BACKGROUND:Twin pregnancies in IVF should be avoided by transferring embryos one at a time, even for frozen cycles. In this study, we investigated the effect of blastomere lysis and cleavage in singleton frozen embryo transfer (sFET) cycles. Outcomes were compared with the transfer of two embryos in frozen transfer cycles (dFET).METHODS:A retrospective analysis was performed on 891 FET cycles, involving 404 sFET and 487 dFET cycles.RESULTS:Overall, in sFET cycles, the pregnancy and implantation rates were 8.9 and 8.7%. When blastomere lysis was more than 25% but no greater than 50%, the pregnancy and implantation rates were 3.2%. If blastomere lysis was greater than 50% there were no pregnancies. If blastomere lysis was less than 25%, but with no cleavage, the pregnancy and implantation rates were 4.1%. The results significantly improved (P = 0.007) in the group with less than 25% lysis, when cleavage occurred. The pregnancy and implantation rates for this group were 17.3 and 16.6%. This was not significantly different from unselected two embryo transfers (22 and 12.7%,P = 0.2 and 0.19, respectively). There were 21 twins with dFET (19.6% of pregnancies) and none in sFET.CONCLUSION:Both blastomere lysis and cleavage affect the outcome in sFET. To avoid the risk of twins, sFET should be considered when the embryo shows less than 25% blastomere lysis and at least one blastomere cleaves.

The aim of this study was to determine the accuracy of sexing fetal cells isolated from cervical mucus. Immunopositive cells identified using a fetal‐specific antibody were isolated and subjected to genetic analysis. Fetal sex was predicted in all 22 samples, as confirmed by analysis of the corresponding placental tissue. This study validates the accuracy of our test for sex diagnosis and confirms the ability to effectively recover and analyse fetal cells from the cervical mucus during early pregnancy.

A fact sheet to assist in assessing basal body temperature with sample charts is in this patient handout. (non-author abstract)

Background: The incidence of polycystic ovaries (PCO) in the Australian population is unknown.Aims: To determine the incidence of PCO in a random population of Melbourne women.Methods: A retrospective survey of the transvaginal ultrasound of female partners of sterile males was undertaken.Results: Twenty-three percent of subjects had polycystic ovaries on ultrasound criteria, 17% bilateral and 6% unilateral.Conclusions: The incidence of PCO in Australian women is similar to that of other Caucasian populations.

BACKGROUNDWith the further development of reproductive technology over the past 2 decades, options for subfertile couples have greatly increased.OBJECTIVEThis article discusses the assessment of common male and female causes of infertility and describes a logical routine for the investigation and treatment of the subfertile couple using a flow chart approach.DISCUSSIONWe suggest an approach to assessment for general practitioners, and outline the likely course of more sophisticated testing and treatments that their patients may then experience.

Background: To bring the success rate of in vitro fertilisation (IVF) procedures to an acceptable level, multiple embryos have historically been replaced. This has resulted in an 'epidemic' of multiple births. The pendulum has now swung full circle and the number of embryos transferred is now being limited. Such high numbers of IVF twins will not be produced in the future.Aim: To review retrospectively the outcome of a series of pregnancies achieved by IVF where the 6 week ultrasound showed the presence of two sacs.Methods: Retrospective study in a university IVF programme that produced 746 IVF pregnancies with twins at 6 weeks of gestation (1991-1999).Results: The main outcome measures were perinatal mortality, pregnancy outcome, gestation at delivery and obstetrics complications reported. Interestingly, by 20 weeks gestation, 184 (24.7%) of pregnancies spontaneously reduced to a singleton, whereas 49 (6.6%) lost both twins. Of the 513 (68.8%) viable twin pregnancies (> 20 weeks), 154 (20.6%) went on to term (> 37 weeks), whereas 250 (33.5%) delivered between 33 and 36 weeks gestation. The perinatal mortality per 1000 births was 6.5 over 37 weeks, 8.0 for 33-36 weeks, 41.7 for 29-32 weeks and 500 for under 28 weeks.

Australian and New Zealand Journal of Obstetrics and GynaecologyVolume 44, Issue 6 p. 580-582 If at first you don't succeed, try, try, try again: A successful birth after 37 cycles of assisted reproductive technology over 11 years Gabor T. KOVACS, Corresponding Author Gabor T. KOVACS Box Hill Hospital and Monash IVF, Monash University, Melbourne, Victoria, AustraliaCorrespondence: Professor Gabor Kovacs, Monash Medical School, Monash University, Box Hill Hospital, Nelson Road, Box Hill, Victoria 3128, Australia. Email: gab.kovacs@boxhill.org.auSearch for more papers by this authorDonna HOWLETT, Donna HOWLETT Monash IVF, Monash University, Melbourne, Victoria, AustraliaSearch for more papers by this author Gabor T. KOVACS, Corresponding Author Gabor T. KOVACS Box Hill Hospital and Monash IVF, Monash University, Melbourne, Victoria, AustraliaCorrespondence: Professor Gabor Kovacs, Monash Medical School, Monash University, Box Hill Hospital, Nelson Road, Box Hill, Victoria 3128, Australia. Email: gab.kovacs@boxhill.org.auSearch for more papers by this authorDonna HOWLETT, Donna HOWLETT Monash IVF, Monash University, Melbourne, Victoria, AustraliaSearch for more papers by this author First published: 06 December 2004 https://doi.org/10.1111/j.1479-828X.2004.00291.xCitations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume44, Issue6December 2004Pages 580-582 RelatedInformation

The transition of in vitro fertilization from research to standard clinical practice has, to a great extent, been as a result of the use of controlled ovarian hyper stimulation. A disadvantage of the availability of multiple embryos has been the replacement of several embryos leading to an epidemic of multiple pregnancies. This retrospective review of 2606 fresh embryo transfers between 2001 and 2003, where either one or two selected embryos were replaced from an available cohort of at least four, shows that single embryo transfers have a similar pregnancy rate without the risk of multiple pregnancy.

OBJECTIVE:To review the results of opinion polls on community attitudes to in-vitro fertilisation (IVF) and other aspects of assisted reproductive technology over a 20-year period.DESIGN, SETTING AND PARTICIPANTS:Fourteen Australia-wide interview surveys that included questions relating to IVF were carried out between July 1981 and November 2001 as part of regular Morgan polls of community attitudes on various topics. Each survey involved about 1000 respondents drawn from randomly selected "cluster points" in urban and rural locations.MAIN OUTCOME MEASURES:The proportion of people who approved or disapproved of various aspects of IVF treatment.RESULTS:Support for IVF to help infertile married couples increased from 77% in 1981 to 86% in 2001. Approval for IVF procedures being supported by Medicare funding rose from 70% in 1981 to 79% in 2000.CONCLUSIONS:Community approval of the use of IVF to treat infertility has risen significantly in Australia over the past 20 years.

A study was undertaken as a controlled comparison of two different superovulation induction protocols currently in use in major Australian in vitro fertilization (IVF) clinics. Thirty patients each from the Monash University and the Royal Women's Hospital (RWH) IVF programs were stimulated for ovulation induction by the other program. Once timing for oocyte retrieval was scheduled, all care reverted to the program from which the patient first came. Results given as pregnancies per patient commencing stimulation were: RWH patients on Monash protocol, 27%; RWH control patients, 15%; Monash patients on RWH protocol, 7%; Monash control patients, 13%. In the year preceding the trial pregnancy rates were 16.9% at Monash and 10.6% at RWH. Stimulation protocols were also compared with respect to each of administration, cost, and patient stress. The results of this cross-over trial demonstrated major differences between the two ovulation induction protocols studied, although it was not possible to conclude that differences in pregnancy rate were due to stimulation alone.

A randomized control trial involving 42 superovulated in vitro fertilization (IVF) patients was carried out to investigate the effects of providing supplementary progesterone (P) around the time of laparoscopy. P was given 12 to 15 hours and 1 hour before and 24 hours after laparoscopy in one group (group B); human chorionic gonadotropin was given 12 hours before laparoscopy in another group (group C); and the remainder received no treatment in addition to normal IVF procedures (group A). There was no difference in fertilization rate, the proportion of normally developing embryos, pregnancy rate, or birth rate between the treatment groups, We conclude that in the superovulation schedule used, P supplementation around the time of laparoscopy does not affect success rate of IVF.