Donna Howlett

The effect of progesterone supplementation around the time of oocyte recovery in patients superovulated for in vitro fertilization

A randomized control trial involving 42 superovulated in vitro fertilization (IVF) patients was carried out to investigate the effects of providing supplementary progesterone (P) around the time of laparoscopy. P was given 12 to 15 hours and 1 hour before and 24 hours after laparoscopy in one group (group B); human chorionic gonadotropin was given 12 hours before laparoscopy in another group (group C); and the remainder received no treatment in addition to normal IVF procedures (group A). There was no difference in fertilization rate, the proportion of normally developing embryos, pregnancy rate, or birth rate between the treatment groups, We conclude that in the superovulation schedule used, P supplementation around the time of laparoscopy does not affect success rate of IVF.

Incidence of polycystic ovaries and polycystic ovary syndrome amongst women in Melbourne, Australia.

Background:  The incidence of polycystic ovaries (PCO) in the Australian population is unknown.

Replacement of one selected embryo is just as successful as two embryo transfer, without the risk of twin pregnancy

The transition of in vitro fertilization from research to standard clinical practice has, to a great extent, been as a result of the use of controlled ovarian hyper stimulation. A disadvantage of the availability of multiple embryos has been the replacement of several embryos leading to an epidemic of multiple pregnancies. This retrospective review of 2606 fresh embryo transfers between 2001 and 2003, where either one or two selected embryos were replaced from an available cohort of at least four, shows that single embryo transfers have a similar pregnancy rate without the risk of multiple pregnancy.

Cross-over trial of superovulation protocols from two major in vitro fertilization centers

A study was undertaken as a controlled comparison of two different superovulation induction protocols currently in use in major Australian in vitro fertilization (IVF) clinics. Thirty patients each from the Monash University and the Royal Womens Hospital (RWH) IVF programs were stimulated for ovulation induction by the other program. Once timing for oocyte retrieval was scheduled, all care reverted to the program from which the patient first came. Results given as pregnancies per patient commencing stimulation were: RWH patients on Monash protocol, 27%; RWH control patients, 15%; Monash patients on RWH protocol, 7%; Monash control patients, 13%. In the year preceding the trial pregnancy rates were 16.9% at Monash and 10.6% at RWH. Stimulation protocols were also compared with respect to each of administration, cost, and patient stress. The results of this cross-over trial demonstrated major differences between the two ovulation induction protocols studied, although it was not possible to conclude that differences in pregnancy rate were due to stimulation alone.

Preliminary report: correct diagnosis of sex in fetal cells isolated from cervical mucus during early pregnancy

The aim of this study was to determine the accuracy of sexing fetal cells isolated from cervical mucus. Immunopositive cells identified using a fetal‐specific antibody were isolated and subjected to genetic analysis. Fetal sex was predicted in all 22 samples, as confirmed by analysis of the corresponding placental tissue. This study validates the accuracy of our test for sex diagnosis and confirms the ability to effectively recover and analyse fetal cells from the cervical mucus during early pregnancy.

Outcome of pregnancies achieved by in vitro fertilisation techniques and diagnosed as twins at the 6 week ultrasound.

Background: To bring the success rate of in vitro fertilisation (IVF) procedures to an acceptable level, multiple embryos have historically been replaced. This has resulted in an ‘epidemic’ of multiple births. The pendulum has now swung full circle and the number of embryos transferred is now being limited. Such high numbers of IVF twins will not be produced in the future.

If at first you don't succeed, try, try, try again: A successful birth after 37 cycles of assisted reproductive technology over 11 years

The present case report, of a woman who underwent treatment from the age of 29 years until achieving pregnancy at 40 years of age, including eight stimulated cycles, 25 clomiphene minimal stimulation cycles, three natural cycles and one thawed–frozen embryo transfer cycle, shows that it is the repeated attempts at embryo transfer that eventually achieved success. The use of minimal stimulated cycles was inefficient.