Does Kruger's strict criteria have prognostic value in predicting ICSI clinical results?

OBJECTIVE: The purpose of this study was to compare clinical results of ICSI for different sperm morphology subgroups divided according to Kruger's classification system. MATERIALS AND METHODS: This retrospectively study was conducted at Zeynep Kamil Training and Researching Hospital in Istanbul (Turkey). The study included 332 intracytoplasmic sperm injection (ICSI) cycles. The patients were under 37 years of age with primary infertility who were admitted to the Department of Reproductive Endocrinology and Infertility, from January 2005 to June 2009. The patients were divided in three groups based on Kruger's strict criteria. Normal sperm morphology was less than 4% in group 1, between 4-14% in group 2, and greater than 14% in group 3. All patients underwent ICSI and embryo transfer (ET) following controlled ovarian hyperstimulation (COH). The groups were compared to the rates of fertilization, implantation, clinical pregnancy, abortion, and live birth. RESULTS: Pregnancy occurred in 132 (39.7%) of all ICSI cycles. There was no statistically significant difference between regarding groups regarding the rates of fertilization, implantation, clinical pregnancy, biochemical pregnancy, abortion, and live birth. CONCLUSION: The authors concluded that the normal sperm morphology defined by Kruger's strict criteria and sperm motility will not be able to predict prognosis of ICSI cycles.

Discrepancy of pre- and postoperative grades of patients with endometrial carcinoma.

PURPOSE: To investigate the diagnostic accuracy of endometrial curettage in patients with endometrial carcinoma. In this retrospective study, pre- and postoperative histopathologic findings of patients with endometrial cancer were investigated. METHODS: 168 patients with the final diagnosis of endometrial cancer were enrolled in the study. Pre- and postoperative histopathologic diagnoses and grades (according to the 1988 FIGO classification) of the patients were compared retrospectively. RESULTS: 22 patients were diagnosed as having endometrial hyperplasia and the remaining 136 patients had endometrial carcinoma preoperatively. Overall discrepancy rate of grades was 39% (31% upgrade, 8% downgrade; p < 0.05). There was also 9% discrepancy between the pre- and postoperative histopathological types. CONCLUSION: It has been suggested that since endometrial cancer patients with low grades according to the preoperative pathologic diagnosis have a potential to upgrade, the management of these patients if myometrial invasion is less than one-half thickness, simply by hysterectomy plus bilateral salpingo-oophorectomy (without lymph node sampling), might actually miss some patients who actually deserve surgical staging. Further studies are needed to draw a sufficient conclusion.