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PubMed2003

Developmental potential of bovine nuclear transfer embryos and postnatal survival rate of cloned calves produced by two different timings of fusion and activation.

We compared developmental potential of somatic cell nuclear transfer (NT) embryos and postnatal survivability of cloned calves produced by two different fusion and activation protocols. As donor cells for NT, bovine cumulus cell-derived cultured cells of passage 5 were used following culture in serum-starved medium for 5-7 days. Enucleated oocytes were fused with donor cells at 21 or 24 hr post maturation. NT embryos fused at 21 hr were activated chemically 3 hr after fusion (DA group) and embryos fused at 24 hr were activated chemically immediately after fusion (FA group). Chemical activation was accomplished by calcium ionophore for 5 min and cytochalasin D + cycloheximide for 1 hr then cycloheximide alone for 4 hr. After in vitro culture in IVD101 medium for 7 days, embryo transfer was performed. Fusion rates were 86 and 84% in the DA and FA groups, respectively. Developmental rate to the blastocyst stage of NT embryos in the DA group was higher than in the FA group (42% vs. 28%). Pregnancy rate did not differ significantly between the DA and FA groups (11/13 and 5/7 at day 35), and 13 cloned calves (including 1 set of twins from a single embryo transfer) were born. High rates of postnatal mortality were observed in both groups. These results suggest that the DA method improves in vitro developmental potential of NT embryos, but the timing of fusion and chemical activation does not affect the pregnancy rate and the survivability of cloned calves.

Animals↗

PubMed2004

Bed rest versus free mobilisation following embryo transfer: a prospective randomised study.

OBJECTIVE: To evaluate the efficacy of two clinical methods of post-embryo transfer protocols in patients undergoing in vitro fertilisation. DESIGN: Prospective, randomised clinical trial. SETTING: Hospital-based clinic for reproductive medicine. SAMPLE: Women under 40 years of age who were undergoing in vitro fertilisation with GnRH pituitary down-regulation and controlled ovarian hyperstimulation. METHODS: Patients were randomised to rest for either 1 or 24 hours after embryo transfer. MAIN OUTCOME MEASURE: Clinical pregnancy per cycle rate (the percentage of cycles started that demonstrated a live fetus on ultrasound examination performed at six or seven weeks of gestation). RESULTS: The clinical pregnancy rates were 21.5% for the 1-hour and 18.2% for the 24-hour post-embryo transfer groups. The implantation rate per embryo was significantly higher in the 1-hour group (14.4%) than in the 24-hour group (9%). CONCLUSION: One-hour and 24-hour rest post-embryo transfer result in comparable rates of clinical pregnancy. However, 24-hour rest results in reduced implantation rate per embryo.

Adult↗

PubMed2006

Differential effects of embryo transfer and maternal factors on anxiety-related behavior and numbers of neuropeptide Y (NPY) and parvalbumin (PARV) containing neurons in the amygdala of inbred C3H/HeN and DBA/2J mice.

The effects of reciprocal embryo transfers were studied on anxiety-related behavior of inbred C3H/HeN and DBA/2J mice on the elevated plus maze (EPM), and related to amygdaloid neuropeptide Y (NPY)- and parvalbumin (PARV)-immunoreactive neurons. Embryo transfer significantly reduced closed arm entries in in-stain-transferred C3H mice, and maternal factors influenced open arm entries only in interaction with genetic background and sex. In DBA/2J-mice, embryo transfer resulted in a reduced number of NPY-immunoreactive (NPY-ir) neurons, while PARV-immunoreactive (PARV-ir) cells were not affected. In C3H/HeN mice, however, in-strain embryo transfer only resulted in a reduction of the number of PARV-immunoreactive neurons. Maternal factors mainly induced changes in the number of NPY-ir neurons in the basolateral complex of the amygdala either directly or in interaction with genetic factors. In summary, in-strain embryo transfer had a minor effect on the behavior of C3H/HeN mice, and a differential influence on the numbers of amygdaloid NPY-ir and PARV-ir neurons of inbred C3H/HeN and DBA/2J mice. Maternal factors had a stronger impact on the numbers of NPY-ir neurons than PARV-ir neurons. The present results indicate that alterations in behavior and amygdala morphology induced by embryo transfer or maternal factors depend on the genetic background of the mouse strains used.

Amygdala↗

PubMed2003

Impact of elective single embryo transfer on the twin pregnancy rate.

BACKGROUND: It is unclear how the implementation of elective single embryo transfer in clinical practice would affect clinical pregnancy and delivery rates and multiple birth rates. METHODS: This retrospective study analysed 1871 IVF/ICSI cycles carried out from 1997 to 2001 in the IVF programme of a single university infertility clinic. RESULTS: The number of elective single embryo transfers increased from 11 to 56%. At the same time the clinical pregnancy rate was relatively stable; mean 34.0% (range 28-42). The number of embryos per embryo transfer decreased from 1.8 to 1.3. The multiple pregnancy and delivery rates dropped markedly from 25 to 7.5% and from 25 to 5% respectively. CONCLUSIONS: An elective single embryo transfer programme can be adopted in daily practice that decreases the twinning rate to <10% and does not affect the overall pregnancy rate.

Adult↗

PubMed2000

Minimal precycle testing and ongoing cycle monitoring for in vitro fertilization and fresh pre-embryo transfer do not compromise fertilization, implantation, or ongoing pregnancy rates.

OBJECTIVE: We sought to assess the fertilization, implantation, and ongoing pregnancy rates with a minimal precycle and ongoing cycle monitoring protocol for in vitro fertilization and embryo transfer. STUDY DESIGN: Retrospective review was conducted of 103 consecutive cycles of fresh in vitro fertilization and embryo transfer from 1996 to 1998. Precycle screening included semen analysis without strict morphologic analysis, and hysterosalpingography-sonohysterography within the last year. Serum prolactin, serum thyroid-stimulating hormone, reactive plasma reagin, human immunodeficiency virus, rubella titer, blood type, hepatitis B surface antigen, and hepatitis C antibody testing was performed on all patients within 3 months of cycle initiation. Women > or =37 years old underwent clomiphene challenge testing. The monitoring protocol included the following: baseline transvaginal ultrasonography after 12 to 14 days of midluteal gonadotropin-releasing hormone agonist down-regulation to assess endometrial thickness and adnexal appearance, transvaginal ultrasonography for follicle evaluation at 7 and 10 days, serum estradiol assay if > or =20 follicles, quantitative beta-human chorionic gonadotropin 12 to 14 days after pre-embryo transfer, repeat quantitative beta-human chorionic gonadotropin 3 to 5 days later, and transvaginal ultrasonography for intrauterine gestational sac confirmation 7 to 9 days after the initial positive pregnancy test result. The dose of gonadotropin used remained constant unless the sonogram obtained on day 7 indicated a suboptimal response (<3 follicles each, with an average diameter of 10 to 12 mm) or hyperresponse (> or =15 follicles with an average diameter of 10 to 12 mm). RESULTS: The per embryo implantation rate (fetal cardiac activity) was 13.1%, and the live birth rate per 100 pre-embryo transfers was 31.5 for patients < or =40 years old. The average number of pre-embryos transferred was 3.1. The singleton pregnancy rate was 71%, and there were no multiple gestations greater than twins. The mean number of oocytes fertilized was 66%. There was 1 case of failed fertilization with intracytoplasmic sperm injection. There were two other cases of failed fertilization. One case of severe ovarian hyperstimulation occurred in spite of cryopreservation of all embryos. CONCLUSIONS: In vitro fertilization and embryo transfer can be accomplished with minimal precycle testing and ongoing cycle monitoring without compromising fertilization, implantation, and ongoing pregnancy rates. This results in reduced overall costs for couples.

Adult↗

PubMed2003

Early cleavage predicts the viability of human embryos in elective single embryo transfer procedures.

BACKGROUND: The reduction of multiple pregnancies by using elective single embryo transfers (eSET) requires critical and careful selection of the embryo for transfer. The current study was undertaken to assess whether early cleavage could be used as a marker of embryo competence in eSET procedures. METHODS: The study included analysis of 178 eSET procedures. All embryos were checked for early cleavage at 25-27 h post insemination or ICSI. The embryos that possessed two cells at 25-27 h post insemination or ICSI were designated as 'early cleavage' (EC) embryos and those that had not yet cleaved were classified as 'no early cleavage' (NEC) embryos. Selection of the embryo for transfer was based on embryo morphology and growth rate on day 2 and not early cleavage. Clinical parameters were compared between 72 EC and 106 NEC single embryo transfers. RESULTS: A significantly higher clinical pregnancy rate was observed after transfer of EC (50%) than NEC (26.4%) embryos. CONCLUSIONS: The current study provides compelling evidence that EC embryos possess significantly higher developmental competence than NEC embryos.

Adult↗

PubMed2005

Trends in embryo transfer practices and multiple gestation for IVF procedures in the USA, 1996-2002.

BACKGROUND: Increasing use of IVF in the USA has been a major contributor to the rising national multiple birth rate. Many have advocated that reducing the number of embryos transferred is essential for addressing the IVF-associated multiple birth problem. METHODS: A population-based sample of 506 072 IVF transfers performed in the USA in 1996-2002 was used to investigate trends in embryo transfer practices and to determine whether any changes in practice patterns have impacted the multiple gestation risk associated with IVF. RESULTS: The proportion of procedures in which >or=3 embryos were transferred declined significantly for most patient groups between 1996 and 2002. However, declines for some groups were not sizeable (from 79 to 73% and from 76 to 71% for fresh, non-donor procedures among women aged 38-40 and 41-42 years respectively) and transferring >or=3 embryos remained the norm for all groups. As of 2002, single embryo transfer had not increased for most groups and remained uncommon. Some declines in overall multiple gestation rates were observed, although multiple gestation risk associated with 2 embryos transferred increased significantly for all groups. CONCLUSIONS: Despite changes in embryo transfer practices, multiple gestation risk remains high, in part due to increased multiple gestation rates associated with the transfer of two embryos.

Adult↗

PubMed2001

[Does bedrest after embryo transfer cause a worse outcome in in vitro fertilization?].

OBJECTIVE: To evaluate the effect of bed rest following embryotransfer (ET) on the results of an in vitro fertilization (IVF) program. DESIGN: A prospective randomized study. SETTING: Gyn.-Obst. Department--Assisted Reproduction Centre, 1st Medical Faculty of Charles University Prague and General Hospital, Prague. METHODS: After randomisation of patients on two groups (N--no bed rest, L--bed rest), embryo transfer (ET) was performed and all patients stand-up 20 minutes later. Group N went home, group L continued bed rest in the hospital overnight. We compared results of IVF in both groups. RESULTS: Both groups (N = 20 patients, L = 18 patients) were comparable in the age, number of previous IVF attempts, stimulation protocol, person performing ET, number of transferred embryos, percentage of ICSI, percentage of diagnosis "tubal infertility" and age of embryos in the day of ET. Results for group N (no bed rest) were in all parameters better than for group L: implantation rate (IR) (22.5% versus 14.5%), IR of high quality embryos (25.8% versus 16.7%), pregnancy rate (50% versus 22.2%, p = 0.08), Take-home baby rate (40% versus 11%, p = 0.07). No of results reached clear statistical significance as the study was finished for ethical reasons (worse results of more difficult therapy in group L). CONCLUSION: The overnight bed rest in the hospital following ET did not ameliorate results of IVF. There is a strong tendency to negative effect of bed rest. Similar results may be found on other authors, but they did not extend the sense of their studies to the question of negative effects of the bed rest after ET, being satisfied with the result of "no worse results after no bed rest".

Adult↗

PubMed1996

The effectiveness of sublingual progesterone administration during cryopreserved embryo transfer cycles: results of a matched follow-up study.

OBJECTIVE: To compare cryopreserved ET pregnancy rates in subjects receiving either sublingual parenteral P. DESIGN: Matched follow-up study. SETTING: University-based assisted reproduction program. PATIENTS: Women undergoing cryopreserved ET between January 1993, and December 1994. Cases received a hormone replacement protocol containing oral E2 and sublingual P and controls received a hormone replacement protocol containing oral E2 and parenteral P. Cases and controls were matched one-to-one according to age, number of embryos transferred, embryo grade, and route of ET. INTERVENTIONS: Cryopreserved embryos were thawed and transferred in all patients in an identical manner independent of the route of P administration. MAIN OUTCOME MEASURES: Clinical and ongoing pregnancy rates. RESULTS: Of 61 ET cycles performed in the sublingual P group, there were 16 clinical pregnancies (26.2%) and 12 ongoing pregnancies (19.7%). Of the 61 ET cycles in the parenteral P group, there were 14 clinical pregnancies (23.0%) and 11 ongoing pregnancies (18.0%). A chi 2 test revealed no significant differences in either clinical or ongoing pregnancy rates according to the route of P administration. CONCLUSIONS: This data suggests that sublingual P administration is an effective alternative to parenteral P administration in preparing the endometrium for the implantation of cryopreserved embryos.

Administration, Sublingual↗

PubMed2006

Effect of using an echogenic catheter for ultrasound-guided embryo transfer in an IVF programme: a prospective, randomized, controlled study.

BACKGROUND: Recent evidence showed that ultrasound-guided embryo transfer significantly increases successful implantation compared to the clinical touch method. It has been postulated that new echodense catheters which are more readily detectable by ultrasound may refine transfer techniques even more, thus improving IVF outcome. METHODS: A prospective, randomized, controlled trial comparing IVF outcome for women undergoing embryo transfer under ultrasound guidance by a single healthcare provider with random assignment according to a computer-generated randomization table to either standard soft Wallace catheter (standard catheter group, n=95) or the new echogenic soft Wallace catheter (echogenic catheter group, n=98). RESULTS: The use of the echodense catheter facilitated catheter identification under ultrasound, and thus the duration of the embryo transfer procedure since the loaded catheter was handed to the physician and up to embryo discharge was significantly shorter in the echogenic catheter group as compared with the standard catheter group. There were 39 and 53 clinical pregnancies in the standard catheter (41%) and echogenic catheter (54.1%) groups, respectively. This was not statistically significant (P=0.08) according to the OR (0.6) and CIs (0.33-1.04). However, twin pregnancy rate was significantly increased (P<0.01) with the use of the new catheter which was the underlying source for obtaining significant increase in implantation rate in this group (37.1%) as compared with the standard catheter group (23.2%). CONCLUSION: This pilot study suggests that the use of the echogenic Wallace catheter simplifies ultrasound-guided embryo transfer but not definite benefit in terms of pregnancy rates was obtained. In contrast, the use of the new catheter was associated with a significant increase in the number of twin pregnancies.

Adult↗

PubMed1988

Periparturient events in ovariectomized embryo transfer recipient mares.

Ovariectomized mares treated with progesterone have established and maintained pregnancy after embryo transfer. This study evaluated the ability of ovariectomized embryo transfer recipients to successfully undergo parturition, raise a foal, and return to a useful reproductive status. Periparturient events in three ovariectomized embryo transfer recipient mares and three intact mares were compared. All mares foaled normally. Mammary scores were similar for both groups and all mares produced sufficient colostrum and milk to allow normal growth of healthy foals. Plasma progesterone levels decreased to < 5 ng/ml by Day 4 post partum in both groups. Progesterone concentrations continued to decrease and remained at <1 ng/ml in ovariectomized mares, but increased after the first postpartum ovulation (Day 9 to 15) in intact mares. Endometrial involution as determined by histological evaluation was complete in ovariectomized mares by Day 10 post partum and in intact mares by Day 11 post partum. As assessed by palpation per rectum and clearance of bacteria from the uterus, uterine involution was similar in all mares. The three ovariectomized mares subsequently received embryos by transcervical transfer and two of them established pregnancy. These results indicate that normal parturition, lactation, maternal behavior and uterine involution are independent of ovarian function.

Journal Article↗

PubMed1988

A randomized trial of human chorionic gonadotropin support following in vitro fertilization and embryo transfer.

This article reports on the effects of human chorionic gonadotropin (hCG) on progesterone (P) and estradiol (E2), luteal phase length, and conception in 116 cycles treated by in vitro fertilization and embryo transfer (IVF-ET). In 60 cycles, the luteal phase was supported by hCG, 1500 IU three times at 2-day intervals from the day of ET. The remaining 56 cycles served as controls. hCG significantly increased the P level (93 +/- 53 versus 62 +/- 46 ng/ml), the P/E2 ratio, and the luteal phase length (17.4 +/- 1.3 versus 12.2 +/- 1.7 days). However, the total pregnancy rate did not significantly differ between the two groups, though the pregnancy rate after transfer of two or three embryos was slightly higher in the hCG group (26.9 versus 22% in the control group), as was the rate of implanted embryo per transferred embryo after transfer of two or three embryos (25 versus 15.3%). It was concluded that, while hCG increased the magnitude and duration of the luteal P secretion, it did not clearly improve the pregnancy rate.

Chorionic Gonadotropin↗

PubMed1985

Matching of embryo stages and grades with recipient oestrous synchrony in bovine embryo transfer.

The efficacy of matching embryos with recipients on the basis of embryo stage and grade and donor-recipient oestrous synchrony was investigated using the records of 13,663 embryos that were collected and transferred at a commercial embryo transfer centre. The selection of early blastocysts for exact oestrous synchrony cows was effective and resulted in the highest pregnancy rates. Selection of early morulae was effective for recipients in oestrus after the donor but not when transferred into exact and negative recipients. The matching of late morulae with recipients in oestrus after the donor was not effective and had no influence on pregnancy rates. The selection of late, hatched and collapsed blastocysts for transfer into recipients in oestrus before the donor was ineffective and pregnancy rates were higher in exact and +12 hour recipients. Pregnancy rates declined 23.6 per cent in quality grades 1 to 4 whereas the range between stages was 13.3 per cent. Higher quality embryos of all stages gave the highest pregnancy rates. Examination of pregnancy rates of grades within stages suggested that the more developed the embryo the more difficult it is to grade. The difference in pregnancy rates between exact and -24 (6.9 per cent) and +24 (4.8 per cent) hour recipients was small and declined a further 4.7 per cent and 9.8 per cent in -36 and +36 hour recipients. Grade 3 and 4 embryos tolerated asynchrony better than grade 1 and 2, and early morulae tolerated asynchrony better than the other stages. It was concluded that the matching of certain embryo stages with the donor-recipient oestrous synchrony is advantageous but not always possible.

Animals↗

PubMed1994

Intramural pregnancy following difficult embryo transfer.

We report an intramural pregnancy following a difficult embryo transfer in a 31 year-old woman, having in-vitro fertilization and embryo transfer for tubal factor infertility. The creation of a 'false passage' at a previous instrumentation of the cervix may be implicated in the ectopic placement of embryos.

Adult↗

PubMed1984

The application of electron microscopy in the evaluation of two- to four-cell human embryos cultured in vitro for embryo transfer.

Eighteen two- to four-cell embryos, cultured in vitro for 32-65 hr after insemination, were examined by transmission electron microscopy to assess their normality and developmental potential. These stages are now being widely used for embryo transfer in in vitro fertilization clinics. They were obtained by inseminating preovulatory oocytes aspirated at laparoscopy, with or without ovarian stimulation, by methods which have yielded normal pregnancies. The organization of seven embryos was apparently normal and their blastomeres had cellular organelles usually present in fertilized ova. Details of their ultrastructure including subtle changes observed on prolonged culture are described. Other embryos showed some normal and obvious abnormal features, such as partial fragmentation and multinucleated blastomeres, or evidence of degeneration.

Blastomeres↗

PubMed2000

Ovulation side and cycle fecundity: a retrospective analysis of frozen/thawed embryo transfer cycles.

The aim of the study was to evaluate a possible lateral difference in ovarian activity and its effect on cycle fecundity. A database was analysed retrospectively which covered 477 cycles in which frozen/thawed embryo transfer had been carried out. The cycles were spontaneous, with no hormonal treatment. Women with ovulation problems as a reason for infertility treatment were excluded. Factors investigated were the side of ovulation, endometrial thickness on cycle days 10-12 and on the day of embryo transfer, and pregnancy rate per embryo transfer. Ovulation was right-sided in 273 of the 477 cycles (57.2%) and left-sided in 204 of the cycles (42. 8%) (95% CI 38.3-47.2, P = 0.002). In the age category of 30-37 years, covering 288 cycles, the incidence of left-sided ovulation was 126 (43.7%, 95% CI 38.0-49.5, P = 0.034). In this category, the endometrial thickness (+/-SD) was significantly greater on the day of embryo transfer (i.e. at time of implantation) when there had been left-sided ovulation compared with right-sided [9.6 mm (2.0) versus 9.1 mm (1.8), P = 0.037]. In addition, the pregnancy rate per embryo transfer was higher when ovulation had been on the left side [32/126 (25.2%) versus right side 24/162 (14.8%), P = 0.035, 95% CI 0.0122-0.199]. In conclusion, right-sided ovulation was more frequent than left-sided in the whole group. This is the first study to report that the side of ovulation has a clinical impact. These data support the hypothesis that the side of ovulation is significant in terms of embryo implantation.

Adult↗

PubMed1996

Serum markers of immune activation in women undergoing in-vitro fertilization and embryo transfer.

We evaluated serum concentrations of two early and sensitive markers of immune activation, interleukin-2 receptor (sIL-2R) and intercellular adhesion molecule-1 (ICAM-1) in two age-matched groups of in-vitro fertilization (IVF)-embryo transfer women, group I (n = 26) without and group II (n = 40) with methylprednisolone (MPD) supplementation of the luteal phase, on the days of oocyte retrieval (sample A) and embryo transfer (B), and second (C) and 13th (D) days post-transfer and in 20 normally cycling women (controls) on the day of luteinizing hormone (LH) peak. No difference in the outcome of the IVF-embryo transfer was observed between groups I and II. In sample A, both immunomarker concentrations showed no significant difference between the two groups of IVF women, while they were significantly higher (P < 0.01) than values in controls. In cycles in which conception occurred, significantly higher immunomarker concentrations were observed in sample A of both groups I and II compared with those in unsuccessful cycles of the same group. A significant decrease of both sIL-2R and ICAM-1 was noticed in sample B only in group II (P < 0.0001 and P < 0.001 respectively; paired t-test) that continued further in the late luteal phase only in the case of conception, independently of MPD supplementation. These data suggest that (i) due to multiple ovulations, IVF-embryo transfer women show elevated concentrations of sIL-2R and ICAM-1 at oocyte retrieval; (ii) since, even at oocyte retrieval stage, high concentrations of immunomarkers are associated with IVF-embryo transfer success, sIL-2R and ICAM-1 could be used as early indicators for conception cycles; (iii) transient suppression of T cell activity by MPD supplementation following IVF-embryo transfer does not improve pregnancy rate.

Embryo Transfer↗

PubMed1995

A simplified method of timing frozen embryo transfers.

OBJECTIVE: Our purpose was to compare a simple artificial hormone replacement regimen with two other protocols incorporating pituitary down-regulation with gonadotropin-releasing hormone agonist for frozen embryo transfers. STUDY DESIGN: We performed a retrospective analysis of pregnancy outcomes after 366 frozen embryo transfers timed by one of three hormone replacement regimens. The three regimens used were regimen A, leuprolide acetate and transdermal estradiol patches; regimen B, leuprolide acetate and oral micronized estradiol; regimen C, only oral micronized estradiol. RESULTS: The outcomes of 366 consecutive frozen embryo transfers according to one of the three regimens were compared and analyzed. The clinical pregnancy rates were 13.7%, 11.4% and 13.5% in regimens A, B and C, respectively. No statistical differences were found among the three regimens. The mean age of the patients in the three groups was comparable. The mean number of frozen embryos transferred with regimen B was slightly higher, but it did not have a positive impact on the pregnancy rate in this group. CONCLUSION: Controlled sequential hormone replacement results in an endometrium suitable for frozen embryo transfers. Pituitary down-regulation is not necessary. Therefore this regimen is not only more simple to use but also more economical.

Cryopreservation↗