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Zygote intrafallopian transfer as a successful treatment for unexplained infertility
Citations from the Literature group, resulting in the birth of 13 healthy infants. There were no statistically significant differences in pregnancy rates (per transfer) between transfers in natural cycles (14%, four pregnancies) and steroid replacement cycles (24r70, 16 pregnancies). Five pregnancies (36%) were established in women with 2 mg of E, daily 13-18 days before embryo transfer with P, starting on the day of or the day following oocyte retrieval. E, was continued for a median of 85 days (range 49-110) and P, for a median of 86 days (range 49-133) after the supposed last menstrual period. Al1 but one delivery was by caesarean section. There were no perinatal death and no ectopic pregnancies. A sperm-zoaa pellucida binding test and in vitro fertilizatlon
303
minogen activation was measured. The plasminogen-dependent hydrolysis of the chromogenic substrate S-2444 in presence of trasylol (Bayer, Leverkusen, Germany) was taken as a measure of plasminogen activator activity in these experiments. NO activity was found in untreated FFs, while exposure to trypsin resulted in emergence of marked plasminogen activator activity. In addition, FFs exhibited trasylol-sensitive chromogenic activity indicative of serine-protease activity. Both the plasminogen activator and serine-protease levels after tryptic activation were significantly higher in NF than in F samples. Thus, while F samples have most of their plasminogen activator in an active form, NF samples have most of their plasminogen activator in a latent, trypsin-activatable form. Follicular fluids also contain inhibitory activities toward plasmin and trypsin. The inhibition of these enzymes correlated positively with the latency of plasminogen activator. These results suggest a direct relationship between the ability of oocytes to fertilize and the overt to latent plasminogen activator activity ratios in the FFs.
Liu DY; Clarke GN; Lopata A; Johnston WIH; Baker HWG Department of Ubstetrics and Gynecoldogy, University of Melbourne, Royal Women’s Hospita/, Melbourne, Vit. 3053; Australia Fertility and Sterility/52/2 (281-287)/1989/ Sperm binding to the zona pellucida was studied in 106 in vitro fertilization (IVF) patients. Oocytes that failed to fertilize in vitro were inseminated with a mixture of equal numbers of test and fertile donor sperm differentially labelled with fluorescein or rhodamine to control for variability in the sperm-zona pellucida binding capacity of oocytes. The ratio of the number of test and control sperm bound to four to six zonae pellucidae was significantly correlated with sperm morphology, viability, motility, motility index, and normal intact acrosomes in semen. The sperm-zona pellucida binding ratio was the most significant factor related to IVF rates by logistic regression analysis. But the proportions of sperm with normal morphology and intact acrosomes in semen also were significant. In patients with < 30% of sperm with normal morphology, there was a highly significant relationship between IVF rate and sperm-zona pellucida binding and a weaker relationship with sperm morphology. In conclusion, the sperm-zona pellucida binding ratio test is useful for predicting sperm fertilizing ability in vitro, particularly in men with poor sperm morphology.
Devroey P; Staessen C; Camus M; De Grauwe E; Wisanto A; Van Steirteghem AC Center for Reproductive Medicine, Academie Hospita1 Vrije Universiteit Brussel, B-1090 Brussels; BeIgium Fertility and Sterility/52/2 (246-249)/1989/ This study describes the zygote intrafallopian transfer treatment in patients with unexplained infertility. After retrieval, the oocytes were inseminated with 80,000 progressive motile sperm cells per milliliter. If fertilization occurred, a maximum of three zygotes were replaced by laparoscopy in the fimbrial end of one healthy fallopian tube. A pregnancy rate of 48.19’0 per zygotic intrafallopian transfer replacement was obtained. Seventeen pregnancies are actually ongoing, two patients delivered, and seven patients miscarried. Even after replacing a maximum of three zygotes, there were 6 twin and 2 triplet pregnancies.
Hnman follicular fluid protease and sntiprotease activities: A suggested correlation with ability of oocytes to undergo in vitro
selective hypogonadotropic
fertilization
Milwidsky A; Kaneti H; Finci Z; Laufer N; Tsafriri A; Mayer M Department of Obstetrics and Gyneoclogy, Hadassah University Hospital, Mount Scopus, Jerusalem 91240; Israel Fertility and Sterility/52/2 (274-280)/1989/ Plasminogen activator activity was determined in human follicular fluids (FFs) obtained during in vitro fertilization procedures. The fibrinolytic activity of plasminogen activator was significantly higher in fluids from follicles that contained oocytes that were later found to fertilize in vitro (group F) as compared with fluids from follicles that contained oocytes that failed to fertilize (NF). To assess whether this differente in overt plasminogen activator activity reflects differences in conversion of an inactive, latent plasminogen activator to the active enzyme, the ability of exogenous trypsin to enhance plas-
Zygote intrafallopian transfer as a successful unexplalned infertility
Hormonal
tberapy end pubertal development
treatment for
in boys with
hypogonadism
Bistritzer T; Lunenfeld B; Passwell JH; Theodor R Institute of Endocrinology, Chaim Sheba Medical Center, Tel Hashomer School of Medicine, Tel Aviv University, Tel Aviv; Israel Fertility and Sterility/52/2 (302-306)/1989/ The authors have compared the effects of treatment with weekly injections of human chorionic gonadotropin (hCG) with those of monthly testosterone (T) injections in males with hypogonadotropic hypogonadism. There was no significant differente in pubertal development as measured by progression through the Tanner stages, final height, or bone age, with the two treatment regimens. The final testicular volume in patients treated with 5,000 U/week of hCG (14.0 f 2.0 ml) was significantly greater than that in patients treated with 250-mg monthly T injections (4.3 f 1.8 ml) (P < 0.01). This study shows that weekly injections of hCG are effective in achieving virilization Int J Gynecol Obstet 31
303
minogen activation was measured. The plasminogen-dependent hydrolysis of the chromogenic substrate S-2444 in presence of trasylol (Bayer, Leverkusen, Germany) was taken as a measure of plasminogen activator activity in these experiments. NO activity was found in untreated FFs, while exposure to trypsin resulted in emergence of marked plasminogen activator activity. In addition, FFs exhibited trasylol-sensitive chromogenic activity indicative of serine-protease activity. Both the plasminogen activator and serine-protease levels after tryptic activation were significantly higher in NF than in F samples. Thus, while F samples have most of their plasminogen activator in an active form, NF samples have most of their plasminogen activator in a latent, trypsin-activatable form. Follicular fluids also contain inhibitory activities toward plasmin and trypsin. The inhibition of these enzymes correlated positively with the latency of plasminogen activator. These results suggest a direct relationship between the ability of oocytes to fertilize and the overt to latent plasminogen activator activity ratios in the FFs.
Liu DY; Clarke GN; Lopata A; Johnston WIH; Baker HWG Department of Ubstetrics and Gynecoldogy, University of Melbourne, Royal Women’s Hospita/, Melbourne, Vit. 3053; Australia Fertility and Sterility/52/2 (281-287)/1989/ Sperm binding to the zona pellucida was studied in 106 in vitro fertilization (IVF) patients. Oocytes that failed to fertilize in vitro were inseminated with a mixture of equal numbers of test and fertile donor sperm differentially labelled with fluorescein or rhodamine to control for variability in the sperm-zona pellucida binding capacity of oocytes. The ratio of the number of test and control sperm bound to four to six zonae pellucidae was significantly correlated with sperm morphology, viability, motility, motility index, and normal intact acrosomes in semen. The sperm-zona pellucida binding ratio was the most significant factor related to IVF rates by logistic regression analysis. But the proportions of sperm with normal morphology and intact acrosomes in semen also were significant. In patients with < 30% of sperm with normal morphology, there was a highly significant relationship between IVF rate and sperm-zona pellucida binding and a weaker relationship with sperm morphology. In conclusion, the sperm-zona pellucida binding ratio test is useful for predicting sperm fertilizing ability in vitro, particularly in men with poor sperm morphology.
Devroey P; Staessen C; Camus M; De Grauwe E; Wisanto A; Van Steirteghem AC Center for Reproductive Medicine, Academie Hospita1 Vrije Universiteit Brussel, B-1090 Brussels; BeIgium Fertility and Sterility/52/2 (246-249)/1989/ This study describes the zygote intrafallopian transfer treatment in patients with unexplained infertility. After retrieval, the oocytes were inseminated with 80,000 progressive motile sperm cells per milliliter. If fertilization occurred, a maximum of three zygotes were replaced by laparoscopy in the fimbrial end of one healthy fallopian tube. A pregnancy rate of 48.19’0 per zygotic intrafallopian transfer replacement was obtained. Seventeen pregnancies are actually ongoing, two patients delivered, and seven patients miscarried. Even after replacing a maximum of three zygotes, there were 6 twin and 2 triplet pregnancies.
Hnman follicular fluid protease and sntiprotease activities: A suggested correlation with ability of oocytes to undergo in vitro
selective hypogonadotropic
fertilization
Milwidsky A; Kaneti H; Finci Z; Laufer N; Tsafriri A; Mayer M Department of Obstetrics and Gyneoclogy, Hadassah University Hospital, Mount Scopus, Jerusalem 91240; Israel Fertility and Sterility/52/2 (274-280)/1989/ Plasminogen activator activity was determined in human follicular fluids (FFs) obtained during in vitro fertilization procedures. The fibrinolytic activity of plasminogen activator was significantly higher in fluids from follicles that contained oocytes that were later found to fertilize in vitro (group F) as compared with fluids from follicles that contained oocytes that failed to fertilize (NF). To assess whether this differente in overt plasminogen activator activity reflects differences in conversion of an inactive, latent plasminogen activator to the active enzyme, the ability of exogenous trypsin to enhance plas-
Zygote intrafallopian transfer as a successful unexplalned infertility
Hormonal
tberapy end pubertal development
treatment for
in boys with
hypogonadism
Bistritzer T; Lunenfeld B; Passwell JH; Theodor R Institute of Endocrinology, Chaim Sheba Medical Center, Tel Hashomer School of Medicine, Tel Aviv University, Tel Aviv; Israel Fertility and Sterility/52/2 (302-306)/1989/ The authors have compared the effects of treatment with weekly injections of human chorionic gonadotropin (hCG) with those of monthly testosterone (T) injections in males with hypogonadotropic hypogonadism. There was no significant differente in pubertal development as measured by progression through the Tanner stages, final height, or bone age, with the two treatment regimens. The final testicular volume in patients treated with 5,000 U/week of hCG (14.0 f 2.0 ml) was significantly greater than that in patients treated with 250-mg monthly T injections (4.3 f 1.8 ml) (P < 0.01). This study shows that weekly injections of hCG are effective in achieving virilization Int J Gynecol Obstet 31