The in vitro fertilization program in Bialystok, Poland.
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Embryo Transfer↗
SEARCH · PubMed Health
Results for “Gamete Intrafallopian Transfer”
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Pituitary down-regulation using leuprolide for the intensive ovulation management of poor prognosis patients having in vitro fertilization (IVF)-related treatments.
A review of 118 treatment cycles in 115 women under prolonged GnRH analogue (GnRHa; leuprolide) treatment is presented. Patients were selected for treatment primarily on the grounds of poor previous response to stimulation (n = 40), advanced age (greater than 35 years; n = 29), previous premature luteinizing hormone (LH) surge (n = 30), polycystic ovarian disease (PCO; n = 12), and elevated androgens without evidence of PCO (n = 5). An overall pregnancy rate of 28.8% per treatment cycle was attained, compared with a pregnancy rate of 6.2% (6/97, of which none went to term) in the previous completed treatment cycle for the same patients. Ovarian response, as measured by oocytes recovered and maximum estradiol levels observed, was significantly improved in all groups and this was associated with a prolonged follicular phase, significantly more human menopausal gonadotropin (hMG) stimulation and a relatively high incidence of ovarian hyperstimulation, particularly in pregnant patients. Of specific techniques in the GnRHa cycle, GIFT produced a pregnancy rate per treatment of 50% (10/20); IVF-ET, 22% (8/36); PROST, 28% (13/46); and TEST, 19% (3/16). No cycles were abandoned, compared with a cancellation rate of 24% in previous cycles without GnRHa. Patients with PCO performed particularly well on GnRHa management, with a pregnancy rate per treatment of 58% (7/12). Pregnancy rates per treatment for the other groups were as follows: elevated age, 27% (9/33), high androgens, 40% (2/5); premature LH surges, 32% (9/28); and poor responders, 17.5% (7/40).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Chromosomal analysis of pregnancy losses in patients undergoing assisted reproduction.
Chromosomal analysis was performed on products of conception from 18 patients having early pregnancy loss after assisted reproduction. Sonographic findings prior to obtaining tissue varied from gestational sacs consistent with a blighted ovum to fetal poles with cardiac activity. The mean age of the patients was 36.3 years. There were nine (50%) normal karyotypes, five (28%) autosomal trisomies, two cases of tetraploidy, one case of monosomy, and a case with two pericentric inversions. The results of this study suggest that patients undergoing assisted reproduction are not at an increased risk for chromosomal abnormalities.
Abortion, Spontaneous↗
Assisted reproduction in Latin America.
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Age Factors↗
Vaginal progesterone as luteal phase support in an IVF/GIFT programme.
To determine whether luteal phase support with vaginal progesterone could improve pregnancy rates in our IVF/GIFT programme, we performed a prospective randomised controlled study. After stimulation with clomiphene citrate/human menopausal gonadotrophin, 123 women received no luteal support and 122 received progesterone pessaries 100 mg b.d. from 48 hours prior to embryo transfer and continued throughout the luteal phase. There was no difference in the pregnancy rate following IVF/ET (6/58 and 10/58 for the pessary and control group respectively), but a significantly higher rate was noted for GIFT (13/34 and 5/42 for the pessary and control group respectively; P less than 0.05). Of interest, only one of the 19 pregnancies using luteal support was extra-uterine, compared with 6/15 in the control group.
Administration, Intravaginal↗
In vitro fertilization techniques with frozen-thawed sperm: a method for preserving the progenitive potential of Hodgkin patients.
The banked sperm of 5 of 13 Hodgkin patients was thawed for assisted reproduction. The post-thaw sperm characteristics were extremely impaired. Nevertheless, in 80% of all trials fertilization in vitro was obtained and conceptus could be transferred. All spouses became pregnant and seven healthy infants were born. One could recommend every Hodgkin patient to bank his sperm before chemotherapy. In vitro fertilization techniques with this frozen-thawed sperm reveal promising results in comparison with artificial insemination to maintain the reproductive capacity of male Hodgkin patients.
Adult↗
Understanding the current status of oocyte donation in the United States: what's really going on out there?
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Embryo Transfer↗
Transport in vitro fertilization--a novel scheme for community-based treatment.
OBJECTIVE: To provide an inexpensive and extensive in vitro fertilization (IVF) service for the Mersey Region, United Kingdom. DESIGN: Twenty-four transport IVF patients treated in two district general hospitals using the central university laboratory as co-ordination point for treatment schedule and embryology. Outcomes were compared with 26 control patients treated in the central unit. SETTING: Royal Liverpool University Hospital, a central IVF unit, and two district general hospitals in the Mersey Region. PATIENTS: Fifty patients under 35 years of age with irreversible tubal damage selected and treated by IVF, half in the central unit and the other half in two district general hospitals. MAIN OUTCOME MEASURES: Pregnancy rate (PR) in the different centers. RESULTS: A PR of 42.3% per cycle in the peripheral hospitals compared with 30.7% per cycle in the central unit. CONCLUSION: Transport IVF is an inexpensive and feasible alternative to standard IVF in a central unit for patients without access to central units.
Adult↗
Some cases of human male infertility are explained by abnormal in vitro human sperm activation.
OBJECTIVE: To determine if a human sperm activation assay can be used to evaluate males exhibiting otherwise unexplained infertility. DESIGN: Sperm from age-matched fertile and idiopathic infertile males were assayed in the human sperm activation assay and the results were compared. A portion of the sperm from the idiopathic infertile males also was used in assisted reproductive technology (ART) attempts at pregnancy. PATIENTS: Idiopathic infertile couples who had extensive fertility testing with no identified problems that would explain their infertility. Fertile males that had fathered one or more children. MAIN OUTCOME MEASURES: Sperm nuclear decondensation-recondensation and DNA synthesis. Pregnancies resulting from ART using semen from a male whose sperm responded abnormally in the human sperm activation assay. RESULTS: Thirteen (22%) of 59 idiopathic infertile males produced sperm that responded abnormally in the human sperm activation assay. Only 1 (1.7%) of 59 fertile males produced sperm that responded abnormally in the human sperm activation assay. The percentage of abnormal responders in the patient group exhibiting unexplained infertility was significantly higher than in the fertile male group. No sperm samples that responded abnormally in the human sperm activation assay resulted in pregnancies when used in ART. CONCLUSIONS: The human sperm activation assay is a new and independent indicator for some cases of infertility that otherwise would be unexplained. The human sperm activation assay appears to have utility in determining a sperm sample's efficacy for fertilization in ART attempts at pregnancy.
Cell Nucleus↗
Profiling assisted reproductive technology: outcomes and quality of infertility management.
OBJECTIVE: To critically appraise the content of the American Society for Reproductive Medicine (ASRM)/Society for Reproductive Technology (SART) Registry. DESIGN: English-language literature review. PATIENT(S): Women undergoing treatment with assisted reproductive technology (ART). INTERVENTION(S): Current ART treatments, including IVF, GIFT, zygote intrafollopian transfer (ZIFT), oocyte micromanipulation, and cryopreserved embryo transfers. MAIN OUTCOME MEASURE(S): Compliance with clinical practice guidelines, and casemix-adjusted rates of live delivery, clinical pregnancy, ectopic pregnancy, miscarriage, birth defects, implantation, fertilization, and retrieval. RESULT(S): Outcomes should be adjusted for variation in patient characteristics known to affect prognosis, including maternal age, the duration of infertility, the presumed cause(s) of infertility, the patient's prior history of treatment for infertility, and diethylstilbestrol exposure. Outcome rates should be reported using the patient as the denominator, as well as cycle, retrieval, and transfer. The statistical significance of observed differences in events rates should be indicated. Because widely accepted clinical practice guidelines related to performance of ART procedures are not available, compliance with practice guidelines cannot currently be assessed. CONCLUSION(S): Reports based on ASRM/SART Registry data can be enhanced by refined casemix adjustment, assessing outcome rates per patient, as well as per component of ART procedure, and by providing an indication of the statistical significance of observed differences in event rates. In addition, a critical appraisal of available evidence related to particular aspects of infertility management would help clarify the areas in which there is an evidentiary basis for formulation of practice guidelines, as well as topics requiring additional clinical research.
Cryopreservation↗
Indications and outcomes of assisted reproduction.
Since 1978 many healthy children have been born after in vitro fertilization and embryo transfer, fulfilling the wishes of many previously childless couples. In vitro fertilization and subsequently developed methods (GIFT, intratubal embryo transfer) have contributed to progress in the diagnosis and treatment of unwanted childlessness. Furthermore these techniques have improved knowledge of ovarian function, fertilization and early embryo development.
Embryo Transfer↗
Trends in assisted reproductive technology.
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Embryo Transfer↗
The influence of advanced age on the outcome of assisted reproduction.
PURPOSE: Our purpose was to determine the influence of age on the outcome of assisted reproduction, with particular interest in women aged 40 years or older. METHODS: A retrospective review of the 779 patients enrolled in the Royal Hospital for Women Fertility Group fertility program between 1987 and 1994 was performed. The results for women aged 40 years or older were compared with those for women between 36 and 39 years and those younger than 36 years. The main outcome measures were pregnancy rate, pregnancy outcome, fertilization rate, and ovarian response. RESULTS: Compared with those in younger women, pregnancy rate, pregnancy outcome, fertilization rate, and ovarian response to controlled ovarian stimulation were significantly worse in women aged 40 years or older. CONCLUSIONS: The outcome of assisted reproduction in women of 40 years of age or older was extremely poor. Compared with those in younger women, pregnancy outcome and ovarian response to controlled ovarian stimulation were significantly worse in women of 40 years or more.
Adult↗
Embryo donation: a review.
BACKGROUND: Embryo donation is currently an uncommon procedure associated with many ethical, legal and psychosocial implications. It is, however, the only answer to infertility in some patients. This article summarizes the indications for embryo donation as well as the procedure and considerations in the preparation of both the donors and the recipients. METHODS: A MEDLINE search was conducted for all English articles using the keywords embryo donation, in vitro fertilization and gamete donation. CONCLUSION: Embryo donation might indeed be the answer to many infertile couples who would otherwise have to resort to childlessness or adoption. The advent of in vitro fertilization and cryopreservation of the spare embryos make these embryos a ready source for potential donors. The success rates of both fresh and freeze-thawed embryo transfers have been encouraging and there do not seem to be any long-term clinical implications for the offspring. However, there remain many legal and psychosocial issues associated with embryo donation.
Attitude↗
Anaesthesia for assisted conception.
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Analgesics, Opioid↗
[Diagnostic in-vitro fertilization].
Unexplained sterility is one of the major problems in the treatment of childless couples. The reason for sterility can be the result of different factors such as andrological or anatomic-physiological dysfunctions. The therapeutic approach to treat patients with unexplained sterility at the Department of Obstetrics and Gynecology, University of Goettingen, is, to exclude those patients from further therapies who obviously have no chance to become pregnant by any technique of reproductive medicine. A so called "diagnostical IVF" gives information about the fertilization capacity of male and female gametes in vitro. The results of a one year study with 85 couples (tubal sterility = 57; idiopathic sterility = 28) indicated, that even with no differences in the number of oocytes retrieved, the fertilization and cleavage rates were significantly higher in the group of patients with tubal sterility (fertilization rate: 63.1% vs 46.1%; cleavage rate: 57.5% vs 40.6%). Thus the transfer rate in patients with unexplained sterility was about 15% lower (68.9%) than in patients with tubal sterility (85.6%). On the other hand, after embryo transfer the pregnancy rate was double in those patients with unexplained sterility (38.7 vs 15.7%). If there is no fertilization of the oocytes in at least two IVF cycles all attempts to fulfill the patients desire for a child seem useless. In contrast successful in vitro fertilization provide the bases for further intrauterine insemination cycles which can be assisted by psychotherapy. This regimen seems helpful to classify patients with unexplained sterility and avoids long lasting frustrating therapies.
Embryo Transfer↗
Upper limb thrombosis associated with assisted conception treatment.
Three cases of upper limb deep venous thrombosis occurring in association with assisted conception treatment are presented. The accepted argument that lower limb thrombosis occurring in cases of complicated or severe hyperstimulation syndrome represents the likeliest thrombo-embolic disorder in this situation is questioned.
Adult↗