An obstetric assessment of the first 100 births from the in vitro fertilization program at Clamart, France

Citations from the Literature

of couples with a negative SPA times 100) was 100% for tubal and unexplained infertility but only 63% for male infertility. T’he high predictive value of the SPA for subsequent IVF outcome in tubal infertility and unexplained infertility warrants its routine use for prescreenlng in IVF programs. Because of the lack of association between SPA and IVF in oligoasthenospermia, the bioassay should not be relied upon for predicting IVF outcome in male subfertility. The overall high association between the animal model and human IVF reinforces the use of the SPA for both basic research and clinical decision making. An obstetric assessment of the first 100 births from the in vitro fertilization program at Ckamart,France Frydman R; Belaisch-Allart J; Fries N; et al. Department d’obstem’que et Gynecologie, Beclere, 92141 Clamart, France

Hopital Antoine

AM. J. OBSTET. GYNECOL.; 154/3 (550-555) 1986 From April, 1981, to July, 1984, 142 pregnancies have been attained after in vitro fertilization and embryo transfer. They are divided into 22 biochemical pregnancies (human chorionic gonadotropin > 20 mu/ml but remaining below 1000 mu/ml), 27 spontaneous abortions, three ectopic pregnancies, and PO ongoing pregnancies, of which 11 were twin pregnancies. The PO women in whom the pregnancies progressed were compared with the 52 women having nonprogressive pregnancies. The two populations did not differ either in age, in the indication for in vitro fertilization and embryo transfer, or in the quality of ovulation or results of semen analysis. The PO ongoing pregnancies were compared with those pregnancies occurring in the same obstetrics department during this period. We found that the in vitro fertilization group had a higher proportion of arterial hypertension (16.5% versus 8.5%, P < 0.05), breech presentations (13.9% versus 4.3%, P < O.OOl), and caesarean sections (46.8% versus 15.5%, P < 0.001) but the sex ratio did not differ.

Programmed oocyte retrieval during routine laparoscopy and embryo cryoprewvrtion for later transfer Frydman R; Rainhorn JD; Forman R; et al. See de Gynecologie-Obstetriqique, Hopital Antoine Beclere, 92I41

Clamart, France

Fixed-schedule ovulation induction and cryopreservation of the obtained embryos was performed in women undergoing a preliminary laparoscopy for infertility investigation before possible inclusion in an in vitro fertilization program. The cycle before follicular stimulation was modified by a progrestogen or an estrogen-progestogen contraceptive pill. Ovarian inaccessibility precluded follicular aspiration in four of 34 patients but at least one oocyte was obtained in 29 of the remaining 30. Although fewer oocytes were obtained in these patients than in a control group undergoing in vitro fertilization treatment, one or more embryos were obtained in 22 patients in the study group. All embryos were frozen and to date 25 embryos from 17 patients have been thawed.

263

Embryos have been placed in 16 of the 17 patients and six pregnancies have been initiated. Three are currently ongoing, one ectopic pregnancy was recorded, and two pregnancies were classified as ‘chemical’. Programmed oocyte retrieval and embryo cryopreservation resulted in an extra chance of pregnancy in patients undergoing a laparoscopy for infertility investigation. Treatment-independent pregnancy after in vitro fertikation and embryo transfer trial Ben-Rafael Z; Mash&h S; Dor J; et al. Interdepartmental Unit of Human Reproduction, The Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel

FERTIL. STERIL.;45/4 (564-567) 1986 This study indicates that SP occur in a higher percentage than theoretically expected after IVF-ET treatment, but it is not conclusive as to whether the SP is independent or a result of the treatment or operative laparoscopy. Our results are in agreement with those of previous studies that have shown that SP occur with almost all kinds of infertility. We therefore reject the previous suggestion of Steptoe, who argued that to prevent ectopic pregnancy from complicating embryo replacement, preparatory electrocauterization of diseased tube should be performed. We also suggest that as long as the results of treatment are below the normal monthly spontaneous conception rate, there is justification for a prospective random study that includes all diagnoses other than BTB. Such a study might help make any future selection of patients for treatment more appropriate. In vitro fextilization in couples with male factor infertility Hirsch I; Young RL; Gibbons WE; et al. Reproductive

Research

Laboratory,

Houston,

TX

77005,

USA

FERTIL. STERIL.;45/5 (659-664) 1986 The data from 83 consecutive in vitro fertilizationembryo transfer cycles were examined with emphasis on the presence of subfertile male parameters, including abnormal sperm density, motility, morphologic features, or an abnormal result in the sperm penetration assay (zona-free hamster ova penetration). There were 25 cycles (21 couples) in which there was a solitary or coexistent abnormal male factor. The presence of a male factor was associated with a lower fertilization rate and fewer embryos transferred. Statistically important reductions in the fertilization rate occurred with reduced sperm density and abnormal motility, but not with abnormal morphologic features. The parameter that was most significantly associated with human ova fertilizability was the ability to exceed two penetrations per egg in the sperm penetration assay.

ONCOLOGY Tumor-associated antigen Ca 125 before and during the aeatment of ovarian carcinoma Kivinen S; Kuoppala T; Leppibmpi M; et al. Int J Gynaecol Obstet 25