Resultados de 3 años de experiencia en reproducción asistida en el centro de biomedicina reproductiva FECUNDAR - Cali, Colombia

  • Jaime Saavedra S.
  • Rodrigo Muñoz Gil
  • Marco Julio Velásquez
  • Consuelo Jaramillo

Resumen

En este trabajo se reporta los resultados en reproducción asistida (FIV) del Centro de Biomedicina Reproductiva (FECUNDAR) Cali - Colombia durante el período 1995-1998.

Se incluyen un total de 254 ciclos iniciados dando como resultado 55 embarazos clínicos con 38 nacidos vivos, lo que da una tasa del 20.2% de nacidos vivos por trasferencia; se utilizaron dos esquemas de inducción de ovulación: GnRH más hMG y Citrato de Clomifeno más hMG, las tasas de embarazo fueron 28.1% y 6.7% respectivamente. El promedio de edad de las pacientes fue de 35 años, encontrándose la mayor tasa de embarazos entre los 25 y 35 años (25.5%) cayendo dramáticamente a 9% después de los 40 años. La principales causas de ingreso al programa de FIV fue la patología tubárica, 120 casos, y Otras causas femeninas 48 casos con unas tasas de embarazos del 32.3% y 34.3 % respectivamente, la infertilidad masculina 19 casos, la múltiple 40 casos, la inexplicada 27 casos presentaron tasas de embarazos de 15.4 %, 17.5% y 13% respectivamente.

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Biografía del autor/a

Jaime Saavedra S.

Profesor Titular. Departamento de Obstetricia y Ginecología. Universidad del Valle. Jefe del Servicio de Medicina Reproductiva. Departamento de Obstetricia y Ginecología. Universidad del Valle. Director General FECUNDAR.

Rodrigo Muñoz Gil

Obstetra y Ginecólogo. Biomedicina Reproductiva. Director
Médico FECUNDAR.

Marco Julio Velásquez
Obstetra y Ginecólogo. BiomedicinaReproductiva. FECUNDAR.
Consuelo Jaramillo
Bióloga. FECUNDAR.

Citas

Steptoe PC, Edwards RG. Birth after reimplantation of human embryo. Lancet 1978; 2: 366-370.

Lopata A, Johnston JWH, Hoult IJ, Speirs AI Pregnancy following intrauterine implantation of an embryo obtained by in vitro fertilization an embryo obtained by in vitro fertilization,of preovulatory egg. Fertil Steril 1980; 33: 117-123.

Heape W. Preliminary note on the transplantation an growth of mammalian ova human in vitro fertilization research. Am J Obstel Gynecol 1983; 146:477-482.

Kerin J, Quinn P Herriot D, Wilson L, Stone B. Effects of follicle induction on ovary and endometrium. In: De Cherney AH (Ed) The control of follicle development, ovulation and luteal function: Lessons from In Vitro Fertilizations. New York, Raven 1987; 112-124.

With in a uterine foster mother. Proc R Soc. 1891 ; 48: 457-465.

Hammond J. Culture of mouse embryos using an egg-saline medium. Nature 1949; 163: 28-33.

Whitten WK. Culture of tubal mouse ova. Nature 1956; 177:96-101.

Austin CR. Observations of the penetration of the sperm into the mammalian egg. Aust J Sci Res 1951; 134:581-586.

Chang M C. Fertilization capacity of spermatozoa deposited in fallopian tubes. Nature 1951; 168:697-702.

Chang MC. Fertilization of rabbit ova in vitro.Nature 1959; 184:406- 411.

Kering JF, W amer GM, Quinn P Jet al. Inciden ce of multiple pregnancy after in vitro fertilization and embryo transfer. Lancet 1983; 2: 537- 542.

Lopata A. Concepts in human in vitro fertilization and embryo transfer. Fertil Steril. 1983; 40: 289-294.

EdwardsRG. In vitro fertilization and embryo replacement: Opening lecture. Ann NY Acad. Sci. 1985; 442-449.

Marrs RP, Vargyas JM, Saito H et al. Clinical applications of techniques used in Smitz J, Ron- El R, Tarlatzis BC. The use of gonadotrophin releasing hormone agonist for in vitro fertilization and other assisted procreation techniques: Experience from three centers. Human Reprod 1992; 7(suppl) 49-54.

Ron-EL R, Herman A, Golan A, Nachum H, Soffer Y, Caspi E. Gonadotropins and releasing hormone agonist: Gonadotropins

protocols in randomized prospective study. Fertil Steril 1991 ; 55: 574-579.

HermanA, Ron-El R, Golan A, Nachum H, Soffer Y, Caspi E. Follicle cysts following menstrual versus mid luteal administration of Gonadotropins hormone analog in IVF. Fertil Steril 1990; 53: 854-859.

Meldrum DR, Wiscot A, Hamilton F, Gutiay AL, Huynh D, Kempton W. Timing of initiation and dose schedule of leuprolide influence the time course of ovarian suppression. Fertil Steril

; 50:400-405.

Ron-El R, Herman A, Golan Van der Ven H, Caspi, Diedrich K. The comparison of early follicular and mid luteal administration of long acting gonadatropin releasing hormone agonist. Fertil Steril '1990; 54: 233-238.

Benadiva CA, Blasco L, Tureck R, Mastroianni L, Flickinger GL. Comparison of different regimens of Gonadotropins releasing hormone analog during ovarian stimulation for in vitro fertilization. Fertil Steril 1990; 53: 4 79-85.

Lejeune B, Barlow P, Puissant F, Delvigne A, Vanrys selberge M, Leroy F. Use of busereling acetate in an in vitro fertilization program: A comparison with classical clomiphene citrate -human menopausal gonadotropin treatment. Fertil Steril 1990; 54: 475-81.

Abdalla HI, Ahuja KK, Leonard T, Morris NN, Honour JW, Jacobs HS. Comparative trial of lutenizing hormone realising hormone analog /human menopusal gonadotropin in an assisted conception program. Fertil Steril 1990; 53:473-478.

Ferrier A, Rasweiler JJ, Bedford JM, Prey K, Berkeley AS. Evaluation of leuprolide acetate and gonadotropins for in vitro fertilization or gamete intrafallopian transfer. Fertil Steril 1990; 54: 90-95.

Lavy G, Restrepo Candelo H, Diamond M, Shapiro B, Grunfeld L, De Cherney AH. Laparoscopic and trasvaginal ova recovery : The effect on ova quality. Fertil Steril, 1988; 49: 1002-1006.

Parsons J, Riddle A, Booker M , et al. Oocyte retrieval for in vitro fertilization by ultrasonically guide needle aspiration via the urethra. Lancet 1985; 1: 1076-1081.

Schulman JD, Dorfmann A, Jones S, Joyce B, Hanser J : Ooccyte retrieval and local anesthesia. N Engl J Med 1985; 312: 1639- 1644.

Booker M, Parsons J. The perurethral technique for ultrassound directed follicle aspiration in an in vitro fertilization and embryo transfer programme: A report of 636 patients cycles. Br J Obstet Gynecol 1990; 97: 499-504.

Parsons J, Pampiglione JS, Saddler AP, Booker MW, Campbell S. Ultrasound directed follicle aspiration for ooccyte collection using the perurethral technique. Fertil Sterill990; 53:97-102.

Lewin A, Laufer N, Rabinowitz R, Margalioth EJ, Bar I, Schenker JG. Ultrasonically guided oocyte collection under a local anesthesia: The first choice method for in vitro fertilization. A comparative study with laparoscopy. Fertil Steril 1986; 257-262.

Dellenbach P, Nisand I, Moreau, et al. Transvaginal sonographically controlled ovarian follicle punture for egg retrieval . Lancet 1984; 1:

-1472.

Kingsland CR, Taylor CT, Aziz N, Bickerton N: Is follicular flushing necessary for oocyte retrieval ? A randomized trial . Hum Reprod 1991 ; 6:382-387.

Coetsier T, Dhout M, De Sutter P, Merchiers E, Versichelen L, Rossell MT. Propofol anaesthesia for ultrasound guide oocyte retrieval: Accumulation of an anaesthetic agent in follicular fluid .Hum Reprod 1992; 7: 1422-1427.

Boyers SP, Lavy G, Rossel JB, De Cherney AH. A paired analysis of in vitro fertilization and cleavage rates, of first versus last recovered preovulatory human oocytes exposed to varying intervals of 100% pneumoperitoneum and general anesthesia. Fertil Steril 1987; 48: 969-974.

Schoeffler PF, Levron JC, Jany L, Brenas FJ, Pouly JL. Follicular concentration of fentanyhl during laparoscopy for oocyte retrieval: Correlation with in vitro fertilization results. Anesthesiology 1998; 69: 663-668.

Bailey Priedham D, Dreshef E, Drury K, Cook C L, Hurst H E, Yussman MA. Follicular fluid Lidocaine levels during trasvaginal oocyte retieval . Fertil Steril 1990; 53: 171-176.

Daya S, Kohut, Gamby J, Yaounglay E. Influence of biood clots in cumulus complex on oocyte fertilization and cleavage. Human Reprod 1990; 15: 744-749.

Veeck LL. Extracorporeal maturation. Norfolk, 1984, Ann NY Acad Sci 1985;442: 357-367.

Veeck LL. The morphologic estimation of mature oocytes and their preparation for insemination. In vitro fertilization -Norfolk. Williams

and Wilkins, Baltimore, 1986a; 81-92.

Lopata A, Patuelo MS, Chang A, James B. A method for motile spermatozoa from human semen .Fertil Steril1976; 27:677- 684.

Mahadevan MM, Trounson AD. The influence of seminal ·characteristics of the succes rate of human in vitro fertilization . Fertil Steril 1984; 42: 400-405.

WolfDP, Byrd W, Dandekar P, Quingley MM. Sperm concentration and fertilization of human eggs in vitro. Biol Reprod. 1984; 31 : 837- 848.

Young Lai EW, Daya S. Increased fertilization of human oocyte with low density at insemination. J In Vitro Fert Embryo Transfer 1991; 8: 176-177. .

Cohen J, De Mounzon S, Lancaster P. World Collaborative Report: VIII World Congress on In vitro Fertilization and alterna te Assisted Reproduction. Oct, 1993, Kyoto, Japan.

AIH. National Perinatal Statistics Unit, Fertil Society of Australia: Assisted Conception Australia and New Zealand 1989, Sydney, Australia Fertility Society, 1991 .

Sepalla M. The world collaborative report on in vitro fertilization and embryo replacement: Current State of the art in January 1984, Ann NY Acad Sci 1984; 442: 558-564.

Cohen J, De Mounzon J, Lancaster P, World Collaborative Report 1991 , published during The 8th World Congress of iVF in Kyoto, 1993.

Lopata A. Concepts in human in vitro fertilization embryo transfer. Fertil Steril 1983; 40: 289-294.

Mars RP, Vargas JM, Saito H et al. Clinical applications of techniques used in human in vitro fertilization research. Am J Obstet Gynecol 1983; 146: 477-482.

Kering J, Quinn P, Herriot D, Wilson L, Stone B. Effects of follicle induction on ovary and endometrium. In De Cherney A H (Ed) The control of follicle development, ovulation and luteal function: Lessons from In Vitro Fertilization. New York, Raven, 1987; 112-126.

Mahadevan MM, Fleetman J, Taylor PJ, LeaderA, Pattinson AH. The effect of the day of luteinizing hormone surge and the outcome of in vitro fertilization. Fertil Steril 1987 ; 47 : 976-981.

KoKKo E, Janne O, Kauppil A, Vinhko R. Cyclic clomiphene citrate treatment lowers cytosol estrogen and progentin receptor combination in the endometrium of postmenopausal women on estrogen replacement therapy. J Clin Endocrinol Metab 1981; 52: 345-536.

Laufer N, Pratt B, De Cherney AH, Naftolin F, Merino M, Markert CL. The in vivo in vitro effects of clomiphene citrate on ovulation , fertilization and development of coltured mouse oocytes. 1983; 147: 633-638.

Laufer N, Barr I, Lewin A, et al. Clomiphene citrate inhibits progesterone secretion o human granulosa luteal cells in long term culture. Proceeding of the 4th World Congress on IVF, Oct 1985, Melbourne, Australia

Olsson JH, Nilson L, Hillensjo T. Effect of clomiphene isomers on progestin synthesis in cultured human granulosa cells. Human Reprod 1987; 2: 463-468.

Seibel MM. The effect o clomiphene citrate on human preovulatory oocyte maturation in vivo. J In Vitro Fert Embryo Transfer 1989; 6 : 3-8.

Laufer N, De Cherney AH, Haseltine FP, et al. The use of high dose of human menopausal Gonadotropins (HMG) in an in vitro fertilization program. Fertil Steril 1983; 40: 734 -739.

Laufer N, De Cherney AH, Haseltine FP, et al. Human in vitro fertilization employing individualized ovulation induced by human menopausal gonadotropin. J In Vitro Fert Embryo Transfer . 1984; 1: 56-61.

Jones GS, GarciaJE, Rosenwaks Z. The role of pituitary gonadotropins in follicular stimulation and ocyte maturation in the human. J . Clin

Endocrino Metab 1984; 59: 178-183.

Moasher SJ, Garcia JE, Rosenwaks Z. The combination of FSH and HMG for induction of multiple follicular maturation for IVF. Ferti Steril 1985; 44: 62-68 .

Jones GS, Acosta AA, Garcia JE, Bernardus RE, Rosenwaks Z. The effect of FSH without additional LH, on follicular stimulation and oocyte development in normal ovulatory women. Fertil Steril 1985; 43: 696-701.

Navot D, Rosenwaks Z. The use of FSH for controlled ovarían hyperstimulation in IVF. J . In Vitro Fert Embryo Transfer 1988 ; 5: 3-8.

Polan ML, Danielle A, Russel JB . Ovulation induction with HMG compared to pure FSH results in differences in FF androgen levels. Presented at the 42nd AnnualMeeting of the American Fertil Society, April, 1986, Toronto, Ontario

Mizununa H, Takagi T, Honjyo S, Ibuki Y, Igarashi M. Clinical pharmacodynamics of urinary follicle stimulating hormone and its applications for pharmacokinetic stimulation program. Fertil Steril 1990; 193 : 263-271.

Out HJ, Mannaerts BMJL, Driessen SGAJ, Coelingh-Bennink HJT. A prospective, randomized, multicentre study comparing recombinant and urinary follicle stimulating hormone (Puregon vs. Metrodin) in vitro fertilization . Human Reprod 1995; 10: 2534-2540.

Laumaye E, Alvarez S, Barlow D et.al Efficacy of recombinant human follicle stimulanting hormone (Gonal F) for stimulating multiple follicular development in assisted reproduction technologies In Morit , Aono T, Tominaga T, Hiroi M (eds) Proceeding s of the VIII Th World Congress on in vitro Fertilization and Alternate Assisted Reproduction, Kjoto, Japan, Sep 1993.

Flemening R, Haxtron MJ, Hamilton MP et al. Successful treatment of infertil women with oligomenorrea using a combination of an LH-RH agonist and exogenous gonadotropins. Br J Obstet Gynaecol 1985 ; 92: 369-375.

Neven S, Hedon B, Bringer Jet al. Ovarian stimulation by combination of a gonadotropin -realizing hormone agonist and Gonadotropins for in vitro fertilization Fertil Steril1987; 47 : 639-645.

Palermo R, Amadeo G, Navot D, Rosenwacks R. Concomitant gonadotropin-realizing hormone agonist and menotropin treatment for the synchronized induction of multipie follicles. Fertil Steril 1988; 48: 290-296.

Smitz J, Ron-El R, Tarlatzis BC. The use of gonadotropin realizing · hormone agonist for in vitro fertilization and other assisted procreation techniques: Experience from the three center. Human Reprod 1992; (Suppl 1) 7: 49-55.

Lenton EA, Sexton L, Lee S, Cooke ID. Progressive Changes in LH/ FSH ratio in women throughout reproductive live. Maturitas, 1988; 10: 35-39.

Scott RD, Toner JP, Muasher SJ. Follicle-stimulanting hormone levels on cycle day 3 are predictive of in vitro fertilization outcome. Fertil Steril1989; 51 651-656.

Publicado
1999-09-30
Cómo citar
1.
Saavedra S. J, Muñoz Gil R, Velásquez MJ, Jaramillo C. Resultados de 3 años de experiencia en reproducción asistida en el centro de biomedicina reproductiva FECUNDAR - Cali, Colombia. Rev. Colomb. Obstet. Ginecol. [Internet]. 30 de septiembre de 1999 [citado 21 de octubre de 2019];50(3):171-7. Disponible en: https://revista.fecolsog.org/index.php/rcog/article/view/999
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