Embryo donation in patients with primary ovarian failure

Abstract

Thirty-six infertile patients with primary ovarian failure, who were referred for oocyte (embryo) donation are reported. After substitution therapy with oestradiol valerate (per os) and progesterone (i.m. or per os), endometrial tissue was made receptive for embryonic implantation, although the endometrial biopsies on day 21 demonstrated a certain delay in development (of 1.6-2.4 days). Six patients became pregnant, three of them delivered four healthy babies, one pregnancy is progressing normally and two ended in an early clinical abortion.

A lower ongoing pregnancy rate can be expected when GnRH agonist is used for triggering final oocyte maturation instead of HCG in patients undergoing IVF with GnRH antagonists

“…Why luteal supplementation in the form of progesterone and E 2 alone does not sustain pregnancy rate is not clear, although it may be that the doses of progesterone and E 2 used are low. If this is the case, increased doses such as those used in patients with primary ovarian insufficiency (Devroey et al, 1988) might improve pregnancy rates. However, the beneficial effect of E 2 and progesterone in high doses after ovarian stimulation for IVF might not be the same as that in patients performing a frozen cycle.…”

Single and multidose pharmacokinetic study of a vaginal micronized progesterone insert (Endometrin) compared with vaginal gel in healthy reproductive-aged female subjects

“…Furthermore, orally administered progesterone has been shown to have limited efficacy in inducing an in-phase secretory endometrium, and evidence indicates a less favorable ART outcome using oral application compared with either the IM or vaginal route (1,9,10).…”

Careful cardiovascular screening and follow-up of women with Turner syndrome before and during pregnancy is necessary to prevent maternal mortality

“…Turner syndrome is often associated with short stature, hypogonadism, renal malformation, cardiac malformation, and hypertension (2), but in the first published reports of egg donation for these patients, no information was available on their health status (3,4). Risks of preeclampsia and hypertension in pregnant women with TS have been described in two studies (5,6).…”