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At least 19 recordsLinked to original sources
PubMed1987

The waiting-list for IVF. The motivations and expectations of women waiting for IVF treatment.

We conducted a written survey of a group of women on the IVF waiting-list at the Dijkzigt Hospital in Rotterdam. The objective of the study was to gain an insight into the motivations and expectations of the women involved. It appeared that the respondents were not very well informed on various aspects of the IVF procedure. They were also too optimistic about the chance that the treatment would be successful in their case. Even if the chance of success was very low (2%) most of the women would still choose IVF. Now that IVF exists the women wish to make use of it. They do not want to run the risk of being sorry later if they let 'the chance of having a child of their own' go by. This 'anticipated decision regret' gives IVF a strongly impelling character. Few women said that they needed a form of social guidance.

Appointments and Schedules↗
PubMed1991

In vitro fertilization-embryo transfer (IVF-ET) in the United States: 1989 results from the IVF-ET Registry. Medical Research International, Society for Assisted Reproductive Technology, The American Fertility Society.

This is the fourth annual report of the United States Registry of in vitro fertilization-embryo transfer (IVF-ET) and related practices. The present report describes the 1989 experiences of 163 United States member clinics with respect to treatments and outcomes. During 1989, the clinics reported performing 24,183 ovarian stimulation cycles. From all treatments, including frozen ET and IVF with donor oocytes, there were with 4,598 clinical pregnancies and 3,472 live deliveries. Ninety-eight percent of the clinics had at least one delivery, and overall a total of 4,736 babies were born. The overall live delivery rates were 14% for IVF (based on 15,392 retrievals), 23% for gamete intrafallopian transfer (GIFT) (based on 3,652 retrievals), 26% for IVF and GIFT in combination (based on 452 retrievals), and 17% for zygote intrafallopian transfer (ZIFT) and related practices (based on 908 retrievals). In addition to these treatments, results are presented for frozen ETs and IVF of donated oocytes.

Abortion, Spontaneous↗
PubMed1992

In vitro fertilization-embryo transfer (IVF-ET) in the United States: 1990 results from the IVF-ET Registry. Medical Research International. Society for Assisted Reproductive Technology (SART), The American Fertility Society.

OBJECTIVE: To summarize the procedures and outcomes of assisted reproductive technology (ART) initiated in the United States in 1990. DESIGN: The registry follows a prospective study format. PARTICIPANTS: One hundred eighty clinics submitted data on their ART treatments to the In Vitro Fertilization (IVF) Registry. MAIN OUTCOME MEASURES: The outcomes measured included clinical pregnancy, ectopic pregnancy, abortion, stillbirth, delivery, chromosomal abnormalities, and congenital defects. RESULTS: During 1990, the clinics reported performing 25,744 ovarian stimulation cycles. From all ART treatments there were 5,150 clinical pregnancies and 3,951 live deliveries. The overall live delivery rates were 14% for IVF (based on 16,405 retrievals), 22% for gamete intrafallopian transfer (based on 3,750 retrievals), and 16% for zygote intrafallopian transfer and related practices (based on 1,370 retrievals). The delivery rates for frozen embryo transfer cycles and IVF with donor egg cycles were 9% and 22%, respectively. CONCLUSIONS: The 1990 results indicate an increase in the use of gonadotropin-releasing hormone analogs and an increase in the number of embryos being transferred per cycle, along with no important changes in clinical pregnancy and delivery rates. In addition, there was an increase in both numbers of frozen embryo transfers and IVF cycles with donor oocytes.

Abortion, Spontaneous↗
PubMedDate not supplied

A lesson from IVF endocrinology: the importance of the follicular phase to success and failure in non-IVF cycles.

Sixty-three patients treated with exogenous gonadotropins for a total of 232 non-IVF cycles were monitored by serum E2 and/or total urinary estrogen excretion. The endocrine profile of follicular phase during HMG-HCG stimulation was evaluated with regard to an effect on the pregnancy rate. Six different follicular phase patterns were observed: A-profiles (daily exponential increase of sE2 or total urinary estrogen values followed by a sustained exponential increase on the day after HCG injection) seem to be necessary to obtain pregnancy, being followed by conception in 21.5% of all cases. Other profiles have lower conception rate (10%); no conception occurred when non exponential E2 rise was observed. The different responses are not related to total dosage of HLG administered. Patients who were treated for hypogonadotropic hypogonadism had a high pregnancy rate (80%) even in absence of post-HCG estrogen rise (G-endocrine profiles. Women aged 35 years must have significantly higher doses of gonadotropins to obtain A-profiles. Monitoring by E2 seems to be more adequate than the TUE only (conceptual pregnancy rate/cycle of 15.25%, versus 10.34%). In conception cycle, midluteal E2/P ratio never exceeds 50.

Adult↗
PubMed1989

In vitro fertilization (IVF)-surrogacy: application of IVF to women without functional uteri.

Women with absent or dysfunctional uteri consented to controlled ovarian stimulation, ovum aspiration, in vitro fertilization, and embryo culture. Cleaving preembryos were transferred to recipient (surrogate) women whose menstrual cycles were in approximate synchrony with the ovum donor. None of the embryo recipients received medication. Six cases are described, resulting in one spontaneous loss at 6 weeks, four full-term deliveries, and one ongoing pregnancy. HLA typing demonstrated all babies to be genotypic offspring of the gamete donors.

Female↗
PubMed1985

Legal issues in IVF.

It is desirable when considering legal issues related to IVF not to restrict attention solely to the impact of laws in existence at the time the IVF technology appeared. Laws then in existence were not designed with IVF in mind. New laws are needed, particularly to deal with legal problems that will arise from 'existing' laws in relation to two unprecedented features of IVF. These are the new technology whereby fertilized human eggs may be frozen, stored and later used for childbearing, and the fact that a 'host' mother may bear an IVF embryo. This chapter has discussed legal issues in IVF by examining in succession: a number of matters of basic social concern that require attention and raise questions that should be answered before new laws are made the need for laws on IVF to rest on clear principles acceptable to the community the application to IVF of 'existing' laws in six countries (France, the United States, Canada, England, Israel and Australia) and the kinds of problem that are thereby raised new laws that have already been created in Australia specifically to regulate IVF, and new laws that are in the course of preparation in the United Kingdom.

Australia↗
PubMed1992

Effects of myomas or prior myomectomy on in vitro fertilization (IVF) performance.

OBJECTIVE: The purpose of this study was to determine the effect of the presence of myomas and prior myomectomy on the pregnancy rate and pregnancy outcome in an in vitro fertilization (IVF) program. DESIGN: Data collected from office and hospital records were analyzed retrospectively. SETTING: Patients (all with private insurance carriers) were enrolled in an academic IVF program at The Jones Institute for Reproductive Medicine. PATIENTS: All IVF patients enrolled in series 26-41, from 1987 to 1990, were reviewed. Only patients with well-documented myomas [by laparoscopy, laparotomy, hysteroscopy, or hysterosalpingography (HSG)] or prior myomectomy (confirmed by operative and pathology report) were included. MAIN OUTCOME MEASURES: Pregnancy rates and pregnancy outcome were the main outcome measures. Pregnancy rates were calculated per preovulatory embryo transfer. Chi-square, Student t-test, and the Whitney-Mann test were used in the statistical analysis and P less than 0.05 was considered significant. RESULTS: Among 1415 IVF patients, 11 had confirmed myomas present and 47 others had prior myomectomies. The mean age of patients with myomas and myomectomy was 37.1 +/- 4.1 and 36.1 +/- 1.9 years, respectively. Ten of the patients with myoma had normal endometrial cavities on HSG. Subserosal tumors were present in 10 of 11 patients with myomas. Ten of the 47 myomectomy patients had an abnormal cavity prior to surgery and all were corrected. About half of the patients with prior myomectomy had subserous myomas, while 10% were submucous in location. Two of the patients had hysteroscopic removal; all the rest were performed abdominally. The ongoing pregnancy rate from fresh embryo transfer for patients with myomas and myomectomy was 20.8 and 16.9%, respectively. This was comparable to the 19.0% ongoing pregnancy rate for all patients in these series. Despite the small number, and the fact that most had subserosal myomas, patients with myomas had a 50% abortion rate, while those postmyomectomy had a 34.2% abortion rate (statistically not significant). Moreover, if subdivided by their primary IVF indications, patients with prior myomectomy had similar ongoing pregnancy rates from fresh embryo transfer compared to the whole IVF population. CONCLUSION: The incidence of myomas or prior myomectomy among infertility patients presenting for IVF was rather low. Myomectomy did not interfere with IVF performance in relation to overall and ongoing pregnancy rate.

Female↗
PubMed1992

Successful parents of in vitro fertilization (IVF): the social repercussions.

A matched comparison was made of 157 parents of preschool twins conceived by one of the following: in vitro fertilization (IVF), infertility workup combined with infertility drug treatment, or spontaneously. The Interview Schedule for Social Interaction was used to examine systematically a comprehensive range of social relationships and the asymmetries therein. Overall, IVF parents reported having deficient social relationships compared with non-IVF parents, and this deficiency was both in size and in affective quality of their available relationships. As anticipated, mothers reported less adequate and available social relationships when compared with their spouses. In the event of a significant finding, mothers from the three groups always had lower mean scores than the fathers. The finding of the extent to which IVF parents were not as socially integrated, compared with the other families of preschool twins, highlights the need to strengthen through mutual aid IVF parents' social networks. The data also suggest the need for ongoing patient care by IVF teams and for support groups to be established exclusively for IVF parents of twins.

Adult↗
PubMed1987

Relative ability of modified versions of the hamster oocyte penetration test, incorporating hyperosmotic medium or the ionophore A23187, to predict IVF outcome.

This study was designed to assess the relationship between IVF outcome and the results obtained with two modified versions of the zona-free hamster oocyte penetration test in which the spermatozoa were pre-incubated with either hyperosmotic medium or the divalent cation ionophore A23187. When the former system was used, a poor correlation with IVF outcome was observed. Samples screened prior to IVF exhibited a 60% false negative rate (failed penetration test, successful IVF), while for those assessed concurrently with IVF, the equivalent figure was 85.7%. Addition of A23187 optimized the penetration system giving higher levels of sperm--oocyte fusion and a more accurate prediction of the capacity of the spermatozoa to fertilize human ova in vitro. With this system the false negative rate was 4.3% for screened samples and 0% for those assessed simultaneously with IVF. These results suggest that the A23187-enhanced system may be of value as a screening criterion for IVF.

Animals↗
PubMed1992

The psychological well-being of infertile women after a failed IVF attempt: the effects of coping.

One hundred infertile women and 73 female controls completed three measures of psychological well-being (depression, self-esteem and self-confidence) on two occasions (Times 1 and 2), coinciding with the beginning and end of a failed IVF attempt by the infertile women. At Time 2, the IVF women were also asked to indicate whether they had used a number of different coping responses, in relation to dealing with their failed IVF attempt. As predicted, IVF women were more depressed and had lower self-esteem than controls prior to the treatment cycle, and both before and after the treatment cycle they were less self-confident. After the failed IVF procedure, IVF women were more depressed and had lower levels of self-esteem than they did prior to the treatment cycle. In terms of the effects of coping on the post-attempt well-being of the IVF women, the use of problem-focused coping was associated with high levels of well-being, while the use of avoidance coping and seeking social support was associated with low levels of well-being.

Adaptation, Psychological↗
PubMed1989

In vitro fertilization, gamete intrafallopian transfer and combined IVF-GIFT results: three-year experience at Chang Gung Memorial Hospital.

A review is presented summarizing the IVF-ET, GIFT and combined IVF-ET-GIFT experienced at Chang Gung Memorial Hospital. Since the building of an aseptic dust free laboratory next to the operation room, the clinical pregnancy rate has been 12.2% per embryo transfer in IVF-ET, 16.7% in the GIFT program and 30.0% in the combined IVF-GIFT program. The overall clinical pregnancy rate was 14.9%. The overall pregnancy rate appeared to be independent of the causes of infertility, be it tubal factor, endometriosis or unexplained infertility. It was lower in couples with male factor or combined factors. The different regimens for follicular stimulation were hMG-hCG, clomiphene-hMG-hCG and FSH-hMG-hCG. No one regimen showed a better pregnancy rate than the others. The methods of oocyte retrieval were laparascopy, laparotomy, transbladder ultrasound-guided, and transvaginal ultrasound-guided retrieval. There were 4.53 oocytes retrieved pertreatment cycle. The transvaginal ultrasoundguided oocyte retrieval has greatly simplified the procedures in the IVF-ET program. The patient selection was important not only for the indications but also for the methods of IVF-ET, GIET and combined IVF-GIFT.

Evaluation Studies as Topic↗
PubMed1992

Influence of sperm parameters on outcome of subzonal insemination in the case of previous IVF failure. off.

Subzonal insemination (SUZI) has been proposed for patients with sperm male factor infertility, and in cases of in-vitro fertilization (IVF) failures. However despite SUZI, there still remain couples with very low fertilization rates and even with fertilization failures. Since sperm parameters are known to influence the IVF fertilization rate, we investigated the relation between sperm parameters and the SUZI issue in cases of previous IVF failures with normal or subnormal sperm. Twenty-seven couples were included in the study and were split into two groups according to whether they had normal or subnormal sperm. In the first part of the study a randomized prospective trial comparing SUZI to classic IVF insemination was carried out (11 cycles). In the second part, all the oocytes had SUZI (35 cycles). None of the control inseminated oocytes fertilized. Including all the cases, the fertilization rate after SUZI was 29.8% with a pregnancy rate of 15.2% per cycle. We concluded that: (i) SUZI is efficient for achieving fertilization in cases of IVF failures; (ii) the post SUZI fertilization rate is inversely correlated to the percentage of acrosome defects in the semen (P < 0.001); and (iii) when the sperm is normal, the oocyte quality might be responsible for the previous IVF failures. In spite of a good fertilization rate for this indication, it seems that the chance of having a baby is low.

Adult↗
PubMed1989

[Results of concomitant psychosomatic studies of IVF patients].

The in vitro fertilization (IVF) treatment is very stressful for the couple. The emotional tension (waiting, hoping) plays a greater role than the bodily complaints (stimulation, follicle puncture). Sometimes the wish to get a child is very strong and is the motivation for IVF treatment. Psychological investigations show that IVF patients have fewer psychological complaints compared with other sterility patients; in the psychoanalytically oriented Giessen test there are no differences compared with other sterility patients. The aim of a treatment for IVF patients is the individual, medically and psychologically oriented therapy - sometimes involving the renunciation of a further IVF therapy.

Adaptation, Psychological↗
PubMed1989

Selection of patients for IVF therapy or alternative therapy methods.

Microsurgery is the treatment of choice for most patients with a tubal factor. In-vitro fertilization--embryo transfer (IVF-ET) is performed in patients with the so-called classical indications: bilateral salpingectomy and tubal damage which is not correctable by means of microsurgery. We also discuss IVF in patients who have not conceived within 1 to 2 years following microsurgery. In women with tubal re-occlusion IVF should be performed. In patients with patent tubes following microsurgery, gamete intra-Fallopian transfer (GIFT) forms part of a controlled clinical study. More clinical experience can perhaps solve the dilemma whether it is beneficial to perform GIFT or to offer IVF primarily to these patients. In patients with andrological infertility, GIFT is offered after six unsuccessful attempts of intrauterine insemination (IUI). In long-standing infertility, GIFT is performed when IUI with ovarian stimulation fails. Patients with genital pathology (patent tubes) are treated with GIFT unless it is not technically feasible. In these cases microsurgery or IVF should be discussed.

Embryo Transfer↗
PubMed1992

The male IVF patient--psychosomatic considerations.

In order to study psychosomatic considerations of the male IVF patient, three issues were investigated. First, the personality traits of sterile males (n = 180) were recorded. Male IVF patients were found to have largely the same personality traits as the general population although they tended to have more dominant and retentive traits. Second, in examining the specific stress experiences during IVF, the individual treatment steps were ranked as being similarly stressful by both partners. Males felt the waiting periods (fertilization? pregnancy?) to be clearly more unpleasant than the physical aspects of treatment (e.g. masturbation). Third, an individual comparison of sperm parameters taken during the diagnostic phase with those measured during the IVF attempt, showed that density and morphology were significantly different. Some practical recommendations to reduce the stress that men experience during IVF include his presence during the treatment steps that the female must undergo, as well as his participation in a self-help discussion group.

Female↗
PubMed1987

One year's experience with programmed oocyte retrieval for IVF.

We have previously described a simplified form of ovulation stimulation for IVF in which the day of presumed oocyte retrieval is determined several weeks in advance. This paper retrospectively analyses this technique in 296 unselected patients over a one year period to assess if the method is suitable for routine use in an IVF programme. Oocyte retrieval was performed on the predetermined day in 70% of patients commencing stimulation. In the remainder, the presumptive day of oocyte retrieval was modified, or the cycle was cancelled. Compared with 356 patients undergoing a comparable classically monitored IVF stimulation during the same period, there was no significant difference in the cancellation rate of cycles prior to oocyte recovery, in the numbers of oocytes or embryos obtained or in the pregnancy rate between the two populations. It is concluded that programmed oocyte retrieval does not have a deleterious effect on the success rate of IVF compared with classical clomiphene citrate/HMG stimulation and it considerably facilitates the administration of an IVF programme.

Clomiphene↗
PubMedDate not supplied

Stress in IVF workers.

Workers in new and personally exacting health services face particular challenges which are not evident in more traditional areas. IVF workers are involved in such an innovative service. Their perception of workplace stressors has not previously been addressed in the literature. Fifty-nine IVF workers and 32 non-IVF workers (in routine obstetrics and gynaecology) completed a battery of standardized psychological questionnaires on the symptomatology of stress and in addition answered questions on workplace problems and work satisfaction. Reported stress was highest among scientific/technical workers who varied significantly from the control group scores. IVF medical staff showed elevated stress scores, but were not significantly separated from controls, except on state anxiety. Work satisfaction scores were generally high for all IVF professions, except for pay and promotion satisfaction scores which were depressed among nurses and scientific/technical staff. It was concluded that this initial survey had revealed important information about the impact of a new scientific and clinical enterprise upon staff and should promote closer examination of the reasons for such reported stress.

Adult↗