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

The new reproductive technologies such as IVF, GIFT, ZIFT, and micromanipulation have had a profound influence on the therapeutic and diagnostic management of infertility, and in turn have resulted in better understanding of human fertilization and embryo development. While the clinical pregnancy rates in GIFT and ZIFT procedures are comparable to the natural fecundity in the population at large, pregnancy rates in IVF have been generally lower. Further investigations should be directed to improve the implantation rates, and to develop better controlled methods of multiple follicle development. Although more studies are needed, a recent report of potential utilization of nonstimulated oocytes for donor programs as well as IVF-cryopreservation was a promising new development (Cha et al. 1989). Other exciting prospects on the horizon are the possibilities of gene transfer for the treatment of certain genetic diseases and diagnostic applications of embryonal biopsy. These new technologies have also generated serious ethical and legal issues. Any ethical or legal guidelines affecting new reproductive technologies should be developed to protect all participants only when the need for regulation is clear. Ethical guidelines and appropriate legislations with contributions from the medical and scientific community are gradually being established worldwide.
Cryopreservation ; Embryo Transfer ; Ethics, Medical ; Female ; *Fertilization in Vitro ; Gamete Intrafallopian Transfer ; Human ; Legislation ; Pregnancy ; Registries ; Surrogate Mothers

OBJECTIVE: The purpose of our study was to investigate the relationship between prognosis of threatened abortion and embryonic heart rate at diagnosis. METHODS: The study group included 86 patients in which a singleton fetus with cardiac activity was initially documented. The study population was divided into successful pregnancy group (73 cases, pregnancy was maintained above 20 weeks of gestation) and spontaneous abortion group (13 cases). We compared the embryonic heart rate, age of mother, gestational age at diagnosis between two groups. RESULTS: A significant difference of embryonic heart rate was noted between the successful group and the spontaneous abortion group (153.1+/-22.9 vs 134.6+/-18.8 beats/min, p=0.0076). There was no statistical difference in the gestational age at diagnosis (8.0+/-1.9 vs 7.5+/-1.9 weeks), the age of mother, and primi para proportion. CONCLUSION: The prognosis of threatened abortion was related to the embryonic heart rate. Embryos with slow heart rates had a greater risk of spontaneous abortion. All cases with slow embryonic heart rate (<110 beats/min) had occurred spontaneous abortion. Therefore, these case were needed more information and aggressive treatment.
Abortion, Spontaneous ; Abortion, Threatened* ; Diagnosis ; Embryonic Structures ; Female ; Fetus ; Gestational Age ; Heart Rate* ; Heart* ; Human ; Humans ; Mothers ; Pregnancy ; Prognosis* ; Surrogate Mothers

Congenital absence of vagina (Mayer-Rokitansky-K ster-Hauser Syndrome) is the second most common etiology of primary amenorrhea and also cause of primary infertility. Management for these women comprise of construction of neovagina for sexual life and screening for associated congenital anomalies and planning of getting her own genetic offspring. As associated assisted reproductive technologies involving in vitro fertilization and embryos transfer to surrogate mother become realizing, it is being possible for these women to have new opportunity of getting her own genetic baby. In most cases, oocyte retrieval for uterine surrogate program have been performed laparoscopically because of difficulty of oocyte retrieval via neovagina. But we have experienced a case of successful surrogate pregnancy via oocyte retrieval through the neovagina in a patient with congenital absence of vagina, so report it after following observation of the babies for 3 years.
Amenorrhea ; Embryonic Structures ; Female ; Fertilization in Vitro ; Human ; Humans ; Infertility ; Mass Screening ; Oocyte Retrieval* ; Oocytes* ; Pregnancy* ; Reproductive Techniques, Assisted ; Surrogate Mothers ; Vagina

A 28-year-old woman with mullerian agenesis presented with primary infertility and was considered for laparoscopic oocyte retrieval and in-vitro fertilisation. Her 27-year-old younger sister served as a gestational carrier. The patient underwent ovarian stimulation and 11 mature oocytes were retrieved by laparoscopy. After successful in-vitro fertilisation, two embryos were transferred to the gestational carrier. Two weeks after embryo transfer, the pregnancy was confirmed by serum human chorionic gonadotropin levels. Another two weeks later, an ongoing singleton pregnancy with foetal heartbeat was confirmed by transvaginal ultrasonography.
Adult ; Female ; Fertilization in Vitro ; methods ; Humans ; Infertility, Female ; genetics ; Mullerian Ducts ; abnormalities ; Oocytes ; Pregnancy ; Surrogate Mothers ; Syndrome ; Tissue and Organ Harvesting ; Urogenital Abnormalities

OBJECTIVE: Recently, enormous amount of the studies about trial of labor after cesarean section has been reported to decrease the rate of cesarean section. This study focused on analyzing multiple variables and results to acknowledge the safety and complications of VBAC (vaginal birth after cesarean section). METHODS AND MATERIALS: This study was performed based on 97 pregnant women who were tried vaginal delivery after cesarean section at Hanyang University Hospital from January 1990 to December 1999. The age of mother, gestational age, estimated fetal body weight by ultrasonography, neonatal body weight, cervical dilatation, cervical effacement, Bishop score, the number of previous vaginal delivery, complications of mother, and complications of fetus were analyzed between successful group (82 patients) and failure group (15 patients) with trial of labor. Student T-test and Chi-square test were used for statistical analysis. RESULTS: In the 97 cases with trial of labor after cesarean, the success rate was 84.5% and failure rate was 15.5%. The estimated fetal body weight by ultrasonography, cervical dilatation and effacement, Bishop score, Apgar score had notable differences between successful group and failure group, while the other factors had not. There was no maternal death or uterine rupture in the cases of trial of labor. CONCLUSION: Trial of labor after cesarean section is relatively safe method of delivery if it is performed under strict indication. It could be suggested that VBAC has relatively little complication in both mother and fetus. The studies with large populations and performed by multi-centers will be needed for the evaluating safety of VBAC and developing safe protocols to decrease the risk of complications.
Apgar Score ; Body Weight ; Cesarean Section ; Female ; Fetal Weight ; Fetus ; Human ; Humans ; Labor Stage, First ; Maternal Death ; Mothers ; Parturition ; Pregnancy ; Pregnant Women ; Surrogate Mothers ; Trial of Labor ; Ultrasonography ; Uterine Rupture ; Vaginal Birth after Cesarean*

OBJECTIVE: Recently, with rising rates of repeat cesarean sections, enormous amount of the studies about trial of labor after cesarean section have been reported to decrease the rate of cesarean section. The purpose of this study is to provide data regarding the safety and the successful prognostic factors of VBAC (vaginal birth after cesarean section). METHODS: This retrospective study was performed based on 194 pregnant women who tried vaginal delivery after cesarean section at Eulji University Hospital from March 1997 to February 2002. The age of mother, gestational age, estimated fetal body weight by ultrasonography, neonatal body weight, cervical effacement, cervical dilatation, Bishop score, the number of previous vaginal delivery, and spontaneous labor were analyzed between successful group (177 patients) and failure group (17 patients) with trial of labor. Student T-test and Chi-square test were used for statistical analysis. RESULTS: 177 cases (91.24%) in 194 cases succeeded in VBAC and 17 cases (8.76%) failed. There was no maternal death or uterine rupture in the cases of trial of labor. The gestational age, estimated fetal body weight by ultrasonography, neonatal body weight, cervical effacement, cervical dilatation, Bishop score, the number of previous vaginal delivery, spontaneous labor had notable differences between the successful group and the failure group. But, There was no significant difference in maternal age. CONCLUSION: The trial of labor after cesarean section is relatively safe method of delivery if it is performed under strict indication. Above findings can be used as possible prognostic factors for the success of VBAC and may reduce the risk and complication of VBAC. The following studies with large populations and performed by multi-centers will be needed for the evaluation of safety and successful prognostic factors of VBAC.
Body Weight ; Cesarean Section ; Cesarean Section, Repeat ; Female ; Fetal Weight ; Gestational Age ; Human ; Humans ; Labor Stage, First ; Maternal Age ; Maternal Death ; Parturition ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Surrogate Mothers ; Trial of Labor ; Ultrasonography ; Uterine Rupture ; Vaginal Birth after Cesarean*

PURPOSE: This study was undertaken to develop an animal model of periventricular leukomalacia (PVL) induced by in utero clamping of pregnant rat aorta in fetal rats. METHODS: A timed pregnanct Sprague-Dawley rat on embryonic day 21 just prior to delivery was sedated and anesthetized, and a Harvard ventilator for small animals was applied. Following laparotomy, the maternal aorta was clamped reversibly for 40 minutes using a surgical clip. The fetal rats were then delivered by Cesarean section, resuscitated if necessary, and reared by a surrogate mother rat until postnatal day 21 to obtain the brain specimen. After systemic perfusion and fixation, 10 microm thick serial brain sections were obtained and stained for pathologic examination and assessment of ventriculomegaly. Ventriculomegaly was assessed by the measured ventricle to total brain volume ratio. RESULTS: Eight out of eleven fetal rats (73%) survived in the ischemia group after induction of in utero ischemia by clamping maternal rat aorta, and all ten survived in the control group. Body and brain weights measured at postnatal day 21 were significantly lower in the ischemia group compared to the control group. In pathologic findings, significant ventriculomagaly (3.67+/-1.21% vs. 0.23+/-0.06%) was observed in the ischemia group compared to the control group; although cystic lesion was not observed, mild (n=6) and moderate (n=2) rerefaction of the brain tissue was observed. CONCLUSION: A fetal rat model of PVL induced by in utero clamping of pregnant rat aorta was developed.
Animals ; Animals, Newborn ; Aorta ; Brain ; Brain Ischemia ; Cesarean Section ; Constriction ; Female ; Human ; Humans ; Infant ; Infant, Newborn ; Ischemia ; Laparotomy ; Leukomalacia, Periventricular ; Models, Animal ; Perfusion ; Pregnancy ; Rats ; Surgical Instruments ; Surrogate Mothers ; Ventilators, Mechanical ; Weights and Measures