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Biomedical subjects

Mark V Sauer

Publications and source records attributed to Mark V Sauer.

44 records · Page 3Linked to original sources
PubMed2002

Establishing a clinical program for human immunodeficiency virus 1-seropositive men to father seronegative children by means of in vitro fertilization with intracytoplasmic sperm injection.

OBJECTIVE: We assessed the safety and efficacy of providing assisted reproduction to men who are seropositive for human immunodeficiency virus type 1 (HIV-1). STUDY DESIGN: HIV-1-serodiscordant couples underwent in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI). Patients were screened for HIV-1 3 and 6 months after embryo transfer to determine safety. Infants and mothers were tested at delivery and at 3 months after delivery. Clinical outcomes were compared with those of matched control couples who had undergone IVF-ICSI to measure efficacy. RESULTS: There were no seroconversions in women (n = 34) or offspring (n = 25) after 55 embryo transfers. Treatment efficacy was similar to that for control couples: retrieved eggs (15.8 +/- 1.3 vs 12.3 +/- 0.8); fertilization rate (64.9% vs 68.0%); embryos cryopreserved (1.1 +/- 0.3 vs 0.3 +/- 0.1, P <.05); clinical pregnancies per embryo transfer (45.5% vs 35.4%); ongoing or delivered pregnancies per embryo transfer (30.9% vs 25.0%). CONCLUSION: Although findings are preliminary, IVF-ICSI provides HIV-1-serodiscordant couples with a reasonably safe means of having children because their assisted reproduction performance is similar to that of conventional patients.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Supraphysiological estradiol levels do not affect oocyte and embryo quality in oocyte donation cycles.

BACKGROUND: The study aim was to determine whether supraphysiological estradiol (E(2)) levels reduce oocyte/embryo quality in oocyte donation cycles. METHODS: A retrospective analysis of 330 consecutive fresh oocyte donation cycles was performed in an assisted reproductive treatment programme between January 1996 and December 2000. Throughout the study period, oocyte donors and recipients followed a standard synchronization regimen that did not vary. A serum E(2) level (peak E(2)) was obtained from all oocyte donors on the morning of HCG administration. Peak E(2) values were grouped by 33rd percentile (group I, <1500 pg/ml; group II, 1500-3000 pg/ml; and group III, >3000 pg/ml). All embryo transfers were performed on day 3 after oocyte recovery. RESULTS: Comparisons between groups revealed no significant differences in the quality of oocytes retrieved, and in fertilization rates. Higher peak E(2) levels were directly correlated with a greater number of oocytes retrieved, embryos available for transfer and cryopreservation, and higher average embryo quality scores (P < 0.005). Compared with group I, group III had significantly higher embryo implantation rates (P < 0.05). CONCLUSIONS: Sustained supraphysiological E(2) levels do not adversely affect the quality of developing oocytes and embryos. On the contrary, elevated E(2) levels are associated with a larger number of oocytes and embryos and high-grade embryos for transfer/cryopreservation and, consequently, improved implantation rates.

Adult↗
PubMed2002

Serum estradiol levels after 4 days of ovarian hyperstimulation in oocyte donors are predictive of embryo quality and clinical outcomes.

OBJECTIVE: To determine whether estradiol (E(2)) levels after 4 days of ovarian hyperstimulation in leuprolide-downregulated cycles are predictive of embryo quality and pregnancy outcome in oocyte donation. MATERIAL AND METHODS: Retrospective analysis of 287 consecutive oocyte donation cycles performed at a university assisted reproduction therapy program between January 1996 and December 2000. Oocyte donors and recipients followed a non-varied standard synchronization regimen. A serum E(2) (day-5 E(2)) was obtained from egg donors the morning after leuprolide acetate downregulation and 4 days after hMG/FSH administration. Day-5 E(2) was categorized into 3 groups: group I <75 pg/ml; group II 75-350 pg/ml, and group III > or =350 pg/ml. All embryo transfers were performed 3 days after oocyte recovery. RESULTS: Elevated day-5 E(2) levels were directly correlated with higher average embryo scores, greater number of oocytes retrieved, and greater number of embryos available for transfer and cryopreservation. Improved pregnancy outcomes were also noted for group III (day-5 E(2) level >350 pg/ml). CONCLUSION: After 4 days of gonadotropin stimulation, an E(2) level of >350 pg/ml is most predictive of higher embryo grade and pregnancy outcome in oocyte donation.

Adult↗
PubMed2002

GnRH antagonist in older IVF patients. Retrieval rates and clinical outcome.

OBJECTIVE: To determine if the use of a midcycle GnRH antagonist provides better clinical outcomes and lower cancellation rates in in vitro fertilization (IVF). STUDY DESIGN: We examined all patients older than 40 years undergoing IVF-embryo transfer cycles between January 1999 and December 2000. Prior to June 2000, controlled ovarian stimulation in women > or = 40 years was performed with follicle stimulating hormone (FSH)/human menopausal gonadotropin (hMG) only and no GnRH agonist or antagonist (group I). After June 2000, following the release of Ganirelix in the U.S., all women > or = 40 years were stimulated with FSH/hMG + Ganirelix (group II). Outcomes of IVF cycles prior to Ganirelix were compared to results after its introduction. RESULTS: Cancellation rates were significantly lower in group II (16%) as compared to group I (67%) (P < .05). In patients with oocytes retrieved, group II had a significantly higher number of recovered oocytes (7.7 +/- 0.8 vs. 5.3 +/- 0.7, P < .05). However, the number of embryos transferred, cumulative embryo scores, implantation rates and ongoing pregnancy rates did not differ significantly between groups. CONCLUSION: Although our results are preliminary, the addition of GnRH antagonist avoids ovarian suppression at the start of controlled ovarian hyperstimulation and prevents the premature LH surge at midcycle. Thus, more patients attempting IVF undergo oocyte retrieval, although clinical outcomes may not necessarily be improved.

Adult↗
PubMed2001

Donor eggs and brother's sperm: creating genetic likeness in the conceptus of an unmarried menopausal woman.

A 51-year old woman desiring to have a child with genetic similarity to herself chose to undergo egg donation using her brother's spermatozoa. Following careful screening of all participants, in-vitro fertilization and embryo transfer was accomplished. The patient failed to become pregnant, but a subsequent embryo transfer using cryopreserved embryos obtained during the initial attempt successfully resulted in a singleton pregnancy. Although rarely requested, under certain circumstances, the choice of a brother as a designated sperm donor, may be reasonable, allowing a woman who would otherwise have no genetic likeness to the child, a chance for motherhood.

Journal Article↗