Results of artificial insemination at home by the partner with cryopreserved donor semen: A randomized study

Citations from the Literature main factors determining embryo implantation in in vitro fertilization. If one embryo implants normally and goes to term, the endometrium can be assumed to be normal. Eighty-one patients (March 1981 to 1987) had transfers of multiple preembryos, resulting in multiple pregnancies with at least one reaching term. The number of gestational sacs at 8 to 12 weeks of pregnancy, at 20 weeks, and the number of term pregnancies were studied longitudinally. Twelve patients (14.8%) had 2 preembryos transferred, 19 (23.5%) had 3, 21 (25.9%) had 4, 17 (21.0%) had 5, 9 (11.18) had 6. and 3 (3.7%) had 7. At 20 weeks 18 patients (22.2@/0)had a single viable fetus, 56 (69.1%) had twins, 6 (7.4%) had triplets, and 1 (1.2%) had quadruplets. A total of 325 pre-embryos were transferred; 178 gestational sacs were observed at 8 to 12 weeks, but only 153 showed fetal heartbeat. Total embryo loss at 8 to 12 weeks was 53.0%; when the ‘index’ embryo was excluded, it reached 61%. Regardless of the number of pre-embryos transferred, only 2.2 embryos on average were able to establish a normal pregnancy. (A) synchronism of the pre-embryos did not affect outcome. Results suggest that with normal endometrial receptivity, the implantation potential of each pre-embryo is different . Results of artificial insemination at borne by Ihe partner witb cryopresewed donor semen: A randomized study Hogerzeil HV; Hamerlynck JVTh; Van Amstel N; Nagelkerke NJD; Lammes FB Department of Obstetrics and Gynecology, Academic Medical Centre, University of Amsterdam, 1105 AZ Amsterdam; Netherlands Fertility and Sterility; 49/6 (1030-1035)/1988/ The use of cryopreserved semen offers the possibility of home insemination by the instructed partner. A comparative study was designed whereby participants were randomly allocated to use home or clinic insemination for six cycles. If no pregnancy had occurred after six cycles, the site of insemination was switched to the opposite location for a maximum of six further cycles. Fifty-three women with primary infertility fulfilling all entry criteria entered the study. In the first 6 cycles out of 29 home starters, 13 pregnancies were conceived, whereas in 24 clinic starters 11 pregnancies occurred, yielding no statistical difference in pregnancy rate. Of 138 couples who did not meet the criteria in the same period, 45 opted for home insemination, resulting in 20 home-inseminated pregnancies. Again, for comparable subgroups no statistical difference in pregnancy rate between home and clinic insemination was found. Induction of the human sperm acrosome reaction by human ooeytes

De Jonge CJ; Rawlins RG; Zaneveld LJD Ob/Gyn Research, Rush-Presbyterian-St. Luke’s Medical Center, Chicago, IL 60612-3864; USA Fertility and Sterility; 50/6 (949-953)/1988/ The acrosome reaction of human spermatozoa incubated in the presence or absence of vested human oocytes was investigated. All gametes were obtained from human in vitro fertilization (IVF) cases. Spermatozoa were collected after incubation

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in insemination medium only and following removal of the oocytes from insemination medium during the IVF procedure. After 16 hours of incubation 18.5% of the spermatozoa in insemination medium alone were acrosome-reacted compared to 31.5% for spermatozoa incubated in medium containing oocytes. The acrosome reaction of spermatozoa incubated with fertilized or unfertilized oocytes was also investigated. The percentage of acrosome reaction did not differ (P > 0.50) between the two groups (29.7% in the fertilized cases versus 30.7% in the unfertilized cases). Completion of oocyte nuclear maturation did not affect the proportion of acrosome-reacted spermatozoa observed with unfertilized eggs. A similar (P > 0.05) percentage of acrosome reacted spermatozoa were observed regardless of whether the unfertilized oocytes had (29Oro)or had not (35%) reached metaphase II. These findings indicate the acrosome reaction of human spermatozoa is enhanced in the presence of vested human oocytes. Furthermore, there is no apparent correlation between the percentage of the population of spermatozoa that acrosome react in the medium and the potential of an oocyte for fertilization. Primary microsurgery for postinflammatory tubal infertility Jacobs LA; Thie J; Patton PE; Williams TJ Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905; USA Fertility and Sterility; 50/6 (SSS-859)/1988/ Pelvic inflammatory disease is a common cause of tubal infertility. The pregnancy outcomes in 161 patients who underwent primary microsurgical tuboplasty for postinflammatory tubal disease at the Mayo Clinic from 1977 through 1981 were evaluated. The outcome (3-year rate) was evaluated for each category of microsurgical procedures. The proximal anastomosis group had a conception rate of 71% (5OOrolive births, 30% spontaneous abortions, 6% ectopic pregnancies). The terminal salpingoneostomy group, which accounted for the largest number of procedures, had a conception rate of 47(r/, (32% live births, 12% spontaneous abortions, 11% ectopic pregnancies). Even after microsurgical tubal reconstruction, most women do not achieve a live birth. Pregnancy outcome is probably related to several factors reflecting the severity of pre-existing intrinsic damage. Prognostic factors that may better predict pregnancy outcome are discussed.

ONCOLOGY Primary staging in ovarian tumors of low malignant potential

Yazigi R; Sandstad J; Munoz AK Division of Gynecology Oncology, Department of Obstetrics and Gynecology, University of Texas, Southwestern Medical School, Dallas, TX 75235; USA Gynecologic Oncology; 31/3 (402-408)/1988/ Surgical staging, consisting of peritoneal washings for cytology, infracolic omentectomy, and biopsies of diaphragm, extrapelvic peritoneum, and pelvic and aortic lymph nodes, was performed in 29 patients with ovarian tumors of low malignant potential, presumed to be either Stage I (25) of Stage II (4), in order to determine the incidence of unsuspected Int J Gynecol Obstet 29