Immunosuppressive properties of follicular fluid and media conditioned by zygotes correlate with subsequent conception in in vitro fertilization.

PROBLEM: Our objective in this study was to correlate immunosuppressive properties of follicular fluid (FF) and media conditioned by zygotes and early embryos with the occurrence of conception in an in vitro fertilization (IVF) program. METHOD OF STUDY: Fifty-seven IVF patients were studied. Donor lymphocytes were incubated with mitogens and FF from mature oocytes or conditioned media from zygotes and early embryos. Proliferation was assessed by radioactive thymidine incorporation. Proliferation Index (PI) was the ratio between radioactive labeling of lymphocytes incubated in the presence and absence of a mitogen. RESULTS: The FFs and media conditioned by zygotes from conception cycles had higher immunosuppressive activity than those from non-conception cycles. CONCLUSIONS: Immunosuppressive activity present in FF and media conditioned by zygotes may be a major determinant of conception in IVF, and may serve as a marker for embryo quality.

Treatment of recurrent inguinal lymphocele by lymphatic leakage mapping and subsequent ligation of lymphatic vessel endings: a case report.

BACKGROUND: Different approaches have been attempted in both prophylaxis and treatment of recurrent inguinal lymphoceles; however, to date none have been consistently effective. We hereby report our preliminary experience with mapping of the lymphatic leakage followed by ligation of these mapped vessels for resolution of a recurrent inguinal lymphocele. CASE: A 73-year-old woman underwent an anterior modified radical vulvectomy with bilateral inguinofemoral lymph node dissection due to squamous cell carcinoma of the vulva. Postoperatively she presented with a recurrent inguinal lymphocele unresponsive to several treatment measures. After 8 weeks, the patient underwent lymphatic leakage mapping and subsequent ligation of lymphatic vessel endings, which resolved her recurrent lymphocele. CONCLUSION: Lymphatic mapping and ligation of afferent lymphatics may be a useful method for treating recurrent lymphoceles after inguinofemoral lymph node dissection. Further studies are warranted to prove the absolute efficacy of this technique.