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Biomedical subjects

P L Matson

Publications and source records attributed to P L Matson.

At least 73 records · Page 4Linked to original sources

Effect of antispermatozoal antibodies in seminal plasma upon spermatozoal function.

The indirect immunobead test for antispermatozoal antibodies of the class IgA, IgG and IgM was applied to the seminal plasma of male partners of infertile couples. The presence of both IgA and IgG was associated with a decreased incidence of good post-coital test results and a reduced rate of fertilization of human oocytes. No significant differences were found for men with IgA or IgG alone when compared to men with no detectable antispermatozoal antibodies.

Autoantibodies↗

The treatment of normospermic infertility by gamete intrafallopian transfer (GIFT).

Gamete intrafallopian transfer (GIFT) was applied in 207 treatment cycles in 73 couples. The pregnancy rate in cycles with only one (2/21, 9.5%) or two (2/29, 6.9%) oocytes transferred was significantly less than that in which four oocytes (36/116, 31.0%) were replaced. The collection of more than four oocytes did not influence the pregnancy rate in that treatment cycle. The overall pregnancy rate was 24.2% (50 of 207) and was similar in the four infertility groups studied (non-occlusive tubal disorders, endometriosis, cervical factor and unexplained infertility) with 28 (56%) of the pregnancies delivered at greater than or equal to 20 weeks. The pregnancy wastage included 4 (8%) ectopic pregnancies and 3 (6%) late pregnancy losses. The 12 multiple pregnancies occurred following the transfer of three and four oocytes.

Fallopian Tubes↗

Early pregnancy wastage after gamete manipulation.

The outcome of 1034 pregnancies in women who conceived after referral for infertility management in seven treatment groups is detailed. The mean early pregnancy wastage (before 20 weeks gestation) was 27% and ranged from 18% after AID (artificial insemination by donor semen) to 33% after IVF-ET (in-vitro fertilization and embryo transfer). These differences were not due to maternal age which was similar in all groups (means between 29.7 and 32.7 years). Excluding the AID group, there was a high rate of ectopic pregnancy which was significantly higher after GIFT (gamete intrafallopian transfer) and was only partly related to underlying tubal disease. Blighted ova was the main category of early pregnancy loss and was highest after AIH (artificial insemination by husband's semen). There was a higher rate of biochemical pregnancies after GIFT, PROST (pronuclear stage tubal transfer) and IVF-ET. Our findings confirm a high pregnancy wastage rate in subfertile women and highlight deficiencies in the sperm separation, gamete handling and IVF/embryo culture techniques.

Abortion, Spontaneous↗

The in vitro fertilization of supernumerary oocytes in a gamete intrafallopian transfer program.

Gamete intrafallopian transfer (GIFT) was performed on a series of 42 couples in whom four oocytes were replaced into the fallopian tubes and the remaining oocytes were inseminated with 100,000 motile spermatozoa. Fertilization in vitro was assessed 16 to 20 hours later. An overall pregnancy rate after GIFT of 40.0% (12/30) in normospermic couples and 16.7% (2/12) in oligospermic couples was seen. Supernumerary oocytes were submitted to in vitro fertilization (IVF) and the findings related to the likelihood of pregnancy. No correlation between IVF and the likelihood of GIFT pregnancies was found in either the oligospermic or normospermic couples. A similar proportion of pregnancies was seen in couples with or without evidence of fertilization of the supernumerary oocytes in both the oligospermic and normospermic couples. However, a high proportion of normospermic couples with no evidence of fertilization had only one oocyte remaining for insemination. These results suggest that the failure of low numbers of supernumerary oocytes to fertilize in vitro after GIFT relates to oocyte selection criteria and does not mean a reduced chance of conception in that treatment cycle.

Fallopian Tubes↗

The role of gamete intrafallopian transfer (GIFT) in the treatment of oligospermic infertility.

Gamete intrafallopian transfer (GIFT) was used to treat 32 couples where the male partner was oligospermic (less than 12 X 10(6) motile spermatozoa per milliliter of semen). Initially, 100,000 motile spermatozoa were transferred per fallopian tube and no pregnancies were achieved in 11 cases. The technique was then modified so that a maximal number of motile spermatozoa were transferred (range, 0.11 to 0.90 X 10(6) spermatozoa) and 6 of 21 (29%) pregnancies resulted, with 325,000 spermatozoa being the lowest number associated with pregnancy. It appears that the modified GIFT technique, whereby an increased number of motile spermatozoa are replaced with the oocytes, is an effective therapy in the treatment of oligospermic infertility.

Fallopian Tubes↗

Pregnancies following pronuclear stage tubal transfer.

Pronuclear stage tubal transfer (PROST) is a technique that involves in vitro fertilization (IVF) of oocytes, followed by the transfer of pronuclear oocytes into the fallopian tubes. It has been developed for its prognostic value of confirming fertilization in couples with oligospermia or asthenospermia and enabling fertilization in cases with antispermatozoal antibodies (ASAB). PROST has provided useful diagnostic information in the management of couples who have failed to conceive in other treatment programs and has particular advantages over IVF for those receiving fresh donated oocytes for ovarian failure. Fourteen pregnancies resulted from 52 transfers, providing a pregnancy rate of 27% per transfer. The pregnancy rates were higher than a matched IVF series in the male factor and female ASAB groups and reached statistical significance for the ovum donation group. It is anticipated that both pregnancy rates and fetal wastage will be improved over conventional IVF and embryo transfer for the described infertility groups.

Antibodies↗

The successful recovery and fertilization of oocytes from the pouch of Douglas.

Two groups of women were studied in whom a proportion of follicles had either ovulated spontaneously (7 women) or ruptured during manipulation at laparoscopy (30 women), and oocytes were recovered from the pouch of Douglas. There were no significant differences in the fertilization rates of oocytes collected in the pouch of Douglas from ovulated follicles, compared with those from the remaining intact follicles [15/20 (75%) vs 14/20 (70%)]. Also, there was no significant difference between the fertilization rate of oocytes from follicles ruptured at the time of oocyte collection and that of oocytes from intact follicles [25/38 (66%) vs 101/140 (72%)]. One woman became pregnant, following the transfer of four four-cell embryos, all derived from spontaneously ovulated oocytes found in the pouch of Douglas. She gave birth to a baby girl. The present study has shown that oocytes may still be retrieved from the pouch of Douglas, despite follicle dispersal; these oocytes can be fertilized; and the embryos derived from ovulated oocytes recovered from the pouch of Douglas may generate an ongoing pregnancy following in vitro fertilization and embryo transfer.

Cell Separation↗

The fertilization of human oocytes by spermatozoa from men with antispermatozoal antibodies in semen.

Seventy-two couples, including 15 with antispermatozoal antibodies in the male partner's semen, were studied in a program of in vitro fertilization and embryo transfer. Cases were further subclassified as normospermic or oligospermic and antispermatozoal antibodies were assessed with categorization into the respective human immunoglobulin classes as determined using the indirect immunobead test. The study reveals that fertilization is significantly reduced (P less than 0.001) only if both IgA and IgG antibodies are present in semen but there is no reduction if either class is present alone. The fertilization rate of oocytes is significantly reduced (P less than 0.001) by sperm from oligospermic samples, and there is a further reduction in those cases with combined IgA/IgG antispermatozoal antibodies.

Autoantibodies↗