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

Initial results with intravaginal cultures (IVC) of human oocytes are reported. Up to 5 oocytes are harvested by follicular puncture guided by transvaginal sonography. Together with washed spermatocytes (final concentration 0.1 to 0.15 x 10(6)/tube) these are transferred to a plastic capsule filled with Menezzo B2 medium. After air-tight closure the capsule is placed into the patient's vagina and left in situ for 48 to 52 hours. Capsule loss is prevented by plugging the vagina with a tampon of appropriate size. In the first 15 females undergoing IVC fertilization was obtained in 56% of cases. Three intact pregnancies were recorded after embryo transfer. Of these, 2 occurred in the group of patients with tubal infertility and one in the group with tubal infertility and an additional andrologic abnormality. Our results and the reports by others suggest that IVC may well facilitate the technique of IVF. Potentially detrimental effects of light exposure and temperature variations on the gametes during conventional IVF are minimized. The more active involvement of the patients is an added psychological benefit.
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PMID:[Intravaginal culture--simplification of IVF]. 226 52

Tubal infertility was treated by in vitro fertilization-embryo transfer (IVF-ET) in 112 couples. Twenty-eight pregnancies were obtained in 140 treatment cycles. Couples are accepted for treatment in our IVF-ET programme if previous semen samples fulfil the inclusion criteria: ejaculate volume greater than 1.5 ml, concentration of spermatozoa greater than 15 x 10(6) ml-1, greater than 40% motile spermatozoa, and greater than 25% spermatozoa with normal morphology. In order to determine to which extent IVF-ET treatment results are influenced by sperm morphology, within this selected group of patients, we have retrospectively analysed the data from both original semen samples and swim-up preparations. The sperm morphology was not related to the outcome of treatment in terms of fertilization (ovum cleavage rate), early embryo development, or pregnancy. Nor was any relationship detected between early embryo development or pregnancy and the degree of improvement in morphology resulting from the swim-up procedure. However, if improvement in morphology by swim-up was high, ovum cleavage rate was low. Sperm morphology within the limits set by our inclusion criteria could not predict the outcome of IVF-ET treatment. It is further concluded that the presence of abnormal spermatozoa at the site of fertilization may be without harm if only the number of normal sperms is high enough.
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PMID:Morphology of seminal and swim-up spermatozoa and the outcome of in vitro fertilization and embryo transfer. 226 33

In spite of the advances in the field of in vitro-fertilization, microsurgery still offers the best chances for treatment of tubal infertility. Because of the irreversible tubal wall pathology the results following microsurgical repair of the postinfectious tubal disease are limited to approximately 30%. No further improvement of the surgical technique is to be expected. According to the birth rate and the rate of extrauterine gestation, microsurgery gives the best results in the correction of filmy adhesions, fimbrial phimosis and proximal tubal occlusion. Distal tubal occlusion with development of hydrosalpinx and extremely thickness of the wall should be treated by IVF-ET. If higher rates of pregnancy are to be achieved in the future in tubal sterility, the treatment of methods (microsurgery, endoscopy and extracorporeal fertilization) must be combined.
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PMID:[Microsurgical therapy in tubal sterility]. 227 15

In the event of non-fertilization of oocytes at the first insemination, repeat insemination is often successful in the IVF procedure. Nevertheless, the value of reinsemination is still controversial. In 56 out of 132 (42%) women treated in our IVF-ET Unit for mechanical infertility by identical induction and aspiration protocols, reinsemination of one or more ova was required. They were divided into two groups. Group I: 79 oocytes from 32 women who were reinseminated with initial semen 24 hours following primary insemination. Group II: 57 oocytes from 24 patients who were reinseminated with fresh semen 24 hours following primary insemination. Fertilization, cleavage and pregnancy rates differed significantly in group I as compared to group II (21.2%, 37.3%, p less than 0.005; 18.6%, 31.9%, p less than 0.001; 18.4%, 29.1%, p less than 0.001). We conclude that reinsemination is a beneficial procedure in cases of non-fertilization of oocytes at the first insemination. Furthermore, the use of fresh semen is preferred to achieve higher fertilization, cleavage and pregnancy rates.
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PMID:Reinsemination in human IVF with fresh versus initial semen: a comparative study. 230 55

An analysis of the influence of women's age on the results of in-vitro fertilization was performed, using 5590 attempts collected during the year 1986. Increasing age was found to be related to decreased success rates from 19.8% per attempt below the age of 25 years, to 9% per attempt at 40 years or more. A cut-off point was found between the ages of 36 and 37 years, using a mathematical model. The decrease was related to a reduction in oocyte production (4.3 +/- 2.8 at 25 years or less and 3.3 +/- 2.1 at 40 years or more, P less than 0.001), and to a reduced implantation rate, whatever the number of transferred embryos. These findings were not due to spouse's age, rank of attempt, infertility diagnosis or oocyte stimulation regimen, since the effect of age remained significant when a logistical model including these confounders was applied. Finally, a woman's age must be considered as a prognostic factor when IVF is proposed to infertile couples.
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PMID:In-vitro fertilization: influence of women's age on pregnancy rates. 232 44

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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PMID:Zygote intrafallopian transfer as a treatment for nontubal infertility: a 2-year study. 239 91

After a brief historical survey and review of the main Swiss centres engaged in medically assisted procreation, the indications for in vitro fertilization and embryo transfer (IVF-ET) are discussed. This technique offers the sterility specialist a new approach in allowing separate investigation of the two gametes and study of their interactions. This therapeutic approach to infertility is thus supplemented by biological data which may modify or highlight some of the etiologic aspects and promote new treatments. The techniques employed at our centre and the results obtained over the past four years are presented. Analysis of IVF pregnancies shows that the obstetric risks can be associated with the characteristics of the groups treated rather than with the IVF technique.
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PMID:[Fertilization in vitro and embryo transfer]. 240 44

The relationship between various measures of oestradiol (E2) secretion and the total number of oocytes retrieved (OR) and cleaved embryos (CE) was characterized in normal ovulatory women stimulated with pure follicle-stimulating hormone (FSH) in a programme for in-vitro fertilization and embryo transfer (IVF-ET). Patients in this study included women with tubal factor as their only cause for infertility. Cycles were monitored with serum E2 concentration and ultrasonography. Human chorionic gonadotrophin (HCG) was administered when two follicles had a maximum diameter greater than 15 mm. The variables used to characterize the E2 secretory response included: (i) the difference between the highest and lowest E2 concentration during stimulation; (ii) the ratio of terminal to initial E2 concentration; (iii) E2 concentration on the day of HCG administration; and (iv) the slope of the E2 curve. These measures of E2 secretion each correlated with both the number of OR and the number of CE. When all E2 variables were considered simultaneously in a stepwise multivariate regression procedure, variations in the number of OR (r2 = 0.84) or CE (r2 = 0.77) could be explained by variation in the E2 secretory profile. Equations derived from these E2 variables may help to identify and improve problem areas within IVF-ET programmes when actual results differ from expected.
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PMID:Results of in-vitro fertilization in normal ovulatory women treated with pure follicle stimulating hormone. Analysis of the oestradiol response. 251 93

From January 1986 to July 1987, 143 patients with unexplained infertility (UI) following 217 IVF attempts were studied and randomly assigned for statistical analysis to be compared with 434 tubal infertility (TI) patients undergoing 748 IVF attempts. The age of patients, previous pregnancy history and stimulation protocols were identical in both groups. In comparison with tubal patients, IVF attempts on the UI group were characterized by the same rates of cycle failure, mean number of oocytes retrieved per cycle, a lower fertilization rate (45.7% UI/59.8% TI) (P less than 0.01) and no difference in cleavage and nidation rates. However, a decrease in the pregnancy rate/attempt (13.8% UI/19.5% TI) tended towards a significant value (P = 0.06). Although the semen parameters were found to be in the normal range during the previous fertility screening in both groups, the incidence of at least one abnormality (count less than 20 X 10(6)/ml, and/or total motility less than 30% and/or abnormal forms greater than 75%) on the day of insemination was found to be significantly higher in UI (20%) than in TI (11%) patients. Moreover, 25% of UI patients did not fertilize any oocytes inseminated, whatever the number of oocytes retrieved. This rate of failed fertilization was significantly lower (9%) in tubal patients. The oestrogen response profiles were similar in both groups, analyzed according to the stimulation protocols.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Results of IVF attempts in patients with unexplained infertility. 251 95

Polycystic ovarian disease may be a cause of hormonal infertility. This condition is often refractory to therapy. Three groups of randomly chosen women with refractory polycystic ovarian disease (PCOD) were treated by induction of ovulation with pFSH/hCG, pFSH/hMG/hCG or after down-regulation of the ovaries with a GnRH analogue (Decapeptyl). Out of 18 patients six conceived in the first in vitro fertilization-embryo transfer (IVF-ET) cycle, and two further women conceived in a later cycle. It is suggested that patients with refractory PCOD should be referred for IVF-ET therapy, possibly after treatment with a GnRH analogue.
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PMID:IVF-ET in women with refractory polycystic ovarian disease. 252 99


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