[Pregnancy after transfer of the gametes into the fallopian tubes]. / Nastuplenie beremennosti putem perenosa gamet v matochnye truby.

Three patients with idiopathic sterility were treated by transferring the gametes into uterine tubes. Clomiphene+ citrate stimulation of superovulation was employed. Preovulatory oocytes were obtained via the laparoscopic approach. Two oocytes with capacitated spermatozoa were placed into the tube of patient 1, four cells into one tube of the second patient, and two cells into each tube of the third patient. Pregnancy started in two cases, uterine in one, eventuating in 12-13 weeks in spontaneous abortion, and tubal in the other, eventuating in tubectomy. These data evidence the possibility of transferring gametes into uterine tubes to sterile patients, in whom sterility is not caused bu tubal diseases.

[Evaluation of ovarian response in ovulation induction]. / Otsenka reaktsii iaichnikov pri provedenii induktsii ovuliatsii.

To decrease the cost of determining estrogens by the High Estrotex (Mochida Pharmaceutica, Japan) method, the authors have modified it, thus reducing the usage of expensive reagents four times. The modified method was applied to evaluate estrogens in 27 infertile patients when stimulating superovulation. The findings were in agreement with the results obtained by foreign special clinics engaged in treating infertility with extracorporeal fertilization followed by embryonal transfer. The pregnancy rate in the females was 15% on an embryonal transfer basis. The modified High-Estrotex method is easy-to-use, rapid, and cost-effective in the measurement of daily urinary estrogen levels. It may be employed both in extracorporeal fertilization and embryonal transfer and in cases which require daily multiple and reliable evaluation of an ovarian response to ovulation inducers.

[Results of the treatment of infertility by the method of extracorporeal fertilization]. / Rezul'taty lecheniia besplodiia metodom ékstrakorporal'nogo oplodotvoreniia.

Outpatient in vitro insemination has been performed in 609 infertile couples in 1145 menstrual cycles. Age of the women ranged from 19 to 44 years and their history of infertility, from 2 to 17 years. Tubal infertility was present in 439 patients and one or both tubes were patent in 170 patients. Superovulation was induced with anti-estrogens and gonadotropins (Humegon and Neopergonal). Preovulatory oocytes were retrieved using transvaginal follicular puncture guided by transvaginal ovarian ultrasonography. A total of 942 punctures yielded 2177 oocytes (2.3 per puncture). The incidence of conception was 63.3% of the entire population and 75.2% of the mature oocyte population. Division was documented in 1176 zygotes (85.2%). Embryo transfers were undertaken in 498 cycles (2.4 embryos per transfer). There were 80 conceptions (16.1% of transfers); 19 (23.7%) of them were "biochemical" and 10 (12.5%) ended in spontaneous abortion; pregnancy was ectopic in 5 (6.3%) patients. As of March 1, 1990, 46 (57.5%) women gave birth to 51 normal infants (5 twins). The therapeutic results are consistent with experience of world clinics.

[Ectopic pregnancy after the treatment of infertility by the method of extracorporeal fertilization]. / Ektopicheskaia beremennost' pri lechenii besplodiia metodom ékstrakorporal'nogo oplodotroreniia.

During October 1987 to June 1989, 609 infertile couples have been treated using in vitro fertilization and embryo transfer (IVF-ET). Of 78 conceptions (15.7% of transferred embryos), 6 (7.7%) pregnancies were ectopic (5 tubal and 1 ovarian). After diagnosis of ectopic pregnancy all the patients were operated; the ovary was resected in 1 patients and tubectomies were done in 5 patients (laparoscopically in 1). All the diagnoses were confirmed histologically. Since prevention of ectopic pregnancy in IVF-ET is not reliable, the patients enrolled for IVF-ET should be considered to be at risk and closely followed up.

[Transvaginal ultrasonography in the treatment of infertility by the method of extracorporeal fertilization]. / Transvaginal'naia ékhografiia pri lechenii besplodiia metodom ékstrakorporal'nogo oplodotvoreniia.

Menstrual cycles of 274 women have been analyzed in order to decide on possibility of follow-up of follicular growth and development using echography and retrieval of preovulatory oocytes using sonographically guided transvaginal access during in vitro fertilization and embryo transfer (IVF-ET). Transvaginal echography proved to be a very efficient tool in monitoring follicle growth during an IVF-ET program and outpatient oocyte retrieval with a minimal injury.