Elder Kay, Johnson Martin H
Bourn Hall Clinic, Bourn, Cambridge CB23 2TN, UK.
Anatomy School and Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, Downing Street, Cambridge CB2 3DY, UK.
Reprod Biomed Soc Online. 2015 Jun;1(1):19-33. doi: 10.1016/j.rbms.2015.04.004.
A survey is presented of the various technical and scientific challenges that had to be met during the 10-year period before the first successful live birth after IVF and embryo transfer was achieved, and the approaches used to meet these challenges is discussed. Records dated from January 1969 to July 1978 indicate that a minimum of 282 women were involved in 495 cycles scheduled for laparoscopic oocyte recovery, of which 457 cycles (92%) proceeded to attempted egg collection. A total of 1361 eggs were recovered over 388 cycles, of which 1237 (91%) are recorded as having been inseminated in 331 (85%) of these cycles. Approximately 221 embryos were described in 165 (43%) of the 388 cycles. A total of 112 embryo transfers were attempted, which resulted in five clinical pregnancies with two live births. This paper discusses the ways in which hormonal stimulation of follicle growth to the pre-ovulatory stage was varied, and the endocrine monitoring of these variations in blood, urine and follicular fluid, as well as their influence on egg recovery and fertilization rates. Variations in media composition and preparation are also described. It is concluded that, whilst driven by scientific reasoning, the approach adopted in trying to achieve successful IVF was empirical rather than evidence-driven.
本文介绍了在体外受精和胚胎移植首次成功实现活产之前的10年期间必须应对的各种技术和科学挑战，并讨论了应对这些挑战所采用的方法。1969年1月至1978年7月的记录表明，至少282名女性参与了495个计划进行腹腔镜取卵的周期，其中457个周期（92%）进行了取卵尝试。在388个周期中共回收了1361枚卵子，其中1237枚（91%）记录为在这些周期中的331个周期（85%）中进行了授精。在388个周期中的165个周期（43%）中描述了约221个胚胎。共尝试了112次胚胎移植，结果有5例临床妊娠并产下2例活婴。本文讨论了将卵泡生长激素刺激至排卵前期的方法如何变化，以及对血液、尿液和卵泡液中这些变化的内分泌监测，以及它们对卵子回收和受精率的影响。还描述了培养基成分和制备的变化。得出的结论是，虽然是由科学推理驱动的，但在尝试实现成功的体外受精时所采用的方法是经验性的，而不是由证据驱动的。
