Papers by kathleen tucker
The Art and Science of Assisted Reproductive Technique (ART)
The Art and Science of Assisted Reproductive Technique (ART), 2003
Journal of andrology
Recent evidence suggests that growth hormone (GH) may enhance physiologic processes, such as sper... more Recent evidence suggests that growth hormone (GH) may enhance physiologic processes, such as spermatogenesis, in addition to causing classical anabolic effects. We have previously shown that testosterone restores spermatogenesis in rats that were made azoospermic by immunization against gonadotropin-releasing hormone (GnRH). In this study, we investigated whether suppression of GH affects spermatogenesis and the ability of testosterone to restore spermatogenesis following immunization against GnRH and/or growth hormone-releasing hormone (GHRH). Twelve rats were actively immunized against GnRH (anti-GnRH), twelve rats were actively immunized against GHRH (anti-GHRH), six rats were immunized against both GnRH and GHRH (anti-GnRH/GHRH), and six rats served as controls. Two weeks after the second booster, six rats each from the anti-GnRH and anti-GHRH groups as well as the six anti-GnRH/GHRH rats received 24-cm testosterone-filled Silastic implants (T), and the remaining six rats from e...
Journal of assisted reproduction and genetics, 1998
Journal of andrology
We have previously shown that suppression of gonadotropins and spermatogenesis can be produced in... more We have previously shown that suppression of gonadotropins and spermatogenesis can be produced in rats by immunization against gonadotropin releasing hormone (GnRH). Administration of testosterone (T) alone is effective in restoring complete spermatogenesis in these rats, although it is not effective in doing so in chronically treated hypophysectomized rats. This suggests that a pituitary factor(s) other than luteinizing hormone (LH) and follicle-stimulating hormone (FSH) is required to restore normal spermatogenesis. The studies described herein test the hypothesis that prolactin (PRL) is the additional requirement for complete restoration of spermatogenesis. Twenty rats were immunized against GnRH, and four groups of five each received either 1) 24-cm T-filled Silastic implant (TSl), 2) TSl plus bromocriptine pellet (B), 3) B plus empty Silastic implant (Sl), or 4) Sl alone. Five nonimmunized rats received Sl alone and served as controls. All rats were sacrificed 2 months after tr...
Seminars in Reproductive Medicine, 1996
The development of ovulation-inducing drugs has enabled clinicians to more effectively treat the ... more The development of ovulation-inducing drugs has enabled clinicians to more effectively treat the hypothalamic, pituitary, and ovarian abnormalities resulting in infertility. Pregnancy rates have been improved with the use of agents such as clomiphene citrate (CC), human menopausal gonadotropin [hMG or follicle-stimulating hormone (FSH) preparations], with gonadotropin-releasing hormone (GnRH) and its analogs, stimulating the development of multiple ovarian follicles and increasing the number of fertilizable oocytes. The use of these drugs is not without certain detrimental or "toxic" consequences. The negative effects from superovulation can occur during follicle development, decreasing the number of healthy oocytes and embryos capable of leading to viable pregnancy. Ovulation induction can lead not only to higher incidences of spontaneous abortions, and multiple and ectopic pregnancies, but also to poor pregnancy rates, due, in part, to asynchrony between embryonic development and the uterine environment. Diseases such as ovarian hyperstimulation syndrome (OHSS), resulting in the secretion of supraphysiologic levels of estradiol, can lend to severe health complications, possibly requiring hospitalization. Most drugs used for ovulation induction can lead to OHSS. Although incidences of OHSS following CC use are less frequent, CC has been associated with hot flushes, multiple gestations, visual disturbances, cervical mucus abnormalities, and luteal phase deficiency. Finally, there are reports that link any or all of the ovulation-inducing drugs with a higher incidence of ovarian and breast cancer, however, a cause-effect relationship has yet to be proven.
Journal of Assisted Reproduction and Genetics, 1996
Our purpose was to determine the effect of Synthetic Serum Substitute (SSS) versus serum suppleme... more Our purpose was to determine the effect of Synthetic Serum Substitute (SSS) versus serum supplementation on fertilization rates and subsequent development o f embo, os from patients undergoing IVF. Procedure: Experiment I compared the ~:ffects g f SSS to human serum on mouse embl3'o development. Two hundred one-cell B6D2FI mouse embt3,as were cultured in lO0-p3 droplets of human tubal fluid (HTF) containing either (I) no protein (control; n = 37), (2) 15% serum J~'om women with tubal infertili O' (n = 44), (31 15% serum from women with endometriosis (n = 49), (4) 15% j,ertile donor serum (n = 33L or (5) t5% SSS (n = 37). Experiment I1 compared the effects o['SSS to haman serum on the development t~' embr)'os from patients undet;eoing IVF. Thirty-three women were bwluded in this stady. A total o f 37I oocytes u'as cultured ill H T F containing either (t) maternal or donor serum (n = 1401 or (2) 15% SSS (n = 231). Embo, o development was evaluated 48 hr after fertilization.
Journal of Assisted Reproduction and Genetics, 1993
Journal of Assisted Reproduction and Genetics, 1996
Purpose: Our purpose was to determine the effect of Synthetic Serum Substitute (SSS) versus serum... more Purpose: Our purpose was to determine the effect of Synthetic Serum Substitute (SSS) versus serum supplementation on fertilization rates and subsequent development of embryos from patients undergoing IVF.
Fertility and Sterility, 1998
Objective: To evaluate the influence of cryopreservation temperature on human sperm motility and ... more Objective: To evaluate the influence of cryopreservation temperature on human sperm motility and morphology. Design: Controlled study, investigator was blinded to the type of cryopreservation. Setting: University-based andrology laboratory. Patient(s): Sixteen semen samples with normal motility and sperm count from men after a fertility work up. Intervention(s): Semen aliquots were either stored in a mechanical freezer at Ϫ70°C or in liquid nitrogen at Ϫ196°C for 7 days or 3 months. Test yolk buffer was used as a cryoprotectant. With use of a programmable freezing unit, all samples were cooled at a controlled rate. Main Outcome Measure(s): Sperm motility and morphology. Result(s): After 7 days of cryopreservation, there was a greater decrease in sperm motility among specimens maintained at Ϫ70°C than among those maintained at Ϫ196°C (47% versus 39% decrease). The difference in sperm motility was even greater after 3 months of cryopreservation (72% versus 39% decrease). No difference in postthaw sperm morphology was detected among sperm preserved at Ϫ70°C versus Ϫ196°C. Conclusion(s): Sperm cryopreservation at Ϫ196°C is superior to cryopreservation at Ϫ70°C. Sperm can be stored at Ϫ70°C for a short period of time with a relatively modest loss of motility.
Fertility and Sterility, 1998
Pregnant rats were fed control rat chow or rat chow incorporated with genistein (approximately 50... more Pregnant rats were fed control rat chow or rat chow incorporated with genistein (approximately 50 g/d) beginning on day 17 of gestation and continuing until the end of lactation (postpartum day 21). Genistein-exposed female pups were divided into two groups on day 21. One group continued to receive a genistein-added diet (G70); the other group was changed to a control diet (Ex-G). At necropsy (days 21 and 70), blood and reproductive tissues were collected. Main Outcome Measure(s): Serum levels of gonadotropins and gonadal steroids and histopathologic examination of the ovaries. Result(s): The weight of the ovaries and uterus and serum levels of E 2 and progesterone in genistein-exposed rats on day 21 (G21) were significantly reduced compared with control rats. On day 70, serum levels of E 2 , progesterone, LH, and FSH were similar in all groups. Atretic follicles and secondary interstitial glands were more common in G70 and Ex-G rats compared with control rats. Cystic rete ovarii was observed in some G70 and Ex-G rats. Conclusion(s): Our data indicate that in utero and lactational exposure to dietary genistein adversely affects reproductive processes in the adult female rat.
Fertility and Sterility, 1997
To determine if a novel, preprogrammed, unmonitored stimulation protocol could reduce the cost of... more To determine if a novel, preprogrammed, unmonitored stimulation protocol could reduce the cost of assisted reproductive technology (ART) without compromising outcome or safety. Prospective, nonrandomized study of unmonitored ART versus traditional monitoring. University ART program. Infertile women aged < 39 years, with a basal FSH level < 15 mIU/mL (conversion factor to SI unit, 1.00) and regular menstrual cycles, undergoing ART. Oocyte retrieval was performed at a predetermined time in 72 unmonitored cycles based on age and basal FSH level. No monitoring of any type was performed before retrieval. There were 86 monitored control cycles. The number of oocytes, and embryos; complications including ovarian hyperstimulation. The total cost for unmonitored ART was significantly less than for monitored cycles. There was no difference between groups for patient age, number of oocytes obtained, or number of metaphase II oocytes. For non-male-factor patients, the number of oocytes fertilized, number of embryos transferred, and the clinical pregnancy rates were comparable. There was one case of severe hyperstimulation requiring hospitalization in the unmonitored group. This novel, unmonitored ovarian stimulation protocol provides ART at a significantly lower cost than is incurred with traditional monitoring, with no apparent compromise in outcome.
Fertility and Sterility, 2005
Fertility and Sterility, 2002
To determine if a fixed-dose stimulation protocol with monitoring limited to a single ultrasound ... more To determine if a fixed-dose stimulation protocol with monitoring limited to a single ultrasound can provide acceptable outcomes in assisted reproduction technologies (ART) procedures in appropriately selected patients. Prospective study of all minimally monitored ART cycles from 1996 through 1998. University ART program. Eligibility included Institutional Review Board consent, age 18-37, basal FSH < or = 10, normal semen parameters, and regular menses. IVF (n = 81) and GIFT (n = 14). A single ultrasound was performed after 8 or 9 days of stimulation in a fixed-schedule long luteal phase leuprolide protocol. No hormone levels were obtained. Human chorionic gonadotropin was administered when at least 2 follicles were projected to reach 18 mm. Pregnancy, delivery, and implantation rates. The clinical pregnancy rates were 51% for IVF and 36% for GIFT. Delivery rates were 42% for IVF and 29% for GIFT. The implantation rates for IVF were 23% and 17% for GIFT. No patient was admitted for ovarian hyperstimulation. We were able to achieve satisfactory pregnancy and delivery rates in properly selected patients with a minimal monitoring protocol, limited to a single ultrasound near the end of a fixed-stimulation regimen. The reduced time commitment and cost led to a very high patient acceptance of this approach.
Fertility and Sterility, 2001
To determine if extended treatment with doxycycline before and after an in vitro fertilization (I... more To determine if extended treatment with doxycycline before and after an in vitro fertilization (IVF) procedure can minimize the detrimental effect of a hydrosalpinx. Retrospective analysis. University IVF program. Patients undergoing IVF, including 17 with a hydrosalpinx, 25 with adhesions or proximal tubal occlusion, and 22 with endometriosis or unexplained infertility. Women with a documented hydrosalpinx were prescribed doxycycline 100 mg twice daily starting 1 week before expected retrieval and continued until 6 days after retrieval. No antibiotics were prescribed in the other groups. Implantation rates and IVF outcomes. Implantation rates were 30% for the doxycycline-treated group of patients with a hydrosalpinx, 27% for the group with tubal occlusion/adhesion, and 24% for the group with endometriosis or unexplained infertility. Eight (47%) of 17 patients with a hydrosalpinx had a live birth, compared with 11 (44%) of 25 for the group with tubal occlusion/adhesion and 12 (55%) of 22 for the group with endometriosis/unexplained infertility. There were no differences between the groups in patient age, number of oocytes retrieved, fertilization rate, or number of blastomeres of the transferred embryos. No detrimental effect of a hydrosalpinx was evident for patients treated with extended doxycycline. Tremendous cost savings can be realized if treatment with 2 weeks of an inexpensive antibiotic provides outcomes comparable to surgical correction of a hydrosalpinx before IVF.
Fertility and sterility, 1997
To determine if a novel, preprogrammed, unmonitored stimulation protocol could reduce the cost of... more To determine if a novel, preprogrammed, unmonitored stimulation protocol could reduce the cost of assisted reproductive technology (ART) without compromising outcome or safety. Prospective, nonrandomized study of unmonitored ART versus traditional monitoring. University ART program. Infertile women aged < 39 years, with a basal FSH level < 15 mIU/mL (conversion factor to SI unit, 1.00) and regular menstrual cycles, undergoing ART. Oocyte retrieval was performed at a predetermined time in 72 unmonitored cycles based on age and basal FSH level. No monitoring of any type was performed before retrieval. There were 86 monitored control cycles. The number of oocytes, and embryos; complications including ovarian hyperstimulation. The total cost for unmonitored ART was significantly less than for monitored cycles. There was no difference between groups for patient age, number of oocytes obtained, or number of metaphase II oocytes. For non-male-factor patients, the number of oocytes fertilized, number of embryos transferred, and the clinical pregnancy rates were comparable. There was one case of severe hyperstimulation requiring hospitalization in the unmonitored group. This novel, unmonitored ovarian stimulation protocol provides ART at a significantly lower cost than is incurred with traditional monitoring, with no apparent compromise in outcome.
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Papers by kathleen tucker