Hyperandrogenemia impairs endometrial vitamin D receptor expression in polycystic ovary syndrome.

Objectives: To determine the effects of hyperandrogenemia and other phenotypic parameters on endometrial vitamin D receptor (VDR-X2 and VDR-X4) expression in women with polycystic ovary syndrome (PCOS) undergoing ovarian stimulation and total embryo freezing.

Methods: Forty-four PCOS patients were divided into four phenotypes according to the criteria for hyperandrogenemia (HA), ovulatory dysfunction (OD), and polycystic ovary morphology (PCOM): phenotype A (HA+OD+PCOM), phenotype B (HA+OD), phenotype C (HA+PCOM), and phenotype D (OD+PCOM). Endometrial VDR expression was determined by real-time PCR and immunohistochemistry.

Endometrial Injury Upregulates Expression of Receptivity Genes in Women with Implantation Failure.

Background: Homeobox genes A10 (HOXA10) and A11 (HOXA11), members of the abdominal B gene family, are responsible for embryonic survival and implantation. This study was planned to investigate whether endometrial injury alters the expression of both transcripts in women with implantation failure.

Methods: A total of 54 women with implantation failure were divided into two equal groups as experimental (scratching) and sham (no scratching).

Comparison of gender-specific human embryo development characteristics by time-lapse technology.

Numerous studies indicate that there might be differences in embryo growth dynamics between male and female embryos. However, current data in humans are scarce and the results are inconclusive or conflicting. This study asks whether there exist gender-specific embryo development kinetics or parameters between human male and female embryos that can be observed by time-lapse technology.

Klinefelter syndrome: does it confer a bad prognosis in treatment of nonobstructive azoospermia?

Objective: To determine the effectiveness of microsurgical testicular sperm extraction (micro-TESE) and intracytoplasmic sperm injection (ICSI) for men with Klinefelter syndrome (KS).

Design: Retrospective clinical study.

Setting: Private IVF center.

Birth after 12 hours of oocyte refrigeration.

Objective: To assess cycle outcome after oocyte refrigeration.

Design: Case report.

Setting: Private IVF center.

Comparison of cabergoline and bromocriptine in patients with asymptomatic incidental hyperprolactinemia undergoing ICSI-ET.

We retrospectively assessed outcomes of in vitro fertilisation in groups of women with asymptomatic incidentally discovered hyperprolactinaemia (AIH) undergoing ovarian stimulation and ICSI-ET relative to the types of dopamine agonist and gonadotropin releasing hormone analogue used. Of 5840 women who underwent COH and ICSI-ET, 239 were included in the study; 122 had been treated with cabergoline, and 117 with bromocriptine, during the COH. The mean age, duration of stimulation, and total number of gonadotropin ampules employed were comparable in the two groups using the agonist and antagonist protocols, as were the number of oocytes retrieved and the proportion of mature MII and fertilised (2pn) oocytes.

Early pregnancy loss rates were different among singleton gestations conceived by ICSI using GnRH agonist and antagonist.

This study compared early pregnancy losses (termination of pregnancy before 12 weeks of gestation, EPL) among conceptions achieved by ICSI according to the type of GnRH analogue for ovarian stimulation. Only singleton gestations (2,184) and fresh embryo transfers were included. GnRH agonist was used in 848 gestations out of 2,184 and GnRH antagonist was used in the remaining 1,336 gestations.

Frozen-thawed cleavage-stage embryo transfer cycles after previous GnRH agonist or antagonist stimulation.

This study presents the results of fresh and frozen-thawed embryo transfers in women undergoing IVF with gonadotrophin-releasing hormone (GnRH) agonists and GnRH antagonists. By evaluating cycle outcomes, the impact of two different protocols on the endometrium was indirectly evaluated. For 714 women, embryos were frozen following day-3 fresh embryo transfer and the outcome of those fresh cycles (329 agonist cycles and 290 antagonist cycles) and subsequent frozen-thawed embryo transfer (91 agonist cycles and 104 antagonist cycles) were evaluated.

Route of progesterone administration for luteal phase support may affect outcome of controlled ovarian hyperstimulation for IVF with ICSI using GnRH antagonist.

Purpose: This study evaluated the impact of route of progesterone administration as luteal phase support on the outcome of assisted conception cycles.

Methods: Intramuscular progesterone in oil (IMP) at 100 mg daily was administered to 903 women following oocyte retrieval whereas vaginal progesterone gel (VMP) at 90 mg was administered twice daily to 1,110 women. Retrospective analysis was performed according to the type of GnRH analogue used.

Early clinical pregnancy loss rate in poor responder patients does not change compared to age-matched normoresponders.

Objective: To investigate the early clinical pregnancy loss rate (ECPLR) of singleton gestations in poor responder (PR) patients.

Design: A retrospective study.

Setting: Private assisted reproductive technology center.

Comparison of preovulatory follicular concentrations of epidermal growth factor, insulin-like growth factor-I, and inhibins A and B in women undergoing assisted conception treatment with gonadotropin-releasing hormone (GnRH) agonists and GnRH antagonists.

Follicular fluid contents of 69 age-matched women undergoing ovarian stimulation with a GnRH agonist and a GnRH antagonist were collected during oocyte retrieval. The groups did not differ in baseline characteristics and in terms of assisted conception treatment outcome. Similarly, follicular fluid levels of epidermal growth factor, insulin-like growth factor, and inhibins A and B were found not to be different.

Outcome of 1114 ICSI and embryo transfer cycles of women 40 years of age and over.

The purpose of this study was to contribute to the development of strategies to obtain acceptable outcomes in assisted reproduction treatments in women over 40 years of age. A retrospective study was carried out on the database of the German Hospital in Istanbul using data from the years 1997 to 2004. A total of 1114 embryo transfer cycles were assessed.

Subclinical pregnancy losses among women undergoing in-vitro fertilization with ICSI.

Background: The purpose of this study is to asses the frequency of subclinical pregnancy loss (SPL) among women undergoing controlled ovarian hyperstimulation (COH) and in-vitro fertilization with ICSI.

Methods: The study was retrospectively conducted in a private IVF center. SPL was defined by a temporary rise in serum beta hCG, along with the absence of signs of intra- and extra-uterine pregnancy by transvaginal ultrasonography.

Comparisons of follicular levels of sex steroids, gonadotropins and insulin like growth factor-1 (IGF-1) and epidermal growth factor (EGF) in poor responder and normoresponder patients undergoing ovarian stimulation with GnRH antagonist.

Objective: To determine the serum and intrafollicular concentrations of sex steroids, epidermal growth factor (EGF) and insulin like growth factor-1 (IGF-1) in women demonstrating poor response to ovarian stimulation with gonadotropins and GnRH antagonists, and to compare the results with age-matched women displaying normal ovarian response.

Study Design: This is a prospective cross-sectional study conducted in a private IVF center. Forty-eight age-matched women producing 5 or fewer oocytes (poor responders) or 10 or more oocytes (normoresponders) at the end of controlled ovarian stimulation for assisted conception participated in the experiment.

Efficiency of changing the embryo transfer time from day 3 to day 2 among women with poor ovarian response: a prospective randomized trial.

Objective: To compare the outcome of day 2 and day 3 embryo transfers in women demonstrating poor ovarian response.

Design: Prospective randomized clinical trial.

Setting: Private assisted reproductive technology center.

Early cleavage morphology affects the quality and implantation potential of day 3 embryos.

Objective: To assess the development and implantation potential of early-cleaved embryos displaying various morphological patterns.

Design: Retrospective analysis.

Setting: Private IVF center.

Impact of coasting in patients undergoing controlled ovarian stimulation with the gonadotropin-releasing hormone antagonist cetrorelix.

Coasting is the most popular modality for the prevention of ovarian hyperstimulation syndrome, but this procedure has not been evaluated in patients undergoing controlled ovarian hyperstimulation (COH) with GnRH antagonists. The impact of coasting in a cycle in which GnRH antagonist is used was evaluated in 29 women, and it was found that coasting did not deleteriously affect the outcome in high-responder patients undergoing COH with GnRH antagonists.

Elevated oestradiol concentrations are not associated with increased first trimester miscarriage rates of singleton gestations conceived by assisted conception treatment.

The study evaluated the impact of elevated oestradiol concentrations on pregnancy loss during the first trimester in singleton gestations conceived via ovarian stimulation and intracytoplasmic sperm injection (ICSI). Following determination of oestradiol concentrations during 6478 ICSI cycles, patients were assorted by oestradiol percentile. Hyper-responders were defined as patients having peak oestradiol concentrations over the 90th percentile (>4200 pg/ml, 685 cycles), moderate responders were defined as patients having peak oestradiol concentrations between the 75th and 90th percentiles (3250-4200 pg/ml, 958 cycles) and normal responders were defined as patients having peak oestradiol concentrations between the 25th and 75th percentiles (1350-3250 pg/ml, 3325 cycles).

Outcomes in couples undergoing ICSI: comparison between fresh and frozen-thawed surgically retrieved spermatozoa.

We retrospectively evaluated the impact of cryopreservation on spermatozoa obtained from patients with azoospermia and used for intracytoplasmic sperm injection (ICSI). Frozen-thawed epididymal spermatozoa (FTEPS) was used in 34 couples, whereas frozen-thawed testicular spermatozoa (FTTS) was used in 50 couples for ICSI during assisted conception, and these results were compared with results using fresh spermatozoa for ICSI in the same individuals. The fertilization rate (FR) was significantly lower for FTTS (65.

Use of both early cleavage and day 2 mononucleation to predict embryos with high implantation potential in intracytoplasmic sperm injection cycles.

Objective: To evaluate the value of early cleavage and day 2 mononucleation as combined parameters in predicting the implantation potential of embryos.

Design: Prospectively designed retrospective cohort analysis.

Setting: Private IVF center.

Effect of oxygen concentration during the incubation of embryos of women undergoing ICSI and embryo transfer: a prospective randomized study.

The hypothesis that ICSI outcome can be improved by culturing human embryos in an atmosphere of controlled O(2) concentration (5%) compared with 20% was tested in a prospective randomized study of 712 transfer cycles. The cycle characteristics and the embryology parameters were similar between groups. The embryo qualities were similar with day 2 transfers; however, they were better with day 3 transfers incubated in 5% O(2) than in 20% O(2).