Biomedical subjects

J Remohí

Publications and source records attributed to J Remohí.

At least 91 records · Page 5Linked to original sources

PubMed1996

Pregnancies after intracytoplasmic sperm injection with cryopreserved testicular spermatozoa.

In 25 patients (14 suffering from obstructive azoospermia, six from non-obstructive azoospermia, three from asthenoazoospermia and two from absence of ejaculation) spermatozoa were extracted from testicular biopsies. Intracytoplasmic sperm injection (ICSI) with fresh testicular spermatozoa was performed in 18 cases; spermatozoa in excess were cryopreserved in pills. No pregnancies were achieved. In the remaining seven patients, testicular spermatozoa were retrieved and cryopreserved during a diagnostic testicular biopsy. After thawing, sperm motility was assessed in 17 cases (68%), and 18 ICSI with cryopreserved testicular spermatozoa were performed. The mean two-pronuclear (2PN) fertilization rate was 59%, the mean cleavage rate was 92%, and six clinical pregnancies were achieved, all of them still ongoing (pregnancy rate 33%). A comparison of the results of ICSI carried out with fresh or cryopreserved testicular spermatozoa showed that the mean 2PN fertilization rates per cycle (53 compared with 55%), mean cleavage rates per cycle (99 compared with 96%) and embryo quality were not significantly different. In conclusion, cryopreservation of testicular spermatozoa is feasible, even in patients with non-obstructive azoospermia, and the results of ICSI with frozen-thawed testicular spermatozoa are similar to those obtained using fresh testicular spermatozoa. Cryopreservation of testicular spermatozoa may avoid repetition of testicular biopsies to retrieve spermatozoa for successive ICSI cycles in patients in whom the only source of motile spermatozoa is the testicle.

Adult↗

PubMed1996

Oocyte donation in women with recurrent pregnancy loss.

The prognosis of couples with recurrent miscarriage is controversial despite efforts made during this century to learn about the physiopathology and treatment of this troublesome condition. Here we present our experiences of employing oocyte donation in eight couples in whom the woman was a low responder to gonadotrophin stimulation and had a previous history of recurrent abortion with negative routine infertility work-up for repeated pregnancy loss. Patients were desensitized with gonadotrophin-releasing hormone analogues and supplemented with oestradiol valerate for a minimum of 15 days until oocytes were donated from in-vitro fertilization and fertile donors. Then, progesterone was added until day 100 of pregnancy. A total of 12 oocyte donation cycles were performed in these patients. Clinical pregnancy and delivery rates per cycle were 75.0 and 66.6% respectively. The delivery rate per patient was 85.7% in this series, and the miscarriage rate per cycle was 11.1%. The results of ovum donation compared favourably with low responders without a history of recurrent abortion undergoing this treatment during the study period. These results strongly suggest that the oocyte may be the origin of infertility in women with idiopathic recurrent miscarriages. In addition, the results question the role of maternal local and systemic factors in early recurrent pregnancy loss, as well as the paternal contribution to its aetiology.

Abortion, Habitual↗

PubMed1996

Role of endometrial factors in regulating secretion of components of the immunoreactive human embryonic interleukin-1 system during embryonic development.

In the study reported here, we localized at the protein level the major components of the interleukin (IL)-1 system in the human embryo, and we investigated the endometrial factors influencing their secretion during embryonic development. To localize these components, we performed immunohistochemical experiments in 44 oocytes and 78 embryos. The following primary antibodies were used: monoclonal mouse anti-human IL-1 receptor type I (IL-1R tl), monoclonal mouse anti-human IL-1 beta, and polyclonal rabbit anti-human IL-1 receptor antagonist (IL-1ra). For embryo culture, human embryos at different developmental stages were cultured in 100-microliters drops of Ham's F-10 medium + 4 mg/ml BSA (n = 33), in 100-microliters drops of Menezo B2 culture medium (n = 18), or in wells with 1 ml of Menezo B2 culture medium (n = 8). For embryo coculture, endometrial stromal cells (ESC) and endometrial epithelial cells (EEC) were isolated from human secretory endometrium and cultured until confluence in 75% Dulbecco's Modified Eagle's Medium and 25% MCDB-105 containing antibiotics and supplemented with 10% charcoal-Dextran-treated fetal bovine serum. Individual human embryos were cocultured with experimental EEC and ESC (n = 23 and n = 4, respectively) for 5 days in 600-microliters drops of Menezo B2 medium, and conditioned medium was removed every 24 h. Human embryos were also cultured with EEC-conditioned medium (n = 9). IL-1 alpha, IL-1 beta, and IL-1ra levels were determined by ELISA in the 24-h culture- or coculture-conditioned media. Immunostaining confirmed the presence of IL-1 beta, IL-1ra, and IL-1R tl in oocytes and embryos in all stages analyzed, with no statistical differences. IL-1 alpha, IL-1 beta, and IL-1ra were absent in conditioned media of cultured embryos and embryos cocultured with ESC. However, when human embryos were cocultured with EEC or with EEC-conditioned medium alone, two different populations of embryos were observed: IL-1 producers (57% and 56%) and IL-1 nonproducers (43% and 44%, respectively). Finally, the IL-1 profile of a single human embryo cocultured with maternal EEC which successfully implanted and developed is presented, this pattern being similar to that described in the IL-1 producer population. These results demonstrate the presence of the IL-1 system in the human embryo. However, the selective release of IL-1 only when embryos were cocultured with EEC or EEC-conditioned medium indicates an obligatory role of the endometrium in the regulation of the embryonic IL-1 system. Furthermore, the differential embryonic production of IL-1 may be related to the implantation capability of the embryos.

Adult↗

PubMed1995

Effect of aging on the female reproductive system: evidence for a role of uterine senescence in the decline in female fecundity.

OBJECTIVE: To determine the effects of age on reproductive performance of women using oocyte donation as an in vivo model. SETTING: Oocyte donation and IVF programs at the Instituto Valenciano de Infertilidad. PATIENTS: Seventy-six women undergoing 90 cycles of ovum donation, who were recipients of 36 donors undergoing IVF, and 9 fertile women. DESIGN: Prospective longitudinal study: [1] recipients underwent an artificial cycle to demonstrate adequate response of the endometrium to exogenous steroids; [2] oocytes from the same cohort of follicles were distributed randomly into recipients younger and older than 40 years; and [3] pregnancies were followed during the first trimester. MAIN OUTCOME MEASURES: Endometrial histology, fertilization, embryo quality, pregnancy, implantation, and abortion rates in both groups of recipients. Serum E2, P and beta-hCG levels during initial pregnancy. RESULTS: Similar implantation rates but significantly higher abortion rates were detected in women > 40 years despite an appropriate action of P on the endometrium and the transfer of embryos in similar number and quality. The secretion of E2 and P by the placenta started earlier in pregnancies included in the group < 40 years. CONCLUSIONS: Age increases pregnancy losses in ovum donation patients after implantation is completed. This is accompanied by a retardation of steroid synthesis and suggests that the mechanism(s) responsible for placenta formation and functioning in the uterus is affected by age. Thus, uterine aging also is a factor influencing the poor reproductive performance of women with advancing age.

Adult↗

PubMed1995

Pregnancy in an azoospermic patient with markedly elevated serum follicle-stimulating hormone levels.

OBJECTIVE: To assess the possibility of achieving a pregnancy in an azoospermic patient with markedly elevated serum FSH level. DESIGN: A case report. SETTING: In vitro fertilization program at the Instituto Valenciano de Infertilidad. PATIENT: An azoospermic patient with small testes and serum FSH level (38.7 mIU/mL) higher than three times normal. Testicular biopsy revealed Sertoli cell-only syndrome with focal spermatogenesis. INTERVENTIONS: Intracytoplasmic microinjection of testicular tissue-extracted spermatozoa. MAIN OUTCOME MEASUREMENTS: Fertilization rate, cleavage rate, clinical pregnancy. RESULTS: Eight of 11 (73%) intact oocytes showed two pronuclei. All of them cleaved normally. Four embryos were replaced into the uterine cavity and the other four were cryopreserved. A twin clinical pregnancy was achieved. CONCLUSION: Spermatozoa may be present in testicular biopsy specimens of azoospermic patients with severe spermatogenic failure despite markedly elevated serum FSH level. These patients can be fertile after intracytoplasmic testicular sperm microinjection.

Adult↗

PubMed1995

Long oestradiol replacement in an oocyte donation programme.

The objective of this study was to optimize, in terms of endometrial receptivity (embryo implantation), the limits of unopposed administration of oestrogens beyond 35 days in an in-vitro fertilization (IVF) and ovum donation programme. Oocytes donated by 182 women undergoing IVF were distributed among 186 women treated by ovum donation. Five groups of recipients were established according to the duration of oestradiol valerate administration, in a 'prolonged follicular phase' protocol, before embryo replacement, employing oestradiol valerate at increasing doses up to 6 mg/day. Gonadotrophin-releasing hormone analogues (GnRHa) were simultaneously administered in ovulatory patients. The dosage of oestradiol valerate was maintained until oocytes were available for insemination and subsequent transfer. Donors and recipients were equally distributed among groups in terms of age and cause of infertility. There was no difference among groups in serum oestradiol concentration the day in which progesterone was added to obtain a secretory transformation of the endometrium. An analysis of the ovum donation cycles showed no difference among groups in pregnancy and implantation rates after the replacement of a similar number of embryos. Successful implantation was observed even after 100 days of unopposed oestradiol valerate administration. Break-through bleeding increasingly appeared according to the duration of oestrogen replacement. These clinical observations provide evidence that the concept of 'prolonged follicular phase' oestrogen replacement for ovum donation can be maintained, at least as long as 15 weeks. However, because of the high (> 44%) incidence of break-through bleeding after 9 weeks, it is advisable to stop oestrogen treatment at this point.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1995

Effects of aging on the female reproductive system.

There is an evident decline in human fertility with age. The fundamental physiological question is whether the ovary, the uterus, or both are affected by the changes induced within the body by senescence. Based on clinical studies performed in in-vitro fertilization (IVF) laboratories, there is no doubt that age affects the oocyte. However, the effect of age on the remaining cellular components of the preovulatory follicle have yet not been fully elucidated. In addition, whether the ability of the uterus to have normal implantation of human embryos is age-related is also a matter of controversy. In this review, we analyse the results of our studies that were conducted in order to answer these relevant questions. In the first series of experiments we tested the hypothesis that the function of granulosa cells is affected in older patients (> or = 40 years). In these experiments, we cultured in vitro granulosa-luteal cells from 15 women aged < 40 years and 18 patients aged > or = 40 years undergoing IVF. Immunoreactive alpha-inhibin and progesterone were measured after 48 and 96 h in culture. The measurements showed a significantly higher secretion of inhibin (P < 0.01) after 48 h, and progesterone (P < 0.05) after 48 and 96 h, in the younger as compared to the older group. In addition, we tested the ability of the uterus to sustain normal implantation by an analysis of our oocyte donation programme. In the first approach, we divided all the transfer cycles according to the age of the recipient. We found no differences among groups with regard to pregnancy, implantation or abortion rates. We explored this fundamental question further by performing oocyte donation cycles in which oocytes from the same donor were distributed into a recipient aged < 40 years and another recipient of > or = 40 years. An analysis of 45 cycles in each group of recipients showed a significant (P < 0.05) increase in abortion rates in older as compared to younger patients. When the serum oestradiol concentrations were followed in those women who carried normal single ongoing pregnancies, we found that a significant increase in blood oestradiol concentrations (which probably represents the luteo-placental shift) was detected 2 weeks earlier in younger than in older patients, suggesting a defective vasculature of the uterus that could ultimately be the cause of an increased abortion rate in patients aged > or = 40 years. In conclusion, we firmly believe that senescence affects both the ovary (oocyte and granulosa cells) and the uterus, and these observations should be taken into account in order to advise our patients.

Aging↗

PubMed1995

Donor-recipient synchronization and the use of gonadotrophin-releasing hormone agonists to avoid the premature luteinizing hormone surge in oocyte donation.

Since the introduction of the oocyte donation technique in humans, a number of reports have been published reflecting the success and improvement of this technique. Initially, the most important problems were donor-recipient synchronization at the moment of donation and the premature secretory changes in the endometrium consequent to the spontaneous luteinizing hormone (LH) rise in patients that still showed ovarian function. Today, with the new substitutive hormonal protocols, these two major problems have been solved. The endogenous LH rise can be avoided by administering gonadotrophin-releasing hormone agonists, without any deleterious effects on implantation when they are used in patients with ovarian function. Donor-recipient synchronization is possible because the recipients can remain indefinitely with substitutive therapy until the donation becomes feasible. Here, our experiences with both new strategies are presented.

Adult↗

PubMed1995

Exploring the mechanism(s) of endometriosis-related infertility: an analysis of embryo development and implantation in assisted reproduction.

Several retrospective analyses of our in-vitro fertilization (IVF) and oocyte donation programmes have been carried out in an attempt to gain clinical knowledge of the factors implied in the aetiology of endometriosis-associated infertility. In a first approach, a comparison was made of the IVF outcome between 96 cycles in 78 patients with tubal infertility and 96 more cycles in 59 women with endometriosis. The results indicate that endometriosis patients had a poor IVF outcome in terms of a reduced pregnancy rate per cycle (P < 0.0004), a reduced pregnancy rate per transfer (P < 0.002) and a reduced implantation rate per embryo replaced (P < 0.003). In a second study, we addressed the analysis of patients undergoing oocyte donation. The results showed that patients with this disease have the same chances of implantation and embryo development in vivo as other recipients when the oocytes come from donors without known endometriosis. However, when the results of oocyte donation were classified according to the nature of the oocytes donated, patients who received embryos derived from endometriotic ovaries showed a significantly (P < 0.05) reduced ability to implant compared with the remaining groups. In a third approach, we evaluated embryo development in vitro when women with and without endometriosis underwent IVF and embryo replacement 72 h after oocyte retrieval. We observed a significantly (P < 0.04) reduced number of blastomeres in embryos from endometriosis patients compared with controls, as well as an increased (P < 0.05) incidence of arrested embryos in vitro. Taken together, these observations suggest that infertility in endometriosis patients may be related to alterations within the oocyte which, in turn, result in embryos of lower quality, as demonstrated in our IVF programme, and a lower ability to implant, as shown in the oocyte donation model.

Embryo Implantation↗

PubMed1995

Efficacy of intracytoplasmic sperm injection using testicular spermatozoa.

In patients with obstructive azoospermia in whom standard microsurgical procedures fail or are unfeasible, the only source of spermatozoa is the testicle. In addition, in some azoospermic patients with severe spermatogenic failure, a few spermatozoa may be present in testicular biopsy specimens despite high serum follicle stimulating hormone concentrations. In all these cases, intracytoplasmic sperm injection (ICSI) with testicular biopsy-extracted spermatozoa may offer the chance of pregnancy. To assess the efficacy of this procedure, we compared the results of two series of ICSI cycles performed during the same time period: 21 cycles using testicular biopsy-extracted spermatozoa and 83 cycles using ejaculated spermatozoa. Mean fertilization rates (59% with testicular and 68% with ejaculated spermatozoa), mean cleavage rates (93% with testicular and 90% with ejaculated spermatozoa), embryo quality (77% good quality embryos in the testicular sperm group and 77% in the ejaculated sperm group) and clinical pregnancy rates (36.8% in the testicular sperm group and 28% in the ejaculated sperm group) were not significantly different in both groups. We conclude that high fertilization, cleavage and pregnancy rates can be achieved with intracytoplasmic testicular sperm injection, reaching levels comparable with those of ICSI using ejaculated spermatozoa.

Adult↗

PubMed1995

Clinical evidence for a detrimental effect on uterine receptivity of high serum oestradiol concentrations in high and normal responder patients.

This study was undertaken to investigate an empirical observation that 'high responder patients have poorer in-vitro fertilization (IVF) outcome than normal responder patients'. The aim of our study was to analyse the effect of high serum oestradiol and progesterone concentrations at the day of human chorionic gonadotrophin (HCG) administration on endometrial receptivity and oocyte-embryo quality in high and normal responder patients. The IVF patients were divided into two groups: 59 high responder patients who voluntarily donated some of their oocytes, and a control group consisting of 105 normal responder patients. Both groups were compared in terms of the number and quality of oocytes retrieved, embryos transferred, fertilization, implantation and gestation rates, serum oestradiol and progesterone concentrations and the oestradiol:progesterone ratio on the day of HCG injection. To ascertain oocyte-embryo quality, a second control group of 96 women undergoing oocyte donation (receiving oocytes from high responder patients) was considered. To assess the impact of steroid concentrations on endometrial receptivity, high responder patients were divided into two subgroups according to oestradiol concentration, above or below the minimal oestradiol and progesterone concentrations (mean--SD) in this group. The normal responder patients were divided into two subgroups according to oestradiol concentration, above or below the maximal oestradiol and progesterone concentrations (mean+SD) in this group. To assess further the relevance of oestradiol concentration on endometrial receptivity, patients were divided into different subgroups according to increasing oestradiol concentration, regardless of whether they were high or normal responders. High responder patients had significantly decreased implantation and pregnancy rates per cycle compared with normal responder patients (33.3 versus 16.3 and 11.1 versus 5.4% respectively; P < 0.05). The results of 108 embryo transfers in 91 recipients who received oocytes from the high responder group showed normal embryo quality. Implantation rates and pregnancies per cycle were significantly lower in high responder patients with serum oestradiol concentrations > 1700 pg/ml compared with those having oestradiol concentrations < or = 1700 pg/ml, as well as in normal responder patients with serum oestradiol concentrations > 2200 pg/ml compared with those having oestradiol concentrations < or = 2200 pg/ml. Considering all the patients together, significant decreases in pregnancy and implantation rates were observed when oestradiol concentrations were > 2500 pg/ml compared with patients having lower oestradiol concentrations. Our clinical results demonstrate that high serum oestradiol concentrations on the day of HCG injection in high and normal responder patients, regardless of the number of oocytes retrieved and the serum progesterone concentration, are detrimental to uterine receptivity without affecting embryo quality.

Chorionic Gonadotropin↗

PubMed1994

Effects of aging on the human ovary: the secretion of immunoreactive alpha-inhibin and progesterone.

OBJECTIVE: To investigate the changes induced by age in the function and secretory pattern of the human ovary. Immunoreactive alpha-inhibin, E2, and P secretion in vivo and in vitro have been compared in two different populations. DESIGN: Prospective study. Women undergoing IVF-ET were divided into two groups according to age: group 1 (32.0 +/- 0.7 years; mean +/- SEM) and group 2 (40.3 +/- 0.3 years). SETTING: In vitro fertilization program at the Instituto Valenciano de Infertilidad. PATIENTS: A total of 33 infertile women with regular menses, undergoing IVF-ET. INTERVENTIONS: Follicle aspiration performed by transvaginal ultrasound. Four follicles per patient were aspirated in individual plastic tubes. Granulosa-luteal cells isolated with Percoll columns and cultured in vitro up to 4 days in the presence of hCG. MAIN OUTCOME MEASURES: In vitro fertilization parameters, serum levels of E2, immunoreactive alpha-inhibin, and P, as well as the secretion of immunoreactive alpha-inhibin and P by the cultured granulosa-luteal cells. RESULTS: Serum immunoreactive alpha-inhibin levels the day of ovum pick-up were significantly lower in group 2 compared with group 1. Incubation of cells for 96 hours showed a significantly higher ability to accumulate immunoreactive alpha-inhibin in group 1 than 2. Human chorionic gonadotropin stimulated immunoreactive alpha-inhibin production after 96 hours. Cells from younger women displayed a significantly higher ability to secrete P than cells from older women. Human chorionic gonadotropin was able to significantly stimulate P production in group 1. CONCLUSIONS: These results confirm previous observations showing a reduced production of immunoreactive alpha-inhibin and steroids of ovaries from older women and suggest that a reduced cellular function, rather than a decrease in the follicular population, is the main mechanism by which these changes are produced.

Adult↗

PubMed1994

Outcome of patients with endometriosis in assisted reproduction: results from in-vitro fertilization and oocyte donation.

A retrospective analysis of our in-vitro fertilization (IVF) and oocyte donation programmes was carried out in order to gain clinical knowledge of the factors involved in the aetiology of the endometriosis-associated infertility. Comparison between the IVF outcomes from 96 cycles in 78 patients with tubal infertility and from 96 cycles in 59 women with endometriosis indicates that endometriosis patients have a poor IVF outcome in terms of reduced pregnancy rate per cycle (P < 0.0004), reduced pregnancy rate per transfer (P < 0.002), and reduced implantation rate (P < 0.003). The analysis of patients undergoing oocyte donation for different reasons, including low response with or without endometriosis, showed that patients with this disease have the same chances of implantation and pregnancy as other recipients when the oocytes came from donors without known endometriosis. However, when the results of oocyte donation were classified according to the origin of the oocytes donated, patients who received embryos derived from endometriotic ovaries showed a significantly (P < 0.05) reduced implantation rate as compared to the remaining groups. Taken together, all these observations suggest that infertility in endometriosis patients may be related to alterations within the oocyte, which in turn result in embryos with decreased ability to implant.

Adult↗

PubMed1994

The use of gonadotrophin-releasing hormone analogues in women receiving oocyte donation does not affect implantation rates.

There is conflicting clinical evidence suggesting a positive role for gonadotrophin-releasing hormone analogues (GnRHa) on implantation in humans. This potential effect was evaluated in this study taking the oocyte donation programme as a model. Patients were randomly allocated into one of the two treatment groups: group I received simultaneous treatment with GnRHa and steroids, and group II only received exogenous steroid replacement. An analysis of the donors and semen quality showed similarity between recipient groups. There was no significant difference between groups in the number and quality of embryos replaced, clinical pregnancy and implantation rates. In summary, using a model in which the endometrium can be analysed independently of the embryos, the results suggest that GnRHa are neither effective nor detrimental for embryo implantation in humans.

Adult↗

PubMed1994

[Twin pregnancy after oocyte donation in a woman with Turner syndrome].

It is extremely rare for pregnancy to occur spontaneously in patients with Turner's syndrome, and if it happens this will have an increased risk of fetal wastage and congenital malformations in the new born, specially of the sexual chromosome. Oocyte donation is at present the technique of choice to release the reproductive wishes of these women. We present a case of a woman with Turner's syndrome, with a 45, X0 karyotype, to whom ovum donation and intrauterine embryo transfer were performed, obtaining a twin pregnancy without complications. A cesarean section was made at term, obtaining two healthy new born infants.

Adult↗

PubMed1993

Daily measurements and in-vitro effects of human chorionic gonadotrophin in the early luteal phase.

The purpose of the present study was to analyse daily measurements of human chorionic gonadotrophin (HCG) in in-vitro fertilization (IVF) cycles and to reproduce the effects of HCG in vitro using human granulosa-luteinized cells from the same patients. The study population consisted of nine women undergoing IVF because of tubal infertility in whom blood was drawn every 24 h from the day of the ovulatory dose of HCG (10,000 IU) until 6 days after ovum pick-up. Granulosa-luteal cells from the follicular aspirates were collected and cultured in vitro up to 6 days in the presence of increasing concentrations (0, 0.01, 0.1, 1.0 and 100.0 IU/ml) of HCG. Serum progesterone and HCG in vivo as well as progesterone accumulation in vitro on days 2, 4 and 6, were the main outcome measures. Maximum HCG concentrations (0.25 IU/ml) were reached the day before ovum pick-up, and continuously decreased until day 6 after ovum retrieval. HCG did not stimulate progesterone production in vitro at any dose tested until day 6 after ovum pick-up. Then, 0.01 IU/ml resulted significantly (P < 0.05) stimulatory compared to controls, while 1.0 IU/ml was inhibitory (P < 0.05). It is concluded that HCG supplementation in an IVF cycle is unnecessary until day 6 after ovum pick-up. On day 6, progesterone production is stimulated with very low concentrations of HCG.

Cells, Cultured↗

PubMed1993

Effects of epidermal growth factor in the final stages of nuclear and cytoplasmic oocyte maturation in humans.

Evidence has accumulated in mammals suggesting a positive role for epidermal growth factor (EGF) as an inducer of oocyte maturation. The potential use of EGF as inducer of cytoplasmic and nuclear maturation was tested in women with > 10 oocytes retrieved in in-vitro fertilization (IVF), since we have previously observed that such oocytes are immature. Oocytes from 17 high responders were randomly allocated to one of the three treatment groups upon retrieval: control receiving no EGF (n = 93), 1.0 ng/ml EGF (n = 92) and 10.0 ng/ml EGF (n = 77) for 6 h before insemination. The rates of fertilization were respectively 54.6, 59.0, and 46.1%, suggesting that EGF is not effective at this maturational stage after this length of exposure. Embryo development was further analysed by the appearance of the embryos under the dissecting microscope and the number of blastomeres developed 48 h after insemination. No difference between groups was observed considering the number of blastomeres developed. However, embryos derived from oocytes treated with 10 ng/ml EGF displayed a worse appearance under the microscope. It is concluded that a 6 h incubation with EGF does not seem to affect cytoplasmic maturation in oocytes obtained after gonadotrophin treatment, as ascertained by the rate of fertilization following oocyte insemination.

Blastomeres↗

PubMed1992

Simultaneous induction of multiple follicular development with gonadotrophins and steroid replacement for in-vitro fertilization.

Simultaneous administration of follicle stimulating hormone, oestradiol valerate and progesterone was employed in a patient with a possible enzymatic deficiency involving low production of oestradiol. The patient became pregnant after in-vitro fertilization. This case demonstrates that this treatment is useful in women with low oestradiol production and subsequent inadequate endometrial development; it also illustrates the role of oestradiol in follicular development and questions the importance of serum oestradiol measurements in the monitoring of ovulation induction.

Adult↗