In vitro fertilization in unstimulated cycles: a clinical trial using hCG for timing of follicle aspiration

Article Abstract:

In vitro fertilization (IVF), egg and sperm are joined under laboratory conditions, and the resulting embryo is implanted into the uterus. IVF is usually carried out with multiple eggs released from the woman's ovaries after hormone treatment (hyperstimulation). However, this process is costly and may produce side effects that are not optimal for implantation. Natural cycles for IVF may be a desirable alternative for some women; the results of this approach are reported for 20 women. The procedure was attempted in thirty-six cycles after the administration of human chorionic gonadotropin (a hormone, used here to help the egg-containing follicles mature). Thirty follicle aspirations (to remove the egg) were performed under sedation and transvaginal ultrasound guidance. Fifty-two oocytes were retrieved, of which 37 fertilized; the fertilization rate was 100 percent, however, for the 25 eggs obtained from dominant follicles (the largest follicle in each cycle). Embryos were transferred to the uterus in 25 cycles, from which 5 clinical pregnancies resulted. One miscarriage occurred after five weeks' gestation; two babies were delivered and the remaining two women were pregnant when this report was written. The overall rate of successful embryo implantation was 14 percent, higher than the rate in stimulated cycles. This, and other evidence, suggests that the hormones used to stimulate the ovaries in conventional IVF programs cause the endometrium (uterine lining) to become less receptive to implantation of the embryo. The natural-cycle procedure is less costly than hyperstimulation and represents an alternative for selected patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Chorionic gonadotropin, Chorionic gonadotropins

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A preliminary report on oocyte donation extending reproductive potential to women over 40

Article Abstract:

Women older than 40 are significantly less fertile than younger women, and when ovarian failure has occurred, their chances of conceiving, even with medical assistance, have been considered nonexistent. Whether the decline in fertility among older women is the result of changes in the eggs or in the endometrium (uterine lining), where implantation of the fertilized egg occurs, is not known. However, it is possible that eggs donated from younger women could be fertilized, then implanted into older women with ovarian failure after appropriate preparation of the recipients' endometria with hormones. This was attempted in seven married women 40 or older with ovarian failure of at least two years' duration. The procedures for preparing the donors and recipients are described. Six pregnancies resulted from eight transfers of embryos to the seven women; 28 embryos were transferred. Ten implantations resulted (36 percent), and six women ultimately became pregnant. One of these miscarried and one fetus died after 40 weeks' gestation of no apparent cause. No differences in outcome were noted for these women as compared with another group of infertile ovulating women under treatment at the same medical center. In fact, the rates of implantation and pregnancy were higher in the seven women with ovarian failure than in the women undergoing standard in vitro fertilization and embryo transfer. The results suggest that women over 40 with severe ovarian failure can become pregnant if appropriate measures are taken, and if the eggs used originate in younger donors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Demographic aspects, Donation of organs, tissues, etc., Tissue donation, Oocytes, Oocyte donation

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Reversing the natural decline in human fertility: an extended clinical trial of oocyte donation to women of advanced reproductive age

Article Abstract:

Oocyte, or egg, donation may be an effective method for becoming pregnant and carrying a child to term for infertile women older than 40. Eggs are donated by younger women and fertilized in vitro with the male partner's sperm. Sixty-five women 40 years old or older who used donated eggs to conceive were compared to 35 women under 40 years old who used donated eggs and to 57 women over 40 years old who underwent in vitro fertilization using their own eggs. The pregnancy rate among women over 40 who used donated eggs was approximately the same as for women under 40 who used donated eggs. The pregnancy rate among women over 40 who underwent standard in vitro fertilization was approximately four times lower than among the other two groups. Women over 40 who conceived using oocyte donation did not experience any unusual complications during their pregnancy or delivery.

Care and treatment, Usage, Innovations, Infertility, Female, Female infertility, Oocyte banks

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