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T al-Shawaf

Publications and source records attributed to T al-Shawaf.

31 records · Page 2Linked to original sources

The reproductive outcome following a superhigh response to stimulation in gamete intrafallopian transfer program.

A retrospective analysis was carried out to assess the outcome of gamete intrafallopian transfer (GIFT) in cycles when more than 10 oocytes were retrieved (superhigh responders) from October 1987 through June 1989. There were 276 (13%) cycles with more than 10 oocytes retrieved among all GIFT cycles initiated during the period. Clomiphene citrate and gonadotropin were employed for ovarian stimulation in 105 (38%) cycles, and gonadotropin releasing hormone agonist in the remaining 171 (62%) cycles, employing either the flare (104 cycles) or the pituitary down-regulation (67 cycles) protocol. A maximum number of four oocytes was transferred per GIFT (3.5 +/- 0.4). The mean number of oocytes retrieved was 14.7 +/- 4.4 (range, 11 to 35). A significantly younger age group (less than 30 years) of patients was noticed in the study (31.9), and fewer women aged 40 and over (6.2%), compared to the general population of our patients. The pregnancy rate was 33.3% (n = 92) per cycle, with a delivery rate of 23.6% (n = 64) per cycle; the pregnancy loss rate was 30.8%. The reproductive outcome was lower in women aged 40 and over (pregnancy rate was 23.5%, but delivery rate was only 5.8% per cycle). The delivery rate was lower in the clomiphene citrate- and gonadotropin-stimulated cycles (51.7% per pregnancy) in relation to gonadotropin-releasing analogue and gonadotropin cycles (76.6% per pregnancy) and significantly so compared with the pituitary down-regulation protocol (83.3% per pregnancy). We conclude that a superhigh response develops more in younger women, and in such circumstances, the use of pituitary down-regulation with gonadotropin-releasing hormone will improve the reproductive outcome.

Adult↗

Pregnancy following gamete intra-fallopian transfer (GIFT) with cryopreserved semen from infertile men following therapy to lymphomas or testicular tumour: report of three cases.

Cryopreserved spermatozoa from men having treatment for lymphoma or testicular tumour have been reported to function sub-optimally. We report on three successful pregnancies following gamete intra-Fallopian transfer (GIFT) using such cryopreserved sperm samples. In one case, ovum donation was required since the woman had premature ovarian failure.

Adult↗

Outcome and complications of assisted reproduction.

This review discusses studies documenting an increase in birth rate associated with in vitro fertilization and gamete intrafallopian transfer. The results of zygote intrafallopian transfer are also encouraging. The rates of chromosomal and congenital abnormalities in assisted reproduction are similar to the rates at which these problems occur in normal pregnancies. Multiple pregnancy is the main determinant of outcome. Singleton pregnancies have higher rates of pregnancy complications. Factors affecting outcome of assisted reproduction include age of the mother, level of basal follicle-stimulating hormone, the number of embryos or gametes transferred, response to ovarian stimulation, and the quality of gametes and eventually of the embryo. Complications of these procedures relate to the technique used. Recent reports have highlighted the effects of multiple gestation in terms of perinatal morbidity, the effect on the family, and the demand for neonatal resources, as well as ethical issues surrounding selective reduction. The use of gonadotropin-releasing hormone agonist has led to an increase in the incidence of severe ovarian hyperstimulation. Other reports document the incidence of ectopic pregnancy in in vitro fertilization with embryo transfer.

Birth Rate↗

Transfallopian tube embryo transfer: successful pregnancy outcome.

A case of partial Asherman syndrome and blocked fallopian tube following complication of cesarean section is presented. Two IVF-ET attempts failed where difficulty at uterine embryo transfer was encountered. Transtubal embryos transferred 48 hr after transvaginal oocyte collection and in vitro fertilization resulted in an in utero pregnancy and delivery.

Adult↗

Fertilization of supernumerary oocytes following gamete intrafallopian transfer (GIFT): correlation with outcome of GIFT treatment.

In the course of 280 consecutive gamete intrafallopian transfer (GIFT) attempts, supernumerary oocytes in excess of those transferred were inseminated in vitro. Pregnancy resulted in 31.1% of patients following the GIFT treatment. The overall in vitro fertilization (IVF) rate of supernumerary oocytes was significantly higher in those who became pregnant (41.2%) than in patients who did not (34.9%). However, the failure to fertilize any supernumerary oocytes was not significantly different between those becoming pregnant (27.6%) and those in whom the treatment failed (37.3%). Failure to fertilize any supernumerary oocytes in vitro was of a higher rate if suboptimal sperm preparation was used or if only one oocyte was left over for in vitro insemination following the GIFT treatment. We concluded that the in vitro fertilization rate was higher in the pregnant group, but the total failure to fertilize or the fertilization of any supernumerary oocytes does not predict the outcome of GIFT. Embryos resulting following fertilization of excess oocytes may be cryopreserved for subsequent use.

Adult↗

Gamete intra-fallopian transfer in non-endometriotic pelvic adhesions.

This report presents our experience with gamete intra-Fallopian transfer (GIFT) in cases with non-endometriotic pelvic adhesions. Two-hundred-and-eight GIFT attempts, where pelvic adhesions were identified laparoscopically in patients with no previous history of endometriosis, were subdivided into two groups: (i) post-surgical (n = 134) and (ii) non-surgical (n = 74). The extent of the adhesions was further classified according to the American Fertility Society (AFS) classification system. The overall clinical pregnancy rate was 39.4% (82 out of 208 attempts). There was no significant difference in the clinical pregnancy rate per attempt between the surgical (38.8%) and the non-surgical (40.5%) groups. A gradual, but not significant decline in the pregnancy rate was noticed from adhesion Stages I to III, but Stage IV had a significantly lower pregnancy rate (22.7%) than Stage I (47.4%). The intra-uterine pregnancy rate was observed to be higher, but not significantly, in the non-surgical (37.8%) than in the surgical (29.1%) cases. The overall ectopic pregnancy rate was 7.2% per attempt and 18.3% per clinical pregnancy. In the post-surgical group, the ectopic pregnancy rate per pregnancy was 3.5 times that in the non-surgical (23.2% versus 6.5%, respectively), and it was significantly higher in Stage IV (40%; two out of five pregnancies) than in Stage I adhesions (11.1%; three out of 27 pregnancies). In cases with a history of tubal surgery, the ectopic pregnancy rate was 33.3% (10 out of 30 pregnancies). Our results indicate that GIFT can offer a successful treatment option for selected cases with non-endometriotic pelvic adhesions.

Adult↗