Time Of Egg Retrieval Research Articles

Assessment of endometrial leukemia inhibitory factor (LIF) levels by uterine flushing at the time of egg retrieval in IVF-ET

Objective: To assess intra-uterine LIF levels by uterine flushing at the time of egg retrieval. To confirm that the procedure had no detrimental effect on pregnancy rates. Design: Prospective study. A matched control group without flushing was used for the first 100 patients. Materials/Methods: Uterine flushings were performed in a total of 148 infertile patients undergoing IVF-ET. The first 100 patients in the study group were compared with a controlled group of 100 patients without flushing matched for age, number of attempts, day-3 FSH and type of procedure (classical IVF or ICSI). Uterine flushing were performed at the time of egg retrieval. The main outcome measures were: IVF-ET results, pregnancy rates, intra-uterine LIF levels. Results: The pregnancy rates were not different in the group of patients with (27%) or without uterine flushing (28%). In 18 cases (12%), the flushing could not be used for technical reasons (small volume, debris). For 60 patients (46%), we were able to detect LIF in the liquid collected after exposure to the uterine cavity. In the group where LIF was detected, the range of detection was 20 to 260 pg/ml (mean = 63.7 SD= 54.8 pg/ml). The pregnancy rates in the LIF detectable and undetectable group were 28.3% and 27.1% respectively (NS). The mean levels of LIF were mean=30.1 SD= 49.3 and mean=28.6 SD=51.2 in the pregnant and not pregnant patients respectively and these results are not statistically different. Conclusions: The flushing procedure at the time of egg retrieval did not adversely affect the pregnancy rates. We report for the first time that LIF could be detected in some patients (46%) at the time of egg retrieval. No correlation were observed towards better pregnancy rates in patients with detectable LIF in the uterine flushing. The mean level of LIF was not different in the pregnant and not pregnant women. The measurements of other cytokines levels is under progress. Access to the endo-luminal secretion of the endometrium during IVF-ET, open a new research area in human implantation. Supported by: None.

Relationship between psychological stress and semen quality among in-vitro fertilization patients.

The purpose of this study was to determine the relationship between psychological stress and semen quality among men undergoing in-vitro fertilization (IVF). We assessed psychological variables, including self-reported stress, and sperm parameters in a group of 40 men undergoing IVF for the first time at a pre-IVF sampling period (T1) and at the time of egg retrieval (T2). Thirty-one patients completed the study. Results indicated that total and motile sperm concentration, total motile spermatozoa, and lateral head displacement decreased significantly from T1 to T2 in a high percentage of participants. In addition, the perceived importance of producing a semen specimen increased significantly (P = 0.001) from T1 to T2, and this change was significantly correlated (P < 0.05) with diminished semen quality at the time of oocyte retrieval. No decline in the semen quality or increase in perceived stress at egg retrieval was observed at T2 in male factor patients (n = 7). This study provides evidence for a significant decline in semen quality of male IVF patients at egg retrieval and demonstrates an inverse relationship between semen quality and specific aspects of psychological stress.

Intravenous albumin does not prevent the development of severe ovarian hyperstimulation syndrome in an in-vitro fertilization programme.

A cohort study was undertaken to compare the effect at the time of oocyte retrieval of the i.v. administration of either 1000 ml of lactated Ringer's solution or 1000 ml of a 5% solution of human albumin on in-vitro fertilization patients at risk for severe ovarian hyperstimulation syndrome (OHSS). A total of 207 patients with an oestradiol concentration > 10,000 pmol/l and/or > 15 follicles (> 10 mm diameter) on the day of human chorionic gonadotrophin (HCG) injection were reviewed. Of these, 158 women received 500 ml of lactated Ringer's solution both before and after egg retrieval, and 49 women received two infusions of 500 ml of 5% human albumin in normal saline at the time of egg retrieval. Severe OHSS developed in two patients who received human albumin and in 10 women who did not receive the albumin. This difference was not statistically significant. There were no differences between the two groups in terms of age, number of follicles punctured at transvaginal oocyte retrieval or oestradiol concentration at the time of HCG injection. The administration of a 5% human albumin solution does not prevent the development of severe OHSS in at risk patients. It does appear to blunt the severity of the condition.