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Biomedical subjects

I L Craft

Publications and source records attributed to I L Craft.

At least 37 records · Page 2Linked to original sources
PubMed1994

Assisted fertilization with intracytoplasmic sperm injection.

OBJECTIVE: To evaluate the significance of intracytoplasmic sperm injection in severe male factor infertility and previous failed fertilization. DESIGN: Prospective observational study. SETTING: Private infertility clinic, London. SUBJECTS: Sixty-nine patients with a long-standing history of infertility of which 48 had previous failed fertilization, 15 had < 1 million progressive motile sperm per ejaculate, and the remaining 6 had obstructive azoospermia. INTERVENTION: Assisted fertilization with primary intracytoplasmic sperm injection was carried out in 69 IVF. OUTCOME: Normal (two pronuclei [2PN]) fertilization and pregnancy rates. RESULTS: A total of 967, oocytes were collected and 785 were subsequently microinjected. Normal fertilization (2PN) occurred in 410 oocytes (52%) and 90.5% of those cleaved. Sixty-four patients underwent ET, with a total of 181 embryos transferred. Twenty-five patients conceived with a pregnancy rate of 39% per transfer. The implantation rate was 16% and the total pregnancy loss rate 24%. Failed fertilization after intracytoplasmic sperm injection occurred in four cases. CONCLUSIONS: Intracytoplasmic sperm injection is increasingly becoming the treatment of choice in infertile couples where assisted fertilization is indicated. The high fertilization and pregnancy rates observed with this technique, together with a low risk of abnormalities, has revolutionized treatment of male factor infertility.

Adult↗
PubMed1994

Intramural pregnancy following difficult embryo transfer.

We report an intramural pregnancy following a difficult embryo transfer in a 31 year-old woman, having in-vitro fertilization and embryo transfer for tubal factor infertility. The creation of a 'false passage' at a previous instrumentation of the cervix may be implicated in the ectopic placement of embryos.

Adult↗
PubMed1994

Experience with assisted fertilization in severe male factor infertility and unexplained failed fertilization in vitro.

We present results of in-vitro fertilization (IVF) cycles using assisted fertilization at our centre. Assisted fertilization was performed in those couples who had failed to fertilize oocytes with conventional IVF, or where this was predicted by the presence of severe male factor infertility. In 20 consecutive assisted fertilization cycles 223 oocytes were subjected exclusively to subzonal insemination (SUZI). Subsequently in 32 consecutive assisted fertilization cycles 418 oocytes were subjected to intra-cytoplasmic sperm injection (ICSI). More oocytes were damaged by ICSI (8.9%) than by SUZI (2.3%) (P = 0.03), but normal fertilization resulted more often after ICSI (56.9%) than SUZI (35.8%) (P = 0.004). Sperm parameters, other than sufficient numbers to perform the procedures, had no effect on fertilization or pregnancy rates. Every cycle led to the transfer of at least one embryo. Pregnancy resulted from eight of the SUZI cycles (40%) and nine of the ICSI cycles (28%). Implantation rates were calculated as 25 and 12% for SUZI and ICSI respectively. The presence of living spermatozoa is the only semen parameter limiting assisted fertilization. At present more centres are able to perform SUZI than ICSI and we feel it is premature to abandon SUZI altogether. Local conditions and success rates should be considered when decisions are made in assisted fertilization cycles.

Adult↗
PubMed1993

Preoperative ultrasonic assessment of women undergoing gamete intrafallopian transfer: a prospective study of 350 cases.

A total of 350 women due to undergo gamete intrafallopian transfer were scanned vaginally on the operation day and the findings were compared with those recorded 2 days previously when human chorionic gonadotropin was administered. The aim was to assess the clinical value of ultrasound assessment on the operation day, especially from a prognostic point of view. Seven women (2%) were found to have already ovulated and evidence of imminent ovulation was detected in another 27 cases (7.7%). There were more frequent and more marked increases in the number of follicles with a diameter of > 14 mm, in the diameter of the leading follicle and in the endometrial thickness in the women who subsequently conceived. The endometrial reflectivity was brighter than the myometrium (grade A) in 77.3% of the women who conceived, compared with only 37.5% of those who did not conceive. These differences were statistically significant. It was concluded that follicular and endometrial changes recorded on the day of gamete intrafallopian transfer may have a prognostic value, as the pregnancy rate was higher in women who had the favorable ultrasonographic features outlined in the study.

Journal Article↗
PubMed1993

Transvaginal crown-rump length measurements of 224 successful pregnancies which resulted from gamete intra-Fallopian transfer or in-vitro fertilization.

The crown-rump lengths (CRL) of 224 pregnancies which resulted from gamete intra-Fallopian transfer (GIFT) or in-vitro fertilization (IVF) were assessed two to four times in the first trimester. The results were compared with some of the published articles which assessed CRL in spontaneous and induced pregnancies. The range of CRL measurements from this study was generally smaller than the previously published data, although all women went on to deliver normal fetuses at full term weighing > 2.5 kg. It was not possible to identify a clear reason for this finding, but factors which might have been relevant included population differences, more accurate estimation of ovulation/conception time, the exclusive use of vaginal ultrasonography in this study and variations in the embryonic implantation/development times. There is a need to review the commonly used CRL charts in view of the increasing use of transvaginal ultrasonography and the increasing number of pregnancies with known ovulation/conception times. Each centre should aim to establish the normal CRL range for its own population.

Adult↗
PubMed1992

Gamete intrafallopian transfer in women who had ectopic pregnancy previously.

Eighty-seven women who had previously had ectopic pregnancy underwent 111 gamete intrafallopian transfers (GIFT). Forty-one women had moderate or severe pelvic adhesions, eight had mild pelvic adhesions, and 18 had had the fallopian tubes surgically repaired. The remaining 20 women had no obvious pelvic abnormality except for the absence of one fallopian tube. After stimulation of superovulation, between two and 22 oocytes were retrieved and two to four were transferred into the fallopian tubes after careful assessment of their condition. Twenty-eight pregnancies were achieved (25.2% per cycle), with 23 live births (20.7% per cycle), four abortions (14.3% of all pregnancies), and one ectopic pregnancy (3.6% of all pregnancies, 0.9% per cycle). This experience shows that GIFT can safely produce a reasonable pregnancy rate in carefully selected women who have had ectopic pregnancy.

Adult↗
PubMed1991

Ectopic pregnancy resulting from gamete intrafallopian transfer and in vitro fertilization. Role of ultrasonography in diagnosis and treatment.

Forty-five cases of ectopic pregnancy occurred after gamete intrafallopian transfer (32 cases) or in vitro fertilization (13 cases). Ultrasonography positively identified ectopic pregnancy in 33 cases (73.4%) and suggested the presence of one in 7 cases (15.6%). There were five false-negative results (11.1%). The incidence of rare types of ectopic pregnancy after assisted fertility procedures, such as ovarian, heterotopic, cervical and ectopic pregnancy, in patients who had undergone a previous salpingectomy was increased. Ultrasound scanning was used to monitor three cases of nonviable ectopic pregnancy; all three required no further treatment. In 14 cases of viable ectopic pregnancy the gestational sac was aspirated and injected with potassium chloride and methotrexate. In seven of those cases no further treatment was needed. Patients who conceive as a result of assisted fertility procedures should be scanned four to six weeks after the procedure or sooner if they are considered at high risk of developing an ectopic pregnancy or if the condition is symptomatic.

Abortion, Induced↗
PubMed1990

The hypoosmotic swelling test and cryosurvival of human spermatozoa.

The hypoosmotic swelling test is a simple laboratory test to evaluate the functional integrity of the membrane of human spermatozoa. This test was performed on 83 samples of human semen before cryopreservation to determine whether it has any predictive value for the cryosurvival of human spermatozoa. Stepwise regression analysis demonstrated that conventional sperm characteristics, including the concentration, motility, normal morphology and viability, of pre-freeze semen samples were of limited value in predicting the cryosurvival of human spermatozoa. Further, the hypoosmotic swelling test results from pre-freeze semen samples did not correlate with the post-thaw motility or the survival rate of spermatozoa after cryopreservation.

Cell Survival↗
PubMed1989

Oocyte donation in 61 patients.

Oocyte donation was performed by gamete intrafallopian transfer in 61 women, 34 of whom were amenorrhoeic. The mean age of the donors was 32 years (range 23-38). Seventy-five treatment cycles gave 29 clinical pregnancies, of which 21 reached term, 3 continue, and 5 were lost (3 miscarriages, 1 tubal, and 1 cervical). 11 (38%) of the women who became pregnant were over 42 years old. When more than four oocytes were transferred, many of the pregnancies were multiple. 8 (38%) of the pregnancies that came to term were complicated by pre-eclamptic toxaemia. When oocytes are obtained from young women, the fertility potential is high irrespective of the recipient's age.

Administration, Sublingual↗
PubMed1987

Ovum donation--a simplified approach.

To date, ovum donation (OD) has involved luteinizing hormone (LH) synchronization between recipient and donor for normally cycling women, and a complex steroid replacement regimen given on a sequential and incremental basis for women with primary or secondary ovarian failure. The authors designed a simple hormonal regimen applicable to both normally cycling women starting early in the cycle, and to those with ovarian failure. It consists of administering 2 mg estradiol (E2) valerate orally three or four times daily, augmented with either 100 mg progesterone (P) in ethyl oleate intramuscularly daily or 100 mg oral progesterone (P) orally three times daily, starting on the day preceding the recovery of the donated oocytes. Gamete intrafallopian transfer procedure was undertaken for women with patent tubes and in vitro fertilization for those with obstructed tubes. The authors report their preliminary experience with 17 women who underwent ovum donation.

Administration, Oral↗
PubMed1987

Oocyte maturity and human follicular fluid prostanoids, gonadotropins, and prolactin after administration of clomiphene and pergonal.

Follicular fluid (FF) and oocytes were obtained from 130 follicles of 52 women in whom ovulation was induced with human menopausal gonadotropin (Pergonal) and clomiphene citrate. Follicular aspiration was performed 36 h after an ovulatory injection of hCG. The concentrations of LH, FSH, PRL, and the prostanoids prostaglandin E2 (PGE2), PGF2 alpha, PGI2 (as 6-oxo-PGF2 alpha), and thromboxane A2 (as TXB2) in the FF were measured by RIA and related to the degree of maturation of the oocyte-corona-cumulus complex mass (OCCC). FF obtained from follicles with immature OCCC contained significantly lower concentrations of all four prostanoids (median concentrations, picograms per mL: PGE2, 88; PGF2 alpha, 85; 6-oxo-PGF1 alpha, 40; TXB2, 50) than those with intermediate OCCC (PGE2, 175; PGF2 alpha, 325; 6-oxo-PGF1 alpha, 130; TXB2, 65) and mature OCCC (PGE2, 425; PGF2 alpha, 860; 6-oxo-PGF1 alpha, 235; TXB2, 78; all P less than 0.01). There were no significant differences between the maturity of the complexes and the concentrations of LH, FSH, or PRL. There were significant correlations between the FF concentrations of LH and FSH and those of all of the prostanoids, but not with PRL, concentrations. These results indicate that the synthesis of prostanoids in the human Graafian follicles may be modulated by gonadotropins and consolidates the view that prostanoids may play a role in human oocyte maturation and ovulation.

6-Ketoprostaglandin F1 alpha↗
PubMed1987

Metabolism of glucose by human embryos.

Glucose turnover, as measured by CO2 production, lactate accumulation and carbon incorporation from [U-14C]glucose as sole energy substrate, was low on the 2nd day of culture of human embryos resulting from in-vitro fertilization but above that of unfertilized oocytes. In general, all parameters of metabolism increased substantially during the following 2 days of development but the rate of increase in lactate production was greater than that of CO2, especially between Days 3 and 4. Within developing embryos, no correlation was evident between the metabolic turnover of glucose and the method of patient stimulation, the morphological quality of embryos or the apparent rate of cleavage in culture. The results indicate that, before Day 3 of development, glucose is not effective as an energy source for the human embryo because of a blockade to glycolysis similar to that in mouse embryos.

Blastocyst↗