No abstract available.
Female ; Humans ; Oocyte Retrieval* ; Oocytes* ; Ovarian Diseases*

The first pregnancy following in-vitro fertilization (IVF) and the subsequent transfer to the surrogate was reported in 1985. Afterward, IVF-surrogacy became a viable reproductive alternative for couples who would otherwise be unable to produce a genetic child. We have experienced a case of successful surrogate pregnancy in patient with congenital absence of vagina (Mayer-Rokitansky-Kuster-Hauser Syndrome). After oocyte retrieval through the neovagina, the embryo transfer was performed to a surrogate gestational mother. Two male babies (2,790 gm, 2020 gm) were delivered at 36+3 weeks of gestation.
Child ; Embryo Transfer ; Family Characteristics ; Female ; Fertilization ; Human ; Humans ; Male ; Oocyte Retrieval ; Pregnancy* ; Surrogate Mothers ; Vagina

It has been decades since the concept of empty follicle syndrome (EFS), in which no oocytes are retrieved in an in vitro fertilization and embryo transfer (IVF-ET) cycle, was introduced. The incidence of this syndrome in patients undergoing IVF-ET has been estimated to be about 0.6-7%. The use of recombinant human chorionic gonadotropin (r-hCG) can be a useful option for the EFS patients with previous failure of oocyte retrieval in IVF-ET cycles. We present a case of empty follicle syndrome with successful oocyte retrieval by the use of r-hCG.
Chorionic Gonadotropin* ; Embryo Transfer ; Fertilization in Vitro ; Humans* ; Incidence ; Oocyte Retrieval* ; Oocytes*

OBJECTIVE: To estimate the predictive value of initial serum B-hCG and progesterone measurement for pregnancy outcome in IVF-ET. METHODS: Serum B-hCG at 11-12th day after embryo transfer and progesterone at 7th day after oocyte aspiration were measured in 48 successful pregnant IVF-ET cases from July 1993 to June 1997. RESULTS: Of 48 cases, 26 cases (54.2%) successfully carried to sustaining gestation and 22 cases (45.8%) failed to sustain gestation. The estimated initial serum B-hCG levels in the normal sustaining pregnancy group (132.28+ 22.42 mlU/ml) were statistical significantly higher than 29.43+8.08 mIU/ml in the failed sustaining pregnancy group (p<0.001), while the estimated initial serum progesterone levels showed no significant differences (p=0.159). In order to determine the predictive values using the Receiver Operator Curve (ROC), an appropriate cutoff value of 38 mIU/ml for initial serum B-hCG was obtained. In IVF-ET pregnancies, the estimated serum B-hCG levels in cases of chemical abortion in failed sustaining pregnancy were significantly lower compared to the normal sustaining pregnancy group (p<0.001). CONCLUSION: The initial serum B-hCG levels at 11 days after embryo transfer could be used to predict the pregnancy outcome in an IVF program. An initial progesterone level acquired on the 7th day after oocyte retrieval is not a useful indicator to predict pregnancy outcome.
Chorionic Gonadotropin* ; Embryo Transfer* ; Embryonic Structures* ; Female ; Humans* ; Oocyte Retrieval ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Progesterone*

Controlled ovarian hyperstimulation is one of the major steps of in vitro fertilization. The inaccessibility or non-visualization of developing follicles on transvaginal sonography (the preferred imaging method) may be misjudged as a poor response, resulting in cycle cancellation. It is necessary to scrupulously appraise proxy indicators for ovarian response, such as estradiol levels, endometrial thickness, and other individual clinical characteristics. This can prompt meticulous transabdominal ultrasound follicular monitoring and oocyte retrieval with the goal of averting cycle cancellation and improving treatment outcomes.
Estradiol ; Fertilization in Vitro* ; Humans ; Infertility ; Oocyte Retrieval ; Ovulation Induction ; Proxy ; Ultrasonography

BACKGROUNDEmbryo quality and receptivity of the endometrium are two factors that determine the results of in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET). There is no consensus of the optimal transfer strategy for normal responders or high responders. The current study aimed to find the optimal transfer strategy for different subgroups of patients.

METHODSFrom April 2010 to December 2010, patients who meet the following criteria were included in this study; primary infertility, female age ≤ 35 years, FSH level on female cycle day 2 - 3 ≤ 12 mIU/ml, at least six good quality embryos available on day three. The clinical outcomes using different transfer strategies between normal responders and high responders were reviewed and compared.

RESULTSFor the normal responders, the clinical pregnancy rate of day three double-embryo transfer (DET) was comparable to that of day five elective single blastocyst transfer (eSBT), 64.04% vs. 60.33% (P > 0.05). For the high responders, the clinical pregnancy rate of day five eSBT was significantly lower than that of day three DET, 43.35% vs. 57.21% (P < 0.05). For the high responders, the rates of clinical pregnancy and implantation in frozen-thawed embryo transfer (FET) cycles were notably higher than in eSBT cycles (64.56% vs. 43.35% and 62.11% vs. 43.35% respectively) (P < 0.05).

CONCLUSIONSFor normal responders, eSBT might be an applicable strategy to reduce multiple pregnancy rates while maintaining acceptable overall pregnancy rates. And in order to reduce multiple pregnancies and increase the chance of pregnancy of high responders, FET may be a preferable strategy.

Adult ; Embryo Transfer ; methods ; Estradiol ; blood ; Female ; Humans ; Oocyte Retrieval ; Pregnancy ; Pregnancy Rate

OBJECTIVETo observe analgesic effect and safety of acupuncture compound anesthesia in transvaginal ultrasound-guided oocyte retrieval.

METHODSThree hundred and sixteen cases undergoing in vitro fertilization and embryo transfer (IVF-ET) were randomly allocated to an acupuncture compound anesthesia group (n = 146) and a simple Pethidine group (n = 170). They received respectively electroacupuncture combined with intramuscular injection of Pethidine and simple intramuscular injection of Pethidine 30 min before oocyte retrieval.

RESULTSThe acupuncture compound anesthesia group was significantly better than the simple Pethidine group in the pain rating and pain score (P < 0.01); the incidence rate of abdominal pain at 1 h and 2-5 h after oocyte retrieval in the acupuncture compound anesthesia group was lower than that in the simple Pethidine group (P < 0.01).

CONCLUSIONIn transvaginal ultrasound-guided oocyte retrieval, acupuncture compound anesthesia has the advances of safety, high effectiveness, rapid recovery after oocyte retrieval, and few side effects.

Acupuncture Analgesia ; Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Oocyte Retrieval ; methods ; Ultrasonography ; Vagina ; diagnostic imaging

Advances in cancer treatment allow women to be cured and live longer. However, the necessary chemotherapy and radiotherapy regimens have a negative impact on future fertility. Oncofertility has emerged as a new interdisciplinary field to address the issue of gonadotoxicity associated with cancer treatment and to facilitate fertility preservation, including oocyte and ovarian tissue cryopreservation. These fertility issues are often inadequately addressed, and referral rates to oncofertility centers are low. The aim of this study was to report the 3-year experience of the San Raffaele Oncofertility Unit. A total of 96 patients were referred to the Oncofertility Unit for evaluation after the diagnosis of cancer and before gonadotoxic treatment between April 2011 and June 2014. Of the 96 patients, 30 (31.2%) were affected by breast cancers, 20 (20.8%) by sarcomas, 28 (29.2%) by hematologic malignancies, 13 (13.5%) by central nervous system cancers, 3 (3.1%) by bowel tumors, 1 (1.0%) by Wilms' tumor, and 1 (1.0%) by a thyroid tumor; 47 (49.0%) were referred for oocyte cryopreservation before starting chemotherapy, 20 (20.8%) were referred for ovarian tissue cryopreservation, and 29 (30.2%) were not recruited. The mean time between the patients' counseling and oocyte retrieval was 15 days (range, 2-37 days). The mean time between the laparoscopic surgery and the beginning of treatment was 4 days (range, 2-10 days). The number of patients who were referred increased over time, whereas the rate of patients who were not recruited decreased, showing an improvement in referrals to the Oncofertility Unit and in the patients' counseling and understanding. Our results indicate that an effective multidisciplinary oncofertility team is necessary for prompt referrals and treatment.
Adolescent ; Adult ; Child ; Child, Preschool ; Counseling ; Female ; Fertility Preservation ; Humans ; Middle Aged ; Neoplasms ; physiopathology ; Oocyte Retrieval

This study investigated the effect of Matrigel on the differentiation and proliferation of luteinized granulosa cells in vitro. Human luteinized granulosa cells (LGC), obtained after the oocyte retrieval from the IVF process were cultured either on plastic or on Matrigel. Phase-contrast microscopy showed that LGC were flat and attached on the surface of poly-D-lysine while they formed three dimensional cell aggregates when cultured on Matrigel. Bromodeoxiuridine (BrdU) labeling followed by immunocytochemistry for BrdU and 3b-hydroxysteroid dehydrogenase (HSD) demon-strated that BrdU-labeld cells were shown in both of the 3b-HSD positive and negative granulosa cells when cells were cultured on Matrigel and on poly-D-lysine. Progesterone secretion was increased until culture day 4, and then slightly decreased. The difference in progesterone secretion between the cells cultured on Matrigel and those on poly-D-lysine was increased, as the culture day was increased. The results suggested that Matrigel provides a better culture environment for LCG and maintains proliferation of LCG.
Bromodeoxyuridine ; Female ; Granulosa Cells* ; Humans* ; Immunohistochemistry ; Lutein ; Microscopy, Phase-Contrast ; Oocyte Retrieval ; Oxidoreductases ; Plastics ; Progesterone

OBJECTIVES: To assess and compare the clinical outcomes between GnRH agonist long protocol and GnRH antagonist short protocol in oocyte donation program. MATERIALS AND METHODS: Of total 18 oocyte donation cycles, controlled ovarian hyperstimulation (COH) were performed with GnRH agonist long protocol and GnRH antagonist short protocol in initial 9 cycles and later 9 cycles, respectively. Oral estradiol valerate and progesterone in oil were administrated to all recipients for endometrial preparation. Oral estradiol administration was started from donor cycle day 1 after full shut down of gonadal axis with GnRH agonist in patients with ovarian function. Progesterone was injected from oocyte retrieval day of donor initially, then continuously till pregnancy 12 weeks if pregnancy was ongoing. We compared the parameters of clinical outcomes, such as number of the retrieved oocytes, fertilization rate, high grade embryo production rate, clinical pregnancy rate, implantation rate, ongoing pregnancy rate, COH duration, total gonadotropin dose for COH between GnRH agonist long protocol group and GnRH antagonist group. Statistical analysis was performed using Mann-Whitney test, p<0.05 was considered as statistically significant. RESULTS: The number of retrieved oocytes, fertilization rate, high grade embryo production rate, clinical pregnancy rate, implantation rate, ongoing pregnancy rate were 14.89+/-7.83, 81%, 64%, 78%, 31%, 78%, respectively in GnRHa long protocol group and 11.22+/-8.50, 79%, 64%, 67%, 34%, 56%, respectively in GnRH antagonist group. There was no significant differences in parameters of clinical outcomes between 2 groups (all p value >0.05). Duration and total gonadotropin dose for COH were 10.94+/-1.70 days and 43.78+/-6.8 vials in 18 cycles, 12.00+/-1.73 days and 48.00+/-6.93 vials in agonist group, 9.88+/-0.78 days and 39.55+/-3.13 vials in antagonist group, respectively. in GnRH agonist long protocol group, significantly longer duration and higher gonadotropin dose for COH were needed (p= 0.012). CONCLUSION: in oocyte donation program, clinical outcomes from controlled ovarian hyperstimulation with GnRH antagonist were comparable to those from GnRH agonist long protocol group, so controlled ovarian hyperstimulation with GnRH antagonist may be effective as GnRH agonist long protocol. At least there may not be harmful effects of GnRH antagonist on oocyte development and quality.
Axis, Cervical Vertebra ; Embryonic Structures ; Estradiol ; Fertilization ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Gonads ; Humans ; Oocyte Donation* ; Oocyte Retrieval ; Oocytes* ; Pregnancy ; Pregnancy Rate ; Progesterone ; Tissue Donors