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PubMedDate not supplied

The effect of female serum antisperm antibodies on in vitro fertilization and embryo transfer.

Twenty-nine women with serum antisperm antibodies underwent in vitro fertilization and embryo transfer. Half the oocytes from each patient were treated with patient-serum-supplemented medium with antibodies (medium A), and the other half with donor-serum-supplemented medium without antibodies (medium B). In 9 cases the antibodies were against the sperm head and these showed a significant difference in the number of embryos obtained between the two media (p = 0.001): 10.5% of fertilization of type 3 and/or 4 oocytes with medium A and 81.2% with medium B. A lower rate resulted also when the antibodies were against the middle and main portion of the tail, but fertilization did not seem to be affected when they were directed against the tail tip. No definite conclusions are possible, however, since the number of cases studied was too small.

Adult↗
PubMed1998

Contamination of embryo transfer catheter and treatment outcome in in vitro fertilization.

PURPOSE: The effect of embryo transfer (ET) catheter contamination with mucus and/or blood on treatment outcome in an in vitro fertilization (IVF) program was evaluated. METHODS: One thousand four ET procedures in 877 patients having conventional IVF in the long (1189 cycle) and short (15 cycles) protocol were analyzed to determine the impact of catheter contamination on the incidence of retained embryos and the clinical pregnancy rate. RESULTS: Catheter contamination with mucus and/or blood is a feature of difficult ET. Embryos were significantly more likely to be retained when the transfer catheter was contaminated with mucus (17.8 versus 3.3%) or blood (12 versus 3.3%). When the catheter was contaminated and an embryo(s) was retained and immediately retransferred, the pregnancy rate was not compromised. The pregnancy rate was significantly reduced when the ET catheter was contaminated with blood (15.5 versus 27.1%; P = 0.002), but no embryo was retained in the catheter set. CONCLUSIONS: Catheter contamination compromises the treatment outcome in IVF only when there is no associated retained embryo(s). As increased vigilance in searching for extruded embryos may not be practical, we suggest that cervical mucus should be routinely aspirated and ET performed as atraumatically as possible.

Adult↗
PubMed2000

The outcome of IVF-embryo transfer treatment in patients who develop three follicles or less.

Among 828 patients undergoing IVF-embryo transfer treatment, the implantation and pregnancy rates of patients who developed < or = 3 follicles were compared prospectively with those patients who had a normal response. Patients who developed 1 to 3 follicles during ovarian stimulation elected to proceed with oocyte collection, have intrauterine insemination if appropriate, or to have their cycle cancelled. In the group of patients who developed < or = 3 follicles and who were aged <40 years, despite a significantly lower number of oocytes collected [2 versus 7; median difference (MD) = 9; confidence interval (CI) = 7-11, and lower number of embryos developed and transferred (1 versus 3; MD = 2; CI = 1-2), no difference in either implantation rate [27.8 versus 20.4%; odds ratio (OR) = 1.58; CI = 0.46-4.54] or pregnancy rate (27.8 versus 36.7%; OR = 0.7; CI = 0.2-2.0) was noted when compared with similarly aged patients who developed >3 follicles. However, in patients aged >40 years who developed < or = 3 follicles, a moderate, albeit non-significant decrease in implantation rate (3.8 versus 7.8%; OR = 1.91; CI = 0.4-57.0) and pregnancy rate (4.2 versus 18.3%; OR = 1.92; CI = 0.38-57.0) was observed when compared with patients of a similar age who developed >3 follicles. Patients aged <40 years, unlike older patients, maintain good implantation and pregnancy rates despite a poor response to ovarian stimulation. This study indicates that for this group of women, continuation of IVF treatment is a better option than cancellation.

Adult↗
PubMed1991

Nordic in vitro fertilization embryo transfer (IVF/ET) treatment outcomes 1982-1989.

In the four Nordic countries, Denmark, Finland, Norway and Sweden, data were compiled from altogether 30 in vitro fertilization (IVF) clinics regarding their treatment outcomes. Two small, recently established IVF clinics in Finland did not respond to the postal inquiry used for data collection. For each clinic, data were collected from the time they commenced activities until June 1989. Preliminary data for the latter half of 1989 was also gathered. The first IVF-baby in this data set was born in Gothenburg in 1982. Seven years later, in December 1989, altogether 35 clinics in the four countries were in operation and 1,290 children had been born. The largest number of clinics, 12, was to be found in Sweden but the number of treatment cycles in relation to the population was highest in Norway with about 340 treatments per million inhabitants annually during 1988-89, with Sweden in second place: 190 treatments per million inhabitants. The ratio of private to public clinics was highest in Finland, where four out of ten clinics were privately run. A mean clinical pregnancy rate per embryo transfer of 20% was recorded and 85% were singleton pregnancies. Spontaneous abortions occurred in 25% and the ectopic pregnancy rate was 7% of all clinical pregnancies. The 'take home baby rate' for 1988-89 was 13% per embryo transfer. There were no major differences between the four countries.

Embryo Transfer↗
PubMed1990

Combined intrauterine and tubal pregnancy after in vitro fertilization and embryo transfer.

A case of combined intrauterine and tubal pregnancy after in vitro fertilization and embryo transfer is reported. As soon as the diagnosis was made at 9 weeks gestation, the fetal heart movement of the tubal pregnancy disappeared, and the patient was managed without surgery throughout the pregnancy course. After an infant was delivered, a right salpingectomy was performed and the diagnosis was histologically confirmed. Risk factors and treatments of combined pregnancy are discussed.

Adult↗
PubMed2002

Effect of prolonged gonadotropin-releasing hormone agonist therapy on the outcome of in vitro fertilization-embryo transfer in patients with endometriosis.

OBJECTIVE: To evaluate the effect of a 3-month course of GnRH agonist administered immediately before IVF-ET in infertile patients with endometriosis. DESIGN: Prospective, randomized trial. SETTING: Three tertiary care assisted reproductive technology programs. PATIENT(S): IVF-ET candidates with surgically confirmed endometriosis. INTERVENTION(S): Twenty-five patients received three courses of a long-acting GnRH agonist, 3.75 mg i.m. every 28 days, followed by standard controlled ovarian hyperstimulation. Twenty-six patients received standard controlled ovarian hyperstimulation with mid-luteal phase GnRH agonist down-regulation or microdose flare regimens. MAIN OUTCOME MEASURE(S): Response to controlled ovarian hyperstimulation, ongoing pregnancy rates per cycle, group implantation rates, and implantation rate per embryo transfer procedure. RESULT(S): The extent of surgically confirmed endometriosis was greater in patients who received the long-acting GnRH regimen for 3 months before IVF-ET. The groups did not differ significantly in terms of dose or duration of gonadotropin stimulation, number of oocytes retrieved, fertilization rate, or number of embryos transferred. Patients who received the long-acting GnRH regimen had significantly higher ongoing pregnancy rates (80% vs. 53.85%) and a trend toward higher implantation rates (42.68% vs. 30.38%). CONCLUSION(S): Prolonged use of GnRH agonist before IVF-ET in patients with endometriosis resulted in significantly higher ongoing pregnancy rates than did standard controlled ovarian hyperstimulation regimens. No deleterious effect on ovarian response was observed.

Adult↗
PubMed1984

Successful in vitro fertilization and embryo transfer in a group of patients with tubal infertility.

Thirty-one patients with severe mechanical infertility were treated with clomiphene citrate and human chorionic gonadotropin (HCG) at the start of our in vitro-fertilization and embryo-transfer program. Laparoscopies were performed 34 to 36 h after HCG administration in 32 cases, oocytes were recovered in 29 (91%) and in 19 (59%) at least one oocyte was fertilized. Embryos were transferred to the uterus in 12 cases (38%) and a pregnancy was established in a woman in whom 3 embryos were transferred. This pregnancy terminated at the 39th week of gestation with the delivery of a healthy female baby.

Adult↗
PubMed2002

Embryo transfer on day 3 using low versus high fluid volume.

OBJECTIVES: To assess the success of in vitro fertilization when embryos were transferred with low or high fluid volume. STUDY DESIGN: A total of 191 consecutive embryo transfer cycles were performed with low (15-20 microl, n=94) or with high (40-50 microl, n=97) fluid volume at an University-based IVF center. In a retrospective analysis, differences in the pregnancy rate were compared by the two-tailed t-test. RESULTS: There was no significant difference with regard to patients' age, number of previous attempts, number of oocytes recovered and fertilization rate. Compared to low fluid volume, a high volume for loading the transfer catheter resulted in significantly higher pregnancy (40% versus 23%, P=0.012) and implantation rate (24.4% versus 14.7%, P=0.011). CONCLUSIONS: For transfer of embryos on day 3 the amount of fluid volume for transfer has a significant impact on pregnancy and implantation rates.

Adult↗
PubMed1983

The Vienna program of in vitro fertilization and embryo-transfer--a successful clinical treatment.

A clinical program for in vitro fertilization (IVF) and embryo transfer (ET) is described. First successes were obtained using media and techniques according to Lopata et al. (1980, Fertil. Steril., 33, 117-120). The 'Vienna IVF and ET-program' was developed after several modifications and led to a pregnancy rate of 34%/ET. Studies on different culture media and their supplements were performed. B2-Menezo-medium supplemented by 15% human serum seemed best suited for human IVF because of its simplicity and readiness for use. However, there was no significant difference in comparison of the fertilization rate between B2 and modified Ham's F10 medium, or statistical difference between the usual 5% O2-5% CO2 and 90% N2 gas mixture for culture and 5% CO2 in air. So the latter can be used as a simpler system. pH measurements established follicular fluid to be very stable at 37 degrees C for several hours both on air and on 5% CO2. It is recommended as an appropriate medium for preincubating oocytes before insemination; eggs can also be transported in this fluid. Based on clinical experience a system of culturing eggs at one specialized IVF center for different hospitals and gynecologists can be discussed.

Carbon Dioxide↗
PubMed1991

Pregnancy complications and short-term follow-up of infants born after in vitro fertilization and embryo transfer (IVF/ET).

Two hundred and six pregnancies occurring after in vitro fertilization (IVF) and embryo transfer (ET) during a 7-year period in Göteborg were analysed with respect to pregnancy outcome. The clinical abortion rate was 26%, the rate of ectopic pregnancy was 10%, the rate of ongoing pregnancies beyond 24 weeks was 15%, and the rate of deliveries was 49% (n = 100). The hospital records of 98 women with the 100 deliveries resulting in 131 infants were studied. Multiple pregnancy occurred in 27%, including one quadruplet and two triplet pregnancies. Preterm birth occurred in 30% of all pregnancies and in 20% of singleton pregnancies. Thirty-four percent of the infants had a birth weight of less than 2500 g. The perinatal mortality was 46/1000, as estimated from the 24th week of pregnancy. The incidence of major malformation, 2.3%, was similar to that reported from studies in the general population. The first 100 infants born were followed up for 18 months to 8 years. Long-term sequelae were associated with immaturity and low birth weight. No problems during follow-up were disclosed in children who had had an uneventful neonatal period. It is concluded that IVF pregnancies are an obstetric risk group requiring special attention.

Adult↗
PubMed1986

Comparison of media used for human in vitro fertilization and embryo transfer programs--a new method of serum preparation.

Two-cell ICR-mouse embryos were cultured to compare media used for human in vitro fertilization and embryo transfer (IVF-ET) programs. When delayed centrifuged (DC, a general method of serum preparation) adult woman's serum (WS) was used as a medium supplement, Whitten's modified Krebs-Ringer-bicarbonate solution (m-KRB) was significantly better in both rate of development to blastocysts (D. R. to b1) and hatching rate (H.R.) than modified Ham's F-10 medium (m-HF10), irrespective of the commercial source of the HF10 powder. As for medium supplements when m-KRB was used as the medium base, immediately cooled and centrifuged (ICC, a new method of serum preparation) WS was significantly better in D.R. to bl. and H.R. than either DC-WS or DC-cord blood serum (CBS). There was no significant difference between DC-WS and DC-CBS. Moreover, ICC-WS gave a much higher H.R. than either bovine serum albumin (BSA) or human serum albumin (HSA), although D.R. to bl. was similar in all three. There was no significant difference between BSA and HSA. In clinical assessment of a human IVF-ET program, both the fertilization rate and the cleavage rate were higher in m-KRB containing ICC-patient's serum (PS) than in m-HF10 containing DC-PS, although the differences were not statistically significant.

Animals↗
PubMed1987

PGF-2 alpha release, progesterone secretion and conceptus growth associated with successful and unsuccessful transcervical embryo transfer and reinsertion in the mare.

The outcome of 23 collections and reinsertions of conceptuses on Days 10.5-13.5, 4 transfers of Day-10.5, and 13 transfers of Day-6.5 embryos (ovulation = Day 0) was monitored in 30 mares. Blood samples were taken before and after each procedure to measure plasma 15-keto-13,14-dihydroprostaglandin F-2 alpha (PGFM), and then daily for progesterone determinations. Mares were also subjected to daily teasing for detection of oestrus, and to uterine ultrasonography for tracing the development of the conceptus. After the reinsertions, 12/23 conceptuses were detectable immediately after the procedure. Of these, 1 developed into a normal foal but 11 disappeared during the next 4 days. All 4 Day-10.5 conceptuses transferred disappeared within 7 days. Of the 13 Day-6.5 conceptuses transferred, 8 were detectable by Day 11.5 and 5 of these developed into healthy foals. The 3 losses occurred between Days 14 and 25. Small increases in PGFM concentrations occurred in 8/23 collection-reinsertion procedures on Days 10.5-13.5 and after 2/25 Day-6.5 recoveries, but during none of the 13 Day-6.5 transfers. A marked reduction (greater than or equal to 40%) in progesterone concentration was noted within 24 h of the procedures in only one Day-10.5 embryo transfer and, in subsequent days, the disappearance of the conceptuses was associated with complete luteolysis in only 1 Day-6.5 transfer, 1 Day-10.5 transfer and 1 Day-12.5 reinsertion.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Epididymal sperm aspiration in conjunction with in-vitro fertilization and embryo transfer in cases of obstructive azoospermia.

Epididymal sperm aspiration is a new treatment for vasal agenesis. In previous reports, epididymal spermatozoa resulted in pregnancy by utilizing in-vitro fertilization (IVF) or gamete intra-Fallopian transfer (GIFT). We sought to investigate the efficacy of epididymal sperm aspiration in conjunction with IVF in patients with congenital absence of the vas deferens or with secondary extended obstruction of spermatic ducts. Fifty-eight attempts were performed in 23 patients (25-50 years). Eight patients (34.7%) had vasal agenesis and 14 (60.8%) presented with vasal secondary extended obstruction. The sperm count was adequate (greater than or equal 20 x 10(6)/ml) in 13.8% of sperm retrievals and sperm motility of 20% was obtained in 15.5% of sperm retrievals. Fourteen attempts at IVF were performed with epididymal sperm counts of 2-44 x 10(6)/ml and motilities of 0-45%. A mean of six mature oocytes (0-13) were inseminated in each case. Five embryo transfers were performed in five patients' wives (35.7%) and two couples had an early pregnancy loss (14.2%). Epididymal sperm aspiration is an advance in treating such patients, as an adequate number of mature spermatozoa can be obtained and used for IVF. However, spermatozoa directly aspirated from the proximal epididymis and with fertilizing capacity in vitro, gave a high rate of embryo degeneration (greater than 50%) after embryo transfer.

Adult↗
PubMed1988

Abdominal pregnancy after in vitro fertilization and embryo transfer.

Ectopic pregnancy continues to be a major complication of in vitro fertilization (IVF) and embryo transfer. We report the first abdominal pregnancy occurring after this therapeutic approach. The patient, a 35-year-old female, presented a frozen pelvis with a history of severe endometriosis and a left salpingectomy. After the transfer of four concepti in her second IVF/embryo transfer attempt, she became pregnant. Unfortunately, ultrasound evaluation five weeks later showed an ectopic pregnancy in the cul-de-sac. During laparotomy, it was noticed that implantation had taken place near the mesentery of the sigmoid and rectosigmoid. A right cornual tubal ligation was performed. Although the benefit of IVF/embryo transfer far outweighs the risk of an ectopic pregnancy, it is imperative that physicians who care for patients after IVF/embryo transfer be fully aware of the possibility of this complication in this high-risk population.

Adult↗
PubMed1986

Effect of exogenous progesterone on pregnancy rates after surgical embryo transfer in mares.

A completely randomized experimental design was used to investigate the effect of supplemental progesterone on pregnancy rates of recipient mares. Every other recipient mare received daily 200 mg progesterone in oil beginning the day of surgical embryo transfer and lasting until either Day 120 of pregnancy or until pregnancy failure was confirmed by ultrasound. Progesterone supplementation did not affect pregnancy rate (P > 0.05). Overall, embryos that did not result in pregnancy were of greater mean diameter than embryos that resulted in pregnancy (P < 0.05). Pregnancy rates tended (P < 0.1) to be greater in recipients that were detected to be ovulating the same day or prior to that of the donor and that had been supplemented with progesterone (75 %) as opposed to untreated control mares of the same synchrony group (40 %). Progesterone supplementation did not affect the incidence of embryonic loss; however, there was a slightly higher loss of pregnancies between Day 15 and 30 in treated versus untreated recipients. There was no effect (P > 0.05) of treatment on pregnancy rate for embryos recovered from fertile versus subfertile donor mares. However, overall, there tended (P < 0.1) to be fewer pregnancies with embryos recovered from subfertile (50 %) as compared to fertile donors (75 %). It was concluded that supplemental progesterone at the dosage and frequency described was not beneficial in improving pregnancy rates in cyclic recipient mares after surgical embryo transfer.

Journal Article↗
PubMed2002

Studies of embryo transfer from cattle clinically affected by bovine spongiform encephalopathy (BSE).

Semen from 13 bulls, eight with clinical bovine spongiform encephalopathy (BSE), was used to artificially inseminate (AI) 167 cows with clinical BSE, and their resultant embryos were collected non-surgically seven days after AI. The viable and non-viable embryos with intact zonae pellucidae were washed 10 times (as recommended by the International Embryo Transfer Society) then frozen. Later, 587 of the viable embryos were transferred singly into 347 recipient heifers imported from New Zealand, and 266 live offspring were born of which 54.1 per cent had a BSE-positive sire and a BSE-positive dam. The recipients were monitored for clinical signs of BSE for seven years after the transfer, and the offspring were monitored for seven years after birth. Twenty-seven of the recipients and 20 offspring died while being monitored but none showed signs of BSE. Their brains, and the brains of the recipients and offspring killed after seven years, were examined for BSE by histopathology, PrP immunohistochemistry, and by electron microscopy for scrapie-associated fibrils. They were all negative. In addition, 1020 non-viable embryos were sonicated and injected intracerebrally into susceptible mice (20 embryos per mouse) which were monitored for up to 700 days, after which their brains were examined for spongiform lesions. They were all negative. It is concluded that embryos are unlikely to carry BSE infectivity even if they have been collected at the end-stage of the disease, when the risk of maternal transmission is believed to be highest.

Animals↗
PubMed2000

Treatment outcome in women with a single ovary versus patients with two ovaries undergoing in vitro fertilization and embryo transfer (IVF/ET).

OBJECTIVE: To compare ovarian response and pregnancy rate between women with one and two ovaries undergoing in vitro fertilization and embryo transfer (IVF/ET). STUDY DESIGN: 20 IVF/ET treatment cycles in ten women with a single ovary were compared with 60 IVF/ET cycles in 47 women with two ovaries. Both groups were matched for age and treated for mechanical infertility. In both groups treatment protocol included gonadotropin releasing hormone/human menopausal gonadotropin/human chorionic gonadotropin (GnRH/hMG/hCG). RESULTS: Effective daily dose of gonadotropins (3.7+/-0.7 vs. 3.6+/-1.0), mean 17beta-estradiol levels on day of hCG administration (1136+/-467 vs. 1343+/-776), number of retrieved oocytes (6.4+/-3.7 vs. 8.3+/-4.2) and number of embryos per transfer (3.0+/-0.7 vs 2.9+/-1.2) were not statistically different between the groups. A significantly higher pregnancy rate was observed among women with one ovary (52.9%) as compared with those with two ovaries (20.8%), (P=0.015). Multivariate logistic regression analysis demonstrated an odds ratio of 5.73 for patients with a single ovary. CONCLUSION: Treatment outcome in patients with a single ovary undergoing IVF/ET is comparable to those with two ovaries. The unexpected significantly higher pregnancy rate observed among these patients need to be further evaluated.

Adult↗