An in vitro fertilization and embryo transfer pilot study: treatment-dependent and treatment-independent pregnancies.

A pilot program of in vitro fertilization and embryo transfer at McMaster University is described. Fourteen couples with a clinical diagnosis of infertility due to apparent tubal dysfunction, with evidence of ovulation, and with normal semen analysis underwent induction of superovulation with human menopausal gonadotropin. At laparoscopy, 82 follicles were aspirated and 19 oocytes were recovered. Eleven oocytes demonstrated cleavage and all inseminated oocytes were transferred 49 to 65 1/2 hours after insemination. In vitro fertilization therapy resulted in two pregnancies, one leading to a spontaneous abortion and the other to the birth of a healthy female infant. At 10 to 12 months after in vitro fertilization therapy in the remaining 12 patients, there were three additional pregnancies (treatment-independent), one ectopic and two intrauterine. One patient was delivered of a healthy female infant. In vitro fertilization therapy should be evaluated by a randomized controlled clinical trial.