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Sydney, Australia

Peura T.,Sydney IVF
Current protocols in stem cell biology | Year: 2011

This unit describes generation of human embryonic stem cell lines from early human embryos. The focus is on actual handling of embryos and early embryonic outgrowths, omitting steps required for actual generation, freezing, and thawing of embryos, as well as further culture and characterization of newly derived stem cells. Hence, the initial culture of embryos to a blastocyst stage is described, followed by removal of the protective zona pellucida layer, isolation of the inner cell mass (ICM), subsequent plating of ICM or whole embryo and, finally, the first few passages of an early embryonic outgrowth. A few alternative procedures for some steps such as zona removal and inner cell mass isolation are described, to allow procedures to be modified according to circumstances.

Karatas J.C.,University of Sydney | Karatas J.C.,Center for Genetics Education | Strong K.A.,University of Sydney | Barlow-Stewart K.,University of Sydney | And 4 more authors.
Reproductive BioMedicine Online | Year: 2010

Preimplantation genetic diagnosis (PGD) was first reported as successful in humans in the early 1990s and nearly two decades later the psychological impact of PGD has not yet been clearly defined. As PGD requires the use of IVF, this paper provides a brief summary of literature related to the various psychological aspects of IVF followed by a review of the literature related to the psychological and broader psychosocial impact of PGD. The current literature includes attitudinal studies of couples for whom PGD may be beneficial and results suggest that those with traumatic reproductive and genetic histories are more likely to find PGD an acceptable treatment option. A small number of studies have used samples of women and couples who have used PGD. Due to a general lack of homogeneity in scope, method and results, these studies have not provided a uniform understanding of the PGD experience. Promisingly, however, two studies on parents of children born after PGD that explored parental stress show no differences between PGD, IVF and natural conception couples. The paper concludes that the missing link in the literature is a prospective study of PGD using validated psychological scales. Suggestions for future research are provided. © 2009 Reproductive Healthcare Ltd. All rights reserved.

Swanton A.,Royal Berkshire Hospital | Lighten A.,Sydney IVF | Granne I.,University of Oxford | McVeigh E.,University of Oxford | And 6 more authors.
Human Reproduction | Year: 2011

Background: Women with ovaries of polycystic morphology (PCO), without any other features of polycystic ovary syndrome (PCOS), respond similarly to women with PCOS when stimulated with exogenous gonadotrophins, and both groups share various endocrinological disturbances underlying their pathology. In women with PCOS, metformin co-treatment during IVF has been shown to increase pregnancy rates and reduce the risk of ovarian hyperstimulation syndrome (OHSS). The aim of this study was to investigate whether metformin co-treatment before and during IVF can also increase the live birth rate (LBR) and lower severe OHSS rates for women with PCO, but no other manifestations of PCOS. Methods: This study was a double-blind, multi-centre, randomized, placebo-controlled trial. The study population included 134 women with ovulatory PCO (and no evidence of clinical or biochemical hyperandrogenism) undergoing IVF treatment at three tertiary referral IVF units. The primary outcome was LBR. Results: In total, 134 women were randomized, 69 to metformin and 65 to placebo. There were no statistically significant differences between the two groups in baseline characteristics. With regard to IVF outcome, no significant improvements were found in the metformin group when compared with the placebo group. In particular, there was no difference between the groups in rates of live birth [metformin n=27 (39.1), placebo n 30 (46.2), (95 confidence interval 0.38, 1.49, odds ratio 0.75)], clinical pregnancy [metformin n=29 (42.0), placebo n 33 (50.8)] or severe OHSS [metformin n=6 (8.7), placebo n=5 (7.7)]. Conclusions: There appears to be no benefit in metformin co-treatment before and during IVF in women with PCO without any other features of PCOS. © 2011 The Author Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.

Karatas J.C.,University of Sydney | Karatas J.C.,Center for Genetics Education | Barlow-Stewart K.,University of Sydney | Barlow-Stewart K.,Center for Genetics Education | And 4 more authors.
Prenatal Diagnosis | Year: 2010

Objective: To provide an in-depth account of the experience of pre-implantation genetic diagnosis (PGD). Method: Exploratory qualitative interview study. Participants were recruited from one major in vitro fertilization (IVF) clinic in Sydney, Australia. Data were collected through 14 in-depth interviews with women at different stages of PGD, utilized a thematic approach and facilitated by NVivo software. Results: Women reported using PGD as empowering and led them to feel in control of their reproductive futures. Health professionals who did not tell women about PGD were seen as a barrier to accessing treatment. The ability to select embryos free from the genetic condition (for which it was at risk) alleviated stress. Despite this, stress experienced with PGD was significant for women, and often related to past experiences of reproductive trauma and grief. The outcome of embryos was also the cause of stress for women. Conclusion: Women undergoing PGD have a diverse range of reproductive and genetic histories, psychosocial circumstances and world views that all interact and impact their experience of PGD. Successful support and care of these women should address all of these factors and tailor the support provided for women using this physically and emotionally complex form of reproductive technology. Copyright © 2010 John Wiley & Sons, Ltd.

Richards A.,Sydney Cancer Center | Boogert T.,Sydney Ultrasound for Women | Livingstone M.,Sydney IVF | Dalrymple C.,Sydney Cancer Center
Ultrasound in Obstetrics and Gynecology | Year: 2012

Ovarian cancer is rarely diagnosed during assisted reproduction. Several case-control and cohort studies have described its incidence within the infertile population well after the assisted reproductive process. We present a case of endometrioid adenocarcinoma that developed during the ovarian stimulation process and show corresponding ultrasound images of its development. Copyright © 2012 ISUOG.

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