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Biomedical subjects

Wilfried Feichtinger

Publications and source records attributed to Wilfried Feichtinger.

8 recordsLinked to original sources
PubMed2004

Minimal stimulation using recombinant follicle-stimulating hormone and a gonadotropin-releasing hormone antagonist in women of advanced age.

OBJECTIVE: To determine whether minimal stimulation with short-term application of low-dose recombinant follicle-stimulating hormone (FSH) together with a gonadotropin-releasing hormone (GnRH) antagonist represents a cost-effective treatment regimen for patients with elevated FSH levels, aged 40 and above. DESIGN: Retrospective cohort study. SETTING: Academically affiliated private in vitro fertilization (IVF) program. PATIENT(S): Eighty-five IVF cycles using minimal ovarian stimulation and 85 cycles with a standard long-stimulation protocol, conducted between January 2000 and January 2002, in women aged 40 and above who had slightly increased FSH levels. INTERVENTION(S): Patients on the long protocol underwent standard cycle monitoring and stimulation. In contrast, women with minimal stimulation had transvaginal sonography initiated on day 8 of the menstrual cycle and at a follicle size of 13 mm. We administered 0.25 mg of GnRH antagonist and 75 IU recombinant FSH daily until ovulation induction. MAIN OUTCOME MEASURE(S): Numbers of oocytes, and rates of cancellation and pregnancy. RESULT(S): Minimal stimulation cycles resulted in a clinical pregnancy rate of 8.2% per started cycle and 10% per embryo transfer (ET), whereas the control group yielded a clinical pregnancy rate of 10.6% per started cycle and of 10.7% per ET (not statistically significant). CONCLUSION(S): In women aged 40 and above with abnormal FSH levels, minimal stimulation protocol achieves similar pregnancy rates to a standard protocol, and thus represents a cost-effective alternative.

Adult↗
PubMed2004

Preimplantation diagnosis (PGD)--a European clinician's point of view.

This paper describes the current status of preimplantation diagnosis from the viewpoint of an experienced clinician specialized in reproductive medicine. Current progress and international experiences with different applications and techniques are being reviewed on the basis of the literature. Particular interest is focused on possible advantages of routinely diagnosing major chromosome aneuploidies in preimplantation-embryos of patients undergoing in vitro fertilization and embryo transfer. Last but not least, a short survey of the international guidelines and legislation is compared to the situation in the author's country, Austria, where it is currently unclear whether preimplantation diagnosis is allowed or not.

Aneuploidy↗
PubMed2003

[Preimplantation diagnosis (PID) in humans from the clinical viewpoint].

This paper describes the current status of preimplantation diagnosis from the viewpoint of an experienced clinician specialized in reproductive medicine. Current progress and international experience with different applications and techniques are reviewed on the basis of the literature. Particular interest is focused on possible advantages of routinely diagnosing major chromosome aneuploidies in preimplantation-embryos of patients undergoing in vitro fertilization and embryo transfer. Last but not least, a short survey of the international guidelines and legislation is compared to the situation in Austria where it is currently unclear whether preimplantation diagnosis is allowed or not.

Aneuploidy↗
PubMed2003

A prospective randomized multicenter study to evaluate the best day for embryo transfer: does the outcome justify prolonged embryo culture?

PURPOSE: This study aimed to evaluate the best day for embryo transfer in a prospective unrestricted randomized multicenter trial. METHODS: Data were collected on a preformed Excel-sheet which contained random numbers from 1 to 5 for each subsequent patient as a preprogrammed day for embryo transfer. Information was requested on patient's age, indication for sterility treatment, stimulation protocol used, numbers of oocytes retrieved, fertilized oocytes, cryopreserved embryos, and cell stage of embryos transferred. RESULTS: A total of 329 embryo transfers were performed, resulting in 106 clinical pregnancies (32.2%). Pregnancy rates achieved were 20.0% on day 1, 30.4% on days 2 and 3, and 50.0% on days 4 and 5 (p = 0.03). CONCLUSIONS: Within the scope of the present randomized multicenter trial, embryo transfers performed on days 4 and 5 enhanced the pregnancy rate significantly, compared to those of days 1, 2, and 3.

Adult↗
PubMed2002

Comparison of stimulation with clomiphene citrate in combination with recombinant follicle-stimulating hormone and recombinant luteinizing hormone to stimulation with a gonadotropin-releasing hormone agonist protocol: a prospective, randomized study.

OBJECTIVE: To compare IVF-ET outcome with a new stimulation protocol using clomiphene citrate (CC) with recombinant FSH and LH to stimulation with the standard long GnRH-a protocol. DESIGN: Prospective randomized study. SETTING: Outpatient infertility clinic in Vienna, Austria. PATIENT(S): Two hundred ninety-four infertile women undergoing IVF-ET; 154 IVF cycles stimulated with CC + recombinant FSH + recombinant LH (group A) and 140 cycles with long GnRH-a suppression + recombinant FSH (group B). INTERVENTION(S): Controlled ovarian hyperstimulation, egg retrieval, and ET. MAIN OUTCOME MEASURE(S): Cycle parameters (number of oocytes, fertilization, number of embryos) and outcome (pregnancy rate, cancellation rate, ovarian hyperstimulation syndrome [OHSS]). RESULT(S): Pregnancy rate per ET was 42.9% (implantation rate, 21.3%) in group A and 36.6% (17.4%) in group B. Cancellation rates were similar. The OHSS occurred in four cases (3%) in group A and 12 cases (10%) in group B. CONCLUSION(S): Stimulation with CC + recombinant FSH + recombinant LH leads to comparable pregnancy rates vs. the long protocol. With this new stimulation, less gonadotropins are used and there is less need for monitoring (lower cost for patient and clinic). The risk of OHSS is reduced as well. Therefore, this protocol should be regarded as the first-line treatment.

Adult↗
PubMed2002

Ascorbic acid supplement during luteal phase in IVF.

PURPOSE: To evaluate the impact of ascorbic acid of different doses as additional support during luteal phase in infertility treatment by means of a prospective, randomized, placebo-controlled, group comparative, double-blind study. METHODS: Voluntary daily oral intake of either ascorbic acid (1, 5, or 10 g/day) or Placebo for 14 days after follicle aspiration for IVF-ET procedure. Data was obtained on 620 cases of women, age <40 years, undergoing first IVF-embryo transfer cycles in two private outpatient infertility clinics. All women were stimulated by the same protocol. The mean age was 31.73 (+/- 4.4 SD) years. RESULTS: No differences in clinical pregnancy rate and implantation rate were noted in statistical logistic regression analysis between the four intake groups. CONCLUSIONS: There was no clinical evidence of any beneficial effect, as defined by main outcome measures, of ascorbic acid on IVF-ET. Our data suggest there is no obvious value of high dosed intake of vitamin C during luteal phase in infertility treatment.

Adult↗
PubMed2002

Do lunar cycles influence in vitro fertilization results?

PURPOSE: Our objective was to investigate the lunar influence on IVF-ET outcomes. METHODS: Between 1992 and 1999 we have completed 7572 preprogrammed IVF-ET treatment cycles with the same stimulation protocol in two outpatient units. (Vienna, Austria and Budapest, Hungary) Multiple regression (SAS; proc Logistic) and two separate analyses were performed on pregnancy rates using a harmonic sinoidal trend based on the synodic and anomalistic lunar cycles respectively. RESULTS: The overall pregnancy rate was 30.9%. The amplitude of harmonic sinoidal, trend for the synodic lunar cycles was chi2 = 1.63,2d.f., p = 0.44 and chi2 = 6.27,2d.f., p = 0.044 for the anomalistic moon periods. For the anomalistic lunar months the amplitude of harmonic sinoidal trend was borderline in terms of higher pregnancy rates with the moon in Perigee. CONCLUSION: The cause of seasonal changes in IVF-ET outcomes is probably very complex. Our results indicate that lunar influence may only be one of the contributing factors. Further studies are needed to clarify unexplained fluctuations of pregnancy outcomes.

Embryo Transfer↗