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Not before the introduction of the Nomarski differential interference contrast optics (DIC), we became aware of the presence of so-called vacuoles on the surface of the sperm head. Before the implementation of motile-sperm organelle-morphology examination (MSOME), no manuscript at all mentioned that spermatozoa free of vacuole-like structures should be selected for injection.

To determine the best day for the selection and transfer of a single embryo, a prospective, randomized study was undertaken that compared the ongoing pregnancy rate (PR) after single embryo transfer (SET) on day 3 with that after single blastocyst transfer (SBT) on day 5. Our results show an overall significantly higher PR after SBT (32.8%) compared with SET (23.2%), and a PR of 40.8% after SBT versus 25.6% after excellent-quality embryos became available.

Mature mouse oocytes were exposed prior to in vitro fertilization to visible light during 1, 2, or 4 hr at an intensity of 4,000 lux. Compared to controls cultured under identical conditions but protected from light, exposed eggs did not show any significant modification of cleavage speed and rate. After transfer of blastocysts obtained in vitro in uteri of pseudopregnant females, the implantation rate and the proportion of normal fetuses were not found to be different in relation to preliminary light exposure of oocytes fertilized and cultured in vitro.

A comparison has been established retrospectively between clomiphene citrate-human menopausal gonadotropin (CC-hMG) and buserelin acetate-hMG treatments in in vitro fertilization trials performed over a 3-year period. The analysis of 466 CC-hMG and 319 buserelin acetate-hMG trials shows that buserelin acetate-hMG stimulation generates a greater ovarian response resulting in higher numbers of oocytes being retrieved (6.2 + 3.8 versus 9.3 + 5.2) and fertilized (2.8 + 2.7 versus 4.3 + 3.8). More embryos are thus obtained, allowing a wider choice for intrauterine replacement and cryopreservation. Mean embryonic vitality scores do not differ (4.33 + 1.51 versus 4.44 + 1.54), implying that the embryonic quality remains similar in both treatments. A premature demise of the corpus luteum occurs in a large proportion of buserelin acetate-hMG cycles. However, when suppletive progesterone treatment is given, there is a trend toward a better implantation rate per embryo, and a significantly higher ongoing pregnancy rate is observed in relation to buserelin acetate-hMG treatment (20%) as compared with CC-hMG cycles (14%).

Among 297 couples who underwent 587 oocyte collection procedures, 95 (16%) total fertilization failures (FF) were observed. This frequency is similar in couples with either normal or only mildly deficient spermatozoa (16.2 and 13.7% respectively) but is almost doubled in cases of moderately and severely defective sperm (26.5%). However, this latter group accounts for only 19% of FF events. The fertilization rate per oocyte (FR) follows an inverse trend. FR was correlated with the final (i.e. after swim-up) sperm count and with initial and final motility of the sperm sample. If the final count and motility were less than 2 x 10(6)/ml and 40% respectively, the FF frequency in the group with partner's spermatozoa was significantly higher and FR significantly lower. FR was inversely correlated with the number of oocytes recovered but FF was found significantly more frequently only when fewer than three eggs were retrieved. No correlation was found between FF and either female causes of infertility, age or dosage of stimulation treatment. However, in the group with donor spermatozoa the FR was significantly lower amongst tubal, endocrinopathic and endometriotic patients (67.6, 67.2 and 56.6 respectively versus 79.7% in harvests from idiopathic cases). FR was decreased and FF increased when ovulation induction resulted from a spontaneous LH peak supplemented with human chorionic gonadotropin (HCG), as compared to induction by HCG alone. In the group using normal or mildly defective spermatozoa, if FF occurs at the first attempt, the frequency of recurrence in further trials is high (29%) and the probability of pregnancy after completed trials is low (12.5%).(ABSTRACT TRUNCATED AT 250 WORDS)

Within the same in vitro fertilization (IVF) program, treatment trials leading to single and multiple ongoing gestation were compared. Rates of cesarean delivery, prematurity and perinatal mortality were found much higher among twin and multiple IVF pregnancies. Our work thus attempts at defining characteristics of proneness to multiple gestation in IVF treatment, in order to try and avoid its occurrence. The mean vitality score of embryos replaced is the most reliable criterion for this purpose, enabling one to replace no more than two embryos when the average score is high. Age of the patient and cause of infertility are almost nondiscriminant in this respect. Ovarian stimulation parameters such as total dosage of gonadotropin treatment and level of estrogenic response, as well as numbers of oocytes and embryos obtained, may serve as secondary criteria for assessing the twinning risk.

The effects of varying pH levels on superovulated mouse oocytes before in vitro fertilization, culture, and transfer were investigated. Mouse oocytes acidified for 1 hour with 20% CO2(pH 6.9) exhibited a wide range of alterations. Five hours after insemination, 25% of these eggs showed different degrees of cytolysis and their perivitelline space contained numerous spermatozoa. At 12 hours normal-looking eggs from this group showed a higher proportion of polypronuclear zygotes than the control group (exposed, 51%; controls, 18%). Acidification thus markedly increased the permeability of the zona pellucida and/or interfered with the normal block to polyspermy. Fewer eggs achieved the two-cell stage among groups submitted to acidotic pH levels (6.9 to 6.6). In contrast, alkaline conditions (pH 7.8) did not reduce the proportion of two-cell embryos. However, only eggs maintained at pH 7.5 were capable of producing 80% of blastocysts. In other groups developmental blockage occurred mainly between stages 2 and 4. A significant reduction was found in the proportion of recipient females becoming pregnant after intrauterine transfer of blastocysts originating from CO2- treated oocytes. This difference might be related to the existence of a large polyploid population among experimental eggs.

A semi-quantitative and non-invasive method for scoring embryos obtained after in-vitro fertilization (IVF) has been defined, aiming at selection of embryos before transfer and at prognostic evaluation of IVF trials. Grading of embryos observed on the inverted micrclscope was essentially based on the amount of anucleate fragments expelled during early cteavage and on developmental speed. Embryos endowed with a high score were more often associated with pregnancy and in particular with the occurrence of maple pregnancy. No difference was observed between scores attributed to embryos related to ongoing, aborted or chankal pmgnades. Average embryonic scores corrrsponding to double and triple transfers differed significantly in failures as well as pregnancies. The better quality of embryos replaced in triple transfers was also apparent from the significantly higher implantation rate per embryo observed in this group. From our results, five criteria including clinical data and embryonic scores can be derived for defining a high risk of multiple pregnancy prior to transfer. It might be warranted to replace only two embryos when these conditions are fulfilled. © 1987 IRL Press Limited.

Among 429 patients admitted in our in-vitro fertilization (IVF) programme during the last 3 years, 106 experienced cancellation of one or more treatment cycles. A low oestrogen (E 2) response represented by far the main reason for cancellation (144/184). Significantly lower clinical pregnancy rates were found in the group of patients with low E 2-cancelled cycles (E 2CC) as compared to the rest of the IVF population (13 versus 37%). Further comparison between these groups showed only little or no difference in the mean age of patients, basal FSH levels, number of egg collections, rate of oocytes obtained and fertilized per trial and mean embryonic vitality score. A large majority of E 2CC patients were found to belong to the tubal infertility group (75%) as opposed to a lower proportion of tubal cases among other IVF patients (56%). E 2CC tubal patients showed a lower pregnancy rate than other cases with abandoned cycles and also than other tubal patients (8.9 versus 25 and 35%, respectively). Mean numbers of previous laparotomies, of attempts at oocyte retrieval and of oocytes recovered per trial were similar in tubal patients with or without E 2CC. However, in the E 2CC tubal group mean age and basal FSH levels were somewhat higher, whereas E 2 peak values and fertilization rates were lower, leading to a greater proportion of trials without embryo transfer. Embryonic scores and the E 2/P ratio at day 3 of the luteal phase did not differ signficantly. It may be concluded that cancelling of a cycle because of a low E 2 response in a patient with tubal infertility is indicative of a poor prognosis in further IVF trials.

Fetal growth, reproductive capacity, and parasitemia were studied in three groups of BALB/c mice: pregnant and chronically infected with Trypanosoma cruzi, non-pregnant but similarly infected, and pregnant but noninfected. The pregnant mice were killed on day 17 of pregnancy. Comparisons of the two pregnant groups showed significant differences in fetal weights and x18 magnified ossification lengths of radius and cubitus, whereas placental weights were not modified. The results indicate that intrauterine growth retardation occurs during chronic murine T. cruzi infection. No difference was noted between the reproductive capacities of the two pregnant groups. Parasitemias were similar in infected pregnant and control groups. Mice of all groups survived infection until killing. Pregnancy, therefore, does not influence chronic murine T. cruzi infection. Parasites were never found in fetal blood, indicating a very low, if any, frequency of transplacental transmission of parasite during the chronic phase of infection., Journal Article, Research Support, Non-U.S. Gov't, SCOPUS: ar.j, info:eu-repo/semantics/published

One hundred forty-six embryo transfers were carried out in the In Vitro Fertilization (IVF) Clinic at St. Pierre Hospital, Brussels, between November 1983 and February 1985. In each of these cases a series of characteristics of the replacement procedure was systematically recorded. Analysis of these data in relation to pregnancy rates indicated that no significant differences appeared among three different operators, the absence or occurrence of cervical bleeding and subjective evaluation of the procedure were related to the chances of establishing a pregnancy, and the duration of replacement had no influence on the outcome of trials. A prospective randomized study of 100 replacements showed that no better pregnancy rate was obtained by placing patients in the knee-to-chest rather than the dorsal position and the addition of a rigid external sleeve to the catheter did not provide any advantage. A simplified method of replacement is thus advocated.

Between March 1983 and March 1986, 108 pregnancies were obtained at the IVF clinic of St Pierre Hospital in Brussels. There were 29 chemical pregnancies (26.8%), five ectopic pregnancies (4.6%), 15 abortions (14%) and 59 ongoing pregnancies of over 20 weeks (54%). Patients who had experienced a chemical pregnancy at first trial displayed a significantly higher rate of ongoing pregnancy at their second attempt. Among the 15 cases of abortion, a chromosomal anomaly was detected in two cases and suspected in a third. Four of the five ectopic pregnancies occurred in patients with previously documented tubal pathology. The ongoing pregnancies were distributed as 44 singletons, 13 pairs of twins, one set of triplets and one set of quadruplets. The Caesarian section rates were 21 and 40% for single and multiple pregnancies, respectively. The prematurity rate was low for singletons (4.5%) but reached 46.6% in multiple pregnancies. Two minor malformations were observed and five perinatal deaths occurred; among these latter, four cases were twins. It appears that perinatal pathology is substantially higher among IVF pregnancies than in the normal population. It is clear, however, that most of this difference is accounted for by the considerably higher rate of twin pregnancy displayed by the former group.

Four-hundred-and-ninety-one oocytes were collected from 142 successive patients attending for in-vitro fertilization. The systematic observation of pronuclei between 14 and 18 h after insemination revealed 27 cases of tripronucleate eggs among 391 fertilized eggs (6.9%), which corresponds to rates generally reported in the literature. The following parameters were analysed in relation to the incidence of these eggs: aetiology of infertility, follicular response to hormonal stimulation, type of ovulatory stimulus, sperm count and motility and the incidence of fertilization. Only fertilization rates and concentration of motile spermatozoa in the insemination medium were found to be correlated with tripronucleate eggs, confirming that the condition is predominantly due to polyspermy. Comparisons with data from animals, and measures aimed at preventing polyspermy are suggested.

Thirty-eight single and 10 multiple pregnancies obtained after in-vitro fertilization were compared. In the group of multiple gestations, maternal age was lower and the amounts of ovulatory drugs given were significantly smaller than in relation to single pregnancies. All multiple pregnancies arose from triple embryo transfers and the embryos from this group exhibited significantly higher vitality scores. In both groups, plasma levels of oestradiol and progesterone followed the same pattern until day 8 after oocyte retrieval. Following implantation, the secretion of these hormones increased more rapidly in multiple pregnancies pointing at greater luteal activity in this group. HCG levels became significantly higher in multiple gestation on day 25 after oocyte collection. Echographic examination showed that, compared to normal pregnancy, growth in both groups of IVF conceptuses was initially retarded but caught up with normal evolution at approximately 30 days after egg retrieval. The need for adjusting the number of embryos transferred not only to expected success rates but also to the risk of high rank multiples is emphasized.

The survival after transfer of frozen-thawed mouse blastocysts obtained from culture of in-vitro fertilized oocytes or 1- and 2-cell ova was compared. About 10% of transferred embryos developed to term in each group and there was no difference between embryos fertilized in vitro or in vivo. In addition to embryonic loss due to transfer, in-vitro cultivation and freezing reduced the proportion of fetuses considered viable at Day 15 of pregnancy (29.8 versus 50.7% and 26.3 versus 50.7% respectively). When used together these procedures had an additive effect on fetal wastage (18.4 versus 50.7%). In-vitro culture also entailed a significant increase of resorbing implantation sites (10.2 versus 4.3%). The re-expansion rate after freezing and thawing of blastocysts grown in vitro was paradoxically greater than that of blastocysts grown in vivo (85.8 versus 54.6%).

One hundred thirty-three couples were classified into four groups according to previous sperm analyses. These couples underwent 237 in vitro fertilization trials that led to 46 clinical pregnancies (19.4%/trial). Clinical pregnancy rate per laparoscopy of the group with male defects was significantly higher than that of the normospermic couples (25 versus 14%, P less than 0.05). The fertilization rate was significantly reduced only if two sperm anomalies were present (P less than 0.05). However, the mean number of embryos transferred did not differ significantly among the four groups, but the proportion of trials without transfer was increased with regard to the severity of sperm defect. Implantation rate per embryo in cases of triple transfer was significantly higher in the group with sperm anomalies as compared with the normospermic cases (18 versus 10%, P less than 0.02). Correction of the male problem through IVF treatment allows higher female fertility to be disclosed in these cases.

Forty-nine placentae from HIV-seropositive mothers were collected in various hospitals in France and Belgium. Twenty [corrected] placentae with seven fetuses from interrupted pregnancies and 29 [corrected] placentae from spontaneous deliveries, including two stillborns and a set of twins, were studied morphologically. No significant abnormalities were observed in the aborted material. The placentae corresponding to deliveries presented no significant gross abnormalities but the ratio of fetal to placental weight was significantly decreased in the study group compared with the control group (6.13 versus 7.41; P less than 0.001), associated with a congestive and mature aspect of the parenchyma. Histologically a high incidence of chorioamnionitis (43 per cent) was found, contrasting with the absence of villitis. A relative villous hypercellularity was observed in the study group compared with the control group. Ultrastructural studies of 13 placentae corresponding to gestations of 10 to 40 weeks are presented. In six cases, retrovirus-like particles were found at various sites, such as villous fibroblasts, syncytiotrophoblast and endothelial cells, and in the free membranes.

We have compared breech twins and breech single births in a population recorded between 1974 and 1978 in 10 Belgian maternity centers. In 190 twin pregnancies, 38 first and 65 second twins were delivered in breech presentation. These twins were compared to 853 singleton breeches, of which 95 delivered by cesarean section were excluded. Data were stratified according to birthweight. No significant difference between twins and singletons was found in terms of perinatal mortality rates. However, Apgar scores below 7 at 5 minutes were significantly less numerous among first twins than among singletons. Therefore, first twins in breech presentation might be at lower risk of fetal distress. This difference should be taken into account in the management of first twins presenting by the breech.

Crude RNA preparations from uteri of oestradiol-treated rats induced the implantation of delayed blastocysts when injected into the parametrium of ovariectomized pregnant rats. Treatment of donor animals with labelled oestradiol showed that this effect could not be due to contamination of the RNA extracts by oestradiol. RNase digestion of these extracts suppressed their capacity to induce implantation. Purified poly (A)-rich RNA from oestrogen-treated uteri failed to elicit implantation although it was capable of increasing epithelial height when repeatedly injected into uterine horns of ovariectomized rats. These results suggest that uterine RNA synthesis might somehow mediate the effects of oestrogen in causing implantation and that RNAs other than messenger RNA might be involved.