The objective of this prospective study was to evaluate the effect of ammonium accumulated in sequential media and determined by enzymatic spectrophotometric method on the blastocyst development in ...281 human embryos from 100 stimulated and natural in vitro fertilization (IVF) cycles. Ammonium concentration was increased in 62% of cycles and was correlated negatively with the blastocyst development after classical IVF, but not after intracytoplasmic sperm injection (ICSI).
Abstract
PURPOSE: To identify a subgroup of twin-prone women undergoing in vitro fertilization (IVF) with blastocyst transfer. MATERIALS AND METHODS OF INVESTIGATION: In a retrospective cohort study, ...2539 IVF cycles (1334 classical IVF and 1205 intracytoplasmic sperm injection ICSI cycles) in 1641 couples in the 3-year period were included. The cycles resulting in blastocysts were analysed in terms of female age, number of IVF attempts, infertility indication, number of developed blastocysts, and pregnancy, twin pregnancy and abortion rates. RESULTS: Blastocysts developed in 52 % of cycles. The pregnancy rate per blastocyst transfer was 43 % and the twin rate per pregnancy 20 %. We found a negative correlation between twin pregnancy rates, female age and number of IVF attempts, and a positive correlation between twin pregnancy rates and number of developed blastocysts. ICSI compromised blastocyst development without directly affecting pregnancy and twin pregnancy rates. Significantly higher twin pregnancy rates (39 % per pregnancy) were observed in women younger than 34 years who had 3 or more developed blastocysts. DISCUSSION, CONCLUSIONS: The subgroup of twin-prone women undergoing blastocyst transfer is characterized by age < 34 years, and number of developed blastocysts ≥ 3. Elective single blastocyst transfer in these selected women would hypothetically reduce twin pregnancy rates from 20 to 8 % per pregnancy.
Germ cell apoptosis in the human testis Martincic, D S; Virant Klun, I; Zorn, B ...
Pflügers Archiv,
01/2001, Letnik:
442, Številka:
6 Suppl 1
Journal Article
Recenzirano
Apoptosis is a widespread phenomena during development. It represents a form of cell death and has a crucial role in tissue homeostasis. Apoptosis is also involved in a number of pathological ...conditions. Spermatogenesis is a dynamic process of germ cell proliferation and differentiation. During regular spermatogenesis, the number of testicular germ cells degenerate by an apoptotic process. The significance of regulating cell population by apoptosis is more apparent when sperm production is halted. The presence and frequency of apoptosis in germ cells of human testis biopsy specimens were tested. The results confirm the presence of germ cell apoptosis but not the apoptosis of Sertoli cells. The increased apoptotic index was observed in patients with azoospermia in comparison with normal but obstructed spermatogenesis.
To estimate the clinical effectiveness of in vitro fertilization treatment in patients with minimal or mild endometriosis (stages I and II) in comparison to the patients with tubal infertility in ...terms of fertilization, pregnancy and livebirth rates.
Retrospective analysis of the outcome of IVF-ET in 612 cycles of the patients with endometriosis (389 stimulated with HMG/HCG and 223 co-treated with GnRH-a) and in 7,339 cycles of the patients with tubal infertility (5,520 stimulated with HMG/HCG and 1,819 co-treated with GnRH-a). RESULLTS: Regardless of the type of ovarian stimulation, the fertilization rate per treated cycle was practically the same in both groups (endometriosis 81.4% vs tubal infertility 84.2%; p = 0.07). However, in the endometriosis group the pregnancy rate was higher (25.3% vs 18.9%; p = 0.000), and so was the livebirth rate (19.0% vs 14.2%; p = 0.003). Considering the type of ovarian stimulation, the fertilization rate in the endometriosis group was almost the same in the HMG/HCG (81.2%) and in the GnRH-a co-treated cycles (81.6%), and did not differ from that in the tubal infertility group (83.6% in the HMG/HCG vs 85.9% in the GnRH-a cycles). In the GnRH-a co-treated cycles the pregnancy rate and the livebirth rate were not significantly higher in the endometriosis group than in the tubal infertility group (27% and 20.2% vs 22.2% and 17.5%). In the HMG/HCG stimulated cycles the pregnancy rate was significantly higher in the endometriosis than in the tubal infertility group (24.3% vs 17.7%; p = 0.004), and so was the livebirth rate (18.4% vs 13.0%; p = 0.008).
In patients with minimal or mild endometriosis the IVF-ET procedure is at least as effective as in patients with tubal infertility.
Objective: To evaluate the hormonal response to the short protocol of gonadotropin-releasing hormone (GnRH) analog (GnRHa) in patients with polycystic ovarian disease (PCOD).
Methods: We enrolled 35 ...patients (20 infertile) with ultrasonographic and hormonal PCOD characteristics. GnRHa Suprefact was applied subcutaneously at a daily dose of 0.9 ml for 9 consecutive days starting on the 10th–15th day after induced or spontaneous bleeding. Blood sampling for follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), estradiol (E
2), estrone (E
1) and dehydroepiandrosterone sulfate (DHEA-S) was performed before the treatment and on days 3 and 4 of GnRHa administration. Student's
t-test was used for the analysis of differences between various mean values. All statistical analyses were performed by the computerized statistical package CSS-Statistica.
Results: Pretreatment hormonal levels (FSH 5.68 ± 1.86 IU/l, LH 14.16 ± 1.72 IU/l, E
2 0.29 ± 0.20 nmol/l, E
1 0.35 ± 0.17 nmol/l, T 3.52 ± 1.40 nmol/l, DHEA-S 7.15 ± 2.89 μmol/l) barely differed on day 3 of GnRHa administration, except for the rise in LH (17.14 ± 10.97 IU/l), which was still not significant. On day 9 of GnRHa application, significant suppression of FSH (3.16 ± 1.55 IU/l) and LH (8.05 ± 5.00 IU/l) was registered compared with pretreatment levels, without changes in the FSH:LH ratio, and in other parameters studied. Although there were no changes in ultrasound characteristics on day 9 of GnRHa administration compared with basal findings, bleeding occurred 14–18 days after the last GnRHa dose in 32 patients. There were three pregnancies out of 20 infertile patients in the treated cycles.
Conclusion: Significant suppression of FSH and LH in PCOD patients does not interfere with ovarian steroid production, which is probably maintained due to higher follicular sensitivity to normal FSH and LH levels. Alternatively it may be the consequence of the unaltered FSH:LH ratio in spite of GnRHa-suppressed absolute values. However the recommencement of menstrual bleeding and 15% of pregnancies in the investigated infertile patients suggest the occurrence of certain temporary intraovarian events, which probably continue after the cessation of GnRHa administration.
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