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PubMed2005

Serum hormones for predicting pregnancy outcome after assisted reproductive technology.

Serum human chorionic gonadotrophin (HCG) in the second and third week after embryo transfer has been used for prediction of pregnancy outcome after assisted reproduction. There are few data on the clinical utility of HCG, progesterone and oestradiol, measured by contemporary immunoassay, in the fourth week after embryo transfer and later. Moreover, large inter-method differences have been described between automated immunoassays, making method-specific cut-off values mandatory. The main aim of this study was to determine assay-specific optimal cut-off values for serum HCG, progesterone and oestradiol for prediction of clinical pregnancy outcome in singleton pregnancies after assisted reproductive techniques, at days 11, 18 and 25 and at week 6 after embryo transfer. A retrospective study was performed on frozen serum samples of 67 singleton pregnancies after assisted reproduction techniques. HCG, oestradiol and progesterone were determined with the automated (random access) VIDAS immunoanalyser. Receiver operating characteristic curve analysis was performed to determine optimal cut-off values. Predictive values were calculated based on the prevalence of non-viable pregnancy after assisted reproduction. It was concluded that measurement of HCG by VIDAS at days 18 and 25, and at week 6 after embryo transfer yields high positive (70.5-100%) and negative (87.2-94.4%) predictive values for clinical pregnancy outcome.

Chorionic Gonadotropin↗
PubMed1989

Assisted reproductive technology with donor gametes: the need for patient preparation.

There are certainly no definitive answers to the questions raised by the use of donor gametes in reproduction, as there are no definitive answers to any of life's most difficult questions. The loss of fertility is usually an unexpected, invisible, deeply painful wound for those couples who are considering the use of donor gametes. As they address the psychological issues of these techniques, they must also heal the wounds created by infertility. This type of grieving and examination of feelings takes time and information. The medical community needs to encourage each couple to resolve the issues around infertility and to use available personal, professional, and written resources to address the dilemmas raised by the use of donor gametes prior to embarking on this type of treatment. In so doing, the couple will reduce the likelihood that the means of conceiving their children will become a source of major conflict in their family. In 1932 Aldous Huxley prophesied the destructive consequences of scientific accomplishment without social involvement and psychological guidance. He said: "The sciences of matter can be applied in such a way that they will destroy life or make the living of it impossibly complex and uncomfortable...unless used as instruments by biologists and psychologists." It is our concern that the procedures for enabling infertile couples to become parents may, if not accompanied by acknowledgment of the unique challenges which they create for all participants in the process, make the living of life "impossibly complex and uncomfortable" for the very families we are trying to help.

Confidentiality↗