RESUMO
OBJECTIVE: To evaluate the safety and efficacy of immunosuppression as an adjunct to improving the success of in vitro fertilization/embryo transfer (IVF-ET). STUDY DESIGN: A randomized, double-blind, placebo-controlled clinical trial. RESULTS: Seventy-five patients were randomized to receive either prednisone (39 patients, 51%) or placebo (36 patients, 49%). Patients in both groups had similar ages and numbers of preembryos transferred. CONCLUSION: Both the implantation and clinical pregnancy rates were higher in the prednisone group (16% vs. 11% and 43.5% vs. 32.3%, respectively). However, these differences did not achieve statistical significance. Evaluation of the ongoing pregnancy rate revealed little difference between the prednisone-treated patients (30.7%) and those receiving placebo (28.0%). There were no side effects reported by patients in either group.
Assuntos
Transferência Embrionária/normas , Fertilização in vitro/normas , Terapia de Imunossupressão/normas , Taxa de Gravidez , Adulto , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Fertilidade/efeitos dos fármacos , Fertilidade/fisiologia , Glucocorticoides/farmacologia , Humanos , Metilprednisolona/farmacologia , Prednisona/farmacologia , GravidezRESUMO
We injected a fluorescent lineage tracer (Texas Red-lysine-dextran) into individual blastomeres of donated human diploid 2- to 8-cell pre-embryos and cultured them to blastocysts. Once pre-embryos reached the expanded blastocyst stage, they were fixed and examined in a scanning confocal microscope to identify the location of fluorescent tracer. In successfully injected pre-embryos that developed to expanded blastocysts, we found that randomly injected blastomeres formed both trophectoderm (TE) and inner cell mass (ICM). More labelled progeny were found in TE than in ICM. Our results show that individual early blastomeres are not yet committed to form either TE or ICM but instead can form both rudiments.
Assuntos
Blastômeros/fisiologia , Fase de Clivagem do Zigoto , Embrião de Mamíferos/fisiologia , Desenvolvimento Embrionário e Fetal , Trofoblastos/fisiologia , Linhagem Celular , Embrião de Mamíferos/citologia , Feminino , Humanos , Microscopia ConfocalRESUMO
Although reports of local injection of MTX in the treatment of EP appeared to be promising, our results do not confirm the efficacy of this approach. Our experience was sufficiently discouraging to prompt discontinuation of a randomized trail; our hope is that others will add to the accumulating data base so that the role of local injection of MTX can be clarified.
