DNA fragmentation of normal spermatozoa negatively impacts embryo quality and intracytoplasmic sperm injection outcome.

Objective: To evaluate DNA fragmentation in morphologically normal sperm recovered from the same sample used for intracytoplasmic sperm injection (ICSI) and to correlate DNA damage with embryo quality and pregnancy outcome.

Design: Prospective study.

Setting: Academic center.

Does storage time influence postthaw survival and pregnancy outcome? An analysis of 11,768 cryopreserved human embryos.

Objective: To evaluate the impact of cryopreservation storage duration on embryo survival, implantation competence, and pregnancy outcome.

Design: Retrospective study.

Setting: Academic tertiary-referral infertility center.

Pregnancy-specific {beta}-1-glycoprotein 1 and human leukocyte antigen-E mRNA in human sperm: differential expression in fertile and infertile men and evidence of a possible functional role during early development.

Background: Mature spermatozoa contain thousands of mRNA transcripts. It has been recently shown that human sperm can deliver RNA into the oocyte, suggesting that mRNAs might have a role before or after fertilization. Human embryos express PSG1 (pregnancy-specific beta-1-glycoprotein 1) and HLA-E (human leukocyte antigen-E), molecules playing a role in implantation and early development.

Sperm chromatin released by nucleases.

In human spermatozoa, 15-20% of histones are retained in the nucleus to coexist with protamines. Hypothetically, nucleohistone regions of sperm chromatin mark DNA sequences for distinctive processing during fertilization and early embryogenesis. The structural organization and molecular composition of nucleohistones in human spermatozoa is poorly studied.

Expression of immunomodulatory genes, their protein products and specific ligands/receptors during the window of implantation in the human endometrium.

We have demonstrated up-regulation of the immunomodulatory genes decay accelerating factor (DAF), interleukin 15 (IL-15) and osteopontin (OPN) during the window of implantation (WOI). Here, we characterized gene expression and determined the localization of their protein products and respective ligands at the opening and closure of the WOI. In addition, we used laser capture microdissection (LCM) to analyze the cell type-specific gene expression.

Oocytes of baboon fetal primordial ovarian follicles express estrogen receptor beta mRNA.

In fetal ovaries of estrogen-suppressed baboons, we have previously shown that follicle numbers were 50% lower than in estrogen-replete animals and contained oocytes with a reduced number of microvilli. In the baboon fetal ovary, although estrogen receptor (ER)alpha and beta have been detected by immunocytochemistry in granulosa cells, it is not known whether oocytes express ER. Because the actions of estrogen are mediated by interaction with cell-specific receptors, the current study determined whether ERalpha/beta mRNA were expressed in oocytes of baboon fetal ovaries obtained on day 165 (term = day 184) of gestation.

Revealing the enigmas of implantation: what is the true impact of ovarian hyperstimulation?

It is agreed that ovarian stimulation results in histopathologic changes and variations in gene expression when compared to natural cycles. However, the enigma is still present: What is the true impact of variable degrees of embryo-endometrium developmental asynchrony in the presence of high clinical embryo implantation rates in IVF? It is postulated that the temporal characterization of gene expression and protein profiles of isolated endometrial compartments might unveil patterns that are critical for the establishment of the window of implantation.

Current status of robotically assisted laparoscopic surgery in reproductive medicine and gynaecology.

Laparoscopic techniques have revolutionized the concept of minimally invasive surgery. Robotically assisted surgery is one of the latest innovations in this field and many operative laparoscopic procedures have been performed in urology, cardiac and general surgery. More recently, the use of robotically assisted techniques have been introduced in gynaecology, and most available studies have shown it to be a safe and effective alternative to conventional laparoscopic surgery.

Organization of chromosomes in spermatozoa: an additional layer of epigenetic information?

Elaborate non-random organization of human sperm chromosomes at different structural levels, starting from the DNA packing by protamines up to the higher-order chromosome configuration and nuclear positioning of chromosome territories, has been discovered. Here, we put forward a hypothesis that the unique genome architecture in sperm provides a mechanism for orchestrated unpacking and ordered activation of the male genome during fertilization, thus offering an additional level of epigenetic information that will be deciphered in the descendant cells.

Cumulative exposure to high estradiol levels during the follicular phase of IVF cycles negatively affects implantation.

Purpose: To investigate the effect of the cumulative exposure to estradiol (E(2)) during the follicular phase on IVF outcome.

Methods: Patients were stimulated with recombinant FSH after GnRH agonist suppression and had a day 3-embryo transfer. Estrogen exposure was determined as the area under the curve (AUC) for serum E(2) levels measured from the first day of stimulation through the day after hCG administration.

Uncomplicated full term pregnancy after da Vinci-assisted laparoscopic myomectomy.

Laparoscopic surgery with the assistance of the da Vinci robotic system has been recently introduced in gynaecology, as this new technology provides three-dimensional vision and easier suture capability. This study reports, for the first time, the case of an uncomplicated full term pregnancy after laparoscopic myomectomy with the assistance of the da Vinci robotic system. The patient was a 35-year-old woman presenting with secondary infertility and a single 3 cm, predominantly intramural, fundal myoma.

Characterisation of a human sperm cell subpopulation marked by the presence of the TSH2B histone.

During the process of mammalian spermiogenesis, a significant reorganisation of the chromatin structure occurs involving the sequential substitution of somatic histones with protamines. In the human sperm nucleus, approximately 15% of the basic nuclear protein complement is maintained as histones. Human testis/sperm-specific histone H2B (hTSH2B) is a variant of the histone H2B expressed exclusively in spermatogenic germline cells and present in some mature sperm cells.

Elective transfer of two embryos: reduction of multiple gestations while maintaining high pregnancy rates.

Purpose: To determine if the elective transfer of two embryos reduced the incidence of multiple gestations while maintaining high pregnancy rates.

Methods: IVF patients and recipients of oocyte donation with an elective day-3 transfer of 2 or 3 embryos were studied.

Result(s): In IVF, the elective transfer of 2 embryos resulted in similar pregnancy rate but significantly reduced the overall incidence of multiple gestations (20% versus 39%) when compared to the elective transfer of 3 embryos.

Short term changes in melatonin and cortisol serum levels after a single administration of estrogen to menopausal women.

Objectives: It has been well-documented that serum melatonin levels are insensitive to estrous or menstrual ovarian steroid variations in the female rat or the human. However, a negative coupling has been already demonstrated between the nocturnal serum melatonin peak and serum E2 concentration during the late premenopausal period in the woman. The objection of the present study was designed to determine if diurnal serum melatonin values can be also lowered by a single administration of estrogen.

Testis/sperm-specific histone 2B in the sperm of donors and subfertile patients: variability and relation to chromatin packaging.

Background: The compaction of human sperm chromatin is the result of replacement of approximately 85% of histones with protamines. Germ-line testis/sperm-specific histone 2B (TSH2B) has been detected in only approximately 30% of mature spermatozoa. Its level in the semen of subfertile patients varies; its function is unknown.

Prostaglandin-endoperoxide synthase (PTGS1 and PTGS2) expression and prostaglandin production by normal monkey ovarian surface epithelium.

Objective: To determine whether hCG regulates the expression of prostaglandin (PG) synthesis enzymes and the production of PGs by normal monkey ovarian surface epithelium (OSE).

Design: Experimental animal study.

Setting: Research laboratory.

Substance P plasma concentration during the LH preovulatory surge of the menstrual cycle in the human.

Objectives: In order to determine the exact pattern of plasma Substance P (SP) concentration during the LH preovulatory surge and the functional correlates which could exist between plasma SP, LH, 17 beta-estradiol (E2) and Progesterone, we performed a detailed analysis of changes in plasma SP concentration, during the critical phases of the LH preovulatory surge in the Human.

Methods: The experimental study was performed in 21 women between the ages of 26 and 35 years. For each subject, blood samples were taken every 15 min, between 07:00 a.

Predictive value of the hemizona assay for pregnancy outcome in patients undergoing controlled ovarian hyperstimulation with intrauterine insemination.

Objective: The hemizona assay (HZA) is an established functional test that examines in vitro sperm-zona pellucida binding capacity with high predictive power for fertilization outcome in IVF. The objective of this study was to evaluate the value of the HZA as a predictor of pregnancy in patients undergoing controlled ovarian hyperstimulation (COH) and intrauterine insemination (IUI).

Design: Prospective clinical study.

ACTH-cortisol activity during the 17beta-estradiol and LH preovulatory surges of the menstrual cycle.

Objectives: A strong positive coupling has been already documented between the adrenocortical axis and the gonadal axis at the time of the initiation of the preovulatory LH surge of the menstrual cycle in the human. The LH preovulatory surge starts in the morning at the time of the acrophase (maximal plasma cortisol values) of the cortisol circadian rhythm. Also, it was shown that morning maximal plasma cortisol values were higher during the follicular phase than during the luteal phase.

Comparative maturation of cynomolgus monkey oocytes in vivo and in vitro.

Background: In vitro maturation (IVM) of oocytes followed by fertilization in vitro (IVF) and embryo transfer offers an alternative to conventional IVF treatment that minimises drug administration and avoids ovarian hyperstimulation. However, the technique is less efficient than maturation in vivo. In the present study, a non-human primate model was used to address the hypothesis that the number of oocytes is increased and their nuclear and cytoplasmic maturity after IVM are improved when maturation is initiated in vivo by priming with hCG.

Cyclic nucleotide phosphodiesterase inhibition increases tyrosine phosphorylation and hyper motility in normal and pathological human spermatozoa.

Our objective was to determine the effect of phosphodiesterase (PDE) inhibition on: 1) tyrosine phosphorylation of human spermatozoa at the tail level; and 2) sperm motion parameters and hyperactivated motility. The study was conducted with normozoospermic and asthenozoospermic samples incubated under in vitro capacitating conditions. The main outcome measures were computer-assisted sperm motion analysis and fluorescent immunodetection of phosphotyrosine-containing proteins.

Safety and efficacy of an extended-regimen oral contraceptive utilizing continuous low-dose ethinyl estradiol.

Objective: To assess the efficacy and safety of Seasonique, a 91-day extended-regimen oral contraceptive (OC) utilizing continuous low-dose ethinyl estradiol (EE) during the typical hormone-free interval.

Methods: A multicenter, open-label, 1-year study of Seasonique [30 microg EE/150 microg levonorgestrel (LNG)] for 84 days followed by EE 10 microg for 7 days was conducted in sexually active, adult women of childbearing potential. All patients completed daily electronic diaries to monitor compliance and bleeding.

Pseudomyxoma peritonei: a rare differential diagnosis of hydrosalpinx.

Objective: To establish the diagnosis of a right hydrosalpinx in a woman with primary infertility.

Design: Case report.

Setting: Departments of Obstetrics and Gynecology and Surgery, academic medical center and teaching hospital.

Effect of coasting on the implantation potential of embryos transferred after cryopreservation and thawing.

Objective: To examine the effect of withholding gonadotropins on the outcome of embryos after cryopreservation and thawing.

Design: Retrospective clinical evaluation of patients having cryopreserved-thawed ET trials with coasting during the corresponding ovarian stimulation cycle.

Setting: Academic tertiary clinical care unit.

Management of infertility in women with polycystic ovary syndrome : a practical guide.

The management of infertility in women with polycystic ovary syndrome (PCOS) centers around options for inducing ovulation. This is an evidence-based review of the management of PCOS, which includes a MEDLINE search of publications between 1986 and May 2005 and a search of the Cochrane Database. Weight loss, exercise, and metformin will induce ovulation in many insulin-resistant women and obese women with PCOS, and should always be the first-line treatment.