RESUMO
The advantages of cultivating human pre-embryos to the stage of blastocites, are well known. The use of media of culture sequential, without the backing of somatic cells, is new. The objective was to cultivate human pre-embryos to the stage of blastocyte to the determine the recuperation indexes, implantation index and pregnancy index in patients subjected to FIVT/TE or ICSI. Once obtained the ovules of patients were injected/inseminated to latter be cultivated for 72 hours using P1 medium at 10% of SSS under mineral oil for, latter, be transferred to a complex medium for blastocites culture for 48 hours, and finally be transferred. Thirteen were included (9 of FIV and 4 of ICSI) obtaining 205 ovules; fertilized 143 and 131 had cellular division. One hundred and twenty one pre-embryos were cultivated to blastocyst stage, from which, 53 reached that stage (43.8%); transferring 28 and freezing 25. In average, 2.1 blastocysts were transferred by patient. There were four pregnancies and one alive newborn, at term for an index of implantation of 14.2% and a pregnancy index of 30.7%. The study shows our initial experience, which demonstrated and acceptable idea of recuperation of blastocysts and pregnancies.
Assuntos
Blastocisto , Transferência Embrionária , Fertilização in vitro , Meios de Cultura , Técnicas de Cultura , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Gravidez , Estudos Prospectivos , Injeções de Esperma Intracitoplásmicas , Fatores de TempoRESUMO
Two cases of premature ovarian failure (POF) diagnosed by clinical symptomatology, persistently elevated levels of gonadotropins and hypoestrogenism, are presented. Gonadal biopsy was done on the patients, which disclosed no evidence of primordial follicles in one and severe reduction in the other. Estrogen substitutive therapy was started to ameliorate their menopausal symptoms and spontaneously conceived. A review of the literature related to the syndrome is presented.
Assuntos
Infertilidade Feminina/tratamento farmacológico , Menopausa Precoce , Adulto , Acetato de Clormadinona/uso terapêutico , Estradiol/análogos & derivados , Estradiol/uso terapêutico , Estrogênios Conjugados (USP)/uso terapêutico , Feminino , Humanos , Recém-Nascido , Infertilidade Feminina/etiologiaRESUMO
From June 1987 thru December 1988, 72 patients entered our gamete intrafallopian transfer (GIFT) program. The average age of our patients was 28 years with of infertility. The causes for being selected to the program were: Unknown (14), Endometriosis (14), Male (13), Ovarian (5), Cervical (9), Tubo-peritoneal (6) and oocyte donation (11). Different follicular stimulation protocols were used, with combinations of clomiphene citrate, human menopausal gonadotropins (hMG) and follicle stimulating hormone (FSH). Monitoring by serial ultrasound scanning until two or more follicles were 16-18 mm and estradiol levels were over 700 pg/ml, after which 10,000 IU of human chorionic gonadotropins (hCG) were injected. After 36 hrs oocyte retrieval was performed. There were 19 clinical pregnancies (26.4%). We feel that this new technique offers a bright and promising future for our infertile population.
Assuntos
Transferência Intrafalopiana de Gameta , Infertilidade/terapia , Adulto , Estudos de Avaliação como Assunto , Feminino , Humanos , Infertilidade Feminina/terapia , GravidezRESUMO
Two patients were admitted to our Gamete Intrafallopian Transfer (GIF) program, and received and ovulation stimulation protocol with Clomiphene Citrate and human menopausal gonadotropin (hMG). Human chorionic gonadotropin (hCG, 10,000 IU IM) was administered when follicle size achieved 18 mm adn oocyte retrieval was scheduled after 36 hours. The estradiol levels in both patients were 1,127 pg/ml respectively at the time hCG was administered, which demonstrates an excellent response to the stimulation. Follicle aspiration was accomplished by transvaginal ultrasound-guided puncture or laparoscopy, and we were unable to recover oocytes in 17 follicles. Our findings support the existence of the "Empty Follicle Syndrome". This pathology may explain some of the infertility causes of our sterile population.
Assuntos
Infertilidade Feminina/etiologia , Oócitos , Folículo Ovariano , Adulto , Feminino , Humanos , Indução da Ovulação , SíndromeRESUMO
Gamete intrafallopian transfer (GIFT) was performed in 11 patients with premature gonadal failure and infertility, with oocyte donation. The sustitutive estrogen therapy with Estradiol Valerinate and Progesterone was maintained up to 100 days after the transfer. In all the cases GIFT was performed between the day 13 and 70 of the cycle. There were 5 pregnancies out of 11 cycles (success rate of 45.4%), one ended with a live child and the four others are on their first, second and third trimester. We are presenting a modified and simplified new protocol for hormonal replacement and our results suggest a new and wide "endometrial window" for the management of this patients. This results offer a promising future for patients with premature gonadal failure.