[Pregnancy after fertilization in vitro and embryo transfer]

The first 13 pregnancies established by in vitro fertilization and embryo transfer. A tubal factor was the main indication for in vitro fertilization (IVF) in 10 patients, whereas in three couples infertility was caused by the infertile sperm. The mean age and duration of infertility in female patients were 33.5 and 11.4 years, respectively. Multiple follicular growth was stimulated by either clomiphene citrate (100-150 mg during 5 days), clomiphene citrate + HMG + HCG, or HMG + HCG. Timing of ovulation was determined by assaying serum estradiol, progesterone and LH levels. The ultrasound monitoring of follicular growth was determined on a daily basis. Endogenous LH surge was observed in one patient, whereas in others 5000-10,000 IU HCG were needed to induce ovulation. All oocytes were recovered by laparoscopy. There were 3.8 oocytes per patient on an average. Fifty-six percent of oocytes were preovulatory. All oocytes were allowed to mature in vitro for 3 to 7 hours (mean 5.7 hours). The fertilization and cleavage rates were 76% and 72% respectively. Only one polyspermic fertilization was observed. Forty-five hours after the insemination the embryos between the 2-cell and 6-cell stages were reimplanted into the uterus. Using various ET cannulas, one to seven embryos per patient (2.7 embryos on the average) were replaced into the uterine cavity, 5 mm below the fundus. Only four embryo replacements were completely atraumatic. No medications were used for the luteal phase support. The corpus luteum function and early pregnancy were controlled by serial measurements of serum progesterone, estradiol and beta HCG. Three clinical miscarriages and full-term deliveries were recorded.(ABSTRACT TRUNCATED AT 250 WORDS)