The recovery of human preovulatory oocytes fertilisation in vitro cleavage and embryo transfer.

An attempt was made to overcome infertility in 27 women by recovery of preovulatory oocytes fertilization in vitro and reimplantation of well cleaved embryos. The technique for laparoscopic recovery of oocytes is described in detail. Contraindications to laparoscopic recovery of oocytes include the excretion of less than 40-50 mcg/day of urinary estrogens on the day of human chorionic gonadotropin (HCG) stimulation untreated ovarian endometriosis previous salpingoplasty or salpingectomy and periovarian adhesions. Methods for priming the ovary and the preparation of donor semen are described. Pronucleate eggs are transferred approximately 12-15 hours after insemination into medium F10 supplemented in various ways with fetal calf serum bovine serum albumin or serum from the patient. Some embryos are rcleaved to the blastocyst stage in this medium. Cleaved embryos are reimplanted high into the uterus near the fundus. Most patients were given supplementary treatments with progesterone and ritodrine was administered just before and after the time of reimplantation to suppress myometrial contractions. For the most part the results of the study were negative. The only evidence suggestive of implantation was a delayed return to menstruation in some patients. Possible explanations for the failure of the method are discussed