serum estradiol levels were significantly lower on the day of triggering final oocyte maturation with 1,005.3 (SD 336.2) vs. 1,977.4 pg/ml (SD 1,106.5) in study and control group, respectively. Similarly, peak estradiol biosynthesis per growing follicle ≥10 mm was lower in the study group (134 pg/ml, SD 158.4 vs. 186.7 pg/ml, SD 84.7). Conclusions: Per retrieved oocyte, a nearly threefold higher dose of FSH had to be administered when ovarian stimulation had been initiated in the luteal phase. Furthermore, the present study casts doubt on the efficacy of initiating ovarian stimulation in the luteal phase in terms of pregnancy achievement. Thus, this concept is currently not feasible for routine use, and it should also be explored further before using it at larger scale in the context of emergency stimulation for fertility preservation.
    No preview · Article · Apr 2013 · Archives of Gynecology
  • N. Bündgen · A. Rody · K. Diedrich · T. Cordes
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    ABSTRACT: Seit der Geburt des ersten Kindes nach IVF-Therapie im Jahr 1978 hat die Reproduktionsmedizin rasante Fortschritte in den Behandlungsmöglichkeiten von Kinderwunschpaaren gemacht. Zuletzt wurden in Deutschland 75.928 ART-Behandlungen mittels IVF/ICSI dokumentiert mit einer klinischen Schwangerschaftsrate von 28,69%. Obwohl die Methoden der ART kontinuierlich verbessert werden, bleiben Risiken der Behandlung, wie das Überstimulationssyndrom, Komplikationen bei der Eizellentnahme, das Mehrlingsrisiko und eine erhöhte kindliche Fehlbildungsrate, bestehen. Paaren mit der Anlageträgerschaft einer schweren genetischen Erkrankung steht nun auch in Deutschland an ausgewählten Zentren und nach einem positiven Ethikvotum die Möglichkeit einer Präimplantationsdiagnostik zur Verfügung, um die psychischen und physischen Belastungen einer ,,Schwangerschaften auf Probe“ zu vermeiden.
    No preview · Article · Jan 2013 · Der Gynäkologe
  • Dr. T. Cordes · K. Diedrich
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    ABSTRACT: Durch die heutzutage deutlich effektivere Therapie von Krebserkrankungen junger Patientinnen und Patienten und die glücklicherweise deutlich gestiegenen Überlebensraten rücken Themen wie der Fertilitätserhalt vor Beginn einer Chemo- oder Strahlentherapie in den Vordergrund. Über die mögliche Nebenwirkung Sterilität müssen die Patienten vor der Behandlung aufgeklärt werden. Da viele junge Patienten in der internistischen Onkologie behandelt werden, ist eine Plattform zur Information und Aufklärung für die Beratung essenziell. In diesem Zusammenhang sind die behandelnden Frauenärzte eine wichtige Instanz, um betroffene Patientinnen, ggf. auch deren Partner, über Therapien und die Möglichkeit des Fertilitätserhaltes zu informieren. So kann der Kontakt zum nächsten beratenden Kinderwunschzentrum hergestellt werden und der Patientin eine sofortige Beratung bei noch nicht abgeschlossenem Kinderwunsch angeboten werden. Ein Gespräch über diese belastende Situation und die vorhersehbaren iatrogen hervorgerufenen Folgeerscheinungen sollte daher mit einer der Patientin nahestehenden Person erfolgen. Optionen vor geplanter zytotoxischer Therapie sind neben den konventionellen reproduktionsmedizinischen Techniken die Gabe von GnRH-Analoga die Oozytenkryokonservierung, die Kryokonservierung von Ovarialgewebe und die In-vitro-Maturation. Der teils noch sehr experimentelle Charakter einzelner Maßnahmen ist bei der individuellen Nutzen-Risiko-Abwägung zu berücksichtigen.
    No preview · Article · Dec 2012 · Der Gynäkologe

  • No preview · Article · Feb 2012 · Cancer Research
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    ABSTRACT: Cyclooxygenase-2 (COX-2) plays a crucial role in prognosis of malignancy and has been associated with carcinogenesis, particularly neoangiogenesis and tumor progression. 15-Hydroxyprostaglandin dehydrogenase (15-PGDH) is described as a tumour suppressor in cancer. The antiproliferative effects of calcitriol [1,25(OH)(2)D(3)] mediated via the vitamin D receptor (VDR) render vitamin D a promising target in breast cancer therapy. The expression of prostaglandin (PG)-metabolizing enzymes, vitamin D-metabolising enzymes and VDR were determined in benign and malignant breast cell lines using western blot analysis. We detected an inverse correlation between the two types of metabolism, a reduced VDR expression in the malignant breast cell lines, and therefore an insufficient induction of 24-hydroxylase in the malignant cells. We suggest the possibility of dysregulation of vitamin D-metabolizing enzymes in malignant breast cell lines.
    Full-text · Article · Jan 2012 · Anticancer research
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    ABSTRACT: The anticarcinogenic potential of vitamin D is attributed to antiproliferative and prodifferentiative effects on cells for a wide variety of carcinomas. The biological effects of 1,25(OH)(2)D (calcitriol) are mediated through a soluble receptor protein termed vitamin D receptor (VDR). However, thus far there have been no studies evaluating the association between VDR expression and vulvar cancer. Using immunohistochemical analysis, VDR expression was evaluated separately in the nucleus, cytoplasm and membrane, in vulvar cancer samples and adjacent non-pathological vulvar tissue from 48 squamous cell carcinoma patients with no prior therapy, and the association between VDR and overall survival was investigated. Overall, among the 48 vulvar cancer cases, nuclear and cytoplasmic VDR expression was present in 47 (97.9%) and 23 (47.9%) cases respectively. The median nuclear VDR expression was significantly higher as compared to the cytoplasmic VDR in the vulvar cancer tissue. No significant correlation between VDR values and the age of the patients was detected. Nuclear and cytoplasmatic VDR in the vulvar cancer tissue were also compared according to the tumor size, and no significant association between mean tumor VDR and tumor size was detected. There was no association between cytoplasmatic VDR expression and OS, but better OS was observed in patients with reduced nuclear VDR expression as compared to those with high VDR expression. VDR may be considered as a useful pathological marker.
    No preview · Article · Jan 2012 · Anticancer research
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    ABSTRACT: Cyclooxygenase-2 (COX-2) is a potential molecular prognostic factor for breast cancer, and calcitriol [1,25(OH)(2)D(3)], the biologically active form of vitamin D, is a promising target in breast cancer therapy. The influence of calcitriol on the proliferation and the effects of calcitriol on the expression of prostaglandin- and vitamin D-metabolising enzymes were examined in benign and malignant breast cells. Calcitriol inhibited the proliferation of MCF-10F and MCF-7 cells but not of invasive MDA-MB-231 cells and reduced the expression of COX-2 and 15-hydroxyprostaglandin dehydrogenase (15-PGDH) in the benign breast cell line MCF-10F. Furthermore, dysregulation in vitamin D-metabolising proteins was detected, especially in MDA-MB-231 cells. These results suggest dysregulation of vitamin D metabolism and a lack of a possible influence of calcitriol on the metabolism of prostaglandins in the malignant breast cell lines.
    Full-text · Article · Jan 2012 · Anticancer research
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    ABSTRACT: The anticarcinogenic potential of vitamin D 25(OH)D has been attributed to the inhibition of proliferation of cells from different carcinomas. Reduced serum levels of 25(OH)D are associated with an increased incidence of various types of cancer. The influence of serum 25(OH)D on the incidence and outcome of patients with vulvar cancer is unknown. The serum 25(OH)D levels in 24 patients with vulvar cancer and 24 age-matched cancer-free patients was investigated. The blood samples were collected between October 2009 and September 2010 and time of blood collection of each patient and control was matched to avoid seasonal variations between the pairs. The median 25(OH)D serum levels in the under 50 year old group of patients were significantly lower in the vulvar cancer group than the controls. The younger cancer group also had an age-related trend of lower median serum level than the older population. In the control population the trend was vice versa, yet this finding was not statistically significant. Serum 25(OH)D has a possible role in the pathogenesis and progression of vulvar cancer, but further investigations of the association of vitamin D and vulvar cancer as well as regarding its influence on patient survival and quality of life are warranted in the future.
    Full-text · Article · Jan 2012 · Anticancer research
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    ABSTRACT: Vitamin D and its active form calcitriol have multiple effects in cancer cells, such as anti-proliferative effects, induction of apoptosis and cell cycle arrest. There is a link between vitamin D metabolism and inflammatory processes, which should be considered in cancer therapy. An association between these two types of metabolism is also observed in breast and ovarian cancer. These inflammatory processes are based on an increase of cyclooxygenase-2 (COX-2) activity. The current study aimed to evaluate the expression of prostaglandin-metabolising enzymes COX-2 and 15-hydroxyprostaglandin-dehydrogenase (15-PGDH) along with the vitamin D receptor (VDR) in benign and malignant breast and ovarian tissues. VDR, COX-2, 15-PGDH and prostanoid receptor E2/E4 expression were measured in tissues by western blot analysis. Additionally, plasma 25(OH)(2)D(3) and PGE(2) levels were measured in healthy patients and cancer patients. We detected an elevated COX-2 and inversely a lowered VDR expression in cancer patients compared to healthy women. Breast cancer patients diagnosed during wintertime had a significantly lower serum level of 25(OH)(2)D(3); PGE(2) serum levels were higher in both types of cancer. These results support the idea of a link between prostaglandin and vitamin D metabolism in regards to their influences on breast and ovarian cancer.
    Full-text · Article · Jan 2012 · Anticancer research
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    ABSTRACT: Die Hauptfunktion der Ovarien ist die zyklische Bereitstellung einer reifen Eizelle zur Fertilisation. Darüber hinaus sorgen die Ovarien für die Entwicklung eines kompetenten, rezeptiven Endometriums, um die Einnistung der befruchteten Oozyte zu gewährleisten. Auf diesen Grundlagen basiert die weibliche Fertilität. Der Follikelpool der Eierstöcke, aus dem nur die wenigsten Follikel im Laufe der reproduktiven Phase zur Selektion und Ovulation gelangen, wird bereits früh in der Embryogenese gebildet. Das sensible Zusammenspiel zwischen Hypothalamus, Hypophyse und Ovar kann durch unterschiedliche Faktoren gestört werden und eine Einschränkung der Ovarfunktion und somit auch der Fertilität zur Folge haben. Die altersbedingte Erschöpfung der ovariellen Reserve ist vor allem gekennzeichnet durch einen hohen Grad an Follikelatresie und -degeneration. Das Anti-Müller-Hormon (AMH) gilt aktuell als bester Marker der ovariellen Reserve. Darüber hinaus können durch Bestimmung des follikelstimulierenden Hormons (FSH) und des Antralen-Follikel-Count (AFC) wichtige Hinweise über die ovarielle Funktion gewonnen werden.
    No preview · Article · Dec 2011 · Der Gynäkologe
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    ABSTRACT: Introduction: It is generally assumed that the prevalence of chromosomal abnormalities is increased in infertile men and inversely correlated with sperm concentration. Guidelines advise to karyotype infertile men, but are not consistent in whom chromosomal screening is indicated. Since karyotyping is time-consuming and costly, a proper selection of patients could enhance cost- effectiveness. We studied the association of chromosomal abnormalities with sperm parameters and hormone levels in a cohort of men eligible for intra- cytoplasmic sperm injection (ICSI) treatment or with azoospermia, in order to determine which subgroup has the highest prevalence of chromosomal abnormalities. Material and Methods: Men with azoospermia and male partners of couples that were eligible for ICSI treatment, irrespective of sperm quality, who visited our fertility clinic between November 1994 and October 2007 were karyotyped. Men whose results of at least one sperm analysis were available were included in the study. Serum levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) were determined. Univariate logistic regression analysis was used to determine the association of chromosomal abnormalities with sperm parameters and hormone levels. Results: A chromosomal abnormality was found in 38 of 1223 cases (3.1%; 95% confidence interval (CI) 2.1-4.1). No association was found between the prevalence of chromosomal abnormalities and sperm volume, concentration, progressive motility or total motile sperm count. In non-azoospermic men the prevalence of chromosomal abnormalities was 2.3% (CI 1.4-3.2) and did not differ significantly between different sperm concentration categories. In non-azoospermic men, no association was found between chromosomal abnormalities and gonadotrophin levels. Azoospermia was significantly associated with the risk of a chromosomal abnormality (15.2%; CI 7.3-23.1) (Odds ratio 7.70; CI 3.72-15.9). The highest prevalence of chromosomal abnormalities was found in men with azoospermia and FSH > 10 IU/l and/or LH > 12 IU/l (23.1%; CI 9.9-36.3). The prevalence in normogonadotrophic azoospermic men was 6.7% (CI 0-15.7). Conclusions: Contrary to the general assumption, this study shows that in azoospermic men or men eligible for ICSI, sperm concentration is not a good predictor for the presence of chromosomal abnormalities, but azoospermia is. In azoospermic men, determination of gonadotrophin levels is useful in the risk assessment for chromosomal abnormalities, as this risk is highest in hypergonadotrophic azoospermia. Therefore, current guidelines on male infertility and chromosomal screening need to be reconsidered.
    No preview · Article · Jan 2011 · Human Reproduction
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    ABSTRACT: The vitamin D metabolizing enzymes 25-, 1α- and 24-hydroxylase are expressed in malignant cells of the cervix and the ovaries. The aim of this study was to obtain further information about the regulation of the aforementioned enzymes by vitamin D, calcidiol and calcitriol in cervical and ovarian cancer. The human cervical adenocarcinoma cell line HeLa and the human ovarian adenocarcinoma cell line OVCAR-3 were incubated with vitamin D, calcidiol and calcitriol. The influence of vitamin D and its metabolites on the expression of 25-, 1α- and 24-hydroxylase was assessed by real-time RT-PCR. Calcitriol significantly increased the 24-hydroxylase mRNA levels in HeLa and OVCAR-3 cells. The expression of 25- and 1α-hydroxylase was not regulated in a statistically significant manner. These results suggest that in HeLa as well as OVCAR-3 cell lines, the metabolism of vitamin D is regulated via the expression of the catabolizing 24-hydroxylase.
    Full-text · Article · Nov 2010 · Anticancer research

  • No preview · Article · Sep 2010 · Fertility and sterility

  • No preview · Article · Jun 2010 · Senologie - Zeitschrift für Mammadiagnostik und -therapie
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    ABSTRACT: Introduction: Ovarian function is controlled not only by endocrine system, but also by autocrine/paracrine regulation in the ovarian cells, which may be mediated by a network of cytokines. The aim of this study was to elucidate the involvement of a multifunctional cytokine, interleukin-6 (IL-6), in human ovarian function especially in human luteolysis. Material and Methods: All subjects were women with normal menstrual cycles (28-35 days), which gave their informed consent to participate in this study. The mean age of the subjects was 39.0 ± 8.7 years (range: 22-53 years, n = 37). Ovarian samples were collected at the time of gynecological operation, and follicular or luteal tissue was isolated macroscopically from each sample. Blood serum was also collected at the same time. All subjects were divided into 3 phases of ovarian cycle (follicular, early-mid luteal, and late luteal phase), according to the date of menstrual cycle and serum hormonal values (classified into follicular phase, if progesterone (P) < 2.0 ng/ml, classified into early-mid luteal phase, if progesterone (P) > 2.0 ng/ml, and classified into late luteal phase, if E2 < 80 pg/ml) at the point of operation. The relative expression levels of IL-6 (n = 37) and its receptors (gp130 and IL-6Rα, n = 21) mRNA in granulosa, theca and luteal cells were analyzed with quantitative RT–PCR using TaqMan technology. The relative values of IL-6 protein in the ovarian tissue were also analyzed with immunoblotting (n = 21). The localization of IL-6 and its receptors, gp130 and IL-6Rα, in the ovarian tissues was examined by immunohistochemical staining (n = 8). All data are presented as the mean ± S.D. Inter-group differences were confirmed with Kruskal-Wallis test, and post-hoc test (Scheffe's F) was used for detecting the significant differences between the groups. Results: The relative level of IL-6 mRNA in late luteal phase (4.46 ± 2.05, n = 8) was significantly higher than those of follicular (1.55 ± 0.94, n = 18: p < 0.00005) and early-mid luteal phase (2.13 ± 0.92, n = 11: p < 0.005). The relative level of mRNA for gp130 in late luteal phase (8.35 ± 5.46, n = 7) was significantly higher than those of follicular phase (1.67 ± 1.93, n = 8: p < 0.05), and the level of IL-6Rα mRNA in late luteal phase (11.66 ± 9.71, n = 7) was significantly higher than those of follicular phase (1.33 ± 2.32, n = 8: p < 0.05) and early-mid luteal phase (2.72 ± 2.40, n = 6: p < 0.05). The relative value of IL-6 protein in the late luteal phase (0.935 ± 0.070, n = 7) was also significantly higher than those of follicular phase (0.751 ± 0.049, n = 8: p < 0.001) and early-mid luteal phase (0.762 ± 0.104, n = 6: p < 0.005). The immunohistochemistry for IL-6 showed positive staining mainly in luteal cells and follicular granulosa cells, and partially in theca cells. The positive staining for gp130 was identified in luteal and granulosa cells as well as the endothelial cells of the capillary vessels. IL-6Rα immunoreactivity was observed in luteal, granulosa and theca cells. Conclusions: Analysis for periodic changes of mRNA and protein revealed that IL-6 was highly expressed in the human ovary of late luteal phase during natural ovarian cycle. The expression of both IL-6 receptors mRNA were also enhanced in the human ovary of late luteal phase during natural ovarian cycle. Immunohistochemical staining showed that IL-6 and its receptors, gp130 and IL-6Rα, were localized in human luteal cells of regressing phase during natural ovarian cycle. These results suggest that IL-6 may act on the corpus luteum of regressing phase and play a significant role to regulate the human ovarian function, possibly as a promoter of human luteolysis.
    Full-text · Article · Jun 2010 · Human Reproduction
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    ABSTRACT: Die Kinderwunschbehandlung mit der kontrollierten, ovariellen Überstimulation mit Gonadotropinen und GnRH-Analoga ist durch den sog. Lutealphasendefekt gekennzeichnet. Dieser kann durch eine Lutealphasenunterstützung (Lutealphasensupport, LPS) behandelt werden. Der Goldstandard ist eine Unterstützung mit vaginalem oder intramuskulärem Progesteron oder aber auch die Gabe von humanem Choriongonadotropin, wobei das vaginale Progesteron aufgrund der Anwenderfreundlichkeit und des geringeren Risikos von Überstimulationssyndromen von Patientinnen und Behandelnden bevorzugt wird. Die Applikation wird üblicherweise spätestens zum Zeitpunkt des Embryotransfers begonnen, und die Dauer der Anwendung sollte zumindest bis zum Schwangerschaftstest erfolgen. In den meisten Zentren wird die Progesteronverabreichung bei Schwangerschaft bis zum sonographischen Nachweis einer intakten intrauterinen Schwangerschaft ausgedehnt. Die zusätzliche Gabe von Östrogenen, Kortikoiden, ASS oder Heparin zeigt keinen evidenten Vorteil bei der LPS. Controlled ovarian stimulation with gonadotrophins and GnRH analogues causes a luteal phase defect. Support of the luteal phase (LPS) is an integral part of IVF treatment cycles. There is consensus that LPS with progesterone or hCG is mandatory in IVF cycles. Vaginal progesterone is commonly used because of the convenience and a lower risk of ovarian hyperstimulation syndrome. LPS is commonly started on the day of embryo transfer and continued until either the day of pregnancy test or until evidence of heart beat on sonography in the case of pregnancy (6–7weeks of pregnancy). There is no evidence that an addition of estrogens, aspirin, steroids, or heparin will improve pregnancy rates. SchlüsselwörterLutealphasenunterstützung-Progesteron-Adjuvante Therapie-Schwangerschaftsraten-IVF KeywordsLuteal phase support-Progesterone-Adjuvant therapy-Pregnancy rate-IVF
    No preview · Article · May 2010 · Gynäkologische Endokrinologie
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    ABSTRACT: In daily practice there are frequently indications of a possibly higher risk of gynecologic malignoma following pregnancy treatment with hormonal stimulation. The data indicate a tendency to higher risk of such disease. It is known that a sterility anamnesis correlates to higher risk of endometrial and ovarian cancer. Other factors for endometrial cancer include infertility and long-term clomifen stimulation. For patients wishing pregnancy the incidence of borderline ovarian tumors appears slightly higher following hormonal stimulation. Current studies indicate that this does not apply to ovarian cancer. Data concerning breast cancer are strongly heterogeneous and show increased risk in some subgroup analyses, but at the present this appears to be unproven. Longer observation periods are needed, especially after ovarian stimulation, because the carcinomic disease peak of the study participants will be reached some years from now. More retrospective epidemiologic analyses of the available data should be carried out in national in-vitro-fertilization registers to substantiate present knowledge.
    No preview · Article · Apr 2010 · Der Gynäkologe

  • No preview · Article · Jan 2010
  • T Cordes · D Fischer · M Thill · S Becker · M Friedrich · D Salehin
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    ABSTRACT: It is known that 1,25(OH)2D3 can be metabolized to 1,24(OH)2D3 in breast tissue. This tissue-specific expression of 24-OHase may act as a pivotal link between vitamin D status (25(OH)D3 level) and the anticancer effects of 1,25(OH)2D3. Different expressions of the enzymes of vitamin D metabolism are found in breast cancer cells and tissues, and alternative splicing may play a role in biological functions and may cause tissue-specific variations. We describe the expression of vitamin D-1alpha-hydroxylase and vitamin D-24-hydroxylase in benign and malign breast tissues. We estimated that alternative splicing of the enzymes would lead to a catalytically dysfunctional product and may lead to a lower reduction of the target protein. Expression of 1alpha-OHase and 24-OHase RNA and protein was assessed using a real-time polymerase chain reaction (RT-PCR) and on protein level by Western blot in benign and malign breast tissue samples. In breast cancer tissue the expression of 1alpha-OHase and 24-OHase were reduced significantly compared to benign breast tissue. The results described above do not support results of previous studies. Alternative splicing of 1alpha-OHase and 24-OHase may regulate the levels of active enzyme but is more likely due to different cell types in samples with the result of testing a variety of tissue samples not purified benign and malign breast cancer cells. The significance of smaller variants in cells has not been clarified either, but it is known that they are not able to use 25(OH)D3 as a substrate to generate 1,25(OH),D3.
    No preview · Article · Jan 2010 · European journal of gynaecological oncology

Publication Stats

240 Citations
65.71 Total Impact Points

Institutions

  • 2004-2014
    • Universitätsklinikum Schleswig - Holstein
      • • Klinik für Gynäkologie und Geburtshilfe (Kiel)
      • • Sektion für Gynäkologische Endokrinologie und Reproduktionsmedizin (Lübeck)
      Kiel, Schleswig-Holstein, Germany
  • 2006-2013
    • University Medical Center Schleswig-Holstein
      • Department of Pediatrics
      Kiel, Schleswig-Holstein, Germany
  • 2010
    • Universität zu Lübeck
      • Department of Obstetrics and Gynecology
      Lübeck Hansestadt, Schleswig-Holstein, Germany