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Results for “Embryo Transfer”

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PubMed2000

Prediction of pregnancy rate of in vitro fertilization and embryo transfer in women aged 40 and over with basal uterine artery pulsatility index.

PURPOSE: The purpose was to determine the effect of basal uterine perfusion on the pregnancy rates of in vitro fertilization and embryo transfer (IVF-ET) in women aged 40 and above. METHODS: A total of 47 patient aged 40 and over underwent IVF-ET. The conception cycles and the nonconception cycles were compared. RESULTS: Of the 47 patients, 4 patients were pregnant (8.5%). The mean age, basal follicle stimulating hormone (FSH), basal estradiol (E2) level, antral follicle count (AFC), number of ampoules of gonadotropin used, E2 levels and endometrial thickness on the day of human chorionic gonadotropin (hCG) administration, number of retrieved and fertilized oocytes, and number of transferred embryos were not statistically significant between the conception and nonconception cycles. However, the basal uterine artery pulsatility index (UA PI) was significantly lower in the conception cycles (P < 0.001). The receiver operating characteristics (ROC) curve analysis for basal FSH, AFC, and basal UA PI in predicting the pregnancy rate of IVF in patients aged > or = 40 were demonstrated. The best prediction rate was achieved by a pulsatility index cutoff of < 2.0 for a receptive uterus. CONCLUSIONS: Increased uterine perfusion in the early follicular phase enhanced the pregnancy rate of IVF in women aged 40 and above. It is therefore essential that patients aged > or = 40 with poor basal uterine perfusion should be identified early in the early follicular phase of the menstrual cycle to apply appropriate intervention to improve the uterine circulation for the subsequent chance of pregnancy.

Adult↗

PubMed2005

Embryo fragmentation as a determinant of blastocyst development in vitro and pregnancy outcomes following embryo transfer.

OBJECTIVE(S): To determine how the type of embryo fragmentation on day 3 affects progression of human embryos to blastocyst and pregnancy rates following embryo transfer. STUDY DESIGN: Retrospective analysis of all in vitro fertilization cycles in patients < or =40 years of age or younger from January 2002 through December 2003, during which time surplus day 3 embryos were transferred to blastocyst medium for extended culture. All embryos (4 cells or more) not suitable for transfer or freezing 72 hours following in vitro fertilization were placed into microdroplets (60 microL) of blastocyst medium and cultured for an additional 48 hours to assess blastocyst formation. Normal blastocyst development required blastulation, a visible inner-cell mass, trophectoderm cells covering 60% of the inner zona surface and thinning of the zona. The rate of blastocyst formation was then analyzed (chi 2 and analysis of variance) against the type of fragmentation 72 hours after insemination. Pregnancy outcomes were analyzed with respect to the pattern of fragmentation in cleaving embryos transferred after 3 days of culture. RESULTS: A total of 1566 embryos were cultured beyond day 3 of development of which 229 (14.6%) reached the blastocyst stage and were frozen. Embryos exhibiting no fragmentation or type I fragmentation had significantly higher blastocyst development rates (27.9% and 19.9%) than embryos with type 2 or 3 fragmentation (13.9 and 8.8, respectively; P < .001). No embryos with type 4 or 5 fragmentation progressed to blastocyst. The average type of fragmentation in transferred embryos correlated with pregnancy outcome and embryo age. CONCLUSION(S): More pervasive embryo fragmentation was associated with a decreasing rate of blastocyst development with day 3 embryos. To the extent that blastocyst development rates of day 3 embryos is an index of embryo viability, our findings establish that careful classification of the type of embryo fragmentation is important in selection of day 3 embryos for transfer. Recent reports of associations among embryo fragmentation, aneuploidy, apoptosis, and patient age support these conclusions.

Adult↗

PubMed2006

Efficiency of changing the embryo transfer time from day 3 to day 2 among women with poor ovarian response: a prospective randomized trial.

OBJECTIVE: To compare the outcome of day 2 and day 3 embryo transfers in women demonstrating poor ovarian response. DESIGN: Prospective randomized clinical trial. SETTING: Private assisted reproductive technology center. PATIENT(S): Two hundred eighty-one women demonstrating poor ovarian response to controlled ovarian hyperstimulation. INTERVENTION(S): Women who were poor responders were randomly allocated to day 2 or day 3 embryo transfer following oocyte retrieval. MAIN OUTCOME MEASURE(S): Implantation rates and pregnancy rates per oocyte retrieval and embryo transfer. RESULT(S): The clinical pregnancy rates per oocyte retrieval (37.2% vs. 21.4%, respectively; P<.05) and per embryo transfer (38.9% vs. 24.1%, respectively; P<.05) were significantly higher in the day 2 embryo transfer group compared with day 3. On the other hand, implantation rates were not different between groups (23.9% vs. 17.2%, respectively; P=.08). CONCLUSION(S): Our results demonstrated that transfering embryos on day 2 could provide an alternative to the management of poor responder patients.

Adult↗

PubMed1998

Ethical aspects of in vitro fertilization and embryo transfer.

In vitro fertilization and embryo transfer (IVF-ET) confronts moral reflection with a wide range of concerns. Some are similar to those raised by artificial insemination such as the procurement of sperm, the goods of marriage and donor gametes. Others are unique to IVF-ET such as surrogacy, the status of the embryo and cryopreservation.

Bioethics↗

PubMed1997

Triplets and embryo transfer policy.

The social and financial consequences of multiple pregnancies following embryo transfer have led us to question our policies and re-evaluate 'good practice' recommendations. A postal survey was carried out to assess current practice regarding embryo transfer policy and to understand the factors on which these decisions are based. The results demonstrated a wide variation in practice throughout the country despite the finding that most centres use the same criteria on which to base their decision to transfer either two or three embryos. Doctors seem to be the most influential individuals in the decision-making process, although when three embryos are transferred, the opinion of the patient is paramount. Patients are usually given information about the risks of multiple pregnancy but despite this, 69% felt that a multiple pregnancy would be the ideal outcome of in-vitro fertilization (IVF). It is strongly advised that patients are given more details of the consequences of multiple pregnancy and that centres which have a high multiple pregnancy rate adopt a policy of transferring only two embryos.

Embryo Transfer↗

PubMed2005

Modern embryo transfer catheters and pregnancy outcome: a prospective randomized trial.

OBJECTIVE: Embryo transfer (ET) is the final crucial step in IVF treatment. The type of catheter used can affect the pregnancy rate (PR). In this prospective, randomized trial we compared the clinical PR between the Wallace and the Cook K-Jet embryo transfer catheters. DESIGN: Prospective, randomized clinical trial. SETTING: A National Health Service Assisted Reproduction Unit. PATIENT(S): One hundred fifty women undergoing a fresh ET. Age more than 40 years, a high basal FSH, a previous difficult ET, or more than six previous ETs were the exclusion criteria. INTERVENTION(S): Women undergoing a fresh ET were randomized at the time of ET to either the Cook K-Jet or Wallace embryo transfer catheter. The randomization was stratified according to age and the number of previous ETs. MAIN OUTCOME MEASURE(S): Clinical PR. RESULT(S): There was no significant difference in the clinical PR between the Wallace and the Cook catheters (22/75 [29.3%] and 23/75 [30.6%], relative risk [RR]: 0.96 [95% confidence interval 0.58-1.58]). CONCLUSION(S): There is no significant difference in the PRs achieved by modern, soft, double-lumen ET catheters.

Adult↗

PubMed1989

[Folliculogenesis and embryo transfer in ruminants].

In ruminant embryo transfer development, the limiting step remains the superovulation of the donor: using both PMSG and pituitary extracts, the superovulatory response is variable. In our research unit, FSH and LH were purified until homogeneity. Superovulatory treatment includes the administration of pure FSH the day following the preovulatory LH pulse and an administration of an LH/FSH mixture in the middle cycle. This biphasic stimulation of folliculogenesis allows superovulatory response with more and higher quality embryos.

Animals↗

PubMedDate not supplied

In vitro fertilization and embryo transfer.

In vitro fertilization and embryo transfer now provide an acceptable therapeutic alternative for some infertile couples. The University of Texas/Houston Medical School uses a nurse-coordinated, in vitro fertilization computer program that combines a variety of nursing interventions. The nurse specialist functions to coordinate clinical and laboratory steps and to interpret the complex process to the couple.

Adult↗

PubMed2001

Transvaginal ultrasound-guided embryo transfer improves pregnancy and implantation rates after IVF.

BACKGROUND: Attempts are constantly being made to improve clinical pregnancy rates after IVF and embryo transfer. Since November 1998, we have gradually been adopting transvaginal ultrasound guidance during embryo transfer. We retrospectively examined the efficacy of this method on pregnancy and implantation rates. METHODS: The results of 846 cycles from our IVF-embryo transfer programme were analysed and comparisons were made between those carried out using ultrasound guidance and those by the clinical touch method. RESULTS: Higher pregnancy and implantation rates (28.9 and 15.2% respectively) were found in the group using the transvaginal ultrasound guidance during embryo transfer compared with those in the group using the clinical touch method (13.1 and 7.0% respectively). The differences were statistically significant (P < 0.01). There was no significant difference in ectopic pregnancy rates between the two groups. CONCLUSION: The use of transvaginal ultrasound-guided embryo transfer significantly improved both pregnancy and implantation rates. Although technically difficult, we suggest its use may maximize the chances of achieving a successful pregnancy outcome.

Adult↗

PubMed1990

Propagation of improved breeds: the role of artificial insemination and embryo transfer.

Artificial insemination (AI) and embryo transfer (ET) are not just reproductive techniques, but indispensable tools for genetic improvement. In this sense, they play an effective part in propagating improved breeds. Analysis of the development of insemination of French cattle breeds since 1960 shows how breeders can alter their genetic choices to meet economic needs. AI and ET also have their place in selection programmes: evaluating bulls by progeny testing, exerting greater selection pressure on the dams of bulls, and shortening the generation interval of breeding animals. Finally, the income of breeders is closely linked to the genetic level of the livestock which they utilise.

Animals↗

PubMed2005

Reduction of high order multiples in frozen embryo transfers.

The aim of this study was to determine if blastocyst frozen embryo transfers are able to reduce the potential for the rate of high order multiples (HOM) (>2 fetal sacs) without affecting the overall pregnancy and implantation potential. Group A included all frozen blastocyst transfers prior to 1 January 2002. Group B included all frozen blastocyst transfers between 1 January 2002 and 12 December 2003. There was no significant difference for survival for the two time periods (79 versus 80%). A significantly (P<0.05) lower number of embryos were transferred in group B (1.9) compared with group A (2.8). There was a significant (P<0.05) reduction of (HOM) from 31 to 3% for groups A and B respectively. Ongoing pregnancy rates for group A resulted in 52% of 25 embryo transfers and 41% of 75 embryo transfers in group B (not significant). Reducing the number of embryos transferred between groups A and B did not significantly impact implantation rates. It is concluded that blastocyst freezing is effective for overall survival, pregnancy and implantation while reducing the rate of high order multiples.

Adult↗

PubMed2005

New Belgian legislation regarding the limitation of transferable embryos in in vitro fertilization cycles does not significantly influence the pregnancy rate but reduces the multiple pregnancy rate in a threefold way in the Leuven University Fertility Center.

After the introduction of new Belgian legislation limiting the number of transferable embryos to prevent multiple pregnancies after assisted reproductive technology, the implantation rate per embryo remained stable at 26% and the clinical pregnancy rate per embryo transfer did not change significantly (37.5% before and 32.5% after legislation), whereas the multiple pregnancy rate per clinical pregnancy decreased threefold from 25.9% to 8.0%) in the Leuven University Fertility Center.

Academic Medical Centers↗

PubMed1982

Luteal phase following oocyte aspiration, in vitro fertilization, and embryo transfer in clomid/HCG-stimulated cycles.

Using basal body temperature and repeated radioimmunological plasma progesterone estimations we monitored the luteal phase in seven patients after the administration of Clomid/hCG, oocyte recovery, in vitro fertilization and embryo transfer. In six of these women, the transferred embryos did not implant, and they bled 13--16 days after oocyte recovery. Neither the basal body temperature charts nor the plasma progesterone levels provided any indication of a luteal phase defect, being indistinguishable from those obtained in a control group of healthy women during the natural cycle. In the seventh woman, transfer of an eight-cell stage embryo resulted in implantation and a pregnancy which, to date (37th week) is developing normally.

Body Temperature↗

PubMed1988

Embryo transfer: its uses and recent developments.

The technique of embryo transfer is now routinely employed in several species and with several objectives. In laboratory animals the technique is used mainly in investigations of reproductive biology, whereas in human beings it is used to overcome specific forms of impaired fertility. Because embryo transfer combined with superovulation of the donor can significantly increase the female reproductive rate its greatest application to date has been in farm animals, in which it is widely used in both research and commercial production. Within the past few years there have been many advances in the techniques used in farm animals, particularly in the area of embryo manipulation. The supply of embryos can now be increased by repeated superovulation and by embryo bisection and there has been significant progress in in vitro fertilisation technology. Deep freeze (-196 degrees C) storage of embryos is now routine and may be combined with direct one-step thawing and removal of cryoprotectant. This technique allows the routine non-surgical transfer of embryos in the field. There is also evidence that a routine non-traumatic procedure for sexing embryos may soon be developed. Identical multiplets or clones have been produced by the microdissection of embryos and more recently by the transfer of nuclei from embryos into unfertilized oocytes. Transgenic animals have been produced by the microinjection of recombinant DNA into one of the pronuclei of single-cell unfertilized ova.

Animal Husbandry↗

PubMed1997

Retrograde tubal embryo transfer in natural cycle in-vitro fertilization.

Two modes of embryo transfer, uterine and tubal, were compared following natural cycle in-vitro fertilization (IVF). Only patients with patent Fallopian tubes were included in the study. Tubal embryo transfer was performed by retrograde tubal cannulation without analgesia on an outpatient basis. Tubal transfer conferred no benefit compared with uterine transfer in male factor infertility with positive fertilization (pregnancy rates of 15.8% in both groups). Although tubal embryo transfer in the patients with unexplained infertility improved the pregnancy rates from 7.8% in uterine transfer (5/64) to 17.6% in the tubal transfer group (13/74), this improvement was not statistically significant.

Adult↗

PubMed2001

Evaluating recipient and embryo factors that affect pregnancy rates of embryo transfer in beef cattle.

The objectives of this experiment were to determine the effects of corpus luteum characteristics, progesterone concentration, donor-recipient synchrony, embryo quality, type, and developmental stage on pregnancy rates after embryo transfer. We synchronized 763 potential recipients for estrus using one of two synchronization protocols: two doses of PGF2alpha (25 mg i.m.) given 11 d apart (Location 1); and, a single norgestomet implant for 7 d with one dose of PGF2alpha (25 mg i.m.) 24 h before implant removal (Location 2). At embryo transfer, ovaries were examined by rectal palpation and ultrasonography. Of the 526 recipients presented for embryo transfer, 122 received a fresh embryo and 326 received a frozen embryo. Pregnancy rates were greater (P < 0.05) with fresh embryos (83%) than frozen-thawed embryos (69%). Pregnancy rates were not affected by embryo grade, embryo stage, donor-recipient synchrony, or the palpated integrity of the CL. Corpus luteum diameter and luteal tissue volume increased as days post-estrus for the recipients increased. However, pregnancy rates did not differ among recipients receiving embryos 6.5 to 8.5 days after estrus (P > 0.1). There was a significant, positive simple correlation between CL diameter or luteal tissue volume and plasma progesterone concentration (r = 0.15, P < 0.01 and r = 0.18, P < 0.01, respectively). There were no significant differences in mean CL diameter, luteal volume or plasma progesterone concentration among recipients that did or did not become pregnant after embryo transfer. We conclude that suitability of a potential embryo transfer recipient is determined by observed estrus and a palpable corpus luteum, regardless of size or quality.

Animals↗

PubMed1981

[The genetic value of embryo transfer in South Africa (author's transl)].

The different applications of embryo transfer from the animal improvement, scientific and commercial point of view are outlined. The most important application in South Africa is the production of the next generation's dairy A.I. bulls out of elite cows after superovulation, inseminations with the best available semen and embryo transfer to many foster mothers. The specific difficulties of running breeding programmes with small active breeding populations are discussed, and it is suggested that elite cows should be brought to special farms or government stations during the period of superovulation and transfer. In this way the disadvantage of small breeding populations could to a certain extent be overcome by embryo transfer.

Animals↗

PubMed2002

Ultrasound measurement of the uterocervical angle before embryo transfer: a prospective controlled study.

BACKGROUND: The study aim was to determine whether moulding the embryo transfer catheter according to the uterocervical angle measured by ultrasound could improve pregnancy and implantation rates. METHODS: Patients were alternately allocated to one of two groups. In the ultrasound-guided group (n = 320), the catheter was moulded according to the uterocervical angle measured by abdominal ultrasound. In controls (n = 320), embryo transfer was performed using the "clinical feel" method. RESULTS: Moulding the embryo transfer catheter according to the uterocervical angle significantly increased clinical pregnancy [(OR = 1.57, 95% CI (1.08-2.27)] and implantation rates [(OR = 1.47, 95% CI (1.10-1.96)] compared with the "clinical feel" method. It also significantly reduced difficult transfers [(OR = 0.25, 95% CI (0.16-0.40)] and blood during transfers [OR = 0.71, 95% CI (0.50-0.99)]. Patients with large angles (>60 degrees ) had significantly lower pregnancy rates compared with those with no angle [OR = 0.36, 95% CI (0.16-0.52)]. CONCLUSIONS: Moulding the embryo transfer catheter according to the uterocervical angle measured by ultrasound increases clinical pregnancy and implantation rates and diminishes the incidence of difficult and bloody transfers.

Catheterization↗