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Biomedical subjects

R Frydman

Publications and source records attributed to R Frydman.

At least 343 records · Page 19Linked to original sources
PubMed1986

Programmed oocyte retrieval during routine laparoscopy and embryo cryopreservation for later transfer.

Fixed-schedule ovulation induction and cryopreservation of the obtained embryos was performed in women undergoing a preliminary laparoscopy for infertility investigation before possible inclusion in an in vitro fertilization program. The cycle before follicular stimulation was modified by a progestogen or an estrogen-progestogen contraceptive pill. Ovarian inaccessibility precluded follicular aspiration in four of 34 patients but at least one oocyte was obtained in 29 of the remaining 30. Although fewer oocytes were obtained in these patients than in a control group undergoing in vitro fertilization treatment, one or more embryos were obtained in 22 patients in the study group. All embryos were frozen and to date 25 embryos from 17 patients have been thawed. Embryos have been placed in 16 of the 17 patients and six pregnancies have been initiated. Three are currently ongoing, one ectopic pregnancy was recorded, and two pregnancies were classified as "chemical." Programmed oocyte retrieval and embryo cryopreservation resulted in an extra chance of pregnancy in patients undergoing a laparoscopy for infertility investigation.

Adult↗
PubMed1986

An obstetric assessment of the first 100 births from the in vitro fertilization program at Clamart, France.

From April, 1981, to July, 1984, 142 pregnancies have been attained after in vitro fertilization and embryo transfer. They are divided into 22 biochemical pregnancies (human chorionic gonadotropin greater than or equal to 20 mU/ml but remaining below 1000 mU/ml), 27 spontaneous abortions, three ectopic pregnancies, and 90 ongoing pregnancies, of which 11 were twin pregnancies. The 90 women in whom the pregnancies progressed were compared with the 52 women having nonprogressive pregnancies. The two populations did not differ either in age, in the indication for in vitro fertilization and embryo transfer, or in the quality of ovulation or results of semen analysis. The 90 ongoing pregnancies were compared with those pregnancies occurring in the same obstetrics department during this period. We found that the in vitro fertilization group had a higher proportion of arterial hypertension (16.5% versus 8.5%, p less than 0.05), breech presentations (13.9% versus 4.3%, p less than 0.001), and caesarean sections (46.8% versus 15.5%, p less than 0.001) but the sex ratio did not differ.

Abortion, Spontaneous↗
PubMed1986

In vitro fertilization management and results in stimulated cycles with spontaneous luteinizing hormone discharge.

During a period of 14 months, in an in vitro fertilization program, 97 ultrasonically guided follicular punctures were performed in women with premature spontaneous luteinizing hormone (LH) discharge (group I) and 217 in women with a normal LH value who received human chorionic gonadotropin injection as a surrogate LH surge (group II). All cycles were stimulated by clomiphene citrate plus human menopausal gonadotropin. In group I, oocytes were not recovered in 35% of punctures, compared with only 21.2% in group II (P less than 0.02). In cycles in which the serum 17 beta-estradiol (E2) levels was less than 1200 pg/ml and the number of follicles greater than or equal to 14 mm diameter monitored was less than three, 69% of punctures in group I and 36.7% of punctures in group II failed to yield oocytes. We suggest that patients stimulated in this way who have a spontaneous LH discharge with an E2 value of less than 1200 pg/ml and less than three follicles 14 mm in diameter present should not proceed to follicular puncture.

Adult↗
PubMed1986

Relationships between embryo transfer results and ovarian response and in vitro fertilization rate: analysis of 186 human pregnancies.

We studied the relationships between "pretransfer" parameters (number of follicles, oocytes, and embryos) and the result (occurrence and quality of pregnancy) obtained by transferring one, two, or three embryos. The analysis concerns 186 pregnancies compared with 186 implantation failures. The chances for an oocyte to cleave or for a pregnancy to continue decreased when the number of preovulatory follicles increased. The number of transferred embryos increased with oocyte cleavage rate in nonpregnant patients and in patients with an ongoing pregnancy, but such a relation was not found in the case of failed pregnancy (biochemical pregnancies and abortions). Failed pregnancies occurred in patients who demonstrated the highest oocyte cleavage rate (94.1%), compared with 81.2% for implantation failure and 84.8% for ongoing pregnancy (P less than 0.01). The cleavage rate was also higher in cases of multiple, compared with single, ongoing pregnancies after the transfer of three embryos (79.7% versus 64.5%, P less than 0.001). An important finding was the higher survival rate after triple-embryo transfer in patients, yielding numerous oocytes. The survival rate (fetuses per transferred embryos) after the transfer of three embryos was 14.9% in patients yielding five oocytes, versus 7.7% in patients yielding 3.4 oocytes (P less than 0.05). These results are related to oocyte and embryo viability and uterine ability for pregnancy.

Abortion, Spontaneous↗
PubMed1986

High pregnancy rate after early human embryo freezing.

Human embryos produced by in vitro fertilization (IVF) were frozen with 1,2-propanediol as a cryoprotectant. Embryo survival after thawing was related to the presence of a nucleus in frozen cells and decreased with the increasing number of cells in the frozen embryo. None of five embryos frozen 3 or 4 days after IVF survived when thawed. Of 48 early embryos (35 patients) frozen 1 or 2 days after IVF, 42 (87.5%) were transferred in 32 patients. Ten pregnancies were initiated after frozen embryo transfer (ET). If we exclude the three infertile patients who had sexual intercourse in the fertile period, the pregnancy rate for each patient who had 1- or 2-day frozen embryo(s) was 22% (7 of 32). One of the pregnancies was obtained after ET of a 1-cell pronucleated frozen and thawed embryo. The rate of ongoing pregnancies after triple fresh ET was 23%. In patients having four embryos obtained in a single IVF cycle, the expected overall liveborn rate in an IVF-ET program including embryo cryopreservation could theoretically equal that of natural human fertility.

Cell Survival↗
PubMed1986

A new approach to follicular stimulation for in vitro fertilization: programed oocyte retrieval.

Programed oocyte retrieval was performed in a group of 35 patients undergoing in vitro fertilization (IVF) treatment. The date of follicular aspiration was decided several months in advance and the cycle prior to oocyte recovery was modified with a progestagen or an estrogen-progestagen contraceptive pill. This was followed by a fixed-schedule ovulation stimulation and induction regimen. Follicular growth was not monitored. Thirty-four of the 35 patients had follicular aspiration, and at least one embryo was obtained in 30 of them. The clinical pregnancy rate (excluding cryopreserved embryos) was 20% per IVF cycle, 21% per attempted oocyte retrieval procedure, and 23% per embryo transfer cycle. Programmed oocyte retrieval is a realistic option for follicular stimulation for IVF treatment and is associated with significant practical and economic benefits.

Contraceptives, Oral, Combined↗
PubMed1986

Sperm factors related to failure of human in-vitro fertilization.

Two groups of men were retrospectively selected according to their observed success in in-vitro fertilization. Seminal and post-migration sperm samples from a low fertilization rate group (less than or equal to 33% cleaved embryos) have been compared to results obtained from a high fertilization rate group (greater than or equal to 66%). It was found that a low mean value of the amplitude of lateral sperm head displacement and an increased percentage of abnormal acrosomes were related to in-vitro fertilization failure. None of the individual sperm factors studied was found to determine in-vitro fertilization success with certainty; only when they were considered in combination was it possible to predict the likelihood of successful in-vitro fertilization of human oocytes.

Acrosome↗
PubMed1986

[Extra-uterine pregnancy and in vitro fertilization].

About 10 p. cent of pregnancies which develop after in vitro fertilization and implantation of the ovum in the uterus are extrauterine. This surprising statement evokes several explanations and the authors consider that their prevention by preliminary tubal sterilization is quite excessive.

Embryo Transfer↗
PubMed1985

Various techniques for oocyte recovery in an in vitro fertilization and embryo transfer program.

Oocyte recovery in an in vitro fertilization and embryo transfer (IVF-ET) program can be performed by laparoscopy or by sonography. Most IVF teams use either one or the other of these methods. In Clamart, we undertook 407 IVF attempts from September 1983 to March 1984, 225 by laparoscopy under general anesthesia, 97 by laparoscopy under local anesthesia, and 85 by sonography. Excluding the recovery techniques, all aspects of the program (ovulation monitoring, culture, and transfer) were identical in order to study the effects of the anesthesia and the ultrasound. We did not find any significant difference in pregnancy rates, inclusive of biochemical pregnancies, among these three recovery methods, although ultrasonically guided puncture gave fewer follicles, oocytes, and embryos than laparoscopy.

Adult↗
PubMed1985

In vitro fertilization in tuberculous infertility.

Twenty women, suffering from infertility due to histologically proved genital tuberculosis, were managed by in vitro fertilization (IVF) in 49 attempts. The main histopathological lesions were tuberculous salpingitis in 12 women, tuberculous endometritis in 5, and pelvic peritoneal tuberculosis in 3. A preliminary evaluation including, particularly, a laparoscopy and a hysteroscopy was performed. Five deliveries and one ongoing pregnancy were obtained. The results suggest that IVF nowadays represents the only treatment for tuberculous infertility.

Adult↗
PubMed1985

Factors affecting human in vitro fertilization: a multifactorial study.

The influence of four factors on the cleavage rate of 705 mature oocytes submitted for in vitro fertilization (IVF) was assessed with the use of a multifactorial method, i.e., logistic regression. The studied factors were (1) the regimen for cycle stimulation, (2) cumulus cell mass appearance, (3) semen quality, and (4) the time of incubation of oocytes before insemination. The logistic function permitted testing the respective influence of each factor on the cleavage rate, with the level of the other factors taken into account. The most important factor was the stimulation treatment, the association of human menopausal gonadotropin with clomiphene citrate (CC) giving better results than CC alone. Time of incubation was demonstrated to have no influence on the cleavage rate, whereas semen quality had an influence. A problem was raised by the existence of an interaction between the stimulation treatment used and the appearance of the cumulus cell mass. It can be concluded that adequate cycle treatment and eventually couple selection with respect to the semen quality of the male partner are to be considered in view of obtaining better results in IVF attempts.

Adult↗
PubMed1985

Ultrasound study of the endometrium during in vitro fertilization cycles.

Ultrasonography is a noninvasive technique for studying the characteristics of the endometrium. This method was used in our in vitro fertilization and embryo transfer program during the periovulatory period for determination of whether there exists a moment at which the uterine mucosa is most favorable for implantation of the ovum. The endometrial thickness was noted in the course of the periovulatory phase. No correlation was found between the ultrasound image and hormonal assays. The endometrial thickness was significantly greater (P less than 0.01) when the in vitro fertilization attempt resulted in a pregnancy, even when considering the number of embryos transferred. However, it was not possible to predict the probability of pregnancy with the use of endometrial thickness.

Embryo Transfer↗