I. Govaerts - Academia.edu (original) (raw)
Papers by I. Govaerts
Contraception, fertilité, sexualité (1992)
Before starting with the clinical application of ICS, aged unfertilized oocytes were gathered for... more Before starting with the clinical application of ICS, aged unfertilized oocytes were gathered for training and were injected with a single sperm or without a spermatozoon as a control group for activation. Oocyte damage, initially as high as 40% was reduced to 15% after 60 oocytes. Normal fertilization (2PN) occurred in 18% of the injected oocytes. After this training period 1,488 metaphase II oocytes collected during 144 cycles were used for ICSI. Results were split up in 3 periods (n = 55, n = 24, n = 57) corresponding to the different improvements made in the technique. Results form ICSI in combination with MESA (n = 6) were analysed separately. Mean fertilization increased from 24% to 77%. Fertilization failures (18% of the cycles during the first period) vanished in the last period. Implantation rate improved from 7.4% to 11.4% and reached finally 26%. Pregnancy rate per oocyte retrieval was 16%, 25% and 54%. For the MESA group fertilization was 28%, implantation rate 17% and pregnancy rate 33% and only one fertilization failure was observed. A total of 50 pregnancies were obtained including 2 obtained after MESA and 2 with cryopreserved embryos. Four healthy children are born, 9 were early abortions, 37 pregnancies are still on-going. Preclinical practice on aged unfertilized oocytes seems useful before starting with clinical ICSI, as high initial oocyte damage could be reduced and subsequent clinical treatment successfully applied. Offering high fertilization and pregnancy rates in cases of infertility with severe male factor it is extremely worthwhile mastering this new technique.
Revue médicale de Bruxelles, 1999
This contribution summarize ten years of in vitro fertilization of clinical work. Activity growth... more This contribution summarize ten years of in vitro fertilization of clinical work. Activity growth, improvements of results (mean fertilization rate increased from 45% to 58%, fertilization failure dropped from 18% to 7%, pregnancy chances gains 9% to reach 44% per trial) and new treatments possibilities (severe male infertility) thanks to the ICSI technic were the major characteristics of this last ten years. The original anonymous oocyte donation program with donors permutation initiated as soon as 1990 has imposed itself due to it's exceptional efficiency with a pregnancy rate of 95% per oocyte pick up on a population of 46 donors and 145 recipient cycles. Thanks to the large population studied (4028 cycles, 1071 pregnancies), the tendencies in human fecundity (impact of age) and the risks linked to multiples pregnancies could be highlighted, stressing the importance of future developments presented in the other contributions following this general presentation of results.
The Lancet, 1995
Sex chromosome abnormalities after intracytoplasmic sperm injection S!R—In't Veld and colle... more Sex chromosome abnormalities after intracytoplasmic sperm injection S!R—In't Veld and colleagues (Sept 16, p 773) report sex chromosomal abnormalities after intracytoplasmic sperm injection (ICSI) in 15 prenatal diagnoses performed for maternal age. At our centre so far 585 prenatal diagnoses have been carried out in pregnancies after ICSI.
Human Reproduction, 1999
A first elective transfer policy of two embryos based solely on embryo morphology was compared to... more A first elective transfer policy of two embryos based solely on embryo morphology was compared to a more restrictive policy transferring two embryos to all patients aged <35 years with less than three previous cycles to reduce the incidence of multiple pregnancies. With a significant reduction in the number of triple transfers from 72.4 to 44.3%, the delivery rates were similar for both policies, 31 and 32.1%. However, the multiple pregnancy rates per transfer significantly decreased from 12.5 to 7.8% (P < 0.05). Of 99 pregnancies, only 24.2% were multiple including 1% of triplets compared to 40.7% multiple pregnancies including 6.7% of triplets for the first policy. Forty-eight transfers of two average embryos with the new policy were compared to 264 transfers of three average embryos with the old policy. Multiple pregnancy rates per transfer were significantly reduced by a third from 23 to 8% (P < 0.05) without a reduction of the pregnancy rates (42 and 48%). This study demonstrated that elective transfer of two embryos reduced the number of multiple pregnancies without impairing the pregnancy rates even with the transfer of average embryos.
Human Reproduction, 1998
This paper analyses the reasons that oocyte and sperm donation are experienced very differently b... more This paper analyses the reasons that oocyte and sperm donation are experienced very differently by couples, despite their apparent similarity, and stresses the impact of the difficulties on donor recruitment in all oocyte donation programmes. The various types of donors (occasional, relational, in-vitro fertilization patient and professional) are described together with their motivations, resistance, advantages and disadvantages. The contradictory consequences with free or paid donation, the particular risks of oocyte donation (in comparison with sperm donation) both for the donor and for the recipient are highlighted. The problem of maintaining anonymity is then analysed in ethical terms but also in terms of technical efficacy. A strategy is described which, due to the decision of retaining anonymity, authorizes the sharing of oocytes between recipients. This has as a consequence, an increase in treatment efficacy by avoiding wastage of oocytes offered as a donation.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1994
Puerperal ovarian vein thrombophlebitis (POVT) is a rare postpartal complication. Its incidence i... more Puerperal ovarian vein thrombophlebitis (POVT) is a rare postpartal complication. Its incidence is about 0.05%. POVT can follow a term pregnancy, a premature delivery, an abortion or an ectopic pregnancy. POVT usually presents as a syndrome consisting in lower abdominal pain and fever which does not respond to adequate antibiotics. We present a case report, in which the diagnosis was based upon computed tomography.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1998
To evaluate the different short-term complications after in vitro fertilization and embryo transf... more To evaluate the different short-term complications after in vitro fertilization and embryo transfer. a retrospective study on 7 years in the fertility clinic of an university hospital. Short-term medical complications were analysed after 1500 transvaginal ultrasonographically guided oocyte retrievals. Ovarian hyperstimulation syndrome (1.8%), pelvic infections (0.4%), intraperitoneal bleeding (0.2%) and adnexal torsions (0.13%) were observed. One case of adnexal torsion occurred during pregnancy (0.18%). Two unusual case of bowel endometriosis were encountered (0.13%). Short-term medical complications after in vitro fertilization and embryo transfer are rare (2.8%). This contrast with the high rate of multifetal pregnancies which increases maternal and perinatal morbidity and mortality and must be considered as the major complication of in vitro fertilization treatment.
Human Reproduction, 1998
The aim of this study was to compare pregnancy characteristics and perinatal outcome of intracyto... more The aim of this study was to compare pregnancy characteristics and perinatal outcome of intracytoplasmic sperm injection (ICSI) pregnancies with pregnancies obtained after in-vitro fertilization (IVF). Retrospectively, 145 ICSI pregnancies were matched with 145 IVF pregnancies using the last menstruation data. The main outcome measures were preclinical and clinical abortions, ectopic pregnancies, multiple gestations, prenatal morbidity, prematurity, Caesarean section, birthweight, perinatal mortality and malformations for singletons, twins and triplets. Although patients were significantly younger (P Ͻ 0.001) in ICSI (31 years) than in IVF (33 years), their infertility duration (5 years) was similar. The mean number of transferred embryos (2.7 embryos per transfer) was similar in IVF and ICSI. The rates of preclinical (15%) and clinical abortions (11% in ICSI versus 15% in IVF) were not different. Four ectopic pregnancies were observed in the IVF group and none in the ICSI group. In ICSI, two minor malformations were detected and two therapeutic abortions were performed respectively for polymalformations and suspicion of cystic fibrosis. The rate of congenital malformation was 2.8% in ICSI and 2.2% in IVF. In this last group, one therapeutic abortion for malformation of neural tube was performed and two minor malformations were detected. The rate of aborted embryonic sacs before 16 weeks of gestation was not significantly lower in ICSI compared with IVF (13.7% versus 20%). The rate of multiple gestations was similar in both groups (31% in IVF and 35% in ICSI). The number of Caesarean sections was similar in IVF and in ICSI and was twice as frequent for twins versus singletons. The number of singletons born by Caesarean section was 21% after ICSI and 17% after IVF. Mean birthweights and gestational ages at birth for twins were significantly higher (P Ͻ 0.05) in ICSI than in IVF (2488 versus 2281 g and 36.5 versus 35.5 weeks). This difference was not observed for singletons. In conclusion, pregnancy characteristics and perinatal outcome after ICSI showed no increase in the number of pathologies in comparison with IVF.
Contraception, fertilité, sexualité (1992)
Before starting with the clinical application of ICS, aged unfertilized oocytes were gathered for... more Before starting with the clinical application of ICS, aged unfertilized oocytes were gathered for training and were injected with a single sperm or without a spermatozoon as a control group for activation. Oocyte damage, initially as high as 40% was reduced to 15% after 60 oocytes. Normal fertilization (2PN) occurred in 18% of the injected oocytes. After this training period 1,488 metaphase II oocytes collected during 144 cycles were used for ICSI. Results were split up in 3 periods (n = 55, n = 24, n = 57) corresponding to the different improvements made in the technique. Results form ICSI in combination with MESA (n = 6) were analysed separately. Mean fertilization increased from 24% to 77%. Fertilization failures (18% of the cycles during the first period) vanished in the last period. Implantation rate improved from 7.4% to 11.4% and reached finally 26%. Pregnancy rate per oocyte retrieval was 16%, 25% and 54%. For the MESA group fertilization was 28%, implantation rate 17% and pregnancy rate 33% and only one fertilization failure was observed. A total of 50 pregnancies were obtained including 2 obtained after MESA and 2 with cryopreserved embryos. Four healthy children are born, 9 were early abortions, 37 pregnancies are still on-going. Preclinical practice on aged unfertilized oocytes seems useful before starting with clinical ICSI, as high initial oocyte damage could be reduced and subsequent clinical treatment successfully applied. Offering high fertilization and pregnancy rates in cases of infertility with severe male factor it is extremely worthwhile mastering this new technique.
Revue médicale de Bruxelles, 1999
This contribution summarize ten years of in vitro fertilization of clinical work. Activity growth... more This contribution summarize ten years of in vitro fertilization of clinical work. Activity growth, improvements of results (mean fertilization rate increased from 45% to 58%, fertilization failure dropped from 18% to 7%, pregnancy chances gains 9% to reach 44% per trial) and new treatments possibilities (severe male infertility) thanks to the ICSI technic were the major characteristics of this last ten years. The original anonymous oocyte donation program with donors permutation initiated as soon as 1990 has imposed itself due to it's exceptional efficiency with a pregnancy rate of 95% per oocyte pick up on a population of 46 donors and 145 recipient cycles. Thanks to the large population studied (4028 cycles, 1071 pregnancies), the tendencies in human fecundity (impact of age) and the risks linked to multiples pregnancies could be highlighted, stressing the importance of future developments presented in the other contributions following this general presentation of results.
The Lancet, 1995
Sex chromosome abnormalities after intracytoplasmic sperm injection S!R—In't Veld and colle... more Sex chromosome abnormalities after intracytoplasmic sperm injection S!R—In't Veld and colleagues (Sept 16, p 773) report sex chromosomal abnormalities after intracytoplasmic sperm injection (ICSI) in 15 prenatal diagnoses performed for maternal age. At our centre so far 585 prenatal diagnoses have been carried out in pregnancies after ICSI.
Human Reproduction, 1999
A first elective transfer policy of two embryos based solely on embryo morphology was compared to... more A first elective transfer policy of two embryos based solely on embryo morphology was compared to a more restrictive policy transferring two embryos to all patients aged <35 years with less than three previous cycles to reduce the incidence of multiple pregnancies. With a significant reduction in the number of triple transfers from 72.4 to 44.3%, the delivery rates were similar for both policies, 31 and 32.1%. However, the multiple pregnancy rates per transfer significantly decreased from 12.5 to 7.8% (P < 0.05). Of 99 pregnancies, only 24.2% were multiple including 1% of triplets compared to 40.7% multiple pregnancies including 6.7% of triplets for the first policy. Forty-eight transfers of two average embryos with the new policy were compared to 264 transfers of three average embryos with the old policy. Multiple pregnancy rates per transfer were significantly reduced by a third from 23 to 8% (P < 0.05) without a reduction of the pregnancy rates (42 and 48%). This study demonstrated that elective transfer of two embryos reduced the number of multiple pregnancies without impairing the pregnancy rates even with the transfer of average embryos.
Human Reproduction, 1998
This paper analyses the reasons that oocyte and sperm donation are experienced very differently b... more This paper analyses the reasons that oocyte and sperm donation are experienced very differently by couples, despite their apparent similarity, and stresses the impact of the difficulties on donor recruitment in all oocyte donation programmes. The various types of donors (occasional, relational, in-vitro fertilization patient and professional) are described together with their motivations, resistance, advantages and disadvantages. The contradictory consequences with free or paid donation, the particular risks of oocyte donation (in comparison with sperm donation) both for the donor and for the recipient are highlighted. The problem of maintaining anonymity is then analysed in ethical terms but also in terms of technical efficacy. A strategy is described which, due to the decision of retaining anonymity, authorizes the sharing of oocytes between recipients. This has as a consequence, an increase in treatment efficacy by avoiding wastage of oocytes offered as a donation.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1994
Puerperal ovarian vein thrombophlebitis (POVT) is a rare postpartal complication. Its incidence i... more Puerperal ovarian vein thrombophlebitis (POVT) is a rare postpartal complication. Its incidence is about 0.05%. POVT can follow a term pregnancy, a premature delivery, an abortion or an ectopic pregnancy. POVT usually presents as a syndrome consisting in lower abdominal pain and fever which does not respond to adequate antibiotics. We present a case report, in which the diagnosis was based upon computed tomography.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1998
To evaluate the different short-term complications after in vitro fertilization and embryo transf... more To evaluate the different short-term complications after in vitro fertilization and embryo transfer. a retrospective study on 7 years in the fertility clinic of an university hospital. Short-term medical complications were analysed after 1500 transvaginal ultrasonographically guided oocyte retrievals. Ovarian hyperstimulation syndrome (1.8%), pelvic infections (0.4%), intraperitoneal bleeding (0.2%) and adnexal torsions (0.13%) were observed. One case of adnexal torsion occurred during pregnancy (0.18%). Two unusual case of bowel endometriosis were encountered (0.13%). Short-term medical complications after in vitro fertilization and embryo transfer are rare (2.8%). This contrast with the high rate of multifetal pregnancies which increases maternal and perinatal morbidity and mortality and must be considered as the major complication of in vitro fertilization treatment.
Human Reproduction, 1998
The aim of this study was to compare pregnancy characteristics and perinatal outcome of intracyto... more The aim of this study was to compare pregnancy characteristics and perinatal outcome of intracytoplasmic sperm injection (ICSI) pregnancies with pregnancies obtained after in-vitro fertilization (IVF). Retrospectively, 145 ICSI pregnancies were matched with 145 IVF pregnancies using the last menstruation data. The main outcome measures were preclinical and clinical abortions, ectopic pregnancies, multiple gestations, prenatal morbidity, prematurity, Caesarean section, birthweight, perinatal mortality and malformations for singletons, twins and triplets. Although patients were significantly younger (P Ͻ 0.001) in ICSI (31 years) than in IVF (33 years), their infertility duration (5 years) was similar. The mean number of transferred embryos (2.7 embryos per transfer) was similar in IVF and ICSI. The rates of preclinical (15%) and clinical abortions (11% in ICSI versus 15% in IVF) were not different. Four ectopic pregnancies were observed in the IVF group and none in the ICSI group. In ICSI, two minor malformations were detected and two therapeutic abortions were performed respectively for polymalformations and suspicion of cystic fibrosis. The rate of congenital malformation was 2.8% in ICSI and 2.2% in IVF. In this last group, one therapeutic abortion for malformation of neural tube was performed and two minor malformations were detected. The rate of aborted embryonic sacs before 16 weeks of gestation was not significantly lower in ICSI compared with IVF (13.7% versus 20%). The rate of multiple gestations was similar in both groups (31% in IVF and 35% in ICSI). The number of Caesarean sections was similar in IVF and in ICSI and was twice as frequent for twins versus singletons. The number of singletons born by Caesarean section was 21% after ICSI and 17% after IVF. Mean birthweights and gestational ages at birth for twins were significantly higher (P Ͻ 0.05) in ICSI than in IVF (2488 versus 2281 g and 36.5 versus 35.5 weeks). This difference was not observed for singletons. In conclusion, pregnancy characteristics and perinatal outcome after ICSI showed no increase in the number of pathologies in comparison with IVF.