Human oocyte and preembryo donation: an evolving method for the treatment of infertility
Article Abstract:
A review of the development of preembryo donation and its potential role in treating infertility in women with nonfunctioning ovaries is presented. The practice works by removing fertilized eggs (gametes) from the uterus before implantation has taken place, then transferring them to an infertile recipient. Originally, gametes could only be removed by washing the uterus (uterine lavage), a technique that resulted in limited recovery of viable preembryos. Egg removal was improved by the introduction of in vitro fertilization, where eggs are removed from the donor by aspiration, then fertilized under laboratory conditions. Donors were required to undergo surgery, though, which limited their participation. It is now possible to remove eggs (oocytes) without surgery, via transvaginal ultrasonography-directed follicle aspiration. Twenty-six clinics performed in vitro fertilization-embryo transfer with donated oocytes in 1988, transferring 158 preembryos to 150 patients. Fifty-one transfers led to pregnancies, and 36 live births were the result (including 12 sets of twins and one set of triplets; a 23 percent success rate). A registry is maintained by the Society of Assisted Reproductive Technology (SART) to record such statistics. This live-birth rate is higher than that for standard in-vitro fertilization. A discussion is presented of ethical questions related to donor payment and anonymity: in many cases, a sister is preferred to an unrelated donor. However, a nonanonymous approach is used at the University of Southern California, where the authors currently practice. One reason for the success of the donated-oocyte program may be its regimen of hormone therapy to prepare the uterine lining of the recipients. These approaches may be applied to help women with infertility associated with hormonal imbalances, age, or other causes. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1990
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The luteal phase of cycles utilizing controlled ovarian hyperstimulation and the possible impact of this hyperstimulation on embryo implantation
Article Abstract:
Elevated progesterone levels may interfere with implantation of the fertilized egg. Researchers measured progesterone levels in 7 egg donors receiving progesterone and compared levels with 19 women cycling spontaneously. They compared tissue samples from the egg donors with 20 women receiving physiologic doses of progesterone. On the day mature eggs were removed from the donors, blood progesterone levels were twice as high as in women cycling spontaneously. Elevated progesterone advanced uterine maturity by two days compared with women receiving physiologic doses. This means that by the time the egg reached the uterus, the uterus would not be receptive.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1997
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