Total globozoospermia associated with increased frequency of immature spermatozoa with chromatin defects and aneuploidy: a case report.

Globozoospermia, characterised by the presence of round spermatozoa lacking acrosomes in an ejaculate, is a known cause of male infertility. Semen analysis, including sperm chromatin structure assay, toluidine blue, chromomycin A3 and aniline blue staining and fluorescence in situ hybridisation, was performed in an infertile globozoospermic patient to establish to which extent these genetic factors contributed to his infertility. No spermatozoa capable of hyaluronan (HA) binding were detected in the HA binding assay. Increased rates of immature spermatozoa with defective replacement of histones by protamines, DNA breaks and disturbed chromatin integrity and sperm aneuploid for the sex chromosomes were observed. Intracytoplasmic sperm injection (ICSI) was used in three in vitro fertilisation (IVF) cycles, and enough morphologically well-developing embryos were obtained in each cycle. However, no pregnancy was achieved. The infertility of our couple, resistant to IVF/ICSI treatment, was most probably caused by a combination of male and female factors.

[Preimplantation genetic diagnosis (PGD) of hereditary cancer syndromes]. / Preimplantacní genetická diagnostika (PGD) hereditárních nádorových syndromu

Advances in molecular biology techniques made possible genotype analysis from one or several cells. This can be used in preimplantation genetic diagnosis (PGD) not only of chromosomal aneuploidy but also of single gene diseases as well as hereditary cancer syndromes. PGD can be a benefit for those cases when the risk of transfer of pathological alteration from parent to offspring is unwelcome. We submit three cases of PGD with the results.

[Aspiration of a gestational sac controlled by vaginal ultrasound in multiple pregnancy for the purpose of selective abortion]. / Aspiration eines Fruchtsacks unter Kontrolle der Vaginalsonographie bei einer Mehrlingsschwangerschaft zum Zweck eines selektiven Abortes.

A case of an infertile married couple by whom the cause of infertility was oligoasthenospermia of man is described. The couple was treated by intrauterine insemination by capacitated spermatozoa in a cycle stimulated by clomiphene. The ultrasonography revealed a pregnancy of triplets. The patient refused a multiple pregnancy and asked for its interruption. As an alternative we proposed the selective abortion by means of an ultrasound-guided aspiration of two gestational sacs. Description of this method and the result are the theme of our paper.

[Assisted reproduction in the treatment of infertile marriages]. / Prínos asistované reprodukce pro lécbu neplodného manzelství.

The authors investigated how treatment of infertile marriages is affected by the introduction of assisted reproduction. They compared the five-year period 1978-1982--485 couples with group II (1983-1987)--787 married couples. In group II successively all methods of assisted reproduction were introduced. The authors found that group II (1983-1987) had by 18.3% more deliveries, as compared with the first period. The increase is due to assisted reproduction in 10.6% and due to other therapeutic methods in 7.7%. The increase occurred in all investigated indication groups using methods of assisted reproduction within the range of 6.9-14.4%.

[The effect of low-dose pre-ovulatory progesterone administration on the outcome of in-vitro fertilization (IVF) and intra-tubal gamete transfer (GIFT)]. / Zum Einfluss niedrigdosierter präovulatorischer Progesterongaben auf die Ergebnisse von In-vitro-Fertilisation (IVF) und intratubarem Gametentransfer (GIFT).

The influence of application of low-dose progesterone 4 hours before induction of ovulation by HCG on the outcome of IVF and GIFT was investigated in a bilateral study. The number of patients was 38 from both clinics for IVF and 36 for GIFT. With a pregnancy rate of 35.3% and 17.6% of ongoing pregnancies per transfer the results of the study are much better than before. The rather low number of patients and the low rate of transfers relativate these results. After GIFT an elevated abortion rate leads to only 11.1% ongoing pregnancies following a pregnancy rate of 33.3%. The effect of progesterone supplementation on the LH-peak and the endometrium should be further investigated to find new ways to increase success of IVF and GIFT treatment.