[In-vitro fertilization--what does it mean for clinical practice?].
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
W Feichtinger
Publications and source records attributed to W Feichtinger.
Preovulatory serum estradiol-17 beta values and ultrasound scans in 17 pregnancies which followed in vitro fertilization and embryo transfer after treatment with clomiphene and hCG.
17 patients whom we treated with clomiphene and hCG became pregnant after in vitro fertilization (IVF) and embryo transfer (ET). We now report on our experience with preovulatory estradiol 17 beta values and ultrasonography in determining the time of hCG administration in these patients. The mean estradiol value just before the hCG injection was 329 +/- 75 pg/ml/follicle. The mean follicle diameter on ultrasound was 23.4 +/- 1.5 mm on the same day. In four cases, we only used estradiol values and in one case only ultrasound for the timing of the hCG injection. Both methods of monitoring follicular growth are discussed.
Adult↗
The effect of 2 mg estradiol-17 beta plus 1 mg estriol, sequentially combined with 1 mg norethisteroneacetate, on LH, FSH, estradiol-17 beta, progesterone, testosterone and prolactin after ovariectomy.
The object of the study was to see whether maintenance of serum estradiol levels corresponding to the early and mid-follicular phase can prevent the gonadotrophin increase following ovariectomy. We also wanted to study the effect on LH and FSH of an additional dose of 1 mg dose of 1 mg norethisterone acetate administered for 10 days during each month. In 22 women with normal cycles 1 mg of estradiol benzoate was injected i.m. at the time of ovariectomy. From the first post-operative day onwards they received daily doses of 2 mg estradiol and 1 mg estriol in the form of micronized tablets. From the 41st to the 50th day and again from the 69th to the 78th day the patients received additional daily doses of 1 mg norethisterone acetate. LH, FSH, estradiol-17 beta, (E2) progesterone (P), testosterone (T), and prolactin (PRL) were measured in intervals of 2-17 days. Even though the estradiol mean values remained constant in the range of 65-115 pg throughout the period under observation, the LH mean levels increased continuously from 8 to a maximum of 23.9 mU/ml, and the FSH mean level from a pre-operative value of 6-48.0 mU/ml on the 85th day. On the 7th day after the last administration of norethisterone acetate LH was slightly depressed while FSH continued to rise slightly. Both FSH and LH are negatively correlated with E2 and this inverse correlation becomes even more pronounced the more time has elapsed after surgery. These findings suggest that not only the estrogens inhibit FSH and LH but also other steroids and/or nonsteroidal ovarian inhibiting factors.
Adult↗
Organization and computerized analysis of in vitro fertilization and embryo transfer programs.
The in vitro fertilization experience of one of the earliest successful programs is presented based on three different center types: (I) large hospital-university, (II) private gynecological office, and (III) egg-embryo transfer from and to centralized laboratory. A computerized analysis of systems I and II for 1982 is presented. No statistically different results were found between system I and system II. System III was abandoned because of unsatisfactory results.
Adult↗
Laparoscopic or ultrasonically guided follicle aspiration for in vitro fertilization?
Ultrasonically guided follicular aspiration is presented as an alternative method to laparoscopy for oocyte harvesting. The method is described in detail and compared to laparoscopic oocyte pickup. The success rate of this technique reached in 1984 compared to that of laparoscopic oocyte pickup was the same: the oocyte recovery rate was 93%, the fertilization rate was 58%, and the pregnancy rate was 13% (normal ongoing pregnancies per treatment cycle). Ultrasonically guided follicular aspiration is shown to be superior to laparoscopic oocyte recovery as far as ovarian accessibility and complication rate are concerned.
Cell Separation↗
Pregnancy following in vitro fertilization and embryo transfer using pure human serum as culture and transfer medium.
Pure heat-inactivated serum of patients adjusted to 280 mOsm was used for preincubation, insemination, and transfer of oocytes in an IVF-ET program. In patients where the oocyte recovery yielded more than two oocytes, two oocytes were chosen randomly for serum cultivation. The 15th patient of that series became pregnant after a transfer of two serum-cultured embryos. The follow-up weekly clinical investigation and ultrasound revealed a normal single pregnancy, now in the 20th week.
Blood↗
[Current status of in vitro fertilization, indications and current problems].
Report about experiences with in vitro fertilization and embryotransfer at the second department of obstetrics and gynecology University of Vienna and study group of extracorporal fertilization. Methodic could be simplified in some details. Results are better with increasing experience. Stimulation treatment using clomiphene-HMG-HCG is done individually.
Clomiphene↗
The Vienna program of in vitro fertilization and embryo-transfer--a successful clinical treatment.
A clinical program for in vitro fertilization (IVF) and embryo transfer (ET) is described. First successes were obtained using media and techniques according to Lopata et al. (1980, Fertil. Steril., 33, 117-120). The 'Vienna IVF and ET-program' was developed after several modifications and led to a pregnancy rate of 34%/ET. Studies on different culture media and their supplements were performed. B2-Menezo-medium supplemented by 15% human serum seemed best suited for human IVF because of its simplicity and readiness for use. However, there was no significant difference in comparison of the fertilization rate between B2 and modified Ham's F10 medium, or statistical difference between the usual 5% O2-5% CO2 and 90% N2 gas mixture for culture and 5% CO2 in air. So the latter can be used as a simpler system. pH measurements established follicular fluid to be very stable at 37 degrees C for several hours both on air and on 5% CO2. It is recommended as an appropriate medium for preincubating oocytes before insemination; eggs can also be transported in this fluid. Based on clinical experience a system of culturing eggs at one specialized IVF center for different hospitals and gynecologists can be discussed.
Carbon Dioxide↗
[Morphologic, endocrine and technical factors in relation to the results of human embryo transfer to the uterus].
Out of 161 cycles in which the procedure was attempted, 20 clinical pregnancies were obtained by in vitro fertilization and embryo transplant. The authors think that among the numerous parameters that can affect the result favourably are: At the time of oocyte recovery large follicles (23 mm) following treatment with Clomid gave oocytes with pregnancy following. Medium B2 added to human serum gave high fertilization rates (80%) and cell division rates (75%) following in vitro culture. Only those embryos where cell division occurred quickly gave rise to pregnancies. As far as the transplant was concerned, the pregnancy rate rose from 12 to 30% according to whether one replaced 1 or 2 embryos in the uterus. Preliminary examination of the cervical canal indicated whether it should be dilated in cases where it was difficult to introduce the catheter. Giving valium made the uterus relax whereas adding blood serum (50 to 75%) in the transfer medium increased the viscosity of this latter. 19 of the 20 pregnancies resulted when the embryo transfer was easily accomplished.
Cell Division↗
The behaviour of LH, FSH, PRL, T, P, estradiol and cortisol under different kinds of general anesthesias during laparoscopic oocyte recovery for in vitro fertilization.
Explore the source record for details and available documents.
Adult↗
Could aspiration of the Graafian follicle cause luteal phase deficiency?
Luteal phase quality was evaluated in 32 patients wih nonstimulated cycles after laparoscopic oocyte recovery for in vitro fertilization. A luteal phase deficiency occurred in two cases (6.2%), the mean duration of the luteal phase was 13.5 +/- 1.3 days in 30 patients, and two patients developed amenorrhea of 23 and 43 days respectively after laparoscopy in spite of normal progesterone values 7 and 9 days after oocyte recovery. Six embryo transfers were performed after fertilization and regular cleavage of the obtained oocytes. No pregnancy resulted from the embryo transfers, although the patients had apparently normal luteal phases. In one patient there was a transient beta-subunit human chorionic gonadotropin (beta-hCG) elevation in serum. Luteal phase deficiency should not be main cause of a nonsuccessful embryo transfer. However, a prophylactic luteal phase support after oocyte recovery and embryo transfer in nonstimulated cycles is proposed.
Chorionic Gonadotropin↗
[Twin pregnancy after laparoscopic oocyte recovery, in-vitro fertilization and embryotransfer (author's transl)].
Explore the source record for details and available documents.
Adult↗
Influence of laparoscopic follicular aspiration under general anaesthesia on corpus luteum progesterone secretion in normal and clomiphene-stimulated cycles.
In 32 patients with unstimulated normal cycles and 24 with cycles stimulated with clomiphene and human chorionic gonadotrophin (hCG) all visible follicles were punctured laparoscopically under general anaesthesia for the purpose of in vitro fertilization. In unstimulated cycles the time of surgery was between 24 and 32 h after the first luteinizing hormone (LH) increase in the urine; in the cycles stimulated with hCG (5000 i.u.) laparoscopy was between 35 and 37 h after injection. Blood samples for progesterone determination were taken about 7 days later. Progesterone levels were compared with those in a control group not subjected to surgery, in which the progesterone levels were determined 7 days after the LH increase. There was no statistically significant difference in the progesterone levels in the unstimulated subjects after laparoscopy compared with those in the control subjects but progesterone levels in the stimulated subjects were significantly higher (p less than 0.01). Durations of the luteal phases showed no significant differences thus laparoscopy under general anaesthesia does not impair luteal function.
Adult↗
[The clinical efficacy of the copper-containing intrauterine devices Nova T and Copper-T-200 Ag in a randomized study (author's transl)].
In a randomized study the clinical efficacy of the traditional intrauterine device. Copper-T-200 Ag was compared with the recently developed model Nova T. Altogether 93 women with regular menstrual cycles were examined; 45 women had a Nova T inserted and 48 the traditional Copper-T-200 Ag. The biosocial data of the women in the two groups did not differ from one another. No pregnancies occurred in either group within the first 12 months. Expulsion occurred in 2 women with Nova T and removal of the device had to be undertaken for bleeding and pain in 3 women with a Copper-T-200 Ag. At 12 months the two models did not differ in the number of recorded incidents. The reliability of randomized studies is discussed, as well as problems arising from the fact that the mode of insertion is not identical with both devices and requires practice in the case of the new model.
Female↗
[Functional and hormonal differences between group I and group II amenorrhoea (WHO classification) (author's transl)].
77 amenorrhoeic women were classified as responding positively or negatively to clomiphene. The results of iterative LRH tests and studying feed-back reactions to steroid administration showed that the two collectives strictly correspond to groups I and II of the WHO classification of amenorrhoea. The LH response to the LRH test was significantly higher in group II than in group I, while there was no difference between the two groups in the FSH response. Oestradiol 17 beta was significantly higher in group II than in group I, but both groups showed a significant increase in E2 three hours after the LRH test. The possible mechanisms of LH production and pool formation, as well as FSH regulatory factors are discussed. This paper demonstrates that clomiphene appears to be ideally suited as a test substance for the classification of amenorrhoea according to its degree of severity.
Adult↗
Results of laparoscopic recovery of preovulatory human oocytes from nonstimulated ovaries in an ongoing in vitro fertilization program.
The technique and results of 50 laparoscopies performed on sterility patients to obtain mature oocytes from Graafian follicles with a view to carrying out in vitro fertilization are described. In 32% of all laparoscopies and in 52% of all punctured follicles it proved possible to obtain a mature oocyte. Different diameters of puncture needles as well as different suction intensities are compared. As a result of increasing experience and improved technique, the exact time for the intervention was correctly determined in 92% of cases. The recovery rate for oocytes was also increased to 58% with respect to laparoscopies carried out.
Cell Separation↗
[Technique of obtaining mature oocytes via laparoscopy for in-vitro fertilisation (author's transl)].
Technique and results of 50 laparoscopies performed on sterility patients to obtain mature oocytes from Graafian follicles to carry out in vitro fertilisation, are reported. In 32% of all laparoscopies and in 52% of all punctured follicles a mature oocyte could be obtained. Different diameters of puncture needles as well as different suction intensities are compared. It is mentioned that through increasing experience and improved technique the exact time for the intervention has been correctly determined in 92%. The recovery-rate for oocytes also could be increased to 58%. A further improvement in this important initial step to a successful in vitro fertilisation program is feasible.
Female↗
[Human in vitro fertilisation and embryotransfer: first results at the 2nd department of obstetrics and gynaecology, university of vienna (author's transl)].
Methods and Results of human in vitro fertilisation at the 2nd Department of Obstetrics and Gynaecology, University of Vienna are reported. Applying preparations of media and culture techniques according to Edwards et al. no satisfactory results could be achieved: only 3 out of 11 preovulatory oocytes were fertilised, no cleavages occurred. Using modified Ham's F 10 medium according to Lopata et al. fertilisation could be observed in 60% as well as regular cleavages in 40%. 5 Embryotransfers have been performed in the 8 cell or in the 16 cell stage respectively. No implantation occurred in 4 of these, in one case evidence for a transient implantation could be proved by an increased activity of SP1 and HCG beta. In this case obviously postimplantation death occurred resulting in a bleeding 16 days after oocyte recovery. Possible reasons for failures in fertilisation and cleavage as well as possibilities for improving the rate of reimplantation are discussed.
Adult↗