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Biomedical subjects

M L Polan

Publications and source records attributed to M L Polan.

At least 73 records · Page 4Linked to original sources
PubMed1988

Gonadal steroids modulate human monocyte interleukin-1 (IL-1) activity.

Interleukin-1 (IL-1), a monocyte and macrophage product, is the mediator of a wide variety of immune responses, including fever, and increases during the luteal phase of the menstrual cycle, concomitantly with progesterone (P). These studies were undertaken to assess the possible relationship between steroidogenesis and IL-1 activity elaborated by human peripheral monocytes. IL-1 was measured with the D-10 thymocyte stimulation bioassay and dose response curves as a function of both estradiol (E2) and P were established. Low concentrations of both E2 (10(-9) M-10(-10) M) and P (10(-8) M-10(-9) M) resulted in maximal IL-1 stimulation. At higher concentrations of both E2 (10(-7) M) and P (10(-7) M-10(-5) M) there was a significant reduction (P less than 0.05) in IL-1 activity. However, neither E2 nor P production by human granulosa-luteal cells cultured with increasing amounts of human IL-1 (0 to 20 IU/ml) was affected in either the absence or presence of human chorionic gonadotropin (hCG, 5 IU/ml). Thus, human peripheral monocyte IL-1 activity appears to be modulated by gonadal steroids; however, a reciprocal relationship between IL-1 and gonadal steroidogenesis was not observed.

Animals↗
PubMed1987

Serum prolactin response to embryo transfer during human in vitro fertilization and embryo transfer.

Serum prolactin (PRL) concentrations around the time of embryo transfer (ET) have not been studied, despite the fact that transient hyperprolactinemia regularly occurs in response to laparoscopy for oocyte recovery and ET itself may be stressful enough to induce a PRL rise. Hyperprolactinemia might compromise luteal support for implantation and contribute to the limited success of ET. We measured serum PRL concentrations in 10 normoprolactinemic women immediately before, during, and after ET and compared the PRL response around ET to that induced by laparoscopy as a measure of the competency of the stress-prolactin axis. Nine of ten patients demonstrated a significant PRL response to surgery. The mean (+/- SEM) intraoperative PRL concentration (124.0 +/- 19.6 ng/ml) was significantly higher than the preoperative level (12.3 +/- 2.4 ng/ml) (P less than 0.01). Three hours after surgery PRL levels had decreased (44.8 +/- 11.5 ng/ml) but remained above baseline. All subjects were normoprolactinemic 48 hr after laparoscopy. Serum PRL concentration did not change significantly in response to ET, with levels of 10.4 +/- 1.7, 12.4 +/- 1.1, and 10.6 +/- 1.8 ng/ml immediately before, during, and 3 hr after ET, respectively. While laparoscopy for in vitro fertilization--embryo transfer commonly induces hyperprolactinemia, the PRL rise is transient, with no carryover to the time of ET. Embryo transfer itself does not induce a significant PRL rise.

Embryo Transfer↗
PubMed1987

A gonadotropin-releasing hormone (GnRH)-like protein in human ovaries: similarity to the GnRH-like ovarian protein of the rat.

The rat ovary contains significant amounts of a GnRH-like protein, but does not contain readily detectable GnRH. We, therefore, determined whether human ovaries contain a similar GnRH-like protein. Extracts of human ovaries as well as rat ovaries, rat hypothalami, and rat plasma were examined for their content of both GnRH-like protein and GnRH. GnRH-like activity was detected by inhibition of binding of GnRH to rat ovarian membrane receptors [radioreceptor assay (RRA)]. GnRH was detected with a specific GnRH RIA. Equivalent amounts of GnRH-like activity were found in both human and rat ovaries, whereas GnRH was not detected. The human and rat ovarian GnRH-like materials had identical retention times after reverse phase high pressure liquid chromatography, and these were clearly different from that of authentic GnRH. Furthermore, the ovarian GnRH-like activity was clearly separated by HPLC from GnRH and GnRH-like activities extracted from rat hypothalami. Plasma contained neither GnRH-like nor GnRh activity. The ovarian GnRH-like activity was protease and heat sensitive, whereas hypothalamic GnRH and GnRH-like activity were protease sensitive, but not heat sensitive. The ovarian GnRH-like protein did not inhibit the specific binding of prostaglandin F2 alpha to rat ovarian membranes under conditions of assay similar to the GnRH RRA. The ovarian GnRH-like protein did not have GnRH peptidase activity, its inhibition of GnRH binding in the RRA was reversible, and bacitracin (protease inhibitor) had no effect on assay of the ovarian GnRH-like protein by RRA. We conclude that the human ovary contains a GnRH-like protein similar, if not identical, to the GnRH-like protein of the rat ovary, which is different from GnRH and the GnRH-like protein of the hypothalamus. The presence of the same GnRH-like material in human and rat ovary raises the possibility that this protein may mediate responses in the human ovary similar to the antigonadotropic actions of GnRH in the rat ovary.

Adult↗
PubMed1987

Endometrial ablation for intractable uterine bleeding: hysteroscopic resection.

Twenty-one patients with intractable uterine bleeding were treated by resectoscopic ablation of the endometrium. All the patients were worked up thoroughly to rule out hormonal or anatomic reasons for their bleeding. In addition, various hormonal regimens were tried to stop the bleeding. Our technique used the modified urologic resectoscope, which is inserted into the uterine cavity. The entire endometrial cavity was ablated using 30 W of coagulating current. Of the 21 patients treated, 14 had blood dyscrasias, four were poor anesthetic risks, and three refused hysterectomy. There were no complications from the procedure. Three patients died from their primary disease, and all the rest, except for one, remained amenorrheic. We conclude that the use of the resectoscope for endometrial ablation is a successful, efficient, safe, and readily available way to treat intractable uterine bleeding.

Cystoscopes↗
PubMed1986

Neosalpingostomy: comparison of 24- and 72-month follow-up time shows increased pregnancy rate.

Seventy-two patients, 54 for 5 years and 18 for 6 years, were evaluated between 1 and 2 years and 5 and 6 years after bilateral neosalpingostomy. A 27.7% intrauterine pregnancy rate was reported in those patients treated between 1976 and 1978, with a 14% ectopic pregnancy rate. The subsequent 5- to 6-year follow-up study revealed an increase in the pregnancy rate to 41.6% and in the ectopic pregnancy rate to 17.1%. The increase in the pregnancy rate may reflect the ability of the fallopian tube for ciliogenesis and intrinsic repair. Thus if patients have not conceived within 2 years of neosalpingostomy for distal tubal obstruction, significant reproductive potential still exists.

Fallopian Tube Diseases↗
PubMed1986

Resectoscopic management of müllerian fusion defects.

Of the 103 patients taken to the operating room for hysteroscopic resection of a septum, 72 underwent successful resection of the septum. The initial hysterogram can identify those patients who may benefit from the procedure but cannot discriminate between bicornuate and septate uteri. Knowledge of the size and contour of the uterus is essential to the final decision to proceed transcervically, opposed to transabdominally. In the transcervical repair group, at the time this article was written, there were 58 term deliveries and 5 ongoing pregnancies greater than 30 weeks (1 had a spontaneous abortion after surgery and subsequently conceived a term pregnancy), for a successful pregnancy rate of 86%. This correlated well with the pregnancy rates observed after metroplasty. Therefore, hysteroscopic resection constitutes a valuable alternative to the classical transabdominal approach.

Abortion, Habitual↗
PubMed1986

The use of pure follicle-stimulating hormone for ovulation induction in normal ovulatory women in an in vitro fertilization program.

Many ovulation induction protocols for follicular development have been reported. The present study examines pure follicle-stimulating hormone (pFSH) and human menopausal gonadotropin for ovulation induction in an in vitro fertilization and embryo transfer program. The study compares the number of ampules, the level of estradiol on the day of human chorionic gonadotropin administration and at laparoscopy, the number of oocytes retrieved, fertilization, cleavage, and pregnancy rates. The peak levels of estradiol on the day of human chorionic gonadotropin administration and the day of laparoscopy were similar, although fewer ampules of pFSH were required to reach similar criteria for oocyte maturation prior to retrieval. The fertilization rates were similar, but the cleavage and pregnancy rates favored the use of pFSH. The use of pFSH may be more physiologic in orchestrating follicular steroidogenesis in normal ovulatory women in an in vitro fertilization and embryo transplant program that subsequently could produce healthier oocytes and an improvement in the pregnancy rate.

Adult↗
PubMed1986

Purines, prostaglandins and peptides--nature and cellular mechanisms of action of local assist and assassin agents in the ovary.

The evidence for a paracrine, progonadotropic role of adenosine in ovarian cells is summarized along with a capsule review of the origin and mechanisms of release and action of adenosine in other tissues. Briefly, adenosine markedly amplified rat and human luteal cell cyclic AMP and progesterone accumulation in the presence, but not the absence, of LH. The site of action of adenosine was found to be intracellular, linked to its phosphorylation, which resulted in increased levels of ATP. In rat luteal cells, adenosine blocked the acute antigonadotropic (luteolytic) action of PGF2 alpha. In the follicle, adenosine release from granulosal cells appeared to be stimulated by FSH. Adenosine and a nonmetabolized adenosine analog, augmented FSH-dependent inhibition of oocyte maturation in the presence or absence of an adenosine transport inhibitor. Inhibition of oocyte maturation by adenosine thus appears to be mediated by extracellular purinergic receptors. Paracrine, antigonadotropic agents also appear to regulate ovarian function. For example, GnRH elicits antigonadotropic activity in rat granulosal and luteal cells. We describe a novel, GnRH-like, ovarian hormone (GLOH) which may be the physiological ligand whose action GnRH mimics in rat ovarian cells. This protein was shown to be distinctly different from GnRH and a variety of other cyclic and noncyclic peptides. PGF2 alpha is a well known leutolytic agent and a summary of the antigonadotropic mechanism of PGF2 alpha action in rat luteal cells is presented. In these cells, the action of GnRH (or possibly the GnRH-like protein) and PGF2 alpha are mediated by separate membrane receptors but they appeared to share the same intracellular second messenger. Evidence for a role of products of phosphoinositol as a mediator of these antigonadotropic agents is summarized. We suggest that the ultimate mediator of antigonadotropic agents is Ca2+ which is released in the luteal cell in response to the intracellular mediator of antigonadotropic agents. For example, pharmacological agents which increase intracellular levels of Ca2+, mimicked the antigonadotropic action of GnRH and PGF2 alpha in rat luteal cells. Also, Ca2+ directly inhibited LH-sensitive adenylate cyclase activity in isolated luteal membranes, a paradigm in which GnRH and PGF2 alpha were inactive. The mechanism of Ca2+ action appeared to be linked to interference with GTP activation of adenylate cyclase. However, removal of extracellular Ca2+ did not abrogate the action of either GnRH or PGF2 alpha.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenosine↗
PubMed1986

Human chorionic gonadotropin stimulation of estradiol production and androgen antagonism of gonadotropin-stimulated responses in cultured human granulosa-luteal cells.

Baseline and gonadotropin-stimulated estradiol production were examined in long term cultures of human granulosa-luteal cells isolated from women undergoing in vitro fertilization. Estradiol production declined by 70% during the first 48 h in culture and was minimally stimulated by the addition of hCG to the culture medium. During subsequent culture from 48-120 h estradiol production was significantly increased over control levels by hCG concentrations greater than 0.1 IU/ml. Incubation with testosterone stimulated estradiol production 100-fold in the presence and absence of gonadotropin. hCG (0.01-10 IU/ml) stimulated a 3- to 13-fold increase in progesterone production. However, at hCG concentrations greater than 1 IU/ml, coincubation with testosterone (10(-7) M) significantly inhibited progesterone production. Dihydrotestosterone also inhibited progesterone production, but to a lesser extent than testosterone. Freshly isolated granulosa-luteal cells specifically bound small amounts of [125I]hCG (less than 1,000 cpm/10(5) cells). Glycine buffer wash was shown to reversibly remove more than 88% of bound hCG and, in freshly isolated cells, increased [125I]hCG binding by 100%. In 5-day cultures, specific [125I] hCG binding nearly doubled from 52,000 cpm/10(5) cells in control cultures to 87,000 cpm/10(5) cells in cultures treated with hCG (0-5 IU/ml). At the highest concentration of hCG (5 IU/ml), testosterone (10(-7) M) significantly inhibited the amount of [125I]hCG specifically bound. In summary, estradiol production in long term cultures of granulosa-luteal cells appears to be gonadotropin dependent. In addition, the presence of testosterone (10(-7) M) antagonizes hCG-stimulated progesterone and LH receptor production by these cells.

Androgens↗
PubMed1986

Ovulation induction with human menopausal gonadotropin compared to human urinary follicle-stimulating hormone results in a significant shift in follicular fluid androgen levels without discernible differences in granulosa-luteal cell function.

Follicular fluid estradiol, progesterone, testosterone, and androstenedione levels were compared in 2 groups of spontaneously ovulatory women undergoing ovulation induction with human menopausal gonadotropin (hMG; which contains equal amounts of LH and FSH) or human urinary FSH (huFSH). The results were correlated with the ratios of embryo cleavage and pregnancy. Although significantly more FSH [1268 +/- 38 (+/- SEM) vs. 953 +/- 38 IU; P less than 0.05] was required for equivalent hyperstimulation in hMG compared to huFSH cycles, the number of oocytes retrieved and fertilized and the number of embryos transferred were similar for the 2 ovulation induction protocols. Forty-two follicles from 21 women stimulated with hMG and 38 follicles from 15 women stimulated with huFSH were examined and found to be representative of the total cohort of aspirated follicles. Follicular fluid estradiol and progesterone levels were similar, but hMG-stimulated follicles contained significantly more testosterone [7.83 +/- 0.52 (+/- SEM) vs. 6.30 +/- 0.42 ng/ml; P less than 0.03] and less androstenedione (24.4 +/- 3.6 vs. 37.8 +/- 5.0 ng/ml; P less than 0.03) than did huFSH-stimulated follicles. Embryonic cleavage rates were similar for all fertilized oocytes from both hMG- and huFSH-stimulated cycles, although pregnancy rates were significantly higher in huFSH cycles (40% vs. 9.5%; P less than 0.05). In addition, aromatase activity, progesterone production, and [125I]hCG-binding activity were compared in granulosa-luteal cells isolated from some of these women. Cells from 21 follicles from 9 women stimulated with hMG and 24 follicles from 9 women stimulated with huFSH were studied. There were no significant differences in aromatase activity, progesterone production, or [125I]hCG binding. Thus, the presence or absence of exogenous LH during ovulation induction with FSH has little direct effect on granulosaluteal cell function. However, the presence of LH during ovulation induction with FSH does appear to alter thecal androgen metabolism, resulting in higher testosterone and lower androstenedione levels in follicular fluid. Such a shift in androgen milieu may impair oocyte development and successful implantation.

Adult↗
PubMed1986

Laparoscopic use of the argon laser in nonendometriotic reproductive pelvic surgery.

The major advantage of the argon laser in laparoscopic reproductive pelvic surgery is the ability to transmit the laser beam along a flexible fiber that can easily be directed at a lesion. Its use has been specifically described for the treatment of endometriosis because the absorption of the argon laser beam (488 + 514 nm) coincides with the pigmented endometriotic implants. It has been suggested that the argon laser would not be as useful in other infertility procedures because the lack of such pigmentation would reduce the lesion's absorption of the laser beam and therefore decrease the laser's efficacy of destruction. The argon laser was used in other kinds of reproductive pelvic surgery in 15 patients over seven months. Procedures performed laparoscopically with the laser were neosalpingostomy, fimbrioplasty, salpingo-oophorolysis, adhesiolysis and ablation of the uterosacral ligaments. Of six patients undergoing laparoscopic surgery with a preoperative diagnosis of pelvic pain, five reported complete resolution of the pain following therapy. There were no intraoperative or postoperative complications. In the short follow-up period, none of the patients conceived. In addition to its use in the treatment of endometriosis, the argon laser, transmitted laparoscopically via a fiber, can be safely used to perform a wide variety of other reproductive pelvic surgical procedures. Its relative efficiency with regard to these procedures, the subsequent pregnancy rates and the laser's ability to ameliorate pelvic pain remain to be established.

Fallopian Tube Diseases↗
PubMed1985

The day of initiation of human menopausal gonadotropin stimulation affects follicular growth in in vitro fertilization cycles.

The attainment of synchronous follicular development in human menopausal gonadotropin/human chorionic gonadotropin-stimulated cycles for in vitro fertilization (IVF) continues to be a perplexing problem. Two regimens of follicle stimulation for IVF cycles were, therefore, compared. Twenty-nine patients commenced human menopausal gonadotropin (hMG) therapy on day 1 of the menstrual cycle (Group I), while 30 women received hMG from the third day of the cycle (Group II). The hMG therapy was tailored to the individual patients's response, based on ultrasonographic measurements of follicular size and serum estradiol (E2) levels. Both groups of patients received a mean of 19.6 +/- 1.4 ampules of hMG over a mean of 6.1 +/- 0.2 days. The pattern of serum E2 and progesterone levels in the periovulatory and luteal phase was not affected by the day of initiation of hMG therapy, although Group I patients demonstrated lower (P less than 0.05) E2 levels on the 2 days prior to human chorionic gonadotropin (hCG) administration. In terms of follicle growth, Group II follicles consistently demonstrated a significantly (P less than 0.01, chi 2 test) larger proportion of medium- and large-sized follicles compared to Group I follicles on almost all of the days when ultrasonographic measurements were taken. In addition, Group II follicles demonstrated an earlier shift (day-1) to the larger follicles than Group I follicles (day 0). Significantly (P less than 0.001) more oocytes were recovered per aspirated follicle in Group II patients, but the fertilization rate per oocyte was greater (P less than 0.003) for Group I oocytes. Nevertheless, pregnancy rates did not differ between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Estradiol↗
PubMed1985

Altered follicular development in clomiphene citrate versus human menopausal gonadotropin-stimulated cycles for in vitro fertilization.

The pattern of periovulatory and luteal phase serum estradiol (E2) and progesterone (P) as well as follicular fluid (FF) E2, P, androgen, gonadotropin, and prolactin concentrations of eight women undergoing clomiphene citrate (CC)/human chorionic gonadotropin (hCG) stimulation and eight women undergoing human menopausal gonadotropin (hMG)/hCG stimulation of follicular development for the purpose of in vitro fertilization were compared. Ovulation was induced with either a 5-day course of CC (100 mg/day beginning on day 5 of the cycle) or an individualized hMG regimen, and laparoscopy was performed 36 hours after hCG administration. The length of the luteal phase was significantly longer (P less than 0.05) in the CC-treated group as compared with the hMG-treated group. The pattern of serum E2 levels differed significantly (P less than 0.01) in that E2 levels were lower in the early and midluteal phase in CC-stimulated cycles; in addition, a delayed second E2 peak was observed in the late luteal phase in these women. Serum P levels, however, were lower in the hMG-stimulated group. Analysis of FF hormone concentrations revealed significantly (P less than 0.05) higher concentrations of E2 and androsterone in the FF of hMG-treated patients. It is concluded that follicular development in CC-stimulated cycles differs markedly from that in hMG-stimulated cycles. These differences may reflect either an altered follicular maturational process or may represent a direct inhibitory effect of CC on follicular steroidogenesis.

Adult↗
PubMed1985

Adenosine differentially amplifies luteinizing hormone- over follicle-stimulating hormone-mediated effects in acute cultures of rat granulosa cells.

Adenosine has been shown to acutely amplify LH-dependent events in luteal cells and FSH-dependent events in granulosa cells. In this study, the specificity of purines on mature rat granulosa cell ATP levels in short term culture was assessed, and a comparison of the relative effect of adenosine on amplification of FSH- and LH-stimulated cAMP accumulation was made. Adenosine rapidly and significantly increased ATP levels in granulosa cells. This effect was maximal (approximately 2-fold) within 60 min of culture and occurred in the absence or presence of FSH or LH. The increase in granulosa cell ATP levels by adenosine was dose dependent, with half-maximal and maximum responses of 10 and 30 microM adenosine, respectively. Dipyridamole (10 microM), a purine transport inhibitor, blocked the adenosine-dependent increase in granulosa cell ATP levels. Adenosine and 5'-AMP were equipotent in increasing cell ATP levels; adenine also increased ATP levels, but was significantly less active (approximately 50% of adenosine), whereas hypoxanthine, inosine, and xanthine were inactive. FSH was consistently found to decrease granulosa cell ATP levels by about 30% in the absence or presence of adenosine, whereas LH had no effect on cell levels of ATP. Both FSH and LH significantly stimulated cAMP accumulation in granulosa cells, but the maximal response to FSH was substantially greater than that to LH. Adenosine significantly amplified cAMP accumulation in response to both FSH and LH, but the effect of adenosine on this response to FSH was modest. Amplification by adenosine of cAMP accumulation in response to LH was substantial and about 2- to 3-fold greater than that seen with FSH. These studies show that purines acutely and specifically increase ATP levels in rat granulosa cells. Since adenosine augments LH-dependent cAMP accumulation to a greater extent than FSH-stimulated cAMP production, we suggest that adenosine may favor premature follicular luteinization and, perhaps, function as a mediator of atresia in the developing follicle.

Adenosine↗
PubMed1985

Adenosine 3',5'-monophosphate levels in human follicular fluid: relationship to oocyte maturation and achievement of pregnancy after in vitro fertilization.

cAMP, estradiol (E2), and progesterone levels were determined in 24 follicular fluid samples obtained from 8 women who conceived after in vitro fertilization and in 47 samples from 26 women who did not. Follicular development was induced by human menopausal gonadotropin, and maturation of retrieved oocytes was assessed by the degree of cumulus mucification and corona dispersal. The mean follicular fluid cAMP concentration was significantly (P less than 0.001) lower in women who became pregnant than in those who did not (106 vs. 241 pmol/ml), while the mean E2 level was significantly (P less than 0.01) higher (727 vs. 497 ng/ml), and the progesterone to E2 ratio was significantly (P less than 0.05) lower (9.5 vs. 18.0). Overall, follicles of immature, intermediate, and mature oocytes did not differ in cAMP content. However, intermediate and mature oocytes from women who became pregnant were derived from follicles containing significantly (P less than 0.01) lower cAMP levels than those of women who did not become pregnant (66 and 122 vs. 233 and 288 pmol/ml, respectively). Furthermore, fertilized oocytes leading to conception originated from follicles with significantly (P less than 0.001) lower cAMP concentrations than the follicles that yielded nonfertilized oocytes or fertilized oocytes not leading to conception (92 vs. 270 and 240 pmol/ml, respectively). Similarly, significantly (P less than 0.05) lower cAMP levels were found in the follicular fluid of cleaved oocytes resulting in a pregnancy compared to those that did not (86 vs. 236 pmol/ml). It is concluded that low levels of cAMP are associated with successful fertilization and cleavage of human oocytes in vitro resulting in viable pregnancies and may, therefore, be used as a marker of optimal follicular development in in vitro fertilization cycles.

Adult↗
PubMed1985

Luteolytic hormones are calcium-mediated, guanine nucleotide antagonists of gonadotropin-sensitive adenylate cyclase.

We suggest that regression of the corpus luteum is an active process induced by PGF2 alpha, GnRH, and a peptide of ovarian origin whose action GnRH mimics (20). The initial events involved in luteolysis occur within minutes, and they are intimately linked to inhibition of LH action. Membrane receptor binding of luteolytic hormones activates production of a second messenger (such as a product of PI turnover) that stimulates release of sequestered, intracellular Ca2+ by a mechanism linked to inhibition of microsomal Ca2+-ATPase activity. The increase in cytosolic Ca2+ inhibits adenylate cyclase activity by blocking GTP-dependent activation of adenylate cyclase. As a result, the cell response to LH is abolished and function is lost.

Adenylyl Cyclases↗
PubMed1984

Human in vitro fertilization employing individualized ovulation induction by human menopausal gonadotropins.

One hundred six women suffering from obstructive tubal disease not corrected by previous surgery were treated in an in vitro fertilization (IVF) program. Ovulation was induced by 3 amps of human menopausal gonadotropin (HMG)/day starting on the third day of the cycle for 5 days. In most of the patients the regimen was continued for another 1-3 days, depending on the individual's ovarian response (mean, 20 +/- 5 amps/cycle). Monitoring consisted of daily follicular ultrasonography and serum estradiol measurements. Human chorionic gonadotropin (HCG), 10,000 IU, was administered when more than two large (1.5 to 1.8 cm in diameter) follicles were visualized. Using this regimen, a mean of five follicles per woman was aspirated, from which a mean of 3.9 ova was recovered. The oocytes were pre-incubated for 8 or 24 hr, according to the morphological degree of mucification and dispersal of the oocyte-corona-cumulus complex. Following exposure to washed spermatozoa for 16 hr, a 68% fertilization rate was obtained. Oocytes were transferred into the uterus 48 hr after laparoscopy. Ninety-nine transfers (93% of the women) of 1-8 embryos (mean, 2.9/woman) were performed and resulted in 16 clinical pregnancies. No pregnancies occurred in 14 women transferred with one to three oocytes in the pronuclear stage and only one pregnancy (7.1%) was obtained in 14 women transferred with one cleaved oocyte. Over 70% of the women were transferred with two or more cleaved oocytes: in this group the pregnancy/transfer rate was 21%. Of the pregnant women 5 of 16 (31%) aborted between 6 and 10 weeks of gestation and 1 (6%) had an ectopic pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗