Employment of a Newly Defined In Vitro Fertilization Protocol to Determine the Cytoskeletal Machinery, DNA Damage, and Subsequent DNA Repair Resulting from Endocrine Disruption by Hexavalent Chromium in Rat Metaphase II Oocytes.

These protocols describe a detailed method to determine the DNA damage and F-actin and microtubule defects of metaphase II oocytes caused by hexavalent chromium, Cr(VI), an endocrine disrupting chemical (EDC). The protocol provides systematic steps to determine protein expression encoded by pluripotency proteins such as Oct4, Nanog, and Cdx2 during early embryonic development. Occupational or environmental exposure to EDCs has significantly increased infertility in both men and women.

Development of a dynamic machine learning algorithm to predict clinical pregnancy and live birth rate with embryo morphokinetics.

Objective: To evaluate the feasibility of generating a center-specific embryo morphokinetic algorithm by time-lapse microscopy to predict clinical pregnancy rates.

Design: A retrospective cohort analysis.

Setting: Academic fertility clinic in a tertiary hospital setting.

Association of ovarian response with picoAMH in women undergoing controlled ovarian hyperstimulation.

Objective: Our study aims to evaluate the diagnostic performance of a high-sensitivity picoAnti-Müllerian Hormone (picoAMH) for predicting ovarian response in women undergoing controlled ovarian hyperstimulation and occurrence of ovarian hyperstimulation syndrome.

Methods: Retrospective cohort study at a single academic fertility center including all patients with picoAMH ELISA who underwent controlled ovarian hyperstimulation. The primary outcome was the number of oocytes retrieved, and secondary outcomes included cycle cancellation and ovarian hyperstimulation syndrome.

The importance of estradiol measurement in patients undergoing in vitro fertilization.

Successful outcomes of in vitro fertilization (IVF) are dependent in part on successful oocyte maturation and retrieval during a controlled ovarian stimulation process, which is guided by serial ultrasound and estradiol measurements. Yet, laboratory analysis of estradiol poses challenges due to the need for accuracy and specificity across concentrations that span multiple orders of magnitude. The Endocrine Society released a 2013 position statement that called for improvements in methods to analyze estradiol, and while some progress has been made in standardization and assay specificity, further work is needed to meet the needs of patients in both the IVF setting and in other clinical contexts.

Validation of the picoAMH assay on the Dynex DS2 platform.

Objectives: Anti-Müllerian hormone (AMH) is increasingly used as a biomarker of ovarian reserve in clinical practice, and is used both for management of fertility treatments and prediction of menopause. We sought to validate the newly FDA-approved Ansh Laboratories MenoCheck picoAMH ELISA on the Dynex-DS2 platform for clinical use in our obstetrics and gynecology center.

Design: Validation of the picoAMH ELISA on the Dynex-DS2 was performed according to CLSI guidelines.

A Novel Ultrasound-Guided Technique for Hysteroscopic Adhesiolysis in High-Risk Patients.

Hysteroscopy is a common gynecologic surgical procedure. Certain diagnoses, notably intrauterine adhesions and cervical stenosis, make hysteroscopy more complicated because of an increased likelihood of complications. Three patients, 1 with cervical stenosis and 2 with Asherman syndrome, underwent ultrasound (US)-guided adhesiolysis.

Accuracy of Two Progesterone Immunoassays for Monitoring In Vitro Fertilization.

Background: Progesterone concentrations are routinely monitored during in vitro fertilization cycles. Immunoassay-based platforms are used most often in this setting because they are simple to use and amenable to same-day sample collection and result-reporting. However, immunoassay methods are subject to variation in specificity between different assay manufacturers.

Optimization of oestradiol assays to improve utility in an in vitro fertilization setting.

Background The measurement of oestradiol is an integral component for the management of ovarian stimulation for in vitro fertilization. Automated immunoassays offer fast assay times and high throughput, with less sensitivity and specificity. The aim of this study is to optimize the oestradiol assay in patients undergoing ovarian stimulation for in vitro fertilization via comparison of oestradiol values obtained using two immunoassays compared with mass spectrometry.

Whole genome prediction for preimplantation genetic diagnosis.

Background: Preimplantation genetic diagnosis (PGD) enables profiling of embryos for genetic disorders prior to implantation. The majority of PGD testing is restricted in the scope of variants assayed or by the availability of extended family members. While recent advances in single cell sequencing show promise, they remain limited by bias in DNA amplification and the rapid turnaround time (<36 h) required for fresh embryo transfer.

Hormonal and Clinical Predictors for Post-egg Retrieval Pain in Women Undergoing Assisted Reproductive Technology Procedures.

Objectives: The intensity of post-egg retrieval pain is underestimated, with few studies examining postprocedural pain and predictors to identify women at risk for severe pain. We evaluated the influence of preprocedural hormonal levels, ovarian factors, and mechanical temporal summation (mTS) as predictors for post-egg retrieval pain in women undergoing in vitro fertilization.

Methods: Eighteen women scheduled for ultrasound-guided egg retrieval under standardized anesthesia and postprocedural analgesia were enrolled.

A meta-analysis of the route of administration of luteal phase support in assisted reproductive technology: vaginal versus intramuscular progesterone.

Objective: To perform an analysis of data with consideration for the current clinically accepted vaginal progesterone (P) or intramuscular (IM) P dosing regimens and the clinically relevant randomized clinical trials published during the time frame 1992 to 2008.

Design: Meta-analysis of progesterone luteal support in IVF cycles using odds ratios (OR) and 95% confidence intervals (CI).

Setting: Previously conducted randomized clinical trials meeting acceptance criteria.

Function and structure of cilia in the fallopian tube of an infertile woman with Kartagener's syndrome.

In Kartagener's syndrome (KS), primary defects of the ciliary axoneme cause dyskinetic ciliary motion. Because ciliary motion is an important factor in normal ovum transport, ciliary dyskinesia may cause infertility. On the other hand, the existence of some ciliary activity, albeit abnormal, may account for fertility in some women with KS.

Development of a human granulosa cell culture model with follicle stimulating hormone responsiveness.

In order to study the effects of follicle-stimulating hormone (FSH) on differentiation of granulosa cells, a well-defined and validated in-vitro culture system is indispensable. In this study, pooled follicular aspirates were stimulated in vitro with FSH and luteinizing hormone (LH) for 2, 4 and 6 days, either immediately after plating or after 7 days of preincubation. Cultures were assayed for progesterone and oestradiol production.

Purification and characterization of a human follicular fluid lipid transfer protein that stimulates human sperm capacitation.

Identification of the mechanisms responsible for sperm capacitation has been an active area of research for nearly four decades. Changes in the lipid composition of the sperm membrane is one of the biochemical events that occurs during sperm capacitation. We have been studying physiological effectors of some of these changes and have identified lipid transfer activity in fractions of human follicular fluid that stimulates sperm penetration of zona-free hamster oocytes.

Early luteal progesterone supplementation during in vitro fertilization cycles. A randomized trial.

The effects of early luteal phase progesterone (P) supplementation were studied in women with endogenous serum P levels less than or equal to 12 ng/mL prior to embryo transfer. From a total of 129 cycles that received the same ovarian hyperstimulation protocol, 72 cycles were characterized by levels less than 12 ng/mL on the day prior to embryo transfer. Of those women, 42 (group B) were started on P supplementation one day prior to embryo transfer, and 30 (group C) were started according to the standard protocol after embryo transfer.

Lipid transfer activity in human follicular fluid: relation to human sperm capacitation.

A potentially important event during sperm capacitation is the loss of sperm membrane cholesterol. Although the exact mechanisms mediating this loss are not known, albumin and high density lipoprotein have been proposed as lipid acceptors. The authors propose that lipid transfer may be involved in capacitation as a specific mediator in the sequence of events leading to sperm membrane cholesterol loss.

Relationship of bacteriologic characteristics to semen indices in men attending an infertility clinic.

Bacteria can be isolated from most seminal fluid samples, but the significance of these microorganisms is uncertain because most men lack symptoms associated with bacterial infection of the reproductive tract. We obtained semen samples from 37 men attending a Special Infertility Clinic and assessed the relationship between seminal fluid microorganisms and seminal fluid analysis including sperm motility, morphology, and concentration; the numbers of polymorphonuclear leukocytes and other white blood cells; and the hamster zona-free oocyte sperm penetration assay. Aerobic and/or anaerobic bacteria were recovered from 36 of the 37 samples.

The clinical relevance of sex selection techniques.

Clinical and laboratory attempts to alter the sex ratio require more complete and thorough study. Improved identification of Y-bearing sperm through chromosome evaluation rather than by F-body identification is critical to provide a more precise definition. The tentative conclusions stated below are based on an assessment of literature from which it is generally difficult to draw conclusions: 1.

Transmission of genital herpes by donor insemination.

This report describes a donor in a therapeutic donor insemination program who asymptomatically acquired a primary herpes simplex virus type 2 (HSV-2) infection from his long-standing sexual partner. His fresh semen was used to inseminate two HSV-seronegative recipients; in one a primary HSV-2 infection developed, and in one it did not. Direct evidence of transmission from donor to recipient was documented by restriction enzyme analysis of the HSV-2 isolates obtained from the donor's semen and from the recipient's cervix.

An in vitro fertilization program using satellite physicians.

In order to provide an in vitro fertilization (IVF) service for a large geographic region, we developed the concept of Satellite IVF Centers. The goals of this program were as follows: 1) to facilitate patient participation by decreasing travel expenditures, time for screening appointments, and IVF cycle cancellations, and 2) to involve community physicians in a regionalized program. We established centers in nine cities within the Washington, Alaska, Montana, and Idaho region serviced by the University of Washington, and in Alberta, Canada.

Comparison of three wash techniques for the removal of microorganisms from semen.

The objective of this study was to compare the effectiveness of three sperm separation techniques for producing samples free of seminal fluid microbes. Each of 11 semen samples were separated by the following techniques: wash, with centrifugation only; swim-up, with undiluted semen layered beneath medium; and wash and swim-up, with centrifuged sperm cells overlain with medium. Microbiology for both aerobic and anaerobic organisms of semen and washes was determined by standard methods.

Human sperm penetration assay as an indicator of sperm function in human in vitro fertilization.

Performance of spermatozoa in a hamster oocyte/human sperm penetration assay (SPA) was correlated with the results of in vitro fertilization (IVF). Forty-two patients underwent 50 IVF cycles. SPA scores were obtained before IVF cycles (screening SPA, n = 30) and, where practical, on the semen sample used for IVF (IVF SPA, n = 26).