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Biomedical subjects

I Craft

Publications and source records attributed to I Craft.

At least 55 records · Page 3Linked to original sources
PubMed1993

Ultrasonic monitoring during replacement of frozen/thawed embryos in natural and hormone replacement cycles.

We evaluated the results of cryopreserved/thawed embryo replacement (FER) to determine if the outcome following transfer in a natural cycle in a defined group was different to that from a hormone replacement cycle, and also to assess vaginal ultrasonographic features that assist in predicting the timing of the transfer. At the London Fertility Centre, 149 consecutive FER cycles were studied retrospectively. Women with proven ovulation and regular cycles were included during natural cycles (n = 77). The hormone replacement cycle group included women with anovulation, irregular cycles and older women (n = 72). In the natural cycle group, transfer was performed following positive urinary luteinizing hormone (LH) surge and confirmation of ovulation by ultrasonography. With the hormone replacement therapy group, gonadotrophin-releasing hormone analogue was used to induce pituitary down-regulation, oestradiol valerate was supplemented followed by regular ultrasound monitoring, and FER 2 days following the initiation of progesterone, which was started once adequate endometrial development was noticed on ultrasonography. The pregnancy and ongoing/delivery rates were analysed in relation to the treatment cycle, age, number and quality of embryos transferred. Ultrasonographic features were examined to evaluate their relationship with the outcome of treatment. The results showed that no difference existed between natural and hormone replacement cycles in pregnancy rates per cycle (26 and 25%), ongoing/delivery rate (20.8% in both groups), and implantation rate (10.3 and 10.6%). Pregnancy rates were not influenced by the number of embryos transferred, stage at which the embryos were cryopreserved, or whether they were extra embryos from in-vitro fertilization/embryo transfer, or gamete intra-Fallopian transfer.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Correlation of ultrasound assessment of endometrial growth and plasma steroid concentrations during superovulation for in vitro fertilization.

Endometrial and follicular development were investigated by ultrasound in 25 normally cycling women who received clomiphene citrate and human menopausal gonadotrophin to induce multiple follicular development for in vitro fertilization. Ultrasonic determination of endometrial thickness and reflectivity grading and follicular number were correlated with daily concentrations of estradiol (E2) and progesterone (p) in peripheral serum. Serum E2 showed a better positive correlation with endometrial thickness than with total number of developing follicles. There was a significant inverse correlation between endometrial thickness and plasma p concentration. The E2 value per follicle and E2/p ratio were both weakly correlated respectively with endometrial thickness. These data indicate that ultrasound determination of endometrial thickness is a useful ultrasonic parameter for monitoring ovarian function for in vitro fertilization. However, endometrial thickness should always be combined with total number of developing follicles, in order to reach decisions concerning timing of oocyte recovery.

Adult↗
PubMed1992

IVF versus GIFT.

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Adult↗
PubMed1992

The influence of ovarian response on gamete intra-Fallopian transfer outcome in older women.

Fecundity declines with increasing age in women. The pregnancy rate is lower in in-vitro fertilization/embryo transfer (IVF/ET) in women aged greater than or equal to 40 years. We analysed 349 consecutive gamete intra-Fallopian transfer (GIFT) cycles in women aged greater than or equal to 40 years to identify factors which affected the outcome. A maximum of four oocytes were transferred in GIFT as recommended by the Interim Licensing Authority; 61 women (17.5%) had a positive serum beta-human chorionic gonadotrophin, 35 (10%) had a miscarriage and 26 (7.5%) delivered live infants. The pregnancy rate was lower than with younger women while the conception loss was higher. Pregnancy and delivery rates increased as the number of oocytes retrieved increased but declined again if greater than 10 oocytes were retrieved. If 1-3 oocytes were retrieved, the pregnancy rate was 9.7% and the delivery rate was 3.9%; if 4-10 oocytes were retrieved, the pregnancy rate was 22.1% and the delivery rate was 10.1%, and when greater than 10 oocytes were retrieved, the rates were 17.6 and 5.9% respectively. The highest pregnancy rate was when four oocytes were transformed in GIFT (22.4%) and the delivery rate was 10.0%. An adequate response to long down-regulation with gonadotrophin-releasing hormone agonist was also a factor associated with high delivery rates (13.5%). We conclude that the delivery rate after GIFT in women aged greater than or equal to 40 years is low, but there is a subgroup who have an acceptable delivery rate because of a good ovarian response. In this group, pituitary down-regulation improves the outcome of treatment.

Adult↗
PubMed1992

Prime factors for seeking infertility treatment amongst Iranian patients.

This paper reports a survey of prime factors for seeking infertility treatment amongst 14 Iranian couples and discusses the implications of the findings in relation to issues related to infertility treatment and the need for comparative research on patients from diverse socioeconomic and cultural backgrounds.

Adult↗
PubMed1992

What is stressful about in vitro fertilization?

The present work was designed to explore whether psychological stress is more related to concerns about the actual physical pain or fear of treatment during in vitro fertilization. Analysis of data for 12 middle-class women from Iran showed that the greatest psychological stress during treatment was associated with worries about the outcome of different stages of treatment rather than fear and pain of the actual procedure.

Adult↗
PubMed1991

The reproductive outcome following a superhigh response to stimulation in gamete intrafallopian transfer program.

A retrospective analysis was carried out to assess the outcome of gamete intrafallopian transfer (GIFT) in cycles when more than 10 oocytes were retrieved (superhigh responders) from October 1987 through June 1989. There were 276 (13%) cycles with more than 10 oocytes retrieved among all GIFT cycles initiated during the period. Clomiphene citrate and gonadotropin were employed for ovarian stimulation in 105 (38%) cycles, and gonadotropin releasing hormone agonist in the remaining 171 (62%) cycles, employing either the flare (104 cycles) or the pituitary down-regulation (67 cycles) protocol. A maximum number of four oocytes was transferred per GIFT (3.5 +/- 0.4). The mean number of oocytes retrieved was 14.7 +/- 4.4 (range, 11 to 35). A significantly younger age group (less than 30 years) of patients was noticed in the study (31.9), and fewer women aged 40 and over (6.2%), compared to the general population of our patients. The pregnancy rate was 33.3% (n = 92) per cycle, with a delivery rate of 23.6% (n = 64) per cycle; the pregnancy loss rate was 30.8%. The reproductive outcome was lower in women aged 40 and over (pregnancy rate was 23.5%, but delivery rate was only 5.8% per cycle). The delivery rate was lower in the clomiphene citrate- and gonadotropin-stimulated cycles (51.7% per pregnancy) in relation to gonadotropin-releasing analogue and gonadotropin cycles (76.6% per pregnancy) and significantly so compared with the pituitary down-regulation protocol (83.3% per pregnancy). We conclude that a superhigh response develops more in younger women, and in such circumstances, the use of pituitary down-regulation with gonadotropin-releasing hormone will improve the reproductive outcome.

Adult↗
PubMed1991

Pregnancy following gamete intra-fallopian transfer (GIFT) with cryopreserved semen from infertile men following therapy to lymphomas or testicular tumour: report of three cases.

Cryopreserved spermatozoa from men having treatment for lymphoma or testicular tumour have been reported to function sub-optimally. We report on three successful pregnancies following gamete intra-Fallopian transfer (GIFT) using such cryopreserved sperm samples. In one case, ovum donation was required since the woman had premature ovarian failure.

Adult↗
PubMed1991

Outcome and complications of assisted reproduction.

This review discusses studies documenting an increase in birth rate associated with in vitro fertilization and gamete intrafallopian transfer. The results of zygote intrafallopian transfer are also encouraging. The rates of chromosomal and congenital abnormalities in assisted reproduction are similar to the rates at which these problems occur in normal pregnancies. Multiple pregnancy is the main determinant of outcome. Singleton pregnancies have higher rates of pregnancy complications. Factors affecting outcome of assisted reproduction include age of the mother, level of basal follicle-stimulating hormone, the number of embryos or gametes transferred, response to ovarian stimulation, and the quality of gametes and eventually of the embryo. Complications of these procedures relate to the technique used. Recent reports have highlighted the effects of multiple gestation in terms of perinatal morbidity, the effect on the family, and the demand for neonatal resources, as well as ethical issues surrounding selective reduction. The use of gonadotropin-releasing hormone agonist has led to an increase in the incidence of severe ovarian hyperstimulation. Other reports document the incidence of ectopic pregnancy in in vitro fertilization with embryo transfer.

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