Per-Olof Karlström

Full‐term newborn after repeated ovarian tissue transplants in a patient treated for Ewing sarcoma by sterilizing pelvic irradiation and chemotherapy

We report the first successful transplantation of cryopreserved ovarian cortical tissue into heavily irradiated tissues in a patient who had received sterilizing pelvic radiotherapy (54 Gy) and 40 weeks of intensive high‐dose chemotherapy for the treatment of Ewings sarcoma 14 years earlier. Repeated transplantation procedures were required to obtain fully functional follicular development. Enlargement of the transplants over time and increase of the size of the uterus were demonstrated on sequential ultrasonographic examinations. Eggs of good quality that could be fertilized in vitro were obtained only after a substantial incremental increase of the amount of ovarian tissue transplanted. Single embryo replacement resulted in a normal pregnancy and the birth of a healthy child by cesarean section at full‐term. No neonatal or maternal postoperative complications occurred. Women facing high‐dose pelvic radiotherapy should not be systematically excluded from fertility preservation options, as is currently the trend.

Hyaluronan-enriched transfer medium in cleavage-stage frozen-thawed embryo transfers increases implantation rate without improvement of delivery rate

OBJECTIVE To investigate the efficacy of hyaluronan-enriched transfer media in cleavage-stage frozen embryo transfer cycles. DESIGN Two commercially available transfer media were prospectively compared in an observational study. SETTING Hospital-based in vitro fertilization clinic. PATIENT(S) Patients (n = 425) undergoing frozen-thawed embryo transfer (FET). The embryos transferred were included in either a study group (high hyaluronic acid [HA], n = 199) or a control group (low HA, n = 226). INTERVENTION(S) Delivery rate per FET; positive hCG rate, biochemical pregnancy rate, clinical pregnancy rate, implantation rate, and clinical abortion rate were secondary outcomes. RESULT(S) The use of HA in the transfer media significantly increased the positive hCG rate (37.2% vs. 25.2%) and implantation rate (23.1% vs. 15.8%) without increasing the delivery rate (21.6% vs. 21.2%). More subjects in the study group with a positive hCG test experienced biochemical pregnancy (28.4% vs. 8.9%). CONCLUSION(S) Addition of HA to transfer media seems to favor attachment of early embryos in FETs without increasing the delivery rate.

Gamete donors motivation in a Swedish national sample: is there any ambivalence? A descriptive study

Objective. To study donors’ motivation and ambivalence before donation of gametes. Design. Cross‐sectional study. Setting. Seven Swedish university hospital clinics. Sample. Of the 220 eligible oocyte donors and 156 eligible sperm donors who were approached, 181 (82%) oocyte donors and 119 (76%) sperm donors agreed to participate. Methods. Gamete donors completed a questionnaire in the clinic prior to the donation. Main outcome measures. Motives and ambivalence towards donation. Results. In general, gamete donors donated for altruistic reasons (95%). A greater percentage of oocyte than sperm donors had a personal experience of biological children, which motivated them to donate (65 vs. 32%). A greater percentage of sperm donors compared with oocyte donors were curious about their own fertility (24 vs. 9%), and they also believed that they were contributing what they regarded as their own good genes to other couples (45 vs. 20%). Prior to donation, potential sperm donors were more ambivalent towards donating than were oocyte donors (39 and 21%, p < 0.001). Conclusions. The motives to donate gametes are mainly altruistic. We conclude that men and women differ in their view towards donating gametes. Sperm donors had a higher degree of ambivalent feelings towards donation than oocyte donors.

Personality characteristics in a Swedish national sample of identifiable oocyte donors

Please cite this paper as: Sydsjö G, Lampic C, Brändström S, Gudmundsson J, Karlström P, Solensten N, Thurin‐Kjellberg A, Svanberg A. Personality characteristics in a Swedish national sample of identifiable oocyte donors. BJOG 2011;118:1067–1072.

Addition of gonadotrophin‐releasing hormone agonist and/or two inseminations with husband's sperm do not improve the pregnancy rate in superovulated cycles

Background. A prospective randomized study was performed to evaluate the addition of a gonadotropin releasing hormone agonist (GnRH‐a) during treatment with human menopausal gonadotropins (hMG) in cycles with artificial inseminations with husbands washed sperm (AIH). We also compared the pregnancy rate per cycle after one versus two AIHs.