In Vitro Fertilization-embryo Transfer Patients Research Articles

Association between domain-specific physical activity and mental health status after embryo transfer in IVF-ET-assisted pregnancy patients

Physical activity has been shown to impact mental health in in vitro fertilization-embryo transfer (IVF-ET) patients, but the relationship between domain-specific physical activity and mental health in this population remains unclear. In a cross-sectional observational study, 208 patients undergoing IVF-ET with long-term ovulation induction cycles were recruited from a reproductive center. The International Physical Activity Questionnaire and the symptom checklist 90 (SCL-90) were used to assess physical activity levels and mental health status, respectively. Analyses of variance and linear regression analyses were conducted to identify the relationship between physical activity and mental health. There were differences between different physical activity level in times of transfers, years of infertility, and times of abortions. Patients with high levels of physical activity had fewer symptoms than those with low levels of physical activity. Occupation, transport and household physical activity had significant negative correlations with the respective SCL-90 factor scores. Linear regression analysis revealed that occupation physical activity was associated with lower depression and anxiety, and transport physical activity and household physical activity were associated with lower obsessive–compulsive, interpersonal sensitivity, depression, anxiety, and psychoticism scores. The study indicates that increased engagement in physical activity, specifically activities related to occupation, transportation, and household, may be associated with improved mental health among IVF-ET patients.

Investigating the impact of the sperm DNA fragmentation index of male partners from infertile couples on in vitro fertilization-embryo transfer outcomes

This study was aimed to elucidate the relationship between sperm DNA fragmentation index (DFI) and semen parameters, and to investigate the impact of these parameters on in vitro fertilization-embryo transfer (IVF-ET) outcomes. The study was conducted on 159 couples undergoing IVF-ET treatment at the Department of Reproductive Health from January 2019 to October 2023. The case group was comprised of 79 patients with sperm DFI of ≥15%, and the control group had 80 patients with <15%fragmentation index. Comprehensive data on semen parameters and the reproductive outcomes were collected and analysed. Comparisons of the case and control groups depicted no significant differences in key parameters including semen volume, sperm concentration, total sperm count, number of retrieved oocytes, rates of mature (MII) oocytes, normal fertilization, cleavage, blastocyst formation, high-quality blastocysts, human chorionic gonadotropin (HCG) positivity, clinical pregnancy, implantation and miscarriage (p > 0.05). However, marked differences were found in the rates of sperm progressive motility, total sperm motility, normal morphology, high-quality embryos, and transferable embryos (p < 0.05). The correlation analysis between sperm DFI and semen parameters exhibited positive correlation between sperm DFI and total sperm count (p < 0.05). The negative correlations were found between the sperm DFI and sperm progressive motility, total sperm motility, or normal morphology (p < 0.01). The findings demonstrated that incorporating sperm DFI as a standard component of semen analysis was advisable, and the sperm DFI as reference tool assisted in predicting the early embryonic development in IVF-ET patients.

Metabolomic and microbiome analysis of cervicovaginal mucus in invitro fertilization-embryo transfer: Toward predicting pregnancy success.

In the context of invitro fertilization-embryo transfer (IVF-ET), factors other than egg quality may be key determinants of treatment success, in particular, maternal factors related to uterine endometrial receptivity and unidentified factors. We therefore aimed to analyze the metabolome and microbiome in IVF-ET patients who did and did not achieve pregnancy. Cervicovaginal mucus was collected from patients undergoing IVF-ET. Metabolite analysis was conducted by liquid chromatography-mass spectrometry and the microbiota were determined by the polymerase chain reaction using universal 16S-rRNA gene bacterial primers by MiSeq sequencing. Patients were classified as pregnant (N = 10) or nonpregnant (N = 13). Metabolic pathways were examined by MetaboAnalyst. Three metabolic pathways, including alanine-aspartate-glutamate metabolism, arginine biosynthesis, and cysteine-methionine metabolism, were commonly decreased at the time of embryo transfer irrespective pregnant outcomes. Notably, pyruvate was decreased in the pregnant group. Amino acid metabolites showed inverse correlations with the presence of anaerobic microbiota in the nonpregnant group. Metabolism decreased during embryo transplantation, with a notable decrease in pyruvate metabolism, particularly in patients who became pregnant. The behavior of metabolites in the pregnant and nonpregnant groups suggests that metabolome analysis in the cervicovaginal mucus may be a diagnostic marker for predicting pregnancy.

Psychological distress, emotion regulation, neuroticism, and sexual relationship on patients with temporary ejaculation failure in vitro fertilization-embryo transfer treatment.

Temporary ejaculation failure on the oocyte retrieval day might leading interruption of the oocyte retrieval procedure. The present study aims to understand the psychosocial factor that affects men with temporary ejaculation failure (TEF) in Vitro fertilization-embryo transfer (IVF-ET) patients, and thus provide new ideas for optimal clinical treatment. In a prospective study, the male patients during IVF treatment in a reproductive center of a tertiary hospital in Shandong were divided into two groups, 70 men with TEF and 79 normal controls. General population sociology and clinical disease were investigated, and the Kessler 10 scale, emotion regulation questionnaire, big five inventory questionnaire, and sex subscale of marriage quality were used to assess the psychological distress, emotion regulation, neuroticism, and satisfaction with sexual life. The scores of perceived distress and neuroticism of the TEF group were higher than the non-TEF group (p < 0.001), and cognitive reappraisal and sexual relationship were significantly lower than those in the non-TEF group (p < 0.001). Psychological distress (OR 1.130, p = 0.031) and neuroticism (OR 1.096, p = 0.050) were risk factors for TEF, while cognitive reappraisal (OR 0.883, p = 0.004) and sexual relationship (OR 0.712, p < 0.001) was protective factors. The present study demonstrates that psychosocial factors influence TEF in IVF-ET patients, which provides the basis for the prevention of the occurrence of TEF in a male undergoing IVF-ET.

Analysis of the levels of hope and influencing factors in infertile women with first-time and repeated IVF-ET cycles

PurposeTo explore the hope levels and influencing factors in infertile women undergoing first-time and repeated in vitro fertilization-embryo transfer (IVF-ET) cycles.MethodsThis study was a cross-sectional and convenient sampling study conducted among patients undergoing IVF-ET from January to June 2019. Patients were divided into first-time and repeated groups by the number of IVF-ET cycles, and then a questionnaire survey was administered. The questionnaire included demographic information, Herth hope index (HHI) scale, Locke-Wallace short marital-adjustment test scale and social support rating scale. Multiple linear regression was used to analyse the influencing factors associated with hope levels.ResultsA total of 298 IVF-ET patients were recruited for the study, including 150 (50.3%) in the first-time cycle group and 148 (49.7%) in the repeated cycle group. The HHI score of the repeated cycle group was significantly lower than that of the first-time cycle group (34.4 ± 3.5 vs. 37.5 ± 3.7, P < 0.001). Multiple linear regression analysis indicated that repeated IVF-ET and age were independently negatively correlated with HHI, with standardized coefficient β values of − 0.895 and − 0.223, respectively (both P < 0.001). High education level (P = 0.002), high monthly income (P = 0.020), high degree of short marital-adjustment test (P < 0.001) and social support rating (P < 0.001) were independently positively correlated with HHI.ConclusionInfertile women undergoing repeated IVF-ET have low hope levels. Maintaining a good marriage adjustment and establishing a good social support and relationship network could effectively improve their hope levels.

Salpingectomy may decrease antral follicle count but not live birth rate for IVF-ET patients aged 35\u201339\u2009years: a retrospective study

PurposeProblems with fallopian tubes are one of the main reasons for women to undergo in vitro fertilization-embryo transfer (IVF-ET). A large proportion of women with ectopic pregnancy, fallopian tube obstruction and hydrosalpinx have had one or both fallopian tubes removed by salpingectomy. With increasing age, ovarian reserve deteriorates, the numbers of retrieved oocytes, available embryos and high-quality embryos are reduced, and the live birth rate for women treated with IVF treatment is affected. Thus, it is important to understand how salpingectomy affects live birth rates for IVF patients of different ages. This study analyzed how patients’ age and salpingectomy influenced ovarian reserve, ovarian response and pregnancy outcomes for infertile women undergoing IVF-ET.MethodsA total of 1922 patients that underwent IVF-ET treatment from January 1, 2012, to December 31, 2018, were included in this retrospective study. The patients were divided into two groups according to whether or not they had a previous history of salpingectomy. The salpingectomy (group A, 534 patients) and control groups (group B, 1388 patients) were then further divided into two subgroups according to patient age (age<35 years, and age 35–39 years). Ovarian reserve, ovarian response, and IVF outcomes were investigated for each subgroup. Logistic regression model was used to estimate the relationship between clinical pregnancy and live births and patients’ baseline characteristics.ResultsIn the salpingectomy group, antral follicle counts (AFC) were significantly lower for the subgroup aged 35 to 39 years compared with the control group. But this difference did not appear in women younger than 35 years. In addition, there were no significant differences in levels of basal follicle stimulation hormone (FSH), basal luteinizing hormone (LH), basal estradiol (E2), total gonadotropins (Gn) dose, duration of Gn, numbers of retrieved oocytes, fertilization rates, numbers of available embryos, live birth rates, clinical pregnancy rates, miscarriage rates, ectopic pregnancy rates, or multiple pregnancy rates between the salpingectomy group and the control group (P > 0.05). Age is a risk factor for the clinical pregnancy and live birth.ConclusionSalpingectomy may decrease antral follicle count but not live birth rate for IVF-ET patients aged 35–39 years. The increased female age was negative related with clinical pregnancy and live birth.

Psychology and adaptation of couples during in vitro fertilization-embryo transfer: a qualitative study

Objective To understand the psychology and inter-adaptation of patients with in vitro fertilization-embryo transfer (IVF-ET) and their spouses. Methods From August to November 2017, this study selected 13 females with IVF-ET and 13 spouses in Reproduction Center of a ClassⅢ Grade A hospital in Anhui Province as subjects by purposive sampling. In-depth semi-structured and individualized interview was carried out for those subjects with the phenomenology study of qualitative research. Colaizzi 7-step analysis was used to sort out and analyze interview data. Results Psychological pressure was common in patients with IVF-ET and their spouses and interacted with each other. Totals of four themes were extracted separately, in patients: (1) being worried about IVF-ET and marital status; (2) bearing stress from family, social and themselves; (3) changes of life style and relationship between husband and wife; (4) coping with stress and adjustment mode solely; in spouses: (1) being worried about IVF-ET and physical condition of their wives; (2) bearing stress from family, work and economy; (3) changes of life style and relationship between husband and wife, (4) lack of coping with stress and adjustment mode. Conclusions We should pay attention to psychological pressure and interaction of IVF-ET patients and their spouses, influence of spouse support and coping style on psychology of IVF-ET patients. Take professional measures to improve the pregnancy outcome by providing targeted health guide and psychological intervention for couples. Key words: Infertility; Sterility; Fertilization in vitro-embryo transfer; Psychological pressure; Spouses; Qualitative research

Quantitative and Qualitative Analyses of Psychological Experience and Adjustment of In Vitro Fertilization-Embryo Transfer Patients.

BackgroundThe aim of this study was to quantitatively analyze the psychosocial characteristics of in vitro fertilization-embryo transfer (IVF-ET) couples and normal couples, and to identify the influencing factors of psychological characteristics and pregnancy outcomes.Material/MethodsThere were 260 infertile couples undergoing IVF-ET and 277 healthy couples of childbearing age in Shengjing Hospital of China Medical University recruited into 2 groups. Psychosocial characteristics were compared to analyze the influencing factors of pregnancy outcomes after IVF-ET. In-depth interviews (n=11) and infertility-related forum posts (n=12) were adopted to obtain the data related to the psychological experience and adjustment. Nvivo 11 software was utilized to collect and analyze the data.ResultsThe levels of anxiety and depression in the IVF-ET group were significantly higher (both P<0.01), the total scores of marital quality scale and social support scale were significantly lower (both P<0.05), immature defense mechanism score was significantly higher (P<0.05), and mature defense mechanism score (P<0.05) was significantly lower than those in the control group. Bod mass index (BMI), family’s rural residence, marital quality, and immature and mature defense mechanisms were influencing factors of depression in IVF-ET female patients (all P<0.05). Marital quality, mature and immature defense mechanisms, concealment factors, and Harm Avoidance (HA) score were influencing factors of depression in IVF-ET males (all P<0.05). The age of the female patient was an independent influencing factor of IVF-ET pregnancy success rate (P<0.01).ConclusionsThe mental health levels of IVF-ET patients were worse than those of fertile couples. The younger the female infertile patient, the higher pregnancy rate of IVF-ET.

Transcutaneous electrical acupoint stimulation for pregnancy of in vitro fertilization-embryo transfer

To observe the impact of transcutaneous electrical acupoint stimulation (TEAS) before and after embryo transfer for the pregnancy of in vitro fertilization-embryo transfer (IVF-ET) patients. A total of 1761 IVF-ET patients of natural cycle or hormone replacement cycle were randomly assigned into an observation group (735 cases) and a control group (1026 cases). IVF-ET was applied in the two groups. TEAS was used for 30 min separately in the observation group on 24 h before transfer and within 2 h after transfer. The acupoints were Zigong (EX-CA 1), Xuehai (SP 10) and Diji (SP 8); Zhongwan (CV 12), Guanyuan (CV 4), Zusanli (ST 36) and Taixi (KI 3). TEAS was not used in the control group. Biochemical pregnancy rate and clinical pregnancy rate were observed 14 d and 4-5 weeks after transfer in the two groups. The biochemical pregnancy rate in the observation group was 62.0% (456/735), which was better than 57.3% (588/1026) in the control group (P<0.05). The clinical pregnancy rate in the observation group was 51.2% (376/735), and it was better than 44.9% (461/1026) in the control group (P<0.05). TEAS could improve the pregnancy rate of IVF-ET patients, and it may be a safe and new assisted method for reproduction without pain.

Oocyte bank set up by comparing different vitrification devices

Our goal is to determine the effects of elevated serum progesterone (P4) at the day of human chorionic gonadotropin (hCG) trigger on the clinical outcomes following in vitro fertilization-embryo transfer (IVF-ET). Retrospective case control study. We reviewed 655 IVF-ET cycles in which ovulation were performed using antagonist protocol. The thresholds of serum P4 were set at 1.4, 2.0 and 2.5 ng/ml. Patients with a level of P4 less than the threshold were subjected to control group, and those with a level higher than threshold were subjected to elevated p4 group. The clinical outcomes between two groups were compared. The total number of retrieved oocytes was significantly higher in elevated P4 group (18.8±10.8, 22.2±10.8 and 25.2±10.8) than in control(12.2±7.7, 14.0±9.1 and 14.8±9.5) at all three P4 thresholds(p=0.000). The number of blastocysts was also significantly higher in elevated P4 group (4.5±4.5, 5.6+5.5 and 6.2±5.9) than in control (2.7±3.1, 3.2±3.5 and 3.2±3.6) at all thresholds (p=0.000). However, when the thresholds were set to 2.0 and 2.5ng/ml, the clinical pregnancy rate was lower in the elevated P4 group (41.6% and 37.3%) than in control (46.3% and 46.0%), but the difference were not statistically significant (p=0.197, p=0.144 respectively). The fertilization rate was not different.Tabled 1HSVHomemadeCryotoptotal% Survived81.484.671.482.6Fertilization Rate88.678.26081.1Transferred2222Blastocyst Rate19.434.910031.2% Positive HCG10062.510077Implantation Rate62.554.557.9 Open table in a new tab Our data demonstrated that higher serum progesterone reflects good follicular recruitment and better chance of obtaining blastocysts for transfer or cryopreservation.Our data suggested that elevated P4 levels may adversely affect clinical pregnancy rate in IVF-ET patients. However, the difference was not sufficient to warrant a clinical intervention such as deferring fresh embryo transfer and freezing all embryos for future transfer.To elucidate the mechanisms underlying the increased probability of pregnancy in FET than ET, additionalfactors should be analyzed.

Related Factors of in vitro Fertilization and Embryo Transfer Patients with Complete Fertilization Failure

Objective To find the possible factors predicting fertilization failure of in vitro fertilization-embryo transfer (IVF-ET). Methods The IVF-ET patients with complete fertilization failure (experimental group, n=32) were analyzed retrospectively. The patients whose oocytes retrieved at the same day and cultured on the same incubators with ≥ 50% fertilization rates were matched as the control (n=56). Results The infertility duration, superovulation days, the rates of primary case, progesterone (P) level >3.12 nmol/L rate and rate of severe abnormal sperm (abnormal sperm rate >95%) in experimental group were significantly higher than those in the control (6.4 ± 3.1 years, 12.6 ± 2.2 d, 56%, 43%, 43% vs 4.6 ± 2.9 years, 11.6 ± 1.3 d, 33%, 23%, 23%, respectively, P Conclusion We should pay attention to these patients with primary infertility, longer infertility duration and superovulation days (>6.4 years and >12.6 d) and having increased level of P on hCG injection day (>3.12 nmol/L), abnormal sperm rate >95% at the same time. They should be included in such patients at high risk of fertilization failure.

Specific and Sensitive Immunoassays Detect Multiple Anti-ovarian Antibodies in Women With Infertility

Serum anti-ovarian antibodies (AOAs) have been shown in autoimmune premature ovarian failure and in vitro fertilization-embryo transfer (IVF-ET) cases. The specificity of assays detecting these antibodies has been questioned. Researchers have used several techniques (e.g., ELISA and indirect immunofluorescence). Few have reported on the non-specificity and the type of molecular and cellular targets. We reported earlier on the presence of naturally occurring anti-albumin antibodies as the likely factor for non-specificity. Having developed a novel blocking recipe, we show substantial elimination of this non-specificity. With these standardized tests, we hereby report multiple targets at protein and histological levels. In our study group, 15 of 50 (30%) patients with premature ovarian failure and 13 of 50 (26%) IVF-ET patients showed the presence of AOAs. Western blotting showed a large number of patients making AOAs to a 90-kDa protein, followed by 97- and 120-kDa proteins. Histochemically, it was evident that the sera of these patients predominantly react with the oocyte; other somatic cellular targets are also involved. The specific non-invasive test developed by us was found to be useful because it could carry out a reliable diagnosis of an autoimmune etiology that would be very helpful to select patients in whom immune-modulating therapy could be recommended, which in turn may restore ovarian function and fertility.

Effect of myomectomy on the outcome of assisted reproductive technologies

To evaluate the impact of myomectomy on in vitro fertilization-embryo transfer (IVF-ET) and oocyte donation cycle outcome. Retrospective case-controlled study of consecutive fresh IVF-ET and oocyte donation patients during a 2-year interval. Private assisted reproductive technology (ART) center. Patients with submucosal leiomyomata resected hysteroscopically (group A: 15 oocyte donor recipients; group 1 = 31 IVF-ET patients) and those with intramural components or strictly intramural leiomyomata that distorted or impinged upon the endometrial cavity resected at laparotomy (group B = 26 oocyte donor recipients; group 2 = 29 IVF-ET patients). Precycle hysteroscopic or abdominal myomectomy and subsequent fresh IVF-ET or oocyte donation. Results of controlled ovarian hyperstimulation as well as ongoing pregnancy and implantation rates were evaluated in comparison with contemporaneous patient groups without such lesions (group C = 552 oocyte donor recipients; group 3: 896 IVF-ET patients). As would be expected, the mean number and size of leiomyomata were significantly larger in patients who underwent abdominal myomectomy. However, neither ongoing pregnancy nor implantation rates were significantly different in comparison with controls among either oocyte donor recipients (group A: 86.7%, 57.8%; group B: 84.6%, 55.2%; group C 77%, 49.1%). The findings were similar for those undergoing IVF-ET in comparison with controls (group 1: 61%, 24%; group 2: 52%, 26%; group 3: 53%, 23%). Precycle resection of appropriately selected clinically significant leiomyomata results in IVF-ET or oocyte donation cycle outcomes that are similar to controls.

Comparison of IVF-ET (in vitro fertilization-embryo transfer) outcome after various therapeutic approaches for ovarian endometriomas

To compare controlled ovarian hyperstimulation (COH) characteristics and IVF outcome among IVF-ET patients who treated with various therapeutic modalities for ovarian endometriomas and to propose effective therapeutic modalities performing to improve outcome before IVF-ET cycle in the patients with ovarian endometriomas.

Ovarian Stimulation and In Vitro Fertilization in Women With Mature Cystic Teratomas

In Brief Objective To report the results of ovulation induction and in vitro fertilization-embryo transfer (IVF-ET) in patients with ovarian cystic teratomas. Methods Six women with ultrasonographically diagnosed ovarian cystic teratomas (mean diameter 2.4 cm) who presented with infertility underwent IVF-ET (n = 4) or ovulation induction (n = 2). Serial ultrasound examinations were used to determine the size of the cystic teratomas during therapy and throughout pregnancy. Results Ovarian stimulation was successful, as evidenced by the serum estradiol concentration on the day of hCG administration (mean in IVF-ET patients, 3558 ± 1319 pg/mL) and the number of oocytes retrieved (10 ± 4.24). Three patients having IVF-ET and both patients having ovulation induction conceived, and six healthy infants were born. Cyst sizes remained unchanged throughout treatment and pregnancy. There were no cyst-related complications during ovulation induction or IVF-ET, or during the entire course of pregnancy, labor, and delivery. Conclusion The presence of ovarian cystic teratoma should not be considered a contraindication for therapy in women undergoing ovulation induction and IVF-ET. Ovulation induction and in vitro fertilization–embryo transfer can be performed successfully in the presence of ovarian cystic teratoma.

Ovarian stimulation and in vitro fertilization in women with mature cystic teratomas

Objective: To report the results of ovulation induction and in vitro fertilization–embryo transfer (IVF-ET) in patients with ovarian cystic teratomas. Methods: Six women with ultrasonographically diagnosed ovarian cystic teratomas (mean diameter 2.4 cm) who presented with infertility underwent IVF-ET ( n = 4) or ovulation induction ( n = 2). Serial ultrasound examinations were used to determine the size of the cystic teratomas during therapy and throughout pregnancy. Results: Ovarian stimulation was successful, as evidenced by the serum estradiol concentration on the day of hCG administration (mean in IVF-ET patients, 3558 ± 1319 pg/mL) and the number of oocytes retrieved (10 ± 4.24). Three patients having IVF-ET and both patients having ovulation induction conceived, and six healthy infants were born. Cyst sizes remained unchanged throughout treatment and pregnancy. There were no cyst-related complications during ovulation induction or IVF-ET, or during the entire course of pregnancy, labor, and delivery. Conclusion: The presence of ovarian cystic teratoma should not be considered a contraindication for therapy in women undergoing ovulation induction and IVF-ET.

Effects of human sera and human serum albumin on mouse embryo culture.

Human proteins normally used to supplement human in vitro fertilization-embryo transfer (IVF-ET) culture media were tested for their effects on mouse embryo development from the zygote stage. These proteins included follicular and luteal-phase maternal sera, fetal cord sera, and both human and bovine serum albumin. Our results revealed that both maternal and fetal cord sera did not permit mouse blastocyst formation. Furthermore, predialysis of the human maternal sera and removal of IgG by protein A column chromatography did not improve their support of mouse embryonic development to the blastocyst stage. Similar detrimental effects were observed with maternal sera from term-pregnant IVF-ET patients. Interestingly, these serum samples had supported the in vitro growth of the human zygotes which resulted in these patients' pregnancies. Only some batches of human serum albumin supported mouse blastocyst formation, whereas all sources of bovine serum albumin were effective in this regard. These results raise the question of the suitability of the mouse embryo culture system as a quality control for the testing of protein supplements for human IVF-ET.

Serum progesterone levels in women treated with human menopausal gonadotropin and human chorionic gonadotropin for in vitro fertilization

For evaluation of the adequacy of luteal function after in vitro fertilization-embryo transfer (IVF-ET), serum progesterone (P) levels were measured on days 3, 7, and 10 after laparoscopic follicle aspiration. Fifty-six infertile patients were treated during 86 cycles with human menopausal gonadotropin-human chorionic gonadotropin (hMG-hCG) for stimulation of follicular development. Serum estradiol (E2) levels were measured daily during hMG-hCG treatment. P levels were determined in 67 cycles. The mean (+/- standard deviation [SD]) of the sums of 3 P levels was 55.63 +/- 24.13 ng/ml. There were 11 pregnancies. The mean of the sums of 3 P levels of pregnant patients was 64.45 +/- 26.23 ng/ml and of 56 nonpregnant cycles was 53.90 +/- 23.35 ng/ml. The duration of luteal phase varied from 9 days to 15 days. The mean of the sums of 3 P values of patients with different luteal phase lengths ranged from 28.8 ng/ml to 60.51 +/- 25.68 ng/ml. The mean of the sums of 3 P levels of women with normal luteal phase and that of women with luteal phase defect by endometrial biopsy study were used as controls for comparison. There was poor correlation (r = 0.3441) between E2 peak levels and P levels; the sum of 3 P levels did not indicate luteal phase inadequacy in IVF-ET patients; and the majority of the nonpregnant cycles (32/56) showed a luteal phase of 11 days or less, in spite of adequate P levels.(ABSTRACT TRUNCATED AT 250 WORDS)

An alternative to in vitro fertilization-embryo transfer: the successful transfer of human oocytes and spermatozoa to the distal oviduct

In vitro fertilization-embryo transfer (IVF-ET) for treatment of irreparable tubal damage provides a means for otherwise hopelessly infertile couples to obtain offspring. Recently a simpler and less expensive procedure was applied as an alternative to IVF-ET to patients with at least one patent fallopian tube. This procedure employs stimulated ovarian cycles, washed and cultured sperm, and laparoscopic aspiration of oocytes. Recovered oocytes and sperm are deposited in the ampulla of the oviduct by means of a catheter. From February 1 to September 28, 1985, 137 cycles yielded 60 laparoscopies (51 patients). Elevated human chorionic gonadotropin observed in 18 cases was confirmed in 12 cases by ultrasound. Nine uterine pregnancies continued with no tubal pregnancy. Success is comparable for this new procedure and IVF-ET. The results suggest that many IVF-ET patients should be offered the simpler and less expensive option of tubal transfer (TT).