Biomedical subjects
Publications and source records attributed to S Gordts.
Microsurgical techniques have changed the outcome of infertility surgery. Tubal anastomosis for reversal of sterilization has resulted in pregnancy rates of up to 65%. In cases of salpingostomy, the ectopic pregnancy rate is quite high. In ovarian microsurgery, postoperative adhesions can be avoided and a 54% pregnancy rate achieved with endometriosis surgery.
In a two-centre prospective study 20 patients with a history of unsuccessful sterility treatment underwent immunization with paternal lymphocytes to improve the pregnancy rate in the subsequent therapeutic AIH or IVF/ET cycle. Unsuccessful sterility treatment was defined as no pregnancy after 8 properly monitored AIH cycles and at least one diagnostic IVF/ET or more than 3 IVF with transfer of 3 embryos. After successful immunization expressed by the induction of Fc-receptor blocking antibodies 10/20 patients became pregnant. Nine of these patients delivered healthy children, one patient experienced a first trimester abortion. A successful second pregnancy occurred in 6 of these patients. No significant correlation between the previous history and pregnancy success could be found, except a slight advantage for patients with a history other than tubal sterility. There were no differences in the anamnestic data as well as in the success rate between the two independent centres Göttingen and Leuven (10 patients each). These data suggest, that adjuvant immunotherapy might improve markedly the pregnancy rates in selected cases of sterility.