Hossam Abdalla

Birth weight: nature or nurture?

OBJECTIVE To investigate the relative role of environmental and genetic factors in the determination of birth weight following ovum donation. METHODS Data from 62 cases of ovum donation were used to examine the relative influence of donor and recipient on birth weight. RESULTS The only discernible factors that significantly influenced birth weight were gestational age and recipients weight. Donor weight, her own birth weight, and the birth weight of the donors own children were not significantly correlated with the birth weight of the child following ovum donation. CONCLUSIONS It is concluded that the environment provided by the human mother is more important than her genetic contribution to birth weight.

Parenting infants conceived by gamete donation.

In recent years, concerns have been raised regarding the potentially negative consequences of gamete donation for parent-child relationships. Findings are presented of a study of families with an infant conceived by gamete donation. Fifty donor insemination families and 51 egg donation families were compared with 80 natural conception families on standardized interview and questionnaire measures of the psychological well-being of the parents, the quality of parent-child relationships, and infant temperament. The differences that were identified indicated more positive parent-child relationships among the gamete donation than the natural conception parents, accompanied by greater emotional involvement with the child. Comparisons were also carried out between the donor insemination and the egg donation parents on their experiences of gamete donation. In contrast to the findings of earlier investigations, the donor insemination and egg donation parents appeared to be more open toward disclosing the donor conception to the child. It was concluded that infants conceived by egg or sperm donation did not appear to be at risk for parenting difficulties.

Obstetric outcome in 232 ovum donation pregnancies

Objective To study the obstetric outcome of ovum donation pregnancies.

Comparative trial of luteinizing hormone-releasing hormone analog/human menopausal gonadotropin and clomiphene citrate/human menopausal gonadotropin in an assisted conception program

To establish the usefulness of a new drug regimen in an assisted conception program, a trial was performed comparing clomiphene citrate (CC) plus human menopausal gonadotropins (hMG) with a new regimen of intranasal luteinizing hormone-releasing hormone (LH-RH) analog plus hMG. One hundred two patient cycles received treatment with CC and hMG and 118 patient cycles received treatment with LH-RH analog and hMG. Fifteen percent of cycles were canceled in the CC group and 8% in the analog group. Four percent of cycles in the CC group were canceled due to premature ovulation. The number of oocytes collected in the analog group was significantly higher than in the CC group (8.5 versus 5.5), as was the number of mature oocytes (3.5 versus 2.7). However, the percentage of mature oocytes was higher in the CC group (54.2% versus 42.3%). The number of embryos resulting from in vitro fertilization as well as the number of cleaving embryos were significantly higher in the analog group (5.2 versus 2.8 and 4.6 versus 2.3, respectively). The pregnancy rate in the analog group was significantly higher than in the CC group (30.6% versus 16.1%), as was the live birth rate (21% versus 8%). Early pregnancy loss was significantly higher in the CC group than in the analog group (35% versus 9%); and the serum level of LH on the day of human chorionic gonadotropin (hCG) administration was also significantly elevated in the CC group when compared with the analog group (8.1 versus 4.1). The use of LH-RH analog and hMG in an assisted conception program results in lower serum levels of endogenous LH and a higher rate of live births.

Health of children conceived after preimplantation genetic diagnosis: a preliminary outcome study.

A preliminary study was conducted on health of children conceived after preimplantation genetic screening and diagnosis (PGD). Forty-nine children were assessed with 66 matched naturally conceived (NC) controls. Primary outcome was neurodevelopmental screening, and secondary outcomes were evidence of other health problems and assessment of parent-child relationships. Study and control children were well matched across relevant socio-demographic variables. Growth parameters at mean age 18 months were normal. The mean Griffiths quotient was 102.7 (+/-13.1) (PGD) and 103.3 (+/-12.8) (NC), both of which were within the normal range, and did not differ significantly. PGD cases were more likely to be lighter, at <2500 g (12 children, 24.5% versus one child 1.5%, P < 0.0001) and born earlier than controls (38.2 +/- 2.6 versus 40.0 +/- 1.4 weeks; P < 0.0001), consistent with other similar studies. PGD families showed no evidence of excess stress in their relationship with their child. The PGD group had significantly higher scores on the warmth-affection sub-scale (P = 0.042), and significantly lower scores on the aggression-hostility and rejection sub-scales (P = 0.030) of the questionnaire. The study showed no major ill effects from PGD on the child health. A larger study is needed to confirm the validity of this conclusion.

Pregnancy in women with premature ovarian failure using tubal and intrauterine transfer of cryopreserved zygotes.

Summary. Twenty‐nine women, mean age 36·3 (SD 5·5) years, with premature ovarian failure received donated ova on an ovum donation programme. Three had Turners syndrome, four a surgical menopause, one a chemotherapy‐induced menopause and 21 had idiopathic premature ovarian failure. All donated oocytes were fertilized with frozenthawed spermatozoa from the recipients partner, and the resulting zygotes were frozen until transfer had been arranged. Overall, 19 women had intrauterine embryo transfer (ET) and a mean of 2·7 (SD 0·9) embryos were transferred on 20 occasions; 10 women underwent zygote intrafallopian transfer (ZIFT) and a mean of 3·5 (SD 0·5) zygotes were transferred on 10 occasions. Both groups were matched for age. The pregnancy rate per transfer was 20% in the ET group and 40% in the ZIFT group. After excluding the 10 women in the ET group who had fewer than three embryos transferred, the pregnancy rates were similar in the two groups, 30% in the ET group and 40% in the ZIFT group. Cryopreserved embryos may be used for ovum donation to preserve anonymity and still show a high pregnancy rate of at least 30% per transfer.

Prednisolone suppresses NK cell cytotoxicity in vitro in women with a history of infertility and elevated NK cell cytotoxicity.

To evaluate the effect of prednisolone on NK cell cytotoxicity in vitro environment and also to compare the effect of prednisolone versus immunoglobulin‐G (IVIG) on NK cell cytotoxicity using in vitro co‐culture with K562 cells.

ORIGINAL ARTICLE: Prednisolone Suppresses NK Cell Cytotoxicity In Vitro in Women With a History of Infertility and Elevated NK Cell Cytotoxicity

To evaluate the effect of prednisolone on NK cell cytotoxicity in vitro environment and also to compare the effect of prednisolone versus immunoglobulin‐G (IVIG) on NK cell cytotoxicity using in vitro co‐culture with K562 cells.

The Relationship of Systemic TNF‐α and IFN‐γ with IVF Treatment Outcome and Peripheral Blood NK Cells

To evaluate the association of serum tumour necrotic factor (TNF)‐α and interferon (IFN)‐γ levels with IVF treatment outcome and peripheral blood NK cells.

Reducing multiple pregnancy in assisted reproduction technology: towards a policy of single blastocyst transfer in younger women

Objectives  To investigate the effects of single blastocyst transfer (SBT) on live birth and multiple pregnancy in women undergoing in vitro fertilisation (IVF).