[In vitro fertilization at our department. A decade's work in figures and facts (1994-2003)]. / In vitro fertilizációs kezelések klinikánkon: Tíz év munkája a számok és eredmények tükrében (1994-2003).

UNLABELLED: We report here on the first decade of in vitro fertilization (IVF) treatments performed at a newly established clinical infertility and assisted reproductive unit. OBJECTIVE: We present the number of treatment cycles, the distribution of treatment modalities ("classical" IVF and intracytoplasmic sperm injection, ICSI) and success rates, and relate them to national and international data. METHODS: During the last decade, ICSI was introduced gradually and is now used routinely at our department. In certain cases of azoospermia, testicular sperm extraction (TESE) is used to retrieve male gametes for ICSI. Embryo cryopreservation, which is also part of the routine, provides the chance to establish pregnancy in subsequent cycles without the need to repeat hormonal stimulation. Preimplantation genetic diagnosis helps us to avoid transferring embryos carrying certain hereditary diseases. RESULTS: 1517 IVF cycles were started in the past ten years. Oocyte pickup and IVF were performed in 1423 cases. In the end of the described period, ICSI was used in more than two thirds of treatment cycles. Pregnancy rates were 39.0% per embryo transfer (ET), 36.3% per oocyte pickup, and 34.0% per started cycle. Clinical pregnancy was achieved in 34.2% per ET, and the delivery rate was 27.9% per ET. These success rates have exceeded the national average every year since 1996. Pregnancy rates in frozen-thawed ET cycles and in cryo-TESE-ICSI cycles are in the range of international data. CONCLUSIONS: We attribute the gradual and continuous improvement in our success rates to rigorous and well-coordinated clinical and laboratory work and to judicious adoption of the latest assisted reproductive techniques.

[First case of successful pregnancy after preimplantation genetic diagnosis]. / Elóébrény-diagnosztikát követóen fogant sikeres terhesség elsó hazai esete.

UNLABELLED: Preimplantation genetic diagnosis is introduced for prevention of genetic disorders. The combination of in vitro fertilization technique and single cell molecular genetic diagnosis allows only unaffected embryos to be selected for embryotransfer, providing a healthy pregnancy and so also avoiding the need for its possible termination. CASE REPORT: The authors report the first successful case of the clinical application of preimplantation genetic diagnosis in Hungary, resulting the birth of an unaffected baby. Preembryonal biopsy and subsequent fluorescent-PCR analysis of the blastomeres taken from the preembryos of a woman who is a carrier for Duchenne muscular dystrophy was performed. Sexing of the preembryos by X and Y chromosome specific primers were performed and three female preembryos were found. RESULT: All three preembryos were transferred into the uterus, which resulted a singleton pregnancy, resulting the birth of a healthy female baby. The authors are offering preimplantation genetic diagnosis with sexing for couples, who are at risk of having a child with X-linked diseases, or are carriers for the delta-F508 mutation of cystic fibrosis. CONCLUSIONS: The application of this diagnostic tool is also planned for other monogenic disorders.