Objective: To determine if a simple morphological classification of embryos was predictive of subsequent pregnancy. Design: Prospective case series. Setting: University-based in vitro fertilization (IVF) program. Patients, Participants: Consecutive embryo transfer (ET) cycles (n = 206). Interventions: Embryos were classified into three grades: (1) equal-size blastomeres with no fragmentation; (2) unequal-size blastomeres; and (3) evidence of fragmentation. Main Outcome Measures: Embryo quality, age, indication for IVF, and stimulation protocol were evaluated for their effect on pregnancy rates (PR's). Results: In cycles in which the best embryo transferred was grade 3, 2, or 1, the clinical PRs per ET were 0% (0/11 cycles), 12.8% (6/47 cycles, P < 0.05), and 21.8% (32/148 cycles, P < 0.05), respectively. When one, two, or three or more grade 1 embryos were replaced, the clinical PRs per ET were 15.6%, 16.3%, and 40% (P < 0.05), respectively. Using logistic regression, embryo quality (P = 0.0011) and patient's age (P = 0.0044) were the only variables that affected PRs. Conclusion: The transfer of more than two good quality embryos had a positive effect, patient's age had a negative effect on PRs after IVF-ET.
In a retrospective analysis of 637 cycles of ovarian stimulation and transvaginal follicular aspiration for various assisted reproductive technologies, severe ovarian hyperstimulation syndrome (SOH) occurred in six (0.94%) cycles. The patients at a high risk of developing SOH in cycles of assisted reproduction were those who had excessive serum oestradiol levels on the day of human chorionic gonadotrophin (HCG) administration (oestradiol > 6000 pg/ml; 38% SOH) and a high number of oocytes obtained (> 30 oocytes; 23% SOH). In those patients with both oestradiol > 6000 pg/ml on the day of HCG administration and > 30 eggs retrieved, the chance of developing SOH was 80%. The higher the serum oestradiol levels and the more eggs retrieved, the higher the pregnancy rates observed. High oestradiol level did not appear to have a detrimental effect on pregnancy rates and outcome. Furthermore, our results are not consistent with suggestions that the addition of gonadotrophin-releasing hormone agonist to ovarian stimulation protocols, follicular aspiration and/or luteal support with progesterone may reduce the incidence of ovarian hyperstimulation syndrome.
Larval, juvenile and adult Galaxias occidentalis were collected with a plankton net and a fine-meshed beach seine from the southern branch of the Collie River in south-western Australia at approximately monthly intervals between January 1984 and December 1986. Seasonal changes in the density of G. occidentalis in the main river and its tributary creeks, and concomitant changes in gonadosomatic index and ovarian morphology, were used to elucidate the reproductive biology of this species. Sexual maturation commenced in autumn and fish moved into small tributaries soon after these creeks had begun to flow in early winter. While spawning commenced as early as June, it peaked in August, when water temperatures started to rise, and was essentially completed by the end of September. Galaxias occidentalis reached maturity at the end of its first year of life. Some fish survived to spawn in the following year and a very limited number into a third, fourth and even a fifth year. Mean fecundity +/- 95% confidence limits increased from 725 +/- 69 in 0+ females (wtBAR = 2.8 g) to 1421 +/- 184 in 1+ females (wtBAR = 6.6 g) and 1538 +/- 449 in II+ females (wtBAR = 8.4 g). The mean diameter of mature, preserved eggs was 1.3 mm. A comparison of the data presented in this paper for G. occidentalis with those recorded for other galaxiids shows that spawning time, fecundity and egg size vary markedly within the family Galaxiidae.