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P Devroey

Publications and source records attributed to P Devroey.

At least 217 records · Page 12Linked to original sources
PubMed1994

Time-course of oocyte activation, pronucleus formation and cleavage in human oocytes fertilized by intracytoplasmic sperm injection.

Knowledge of the timing of the stages of fertilization in humans is still limited because the time of gamete fusion is not known when pre-ovulatory or in-vitro matured cumulus-enclosed oocytes are inseminated. We therefore studied the morphological nuclear changes in 14 patients' oocytes by means of light microscopic observation at 2, 4, 6, 8, 16, 18 and at 20 h after intracytoplasmic single sperm injection (ICSI). A total of 144 metaphase II oocytes were injected with the spermatozoa of the patients' partners. Out of the 134 oocytes that survived the injection, 93 displayed two pronuclei in the course of the observation period (69%). Out of the 93 normally fertilized oocytes, 21 extruded the second polar body at 2 h after micro-injection (23%) and 63 oocytes at 4 h (68%). Pronuclei appeared as early as 6 h after ICSI in 16 normally fertilized oocytes (17%). At 8 h, 75 (80%) oocytes had two visible pronuclei, at 16 h 92 (99%), at 18 h 76 (82%) and at 20 h 63 (68%). In 24 oocytes (26%) the appearance of pronuclei was asynchronous, while the disappearance of the pronuclei was always synchronous, except in one oocyte. Nine of the 134 successfully injected oocytes showed three equal-sized pronuclei (6.7%). Four of the nine multi-pronucleated oocytes did not extrude the second polar body at all, while the time sequence of appearance of pronuclei was similar to that of the normally fertilized oocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Prospective follow-up study of 55 children born after subzonal insemination and intracytoplasmic sperm injection.

In 163 couples referred for assisted fertilization, pregnancy was established by subzonal insemination (SUZI), intracytoplasmic sperm injection (ICSI) or a combination of both techniques. These couples agreed to participate in a prospective study that included a prenatal diagnosis and clinical follow-up of the children. No cytogenetic aberrations were observed in 43 children tested. In 23 pregnancies occurring after SUZI, 15 women gave birth to 21 children. After replacement of combined SUZI and ICSI embryos, 10 pregnancies resulted in 8 deliveries with 10 children. Transfer of ICSI embryos led to 130 pregnancies ending in 20 deliveries with 24 children, with many others still ongoing successfully. In total, 55 children have been examined: 29 boys and 26 girls. One child from a singleton pregnancy presented multiple congenital malformations; one twin child presented a quadriparesis. In this observational study on a limited number of children, the incidence of major malformations was not different from the incidence in the general population.

Abnormalities, Multiple↗
PubMed1994

The influence of pentoxifylline on motility and viability of spermatozoa from normozoospermic semen samples.

In order to evaluate the effects of pentoxifylline on sperm motility and longevity, a controlled in-vitro study was conducted on normozoospermic donor semen samples using the Cellsoft automated system for sperm motility analysis. After incubation and selection, pentoxifylline was found to improve the recovery of spermatozoa and to increase their velocity. In the subgroup of progressively motile spermatozoa, curvilinear velocity was also enhanced. It is concluded that pentoxifylline has an effect on the vigour, but not on the pattern, of sperm motion. Pentoxifylline did not improve the motility characteristics of senescent spermatozoa in normozoospermic sperm samples. Sperm survival, as shown by supra-vital staining, and motility longevity both decreased with time after pentoxifylline treatment.

Automation↗
PubMed1994

The use of recombinant FSH for ovulation induction.

Recombinant human FSH (recFSH) was tested in a phase II study in 50 couples superovulated for IVF. Rec FSH alone was used in 10 women (Group 1). Intranasal buserelin spray (150 micrograms x 4 daily) was used in a flare-up protocol (10 women; Group 2) or in a desensitization protocol (10 women; Group 3) in combination with rec FSH. Desensitization using Triptorelin depot (3.75 mgIM) followed by rec FSH was given to 10 women (Group 4), while the same agonist was used subcutaneously (200 micrograms/daily) in Group 5 (10 women). In the five groups rec FSH induced multiple follicular growth. Significantly more ampoules rec FSH were required when a GnRH agonist was used. I all groups 9 to 11 mature oocytes were retrieved per cycle. In 6 couples there was an absence of fertilization due to severe sperm anomalies (5 couples); one couple suffered from idiopathic infertility. Fertilization and cleavage was normal in 44 couples. Forty-three transfers of 2.3 to 2.8 embryos yielded 10 pregnancies. Nine healthy babies were born. Superovulation for IVF was successful and safe by using rec FSH alone or in combination with various GnRHa dosages and protocols.

Buserelin↗
PubMed1994

Cryopreservation of supernumerary multicellular human embryos obtained after intracytoplasmic sperm injection.

OBJECTIVE: To investigate the pregnancy rate of frozen-thawed human supernumerary multicellular embryos that were cryopreserved after intracytoplasmic sperm injection or IVF. DESIGN: A clinical study. SETTING: Consenting patients in an academic research environment. PATIENTS: Couples with severe male infertility, indicated by failed or sporadic fertilization after IVF or subzonal insemination or by < 500,000 progressively motile spermatozoa in the entire ejaculate, and couples for IVF during the same period. INTERVENTIONS: After microinjection or IVF, the three best-quality embryos were transferred, and 1,171 embryos from intracytoplasmic sperm injection compared with 2,495 embryos from IVF were frozen with dimethyl sulphoxide. Of these, 413 and 969 embryos were thawed, respectively. MAIN OUTCOME MEASURE: The survival rate, the total and clinical pregnancy rates, the delivery rate, and the preclinical abortion rate were calculated. RESULTS: Fifty-three percent of the thawed intracytoplasmic sperm injection embryos survived. Twenty-two pregnancies have been established in 101 transfers, corresponding to a total pregnancy rate of 21.8% per transfer. The clinical pregnancy rate was 12.9% per transfer and the delivery rate was 5.9% per transfer. Of the IVF embryos, 51% survived and 37 pregnancies have been established in 253 transfers. The total and clinical pregnancy rates and the delivery rate were 14.6%, 10.7%, and 7.1%, respectively. The preclinical abortion rate was 40.9% for cryopreserved intracytoplasmic sperm injection embryos and 27.0% for IVF embryos. CONCLUSIONS: The high incidence of preclinical abortions after transfer of human embryos cryopreserved after intracytoplasmic sperm injection requires extension of the series.

Abortion, Spontaneous↗
PubMed1993

Polymerase chain reaction analysis of the cystic fibrosis delta F508 mutation in human blastomeres following oocyte injection of a single sperm from a carrier.

The efficiency of the polymerase chain reaction (PCR) in detecting the cystic fibrosis (CF) delta F508 mutation (which is the most common mutation of CF) was assessed in single human blastomeres. Twenty-one human immature oocytes (germinal-vesicle-stage oocytes) that had been donated for research were matured in vitro and a single spermatozoon from a carrier of the CF delta F508 mutation was injected into the ooplasm. Fourteen embryos were obtained after intracytoplasmic sperm injection (ICSI). PCR analysis was carried out on 70 single blastomeres isolated from these 14 embryos. The results showed that the efficiency of DNA amplification by PCR in single nucleate blastomeres was 94 per cent (59/63). There were no false-positive results since none of the blank samples or the blastomeres without a nucleus showed an amplified signal. We found that nine embryos were homozygous for the unaffected genotype and that four embryos were heterozygous since they contained both the unaffected and the delta F508 genotype. In a four-cell embryo, we observed the homozygous unaffected genotype in one blastomere and a heterozygous delta F508/unaffected genotype in the other three blastomeres.

Blastomeres↗
PubMed1993

Pentoxifylline is not useful in enhancing sperm function in cases with previous in vitro fertilization failure.

OBJECTIVE: To assess the efficiency of the addition of pentoxifylline to spermatozoa for in vitro fertilization (IVF) in cases with previous fertilization failure. DESIGN: After retrieval, oocytes were divided at random and inseminated with spermatozoa prepared with or without pentoxifylline. SETTING: In vitro fertilization program of the Centre for Reproductive Medicine of the Dutch-speaking Brussels Free University, Belgium, a tertiary referral institution. PATIENTS: Couples in this study were undergoing a second or third IVF attempt for the treatment of male factor infertility. INTERVENTIONS: Sperm samples were divided into two equal parts. The first part was prepared with 3.6 mM pentoxifylline (treatment group) and the other part without pentoxifylline (control group). After swim-up, oocytes were randomly inseminated with spermatozoa from either treatment. MAIN OUTCOME MEASURES: Fertilization and cleavage rates after IVF. RESULTS: Overall a fertilization rate of 8.8% was achieved with no significant differences between treatment and control groups. Cleavage rate was 81.5% and was not different between groups. CONCLUSIONS: This study demonstrates no therapeutic advantage of using pentoxifylline in IVF for male factor infertility in cases with previous fertilization failure.

Adult↗
PubMed1993

Efficiency of polymerase chain reaction assay for cystic fibrosis in single human blastomeres according to the presence or absence of nuclei.

OBJECTIVE: To amplify by polymerase chain reaction (PCR) assay the region of the most common mutation of cystic fibrosis (CF) in human blastomeres. DESIGN: Blastomeres were isolated from two- to eight-cell tripronucleate embryos. The nuclear status of blastomeres was recorded by light microscopy (LM) and by fluorescence microscopy after vital labeling with the fluorochrome Hoechst 33342 (H-33342; Sigma, Brussels, Belgium). In each blastomere the region around the delta F508 mutation site was amplified by two PCRs with nested primers. SETTING: Research units of the Centres for Reproductive Medicine and Medical Genetics of the Dutch-speaking Free University of Brussels, Belgium. RESULTS: The presence of a nucleus by LM in 118 of 160 blastomeres was always confirmed by fluorescence microscopy, and in 10 additional blastomeres the nucleus was only visible by fluorescence microscopy. In the PCR assay all blanks were negative and in nucleate blastomeres (assessed by LM) the amplification rate was 96%. After staining with Hoechst dye the percentage of amplification was 71% or 91% if PCR was performed 2 hours or 20 hours after coloration. CONCLUSION: Efficient preimplantation diagnosis for CF on blastomeres requires assessment of nuclear status by LM and vital staining on blastomeres that are anucleate by LM.

Benzimidazoles↗
PubMed1993

Sperm characteristics and outcome of human assisted fertilization by subzonal insemination and intracytoplasmic sperm injection.

OBJECTIVE: To investigate the influence of sperm characteristics on the treatment by subzonal insemination (SUZI) and intracytoplasmic sperm injection of couples with severe male infertility. DESIGN: A retrospective analysis of 300 consecutive cycles of assisted fertilization concerning 202 infertile couples was performed. One hundred fifty-three couples underwent 362 unsuccessful IVF cycles, whereas on 49 couples IVF was not performed because of poor sperm characteristics. SETTING: Procedures were performed in an institutional research environment. PATIENTS, PARTICIPANTS: Couples in which the male partner was the presumed cause of repeated failure to achieve conception by IVF or in which seminal parameters were unacceptable for IVF. INTERVENTIONS: Three hundred transvaginal oocyte retrievals were performed after superovulation by GnRH agonist and gonadotropins. MAIN OUTCOME MEASURES: After SUZI and intracytoplasmic sperm injection the following parameters were evaluated: fertilization, cleavage, pregnancy, and implantation rates in relation to the sperm parameters and the proportion of acrosome-free spermatozoa after different treatments. RESULTS: Normal fertilization occurred in 18% of the oocytes treated by SUZI and in 44% after intracytoplasmic sperm injection. Only the treatment by electroporation showed a positive correlation with the fertilization rate. Fourteen pregnancies were obtained after SUZI, 8 pregnancies after intracytoplasmic sperm injection, and 8 pregnancies after a combination of the two procedures. A score calculated from the sperm parameters after selection correlated with the fertilization obtained after SUZI, whereas a score calculated from the parameters before sperm selection correlated with the pregnancy rate. Sperm morphology influenced the implantation rate of the embryos obtained with these two procedures. CONCLUSIONS: Intracytoplasmic sperm injection and SUZI can successfully treat couples who fail IVF or who cannot benefit from IVF. Different treatments can be applied to semen samples to increase the number of acrosome-reacted spermatozoa. The few significant relations found between sperm characteristics and the outcome of assisted fertilization cannot predict the outcome.

Adult↗
PubMed1993

Embryo reduction in triplet pregnancies after assisted procreation: a comparative study.

OBJECTIVES: To evaluate pregnancy outcome after selective embryo reduction by transcervical aspiration or transvaginal puncture and intrathoracal injection with potassium chloride (KCl) in triplet pregnancies occurring after assisted procreation and to compare this outcome with that for triplets not undergoing embryo reduction. DESIGN: Retrospective case series. SETTING: In vitro fertilization program of the Centre for Reproductive Medicine of the Dutch-speaking Brussels Free University, Belgium, which is a tertiary referral institution. PATIENTS: Seventy-two patients presenting a triplet pregnancy after assisted procreation. INTERVENTION: Transcervical aspiration embryo reduction at 8 to 9 weeks of pregnancy or transvaginal puncture and intrathoracal injection of KCl at 9 to 10 weeks of pregnancy. MAIN OUTCOME MEASURES: Rate of spontaneous embryo reduction, complications relating to the procedure, pregnancy, and neonatal outcome. RESULTS: The rate of spontaneous reduction was 18%. Among the 14 patients undergoing transcervical aspiration, 3 aborted and 4 lost an additional fetus. The transvaginal puncture technique had a lower complication rate (2/19). Neonatal outcome was improved in pregnancies after selective embryo reduction. After transvaginal puncture, the outcome was comparable with that for twin pregnancies after assisted procreation. CONCLUSIONS: Triplet pregnancies after assisted procreation had a poor neonatal outcome. The outcome was improved after spontaneous reduction. Transcervical aspiration should not be used because of its high rate of early and late complications. Transvaginal puncture had less early complications, but the technique might be associated with prematurity and third trimester fetal death. In triplet pregnancies, embryo reduction decreases the number of babies going home per patient, but the quality of life of the remaining babies is improved.

Abortion, Induced↗
PubMed1993

A prospective randomized study on oestradiol valerate supplementation in addition to intravaginal micronized progesterone in buserelin and HMG induced superovulation.

A prospective randomized study was conducted to evaluate the use of adding oestradiol valerate 6 mg per os daily to intravaginal micronized progesterone (600 mg daily) as luteal supplements. The study comprised 378 infertile women superovulated with a gonadotrophin releasing-hormone agonist (GnRHa) and human menopausal gonadotrophins (HMG) for in-vitro fertilization (IVF) or zygote intra-Fallopian transfer (ZIFT). The clinical pregnancy rate was similar (29%) whether or not oestradiol valerate was added to intravaginal progesterone. Eighteen out of twenty-two endometrial biopsies were in phase, and morphological evaluations of the two luteal supplementation groups were not different. Serum hormone profiles in singleton pregnancies showed a similar day of appearance of human chorionic gonadotrophin (HCG) in both protocols but significantly lower oestradiol concentrations arose in the group without oestradiol valerate. In 32% of the singleton pregnancies, the first appearance of HCG occurred later than day 12 after HCG injection; in those ongoing pregnancies, corpus luteum rescue--as measured by significantly lower serum oestradiol and progesterone concentrations--was compromised. This study provided no evidence of any benefit of routinely supplementing GnRHa/HMG cycles with oestradiol valerate in addition to intravaginal micronized progesterone.

Administration, Intravaginal↗
PubMed1993

Avoidance of triplet pregnancies by elective transfer of two good quality embryos.

Attempts to increase the probability of a successful pregnancy in in-vitro fertilization (IVF) treatment by increasing the number of embryos transferred automatically also increase the probability of multiple pregnancies and their attendant risks. Even where the number of transferred embryos is limited to a maximum of three as in this and other centres, there is a high incidence of twins and triplets. The question therefore arises whether the number of transferred embryos should be further limited to a maximum of two in cases where the prognosis is otherwise good. The only objection to this idea is a possible lowering of pregnancy rate. The present study set out to investigate this question. No significant lowering of pregnancy rate was found, so that limiting the number of transferred embryos to two where the prognosis is otherwise good has now become standard practice in our centre. A good IVF prognosis was defined by the following criteria: first attempt for IVF, less than 37 years old, and good embryo development. From 183 patients fulfilling these criteria, 80 agreed to the transfer of two embryos (group 1) and 103 opted for a triple transfer (group 2). Patient characteristics and embryology results were similar in the two groups. In group 1, 34 patients (42.5%) became pregnant and in group 2, 50 (48.5%). This difference is not significant. Similarly, twin pregnancy rates in both groups were high; eight twin pregnancies (23.5%) in group 1 and 12 (24%) in group 2.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Effect of pentoxifylline on implantation and post-implantation development of mouse embryos in vitro.

Previous work from our laboratory has revealed that brief exposure of mouse zygotes to 3.6 and 7.2 mM pentoxifylline reduced cell numbers in mouse embryos reaching the blastocyst stage in vitro. Since a decrease in cell numbers may impair further development, the present study aimed to assess the implantation in vitro and the development beyond implantation of these embryos. Blastocysts cultured from the one-cell stage in the presence of 5, 10 and 50 microM pentoxifylline, i.e. concentrations expected in the secretions of the genital tract after oral administration, were shown to develop normally to the egg cylinder stage in vitro. Blastocysts, obtained after culture in vitro of zygotes exposed approximately 29 h after human chorionic gonadotrophin (HCG) for 30 min to 3.6 and 7.2 mM pentoxifylline, i.e. the concentrations used for enhancing sperm function in vitro, could implant but their development to the egg cylinder stage was found to be impaired. The same effect was noticed if blastocysts, grown in vitro from the one-cell stage, were exposed to 3.6 and 7.2 mM pentoxifylline for 30 min in vitro approximately 120 h after HCG. These findings imply that when pentoxifylline is used to enhance sperm function in vitro, it should be washed out of the preparation used for insemination.

Animals↗
PubMed1993

Loa loa microfilariae aspirated during oocyte retrieval.

Loa loa is a filarial parasite which is mainly confined to West and Central Africa. Although considered as mildly pathogenic for people living in endemic areas, its appearance in other places might be a cause for concern. We report here the unusual finding of Loa loa microfilariae in the follicular aspirate of a 35-year-old black women during oocyte retrieval for in-vitro fertilization. Most likely these microfilariae were aspirated, along with follicular fluid, from the small blood vessels around the ovarian follicles, which are frequently lacerated during ovarian puncture. Despite the spectacular microscopic view of vigorous moving worms trapped on the cumulus cells, the presence of Loa loa microfilariae does not seem to prevent fertilization and cleavage completely.

Adult↗
PubMed1993

Intracytoplasmic single sperm injection of 1-day-old unfertilized human oocytes.

Although the average fertilization rate in most in-vitro fertilization (IVF) centres is approximately 60-70%, there are cases of complete or virtually complete fertilization failures. The aim of our work was to study the fertilization and the subsequent cleavage characteristics of 1-day-old human oocytes treated by intracytoplasmic single sperm injection (ICSI) after failing to fertilize during the standard IVF procedure. A total of 115 metaphase II 1-day-old unfertilized oocytes were collected from 23 patients. No additional treatment was applied to the oocytes or to the semen sample. A single spermatozoon from the patient's husband was injected into the cytoplasm of each of these oocytes 21-33 h after ovum retrieval. Injected oocytes were observed at 16-18 h and again 42-44 h after the ICSI procedure. Of the injected oocytes, 92% (n = 106) were intact after ICSI, 38% (n = 44) had two distinct pronuclei and there was no difference in the fertilization rate of oocytes when andrological and non-andrological patients were compared. Similarly, there was no difference in the fertilization rate after ICSI where patients with acceptable or good (> 15%) fertilization after standard IVF were compared to patients who had poor (< or = 15%) fertilization after IVF. There was no significant difference in the sperm concentration or in the progressive forward motility (a + b motility) in these groups except where a + b motility of andrological and non-andrological patients was compared. The majority (84%) of the normally fertilized oocytes cleaved and most (77%) of these embryos showed < 20% fragmentation 2 days after the ICSI procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Cellular Senescence↗
PubMed1993

Cytogenetic and morphological observations of single pronucleated human oocytes after in-vitro fertilization.

At 16-18 h after insemination, 5.5% of the inseminated oocytes displayed only one pronucleus. The incidence of single-pronucleated oocytes was not correlated with the age of the patient. Cytogenetic analysis of 41 embryos derived from single-pronucleated oocytes revealed a haploid chromosome complement in 12.2%, a diploid chromosome complement in 80.5% and a triploid set in 7.3% of the embryos. In one diploid metaphase, a Y chromosome could be clearly demonstrated. A total of 312 single-pronucleated oocytes were evaluated twice (at 16-18 h and at 20-24 h after insemination). In 25% of the single-pronucleated oocytes a second pronucleus was observed 4-6 h later, suggesting asynchronous or delayed pronuclear formation. The cleavage of these embryos was similar to the cleavage of embryos with two pronuclei at the first evaluation. Parthenogenetic activation and asynchronous pronuclei may both be mechanisms leading to the morphological observation of a single pronucleus. In clinical practice, the second repeat observation of single-pronucleated oocytes became part of the standard procedure.

Cell Nucleus↗