Sperm recovery and IVF after testicular sperm extraction (TESE): effect of male diagnosis and use of off-site surgical centers on sperm recovery and IVF.

Objective: Determine whether testicular sperm extractions and pregnancy outcomes are influenced by male and female infertility diagnoses, location of surgical center and time to cryopreservation.

Patients: One hundred and thirty men undergoing testicular sperm extraction and 76 couples undergoing 123 in vitro fertilization cycles with testicular sperm.

Outcome Measures: Successful sperm recovery defined as 1-2 sperm/0.

Sperm banking for fertility preservation: a 20-year experience.

Objective: Sperm banking is an effective method to preserve fertility, but is not universally offered to males facing gonadotoxic treatment in the United States. We compared the disposition and semen parameters of cryopreserved sperm from individuals referred for sperm banking secondary to a cancer diagnosis to those of sperm from men banking for infertility reasons.

Study Design: We performed a retrospective cohort study that reviewed 1118 records from males who presented to bank sperm at Washington University between 1991 and 2010.

Insulin-stimulated glucose uptake occurs in specialized cells within the cumulus oocyte complex.

The oocyte exists within the mammalian follicle surrounded by somatic cumulus cells. These cumulus cells metabolize the majority of the glucose within the cumulus oocyte complex and provide energy substrates and intermediates such as pyruvate to the oocyte. The insulin receptor is present in cumulus cells and oocytes; however, it is unknown whether insulin-stimulated glucose uptake occurs in either cell type.

Associations between free fatty acids, cumulus oocyte complex morphology and ovarian function during in vitro fertilization.

Objective: To determine if follicular free fatty acid (FFA) levels are associated with cumulus oocyte complex (COC) morphology.

Design: Prospective cohort study.

Setting: University in vitro fertilization (IVF) practice.

Polycystic ovary syndrome and maternal obesity affect oocyte size in in vitro fertilization/intracytoplasmic sperm injection cycles.

To determine the impact of maternal metabolic state on oocyte development in women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI), we retrospectively analyzed a cohort of women with PCOS undergoing IVF/ICSI from 2008-2009 in a university-based fertility center. We determined that women with PCOS and obesity have smaller oocytes than control subjects, and that when further subdivided by body mass index, both PCOS and obesity independently influence oocyte size.

Disposition of cryopreserved embryos by infertility patients desiring to discontinue storage.

Objective: To review our patients' decisions for disposition of their cryopreserved embryos and compare the findings with those reported in the scientific literature. Patients who no longer wish to store their cryopreserved embryos have three choices: discarding, donation to research, or donation to someone else for initiation of a pregnancy.

Design: Retrospective review of patient records from January 2002 to July 2007 to determine preferences for embryo disposition.

A prospective, randomized, double-blinded study of assisted hatching in women younger than 38 years undergoing in vitro fertilization.

Objective: To determine whether assisted hatching is beneficial to IVF patients younger than 38 years whose embryos have a thickened zona pellucida (ZP).

Design: Prospective, randomized, double-blinded, crossover study.

Setting: University-based infertility center.

Morbid obesity is associated with lower clinical pregnancy rates after in vitro fertilization in women with polycystic ovary syndrome.

Objective: To determine whether morbid obesity is associated with decreased pregnancy and live birth rates after IVF in women with polycystic ovary syndrome (PCOS).

Design: Retrospective cohort study.

Setting: University-based fertility center.

Encouraging patient-driven single-embryo transfer.

Single-embryo transfer (SET) removes the risk of multiples in in vitro fertilization (IVF), but women with unfavorable IVF prognosis have been dissuaded from SET despite their desire to avoid multiples. In our clinic, 54% of the women who requested SET delivered healthy singletons, even though only two of them had met the American Society for Reproductive Medicine's SET guidelines. This demonstrates the value of encouraging patient-driven SET.

A randomized, prospective study comparing laser-assisted hatching and assisted hatching using acidified medium.

Objective: To compare the clinical outcomes of patients whose transferred embryos underwent either laser-assisted hatching or hatching with acidified medium.

Design: Randomized, prospective, double-blinded study.

Setting: University-based IVF center.

Developmental potential of in vitro- and in vivo-matured human oocytes collected from stimulated and unstimulated ovaries.

The study by Li and coworkers demonstrated that human oocytes collected from the unstimulated ovary have high rates of meiotic spindle and chromosome abnormalities. Until improvements can be made to culture conditions, in vitro maturation protocols for patient treatment should be considered experimental.

Targeted and restricted complement activation on acrosome-reacted spermatozoa.

A specific hypoglycosylated isoform of the complement regulator membrane cofactor protein (MCP; CD46) is expressed on the inner acrosomal membrane (IAM) of spermatozoa. This membrane is exposed after the acrosome reaction, an exocytosis event that occurs upon contact with the zona pellucida. We initiated this investigation to assess MCP's regulatory function in situ on spermatozoa.

Expression of mRNAs for DNA methyltransferases and methyl-CpG-binding proteins in the human female germ line, preimplantation embryos, and embryonic stem cells.

Recent evidence indicates that mammalian gametogenesis and preimplantation development may be adversely affected by both assisted reproductive and stem cell technologies. Thus, a better understanding of the developmental regulation of the underlying epigenetic processes that include DNA methylation is required. We have, therefore, monitored the expression, by PCR, of the mRNAs of DNA methyltransferases (DNMTs), methyl-CpG-binding domain proteins (MBDs), and CpG binding protein (CGBP) in a developmental series of amplified cDNA samples derived from staged human ovarian follicles, oocytes, preimplantation embryos, human embryonic stem (hES) cells and in similar murine cDNA samples.

Randomized controlled study of human zona pellucida dissection using the zona infrared laser optical system: evaluation of blastomere damage, embryo development, and subsequent hatching.

Objective: To assess the effect of laser hatching on human embryo damage and subsequent development using the Zona Infrared Laser Optical System (ZILOS).

Design: Randomized controlled study.

Setting: Tertiary care fertility clinic.

Functional studies of subcutaneous ovarian transplants in non-human primates: steroidogenesis, endometrial development, ovulation, menstrual patterns and gamete morphology.

Background: The study objective was to determine if ovarian function would be restored following fresh and cryopreserved extrapelvic autologous ovarian transplantation and if vascular endothelial growth factor (VEGF) administration would augment the success rate.

Methods: Sixteen regularly cycling female cynomolgus monkeys underwent bilateral oophorectomy and were randomly assigned to one of three treatment groups: (i) sham transplant group (n = 5) underwent transplantation of pieces of adipose tissue; (ii) fresh autologous ovarian transplantation without VEGF administration (n = 6) and (iii) fresh autologous ovarian transplantation with 1 microg of VEGF (n = 5) administered at the transplantation site daily for 14 days after transplantation. The ovarian tissue from the sham transplanted group was cryopreserved.

Characterization of telomerase activity in the human oocyte and preimplantation embryo.

Telomerase, a ribonucleoprotein, has been described as an essential component of highly proliferative cells as it stabilizes the telomeres and avoids cellular senescence. The objective of this study was to modify the polymerase chain reaction-based telomeric repeat amplification protocol to detect telomerase activity in the single cell and to characterize the activity expressed in the human oocyte through to the blastocyst stage embryo. A comparative evaluation of telomerase activity and developmental stage was conducted using discarded or donated human oocytes and embryos.

Microinjection of antisense c-mos oligonucleotides prevents the progression of meiosis in human and hamster oocytes.

Objective: To investigate the role of c-mos proto-oncogene in the progression of meiosis in human and hamster oocytes.

Design: Controlled basic research study.

Setting: Assisted reproduction units at medical institutions.

Use of human gametes obtained from anonymous donors for the production of human embryonic stem cell lines.

Objective: To investigate the use of donated gametes for the production of human embryonic stem cell lines.

Design: Basic research study.

Setting: Assisted Reproductive Technology (ART) program at an academic institution.

Evaluation of the meiotic spindle apparatus in metaphase II human oocytes following cytoplasmic donation.

Purpose: To determine if the removal of cytoplasm from metaphase II human donor oocytes damages the meiotic spindle apparatus.

Materials And Methods: Cryopreservation of metaphase II human oocytes was performed using a fast-freeze, fast-thaw protocol. Upon thaw, oocytes were incubated for 3-4 h and then used for cytoplasmic donation (test oocytes).

Human embryos derived from in vitro and in vivo matured oocytes: analysis for chromosomal abnormalities and nuclear morphology.

Purpose: To determine whether embryos resulting from oocytes matured in vitro have a higher incidence of nuclear and/or genetic abnormalities compared to embryos resulting from oocytes matured in vivo.

Methods: Fluorescence in situ hybridization analysis for chromosomes X, Y, and 18 was used to compare the rates of aneuploidy, mosaicism, and nuclear abnormalities in embryos derived from oocytes that were prophase I at aspiration (immature group) to that observed in embryos resulting from oocytes that were metaphase I or II at aspiration (mature group).

Results: Based on nuclear morphology, significantly more embryos in the mature group (23%) were classified as normal compared to embryos in the immature group (3%).

Incidence of aneuploid spermatozoa from subfertile men: selected with motility versus hemizona-bound.

Spermatozoa-zona pellucida binding selects for human spermatozoa with progressive motility, normal morphology and functional competency. We postulated that this gamete interaction would also act to select against spermatozoa with chromosomal numerical aberrations. Spermatozoa from 41 men participating in the intracytoplasmic sperm injection (ICSI) programme were evaluated for the incidence of aneuploidy of chromosomes 18, X and Y.

Is the timing of implantation affected by zona pellucida micromanipulation?

Purpose: Our purpose was to examine the timing of implantation and early embryo development following uterine transfer of oocytes/embryos previously subjected to zona pellucida micromanipulation.

Methods: A total of 68 singleton pregnancies resulting from IVF and embryo transfer with/without micromanipulation. Patients were divided into four groups according to the type of micromanipulation technique: assisted hatching, embryo biopsy, intracytoplasmic sperm injection, and no micromanipulation (control group).

Embryo implantation in in vitro fertilization and intracytoplasmic sperm injection: impact of cleavage status, morphology grade, and number of embryos transferred.

Objective: The aims of this study were to compare preimplantation embryo quality in intracytoplasmic sperm injection (ICSI) with standard IVF and to examine the impact of age and number and quality of embryos transferred on implantation and pregnancy.

Design: Retrospective, controlled clinical study.

Setting: Academic tertiary center.

Pregnancy following transfer of ooplasm from cryopreserved-thawed donor oocytes into recipient oocytes.

Objective: To determine if frozen-thawed donor oocytes could be used to provide cytoplasm for transfer into patients' oocytes to improve subsequent embryonic development.

Design: Prospective evaluation of the procedure in consenting IVF patients.

Setting: Assisted reproductive technology program.