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Results for “In Vitro Fertilization (IVF)”

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PubMed1996

Does in vitro fertilization (IVF) influence the levels of sperm and zona pellucida (ZP) antibodies in infertile women?

The levels of sperm and zona pellucida antibodies in 250 women divided into four groups according to number of recurrent IVF failures (1-4) were analysed and compared with results of a control group of 211 unexplained infertile women never treated by IVF. Sperm antibodies in serum and in ovulatory cervical mucus were determined by mixed antiglobulin reaction (MAR) test, serum zona pellucida antibodies were detected using passive haemagglutination and ELISA. These tests showed increased occurrence of zona pellucida antibodies in women after repeated IVF. Zona pellucida antibodies were found in 20% after on unsuccessful IVF (similarly to 27% in the control group), but in 64% after two, in 91% after three and in 4 of 5 cases after four IVF failures. Sperm IgG, A, M, and E antibodies in serum and in ovulatory cervical mucus do not seem to be influenced by IVF procedure. The results show evolution of autoimmune process due to repeated ovarial intervention during oocyte collections. Presence of zona pellucida antibodies, on the other hand, may become a cause of IVF failure.

Adult↗
PubMed1990

Comparison of singleton and multiple pregnancies in in vitro fertilization (IVF) and embryo transfer (ET).

The purpose of this study was to analyze factors associated with multiple gestations in IVF-ET. Twenty-seven multiple gestations conceived following IVF-ET resulted in the delivery of 20 sets of twins and three sets of triplets. One quadruplet pregnancy was terminated due to heavy bleeding. There were four "vanishing sacs," two of which resulted in a twin pregnancy and two in singletons. These were compared to 88 singleton IVF-ET gestations. The only significant difference found was the higher numbers of embryos transferred in the multiple gestation group. No difference was found between the two groups in diagnosis, stimulation protocol, estradiol, response, number of eggs, fertilization, and cleavage rate. Maternal age was younger in the multiple-gestation group, though not statistically significant. It is thus suggested that limitation of the number of embryos transferred is the only means to reduce the incidence of multiple gestations in IVF-ET.

Adult↗
PubMed2005

In vitro fertilization (IVF) versus gonadotropins followed by IVF as treatment for primary infertility: a cost-based decision analysis.

OBJECTIVE: To compare the economic consequences of proceeding directly to IVF to those of proceeding with gonadotropins followed by IVF in patients <35 years of age with unexplained infertility. DESIGN: A decision-tree model. The model incorporated the cost and success of each infertility regimen as well as the pregnancy-associated costs of singleton or multiple gestations and the risk and cost of cerebral palsy. MAIN OUTCOME MEASURE(S): Cost per live birth. RESULT(S): Both treatment arms resulted in a >80% chance of birth. The gonadotropin arm was over four times more likely to result in a high-order multiple pregnancy (HOMP). Despite this, when the base case estimates were utilized, immediate IVF emerged as more costly per live birth. In sensitivity analysis, immediate IVF became less costly per live birth when IVF was more likely to achieve birth (55.1%) or cheaper (11,432 dollars) than our base case assumptions. CONCLUSION(S): After considering the risk and cost of HOMP, immediate IVF is more costly per live birth than a trial of gonadotropins prior to IVF.

Costs and Cost Analysis↗
PubMed1990

Small increases in circulating luteinizing hormone (LH) concentrations shortly before human chorionic gonadotropin (hCG) are associated with reduced in vitro fertilization (IVF) pregnancy rate.

The effects of slight elevations in serum LH just before hCG administration on IVF cycle outcome were studied in 219 women undergoing retrieval. One hundred seven patients were stimulated using human menopausal gonadotropin (hMG), and 112 received clomiphene citrate and hMG. Serum LH, estradiol (E2), and progesterone concentrations were measured before and during controlled ovarian stimulation. Retrospectively the women were subdivided into three groups based on serum LH before hCG: Group I, less than 50% LH rise from baseline (BL) value (mean of day 2 and day 7); Group II, LH rise greater than or equal to 50% but less than 2 x BL; and, Group III, LH rise greater than or equal to 2 x BL. The fertilization and cleavage rates were similar in all groups. However, a greater than or equal to 50% rise in serum LH before hCG was associated with a significantly reduced IVF pregnancy rate.

Chorionic Gonadotropin↗
PubMed2002

Early pregnancy loss in in vitro fertilization (IVF) is a positive predictor of subsequent IVF success.

OBJECTIVE: To determine the significance of biochemical pregnancy losses and clinical spontaneous abortion (SAB) on outcomes of future IVF cycles. DESIGN: Retrospective cohort study. SETTING: Academic IVF program. PATIENT(S): Women with a history of unsuccessful IVF attempts undergoing IVF. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate. RESULT(S): Patients with an early pregnancy loss had a greater ongoing clinical pregnancy rate in the immediate next cycle when compared with those women who had a negative pregnancy test (37.3% vs. 27.3%). Patients with a history of a biochemical pregnancy or a clinical spontaneous abortion had an ongoing clinical pregnancy rate in the next cycle of 38.4% and 42.3%, respectively, compared with 27.3% in women who had a history of a negative pregnancy test. The cumulative pregnancy rate after the first IVF attempt was 54.1% in patients with a previous biochemical pregnancy loss, 61.4% in those with a previous clinical SAB, and 46.5% in women with a previous negative pregnancy test. CONCLUSION(S): Women who experience an early pregnancy loss after IVF have a greater likelihood of success in subsequent IVF cycles when compared with patients who fail to conceive.

Abortion, Spontaneous↗
PubMed1990

[The effect of low-dose pre-ovulatory progesterone administration on the outcome of in-vitro fertilization (IVF) and intra-tubal gamete transfer (GIFT)].

The influence of application of low-dose progesterone 4 hours before induction of ovulation by HCG on the outcome of IVF and GIFT was investigated in a bilateral study. The number of patients was 38 from both clinics for IVF and 36 for GIFT. With a pregnancy rate of 35.3% and 17.6% of ongoing pregnancies per transfer the results of the study are much better than before. The rather low number of patients and the low rate of transfers relativate these results. After GIFT an elevated abortion rate leads to only 11.1% ongoing pregnancies following a pregnancy rate of 33.3%. The effect of progesterone supplementation on the LH-peak and the endometrium should be further investigated to find new ways to increase success of IVF and GIFT treatment.

Adult↗
PubMed1997

Assisted hatching increases the implantation and pregnancy rate of in vitro fertilization (IVF)-embryo transfer (ET), but not that of IVF-tubal ET in patients with repeated IVF failures.

OBJECTIVE: To assess the effect of augmenting IVF with assisted hatching in the treatment of patients with repeated IVF failures. DESIGN: Prospective randomized study. SETTING: Division of Reproductive Endocrinology and Infertility of National Taiwan University Hospital. PATIENT(S): From July 1993 to February 1996, 49 patients with repeatedly failed IVF were treated with assisted hatching and were compared with 51 control subjects without assisted hatching. INTERVENTION(S): Assisted hatching. MAIN OUTCOME MEASURE(S): Pregnancy rate and implantation rate per embryo after IVF-ET or IVF-tubal ET (TET) were measured. RESULT(S): The pregnancy rate (PR) in the assisted hatching group was found to be 36.7% compared with 19.6% in the control group, but the difference was not significant. When only patients receiving IVF-ET were considered, it was observed that the PR was significantly higher in the assisted hatching group than the control group (42.4% versus 16.1%). With IVF-TET however, the PR was found to be similar in both assisted hatching and control groups (25.0% and 25.0%, respectively). The rate of embryonic implantation in the IVF-ET patients was 11.0%, which was significantly higher than that of control embryos (3.7%). CONCLUSION(S): These results implied that IVF-ET, combined with assisted hatching, may improve the PR and implantation rate in patients with repeated IVF failures, but the same was not true in the case of IVF-TET.

Embryo Implantation↗