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

A total of 512 consecutive patients with tubal infertility underwent ovarian hyperstimulation for the purpose of IVF-ET, resulting in a total of 829 attempts and 890 transfers (fresh and cryo). Overall, 218 clinical pregnancies were achieved, of which 114 (52.3%) resulted in live births, and 38 (17.4%) were ongoing (greater than or equal to 20 weeks of gestation) at the conclusion of the study. The total live birth and ongoing pregnancy rate per patient was 29.7% (three patients conceived twice). The probability for a patient to achieve a live or ongoing pregnancy was 42.7% after three attempts and 85.3% after six attempts. We conclude that IVF-ET using contemporary technology offers an effective alternative to surgery for tubal obstruction.
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PMID:In vitro fertilization: effective alternative to surgery for distal tubal occlusion. 200 35

Empirical therapy for subfertility using assisted reproductive technologies recently has gained popularity; however, the cost-effectiveness of these therapies, compared with an untreated control group, has not been established. Similarly, there has been no comparative cost analysis of the utility of controlled ovarian hyperstimulation and IUI in the management of the same condition. Significant PRs in untreated couples with subfertility mandate the design and execution of controlled trials to ascertain the role of controlled ovarian hyperstimulation and IUI in infertility therapy. Various disorders of subfertility have been treated with controlled ovarian hyperstimulation and IUI. The rationale for this therapy is the increase in gamete density at the site of fertilization, as with GIFT and IVF when used for management of the same problems. The live birth rate per initiated cycle and risk of complications are similar to results recently reported for GIFT and IVF. The utility of controlled ovarian hyperstimulation and IUI still remains controversial. When the relatively low direct and indirect costs of controlled ovarian hyperstimulation and IUI are considered, acknowledging the lack of prospective, controlled studies, this procedure appears to be at least as cost-effective as GIFT and IVF.
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PMID:Controlled ovarian hyperstimulation and intrauterine insemination for treatment of infertility. 190 Apr 77

A microinsemination technique was evaluated for treating our program's most severe cases of male-factor infertility. Oocytes were inseminated with high concentrations of motile sperm (1 to 9 x 10(6)/ml) in 10 to 150 microliters within embryo cryopreservation straws. Fertilization was obtained in 20 of 29 (69%) couples treated by this technique. In the 15 patients in which only embryos generated from the straw technique were transferred, 7 clinical pregnancies resulted (46.7% per transfer). The implantation rate for couples receiving embryos from the straw technique only (12/58; 20.7%) compared favorably to that observed for other cases treated during this same time period with regular insemination techniques (111/766; 14.5%). Clinical pregnancy rates per transfer for IVF-ET, TET, and PROST were 33.0% (1/3), 0% (0/2), and 60.0% (6/10), respectively. The percentage of polyploidic embryos was significantly lower (P less than 0.0001) for male-factor patients treated by the straw technique with high sperm concentrations than for non-male-factor patients treated during this same time period with standard sperm concentrations. Normal births have resulted from straw inseminations with 3.4 x 10(6) and ongoing pregnancies with 5.0 x 10(6) motile sperm/ml. The results of this study suggest that some cases of male-factor infertility can be successfully treated by insemination with high concentrations of motile sperm in embryo cryopreservation straws. A technique of centrifuging sperm in straws was also developed to concentrate the entire fraction of washed sperm into 10 microliters. Further development of this technique may allow treatment of more severe cases of oligo/asthenospermia by microinsemination with high concentrations of motile sperm than is presently possible with standard washing techniques.
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PMID:Treatment of severe male-factor infertility with high concentrations of motile sperm by microinsemination in embryo cryopreservation straws. 206 78

Intrauterine insemination by itself for multiple and/or severe infertility factors had no benefit over cervical cap with whole ejaculate or coitus in this study. The PRs for IUI and cervical cap with whole ejaculate or coitus were similar and low, suggesting that IUI by itself has limited, if any, utility in enhancing PRs in this type of infertility population. Couples attempting IUI should be advised about the low probability of achieving pregnancy. Ovulation stimulation and/or heterologous donor insemination, IVF, or gamete intrafallopian transfer may be beneficial therapeutic options.
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PMID:Failure of intrauterine insemination in a refractory infertility population. 207 Aug 68

Gamete intrafallopian transfer (GIFT) is performed currently using laparoscopy. We report on a pilot-study from 1.1.1987 to 31.12.1987 and from 1.5.1988 to 30.4.1989, in which we used hysteroscopy instead of laparoscopy for the GIFT-procedure. The entering conditions were: unexplained (idiopathic) infertility, failure of previous treatments, proven fertilization capability of the gametes in at least one IVF attempt, and request of the married couple to dispense with laparoscopy during GIFT procedure. Hysteroscopic GIFT was initially performed on hysterectomy specimens, using the Chorionoskop. Continuous flow CO2 through the fallopian tubes did not result in loss of gametes. Twenty-four treatment cycles were performed in 16 patients. In 19 cycles, gametes were transferred into one tube, and in two cycles they were transferred into both tubes. Four of 16 women conceived: one patient delivered at term, three pregnancies ended in a first trimester abortion. These results demonstrate that the hysteroscopic approach to intrafallopian gamete transfer can be successful. However, the technique is demanding and requires extensive training. We conclude that further improvements of hysteroscopic GIFT are needed.
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PMID:Hysteroscopy for gamete intrafallopian transfer (GIFT). 207 17

Concurrent pregnancy and implantation (sacs/embryos transferred) rates were compared for 84, 77 and 49 cases of in-vitro fertilization-embryo transfer (IVF-ET), pronuclear stage embryo transfer (PROST) and gamete intra-Fallopian transfer (GIFT), respectively. All cases reported occurred during an 18-month interval since the initiation of PROST by our programme. Leuprolide acetate was used with follicle stimulating hormone and human menopausal gonadotrophin for follicular stimulation of all but donor oocyte cases (n = 9). Clinical pregnancy (per transfer) and implantation rates were significantly higher (P less than 0.03) for PROST (52.4%, 20.2%) in comparison with IVF-ET (26.9%, 11.4%). Rates for GIFT (48.9%, 18.4%) were not significantly higher (P = 0.10, 0.14) than for IVF-ET. This was probably due to the lower number of GIFT than PROST procedures performed. The total pregnancy rate for GIFT (biochemical, ectopic and clinical combined) was significantly greater (P less than 0.05) than for IVF-ET. Pregnancy and implantation rates for PROST and GIFT were similar. These results support the use of PROST rather than IVF-ET for all cases in which the woman has one functional Fallopian tube. Furthermore, to maintain equivalent rates of pregnancy with PROST and GIFT, it is suggested that GIFT should not be used for cases of male-factor infertility without first documenting normal rates of in-vitro fertilization with PROST.
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PMID:Comparison of concurrent pregnancy rates for in-vitro fertilization--embryo transfer, pronuclear stage embryo transfer and gamete intra-fallopian transfer. 208 6

Eighty-one women suffering from occluded Fallopian tubes and 29 women with unexplained infertility were treated with in vitro fertilization and embryo transfer (IVF-ET). All procedures were carried out on outpatients. A total of 24 pregnancies were achieved in the group of patients with occluded tubes whereas eight became pregnant in the group of patients treated for unexplained infertility. From these results, it is expected that 30% of women suffering from occluded tubes or unexplained infertility can achieve pregnancy following two IVF-ET treatment cycles.
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PMID:[In vitro fertilization and embryo transfer in a Deaconess Institution. Experience from the first years]. 211 85

A successful human twin IVF pregnancy is reported after using a single 50 micrograms dose of LHRH agonist nasal spray (Buserelin) to induce an ovulatory endogenous gonadotrophin surge 34 h prior to oocyte collection. The couple had 10 years of primary male factor infertility, associated with significant anti-sperm antibodies. The clinical features and endocrine profile are presented.
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PMID:IVF pregnancy after induction of an ovulatory endogenous gonadotrophin surge using an LHRH agonist nasal spray. 211 45

In earlier IVF programmes, subcutaneous buserelin (Suprefact, Hoechst) was initially administered three times per day (200 micrograms x 3); then twice daily (300 micrograms x 2). We now suggest that a single administration of 600 micrograms daily may be equally effective. In a preliminary study, 20 patients were selected on the basis of tubal or idiopathic infertility and received 0.6 ml buserelin subcutaneously once a day, beginning on day 1 or 2 of the cycle. A sufficient pituitary desensitization was obtained on day 10 in 75% of patients and on day 16 for 100% and the ongoing pregnancy rate was 35% per treatment cycle. A randomized study comparing the effect of 600 micrograms of buserelin administered in one (n = 50) or two injections (n = 46), has been carried out and indicates that the results in terms of the ovarian suppression and pregnancy rates, were similar. Therefore, this protocol represents a simplification of the treatment with buserelin.
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PMID:An improved use of buserelin in ovarian stimulation for in-vitro fertilization. 211 46

Part of a cost-effectiveness study on in-vitro fertilisation was the evaluation of the medical results of this fertility treatment. Data were prospectively collected from more than 3000 IVF treatments in the five Dutch hospitals during a two-year period. The average take-at-least-one-healthy-baby-home rate per started treatment was 10% (the average clinical pregnancy rate per embryo transfer was 20%). After several IVF treatments about one in three or four couples were successful. Ranges in results were mainly caused by patient characteristics, the individual treatment number and the treating hospital. Male subfertility and long-lasting and primary infertility result in a bad prognosis. Success rates differed substantially between hospitals, even after correction for patient mix.
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PMID:[The results of in-vitro fertilization in a Dutch multicenter study]. 212 64


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