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Biomedical subjects

R G Edwards

Publications and source records attributed to R G Edwards.

At least 163 records · Page 9Linked to original sources
PubMed1985

Pregnancies following the frozen storage of expanding human blastocysts.

Human blastocysts were frozen in Earle's solution containing pyruvate and human serum, using glycerol as cryoprotectant, and stored in liquid nitrogen. Thawed blastocysts were replaced in 11 patients, which resulted in two pregnancies. One blastocyst giving a pregnancy was hatching when replaced. Three parameters appeared to be important for embryo survival and implantation: the interval between ovulation and replacement of the thawed blastocysts, satisfactory embryonic development before freezing, and the stage of blastulation when cooling began.

Blastocyst↗
PubMed1985

In vitro fertilization using cryopreserved donor semen in cases where both partners are infertile.

The incidence of pregnancy after in vitro fertilization (IVF) was studied in a group of 38 couples (55 cycles) where both partners were infertile. Cryopreserved donor semen (IVF-D) was used in all cycles. Results were compared with those in a control group of couples where the husband's semen was considered normal and only the wife was infertile. No significant differences were found between the IVF-D and control groups in the incidence of fertilization (80% versus 72%), pregnancy per cycle (33% versus 29%), and abortion (18% versus 20%), despite the considerably lower percentage of motile spermatozoa in the IVF-D group. Forty percent of patients, each treated unsuccessfully with at least 12 artificial inseminations with donor semen, became pregnant after one or two IVF-D cycles. It is concluded that IVF with frozen donor semen is a beneficial treatment for couples where both partners are infertile.

Female↗
PubMed1985

Cryopreservation of cleaving embryos and expanded blastocysts in the human: a comparative study.

The survival and implantation capacity of cryopreserved cleaving (5-cell to 10-cell) human embryos and expanded blastocysts was compared. Twice as many cleaving embryos were frozen as were expanding blastocysts because of the low developmental potential of human embryos in vitro. However, significantly more expanded blastocysts survived cryopreservation than cleaving embryos, and relatively more pregnancies were established by the replacement of thawed blastocysts than by the replacement of thawed cleaving embryos. Cleaving embryos from 26 women were thawed; 17 had thawed embryos replaced, and 4 subsequently became pregnant. Expanded blastocysts were thawed from 23 other women; 15 had thawed blastocysts replaced, and 8 subsequently became pregnant. The pregnancy of one patient in each group aborted; both patients were over 40 years of age. It is estimated that by maintaining the current policy of replacing three fresh embryos and freezing any remaining embryos when they reach blastocyst stage, the total incidence of pregnancy would increase by 3%.

Abortion, Spontaneous↗
PubMed1985

The influence of transient hyperprolactinemia on in vitro fertilization in humans.

Hormonal stimulants of ovarian follicular maturation and anesthesia/surgery were examined for their effects on the concentration of plasma and follicular fluid PRL. Forty-seven patients undergoing in vitro fertilization for the treatment of infertility were selected at random for this prospective study. Patients given human menopausal gonadotropin and clomiphene citrate had significantly higher levels of plasma PRL compared to those given clomiphene only. Anesthesia/surgery elevated plasma PRL levels in all patients, by as much as 50-fold and to as high as 7878 mIU/liter. Follicular fluid PRL levels were correlated with preanesthetic plasma PRL concentrations, but the latter were not correlated with plasma 17 beta-estradiol. Elevated plasma or follicular fluid PRL concentrations had no effect on in vitro fertilization of oocytes or embryonic development. Although not significant, the incidence of pregnancy was highest in the group of patients with the lowest preanesthetic plasma PRL levels.

Anesthesia↗
PubMed1985

A statistical evaluation of implantation after replacing one or more human embryos.

All the available data relating to pregnancy and multiple implantations from Bourn Hall Clinic are used to assess the accuracy of two statistical models of implantation. The simple binomial model was found to be incapable of describing both the pregnancy rates and the incidence of multiple implantations, whereas a two-parameter model, incorporating both patient and embryo variability, provided a good fit to the data. The estimates obtained for the two parameters in the second model suggested that 36% of the embryos could implant, and that 43% of patients were capable of sustaining implantation. The Maximum Likelihood method of constructing 95% confidence limits on the estimates of the parameter values is demonstrated.

Embryo Implantation↗
PubMed1984

Factors influencing the success of in vitro fertilization for alleviating human infertility.

The program for in vitro fertilization at Bourn Hall began in October 1980. Various types of infertility have been treated during this time using the natural menstrual cycle or stimulation of follicular growth with antiestrogens and gonadotrophins. Follicular growth and maturation are assayed by urinary estrogens and LH, monitored regularly during the later follicular stage. Many patients had an endogenous LH surge; others needed an injection of HCG to induce ovulation. All oocytes were recovered by laparoscopy. Wide variations occurred in the time interval between the start of the LH surge and oocyte recovery and between oocyte recovery and insemination. Embryos taken between the one- and the eight-cell stage were replaced into their mother, no standard procedure being adopted for all patients. The results of all treatments including patient's responses during the follicular and luteal phases, oocyte recovery, fertilization, cleavage, replacement, implantation, abortion, and birth and the effect of factors such as replacing two or more embryos, maternal age, and previous obstetric history are described in detail. The incidence of implantation after embryo replacement improved from 16.5% initially to 30% currently. More than 118 babies have been born, and many pregnancies are continuing.

Abortion, Spontaneous↗
PubMed1984

The application of the zona-free hamster egg test for the prognosis of human in vitro fertilization.

The zona-free hamster egg test was carried out using spermatozoa from 15 men which consistently failed to fertilize their wives' oocytes in vitro. Spermatozoa from nine of these men fertilized hamster eggs in vitro, indicating that positive results in this assay are an unreliable guide to human in vitro fertilization. Donor spermatozoa were needed to fertilize the wife's oocytes in three of these cases. Nevertheless, the proportion of hamster egg penetration was significantly lower compared with spermatozoa from 15 men who could fertilize their wives' oocytes in vitro. The hamster assay also failed to indicate the establishment of pregnancy.

Adult↗
PubMed1984

Analysis of 25 infertile patients treated consecutively by in vitro fertilization at Bourn Hall.

Twenty-five infertile women suffering from tubal disorders were treated consecutively by in vitro fertilization over a 14-day period. Follicular growth in 24 of them was stimulated with clomiphene citrate, ovulation being induced by an endogenous surge of luteinizing hormone or an injection of human chorionic gonadotropin. One patient was given tamoxifen and had an endogenous luteinizing hormone surge. One or more oocytes were fertilized, and at least one embryo was replaced in 19 patients. Nine pregnancies were established, and eight infants have been delivered, a pregnancy rate of 36% per laparoscopy and 47% per replacement. A detailed analysis of each patient is presented.

Adult↗