Ultrastructural analysis of granulosa cells of IVF patients.

OBJECTIVE: To compare the percentage and ultrastructure of normal and abnormal granulosa cells and their effect on fertilization and pregnancy rate between gonadotropin releasing hormone (GnRH) agonist and antagonist treatment. MATERIALS AND METHODS: In this study, granulosa cells obtained from 22 women undergoing in vitro fertilization (IVF) treatment due to unexplained infertility with either with GnRH agonist (n = 11) or GnRH antagonist (n = 11) were evaluated by light and electron microscopy. RESULTS: GnRH agonist and antagonist therapy was found to have no effect in terms of abnormal granulosa cell percentage (0.0679 ± 0.08977 vs 0.0481 ± 0.05164; p > 0.05), fertilization [85 (45-90) vs 75 (64-93)] and pregnancy rate (37% vs 46%). Light microscopic observations showed similar features of normal cells of agonist and antagonist-treated cells. Ultrastructural evaluation also revealed that there was no difference between cells of two treatment groups. CONCLUSION: Both GnRH agonist and antagonist treatment for ovarian stimulation may have similar effects on granulosa cells at the morphological and ultrastructural level, as well as on fertilization and pregnancy rates.

Live birth after transfer of vitrified-warmed blastocyst derived from ICSI with frozen-thawed sperm: case report.

OBJECTIVE: A live birth after transfer of vitrified-warmed blastocyst derived from intracytoplasmic sperm injection (ICSI) with frozen-thawed sperm of a male cancer patient is described. MATERIALS AND METHODS: A case report from a tertiary center for assisted reproductive technologies. The 35-year-old male patient had been diagnosed with testicular tumor nine years ago. He had unilateral orchiectomy operation after the diagnosis. Four years after the first operation, he was diagnosed with another testicular tumor in the other testis. He admitted to our center with the demand of sperm preservation before the second surgery. The sperm samples were cryopreserved and stored in liquid nitrogen until required. The patient had no chemotherapy or radiotherapy after the operations. After he completed his oncologic follow up, ICSI was decided with his frozen samples. Although the couple failed to conceive with the fresh cycle, the remaining embryos were frozen and revealed a pregnancy in the subsequent frozen-thawed cycle. RESULTS: A healthy female infant with a birth weight of 3,700 g was born by cesarean section at 38th weeks of the gestation. CONCLUSION: Giving detailed information about fertility-saving management in male patients is important in those who wish to bear children. However, both the patients and physicians should be cautious that preservation should be performed before surgery and/or adjuvant therapy. In this respect, assited reproductive technology (ART) and related facilities yield chance of pregnancy in such population.

Manual versus computer-automated semen analysis.

OBJECTIVE: To evaluate agreement of conventional sperm analysis with computer-aided semen analysis (CASA) regarding concentration, motility, and morphology using samples from infertile men. MATERIALS AND METHODS: In this study a total of 195 male partners of couples who underwent evaluation of infertility were included. All semen samples were examined by conventional method and CASA in terms of morphology, motility, and concentration. Pearson correlation analysis and the Bland-Altman method were used to assess correlation and agreement between conventional semen analysis and CASA measurements. RESULTS: When the two methods were compared in terms of concentration, motility, and morphology, there was a statistically significant correlation in all variables. The best correlation was obtained for sperm concentration. However, there was a poor correlation for sperm morphology between conventional method and CASA. Sperm concentration and morphology obtained by CASA were 14% and 87% lower, respectively; motility was 21% higher than the conventional method. CONCLUSION: Although CASA systems are objective and rapid, they should be evaluated in terms of cost-effectiveness, however they may be useful in over-loaded assisted reproductive technique (ART) clinics.

Can combination of Day 3 and Day 5 embryo morphology be useful to predict pregnancy in in-vitro fertilization cycles?

OBJECTIVE: To determine whether embryos having all top qualified both on Day 3 and Day 5 have higher pregnancy rates than the oth- ers. MATERIALS AND METHODS: The study included 143 consecutive cycles were recruited in which Day 5 embryo transfer was available. Cleavage stage embryos were graded according to 1 to 4 scoring system, based on fragmentation, cell symmetry, and blastomere num- ber. Among cleavage stage embryos, Grade 1 and Grade 2a/2b were further stratified as 'top quality' embryos to be transferred, others were defined as control group. Blastocyst stage embryos were graded from 1 to 6 according to intracellular mass (ICM) and trophec- toderm (TE). Day 5 fresh embryo transfer was performed in all cases using soft catheter. Positive pregnancy test was accepted when serum beta-human chorionic gonadotrophin (1-hCG) exceeded 20 mIU/ml. RESULTS: On the cleavage stage, top quality embryo was available in 47 of 143(32.9%) cases. Of the 47 embryos, the number of cases reaching any Grade 4, 3 quality, and early blastocyst on Day 5 were 22 (46.8%), 15 (31.9%), and 10 (21.3%). The respective figures on the control group (n = 96) were 33 (34.4%), 37 (38.5%), and 26 (27.1%) (p > 0.05). The pregnancy rates were also similar. CONCLUSION: All top qualified embryos both on Day 3 and 5 did not reveal higher pregnancy rate than the others.

Human spermatozoa antigens in unexplained infertility.

OBJECTIVE: To determine and compare the immunolocalization of functionally important antigens in human spermatozoa in an unexplained infertility (UI) group. MATERIALS AND METHODS: In this study, the sperm samples of 20 patients undergoing evaluation belonging to normozoospermic group, whose primary reason of infertility was under investigation for this purpose, were screened. CD46, CD55 and CD52, CD69, CD98, fMLP, HI307, and 80280 were stained on the spermatozoa through indirect immunofluorescence technique. RESULTS: In addition to CD46, CD55, and CD52 antigens, which are known to be localized on human spermatozoa, significant immunolocalization of several novel antigens including: CD52, CD69, CD98, fMLP, HI307, and 80280 were determined on the spermatozoa of the unexplained infertility group, possibly reflecting important roles in the pathophysiology of such unresolved clinical situations. CONCLUSION: Identification and characterization of antigens present on sperm cells is crucial for understanding of the diagnosis and treatment of unexplained infertility. Further studies were conducted to evaluate a possible correlation between the expression of these antigens and clinical outcomes in different well-defined infertility groups.