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The Oldham Notebooks: an analysis of the development of IVF 1969–1978. III. Variations in procedures

机译:《奥德姆笔记本》:试析1969-1978年的试管婴儿。三,程序变化

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A survey is presented of the various technical and scientific challenges that had to be met during the 10-year period before the first successful live birth after IVF and embryo transfer was achieved, and the approaches used to meet these challenges is discussed. Records dated from January 1969 to July 1978 indicate that a minimum of 282 women were involved in 495cycles scheduled for laparoscopic oocyte recovery, of which 457cycles (92%) proceeded to attempted egg collection. A total of 1361 eggs were recovered over 388cycles, of which 1237 (91%) are recorded as having been inseminated in 331 (85%) of these cycles. Approximately 221 embryos were described in 165 (43%) of the 388cycles. A total of 112 embryo transfers were attempted, which resulted in five clinical pregnancies with two live births. This paper discusses the ways in which hormonal stimulation of follicle growth to the pre-ovulatory stage was varied, and the endocrine monitoring of these variations in blood, urine and follicular fluid, as well as their influence on egg recovery and fertilization rates. Variations in media composition and preparation are also described. It is concluded that, whilst driven by scientific reasoning, the approach adopted in trying to achieve successful IVF was empirical rather than evidence-driven.
机译:在完成IVF和胚胎移植后的首次成功活产之前的十年中,提出了一项针对在十年期间必须解决的各种技术和科学挑战的调查,并讨论了用于应对这些挑战的方法。 1969年1月至1978年7月的记录表明,至少有282名妇女参与了计划进行腹腔镜卵母细胞恢复的495个周期,其中457个周期(占92%)进行了尝试收集卵子的过程。在388个循环中共回收了1361个卵,其中1237个(91%)被记录为在这些循环中的331个(85%)被授精。在388个周期的165个周期(43%)中描述了大约221个胚胎。总共尝试了112次胚胎移植,导致5例临床妊娠中有2例活产。本文讨论了改变促排卵前荷尔蒙分泌的荷尔蒙的方式,以及对这些血液,尿液和卵泡液变化的内分泌监测,以及它们对卵回收率和受精率的影响。还描述了培养基组成和制备的变化。结论是,尽管受到科学推理的推动,但为成功实现试管婴儿而采用的方法是经验性的,而非循证的。

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