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Factors influencing the success of in vitro fertilization for alleviating human infertility

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Abstract

The program for in vitro fertilization at Bourn Hall began in October 1980. Various types of infertility have been treated during this time using the natural menstrual cycle or stimulation of follicular growth with antiestrogens and gonadotrophins. Follicular growth and maturation are assayed by urinary estrogens and LH, monitored regularly during the later follicular stage. Many patients had an endogenous LH surge; others needed an injection of HCG to induce ovulation. All oocytes were recovered by laparoscopy. Wide variations occurred in the time interval between the start of the LH surge and oocyte recovery and between oocyte recovery and insemination. Embryos taken between ooc one- and the eight-cell stage were replaced into their mother, no standard procedure being adopted for all patients. The results of all treatments including patient's responses during the follicular and luteal phases, oocyte recovery, fertilization, cleavage, replacement, implantation, abortion, and birth and the effect of factors such as replacing two or more embryos, maternal age, and previous obstetric history are described in detail. The incidence of implantation after embryo replacement improved from 16.5% initially to 30% currently. More than 118 babies have been born, and many pregnancies are continuing.

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References

  1. Edwards RG, Steptoe PC, Purdy JM: Establishing full-term pregnancies using cleaving embryos grown in vitro. Br J Obstet Gynaecol 1980;87:737–756

    PubMed  Google Scholar 

  2. Steptoe PC, Edwards RG, Purdy JM: Clinical aspects of pregnancies established with cleaving embryos grown in vitro. Br J Obstet Gynaecol 1980;87:757–768

    PubMed  Google Scholar 

  3. Madelenat P, Palmer R: Etutle critique des liberations percoelioscopiques des adherends per-annexielles. SGO Paris. J Gynecol Obstet Biol Reprod 1979;8(4):347–352

    Google Scholar 

  4. Brown JB, Evans JH, Adey FD, Taft HD, Townsend L: Factors involved in the induction of fertile ovulation with human gonadotrophins. Br J Obstet Gynaecol 1969:76:289–307

    Google Scholar 

  5. Edwards RG, Anderson G, Pickering J, Purdy JM: Rapid assay of urinary LH in women using a simplified method of Hi-Gonavis,In Human Conception in Vitro, RG Edwards, JM Purdy (eds) London, Academic Press, 1982, pp 19–34.

    Google Scholar 

  6. Kratochwil A, Urban G, Friedrich F: Ultrasonic tomography of the ovaries. Ann Chir Gynaecol Fenniae 1972;61:211–214

    Google Scholar 

  7. Kistner RW: Induction of ovulation with clomiphene citrate.In Progress in Infertility, SJ Behrman, RW Kistner (eds), Boston, Little, Brown, 1975, p 509

    Google Scholar 

  8. Lunenfeld B: The use of human menopausal gonadotrophins in gonadal pathology.In The Ovary, W Inguilla, RB Greenblatt (eds). Springfield, IL C. C Thomas, 1969

    Google Scholar 

  9. Edwards RG, Purdy JM (eds). Human Conception in Vitro. London, Academic Press, 1982

    Google Scholar 

  10. Edwards RG: Test-tube babies. Nature 1981;293:253–356

    PubMed  Google Scholar 

  11. Steptoe PC, Edwards RG: Laparoscopic recovery of preovulatory human oocytes after priming of ovaries with gonadotrophins. Lancet 1970;1:683–689

    PubMed  Google Scholar 

  12. Steptoe PC, Webster J: Laparoscopy of the normal and disordered ovary.In Human Conception in Vitro, RG Edwards, JM Purdy (eds), London, Academic Press, 1982, pp 97–103

    Google Scholar 

  13. Edwards RG, Purdy JM, Steptoe PC, Walters DE: The growth of human preimplantation embryos in vitro. Am J Obstet Gynecol 1981;141:408–416

    PubMed  Google Scholar 

  14. Fishel SB, Edwards RG: Essentials of fertilization.In Conception in Vitro, RG Edwards, JM Purdy (eds). London, Academic Press, 1982, pp 157–179

    Google Scholar 

  15. Purdy JM: Methods for fertilization and embryo culture in vitro.In Human Conception in Vitro, RG Edwards, JM Purdy (eds). London, Academic Press, 1982, pp 135–148

    Google Scholar 

  16. Edwards RG: Human conception in Vitro: New opportunities in medicine and research.In In Vitro Fertilization and Embryo Transfer, C Wood, AO Trounson (eds). London, Churchill Livingston, 1984 (in press)

    Google Scholar 

  17. Trounson AO, Mohr LR, Wood C, Leeton JF: Effect of delayed insemination on in-vitro fertilization culture and transfer of human embryos. J Reprod Fertil 1982;64:285–294

    PubMed  Google Scholar 

  18. Edwards RG, Fishel SB, Purdy JM: In vitro fertilization of human eggs: Analyses of follicular growth, ovulation and fertilization.In Fertilization of the Human Egg in Vitro, HM Beier, HR Lindner (eds). Berlin, Springer-Verlag, 1983, pp 169–188

    Google Scholar 

  19. Fishel SB, Edwards RG, Purdy JM: In vitro fertilization of human eggs: Factors associated with embryonic development in vitro, replacement of embryos and pregnancy.In Fertilization of the Human Egg in Vitro, HM Beier, HR Lindner (eds). Berlin, Springer-Verlag, 1983, pp 251–269

    Google Scholar 

  20. Cohen J, Euser R, Schenck PE, Brugman FW, Zeilmaker GH: Motility and morphology of human spermatozoa in split ejaculates. Andrologia 1981:13:491–498

    PubMed  Google Scholar 

  21. Cohen J: Unpublished

  22. Fishel SB, Edwards RG, Purdy JM: Births after prolonged delay between oocyte recovery and fertilization in vitro. Gamete Research 1984;9 (in press)

  23. Feichtinger W, Kemeter P, Szalay S, Janisch H: Early hormone parameters and embryonic development in pregnancies established by in vitro fertilization and embryo transfer.In Fertilization of the Human Egg in Vitro, HM Beier, HRLindner (eds). Berlin, Springer-Verlag, 1983, pp 329–340.

    Google Scholar 

  24. Edwards RG, Steptoe PC: Current status of in vitro fertilization and implantation of human embryos. Lanet 1983; ii:1265–1270

    Google Scholar 

  25. Zyl JA van, Menkveld R, Kotze J van W, Retief AE, Niekirk WA: A seven-year survey of the incidence of chromosomal aberrations, treatment and pregnancy rates. Int J Infertil 1975;20:129–132

    Google Scholar 

  26. Aafjes JH, van der Vijver JCM, Schenck PE: The duration of infertility: An important datum for the fertility prognosis of men with semen abnormalities. Fertil Steril 1978;30:423

    PubMed  Google Scholar 

  27. Scott JS, Jones WR: Immunology of Human Reproduction. London, Academic Press, 1976

    Google Scholar 

  28. Berger RE, Karp LE, Williamson RA, Koehler J, Moore DE, Holmes KK: The relationship of pyospermia and seminal fluid bacteriology to sperm function as reflected in the sperm penetration assay. Fertil Steril 1982;37:557–564

    PubMed  Google Scholar 

  29. Cohen J, Weber RFA, van der Vijver JCM, Zeilmaker GH: In vitro fertilizing capacity of human spermatozoa with the use of zona-free hamster ova: Interssay variation and prognostic value. Fertil Steril 1982;37:565–572

    PubMed  Google Scholar 

  30. Jones GES: The Inteal phase defect. Fertil Steril 1976;27:351–356

    PubMed  Google Scholar 

  31. Lenz S, Lauritsen JG: Ultrasonically guided percutaneous aspiration of human follicles under local anaesthesia: A new method of collecting oocytes for in vitro fertilization. Fertil Steril 1982;38:673–677

    PubMed  Google Scholar 

  32. Wikland M, Nilsson L, Hansson R, Hamberger L, Janson PO: Collection of human oocytes by the use of sonography. Fertil Steril 1983;39:603–608

    PubMed  Google Scholar 

  33. Edwards RG, Steptoe PC: A Matter of Life. London, Hutchinsons, 1980

    Google Scholar 

  34. Trounson A: Factors controlling normal embryo development and implantation.In Fertilization of the Human Egg in Vitro, HM Beier, HR Lindner (eds). Berlin, Springer-Verlag, 1983

    Google Scholar 

  35. Edwards RG: Studies on human conception. Am J Obstet Gynecol 1973;117:587–601

    PubMed  Google Scholar 

  36. Lopata A, Brown JB, Leeton JF, Talbot J, Wood C: In-vitro fertilization of preovulatory oocytes and embryo transfer in infertile patients treated with clomiphene and human chorionic gonadotrophin. Fertil Steril 1978;30:27–35

    PubMed  Google Scholar 

  37. Trounson AO, Leeton JF, Wood C, Webb J, Wood J: Pregnancies in humans by fertilization of vitro and embryo transfer in the controlled ovulatory cycle. Science 1981;212:681–682

    Google Scholar 

  38. Wood C, Trounson A, Leeton J, McKenzie Talbot J, Buttery B, Webb J, Wood J, Jessup D: A clinical assessment of nine pregnancies obtained by in-vitro fertilization and embryo transfer. Fertil Steril 1981;35:502–508

    PubMed  Google Scholar 

  39. Garcia JE, Jones GS, Acosta AA, Wright G Jr: Human menopausal gonadotrophin/human chorionic gonadotropin follicular maturation for oocyte aspiration: Phase I, 1981. Fertil Steril 1983;39:167–173

    PubMed  Google Scholar 

  40. Garcia JE, Jones GS, Acosta AA, Wright G Jr: Human menopausal gonadotrophin/human chorionic gonadotropin follicular maturation for oocyte aspiration: Phase II, 1981. Fertil Steril 1983;39:174–179

    PubMed  Google Scholar 

  41. Vargyaa JM, Marrs RP, Kletzky OA, Mishell DR Jr: Correlation of ultrasonic measurement of ovarian follicle size and serum estradiol levels of ovulatory patients following clomiphene citrate for in vitro fertilization. Am J Obstet Gynecol 1982;144:569–573

    PubMed  Google Scholar 

  42. Buttery B, Trounson A, McMester RC, Wood C: Evaluation of diagnostic ultrasound as a parameter of follicular development in an in vitro fertilization program. Fertil Steril. 1983;39:458–463

    PubMed  Google Scholar 

  43. Fowler RE, Chan STH, Walters DE, Edwards RG, Steptoe PC: Steroidogenesis in human follicles approaching ovulation as judged from assays of follicular fluid. J Endocrinol 1977;72:259–271

    PubMed  Google Scholar 

  44. Fowler RE, Edwards RG, Walters DE, Chan STH, Steptoe PC: Steroidogenesis in preovulatory follicles of patients given human menopausal and chorionic gonadotrophins as judged by the radioimmunoassay of steroids in follicular fluid. J Endocrinol 1978;77:161–169

    PubMed  Google Scholar 

  45. Kemeter P, Salzer H, Breitenecker G, Friedrich F: Progesterone, oestradiol-17β and testosterone levels in the follicular fluid of tertiary follicles and graafian follicles of human ovaries. Acta Endocrinol 1975;80:686–704

    PubMed  Google Scholar 

  46. Testart J, Frydman R, Castanier M, Lasalle B, Belaisch J: Influence of ovarian stimulation on follicular fluid steroid levels and fertilization of the oocyte.In Fertilization of the Human Egg in Vitro, HM Beier, HR Lindner (eds). Berlin, Springer-Verlag, 1983, pp 73–82

    Google Scholar 

  47. Testart J, Frydman R, De Mouzon J, Lassale B, Belassch JC: A study of factors affecting the success of human fertilization in vitro. I. Influence of ovarian stimulation upon the number and condition of ooctyes collected. Biol Reprod 1983;28(2):415–424

    PubMed  Google Scholar 

  48. Fishel SB, Edwards RG, Walters DE: Follicular steroids as a prognosticator of successful fertilization of human oocytes in vitro. J Endocrinol 1983;99:335–344

    PubMed  Google Scholar 

  49. Carson RS, Trounson AO, Findlay JK: Successful fertilization of human oocytes in vitro: Concentration of oestradiol-17B, progesterone and androstenedione in the antral fluid of donor follicles. J Clin Endocrinol Metab 1982;55:798–799

    PubMed  Google Scholar 

  50. Finn CA: Investigations into ageing in experimental animals.In The Menopause, RJ Beard (ed). Lancaster, MTP Press, 1976, pp 1–23

    Google Scholar 

  51. Bongaarts: Family Plan Perspect 1982;14:75

    Google Scholar 

  52. Craft I, Djahanbakhch O, Mcleod F, Bernard A, Greens S, Twigg H, Smith W, Lindsey K, Edmonds K: Human pregnancy following oocyte and sperm transfer to the uterus. Lancet 1982;1:1031–1033

    PubMed  Google Scholar 

  53. Steptoe PC, Edwards RG: Reimplantation of a human embryo with subsequent tubal pregnancy. Lancet 1976;1:880–882

    PubMed  Google Scholar 

  54. Angell RR, Aitken RJ, van Look PFA, Lumsden MA, Templeton AA: Chromosome abnormalities in human embryos after in vitro fertilization. Nature 1983;5915:336–337

    Google Scholar 

  55. Edwards RG: Chromosomal abnormalities in human embryos. Nature 1983;303:283

    PubMed  Google Scholar 

  56. Edwards RG: The current clinical success of human in-vitro fertilization. Rec Prog Hum in Vitro Fertil Vienna 1983 (in press)

  57. Biggers JD: Appendix in Human in Vitro Fertilization and Embryo Transfer. HEW Report. Washington DC, US Goyernment Printing Officer, 1979

    Google Scholar 

  58. Speirs AL, Lopata A, Gronow MJ, Kellow GN, Johnsion WIH: Analysis of the benefits and risks of multiple embryo transfer. Fertility and Sterility. 1983;39:468–471

    PubMed  Google Scholar 

  59. Lopata A, Martin M, Oliva K, Johnston I: Embryonic development and blastocyst implantation following in vitro fertilization and embryo transfer. Fertil Steril 1982;38:682–687

    PubMed  Google Scholar 

  60. Testart J, Lassalle B, Frydman R, Belaisch JC: A study of factors affecting the success of human fertilization in vitro. II. Influence of semen quality and oocyte maturity on fertilization and cleavage. Biol Reprod 1983;28:425–432

    PubMed  Google Scholar 

  61. Veeck LL, Wortham JWE Jr, Wimyer J, Sandow BA, Acosta AA, Garcia JE, Jones GS, Jones HW: Maturation and fertilization of morphologically immature human oocytes in a program of in vitro fertilization. Fertil Steril 1983;39:594–602

    PubMed  Google Scholar 

  62. Foreman R, Fishel S, Edwards RG: In preparation, 1983

  63. Fishel SB, Edwards RG, Steptoe PC, Purdy JM, Webster J: Establishing and maintaining pregnancy by in vitro fertilization. Serono Symposium, Carmel, 1983 (in press)

  64. Jongbloet PH, Bezemer PD, Van Erkelens-Zwets AH, Theune JA: Seasonality of anencephalic births and preovulatory overipeness ovopathy. Chronobiologia 1982;9:273–280

    PubMed  Google Scholar 

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Authors and Affiliations

  1. The Physiological Laboratory, Bourn Hall Clinic, Cambridge University, CB2 3EG, Cambridge, U.K.

    R. G. Edwards

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  1. R. G. Edwards
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  2. S. B. Fishel
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  3. J. Cohen
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  4. C. B. Fehilly
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  5. J. M. Purdy
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  6. J. M. Slater
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  7. P. C. Steptoe
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  8. J. M. Webster
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Edwards, R.G., Fishel, S.B., Cohen, J. et al. Factors influencing the success of in vitro fertilization for alleviating human infertility. J Assist Reprod Genet 1, 3–23 (1984). https://doi.org/10.1007/BF01129615

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