SUNScholar - Browsing by Author "Kruger, T. F."

Browsing by Author "Kruger, T. F."

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Assisted reproduction in the HIV-serodiscordant couple
(Health & Medical Publishing Group, 2007-01) Nosarka, S.; Hoogendijk, C. F.; Siebert, T. I.; Kruger, T. F.
ENGLISH ABSTRACT: No abstract available
The development of one- and two-cell mouse embryos in the absence of human serum
(Health & Medical Publishing Group, 1986) Kruger, T. F.; Stander, F. S. H.; Smith, K.; Lombard, C. J.
One- and two-cell embryos were obtained from F1 hybrid female mice stimulated with human menopausal gonadotrophin and randomly distributed into two groups - group 1 (no serum) and group 2 (10% patient's serum). Fifty of 53 (94.3%) one-cell embryos in group 1 had cleaved to the blastocyst stage and 44 of 49 (89.79%) in group 2 after 96 hours (no significant difference - chi-square test). In the two-cell embryos in group 1, 78 of 89 (87.6%) reached the blastocyst stage after 72 hours and 80 of 86 (93.02%) in group 2 (no significant difference - chi-square test). According to microscopic evaluation cleavage to the blastocyst stage without serum supplementation is possible. The value of serum is discussed.
The effect of fluorescent light on the cleavage of two-cell mouse embryos
(Health & Medical Publishing Group, 1985) Kruger, T. F.; Stander, F. S. H.
Two-cell mouse embryos were subjected to fluorescent light, 2,900 lux, for 30 minutes, and the cleavage compared with that in a control group. There was no statistically significant difference in the results. In both groups 90% of two-cell embroys reached the expected level of cleavage. The possible effect of fluorescent light on the oocyte is discussed.
The effect of surgical glove powder on cleavage of two-cell mouse embryos in an in vitro fertilization programme
(Health & Medical Publishing Group, 1985) Kruger, T. F.; Cronje, H. S.; Stander, F. S. H.; Menkveld, R.; Conradie, E.
The effect of surgical glove powder on the development of early mouse embryos was studied. Embryos from F1 hybrid mice (C57 B1/6 x CBA) were suspended in Whittingham's T6 growth medium with 10% human serum, using Petri dishes (Falcon 3001). Contamination was brought about by a sterile, powdered, surgical glove touching the surface of the growth medium for less than a second in group I, and in group II the same procedure was followed but the glove was rinsed beforehand with sterile, four times distilled water and air-dried. In the control group (group III) no contamination with surgical glove powder occurred. In group I only 9 of 137 embryos (7%) reached the blastocyst stage, in contrast with 110 of 196 (56%) in group II and 258 of 287 (90%) in group III. The differences in results between groups I and III, groups I and II, and groups II and III were found to be statistically significant (P < 0.001) by the chi-square test. It is concluded that surgical gloves are a potent inhibitor of early embryonic growth. In an in vitro fertilization programme including follicle aspiration and embryo transfer, contamination of embryos with these gloves should be avoided at all costs.
The effect on cleavage of two-cell mouse embryos after a delay in embryo retrieval in a human in vitro fertilization programme
(Health & Medical Publishing Group, 1985) Kruger, T. F.; Stander, F. S. H.
Two-cell mouse embryos are used for quality control in a human in vitro fertilization programme. A controlled experiment was designed to evaluate the effect on cleavage of two-cell mouse embryos after a delay in embryo retrieval. In the test group, two fallopian tubes were incubated in Whittingham's T6 medium for 2 1/2 hours per experiment before the embryos were removed for culture. In the control group embryos were removed from the fallopian tubes immediately after the mice were sacrificed. Five experiments were performed. Eight of 141 two-cell embryos (5,7%) reached the balstocyst stage in the test group, and in the control group 143 of 151 two-cell embryos (94,7%) reached the blastocyst stage after 72 hours. Embryos must be removed immediately after the mice are sacrificed to obtain constant results. If not, poor cleavage can lead to unnecessary confusion in the laboratory.
Factors affecting pregnancy outcome in a gamete intrafallopian transfer (GIF) programme
(Health & Medical Publishing Group, 2003-07) De Bruijn, J. M.; Kruger, T. F.; Van der Merwe, J. P.; Stander, F. S. H.; Lombard, C. J.
Objective. To identify the factors that most significantly affected pregnancy rates in a gamete intrafallopian transfer (GIFT) programme. Methods. A total of 863 GIFT cycles were analysed retrospectively. The variables found to be associated significantly with pregnancy were then used to obtain multivariate analysis using logistical regression. Results. Overall and ongoing pregnancy rates were significantly better in patients ≤ 38 years than in patients > 38 years (37.3% and 28.4% v. 23.7% and 11.0% respectively), and age was positively associated with success after GIFT (odds ratio (OR) 1.87, 95% confidence interval (CI): 1.22 - 2.85). Metaphase I (MI) oocytes were negatively associated with pregnancy (OR 1.54, 95% CI: 0.28 - 1.04). The highest pregnancy rates occurred when 3 metaphase II (MII) oocytes were transferred (39.8%, OR 7.51, 95% CI: 1.74 - 32.42). With regard to sperm morphology, overall pregnancy rates of 25.5% (≤ 4% normal forms) and 37.2% (> 4% normal forms) were obtained. Morphology of > 4% normal forms was positively associated with pregnancy (OR 1.58, 95% CI: 1.04 - 2.42). Conclusion. The results of this study suggest that the most important factors influencing pregnancy rates in a GIFT programme are the woman's age and those factors pertaining to the characteristics of the gametes. Considering the emotional and financial costs it is important to relate this information to all prospective participants in a GIFT programme.
Genital tuberculosis at Tygerberg Hospital : prevalence, clinical presentation and diagnosis
(Health & Medical Publishing Group, 1992) Margolis, K.; Wranz, P. A. B.; Kruger, T. F.; Joubert, J. J.; Odendaal, H. J.
Over a period of 30 months (1 July 1986-31 December 1988) 57 cases of genital tuberculosis were diagnosed at Tygerberg Hospital. Forty of these cases were diagnosed as a result of routine screening in 650 patients who presented with infertility and the other 17 were diagnosed in patients admitted to the gynaecological wards. The prevalence in patients presenting with infertility was 6,15%. The commonest gynaecological presenting symptom was infertility (73,7%). Dysmenorrhoea in 29,8% and deep dyspareunia in 12,3% were the only other frequently occurring gynaecological symptoms. Menstruation was normal in 50 patients (87,7%). Seven per cent of patients were postmenopausal. Abdominal symptoms were only present in 15,8%. These findings re-emphasise that genital tuberculosis is often a disease absent of or with few symptoms. General, abdominal and pelvic examinations were normal in 56,1% of patients and even when clinical signs were present they were nonspecific. Menstrual fluid collection and culture proved to be the most reliable diagnostic procedure, since it was positive in 11 patients in whom premenstrual endometrial sample cultures were negative and also in 17 patients in whom histological examination of premenstrual endometrial samples for tuberculosis were negative. The possible reasons for this and its clinical importance are discussed. Other than histological examination of operation and/or biopsy specimens, special investigations proved to be of little help in the diagnosis of genital tuberculosis.
Human pregnancy after transfer of intact frozen-thawed embryos
(Health & Medical Publishing Group, 1989) Erasmus, E.L.; Van der Merwe, J. P.; Kruger, T. F.; Stander, F. S. H.; Menkveld, R.
Since the birth of the first baby as a result of in vitro fertilisation (IVF) in 1978, many clinics around the world have achieved pregnancies and births for their patients by using IVF and gamete intrafallopian transfer procedure. With the storage of excess embryos, multiple laparoscopies can be avoided; this has favoured in the development of better cryopreservation techniques. In our clinic 8-cell human embryos are frozen in a 1,5M dimethyl sulphoxide solution as cryoprotectant using the slow freeze-thaw method. Sixteen thawed embryos were replaced in 8 patients, resulting in 1 pregnancy. Of the thawed embryos 51,6% survived the freezing process in that they had 50% or more of the original number of blastomeres and also the zona pellucida intact.
Implementation of an office-based semen preparation method (SEP-D Kit) for intra-uterine insemination (IUI) : a controlled randomised study to compare the IUI pregnancy outcome between a routine (swim-up) and the SEP-D Kit method
(Health & Medical Publishing Group, 2012-03-29) Gentis, R. K.; Siebert, I.; Kruger, T. F.; De Beer-Windt, M. L.
The aim of this study was to compare the Sep-D kit with the standard swim-up sperm washing method regarding pregnancy outcomes.
The in vitro fertilisation programme at Tygerberg Hospital and the University of Stellenbosch. Five years' experience, April 1983 - January 1988
(Health & Medical Publishing Group, 1990) Kruger, T. F.; Van der Merwe, J. P.; Odendaal, H. J.; Stander, F. S. H.; Grobler, G. M.; Hulme, V. A.; Erasmus, E. L.; Coetzee, K.; Windt, M.-L.; Swart, Y.; Smith, K.; Menkveld, R.
The results of the in vitro fertilisation programme at Tygerberg Hospital for the period April 1983 to January 1988 are presented. Of the 1117 laparoscopies performed, 825 patients reached the transfer stage. A live-birth rate of 9.3% was achieved. The pregnancy rate after transfer of 4 embryos was 25,9% compared with 15,4% after 2 embryos and 10,8% after 3 embryos (P = 0.0001). The multiple pregnancy rate was 2.8% in the group receiving 2 embryos and 11.7% and 10,4% in those receiving 3 and 4 embryos, respectively. Of the 77 successful pregnancies (90 babies), 1 baby died at 34 weeks' gestation as the result of abruptio placentae due to preeclampsia and 1 cot death occurred. The only congenital abnormality encountered was a cleft palate.
Induction of ovulation in phase I of the in vitro fertilization and embryo transfer programme at Tygerberg Hospital
(Health and Medical Publishing Group (HMPG), 1985-05) Van Schouwenburg, J. A. M. H.; Kruger, T. F.
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.
Is the use of a GnRH antagonist effective in patients with polycystic ovarian syndrome? A South African perspective
(Health & Medical Publishing Group, 2012-01-19) Siebert, T. I.; Kruger, T. F.; Grieve, C. L.; Steyn, D. W.
Introduction. Polycystic ovarian disease (PCOS) can account for up to 35 - 40% of the female factor causes of infertility. These patients present as medically complex cases and are challenging to manage and treat successfully. They are resistant to treatment and are often offered controlled ovarian stimulation (COS) and in vitro fertilisation (IVF) technology. Aim. The aim of this study was to assess whether there was a difference in the pregnancy outcomes of women with PCOS when a standard gonadotrophin-releasing hormone (GnRH) antagonist (cetrorelix) protocol was used for ovarian stimulation, compared with non-PCOS patients undergoing IVF. Methods. A retrospective patient record audit was performed on 142 patients with PCOS and 501 non-PCOS patients undergoing a similar cetrorelix-based COS treatment protocol during a specified time period. Results. The main primary outcome was an ongoing pregnancy at 12 weeks, achieved in 34% of patients in the PCOS group and 27% in the non-PCOS group. This was not significantly different (p=0.07). No patient in the PCOS group experienced severe hyperstimulation syndrome. Conclusion. There was no significant difference in pregnancy rates in patients with PCOS undergoing GnRH-antagonist ovarian stimulation compared with non-PCOS patients. The fact that no hyperstimulation syndrome occurred makes this an attractive option for women with PCOS.
Kunsmatige intrauteriene inseminasie met gewaste voorbereide eggenootsemen
(Health & Medical Publishing Group, 1987-10) De Villiers, T. J.; Kruger, T. F.; Van der Merwe, J. P.; Menkveld, R.
ENGLISH ABSTRACT: Intra-uterine insemination with washed spermatozoa of the husband was evaluated in 42 infertile couples during 103 treatment cycles. A pregnancy rate of 47.3% was obtained after an average of 2 treatment cycles in a group of patients in whom hostile cervical mucus was the only known cause of infertility. A pregnancy rate of 21.7% was obtained after an average of 2.6 treatment cycles in a group of patients in whom low sperm morphology was the only known cause of infertility. The overall conception rate of 33.3% compares favourably with that in other published series.
Laparoscopic myomectomy for infertile patients with intramural fibroids : a retrospective study at a tertiary endoscopic centre
(Health & Medical Publishing Group, 2011-09) Lourens, Renardo J.; Siebert, T. I.; Kruger, T. F.; Van der Merwe, J. P.
Background. The safety of laparoscopic myomectomy has been questioned, especially in the case of fibroids. Objectives. To assess the safety of laparoscopic myomectomy for intramural fibroids and study the subsequent effect on fertility. Methods and settings. A retrospective study of a tertiary endoscopic centre specialising in laparoscopic myomectomy. Results. Eighty-seven patients were studied, and there were no major complications. The conversion rate from laparoscopy to laparotomy was 3.4% (3/87), in all cases due to multiple fibroids. There was 1 case of uterine perforation during hysteroscopy. The overall pregnancy rate was 29/64 (45.3%), with a spontaneous pregnancy rate of 18/29 (62.0%). Conclusions. Laparoscopic myomectomy can be regarded as a safe alternative to abdominal myomectomy in the hands of the experienced surgeon, resulting in good subsequent pregnancy rates.
Laparoscopic Strassman's metroplasty for bicornuate uterus - is it relevant?
(Health & Medical Publishing Group, 2012-09-06) Matsaseng, T.; Kruger, T. F.
The mean incidence of bicornuate uterus in Müllerian duct anomalies is approximately 25%, and it is associated with abortion, preterm delivery and term delivery rates of 36%, 23% and 40.6%, respectively. Open abdominal metroplasty has been shown to significantly improve pregnancy outcomes in patients with bicornuate uterus. However, minimally invasive laparoscopic metroplasty could be an alternative. A 24-year-old woman with a bicornuate uterus and poor reproductive outcomes underwent laparoscopic Strassman’s metroplasty. The procedure was completed safely within 180 minutes with minimum blood loss. At follow-up hysteroscopy and laparoscopy 2 months later, minimal adhesions in the pelvis were noted and removed. There were no synechiae in the uterine cavity. It is concluded that laparoscopic metroplasty is a safe and relevant alternative to conventional abdominal metroplasty, with minimal adhesion formation.
Microsurgical testicular sperm extraction for testicular failure: the South African experience and first successful pregnancy
(Medpharm Publications, 2021-06) Zarrabi, A. D.; Kruger, T. F.
BACKGROUND: In men with non-obstructive azoospermia (NOA), biological fatherhood is only possibly by specialised microsurgical sperm retrieval techniques (micro-TESE), only recently introduced to South Africa. This study aimed to analyse the spectrum of causes of NOA and the outcomes of micro-TESE, including live births, following the use of this technique in South Africa METHODS: This was a retrospective review of all micro-TESE cases performed in South Africa by a single surgeon from 2014 to 2018. Data collected prospectively included: patient demographics, preoperative blood results, cause of azoospermia, intraoperative findings and postoperative complications. The primary outcome measured was surgical success of micro-TESE, which was defined as testicular sperm successfully retrieved and cryopreserved. Subsequent live births from assisted reproductive technology (ART) using the cryopreserved sperm were also documented RESULTS: Twenty-six men with NOA underwent micro-TESE between May 2014 and April 2018. Mean preoperative total testosterone level was 12.0 nmol/l (IQR 5.2) and follicle-stimulating hormone level 23.5 IU/l (IQR 15.6). Genetic testing was performed as part of the preoperative work-up in only 10 of the 26 patients. A specific cause of NOA was identified in 9 of the 26 patients and included Klinefelter syndrome (1 patient), Y-chromosome AZFc microdeletion (1 patient), undescended testicles (5 patients) and chemotherapy (2 patients). The average testicular volume was 9.05 ml (IQR 5.6), and the mean duration of surgery 95.8 minutes (IQR 28.0). The overall sperm retrieval rate was 34.6%. A single pregnancy and subsequent live birth were recorded from a total of eight cycles of intracytoplasmic sperm injection (ICSI): four female partners had one ICSI cycle each and two females underwent two cycles each. Frozen and thawed sperm was used in seven of the ICSI cycles and fresh sperm in one cycle CONCLUSION: In this South African series, sperm retrieval rates of micro-TESE for non-obstructive azoospermia were comparable to those reported internationally. Preoperative genetic testing should be increased to optimise the selection of surgical candidates
Osmolarity studies with different containers and volumes in a human in vitro fertilization programme
(Health and Medical Publishing Group (HMPG), 1985-10) Kruger, T. F.; Stander, F. S. H.; Menkveld, R.; Lombard, C. J.
[No abstract available]
Ovulasie-induksie vir in vitro-bevrugting in Tygerberg-hospitaal
(Health & Medical Publishing Group, 1987) Van der Merwe, J. P.; Kruger, T. F.; Lombard, C. J.; Muller, L. M. M.
The protocol for in vitro fertilisation (IVF) at Tygerberg Hospital is presented and the results are analysed. Indications for ovulation induction for IVF included the following: (a) irreversible tubal damage; (b) infertility due to immunological factors; (c) male factor - infertility; and (d) endometriosis. A combination of human menopausal gonadotrophin (HMG) and clomiphene citrate (Clomid; Mer-National) and human chorionic gonadotrophin was used. Clomid is given in dosages of 100 mg for 5 days depending on the cycle length. Three doses of HMG (150 IU) are given on alternate days, starting on the second day of clomiphene treatment. If the leading follicle has not reached a mean diameter of 14 mm the day after the last HMG dose, another dose is given. This dosage is continued until the leading follicle reaches a diameter of 14 mm. A total of 109 cycles in 100 patients was analysed. Ova were considered to be mature as soon as the dominant follicle had reached a sonographic average diameter of 18 mm, another two follicles of 16 mm average diameter being present. Serum luteinising hormone levels were determined 4-hourly from the stage when the leading follicles exceeded an average diameter of 14 mm. In this study the pregnancy rate was 21.3% per laparoscopy and 24,4% per embryo transfer. The oestradiol levels on the 5th day of treatment have a predictive value of the length of stimulation.
Results of phase I of the in vitro fertilization and embryo transfer programme at Tygerberg Hospital
(Health and Medical Publishing Group (HMPG), 1985-05) Kruger, T. F.; Van Schouwenburg, J. A. M. H.; Stander, F. S. H.; Van den Heever, A. D.; Van Zyl, J. A.; Menkveld, R.; Kopper, K.; De Villiers, A.; Conradie, E.; Odendaal, H. J.; De Villiers, J. N.
Phase I (3 June - 31 October 1983) of the in vitro fertilization (IVF) programme at Tygerberg Hospital is outlined in this article. This programme led to the birth of the first IVF baby in South Africa after fertilization and embryo transfer (ET) took place at this institution. The baby was born on 29 April 1984; a second baby was born on 20 June 1984. During phase I 24 laparoscopies were performed; 32 oocytes were obtained from 56 follicles, of which 62.5% were fertilized. Eleven ETs were performed, which led to 3 pregnancies. An ongoing pregnancy rate of 18% per ET and a pregnancy rate of 12,5% per laparoscopy were achieved.
Results of the in vitro fertilization programme at Tygerberg Hospital, phases II and III
(Health & Medical Publishing Group, 1986-03) Kruger, T. F.; Van der Merwe, J. P.; Stander, F. S. H.; Menkveld, R.; Van den Heever, A. D.; Kopper, K.; Odendaal, H. J.; Van Zyl, J. A.; De Villiers, J. N.
Phases II and III of the human in vitro fertilization programme at Tygerberg Hospital are presented. In phase II, 42 laparoscopies were performed and oocytes were obtained from 76% of the follicles aspirated, but with a fertilization rate of only 37%. The viable pregnancy rate per embryo transfer was 4%. Important changes took place in the programme, which led to a fertilization rate of 77% in phase III. Of the 78 patients subjected to laparoscopy, 65 (83%) reached the embryo transfer stage, resulting in a clinical pregnancy rate per embryo transfer of 23%, and with a 19% pregnancy rate per laparoscopy. The changes, methods and results of phases II and III are discussed.

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