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Breakeven costs for embryo transfer in a commercial dairy herd.

Differences in Estimated Breeding Values expressed in dollars were compared by simulation of two, 100-cow, closed herds. One herd practiced normal intensity of female selection. The other herd generated various herd replacements by embryo transfer by varying 1) selection rate of embryo transfer dams and 2) numbers of daughters per dam from which embryos were transferred, while varying the merit of mates of embryo transfer dams. Estimated Breeding Value dollars were compounded each generation and regressed to remove age adjustments and added feed and health costs. Beginning values in both herds included a standard deviation of 55 Cow Index dollars, herd average of -23 Cow Index dollars, and a 120 Predicted Difference dollars for mates of dams not embryo transferred. Average merit of all sires used increased $12 per year. Herd calving rate (.70), proportion females (.5), calf loss (.15), and heifer survival rate (.83) were used. Breakeven cost per embryo transfer cow entering the milking herd was computed by Net Present Value analysis using a 10% discount rate over 10 and 20 yr. Breakeven cost or the maximum expense that would allow a 10% return on the expenditure ranged from $135 to $510 per surviving cow, $24 to $125 per transfer, $47 to $178 per pregnancy, and $81 to $357 per female calf born. As the number of replacements resulting from embryo transfer increased, breakeven cost per embryo transfer cow decreased due to diminishing return.

Animal Husbandry↗

Effect of a sonographically diffusely enlarged uterus without distinct uterine masses on the outcome of in vitro fertilization-embryo transfer.

PURPOSE: Our objective was to study the effect of a sonographically diffusely enlarged uterus without distinct uterine masses on the outcome of in vitro fertilization-embryo transfer (IVF-ET). METHODS: Nineteen primary infertility patients undergoing IVF-ET who had a sonographically diffusely enlarged uterus without distinct uterine masses were enrolled. An age-controlled group of 144 primary infertility patients undergoing IVF-ET with a normal uterus and no history of uterine surgery was included. RESULTS: The age, day 3 follicle stimulating hormone, antral follicle count, ovarian response, endometrial thickness, number of retrieved and fertilized oocytes, number of transferred embryos, clinical pregnancy rate, and total delivery rate were not statistically different between the two groups (P < 0.05). Patients with a sonographically diffused enlarged uterus without distinct uterine masses had a higher spontaneous abortion rate (66.7%) than controls (P < 0.04; odds ratio = 7.5; 95% confidence interval, 1.16-48.56). CONCLUSIONS: A high spontaneous abortion rate was found in patients with a sonographically diffusely enlarged uterus without distinct uterine masses undergoing IVF-ET. Enhanced luteal support was required.

Abortion, Spontaneous↗

Predictors of success after embryo transfer: experience from a single provider.

OBJECTIVE: Our goal was to examine the variables present at the time of embryo transfer and to determine their effects on the clinical pregnancy rate. STUDY DESIGN: All fresh and frozen embryo transfers during a 3-year period in a university-based in vitro fertilization program were examined. Female age, previous in vitro fertilization attempt, diagnosis, embryo number and quality, transfer technique, and presence of a clinical pregnancy were recorded for each couple. Logistic regression analyses were performed both univariately and multivariately to determine the association between a clinical pregnancy and the independent variables. RESULTS: All transfers during the study period were included in the analysis. The four primary diagnoses were pelvic or tubal disease, male factor infertility, unexplained infertility, and endometriosis. The 46 frozen embryo transfers had a clinical pregnancy rate similar to that among the 159 fresh embryo transfers and were therefore included in the analysis. One variable was found to significantly affect the outcome, the number of high-grade embryos placed. The presence of a previous failed embryo transfer tended to lower the success rate for future attempts; however, this result did not reach statistical significance. The catheter type and the transfer difficulty did not affect outcome. CONCLUSION: The two most important variables for predicting a clinical pregnancy are a first-time transfer and the number of high-grade embryos placed. Neither the type of embryo transfer catheter used nor the diagnosis affected outcome. In this small sample difficult embryo transfers did not diminish the chance for a successful outcome.

Adult↗

Elective single embryo transfer: the value of cryopreservation.

In-vitro fertilization is associated with a high rate of multiple pregnancies, a consequence of the number of embryos transferred. There is a challenge in avoiding even twin pregnancies in assisted reproduction, and this can be accomplished with elective single embryo transfer and a good cryopreservation programme. In our follow-up study, we analysed all our elective single embryo transfers during 1998-1999. In all these cycles at least one embryo was frozen. A total of 127 elective single embryo transfers were performed with a clinical pregnancy rate of 38.6%. The highest implantation rate was obtained with four-cell embryos with <10% fragmentation (39.8%). Thirty-four patients have delivered (26.8%), one of these being a monozygotic pregnancy. In total 129 frozen-thawed cycles have been achieved in 83 patients. One frozen-thawed embryo has been transferred in 46 cycles with a clinical pregnancy rate of 17.4%, and two embryos have been transferred in 83 cycles, with a clinical pregnancy rate of 37.3%. Up until now, 66 of 125 patients in our single embryo transfer programme have delivered or have on-going pregnancies, and 77 still have embryos frozen. The cumulative delivery rate per oocyte retrieval is 52.8% and the twin rate 7.6%. We conclude that elective single embryo transfer with a good cryopreservation programme results in very acceptable pregnancy rates with a low risk of twins. This is a cost-effective practice that substantially reduces all risks associated with multiple pregnancies and lowers the cost per delivery.

Cost-Benefit Analysis↗

Defining women who are prone to have twins in in vitro fertilization--a necessary step towards single embryo transfer.

PURPOSE: The aim of the present study was to identify subsets of women undergoing two-embryo transfer in in vitro fertilization (IVF) who are prone to give birth to twins. METHODS: During 1990 to 2002 4580 day 2 or day 3 two-embryo transfers were conducted and these constituted the study population. RESULTS: By selecting combinations of factors, some subsets of patients where single-embryo transfer might be conducted would reduce the estimated twin rate by 60%, but requiring single-embryo transfer in only approximately one third of the patients. Examples of such selected groups were patients less than 33 years of age with two top quality embryos, patients less than 39 years of age with two top quality embryos and conducting their first IVF cycle, and patients less than 39 years of age with two top quality embryos and two optimal cleavage cells. CONCLUSION: By combining factors, subsets of patients with both a high birth and twin rate that could be recommended single embryo transfer were identified.

Adult↗

Day 2 elective single embryo transfer in clinical practice: better outcome in ICSI cycles.

BACKGROUND: Single embryo transfer (SET) after IVF/ICSI has been shown to result in an acceptable pregnancy rate in selected subjects. In our unit, SET is routinely carried out among women under the age of 36 in the first or second treatment cycle when a top-quality embryo is available. In order to define further the selection criteria for SET, we have analysed the outcome of elective SET (eSET), including the cumulative pregnancy rate after frozen embryo transfers, performed in the years 2000-2002 in the Oulu Fertility Center. METHODS: During the study period, a total of 1271 transfers were performed, and in 468 cycles SET (39% of all transfers) was carried out. Of the SET cycles, in 308 cases a top-quality embryo was transferred on day 2 and extra embryos were frozen. Of these eSET cycles, ICSI was carried out in 87 cycles (28%). RESULTS: The overall clinical pregnancy rate per transfer was 34.7% in the eSET cycles. In the eSET ICSI cycles, the clinical pregnancy rate was significantly higher than in the corresponding IVF cycles (50.6 versus 28.5%, P < 0.001). The cumulative pregnancy rate per patient after fresh and frozen embryo transfers was also significantly higher after ICSI (71.2 versus 53.4%, P < 0.01). CONCLUSIONS: A high cumulative pregnancy rate per oocyte retrieval can be achieved after eSET in daily clinical practice. The implantation rate of fresh top-quality embryos in the ICSI cycles was significantly higher than in the IVF cycles, possibly due to more successful selection of the embryo for embryo transfer on day 2 after ICSI. In addition, our data suggest that embryo quality is a more important determinant of outcome than the age of the woman.

Adult↗

The usefulness of ultrasound guidance in frozen-thawed embryo transfer: a prospective randomized clinical trial.

BACKGROUND: Recent randomized controlled trials have shown that implantation and pregnancy rates were improved with ultrasound-guided embryo transfer compared with clinical touch in fresh IVF cycles associated with supraphysiological ovarian steroid levels. However, the usefulness of ultrasound guidance in frozen-thawed embryo transfer where potential hormonal influences are lacking has not been appropriately investigated. METHODS: A total of 184 consecutive patients undergoing thawed embryo transfer cycles with hormone replacement under pituitary suppression were randomized by computer-generated randomization table to two study groups: 93 had ultrasound-guided (group 1) and 91 had clinical touch (group 2) embryo transfer. RESULTS: There was equal distribution between the two study groups with respect to the main demographic and baseline characteristics of the patients as well as the characteristics of both prior IVF cycles from which embryos were generated and cryopreserved-thawed embryo transfer cycles. However, both pregnancy and implantation rates in group 1 (34.4 and 19.8% respectively) were significantly higher than the corresponding values (19.7 and 11.9%) in group 2. CONCLUSIONS: Ultrasound guidance in frozen-thawed embryo transfer significantly increases pregnancy and implantation rates.

Adult↗

Monozygotic twin delivery following reduction from quadramniotic-dichorionic gestation established after ICSI and embryo transfer: Case report.

We report the delivery of healthy monozygous (MZ) twins in a 31 year-old nulligravida following gonadotrophin ovulation induction, ICSI, assisted hatching and fresh embryo transfer. Although a sonogram on day 35 confirmed that two of four transferred embryos had implanted, a second transvaginal sonogram 1 week later showed each gestational sac had two conceptuses-all four were associated with distinct amniotic compartments. Cardiac activity was observed in all four embryos. At 12 weeks and 5 days gestation, chorionic villus sampling was performed on fetuses 1 and 2 which were euploid for chromosomes 13, 18, 21, X and Y via fluorescence in-situ hybridization analysis. Subsequent KCl injection into sacs 3 and 4 resulted in asystole for these fetuses, while cardiac activity in sacs 1 and 2 remained unchanged after reduction. A twin vaginal delivery occurred at 36 weeks gestation, resulting in the birth of two male infants and one placenta. This case represents the first known report of human quadruplet pregnancy consisting of two MZ twin sets conceived by assisted reproductive techniques. Our report reviews proposed mechanisms for explaining twinning, with special emphasis on zona pellucida micromanipulation and subsequent MZ twin induction.

Adult↗

Serum concentrations of oestradiol-17beta, progesterone, relaxin and chorionic gonadotrophin during blastocyst implantation in natural pregnancy cycle and in embryo transfer cycle in the rhesus monkey.

The present study was undertaken to assess the temporal association between the profiles of serum concentrations of oestradiol-17beta, progesterone, chorionic gonadotrophin (CG) and relaxin in pregnancies established naturally, and after embryo transfer, as well as in failed pregnancies in rhesus monkeys. In naturally mated cycles (group 1) a conception rate of 75% was obtained. In group 1, the mean day of CG detection in serum was 11.5 +/- 1.9 day post-ovulation, and for relaxin, 9.0 +/- 2.5 day post-ovulation. In group 2, embryo transfer to synchronous, non-mated surrogate recipients was performed; seven embryo transfer cycles yielded three pregnancies which were allowed to continue to term and normal infants were delivered. In embryo transfer cycles the mean day of CG detection was 14.8 +/- 1.8 day post-ovulation, and for relaxin, 11.4 +/- 2.6 day post-ovulation. A delay of about 3 days was observed in the appearance in circulation of CG (P < 0.05) and also of relaxin (P < 0.05) between natural mated and embryo transfer conception cycles. Significant differences (P < 0.05 for progesterone and P < 0.03 for oestradiol) were obtained for the areas under the curves for progesterone and oestradiol between days 12 and 16 in conception cycles compared with failed pregnancies. These data provide the first observation of the normal hormonal signals associated with maternal recognition of transferred embryos during the peri-implantation period, and suggest that the use of such an experimental primate embryo transfer model may help to elucidate components of maternal and embryonic signal-response mechanisms during embryo implantation.

Abortion, Veterinary↗

A clinical assessment of nine pregnancies obtained by in vitro fertilization and embryo transfer.

An analysis of nine pregnancies resulting from in vitro fertilization and embryo transfer was made in order to identify factors common to all of the pregnancies. These factors included clomiphene stimulation; general anesthesia for laparoscopy; identification of large follicles (greater than 8 ml) and a mature oocyte; preincubation of the oocyte for 4.7 to 6.5 hours in vitro before insemination; insemination with 0.8 to 1.3 x 10(6) fresh spermatozoa from fertile samples; transfer to the uterus of two-, four-, and eight-cell embryos, 38 to 50 hours after insemination; and uncomplicated uterine transfers of embryos. It was difficult to determine whether these factors are causal or coincidental in the attainment of successful pregnancies. The detailed analysis was useful in demonstrating factors which did not prevent the establishment of pregnancy by in vitro fertilization and embryo transfer. These factors included a variety of causes of infertility, including idiopathic and male infertility; age of the infertile woman over 35 years; the presence of T-mycoplasma in the genital tract; the use of human chorionic gonadotropin; a variety of agents used for general anesthesia; the use of carbon dioxide to induce pneumoperitoneum; a delay of up to 50 minutes in the interval between the induction of general anesthesia and oocyte recovery; the use of antiprostaglandins at the time of embryo transfer; and a brown discharge from the vagina following embryo transfer.

Embryo Transfer↗

The use of intra-endometrial embryo transfer for increasing the pregnancy rate.

It has been demonstrated previously that pregnancy can be achieved by the direct insertion of embryos into the endometrial stroma (intra-endometrial embryo transfer) of mice. In this study we evaluated whether intra-endometrial transfer resulted in a higher pregnancy rate than conventional embryo transfer. Mouse blastocysts (ICR strain), recovered on day 4 of pregnancy, were transferred into pseudopregnant day 2, day 3 and day 4 mice of the same strain; 1-, 2- and 8-cell embryos were also transferred into pseudopregnant day 4 mice. In intra-endometrial embryo transfer, a 27 gauge injection needle was inserted near the utero-tubal junction into the endometrial stroma and then removed; one blastocyst was transferred into each uterine horn with a glass micropipette. Conventional transfers were performed simultaneously as controls. The pregnancy rates and embryonic viability rates were evaluated 9 days after embryo transfer. Furthermore, the rates of live birth for intra-endometrial and conventional embryo transfers were compared when blastocysts were transferred into pseudopregnant day 4 uteri by both methods. In the transfer to pseudopregnant day 2 recipients, the pregnancy and embryonic viability rates were significantly higher (P < 0.01) in intra-endometrial [23.4 (11/47) versus 15.9% (15/94)] than in conventional embryo transfer [4.3 (2/46) versus 2.2% (2/92)]. In the transfer to pseudopregnant day 3 recipients, both rates were also higher (P < 0.01) in intra-endometrial [90.9 (40/44) versus 87.5% (77/88)] than in conventional transfer [67.4 (31/46) versus 64.1% (59/92)].(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Low fatty acid amide hydrolase and high anandamide levels are associated with failure to achieve an ongoing pregnancy after IVF and embryo transfer.

Human reproduction is a rather inefficient process, yet the molecular reasons for this inefficiency remain unknown. IVF and embryo transfer (IVF-embryo transfer) also results in a high frequency of implantation failures and early spontaneous abortions. Here we show that the anandamide (AEA)-degrading enzyme, fatty acid amide hydrolase (FAAH), had significantly lower activity (46 +/- 17 versus 161 +/- 74 pmol/min per mg protein) and protein content (0.10 +/- 0.03 versus 0.23 +/- 0.06 units) in lymphocytes of IVF-embryo transfer patients who failed to achieve an ongoing pregnancy than in those who become pregnant, and this was paralleled by a significant increase in blood AEA (4.0 +/- 2.2 pmol/ml and 0.9 +/- 1.0 pmol/ml respectively). The blood levels of the other endocannabinoid, 2-arachidonoylglycerol, or of the AEA congener, N-palmitoylethanolamine, which are metabolized by enzymes different from FAAH, was not different between the pregnant and nonpregnant women, nor was there any difference in the activity of the AEA membrane transporter or the amounts of cannabinoid receptors in lymphocytes. Taken together with the reported negative effects of AEA on embryo implantation, this study indicates that low FAAH activity and subsequent increased AEA levels in blood might be one of the causes of implantation failure or pregnancy loss, thereby leading to a better understanding of the pathophysiological and therapeutic implications of endocannabinoids in human fertility.

Adult↗

The production of EAE-free lambs from infected dams using multiple ovulation and embryo transfer.

This investigation aimed to ascertain whether embryo transfer was a feasible method of breaking the disease cycle caused by Chlamydia psittaci (ovis). Ten naive ewe lambs were inoculated orally with the T76 and G188 isolates of C. psittaci (ovis) in late pregnancy. Five animals which sero-converted to the complement fixation test (CFT) were used as donors for a multiple ovulation and embryo transfer programme. Three ewes excreted chlamydiae at parturition 1 year after inoculation, with one animal exhibiting a CFT titre indicative of clinical disease. Twelve embryos collected from these three donors and transferred to seven disease-free recipients survived and were not infected, nor were their recipient dams. It therefore appears possible to infect ewe lambs during the final stages of pregnancy with the disease manifesting itself during the following breeding season. Embryos collected from infected animals do not appear to transmit the chlamydia causing enzootic abortion.

Abortion, Septic↗

Impact of the assessment of early cleavage in a single embryo transfer policy.

The policy of single embryo transfer (SET) adopted for women <36 years old since 1 July 2003, strongly calls for improvement of embryo selection. A total of 196 cycles in which SET was performed were randomly allocated to two groups. In the first group, early cleavage was assessed (ECA) 25 h after insemination. The embryo with the best score that cleaved early, if present, was selected for transfer. In the second group, early cleavage was not assessed (ECNA) and embryo selection was based solely on the embryo score. Ninety-eight cycles were allocated in the ECA and ECNA group respectively. Early cleavage occurred in 64% of cycles and 32.2% of embryos. Patient population and embryo morphology were similar between the two groups, and similar delivery rates were observed (27.6 versus 24.5% respectively in the ECA and ECNA groups). The assessment of early cleavage as additional parameter did not improve the delivery rate in the single embryo transfer policy.

Adult↗

Techniques and success of embryo transfers in Angora goats.

Thirty-five mixed-age Angora does were subjected to superovulation and oestrous synchronization and of the 34 which were subsequently entire mated, 33 were subjected to surgical egg recovery approximately five days after oestrus. These 33 donors averaged 8.8 ovulations and 2.5 large (>5 mm) follicles. All corpora lutea in six donors were undergoing premature regression. The average donor egg recovery rate, egg fertilization rate and percent of eggs transferable was 82,87 and 81%, respectively, giving 6.8 eggs, 6.0 embryos and 5.5 transferable embryos per donor. Egg recovery was reduced dramatically when premature regressing corpora lutea were present. Recipient feral does were synchronized and 183 embryos transferred surgically to 133 recipients. Eighty-eight (66%) of the recipients kidded producing 118 kids (64% embryo survival). The 35 potential donors produced 36 kids from their natural mating which occurred shortly after surgery. Thus the donors produced a total of 154 kids from embryo transfer and natural mating, an average of 4.4 kids/doe/breeding season. This rate of reproduction is four to five times faster than normal and confirms that the technique achieves its objective of rapidly increasing the number of offspring from selected animals.

Journal Article↗

Bovine embryo transfer pregnancies. II. Lengths of gestation.

Lengths of gestation were determined from 1,484 pregnancies resulting from embryo transfer procedures. Least-square means of lengths of gestation by breed of embryos (P less than .005) were: Holstein, 278.7; Angus, 281.0; Hereford, 285.7; Simmental, 287.6 and Limousin, 289.7 d. Recipient breed had a small effect on length of gestation (P less than .005). The length of gestation for recipients less than 4 yr old was 2.7 d shorter (P less than .005) than for older recipients. As asynchrony of recipient and donor estrus changed by 1 d, length of gestation changed linearly by .78 d (P less than .005). Male calves were carried 1.4 d longer than females (P less than .005). Embryo age at time of transfer, embryo quality, length of embryo storage between collection and transfer, and donor age did not affect length of gestation significantly. Lengths of gestation of 185 embryo transfer pregnancies were 1.5 d longer (P greater than .1) than those of 305 matched control pregnancies from the same farms. We conclude that length of gestation of embryo transfer calves and length of gestation of non-embryo transfer calves are influenced by similar factors.

Animals↗

[Intravaginal culture and embryo transfer].

The intra-vaginal culture and embryo transfer is based on the principle of fertilization of hyman ovocytes in the absence of CO2-enriched air. Ovocytes and spermatozoa are placed in a water-tight tube filled with B2 medium and placed in the vagina during the culture. Once the culture is done, the embryos are replaced in the uterus. The various studies done with intra-vaginal culture and embryo transfer, their results as well as future prospects are reviewed in detail.

Cells, Cultured↗