Pregnancy results after ovum donation following one to seven embryo transfers.

OBJECTIVE: To determine whether failure to achieve pregnancy after repeated ET after ovum donation was due to an endometrial defect or to the embryo quality. DESIGN: Retrospective data analysis. SETTING: A private infertility center. PATIENT(S): Four hundred sixty-seven donors (513 cycles) undergoing IVF donating oocytes to 266 recipients (423 cycles). INTERVENTION(S): Hormonal endometrial preparation with increasing dosages of valerate E2 (2,4, and 6 mg) and 100 mg of P. MAIN OUTCOME MEASURE(S): Pregnancy rates (PRs) and abortion rates in patients undergoing one to seven ETs after ovum donation. RESULT(S): Pregnancy rates in recipients that had one or two ETs were significantly higher (34.8%) compared with those of recipients having three or more ETs (15.1%). Abortion rates were significantly higher (54.5%) in recipients repeating more than three ETs than in the recipients having one or two ETs (29.1%). CONCLUSION(S): Recipients that had failed to establish a pregnancy after two ETs had a lower PR in successive attempts, possibly because of a defect of their endometrial lining.

Triplet pregnancy and fetal reduction counselling.

The aim of this study was to compare the fetal loss between triplet pregnancies that underwent fetal reduction to twins and triplets which continued in spite of reduction being suggested to all of them. During a five year period a total of 3,518 cycles underwent ovarian stimulation with GnRH analogues, HMG, pure-FSH and HCG for the purpose of IVF; 2,918 women underwent ovarian aspiration leading to 2,380 embryotransfers. A total of 560 clinical pregnancies were detected with 24 clinical triplet pregnancies. Fourteen women continued their triplet pregnancy while 10 women underwent fetal reduction to twins. From 42 fetuses (14 triplets) starting the third trimester only 29 survived (total fetal loss 30.9%). From 14 fetuses (7 twins) starting the third trimester all survived. Three twins were lost during the second trimester due to cervix incompetence. Fetal reduction to twins must be proposed to each multifetal pregnancy, considering the very serious high mortality rate.

The effect of pentoxifylline on sperm motility, oocyte fertilization, embryo quality, and pregnancy outcome in an in vitro fertilization program.

OBJECTIVE: To study the effect of pentoxifylline on sperm motility, oocyte fertilization, embryo cleavage, and quality as well as pregnancy outcome on asthenospermic patients participating in an IVF program. DESIGN: Prospective randomized study. SETTING: Private IVF unit. PATIENTS: Ninety-seven couples, 24 of whom were repeating IVF. Two semen specimens were obtained from each patient and each specimen was divided equally into two parts, nontreated (control semen) and pentoxifylline-treated (treated semen). MAIN OUTCOME MEASURE: Sperm progressive motility, oocyte fertilization. RESULTS: Overall and progressive motility did not differ significantly between the two semen specimens. There was a significant increase in the progressive motality of the pentoxifylline-treated semen compared with control semen. No significant difference was noticed between control and treated semen in fertilization rate, cleavage rate, embryo quality, and pregnancy rate. The percentage of patients who fertilized only with control semen (9.3%) was not significantly different from that of patients who fertilized only with treated semen (10.3%). Couples who were repeating IVF did not show significant difference in fertilization between the present study and previous attempts. CONCLUSION: Our results showed that although the sperm progressive motility is improved after pentoxifylline treatment, it is doubtful whether this effect is of any clinical significance.