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Results for “In Vitro Fertilization (IVF)”

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PubMed1998

Influence of bacteria and leukocytes on the outcome of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

The influence of bacteria and/or leukocytes on the outcome of IVF or ICSI is influenced by three factors which have little in common with in vivo conditions: 1) The process of ejaculate preparation (swim-up, Percoll) with antibiotic buffered media; 2) The small amount of inseminated spermatozoa (100,000 per culture); 3) The short cultivation time. From the very beginning, these factors limit whatever the influence of bacteria and leukocytes on fertilization and embryonic development in vivo may be. Despite the contradictory results published so far, the influence of bacteria and/or leukocytes on the functional integrity of spermatozoa during the process of IVF or ICSI can be ignored. Furthermore, during IVF or ICSI the spermatozoon does not act as a vector for the transportation of bacteria into the ooplasm.

Bacteria↗
PubMed1990

Optimization and simplification of culture conditions in human in vitro fertilization (IVF) and preembryo replacement by serum-free media.

The results of 220 consecutive IVF treatments are presented, comparing the use of culture media supplemented with either patient serum (Group 1; n = 110), or Medi-Cult SSR 2 synthetic serum replacement with pyruvate, and human serum albumin (HSA) (GEA BioTech, Hvidovre, Denmark) (Group 2; n = 110). In both groups the Medi-Cult Hybritest was used for routine quality testing. A significantly (P less than 0.05) increased rate of deliveries/ongoing pregnancies was observed with the Group 2 medium. However, no significant differences in fertilization rate, cleavage rate, or implantation rate were observed. It is concluded that the serum-free culture medium described and the testing for absence of cytotoxicity in a sensitive bioassay (Hybritest) have yielded culture conditions capable of sustaining the development in vitro of human preembryos without impairing the fertilization process or the implantation rate, ultimately resulting in a significantly increased rate of deliveries/ongoing pregnancies and an apparently decreased abortion rate. The potential harmful effects of serum and the need for blood sampling and preparation further increase the advantages of replacing serum with the synthetic serum replacement SSR 2 in an IVF program.

Culture Media↗
PubMed1995

Ovarian function in relation to the outcome of in vitro fertilization (IVF) treatment in regularly menstruating women with tubal infertility.

STUDY DESIGN: Ovarian endocrine function was evaluated in 53 regularly menstruating women, 27 to 38 years of age, who failed to conceive at least 2 years following reconstructive surgery for tubal infertility. Thirty apparently healthy women, 24 to 40 years of age with proven fertility, served as controls. Blood samples were obtained daily on cycle days 2-4 and 22-26 to assess FSH, E2, and P4 results. RESULTS: There was a tendency for women with more advanced tubal damage to be subjected to more extensive surgery. Based on extent of reconstructive surgery, the patients were divided into three groups. Group A (n = 29) had less extensive surgery, limited to the fallopian tubes, group B (n = 14) included patients with extended adhesiolysis, and group C (n = 10) comprised patients that had the most extensive reconstructive procedures involving ovarian surgery. Significantly highest FSH levels were found in group C (P < 0.001) compared to groups A and B in the early follicular phase. During the luteal phase, E2 levels were lower in groups B (P < 0.01) and C (P < 0.001) compared to group A. P4 levels were lower in group C compared to groups A and B. CONCLUSION: When the patients underwent IVF treatment higher grades of tubal damage, more extensive surgery and hormonal signs of ovarian insufficiency were highly related to treatment failure.

Adult↗
PubMed1994

Addition of a gonadotropin releasing hormone (GnRH) antagonist and exogenous gonadotropins to unstimulated in vitro fertilization (IVF) cycles: physiologic observations and preliminary experience.

PURPOSE: To describe our preliminary experience with the addition of a GnRH antagonist (Nal-Glu) and exogenous gonadotropins (follicle stimulating hormone; FSH) to unstimulated IVF cycles. METHOD: Seven spontaneously ovulatory women underwent eight unstimulated IVF cycles at our institution. They were treated with a single dose of Nal-Glu, 50 micrograms/kg, or with a combination of Nal-Glu, 50 micrograms/kg, and exogenous FSH, 150-300 IU, during the late follicular phase of spontaneous cycles. They then received 10,000 IU of human chorionic gonadotropin (hCG) to time accurately follicle aspiration in unstimulated IVF cycles. RESULTS: Two women underwent three cycles with Nal-Glu alone on the day of hCG administration. One pregnancy resulted. Five women underwent five cycles with 3 to 6 days of daily Nal-Glu and FSH. Four of these cycles resulted in aspiration after the FSH dose was increased to 300 IU. Nal-Glu and FSH allowed continued development of the dominant follicle without the occurrence of luteinizing hormone (LH) surge. CONCLUSIONS: (1) Nal-Glu alone given 18 hr prior to hCG did not interfere with continued follicle viability or with the attainment of pregnancy. (2) Simultaneous Nal-Glu and FSH allowed for continued growth and development of the dominant follicle without the occurrence of an LH surge. (3) This preliminary experience confirms the feasibility of this novel approach, which may ultimately enhance the efficacy of unstimulated IVF cycles by eliminating premature ovulation and maximizing control of gonadotropin delivery to the developing follicle.

Adult↗
PubMed2000

Rescue intracytoplasmic sperm injection (ICSI)-salvaging in vitro fertilization (IVF) cycles after total or near-total fertilization failure.

OBJECTIVE: To evaluate the effectiveness of delayed oocyte reinsemination by ICSI (rescue ICSI) after total or near-total fertilization failure (</=25%) in IVF. DESIGN: A retrospective clinical study. SETTING: Non-hospital-based IVF program. PATIENT(S): Thirty IVF cycles with total fertilization failure and two cycles with </=25% initial fertilization. MAIN OUTCOME MEASURE(S): Fertilization and pregnancy rates after rescue ICSI. INTERVENTION(S): Rescue ICSI 19-22 hours after initial oocyte insemination. RESULT(S): A fertilization rate of 60.2% was achieved with rescue ICSI (141 of 234 oocytes, 29 of 32 patients). Of 30 patients with total fertilization failure, 27 had fresh transfers with rescue ICSI embryos. Two additional patients with </=25% initial fertilization had subsequent replacement of frozen-thawed rescue ICSI embryos. Six pregnancies resulted, including three singleton, one twin, one missed abortion, and one ectopic pregnancy (20.7%). One of the singleton pregnancies resulted from replacement of four frozen-thawed embryos and is the first known pregnancy achieved from cryopreserved rescue ICSI embryos. CONCLUSION(S): Rescue ICSI should be considered in the presence of total or near-total fertilization failure in IVF. Early application of rescue ICSI (19-22 hours after insemination) may be critical for establishing fertilization within an optimal window and producing viable embryos and pregnancies.

Adult↗
PubMed2006

Intracytoplasmic sperm injection (ICSI) in unexplained and stage I endometriosis-associated infertility after fertilization failure with in vitro fertilization (IVF).

PURPOSE: To investigate possible differences between unexplained and stage I endometriosis-associated infertility in ICSI cycles conducted after low fertilization (<20%) in preceding IVF cycles with normal semen parameters. METHODS: Retrospective cohort study consisting of patients with unexplained (n=48) and stage I endometriosis-associated infertility (n=43) with a minimum of one IVF cycle with <20% fertilized oocytes and normal semen quality, treated with ICSI from January 1997 to January 2006. Age matched male factor infertility patients (n=91) were used as controls. RESULTS: Diploid fertilization rate was significantly lower in the stage I endometriosis-associated infertility group compared to the unexplained infertility group. Score of the transferred embryos, implantation rate, pregnancy rate and outcome were similar in the two groups. CONCLUSIONS: ICSI appears to be an efficient treatment option after fertilization failure with IVF in unexplained and stage I endometriosis-associated infertility.

Adult↗
PubMed2005

In vitro fertilization (IVF) in Sweden: infant outcome after different IVF fertilization methods.

OBJECTIVE: To compare infant outcome after different IVF techniques. DESIGN: A register study in Sweden of IVF infants compared with all infants born. SETTING: National health registers. PATIENT(S): We studied 16,280 IVF infants, 30% of whom were conceived by intracytoplasmic sperm injection (ICSI). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Multiple births, infant sex, preterm birth, low birth weight, and small for gestational age among singletons, mortality, low Apgar score, neonatal diagnoses. RESULT(S): Twinning was less frequent after frozen standard IVF (18.1%) and after ICSI (21.8%) than after fresh standard IVF (24.4%). The male/female ratio was significantly increased in infants conceived after standard IVF. No significant differences were seen between singleton infants conceived after different IVF methods with respect to preterm birth, low birth weight, or infant mortality, with the possible exception of frozen standard IVF, for which some of these rates were lower than after fresh standard IVF. Infants born after ICSI had an indicated lower risk of respiratory problems than infants born after standard IVF. CONCLUSION(S): Little difference in outcome was seen after different IVF methods. The differences observed might be due to dissimilar characteristics of the treated women (e.g., because ICSI was mainly used in connection with male infertility).

Confidence Intervals↗
PubMedDate not supplied

A fixed stimulation protocol for in vitro fertilization (IVF) without determinations of hormones in blood.

A new fixed schedule of ovarian stimulation for IVF was developed, which is not only simpler and easier to handle for the patients but also yields better fertilization and pregnancy rates. The period and beginning of stimulation are shifted by means of a contraceptive pill, so that stimulation can generally be started on a Sunday. The patient takes 100 mg clomiphene for 5 days and 7.5 mg prednisolone for 30 days to suppress possible exaggerated adrenal androgens; she also receives 150 IU of human menopausal gonadotropin (HMG) i.m. every other day from her family physician. From the 8th day of stimulation onwards, follicular growth is registered by daily ultrasound at the IVF center. When the dominant follicle exceeds 18 mm in diameter, 5000 IU human chorionic gonadotrophin (hCG) is given. Blood sampling for hormone estimations is not necessary, and only one sample of urine is needed for the LH estimation before hCG. In comparison to clomiphene citrate (Clomid) alone, Clomid plus HMG/FSH and HMG/FSH alone, this protocol resulted in significantly higher fertilization and pregnancy rates per follicular puncture. The rate of abortions and extrauterine pregnancies, on the other hand decreased. When comparing repetitive IVF cycles with the first IVF cycle, a significant reduction of oocytes in repetitions was found, but no difference was found in the number of fertilized eggs. The pregnancy rate, on the other hand, increased in the repeat cycles.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Protocols↗
PubMed1995

Comparison between nafarelin acetate and D-Trp6-LHRH for temporary pituitary suppression in in vitro fertilization (IVF) patients: a prospective crossover study.

PURPOSE: Nafarelin acetate is a new gonadotropin releasing (GnRH) agonist analogue with unique potency, intranasal administration, and convenient storage. Hence, nafarelin was considered as an alternative for temporary pituitary suppression in patients undergoing ovulation induction in IVF. A crossover treatment in a prospective study was performed including 40 women with bilateral obstructed tubes and normal ovarian function, treated in 80 ovulation induction cycles using the long protocol. Twenty patients used nafarelin acetate 600 micrograms/daily in their first cycle and received D-Trp6-LHRH, 0.5 mg/daily, in their following cycle. The other 20 women used decapeptyl in their cycle and received nafarelin in the second. RESULTS: Estradiol suppression was achieved by both D-Trp6-LHRH and nafarelin at equal time intervals. The average total number of ampoules (P = 0.0005) and the length of administration of hMG required for ovarian stimulation (P = 0.0002) and the time interval between GnRHa initiation to oocyte retrieval (P = 0.04) was significantly lower in nafarelin cycles. The number and the distribution between large and small follicles as well as the average number of oocytes retrieved did not differ between the two GnRH analogues. CONCLUSION: Our results demonstrate that nafarelin acetate is comparable to D-Trp6-LHRH for temporary pituitary suppression used for controlled ovarian stimulation in IVF patients. However, using nafarelin ovarian stimulation was achieved with few ampoules of hMG, administered for a shorter period of time, thus with a lesser cost.

Adult↗
PubMed1994

Individualized gonadotropin regimens for follicular stimulation in macaques during in vitro fertilization (IVF) cycles.

Follicular stimulation was compared in macaques receiving sequential gonadotropin treatment which was terminated after seven, eight, or nine days depending on the time required to attain preselected criteria of follicular maturation. Although estradiol levels and follicle sizes varied, the number of follicles and oocytes/animal, oocyte nuclear maturity, IVF rates and progesterone levels during the luteal phase were similar among groups. Reducing the duration of gonadotropin treatment to individualize follicular stimulation regimens does not compromise follicle or gamete quality.

Animals↗