Øystein Magnus

In vivo fertilization procedures in infertile women with patent fallopian tubes: a comparison of gamete intrafallopian transfer, combined intrauterine and intraperitoneal insemination, and controlled ovarian hyperstimulation alone.

This prospective study was undertaken to evaluate the relative efficacy of three in vivo methods of assisted fertilization in 150 infertile women with patent fallopian tubes: gamete intrafallopian transfer (GIFT), combined intrauterine and direct intraperitoneal insemination (IUI + DIPI), and controlled hyperstimulation (COHS) alone. The clinical pregnancy rate was highest in the IUI/DIPI and GIFT groups: IUI/DIPI, 29.3%; GIFT, 28.6%; and COHS, 8.9%. We believe that controlled ovarian hyperstimulation combined with IUI and DIPI is a good alternative to GIFT.

The first attempt at IVF treatment. Results and requirements for a satisfactory success rate

The purpose of this study was to report the success rate of the first IVF treatment in 161 patients who attended our department in 1988. The indications for IVF were tubal damage in 84 couples (52.1%), unexplained infertility and endometriosis (with patent tubes) in 61 couples (37.9%), and polycystic ovarian syndrome in 16 couples (10%). Clinical pregnancies were diagnosed in 40 patients, giving an overall clinical pregnancy rate of 35.4% per embryo transfer. In the group of patients with unexplained infertility or endometriosis one in three of the embryo transfer cycles will predictably result in a birth, one in four in the group of patients with tubal damage or polycystic ovarian syndrome. These results invite discussion of the possible reasons for the success of our IVF program.

OOCYTE RETRIEVAL IN AN IVF PROGRAM

Abstract. From 1 April 1986 to 20 May 1987, 160 oocyte retrievals were performed in our IVF program. 80 oocyte retrievals were done by laparoscopy under general anaesthesia and 80 under light sedation and local analgesia using transvaginal ultrasound guided follicle puncture. More oocytes were recovered with the ultrasound procedure than with laparoscopy, 616 versus 478. The fertilization rate was higher when the oocytes were collected with the ultrasound procedure, vis‐a‐vis laparoscopy, 70.6% versus 59.6%. The number of embryos transferred was greater in the former than in the latter group, 300 versus 182. There were 13 clinical pregnancies in the laparoscopy group versus 17 in the ultrasound group. There were no serious complications in either group. Transvaginal ultrasound guided follicle aspiration is a safe and simple procedure.

Pregnancy outcome according to male diagnosis after ICSI with non-ejaculated sperm compared with ejaculated sperm controls.

The aim of this study was to describe pregnancy outcome in couples who had undergone ICSI using non-ejaculated sperm from men with non-obstructive azoospermia, obstructive azoospermia and aspermia compared with the outcome of ICSI with ejaculated sperm from men with severe oligozoospermia, treated during the same time period. This nationwide cohort study included all children born after ICSI with non-ejaculated sperm in Norway, from when the method was first permitted in Norway in April 2004 to the end of 2010, resulting in 420 pregnancies and a total of 359 children. In 235 of these children, the father was diagnosed with obstructive azoospermia, in 72 with non-obstructive azoospermia, in 31 with aspermia, and in 21 the male cause was unclassifiable. The control group consisted of 760 children from 939 pregnancies conceived by ICSI with ejaculated sperm. Sex ratio, birth weight, rate of pregnancy loss and congenital malformations were not significantly associated with sperm origin or the cause of male factor infertility.

Pregnancy After Translaparoscopic Embryo Intrafallopian Transfer (Eift)

Gamete Intrafallopian Transfer (GIFT) has in many clinics become the preferred treatment for infertility in selected couples (1–4). The GIFT procedure presupposes optimal conditions for fertilization and early embryo growth. However, whether fertilization has occurred cannot be established unless pregnancy ensues. This problem arises especially in those cases where a low fertilization rate is to be expected as in couples with male factor. An alternative to GIFT would then be to undertake in vitro fertilization followed by embryo intrafallopian transfer (EIFT). We report here a pregnancy following transfer of 2–6‐stage embryos to the Fallopian tubes.

Gamete Intrafallopian Transfer (GIFT): The Results Of 83 Consecutive Treatments

Eighty‐two couples were treated with gamete intrafallopian transfer (GIFT) in 93 treatment cycles. Twenty‐three clinical pregnancies resulted. Pregnancies were obtained in 40% of the cases where 5 or more ova were placed in the Fallopian tubes. In the cases where 4 or fewer ova were transferred, the pregnancy rate was 12%. Three miscarriages and one ectopic pregnancy occurred. Sixteen of the pregnancies were singleton, there were 5 twins, 1 triplet and 1 quadruplet. According to the present material, GIFT seems to represent a significant improvement in selected groups of patients.

Pregnancies after intrafallopian transfer of embryos.

Six patients with a history of infertility of more than 4 years were offered in vitro fertilization (IVF) followed by translaparoscopic embryo transfer to the fallopian tubes. Three of the patients became pregnant. In one patient the oocytes did not fertilize in vitro. Intrafallopian transfer of embryos may be an alternative to gamete intrafallopian transfer (GIFT) or IVF, especially in those cases where confirmation of fertilization is wanted.