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Biomedical subjects

A Trounson

Publications and source records attributed to A Trounson.

At least 91 records · Page 5Linked to original sources
PubMed1986

Cryopreservation of human embryos: progress on the clinical use of the technique in human in vitro fertilization.

Embryo cryopreservation has been studied at Monash University since 1981 and has been available to patients since mid-1983. Of approximately 1200 patients' cycles of in vitro fertilization (IVF), 445 have had excess embryos which they requested to be frozen. To date 205 patients have requested thawing of their embryos and 144 have had frozen-thawed embryos replaced in utero, resulting in 16 pregnancies. Four of these pregnancies aborted, four are ongoing, and eight deliveries have resulted, including one stillbirth at 26 weeks and one set of twins. Analysis of the data collected to date shows that patients with three or more embryos frozen have a significantly higher pregnancy rate than patients with one or two embryos frozen (23 versus 4%, respectively). Embryo viability, but not embryo survival, following freeze-thawing is related to the degree of embryonic fragmentation and the cell stage at freezing. Eight-cell embryos had a significantly higher viability than other cleavage stages. Those resulting in pregnancy tended to be the faster-dividing eight-cell embryos and were undamaged after freezing and thawing. However, when considering all cleavage stages, there was little effect of freezing damage on embryo viability, providing that at least 50% of the cell complement of embryos were intact and the zona pellucida was undamaged. Nor was there any marked effect of the age of embryos postinsemination. It is also possible that patients who were pregnant following the initial embryo replacement on the cycle of IVF treatment are more likely to conceive following replacement of their frozen-thawed embryos.

Cell Count↗
PubMed1986

Successful fertilization, embryo development, and pregnancy in human in vitro fertilization (IVF) using a chemically defined culture medium containing no protein.

A randomized control trial involving the fertilization and culture of human embryos in culture medium (T6) containing either 10% maternal serum or no protein or amino acid supplement was carried out to assess the effect of deletion from culture of all fixed nitrogen on fertilization, embryo development, and embryo viability. There was no difference in fertilization rates (68 vs 69%), development of apparently normal embryos (96 vs 97%), pregnancy rate (18 vs 14%), or birth rate (13 vs 11%) between protein-containing and protein-free media. Deletion of protein from the culture medium may enable the constitution of more appropriate and defined culture media for human in vitro fertilization (IVF).

Culture Media↗
PubMed1986

Pregnancy established in an infertile patient after transfer of an embryo fertilized in vitro where the oocyte was donated by the sister of the recipient.

A successful pregnancy in a patient suffering from infertility due to severe tubal disease has been achieved following the transfer of embryos fertilized in vitro following the donation of oocytes by the sister of the recipient. Both sisters ovulated irregularly and asynchronously. The donor's menstrual cycle varied from 24 to 30 days and the recipient's cycle varied from 23 to 26 days. Synchronization of ovulation was achieved by matching the onset of their menstrual cycles prior to treatment by in vitro fertilization and by manipulating the follicular phase of both the donor and the recipient during the cycle of treatment. Ten oocytes were collected from the donor and all were inseminated with spermatozoa from the recipient's husband. Nine normal embryos developed and three were transferred to the uterus of the recipient sister, 55 hr after laparoscopic egg collection. A normal singleton pregnancy resulted.

Embryo Transfer↗
PubMed1986

Regulation of prostaglandin biosynthesis by human ovarian follicular fluid: a mechanism for ovulation?

We have studied the effect of human ovarian follicular fluid on PG production by bovine seminal vesicles in vitro and found that hFF1 contains a factor of high molecular weight (Mr greater than 30,000) which inhibits PG synthase in a dose-dependent manner. Exposure of this substance to protease activity produced a factor of lower molecular weight (Mr less than 1000) which stimulated PG synthase activity. If this is true of ovarian follicles in vivo, it is possible that increased follicular protease activity stimulates PG synthesis at the time of ovulation.

Animals↗
PubMed1986

An analysis of factors associated with ectopic pregnancy in a human in vitro fertilization program.

Between 1980 and 1985, in Monash University in vitro fertilization (IVF) program, ectopic pregnancy occurred in 10 of 256 IVF pregnancies. The incidence of ectopic pregnancy between 1983 and 1984 was 4% of the total pregnancies, or 4.2% of pregnancies excluding biochemical pregnancies. The incidence of ectopic pregnancy was distributed equally across the infertility classifications (tubal, idiopathic, male factor, and mixed). There appeared to be no relationship between superovulatory methods, endocrine changes before egg recovery, laparoscopic procedures, embryo transfer procedures, and number of embryos transferred. Nine of the ten patients were classified as having either tubal factor infertility before IVF or chronic tubal inflammation, which probably existed at the time of embryo replacement. No ectopic pregnancies were recorded in the 33 pregnancies obtained with superovulation with the use of clomiphene citrate alone. We were unable to identify a major predisposing factor for ectopic pregnancy in IVF.

Adult↗
PubMed1986

The effect of progesterone supplementation around the time of oocyte recovery in patients superovulated for in vitro fertilization.

A randomized control trial involving 42 superovulated in vitro fertilization (IVF) patients was carried out to investigate the effects of providing supplementary progesterone (P) around the time of laparoscopy. P was given 12 to 15 hours and 1 hour before and 24 hours after laparoscopy in one group (group B); human chorionic gonadotropin was given 12 hours before laparoscopy in another group (group C); and the remainder received no treatment in addition to normal IVF procedures (group A). There was no difference in fertilization rate, the proportion of normally developing embryos, pregnancy rate, or birth rate between the treatment groups, We conclude that in the superovulation schedule used, P supplementation around the time of laparoscopy does not affect success rate of IVF.

Chorionic Gonadotropin↗
PubMed1986

Plasma progesterone and prolactin changes in superovulated women before, during, and immediately after laparoscopy for in vitro fertilization and their relation to pregnancy.

To define changes in peripheral plasma progesterone (P) and prolactin (PRL) levels in relation to oocyte recovery for in vitro fertilization (IVF), the authors studied these hormones in 20 women before, during, and after oocyte recovery for IVF. The patients were superovulated with clomiphene citrate and human menopausal gonadotropin and underwent general anesthesia (19 women) or epidural anesthesia (1 woman) and laparoscopy for follicular aspiration. One half of the women were given bromocriptine to control PRL levels during anesthesia. There was a marked drop in P levels (mean decrease of 76%) within the 2 hours after induction of anesthesia and follicular aspiration. PRL levels rapidly rose in patients not treated with bromocriptine. Four of the 20 patients became pregnant after embryo transfer, and in these women P levels were significantly higher than in nonpregnant patients before and during oocyte recovery. Changes in PRL levels and P levels during oocyte retrieval were not related to the occurrence of pregnancy.

Anesthesia, Epidural↗
PubMed1986

Cross-over trial of superovulation protocols from two major in vitro fertilization centers.

A study was undertaken as a controlled comparison of two different superovulation induction protocols currently in use in major Australian in vitro fertilization (IVF) clinics. Thirty patients each from the Monash University and the Royal Women's Hospital (RWH) IVF programs were stimulated for ovulation induction by the other program. Once timing for oocyte retrieval was scheduled, all care reverted to the program from which the patient first came. Results given as pregnancies per patient commencing stimulation were: RWH patients on Monash protocol, 27%; RWH control patients, 15%; Monash patients on RWH protocol, 7%; Monash control patients, 13%. In the year preceding the trial pregnancy rates were 16.9% at Monash and 10.6% at RWH. Stimulation protocols were also compared with respect to each of administration, cost, and patient stress. The results of this cross-over trial demonstrated major differences between the two ovulation induction protocols studied, although it was not possible to conclude that differences in pregnancy rate were due to stimulation alone.

Adult↗
PubMed1986

The successful use of human amniotic fluid for mouse embryo culture and human in vitro fertilization, embryo culture, and transfer.

The development of mouse and human embryos was assessed in human amniotic fluid to determine its suitability as a culture medium for human in vitro fertilization (IVF). Two-cell mouse embryos developed to blastocysts after 72 hours at rates similar to that in Whittingham's T6 + 10% fetal calf serum. Significantly more mouse embryos hatched in amniotic fluid. No difference was found between individual patient's amniotic fluids obtained at 16 to 21 weeks' gestation. A preliminary trial comparing amniotic fluid with T6 + maternal serum in human IVF showed no significant difference in fertilization rate and embryo development during 42 to 48 hours in vitro. Expanded blastocysts were obtained in amniotic fluid after 5 days in vitro. Four pregnancies were obtained in 9 patients' transferred embryos grown in amniotic fluid and with 2 or 12 patients' transferred embryos grown in T6 + maternal serum.

Amniotic Fluid↗
PubMed1986

Detection of the LH surge for AID, AIH and embryo transfer using a twice daily urinary dip-stick assay.

The detection of the spontaneous LH surge in 12 infertile women being monitored for transfer of frozen-thawed or donor embryos was studied using plasma radioimmunoassay (RIA), urinary RIA and a dip-stick enzyme immunoassay. Ten of the 12 women had plasma LH surges and in all but one woman the dip-stick assay detected the LH surge to within 12 h of the plasma RIA. The urinary RIA detected the LH surge in only six of the 10 women. In two of these cases the surge was detected 24 h and 36 h later than by plasma RIA. The dip-stick assay has many advantages and could be usefully integrated as a mode of monitoring ovulation in infertility therapy.

Embryo Transfer↗
PubMed1985

Deep-freezing and transfer of human embryos.

Studies on the cryopreservation of 162 four-cell and eight-cell human embryos indicate that morphological survival and pregnancies can be achieved by specific techniques of freezing and thawing. Survival rates are highest when embryos are cooled at 0.3 degrees C/min to -80 degrees C in the presence of 1.5 M dimethylsulfoxide (DMSO) and thawed at +8 degrees C/min from -80 to +4 degrees C. Morphological survival of four-cell and eight-cell human embryos after freezing and thawing is not affected by irregularites in blastomere size or the presence of small cytoplasmic fragments. Light and electron microscopic examination of fixed specimens indicates a good correlation between the appearance of frozen-thawed embryos at the dissecting microscope level and the extent of cryoinjury. Sixty-eight of 136 four-cell and eight-cell embryos (50%) survived with half or more of their blastomeres intact when cooled to low temperatures and thawed at the rates described. The transfer of these 68 embryos into 45 patients resulted in nine pregnancies.

Embryo Transfer↗
PubMed1985

Support of the luteal phase in in vitro fertilization programs: results of a controlled trial with intramuscular Proluton.

There is disagreement among in vitro fertilization (IVF) programs as to the need to administer exogenous progesterone to support the luteal phase of patients undergoing embryo transfer after IVF. We examined the effect on pregnancy rates of Proluton, 50-mg daily injections given on days 7-16 following oocyte recovery, in 186 women undergoing IVF treatment using a combined stimulation regime of clomiphene and human menopausal gonadotropin (hMG). One group was deliberately selected for treatment on the possible criterion of luteal-phase deficiency and two other groups were randomly selected into a treatment and a control group. No effect on pregnancy rate was noted in any of these groups. These results indicate that extension of the luteal phase with exogenous progesterone is unlikely to have a significant effect on increasing the pregnancy rate in IVF programs using similar treatment regimes.

17 alpha-Hydroxyprogesterone Caproate↗
PubMed1985

Factors influencing pregnancy rates following in vitro fertilization and embryo transfer.

In 831 patients having 1533 in vitro fertilization treatments, pregnancy rates were examined in relation to clinical and laboratory factors. Pregnancy rates were significantly affected by the month and year of treatment, the age of the patient, the type of ovarian stimulation, the use of human chorionic gonadotropin, the number of eggs collected, the number of eggs fertilized, the number of embryos developed, and the number of embryos transferred. The most important factors determining pregnancy rates were the number of oocytes collected and the number of embryos transferred. The low pregnancy rate when only one egg was collected raises the problem of how to predict and manage such a patient in a current or future treatment cycle.

Adult↗