Browsing by Author "Van Schouwenburg, J. A. M. H."
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- ItemInduction 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.
- ItemParameters of ovulation in spontaneous ovulatory cycles(Health & Medical Publishing Group, 1984) Van Schouwenburg, J. A. M. H.The parameters of ovulation used at the infertility clinic of Tygerberg Hospital were evaluated in 45 spontaneously ovulating women. The mean maximum preovulatory serum oestradiol level was 1,274 pmol/l with a standard deviation of 432 pmol/l and an average daily increase of 245 pmol/l over the last 3 preovulatory days. Normal values were identified for a cervical mucus scoring system similar to the Insler system. The mean midluteal serum progesterone values was 25,5 nmol/l with a standard deviation of 7.5 nmol/l. Ultrasound examinations of the ovaries to diagnose ovulation were used for the first time in Tygerberg Hospital; the average of maximum diameters in three dimensions was used to measure follicles. The average daily pre-ovulatory growth rate was 2.3 mm and the maximum follicle size 20.5 mm with a standard deviation of 2.3 mm. The most common ultrasonic signs of ovulation were reduction in folicle size, development of irregular borders and intrafollicular echoes. In 5 patients endometrial histological dating lagged more than 2 days behind ultrasonic signs of ovulation. These were considered cases of luteal phase insufficiency. The maximum pre-ovulatory serum oestradiol levels were statistically significantly lower in these cases.
- ItemResults 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.