Publications by authors named "Katharine V Jackson"

9 Publications

  • Page 1 of 1

Empty follicle syndrome--does repeat administration of hCG really work?

Fertil Steril 2010 Jun 13;94(1):375-7. Epub 2009 Nov 13.

Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.

In this retrospective case series with historic control subjects, repeat administration of hCG after failure to retrieve oocytes from the first ovary in the setting of unexpectedly low serum hCG levels resulted in unsuccessful IVF outcomes. This represents the largest case series to date regarding repeat administration of hCG in so-called "false" empty follicle syndrome cycles and indicates that patients should be counseled regarding the low likelihood of cycle success after repeat administration of hCG in this setting.
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http://dx.doi.org/10.1016/j.fertnstert.2009.09.040DOI Listing
June 2010

Incidence and development of zygotes exhibiting abnormal pronuclear disposition after identification of two pronuclei at the fertilization check.

Fertil Steril 2010 Aug 23;94(3):965-70. Epub 2009 May 23.

Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.

Objective: To determine the incidence, developmental potential, and clinical implications of embryos having one pronucleus (1PN) or three pronuclei (3PN) at early cleavage, despite exhibiting 2PN at the fertilization check.

Design: Retrospective cohort study.

Setting: Hospital-based academic medical center.

Patient(s): All IVF cycles from January 2006 through May 2008 having 2PN zygotes that subsequently transitioned to 1PN or 3PN before cleavage, matched to cycles having 2PN zygotes progressing to cleavage without intervening abnormal pronuclear disposition.

Intervention(s): Standard IVF protocol.

Main Outcome Measure(s): Incidence, day 3 development, and implantation rates of 2PN zygotes transitioning to 1PN and 3PN states before cleavage, compared with normal embryos.

Result(s): The incidences of 1PN and 3PN zygotes were 2.9% and 0.4%, respectively. Both types of abnormal zygote showed slower day 3 cleavage, although only the 1PNs exhibited higher fragmentation and asymmetry compared with controls. The 1PN zygotes had a 6.4% implantation rate and viable pregnancy rate of 1.3%. Of the nine 3PN zygotes transferred, none implanted.

Conclusion(s): Two-pronuclear zygotes transitioning through 1PN or 3PN states tend to develop into poorer-quality embryos than 2PN control zygotes. Patients should be counseled regarding the very low likelihood of viable pregnancy after transfer of these abnormally developing zygotes.
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http://dx.doi.org/10.1016/j.fertnstert.2009.04.018DOI Listing
August 2010

hMG increases the yield of mature oocytes and excellent-quality embryos in patients with a previous cycle having a high incidence of oocyte immaturity.

Fertil Steril 2009 Sep 7;92(3):946-949. Epub 2009 Apr 7.

Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

In a selected group of patients with >20% oocyte immaturity during an IVF cycle with FSH alone, the addition of hMG to the stimulation protocol results in a higher yield of mature oocytes and excellent-quality embryos.
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http://dx.doi.org/10.1016/j.fertnstert.2009.02.039DOI Listing
September 2009

In vitro fertilization outcomes after transfer of embryos contaminated with yeast.

Fertil Steril 2009 Jan 4;91(1):294-7. Epub 2008 Mar 4.

Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02052, USA.

In this retrospective, matched-paired study, yeast in the embryo culture medium was associated with a trend toward decreased developmental competency that was more pronounced when observed early in culture. Because live births occurred after transfer of embryos in the yeast-contaminated group, we concluded that yeast contamination is not a reason to cancel embryo transfer (ET).
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http://dx.doi.org/10.1016/j.fertnstert.2007.11.032DOI Listing
January 2009

Coasting vs. cryopreservation of all embryos for prevention of ovarian hyperstimulation syndrome in in vitro fertilization.

Fertil Steril 2008 Oct 27;90(4):1259-62. Epub 2007 Dec 27.

Department of Obstetrics and Gynecology, Division of Reproductive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

In the patient at risk for ovarian hyperstimulation syndrome, coasting will result in fewer eggs retrieved and embryos produced when compared with cryopreservation of all embryos. However, both strategies are associated with a similar incidence of ovarian hyperstimulation syndrome, with achievement of comparable cumulative pregnancy rates.
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http://dx.doi.org/10.1016/j.fertnstert.2007.07.1383DOI Listing
October 2008

Early compaction on day 3 may be associated with increased implantation potential.

Fertil Steril 2006 Nov 14;86(5):1386-91. Epub 2006 Sep 14.

Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.

Objective: To determine whether day 3 embryos exhibiting early compaction have an improved implantation potential compared to embryos without compaction.

Design: A retrospective cohort study.

Setting: Hospital-based academic medical center.

Patient(s): Women <38 years of age undergoing IVF cycles between November 2001 and December 2004 having a day 3 transfer of one or two embryos with >8 cells.

Intervention(s): Standard IVF protocol.

Main Outcome Measure(s): Compaction grading and implantation rates of 1,047 embryos as related to fragmentation of >or= 8-cell embryos in patients with either 0% or 100% implantation.

Result(s): Compaction grading was strongly associated with implantation potential; however, the direction of this effect depended on the degree of fragmentation. In embryos with <10% fragmentation, implantation rates increased with the degree of compaction (grade 1, 25%; grade 2, 33%; and grade 3, 47%); in embryos with >or=10% fragmentation, the effect was reversed (grade 1, 38%; grade 2, 20%; and grade 3, 9%).

Conclusion(s): Assessing the degree of compaction can be a valuable addition to traditional morphologic assessment in identifying optimal embryos for transfer on day 3.
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http://dx.doi.org/10.1016/j.fertnstert.2006.03.051DOI Listing
November 2006

Benefit of intracytoplasmic sperm injection in patients with a high incidence of triploidy in a prior in vitro fertilization cycle.

Fertil Steril 2006 Oct 11;86(4):825-9. Epub 2006 Sep 11.

Department of Obstetrics and Gynecology, Stanford University Medical Center, Stanford, California, USA.

Objective: To test the hypothesis that intracytoplasmic sperm injection (ICSI) overcomes a high incidence of tripronucleate zygotes resulting from standard insemination in a previous cycle.

Design: A retrospective analysis of matched-pair cycles.

Setting: Assisted reproductive technologies (ART) program of Brigham and Women's Hospital.

Patient(s): Ninety-five patients with a > or = 20% incidence of tripronucleate zygotes in an IVF cycle with use of ICSI in a subsequent attempt.

Intervention(s): Cycles with either standard insemination or ICSI.

Main Outcome Measure(s): Incidence of diploid (2pn) and triploid (3pn) zygotes and number and quality of embryos obtained.

Result(s): Patient age, ampules of gonadotropin used, peak E2, number of follicles at hCG trigger, and total number of oocytes were all significantly higher in the ICSI cycles, but the number of mature oocytes did not differ. After ICSI, the percentage of 2pn was higher (65.0% vs. 34.1%) and the percentage of 3pn was lower (5.0% vs. 33.9%) than after IVF, and more diploid embryos were obtained with ICSI (5.5 +/- 3.7 vs. 3.4 +/- 2.2 [mean +/- SD]). There was no difference in embryo quality between the two groups.

Conclusion(s): ICSI appears beneficial in women with a high 3pn occurrence from IVF because it increases the number of diploid zygotes without affecting embryo quality.
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http://dx.doi.org/10.1016/j.fertnstert.2006.03.043DOI Listing
October 2006

Effects of culture medium on HCG concentrations and their value in predicting successful IVF outcome.

Reprod Biomed Online 2006 May;12(5):590-8

Department of Obstetrics and Gynecology, ASBI-3, Room 082, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.

The hypothesis was tested that the medium used to culture embryos affects the concentration of human chorionic gonadotrophin (HCG) early in pregnancy. The value of these concentrations in predicting successful outcome was also assessed for each medium studied. Patients undergoing IVF between January 1998 and December 2004 and having a day 3 embryo transfer were stratified into one of four groups according to the medium in which their embryos were cultured (P1, IVF500, G1.2, and G1.3). Using receiver operating characteristic (ROC) curve analysis, cut-off values for serum HCG concentrations on day 15 after embryo transfer were calculated for optimal discrimination between cycles resulting in implantation failure and success for each medium. Cut-off points were chosen to maximize sensitivity and specificity. For viable singleton pregnancies, mean HCG concentrations were greater for G1.3 and lower for IVF500 compared with the other media. Discriminatory HCG cut-off concentrations for predicting implantation success were lowest for IVF500, intermediate for P1 and G1.2 and highest for G1.3. The data support the hypothesis that the medium used to culture embryos significantly affects the concentrations of HCG early in pregnancy. Furthermore, when using HCG cut-off concentrations to assess pregnancy outcome, medium type should be taken into consideration.
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http://dx.doi.org/10.1016/s1472-6483(10)61185-6DOI Listing
May 2006

Day 3 and day 5 morphological predictors of embryo viability.

Reprod Biomed Online 2003 Apr-May;6(3):323-31

Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, ASB 1+3, Room 082, Boston, MA 02115, USA.

Controlling multiple pregnancies in patients undergoing artificial reproductive procedures requires consideration of single embryo transfers. Therefore, refinements for embryo evaluation are needed that select for the most developmentally competent embryo. The present study was designed to identify day 3 and day 5 morphological predictors of viability following transfers in which the morphology and fate of each embryo was precisely determined. Assessments on day 3 included cell number, and the extent of fragmentation and asymmetry, and on day 5, the developmental stage. Embryos resulting in a viable fetus at 11 weeks gestation were considered developmentally competent. The relationships among individual and collective embryo morphological characteristics were evaluated. Analysis of the interactions among morphological characteristics of embryos transferred on day 3 enabled identification of a multivariable selection order. Assessment of day 5 embryos revealed that expanding and expanded blastocysts exhibited comparable developmental potential that was superior to that of either morulae or early blastocysts. However, expanding or expanded blastocysts derived from 7-cell or 8-cell embryos were developmentally superior to those derived from other cleavage stages, regardless of fragmentation or asymmetry. Collectively, these findings further understanding of morphological predictors of viability, thereby improving the ability to select the most viable embryo for transfer.
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http://dx.doi.org/10.1016/s1472-6483(10)61852-4DOI Listing
December 2003
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