Embryo Transfer

Köpeklerde, dondurulmufl sperma ile sun'i tohumlama son y›llarda yayg›n olarak kullan›lmaktad›r. Köpek spermas›n›n dondurulmas›nda ilk baflar› 1954 y›l›nda Rowson taraf›ndan bildirilmifl, 1969'da Seager dondurulmufl sperma ile ilk gebeli¤i elde etmifltir (1). Bu geliflmelere ba¤l› olarak Amerika, Kanada ve baz› Avrupa ülkelerinde köpek spermas›n›n dondurulmas› büyük bir

Information on the outcomes of ART treatments in Ireland is not readily available to Irish practitioners. The data for hospital affiliated clinics has been made available for many years and is included in the hospital reports. We present a 10-year analysis of the Irish ART results voluntarily reported by six out of seven IVF clinics. The data was collected from published ESHRE reports and from results (2007-8) not yet published. Data collected included: number of clinics and ART cycles, female age, clinical and multiple pregnancy rates and treatment complications. The clinical pregnancy rate per embryo transfer was 31.7% for IVF and 29.8% for ICSI. The proportion of singleton, twin and triplet deliveries for IVF and ICSI combined was 75%, 23.35% and 1.64%. The rate of ovarian hyperstimulation was 0.8%. ART practice in Ireland is safe, effective and responsible. Financial and societal savings could result from the introduction of state funded IVF with compulsory eSET where recommended.

The average age of women bearing their first child has increased strongly. This is an important reproductive health problem as fertility declines with increasing female age. Unfortunately, IVF using fresh oocytes cannot compensate for this age-related fertility decline. Oocyte freezing could be a solution. We used the Markov model to estimate the cost-effectiveness of three strategies for 35-year-old women who want to postpone pregnancy till the age of 40: Strategy 1: women undergo three cycles of ovarian hyperstimulation at age 35 for oocyte freezing, then at age 40, use these frozen oocytes for IVF; Strategy 2: women at age 40 attempt to conceive without treatment; and the reference strategy: women at age 40 attempt to conceive and, if not pregnant after 1 year, undergo IVF. Sensitivity analyses were carried out to investigate assumptions of the model and to identify which model inputs had most impact on the results. results: Oocyte freezing (Strategy 1) resulted in a live birth rate of 84.5% at an average cost of E10 419. Natural conception (Strategy 2) resulted in a live birth rate of 52.3% at an average cost of E310 per birth. IVF (the reference strategy) resulted in a cumulative live birth rate of 64.6% at an average cost of E7798. The cost per additional live birth for the oocyte freezing strategy was E13 156 compared to the IVF strategy. If at least 61% of the women return to collect their oocytes, and if there is a willingness to pay E19 560 extra per additional live birth, the oocyte freezing strategy is the most cost-effective strategy. conclusion: Oocyte freezing is more cost effective compared to IVF, if at least 61% of the women return to collect their oocytes and if one is willing to pay E19 560 extra per additional live birth. Our Markov model shows that, considering all the used assumptions, oocyte freezing provides more value for money than IVF.

Testicular sperm extraction (TESE) in adult patients with nonmosaic 47,XXY provides a sperm retrieval rate (SRR) of approximately 50%. Age is the only significant prognostic factor. Whether TESE should be performed in adolescent patients for sperm cryopreservation remains to be determined. The objective of the study was to compare SRR between young (15-23 y) and adult (Ͼ 23 y) patients with 47,XXY, and to determine whether previous androgenic treatment had a deleterious effect. We designed a prospective comparative study between two groups enrolled in parallel from September 2010 onward. Setting: University hospital. Patients: Forty one patients with nonmosaic 47,XXY karyotype and azoospermia were included. Twenty five patients from 15-22 years of age were assigned to the "Young" group, and 16 patients age 23 years or more, to the "Adult" group. A bilateral testicular open biopsy was performed by a single surgeon. The reproductive biologist who performed TESE was blind to the patient's age. Principal Outcome Measure: The main outcome measure was the SRR. The TESE procedure was considered positive if at least 20 sperm cells could be cryopreserved for intracytoplasmic sperm injection. Results: SRR was 13/25 ϭ 52% in the Young group and 10/16 ϭ 62.5% in the Adult group, the difference being nonsignificant (P ϭ .73). Ages were 24.3 Ϯ 7.4 years in the 23 cases of positive TESE, and 23.7 Ϯ 7.4 in the 18 cases of negative TESE, the difference being nonsignificant (P ϭ .42). SRR was 9/17 ϭ 52.9% for patients with and 14/24 ϭ 59.1% for patients without previous testosterone (T) treatment, the difference being nonsignificant (P ϭ .98). According to the present results, performing TESE at a younger age (15-23 y) in patients with azoospermic nonmosaic 47,XXY Klinefelter did not increase SRR relative to adult patients (25-39 y). Previous replacement treatment with moderate doses of T did not seem to be deleterious for the recovery of sperm cells by TESE.

Preimplantation genetic diagnosis (PGD) allows birth of unaffected children for couples at risk for a genetic disorder. We present the strategy and outcome of PGD for four lysosomal storage disorders (LSD): Tay-Sachs disease (TSD), Gaucher disease (GD), Fabry disease (FD), and Hunter syndrome (HS), and subsequent development of stem cell lines. For each disease, we developed a family-specific fluorescent multiplex single-cell PCR protocol that included the familial mutation and informative markers surrounding the mutation. Embryo biopsy and PGD analysis were performed on either oocytes (polar bodies one and two) or on single blastomeres from a six-cell embryo. We treated twenty families carrying mutations in these lysosomal storage disorders, including 3 couples requiring simultaneous analysis for two disorders (TSD/GD, TSD/balanced Robertsonian translocation 45XYder(21;14), and HS/oculocutaneus albinism). These analyses led to an overall pregnancy rate/embryo transfer of 38% and th...

ObjectivesPreimplantation genetic diagnosis (PGD) enables the identification of affected embryos prior to implantation. We present for the first time three families in which either the oocytes or embryos obtained from female carriers of mutations in the iduronate‐2‐sulfatase (IDS) gene underwent PGD for mucopolysaccharidosis type II (Hunter syndrome). Furthermore, we report the first ever derivation of a Hunter's syndrome (46, XX) human stem cell line from embryos (HESC) carrying the IDS and oculocutaneus albinism type 2 mutations.MethodsCombined polar body (PB) 1 and 2 or a single cell of a six‐ to eight‐cell embryo (blastomere) was used for genetic analysis by multiplex polymerase chain reaction assay using six microsatellite polymorphic markers flanking the gene and mutation.ResultsOne couple underwent four PB‐PGD cycles, with birth of a healthy girl; the second couple with one PB‐PGD cycle had healthy twins; the third couple underwent seven cycles of double PGD for Hunter an...

Purpose Development of a molecular PGD protocol for a male with an X-linked deletion in the SHOX gene region, located in the pseudoautosomal region of the X/Y chromosomes. Due to excessive recombination in this region, the deletion can be found in male offspring. Methods We developed a 13 marker multiplex fluorescent PCR protocol: 3 markers within the deleted SHOX region, 5 flanking markers, 3 informative markers on chromosome 21 (advanced maternal age) and 2 markers for sex determination. Results Of four embryos, two wild type males, diploid for chromosome 21 were transferred resulting in twin boys. One embryo was an affected female and another embryo was Turner. Amniocentesis confirmed the implanted embryos were males (46XY), with no recombinations. Conclusions While many X-linked disorders can be analyzed by sexing, genes located in the pseudoautosomal regions have high XY recombination rates, requiring multiple markers to enable an accurate diagnosis.

problems are not encountered when IVF is performed in a Netherlands natural cycle. On the other hand, NIVF meets other problems 1 To whom correspondence should be addressed at: Department of such as an increased risk of cancellation of the attempt due to Obstetrics and Gynaecology, IVF Center, PO Box 7057, a luteinizing hormone (LH) surge , poor 1007 MB Amsterdam, The Netherlands follicle development , no oocyte during The results of in-vitro fertilization in natural cycles (NIVF) oocyte retrieval, no fertilization or polyspermic fertilization in women with tubal infertility at our department are with no embryo transfer as a consequence ) presented. The study had a prospective design. We needed and a considerably lower pregnancy rate per started cycle 75 cycles in 50 patients to obtain one oocyte from each versus SIVF . Nevertheless, there is a patient. Successful oocyte recovery rate was 67% per rising interest in NIVF among patients. It feels more comfortstarted cycle and 82% per oocyte retrieval. Thirty-five able to the patient and the physical burden of NIVF is perceived embryos were transferred and resulted in four ongoing to be much lower than that of SIVF. pregnancies (5.3% per cycle, 6.5% per oocyte retrieval, In this report we present our experience with NIVF and the 11.4% per embryo transfer and 11.4% per embryo). Six results from a selected group of 50 patients who underwent, patients who participated in the study made a second in total, 75 monitored natural IVF cycles. attempt at NIVF. Five of them conceived of which four were ongoing. Cumulative ongoing pregnancy rates are 9.8% per cycle, 11.9% per oocyte retrieval, 19.5% per Materials and methods embryo transfer and 19.5% per embryo. We conclude that Fifty patients, aged between 22 and 38 years and with a history of pregnancy for patients with tubal infertility. secondary tubal infertility, underwent in total 75 cycles of NIVF at Key words: HCG/IVF/natural cycle/pregnancy rates our department. The patients were offered a free treatment, as at that time we had no experience with NIVF. All patients had a regular ovulatory cycle between 24 and 35 days. This was confirmed by at least three biphasic basal body temperature charts prior to the treatment cycle and an endometrial biopsy, taken in a previous cycle

BACKGROUND Recurrent pregnancy loss (RPL) is linked to lower vitamin D levels and altered immune responses, though unclear mechanisms. This study aimed to identify the effect of vitamin D on the balance between interleukin (IL)-10/IL-17A in women with RPL. METHODS This case-control study was conducted at the Bint Al-Huda Teaching Hospital, Thi-Qar Governorate, Iraq, from August 2022 to March 2023. Three study groups were included: RPL (47 women), non-aborted pregnant (40 women), and control (38 women). The sera concentrations of IL-17A, vitamin D, and IL-10 had been quantitatively detected using ELISA. SPSS was used for statistical analysis. RESULTS Women with RPL had significantly lower vitamin D levels (19.6 ng/ml) and higher IL-17A levels (35.66 ng/l) than the non-aborted pregnant (23.46 ng/ml, 24.04 ng/l) and control groups (25.69 ng/ml, 19.87 ng/l). IL-10 levels were substantially depleted in the RPL group (3.96 pg/ml), leading to a statistically lower IL-10/IL-17A ratio (0.19) than in the non-aborted pregnant (0.58) and control (1.60) groups. Regression analysis revealed a valuable positive association between vitamin D and IL-17A in all groups and between vitamin D and IL-10/IL-17A ratio in RPL and control groups. Vitamin D was also significantly associated with IL-10 in the non-aborted pregnant group. However, no statistical relationship was reported between vitamin D and IL-10 levels in the RPL and control groups. CONCLUSIONS Increased IL-17A and decreased IL-10 contributed to unexplained RPL. The IL-10/IL-17A ratio predicted endometrial function, and vitamin D affects these cytokines, potentially reducing inflammation.

BACKGROUND: The success of IVF treatment is dependent upon embryo quality and coordinated growth and differentiation of the endometrium. Aromatase P450 expression in the human endometrium is thought to be restricted to women with proliferative reproductive tract disorders such as endometriosis, leiomyomas and adenomyosis. METHODS: To determine whether endometrial aromatase P450 mRNA expression is prognostic of IVF outcome, we quanti®ed transcript levels in biopsy specimens from a cohort of subfertile patients awaiting IVF treatment using real-time quantitative PCR. RESULTS: Aromatase P450 transcripts were detected in all endometria examined, although the levels varied considerably between samples, ranging from 0.22 to 486.6 arbitrary units (a.u.). The clinical pregnancy rate in women with high endometrial aromatase P450 mRNA levels (b8.3 a.u.; n = 21) was 9.5% compared with 30.1% in those patients with low expression levels (<8.3 a.u.; n = 101) (P < 0.05). The cycle day of the endometrial biopsy, cause of infertility, age, parity, number of oocytes collected and number of embryos transferred did not differ between patients with high versus low endometrial aromatase P450 mRNA levels (P > 0.1). CONCLUSIONS: Our results indicate that endometrial P450 mRNA levels can identify women at increased risk of IVF treatment failure.

Continuous failures to achieve a pregnancy despite effective embryo transfers is extremely distressing for couples. In consequence, many adjuvant therapies to IVF have been proposed to achieve an "ideal" immune environment. We here focus on Intralipid® therapy (IL) reported to have immunosuppressive properties on NK cells. Method of study: 94 patients exhibited an immune profile of endometrial over-immune activation and an history of repeated implantation failures despite multiple embryos transfers (RIF). They received a slow perfusion of Intralipid®. We here report the live birth rate following the procedure at the next embryo transfer. To get new insight on its mechanism of action, a second immune profiling had been performed under Intralipid® before the embryo transfer. Results: The live birth rate of the RIF cohort treated with Intralipid® reached 54% (51/94) at the next embryo transfer. In patients successfully pregnant under Intralipid® who benefitted of a test of sensibility before the embryo transfer, we observed a significant decrease of the three biomarkers used to diagnose the over-immune endometrial activation (CD56 cells; IL-18/TWEAK, IL-14/FN-14). Conclusions: Double blind placebo versus Intralipid® studies should be conducted. Intralipid® may be an option to explore in RIF patients who exhibit an over-immune activation of uNK cells.

Continuous failures to achieve a pregnancy despite effective embryo transfers is extremely distressing for couples. In consequence, many adjuvant therapies to IVF have been proposed to achieve an "ideal" immune environment. We here focus on Intralipid® therapy (IL) reported to have immunosuppressive properties on NK cells. Method of study: 94 patients exhibited an immune profile of endometrial over-immune activation and an history of repeated implantation failures despite multiple embryos transfers (RIF). They received a slow perfusion of Intralipid®. We here report the live birth rate following the procedure at the next embryo transfer. To get new insight on its mechanism of action, a second immune profiling had been performed under Intralipid® before the embryo transfer. Results: The live birth rate of the RIF cohort treated with Intralipid® reached 54% (51/94) at the next embryo transfer. In patients successfully pregnant under Intralipid® who benefitted of a test of sensibility before the embryo transfer, we observed a significant decrease of the three biomarkers used to diagnose the over-immune endometrial activation (CD56 cells; IL-18/TWEAK, IL-14/FN-14). Conclusions: Double blind placebo versus Intralipid® studies should be conducted. Intralipid® may be an option to explore in RIF patients who exhibit an over-immune activation of uNK cells.

BACKGROUND: Most implantation failures after successful in vitro fertilization-embryo transfer (IVF-ET) result from inadequate uterine receptivity. There is currently no way to predict this receptivity. METHODS: We investigated whether the detection of interleukin-(IL)18 by ELISA in uterine luminal secretions might predict implantation failure. Secretions of 133 patients enrolled in our IVF-ET program were sampled by uterine flushing immediately before oocyte retrieval. We assessed the following outcomes: pregnancy rate, multiple pregnancy rate, and implantation rate per embryo transferred. RESULTS: Interleukin-18 was detected in the flushing fluid of 38 patients (28.6%). Although the two groups were comparable for all other characteristics (age, etiology, ovarian reserve, number of embryos transferred, quality of embryos), all outcome variables differed significantly. The pregnancy rate was 37.9% in the IL-18 2ve group and 15% in the IL-18 1 ve group, the multiple pregnancy rate 27.7% and 0%, and the implantation rate per embryo transferred 19.4% and 6.7% (all comparisons, P 5 0.02). Only embryos meeting good quality criteria were transferred to 65 patients: 50 IL-18 2ve and 15 IL-18 1ve. The pregnancy rate was 51% for the IL-18 2ve group and 20% for the IL-18 1ve group, the multiple pregnancy rate 36% and 0.0%, respectively, and the implantation rate 29% and 8.3% (P 5 0.02). CONCLUSION: This noninvasive and simple method predicted inadequate uterine receptivity, independent of embryo quality.

Objective: To assess intrauterine levels of leukemia inhibitory factor (LIF) by uterine flushing at the time of egg retrieval and to confirm that the procedure has no detrimental effect on pregnancy rates. Design: Prospective study. Setting: Assisted reproductive unit of a university hospital. Patient(s): Uterine flushing was performed in 148 IVF patients. The first 100 patients were compared with a matched control group. Intervention(s): Uterine flushing at the time of egg retrieval. Main Outcome Measure(s): IVF-ET results, pregnancy rates, and intrauterine LIF levels. Result(s): Pregnancy rates were not different in the group of patients with (27%) or without uterine flushing (28%). Leukemia inhibitory factor was detected in 60 patients (46%). Pregnancy rates did not differ between patients' detectable LIF and those in whom LIF was undetectable. Mean levels of LIF were 30.1 Ϯ 49.3 pg/mL and 28.6 Ϯ 51.2 pg/mL in pregnant and nonpregnant patients respectively. The flushing procedure at the time of egg retrieval did not adversely affect pregnancy rates. Leukemia inhibitory factor was detected in 46% of patients at the time of egg retrieval, but no correlation were observed with better pregnancy rates in patients with detectable LIF. Mean LIF levels did not differ in pregnant and nonpregnant women. Access to endoluminal secretions of the endometrium during IVF-ET may represent a new research in human implantation. (Fertil Steril 2003;79:900 -4.

Objective: To investigate the endometrial immunohistochemical staining of interleukin (IL)-12 and IL-18 and to quantify the CD56 bright natural killer (NK) cells in relation to Doppler vascular disorders. Design: Controlled clinical study. Setting: Research unit of a university hospital. Patient(s): Thirty-five women with repeated implantation failure after ET in IVF and 12 fertile control patients. Intervention(s): Ultrasound evaluation and endometrial biopsy on day 20. Main Outcome Measure(s): The balance between IL-12 and IL-18, the number of NK cells, and the vascular status among fertile and implantation failure patients. The control patients displayed normal vascular parameters, a weak anti-IL-12 staining, a consistent moderate stromal anti-IL-18 staining, and fewer than 15 NK cells/field. This pattern was observed among only 17% (6/35) of the implantation failure group. The remaining patients fit into one of two patterns: [1] 37% (13/35) had more than 40 NK cells/field with a strong anti-IL-12 and/or anti-IL-18 staining, and [2] the remaining 46% (16/35) had a marked local depletion of IL-18 and IL-12. Respectively, 85% and 31% of two groups displayed abnormal vascular parameters. Distinctions between the different local dysregulations of the cytokine network may provide clues for further exploration and treatment. (Fertil Steril 2004;81:59 -65.

Objective: To document in the endometrium the correlation among the interleukin (IL)-12, -15, and -18 mRNA and the correlation between cytokine levels, vascular status, and endometrial natural killer (NK) cell count in the context of recurrent implantation failure. Design: A pilot study. Setting: Department of Reproductive Immunology. Patient(s): Women who failed to become pregnant after repeated IVF-embryo transfer and fertile control subjects. Intervention(s): Ultrasonic evaluation and endometrial biopsy in luteal phase. Main Outcome Measure(s): Uterine artery Doppler, count of uterine CD56 bright cells/field, and quantification by real-time polymerase chain reaction (PCR) to monitor IL-12 family (IL-12p40, IL-12p35, EBI3, IL-23), the IL-18 system (IL-18, IL-18R, IL18BP), and the IL-15 mRNA ratio. The uterine artery Doppler and the CD56 bright cell counts were significantly different in fertile and infertile patients. The mean uterine artery pulsatility index correlated significantly negatively with the IL-18/actin ratio suggesting a defect of the cytokine-dependent vascular remodeling pathway. The number of uterine CD56 bright cells was significantly correlated with the IL-15/actin and IL-18/IL-18BP ratios. Thus, IL-18 and IL-15 seems to be involved in the local recruitment and the activation of uterine natural killer (uNK) cells. IL-18 was itself correlated with IL-15 and IL-12, suggesting a local control of uNK cells activation. The assessment of the tripod IL-12/-15/-18 shows distinct immune-related mechanisms that are involved in the broader context of inadequate uterine receptivity.

Á Deus, por me dar força e determinação para chegar até aqui! A toda minha família. Em especial aos meus pais Jair e Fátima e a minha irmã Letícia. Obrigada por todo apoio, incentivo e por entenderem a minha ausência em muitos momentos importantes e em muitas datas especiais. Saibam que mesmo distantes vocês são tudo para mim. Também gostaria de agradecer ao Puppinho que foi e sempre será membro da nossa família. Mesmo ausente você será sempre lembrado e muito amado por todos nós. Ao Murillo Meschiatti, obrigada por toda ajuda, apoio, companheirismo e, principalmente, por estar sempre presente nos momentos mais difíceis, sempre acreditando em mim, me incentivando e me convencendo a nunca desistir. Patinha de avestruz, você me mostrou que, realmente, "no matter who you are, no matter where you go in life, in some point, you will need somebody, to stand by you" Ao Orientador Prof. Dr. Roberto Sartori Filho o meu sincero muito obrigada por me dar a oportunidade de chegar até aqui.

Objetivou-se avaliar o efeito da alta ingestão de matéria seca (AIMS) sobre a resposta superovulatória de vacas mestiças Nelore x Simental. Quatorze vacas não lactantes, com escore de condição corporal (ECC) igual a 4,0 (escala de 1 a 5), foram divididas aleatoriamente em dois grupos (Manutenção=M ou alta ingestão de matéria seca=AIMS). De sete dias antes do início da superovulação (SOV) até o final das aplicações de FSH, as vacas do grupo AIMS receberam dieta com 180% da manutenção. O grupo M recebeu dieta de manutenção. Sete dias após a IA, os embriões foram colhidos e avaliados. Quarenta dias após, inverteram-se os tratamentos e realizou-se uma nova SOV. Para comparação entre os grupos, utilizou-se o teste t pareado. Os resultados estão apresentados em média ± erro-padrão. O número de folículos recrutados detectados por ultrassonografia (19,6±1,8 e 16,4±2,0) e ovulados (15,0±1,6 e 13,0±1,6) não diferiu entre os grupos M e AIMS, respectivamente (P>0,10). Entretanto, os números de estruturas totais (14,1±2,3 e 9,5±1,5) e embriões viáveis (10,1±2,1 e 6,7±1,5) colhidos foram maiores no grupo M (P<0,05). Conclui-se que, nas condições deste estudo, AIMS previamente à SOV pode comprometer a produção embrionária em vacas de elevado ECC.

Mouse spermatozoa can be freeze dried without losing genetic integrity and reproductive potential. However, it is not known if freeze-dried mouse cells similarly maintain their genetic integrity and developmental potential following nuclear transfer. Here, we investigated the developmental capacity and embryonic stem (ES) cell derivation of reconstructed oocytes by nuclear transfer using freeze-dried cumulus or ES cells. Cumulus and ES cells were lyophilized overnight and stored at 4 C for up to 1 week. After rehydration, all cells showed membrane damage and were unviable. However, following nuclear transfer, 1-4% of the reconstructed oocytes developed to the blastocyst stage. A total of five nuclear transfer ES (ntES) cell lines were generated from blastocysts and morulae. All ntES cell lines had normal karyotypes and were positive for the ES-cell-specific markers (alkaline phosphatase, Oct3/4 and Nanog). After aggregation of ntES cells with fertilized embryos, chimeric mice with a high level of coat color chimerism were generated. Our findings show that the genomic integrity of cells can be maintained after freeze-drying and that it is possible to produce offspring from the cells using nuclear transfer techniques.

Somatic cell nuclear transfer (SCNT) cloning is the sole reproductive engineering technology that endows the somatic cell genome with totipotency. Since the first report on the birth of a cloned sheep from adult somatic cells in 1997, many technical improvements in SCNT have been made by using different epigenetic approaches, including enhancement of the levels of histone acetylation in the chromatin of the reconstructed embryos. Although it will take a considerable time before we fully understand the nature of genomic programming and totipotency, we may expect that somatic cell cloning technology will soon become broadly applicable to practical purposes, including medicine, pharmaceutical manufacturing and agriculture. Here we review recent progress in somatic cell cloning, with a special emphasis on epigenetic studies using the laboratory mouse as a model.

Mouse spermatozoa can be freeze dried without losing genetic integrity and reproductive potential. However, it is not known if freeze-dried mouse cells similarly maintain their genetic integrity and developmental potential following nuclear transfer. Here, we investigated the developmental capacity and embryonic stem (ES) cell derivation of reconstructed oocytes by nuclear transfer using freeze-dried cumulus or ES cells. Cumulus and ES cells were lyophilized overnight and stored at 4 C for up to 1 week. After rehydration, all cells showed membrane damage and were unviable. However, following nuclear transfer, 1-4% of the reconstructed oocytes developed to the blastocyst stage. A total of five nuclear transfer ES (ntES) cell lines were generated from blastocysts and morulae. All ntES cell lines had normal karyotypes and were positive for the ES-cell-specific markers (alkaline phosphatase, Oct3/4 and Nanog). After aggregation of ntES cells with fertilized embryos, chimeric mice with a high level of coat color chimerism were generated. Our findings show that the genomic integrity of cells can be maintained after freeze-drying and that it is possible to produce offspring from the cells using nuclear transfer techniques.

Nuclear transfer can be used to generate embryonic stem cell lines from somatic cells, and these have great potential in regenerative medicine. However, it is still unclear whether any individual or cell type can be used to generate such lines. Here, we tested seven different male and female mouse genotypes and three cell types as sources of nuclei to determine the efficiency of establishing nuclear transfer embryonic stem cell lines. Lines were successfully established from all sources. Cumulus cell nuclei from F 1 mouse genotypes showed a significantly higher cumulative establishment rate from reconstructed oocytes than from other cells; however, there were no genotype differences in success rates from cloned blastocysts. Thus, the overall success depends on preimplantation development, and, once embryos have reached the blastocyst stage, the genotype differences disappear. All mouse genotypes that were tested demonstrated at least one cell line that subsequently contributed to germline transmission in chimeric mice, so these cell lines clearly possess the same potential as embryonic stem cells derived from fertilized embryos. Thus, nuclear transfer embryonic stem cells can be generated relatively easily from a variety of inbred mouse genotypes and cell types of both sexes, even though it may be more difficult to generate clones directly. assisted reproductive technology, early development, embryo 1

Infertility affects relatively large number of couple both globally as well as in India. There are sparse data on the prevalence of infertility in India. This study describes the correlates and prevalence of infertility among couples in Ambala, India . This study is a cross sectional study done in the urban field practice area of M. M. Institute of Medical Sciences & Research, during January 2013 to December 2013. Couples having infertility were identified using WHO definition by house to house survey and interviewed to know various epidemiological correlates including demographic characteristics, etiology and treatment if taken for the same. There were total of 4456 eligible couples and 534 were found to be having primary or secondary infertility. The study showed that among eligible couples prevalence of primary infertility was 6.1%, while secondary infertility was 5.7%. Among couples with primary infertility male factors were responsible in 49(17.95%), female factors in 86(31.5%)...

To examine the impact of smoking among females on controlled ovarian stimulation (COS), at intra-cytoplasmatic sperm injection (ICSI) outcome. A prospective analysis of outcomes of 876 women (fresh, non donor cycles) of which 559 (63.8%) were non-smokers, 317 (36.2%) were smokers, underwent standard COS/ICSI treatment. Among smokers, the average time of COS, expressed in days, was significantly longer compared with non-smokers (10.5±2.10 vs. 10±1.90 p less than 0, 05). There were no registered significant differences in the number of retrieved oocytes, (10.4±6.8 vs10.3±6.9), mature oocytes (8.6±5.8 vs. 8.4±5.9), in the group of non-smokers versus smokers. However, smoking and age have a significant impact of the number of high-quality embryos, i.e. older smokers had a lower number of high-quality transferred embryos (non-smokers ≥ 35 years : smokers ≥ 35 years; 1.9±1.1 vs. 1.6±1). On multiple logistic regression analysis, factor that had a significantly negative impact of clinical p...

To analyze the luteal phase of six patients undergoing controlled ovarian hyperstimulation (COH) with hMG and a new GnRH antagonist, Cetrorelix, without receiving luteal phase supplementation. Design: Phase II study involving the first six patients who did not receive luteal phase support. Setting: Tertiary referral center. Six healthy women undergoing COH for assisted reproductive techniques. Oocyte retrieval was performed 36 hours after hCG administration, followed by embryo transfer 2 days later. No luteal phase supplementation was given. Main Outcome Measure(s): Serum E 2 , progesterone, LH, and FSH concentrations were measured. The length of the luteal phase was Յ12 days in three of the six patients. One of the patients in whom the luteal phase was Ͼ12 days had a low serum progesterone concentration (2.9 ng/mL) on day 10. Serum LH concentrations decreased after the preovulatory hCG injection in all patients. However, a progressive increase in LH was observed after day 7, reaching normal values. Corpus luteum function seems to be impaired in cycles that are stimulated with hMG and the GnRH

Lactation performance is dependent on both the genetic characteristics and the environmental conditions surrounding lactating cows. However, individual variations can still be observed within a given breed under similar environmental conditions. The role of the environment between birth and lactation could be better appreciated in cloned cows, which are presumed to be genetically identical, but differences in lactation performance between cloned and noncloned cows first need to be clearly evaluated. Conflicting results have been described in the literature, so our aim was to clarify this situation. Nine cloned Prim&#39; Holstein cows were produced by the transfer of nuclei from a single fibroblast cell line after cell fusion with enucleated oocytes. The cloned cows and 9 noncloned counterparts were raised under similar conditions. Milk production and composition were recorded monthly from calving until 200d in milk. At 67d in milk, biopsies were sampled from the rear quarter of the ...

To compare the clinical outcomes of patients with vitrified-thawed embryos transferred using either the 0.25 mL straw method and the pull and cut straw (PNC) method. To evaluate the clinical outcomes of patients with transferred embryos that underwent assisted hatching at the cleaved embryo (day 3) or the blastocyst (day 5) stage. The study population consisted of women who underwent vitrified-warmed embryo transfer between May 2000 and December 2011 and assisted hatching was performed after warming of embryos. Cycles of thawing between assisted hatching treated and non treated groups were compared for survival and pregnancy rates. The PNC vitrification method improved survival and pregnancy rates in partial lysed embryos. While assisted hatching did not affect the developmental and clinical pregnancy rates of the vitrified-warmed blastocyst group, it did increase the pregnancy rate of poor quality vitrified-warmed cleaved embryos. These results suggest that PNC may increase the num...

Objective To investigate the effect of L-carnitine supplementation during the controlled ovarian stimulation (COS) cycle with antagonist protocol in patients with polycystic ovary syndrome (PCOS) diagnosis undergoing IVF/ICSI treatment. This was a double-blind clinical trial study including 110 patients with PCOS attended to Royan Institute between March 2020 and February 2023. At the beginning of the COS cycle, the eligible patients were allocated into two groups randomly according to the coding list of the drugs prepared by the statistical consultant. In the experimental group, patients received 3 tablets daily (L-carnitine 1000 mg) from the second day of menstruation of the previous cycle until the puncture day in the cases of freeze-all embryos (6 weeks) or until the day of the pregnancy test (8 weeks) in fresh embryo transfer cycle. In the control group, patients received 3 placebo tablets for the same period of time. Weight assessment and fasting blood sugar and insulin tests, as well as serum lipid profile were also measured at the baseline and ovum pick-up day. The results of the COS cycle as well as the implantation and pregnancy rates were compared between groups. Results Finally, 45 cases in L-carnitine group versus 47 cases in the placebo group were completed study per protocol. Data analysis showed that the two groups were homogeneous in terms of demographic characteristics and baseline laboratory tests and severity of PCOS. There is no statistically significant difference in terms of the oocyte recovery ratio and oocyte maturity rate, and the number and quality of embryos, as well as the rates of the fertilization, chemical and clinical pregnancy between groups. However, the means of weight (P < 0.001) and serum levels of fasting blood sugar (P = 0.021), fasting insulin (P = 0.004), triglyceride (P < 0.001) and cholesterol (P < 0.001), LDL (P < 0.001) have significantly decreased in women after consuming L-carnitine supplementation.

Study question What is the effect of COVID-19 infection on pregnancy rates in frozen embryo transfer (FET) cycles? Summary answer Past COVID-19 infection decreased pregnancy rates in FET cycles, especially in patients with recent infection. What is known already ACE2 and TMPRSS2 are expressed in the endometrium, potentially enabling SARS-COV-2 viral invasion of the cells. Unlike with bacterial infections, the effect of viral infections in general on implantation and pregnancy rates is unclear. Some evidence suggests that early embryonic and trophoblastic infection, may result in impaired implantation or placentation. A recently published study including both recovered and vaccinated patients did not find an effect of COVID-19 immunity on FET cycle outcomes. The study did not stratify by time from infection thus the immediate consequences of infection on pregnancy rates could not be properly evaluated. Study design, size, duration A retrospective cohort study, including 41 COVID-19 r...

Purpose To study the effect of SARS-CoV-2 infection on pregnancy rates in frozen embryo transfer (FET) cycles. Methods A retrospective cohort study including women under the age of 42 with documented SARS-CoV-2 infection up to 1 year prior to treatment, undergoing FET cycles in the first half of 2021, with transfer of embryos generated prior to the infection. Controls were SARS-CoV-2 non-diagnosed, non-vaccinated women matched by age, number, and day of embryo transfer. Demographic and cycle characteristics and outcomes were compared. Results Forty-one recovered women and 41 controls were included. Pregnancy rates were 29% and 49% respectively (p = 0.070). Stratification by time from SARS-CoV-2 infection to transfer into ≤ 60 and > 60 days revealed a difference in pregnancy rates, with women in the COVID group having lower pregnancy rates if infected in proximity to the transfer (21% vs. 55%; p = 0.006). In a logistic regression model, infection was a significant variable (p = 0.05, OR 0.325, 95% CI 0.106-0.998). Logistic regression applied on the subgroup of women infected in proximity to the transfer further strengthened the univariate results, with COVID-19 remaining a significant parameter (p = 0.005, OR 0.072, 95% CI 0.012-0.450). Conclusions In FET cycles of patients with past SARS-CoV-2 infection, in which oocytes were retrieved prior to infection, decreased pregnancy rates were observed, specifically in patients who recovered less than 60 days prior to embryo transfer. Pending further studies, in cases of FET cycles with limited number of embryos, postponing embryo transfer for at least 60 days following recovery from COVID-19 might be considered when feasible.

Background Hepatitis B virus (HBV) infection is a major global health issue, affecting millions of individuals worldwide. Chronic HBV infection is associated with various systemic health complications, including liver disease with its impact on reproductive health in male fertility. Methods This study investigated the impact of HBV on sperm quality in a cohort of 1566 male infertile patients undergoing assisted reproductive treatment from 2021 to 2024. Patients aged 23 to 40 years (mean age 34.2 ± 3.62 years) were categorized into HBV-positive (783 cases) and HBV-negative (783 cases) groups based on serological tests for hepatitis B surface antigen (Hbs Ag). Results HBV-positive and HBV-negative groups exhibited significantly lower progressive motility (41.3% vs. 43.0%; P = 0.006), sperm concentration (53.6 vs. 59.8 × 10 6 /mL; P = 0.009), and normal morphology (4.5% vs. 5.0%; P < 0.001), with reduced viability (P = 0.027). No differences were observed in semen volume (P = 0.807) or DNA fragmentation index (P = 0.970). Conclusion HBV infection is associated with impaired sperm motility, concentration, and morphology in infertile men.
Highlights • HBV seropositivity exhibits negative associations with progressive motility, sperm concentration, and normal morphology in infertile men. • The absence of association with DNA fragmentation indicates that HBV may impair spermatogenesis through pathways independent of direct genetic damage. • HBV exhibits associations with poorer sperm quality.

Objective: To review the mechanisms by which endometriosis may affect reproductive function. Design: Review of the English literature from 1986 to 2007 after searching Medline, EMBASE, Cochrane, and BIOSIS, as well as relevant meeting abstracts. Setting: Fertility research center and obstetrics and gynecology department in a tertiary care hospital. There is compelling evidence in the literature that endometriosis has detrimental effects on ovarian and tubal function and uterine receptivity, resulting in female infertility. The mechanisms of infertility associated with endometriosis remain controversial and include abnormal folliculogenesis, elevated oxidative stress, altered immune function, and hormonal milieu in the follicular and peritoneal environments, and reduced endometrial receptivity. These factors lead to poor oocyte quality, impaired fertilization, and implantation. Through unraveling the mechanisms by which endometriosis leads to infertility, researchers are sure to find a nonsurgical means to diagnose endometriosis, most likely through serum and peritoneal markers. Cytokines, interleukins, oxidative stress markers, and soluble cellular adhesion molecules all show potential to be used as a reliable marker for diagnosing endometriosis. After analyzing the pathogenic mechanisms of endometriosis, it seems that the future treatment of this entity may include cyclo-oxygenase-2 inhibitors, immunomodulators, or hormonal suppressive therapy to eliminate the need for surgical treatment of endometriosis.

Background: Endometrium disorders cause significant failure in fertility. Our study aimed to investigate the cellular, histological, and molecular properties of patients with thin endometrium compared to healthy endometrium without pathological conditions (n = 6). Methods: This study was a randomized control (n = 6) in which samples of thin endometrium were obtained from IVF patients enrolled in the IVF clinic in the National Hospital Ciptomangunkusumo, Jakarta, Indonesia, from 2018 to 2019. The typical samples were taken from patients who underwent tubectomy with no pathological findings in the endometrium. Endometrial cells were isolated using an enzymatic method transported in medium, PCR samples were used in an RNA solution, and histology samples were stored in neutral-buffered formalin 10% (v/v). Results: The number of cells, presented as density of cells mg -1 wet weight during endometrial biopsy, was about 10,190 cells mg -1 wet weight in the healthy-endometrium group, while the thin-endometrium group had 3305 cells mg -1 wet weight. A flow cytometry analysis of the endometrial in the healthy group showed all panels were significantly higher compared to the thin group: BCRP1/Breast Cancer-Resistant Protein (74.85 ± 15.63% vs. 15.58 ± 7.19%), ICAM-1/Intercellular Adhesion Molecule or CD54 (35.76 ± 6.23% vs. 7.24 ± 1.65%), PECAM/platelet endothelial cell adhesion molecule-1 or CD31 (29.42 ± 2.16% vs. 4.19 ± 2.03%), and cKit/type III receptor tyrosine kinase or CD117 (27.29 ± 1.93% vs. 5.32 ± 2.38%). The exception was SUSD-2/Sushi Domain Containing Protein-2, although these results were insignificant (1.33 ± 0.39% vs. 0.26 ± 0.39%, respectively) (mean ± 95% C.l). Endometrial receptivity, indicated by HOXA10/Homeobox protein-10, LIF/Leukemia inhibitory factor, SPP1/osteopontin, and VEGF/Vascular Endothelial Growth Factor, was significantly higher in the healthy group compared to the thin group. Immunohistochemical labelling showed that E-cadherin, estrogen/ER-α, and progesterone receptors/PR were found in healthy-endometrium patients while they were less expressed among thin-endometrium patients. Conclusions: Patients with healthy endometrium had significantly higher cell numbers per mg, significantly higher endometrial and endothelial cells, and expressed higher receptivity genes than patients with thin endometrium, although the SUSD-2-positive cells showed no difference.

Background: Endometrium disorders cause significant failure in fertility. Our study aimed to investigate the cellular, histological, and molecular properties of patients with thin endometrium compared to healthy endometrium without pathological conditions (n = 6). Methods: This study was a randomized control (n = 6) in which samples of thin endometrium were obtained from IVF patients enrolled in the IVF clinic in the National Hospital Ciptomangunkusumo, Jakarta, Indonesia, from 2018 to 2019. The typical samples were taken from patients who underwent tubectomy with no pathological findings in the endometrium. Endometrial cells were isolated using an enzymatic method transported in medium, PCR samples were used in an RNA solution, and histology samples were stored in neutral-buffered formalin 10% (v/v). Results: The number of cells, presented as density of cells mg -1 wet weight during endometrial biopsy, was about 10,190 cells mg -1 wet weight in the healthy-endometrium group, while the thin-endometrium group had 3305 cells mg -1 wet weight. A flow cytometry analysis of the endometrial in the healthy group showed all panels were significantly higher compared to the thin group: BCRP1/Breast Cancer-Resistant Protein (74.85 ± 15.63% vs. 15.58 ± 7.19%), ICAM-1/Intercellular Adhesion Molecule or CD54 (35.76 ± 6.23% vs. 7.24 ± 1.65%), PECAM/platelet endothelial cell adhesion molecule-1 or CD31 (29.42 ± 2.16% vs. 4.19 ± 2.03%), and cKit/type III receptor tyrosine kinase or CD117 (27.29 ± 1.93% vs. 5.32 ± 2.38%). The exception was SUSD-2/Sushi Domain Containing Protein-2, although these results were insignificant (1.33 ± 0.39% vs. 0.26 ± 0.39%, respectively) (mean ± 95% C.l). Endometrial receptivity, indicated by HOXA10/Homeobox protein-10, LIF/Leukemia inhibitory factor, SPP1/osteopontin, and VEGF/Vascular Endothelial Growth Factor, was significantly higher in the healthy group compared to the thin group. Immunohistochemical labelling showed that E-cadherin, estrogen/ER-α, and progesterone receptors/PR were found in healthy-endometrium patients while they were less expressed among thin-endometrium patients. Conclusions: Patients with healthy endometrium had significantly higher cell numbers per mg, significantly higher endometrial and endothelial cells, and expressed higher receptivity genes than patients with thin endometrium, although the SUSD-2-positive cells showed no difference.

Background: Endometrium disorders cause significant failure in fertility. Our study aimed to investigate the cellular, histological, and molecular properties of patients with thin endometrium compared to healthy endometrium without pathological conditions (n = 6). Methods: This study was a randomized control (n = 6) in which samples of thin endometrium were obtained from IVF patients enrolled in the IVF clinic in the National Hospital Ciptomangunkusumo, Jakarta, Indonesia, from 2018 to 2019. The typical samples were taken from patients who underwent tubectomy with no pathological findings in the endometrium. Endometrial cells were isolated using an enzymatic method transported in medium, PCR samples were used in an RNA solution, and histology samples were stored in neutral-buffered formalin 10% (v/v). Results: The number of cells, presented as density of cells mg -1 wet weight during endometrial biopsy, was about 10,190 cells mg -1 wet weight in the healthy-endometrium group, while the thin-endometrium group had 3305 cells mg -1 wet weight. A flow cytometry analysis of the endometrial in the healthy group showed all panels were significantly higher compared to the thin group: BCRP1/Breast Cancer-Resistant Protein (74.85 ± 15.63% vs. 15.58 ± 7.19%), ICAM-1/Intercellular Adhesion Molecule or CD54 (35.76 ± 6.23% vs. 7.24 ± 1.65%), PECAM/platelet endothelial cell adhesion molecule-1 or CD31 (29.42 ± 2.16% vs. 4.19 ± 2.03%), and cKit/type III receptor tyrosine kinase or CD117 (27.29 ± 1.93% vs. 5.32 ± 2.38%). The exception was SUSD-2/Sushi Domain Containing Protein-2, although these results were insignificant (1.33 ± 0.39% vs. 0.26 ± 0.39%, respectively) (mean ± 95% C.l). Endometrial receptivity, indicated by HOXA10/Homeobox protein-10, LIF/Leukemia inhibitory factor, SPP1/osteopontin, and VEGF/Vascular Endothelial Growth Factor, was significantly higher in the healthy group compared to the thin group. Immunohistochemical labelling showed that E-cadherin, estrogen/ER-α, and progesterone receptors/PR were found in healthy-endometrium patients while they were less expressed among thin-endometrium patients. Conclusions: Patients with healthy endometrium had significantly higher cell numbers per mg, significantly higher endometrial and endothelial cells, and expressed higher receptivity genes than patients with thin endometrium, although the SUSD-2-positive cells showed no difference.

Background: Endometrium disorders cause significant failure in fertility. Our study aimed to investigate the cellular, histological, and molecular properties of patients with thin endometrium compared to healthy endometrium without pathological conditions (n = 6). Methods: This study was a randomized control (n = 6) in which samples of thin endometrium were obtained from IVF patients enrolled in the IVF clinic in the National Hospital Ciptomangunkusumo, Jakarta, Indonesia, from 2018 to 2019. The typical samples were taken from patients who underwent tubectomy with no pathological findings in the endometrium. Endometrial cells were isolated using an enzymatic method transported in medium, PCR samples were used in an RNA solution, and histology samples were stored in neutral-buffered formalin 10% (v/v). Results: The number of cells, presented as density of cells mg-1 wet weight during endometrial biopsy, was about 10,190 cells mg-1 wet weight in the healthy-endometrium group, while the thin-endometrium group had 3305 cells mg-1 wet weight. A flow cytometry analysis of the endometrial in the healthy group showed all panels were significantly higher compared to the thin group: BCRP1/Breast Cancer-Resistant Protein (74.85 ± 15.63% vs. 15.58 ± 7.19%), ICAM-1/Intercellular Adhesion Molecule or CD54 (35.76 ± 6.23% vs. 7.24 ± 1.65%), PECAM/platelet endothelial cell adhesion molecule-1 or CD31 (29.42 ± 2.16% vs. 4.19 ± 2.03%), and cKit/type III receptor tyrosine kinase or CD117 (27.29 ± 1.93% vs. 5.32 ± 2.38%). The exception was SUSD-2/Sushi Domain Containing Protein-2, although these results were insignificant (1.33 ± 0.39% vs. 0.26 ± 0.39%, respectively) (mean ± 95% C.l). Endometrial receptivity, indicated by HOXA10/Homeobox protein-10, LIF/Leukemia inhibitory factor, SPP1/osteopontin, and VEGF/Vascular Endothelial Growth Factor, was significantly higher in the healthy group compared to the thin group. Immunohistochemical labelling showed that E-cadherin, estrogen/ER-α, and progesterone receptors/PR were found in healthy-endometrium patients while they were less expressed among thin-endometrium patients. Conclusions: Patients with healthy endometrium had significantly higher cell numbers per mg, significantly higher endometrial and endothelial cells, and expressed higher receptivity genes than patients with thin endometrium, although the SUSD-2-positive cells showed no difference.

Purpose: The presence of a clear half-moon-like zone of cytoplasm in oocytes is called “halo effect.” The prognostic value of this effect is not yet determined. Aligned nucleoli in pronuclei (PN) represent a further polarization phenomenon and a marker for implantation potential. Aim of the prospective study was to evaluate the influence of the halo effect on IVF outcome and

Every year numerous females are detected infertile as infertility becomes a major problem in reproductive lives, worldwide. The purpose of this study is to evaluate the effectiveness of intrauterine infusion of autologous platelet-rich plasma (PRP) in infertile women undergoing frozen embryo transfer cycles with suboptimal endometrium. A total of 61 women between 22 to 40 years of age were included in the study. Based on hysteroscopy findings they were divided into group A (Normal hysteroscopy findings) and group B (Abnormal hysteroscopy findings). Intrauterine instillation of autologous PRP was done in women having an endometrial thickness of ≤7 even after giving Estradiol valerate therapy. After 48 and 72 hours of PRP infusion, an increase in EMT was evaluated. Embryo transfer was performed when the endometrium reached an optimal pattern in terms of thickness, appearance, and vascularity.EMT increased significantly (p 0.05) in Group B compared to Group A. Between both groups, ther...

Spinal muscular atrophy (SMA) is a severe neurodegenerative autosomal recessive disorder, second only in frequency to cystic fibrosis. In its most severe form, SMA type I (Werdnig-Hoffman), death invariably ensues before age 2 years from respiratory failure or infection. Around 98% of clinical cases of SMA are caused by the homozygous absence of a region of exons 7 and 8 of the telomeric copy of the SMN gene (SMN1) on chromosome 5. We have developed a novel means of preimplantation diagnosis of SMA using a nested polymerase chain reaction (PCR) amplification of exon 7 of SMN, followed by a HinfI restriction digest of the PCR product enabling the important SMN1 gene to be distinguished from the centromeric SMN2 gene which has no clinical phenotype. This method was designed to reduce the likelihood of misdiagnosis. Five couples were treated using this method. Four proceeded to embryo transfer which resulted in six liveborns (one singleton, one twin and one triplet), all free of SMA. Embryo transfer was not performed in one cycle because of PCR contamination.

Multiple pregnancy (MP) is widely recognized as the single biggest risk to children born as a result of assisted reproduction treatment. There is an emerging trend in Europe and Canada to promote single-embryo transfer (SET). In this issue, Gleicher argues that twin pregnancies should not be seen as an unfavourable outcome of assisted reproduction treatment. He argues that SET policies 'make no sense' since they will aggravate already unsatisfactory population growth in some countries. He also argues that governmental intervention to impose SET policies, despite proving successful in reducing MP, are inappropriate. The overwhelming evidence in the literature indicates that his opinion is not supported by credible data. Views should be based on solid data rather than personal judgement. Governmental interventions to reduce twin pregnancies, as demonstrated previously in Belgium and now in Que ´bec, have been successful. The risks of twin pregnancies are real and borne by women and children, not their doctors. Doctors managing infertile couples are no longer entitled to take risks with the health of the next generation. RBMOnline

background: Debate exists regarding the effect of raised BMI on the outcome of pregnancies after assisted reproduction technology. We assessed the effect of BMI on the risk of miscarriage in women conceiving following single blastocyst transfer (SBT) after controlling for confounding factors. methods: Fresh and cryo-thawed cycles of SBT that resulted in a pregnancy between January 2006 and March 2010 were included. Patients with BMI , 18.5 kg/m 2 or older than 40 years were excluded. Patients were grouped according to their BMI at the start of treatment cycle. The main outcome measure was the miscarriage rate before 23 weeks gestation. Confounding variables examined included female age, duration and cause of infertility, previous miscarriage, smoking status and quality of blastocyst replaced. results: A total of 413 women conceived following SBT in fresh (n ¼ 325) or cryo-thawed (n ¼ 88) IVF cycles, of whom 244 had a normal BMI (18.5-24.9) and 169 had a raised BMI of ≥25. Overall, 27% (113/413) of women miscarried before 23 weeks gestation. Women with a BMI of ≥25 had more than double the risk of miscarriage compared with women who had normal BMI [38 versus 20%, odds ratio (OR): 2.4, 95% confidence interval (CI) 1.6 -3.8, P , 0.001, respectively]. After adjusting for confounding variables, having a BMI of ≥25 significantly increased the risk of clinical miscarriage before 23 weeks gestation in both fresh (adjusted OR ¼ 2.7, 95% CI 1.5 -4.9, P ¼ 0.001) and cryo-thawed IVF cycles (OR ¼ 6.8, 95% CI 1.5-31.1, P ¼ 0.012). conclusions: Raised BMI is independently associated with higher miscarriage rate after IVF treatment.

is a consultant clinical scientist and is head of the molecular genetic group within the Centre for Preimplantation Genetic Diagnosis at Guy's and St. Thomas' Hospital; this service provides preimplantation genetic diagnosis (PGD) for couples at risk of inherited single-gene defects. She introduced the approach of preimplantation genetic haplotyping in 2006 which won the centre a national Hospital Doctor award for innovation. She has recently joined the steering committee of the ESHRE PGD consortium.

drug.'3 A recent review of experience with azathioprine in 27 patients over a median duration of seven years suggested that side effects were few, and treatment had had to be discontinued in only four patients'4; all of the others improved and were able to take lower dosages of anticholinesterase drugs and corticosteroids. It has been argued that corticosteroids and immunosuppressants do not diminish the already low mortality from myasthenia gravis,j but there is little doubt that they improve the quality of life. Despite the lack of evidence from rigorous controlled trials the conclusion must be that the outlook for patients with myasthenia gravis has improved considerably over the past

buena calidad en día 3. Objetivo: comparar los resultados reproductivos de los embriones transferidos en día 3 vs en día 5 en pacientes menores de 35 años de edad. de las transferencias en día 3, todas las pacientes cumplieron los criterios de por lo menos ocho células en la mañana del día 3, y vs vs vs vs vs se realizó la transferencia embrionaria en día 3 vs vs vs Conclusión: transferir en día 5 no muestra diferencias estadísticas en la tasa de embarazo y recién nacidos vivos que en las que se

Antecedentes: el ciclo natural combinado con maduración in vitro (MIV) es una alternativa a los protocolos convencionales de fertilización in vitro estrategia es una opción atractiva para disminuir los costos. Objetivo: comunicar la experiencia inicial del ciclo natural de fertilización in vitro combinado con maduración in vitro en pacientes ovulatorias con infertilidad por diversas causas. Pacientes y método: se hizo un estudio prospectivo de serie de casos, en el que se incluyeron 10 pacientes infértiles, con menstrua-hCG cuando el folículo dominante alcanzó un diámetro de 14 mm. Se analizó el porcentaje de maduración, embarazo clínico e índice de implantación. Cada ovocito maduro fue inseminado por inyección intracitoplasmática de espermatozoides (ICSI). in vitro después de la inyección intracitoplasmática de espermatozoides; no se canceló ningún ciclo. A todas las pacientes se les realizó una transferencia de embriones (en tres casos con un embrión derivado del ovocito del folículo dominante, y en los siete restantes con mulante al tercer día en el grupo de no embarazo en comparación con el de embarazo (30.5 vs vs embarazo vs vs p < 0.04). Conclusiones: el ciclo natural de fertilización in vitro combinado con maduración in vitro es una opción efectiva y atractiva para pade embarazo múltiple y del síndrome de hiperestimulación ovárica. Palabras clave: ovocitos, maduración in vitro.

Predetermining embryo sexing before the time of conception could be controlled before fertilization of the oocyte or detected after fertilization. These methods are expensive, time-consuming and negatively affect the development of embryos. The methods used for embryo sexing are based on sperm separation before fertilizing the oocyte or molecular basis of nuclear or mitochondrial DNA. The selection of spermatozoon fertilizing controls the sex of the zygote in vivo or in vitro matured oocytes. In addition, the detection of embryo sexing is determined through aspiration of one cell from the eight-cell stage embryo and investigated through PCR. The oocyte fertilization by a spermatozoon bearing a Y-chromosome gives male offspring, although that fertilized by a spermatozoon bearing an X-chromosome gives female offspring. The embryonic cell aspiration negatively affected the further developmental competence of embryos. Therefore, establishing a new method for embryo sexing in mammals through measurable morphological criteria (zona pellucida, homogeneity of cytoplasm, previtelline space and stage of development) is a great boon in animals and humans. The success in embryo sexing through morphological criteria maximizes the advantages of assisted reproductive techniques. Therefore, the present review article addresses and discusses the preselection of embryo sexing at the time of conception and their limitation and effects in addition to sperm fertilizing parameters on mammals.