Role of coculture in human in vitro fertilization: a meta-analysis.

OBJECTIVE: To evaluate the role of coculture in human IVF. DESIGN: Meta-analysis. SETTING/PATIENT(S)/INTERVENTION(S): A literature search was performed using the Cochrane Menstrual Disorders and Subfertility Group Trials register, the Cochrane Central register of Controlled Trials on the Cochrane Library (2006), and MEDLINE (January 1966 to March 2006). MAIN OUTCOME MEASURE(S): Primary outcomes measured were implantation rates and pregnancy rates (clinical and ongoing). Secondary outcomes included evaluation of pre-embryo development based on average number of blastomeres per embryo. RESULT(S): A total of 17 prospective, randomized trials were identified. There was an overall statistically significant effect of coculture on the implantation rate, clinical pregnancy rate, and ongoing pregnancy rate. The cocultured embryos had greater numbers of blastomeres, although the data were heterogeneous. CONCLUSION(S): This is the first systematic, evidence-based review of randomized controlled trials to objectively determine the potential benefits of coculture in human IVF. The pooled data of human trials on coculture demonstrate a statistically significant improvement in blastomere number, implantation rates, and clinical and ongoing pregnancy rates.

Granulocyte-macrophage colony stimulating factor (GM-CSF) and co-culture can affect post-thaw development and apoptosis in cryopreserved embryos.

PURPOSE: The objective of this study was to evaluate the effects of growth factor supplementation and Vero cell co-culture on apoptosis and development of frozen thawed one-cell mouse embryos. METHODS: The following treatment regimens were assessed: (a) control medium (b) Vero cell co-culture and (c) growth factor supplemented medium. The individual growth factors tested were: GM-CSF, IGF-I, IGF-II, TNF-alpha, FGF-4, LIF, TGF-alpha, TGF-beta, IL-6, PDGF and EGF. Blastocyst development and differentiation were monitored. At termination of the experiments, overall blastomere number and apoptosis were assessed using the TUNEL assay. RESULTS: No differences were observed in blastulation and hatching rates. ICM differentiation in thawed embryos was notably improved with either co-culture or growth factor supplementation. The only growth factor significantly modulating apoptosis in thawed embryos was granulocyte-macrophage colony stimulating factor (GM-CSF). GM-CSF enhanced continued cell survival and prevented apoptosis but did not influence overall cell number in developing blastocysts. Vero cell co-culture significantly increased cell number in blastocysts (124+/-42 vs 100+/-44 in control; P<0.05). Embryonic apoptosis was higher in the co-cultured embryos. The increased presence of apoptotic cells in blastocysts of high cell number may reflect the regulatory role of apoptosis in balancing ICM: TE ratios. CONCLUSION: These data indicate that culture conditions can modulate post-thaw embryonic development and apoptosis.

Fertility after cancer: a prospective review of assisted reproductive outcome with banked semen specimens.

OBJECTIVE: To examine the outcome of assisted reproduction techniques (ART) using cryopreserved semen from patients with cancer. DESIGN: Prospective. SETTING: Therapeutic semen banking program at a tertiary healthcare center. PATIENT(S): Twenty-nine men with cancer who cryopreserved their sperm before treatment at our facility from 1982 to 2001 and withdrew their samples for assisted reproduction (IUI, IVF, or intracytoplasmic sperm injection [ICSI]). INTERVENTION(S): Sperm bank records were used to identify the patients. Information on fertility potential indices was obtained from medical records and through interviews. Of the 29 patients, 9 had testicular cancer, 12 had Hodgkin's disease, and 8 had other types of cancer. MAIN OUTCOME MEASURE(S): Pregnancy and live births. RESULT(S): A total of 87 ART cycles (42 IUI, 26 IVF, and 19 ICSI) was performed. Of those cycles, 18.3% resulted in pregnancy (7% IUI, 23% IVF, and 37% ICSI), and 75% of the pregnancies resulted in a live birth (100% IUI, 83% IVF, and 57% ICSI). There was no significant difference in the outcomes when the results were stratified by type of ART and malignancy. None of the 11 infants who were born had congenital anomalies. CONCLUSION(S): Our findings emphasize the need for physicians to discuss the issue of semen cryopreservation with all men of reproductive age who have cancer before antineoplastic therapy is started.

Social and economic impact of childhood asthma.

In order to assess the social, educational and economic impact in children with asthma and their families, we studied 162 children with bronchial asthma. The patients and their parents were interviewed to assess the restriction on various activities of the child and family, the impact on schooling and expenditure on therapy. One hundred and forty one (87%) children had either mild or moderate persistent asthma. Nearly two thirds of children had some restriction placed on their play activities because of asthma. Restrictions on other physical activities and social activities were reported in half the children. Children had absented from school for a median of 4 days in preceding 6 months. All these restrictions were more common in children with more severe disease and/or poor control of symptoms. The median monthly expenditure on child's medication was Rs. 333, i.e., about one third of monthly per capita income. Childhood asthma has significant adverse impact on child's daily activities, schooling, and family life and finances.

Enhanced chemiluminescence assay vs colorimetric assay for measurement of the total antioxidant capacity of human seminal plasma.

Although the enhanced chemiluminescence assay is commonly used to measure the nonenzymatic total antioxidant capacity (TAC) of the human seminal plasma, it is cumbersome, expensive, and time-consuming. We describe herein an alternate method to measure TAC that is based on the ability of antioxidants in seminal plasma to interfere with a reaction between 2,2'-azino-di-[3-ethylbenzthiazoline sulphonate] and metmyoglobin with H(2)O(2). This reaction produces a relatively stable blue-green color with absorbance maxima at 600 nm. We compared this colorimetric assay with our established chemiluminescence method and assessed quality control parameters (ie, intra-assay and interassay variabilities) in addition to intraobserver and interobserver differences. Our results show that the colorimetric assay was fairly predictive of antioxidant capacity similar to the chemiluminescence assay (P <.001). Furthermore, there was a high level of agreement between the duplicate measures by the same observer (intraobserver) and intra-assay variability, with a concordance correlation coefficient of 0.99. The interassay coefficient of variation was 4.7% (overall). The mean +/- SD of the difference between the 2 observers was 2.98% +/- 4.1%. In conclusion, we found that the colorimetric assay is a reliable and accurate method to evaluate seminal TAC, and it could be used as a simpler, rapid, and cheaper alternative to the chemiluminescence assay.