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Biomedical subjects

J Leeton

Publications and source records attributed to J Leeton.

At least 55 records · Page 3Linked to original sources
PubMed1986

The search for donor eggs: a problem of supply and demand.

Although seven babies who were conceived in vitro with donated oocytes have been born in the Monash-Epworth programme, the availability of this service is now threatened because of the scarcity of oocytes for donation. Previously oocytes were donated by infertile women undergoing oocyte collection in the in vitro fertilisation programme, but this supply has been severely curtailed since cryopreservation of their embryos has been made available to them. Other sources of donated oocytes have included collecting oocytes from women undergoing laparoscopic sterilization, infertile women finding their own (known) donors, and fertile women donating all their oocytes for altruistic reasons on an in vitro fertilisation programme. The latter two categories offer the greatest chance of collecting mature oocytes for donation.

Female↗
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↗
PubMed1984

Unexplained infertility and the possibilities of management with in vitro fertilization and embryo transfer.

The aetiology of idiopathic infertility largely appears to lie within the female genital tract. The causes may be related to psychological, hormonal or biological factors that could influence sexual behaviour or function of the cervix, uterus, tubes or ovaries. Carefully controlled prospective studies are needed to evaluate diagnoses and therapy. Management of cases of long-standing idiopathic infertility in an IVF programme is indicated if the pregnancy rates of the programme are greater than 10%, as it will aid in both diagnosing the underlying cause as well as offering a significantly higher chance of pregnancy than either expectancy or other treatments.

Embryo Transfer↗
PubMed1984

The use of donor eggs and embryos in the management of human infertility.

The use of donor eggs and embryos is indicated in those infertility cases where the recipient's eggs are either absent, unavailable or inappropriate for in vitro fertilization (IVF) and embryo transfer (ET) programmes. Donor eggs may be fertilized by either the sperm of the recipient's husband (donor egg programme) or by donor sperm (donor embryo programme), in vitro or in vivo and may be transferred as either fresh or frozen-thawed embryos. Human pregnancies and livebirths have recently been reported following the donation of embryos fertilized both in vitro and in vivo. The development of this new technique will allow the achievement of normal pregnancy in infertile women who hitherto had no possible chance of pregnancy.

Adult↗
PubMed1983

Pregnancy established in an infertile patient after transfer of a donated embryo fertilised in vitro.

In vitro fertilisation after stimulation of the ovulatory cycle has led to successful pregnancy. If more oocytes are recovered than are needed they may be left unfertilised, preserved, or donated to a recipient couple from whom oocytes cannot be obtained. A case of human pregnancy initiated by transfer of a donated embryo fertilised in vitro is reported. The donor was a 42 year old woman with primary infertility from whom six follicles were aspirated after stimulation of the ovulatory cycle. The recipient was a 38 year old infertile woman who had undergone several unsuccessful attempts for artificial insemination from a donor. Five oocytes were recovered from the donor's six follicles, four of which were inseminated with spermatozoa of the donor's husband and the fifth with a frozen sample of semen. Three of the four embryos fertilised by her husband were returned to the donor and the fifth was transferred to the recipient. No pregnancy was recorded in the donor, but pregnancy was confirmed in the recipient, though spontaneous abortion occurred after 10 weeks. This case will give useful information for further study of in vitro fertilisation, but also raises many ethical issues.

Adult↗
PubMed1982

The technique for human embryo transfer.

In a program of human in vitro fertilization (IVF), the results of 204 attempted intracervical embryo transfers (ETs), using a variety of catheters in three trials over 18 months, have been analyzed for the ease of transfer and pregnancy rate. In nulliparous patients, transfers were more difficult than in multiparous patients; and a closed-end Teflon catheter was found to be more easily passed through the smaller cervical canal than an open-end catheter. The overall pregnancy rate was 17% (March 1980 to August 1981) and was not related to catheter type, although when chemical pregnancies were excluded, it was found that transfers using open-end catheters were more successful. The transfer procedure developed finally for routine use incorporates a consideration of these results.

Embryo Transfer↗
PubMed1982

The management of infertility: where to stop.

Many empirical traditional treatments for infertility may improve various fertility parameters but have no proven effect on clinical fertility. Diagnosis and management of ovulation disorders can be undertaken by most gynaecologists and the results are relatively good. Effective treatment for male infertility is poor and largely empirical, and artificial insemination by donor (AID) remains the mainstay of management. Tubal infertility may be overcome by surgery, particularly microsurgery, in selected cases especially sterilization reversal with minimal damage. Severe tubal disease is best managed by effective in vitro fertilization (IVF) programmes. Criteria of selection for IVF treatment include ovarian accessibility at laparoscopy and a normal semen sample. As many of the new techniques are difficult and contentious the decision to accept, reject or discontinue treatment should be made by the couple themselves after they have received a full and unbiased appraisal of their problem and its chance of successful management.

Amenorrhea↗
PubMed1982

A preliminary psychosocial follow-up of parents and their children conceived by artificial insemination by donor (AID).

Forty-three couples who first conceived by artificial insemination by donor (AID) between 1975-1977 jointly completed an anonymous questionnaire about their attitudes to the AID programme. There were 80 children, and 30 couples had 2 or more children by AID. All children developed normally. The attendance rate of husbands at the births was 94%. All but one couple reported stable marriages and the majority thought that the AID pregnancies had improved their marital relationship, and none thought it had deteriorated. Selection for treatment relied upon the traditional medical interview only and no structured psychosocial interviews were used. The majority of the couples (84%) did not plan to tell their children of their AID origins.

Australia↗
PubMed1981

A clinical assessment of nine pregnancies obtained by in vitro fertilization and embryo transfer.

An analysis of nine pregnancies resulting from in vitro fertilization and embryo transfer was made in order to identify factors common to all of the pregnancies. These factors included clomiphene stimulation; general anesthesia for laparoscopy; identification of large follicles (greater than 8 ml) and a mature oocyte; preincubation of the oocyte for 4.7 to 6.5 hours in vitro before insemination; insemination with 0.8 to 1.3 x 10(6) fresh spermatozoa from fertile samples; transfer to the uterus of two-, four-, and eight-cell embryos, 38 to 50 hours after insemination; and uncomplicated uterine transfers of embryos. It was difficult to determine whether these factors are causal or coincidental in the attainment of successful pregnancies. The detailed analysis was useful in demonstrating factors which did not prevent the establishment of pregnancy by in vitro fertilization and embryo transfer. These factors included a variety of causes of infertility, including idiopathic and male infertility; age of the infertile woman over 35 years; the presence of T-mycoplasma in the genital tract; the use of human chorionic gonadotropin; a variety of agents used for general anesthesia; the use of carbon dioxide to induce pneumoperitoneum; a delay of up to 50 minutes in the interval between the induction of general anesthesia and oocyte recovery; the use of antiprostaglandins at the time of embryo transfer; and a brown discharge from the vagina following embryo transfer.

Embryo Transfer↗
PubMed1980

Sterilization operations in Australia.

The proportion of males and females in Australia having privately performed sterilization operations has been estimated from 1976 operation rates for each age group and for each State. These figures indicate that 60% of Australian couples (maximum: 74% in Western Australia; minimum: 53% in Victoria) will choose this form of birth control during their fertile lifetime. A general practitioner survey in March, 1978, indicated this proportion would be an underestimate. If this rate of sterilization continues, we will challenge the United States as the country with the highest prevalence of sterilized couples.

Adult↗