Induction of ovulation in phase I of the in vitro fertilization and embryo transfer programme at Tygerberg Hospital.

Two different protocols for ovulation induction used in phase I of the in vitro fertilization (IVF) programme at Tygerberg Hospital are presented. Previous experience with gonadotrophins and clomiphene citrate was applied in the development of the protocols. By means of experience gained during ovulation induction it was possible to establish critical values for the parameters of follicle maturity, which are used to determine the optimal time for follicle aspiration. Ultrasonically measured follicle size, critical serum oestradiol levels for each mature follicle and cervical mucus scoring were the parameters used. Fifty-one ova were obtained during 29 of the 34 attempts at follicle aspiration. Only 5 of the ova were immature. At least 1 mature ovum was obtained at 80% of all laparoscopies. Twenty-three embryos were transferred to 15 patients, and 3 pregnancies occurred. As a result of this programme 2 babies were born--the first in South Africa by IVF and embryo transfer.