An inclusion fluorescent-antibody assay (IFA) with McCoy cells infected with Chlamydia trachomatis serovar L2 was compared with a single-antigen (L2) microimmunofluorescence (MIF) assay for the detection of antichlamydial antibodies. A total of 562 serum specimens were tested by both assays, and sera representing a range of titers were tested for their ability to neutralize the infectivity of C. trachomatis. Overall, there was poor correlation between the two assays (r2 = 0.62). With most sera the inclusion IFA was more sensitive. There was better correlation between IFA titer and ability to neutralize the five serovars tested (L2, L3, C, E, and F) than between the MIF assay and neutralization. In summary, the IFA appeared to be more sensitive than the MIF assay for detecting antibodies to C. trachomatis.
To date the main limitation of in-vitro fertilization-embryo transfer (IVF-ET) programmes is that transcervical transfer of embryos results in a rate of low implantation. On the other hand, the technique of gamete intra-Fallopian transfer (GIFT) does not contribute to information on oocyte fertilization rates, and the time of oocyte exposure to sperm may be limited. The development of ultrasonically guided follicular aspiration will allow transfer of embryos generated in vitro to the Fallopian tubes performing only one surgical procedure in the process. We have performed 25 intra-tubal embryo transfers in the cynomolgus monkey (Macaca fascicularis). Ovarian stimulation, follicular aspiration and IVF procedures have been reported previously by Balmaceda. ETs were performed via laparotomy. Embryos at the 2-, 4- or 9-cell stage were loaded into a tom-cat catheter in 5 microliter of culture medium and delivered to the mid-ampullary portion of the tube. Seven ETs performed during stimulated cycles resulted in one pregnancy, and 18 ETs performed in synchronized recipients resulted in six pregnancies. Ten ETs were performed 0-24 h, eight performed 24-48 h and seven performed 72-110 h after follicular aspiration or ovulation, and resulted in 4, 3 and 0 pregnancies respectively. Our results demonstrate that intra-tubal embryo transfer can result in normal intra-uterine pregnancies and suggest that both ovarian stimulation and cycle synchronization affect the probability of embryo implantation.
We have combined intrauterine insemination (IUI) and controlled ovarian hyperstimulation (COH), for the treatment of infertility due to different aetiologies, prior to performing GIFT. To date, we have treated 186 patients over a total of 489 cycles. The mean age of the patients was 34.1 +/- 4 years and the mean duration of infertility was 4.8 +/- 2.8 years. Follicular development was induced with human menopausal gonatrophin (HMG). Patients were monitored using serum oestradiol determinations and ovarian ultrasound. Two intrauterine inseminations were performed 12 and 36 h after HCG injection. Semen samples were prepared utilizing one of two techniques, swim-up or Percoll gradient. A total of 33 pregnancies have occurred, the gross pregnancy rate being 17.7% per patient and 6.7% per cycle. The cumulative pregnancy rate was 30%. Thirty-one pregnancies (94%) occurred within the first four cycles of treatment. During the same period of time, the pregnancy rate per cycle in patients treated with gamete intra-Fallopian transfer (GIFT) was 32.9%. Our data suggest that IUI combined with COH can result in pregnancy in a significant proportion of patients, but that the efficiency per cycle of the technique is significantly lower than GIFT.
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