Archive for Fertility News
Objective: To evaluate the presence of spermatogonia in men diagnosed with Klinefelter syndrome (KS), in whom no testicular spermatozoa were recovered by testicular sperm extraction.Design: Retrospective case series.Setting: University hospital.Patient(s): Testicular samples from 22 nonmosaic 47,XXY men, aged 24–43 years, with no spermatozoa at multiple biopsies.Intervention(s): Paraffin-embedded testicular tissue was sectioned and stained with hematoxylin-eosin, and immunostainings were performed for both MAGE-A4 and vimentin.Main Outcome Measure(s): The presence of spermatogonia.Result(s): Massive fibrosis and hyalinization were observed in all men with KS. Spermatogonia were observed in 4 of 22 men with KS, with differentiation up to the spermatocyte level in 2 of them.Conclusion(s): A few men with KS, having no spermatozoa after testicular sperm extraction, still had few spermatogonia. These patients may eventually benefit from in vitro maturation using spermatogonial stem cells. The adult KS population can thus be divided into three subgroups: one subgroup showing focal spermatogenesis, a second having spermatogonia, and a third group in which no germ cells can be recovered. Further research is necessary to unravel the mechanism leading to these different patterns in patients with KS.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To determine whether elective single embryo transfer (eSET) lowers the risk of poor perinatal outcomes associated with IVF, when [1] compared with double embryo transfer (DET) or multiple embryo transfer (MET), and separately, [2] compared with spontaneous conceptions.Design: Systematic review and meta-analysis.Setting: Centers for reproductive care.Patient(s): Infertility patients.Intervention(s): MEDLINE, Embase, and bibliographies were searched for the period 1978–2011. Two reviewers independently assessed titles, abstracts, and full studies, extracted data, and assessed quality. Dichotomous data were pooled using relative risks and continuous data with mean differences using a random effects model. Randomized controlled trials (RCTs), case–control studies, and cohort studies that examined any of the primary or secondary outcomes in singleton, twin, or multiple-order infants conceived by eSET as compared with [1] those conceived by DET or MET or [2] spontaneously conceived singleton gestations were included.Main Outcome Measure(s): Primary outcomes were preterm birth (PTB, <37 weeks’ gestation) and low birth weight (LBW, <2,500 g).Result(s): Sixteen studies were included (eight RCTs, eight cohort studies). Compared with DET-conceived infants, eSET-conceived singletons were less likely to be born either preterm (RCT-based relative risk [RR] 0.37, 95% confidence interval [CI] 0.25–0.55) or with LBW (RCT-based RR 0.25, 95% CI 0.15–0.45; cohort study RR 0.51, 95% CI 0.29–0.91). However, compared with spontaneously conceived singletons, eSET gestations had higher risks of PTB (RR 2.13, 95% CI 1.26–3.61), placenta previa (RR 6.02, 95% CI 2.79–13.01), gestational diabetes (RR 1.69, 95% CI 1.19–2.42), and ectopic pregnancy (RR 6.40, 95% CI 4.38–9.35).Conclusion(s): Elective single embryo transfer is associated with decreased risks of PTB and LBW compared with DET but higher risks of PTB compared with spontaneously conceived singletons.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To assess the developmental kinetics of human embryos and their ability to develop to morphologically normal blastocysts.Design: Experimental study on human embryos donated for research using a time-lapse imaging system based on individual embryo culture in poly(dimethylsiloxane) microwells and monitored using a microscope inside the incubator.Setting: Private fertility clinic.Patient(s): Surplus embryos donated by couples after undergoing fertility treatment.Intervention(s): None.Main Outcome Measure(s): Blastocyst score and times required from beginning to completion of the second and third mitotic divisions.Result(s): The time required for completion of the second division (the three- to four-cell stage) was shorter in embryos that developed to high-scoring blastocysts (0.7 hours, n = 17) than in those forming low-scoring blastocysts (3.7 hours, n = 24). Similarly, the mean time required to completion of the third division (five- to eight-cell stage) was also significantly shorter in embryos forming high-scoring blastocysts (5.7 hours) than among those forming low-scoring blastocysts (16.9 hours).Conclusion(s): Individual embryos with the potential to develop to high-scoring blastocysts could be selected at 2–3 days of culture using this system by examining the times required to complete the second and third mitotic divisions.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To determine the incidence of fragmented oocytes in intracytoplasmic sperm injection (ICSI) cycles, describe the developmental potential of their sibling oocytes, and define clinical outcomes from affected cycles.Design: Case-control study.Setting: Academic medical center.Patient(s): All ICSI cycles from January 2006 to December 2010 (n = 2,844) were reviewed for the presence of fragmented oocytes at cumulus stripping or fertilization check (n = 93). Sibling oocytes and corresponding embryos from index cycles were compared with matched control cycles without fragmented oocytes.Intervention(s): None.Main Outcome Measure(s): Cycle characteristics, embryo quality, and pregnancy rates per retrieval.Result(s): The incidence of ICSI cycles containing at least one fragmented oocyte was 3.3% (93/2,844). Twelve patients were represented more than once in these 93 index cycles. Only the first cycles (n = 81) were included, of which 28 contained fragmented oocytes at cumulus stripping, 48 at fertilization check, and five at both. Compared with matched controls, index cycles had fewer good-quality embryos available for transfer (18.8% vs. 32.1%) and significantly lower rates of implantation (20.3% vs. 32.7%), clinical pregnancy (33.3% vs. 58.0%), and ongoing delivery (29.6% vs. 49.4%). The cumulative ongoing delivered rate was also significantly lower for index cycles (32.1% vs. 55.6%), with no difference in the percentage of cycles with cryopreserved embryos remaining at study conclusion (13.5% vs. 23.5%).Conclusion(s): Cohorts containing fragmented oocytes have decreased developmental potential. The biologic mechanisms underlying this occurrence merit further investigation, and patient counseling should reflect the possible decreased success rates associated with this aberrant developmental pattern.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To compare the efficacy of intravaginal and IMP for luteal phase support in IVF cycles.Design: Prospective trial.Setting: Tertiary care private practice.Patient(s): Women 25–44 years old with infertility necessitating treatment with IVF. From April 1, 2008–April 1, 2009, 511 consecutive patients were enrolled; 474 completed participation, and 37 were excluded for no autologous ET (freeze all, donor recipients, failed fertilization/cleavage). There were no demographic differences between the two treatment groups.Intervention(s): Luteal phase support using either Crinone or P in oil starting 2 days following oocyte retrieval.Main Outcome Measure(s): Pregnancy and delivery rates stratified by patient age.Result(s): Overall, patients who received vaginal P had higher pregnancy (70.9% vs. 64.2%) and delivery (51.7% vs. 45.4%) rates than did patients who received IMP. Patients <35 who received vaginal P had significantly higher delivery rates (65.7% vs. 51.1%) than did patients who received IMP. There were no differences, regardless of age, in the rates of biochemical pregnancy, miscarriage, or ectopics.Conclusion(s): In younger patients undergoing IVF, support of the luteal phase with Crinone produces significantly higher pregnancy rates than does IMP. Crinone and IMP appear to be equally efficacious in the older patient.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To examine the effect of height, weight, and body mass index (BMI) on the risk of preterm birth of singleton and twin pregnancies conceived by vitro fertilization (IVF).Design: Retrospective cohort study using 2006–2008 data from the Society for Reproductive Technology Clinic Outcome Reporting System (SART CORS).Setting: SART-associated assisted reproductive technology programs.Patient(s): 56,556 singleton and 23,804 twin live births resulting from fresh nondonor IVF cycles.Intervention(s): None.Main Outcome Measure(s): Rates of very early preterm (VEPTB; <28 weeks), very preterm (VPTB; <32 weeks), and preterm birth (<37 weeks) births.Result(s): In both singleton and twin births, increased maternal height was associated with a decreased risk of preterm birth. Maternal overweight and obesity were associated with significantly increased risk of VEPTB and VPTB in twin pregnancies. For very obese women (BMI > 35 kg/m2) twins were associated with a threefold increased risk of VEPTB (6.1% vs. 2.0%) and a twofold increased risk of VPTB (11.5% vs. 5.9%) compared with women of normal weight (BMI 18.4–24.9 kg/m2).Conclusion(s): Obesity and short stature significantly increase the risk of VEPTB and VPTB in twins conceived by IVF.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To determine the cost-effectiveness of medical and surgical management of early pregnancy loss.Design: Analyses of cost, effectiveness, and incremental cost-effectiveness ratios and utilities of a multicenter trial with 652 women with first-trimester pregnancy failure randomized to medical or surgical management.Setting: Analysis of data from a multicenter trial.Patient(s): Secondary analysis of a multicenter trial.Intervention(s): Cost-effectiveness analysis.Main Outcome Measure(s): Cost and effectiveness of competing treatment strategies.Result(s): Cost analysis of treatment demonstrates an increased cost of US$336 for 13% increased efficacy of surgical management. This analysis was sensitive to the probability of an extra office visit, the cost of the visit, and the probability of success. When the surgical arm is divided into outpatient manual vacuum aspiration (MVA) versus inpatient electric vacuum aspiration (EVA), there is an increased cost of $745 for EVA but a decreased cost of $202 for MVA compared with medical management. In general, MVA was found to be more cost-effective than medical management. For treatment of incomplete or inevitable abortion, medical management was found to be less costly and more efficacious. Utilities studies demonstrated that a patient would need to prefer surgery 14% less than medication for its treatment efficacy to be outweighed by the desire to avoid surgery.Conclusion(s): Surgical or medical management of early pregnancy failure can be cost effective, depending on the circumstances. Surgery is cost effective and more efficacious when performed in an outpatient setting. For incomplete or inevitable abortion, medical management is cost effective and more efficacious.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To investigate whether antitrophoblast antibodies are associated with unexplained recurrent miscarriages, we used choriocarcinoma cells JEG-3, since these cells are negative for class I and II antigens, but they do express HLA-G, resembling an antigen expression of endovascular and interstitial trophoblasts.Design: Case-control study.Setting: Academic research center.Patient(s): One hundred ninety-four patients with two or more consecutive, idiopathic recurrent miscarriages (RM; <20 weeks of gestation) were compared with 110 controls with normal pregnancies and without pregnancy complications.Intervention(s): Anti-JEG-3 reactivities were measured by using flow cytometry and comparisons with two in-house standards antibody samples of low and high reactivity.Main Outcome Measure(s): Anti-JEG-3 reactivities above the 95% confidence interval of controls were defined as positive.Result(s): Sera of RM patients reacted significantly stronger with JEG-3 cells than that of controls. In addition, RM patients significantly more often had positive anti-JEG-3 reactivities (17.5%) than controls 5%. This difference was markedly increased with a subgroup of 80 RM patients who had three or more miscarriages, as 27 of these women (34%) were anti-JEG-3 positive.Conclusion(s): Antitrophoblast antibodies show significantly more mean channel shift reactivities, and positive reactivities are significantly more prevalent in RM patients as compared with controls. Such antibodies may be involved in mechanisms affecting pregnancies.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To evaluate the cumulative pregnancy rate (CPR) per patient after in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI) cycles in patients with endometriomas and to evaluate the determinant factors of CPR per patient.Design: Retrospective study from January 2007 to October 2008.Setting: Tertiary care university hospital.Patient(s): 103 patients who had undergone IVF treatment, comprising isolated endometriomas (n = 30) and endometriomas with associated deep infiltrating endometriosis (DIE) (n = 73).Intervention(s): None.Main Outcome Measure(s): Clinical pregnancy rate after IVF-ICSI cycle.Result(s): The total number of cycles was 162, and the median number of cycles per patient was 1 (1 to 5). Fifty-eight women (56.3%) became pregnant. The total number of endometriomas and size of the largest endometrioma and bilateral endometriomas had no impact on the CPR per patient. Using multivariable analysis, the associated DIE and antimüllerian hormone serum level (?1 ng/mL) were independent factors associated with a decrease in the pregnancy rate per patient. Overall, the CPR per patient was 73.7%, and it increased until the third cycle with no benefit for additional cycles. The CPR per patient for women with isolated endometriomas and women with endometriomas and associated DIE was 82.5% and 69.4%, respectively.Conclusion(s): Associated DIE has a negative impact on assisted reproduction results in patients with endometriomas. Moreover, our data show that after three IVF-ICSI cycles the CPR per patient is not improved and that surgery should be considered.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To assess the relationship between endometriotic lesions with associated nerve fibers with both pain and peritoneal fluid (PF) cytokine concentrations based on lesion location.Design: An observational study.Setting: University hospital.Patient(s): Premenopausal women undergoing laparoscopy.Intervention(s): The pain experienced by patients was recorded before surgery and ectopic endometrial tissue excised and matching PF collected during laparoscopy. Immunohistochemistry was performed on endometriotic tissue sections to identify nerve fibers and PF cytokine concentrations determined.Main Outcome Measure(s): The pain experienced by women with endometriosis, the lesion locations, and the prevalence and proximity of nerve fibers to endometriotic lesions, as well as the PF concentrations of multiple cytokines.Result(s): Lesions from the rectovaginal septum were significantly more likely to be associated with a nerve fiber and report more menstrual pain than lesions from other regions. The PF glycodelin concentrations were also significantly higher in samples with an endometriotic-associated nerve. In peritoneal endometriotic lesions significantly more menstrual pain was reported when endometriotic lesions were associated with nerve fibers, although no difference was observed between the cytokine concentrations. Ovarian endometriotic lesions were rarely associated with nerve fibers.Conclusion(s): The presence of endometriosis-associated nerve fibers appear to be related to both the pain experienced by women with endometriosis and the concentration of PF cytokines; however, this association varies with the lesion location.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To investigate the effect of prior chemotherapy and radiation on assisted reproductive technology (ART) outcomes.Design: Retrospective cohort study.Setting: University-based infertility clinic.Patient(s): Female cancer survivors who had received chemotherapy or radiation and all other women undergoing first-fresh IVF/intracytoplasmic sperm injection (ICSI) cycles.Intervention(s): Survivors’ ART outcomes were compared with all women undergoing first-fresh IVF/ICSI cycles and those with male-factor infertility only. Multivariate logistic and Poisson regression analyses were used to estimate the effect of cancer therapy on ART outcomes.Main Outcomes Measure(s): Number of oocytes retrieved and embryos obtained; odds of cycle cancelation, clinical pregnancy, and live birth.Result(s): Compared with others undergoing IVF/ICSI, survivors had significantly fewer oocytes retrieved and embryos available for transfer. In addition, survivors were significantly more likely to be canceled (odds ratio [OR] 5.60, 95% CI 2.94–10.66) and had lower pregnancy and live birth rates (OR 0.30, 95% CI 0.13–0.68; and OR 0.27, 95% CI 0.10–0.69; respectively). Odds ratios were stronger when the comparison group was restricted to those with male-factor infertility only.Conclusion(s): Women who have received systemic therapy for malignancy should be considered to be low responders and counseled that their per-cycle live birth rate is lower than that of their peers. These data strongly support offering fertility preservation before cancer therapy when possible.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To describe the first live birth after transplantation of ovarian tissue following overnight transportation of the tissue before freezing.Design: Technical note.Setting: University department of obstetrics and gynecology.Patient(s): A 25-year-old cancer survivor with previous Hodgkin disease and relapse.Intervention(s): The ovarian tissue was kept cool for >20 hours in a special transport medium and a special cooling device before it was cryopreserved. After premature ovarian failure due to preconditioning chemotherapy for bone marrow transplantation, the cryopreserved ovarian tissue was transplanted orthotopically.Main Outcome Measure(s): Resumption of ovarian function after transplantation, recovery of fertility, and pregnancy.Result(s): Ovarian function returned in the patient 3 months after transplantation, as shown by follicle development and estrogen production. During the fifth menstrual cycle, mild stimulation with FSH was initiated in accordance with a low-dose protocol. When ultrasonography revealed a follicle 18–20 mm in size in the ovarian graft, hCG was added and the patient had sexual intercourse at the optimal time point. On day 14 of the luteal phase, hCG concentration and vaginal echography confirmed a viable intrauterine pregnancy, which resulted in a healthy live birth.Conclusion(s): Overnight transportation of ovarian tissue appears to be possible in combination with appropriate transportation logistics. However, further investigations are needed before this procedure can be offered as a chance for women to preserve fertility independently of direct access to a tissue-processing bank.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To search for WNT7A gene mutations in a cohort of 191 Chinese Han patients with müllerian duct abnormalities (MDAs).Design: Phenotypic and mutational study.Setting: University hospital.Patient(s): A total of 191 Chinese Han patients with MDAs and 192 healthy control individuals.Intervention(s): Genomic DNA extracted from blood samples, all coding regions amplified by polymerase chain reaction (PCR) then directly sequenced to screen variants.Main Outcome Measure(s): Not applicable.Result(s): The sequence analysis revealed one novel synonymous variant and three known single-nucleotide polymorphisms (SNPs).Conclusion(s): The results indicate that mutations in the coding sequence of WNT7A are not responsible for müllerian duct abnormalities in the Chinese population.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To characterize chromosomal error types and parental origin of aneuploidy in cleavage-stage embryos using an informatics-based technique that enables the elucidation of aneuploidy-causing mechanisms.Design: Analysis of blastomeres biopsied from cleavage-stage embryos for preimplantation genetic screening during IVF.Setting: Laboratory.Patient(s): Couples undergoing IVF treatment.Intervention(s): Two hundred seventy-four blastomeres were subjected to array-based genotyping and informatics-based techniques to characterize chromosomal error types and parental origin of aneuploidy across all 24 chromosomes.Main Outcome Measure(s): Chromosomal error types (monosomy vs. trisomy; mitotic vs. meiotic) and parental origin (maternal vs. paternal).Result(s): The rate of maternal meiotic trisomy rose significantly with age, whereas other types of trisomy showed no correlation with age. Trisomies were mostly maternal in origin, whereas paternal and maternal monosomies were roughly equal in frequency. No examples of paternal meiotic trisomy were observed. Segmental error rates were found to be independent of maternal age.Conclusion(s): All types of aneuploidy that rose with increasing maternal age can be attributed to disjunction errors during meiosis of the oocyte. Chromosome gains were predominantly maternal in origin and occurred during meiosis, whereas chromosome losses were not biased in terms of parental origin of the chromosome. The ability to determine the parental origin for each chromosome, as well as being able to detect whether multiple homologs from a single parent were present, allowed greater insights into the origin of aneuploidy.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To investigate a putative role of TSPYL1 in male idiopathic infertility.Design: Clinical article.Setting: University hospital.Patient(s): A total of 104 infertile men were selected with idiopathic nonobstructive azoospermia, cryptozoospermia, oligozoospermia, oligonecrozoospermia, and oligoasthenoteratozoospermia (OAT) syndrome, along with a control group of 106 men with proven paternity.Intervention(s): Mutation screening of the coding region and parts of the 5? and 3? untranslated regions of the TSPYL1 gene was performed by polymerase chain reaction and sequencing.Main Outcome Measure(s): Occurrence of TSPYL1 single-nucleotide polymorphisms (SNPs) and mutations.Result(s): In these cohorts, eight known TSPYL1 SNPs were identified, none of which was significantly associated with male infertility. Two potentially disease-causing variants were detected in the infertile cohort: one man with azoospermia was found to be heterozygous for the novel TSPYL1 variant c.419C>G (p.Ser140Cys), and the rare substitution c.1098C>A (p.Phe366Leu) was identified in a man with OAT syndrome in the heterozygous state. Additionally, one fertile man was found to be heterozygous for the rare variant c.487G>A (p.Val163Ile). In silico analyses predicted a nonpathogenic effect for all amino acid exchanges, although protein features might be affected by p.Ser140Cys and p.Phe366Leu, respectively.Conclusion(s): Mutations in the TSPYL1 gene do not seem to play a major role in the pathogenesis of idiopathic male infertility, and mutation screening of the TSPYL1 gene can currently not be recommended in routine diagnostics of idiopathic male infertility.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To determine women’s healthcare providers’ knowledge and attitudes regarding genetic disorders and expanded genetic screening.Design: Survey of American Society for Reproductive Medicine 2010 and American College of Obstetricians and Gynecologists 2011 Annual Meeting attendees. The survey included 60 items (12 demographic, 10 knowledge, and 38 attitude). Attitudes were assessed with a 5-point Likert scale. Chi-square or t tests determined significance.Setting: American Society for Reproductive Medicine 2010 and American College of Obstetricians and Gynecologists 2011 Annual Meeting.Patient(s): A total of 203 participants completed the survey. Of these, 48% were male, 61% were physicians, 73% were Caucasian, and 42% were aged 35–50 years.Intervention(s): None.Main Outcome Measure(s): None.Result(s): Physicians had better knowledge scores than other participants (87% vs. 79%). Knowledge was not influenced by prior personal/family experience with genetic screening. Fewer correct answers were observed for the probability of a positive test (65.2%), the risk of transmitting a gene mutation (62.2%), and the risk of having an affected child (56.2%). Very few participants (18.3%) disagreed with the notion of carrier screening as socially responsible behavior. Some had concerns about test result confidentiality (40.1%) and resulting insurance rate increases (37.0%). Assuming equal costs, most participants preferred to be tested for a larger number of diseases (77.7%) and believed posttest counseling to be helpful (83.7%).Conclusion(s): Women’s healthcare providers generally had good knowledge and positive attitudes about genetic disorders and expanded genetic screening. Specific misperceptions, both medical and legal, require education.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To assess oxidative stress status in coronary artery disease (CAD) patients according to gender.Design: Case-controlled, observational, retrospective study.Setting: Clinical and research center.Patient(s): A total of 55 postmenopausal women and 108 men (mean age: 66 ± 9 years), including 72 patients with angiographically proven CAD (CAD(+), 19 women) and a group of 91 age-matched controls (CAD(?), 36 women).Intervention(s): None.Main Outcome Measure(s): Oxidant/antioxidant balance as a global index (oxidative index) obtained using two commercial assays (d-ROMs and OXY Adsorbent Test, respectively) for estimation of levels of reactive oxygen metabolites and total antioxidant status.Result(s): There was a statistically significant difference in oxidative stress status between men and women who were CAD(?) (?0.424 ± 1.3 vs. 0.64 ± 1.1 arbitrary units, respectively), but the CAD(+) women had oxidative stress levels almost three times those of the CAD(+) men (2.45 ± 2.5 vs. 0.9 ± 1.6 arbitrary units, respectively). After adjustment in the multivariate model, age and oxidative stress status in women and diabetes and age in men remained as statistically significant predictors of positive CAD findings.Conclusion(s): Oxidative stress status was a powerful predictor of CAD in women. This result may have important implications for the differences between sexes in CAD physiopathology.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To determine the knowledge about fertility and assisted human reproduction (AHR) treatments of a large sample of childless women.Design: Self-report questionnaire comprising two self-ratings of current fertility and AHR knowledge, and 16 knowledge questions related to fertility and AHR.Setting: Online.Patient(s): A total of 3,345 childless women between the ages of 20 and 50.Intervention(s): None.Main Outcome Measure(s): Knowledge of fertility and AHR.Result(s): The majority of participants rated themselves as having some knowledge or being fairly knowledgeable about fertility and AHR. However, on the 16 knowledge questions, overall knowledge was low, with 50% or more of the sample answering only 6 of 16 questions correctly.Conclusion(s): The data suggest that the women in the study have no coherent body of knowledge regarding age-related fertility and AHR treatment options. With an increasing number of women electing to delay childbearing, there is a critical need for public education regarding age-related fertility declines and the availability, costs, and limitations of AHR. This study offers important mental health contributions to infertility prevention and public health education efforts.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To understand whether and to what extent U.S. IVF clinics inform egg donors that resultant embryos initially intended to be implanted for reproductive purposes may in fact be used for research instead.Design: Four hundred seventy U.S. IVF clinics were asked to respond to a questionnaire and provide a copy of the egg donor consent form(s) used at the clinic.Setting: Four hundred seventy U.S. IVF clinics listed in a Centers for Disease Control and Prevention database; only forms from clinics that both accepted donor eggs and provided excess embryos for research were analyzed for content.Patient(s): Not applicable.Intervention(s): Not applicable.Main Outcome Measure(s): Responses to the questionnaire, demographic data from a Centers for Disease Control and Prevention database, and the content of egg donor consent forms.Result(s): Of 222 U.S. IVF clinics that responded to our query, 100 clinics both accepted donor eggs and provided some excess embryos for research. We received 66 consent forms from these 100 clinics, which showed that although most egg donor consent forms inform donors that they will not have control over embryos resulting from their eggs, 30% inform them that some embryos may be used for research, and even fewer mention stem cell research.Conclusion(s): Egg donors in the United States, including some who may have a moral objection to research and stem cell research, are not being informed that embryos created with their donated eggs may in fact be used for these purposes. This can be corrected with the inclusion of succinct, nontechnical language in egg donor consent forms.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To examine: 1) current knowledge on normal biologic variation of seminal parameters; 2) how stress and psychological factors affect sperm quality in fertile and infertile males; and 3) how mental illness and psychopharmacologic agents can affect male fertility.Design: English-language Medline, Embase, and Psycinfo were searched for relevant publications (from 1970 to January 2011) for systematic review.Setting: None.Patient(s): None.Intervention(s): None.Main Outcome Measure(s): Possible effects of stress, mood, and psychotropic medications on male factor fertility.Result(s): Male-factor infertility is influenced by myriad factors (obesity, tobacco, etc.). Stress alone may reduce testosterone levels and spermatogenesis. Infertility assessment and treatment can lead to distress and negatively affect sperm samples. Available research has failed to control for potentially confounding variables.Conclusion(s): Although some trends have been identified, larger-scale studies that adequately control all confounding variables are needed before conclusions can be made about the relationship between stress, psychotropic agents, and male infertility.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To examine the impact of hormones used for controlled ovarian hyperstimulation (COH) on normal and malignant breast cell growth and proliferation.Design: In vitro study of cultured normal and malignant breast cell lines.Setting: Academic medical center.Patient(s): None.Intervention(s): Normal and malignant breast cell lines cultured in two- and three-dimensional (2D and 3D) systems and treated with follicle-stimulating hormone (FSH), luteinizing hormone (LH), or FSH with LH or human chorionic gonadotropin (hCG).Main Outcome Measure(s): Effects of treatment on cell proliferation in 2D culture using the MTS assay and on colony growth in 3D culture.Result(s): Compared with untreated cells, normal MCF-10A cells showed a decrease in proliferation and colony size when exposed to a combination of FSH and hCG. The HCC 1937 cells treated with FSH and LH also showed a decrease in colony growth but no change in proliferation. None of the treatments had an effect on the proliferation or colony size of the MCF-7 cells.Conclusion(s): Follicle-stimulating hormone, LH, and hCG do not appear to cause an increase in cell proliferation or colony growth in either normal or malignant mammary epithelial cell lines. The potential risk for mammary cell transformation associated with these agents may be related to indirect endocrine effects on breast cell physiology.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To evaluate the contraceptive ability of two B-cell epitopes in CatSper1.Design: In vivo study with mice.Setting: University laboratory animal service center.Animal(s): BALB/c mice.Intervention(s): Two predicted B-cell epitopes in the extracellular part of transmembrane domains and pore region of CatSper1 were synthesized to immunize male mice.Main Outcome Measure(s): Fertility, epididymal sperm function, and the presence of specific antibody in immunized males were investigated.Result(s): Significant reduction of fertility was observed in mating trial with no evident systemic illness or abnormal mating behavior. Epididymal sperm of epitope-immunized males exhibited impaired ability to fertilize eggs in vitro, and showed sperm agglutination in some animals, while presenting no changes in sperm viability or progressive motility. High titer of antibodies was induced in the sera, and the antibodies’ specificity was confirmed. The binding of the antibodies to epididymal sperm of epitope-immunized males was observed.Conclusion(s): CatSper members could be the effective and viable targets for immunocontraception. These two epitopes in CatSper1 share high identity between mouse and human and may be effective for fertility regulation in humans.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To detect plasminogen and plasminogen activators (PA) in oviduct and oocytes and to clarify the role of the plasminogen/plasmin system on mammalian fertilization.Design: Experimental prospective study.Setting: Mammalian reproduction research laboratory.Animal(s): Oviducts and ovaries from porcine and bovine females were collected at slaughterhouse. A total of 52 oviducts and 2,292 oocytes were used. Boar and bull ejaculated spermatozoa were also used.Intervention(s): Plasminogen concentration in oviductal fluid (OF) through the cycle was measured. Immunolocalization of plasminogen and PAs in oocytes was carried out before and after fertilization. Porcine and bovine oocytes were in vitro fertilized, with plasminogen and plasmin added to the culture medium at different concentrations.Main Outcome Measure(s): Plasminogen concentration in OF. Plasminogen and PAs immunolocalization in oocytes. Penetration and monospermy rates, number of spermatozoa in the ooplasma and on the zona pellucida (ZP) after IVF.Result(s): Oviductal fluid contains about 92 ?g/mL of plasminogen. The mature oocyte shows immunoreactivity toward plasminogen and toward PAs on its oolemma and ZP. After fertilization, plasminogen and PAs immunolabeling decreases in the oocyte, suggesting its conversion into plasmin. When exogenous plasminogen is added to the IVF medium, sperm entry into the oocyte is hampered, suggesting that the role of plasminogen activation during fertilization is to reduce the number of (or to select) penetrating spermatozoa.Conclusion(s): The plasminogen/plasmin system is activated during gamete interaction and regulates the sperm entry into the oocyte.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To investigate the vascular dysfunction caused by insulin resistance in polycystic ovary syndrome (PCOS) and the effectiveness of vitamin D in an animal model.Design: Controlled experimental animal study.Setting: Animal laboratory at a university research institute.Animal(s): Thirty female Wistar rats.Intervention(s): Rats were divided into groups at age 21–28 weeks. Twenty of them were subjected to dihydrotestosterone (DHT) treatment (83 ?g/d); ten of them also received parallel vitamin D treatment (120 ng/100 g/wk). Oral glucose tolerance tests with insulin level measurements were performed. Gracilis arterioles were tested for their contractility as well as their nitric oxide (NO)–dependent and insulin-induced dilation using pressure arteriography.Main Outcome Measure(s): Several physiologic parameters, glucose metabolism, and pressure arteriography.Result(s): DHT treatment increased the passive diameter of resistance arterioles, lowered norepinephrine-induced contraction (30.1 ± 4.7% vs. 8.7 ± 3.6%) and reduced acetylcholine-induced (122.0 ± 2.9% vs. 48.0 ± 1.4%) and insulin-induced (at 30 mU/mL: 21.7 ± 5.3 vs. 9.8 ± 5.6%) dilation. Vitamin D treatment restored insulin relaxation and norepinephrine-induced contractility; in contrast, it failed to alter NO-dependent relaxation.Conclusion(s): In DHT-treated rats, in addition to metabolically proven insulin resistance, decreased insulin-induced vasorelaxation was observed and was improved by vitamin D treatment without affecting NO-dependent relaxation. The reduction in insulin-induced dilation of arterioles is an important as yet undescribed pathway of vascular damage in PCOS and might explain the clinical effectiveness of vitamin D treatment.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
Objective: To obtain insight into the effects of androstenedione on ovarian folliculogenesis and oogenesis.Design: Experimental study.Setting: St. Marianna University School of Medicine.Animal(s): Prepubertal (14-day-old) BDF1 female mice.Intervention(s): Early secondary follicles were isolated from the ovaries and were cultured individually in vitro with or without androstenedione (10?11 to 10?5 M) for 12 days. Thereafter, the follicles were treated with hCG and epidermal growth factor (EGF).Main Outcome Measure(s): Diameters and morphology of follicles and oocytes; E2 and P secretion; and chromatin configuration and expression of growth differentiation factor 9 (GDF9) in oocytes were examined.Result(s): Early secondary follicles developed to the preovulatory stage. Androstenedione treatments increased the follicle diameters, reduced survival rates of follicles, and promoted the formation of follicles with abnormal morphology, including misshapen oocyte. The secretion of E2 and P was significantly higher in androstenedione-exposed follicles. Androstenedione prevented the alteration in chromatin configuration and reduced oocyte GDF9 expression. When follicles cultured with androstenedione were treated with hCG and EGF, the first polar body exclusion, chromosome alignment on metaphase plate, and spindle assembly were inhibited in the oocytes.Conclusion(s): These results demonstrate that excess androgen induces abnormalities in the morphology and function of developing oocytes, which impairs oocyte meiotic competence.Source:
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Posted on January 31, 2012 | Filed under Fertility News | Permalink
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