Fertility and Sterility

To compare the clinical outcomes of cryopreservation according to the indications for freezing and the outcomes of the fresh cycle from which the embryos were derived. Retrospective study. Private assisted-reproduction unit. Three thousand, three hundred and sixty-eight embryos in 702 frozen-thawed embryo transfer (ET) cycles. Clinical outcomes of frozen-thawed ET cycles in which embryos were derived from fresh conception cycles (n = 436), from fresh nonconception cycles (n = 180), or where the fresh cycle was cancelled due to impending ovarian hyperstimulation syndrome (OHSS) (n = 86). Cryosurvival, clinical pregnancy, and implantation rates. Despite similar cryosurvival rates and the transfer of a similar number of embryos, significantly higher clinical pregnancy and implantation rates were obtained in the fresh-conception and OHSS groups. The implantation potential of frozen-thawed embryos that were not selected in a prior fresh cycle was comparable to that of embryos selected for fresh transfer. The success of frozen-thawed ET depends on the outcome of fresh ET and the indications for cryopreservation. Success is similar to that of fresh ET cycles in patients who had all their embryos frozen due to impending OHSS.

... The role of major histocompatibility complex class I antigens in tumorigenesis: future applications in cancer therapy. Auteur(s) / Author(s). NAPOLITANO L. (1) ; VOGEL J. ; JAY G. ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s). ... Tumor. ; Antígeno histocompatibilidad clase ...

A better understanding of the different phenotypes and of their endocrine and metabolic characteristics permits investigators to distinguish three main androgen excess disorders: classic polycystic ovary syndrome (PCOS), mild ovulatory PCOS, and idiopathic hyperandrogenism. These androgenic phenotypes differ more for the severity of the endocrine and metabolic alteration than for the etiopathogenetic mechanisms. The appearance of a particular androgenic phenotype is determined by a sum of genetic and environmental factors, but mostly by body weight.

To determine whether measures of ovarian reserve differ between females exposed to cancer therapies in a dose-dependent manner as compared with healthy controls of similar age and late reproductive age. Cross-sectional analysis of data from a prospective cohort study. University medical center. Seventy-one cancer survivors aged 15-39 years; 67 healthy, similarly aged unexposed subjects; and 69 regularly menstruating women of late reproductive age (40-52 years). None. Early follicular-phase hormones (FSH, E(2), inhibin B, antimüllerian hormone [AMH]) and ovarian ultrasound measurements (ovarian volume and antral follicle counts [AFC]) were compared using multivariable linear regression. In adjusted models, FSH, AMH, and AFC differed between exposed vs. unexposed subjects (FSH 11.12 mIU/mL vs. 7.25 mIU/mL; AMH 0.81 ng/mL vs. 2.85 ng/mL; AFC 14.55 vs. 27.20). In participants with an FSH <10 mIU/mL, survivors had lower levels of AMH and AFC compared with controls. Alkylating agent dose score was associated with increased levels of FSH and decreased levels of AMH. Exposure to pelvic radiation was associated with impairment in FSH, AMH, AFC, and ovarian volume. Antimüllerian hormone was similar in women previously exposed to high-dose cancer therapy and 40-42-year-old controls. Measures of ovarian reserve are impaired in a dose-dependent manner among cancer survivors compared with unexposed females of similar age. Reproductive hormone levels in menstruating survivors exposed to high-dose therapy are similar to those in late-reproductive-age women. The predictive value of measures for pregnancy and menopause must be studied. CLINICALTRIALS.GOV IDENTIFIER: NCT01143844.

To analyze whether a change in three-dimensional structure of the zona pellucida could indicate suboptimal gamete quality. Prospective study. Women's general hospital. A total of 72 patients who gave informed consent. The birefringence of all oocytes was prospectively analyzed with an automatic user-independent polarization microscopy imaging system. Birefringence of the inner zona layer, preimplantation development, implantation, and pregnancy. In approximately one third of all gametes (244/712), the system's automatic detection of the inner zona layer did not succeed. This phenomenon was a negative predictor of compaction (P<0.01), blastulation (P<0.001), and pregnancy (P<0.001). In cases of successful zona imaging, the score based on the birefringence of the inner zona layer was a strong predictor of blastocyst formation but not of embryo quality or pregnancy (P>0.05). Interestingly, antagonist protocol resulted in lower zona scores as compared with the long protocol (P<0.05). Combining the information from both undetected and detected oocytes, zona imaging was a helpful tool in oocyte selection. This knowledge might further help to reduce both the time in culture and the number of concepti considered for transfer.

To present a case of an acute hemoperitoneum caused by a ruptured ovarian cyst in a late twin pregnancy. Case report study. Department of Obstetrics and Gynecology, Medical University of Graz, Austria. A woman with a history of surgery for endometriosis and currently pregnant with dichorionic twins after IVF presented with acute abdominal pain. Serial ultrasound assessment revealed a massive hemoperitoneum that was caused by a ruptured endometriotic ovarian cyst. Emergency laparotomy was performed. Hemostasis. Laparotomy led to operative hemostasis and preterm cesarean section of healthy twins at 27 weeks of gestation. Endometriosis occurs in about 10% of women of reproductive age and carries an infertility rate of up to 50%. Severe endometriosis used to be a rare event in patients with spontaneously conceived pregnancies. However, during the last decade, the increased use of assisted reproductive technologies has led to higher fertility rates in patients with endometriosis and to a higher incidence of multiple gestations. Therefore, the number of pregnant women with endometriosis and associated complications may rise.