By Ann Westmore (auth.), Carl Wood CBE, FRCS, FRCOG, FRACOG, Alan Trounson MSc, PhD (eds.)
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As the technique of ET has been improved, the number of failed transfers has diminished. Despite this, failure does occur in 1 or 2 per 100 patients. Most infertility clinics use fertility drugs to increase the chances of conception in patients having IVF. In our own experience, the chances of establishing pregnancy are high if multiple embryos are produced (Trounson et al. 1981a). For example, in a recent trial, pregnancy rates were 12%, 28% and 40% after the transfer of one, two or three embryos respectively.
It is not possible to clone embryos from adult tissues at the present time. There is very little medical or scientific reason for pursuing this procedure in the human except for the possible removal of a cell to determine whether the embryo carries a genetic abnormality. The cell or cells extracted from the embryo would be examined immediately for chromosome karyotype, and embryos of only normal genetic constitution transferred back to the patient. Such a procedure would depend on whether the particular genetic disease can be identified by examination of chromosomes.
3 Syphilis All patients are screened for syphilis by VDRL test. The need to investigate further any patient with a positive titre, and appropriately treat the infection, is obvious. 4 Hepatitis B Surface Antigen Hepatitis B is tested for, as all these patients undergo numerous blood tests, and there is a high risk of the staff being infected. Maternal serum is also used in the preparation of the culture medium, thus equipment can also be contaminated. 5 Cytomegalovirus The reason for screening for cytomegalovirus (CMV) is more for reassurance than for any therapeutic purpose.