The Vienna program of in vitro fertilization and embryo-transfer--a successful clinical treatment.

A clinical program for in vitro fertilization (IVF) and embryo transfer (ET) is described. First successes were obtained using media and techniques according to Lopata et al. (1980, Fertil. Steril., 33, 117-120). The 'Vienna IVF and ET-program' was developed after several modifications and led to a pregnancy rate of 34%/ET. Studies on different culture media and their supplements were performed. B2-Menezo-medium supplemented by 15% human serum seemed best suited for human IVF because of its simplicity and readiness for use. However, there was no significant difference in comparison of the fertilization rate between B2 and modified Ham's F10 medium, or statistical difference between the usual 5% O2-5% CO2 and 90% N2 gas mixture for culture and 5% CO2 in air. So the latter can be used as a simpler system. pH measurements established follicular fluid to be very stable at 37 degrees C for several hours both on air and on 5% CO2. It is recommended as an appropriate medium for preincubating oocytes before insemination; eggs can also be transported in this fluid. Based on clinical experience a system of culturing eggs at one specialized IVF center for different hospitals and gynecologists can be discussed.