Social and psychological factors affecting fertility. XI. The interrelation of fertility, fertility planning, and feeling of economic security.
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Emotions↗
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Social and psychological factors affecting fertility. XII. The relationship of general planning to fertility planning and fertility rates.
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Birth Rate↗
Social and psychological factors affecting fertility. XVI. Fertility rates and fertility planning by character of migration.
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Birth Rate↗
Implications of complete fertilization failure after intracytoplasmic sperm injection for subsequent fertilization and reproductive outcome.
With the introduction of intracytoplasmic sperm injection (ICSI), couples with severe male factor infertility have achieved fertilization and clinical pregnancy rates comparable to other in-vitro fertilization (IVF) patients. However, failure of fertilization still occurs in some patients despite the utilization of microsurgical sperm injection techniques. How such fertilization failure after ICSI might impact later ICSI treatment(s) is unknown. In this investigation, couples with complete fertilization failure after ICSI treated from August 1993 to August 1996 were identified (index cycle, n = 21). Additionally, fertilization data from any previous or subsequent infertility treatments were evaluated. Seven patients (33%) had at least one IVF treatment before the index cycle, although no deliveries occurred. Of patients with complete fertilization failure in the index cycle, 48% (n = 10) underwent at least one subsequent ICSI cycle which proceeded to oocyte retrieval. The remainder (n = 11) elected to discontinue treatment. Although six subsequent cycles were cancelled due to poor follicular response (< or = 2 mature oocytes), all patients electing to continue treatment eventually achieved a subsequent embryo transfer. The clinical pregnancy rate per transfer was 45.4% for this group; the delivery and ongoing pregnancy rate per transfer was 36.3%. Review of semen parameters, superovulation characteristics or other clinical parameters during the three study cycles (pre-index, index, and post-index) was not prognostic of fertilization success or reproductive outcomes in later treatments. Fertilization failure with ICSI therefore could not be predicted by prior cycle performance, although total immotility of spermatozoa at time of oocyte retrieval, total teratozoospermia, and low oocyte yield were common characteristics of couples experiencing complete fertilization failure with ICSI. These findings suggest that fertilization failure in one ICSI cycle does not preclude successful fertilization and delivery in a later ICSI treatment.
Counseling↗
Migration sedimentation technique as a predictive test for the fertilizing capacity of spermatozoa in an in-vitro fertilization programme.
The migration-sedimentation technique (MST) has been proposed as a means of separating high quality motile spermatozoa. The present study was conducted in order to evaluate whether sperm performance following separation by MST predicts their fertilizing capacity in an in-vitro fertilization (IVF) programme. Ninety semen specimens were analysed for use in an IVF-embryo transfer (ET) programme. Each specimens was divided into two parts: one was processed in the IVF programme and was used after sperm swim-up separation for insemination of human ova. The other aliquot (0.2 ml) was separated by MST, and the sperm then characterized by their concentration, motility, degree of motility and morphology. Sperm characteristics after separation by MST were then correlated with the results of the IVF-fertilization rates. In 79 of 90 IVF-ET cycles, at least one oocyte was fertilized. All post-MST sperm characteristics were significantly higher in cycles with fertilizations compared to IVF cycles without fertilization. A larger percentage of the total motile spermatozoa were recovered after MST in semen specimens with fertilization, compared to semen specimens without fertilization (39.9 +/- 3.6 and 20.6 +/- 6.6%, respectively; P < 0.05). This value was correlated with the percentage of fertilized oocytes (r = 0.24; P < 0.02). More IVF cycles with fertilizations were recorded in cases in which the recovery of motile sperm was > 25% (P < 0.005), or when more than 1.5 x 10(6) motile spermatozoa were recovered after MST (P < 0.0001). As sperm characteristics after MST correlated significantly with their fertilizing capacity, the MST test could be used in evaluation of the fertilizing capacity of spermatozoa.
Cell Separation↗
The effect of antioxidant treatment on human spermatozoa and fertilization rate in an in vitro fertilization program.
OBJECTIVE: To study the possible influence of antioxidant treatment on human spermatozoa and the fertilization rate in an IVF program. DESIGN: Prospective study. SETTING: In Vitro Fertilization Unit, Serlin Maternity Hospital, and the Laboratory of Male Fertility, Bar-Ilan University, Ramat-Gan, Israel. PATIENTS: Fifteen fertile normospermic male volunteers who had low fertilization rates in their previous IVF cycles. INTERVENTIONS: Vitamin E (alpha-tocopherol) 200 mg daily by mouth for 3 months. MAIN OUTCOME MEASURES: Lipid peroxidation potential (amount of malondialdehyde [MDA]), quantitative ultramorphologic analysis of spermatozoa, and fertilization rate per cycle. RESULTS: The high MDA levels significantly decreased from 12.6 +/- 9.4 nmol/10(8) spermatozoa to normal levels of 7.8 +/- 4.2 nmol/10(8) spermatozoa after 1 month of treatment. The fertilization rate per cycle increased significantly from 19.3 +/- 23.3 to 29.1 +/- 22.2 after 1 month of treatment. No additional effects on MDA levels and fertilization rate were observed after completion of treatment. With regard to the quantitative ultramorphologic analysis, none of the sperm cell subcellular organelles were affected significantly by vitamin E treatment. CONCLUSION: Vitamin E may improve the fertilization rate of fertile normospermic males with low fertilization rates after 1 month of treatment, possibly by reducing the lipid peroxidation potential, and with no change of the quantitative ultramorphologic analysis of subcellular organelles.
Administration, Oral↗
Effect of fly ash, organic wastes and chemical fertilizers on yield, nutrient uptake, heavy metal content and residual fertility in a rice-mustard cropping sequence under acid lateritic soils.
A field experiment was conducted for two years in sandy loam acid lateritic soil to study the direct effect of fly ash, organic wastes and chemical fertilizers on rice (Oryza sativa) and their residual effect on mustard (Brassica napus var glauca) grown in sequence. Rice yields were higher when fly ash, organic wastes and chemical fertilizers were used in an integrated manner as compared to sole application of chemical fertilizers. Yields of mustard were also higher under the residual effect of the former rather than the latter. However, this beneficial residual effect under integrated nutrient sources was inadequate for the mustard crop in the low fertility test soil. Hence, direct application of fertilizers was needed, in addition to residual fertility. The effect of fly ash on mean rice equivalent yield of the rice-mustard cropping sequence was highest (up to 14%) when it was used in combination with organic wastes and chemical fertilizers. While the yield increase was 10% when it was used in combination with only chemical fertilizers. The minimum yield advantage, 3%, occurred when fly ash was applied alone. The equivalent yield of the rice-mustard cropping sequence was equally influenced by either of the organic wastes. Cadmium and Ni content in rice grain and straw were less under the direct effect of fly ash. The residual effect on mustard was similar for Ni content in seed and stover; however, Cd content was increased. Beneficial residual soil chemical properties in terms of pH, organic carbon and available N, P and K were noted for integrated nutrient treatments involved fly ash, organic wastes and chemical fertilizers as compared to continuous use of only chemical fertilizers. Application of fly ash alone was effective in raising soil available P. Thus, integrated use of fly ash, organic wastes and chemical fertilizers was beneficial in improving crop yield, soil pH, organic carbon and available N, P and K in sandy loam acid lateritic soil.
Agriculture↗
The relationship of semen parameters to fertilization in patients participating in a program of in vitro fertilization.
Approximately 80% of the patients in a program of in vitro fertilization (IVF) will fertilize an oocyte. The purpose of this study was to determine which parameters of the semen analysis influence fertilization in vitro. Of 120 patients participating in an in vitro fertilization program, 98 achieved fertilization of at least one mature oocyte and 22 did not. Ovulation induction was standardized and patients whose sperm was exposed to at least one mature oocyte (by light microscopy) were included in the study. Semen washing was accomplished using a "swim-up" technique. Semen parameters were assessed both before (raw) and after washing. Following insemination with 100,000 motile sperm, fertilization was determined by the presence of pronuclei or cleavage. Mean sperm count and motility were higher in patients who fertilized. However, morphology was similar. Fertilization was more likely to occur with a raw density greater than 104 million/ml and a motility greater than 64%, as well as with a density greater than 18 million/ml and a motility greater than 86% following washing. Furthermore, washing lowered sperm counts by 75% and increased motility by 25% but had no effect on morphology. This study demonstrates that sperm count and motility, but not morphology, influence fertilization in a program of in vitro fertilization and that patients with higher counts and motility have a greater probability of fertilization.
Female↗
Pregnancy and birth rates of live infants after in vitro fertilization in women with an without previous in vitro fertilization pregnancies: a study of eight thousand cycles at one center.
OBJECTIVE: Our aim was to compare the cumulative conception and live-birth rates after in vitro fertilization in women undergoing their first course of in vitro fertilization treatment with those in women undergoing their second course of treatment, having previously achieved an in vitro fertilization pregnancy. This study occurred in a tertiary referral-assisted conception unit. STUDY DESIGN: The cumulative conception rates obtained by life-table analysis in 4115 women having their first course of in vitro fertilization therapy (7327 treatment cycles leading to 1123 pregnancies) were compared by means of the log-rank test with those of 331 women in their second course of treatment, having previously achieved an in vitro fertilization pregnancy (561 treatment cycles leading to 138 second in vitro fertilization pregnancies). Similarly, the cumulative live birth rates of 3824 women in their first course of treatment (7136 treatment cycles leading to 732 live births) were compared with those of 105 women in their second course of treatment, having previously achieved an in vitro fertilization live birth (205 treatment cycles leading to 33 second in vitro fertilization live births). RESULTS: The cumulative conception rates and cumulative live birth rates were significantly higher in women having their second course of in vitro fertilization treatment than in those having their first course (cumulative conception rate: p = 0.0001; cumulative live birth rate, p = 0.007). After five cycles of in vitro fertilization, the cumulative conception rates and cumulative live birth rates were 49.8% (95% confidence interval, 46.3% to 53.5%) and 39.0% (95% confidence interval, 35.4% to 42.9%), respectively, in those having their first course of treatment compared with 69.9% (95% confidence interval, 57.6% to 81.3%) and 68.6% (95% confidence interval, 46.1% to 88.5%), respectively, in those having their second course. The estimated median numbers of cycles taken to achieve a pregnancy and live birth (assuming all women could potentially undergo the same number of cycles) were six and eight, respectively, in the first course of treatment compared with only three and five in the second course. CONCLUSION: Women who have achieved a previous in vitro fertilization pregnancy have significantly higher cumulative conception rate and cumulative live birth rates compared with those of women having their first course of treatment.
Adult↗
Defective sperm-zona pellucida interaction: a major cause of failure of fertilization in clinical in-vitro fertilization.
Sperm-zona pellucida binding and penetration were assessed on the oocytes that failed to fertilize from couples with >/=3 oocytes treated by standard in-vitro fertilization (IVF). There were four groups: fertilization rate 0% (n = 369), 1-25% (n = 194), 26-50% (n = 81) and 51-95% (n = 100). Of the couples with zero fertilization rate 70% had </=5 spermatozoa bound per zona pellucida and 42% had no spermatozoa penetrating the zona pellucida of any oocyte. In contrast, in the 51-95% fertilization rate group, only 17% had </= 5 spermatozoa bound per zona pellucida and 6% had no spermatozoa penetrating the zona pellucida. There was a significantly higher frequency of poor sperm morphology (</= 5% normal) in couples with zero fertilization rate (36%) than in the fertilization rate group 51-95% (7%). Incubation of oocytes from 68 couples with zero fertilization rate and low sperm-zonae pellucidae binding with fertile donor spermatozoa resulted in normal sperm-zona pellucida binding and most zonae pellucidae being penetrated. In conclusion, defective sperm-zona pellucida interaction was the major cause for low fertilization rates in standard IVF. This was usually because of defects of the spermatozoa rather than defects of the oocytes. Sperm defects likely to cause failure of fertilization should be diagnosed before commencing IVF and the patients directed to intracytoplasmic sperm injection.
Female↗
Fertility of cooled and frozen rabbit sperm measured by competitive fertilization.
The fertility of rabbit sperm that had been cooled to 5 degrees C or frozen and thawed was determined by competitive fertilization. Treatments were identified by labeling sperm with fluorescein isothiocyanate (FITC) or tetramethylrhodamine B isothiocyanate (TRITC). Sperm from different treatments were mixed and used in a competitive insemination experiment. Does were inseminated 5, 10 or 15 h prior to ovulation. Time of ovulation was controlled by injections of luteinizing hormone. The functional sperm transport, as determined by the number of sperm transported to the site of fertilization and capable of fertilizing oocytes, was estimated by counting the total number of differently stained sperm that surrounded or fertilized each oocyte. The fertility of sperm cooled to 5 degrees C was not affected (p less than 0.05) as compared to fertility of uncooled sperm. Functional sperm transport at all times of insemination and fertilization ratio at insemination 10 or 15 h before ovulation were reduced (p less than 0.05) for frozen-thawed vs. cooled sperm. No difference in fertilization ratio (p greater than 0.05) occurred, however, when does were inseminated 5 h before ovulation. While sperm survival and capacitation time appeared to play roles in fertility of frozen-thawed sperm, the most important factor was reduced functional sperm transport. However, fertility of frozen-thawed sperm was improved when the time from insemination to ovulation was reduced.
Animals↗
[The rate of polyploid fertilization of ovocytes in in vitro fertilization in patients with an increased ovarian response].
Polyploid fertilization is a common cause of human embryo's early loss in in vivo (1-2%) and in in vitro fertilization (3-5%) as well. Cause of increased rate of polypoid fertilization in in vitro fertilization is multifactorial. The aim of this paper was to establish if high ovarian response to exogenous hormone stimulation of ovaries can be one of the causes of increased incidence of polyploid fertilization. The research included 125 patients from whom 568 ovocytes were obtained by ultrasound aspiratory punction of ovarian follicles. The gathered results point to the fact that exogenous ovarian stimulation and the degree of ovarian response have a significant influence on increase of polyploid fertilization's rate. Thus, in the group of patients from whom 11 or more ovocytes were obtained, the rate of polyploid fertilization amounted to 11.3%, whereas it is statistically significantly higher (p < 0.01) in regard to those in whom less important difference in the rate of polyploid fertilization considering applied schemes of ovulation's stimulation (p > 0.1) was not established nor was it established considering the age of patients (p > 0.05). Despite the fact that the rate of polyploid fertilization in in vitro conditions is higher that in the natural conception, this method of treating marital infertility opens a unique possibility to identify all irregularities considering fertilization and prevent development of such embryos on time as it happens at the very beginning of the preimplantational stage of ovum's fertilization in laboratory conditions.
Adult↗
[Studies of fertilizing capacity of spermatozoa from infertile men with oligozoospermia. AIH by washed and concentrated spermatozoa and in vitro fertilizing capacity to zona free hamster eggs (author's transl)].
The fertilizing abilities of spermatozoa from infertile men with oligozoospermia were evaluated by examining pregnancy rates after AIH using washed and concentrated spermatozoa, and also by in vitro fertilizing rates to zona free hamster eggs. The spermatozoa from ten oligozoospermic men with less than 20 x 10(6)/ml of sperm counts were used in the experiments. After the procedures of washing and concentrating spermatozoa from oligozoospermic men, the sperm concentration was increased from two to six times and the sperm motility was also increased up to two times. However none of the patients' wives conceived after several AIHs with washed and concentrated spermatozoa. When the in vitro fertilization of zona free hamster eggs by the spermatozoa was used, the fertilization rates were null in case of 7 oligozoospermic patients, and 5, 10 and 33.3% in case of another 3 oligozoospermic patients respectively in contrast with 73.3% in use of spermatozoa from control fertile men. The fertilizing abilities of spermatozoa from husbands of 4 sterile couples with an unknown cause were examined by in vitro fertilization test and 7.1, 37.5, 50.0 and 55.6% fertilization rates were obtained. Among these men, the spermatozoa from one man indicated a very low fertilization rate without any other pathological findings. This suggests that the impairment of fertilizing ability of spermatozoa might be present in the case of sterile men with an unknown cause.
Adult↗
Temporal dimensions of the fertility transition: an age-period-cohort analysis of frontier fertility.
"This paper evaluates age, period, and cohort effects on marital fertility during onset of the Utah fertility transition (1880-1900). Computerized genealogies are used to derive age-period-cohort fertility rates for 49,842 once-married couples. Age, period and cohort effects on marital fertility are then estimated using Johnson's (1985) relational model. Declining marital fertility in Utah is shown to be explained by both lower fertility levels across periods and increasing age-specific limitation across cohorts. Direct cohort effects on fertility are insignificant. These results are consistent with prior research, and the view that fertility levels were adaptive (in part through birth spacing across ages) to immediate contexts of childbearing while age-specific fertility truncation increased across cohorts (in part through the more general diffusion of contraceptive innovations)."
Age Factors↗
The use of rat in vitro fertilization to detect reductions in the fertility of spermatozoa from males exposed to ethylene glycol monomethyl ether.
An in vitro fertilization (IVF) assay sensitive enough to detect changes in the fertilizing capacity of spermatozoa would be a useful tool with which to investigate the action of testicular toxicants. A known testicular toxicant, ethylene glycol monomethyl ether (EGME), was used to induce specific lesions in the germinal epithelium so that the ability of a rat IVF system to detect changes in fertility could be tested. Male rats were given single, oral doses of 50, 100, and 200 mg EGME/kg. Spermatozoa were recovered from the cauda epididymides of these males at intervals after treatment; their fertility was assessed using IVF, and the testes were processed for histologic examination. The fertility of the control males was consistently greater than 65%. Spermatozoa from males treated with EGME had reduced fertility at specific times after dosing. Thus, after 50 mg EGME/kg there was reduced fertility at 5 weeks; after 100 mg EGME/kg there was reduced fertility at 3.5, 4.5, 5, 6, and 6.5 weeks, and after 200 mg EGME/kg there was reduced fertility at 2 and 3 weeks, between 4.5 and 6 weeks, and at 7 weeks. This corresponded to damage to the elongated spermatids (2, 3, and 3.5 weeks), pachytene spermatocytes (4.5 to 6 weeks), and leptotene and preleptotene spermatocytes (7 weeks). This accords well with the data from serial breeding trials and reports of histologic damage after exposure to EGME. Therefore, using IVF it was possible to detect EGME-induced changes in fertilizing capacity which correlated closely with observations of testicular damage. It was also possible to demonstrate a clear dose response to EGME.
Animals↗
Intracytoplasmic sperm injection overcomes previous fertilization failure with conventional in vitro fertilization.
OBJECTIVE: To evaluate the outcome of intracytoplasmic sperm injection (ICSI) in patients with previous idiopathic fertilization failure (< or =20% fertilization rate) after conventional IVF. DESIGN: Retrospective analysis. SETTING: IVF program at a university medical center. PATIENT(S): Twenty-five patients who underwent 38 ICSI cycles after experiencing unexplained fertilization failure with conventional IVF (group A) and 87 patients who underwent 118 ICSI cycles for male factor indications during the same period (group B). INTERVENTION(S): Intracytoplasmic sperm injection was performed in a subsequent cycle after fertilization failure with conventional IVF. MAIN OUTCOME MEASURE(S): Outcomes of IVF were compared between groups A and B. RESULT(S): Fertilization was achieved with ICSI in all patients with previous fertilization failure. The mean (+/- SD) fertilization rate (68%+/-21% vs. 64%+/-22%), implantation rate per embryo (22.6% vs. 20%), and delivery rate per cycle (47.3% vs. 49.1%) did not differ significantly between groups A and B. Overall, 72% of patients with previous unexplained fertilization failure had a successful pregnancy after ICSI. CONCLUSION(S): Intracytoplasmic sperm injection can overcome unexplained fertilization failure caused by a potentially occult gamete abnormality, with the same fertilization, implantation, and pregnancy rates as are seen in patients with abnormal sperm parameters.
Adult↗
Cryopreservation of human oocytes and fertilization by two techniques: in-vitro fertilization and intracytoplasmic sperm injection.
Human oocyte cryopreservation results in poor survival and subsequent fertilization rates. It has been suggested that freeze-thaw-induced changes in the zona pellucida may impair sperm penetration or attachment. The aim of this study was to compare fertilization and cleavage rates in cryopreserved oocytes inseminated by conventional in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). A total of 220 oocytes, obtained from volunteers who had undergone ovarian stimulation, were cryopreserved using a slow freeze-rapid thaw protocol with 1.5 M propanediol as the cryoprotectant. Surviving oocytes (n = 74, 34.4%) were randomly allocated for fertilization by conventional IVF (group 1) or ICSI (group 2) using cryopreserved spermatozoa from a single donor of proven fertility. Fertilization was achieved in five (13.5%) of the oocytes in group 1 and 17 (45.9%) in group 2 (P < 0.005), with only one oocyte in group 1 exhibiting normal fertilization as opposed to 16 (43.2%) in group 2 (P < 0.001). Similarly, one oocyte fertilized by IVF cleaved, while all fertilized with ICSI cleaved (P < 0.001). We conclude that although the survival of oocytes is poor following cryopreservation, fertilization and cleavage rates can be enhanced significantly using ICSI. These data also suggest that the method of cryopreservation used in this study affected the zona pellucida, such that normal sperm attachment or penetration was impaired.
Cleavage Stage, Ovum↗
Experience with assisted fertilization in severe male factor infertility and unexplained failed fertilization in vitro.
We present results of in-vitro fertilization (IVF) cycles using assisted fertilization at our centre. Assisted fertilization was performed in those couples who had failed to fertilize oocytes with conventional IVF, or where this was predicted by the presence of severe male factor infertility. In 20 consecutive assisted fertilization cycles 223 oocytes were subjected exclusively to subzonal insemination (SUZI). Subsequently in 32 consecutive assisted fertilization cycles 418 oocytes were subjected to intra-cytoplasmic sperm injection (ICSI). More oocytes were damaged by ICSI (8.9%) than by SUZI (2.3%) (P = 0.03), but normal fertilization resulted more often after ICSI (56.9%) than SUZI (35.8%) (P = 0.004). Sperm parameters, other than sufficient numbers to perform the procedures, had no effect on fertilization or pregnancy rates. Every cycle led to the transfer of at least one embryo. Pregnancy resulted from eight of the SUZI cycles (40%) and nine of the ICSI cycles (28%). Implantation rates were calculated as 25 and 12% for SUZI and ICSI respectively. The presence of living spermatozoa is the only semen parameter limiting assisted fertilization. At present more centres are able to perform SUZI than ICSI and we feel it is premature to abandon SUZI altogether. Local conditions and success rates should be considered when decisions are made in assisted fertilization cycles.
Adult↗