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PubMed1976

[The practice of heterologous insemination in the treatment of androgenic sterility].

Except of adoption the heterologous insemination has for some years in the GDR been a part of the therapeutic possibilities of a couple's androgen sterility. However, there is no uniform conception on practical proceeding, juridical problems, selection of sperm donors and documentation of data. This paper describes the practical proceeding at the women's hospital of Berlin's Humboldt University (Charité). It contains, among other things, an indication list, regulations for medical examination, instruction and juridical securing of both the donor and the married couple. Documentation of data under special regard of professional discretion is also dealt with.

Adult↗
PubMed1976

Duplication-deficiency of the short arm of chromosome 8 following artificial insemination.

A chromosomally abnormal child with psychomotor retardation and multiple anomalies, including agenesis of the corpus callosum and cleft palate, was born following artificial insemination by donor. Chromosomal and conventional markers were used to ascertain paternity. Various banding techniques were employed to identify the origin of the extra chromosomal material as most likely a duplication-deficiency of the short arm of chromosome No. 8.

Abnormalities, Multiple↗
PubMed1976

Artificial insemination using donor semen: a review of 171 cases.

This report represents a summary of our experience with 171 unselected cases of artificial insemination by donor (AID) over a 4-year period. It must be stressed that the study was retrospective and subject to many of the problems of analyzing such data. However, the information gained may aid the clinician in his approach to candidates for AID. The most critical points revealed by the survey are as follows: 1. Age, length of infertility, and proven fertility, within certain limitations, appear not to be of prime importance in determining the outcome of AID. 2. Of those patients conceiving, the majority will do so within three cycles of exposure, and 90% will have done so within six cycles of exposure. 3. An adequate trial of AID therapy should last at least 6 months. 4. Although the frequently reported conception rate of up to 70% may be expected in patients with correctable anovulation or with normal reproductive organs, a marked diminution in the success rate should be expected in candidates with disorders such as endometriosis, tubal disease, pelvic adhesions, and uterine abnormalities.

Adult↗
PubMed1991

[Direct intraperitoneal insemination. Authors' experience].

We present our experience with the method of Direct Intraperitoneal Insemination (DIPI) in cases of infertility during 56 cycles with ovarian stimulation in 15 women 53.3% of our cases are primary sterility cases. The principal indication for DIPI was male factor (six cases), endometriosis three cases, cervical hostility, three cases and compound cases the other ones. The average age was 33.7% years. Always we used the induction of ovulation according to the protocol of Frydman with clinical monitorization. The seminal fluid was treated with the swim-up method and was placed in the pelvic peritoneum with a spinal needle by direct transvaginal puncture, during the ovulatory period. We have obtained five pregnancies (33.3%) one of them ectopic (6.66). We have been successful in all cases of cervical hostility and in one case of compound etiology. There are no complications in this series with DIPI. It is discussed the place of DIPI among the technology of assisted fertilization.

Adult↗
PubMed1990

Sextuplet pregnancy after human menopausal gonadotropin superovulation and intrauterine insemination. A case report.

Sextuplet pregnancy occurred after human menopausal gonadotropin ovulation induction, intrauterine insemination and human chorionic gonadotropin support in the luteal phase. The patient's peak serum estradiol concentration was 861 pg/mL, and ultrasound monitoring demonstrated only one follicle greater than 11 mm in diameter. The possibility of high-order multiple birth exists despite intensive monitoring efforts for this therapy.

Adult↗
PubMed1990

Effect of sperm morphology and motile sperm count on outcome of intrauterine insemination in oligozoospermia and/or asthenozoospermia.

Eighty-six couples with long-standing infertility and poor postcoital test, due to oligozoospermia and/or asthenozoospermia (68 cases) or mucus hostility (18 cases), were treated by 411 intrauterine inseminations (IUI) with motile sperm suspensions from the husband's semen. The pregnancy rate per couple in the group with abnormal semen was lower than in the group with mucus hostility (22% versus 38.9%). Influence of seminal and other parameters on outcome of IUI was assessed by discriminant analysis, and a significant correlation with pregnancy rate was found for motile sperm count and sperm morphology. Teratozoospermia (normal morphology less than 50%) affected the outcome of IUI both when associated with moderate oligozoospermia and/or asthenozoospermia (motile sperm count greater than or equal to 5 X 10(6)/mL) (success rate per couple: 11.1%), and, even more, when associated with severe oligozoospermia and/or asthenozoospermia (motile sperm count less than 5 X 10(6)/mL), where no pregnancy was achieved. In the absence of teratozoospermia, the success rate per couple both in severe and in moderate oligozoospermia and/or asthenozoospermia had similar results (33.3% versus 35.7%). In conclusion, the absence of teratozoospermia appears to be an effective criterion for selecting couples with infertility due to oligozoospermia and/or asthenozoospermia who may benefit from IUI.

Adult↗
PubMed1990

[Simultaneous occurrence of bilateral extrauterine pregnancy and ovarian hyperstimulation syndrome following artificial heterologous insemination (differential diagnostic difficulties)].

Simultaneous occurrence of bilateral extrauterine pregnancy and hyperstimulation syndrome of the ovary following artificial heterologous insemination, meaning difficulty in the differential diagnosis, is described. In connection with the case the protocol of induction of ovulation used regularly by the authors is presented and the necessary monitoring model is described. If the observation is suitable the emergency operation of a patient in bad physical condition can be avoided in the opinion of the authors. The close correlation between the hyperstimulation of the ovary and early-pregnancy as well as the favourable spontaneous healing disposition of the cystic alteration is highlighted. It is held important that a laparotomy performed in connection with acute abdominal symptoms should be conservative for the genitals--possibly even in case of extrauterine pregnancy--in order to maintain the chances for a later fertility.

Adult↗
PubMed1990

Pregnancy outcome, health of children, and family adjustment after donor insemination.

We evaluated the pregnancies of 427 women who conceived through artificial insemination by donor (AID) at our clinic over a 12-year period. Initial phone contact was followed by a questionnaire. Outcome was known for 594 of the 606 pregnancies, with a total of 502 live-born children including 15 sets of twins. The spontaneous abortion rate was 16.5%, with no difference between fresh- and frozen-semen pregnancies. Significant correlations were found between spontaneous abortion rate and maternal age (P less than .001) and spontaneous abortion rate and cycle of conception (P less than .025). Follow-up was completed on 481 children, among whom the following were found: one chromosomal anomaly, 22 major congenital anomalies, four children with possibly syndromic conditions, and 38 with minor congenital anomalies. Of the school-aged children, 5.8% had recognized learning disabilities and 10.5% were considered gifted by their schools. We also investigated the psychological impact of AID on each family. The majority of couples (71.7%) informed their obstetricians of the AID. Half of the couples did not tell any family or friends. Many couples did not (47%) or probably did not (14%) plan to tell their children of their origins. The divorce rate among those with AID children was 7.2%, which was significantly less (P less than .01) than that in a matched population. Psychological counseling specifically related to AID was sought by 2.8% of the couples. We conclude that AID children are at similar risk for congenital anomalies as normally conceived children, but they experience lower rates of family dissolution.

Abortion, Spontaneous↗
PubMed1977

Sperm-freezing and donor insemination.

A comparison between freezing of human sperm using glycerol or glycerol egg-yolk citrate is presented. Freezing was performed with a gradual lowering of the temperature using alchol-liquid nitrogen or by immersion into liquid nitrogen. Great variations were observed within the same donor sperm sample when the sperm was frozen according to different techniques and marked post-thaw, motility variations were also found between spermatozoa from different donors. No statistically significant differences were found in the number of pregnancies obtained following inseminations with sperm frozen according to the two methods.

Citrates↗
PubMed1990

Sperm washing and intrauterine insemination for cervical factor, oligospermia, immunologic infertility and unexplained infertility.

The cumulative pregnancy rate was evaluated for 56 couples undergoing 227 intrauterine inseminations (IUIs) after sperm washing. The indications for IUI were cervical factor, oligospermia, immunologic infertility and unexplained infertility. The overall pregnancy rate was 21.4%, with a 0.289 cumulative probability of conception after six cycles. Within each category the pregnancy rates were 25% for cervical factor, 60% for women with antisperm antibodies, 20% for men with antisperm antibodies and 7% for oligospermia.

Clinical Trials as Topic↗
PubMed1989

Intrauterine insemination and ovulation stimulation as treatment of infertility.

Fecundity rates were measured for 302 patient-couples in 991 cycles of intrauterine insemination (IUI) between January 1984 and December 1986 in terms of the diagnoses and whether human menopausal gonadotropin (hMG) was also employed. Those rates were compared with the fecundity rates in 255 of the couples followed in 2,668 untreated cycles. IUI was most beneficial for cervical factor infertility, with a monthly yield of 0.11 in conjunction with hMG and for poor postcoital tests in general but was less impressive when seminal parameters were abnormal. The addition of hMG when ovulation was normal (as an independent variable) did not yield results statistically superior to those of IUI alone (fecundity = 0.06 versus 0.03), but the addition of hMG to the regimen gave an improvement over IUI alone when endometriosis had been diagnosed and in the presence of cervical factor infertility. One serious side effect of therapy was a pelvic abscess, which required hospitalization but not surgery.

Adult↗
PubMedDate not supplied

Factors affecting the success of artificial insemination by frozen donor semen.

The records of 227 couples who received artificial insemination by frozen donor semen in 984 treatment cycles were analysed to find out the factors affecting the pregnancy rates. The cumulative pregnancy rate at 6 months was 46.8% and the pregnancy rate per cycle was 10%. The pregnancy rates were adversely affected by (1) increase in the recipient age above 30 years, (2) irregularity of menstrual cycles, (3) the use of clomiphene citrate for induction of ovulation, and (4) low cervical mucus scores. Among our donor semen samples selected with a set of criteria, the sperm counts and initial and post-thaw motility did not affect the pregnancy rates.

Adult↗
PubMedDate not supplied

Male subfertility and the outcome of intrauterine insemination.

Seven out of 27 infertile women conceived by intrauterine insemination (IUI, 26%), one of them twice. Three other pregnancies occurred spontaneously after the discontinuation of treatment. A comparison of the data obtained from 65 treatment cycles revealed that the number of motile spermatozoa per ml of ejaculate and per ml of medium after swim-up preparation was higher in the ultimately fertile group as compared to the patients who failed to conceive. It is concluded that male subfertility affects the outcome of IUI unfavorably.

Adult↗
PubMedDate not supplied

[Male sterility and artificial insemination using donor semen. Our experience].

There has been a considerable increase in the demand for artificial insemination with donor semen (A.I.D.) in Italy during the past 5 years. This study describes the 4 year experience of an infertility practice which maintains a frozen bank as its primary source of A.I.D. The overall pregnancy rate was 52.27%. There is a significant difference in pregnancies in various age groups. Our pregnancy rate was 72.2% for those women under 31 and 31.5% for those over 31.

Adult↗
PubMedDate not supplied

Incidence of spontaneous abortion following artificial insemination by donor.

This study examines the frequency of spontaneous abortions in pregnancies achieved by artificial inseminations with donor semen (AID), with special respect to the use of cryopreserved semen and ovulation induction with clomiphene citrate. The abortion rate was found to be similar in AID series using frozen semen to those using fresh semen, nor was the rate increased in composite AID series (both fresh and frozen semen) when compared with the rate of spontaneous abortions in the general population. When clomiphene was used, the abortion rate was increased only in groups of anovulatory and irregularly ovulating women. Those AID series where all women treated are given clomiphene show no increase in abortion rates. The discussion is focused on factors that influence the abortion rate and on possible etiological factors.

Abortion, Spontaneous↗
PubMed1989

[Male infertility and intrauterine insemination with abnormal sperm].

Intra-uterine insemination of capacitated sperm has disappointing results when this sperm is abnormal, since the overall pregnancy rate does not exceed 11 p. cent of the couples who have not given up before the 6th cycle of treatment. However, considering the ineffectiveness of the treatments of idiopathic or secondary oligo-astheno-teratospermia, and the still limited effectiveness of fertilization in vitro with his type of sperm, intra-uterine CAI may currently be offered for a limited time to sterile couples with very abnormal sperm, contingent on a precise methodology in the preparation of the sperm as well as the time of ovulation.

Female↗
PubMed1989

[Partnership status in preparation for therapeutic donor insemination].

An investigation is presented which inquiries the psychological problems of sterile couples after diagnosing of male infertility. The interpretation of conversation topics accomplished by 460 couples suggests that coping with infertility by the couple, the character of the desire for a child, the level of stress tolerance, the ability to cooperation and the agreement to compromise determine the psychological situation of a couple infertile by male. These facts should be taken into consideration in regard of the therapeutic insemination by donor.

Adaptation, Psychological↗