Birth of two infants with normal karyotype after intracytoplasmic injection of sperm obtained by testicular extraction from two men with nonmosaic Klinefelter's syndrome.

Objective: To report two births of a healthy male and a healthy female baby after use of testicular spermatozoa from two patients with nonmosaic Klinefelter's syndrome.

Design: Case report.

Setting: General academic hospital with IVF center and university institute of human genetics.

Pregnancy after in vitro fertilization, cryopreservation, and embryo transfer.

We reported on the first pregnancy achieved in the Erlangen IVF program after cryopreservation and embryo transfer. After hMG stimulation in the first treatment cycle, nine oocytes were retrieved by laparoscopy from a 31-year-old woman and three embryos transferred. Five other oocytes were fertilized and developed to four- to eight-cell embryos, which were subsequently cryopreserved.

[Ultrasound controlled follicle puncture in the "2 instrument technic"].

The authors present a new instrumentarium for ultrasonically guided transabdominal-transvesical follicular puncture. Permanent sonographic imaging of the puncture cannula and precise puncturing without being impeded by the resistance of the abdominal wall are provided by an attachment functioning as an adjustable target device developed for the soundhead of the sector scanner DIASONICS DS 1 and by introduction of a trocar with a puncture cannula sliding within the trocar at low resistance ("two-instruments technique"). In 12 women, 47 follicles were punctured, 30 human oocytes were collected, 12 embryos transferred and two pregnancies achieved after in vitro fertilisation (twins in one woman, a single child in another).

In vitro fertilization and embryo transfer of pre-ovulatory rabbit oocytes.

The objective of this study was to develop an effective and successful technique of in vitro fertilization in rabbits that could lead us to start treatment of infertile couples by using extracorporal fertilization. Pre-ovulatory oocytes were harvested from follicles of virgin does 9 h after induction of ovulation by hCG injection, and incubated with in vivo capacitated sperm for 5 h. An 82% in vitro fertilization rate was achieved.

[Induction of secondary labor in triplet pregnancy].

After premature birth of the first triplet we successfully delayed the delivery of the remaining triplets for 21 days until the 29th week of gestation. The 36 year-old patient from Africa (Uganda) was suffering secondary sterility due to bilateral salpingectomy. After transfer of four in-vitro fertilised eggs, triplets were diagnosed ultrasonographically in the 7th week of gestation.

[Comparison between the radioimmunologic measurement of plasma E2 and estrogen determination in urine using a hemagglutination inhibition test].

To prove the diagnostic value of a new haemagglutination inhibition test (HI-Estrotec), urinary and plasma oestrogens were simultaneously measured in 42 stimulated cycles of 40 women of the Erlangen IVF programme. Comparing the results of all paired samples, there was a correlation coefficient r = 0.6968.

Triploid embryo after in vitro fertilization.

A case of a triploid embryo (69,XXX) resulting from in vitro fertilization is reported. The pregnancy ended in spontaneous abortion 44 days after embryo transfer. The embryo showed anomalies considered typical of triploidy but molar changes were not noted.

Experiences with the first 100 consecutive pregnancies achieved after in vitro fertilization and embryo transfer at the University Women's Hospital in Erlangen.

As of March 31, 1985, 100 clinical pregnancies have been achieved since the program for extracorporeal fertilization was started in Erlangen. 531 (71%) of 768 follicular punctures resulted in an embryo transfer. The overall pregnancy rate is 13% with regard to the total number of laparoscopies and 19% with regard to the number of embryo transfer.

A new set of instruments for sonographically controlled follicular puncture.

A new device for sonographically controlled follicular puncture was introduced which improves both safety and comfort during egg retrieval. A steering attachment developed especially for the transducer of the DIASONICS DS 1 sector scanner increased the precision of transabdominal-transvesical follicular puncture. The "two-instrument method" (aspiration needle gliding smoothly within a trocar) ensured highly reliable, continuous sonographic imaging of the aspiration needle as well as precise puncture without the procedure being hindered by tissue resistance.

[Pregnancy following ultrasound guided transabdominal-transvesicle follicle puncture under peridural anesthesia within the scope of an IVF program].

The authors report on the case of a 28-year old married woman who was treated according to their IVF-programme after both Fallopian tubes had been removed Three embryo transfers after follicular aspiration by laparoscopy and IVF did not lead pregnancy. In a fourth attempt in May 1984 ovarian stimulation was effected via hMG (Pergonal); 10,000 IU hCG were administered on day 12 of the menstrual cycle. 35 hours later 7 oocytes were recovered via ultrasonically guided percutaneous follicular aspiration under epidural anaesthesia.

[The Erlangen in-vitro fertilization program--results to date].

The authors describe the development of the Erlangen in-vitro fertilisation programme during the past 2 1/2 years. Details of the instrumentarium and of the individual steps are described, such as stimulation and control of cycle, follicle puncture and embryo transfer. By 31.

[Use of frozen sperm for in vitro fertilization. A case report].

A case of a man with a malignant testicular tumor is reported; during the time between orchiectomy and retroperitoneal lymphadenectomy his semen was preserved and stored in liquid nitrogen (-196 degrees C). Due to postoperative ejaculation disturbance resulting in infertility of the husband, artificial insemination with cryopreserved semen was performed over a period of 9 months without leading to conception. During a laparoscopy and perturbation, which were combined with an attempt for in vitro fertilization (IVF), three oocytes were collected and fertilized in vitro by cryopreserved spermatozoa of the husband.

[Contrary trends of treated carcinomas of the cervix and breast. Observations in a hospital with a relatively low population mobility between 1963 and 1982].

In a clinic serving a district area with a rather constant population the number of clinical carcinomas of the cervix dropped during the past two decades, whereas during the same period the number of carcinomas of the breast which were clinically identifiable showed a four-fold increase. The diagnostic criteria are comparable. No explanation for this development trend can be offered.

Hormonal and ultrasonic characteristics of 23 clomiphene citrate stimulated cycles resulting in pregnancies after in vitro fertilization and embryo transfer.

In vitro fertilization (IVF) and embryo transfer (ET) were successful in 24 clomiphene citrate stimulated cycles in 22 patients. Ovarian follicular growth was monitored by ultrasound (US) and serum estradiol (E2) concentrations in order to determine the most favorable time for the induction of ovulation by administration of human chorionic gonadotropin (hCG). The day of the hCG injection was considered day 0.

Improvement of follicular puncture and oocyte recovery at Erlangen.

The instruments for oocyte collection for IVF developed at Erlangen as a result of experience over a period of two years are described in detail. In a consecutive series of 30 IVF attempts (30 patients), 77 oocytes were collected from 78 follicles. The advantages of our very simple and successful system are discussed, and compared to other systems.

Bilateral tubal pregnancy following in vitro fertilization and embryo transfer.

A case of bilateral tubal pregnancy resulting from in vitro fertilization and the transfer of two embryos is reported. Because the husband had retrograde ejaculation after surgical treatment of a malignant testicular tumour, cryopreserved semen was used.

[Cryoconservation of 8-celled stage rabbit embryos in an automated "open system"].

Rabbit embryos were successfully frozen at the 8-cell stage, employing a rapid and a slow freezing-thawing program. They were then stored at -196 degrees C (liquid nitrogen) for 10 to 60 days. After thawing the embryos were examined for viability in vitro and in vivo.

Luteal phase following oocyte aspiration, in vitro fertilization, and embryo transfer in clomid/HCG-stimulated cycles.

Using basal body temperature and repeated radioimmunological plasma progesterone estimations we monitored the luteal phase in seven patients after the administration of Clomid/hCG, oocyte recovery, in vitro fertilization and embryo transfer. In six of these women, the transferred embryos did not implant, and they bled 13--16 days after oocyte recovery. Neither the basal body temperature charts nor the plasma progesterone levels provided any indication of a luteal phase defect, being indistinguishable from those obtained in a control group of healthy women during the natural cycle.