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SUZUKI M. In vitro fertilization in Japan - early days of in vitro fertilization and embryo transfer and future prospects for assisted reproductive technology. PROCEEDINGS OF THE JAPAN ACADEMY. SERIES B, PHYSICAL AND BIOLOGICAL SCIENCES 2014; 90:184-201. [PMID: 24814992 PMCID: PMC4104513 DOI: 10.2183/pjab.90.184] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 02/12/2014] [Indexed: 05/30/2023]
Abstract
Assisted reproductive technology (ART) such as in vitro fertilization (IVF) and embryo transfer (ET) has been essential in the treatment of infertility. The world's first IVF-ET baby was born in 1978 based on the technique developed by Dr. Robert Edwards and Dr. Patrick Steptoe. In Japan, the first IVF-ET birth was reported in 1983 by Prof. Masakuni Suzuki at Tohoku University School of Medicine. IVF-ET is a procedure used to achieve pregnancy that consists of extracting oocytes from an infertile woman, fertilizing them in vitro, and transferring fertilized eggs into the patient's uterine cavity (Fig. 1). Since the first report of successful IVF-ET, numerous techniques related to ART, such as cryopreservation of oocytes and embryos, gamete intrafallopian transfer (GIFT), and microinsemination, have been developed and refined (Table 1). Herein we describe the history of basic research in IVF-ET that led to human applications, how the birth of the first IVF-ET baby was achieved in Japan, the current status of ART in Japan, issues related to ART, and future prospects for ART.
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Leeton J. The early history of IVF in Australia and its contribution to the world (1970-1990). Aust N Z J Obstet Gynaecol 2005; 44:495-501. [PMID: 15598283 DOI: 10.1111/j.1479-828x.2004.00305.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Although Edwards and Steptoe achieved the first IVF pregnancy and birth in 1978, the majority of pioneering developments in IVF during the eighties came from Australia. They included the world's first donor egg pregnancy, the first frozen embryo pregnancy and the first IVF multiple pregnancies. Australia also produced the first national guidelines for IVF practices, the first statute legislation protecting donor gamete pregnancies, and Victoria proclaimed the first statute legislation regarding control of IVF procedures. The reporting of the outcome of all IVF pregnancies began in 1980 as another world initiative.
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Affiliation(s)
- John Leeton
- Department of Obstetrics and Gynaecology, Monash Medical Centre, Melbourne, Victoria, Australia
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Kitamura S, Sugiyama T, Iida E, Miyazaki T, Yoshimura Y. A new hysteroscopic tubal embryo transfer catheter: development and clinical application. J Obstet Gynaecol Res 2001; 27:281-4. [PMID: 11776511 DOI: 10.1111/j.1447-0756.2001.tb01270.x] [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: 11/29/2022]
Abstract
OBJECTIVE Development and clinical application of a new hysteroscopic tubal embryo transfer catheter. METHOD Catheterization was performed in 60 patients at hysteroscopic insemination into tube, using 3 French catheters, in which the distal 3, 4, and 5 cm tapered to 2 French. Hysteroscopic tubal embryo transfer and conventional IVE-ET were performed in 30 patients with normal tubes, who failed to achieve pregnancy after 2 IVF-ET trials. RESULT The success rate of complete insertion with the catheter tapering at the distal 3 cm was significantly higher than that at the distal 5 cm. Since we obtained the highest success rate of insertion with the catheter tapering at the distal 3 cm, we selected this catheter for the h-TEST. The rate of pregnancy in h-TEST was significantly higher than that in conventional ET. CONCLUSION The h-TEST using our catheter was useful for establishing pregnancy in assisted reproduction.
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Affiliation(s)
- S Kitamura
- Department of Obstetrics and Gynecology, Ogikubo Hospital, Tokyo, Japan
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De Geyter C, De Geyter M, Meschede D, Behre HM. Assisted Fertilization. Andrology 2001. [DOI: 10.1007/978-3-662-04491-9_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kitamura S, Miyazaki T, Iwata S, Akaboshi K, Osawa Y, Yoshimura Y. Ultrastructural evaluation following catheterization of the fallopian tube with a hysteroscopic catheter. J Assist Reprod Genet 1998; 15:411-7. [PMID: 9717115 PMCID: PMC3454806 DOI: 10.1007/bf02744933] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Our purpose was to assess the morphology and ultrastructural changes in the tubal epithelium following catheterization of the fallopian tube. METHODS Fallopian tubes were obtained from 20 women who had undergone hysterectomies. Catheterization was performed in 20 tubes using a catheter developed for hysteroscopic tubal embryo transfer. The catheter has a 3-French diameter, tapering to 2 French (0.66 mm) at the tip portion. The 20 contralateral tubes served as controls and were not catheterized. Ultrastructural changes were examined by scanning electron microscopy and transmission electron microscopy. RESULTS Scanning electron microscopy showed no transformation or defects of the tubal epithelium surface in catheterized or control tubes. Transmission electron microscopy showed no significant differences in the percentage of abnormal desmosomes and the percentage of basement membrane in ciliated and nonciliated cells between catheterized and noncatheterized tubes. No transformation or defects were observed in catheterized or noncatheterized tubes. CONCLUSIONS These findings suggest that catheterization of the tube using a hysteroscopic catheter caused no acute damage to the tubal epithelium.
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Affiliation(s)
- S Kitamura
- Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo, Japan
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Abdalla HI, Billett A, Kan AK, Baig S, Wren M, Korea L, Studd JW. Obstetric outcome in 232 ovum donation pregnancies. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1998; 105:332-7. [PMID: 9532996 DOI: 10.1111/j.1471-0528.1998.tb10096.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To study the obstetric outcome of ovum donation pregnancies. DESIGN A retrospective analysis of 232 ovum donation pregnancies in the six years from 1988 to 1993. SETTING Infertility clinic in a private hospital. PARTICIPANTS All ovum donation recipients that achieved pregnancy in the clinic during the stated time period. MAIN OUTCOME MEASURES Percentages of live birth and miscarriages and ectopic pregnancies; number of sacs identified in the uterus at early (four weeks after transfer) and later scans; incidence of antepartum and postpartum haemorrhage; incidence of pregnancy-induced hypertension; incidence of preterm, low birthweight and small-for-gestational age babies; and incidence of operative deliveries. RESULTS Of 232 pregnancies, 151 babies were born (live birth rate of 20%); and 81 were lost (57 before eight weeks, 17 after eight weeks and seven ectopic pregnancies). In nine cases there were no intrauterine sacs at the early scan (two 'chemical pregnancies' and seven ectopic pregnancies). In 169 cases there was initially one intrauterine sac, ending with 102 singleton deliveries (60%); in 47 cases there were initially two intrauterine sacs, ending with 11 singleton deliveries (23%) and 32 twin deliveries (68%); in the seven cases where three sacs were identified initially, there were no singleton deliveries, three twin deliveries (one selective fetal reduction) and three triplet deliveries. Women with premature ovarian failures had a significantly higher pregnancy rate compared with those with functioning ovaries (P < 0.02). However, in the former group, the miscarriage rate was also significantly higher (P < 0.03) so that the number of term births was similar. The incidence of vaginal bleeding was 12% in the first trimester, 1.5% in the second trimester, and 2% in the third trimester. The incidence of postpartum haemorrhage was 12%. Thirty-two women had pregnancy-induced hypertension (23% of all deliveries). This occurred in 22/105 singletons (21%), 7/32 twins (22%) and in all three (100%) of the triplets. In the singleton group 13% of infants were preterm, 18% had a birthweight < 2.5 kg and 15% were < 3rd centile for birthweight at delivery (small-for-gestational age). Ovarian function was found to be the only factor that significantly influenced the incidence of small-for-gestational age babies (odds ratio 8.84; 95% confidence interval 1.1-70.0; P = 0.007). The overall operative delivery rate was 85% with the caesarean section rate being 69%. CONCLUSIONS Women who become pregnant following oocyte donation should be considered obstetrically as high risk, especially those with ovarian failure because of the increased incidence of small-for-gestational age infants in these pregnancies. They are also at higher risk of pregnancy-induced hypertension and postpartum haemorrhage.
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Affiliation(s)
- H I Abdalla
- Fertility and Endocrinology Centre, In Vitro Fertilisation Unit, Lister Hospital
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Abstract
At least one in ten couples of reproductive age is affected by infertility. Tubal disease, ovulatory defects, endometrosis and abnormal sperm physiology are the most common causes of failure to conceive. Many of these disorders can be treated successfully with surgery, ovulation induction or intrauterine insemination, but in selected cases, or where there is long-standing intractable infertility, assisted reproductive technology (ART) becomes the treatment of choice. We provide an overview of the techniques for assisted reproduction, including in vitro fertilization, gamete intrafallopian transfer and other related procedures. Indications for treatment, patient evaluation and advances in reproductive technology including embryo cryopreservation, micromanipulation and donor gametes are also reviewed.
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Affiliation(s)
- W P Hummel
- San Diego Fertility Center, Poway, CA 92064, USA
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Serour GI, Aboulghar MA, Mansour RT. Bioethics in medically assisted conception in the Muslim world. J Assist Reprod Genet 1995; 12:559-65. [PMID: 8580648 DOI: 10.1007/bf02212574] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Bibliography. Fertil Steril 1994. [DOI: 10.1016/s0015-0282(16)57141-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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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.
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Affiliation(s)
- S H Chen
- Department of Gynecology and Obstetrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland
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Patton GW, Holtz G, Edwards A, Swartz K. Transvaginal embryo transfer during the zygote intrafallopian tube transfer procedure. Am J Obstet Gynecol 1994; 171:359-63; discussion 363-4. [PMID: 8059813 DOI: 10.1016/s0002-9378(94)70035-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Our purpose was to evaluate a tactile non-ultrasonographically directed approach to transvaginal tubal cannulation and embryo transfer during the zygote intrafallopian tube transfer procedure. STUDY DESIGN We studied the application of the tactile approach to transvaginal tubal cannulation and embryo transfer in 68 consecutive zygote intrafallopian tube transfer cycles. RESULTS The tactile approach to transvaginal tubal cannulation and subsequent embryo transfer was successful in 93% of couples. Pregnancy occurred in 16 of the 63 (25%) women undergoing a successful transvaginal embryo transfer. CONCLUSION The tactile approach to transvaginal tubal cannulation was found to be easily learned and provided a safe and convenient method of tubal embryo transfer. This low-cost approach, which has application to transfer of both embryos and gametes, deserves further study.
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Affiliation(s)
- G W Patton
- Southeastern Fertility Center, Mt. Pleasant, SC 29464
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Frederick JL, Ord T, Stone SC, Balmaceda JP, Asch RH. Frozen zygote intrafallopian transfer: a successful approach for transfer of cryopreserved embryos**Presented at the 41st Annual Meeting of the Pacific Coast Fertility Society, Indian Wells, California, April 14 to 18, 1993. Fertil Steril 1994. [DOI: 10.1016/s0015-0282(16)56583-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Khastgir G, Abdalla H, Studd JW. The case against ovarian biopsy for the diagnosis of premature menopause. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1994; 101:96-8. [PMID: 8305405 DOI: 10.1111/j.1471-0528.1994.tb13071.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- G Khastgir
- Fertility and Endocrinology Centre, Lister Hospital, London
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Franco Júnior JG, Baruffi RL, Mauri AL, Pertersen CG, Campos MS, Oliveira JB. Donation of oocytes as treatment for infertility in patients with premature ovarian failure. Awarded the "Nicolau de Moraes Barros" prize for gynecology. SAO PAULO MED J 1994; 112:510-6. [PMID: 7871317 DOI: 10.1590/s1516-31801994000100008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
A total of 7 cycles of embryo transfer by oocyte donation were performed on 5 patients with premature ovary failure (POF). All donors were under 35 of age and the recipients average age was 38.6 years. For synchronization between donor and recipient a semi programmed menstrual cycle was used by means of oral contraceptive followed by ovarian stimulation of donor with clomiphene citrate and human menopausal gonadotrophin. The recipients were easily adjusted to the donors by a flexible model of gradually increasing doses of estradiol valerianate. The average number of oocytes donated was 3.14 and average embryo cleavage rate was 80.2%. The average number of embryos transferred was 2.57. Embryo implantation rate was 22.2%. Clinical gestations occurred in 57.1% of the cycles. This series is probably the first one in Brazilian literature on oocyte donation as treatment for infertility in patients with premature ovarian failure.
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Affiliation(s)
- J G Franco Júnior
- Centro de reprodução Humana da Fundação Maternidade Sinhá Juqueira, São Paulo, Brazil
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Scholtes MC, Roozenburg BJ, Verhoeff A, Zeilmaker GH. A randomized study of transcervical intrafallopian transfer of pronucleate embryos controlled by ultrasound versus intrauterine transfer of four- to eight-cell embryos. Fertil Steril 1994; 61:102-4. [PMID: 8293822 DOI: 10.1016/s0015-0282(16)56460-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To establish the value of transcervical intrafallopian transfer of zygotes and the accuracy of fallopian cannulation. DESIGN A prospective randomized study, comparing ultrasonically controlled transcervical intrafallopian transfer of zygotes with intrauterine transfer of cleaved embryos. SETTING Department of IVF of the Rotterdam Academic Hospital. PATIENTS One hundred forty-five patients with patent tubes entered the IVF program. MAIN OUTCOME MEASURE Pregnancy rates in both groups and ultrasound (US) assessment during fallopian cannulation and ET. RESULTS Transvaginal cannulation of the tube appears not to be sufficiently accurate when performed without US guidance. Catheter damage occurred in many cases. The previously reported superior implantation rate after intrafallopian transfer in comparison with intrauterine transfer could not be confirmed. CONCLUSIONS Intrauterine transfer of cleaved embryos remains the method of choice in IVF.
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Affiliation(s)
- M C Scholtes
- Department of Obstetrics and Gynecology, Academic Hospital Dijkzigt, Erasmus University Rotterdam, The Netherlands
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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.
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Affiliation(s)
- C Mastroyannis
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Friedler S, Lewin A, Schenker JG. Methodology of human embryo transfer following assisted reproduction. J Assist Reprod Genet 1993; 10:393-404. [PMID: 8019087 DOI: 10.1007/bf01228088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Abstract
OBJECTIVE To evaluate publications that introduced novel diagnostic and therapeutic transcervical procedures on the fallopian tubes. DESIGN Major studies that conceptually changed the therapeutic approach to the fallopian tubes were reviewed. Minor publications were also included if they introduced a new concept or contributed to the topic. Clinical publications were selected if they involved transcervical diagnosis and treatment of fallopian tubes. RESULTS Transcervical tubal catheterization procedures for diagnosis of tubal disease, tubal obliteration, tubal recanalization, and tubal medication are minimally invasive procedures that can improve our understanding and diagnostic accuracy of tubal disease. These procedures allow transcervical treatment of proximal tubal occlusion. Further improvements in equipment and methodology are promising. Transcervical tubal occlusion, gamete and embryo deposition, and treatment of ectopic pregnancy may all be performed using the transcervical approach. CONCLUSION Transcervical tubal catheterization can replace microsurgery and IVF in selected patients with proximal tubal occlusion, improve the diagnostic accuracy of tubal disease, and deliver medications to the fallopian tubes. Cumulative knowledge suggests that transcervical tubal catheterization should become a universally accepted, taught, and practiced approach in the diagnosis and treatment of the fallopian tubes.
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Affiliation(s)
- F Risquez
- Centro Medico Docente La Trinidad, Caracas, Venezuela
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Seracchioli R, Maccolini A, Porcu E, Borini A, Cattoli M, Ciotti P, Violini F, Flamigni C. The role of gamete intrafallopian transfer (GIFT) and tubal embryo transfer (TET) in the treatment of patients with patent tubes associated with male infertility factor. J Assist Reprod Genet 1993; 10:266-70. [PMID: 8130431 DOI: 10.1007/bf01204940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE The relative effectiveness of gamete intrafallopian transfer (GIFT) and tubal embryo transfer (TET) combined with superovulation in the treatment of infertile patients with patent tubes were compared. Four hundred fifty consecutive cycles were divided into two periods. During the first period (216 cycles), the only technique employed was GIFT, couples being divided into two groups: group A, couples with normospermic partners (118 cycles); and group B, couples with male infertility factor (98 cycles). During the second period (234 cycles), 140 cycles of GIFT were performed in couples with normospermic partners (group C). TET was utilized in 94 cycles (group D), in the case of couples with male infertility factor. RESULTS Results demonstrate that the pregnancy rate with GIFT in the case of oligoasthenospermic partners (group B) is significantly lower than that of normospermic partners (groups A and C) (P = 0.0001) and than that with TET in the case of oligoasthenospermic partners (group D) (P = 0.0001). CONCLUSION The implantation rate is also significantly different between these groups (B vs A, P = 0.0001; B vs C, P = 0.0001; B vs D, P = 0.01).
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Affiliation(s)
- R Seracchioli
- Department of Obstetrics and Gynaecology, University of Bologna, Italy
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Yang YS, Melinda S, Ho HN, Hwang JL, Chen SU, Lin HR, Huang SC, Lee TY. Effect of the number and depth of embryos transferred and unilateral or bilateral transfer in tubal embryo transfer (TET). J Assist Reprod Genet 1992; 9:534-8. [PMID: 1299386 DOI: 10.1007/bf01204250] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Our purpose was to evaluate the possible effects of the number of embryos transferred, the depth of embryos placed within the tube(s), and unilateral or bilateral tubal transfer on pregnancy initiation in tubal embryo transfer (TET). METHODS One hundred eight consecutive TET cycles were analyzed. Oocyte retrievals were carried out by transvaginal ultrasound-guided aspiration of follicles. Forty-eight hours after oocyte retrieval, the developing embryos at the stage of two to four cells were transferred into the fallopian tube(s) by laparoscopy. A maximum of four embryos was transferred to each patient. RESULTS The pregnancy rates were similar among the cycles in which two, three, or four embryos were transferred. In addition, there was no significant difference in the pregnancy rate whether the embryos were deposited > 4 cm or between 3 and 4 cm into the tube(s). Although the pregnancy rate was greater in cycles of bilateral tubal transfer, the difference from that of unilateral transfers was not significant. CONCLUSION Our data indicate that when two to four embryos were transferred and the embryos were placed > or = 3 cm within the tube(s), unilateral or bilateral tubal transfer had little influence on the ultimate success of TET.
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Affiliation(s)
- Y S Yang
- Department of Obstetrics and Gynaecology, College of Medicine, National Taiwan University, Taipei, R.O.C
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Würfel W, Haas-Andela H, Krüsmann G, Rothenaicher M, Hirsch P, Kwapisz HK, Haas J, Högemann I, Fiedler K. Prenatal diagnosis by amniocentesis in 82 pregnancies after in vitro fertilization. Eur J Obstet Gynecol Reprod Biol 1992; 44:47-52. [PMID: 1534056 DOI: 10.1016/0028-2243(92)90312-m] [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: 12/27/2022]
Abstract
We report on the outcome of 82 amniocenteses (AC) carried out during pregnancies after in vitro fertilization (IVF) from 1-1-1985 to 31-12-1989. The main indication for amniocentesis was a maternal age of greater than or equal to 35 years. In 48 cases, we found an anterior placenta and assumed that this was related to the position in which the uterine embryo transfer was performed. In six pregnancies, we found an abnormal karyotype, including two cases of trisomy 21; the two couples decided for abortion. Four aberrations in the fetal karyotypes were also present in either the mother or the father, the resulting children are healthy. The further course of pregnancies after IVF and AC was characterized by a higher incidence of toxemia, uterine bleeding before the 28th week of gestation, abruptio placentae, and premature deliveries, when compared to the course of pregnancies after spontaneous conception. We believe that these occurrences were not caused by AC, as the incidence was higher in all our pregnancies after IVF (without AC) and has also been reported in pregnancies after ovarian hyperstimulation without IVF. Therefore, we see no reason to renounce AC after IVF. However, the special risks inherent in pregnancies after IVF must always be discussed with the couple.
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Affiliation(s)
- W Würfel
- Frauenklinik Dr. Krüsmann, Munich, FRG
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Letur-Konirsch H. [Infertility in a couple. Focus on the different techniques of medically assisted procreation]. Rev Med Interne 1992; 13:135-41. [PMID: 1410887 DOI: 10.1016/s0248-8663(05)82197-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In view of the advent of effective medically assisted procreation (MAP) techniques, it is now more necessary than ever to use the most strict and systematized methods in the management of couples who consult for infertility. The authors present the modalities of this management and review the present MAP techniques which are all based on bringing together the gametes in an optimal environment conditioned by the clinical situation of the couple. The main results obtained are presented under the headings: percentage of success, multiple pregnancies prevention policy and future of the children.
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Affiliation(s)
- H Letur-Konirsch
- Service de Gynécologie-Obstétrique, Hôpital Antoine Béclère, Clamart
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Robinson D, Syrop CH, Hammitt DG. After superovulation-intrauterine insemination fails: the prognosis for treatment by gamete intrafallopian transfer/pronuclear stage transfer. Fertil Steril 1992; 57:606-12. [PMID: 1740206 DOI: 10.1016/s0015-0282(16)54908-5] [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: 12/28/2022]
Abstract
OBJECTIVE To determine the prognosis for gamete intrafallopian transfer (GIFT)/pronuclear stage transfer (PROST) treatment after prior superovulation-intrauterine insemination (IUI). DESIGN Matched, retrospective. SETTING Outpatient university endocrine-infertility program. PATIENTS, PARTICIPANTS One hundred forty-four women matched for infertility factors and age were studied according to the following three treatment groups: superovulation-IUI only, GIFT/PROST only, or GIFT/PROST after superovulation-IUI. MAIN OUTCOME MEASURES Per cycle and cumulative pregnancy rates (PRs) were compared utilizing life table analysis. RESULTS Cumulative PRs (0.408) for superovulation-IUI only were lower than initial (0.469) and cumulative (0.802) cycle fecundity of GIFT/PROST (P = 0.002). Per cycle and cumulative PRs did not differ between GIFT/PROST only versus GIFT/PROST after superovulation-IUI. CONCLUSIONS Gamete intrafallopian transfer/PROST may be cost-effective when compared with superovulation-IUI. The prognosis for GIFT/PROST success is not negatively affected by earlier superovulation-IUI treatment failure.
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Affiliation(s)
- D Robinson
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City 52242-1009
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Balmaceda JP, Alam V, Roszjtein D, Ord T, Snell K, Asch RH. Embryo implantation rates in oocyte donation: a prospective comparison of tubal versus uterine transfers. Fertil Steril 1992; 57:362-5. [PMID: 1735489 DOI: 10.1016/s0015-0282(16)54846-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To compare pregnancy and implantation rates in tubal and uterine transfers during a hormonal replacement cycle in an oocyte donation program. DESIGN Prospective randomized. PATIENTS Forty-two consecutive patients who entered an oocyte donation program. INTERVENTIONS Twenty-two patients were assigned for uterine transfer and 20 for tubal embryo transfer (ET). RESULTS Twenty-three pregnancies were achieved, 12 (54.5%) after uterine transfers and 11 (57.9%) after tubal transfers. Implantation rates in both groups are not significantly different (17.4% uterine transfers versus 21.5% tubal ETs). CONCLUSIONS Our results suggest that in hormonal replacement cycles (uniform endometrial stimulation) there is no advantage in transferring embryos to the fallopian tube. Furthermore, embryo quality and endometrial receptivity appear to be significantly more important than the time of entrance of an embryo to the uterine cavity in determining its chances of implantation.
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Affiliation(s)
- J P Balmaceda
- Division of Reproductive Endocrinology and Infertility, University of California, Irvine, Orange
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27
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Abyholm T, Tanbo T, Dale PO, Magnus O. In vivo fertilization procedures in infertile women with patent fallopian tubes: a comparison of gamete intrafallopian transfer, combined intrauterine and intraperitoneal insemination, and controlled ovarian hyperstimulation alone. J Assist Reprod Genet 1992; 9:19-23. [PMID: 1617244 DOI: 10.1007/bf01204109] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This prospective study was undertaken to evaluate the relative efficacy of three in vivo methods of assisted fertilization in 150 infertile women with patent fallopian tubes: gamete intrafallopian transfer (GIFT), combined intrauterine and direct intraperitoneal insemination (IUI+DIPI), and controlled hyperstimulation (COHS) alone. The clinical pregnancy rate was highest in the IUI/DIPI and GIFT groups: IUI/DIPI, 29.3%; GIFT, 28.6%; and COHS, 8.9%. We believe that controlled ovarian hyperstimulation combined with IUI and DIPI is a good alternative to GIFT.
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Affiliation(s)
- T Abyholm
- Department of Obstetrics and Gynecology, National Hospital, University of Oslo, Norway
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28
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Yang YS, Hwang JL, Ho HN, Lien YR, Lin HR, Chiu YH, Lee TY. Translaparoscopic tubal embryo transfer: preliminary experience at National Taiwan University Hospital. ASIA-OCEANIA JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1991; 17:255-9. [PMID: 1953437 DOI: 10.1111/j.1447-0756.1991.tb00270.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Forty-six couples with various causes of infertility were treated by tubal embryo transfer. Oocyte retrievals were carried out under ultrasound guidance transvaginally and embryos were transferred 48 hours later by laparoscopy into fallopian tubes. Totally 52 cycles were stimulated and 45 retrievals were performed with an average of 8.1 oocytes per retrieval. The average fertilization rate was 54.8%. The implantation rate was 23.8% and the pregnancy rate was 53.5% per transfer. The pregnancy rate per transfer was comparable whether 3 or 4 embryos were transferred. Nine (39.1%) of the 23 pregnancies had multiple pregnancies. Six cases (26.1%) aborted in the first trimester and the remaining 17 were ongoing or term delivery.
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Affiliation(s)
- Y S Yang
- Department of Obstetrics and Gynecology, Medical College, Taipei, Taiwan, ROC
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29
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Bongers MY, Bernardus RE, Schoemaker J, Vermeiden JW. Peritoneal oocyte and sperm transfer: a prospective pilot study. Fertil Steril 1991; 56:147-8. [PMID: 2065796 DOI: 10.1016/s0015-0282(16)54436-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- M Y Bongers
- Department of Obstetrics and Gynecology, Free University Hospital, Amsterdam, The Netherlands
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30
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Bauer O, Diedrich K, van der Ven H, al-Hassani S, Krebs D. The transvaginal intratubal transfer. A new treatment in male infertility. Ann N Y Acad Sci 1991; 626:467-7. [PMID: 2058967 DOI: 10.1111/j.1749-6632.1991.tb37939.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- O Bauer
- Medizinische Einrichtungen der Rheinischen, Friedrich-Wilhelms-Universität Bonn, Germany
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31
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Capitanio GL, Ferraiolo A, Croce S, Gazzo R, Anserini P, de Cecco L. Transcervical selective salpingography: a diagnostic and therapeutic approach to cases of proximal tubal injection failure. Fertil Steril 1991; 55:1045-50. [PMID: 2037102 DOI: 10.1016/s0015-0282(16)54350-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Evaluation of selective salpingography for diagnosis and treatment of tubal injection failure during hysterosalpingography (HSG). DESIGN Prospective study. SETTING Obstetrics and Gynecology Department, University of Genoa (Italy)--tertiary care. PATIENTS One hundred eighty infertile women with unilateral or bilateral proximal tubal injection failure during HSG were submitted to the procedure. INTERVENTION Under fluoroscopy, a 4.5-F nylon catheter (3-F tip) was inserted into the ostium with or without the aid of a J-shaped, coaxial, angiographic guide wire, and 2 to 3 mL of contrast medium were injected. The procedure lasts 20 to 30 sec/tube. MAIN OUTCOME MEASURES Of 155 tubal ostia, 145 (94.2%) were catheterized. RESULTS Of the 146 catheterized tubes, 110 (75%) were rendered patent. Of the others, 21 (14.3%) presented hydrosalpinx or distal obstructions, and isthmic obstruction was present in 5 (3.4%). Patency of at least one tube was achieved in 82 (81.2%) of the 101 catheterized women; 8 conceived spontaneously and 11 after gamete intrafallopian transfer to the recanalized tube. CONCLUSIONS During HSG, selective salpinography can be performed when proximal injection failure is observed to determine its cause or to restore patency.
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Affiliation(s)
- G L Capitanio
- Istituto di Ginecologia ed Ostetricia, Ospedale SS. Annunziata, Chieti, Italy
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32
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Affiliation(s)
- R Sayegh
- University of Pennsylvania School of Medicine, Philadelphia 19104-4283
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33
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The first attempt at IVF treatment. Results and requirements for a satisfactory success rate. Eur J Obstet Gynecol Reprod Biol 1991; 38:125-32. [PMID: 1995381 DOI: 10.1016/0028-2243(91)90189-r] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The purpose of this study was to report the success rate of the first IVF treatment in 161 patients who attended our department in 1988. The indications for IVF were tubal damage in 84 couples (52.1%), unexplained infertility and endometriosis (with patent tubes) in 61 couples (37.9%), and polycystic ovarian syndrome in 16 couples (10%). Clinical pregnancies were diagnosed in 40 patients, giving an overall clinical pregnancy rate of 35.4% per embryo transfer. In the group of patients with unexplained infertility or endometriosis one in three of the embryo transfer cycles will predictably result in a birth, one in four in the group of patients with tubal damage or polycystic ovarian syndrome. These results invite discussion of the possible reasons for the success of our IVF program.
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34
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al-Shawaf T, Serhal P, Fiamanya W, Harper J, Craft I. Transfallopian tube embryo transfer: successful pregnancy outcome. JOURNAL OF IN VITRO FERTILIZATION AND EMBRYO TRANSFER : IVF 1990; 7:337-40. [PMID: 2077087 DOI: 10.1007/bf01130586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A case of partial Asherman syndrome and blocked fallopian tube following complication of cesarean section is presented. Two IVF-ET attempts failed where difficulty at uterine embryo transfer was encountered. Transtubal embryos transferred 48 hr after transvaginal oocyte collection and in vitro fertilization resulted in an in utero pregnancy and delivery.
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35
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Abstract
Zygote intrafallopian transfer (ZIFT) was used as a treatment for long-standing nontubal infertility for a 2-year period. The overall clinical pregnancy rate for 114 tubal transfers was 40.4% with a delivery/ongoing rate of 34.2%. Concurrent use of in vitro fertilization and embryo transfer (IVF-ET) for tubal factor infertility gave significantly lower clinical pregnancy and delivery/ongoing rates (21.1% and 15.8%, respectively). The use of gamete intrafallopian transfer (GIFT) for nontubal infertility yielded a 32% clinical pregnancy rate and a 26% delivery rate for 53 transfers. Zygote intrafallopian transfer resulted in an implantation rate per zygote of 17% overall compared with 8.1% per embryo for IVF-ET and 11.2% per oocyte for GIFT. The transfer of three zygotes per patient gave the same clinical pregnancy rate as the transfer of four while reducing the incidence of multiple gestation from 19% to 7.8% per transfer. No significant decline in the clinical pregnancy or delivery rate was seen with ZIFT in women aged 25 through 39.
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36
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Rotsztejn DA, Remohi J, Weckstein LN, Ord T, Moyer DL, Balmaceda JP, Asch RH. Results of tubal embryo transfer in premature ovarian failure. Fertil Steril 1990; 54:348-50. [PMID: 2379637 DOI: 10.1016/s0015-0282(16)53717-0] [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: 12/31/2022]
Abstract
The transfer of embryos generated in vitro to the fallopian tubes in 11 cases of premature ovarian failure resulted in 9 clinical pregnancies. This approach may have theoretical advantages over GIFT and IVF-ET in agonadal patients.
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Affiliation(s)
- D A Rotsztejn
- Department of Obstetrics and Gynecology, University of California, Irvine, Orange 92668
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37
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Scholtes MC, Roozenburg BJ, Alberda AT, Zeilmaker GH. Transcervical intrafallopian transfer of zygotes. Fertil Steril 1990; 54:283-6. [PMID: 2199230 DOI: 10.1016/s0015-0282(16)53704-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Reportedly, gamete intrafallopian transfer and zygote intrafallopian transfer are successful methods in assisted conception. This pilot study describes the experiences and results of a recently developed technique of vaginal transcervical intrafallopian transfer. In a group of 38 women with unexplained infertility, oocytes were retrieved. In 25 patients, pronucleate embryos were transferred to the fallopian tubes. A positive pregnancy test was reported in 8 cases. Considerations pertaining to this method and technical implications are discussed.
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Affiliation(s)
- M C Scholtes
- Department of Obstetrics and Gynecology, Academic Hospital Rotterdam-Dijkzigt, The Netherlands
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38
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Pool TB, Martin JE, Ellsworth LR, Perez JB, Atiee SH. Zygote intrafallopian transfer with "donor rescue": a new option for severe male factor infertility. Fertil Steril 1990; 54:166-8. [PMID: 2358083 DOI: 10.1016/s0015-0282(16)53656-5] [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: 12/31/2022]
Abstract
Clinical pregnancies have been initiated by ZIFT using zygotes produced by reinsemination of oocytes with donor sperm ("donor rescue") after an initial 15- to 20-hour exposure to husband's sperm. A total of 54 oocytes from four couples experiencing failed fertilization by husband's sperm were reinseminated with donor sperm, resulting in 38 zygotes (70.4% fertilization). Four zygotes were transferred during ZIFT in each case and resulted in two (50%) continuing pregnancies. Additional zygotes from donor reinsemination were cryopreserved for each couple. Donor rescue expands the utility of ZIFT as a treatment for male factor infertility.
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Affiliation(s)
- T B Pool
- Southwest Texas Methodist Hospital, San Antonio
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39
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Jequier AM, Cummins JM, Gearon C, Apted SL, Yovich JM, Yovich JL. A pregnancy achieved using sperm from the epididymal caput in idiopathic obstructive azoospermia. Fertil Steril 1990; 53:1104-5. [PMID: 2351233 DOI: 10.1016/s0015-0282(16)53597-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- A M Jequier
- PIVET Medical Centre, Leederville, Perth, Western Australia
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40
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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.
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Affiliation(s)
- J L Yovich
- PIVET Medical Centre, Perth, Western Australia
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41
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Yovich JM, Edirisinghe WR, Cummins JM, Yovich JL. Influence of pentoxifylline in severe male factor infertility. Fertil Steril 1990; 53:715-22. [PMID: 2180749 DOI: 10.1016/s0015-0282(16)53470-0] [Citation(s) in RCA: 128] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Two in vitro fertilization sperm preparation protocols using pentoxifylline (long and short exposure before insemination) were studied in 57 couples (61 cycles) with male factor infertility. For each cycle, oocytes were divided into two groups for insemination using either pentoxifylline-treated or control semen. Fertilization rates improved over controls in the short protocol (P less than 0.001) and fewer couples experienced fertilization failure (P = 0.02). Sixteen pregnancies ensued (30% per collection with the short protocol), and 4 were from cases with less than 1.0 X 10(6) progressively motile sperm count per milliliter, 1 being as low as 0.2 X 10(6) progressively motile count per milliliter. Seventeen healthy infants have now delivered and pregnancy wastage is not increased. Pentoxifylline is thus a useful sperm treatment for cases of male factor infertility.
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Affiliation(s)
- J M Yovich
- PIVET Medical Centre, Leaderville, Perth
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42
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al-Shawaf T, Ah-Moye M, Junk S, Brinsden P, Craft I. Fertilization of supernumerary oocytes following gamete intrafallopian transfer (GIFT): correlation with outcome of GIFT treatment. JOURNAL OF IN VITRO FERTILIZATION AND EMBRYO TRANSFER : IVF 1990; 7:98-102. [PMID: 2358733 DOI: 10.1007/bf01135582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In the course of 280 consecutive gamete intrafallopian transfer (GIFT) attempts, supernumerary oocytes in excess of those transferred were inseminated in vitro. Pregnancy resulted in 31.1% of patients following the GIFT treatment. The overall in vitro fertilization (IVF) rate of supernumerary oocytes was significantly higher in those who became pregnant (41.2%) than in patients who did not (34.9%). However, the failure to fertilize any supernumerary oocytes was not significantly different between those becoming pregnant (27.6%) and those in whom the treatment failed (37.3%). Failure to fertilize any supernumerary oocytes in vitro was of a higher rate if suboptimal sperm preparation was used or if only one oocyte was left over for in vitro insemination following the GIFT treatment. We concluded that the in vitro fertilization rate was higher in the pregnant group, but the total failure to fertilize or the fertilization of any supernumerary oocytes does not predict the outcome of GIFT. Embryos resulting following fertilization of excess oocytes may be cryopreserved for subsequent use.
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Affiliation(s)
- T al-Shawaf
- Fertility and IVF Unit, Humana Hospital Wellington, London, England
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43
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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
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44
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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.
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Affiliation(s)
- H Fakih
- Saginaw Cooperative Hospital, Inc., Michigan 48602
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45
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Ng SC, Bongso A, Sathananthan H, Ratnam SS. Micromanipulation: its relevance to human in vitro fertilization. Fertil Steril 1990; 53:203-19. [PMID: 2404802 DOI: 10.1016/s0015-0282(16)53267-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- S C Ng
- Department of Obstetrics and Gynaecology, National University of Singapore
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46
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47
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Bustillo M, Schulman JD. Transcervical ultrasound-guided intrafallopian placement of gametes, zygotes, and embryos. JOURNAL OF IN VITRO FERTILIZATION AND EMBRYO TRANSFER : IVF 1989; 6:321-4. [PMID: 2699485 DOI: 10.1007/bf01138769] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- M Bustillo
- Genetics & IVF Institute, Fairfax, Virginia 22031
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48
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49
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Abdalla HI, Baber RJ, Kirkland A, Leonard T, Studd JW. Pregnancy in women with premature ovarian failure using tubal and intrauterine transfer of cryopreserved zygotes. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1989; 96:1071-5. [PMID: 2804010 DOI: 10.1111/j.1471-0528.1989.tb03383.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Twenty-nine women, mean age 36.3 (SD 5.5) years, with premature ovarian failure received donated ova on an ovum donation programme. Three had Turner's syndrome, four a surgical menopause, one a chemotherapy-induced menopause and 21 had idiopathic premature ovarian failure. All donated oocytes were fertilized with frozen-thawed spermatozoa from the recipient's partner, and the resulting zygotes were frozen until transfer had been arranged. Overall, 19 women had intrauterine embryo transfer (ET) and a mean of 2.7 (SD 0.9) embryos were transferred on 20 occasions; 10 women underwent zygote intrafallopian transfer (ZIFT) and a mean of 3.5 (SD 0.5) zygotes were transferred on 10 occasions. Both groups were matched for age. The pregnancy rate per transfer was 20% in the ET group and 40% in the ZIFT group. After excluding the 10 women in the ET group who had fewer than three embryos transferred, the pregnancy rates were similar in the two groups, 30% in the ET group and 40% in the ZIFT group. Cryopreserved embryos may be used for ovum donation to preserve anonymity and still show a high pregnancy rate of at least 30% per transfer.
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Affiliation(s)
- H I Abdalla
- Lister Fertility and Endocrinology Centre, Lister Hospital, London
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50
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Devroey P, Staessen C, Camus M, De Grauwe E, Wisanto A, Van Steirteghem AC. Zygote intrafallopian transfer as a successful treatment for unexplained infertility. Fertil Steril 1989; 52:246-9. [PMID: 2666176 DOI: 10.1016/s0015-0282(16)60850-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This study describes the zygote intrafallopian transfer treatment in patients with unexplained infertility. After retrieval, the oocytes were inseminated with 80,000 progressive motile sperm cells per milliliter. If fertilization occurred, a maximum of three zygotes were replaced by laparoscopy in the fimbrial end of one healthy fallopian tube. A pregnancy rate of 48.1% per zygote intrafallopian transfer replacement was obtained. Seventeen pregnancies are actually ongoing, two patients delivered, and seven patients miscarried. Even after replacing a maximum of three zygotes, there were 6 twin and 2 triplet pregnancies.
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Affiliation(s)
- P Devroey
- Center for Reproductive Medicine, Vrije Universiteit Brussel, Belgium
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