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In many in-vitro fertilization (IVF) programmes, the transvaginal approach is now the most widely used method for ultrasound-guided oocyte retrieval. Sometimes, however, the position of the ovaries is such that it might not be possible to aspirate the follicle transvaginally without puncturing the uterine wall. Between May and November 1988, we performed 518 transvaginal, ultrasound-guided oocyte retrievals for IVF or zygote intra-Fallopian transfer (ZIFT). During this period, 22 transuterine punctures (4.2%) were necessary to reach one of the ovaries. To investigate the effect of uterine laceration on the results of IVF/ZIFT treatment, the outcome of treatment was compared between patients who had a transuterine puncture and a control group of patients treated by IVF or ZIFT during the same period without transuterine puncture. Seven of 16 patients who had a transuterine puncture became pregnant after IVF, compared to 84 pregnancies out of 347 cases (24.2%) in the control group. After ZIFT, two pregnancies (2/6) were achieved in patients with uterine laceration, compared to 46 pregnancies out of 149 procedures (30.8%) in the control group. These differences were not statistically significant. Transuterine puncture during transvaginal oocyte retrieval does not seem to have an adverse effect on the results of human IVF and ZIFT treatment. [ABSTRACT FROM AUTHOR]

The results of 42 zygote intra-Fallopian transfer cycles in 37 couples with persistent male infertility are reported. Of 396 retrieved oocytes, 39.1% fertilized normally and 63 zygotes were replaced in 25 cycles. Twelve patients became pregnant, including two twin pregnancies. The pregnancy rate was 28.6% per started cycle and 48.0% per replacement. The implantation rate per replaced zygote was 22.2% (14 of 63 replaced zygotes implanted). Sixty-two supernumerary zygotes or embryos were cryopreserved for later use. [ABSTRACT FROM PUBLISHER]

The aim of the study was to evaluate cefepime, a "fourth generation" cephalosporin, for its in vitro activity in comparison with 5 other broad spectrum antibiotics against clinical isolates from ICU and haematology patients. The strains were isolated from blood (8%), lower respiratory tract (41%), upper respiratory tract (14%), urine (20%) and other sites (17%). They were divided into: 28 non-inducible Enterobacteriaceae, 35 inducible Enterobacteriaceae, 20 non-fermenters, 10 S. aureus and 10 Streptococcus spp. The MIC-values were determined by E-test. Overall, the rank order of susceptibility was cefepime (93%), imipenem (90%), piperacillin-tazobactam (81%), ciprofloxacin (79%), ceftriaxone (75%) and ceftazidime (74%). Only cefepime was able to inhibit all inducible Enterobacteriaceae. Against Pseudomonas aeruginosa, cefepime had the same activity as ceftazidime. With the exception of ceftazidime (65%), all beta lactams demonstrated good activity against Gram positive cocci. The excellent activity against most Gram negative and Gram positive pathogens suggests that cefepime may be useful in the treatment of serious infections in the described patient population.

This study describes the zygote intrafallopian transfer treatment in patients with unexplained infertility. After retrieval, the oocytes were inseminated with 80,000 progressive motile sperm cells per milliliter. If fertilization occurred, a maximum of three zygotes were replaced by laparoscopy in the fimbrial end of one healthy fallopian tube. A pregnancy rate of 48.1% per zygote intrafallopian transfer replacement was obtained. Seventeen pregnancies are actually ongoing, two patients delivered, and seven patients miscarried. Even after replacing a maximum of three zygotes, there were 6 twin and 2 triplet pregnancies.