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PubMed2004

Prostaglandin F2alpha supplemented semen improves reproductive performance in artificially inseminated sows.

The objective of this study was to assess the effects of the addition of prostaglandin F2alpha (PGF2alpha) to semen, to increase reproductive performance in sows. Sows in 11 large production units, were inseminated (AI) either with PGF2alpha enriched fresh semen (group 1, n=1258) or with untreated fresh semen (group 2, n=1101). Conception rate, regular return to estrus, farrowing rate, subsequent total and live-born litter size, subsequent weaning to estrus intervals, pigs born and pigs weaned per sow per year were evaluated. Conception and farrowing rates, as well as regular returns to estrus were altered beneficially (P<0.001) with PGF2alpha supplemented semen. Subsequent total-born (P<0.06) and subsequent live-born (P<0.15) litter size, as well as subsequent weaning to estrus intervals (P<0.22), were not affected to the same extent. Total pigs born (P<0.05) and pigs weaned (P<0.04) per sow per year were increased by using PGF2alpha supplemented semen.

Animals↗
PubMed1999

A reciprocal translocation between autosomes 8 and 10 in a boar used for artificial insemination service and its effects on litter size.

The low number of piglets per litter was the reason why a Finnish Yorkshire breed boar used for artificial insemination (AI) was taken for cytogenetic study. The boar had a reciprocal translocation between autosomes 8 and 10, resulting in a reduction in its litter size of about 19%. In addition the litter sizes were counted from 16 female offspring of this 2n = 38,XY; rcp(8;10)(p1.1;q1.3) boar.

Animals↗
PubMed2000

Growth hormone treatment of breeding bulls used for artificial insemination improves fertilization rates.

To evaluate new therapeutical concepts for male subfertility, we tested the effects of exogenous recombinant bovine growth hormone (rbGH) on various endocrine and metabolic parameters both in blood and in seminal plasma of bulls. Sperm quality was assessed morphometrically and by monitoring the number of successful artificial inseminations (AIs) defined as non-return rates (NRR). Aliquots of 450 semen samples were used from each bull and each experimental period (4 wk before, 14 weeks during and 6 wk after treatment). Six out of ten sires (average age 8.4 years) were treated every two weeks with 640-mg depot formulated rbGH (Eli Lilly). Four bulls received vehicle only. Blood plasma bGH, IGF-I, insulin and glucose concentrations were increased with rbGH treatment. In seminal plasma there was no effect of rbGH treatment on fructose and citrate or on testosterone concentrations. With one exception, rbGH-treated bulls had greater IGFBP-3 concentrations in seminal plasma. Motility of spermatozoa after freezing and thawing was increased compared with pretreatment rates. Most interestingly, the number of successful AIs was increased by an average of 6.0% NRR when ejaculates from rbGH-treated bulls were used.

Animals↗
PubMed1993

Factors affecting fertility with artificial insemination.

Man's intervention in the natural processes of reproduction with the use of AI has allowed rapid genetic improvement in beef and dairy herds and has resulted in a marked increase in livestock productivity. In today's tough economic climate, high reproductive efficiency is of utmost importance for livestock enterprises to remain viable. Many factors affect the success of AI programs; of particular importance are the health and nutritional management of the herd and accurate, efficient heat detection. Good management combined with knowledge, technical expertise and careful attention to detail in the timing of insemination in relation to the period of estrus, semen handling, and correct semen placement in the uterus ensure the successful use of AI.

Animals↗
PubMed2001

[Comparison of 2 therapeutic strategies in severe endometriosis, in young women consulting for sterility or pain. II. In the case of infertility, value of ovarian stimulation with intrauterine insemination after surgery].

AIM OF THE STUDY: Define the best medico surgical strategy in infertile women with stage III-IV endometriosis. MATERIAL AND METHODS: Two groups, A (N26) and B (N 37), treated for infertility associated or not with pelvic pain, due to stage AFS III or IV endometriosis, were compared. They had similar surgical procedure: operative laparoscopy including resection of endometriotic lesions, more particularly endometriomas and rectovaginal septum nodules. Associated medical strategy was different: group A, operative laparoscopy without preoperative treatment and in 40% a second laparoscopy taking place after 2-3 months of LHRH analogues; no post operative treatment; group B, operative laparoscopy taking place after ovarian blockage with 3-6 weeks of Diane (Androcur + ethinyl estradiol), then 2-3 months of analogue postoperative treatment immediately followed by ovarian stimulation (OS) + intrauterine insemination (IUI) in women more than 30 years old with operative tubes (N 22), no treatment for six months in similar cases less than 30 (N 5), and IVF in women with damaged tubes (N 5) or after OS + IUI failure (N 4). One patient refused two patients with high FSH level had oocyte donation. RESULTS: Two years evolutive pregnancy rate was significantly higher (p < 0.01) in group B (59%) versus group A (23%) and was higher after OS + IUI (68%) than after IVF (55%) or without any treatment in women < 30 (43%). The difference is equally significant by age (p < 0.05), for endometriomas (p < 0.01) and for recurrences (p < 0.01). CONCLUSION: Similar results obtained for pelvic pain (see chapter I) suggest that both strategies are similarly successful in treating endometriosis. These results confirm the interest of an ART after surgery for stage III-IV endometriosis and show that OS + IUI, a less costly than IVF technique, can be used successfully in selected cases with operative tubes.

Adult↗
PubMed2001

[Acceptability and value of autoinjection of gonadotropins for ovarian stimulation in intrauterine insemination].

OBJECTIVES: To evaluate the acceptability, the personal and economic benefit of subcutaneous self-injections of recombinant FSH within mono-ovulating stimulation for Intra Uterine Insemination (IUI). PATIENTS AND METHODS: Women aged < 42 years' old, enrolled for a series of three IIU associated with ovarian stimulation with FSH. All had an infertility > 2 years, at least one patent fallopian tube, and normal FSH and estradiol levels at day three of the cycle. In the male partner, the migration test yielded > 10(6) mobile spermatozoa with survivals > 10% after 24 h. Once entered in the study, the patients (with or without their partners) were informed and shown how to administer the injection. After each cycle, they filled up a questionnaire evaluating the training and the possible difficulties they had with their infertility treatment. RESULTS: Forty women were treated. 103 cycles were achieved (including 40 first cycles, 35 second cycles and 28 third cycles) 99 IUI were performed and ten pregnancies were obtained. Four cycles were cancelled: Premature fall of estradiol levels (n = 2), multiple pregnancy risk (n = 1) and spontaneous ovulation (n = 1). Three pregnancies occurred spontaneously between treatment cycles. All the patients appreciate to perform subcutaneous self-injections (themselves or by the partner) without any deleterious effect on stimulation cycles results and they expressed their will to continue for the next treatment cycles. CONCLUSION: After a quick initiation to subcutaneous injections, and its use, women appreciated their active involvement in the treatment and the self-sufficiency so achieved. By planning an educational program, medical staff could participate to improve the stress experienced by the women and their partners through the infertility treatment.

Adult↗
PubMed2004

Endometrial thickness cannot predict ongoing pregnancy achievement in cycles stimulated with clomiphene citrate for intrauterine insemination.

To date, limited data exist concerning the relation between endometrial thickness on the day of human chorionic gonadotrohin (HCG) administration and ongoing pregnancy achievement in cycles stimulated with clomiphene citrate for intrauterine insemination (IUI). In a prospective study, 168 couples were stimulated with clomiphene citrate from day 3 to day 7 of the cycle and endometrial thickness was assessed by ultrasound three times on the day of ovulation triggering. Ovulation was induced with HCG as soon as >/=1 follicle of >/=17 mm was present at ultrasound independently of endometrial thickness. IUI was performed 36 h after HCG administration. The main outcome measure was ongoing pregnancy. No difference was observed in endometrial thickness between patients who did or did not achieve an ongoing pregnancy (7.6 +/- 0.3 versus 7.6 +/- 0.2 respectively; P = 0.7). No discriminative ability of endometrial thickness on the achievement of ongoing pregnancy could be shown by receiver operating characteristic (ROC) curve analysis (area under the ROC curve 0.51, 95% CI: 0.44-0.59). In conclusion, endometrial thickness cannot predict ongoing pregnancy achievement in IUI cycles stimulated with clomiphene citrate.

Adult↗
PubMed2006

Letrozole versus human menopausal gonadotrophin in women undergoing intrauterine insemination.

This pilot study was conducted to compare the results of intrauterine insemination (IUI) under ovarian stimulation with either letrozole (Femara) or human menopausal gonadotrophin (HMG). A randomized controlled trial was conducted. Eighty women aged 20-35 years with unexplained infertility of at least 2 years' duration were randomized according to a computer-generated randomization list into the letrozole group and the HMG group. Letrozole was administered at 5 mg/day from day 3 to day 7 of the IUI cycle. HMG injections were started on day 3 at a dose of 75 IU for women under 30 years old and 150 IU for women over 30 years old and monitored periodically by vaginal ultrasound and oestradiol concentrations. The variables selected for analysis were clinical pregnancy rate, endometrial thickness, length of follicular phase and number of preovulatory follicles. No statistically significant difference in clinical pregnancy rates per cycle was found for patients in the letrozole or HMG group (18.4 versus 15.7%). Cost was significantly higher in the HMG stimulation cases (P < 0.001) and no injections were required in the letrozole group. In conclusion, letrozole offers a new treatment regimen in ovarian stimulation regimens for IUI that is cost effective, simple and convenient for the patients.

Adult↗
PubMed2007

Intrauterine insemination in The Netherlands.

The aim of this retrospective study was to assess the results of intrauterine insemination (IUI) in The Netherlands, using data from 2003 taken from hospital annual reports and reports from individual gynaecologists. By extrapolation, the total number of IUI cycles performed that year nationwide, and the related outcomes, was estimated. IUI was performed in 91 of the country's 101 hospitals. Of these, 58 (64%) registered their IUI results and performed 19,846 IUI cycles. The mean pregnancy rate per cycle was 9.0% and the ongoing pregnancy rate per cycle was 7.3%. Multiple pregnancies occurred in 9.5% of the ongoing pregnancies. Extrapolation of the data suggested that approximately 28,500 IUI cycles were performed, of which approximately 2000 resulted in an ongoing pregnancy. The number of multiple pregnancies following IUI was estimated to be 180 (9.0%). According to the national IVF registry, 9761 IVF cycles were started in 2003, resulting in 2,028 ongoing pregnancies (20.8% per cycle) and 439 twin pregnancies (21.6% per ongoing pregnancy). In conclusion, the pregnancy rate per IUI cycle in The Netherlands (9.0%) was comparable with that reported in the international literature (8.7%). The contribution made by IUI to the number of multiple pregnancies in The Netherlands was much smaller than the contribution made by IVF.

Female↗
PubMed2004

Gonadotrophin ovarian stimulation and intrauterine insemination for unexplained infertility.

Over the past 15 years, there has been a marked increase in the use of ovulation induction and intrauterine insemination (IUI) for the treatment of unexplained infertility. However, although ovulation induction and IUI have rapidly gained popularity, clinical use is based largely on practical experience rather than on well-designed scientific studies. This article summarizes the evidence in this area. Despite clinical heterogeneity and different methodological qualities of the trials, it can be concluded that ovulation induction significantly improves the probability of conception in couples with unexplained infertility, particularly when associated with IUI. It is remarkable, though, that there has been only one large-scale, randomized trial of ovulation induction plus IUI in the treatment of unexplained infertility in which one of the study arms is an untreated control group. For couples requiring treatment, the complication rate must be minimized, particularly the occurrence of high-order multiple pregnancy. Evaluation of the effectiveness and safety of low-dose gonadotrophin administration in patients with unexplained infertility is limited and further studies are warranted.

Gonadotropins↗
PubMedDate not supplied

Should requests for donor insemination on social grounds be expanded to transsexuals?

Donor insemination may provide an answer to transsexuals with female partners who have a wish for a child. Although the follow-up on children born in the context of these families is non-existent and the follow-up on transsexuals after sex reassignment surgery (SRS) is limited, fertility centres might consider accepting the requests of transsexuals with a female partner. Between 1997 and 2001, nine couples presented themselves at the Centre for Reproductive Medicine of the Dutch-speaking Brussels Free University, of whom five couples were accepted. Nevertheless, some caution is called for because transsexualism is socially not accepted. Moreover, transsexualism is still considered to be psychiatric condition. The following recommendations should be taken in consideration. Treatment should be limited to female-to-male transsexuals with a female partner. A multidisciplinary team of specialists should carry out the diagnosis for gender identity. Developmental problems of the gender-disordered child might interfere with socio-economic, psychological and emotional stability in adulthood. The period of sex reassignment should be nearly completed.

Adaptation, Psychological↗
PubMed2006

Clomiphene citrate challenge test predicts outcome of intrauterine insemination in women aged under 37 years.

The clomiphene citrate challenge test is a tool to predict ovarian reserve and fertility. It has mainly been used as a predictor of success of IVF/intracytoplasmic sperm injection (ICSI) cycles. Infertile young women with diminished ovarian reserve have a worse prognosis than women with adequate ovarian reserve attempting IVF/ICSI cycles. Nothing is known regarding the outcome of young women with diminished ovarian reserve undergoing low-complexity assisted reproductive treatment such as ovulation induction plus intrauterine insemination (IUI). This study included all women under 37 years who consulted in the authors' centre between May 2004 and August 2005 who underwent ovulation induction and IUI. Ninety-six women younger than 37 years with adequate ovarian reserve, and 50 women with diminished ovarian reserve were found. The pregnancy rate and pregnancy rate per cycle in the adequate ovarian reserve group were significantly higher than those of the diminished ovarian reserve group (46.7% versus 25%, P < 0.02 ; 15.9% versus 7.6%, P < 0.02 respectively). It is concluded that the clomiphene citrate challenge test is a good predictor of low-complexity infertility intervention outcome, and represents an effective tool to establish a prognosis. Therefore, it is very useful in planning therapy, and advising the infertile couple.

Adult↗
PubMedDate not supplied

Counselling lesbian couples: requests for donor insemination on social grounds.

Fertility centres are increasingly involved in dealing with requests from lesbian couples for donor insemination (DI). Data were collected on 95 Belgian lesbian couples who applied for DI. The majority of couples were well integrated in a social environment (family, friends and work) that consisted mainly of heterosexuals. They tended to be open about their homosexuality and most couples considered the social environment to be tolerant towards their homosexual orientation. Couples who considered alternatives to DI would have liked to have had more information on the donor and were more inclined to introduce a 'godfather' who would take special interest in the child. Couples who considered DI to be the best solution considered the absence of a father to be less of a problem for the child and wished to have no information at all as regards the donor. Approximately half the couples considered their family a two-mother unit. For the other couples, the family unit consisted of a mother and her partner who shared parental responsibility for the child equally. The issues that are considered important to cope with and on which lesbian couples should be counselled are presented in the discussion.

Adult↗
PubMed2003

Do basal oestradiol and oestradiol:androgens and oestradiol:FSH ratios reflect pregnancy potential of women receiving intrauterine insemination during natural cycles?

The aim of this retrospective study was to evaluate whether basal hormone profiles could be related to the ability to achieve pregnancy in women receiving intrauterine insemination (IUI) treatment during their natural menstrual cycle. Serum hormone profiles on cycle day 3 of naturally menstruating women were assessed in a total of 163 treatment cycles (29 conceptional and 53 non-conceptional cycles of 27 women who became pregnant and 81 non-conceptional cycles of 33 women who did not become pregnant). Basal concentrations of LH, FSH and prolactin were similar between conceptional and non-conceptional cycles. In contrast, concentrations of oestradiol in conceptional cycles (38 +/- 26 pg/ml: mean +/- SD) were significantly higher than those in non-conceptional cycles (23 +/- 18 pg/ml) (P = 0.0003). Concentrations of androstenedione and testosterone were lower but not significantly so in conceptional cycles as compared with non-conceptional cycles. The ratios of oestradiol/androstenedione, oestradiol/testosterone and oestradiol/FSH were significantly higher in conceptional as compared with non-conceptional cycles (29, 2.3, 6.2 versus 17, 1.2, 3.6 respectively) (all P < 0.006). Thus, increased concentrations of oestradiol and increased oestradiol/androgens and oestradiol/FSH ratios already on day 3 of the natural menstrual cycle correlate with the likelihood of achieving conception during the following IUI treatment. Therefore, measurement of basal hormones, including androstenedione and testosterone, may be useful to assess the health status of the coming dominant follicle.

Adult↗
PubMed2002

Toward a family-building approach to donor insemination.

Donor insemination (DI) is the oldest and simplest method of "treating" male infertility. The medical profession, prospective parents, legislators, and society in general are increasingly recognizing that providing DI services involves far more than facilitation of conception. This paper explores a multidisciplinary family-building approach to DI as an alternative to a treatment-of-infertility approach, and describes the need to provide patients with a broader and deeper preparation for this special type of parenthood. The short-term medical ease of the procedure is contrasted with the complexity and seriousness of the long-term social and psychological issues generated for the gamete provider, the recipient couple, and the offspring by the secrecy surrounding the procedure.

Adaptation, Psychological↗
PubMed2000

Secrecy among Israeli recipients of donor insemination.

Patterns of discretion and disclosure of fertility-related information among Israeli recipients of donor insemination (DI) are explored. Based on questionnaires completed by recipients in four sperm banks, we studied differences between married women and men. We found that most Israeli recipients conceal the treatment from their friends and relatives. Women and men, however, differ in their disclosure patterns: women are somewhat more open about the general fertility problem, but conceal the male factor; men are more discreet. However, men who disclose the fertility problem also tell about their own impairment. DI appears to be the most secretive issue in this context. Recipients who confided in anyone about their problem restricted it mostly to family relatives. The results are interpreted in terms of Israeli pronatalism, traditional concepts of the natural family, as well as elements of macho culture. Public education is highly recommended in order to open and "normalize" DI in Israel.

Attitude↗
PubMed2000

The effect of patient and semen characteristics on live birth rates following intrauterine insemination: a retrospective study.

PURPOSE: To identify characteristics of female patients and of semen that were associated with live birth following intrauterine insemination (IUI). METHODS: Retrospective review of medical and laboratory results from 533 women who underwent IUI with partner's sperm from 1993 through 1995. RESULTS: Among 1728 cycles, 116 (6.7%) resulted in live deliveries. Among the 38 patient and semen variables analyzed, only 3 were associated with successful IUI outcome: female age < 37.7 years at the time of treatment (P = 0.02); the absence of any corrective pelvic surgery (P < 0.001); and postwash sperm motility (P = 0.006). Couples with none of these three risk factors achieved per-cycle pregnancy rates of 12.4%. Women with two risk factors (age and pelvic surgery) achieved per-cycle pregnancy rates of 4.6% when sperm had good postwash motility. No pregnancies were achieved when low postwash motility was combined with any other risk factor. CONCLUSIONS: Advanced female age, poor postwash sperm motility, and a history of corrective pelvic surgery are significant risk factors for poor IUI success rates. Poor postwash sperm motility in combination with either of these other two risk factors resulted in no successful pregnancies.

Adult↗
PubMed2000

Late fertilization of unfertilized human oocytes in in vitro fertilization and intracytoplasmic sperm injection cycles: conventional insemination versus ICSI.

PURPOSE: The aim of this study was to evaluate the efficacy of intracytoplasmic sperm injection (ICSI) in comparison with conventional reinsemination using fertilization failed oocytes by conventional in vitro fertilization (IVF). METHODS: Oocytes were collected from patients of IVF or ICSI cycles. Patients were grouped by fertilization techniques: group 1: conventional IVF; group 2: reinsemination after conventional IVF failure; group 3: regular ICSI; group 4: 1-day-old ICSI after conventional IVF failure; group 5: 2-day-old ICSI after conventional IVF failure; group 6: re-ICSI after regular ICSI failure. RESULTS: In different insemination groups, normal fertilization rate was higher (P < 0.001) in 1-day-old ICSI (47.1%) and 2-day-old ICSI groups (40.0%) than in reinsemination (14.7%). Abnormal fertilization rate was higher (P < 0.05) in re-ICSI group (21.7%) than any other groups (range: 0-8%). Cleavage rate was higher in 1-day-old (36.7%) and 2-day-old ICSI groups (36.0%) than in reinsemination (5.3%, P < 0.001) or re-ICSI groups (17.4%, P < 0.05). Pregnancy rate was 27.6% and 20.0% in conventional IVF and regular ICSI groups, respectively. However, 1-day-old ICSI (group 4) and 2-day-old ICSI (group 5) were attempted once embryo transfer (ET) but failed pregnancy occurred in each group. CONCLUSIONS: In fertilization failure cycles, late ICSI increases the rate of fertilization and embryonic development and may rescue the completely failed attempt of pregnancy.

Adult↗