Embryo transfer

Pivotal pre-approval safety and efficacy was assessed in a randomized, open label, multicentre study of infertile females undergoing in vitro fertilization and embryo transfer. The primary efficacy parameter was the mean number of oocytes retrieved, which (at 13.6) was similar to the number retrieved when urinary-derived hCG was used. Serious potential side effects can include ovarian over/hyper-stimulation, sometimes with pulmonary or vascular complications. The product is marketed by Serono Inc. 

G. Other applications Limited data show some beneficial effects of leuprolide in the treatment of breast cancer. According to Micromedex, there is good documentation that leuprolide is effective for bowel pain and nausea associated with irritable bowel syndrome. Leuprolide has been used for controlled ovarian hyperstimulation to enhance the in vitro fertilization-embryo transfer procedure. In endometriosis, the goal of treatment is pain relief and reduction of endometriotic lesions. In children with central precocious puberty, stimulated and basal gonadotropins are reduced to prepubertal levels. Testosterone and estradiol are reduced to prepubertal levels in males and females, respectively. 

According to IFOAM standards and EU regulations, breeding practices should respect the animals natural behaviour. Therefore, natural mating is preferred. Methods that depend on complex technologies should be avoided. Embryo transfer and cloning are prohibited. Hormones to induce ovulation and birth are prohibited unless for medical reasons, although AI is permitted. 

In 71 women undergoing in vitro fertilization and embryo transfer using recombinant human follicle-stimulating hormone in doses sufficient to attain a pregnancy rate of 24% (10), the main adverse effect was mild pain at the site of injection (less than 20% of patients) but there were two cases of ovarian hyperstimulation syndrome. In less than 10% of patients, redness, swelling, or bruising was seen and one patient developed headache. 

In a study of the relevance of the serum concentration of human chorionic gonadotrophin in 849 IVF cycles there were no significant relations between hCG concentrations and the proportion of follicles yielding oocytes, the fertilization rate, blastulation rate, or the probabilities of embryo transfer, implantation, or clinical pregnancy (32). This result again stresses the desirability of using moderate doses of hCG, which seems to reduce the risk of ovarian hyperstimulation while maintaining efficacy. 

Chang P, Kenley S, Burns T, Denton G, Currie K, DeVane G, O Dea L. Recombinant human chorionic gonadotropin (rhCG) in assisted reproductive technology results of a clinical trial comparing two doses of rhCG (Ovidrel) to urinary hCG (Profasi) for induction of final follicular maturation in in vitro fertilization-embryo transfer. Fertil Steril 2001 76(l) 67-74. 

Lesny P, Maguiness SD, Hay DM, Robinson J, Clarke CE, Killick SR. Ovarian hyperstimulation syndrome and benign intracranial hypertension in pregnancy after in-vitro fertilization and embryo transfer case report. Hum Reprod 1999 14(8) 1953-5. 

Mancini A, Milardi D, Di Pietro ML, Giacchi E, Spagnolo AG, Di Donna V, De Marinis L, Jensen L. A case of forearm amputation after ovarian stimulation for in vitro fertilization-embryo transfer. Fertil Steril 2001 76(l) 198-200. 

Olivennes F, Belaisch-Allart J, Emperaire JC, Dechaud H, Alvarez S, Moreau L, Nicollet B, Zorn JR, Bouchard P, Frydman R. Prospective, randomized, controlled study of in vitro fertilization-embryo transfer with a single dose of a luteinizing hormone-releasing hormone (LH-RH) antagonist (cetrorelix) or a depot formula of an LH-RH agonist (triptorelin). Fertil Steril 2000 73(2) 314-20. 

Damario, M.A., et al. 1999. Crinone 8% vaginal progesterone gel results in a lower embryonic implantation efficiency after in vitro fertilization-embryo transfer. Fertil Steril 72 830. 

Prior to embryo transfer, embryos should be washed following the IETS protocol if the sperm or oocytes were collected from animals with an unknown or unacceptable health status (24). 

Stringfellow, D. A. and Seidel, S. M. (eds.) (1998) Manual of the International Embryo Transfer Society procedural guide and general information for the use of embryo transfer technology, emphasizing sanitary procedures, 3rd ed. International Embryo Transfer Society, Illinois. 

Mesrogli M Dieterle S (1993) Embryonic losses after in vitro fertilization and embryo transfer. Acta Obstet Gynecol Scand, 72(1) 36-38. 

After the age of 35 in women, fecundity decreases sharply. Delaying childbearing until the age of 35 or beyond is therefore one of the major reasons why in the last decade attention has been drawn to the decline in fertility in older women (Gl, S8, S26, V2). The number of couples seeking help for infertility problems after their 30s and even 40s is increasing (P6). People of advancing age are destined to end up in a sort of age trap of declining fecundity and therefore the need for more time to conceive on the one hand and, on the other hand, less time available to conceive because of declining fecundity. The older the people are who need infertility treatment, the more they will feel the pressure to conceive within a short period of time (P7) the demand for assisted reproduction techniques, such as intrauterine insemination (IUI) after ovarian hyperstimulation or in-vitro fertilization (IVF) and embryo transfer, will therefore increase. 

With the use of assisted reproductive techniques, the need to assess the chance of success of the treatment has increased (SI8). Determining the chance of success serves two goals first, it can help the couple realize that assisted reproduction can in no way guarantee offspring and that a realistic approach toward infertility therapy means accepting the chance of failure. Second, it can lighten the burden of waiting 2 weeks between oocyte retrieval and embryo transfer in an IVF treatment. 

Choosing the right embryo(s) for embryo transfer is essential in optimizing pregnancy rates in IVF. If transfer of only one embryo in order to prevent multiple... 

A2. Andersen, C. Y., Levels of steroid-binding proteins and steroids in human preovulatory follicle fluid and serum as predictors of success in in vitro fertilization-embryo transfer treatment. J. Clin. Endocrinol. Me lab 71, 1375-1381 (1990). 

C6. Chryssikopoulos, A., Mantzavinos, T., Kanakas, N., Karagouni, E., Dotsika, E., and Zourlas, P. A., Correlation of serum and follicular fluid concentrations of placental protein 14 and CA-125 in in vitro fertilization-embryo transfer patients. Fertil. Steril. 66, 599-603 (1996). 

G7. Goswami, S. K., Chakravarty, B. N., and Kabir, S. N., Significance of an abnormal response during pituitary desensitization in an in vitro fertilization and embryo transfer program J. Assist. Reprod. Genet. 13, 374-380 (1996). 

H10. Hofmann, G. E., Khoury, J., Johnson, C. A., Thie, J., and Scott, R. T., Jr., Premature luteinization during controlled ovarian hyperstimulation for in vitro fertilization-embryo transfer has no impact on pregnancy outcome. Fertil. Steril. 66, 980-986 (1996). 

Jl. Jackson, K. V., Ginsburg, E. S., Hornstein, M. D., Rein, M. S., and Clarke, R. N., Multinucleation in normally fertilized embryos is associated with an accelerated ovulation induction response and lower implantation and pregnancy rates in in vitro fertilization-embryo transfer cycles. Fertil. Steril. 70, 60-66 (1998). 

Kl. Kagawa, T., Shuji, Y., Souya, N., Shinji, M., and Toshihiro, A., Relationship among serum levels of luteinizing hormone, estradiol, and progesterone during follicle stimulation and results of in vitro fertilization and embryo transfer (IVF/ET). J. Assist. Reprod. Genet. 9, 106-112 (1992). 

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