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PubMed2006

Acupuncture prior to and at embryo transfer in an assisted conception unit--a case series.

Over a period of three years, acupuncture was offered to patients entering assisted reproduction therapy. Acupuncture sessions were given at varying, but usually weekly, intervals during the in vitro fertilisation (IVF) cycle, and immediately before and after embryo transfer. Twenty two patients (average age 36.2 years) were treated over a total of 26 IVF cycles and 15 pregnancies were achieved, as determined by presence of foetal heartbeat on ultrasound at four weeks post embryo transfer. This was a success rate of 57.7% compared with 45.3% for patients in the IVF unit not treated with acupuncture (P > 0.05). Relaxing effects were noted following acupuncture and it is speculated that this may have contributed to the increase in pregnancy rate for the acupuncture group.

Acupuncture Therapy↗

PubMed2000

High serum oestradiol concentrations in fresh IVF cycles do not impair implantation and pregnancy rates in subsequent frozen-thawed embryo transfer cycles.

High oestradiol concentrations may be detrimental to the success of in-vitro fertilization (IVF) treatment. A total of 1122 women aged <40 years who were undergoing their first IVF cycle were evaluated retrospectively. Serum oestradiol concentrations on the day of human chorionic gonadotrophin (HCG) administration were categorized into three groups: group A <10 000 pmol/l; group B 10 000-20 000 pmol/l and group C >20 000 pmol/l. In fresh cycles, group A had significantly lower pregnancy rates per transfer (16.2 versus 23.7% respectively, P = 0.005, chi(2)) and implantation rates (8.7 versus 11.7% respectively, P = 0.037, chi(2)), when compared with group B. The pregnancy rate per transfer in group C was significantly lower than that in group B (12.1 versus 23.7%, P = 0.049, chi(2)) and group C had the lowest implantation rate (6.4%). In frozen-thawed embryo transfer cycles, implantation rates in groups A, B and C were similar (7.5, 8.1 and 9.6% respectively) and the pregnancy rates were also comparable in all groups. In conclusion, high serum oestradiol concentrations in fresh IVF cycles may adversely affect implantation and pregnancy rates. Embryo quality seemed unaffected as excess embryos from different groups had similar implantation and pregnancy rates in frozen-thawed embryo transfer cycles. The reduced implantation was probably due to an adverse endometrial environment resulting from high serum oestradiol concentrations.

Adult↗

PubMed1985

Factors influencing pregnancy rates following in vitro fertilization and embryo transfer.

In 831 patients having 1533 in vitro fertilization treatments, pregnancy rates were examined in relation to clinical and laboratory factors. Pregnancy rates were significantly affected by the month and year of treatment, the age of the patient, the type of ovarian stimulation, the use of human chorionic gonadotropin, the number of eggs collected, the number of eggs fertilized, the number of embryos developed, and the number of embryos transferred. The most important factors determining pregnancy rates were the number of oocytes collected and the number of embryos transferred. The low pregnancy rate when only one egg was collected raises the problem of how to predict and manage such a patient in a current or future treatment cycle.

Adult↗

PubMed1987

Embryo transfer as a means of controlling the transmission of viral infections. X. The in vivo exposure of zona pellucida-intact porcine embryos to swine vesicular disease virus.

Two experiments involving the transfer of embryos from donors infected with swine vesicular disease virus (SVDV) to "clean" recipients were carried out. In Experiment 1, 47 embryos were collected from 4 SVDV-infected donors and transferred to 2 recipients that subsequently produced 10 piglets. All of the recipients and piglets remained seronegative for SVDV. In addition to the transfers, 10 embryos and 58 unfertilized eggs from the infected donors were assayed in vitro and found to be negative for SVDV infectivity. A fifth donor was also inoculated with SVDV in this experiment, but it could not be demonstrated that infection had occurred. This SVDV-exposed donor provided two embryos for transfer and one embryo and two unfertilized eggs for in vitro assay. In Experiment 2, 158 embryos from 9 infected donors were transferred to 7 recipients, resulting in 12 piglets. A total of 7 embryos and 37 unfertilized eggs were assayed in vitro. The recipients, piglets, and embryos/eggs were all negative for SVDV infectivity. Although a final conclusion on the safety of using embryo transfer for the control of swine vesicular disease (SVD) is not possible, the results obtained justify additional studies.

Journal Article↗

PubMed1999

Factors affecting pregnancy rate following nonsurgical embryo transfer in buffalo (Bubalus bubalis): a retrospective study.

The objectives of this study were to determine the pregnancy rate and factors affecting it following nonsurgical embryo transfer in buffalo. Donor buffalo were superovulated with FSH, and embryos collected nonsurgically were evaluated for stage of development and quality. They were transferred nonsurgically to 91 recipients on Days 5 to 7 of the natural (n = 52) or induced (n = 39) estrus (estrus = Day 0). The overall pregnancy rate of 24/91(26.4%) was higher than in earlier reports for buffalo but was much lower than in cattle. Pregnancy rates were not affected by season (autumn vs winter), side of transfer (right vs left uterine horn), or type of estrus (spontaneous vs induced). The pregnancy rate was high 11/27(40.7%) when donors and recipients were closely synchronized, while it was compromised when recipients were in estrus at +12 h (1/7, 14.3%) and at -12 h (5/27, 18.5%). Asynchrony beyond 12 h on either side resulted into conception failure. The pregnancy rate tended to increase with the increase in CL size of recipients, while stage of embryonic development had no effect. The transfer of an 8-cell embryo with a 16-cell embryo led to the birth of heterosexual twins, indicating that the uterine milieu of Day 5 to 6 recipients may be tolerated by the out-of-phase 8-cell embryo, at least in the presence of a more mature embryo. Embryo quality had the greatest effect on pregnancy rate as it was higher (P < 0.005) after the transfer of Grade I than Grade III embryos (6/10, 60.0% vs 3/36, 13.9%). Assessment of returns to estrus indicated that among nonpregnant recipients, 17/67 (25.4%) embryos never matured sufficiently to prevent luteolysis through maternal recognition of pregnancy (MRP), while 14/67 (20.8%) embryos probably died following MRP. These results indicate that efforts to increase pregnancy rate following embryo transfer in buffalo should include prevention of luteolysis during the first week of transfer and a reduction in the incidence of embryonic mortality.

Animals↗

PubMed2000

[Effect of intrafollicular interleukin-6 levels on the secretion of estradiol and progesterone in patients treated with in vitro fertilization and embryo transfer].

The objective was to evaluate the relationship between follicular fluid levels of Interleukin-6 (IL-6) and the seric concentrations of estradiol and progesterone during controlled ovarian hyper-stimulation. The levels of IL-6 were measured in follicular fluid of 15 patients undergone to in vitro fertilization and embryo transfer and correlated with the values of seric estradiol and progesterone. There were a negative correlation between follicular levels of IL-6 and either estradiol and progesterone. Four patients achieved pregnancy following embryo transfer (pregnancy rate 26.6%), one of them aborted. As conclusion, the increased levels of IL-6 may be a reaction to controlled ovarian hyper-stimulation and probably a protective response. According to the reduction of estradiol, there may be a subtle reduction in aromatase action by effect of IL-6 and other cytokines.

Adult↗

PubMed1997

Candida glabrata chorioamnionitis following in vitro fertilization and embryo transfer.

Candida glabrata is a yeast which is considered to be a commensal of the vagina with limited pathogenicity in the immunocompetent host. We report 2 cases of severe chorioamnionitis occurring in pregnancies achieved by in vitro fertilization techniques which resulted in preterm delivery and pregnancy loss. Candida glabrata as the causative agent was probably introduced into the uterus by the cannula at the time of embryo transfer. It is recommended that appropriate investigation of the microbial flora of the cervix be undertaken and treatment instituted prior to embryo transfer in order to prevent this complication.

Adult↗

PubMed2006

Acceptance of single-embryo transfer by patients.

In New Zealand, patient motivation to accept single-embryo transfer can be measurably changed within a short period of time if patients are provided with credible clinical written and verbal communication, in addition to funding incentives from the Ministry of Health.

Adult↗

PubMed2005

Comparison of artificial insemination versus embryo transfer in lactating dairy cows.

Conception rates (CR) are low in dairy cows and previous research suggests that this could be due to impaired early embryonic development. Therefore, we hypothesized that CR could be improved by embryo transfer (ET) compared with AI. During 365 days, 550 potential breedings were used from 243 lactating Holstein cows (average milk production, 35 kg/day). Cows had their ovulation synchronized (GnRH-7d-PGF(2alpha)-3d-GnRH) and they were randomly assigned for AI immediately after the second GnRH injection (Day 0) or for transfer of one embryo 7 days later. Circulating progesterone concentrations and follicular and luteal size were determined on Days 0 and 7. Pregnancy diagnosis was performed on Days 25 or 32 and pregnant cows were reevaluated on Days 60-66. Single-ovulating cows with synchronized ovarian status had similar CR on Days 25-32 with ET (n = 176; 40.3%) and AI (n = 160; 35.6%). Pregnancy loss between Days 25-32 and 60-66 also did not differ (P = 0.38) between ET (26.2%) and AI (18.6%). When single (n = 334) and multiple (n = 57) ovulators were compared, independent of treatment, multiple ovulators had greater (P < 0.001) circulating progesterone concentrations on Day 7 (2.7 ng/ml versus 1.9 ng/ml) and there was a tendency (P = 0.10) for a greater CR in multiple ovulators (50.9% versus 38.1%). However, there was no difference in CR between AI and ET cows with multiple ovulations (50.0% versus 51.7%). In single-ovulating cows, CR tended to be lower for AI than ET in cows ovulating smaller follicles (diameter < or = 15 mm; 23.7% versus 42.3%; P = 0.06) but not average-diameter follicles (16-19 mm; 41.2% versus 37.3%; P = 0.81) or larger (> or =20 mm; 34.3 versus 51.0%; P = 0.36) follicles. Thus, although ET did not improve overall CR in lactating cows, follicle diameter and number of ovulating follicles may determine success with these procedures.

Animals↗

PubMed1996

Yeast infection of sperm, oocytes and embryos after intravaginal culture for embryo transfer.

OBJECTIVE: To report a case of an embryo culture infected with Candida albicans after intravaginal culture. DESIGN: Case report. SETTING: Private infertility practice and university medical center. PATIENT: A couple with tubal and male factor infertility. INTERVENTIONS: Superovulation, oocyte recovery, Percoll sperm preparation, and intravaginal culture of sperm and oocytes in a tissue culture tube. MAIN OUTCOME MEASURES: Yeast infection of sperm, oocyte, and embryo culture. RESULTS: Candida albicans infection occurred in the sperm, oocyte, and embryo culture when cultured in a sealed tube in the vagina. Candida albicans also was found in the prepared sperm suspension culture in a separate tube kept in a 37 degrees C incubator. CONCLUSIONS: Infection of the embryo culture with C. albicans probably occurred when contaminated sperm was added at the time of insemination. Sperm preparation by the Percoll gradient centrifugation failed to eliminate C. albicans in the semen.

Adult↗

PubMedDate not supplied

In-vitro fertilization and embryo transfer in women aged 40 years and over.

The decline of fertility with age and its possible causes are discussed; in particular the effect of ageing of oocytes and the uterus, and the effect of the ageing processes on the results of in-vitro fertilization (IVF) and embryo transfer in women aged > or =40 years. The role of prestimulation testing in older women is considered together with the importance of screening and counselling these patients about the likelihood of achieving a live birth. The potential problems that they may face should they become pregnant are reviewed, together with the role of oocyte donation as an alternative treatment for patients with reduced ovarian reserve. Possible ways of improving the chances of achieving a live birth in older women using their own oocytes are reviewed, including the use of more effective stimulation protocols, assisted embryo hatching and co-culture and high order embryo transfer. The outcome of pregnancies in older women and some of the ethical problems relating to their treatment are also discussed.

Adult↗

PubMed2007

Transgenerational inheritance of the insulin-resistant phenotype in embryo-transferred intrauterine growth-restricted adult female rat offspring.

To determine mechanisms underlying the transgenerational presence of metabolic perturbations in the intrauterine growth-restricted second-generation adult females (F2 IUGR) despite normalizing the in utero metabolic environment, we examined in vivo glucose kinetics and in vitro skeletal muscle postinsulin receptor signaling after embryo transfer of first generation (F1 IUGR) to control maternal environment. Female F2 rats, procreated by F1 pre- and postnatally nutrient- and growth-restricted (IUGR) mothers but embryo transferred to gestate in control mothers, were compared with similarly gestating age- and sex-matched control (CON) F2 progeny. Although there were no differences in birth weight or postnatal growth patterns, the F2 IUGR had increased hepatic weight, fasting hyperglycemia, hyperinsulinemia, and unsuppressed hepatic glucose production, with no change in glucose futile cycling or clearance, compared with F2 CON. These hormonal and metabolic aberrations were associated with increased skeletal muscle total GLUT4 and pAkt concentrations but decreased plasma membrane-associated GLUT4, total pPKCzeta, and PKCzeta enzyme activity, with no change in total SHP2 and PTP1B concentrations in IUGR F2 compared with F2 CON. We conclude that transgenerational presence of aberrant glucose/insulin metabolism and skeletal muscle insulin signaling of the adult F2 IUGR female offspring is independent of the immediate intrauterine environment, supporting nutritionally induced heritable mechanisms contributing to the epidemic of type 2 diabetes mellitus.

Animals↗

PubMed1986

An alternative to in vitro fertilization-embryo transfer: the successful transfer of human oocytes and spermatozoa to the distal oviduct.

In vitro fertilization-embryo transfer (IVF-ET) for treatment of irreparable tubal damage provides a means for otherwise hopelessly infertile couples to obtain offspring. Recently a simpler and less expensive procedure was applied as an alternative to IVF-ET to patients with at least one patent fallopian tube. This procedure employs stimulated ovarian cycles, washed and cultured sperm, and laparoscopic aspiration of oocytes. Recovered oocytes and sperm are deposited in the ampulla of the oviduct by means of a catheter. From February 1 to September 28, 1985, 137 cycles yielded 60 laparoscopies (51 patients). Elevated human chorionic gonadotropin observed in 18 cases was confirmed in 12 cases by ultrasound. Nine uterine pregnancies continued with no tubal pregnancy. Success is comparable for this new procedure and IVF-ET. The results suggest that many IVF-ET patients should be offered the simpler and less expensive option of tubal transfer (TT).

Embryo Transfer↗

PubMed1993

Selection criteria for human embryo transfer: a comparison of pyruvate uptake and morphology.

PURPOSE: Pyruvate uptake is higher in human embryos developing to the blastocyst stage than those arresting at cleavage stages. To investigate whether pyruvate uptake provides an improved criterion for selecting embryos for transfer, we have measured uptakes by individual embryos noninvasively over 24-hr periods between the first day (day 1) postinsemination and embryo transfer on day 2 to 3 and correlated the levels with implantation and pregnancy outcome. RESULTS: The mean uptake was significantly lower for embryos that implanted than for those which failed to implant: 22.9 +/- 1.0 and 27.1 +/- 0.6 pmol/embryo/hr, respectively on day 2, and 22.4 +/- 1.5 and 26.9 +/- 0.8 pmol/embryo/hr, respectively, on day 3, but the wide range of uptakes by individual embryos was overlapping. CONCLUSION: We conclude that pyruvate uptake as the sole criterion for embryo selection cannot predict which embryos will implant after transfer. Assessment of embryos using morphological and developmental criteria, therefore, remains the most consistent, though inefficient, indicator of pregnancy potential.

Adult↗

PubMed1999

[Analyses of the factors affecting the occurrence of polypronuclear embryos in in-vitro fertilization and embryo transfer].

OBJECTIVE: To investigate the factors affecting the occurrences of the polypronuclear embryos in in-vitro fertilization and embryo transfer (IVF-ET). METHODS: The data from 145 IVF-ET cycles and 1,168 oocytes were analyzed by logistic regression for multiple factors. The influences of the couple's age, the superovulation stimulation protocols, the number of the follicles punctured and the oocytes obtained, the preinseminational interval, the quality and quantity of seminal and inseminational sperms, and the oocyte fertilization ratio on the incidences of the polypronuclear embryos from the matured, and immature oocytes were examined respectively. RESULTS: The incidence of the polypronuclear embryos from matured oocytes was significantly negatively correlated with the women age and the number of the follicles punctured, and the incidence from immature oocytes was significantly positively correlated with the density of sperms at grade a and b and the oocyte fertilization ratio. CONCLUSIONS: The woman's age and the number of follicles are the main factors which influence the occurrence of polypronuclear embryos from matured oocytes, while the density of the seminal sperm with high motility and the fertilization ratio play important roles in the occurrence of polypronuclear embryos in immature oocytes. Stimulating greater number of follicles might be benefit for the reduction of occurrence of polypronuclear embryos.

Embryo Transfer↗

PubMed1986

In vitro fertilization and embryo transfer: two-year experience.

Between February 1983 and January 1985, 206 laparoscopies were performed on 172 women following controlled ovarian hyperstimulation with human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG). Sixty-four clinical pregnancies advanced beyond the sixth week of gestation and were confirmed by ultrasound; and 37.2% of the patients conceived after in vitro fertilization and embryo transfer. The clinical pregnancy rate was 31.1% when based on the number of laparoscopies performed and 33.9% when based on the number of embryo transfers. There were 12 multiple pregnancies (18.8%), 11 miscarriages (17.2%), and one ectopic (tubal) pregnancy (1.6%). The most important factors contributing toward the success of this program were the establishment of specific criteria for patient selection, rigid adherence to clinical and laboratory protocols, and the maintenance of strict quality control.

Abortion, Spontaneous↗

PubMed1995

The relationship of endometriosis to endometrial sonographic studies prior to administration of human chorionic gonadotrophin in patients undergoing in-vitro fertilization and embryo transfer.

The objective of this prospective comparative study was to investigate the relationship of endometriosis to endometrial thickness and sonographic echo pattern prior to the administration of human chorionic gonadotrophin (HCG). Patients were matched by age and ovarian stimulation protocol. A total of 210 patients undergoing in-vitro fertilization (IVF) and embryo transfer at a university-related IVF centre were enlisted. Of these, 105 women with laparoscopic confirmation of endometriosis were compared to an equal number of patients with laparoscopic confirmation of no endometriosis. Mean endometrial thickness did not differ between the groups (12.7 +/- 2.9 versus 12.2 +/- 2.5 mm). The distribution of echo patterns was also the same, irrespective of diagnosis. Evaluation of clinical pregnancy rates showed no reduction in patients with endometriosis, regardless of stage, nor when comparing patients to controls. Endometriosis has no effect on the endometrial thickness or echo pattern measured by sonography prior to administration of HCG or the pregnancy rates following IVF and embryo transfer.

Adult↗

PubMed2006

Outcome of 1114 ICSI and embryo transfer cycles of women 40 years of age and over.

The purpose of this study was to contribute to the development of strategies to obtain acceptable outcomes in assisted reproduction treatments in women over 40 years of age. A retrospective study was carried out on the database of the German Hospital in Istanbul using data from the years 1997 to 2004. A total of 1114 embryo transfer cycles were assessed. The pregnancy, implantation and delivery rates of the assessed population were 18.2, 8.3 and 10.9% respectively. The results showed that the demographics and outcome of cycles of women at 40 years differed significantly from those over 40. Cycles in which six or more oocytes were retrieved displayed better characteristics and outcome than those with five or fewer. The clinical pregnancy and delivery rates after transfer of three embryos were similar to four or more. Therefore, women over 40 years with a good ovarian response and at least three embryos available for transfer have an acceptable pregnancy and delivery rate with a low multiple pregnancy risk.

Adult↗