1
|
Dooley M, Lim-Howe D, Savvas M, Studd JW. Early Experience with Gamete Intrafallopian Transfer (GIFT) and Direct Intraperitoneal Insemination (DIPI). J R Soc Med 2018; 81:637-9. [PMID: 3210194 PMCID: PMC1291840 DOI: 10.1177/014107688808101108] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We present our early experience with gamete intrafallopian transfer (GIFT) and direct intraperitoneal insemination (DIPI) combined with intrauterine insemination (IUI), two recently described methods of assisting conception in patients with patent fallopian tubes. Sixty-nine patients (93 cycles) were entered into the study. Thirty-three patients (51 cycles) entered the DIPI/IUI programme and 36 patients (42 cycles) entered the GIFT programme. The mean age, duration and aetiology of infertility were similar in both groups. In the GIFT programme 12 pregnancies occurred, which is a 29% pregnancy rate per cycle and a 33% pregnancy rate per patient. In the DIPI/IUI programme only 3 pregnancies occurred, being a 6% pregnancy rate per cycle and a 9% pregnancy rate per patient. With the live birth rate of in vitro fertilization (TVF) being 12% per embryo transfer, we conclude that GIFT is more successful than either DIPI/IUI or IVF in patients with patent fallopian tubes. Further controlled studies are required to assess the future role of DIPI/IUI in clinical practice.
Collapse
Affiliation(s)
- M Dooley
- Fertility and Endocrinology Centre, Lister Hospital, London
| | | | | | | |
Collapse
|
2
|
Affiliation(s)
- D H Barlow
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford
| |
Collapse
|
3
|
Bikherton NJ, Chandler CJ. Gynaecological case reports: Pregnancy following gamete intrafallopian transfer at a district general hospital. J OBSTET GYNAECOL 2009. [DOI: 10.3109/01443618809008822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
4
|
Abstract
Despite improvements in both diagnostic assessment and treatment of infertile couples, many couples still have no explanation for their infertility. Unexplained infertility (the failure to conceive of a couple in whom no definitive cause for infertility can be found) has an incidence of 10-20% in all infertile couples. The incidence varies with the population studied and with the criteria used. Unexplained infertility is not an absolute condition but rather a relative inability to conceive, and many of these couples may conceive without treatment. The treatment options for unexplained infertility are several and the treatment results are promising. Expectant management can be recommended if the woman is under 28-30 years of age and the infertility duration is less than 2-3 years. In vitro fertilization (IVF) has revolutionized the treatment of infertile couples, as well as profoundly increasing the basic understanding of human reproduction. IVF can be used as both a diagnostic and a therapeutic tool in couples with unexplained infertility. The pregnancy rates with IVF are good, at 40% per treatment cycle. In addition, the outcome of pregnancies among women with unexplained infertility is generally comparable to that of spontaneous and other pregnancies using assisted reproductive technologies.
Collapse
Affiliation(s)
- R Isaksson
- Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland
| | | |
Collapse
|
5
|
Abstract
OBJECTIVES The purpose of this study was to assess the coping mechanisms in patients presenting for in-vitro fertilization (IVF). METHODS We evaluated thirty consecutive couples presenting for in-vitro-fertilization. All couples were interviewed individually at first, and then together, using a semi-structured interview technique. Psychiatric diagnoses were made using the Diagnostic and Statistical Manual-IV (DSM-IV) criteria. Coping mechanisms used by the individuals were assessed using the Mechanisms of Coping Scale (MOCS). Other instruments used were Hamilton Depression Rating Scale (HAM-D-17), Hamilton Anxiety Rating Scale (HAM-A), Brief Psychiatric Rating Scale (BPRS), Self-Rating Symptom Scale (SRSS), and Eysenck Personality Inventory (EPI). RESULTS The mean age of the sixty patients was 32.3 +/- 5.2 years. Fatalism was the commonest factor on the mechanisms of coping scale. Analysis of variance (ANOVA) across all factors of the MOCS for demographic factors showed that men used problem-solving mechanisms significantly more often than women (F = 3.0, df = 1, 58, p < 0.05). ANOVA across coping factors on stressors with post-hoc tests of significance revealed that individuals facing social stress used fatalism significantly more often than other coping mechanisms, while those facing career stress used problem-solving significantly more often than other coping mechanisms (F = 5.6, df = 1, 58, p < 0.05 and F = 3.04, df = 1, 58, p < 0.01 respectively). ANOVA across coping factors on HAM-D-17 scores revealed that individuals who used fatalism had significantly higher HAM-D-17 scores compared to those who did not (F = 4.4, df = 1, 58, p < 0.05). ANOVA across coping factors on HAM-A scores revealed that individuals who used escape-avoidance had significantly lower HAM-A scores than those who did not (F = 4.3, df = 1, 58, p < 0.05). ANOVA across coping factors on SRSS scores revealed that individuals who used passivity or fatalistic coping mechanisms had significantly higher scores on SRSS than who did not (F = 4.6, df = 1, 58, p < 0.05 and F = 3.5, df = 1, 58, p < 0.05). CONCLUSIONS Differential patterns of coping were found among the sixty individuals presenting for IVF and were associated with a variety of factors including gender, education, stressors, and levels of depression, anxiety, and overall psychopathology. Efforts to recognize and recruit the coping mechanisms of infertile individuals are likely to enhance their ability to participate effectively in treatment.
Collapse
Affiliation(s)
- S Sonawalla
- Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | | | | |
Collapse
|
6
|
Steinberg EP, Holtz PM, Sullivan EM, Villar CP. Profiling assisted reproductive technology: outcomes and quality of infertility management. Fertil Steril 1998; 69:617-23. [PMID: 9548148 DOI: 10.1016/s0015-0282(97)00566-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To critically appraise the content of the American Society for Reproductive Medicine (ASRM)/Society for Reproductive Technology (SART) Registry. DESIGN English-language literature review. PATIENT(S) Women undergoing treatment with assisted reproductive technology (ART). INTERVENTION(S) Current ART treatments, including IVF, GIFT, zygote intrafollopian transfer (ZIFT), oocyte micromanipulation, and cryopreserved embryo transfers. MAIN OUTCOME MEASURE(S) Compliance with clinical practice guidelines, and casemix-adjusted rates of live delivery, clinical pregnancy, ectopic pregnancy, miscarriage, birth defects, implantation, fertilization, and retrieval. RESULT(S) Outcomes should be adjusted for variation in patient characteristics known to affect prognosis, including maternal age, the duration of infertility, the presumed cause(s) of infertility, the patient's prior history of treatment for infertility, and diethylstilbestrol exposure. Outcome rates should be reported using the patient as the denominator, as well as cycle, retrieval, and transfer. The statistical significance of observed differences in events rates should be indicated. Because widely accepted clinical practice guidelines related to performance of ART procedures are not available, compliance with practice guidelines cannot currently be assessed. CONCLUSION(S) Reports based on ASRM/SART Registry data can be enhanced by refined casemix adjustment, assessing outcome rates per patient, as well as per component of ART procedure, and by providing an indication of the statistical significance of observed differences in event rates. In addition, a critical appraisal of available evidence related to particular aspects of infertility management would help clarify the areas in which there is an evidentiary basis for formulation of practice guidelines, as well as topics requiring additional clinical research.
Collapse
Affiliation(s)
- E P Steinberg
- Covance Health Economics and Outcomes Services Inc., Washington, DC 20005-3934, USA
| | | | | | | |
Collapse
|
7
|
Aboulghar MA, Mansour RT, Serour GI, Sattar MA, Amin YM. Intracytoplasmic sperm injection and conventional in vitro fertilization for sibling oocytes in cases of unexplained infertility and borderline semen. J Assist Reprod Genet 1996; 13:38-42. [PMID: 8825165 DOI: 10.1007/bf02068867] [Citation(s) in RCA: 79] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE In a prospective study, conventional IVF and intracytoplasmic sperm injection (ICSI) were performed on sibling oocytes of 22 patients with unexplained infertility (Group A) and 24 patients with borderline semen (Group B). RESULTS In Group A, there was no significant difference (P = 0.070) in the fertilization rate per oocyte between ICSI (63%) and conventional IVF (50.7%), however, there was total failure of fertilization in conventional IVF in 5 of the 22 patients with IVF and none in ICSI. In group B, there was a significant difference (P < 0.001) between the fertilization rate per oocyte in ICSI (59%) and conventional IVF (27.1%). There was total failure of fertilization in 11 patients after conventional IVF and none after ICSI. CONCLUSIONS The study showed that 22.7% of unexplained infertility and 45.8% of patients with borderline semen would have lost their chance of embryo transfer completely because of total failure of fertilization if ICSI was not performed on some oocytes in this cycle.
Collapse
Affiliation(s)
- M A Aboulghar
- Department of Obstetrics and Gynecology, Cairo University, Egypt
| | | | | | | | | |
Collapse
|
8
|
Silva PD, Meisch AL, Meisch JK, Kang SB, Rooney B. Factors associated with improving success rates with gamete intrafallopian transfer under thin-needle spinal anesthesia. J Assist Reprod Genet 1995; 12:569-73. [PMID: 8580651 DOI: 10.1007/bf02212576] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE In order to reduce the risk of major anesthetic complications associated with laparoscopic gamete intrafallopian transfer procedures, we have exclusively used thin-needle spinal anesthesia over the years 1991 - 1994. This paper will review complication rates in order to further establish the safety profile of GIFT under thin-needle anesthesia and report the changes in our GIFT protocol from 1991 to 1994 which have been associated with a statistical improvement in the implantation rate from 11% to 23% (P = 0.01) and an increase in delivery rates from 29% to 42% per transfer procedure. METHODS Sixty-eight laparoscopic GIFT procedures were done in women with at least one patent oviduct and failure to respond to less invasive treatment. Clinical variables were analyzed to determine if similar patient populations had been treated over the study period. RESULTS The improved delivery rates and implantation rates could not be explained by patient selection. No major perioperative complications occurred. Minor perioperative complications and difficulties included one patient requiring general anesthesia, one patient developing a spinal headache which could be managed conservatively at home, and one patient requiring a minilaparotomy to complete the GIFT procedure. The more serious complications occurred as a result of the superovulation and multiple oocyte transfer rather than the surgical or anesthetic technique. These included two patients with severe ovarian hyperstimulation requiring hospitalization, and five delivered triplet pregnancies. Factors associated with improving success rates included improvements in semen and equipment preparation as well as an increase in the number of sperm transferred from 200,000 to 500,000. CONCLUSIONS GIFT can be performed with relative safety under thin needle spinal anesthesia with high implantation and delivery rates if care is made to optimize sperm and equipment preparation. GIFT under thin-needle spinal anesthesia may be an attractive alternative for treatment of longstanding nontubal infertility in couples willing to take the risk of ovarian hyperstimulation and multiple pregnancy.
Collapse
Affiliation(s)
- P D Silva
- Department of Obstetrics and Gynecology, Gundersen/Lutheran Medical Center, La Crosse, Wisconsin, USA
| | | | | | | | | |
Collapse
|
9
|
Abstract
OBJECTIVE To collect results of gamete intrafallopian transfer on a large scale in order to compare treatment indications, results, and factors which influence the success rates; to evaluate whether gamete intrafallopian transfer is well-established and what the real place of this procedure is among other assisted reproduction techniques. DESIGN Data relating to gamete intrafallopian transfer were collected from World Reports, national registries of different countries and meta-analysis of medical publications during the years 1986-1991. SUBJECT Official registries reported 47,200 treatment cycles and 18,759 treatment cycles were analysed from ten medical publications. RESULTS The procedure accounts for 13.5% of all assisted reproduction techniques but its popularity varies significantly among countries. The same indications for gamete intrafallopian transfer are followed by all countries, but great differences exist with regard to the proportional share of each etiology. Also, the share has changed considerably over the years. TREATMENT OUTCOME: 10,667 clinical pregnancies were reported which represent 24% of treatment cycles and 29% of ovum pick-up. The live birth rate was 23.3%; abortion rate, 22%; and ectopic pregnancy rate, 5.5%. The stillbirth rate was 2.3% and the malformation rate was 2.8%, not confined to specific organs or systems. There were 19.5% twins, 4.6% triplets and 0.3% quadruplets or more. The number of transferred oocytes influenced pregnancy rates: 28% for transfer of four oocytes and only 10% following transfer of one oocyte. The cause of infertility might influence the results and the poorest results are obtained for male factor infertility. In most cases correlation of success rates reported by leading units through medical publications closely resembles the overall national registries results. Indications for this treatment were broadened over the years, but its role among other assisted reproduction technologies is not agreed upon, especially for male factor and unexplained infertility. CONCLUSIONS Gamete intrafallopian transfer carries an overall higher pregnancy rate than in vitro fertilization. Quality control by professional or public associations should be established and more research employed over indications for treatment and results in order to establish when GIFT is the treatment of choice and when other modes of treatment should be preferred.
Collapse
Affiliation(s)
- D Meirow
- Department of Obstetrics and Gynecology, Hadassah University Hospital, Ein-Kerem, Jerusalem, Israel
| | | |
Collapse
|
10
|
Abstract
OBJECTIVE To review milestones in the care of the infertile couple over the past five decades. DATA RESOURCES All issues of Fertility and Sterility were reviewed beginning with the first issue published in 1950 through volume 61, number 1 (January 1994). Other significant articles from the literature were reviewed as identified by directed Medline searches. RESULTS This historical review gives the reader a sense of the evolution of modern reproductive technology--how the past has shaped the present--through the development of modern surgical techniques, methods of ovulation induction, laparoscopy, ultrasound, endocrine assays, in vitro fertilization, cryopreservation of sperm and preembryos, and microscopic procedures on gametes and preembryos. CONCLUSIONS The remarkable capabilities of modern reproductive technologies are only possible because of the culmination of decades of innovative research.
Collapse
Affiliation(s)
- S H Chen
- Department of Gynecology and Obstetrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | | |
Collapse
|
11
|
Fakih H, Marshall J. Subtle tubal abnormalities adversely affect gamete intrafallopian transfer outcome in women with endometriosis. Fertil Steril 1994; 62:799-801. [PMID: 7926090 DOI: 10.1016/s0015-0282(16)57007-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To evaluate prospectively the impact of subtle tubal disorders on GIFT pregnancy rates in women with pelvic endometriosis. DESIGN A prospective comparison of pregnancy rates in different stages of endometriosis while controlling for the presence of tubal abnormalities. INTERVENTIONS A total of 146 patients with endometriosis underwent 201 GIFT procedures. During laparoscopy special attention was brought to the fallopian tubes and any anatomical disorders were recorded. Tubal abnormalities included tubal sacculations, diverticulae, convolutions, phimosis, fimbrial agglutination, and peritubal adhesions. Best tube was considered in the final analysis. RESULTS The presence of tubal abnormalities significantly lowered the pregnancy rates in all stages of endometriosis. When we controlled for age, semen characteristics, number of mature oocytes transferred, and tubal status, the extent of anatomical tubal disorders was the most important prognostic factor in determining pregnancy outcome. CONCLUSION The extent of tubal abnormalities rather than the stage of endometriosis seems to be an important prognostic factor in determining GIFT pregnancy rates. Couples should be counseled accordingly and accurate prognostic parameters should be explained before enrollment in a GIFT program.
Collapse
Affiliation(s)
- H Fakih
- Saginaw Cooperative Hospitals, Inc., Michigan 48602
| | | |
Collapse
|
12
|
Abstract
OBJECTIVE To compare stimulation and outcome variables for IVF in stimulated cycles when ova are retrieved during diagnostic infertility laparoscopy versus transvaginal ultrasound (US) directed retrieval and to investigate the presence of unexpected failed fertilization in the diagnostic laparoscopy group, which allows an opportunity to diagnosis an etiology of infertility based on gamete interaction. DESIGN Consecutive patients who needed infertility diagnostic laparoscopy and agreed to combination with IVF were compared with concurrent patients undergoing transvaginal US IVF. Male factor screening parameters (semen analysis, sperm penetrating assay) and resultant fertilization were analyzed for these patients. SETTING The George Washington University Hospital, a tertiary referral center offering assisted reproductive technologies. Patients for diagnostic laparoscopy combined with IVF were enrolled in the Program of Oocyte Retrieval at Diagnostic Laparoscopy (PORDL). PARTICIPANTS One hundred twenty-four women enrolled for diagnostic laparoscopy combined with IVF; 237 women were concurrently enrolled for transvaginal US IVF. RESULTS Response variables (number of follicles, days of monitoring, ampules of hMG, maximum E2) between the two groups were similar. Outcome variables (ova retrieved, ova fertilized, ova cleaved, clinical pregnancy rate per embryo transferred) were similar despite a significantly higher number of embryos transferred for the transvaginal US group. The clinical pregnancy rate per cycle was similar, 26% versus 28% for the women in the transvaginal US versus those women in the PORDL group, as was the clinical pregnancy rate per ET, 31% versus 34%, respectively. The number of fertilized ova for each group was not significantly different: 5.5 +/- 0.3 for the transvaginal group versus 4.8 +/- 0.4 for the PORDL group. Patients in the PORDL group with a known male factor (group B) had a lower fertilization rate than those with no male factor (group A). Within the group A with no detectable male factor prospectively, 17.2% had unexpectedly poor fertilization (group A1), whereas the rest of the group A patients had higher fertilization rates as was expected (group A2). The clinical pregnancy rate per ET for group A1 was 0% compared with 43.4% for the group A2 patients. CONCLUSIONS In vitro fertilization can be successfully performed during diagnostic laparoscopy yielding comparable results to transvaginal ultrasound IVF while gaining diagnostic information concerning sperm-ova interaction (i.e., fertilization).
Collapse
Affiliation(s)
- P R Gindoff
- Department of Obstetrics and Gynecology, George Washington University Medical Center, Washington, D.C. 20037
| | | | | |
Collapse
|
13
|
Baeten S, Bouckaert A, Loumaye E, Thomas K. A regression model for the rate of success of in vitro fertilization. Stat Med 1993; 12:1543-53. [PMID: 8235177 DOI: 10.1002/sim.4780121703] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The treatment of infertility by in vitro fertilization involves several aspects of human reproductive physiology. Since failures are still numerous and since improved techniques are becoming increasingly available, it is important to develop a model where the components of success are identified, allowing estimation of the occurrence of these components of success in the infertile population. The model of Speirs reduces these components to two: uterine receptivity and embryo viability. The probabilities of uterine receptivity and embryo viability were estimated here in a retrospective study of patients in a Belgian hospital sample. For comparison, Australian and U.S. data were used. It was shown that the estimate of uterine receptivity for the Belgian sample is located between the estimates for Australian and U.S. samples. In view of the psychological problem of repeated unsuccessful attempts at in vitro fertilization in some patients, it is important to be able to single out some prognostic factors that would allow more precise estimation of the probability for success in each case. A regression method was developed for that purpose. Only the effect of age, in the Belgian sample, was found to influence uterine receptivity significantly.
Collapse
Affiliation(s)
- S Baeten
- Unit of Medical Mathematics, Faculty of Medicine, Catholic University of Louvain, Brussels, Belgium
| | | | | | | |
Collapse
|
14
|
Mastroyannis C. Gamete intrafallopian transfer: ethical considerations, historical development of the procedure, and comparison with other advanced reproductive technologies. Fertil Steril 1993; 60:389-402. [PMID: 8375514 DOI: 10.1016/s0015-0282(16)56148-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To report on ethical considerations regarding GIFT as well as the developmental history of the procedure and to review the literature and compare it with other advanced reproductive technologies (ARTs). DESIGN Indications, patient screening, recent evaluations, methods of ovarian hyperstimulation and oocyte retrieval-assessment, gamete transfer and pregnancy outcome are discussed in this review. A comparison of GIFT with other ARTs is also attempted. MAIN OUTCOME MEASURES Gamete intrafallopian transfer pregnancy determination and outcome. CONCLUSIONS Gamete intrafallopian transfer is an ethically acceptable procedure by different religious groups. In a selected group of patients, GIFT is an acceptable and, in some occasions, a preferable procedure to other ARTs.
Collapse
Affiliation(s)
- C Mastroyannis
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
15
|
Nelson JR, Corson SL, Batzer FR, Gocial B, Huppert L, Go KJ, Maislin G. Predicting success of gamete intrafallopian transfer**Presented in part at the 48th Annual Meeting of The American Fertility Society, New Orleans, Louisiana, October 31 to November 5, 1992. Fertil Steril 1993. [DOI: 10.1016/s0015-0282(16)56047-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
16
|
Yazigi RA, Chi MM, Mastrogiannis DS, Strickler RC, Yang VC, Lowry OH. Enzyme activities and maturation in unstimulated and exogenous gonadotropin-stimulated human oocytes. THE AMERICAN JOURNAL OF PHYSIOLOGY 1993; 264:C951-5. [PMID: 8097373 DOI: 10.1152/ajpcell.1993.264.4.c951] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
With the advent of new techniques of human in vitro fertilization (IVF), identifying parameters of oocyte quality to allow selection of those most likely to fertilize becomes crucial. Morphology of oocytes, which correlates positively with biological performance, is the currently utilized classification criterion. However, biological links between form and function are tenuous, and underlying mechanisms remain elusive. We investigated whether biochemical activation is quantitatively associated with the stages of maturation in ova obtained from patients undergoing gynecologic surgery during unstimulated cycles and women undergoing IVF after exogenous gonadotropin stimulation. Changes in selected enzymes from protein, lipid, and carbohydrate metabolism (hexokinase, phosphoglucomutase, glycogen synthetase, uridine diphosphoglucose pyrophosphorylase, glucose-6-phosphate dehydrogenase, cytosolic thiolase, beta-hydroxyacyl-CoA dehydrogenase, alanine aminotransferase, and aspartate aminotransferase) were determined simultaneously, in individual oocytes, utilizing a highly sensitive biochemical methodology. Several enzyme activities paralleled maturation grade and were higher in stimulated oocytes after correction for grade. These biochemical findings quantify metabolic and functional changes that increase as ova mature, possibly contributing to their reproductive performance.
Collapse
Affiliation(s)
- R A Yazigi
- Department of Molecular Biology, Washington University School of Medicine, St. Louis, Missouri 63110
| | | | | | | | | | | |
Collapse
|
17
|
Chen GD, Lin MT, Lee MS, Wu NA, Huang CC. Supernumerous oocytes transferred in gamete intrafallopian transfer (GIFT). J Assist Reprod Genet 1993; 10:219-23. [PMID: 8400735 DOI: 10.1007/bf01239225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- G D Chen
- Department of OB/GYN, Chun Shang Medical College Hospital, Taichung, Taiwan, R.O.C
| | | | | | | | | |
Collapse
|
18
|
Jackson KV, Clarke RN, Nureddin A, Hornstein MD, Rein MS, Friedman AJ. A self-programmable in vitro fertilization/gamete intrafallopian transfer patient database management system for MacIntosh computers. J Assist Reprod Genet 1993; 10:58-66. [PMID: 8499681 DOI: 10.1007/bf01204442] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Our purpose was to develop a data processing system for a large in Vitro Fertilization/Gamete Intrafallopian Transfer (IVF/GIFT) practice which would (1) require minimal data entry time, (2) be easy to operate, (3) be simple to construct (no knowledge of procedural language or programming necessary), and (4) quickly collate and reduce data. RESULTS A database management system was successfully constructed on an Apple MacIntosh computer which met the above criteria. The key elements of this database were its user-friendly features (MacIntosh-based system), adaptability (user was constantly able to update and revise the program as informational needs changed), and ability to perform complex searches and data analyses imposed by the individual operators. CONCLUSIONS The software and hardware described in this report were found to be highly effective in meeting the ever-changing administrative and clinical needs of our IVF/GIFT program.
Collapse
Affiliation(s)
- K V Jackson
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham & Women's Hospital, Boston, Massachusetts 02115
| | | | | | | | | | | |
Collapse
|
19
|
Affiliation(s)
- H Meinertz
- Institute of Medical Microbiology, University of Aarhus, Denmark
| |
Collapse
|
20
|
Diedrich K, Bauer O. Indications and outcomes of assisted reproduction. BAILLIERE'S CLINICAL OBSTETRICS AND GYNAECOLOGY 1992; 6:373-88. [PMID: 1424331 DOI: 10.1016/s0950-3552(05)80093-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Since 1978 many healthy children have been born after in vitro fertilization and embryo transfer, fulfilling the wishes of many previously childless couples. In vitro fertilization and subsequently developed methods (GIFT, intratubal embryo transfer) have contributed to progress in the diagnosis and treatment of unwanted childlessness. Furthermore these techniques have improved knowledge of ovarian function, fertilization and early embryo development.
Collapse
|
21
|
Marmar JL, Corson SL, Batzer FR, Gocial B. Insemination data on men with varicoceles**Presented at the 47th Annual Meeting of The American Fertility Society, Orlando, Florida, October 21 to 23, 1991. Fertil Steril 1992. [DOI: 10.1016/s0015-0282(16)55028-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
22
|
Yeko TR, Nicosia SM, Maroulis GB, Bardawil WA, Yusoff Dawood M. Histology of midluteal corpus luteum and endometrium from clomiphene citrate-induced cycles*†*Presented at the 38th Annual Meeting of the Society for Gynecologic Investigation, San Antonio, Texas, March 20 to 23, 1991.†Supported by an American College of Obstetricians and Gynecologists (ACOG)-Ortho Fellowship grant, and by ACOG District VI, Illinois Section, Research grant, Chicago, Illinois. Fertil Steril 1992. [DOI: 10.1016/s0015-0282(16)54771-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
23
|
Davis RO, Overstreet JW, Asch RH, Ord T, Silber SJ. Movement characteristics of human epididymal sperm used for fertilization of human oocytes in vitro. Fertil Steril 1991; 56:1128-35. [PMID: 1743333 DOI: 10.1016/s0015-0282(16)54728-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
STUDY OBJECTIVE To develop mathematical models using kinematic parameters from Computer-Aided Sperm Analysis (CASA) that predict the fertilization rate of sperm recovered from the caput epididymidis and to test the hypothesis that fertilization was enhanced by the presence of specific sperm subpopulations in the inseminate. SETTING In vitro fertilization (IVF) program. PATIENTS Thirteen patients with congenital absence of the vas deferens provided epididymal sperm for IVF as well as for CASA. RESULTS The mathematical model that was most predictive of fertilization rates included kinematic parameters of the epididymal aspirate (percent motility), the inseminate used for IVF (curvilinear velocity [VCL]), and the change in sperm movement after in vitro processing by the mini-Percoll technique (difference in amplitude of lateral head displacement [ALH]). Multivariate cluster analysis revealed that inseminates that resulted in higher fertilization rates had subpopulations of sperm that were characterized by high VCL and high mean angular displacement, as well as a greater change in ALH after processing. CONCLUSION In vitro fertilization with epididymal sperm was more likely to succeed when the sperm population that was initially aspirated had a higher proportion of motile cells and when these sperm were capable of capacitation in vitro as indicated by the appearance of sperm subpopulations with motility that resembled hyperactivation.
Collapse
Affiliation(s)
- R O Davis
- Division of Reproductive Biology and Medicine, University of California, Davis 95616
| | | | | | | | | |
Collapse
|
24
|
Fayrer-Hosken RA, Caudle AB. The laparoscope in follicular oocyte collection and gamete intrafallopian transfer and fertilization (GIFT). Theriogenology 1991; 36:709-25. [PMID: 16727040 DOI: 10.1016/0093-691x(91)90337-d] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/1990] [Accepted: 08/30/1991] [Indexed: 11/28/2022]
Abstract
Laparoscopic recovery of bovine follicular oocytes was studied. The collection of oocytes from the superovulated bovine ovary was maximized by standardizing the collection technique. The technique was highly successful, with a 79% oocyte recovery rate of the follicles aspirated. Collected oocytes were transferred to the inseminated recipient's oviduct with a minimum of trauma through the laparoscope. This gamete intrafallopian transfer and fertilization (GIFT) resulted in multiple embryo recovery in the cow. Oviductal catheterization and the potential of GIFT are described and discussed.
Collapse
Affiliation(s)
- R A Fayrer-Hosken
- Department of Large Animal Medicine and Physiology & Pharmacology College of Veterinary Medicine The University of Georgia Athens, GA 30602 USA
| | | |
Collapse
|
25
|
Macourt D, Engel S, Jones RF, Zaki M. Pregnancy by gamete intrafallopian transfer (GIFT) with sperm aspirated from the vaso-epididymal junction of spinal injured man: case report. PARAPLEGIA 1991; 29:550-3. [PMID: 1775362 DOI: 10.1038/sc.1991.79] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
26
|
Possati G, Seracchioli R, Melega C, Pareschi A, Maccolini A, Flamigni C. Gamete intrafallopian transfer by hysteroscopy as an alternative treatment for infertility. Fertil Steril 1991; 56:496-9. [PMID: 1894028 DOI: 10.1016/s0015-0282(16)54547-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate efficacy and safety of the hysteroscopic cannulation by flexible catheter of the fallopian tubes for gamete intrafallopian transfer (GIFT). DESIGN We studied the pregnancy rate (PR) and the safety of this new technique. SETTING All patients were enlisted for GIFT at our Reproductive Medicine Unit. PATIENTS We treated 26 patients whose infertility causes were terminal tubal damage, male factors, unexplained factors, and endometriosis. Patients with uterine tubal ostia unsuitable for gamete transfer or cervical incontinence were not included in the group. INTERVENTIONS The patients underwent ovulation induction and oocyte retrieval by transvaginal ultrasonically guided puncture. The gamete transfers were carried out by hysteroscopic procedure using a flexible catheter put through the operating channel. MAIN OUTCOME MEASURE The efficacy was evaluated by the PR (25.9%). RESULTS Seven clinical pregnancies were obtained, but two patients aborted during the first weeks of pregnancy. No ectopic pregnancies were observed. CONCLUSIONS Our results indicate that hysteroscopic GIFT is an alternative, safe, effective, and not invasive technique for fertility problems.
Collapse
Affiliation(s)
- G Possati
- Department of Obstetrics and Gynecology, University of Bologna, Italy
| | | | | | | | | | | |
Collapse
|
27
|
Gürgan T, Kişnişçi H, Yarali H, Aksu T, Zeyneloğlu H, Develioğlu O. The value of human menopausal gonadotropin treatment in patients with unexplained infertility. Int J Gynaecol Obstet 1991; 35:327-30. [PMID: 1682180 DOI: 10.1016/0020-7292(91)90666-s] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The role of multiple ovulation with human menopausal gonadotropin (HMG) in the treatment of unexplained infertility is evaluated. Of a total 73 patients with unexplained infertility, 39 received four cycles of HMG, whereas, 34 were left untreated. Eight (20.5%) women conceived during HMG treatment, in comparison to only 1 (2.9%) in the control group (P less than 0.05). This study gives further credit to the value of HMG treatment for unexplained infertility.
Collapse
Affiliation(s)
- T Gürgan
- Hacettepe University, Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
28
|
Dain LB, Stein P, Krimer AR, Asch RH, de Fried EP, Charreau EH, Tesone M. Progesterone production in cultured human granulosa cells: correlation with follicular fluid hormone levels. Fertil Steril 1991; 55:1093-8. [PMID: 1903728 DOI: 10.1016/s0015-0282(16)54358-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
STUDY OBJECTIVE To examine the progesterone (P) production by cultured granulosa cells and the hormonal content in the follicular fluid (FF) of ovarian-hyperstimulated women. DESIGN Retrospective. SETTING Private Fertility Clinic and National Research Institute. PATIENTS Eighteen patients undergoing in vitro fertilization or gamete intrafallopian transfer programs. RESULTS Progesterone levels Measured in the culture medium of granulosa cells decreased sixfold with culture time. Human luteinizing hormone (LH) increased P production only when basal P production was less than 1 microgram/mL. Granulosa cell P production in culture was negatively correlated with FF LH-human chorionic gonadotropin (hCG) levels. Follicular fluid follicle-stimulating hormone (FSH) levels were positively correlated with FF P and 17 beta-estradiol (E2) concentrations. Similar results were found between FF LH (hCG) and E2 levels, but there was no relationship between FF LH (hCG) and FF P values. CONCLUSION The high dose of hCG administered during gonadotropin treatment could induce a decrease in the in vitro granulosa cell P production.
Collapse
Affiliation(s)
- L B Dain
- Instituto de Biologia y Medicina Experimental, Buenos Aires, Argentina
| | | | | | | | | | | | | |
Collapse
|
29
|
Rabar FG. Gamete intrafallopian transfer. Another approach for the treatment of infertility. AORN J 1991; 53:1466-7, 1469-71, 1473-5. [PMID: 1863064 DOI: 10.1016/s0001-2092(07)68988-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- F G Rabar
- Hospital of the University of Pennsylvania, Philadelphia
| |
Collapse
|
30
|
Iffland CA, Reid W, Amso N, Bernard AG, Buckland G, Shaw RW. A within-patient comparison between superovulation with intra-uterine artificial insemination using husband's washed spermatozoa and gamete intrafallopian transfer in unexplained infertility. Eur J Obstet Gynecol Reprod Biol 1991; 39:181-6. [PMID: 1903346 DOI: 10.1016/0028-2243(91)90055-p] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The purpose of this study was to evaluate the success of gamete intrafallopian transfer (GIFT) and superovulation with intra-uterine artificial insemination (S-IUI) in couples with long-term unexplained infertility. Thirty-nine couples were offered three attempts at each treatment. Sixty-three IUI cycles were completed with a pregnancy rate of 1.5% per cycle. Forty-nine GIFT procedures were carried out with a pregnancy rate of 26.5% per cycle. The cumulative conception rate after three cycles of GIFT was 0.56. GIFT appears to offer a far greater chance of pregnancy than S-IUI in unexplained infertility.
Collapse
Affiliation(s)
- C A Iffland
- Academic Department of Obstetrics and Gynaecology, Royal Free Hospital, London, U.K
| | | | | | | | | | | |
Collapse
|
31
|
Penzias AS, Alper MM, Oskowitz SP, Berger MJ, Thompson IE. Gamete intrafallopian transfer: assessment of the optimal number of oocytes to transfer. Fertil Steril 1991; 55:311-3. [PMID: 1899394 DOI: 10.1016/s0015-0282(16)54121-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The optimum number of oocytes that should be transferred at the time of gamete intrafallopian transfer (GIFT) is important information. Nonessential oocytes can be inseminated and frozen for later use or the extra oocytes can be donated to another women. In this preliminary study, the results of 399 consecutive GIFT procedures were evaluated retrospectively as a function of the number of oocytes transferred. Women who received four or more oocytes were three times more likely to achieve a clinical pregnancy than those who received three or less. There was no statistically significant difference in pregnancy rates between patients who received five, six, seven, or eight oocytes. Oocytes in excess of five may be more effectively used if they are fertilized and frozen as embryos for later transfer rather than replacing them all at the time of GIFT.
Collapse
|
32
|
Yeko TR, Khan-Dawood FS, Dawood MY. Luteinizing hormone and human chorionic gonadotropin receptors in human corpora lutea from clomiphene citrate-induced cycles**Presented in part at the 36th Annual Meeting of the Society for Gynecologic Investigation, San Diego, California, March 15 to 18, 1989. This work was supported by an American College of Obstetricians and Gynecologists-Ortho Fellowship Grant and ACOG District VI, Illinois Section, Research Grant. Fertil Steril 1990. [DOI: 10.1016/s0015-0282(16)53815-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
33
|
Chan YM, Chan SY, Tucker MJ, Wong CJ, Leong MK, Leung CK. Successful pregnancies resulting from the use of prolonged-incubation human spermatozoa in gamete intrafallopian transfer. Fertil Steril 1990; 54:730-2. [PMID: 2209897 DOI: 10.1016/s0015-0282(16)53838-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Human spermatozoa that were incubated overnight at room temperature before intrafallopian transfer with freshly collected oocytes gave rise to successful pregnancies and normal live births. The resulting pregnancy rate per transfer of 50% (4 of 8) compared favorably with the average pregnancy rate of 41.8% (38 of 91), achieved by our standard spermatozoal preparation procedure that prepared the spermatozoa approximately 2 hours before the GIFT operation. This new approach for the preparation of human spermatozoa would be applicable to oligospermic patients and some GIFT patients whose partners may have difficulties in producing a semen specimen immediately before the GIFT operation.
Collapse
Affiliation(s)
- Y M Chan
- IVF Center, Hong Kong Sanatorium and Hospital, Happy Valley
| | | | | | | | | | | |
Collapse
|
34
|
Jansen RP, Anderson JC, Birrell WS, Lyneham RC, Sutherland PD, Turner M, Flowers D, Ciancaglini E. Outpatient gamete intrafallopian transfer: a clinical analysis of 710 cases. Med J Aust 1990; 153:182-8. [PMID: 2143803 DOI: 10.5694/j.1326-5377.1990.tb136856.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
From February 1986 to June 1989 445 infertile couples were treated with a total of 710 treatment cycles involving laparoscopic gamete intrafallopian transfer (GIFT). The median age of the female partner was 33.5 years (range, 24 to 49 years) and the median duration of infertility was 4 years (range, 2 to 20 years). The final outcome of all 217 clinical pregnancies is known. There were 150 live births among which all but one baby survived, comprising 112 singleton births, 28 twin births, nine triplet births and one quadruplet birth. There were no still births, but there were two premature, multiple live births (one triplet, one quadruplet) among which no babies survived the neonatal period. Overall, 40 of the 152 potentially viable pregnancies were multiple (26.3%). Three of 206 potentially viable babies were born with congenital anomalies (1.5%). There were 50 clinical spontaneous abortions (24.8% of uterine pregnancies), one termination of pregnancy for Down's syndrome, and 14 ectopic pregnancies rate was 30.6% per laparoscopy and, among 740 initiated cycles, a live and surviving birth-per-initiated-cycle rate of 20.2%, or 33.7% to date per couple entering the programme. The 710 laparscopies resulted in two serious complications (0.3%), one of which required laparotomy. Eight other patients were admitted to hospital for rest and observation because of painful ovarian enlargement in the luteal phase. The total inpatient admission rate was 1.4%. Outpatient laparoscopic GIFT under general anaesthesia is a safe and effective procedure when conventional treatment for infertility has been unsuccessful.
Collapse
|
35
|
|
36
|
Yovich JL, Draper RR, Turner SR, Cummins JM. Transcervical tubal embryo-stage transfer (TC-TEST). JOURNAL OF IN VITRO FERTILIZATION AND EMBRYO TRANSFER : IVF 1990; 7:137-40. [PMID: 2380619 DOI: 10.1007/bf01135676] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Ultrasound-guided transcervical tubal cannulation (TC-TEST) was used to replace embryos to the fallopian tubes in 17 women whose fallopian tubes were inaccessible by the abdominal route but where at least one tube was shown to be freely patent on a preliminary hysterosalpingogram investigation. In two further cases, the fallopian tubes proved impossible to cannulate, and along with two instances where difficulty was experienced, a common underlying feature was an arcuate or septate configuration of the uterus. Three pregnancies ensued (17%) in cases where the procedure was free of difficulty and the transfers were demonstrably intratubal: two went to term and the third resulted in an ectopic pregnancy. The procedure has so far not shown a benefit over conventional IVF-ET and probably should be avoided in women with any type of tubal disorder.
Collapse
Affiliation(s)
- J L Yovich
- PIVET Medical Centre, Perth, Western Australia
| | | | | | | |
Collapse
|
37
|
|
38
|
Melis GB, Strigini F, Mais V, Paoletti AM, Olivieri L, Antinori D, Guerriero S, de Ruggiero A, Petacchi FD, Fioretti P. Critical reappraisal of the clinical effectiveness of different methods of assisted fertilization. J Endocrinol Invest 1990; 13:263-74. [PMID: 2195100 DOI: 10.1007/bf03349557] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- G B Melis
- Istituto di Ginecologia ed Ostetricia, Università di Pisa, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Fakih H, Vijayakumar R. Improved pregnancy rates and outcome with gamete intrafallopian transfer when follicular fluid is used as a sperm capacitation and gamete transfer medium. Fertil Steril 1990; 53:515-20. [PMID: 2307248 DOI: 10.1016/s0015-0282(16)53350-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Follicular fluid (FF) is a dynamic medium rich in steroids, polypeptide hormones, and growth factors. Preovulatory FF can stimulate spermatozoal acrosome reaction. Moreover short preincubation of washed sperm with FF improves sperm performance in the hamster egg penetration assay. In the current study, FF was used to capacitate sperm and as a transfer medium in 131 gamete intrafallopian transfer (GIFT) procedures. Ham's F-10 medium (GIBCO, Grand Island, NY) with 50% maternal serum was used in another 29 GIFT procedures. In the Ham's F-10 group, 29 GIFT procedures were performed in 25 patients with a pregnancy rate of 21% per laparoscopy and 24% per patient. In the FF group, 131 GIFT procedures were performed in 100 patients with a pregnancy rate of 50% per laparoscopy and 66% per patient, with a 59% ongoing pregnancy rate per patient. The most significant improvement was in the male factor group with a pregnancy rate of 0% in the Ham's F-10 group and 44% per procedure in the FF group. We conclude that the use of FF for sperm capacitation and as a gamete transfer medium significantly improves GIFT pregnancy rates and outcome.
Collapse
Affiliation(s)
- H Fakih
- Saginaw Cooperative Hospital, Inc., Michigan 48602
| | | |
Collapse
|
40
|
Pouly JL, Janny L, Canis M, Vye P, Boyer C. Gamete intrafallopian transfer: benefits of programmed stimulation. Fertil Steril 1989; 52:1012-7. [PMID: 2591558 DOI: 10.1016/s0015-0282(16)53167-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Fifty-six cycles of gamete intrafallopian transfer (GIFT) were performed after programming by administration of norethisterone in the previous cycle. Ovarian hyperstimulation was achieved with clomifene citrate and human menopausal gonadotropins. Only one GIFT was performed during a weekend (1.8%). The implantation rate was 41.1% and the evolutive pregnancy rate 30.4%. The endocrinological influence of these regimens are discussed by comparison of those observed in an in vitro fertilization program. The main influence is a decreased serum luteinizing hormone (LH) level in the preovulatory phase.
Collapse
Affiliation(s)
- J L Pouly
- Service de Gynécologie et Obstétrique, Polyclinique Phillipe Marcombes, Centre Hospitalier et Universitaire, Clermont Ferrand, France
| | | | | | | | | |
Collapse
|
41
|
Guzick DS, Balmaceda JP, Ord T, Asch RH. The importance of egg and sperm factors in predicting the likelihood of pregnancy from gamete intrafallopian transfer. Fertil Steril 1989; 52:795-800. [PMID: 2806621 DOI: 10.1016/s0015-0282(16)61033-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The relative contribution of factors affecting the probability of pregnancy from gamete intrafallopian transfer was estimated using data from 218 cycles performed in San Antonio, Texas, and Orange, California. Mature eggs, all of which contained an expanded cumulus, were subclassified according to the corona radiata; those with a starburst corona were considered the most fully mature. Sixty-two clinical pregnancies were established, representing a pregnancy rate of 28.4%. Excluding 49 cases of male factor infertility, the pregnancy rate was 34.9%. Pregnancy rates were not significantly different according to age, cause of female factor infertility, parity, duration of infertility, stimulation protocol, or estradiol level. The only variables having a strong association with pregnancy were sperm and egg parameters. Sperm motility and morphology were statistically more important than sperm density. Based on odds ratios calculated from multiple logistic analysis, pregnancy was 3.80 times more likely if three or more fully mature eggs were transferred, 0.34 times as likely if motility were less than or equal to 30%, and 0.22 times as likely if normal morphology was less than or equal to 50%, controlling for other egg and sperm factors. If all egg and sperm factors in a given cycle were unfavorable, the probability of pregnancy estimated by the logistic model was 4%, whereas if all were favorable the probability of pregnancy in that cycle was 59%.
Collapse
|
42
|
Yee B, Rosen GF, Chacon RR, Soubra S, Stone SC. Gamete intrafallopian transfer: the effect of the number of eggs used and the depth of gamete placement on pregnancy initiation. Fertil Steril 1989; 52:639-44. [PMID: 2806603 DOI: 10.1016/s0015-0282(16)60978-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The role of the fallopian tube in initiating pregnancy was examined in 246 consecutive gamete intrafallopian transfer (GIFT) cycles. Before actual transfer, the ampulla of each tube was measured to determine the depth at which gametes could be placed. Fifty-seven transfers were made with four oocytes into a single tube; of these, when gametes were deposited deeper than 4 cm, the pregnancy rate was higher than when they were placed at between 3 to 4 cm (69.6% compared with 41.2%). Presumably, a deeper placement is more secure and decreases the likelihood of gamete displacement. The pregnancy rate also rose with the number of oocytes used: from 0% with a single oocyte to 42.9% with four oocytes.
Collapse
Affiliation(s)
- B Yee
- California College of Medicine, University of California, Irvine, Orange
| | | | | | | | | |
Collapse
|
43
|
Kaplan CR, Olive DL, Sabella V, Asch RH, Balmaceda JP, Riehl RM, Groff TR, Burns WN, Schenken RS. Gamete intrafallopian transfer vs superovulation with intrauterine insemination for the treatment of infertility. JOURNAL OF IN VITRO FERTILIZATION AND EMBRYO TRANSFER : IVF 1989; 6:298-304. [PMID: 2632659 DOI: 10.1007/bf01139186] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Superovulation with intrauterine insemination (SO-IUI) has been suggested as an alternative to gamete intrafallopian transfer (GIFT), despite the absence of controlled or comparative trials. We retrospectively analyzed all GIFT and SO-IUI cycles performed concurrently from January 1985 to August of 1987 at a single university center. Pregnancy rates were significantly better for GIFT than SO-IUI (P less than 0.001), with an odds ratio of 3.25 (P = 0.001). Stepwise multiple logistic regression identified factors that correlate with pregnancy: absence of endometriosis (P = 0.05), infertility less than 3 years' duration (P = 0.002), TMS greater than or equal to 30 X 10(6) (P = 0.005), and treatment with GIFT rather than SO-IUI (P = 0.001). These data give a first approximation of the increased efficacy of GIFT versus SO-IUI and provide valuable insight into significant confounding variables to be considered when planning a randomized, prospective trial to evaluate these techniques.
Collapse
Affiliation(s)
- C R Kaplan
- Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio 78284
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Tucker MJ, Leung CK, Leong MK, Marriott VM, Chan YM, Wong CJ, Chan HH. Routine gamete intrafallopian transfer (GIFT): a highly successful option for treatment of non-tubal infertility. ASIA-OCEANIA JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1989; 15:245-51. [PMID: 2597087 DOI: 10.1111/j.1447-0756.1989.tb00184.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Gamete intrafallopian transfer (GIFT) is increasingly accepted as a realistic alternative to in vitro fertilization (IVF), or intrauterine insemination (IUI) for treatment of non-tubal infertility. The lack of information on fertilization capacity of the gametes, the greater cost relative to IUI, and the partly unsubstantiated claims of higher success rates, caused us some concern with the readiness with which GIFT had been accepted as a standard infertility treatment. So we undertook a provisional GIFT programme with these considerations in mind, and we report on the first 91 GIFT cycles performed in our clinic. Sixty of the patients (62 cycles) treated suffered from idiopathic infertility, 12 from minimal endometriosis, 9 from male factor infertility, and 8 from ovulatory dysfunction. An initial clinical pregnancy rate of 41% (38/91) was achieved; pregnancy loss was 23% (9/38), giving a continuing pregnancy rate of 32% (29/91). Given this undeniably encouraging result, and the potential for diagnostic IVF, embryo freezing, and ovum donation with surplus oocytes collected from this GIFT programme, we now have adopted GIFT permanently as a treatment to complement our IVF and IUI programmes.
Collapse
|
45
|
Affiliation(s)
- V Gomel
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| |
Collapse
|
46
|
Leung CK, Leong MK, Chan YM, Wong CJ, Chan HH, Tucker MJ. Fallopian replacement of eggs with delayed intrauterine insemination (FREDI): an alternative to gamete intrafallopian transfer (GIFT). JOURNAL OF IN VITRO FERTILIZATION AND EMBRYO TRANSFER : IVF 1989; 6:129-33. [PMID: 2794729 DOI: 10.1007/bf01130775] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This report contains details of what is the first group of patients with nontubal infertility to undergo fallopian replacement of eggs with delayed intrauterine insemination (FREDI). Twenty-three patients suffering from idiopathic or immune infertility, polycystic ovarian disease (PCOD), or mild endometriosis underwent follicular stimulation with human menopausal gonadotropin and/or pure follicle-stimulating hormone plus human chorionic gonadotropin prior to laparoscopic pickup of eggs of varying maturity. Eggs without spermatozoa were transferred at the time of laparoscopy. Subsequent high intrauterine insemination (IUI) of washed spermatozoa at a time when egg maturation within the tubes was judged to be complete enabled a cohort of fully capacitated spermatozoa to meet fully mature eggs in a totally physiological manner. Eight clinical pregnancies arose from this group, one healthy, male infant has been delivered, and four pregnancies remain ongoing. Although based on a small population of patients, it does seem that in vivo egg maturation following replacement in the fallopian tube is an effective alternative to in vitro maturation and, with the increased control over timing of egg insemination, leads us to propose FREDI as a flexible new therapeutic approach for the treatment of nontubal infertility.
Collapse
Affiliation(s)
- C K Leung
- IVF Centre, Hong Kong Sanatorium & Hospital, Happy Valley
| | | | | | | | | | | |
Collapse
|
47
|
Chan YF, O'hoy KM, Wong A, So WK, Ho PC, Tsoi MM. Psychosocial evaluation in an IVF/GIFT program in Hong Kong. J Reprod Infant Psychol 1989. [DOI: 10.1080/02646838908403577] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
48
|
Rodriguez-Rigau LJ, Ayala C, Grunert GM, Woodward RM, Lotze EC, Feste JR, Gibbons W, Smith KD, Steinberger E. Relationship between the results of sperm analysis and GIFT. JOURNAL OF ANDROLOGY 1989; 10:139-44. [PMID: 2715102 DOI: 10.1002/j.1939-4640.1989.tb00075.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In vitro fertilization (IVF) and GIFT have been proposed as therapeutic approaches in infertile couples where a significant male factor is present. To date, few published data are available relating the success rate of GIFT to the severity of the male factor. In this report the results of the first 172 GIFT cases were analyzed. The overall pregnancy rate was 18.0%. The relationship between the occurrence of pregnancy and sperm count (millions/ml), total sperm count (millions/ejaculate), % motility, motile sperm count (millions/ml) and total motile sperm count (millions/ejaculate) were examined. Significant direct correlations were observed between the clinical pregnancy rate and sperm count, total sperm count, motile sperm count and total motile sperm count. Motile sperm count and total motile sperm count had the best correlations with clinical pregnancy rates, which were over 24.0% in groups with motile sperm counts exceeding 40 X 10(6) cells/ml or total motile sperm counts greater than 100 X 10(6)/ejaculate. The clinical pregnancy rates were 12.5% and 7.7%, respectively, for groups with motile sperm counts under 10 X 10(6)/ml and total motile sperm counts below 25 X 10(6)/ejaculate. No correlation was found between percent motile cells and pregnancy rate. Results of the sperm penetration assay using zona-free hamster eggs were available in a subpopulation of 27 patients. No significant correlation between this sperm penetration assay and pregnancy rate could be demonstrated. The incidence of chemical pregnancy showed a significant negative correlation with the total motile sperm count, indicating a higher incidence of early pregnancy wastage in cases of oligozoospermia.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
|
49
|
|
50
|
Marconi G, Auge L, Oses R, Quintana R, Raffo F, Young E. Does sexual intercourse improve pregnancy rates in gamete intrafallopian transfer? Fertil Steril 1989; 51:357-9. [PMID: 2643533 DOI: 10.1016/s0015-0282(16)60507-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- G Marconi
- Instituto de Fertilidad, Buenos Aires, Argentina
| | | | | | | | | | | |
Collapse
|