Effect of sperm treatment with exogenous platelet-activating factor on the outcome of intrauterine insemination

OBJECTIVE: To evaluate the effect of sperm treatment with exogenous platelet-activating factor (PAF) on IUI clinical pregnancy rate. DESIGN: Prospective randomized study. SETTING: Assisted Reproduction Unit, 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Athens, Greece. SUBJECT(S): Fifty-two couples with unexplained infertility, candidates for IUI. INTERVENTION(S): Sperm treatment with an exogenous mixture of PAF (final concentration, 10(-7) mol/L) in sperm-washing medium, direct swim-up technique of sperm preparation, a maximum of six IUI cycles per couple with or without PAF treatment. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate (pregnancies confirmed by ultrasonography per hundred cycles). RESULT(S): The overall clinical pregnancy rate after a maximum of six IUI cycles was significantly higher when sperm was treated with PAF compared with the rate after the direct swim-up technique (23.07% vs. 7.92%). CONCLUSION(S): Treatment of sperm with exogenous PAF might improve the clinical outcome of IUI in cases of unexplained infertility.     

Subfertility, fecundability, and the impact of laparoscopy on conception rates

Confusion is common when trying to compare the outcome of different fertility treatments. Calculation of fecundability is an excellent adjunct to reports that show cumulative conception totals after a period of observation or treatment.     

促性腺激素释放激素激动剂对子宫内膜异位症不孕患者在位内膜一氧化氮合酶表达的影响

目的探讨一氧化氮合酶(NOS)在子宫内膜异位症(内异症)不孕患者在位子宫内膜(在位内膜)中的表达及促性腺激素释放激素激动剂(GnRHa)对其表达的影响。方法采用免疫组化方法及蛋白印迹方法,对30例Ⅲ～Ⅳ期内异症不孕患者(内异症组)及19例有正常生育史的宫颈原位癌患者(对照组)的在位内膜进行内皮型NOS(eNOS)及诱生型NOS(iNOS)表达的定位及半定量检测,内异症组中18例行GnRHa治疗(治疗组);采用电化学发光法,同时测定患者血清雌二醇及孕酮水平。结果eNOS在子宫内膜的腺上皮、腔上皮及血管内皮细胞中均有表达;iNOS仅在子宫内膜的腺上皮和间质细胞中微弱表达。eNOS在增生期早、中、晚期和分泌期早、中、晚期在位内膜中的相对表达水平,内异症组分别为0.30±0.04,0.40±0.03,0.49±0.03,0.43±0.04,0.55±0.04和0.48±0.03,治疗组分别为0.22±0.03,0.37±0.03,0.45±0.04,0.35±0.05,0.50±0.03和0.41±0.00,对照组分别为0.21±0.03,0.33±0.03,0.45±0.04,0.40±0.03,0.47±0.05和0.41±0.03。在整个月经周期中,内异症组患者在位内膜eNOS相对表达水平持续性高于对照组患者,但仅在增生期早、中期及分泌期中、晚期两组比较,差异有统计学意义(P<0.05);与内异症组比较,治疗组在位内膜eNOS相对表达水平均有所下降,但仅在增生期早期及分泌期早、中期比较,差异有统计学意义(P<0.05)。3组子宫内膜中均未检出iNOS的表达。血清雌二醇或孕酮水平与子宫内膜eNOS表达水平均呈正相关(P<0.01)。结论eNOS在内异症患者在位内膜中的高表达,可能与其发病及其所致的不孕有关,GnRHa治疗可降低内异症患者在位内膜eNOS的表达。     

No partial <Emphasis Type="Italic">DAZ</Emphasis> deletions but frequent gene conversion events on the Y chromosome of fertile men

Purpose: Recently, partial DAZ deletions on the Y chromosome were identified in infertile men. To determine the clinical importance of partial DAZ deletion, we studied the number of DAZ copies in a well-defined population of 47 fertile men.Methods: The number of DAZ gene copies was determined by PCR assays, qualitative and quantitative DNA blot experiments.Results: Using semi-quantitative Southern blot, no partial DAZ deletion was detected in fertile men. In many cases, the results were discordant with the PCR assays and qualitative DYS1-blot experiments suggesting that the molecular events detected by the later methods could reflect gene conversion events. Many fertile men present four copies of the DAZ genes but an atypical organization of this DAZ locus. No difference in sperm concentration and motility in the fertile men were observed according to the different DAZ-haplotypes.Conclusion: The different DAZ-haplotypes are compatible with normal spermatogenesis.     

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.