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Biomedical subjects

P L Matson

Publications and source records attributed to P L Matson.

At least 55 records · Page 3Linked to original sources
PubMed1991

Cryopreservation of human embryos at the pronucleate, early cleavage, or expanded blastocyst stages.

Supernumerary embryos following treatment by IVF or GIFT were cryopreserved at the pronucleate, early cleavage or expanded blastocyst stages. The success of embryo cryopreservation at these stages was evaluated in terms of (i) the proportion of embryos surviving the freeze/thaw procedure; (ii) the proportion of patients reaching embryo replacement; and (iii) the incidence of pregnancy per replacement. Significantly more embryos survived when frozen/thawed at the pronucleate (44/61; 72%) or early cleavage stages (48/80; 60%), than at the expanded blastocyst stage (13/34; 38%). A significantly higher proportion of patients had embryo replacements when embryos were frozen/thawed at the pronucleate (17/19; 89%) or early cleavage stages (21/24; 88%), than at the expanded blastocyst stage (9/17; 53%). Following replacement of frozen/thawed pronucleate and early cleavage stage embryos, clinical pregnancy rates of 8/17 (47%) and 3/21 (14%) clinical pregnancies were achieved, respectively. No pregnancies were achieved following replacement of frozen/thawed expanded blastocysts.

Blastocyst↗
PubMed1991

The use of biosynthetic human growth hormone to augment ovulation induction with buserelin acetate/human menopausal gonadotropin in women with a poor ovarian response.

The present study has demonstrated the usefulness of GH in augmenting buserelin acetate/hMG to stimulate the rate of growth of follicles in women regarded as poor responders. The PR achieved was extremely encouraging in a group of patients whose prognosis was otherwise poor. Further studies are required to confirm these preliminary data.

Adult↗
PubMed1991

Serum inhibin as an index of ovarian function in women undergoing pituitary suppression and ovarian stimulation in an in vitro fertilization program.

Serum inhibin concentrations, determined by radioimmunoassay, were measured in women undergoing pituitary suppression with buserelin and subsequently ovarian stimulation with human menopausal gonadotropin (hMG). Three types of treatment cycle were investigated, namely (1) cycles showing a normal ovarian response and resulting in a pregnancy; (2) cycles showing a poor response to the hMG, and (3) cycles previously showing a poor ovarian response but augmented with biosynthetic human growth hormone. Good correlations were seen between serum inhibin concentrations and serum progesterone in the luteal phase prior to buserelin (Rs = 0.68), serum oestradiol on the 8th day of hMG administration (Rs = 0.82) or the day of ovulatory trigger (Rs = 0.78), and the number of follicles greater than or equal to 14 mm on the day of ovulatory trigger (Rs = 0.71). These results show inhibin to be a good index of ovarian function in women exhibiting a range of ovarian responses to stimulation in an in vitro fertilization program.

Adult↗
PubMed1990

Measurement of human chorionic gonadotropin during early pregnancy: a comparison of two immunoradiometric assays.

Evidence of implantation following either in vitro fertilization and embryo transfer (IVF-ET) or gamete intrafallopian transfer (GIFT) was obtained by collecting blood on days 10, 12, 14, 16, and 18 after oocyte recovery (day 0), and retrospectively measuring human chorionic gonadotropin (hCG). This was done using immunoradiometric assays for hCG, manufactured either by Serono Diagnostics Ltd. (MAIAclone) or Diagnostics Products Corporation (IRMA-count). The analysis of 63 serum samples by both kits showed a good correlation (r = 0.99) but the Serono (y) method gave values which were consistently greater (y = 1.58x + 4.89) than those of the DPC (x) method. A comparison of the hCG profile of singleton pregnancies measured with either the Serono (n = 33) or DPC (n = 22) kits gave a similar relationship. These results suggest that great care must be taken when comparing results from different laboratories using different kits. Also, consideration must be given to the possible loss of a continuous database should a laboratory change kit.

Chorionic Gonadotropin↗
PubMed1990

Use of buserelin in an IVF programme for pituitary-ovarian suppression prior to ovarian stimulation with exogenous gonadotrophins.

Daily s.c. injections of buserelin were commenced in the mid-luteal phase of the preceding cycle in 118 women undergoing in-vitro fertilization (IVF) and embryo transfer. Ovarian and pituitary suppression was said to have been adequately achieved when serum oestradiol was less than 50 pg/ml, serum LH less than 2.0 IU/l, no ovarian cysts greater than or equal to 10 mm diameter were present and menstruation had occurred. Nine groups of women were retrospectively identified after the administration of buserelin for 12 days according to whether pituitary and ovarian suppression had been achieved or not, and the reason for extended buserelin treatment prior to ovarian stimulation. Upon adequate suppression, patients were grouped in terms of the duration of exposure to buserelin, and ovarian stimulation was then started by daily injections of human menopausal gonadotrophin. There appeared to be no differences in the ovarian response for women down-regulated by day 12, 19 or greater than or equal to 26 days; those women requiring extended buserelin treatment did equally well compared to those women down-regulating quickly, in terms of number of oocytes recovered and fertilization rate. Clinical pregnancy rates per embryo transfer were 27/68(40%), 8/33(26%) and 4/17(24%) for those women down-regulated by days 12, 19 or greater than or equal to 26 respectively, and were not significantly different.

Adult↗
PubMed1990

Endocrine changes in women conceiving during treatment with an LHRH agonist.

We report on eight patients who conceived during pituitary desensitization with buserelin in the luteal phase of the menstrual cycle. Pregnancy was diagnosed between day 12 and 21 of buserelin administration. Analysis of serum luteinizing hormone on day 12 showed that pituitary desensitization occurred in conjunction with increasing production of ovarian steroid hormones. Serum concentrations of human chorionic gonadotrophin (HCG) were less than 10 IU/l on day 1 of buserelin administration for seven of the eight patients. The serum concentration of HCG on day 12 showed a median value of 722 IU/l (range 14.6-798 IU/l). Five of the eight patients were given HCG support (10,000 IU) following the diagnosis of pregnancy--three of these patients have ongoing pregnancies and the remaining two had blighted ova on scan. Of the remaining three patients, one had a singleton pregnancy which miscarried at 9 weeks, one had a blighted ovum on scan and bled per vagina shortly after this, and one bled per vagina prior to a scan being carried out. Our results show that pregnancy can occur during pituitary desensitization with buserelin, despite patients being counselled not to have unprotected intercourse in the cycle during which administration commences. An HCG assay on day 1 of buserelin administration is not helpful. Pregnancy should be suspected when ovarian steroid production persists despite complete pituitary down-regulation.

Adult↗
PubMed1990

Fertilization in vitro of supernumerary oocytes following gamete intra-fallopian transfer (GIFT).

Gamete intra-Fallopian transfer (GIFT) was performed in 130 treatment cycles over a 17-month period. In 91% (118/130) of the cycles one or more oocytes were available for insemination in vitro and only GIFT cycles with supernumerary oocytes were included in the present study. Pituitary and ovarian suppression was achieved with buserelin followed by stimulation of multifollicular development by human menopausal gonadotrophin (HMG). Failure of supernumerary oocytes to fertilize was associated with a significantly reduced pregnancy rate (3/23; 13%) compared to cycles where fertilization occurred in vitro (35/95; 37%). These findings demonstrate that the outcome of IVF of supernumerary oocytes may be of particular diagnostic value in couples where the female partner has not conceived following treatment by GIFT after pituitary down-regulation with buserelin and ovarian stimulation with HMG.

Adult↗
PubMed1990

The cryopreservation of donor semen by a simplified method: use in an IVF and GIFT programme.

The cryopreservation of semen used in assisted reproduction procedures was carried out exclusively by a simplified method in which a mixture of semen and cryoprotectant was contained in 1-ml tuberculin syringes and plunged directly into liquid nitrogen. Donor semen samples halved and frozen in syringes and in straws in a controlled-rate freezer showed no significant difference in post-thaw motility (P = 0.217) or survival (P = 0.217) after 30 min. However, after 180 min the survival rate showed a significant reduction in syringes (P = 0.045). A significant difference (P less than 0.00008) in the rate of fertilization of oocytes was seen in IVF cycles using frozen-thawed donor sperm (58/142, 42%) when compared to fresh sperm from husbands (2315/3926, 59%). A significant reduction (P less than 0.00005) in fertilization rate was also observed in the case of supernumerary oocytes in GIFT cycles with the cryopreserved donor sperm (29/132, 22%) compared to the husbands' sperm (239/514, 46%). However, the pregnancy rate following IVF and embryo replacement was the same after fertilization with fresh sperm (75/351, 21%) as opposed to frozen sperm (3/14, 21%). Furthermore, a higher pregnancy rate was observed in GIFT with frozen donor sperm (9/19, 47%) than with fresh sperm from husbands (28/103, 27%), though this was not statistically significant (P = 0.079). These results show this simplified methods of semen cryopreservation to be effective when used in an IVF and GIFT programme, giving pregnancy rates comparable to fresh normospermic semen samples. The method is simple, quick and inexpensive.

Cell Survival↗
PubMed1989

Quality control in an in-vitro fertilization laboratory: use of human sperm survival studies.

A bioassay procedure is described for quality control testing of various disposable items used in routine IVF procedures. This bioassay is performed over 4 days and uses the survival of human sperm in vitro at room temperature to assess which products are suitable for use. New products were tested for cytotoxicity using a general screening method and subsequent batches of every suitable item tested to detect interbatch variation. Products were considered suitable or unsuitable for use depending upon a calculated sperm survival index. Two main types of product were found to be cytotoxic, namely certain brands of syringe and surgical gloves, the common feature of both being the presence of rubber components. The bioassay was also used to investigate further the cytotoxic effect of the powdered and starch-free surgical gloves. The cytotoxic substances from both types of surgical glove were readily transferred to an embryo replacement catheter by touch, and washing of the gloves reduced this effect only moderately. The bioassay has proved inexpensive and convenient but more importantly it has been invaluable for detecting potential sources of cytotoxicity before they are introduced into a standard IVF protocol.

Cell Survival↗
PubMed1989

The incidence and influence upon fertility of antisperm antibodies in seminal fluid following vasectomy reversal.

Seminal plasma samples from men undergoing vasovasostomy were analysed for antisperm antibodies using the indirect immunobead test. A pre-operative assessment showed antisperm antibodies of either IgA or IgG class to be present in 9/27 (33.3%) men. A significant increase (P less than 0.05) in the post-operative incidence of the antibodies was seen in the men who achieved patency (27/45, 60%) but not in those men for whom no sperm were seen in the ejaculate (4/10, 40%). After follow-up for a minimum of 1 year, conception rates for couples in which the male partner had achieved patency were similar in the groups with no antibodies detected post-operatively (12/18, 66.7%) or with IgA alone (2/3, 66.7%), but was reduced significantly in the presence of IgG (1/9, 11.1%; P less than 0.05) or IgA + IgG (3/15, 20.0%; P less than 0.01).

Autoantibodies↗
PubMed1989

Fertilization of human oocytes in vitro by spermatozoa from oligozoospermic and normospermic men.

Sperm were isolated from the semen of oligozoospermic (less than 20 x 10(6) sperm/ml) and normospermic (greater than or equal to 20 x 10(6) sperm/ml) men in an in-vitro fertilization (IVF) programme. Oocytes from the female partners were inseminated with either 75 or 100 x 10(3) motile sperm and checked for fertilization after 16-20 h. A significant reduction in the overall fertilization rate of oocytes was seen for the oligozoospermic group compared to the normospermic group, at both insemination concentrations. In the oligozoospermic group, a fertilization rate of 31% (19/61) was achieved when oocytes were inseminated with 75 x 10(3) sperm, and 38% (9/24) when inseminated with 100 x 10(3) sperm. This compared with rates of 57% (397/696) and 64% (650/1018), respectively, for normospermic cases at both insemination concentrations. No evidence of fertilization was seen in 36% (4/11) and 67% (4/6) of oligozoospermic cases when 75 or 100 x 10(3) sperm were used, compared with values of 13% (17/133) and 9% (20/212), respectively, in normospermic cases. After excluding zero cases, the fertilization rate of oocytes for the oligozoospermic group (75%; 9/12) was similar to the normospermic group (70% 650/935) when 100 x 10(3) sperm were used. However, when 75 x 10(3) sperm were used, the fertilization rate for the oligozoospermic group (41%; 19/46) was significantly lower than that of the normospermic group (62%; 397/645). Following the transfer of embryos into the female partner, clinical pregnancies were diagnosed in 2/7 (29%) oligozoospermic cases and 27/267 (10%) normospermic cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1988

Hormonal profiles and embryo quality in women with severe endometriosis treated by in vitro fertilization and embryo transfer.

A study was undertaken comparing the outcomes of 30 women with infertility due to untreated severe (grade IV) pelvic endometriosis with a comparable series of 28 women whose infertility was caused solely by irreversible tubal disease. There were no significant differences in either the follicular phase or luteal phase hormonal profiles of estradiol and progesterone, but there was a significantly reduced pregnancy rate in those women with severe endometriosis. In part, this was due to the recovery of fewer oocytes from the endometriosis patients (P less than 0.001) despite the fact that the peak estradiol levels and ovarian accessibility were similar in the two groups. However, there were no significant differences in the proportion of oocytes that fertilized or the number that demonstrated normal embryo growth and high-grade embryo quality. There also appears to be an implantation inhibitory factor in patients with severe endometriosis as the pregnancy rate/embryo transferred and number of gestational sacs identified/embryo transferred were significantly reduced (P less than 0.05).

Embryo Transfer↗
PubMed1988

Methods of water purification for the preparation of culture media in an IVF-ET programme.

Five methods of water purification for culture media preparation have been described. The quality of media thus prepared has been assessed retrospectively by relating to the fertilization and pregnancy rates of a total of 646 treatment cycles in an in-vitro fertilization and embryo transfer (IVF-ET) programme. All media for human use was subjected to quality control assessment in a mouse embryo culture system. Although no differences were seen in the fertilization rates or the proportion of women proceeding to embryo transfer, significant differences were seen in the pregnancy rates. The highest pregnancy rates were obtained using rainwater distilled six times (22/100, 22%) or eight times (40/184, 21.7%), and water polished using a Milli-Q water purifying system (41/181, 22.7%). Significantly lower pregnancy rates were obtained when the water was purified using an alternative Milli-Q system (9/89, 10.1%) or dam water distilled six times (6/63, 9.5%). These findings may reflect contamination of local dam water supplies but demonstrate the difficulty in purifying water for the preparation of culture medium.

Culture Media↗
PubMed1988

The treatment of infertility by the high intrauterine insemination of husband's washed spermatozoa.

A total of 345 couples with non-tubal infertility on an IVF waiting list underwent 702 treatment cycles involving daily intrauterine inseminations of husband's washed spermatozoa (AIH) over 3 days of the periovulatory period, following ovarian stimulation. Pregnancy rates achieved were dependent upon the underlying infertility disorder, with similar rates noted in those with a negative post-coital test (15.8%) or where antispermatozoal antibodies were present in either the male (18.5%) or female (17.1%) partner. These rates were significantly higher than for couples with poor cervical mucus (4.7%), asthenozoospermia (0%), endometriosis (mild, 7.7%; severe, 4.1%) or unexplained infertility (8.5%), while discrete oligozoospermia showed mid-range results (10.3%). Pregnancy outcome revealed a high level of early wastage (33.3%), mainly in the blighted ovum category, however congenital abnormalities (5.6%) were not significantly increased. It is concluded that the procedure of AIH should be considered for infertility due to poor sperm--mucus interaction, antispermatozoal antibodies and simple oligozoospermia, prior to IVF-related treatments.

Evaluation Studies as Topic↗