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PubMed1986

An in vitro fertilization and embryo transfer pilot study: treatment-dependent and treatment-independent pregnancies.

A pilot program of in vitro fertilization and embryo transfer at McMaster University is described. Fourteen couples with a clinical diagnosis of infertility due to apparent tubal dysfunction, with evidence of ovulation, and with normal semen analysis underwent induction of superovulation with human menopausal gonadotropin. At laparoscopy, 82 follicles were aspirated and 19 oocytes were recovered. Eleven oocytes demonstrated cleavage and all inseminated oocytes were transferred 49 to 65 1/2 hours after insemination. In vitro fertilization therapy resulted in two pregnancies, one leading to a spontaneous abortion and the other to the birth of a healthy female infant. At 10 to 12 months after in vitro fertilization therapy in the remaining 12 patients, there were three additional pregnancies (treatment-independent), one ectopic and two intrauterine. One patient was delivered of a healthy female infant. In vitro fertilization therapy should be evaluated by a randomized controlled clinical trial.

Adult↗

PubMed1994

[Bovine progressive degenerative myeloencephalopathy ("Weaver syndrome") in brown Swiss x Braunvieh cattle: reproductive occurrences, results of embryo transfer].

In the time between 1989 and 1991 seven Brown Swiss heifers, which had clinical signs of the Weaver syndrome were kept at the Bavarian Institute of Animal Breeding in Grub. This was in order to investigate this hereditary trait further. The number of animals carrying this genetic defect was increased by means of embryo transfer. Both cycle observations and ovary controls by means of rectal palpation resulted largely in physiological data and findings. All seven animals responded to superovulation treatment which was induced by sequential doses of p-FSH (32 mg) or of a single dose of 2,000 IU PMSG. The donors were flushed a total of 32 times without problem. On average 5.3 ova were recovered, 2.8 of which were viable and suitable for transfer. These are statistically only 50% of the normal value in a routine ET programme. Following the transfer of fresh and frozen embryos the pregnancy rate was 53%. There was only one abortion observed from 48 pregnancies.

Animals↗

PubMed1993

[A quality control for the culture system using endotoxin assays in human in vitro fertilization and embryo transfer].

The purpose of this study is to investigate the effects of endotoxin on human in vitro fertilization and embryo transfers (IVF-ET) and to evaluate a quality control system for a culture medium using endotoxin assays. Before the final water purification (in an ultra-pure water system with a depyrogen filter) of the medium, the sources of water were pre-purified as follows; (I) distillation-->deionization x 2, (II) distillation-->ultra-pure water system or (III) reverse osmosis system. The limulus amebocyte lysate gelation tests (sensitivities of 0.03 and 0.25EU/ml) were used to detect endotoxin in the medium and in pre-purified water (pre-water). No pregnancies occurred in the endotoxin-positive medium (endotoxin > or = 0.03EU/ml). The endotoxin-negative medium resulted in a 33.3% pregnancy rate and 13.4% implantation rate. No statistical differences in the implantation rate were found among these methods of pre-purification (I: 12.5%, II: 13.4% and III: 20.0%). Endotoxin was detected in all the pre-water between 0.25 and 4.0EU/ml. The clinical pregnancy rate (36.6%) and the implantation rate (16.9%) in pre-water of endotoxin < 0.25EU/ml were significantly higher than those (10.5% and 5.5%) in pre-water of endotoxin > or = 0.25EU/ml (p < 0.05). We confirmed that a very low concentration of endotoxin disturbed a human embryo implantation. Endotoxin assays, not only in the media, but also in pre-water before final purification are useful as a quality control for the IVF-ET program.

Culture Media↗

PubMed1997

The role of uterine straightening by passive bladder distension before embryo transfer in IVF cycles.

PURPOSE: The present study investigated the effect of bladder distension on in vitro fertilization and embryo transfer (IVF-ET) results. METHODS: The study comprised 796 patients after successful transvaginal oocyte pickup and IVF, who, on the basis of bladder filling for ET, were divided into two groups. In group E, 385 patients underwent ET with an empty bladder, and in group F, 411 patients underwent ET with a full bladder. RESULTS: Sixty-four pregnancies were achieved in group E (16.6%), compared to 110 pregnancies in group F (26.8%, P = 0.006). A similar pregnancy loss rate was observed in both groups, 13 in group E (20.3%) and 29 in group F (26.4%; P = NS). CONCLUSIONS: A significantly higher pregnancy rate was achieved with routine bladder distension before ET, probably attributable to the smooth and easy insertion of the ET catheter.

Adult↗

PubMed1995

[Fate of two different stages of embryos transferred to an identical recipient in mice].

To define the developmental fate of two different stages of embryos existing together in the mouse reproductive tract, different stages of fresh and frozen-thawed embryos were transferred separately into the oviducts of identical recipients. ICR and FvB embryos were flushed from the oviducts and/or uterus of superovulated females on Day 1 (2-4-cell stage) and Day 2 (8-cell-morula stage) of pregnancy. Day 1 embryos were transferred separately to the right or left oviduct of recipients, while the other oviduct received Day 2 embryos. There were no significant differences between Day 1 and Day 2 embryos with respect to the number of implantation sites and live fetuses in either the fresh or frozen-thawed embryos. These results concerning to the embryonic stage were similar to those of control experiments, in which Day 1 or Day 2 embryos were transferred to both right and left oviducts of recipients. Furthermore, no strain differences were observed in this study. No developmental retardation or anomalies were observed in fetuses derived from either Day 1 or Day 2 embryos. The embryo transfer in this study revealed that differences in developmental stage at preimplantation were synchronized by the maternal uterine environment.

Animals↗

PubMed1992

Further observations on serial serum immunoreactive inhibin levels in the luteal phase and early gestation after ovarian stimulation for in vitro fertilization and embryo transfer.

Serum immunoreactive inhibin of the luteal phase was measured by radioimmunoassay in 71 patients in vitro fertilization and embryo transfer (IVF-ET). The correlation between the pregnancy outcome and the serial inhibin pattern from the luteal phase to early gestation was studied. In nonconception cycles (n = 35), serum inhibin concentration rose and reached a peak level around 5 or 6 days after oocyte pick-up (OPU), then fell to the level of the early follicular phase. In conception cycles (n = 22), serum inhibin levels rose again 10-15 days after OPU. Serum inhibin levels were significantly higher from 10 days after OPU in multiple pregnancy (n = 5) than in single pregnancy (n = 17). In viable single pregnancy (n = 17), serum inhibin levels were significantly higher than in non-viable pregnancy (n = 14) from 15 days after OPU. Serum inhibin levels in early gestation correlated well with the pregnancy outcome of IVF-ET. These data suggest that inhibin is an important factor for the diagnosis of pregnancy outcome.

Abortion, Spontaneous↗

PubMed2005

[Influence of female age on the pregnancy and obstetric outcome in in vitro fertilization and embryo transfer].

OBJECTIVE: To investigate the influence of female age on the pregnancy and obstetric outcome of in vitro fertilization and embryo transfer, expecting to select the most suitable strategy for women with different ages. METHODS: One thousand three hundred and one IVF-ET cycles from January 2002 to May 2005 were analyzed retrospectively. All the cycles were divided into five groups by female age: < or = 25, 26 to approximately 29, 30 to approximately 34, 35 to approximately 39 and > or = 40 years. RESULTS: The pregnancy rate was significantly lower( 58.2%, 60.0%, 52.3%, 45.7% and 29.41% respectively, P < 0.05), and implantation rate was significantly lower too(40.8%, 39.72%, 33.78%, 29.6% and 13.9% respectively, P < 0.05). But the abortion rate increased dramatically (5.3%, 6.8%, 9.7%, 11.6% and 26.7% respectively) and multiple pregnancy rate decreased (57.9%, 45.5%, 41.9%, 46.5% and 6.7% respectively). There were no significant differences about the obstetric results (premature delivery, gestational age, birth weight, caesarean). CONCLUSION: With the age growing, the implantation rate, pregnancy rate and multiple rate decreased, while the abortion rate increased, especially when the age over 40. Suitable controlled ovarian hyperstimulation regimens and improving oocyte quality were described for elder women. For younger women, suitable transfer strategy should be advised to decrease multiple pregnancy without decrease in the ongoing pregnancy rate.

Adult↗

PubMed2001

Ovarian response during IVF-embryo transfer cycles after laparoscopic ovarian cystectomy for endometriotic cysts of >3 cm in diameter.

BACKGROUND: Ovarian response during IVF cycles after laparoscopic ovarian cystectomy for endometriotic cysts >3 cm is controversial. A retrospective study was designed to study this problem. METHODS: At laparoscopy, endometriomas >3 cm were treated by ovarian cystectomy, whilst adhesions and peritoneal endometriosis were treated using conventional techniques. Ovarian stimulation was achieved with clomiphene and gonadotrophins or with gonadotrophins after a desensitization with gonadotrophin-releasing hormone agonists. Three groups of patients were retrospectively selected from an IVF-embryo transfer database: patients who underwent laparoscopic ovarian cystectomy for an endometrioma >3 cm (Group A, n = 41), patients with endometriosis without ovarian endometrioma (Group B, n = 139) and patients with tubal infertility (Group C, n = 59). RESULTS: The groups did not differ in age. In the first IVF cycle, the mean (+/- SD) numbers of oocytes and of embryos were 9.4 +/- 6.2 and 4.7 +/- 3.6 respectively in group A and 11.6 +/- 7.5 and 5.1 +/- 4.9 in group B (not significant). The results did not differ in cycles 2 and 3 or when compared according to age. No difference was found when comparing patients with endometriosis and patients with tubal infertility. CONCLUSION: The number of oocytes and embryos obtained was not significantly decreased by laparoscopic cystectomy, suggesting that in experienced hands this procedure may be a valuable surgical tool for the treatment of large ovarian endometriomas. However, great care must be taken to avoid ovarian damage.

Adult↗

PubMed1996

Simultaneous program of natural-cycle in vitro fertilization and cryopreserved-thawed embryo transfer.

PURPOSE: This clinical study was designed to identify and compare the pregnancy rates of simultaneous program of natural-cycle IVF and cryopreserved-thawed ET (NICE) with those of natural-cycle IVF and cryopreserved-thawed ET. METHODS: All three groups comprised spontaneously ovulating infertile women under the age of 40 and without any male factor present. The NICE program was performed in 36 patients (47 cycles) who had previously undergone IVF-ET resulting in cryopreserved embryos. As control groups, the natural-cycle IVF was performed in 45 patients (80 cycles), and the cryopreserved-thawed ET alone in 29 patients (40 cycles). RESULTS: The cancellation rate of the initiated cycles prior to ET was 19.1% (9/47) in the NICE group, 23.8% (19/80) in the natural-cycle IVF group, and 2.5% (1/40) in the cryopreserved-thawed ET group. The mean number of embryos transferred was 4.0 +/- 1.1 (2-5) in the NICE group, 1.0 in the natural-cycle IVF group, and 4.2 +/- 1.8 (1-5) in the cryopreserved-thawed ET group. The clinical pregnancy rates per aspiration cycle (32.5%) and per ET cycle (34.2%) in the NICE group were significantly higher than those (14.9, 16.4%) in the natural-cycle IVF group. The clinical and delivered pregnancy rates per ET (34.2, 26.3%) in the NICE group were higher than those (20.5, 15.4%) in the cryopreserved-thawed ET group, without statistical significance. CONCLUSIONS: Since the NICE program results in saving the fresh oocyte for patients participating in cryopreserved-thawed ET, more favorable pregnancy rates may be obtained from NICE cycles in women ovulating normally who had previously undergone IVF-ET with embryo cryopreservation.

Adult↗

PubMed2000

The presence of small uterine fibroids not distorting the endometrial cavity does not adversely affect conception outcome following embryo transfer in older recipients.

PURPOSE: To determine if uterine fibroids have a negative impact in older patients having embryo transfer (ET). METHODS: Comparison of clinical and viable pregnancy rates, implantation rates, and spontaneous abortion rates in older (>35) oocyte or embryo recipients with uterine leiomyomata compared to comparable patients without fibroids. RESULTS: The clinical pregnancy rate per transfer was 56% in the fibroid group vs 64% for the controls. Implantation rates were also very similar (33 vs 32%7). There were no spontaneous abortion or preterm deliveries <32 weeks in the fibroid group and the average term of pregnancies was also similar. CONCLUSION: Small fibroids not distorting the uterine cavity do not seem to negatively affect conception outcome even in older women.

Adult↗

PubMed1993

Nuclear transfer in cattle: effect of nuclear donor cells, cytoplast age, co-culture, and embryo transfer.

There are many factors affecting the efficiency of nuclear transfer technology. Some are evaluated here using our novel approach by enucleating oocytes at 20-22 hr after in vitro maturation (IVM), culturing the enucleated oocytes (cytoplasts) for 8-10 hr or 18-20 hr to gain activation competence and then conducting nuclear transfer. In the first experiment, we demonstrated that cumulus cell (CC) monolayer can support some cloned embryos to develop into morulae or blastocysts. Co-culture with CC and bovine oviduct epithelial cell (BOEC) monolayers resulted in no differences (P > 0.05) in supporting the development of cloned embryos (Experiment 2). When in vitro matured oocytes were enucleated at 22 hr after IVM followed by nuclear transfer 18-20 hr later, cleavage and morula or blastocyst development of the cloned embryos were similar to those resulting from the enucleated oocytes which had been matured in vivo (Experiment 3). Frozen embryos as nuclear donor cells worked equally well as fresh embryos for cloning in embryo development which was superior to IVF embryos (Experiment 4). However, fresh embryos resulted in a higher proportion (P < 0.05) of blastomere recovery than did frozen of IVF embryos. Finally, embryo transfer of cloned embryos from our procedure produced a viable calf, demonstrating the commercial value of this novel approach of the technology.

Animals↗

PubMedDate not supplied

Second-trimester heterotopic pregnancy after in vitro fertilization and embryo transfer--a case report and review of the literature.

Seven cases of heterotopic pregnancies following in vitro fertilization (IVF) and embryo transfer (ET) have been seen. In these cases, concomitant intrauterine and extrauterine pregnancies were described in the first trimester. We present the first case of second-trimester heterotopic pregnancy after IVF with successful surgical treatment of the ectopic pregnancy and subsequent full-term birth of the intrauterine pregnancy. The etiologic factors, possible explanation for the relatively frequent occurrence of heterotopic pregnancies in IVF, and the diagnostic difficulties are presented.

Embryo Transfer↗

PubMed1997

Prostaglandin F2alpha release associated with an embryo transfer procedure in the mare.

The pattern of the main metabolite of prostaglandin (PG) F2alpha was recorded following a nonsurgical embryo transfer technique in 9 mares under field conditions in Estonia. Three patterns were observed. Two of them were characterised by PG release, thereas the third was not. A tendency towards a shortened cycle was seen in 3 mares. Observations were made regarding the manipulation of the uterus as being normal or difficult to perform. In general, mares where the procedure was considered difficult were also found to have a PG release.

Abortifacient Agents, Nonsteroidal↗

PubMed1998

[The study on the relationship between luteal phase serum sex hormone levels and pregnancy outcome in in vitro fertilization embryo transfer cycle].

OBJECTIVE: To study the influence of maternal endocrine factors on clinical pregnancy outcome in an in Vitro Fertilization Embryo Transfer (IVF-ET) program. METHODS: 62 IVF-ET treatment cylces were studied. Luteal phase serum sex hormone levels [estrogen (E2), progesterone (P), prolactin (PRL)] in natural and superovulation cycles were measured by radioimmunoassay and the clinical pregnancy outcome was observed. RESULTS: Serum luteal phase sex hormone levels were higher than in natural cycles (P < 0.05). P level and P/E2 ratio in progesterone supplementation group were higher than the group without progesterone supplementation (P < 0.05). In pregnancy group serum E2(4,885.5 +/- 1,269.0 pmol/L) was lower, PRL (66.4 +/- 26.8 micrograms/L), P/E2 (373.0 +/- 152.5) were higher than in nonpregnancy group (E2 6,091.2 +/- 1,522.1 pmol/L, PRL 49.1 +/- 24.1 micrograms/L, P/E2 227.4 +/- 116.7) (P < 0.05). When P/E2 ratio was between 300-400 and PRL level was between 60-100 micrograms/L, the clinical pregnancy rate increased markedly (P < 0.05). CONCLUSION: Luteal phase serum sex hormone level may influence embryo implantation in IVF-ET. In order to improve the clinical pregnancy rate, it is very necessary to supplement progesterone for the IVF-ET patients according to the different sex hormone levels.

Embryo Transfer↗

PubMedDate not supplied

Pathologic examination of placentas from singleton and twin pregnancies obtained after in vitro fertilization and embryo transfer.

A pathologic investigation was conducted on 100 placentas collected from pregnancies resulting from in vitro fertilization (IVF) and intrauterine embryo transfer (ET), including 70 singleton pregnancies, 20 twin pregnancies, and 10 multiple pregnancies complicated by the vanishing twin (VT) phenomenon (n = 5) or artificially reduced (n = 5). These results were compared with those for 70 spontaneous spontaneous singleton and 20 spontaneous twin pregnancies. In cases of singleton pregnancies, the incidence of abnormal placental shapes was significantly different (P < .025) in the IVF group compared to controls. A significant (P < .005) difference was also observed between these groups in terms of umbilical cord insertion. The mean distance between the cord insertion and the closest placental margin was significantly (P < .001) shorter among IVF singleton pregnancies (3.19 +/- 1.83 versus 4.62 +/- 2.23 cm). In cases of twin pregnancy, no difference was found between IVF and spontaneous pregnancy in the incidence of pregnancy complications and distribution of cord insertion. First-trimester bleeding was the only clinical sign of the disappearance of an embryo in multiple pregnancies complicated by the VT phenomenon and was not observed in multiple pregnancies artificially reduced. The present findings support the hypothesis that marginal cord insertion is secondary to oblique orientation of the blastocyst at the nidation. A larger trial is now required, analyzing the placental features from IVF pregnancies in relation to the etiology of infertility.

Adult↗

PubMed2000

Initial IVF-ET experience with assisted hatching performed 3 days after retrieval followed by day 5 embryo transfer.

OBJECTIVE: To report our initial IVF-ET experience combining assisted hatching performed 3 days after oocyte retrieval with day 5 embryo transfer (ET). DESIGN: Retrospective review of 110 consecutive IVF cycles not involving donor oocytes, including 16 cycles that involved assisted hatching performed 3 days after oocyte retrieval in combination with day 5 ET. SETTING: Academic teaching hospital IVF center. PATIENT(S): Eighty-six consecutive IVF patients undergoing ET. INTERVENTION(S): Assisted hatching using acid Tyrode's solution performed 3 days after oocyte retrieval in selected cases in combination with day 3 or 5 ETs. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate per ET. RESULT(S): Of the 16 women undergoing day 5 ET following day 3 assisted hatching, 14 had a clinical pregnancy. These included 11 ongoing/delivered singletons and 2 ongoing/delivered twin pregnancies, neither of which was monochorionic. These clinical and ongoing/delivered pregnancy rates compared very favorably with those of 54% and 46%, respectively, for the 35 patients undergoing day 5 ETs without assisted hatching, even though the latter group appeared to be better IVF candidates based on the prognostic factors commonly used to predict success. CONCLUSION(S): Our experience suggests that day 3 assisted hatching followed by day 5 ET may be a useful combination in selected patients. Although not seen in our small series, an increased risk of monochorionic pregnancies remains a theoretical concern when such a combination is used, since both assisted hatching and blastocyst transfers have been independently linked to an increased risk in some reports.

Embryo Transfer↗

PubMed2005

[Predictive value of endometrial ultrasonography and age for the outcome of in vitro fertilization-embryo transfer].

OBJECTIVE: To assess the predictive value of endometrial ultrasonography and age for the outcome of in vitro fertilization-embryo transfer (IVF-ET). METHODS: A total of 305 women with tubal occlusion were studied. Superovulation was induced and transvaginal ultrasonography was employed for monitoring the endometrial thickness and endometrial patterns on the day of human chorionic gonadotrophin (hCG) administration. Pregnancy was diagnosed by ultrasonography of the intrauterine gestational sac. RESULTS: No difference was noted in the endometrial thickness or endometrial patterns between pregnant and nonpregnant groups, but the least endometrial thickness essential for pregnancy was 7 mm. The pregnant rate of women aged 20-34 years was higher than that of women aged 35 years or above. CONCLUSIONS: Neither endometrial thickness nor endometrial patterns detected by transvaginal ultrasonography on the day of hCG administration allows a reliable prediction of pregnancy. The least endometrial thickness essential for pregnancy is 7 mm and the pregnant rate of women aged 20-34 years was higher than those aged 35 years and above.

Adult↗

PubMed2004

Postnatal insulin secretion and sensitivity after manipulation of fetal growth by embryo transfer in the horse.

This study examined the effects of intrauterine growth on insulin secretion and resistance in newborn foals. Embryo transfer between small pony and large Thoroughbred mares was used to produce four groups of foals with different birth weights (pony in pony n=7; pony in Thoroughbred n=7; Thoroughbred in Thoroughbred n=8; Thoroughbred in pony n=8). On day 2 after birth, glucose (0.5 g/kg) was administered intravenously to the foal and blood samples were taken for 2 h to determine plasma glucose and insulin concentrations. On day 3, insulin sensitivity was assessed by giving insulin (0.75 U/kg i.v.) and measuring the decrement in plasma glucose in the foals. There were no significant differences in insulin secretion, insulin sensitivity or glucose tolerance between the control and growth-retarded Thoroughbred foals. Overgrown pony foals delivered by Thoroughbred mares had higher basal insulin levels and greater beta cell responses to glucose than the other groups of foals. The relationship between plasma glucose and insulin was also significantly steeper in overgrown pony foals than in the other groups. Variations in intrauterine growth rate, therefore, affect postnatal insulin secretion in the horse. More specifically, it is overgrowth, not growth retardation in utero that alters equine beta cell function in the immediate neonatal period.

Animals↗