11/99. pregnancy following fertilization of zona-free, coronal cell intact human ova: Case Report.A pregnancy by intracytoplasmic sperm injection (ICSI) of a couple whose oocytes were recovered without a zona pellucida is reported. Previous IVF/ICSI cycles indicated all oocytes had either very thin or no zona pellucida at the time of cumulus removal prior to ICSI. As a result, many ova were very fragile and lysed upon handling. In the latest attempt, six ova were recovered. After coronal cell dissection of two ova where both lacked a zona pellucida and one lysed, it was elected to attempt to inject the remaining four ova without removal of their coronal cells. The zona pellucida was not visible through the cell layer and the position of the polar body in three ova was speculative. Two embryos possessed normal pronuclei on day 1, and displayed six blastomeres prior to transfer on day 3. During preparation for transfer, sufficient coronal cells fell away to confirm both embryos lacked a zona pellucida. pregnancy was confirmed by ultrasound observation of a fetal heart 4 weeks later. This report documents that where the zona pellucida is absent, the coronal cells provide sufficient support to maintain blastomere interaction and embryo viability and the zona pellucida is not essential for early embryo development and pregnancy.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
12/99. Assisted reproductive technologies in conjunction with conservatively treated endometrial adenocarcinoma. A case report.This case report illustrates the successful use of assisted reproductive technologies (ARTs) in a patient receiving conservative treatment for endometrial adenocarcinoma. A 31-year-old infertile woman, diagnosed as FIGO stage Ia endometrial adenocarcinoma (grade 1), received oral medroxyprogesterone acetate 400 mg/day for 12 weeks. Endometrial curettage was performed and the absence of endometrial carcinoma was confirmed. A single pregnancy was achieved with in vitro fertilization and embryo transfer. A healthy female infant was born via cesarean section at 42 weeks' gestation. The carcinoma has not recurred, and the patient now desires a second child. We conclude that ART combined with progesterone treatment might be a powerful option for the treatment of infertile patients with early stage, well-differentiated endometrial adenocarcinoma.- - - - - - - - - - ranking = 0.25keywords = embryo (Clic here for more details about this article) |
13/99. Orthotopic reimplantation of cryopreserved ovarian cortical strips after high-dose chemotherapy for Hodgkin's lymphoma.BACKGROUND: infertility is a common late effect of chemotherapy and radiotherapy, and has a substantial effect on the quality of life for young survivors of cancer. For men, semen cryopreservation is a simple way of preserving reproductive potential but for women, storage of mature eggs rarely proves successful, and the alternative-immediate in vitro fertilisation with cryopreservation of embryos-is not always appropriate. Reimplantation of cryopreserved ovarian tissue has been shown to restore natural fertility in animals. We applied this technique in a woman who had received sterilising chemotherapy for lymphoma. methods: A 36-year-old woman underwent a right oophorectomy with cryopreservation of ovarian cortical strips before receiving high-dose CBV chemotherapy for a third recurrence of Hodgkin's lymphoma. 19 months later, when serum sex steroid analysis confimed a postmenopausal state, two ovarian cortical strips were thawed and reimplanted-one onto the left ovary and another at the site of the right ovary. FINDINGS: 7 months after reimplantation of ovarian cortical strips, the patient reported resolution of hot flashes and, for the first time, oestradiol was detected in the serum. This finding was associated with a decrease in the concentrations of follicle-stimulating hormone and luteinising hormone, and ultrasonography revealed a 10 mm thick endometrium, a poorly visualised left ovary, and a 2 cm diameter follicular structure to the right of the midline. The patient had one menstrual period, but by 9 months after the implantation, her sex steroid concentrations had returned to those seen with ovarian failure. INTERPRETATION: Orthotopic reimplantation of frozen/thawed ovarian cortical strips is a well tolerated technique for restoring ovarian function in women treated with sterilising chemotherapy for cancer.- - - - - - - - - - ranking = 0.25keywords = embryo (Clic here for more details about this article) |
14/99. pregnancy and delivery after cryopreservation of zygotes produced by in-vitro matured oocytes retrieved from a woman with polycystic ovarian syndrome.This case report describes the birth of a healthy infant after cryopreservation of zygotes produced by in-vitro matured oocytes retrieved from an anovulatory woman with polycystic ovarian syndrome (PCOS). To initiate the treatment cycle, the patient received intravaginal progesterone at night for 10 days to induce a withdrawal bleed. oocyte retrieval was performed on day 11 following a withdrawal bleed. The patient was administered 10,000 IU of HCG subcutaneously 36 h prior to oocyte collection. A total of 63 immature oocytes were obtained; 10 were morphologically abnormal. Following incubation for 24--48 h in the maturation medium, TC-199 supplemented with 20% patient's own serum, 75 mIU/ml FSH and LH, 77.4% (41/53) of the oocytes were at the metaphase-II stage. Thirty-one (31/41, 75.6%) were fertilized using ICSI with her husband's spermatozoa, 15 fertilized oocytes were cultured for embryo transfer and 16 were frozen at the pronuclear stage. pregnancy ensued following fresh embryo transfer. Unfortunately, the pregnancy was miscarried eight weeks later. However, the second frozen-thawed embryo transfer attempt resulted in a full-term pregnancy with delivery of a healthy male infant.- - - - - - - - - - ranking = 0.75keywords = embryo (Clic here for more details about this article) |
15/99. Reduction of ovarian torsion 1 week after embryo transfer in a patient with bilateral hyperstimulated ovaries.OBJECTIVE: To report a rare case of unilateral ovarian torsion 1 week after embryo transfer in a patient with bilateral hyperstimulated ovaries. DESIGN: Case report and literature review. SETTING: Reproductive Endocrine division in a university teaching hospital. PATIENT(S): infertility patients undergoing IVF-ET. INTERVENTION(S): Laparoscopic reduction of adnexa 1 week after ET. MAIN OUTCOME MEASURE(S): Successful preservation of the affected adnexa. RESULT(S): Delivery of 3.324 kg male infant with preservation of the affected ovary. CONCLUSION(S): Untwisting of the affected ovary at laparoscopy without aspiration reduction of cystic masses is appropriate. The outcome of the pregnancy (even very early) in patients with torsion of the adnexa may be favorable after a laparoscopic unwinding of the affected adnexa.- - - - - - - - - - ranking = 1.25keywords = embryo (Clic here for more details about this article) |
16/99. Successful pregnancy in an infertile woman with endometrial hyperplasia and embryo transfer. A case report.BACKGROUND: Successful pregnancy in a woman with complex endometrial hyperplasia with atypia was treated conservatively with gestagens. CASE: The patient was initially diagnosed with complex hyperplasia of the endometrium with atypia by endometrial curettage and treated with several cycles of different gestagens. After repeated endometrial curettage, in vitro fertilization and embryo transfer were introduced for immediate treatment of the patient's infertility in order to avoid the risk of recurrent hyperplasia of the endometrium from estrogens. A single pregnancy was achieved after transfer of embryos obtained from intracytoplasmic sperm injection. This was performed due to poor semen characteristics. The patient delivered a normal, healthy male infant at term. CONCLUSION: Conservative treatment of complex endometrial hyperplasia with atypia in young women wishing to preserve fertility should be considered in carefully selected cases.- - - - - - - - - - ranking = 1.5keywords = embryo (Clic here for more details about this article) |
17/99. blastocyst development and pregnancies after IVF of mature oocytes retrieved from unstimulated patients with PCOS after in-vivo HCG priming.A major side-effect of controlled ovarian stimulation (COS) in patients with polycystic ovarian syndrome (PCOS) is the risk of ovarian hyperstimulation syndrome (OHSS). In-vitro maturation (IVM) of immature oocytes represents a potential alternative for the fertility treatment of these patients. Two patients at high risk of OHSS were primed with 10,000 IU HCG 36 h before oocyte retrieval. After retrieval, oocyte maturity was evaluated. oocytes considered to be mature at the time of collection were inseminated by IVF or ICSI, and the resulting embryos were cultured to blastocysts. Transfer of these blastocysts resulted in pregnancy in both patients. Immature oocytes were cultured in YS medium supplemented with 30% human follicular fluid, 1 IU/ml rFSH, 10 IU/ml HCG and 10 ng/ml epidermal growth factor (rhEGF). After in-vitro maturation of the oocytes, ICSI was performed. Two and five expanded blastocysts were obtained after 5 day culture and were cryopreserved. This report indicates that mature oocytes can be collected at the time of retrieval using only in-vivo HCG priming in women with PCOS, and clinical pregnancy can be established by transfer of blastocysts derived from the mature oocytes. This approach opens a potential for a new dimension in the management of patients with PCOS.- - - - - - - - - - ranking = 10.74521332719keywords = blastocyst, embryo (Clic here for more details about this article) |
18/99. Severe hypertriglyceridemia and pancreatitis following hormone replacement prior to cryothaw transfer.PURPOSE: A case of acute pancreatitis with severe hypertriglyceridemia occurred following use of intramuscular estradiol valerate during endometrial preparation for cryopreserved embryos. methods: A 30-year-old woman with primary infertility and a past history of well-controlled hypothyroidism, underwent endometrial development with intramuscular estradiol valerate in preparation for the transfer of cryopreservred embryos. RESULTS: Initial hospitalization, discontinuation of all estrogens, aggressive intravenous fluid hydration, and initiation of low-fat diet with additional gemfibrozil treatment resulted in complete resolution of all symptoms related to the pancreatitis including the hyperlipidemia. A subsequent cryothaw cycle using oral estradiol resulted in a viable pregnancy with only mild increases in the patient's triglyceride and cholesterol levels noted throughout her 38-week gestation. CONCLUSION(S): Estradiol valerate, a commonly used form of estrogen for endometrial preparation during cryothaw cycles, may cause severe hypertriglyceridemia and acute pancreatitis in certain predisposed individuals. Oral and transdermal estrogens should be the preferred method of endometrial preparation in patients at high risk for lipid metabolism disorders, such as patients with polycystic ovarian syndrome and familial hypertriglyceridemia. These estrogens are more rapidly metabolized and have a shorter half life compared to that of estradiol valerate.- - - - - - - - - - ranking = 0.5keywords = embryo (Clic here for more details about this article) |
19/99. Successful pregnancy in a 42-year-old woman with imminent ovarian failure following ovulation induction with ethinyl estradiol without gonadotropins and in vitro fertilization.PURPOSE: To describe the methodology used to induce ovulation in a 41-year-old woman with imminent ovarian failure and tubal factor so that in vitro fertilization-embryo transfer (IVF-ET) could be performed. methods: ethinyl estradiol was used to suppress elevated serum follicle stimulating hormone (FSH) levels, thus theoretically allowing restoration of down-regulated FSH receptors and response to endogenous gonadotropins. RESULTS: One oocyte was retrieved and fertilized and one embryo was transferred. The patient conceived and is presently in her last trimester. CONCLUSION: Successful pregnancy following IVF-ET is possible in women with imminent ovarian failure - even in women older than age 40.- - - - - - - - - - ranking = 0.5keywords = embryo (Clic here for more details about this article) |
20/99. 47,XX mar karyotype containing genes from the azoospermia factor region. A case report.BACKGROUND: Abnormal embryo development is the major cause of implantation failure and accounts for the low rate of human fertility in vitro and in vivo. Chromosome abnormalities are widely involved in this process through meiotic nondisjunction, fertilization abnormalities and mitotic nondisjunction. CASE: In our assisted reproductive technology program a couple underwent cytogenetic analysis. The woman had a 47,XX mar karyotype. We investigated this patient by chromosome analysis, fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR) dna analysis. The marker chromosome was found to be very similar to a y chromosome in size and QFQ staining pattern. Therefore, it was tested by FISH using alpha- and beta-satellite dna specific for the y chromosome, some YACs specific for the long arm of the y chromosome and alpha-satellite dna specific for 15 chromosomes as probes. In order to define this marker, the next step was PCR amplification of the whole genomic dna using specific landmarks (sequence-tagged sites) to encompass the azoospermia factor (AZF) region on the long arm of the y chromosome. CONCLUSION: A woman had an extra chromosome containing centromeric dna derived from the Y and 15 other chromosomes, heterochromatic regions derived from 15 chromosomes and a large heterochromatic block at the end of the long arm that definitely was not y chromosome heterochromatin (beta-satellite). PCR showed several genes of the y chromosome long arm that are assumed to be involved in male gametogenesis. Phenotypic effects could not be excluded because of the presence of AZF genes. Oocyte karyotyping might better explain the role of the genetic problem on female infertility.- - - - - - - - - - ranking = 0.25keywords = embryo (Clic here for more details about this article) |
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