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Query: UMLS:C0021359 (infertility)
 26,075 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Luteal function, endometrial receptivity, endometrial prolactin and glycoprotein secretions, blastocyst-secreted immunomodulant factors and embryo quality are nowadays considered the main determinants involved in embryo implantation control. The endometrial factors are progesterone-dependent. Out of 128 cycles of ART (AIH-IU, GIFT, IVF-ET), performed in 67 women at the Dept. of Obstetrics and Gynaecology of Parma during the period 1986-1991, 31 conceptions were obtained (pregnancy rate: 24.21%), 7 of which miscarried (abortion rate: 22.58%). According to these data, ART high abortion rate is possibly connected with poor luteo-endometrial function and poor embryo quality. Controlled ovarian hyperstimulation is thought to inhibit embryo implantation after IVF-ET by decreasing endometrial receptivity. Such a situation can be treated either by exogenous progesterone administration or by tubal techniques (GIFT, TET) performed in non-tubal infertility. Both strategies showed to better endometrial receptivity. A delayed intrauterine embryo transfer at blastocyst stage, when cocultures allow to, is supposed to raise the implantation rate in tubal infertility by enhancing embryo selection and endometrial receptivity. This paper also reports preliminarily on the predictive value of beta-HGC and estradiol levels, as well as of endometrial thickness, on early pregnancy outcome.
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PMID:Endocrine abortion in assisted reproduction technologies (ART). 134 Jun 56

Intrafollicular insemination is a promising new development that may have a major impact on ART, notably in the treatment of male factor infertility. Reported is the first successful intrafollicular insemination in the United States and the first successful intrafollicular insemination for male factor infertility. Although the results are encouraging, further investigations are currently underway to critically evaluate intrafollicular insemination.
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PMID:Intrafollicular insemination for male factor infertility. 163 20

Controlled ovarian hyperstimulation was given to a study group consisting of male factor, endometriosis, and unexplained infertility. The aim of the study was to determine whether COH might be of value for such couples in a setting lacking ART facilities. When compared with their own spontaneous cycles or with a control group (untreated but scanned), COH proved significantly better for unexplained infertility. However, COH was not significantly effective for male factor infertility. This study shows that COH should be offered routinely in general hospitals to couples on long-term waiting lists for ART (especially those facing enforced expectant management).
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PMID:Controlled ovarian hyperstimulation: an adjunct to assisted reproductive technology. 819 34

Each year, thousands of pregnancies are achieved worldwide by in vitro fertilization (IVF) and its modifications, commonly grouped under the general term "assisted reproductive techniques" (ARTs). The IVF program at the University of Southern California (USC) was among the first to be established in the United States and had the distinction of achieving success, in 1981, with the first IVF infant to be born on the West Coast. This paper discusses patient selection, superovulation techniques, methods of follicle aspiration, sperm preparation, embryo transfer procedures and management of the luteal phase of ART cycles. The various ARTs are described, as are the expected success rates. Particular emphasis is placed on the techniques of oocyte donation and unstimulated IVF, both of which play prominent roles in the treatment of infertility in the USC program.
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PMID:In vitro fertilization and other assisted reproductive techniques. 850 32

Freezing of the human embryos has been routinely used in the world for over 10 years in the treatment of infertility by the ART. Excessive fertilized oocytes and embryos can be frozen and preserved in the temperature of liquid nitrogen. The risk of multiple pregnancies is reduced and enhancement of pregnancy rates can be obtained owing to cryopreservation. The author presents theoretical principles of embryo freezing by slow cooling with 1, 2 propanediol and saccharose as a cryoprotectant.
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PMID:[Cryopreservation of embryos--used for treatment of infertility by means of assisted reproductive techniques (ART)]. 892

The human genome project will result in many new diagnostic techniques applicable to assisted reproduction. These may be directed both at infertile patients as well as at patients who seek ART because they carry a deleterious genetic disease. There are many potential advantages to the use of preprocedural testing as a means of obtaining additional preliminary information that might allow patients to make a more informed choice, either when deciding between ART and adoption or when comparing the benefits of various ART procedures. The cost of testing is relatively low when compared with the cost of additional IVF or ICSI cycles. In the case of genetic screening protocols, the results may be useful not only to the patient but also to the next generation. Genetic counseling should be made available in concert with expanded opportunities, both for diagnosing infertility and for making preimplantation genetic diagnoses. Already some of the genetic screening that has occurred because of discoveries made during the human genome initiative has become a regulatory concern with regard to insurance availability and other issues. When counseling patients, it is important to point out that certain tests hold far more prognostic value and/or serious health implications than others. A test to diagnose breast cancer susceptibility, for example, holds more serious ramifications than the less predictive test that detects the phenotype for Klinefelter's syndrome. Presymptomatic prognostic screening systems, such as the tests currently used to detect genetic mutations related to breast and prostate cancer and cystic fibrosis, provide diagnostic clues but also have serious societal implications. We are on a rather slippery slope when we attempt to determine which tests actually might prove beneficial to patients, both individually and collectively. Therefore, as part of patient counseling, cost-benefit ratios, in addition to clinical and preventive implications, should be weighed.
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PMID:Panel One: marketing strategies and informing the patient/consumer. Infertility diagnostic techniques: the rush to market. 920 65

Although ART offers important options for the treatment of infertility, the decision to use ART involves many factors in addition to success rates. Going through repeated ART cycles requires substantial commitments of time, effort, money, and emotional energy. Couples and individuals considering ART should carefully examine all related financial, psychologic, ethical, and medical issues before beginning treatment. They should also contact ART clinics to discuss their specific medical situation and potential for success using ART. The next published report will feature 1996 data and provide a listing of clinics that did not submit data. Eventually, the annual report will include information from all U.S. fertility clinics, not just those that are SART members.
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PMID:1995 assisted reproductive technology success rates: national summary and fertility clinic report. 958 Sep 8

The association between endometriosis and infertility is well established, and different mechanisms have been postulated to cause infertility depending on the stage of endometriosis. Controlled ovarian hyperstimulation improves pregnancy outcome for minimal to mild endometriosis; however, there are no randomized controlled studies of this technique in patients with severe disease. Further, ART appears to have an overall beneficial effect for all stages of endometriosis. Based on the current staging system, several studies have not been able to demonstrate a significant difference in true outcomes for different stages of the disease. The limitations of these studies have been discussed above. Similarly, the effect of endometriomas when considered independent of the stage is still unclear. In addition to ART, pretreatment with GnRH analogues or surgical intervention may be beneficial and needs to be addressed in randomized controlled studies. It is evident that we urgently need large randomized studies to answer several questions about the treatment of endometriosis-associated infertility with ART. Although our current practice is based primarily on retrospective observational studies and small randomized studies, the overall impact on pregnancy outcome is beneficial.
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PMID:Endometriosis and assisted reproductive technologies. 1045 78

The presence of ZP autoantibodies in serum and Ffl samples of 109 women attending the ART Center in Kiev was investigated using IIF and ELISA. Positive serum and Ffl samples examined by both methods were found in 20 (18.34%) and in 19 (17.43%) patients respectively; 31 (28.44%) serum samples and 33 (30.27 %) Ffl samples analyzed by IIF were positive; of the samples analyzed by ELISA 21 (19.26%) and 20 (18.34%), respectively, were positive. No relationship was found between ZP autoantibody incidence and the type and cause of infertility. A significant prevalence of ZP autoantibodies detected by ELISA in Ffl was found in patients with fertilization failure (39.13%) and with low fertilization rate (42.85%) when compared to patients with middle fertilization rate (5.71%) and high fertilization rate (8.1%). The clinical significance of ZP autoantibodies in Ffls for in vitro fertilization outcome was suggested.
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PMID:Zona pellucida autoantibodies in women undergoing ART. 1073 35

As we have entered into the new millennium, it is difficult not to recognize ART as one of the most dynamic and rapidly emerging fields in all of medicine. What began as an experimental procedure in animals has developed into a multidisciplinary technology. A great debt is owed to the field of animal husbandry. In humans, implantation is inefficient and has been recognized as the rate-limiting step in reproduction. In vitro fertilization has allowed the observation of human gamete interaction in the laboratory. A milestone was reached when ART allowed couples with infertility to have success rates that exceeded those associated with normal human fecundity. Continued innovations are improving the rate of embryonic implantation. Blastocyst transfer will have a major role in the future of ART. It is common for the couple with infertility to battle their problem by increasing the frequency of intercourse because it is the only weapon at their disposal. So, too, did clinicians increase the number of embryos transferred to the uterus. New developments promise to challenge the long-held contention that successful IVF/embryo transfer is positively correlated with the number of oocytes retrieved or the number of embryos transferred. More accurate reporting will enable us to measure the impact of technologic improvements that improve implantation rates and decrease multiple gestations. The future holds the promise of some tangible goals. The development of in vitro maturation of immature oocytes could lead to an era in which oocytes are harvested without the need for controlled ovarian hyperstimulation. This would provide for the possibility of the banking of gametes. Women could preserve or store their fertility at a young age in a manner similar to that which has been possible for men for decades. They could avoid the increased risk for aneuploidy seen with the age of 35, and theoretically, they should have a lower risk for miscarriage. The future is near. One day, ART will be perfected so that a single embryo transfer will be the standard of care. Soon it will be possible to know all about the genetic makeup of that embryo and it will be routinely selected from its cohort by virtue of those genetic traits.
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PMID:An appreciation of modern ART. 1110 Mar 8


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