Sydney IVF

Sydney, Australia

Sydney IVF

Sydney, Australia
SEARCH FILTERS
Time filter
Source Type

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.


Peura T.,Sydney IVF | Schaft J.,Sydney IVF | Dumevska B.,Sydney IVF | Stojanov 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. © 2011 by John Wiley & Sons, Inc.


Traversa M.V.,Sydney IVF | Carey L.,Sydney Genetics | Leigh D.,Sydney IVF
Molecular Human Reproduction | Year: 2010

Preimplantation genetic diagnosis (PGD) for structural chromosome abnormalities traditionally uses fluorescence in situ hybridization (FISH) techniques. Although relatively straight forward, FISH is technically demanding with several process problems which include cell loss, cell overlap, variable cell fixation and hybridization as well as sample mosaicism. Increasingly, alternative techniques for chromosome analysis in embryos are being investigated in an attempt to improve on current test outcomes. Here, we report on the first routine application of a polymerase chain reaction (PCR)-based protocol for translocation analysis utilizing multiplexed short tandem repeat (STR) markers located on both segments of the translocated chromosomes. Resulting STR profiles permit the analysis of qualitative dosage of each chromosomal segment to identify translocation malsegregants from the balanced/normal chromosome complements. A total of 29 patients have undergone clinical PGD testing of 78 embryos using this method. The proportion of alternate segregations (i.e. balanced carrier and non-carriers) detected for reciprocal and Robertsonian translocation carriers was 33% and 77%, respectively. Fetal heart pregnancy rates per embryo transferred was 46% for reciprocal carriers and 40% for Robertsonian carriers (mean number of embryos transferred was 1.0). This novel approach can be applied easily within any existing PGD PCR laboratory and allows for a significant improvement in the identification of segregation types when compared with the standard FISH protocol using combinations of distal and proximal probes. This approach increases test robustness and reliability with improved interpretation of segregation outcomes, decreased analysis time and also enables the straight forward combining of structural chromosome analysis with monogenic testing. © The Author 2010. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org.


Karatas J.C.,University of Sydney | Karatas J.C.,Royal North Shore Hospital | 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.


Karatas J.C.,University of Sydney | Barlow-Stewart K.,Center for Genetics Education | Meiser B.,University of New South Wales | Meiser B.,Prince of Wales Hospital | And 5 more authors.
Human Reproduction | Year: 2010

Background Women often enter preimplantation genetic diagnosis (PGD) treatment following traumatic reproductive and genetic histories, the detrimental psychological effects of which are known to be long lasting in some cases. In addition, attempting IVF with PGD requires an in-depth understanding of the aspects of the technology. The level of information that is required and retained by women entering treatment is important for clinicians to understand. To date, neither of these issues has been explored empirically. To address this, we assessed mood and information-seeking behavior in a sample of women entering PGD. Methods Fifty women entering PGD treatment completed self-administered questionnaires that assessed anxiety, depression, knowledge of technical aspects of PGD, expectancy of establishing a pregnancy and unmet information needs. Result SAnxiety and depression rates were similar to normal population data. State anxiety was associated with degree of financial worry [β = 0.36, t = 2.60, P = 0.01, 95% confidence interval (CI): 0.03-0.23], and living in an inner metropolitan area (β = 0.30, P = 0.03, 95 CI: 0.32-10.81). Unmet information needs were positively associated with women's education (β = 0.97, P = 0.01, 95% CI: 0.22-1.73). Lastly, expectancy of establishing a pregnancy was above that of what clinicians provide as realistic PGD pregnancy chances and, unexpectedly, was also associated with degree of financial worry (β = 0.36, P = 0.01, 95% CI: 0.07-0.56). Conclusions Women entering PGD are emotionally well adjusted although the financial costs associated with PGD are associated with increases in anxiety. The study is limited by its small sample size and the fact that partners were not assessed. © The Author 2010.


Karatas J.C.,University of Sydney | Barlow-Stewart K.,Center for Genetics Education | Barlow-Stewart K.,University of Sydney | Meiser B.,University of New South Wales | And 5 more authors.
Human Reproduction | Year: 2011

Background PGD has been described in previous cross-sectional and retrospective studies as a stressful experience. No prospective studies of the psychological impact of PGD are currently available. Methods Using a prospective study design, validated measures exploring anxiety and depression were used to assess women using PGD prior to treatment, following embryo transfer, following the pregnancy test result and at 24 weeks of pregnancy. Maternal-fetal attachment was also assessed during pregnancy. Results The prospective design revealed the cyclical pathway through PGD for many women, often comprising repeated cycles of ovarian stimulations and IVF and frozen embryo transfers. As predicted, there were significant fluctuations in womens anxiety scores, with increases observed following embryo transfer and pregnancy testing. Womens anxiety scores returned to baseline levels during pregnancy as assessed at 24 weeks gestation. Depression scores did not significantly fluctuate during PGD. Maternal-fetal attachment scores in this sample did not differ from the normative Australian data. Conclusions For some women, the PGD pathway is convoluted and requires multiple IVF cycles and embryo transfers to achieve pregnancy. A subset of women experience significant emotional burden during PGD treatment, and it is these women who require closer attention and support. In this sample, emotional adjustment in pregnancy following PGD appears to be sound. © 2010 The Author.


Stark A.,Sydney IVF | Morgan G.,Sydney IVF
Twin Research and Human Genetics | Year: 2011

Izabella and her partner sought pre-implantation genetic diagnosis (PGD) because Izabella had retinoblastoma due to a deletion in chromosome 13 and they want to have children not at genetic risk of retinoblastoma. Fortunately, Izabella's tumor was unilateral and was treated successfully and she is well. Izabella's chromosome abnormality is mosaic with 70% of lymphocytes having the deletion. This mosaicism may not be present in Izabella's ovaries. The couple went through PGD on two occasions and 13 embryos were tested. None had the deleted chromosome 13. IVF and PGD failed to produce a pregnancy. The couple wished to know what the experience provides as to the risk to their offspring: in particular, does it indicate a risk low enough to be acceptable if they go ahead with a natural pregnancy instead of another resort to PGD? Also, the couple did not want prenatal diagnosis. The situation therefore requires an estimate of the probability that an embryo will have the deletion. Counseling is problematic because there is no obvious way of selecting a prior probability from which to compute a Bayesian estimate of risk. Two solutions are offered, depending on the amount of information available about genes transmitted from the maternal grandparents.


Karatas J.C.,University of Sydney | Karatas J.C.,Royal North Shore Hospital | Barlow-Stewart K.,University of Sydney | Barlow-Stewart K.,Royal North Shore Hospital | 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.


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.


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.

Loading Sydney IVF collaborators
Loading Sydney IVF collaborators