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Control of human ovulation, fertilization and implantation.

Ovulation fertilization and implantation are studied in human beings. Control of ovulation involved the use of not more than 1125 IU human menopausal gonadotropin (HMG) as a means of stimulating follicular growth followed 6-9 days later by 5000 IU human chorionic gonadotrophin (HCG) to stimulate ovulation. The level of urinary estrogens and pregnanediol was used to monitor the follicular changes in the ovary and the corpus luteum respectively. Few patients ovulated before HCG was given. The level of urinary estrogens was found to be required to exceed 50 mcg/day before HCG could be given. Preovulatory follicles were recovered by laparoscopy. Using 1125 IU HMG an average of 11.6 follicles were recovered with 5.1 large follicles per patient. Oocytes taken from preovulatory follicles are the most suitable for studies of fertilization and cleavage. Fertilization took place in vitro with spermatozoa in concentrations of 10 less than 6 more than/ml devoid of seminal plasma in a medium of Tyrodes solution and albumin with pyruvat e and penicillin added and incubated at 37 degrees C for 1 1/2 hours. The culture media was ph 7.4. All the criteria normally used for fertilization are seen in human oocytes. Pronucleate eggs were transferred into supplemented Hams media F10 for further growth. Reimplantations of 14 embryos between the 8 and 16 cell stages of development into their mothers uterus by passing through the cervix a catheter of 2 mm diameter with a smaller canula containing embryo threaded through it were unsuccessfully attempted. In conclusion follicular stimulation the collection of oocytes fertilization and cleavage in vitro have been successful. Failure of implantation could be for reasons of uterine contraction unripe follicles at the time of HCG administration immature preovulatory oocytes the in vitro culture of embryos or genetic disorders in the embryo. Laparoscopic implantations of the embryo remains an untested method of reimplantation. Reproductive information gained from this research can be applied to new contraceptive techniques infertility and genetic disorders.