[Pregnancies obtained by oocyte aspiration, in vitro fertilization, and embryo transfer during clomid/HCG stimulated cycles (author's transl)]

Decidual cell FKBP51-progesterone receptor binding mediates maternal stress-induced preterm birth

Depression and posttraumatic stress disorder increase the risk of idiopathic preterm birth (iPTB); however, the exact molecular mechanism is unknown. Depression and stress-related disorders are linked to increased FK506-binding protein 51 (FKBP51) expression levels in the brain and/or FKBP5 gene polymorphisms. Fkbp5-deficient (Fkbp5 ^-/-) mice resist stress-induced depressive and anxiety-like behaviors. FKBP51 binding to progesterone (P4) receptors (PRs) inhibits PR function. Moreover, reduced PR activity and/or expression stimulates human labor. We report enhanced in situ FKBP51 expression and increased nuclear FKBP51-PR binding in decidual cells of women with iPTB versus gestational age-matched controls. In Fkbp5 ^+/+ mice, maternal restraint stress did not accelerate systemic P4 withdrawal but increased Fkbp5, decreased PR, and elevated AKR1C18 expression in uteri at E17.25 followed by reduced P4 levels and increased oxytocin receptor (Oxtr) expression at 18.25 in uteri resulting in PTB. These changes correlate with inhibition of uterine PR function by maternal stress-induced FKBP51. In contrast, Fkbp5 ^-/- mice exhibit prolonged gestation and are completely resistant to maternal stress-induced PTB and labor-inducing uterine changes detected in stressed Fkbp5 ^+/+ mice. Collectively, these results uncover a functional P4 withdrawal mechanism mediated by maternal stress-induced enhanced uterine FKBP51 expression and FKPB51-PR binding, resulting in iPTB.

In vitro fertilization and embryo transfer of pre-ovulatory rabbit oocytes

The objective of this study was to develop an effective and successful technique of in vitro fertilization in rabbits that could lead us to start treatment of infertile couples by using extracorporal fertilization. Pre-ovulatory oocytes were harvested from follicles of virgin does 9 h after induction of ovulation by hCG injection, and incubated with in vivo capacitated sperm for 5 h. An 82% in vitro fertilization rate was achieved. The fertilized ova were cultivated for an additional 20, 44 and 68 h, and until they reached the hatched blastocyst stage. Most of these embryos (439) were transferred to 42 pseudopregnant recipients, asynchronous in the sense that they had been given hCG injections 0, 6, 12, 18, 24, 36 and 42 h later than the rabbits from which the ova had been obtained. With this type of synchronicity implantation rates of 31, 78, 52, 33, 52, 33, 51 and 10% were achieved, respectively. One hundred and twenty-eight embryos were not transferred to recipients but cultured in Ham's F-10 medium supplemented with 20% FCS. 77% of these embryos reached the stage of hatched blastocyst. A total of 143 young were born after 28-32 days of gestation and all are fertile till the third generation. Our results were obtained in a consecutive series of experiments, and demonstrated that in vitro fertilization can be made to work quite well in the rabbit, which in the early stages of embryogenesis has sufficient similarity to the human to make it a useful model for those wishing to acquire techniques applicable to human fertilization in vitro and embryo transfer.

Experiences with the first 100 consecutive pregnancies achieved after in vitro fertilization and embryo transfer at the University Women's Hospital in Erlangen

As of March 31, 1985, 100 clinical pregnancies have been achieved since the program for extracorporeal fertilization was started in Erlangen. 531 (71%) of 768 follicular punctures resulted in an embryo transfer. The overall pregnancy rate is 13% with regard to the total number of laparoscopies and 19% with regard to the number of embryo transfer. The most effective stimulation proved to be the pure hMG regimen. Employing this protocol, we have achieved a clinical pregnancy rate after IVF and ET of 32% during the last 6 months. Oocyte recovery related to the number of patients is 97%, with laparoscopy being superior to ultrasonically guided puncture. The success rate is appreciably affected by both the number of transferred embryos and the atraumatic transfer technique. We question the rationale of supporting the luteal phase.

Bilateral tubal pregnancy following in vitro fertilization and embryo transfer

A case of bilateral tubal pregnancy resulting from in vitro fertilization and the transfer of two embryos is reported. Because the husband had retrograde ejaculation after surgical treatment of a malignant testicular tumour, cryopreserved semen was used.