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H Wramsby

Publications and source records attributed to H Wramsby.

At least 19 recordsLinked to original sources
PubMed1994

Selection of ovarian stimulation protocol is related to IVF treatment outcome in women 35 years of age and older.

PURPOSE: The aim of this study was to assess if the woman's age influenced IVF treatment outcome when a long GnRHa-hMG or a CC-hMG ovarian stimulation protocol was used. Two hundred women were included in the study, 100 women under the age of 35 and 100 women 35 years of age and older (mean 31.8 years and 36.7 years respectively). In the younger group as well as in the older group 50 women were stimulated according to a GnRHa-hMG protocol and 50 women received a CC-hMG regimen. RESULTS: Significant differences between stimulation protocols were found in the older group for the mean numbers of oocytes recovered (4.7 vs 3.0), preembryos obtained (3.2 vs 2.0) and replaced (2.3 vs 1.7), as well as pregnancy (30% vs 10%) and delivery (24% vs 4%) rates per replacement. CONCLUSION: It is concluded that women over 35 years of age seem to have a more favorable outcome of IVF treatment when using a long GnRHa-hMG protocol compared with CC-hMG, while this difference was not as obvious and lacking statistical significance under the age of 35.

Adult↗
PubMed1991

Nordic in vitro fertilization embryo transfer (IVF/ET) treatment outcomes 1982-1989.

In the four Nordic countries, Denmark, Finland, Norway and Sweden, data were compiled from altogether 30 in vitro fertilization (IVF) clinics regarding their treatment outcomes. Two small, recently established IVF clinics in Finland did not respond to the postal inquiry used for data collection. For each clinic, data were collected from the time they commenced activities until June 1989. Preliminary data for the latter half of 1989 was also gathered. The first IVF-baby in this data set was born in Gothenburg in 1982. Seven years later, in December 1989, altogether 35 clinics in the four countries were in operation and 1,290 children had been born. The largest number of clinics, 12, was to be found in Sweden but the number of treatment cycles in relation to the population was highest in Norway with about 340 treatments per million inhabitants annually during 1988-89, with Sweden in second place: 190 treatments per million inhabitants. The ratio of private to public clinics was highest in Finland, where four out of ten clinics were privately run. A mean clinical pregnancy rate per embryo transfer of 20% was recorded and 85% were singleton pregnancies. Spontaneous abortions occurred in 25% and the ectopic pregnancy rate was 7% of all clinical pregnancies. The 'take home baby rate' for 1988-89 was 13% per embryo transfer. There were no major differences between the four countries.

Embryo Transfer↗
PubMed1990

Dose previous Chlamydia trachomatis infection influence the pregnancy rate of in vitro fertilization and embryo replacement?

The association between previous chlamydial infection, as reflected by the presence of chlamydial antibodies (specific serum immunoglobulin G antibodies with a titer greater than or equal to 32) and pregnancy outcome after in vitro fertilization and embryo replacement was studied in 121 infertile women with tubal damage. The antibody prevalence was 74.4%; the overall pregnancy rate was 26.4%. No difference in seropositivity was detected between those who became pregnant and those who did not (71.9% versus 75.3%). The geometric mean titers were also similar in the two groups. Even after subdivision of the cases into primary or repeated in vitro fertilization attempts, or after stratification of the material according to the number of embryos used for replacement, there was no correlation between chlamydial antibodies and pregnancy rate. Thus, past infection with Chlamydia trachomatis did not influence the outcome of in vitro fertilization and embryo replacement treatment in this study.

Adult↗
PubMed1989

Evaluation of variations in pregnancy rates, implantation rates and early abortion rates within an in-vitro fertilization programme.

Despite the application at this clinic of a standardized programme for in-vitro fertilization of human oocytes over the last 27 months, great variations in the rates of implantation, clinical pregnancy and early abortion have been observed during certain periods. A retrospective evaluation of these results showed that these variations occurred in periods when various commercially available batches of Earle's medium (the medium was the only variable changed during the 27 months) were used and that two sub-optimal batches of Earle's medium from one of the sources used during one of three periods (period 2) was most likely to be responsible for sub-optimal embryo quality and, consequently, for a halving of the pregnancy rate (30 versus 15%) and of the implantation rate (11 versus 5%) and an increase in the early abortion rate (23 versus 50%). It is concluded that the quality of the culture medium is of major importance for the success of an IVF programme. The factor(s) in the medium responsible for the decrease in embryo quality has not been identified.

Abortion, Spontaneous↗
PubMed1988

Chromosome analysis of preovulatory human oocytes and oocytes failing to cleave following insemination in vitro.

These investigations were carried out within a clinical in vitro fertilization and egg replacement program. A gradual fixation method for chromosome preparations of animal oocytes, when modified and applied to human oocytes, gave numerical analyzability in about 80%. Of preovulatory oocytes recovered in stimulated cycles, 53% of oocytes with numbers of chromosomes in the haploid range had an apparently normal set of 23 chromosomes. Oocytes with a very low number of chromosomes or in first meiosis were also found. In a separate investigation the chromosome constitution of oocytes not showing clinical signs of fertilization 48 hours after insemination in vitro was also studied. Of the oocytes with numbers of chromosomes in the haploid range, 50% had a normal 23,X karyotype. A different distribution of abnormal chromosome preparations was found, compared with the preovulatory oocytes. Twelve oocytes (16%) carrying between 10 and 18 chromosomes were found among the inseminated oocytes, but none in the other study. Moreover, 15 preparations displayed no chromosomes in the inseminated oocytes, whereas in the uninseminated group, none lacked chromosomes completely. These results may indicate how unfertilized human oocytes in vitro undergo chromosome loss and degeneration and could represent different stages of degeneration. Among both preovulatory and unfertilized oocytes the distribution between hyper- and hypohaploid oocytes was of particular interest in that hypohaploid chromosome complements were in excess. This finding supports the hypothesis that aberration in the number of chromosomes in an oocyte is caused not only by nondisjunction but also by anaphase lag, since nondisjunction alone would result in a 1: 1 ratio between hyper- and hypohaploid complements. In conclusion, human oocytes recovered for in vitro fertilization seem to have an incidence of numerical chromosome abnormalities in the region of 40-50%. This is close to the figures estimated on the basis of observations made in spontaneous abortions and could be a major explanation for the low developmental potential of human cleavage stage ova.

Cell Division↗
PubMed1987

Chromosome analysis of human oocytes recovered from preovulatory follicles in stimulated cycles.

To investigate the incidence and types of abnormalities of chromosome number in oocytes, we recovered preovulatory oocytes from 17 women who were undergoing clomiphene stimulation and laparoscopy because of infertility. Twenty-three oocytes were recovered and studied after they had been fixed with a gradual-fixation method: 17 of the oocytes had numbers of chromosomes in the haploid range (19 to 25 second-metaphase chromosomes), 4 had only 1 to 5 chromosomes, 1 was not analyzable, and 1 had 23 chromosome bivalents in the first metaphase. Of the oocytes with chromosome numbers in the haploid range, nine had an apparently normal haploid set of 23 chromosomes. Two had 1 to 2 additional chromosomes, three lacked 2 to 4 chromosomes, and three had totals of chromosomes that were close to 23 but could not be determined with certainty. We conclude that infertile women undergoing clomiphene stimulation have a high proportion (nearly 50 percent) of oocytes with an abnormal karyotype. If this is also true of fertile women, including those not taking clomiphene, it may explain the high frequency of chromosome aberrations occurring in early spontaneous abortion and the low pregnancy rate after in vitro fertilization.

Abortion, Spontaneous↗
PubMed1987

Chromosome analysis of human oocytes failing to cleave after insemination in vitro.

Seventy-six human oocytes lacking signs of fertilization 48 h after insemination in vitro were fixed for chromosome analysis. Only one out of 61 oocytes showed mitotic chromosomes indicating fertilization. Thus, non-cleavage is almost synonymous with non-fertilization. Chromosomes in second meiosis were found in 60 oocytes, of which 52 (86.7%) were analysable. Of these, only 18 (34.6%) displayed an apparently normal 23,X karyotype. Fifteen preparations showed no chromosomes at all but some contained small nuclei, most likely due to degeneration. An earlier stage of degeneration could be represented by a group of second meiosis oocytes (20.0%) carrying between 10 and 18 chromosomes. The large proportion of chromosome abnormalities in this sample might have been due to the fact that the oocytes were unfertilized and perhaps that abnormal oocytes had matured due to ovarian stimulation.

Adult↗
PubMed1987

Ploidy in human cleavage stage embryos after fertilization in vitro.

Chromosome preparations were made from 15 cleaved human embryos in the 2- to 12-cell stage after in-vitro fertilization. All showed two pronuclei before the first cleavage. Twelve had at least one diploid metaphase, while three had interphase nuclei only. There was no evidence of parthenogenetic haploid cleavage. As expected, the frequency of metaphases increased with duration of colchicine treatment: 25 and 55% of the cells reached metaphase after 6-13 and 16-24 hours' treatment, respectively. Cleaved embryos with 'ideal' blastomere numbers (2, 4 or 8) showed a considerably higher metaphase frequency than others. For a more detailed chromosome analysis the technique will have to be further improved. The asynchronous cleavage of blastomeres makes optimal treatment by mitogens difficult.

Adult↗
PubMed1987

Pregnancy rate in relation to number of cleaved eggs replaced after in-vitro fertilization in stimulated cycles monitored by serum levels of oestradiol and progesterone as sole index.

A simple model for monitoring ovarian stimulation in in-vitro fertilization cycles was designed using daily serum levels of 17 beta-oestradiol and progesterone as the only index to determine the day of ovum retrieval. Human chorionic gonadotropin was administered in the evening 2 days after a level of 2500 pmol/l oestradiol in serum was exceeded provided the serum progesterone level was less than 5 nmol/l. Ovarian stimulation was initiated in 128 women scheduled for laparoscopic oocyte retrieval. Twelve cycles (9%) were cancelled before ovum pick up due to sub-optimal hormone levels in serum and five for other reasons. In 107 successful laparoscopies, 616 oocytes (mean 5.8 per laparoscopy) were recovered. The cleavage rate after IVF was 65% in the egg replacement group. In 87 women, a total of 271 cleaved eggs (range 1-6, mean 3.1) were replaced. The most important factor for establishing a pregnancy was the number of eggs replaced at the same time. Clinical pregnancies were achieved after 30% of replacements, increasing to 50% after replacement of 5-6 eggs. The ongoing/delivered pregnancy rate after the 18th week of gestation was 69%. It was concluded that the simple monitoring model used was consistent with a high pregnancy rate and a low rate of cancelled cycles.

Chorionic Gonadotropin↗
PubMed1986

Importance of the use of short and long sperm pre-incubation periods in assessing the fertilizing capacity of human spermatozoa by hamster test.

The fertilizing capacity of semen samples of seven fertile men was studied in vitro using zona-free hamster ova (hamster test). Spermatozoa of each sample were pre-incubated 4 or 24 h before ova were inseminated for 3 h. An extended insemination for an additional 3 h was also performed after the shorter pre-incubation. The overall ovum penetration rate changed from 0 to 100% (mean 52%) after short (4 h) sperm pre-incubation and from 10 to 100% (mean 55%) after long (24 h) pre-incubation. Taking into account the combination of short and long pre-incubation periods, all donors reached a penetration rate of 67 to 100%. The results indicate that both short and long pre-incubation periods must be employed when the hamster test is used diagnostically to assess the fertilizing capacity of human spermatozoa.

Animals↗
PubMed1984

Some clinical results of in vitro fertilization by the Malmö Group, Sweden.

In our in vitro fertilization program, only clomiphene/human chorionic gonadotropin-stimulated cycles have been used, yielding 1.6 preovulatory oocytes/woman at follicle aspiration. The cleavage rate was significantly influenced by the percentage of abnormal spermatozoa and by the percentage of motile spermatozoa in the spermiograms. At embryo replacement, a tilted uterus obtained by a full bladder in the woman simplifies the replacement procedure. In the last 12 months, 47 embryo transfers have been carried out, resulting in five clinical pregnancies. Of these pregnancies, one has proceeded to term, one resulted in a miscarriage, and three resulted in ectopic pregnancies.

Adult↗
PubMed1984

A gradual fixation method for chromosomal preparations of human oocytes.

Eleven oocytes were recovered after follicle aspiration carried out in nine women during laparoscopy or laparotomy. All oocytes were classified as preovulatory, judged by the fully dissociated cumulus. After elimination of the cumulus, ten of the oocytes exhibited the first polar body, and one was degenerated. A gradual fixation method was used for the chromosomal preparation of the oocytes. The quality of the preparations was improved, compared with the previously used air-drying technique. Nine of ten preparations from oocytes with first polar body displayed chromosomes. These sets consisted of well-spread meiotic chromosomes, and in six of them the chromosome complements of the first polar body could be seen, although quite distinct from the oocyte complement. Of eight preparations where the chromosomes could be counted, six showed 23 chromosomes, and two were abnormal, showing 21 and 16 chromosomes.

Chromosomes, Human↗