Chromatin Morphology in Human Germinal Vesicle Oocytes and Their Competence to Mature in Stimulated Cycles.

The search for simple morphological predictors of oocyte quality is an important task for assisted reproduction technologies (ARTs). One such predictor may be the morphology of the oocyte nucleus, called the germinal vesicle (GV), including the level of chromatin aggregation around the atypical nucleolus (ANu)-a peculiar nuclear organelle, formerly referred to as the nucleolus-like body. A prospective cohort study allowed distinguishing three classes of GV oocytes among 135 oocytes retrieved from 64 patients: with a non-surrounded ANu and rare chromatin blocks in the nucleoplasm (Class A), with a complete peri-ANu heterochromatic rim assembling all chromatin (Class C), and intermediate variants (Class B). Comparison of the chromatin state and the ability of oocytes to complete meiosis allowed us to conclude that Class B and C oocytes are more capable of resuming meiosis in vitro and completing the first meiotic division, while Class A oocytes can resume maturation but often stop their development either at metaphase I (MI arrest) or before the onset of GV breakdown (GVBD arrest). In addition, oocytes with a low chromatin condensation demonstrated a high level of aneuploidy during the resumption of meiosis. Considering that the degree of chromatin condensation/compaction can be determined in vivo under a light microscope, this characteristic of the GV can be considered a promising criterion for selecting the best-quality GV oocytes in IVM rescue programs.

Proinflammatory mediators and reproductive failure in women with uterine fibroids.

OBJECTIVE: study the levels of proinflammatory mediators and their correlation with reproductivefailure in women with uterine fibroids (UF). MATERIALS AND METHODS: 90 women aged 18 - 45 years (mean age - 33.9 ± 0.31) were recruited in the study: 60 women with UF were included in the study group and 30 healthy women were included in the control group. The lymphocyte count was performed with laser-based flow cytofluorimetry. The levels of C-reactive protein (CRP), interferon IFN-ß (IFN-ß), interferon-γ (IFN-γ), tumor necrotizing factor α (TNF-α) and basic fibroblast growth factor (FGF basic) were detected with ELISA test. The diagnosis of UF was confirmed with histological examination of biopsy specimen. RESULTS: Typical clinical features of UF (abnormal uterine bleeding, pelvic pains, symptoms of adjacent organs compression) were found in 66.67% women in the study group while 18.33% of them had miscarriages and 26.67% had infertility. Women with UF had significantly higher absolute count of lymphocytes: CD3+, CD19+, CD16+CD56+, CD4+, CD8+, CD95+CD3+, proinflammatory mediators: TNF-α, IFN-ß, CRP, FGF basic and decreased levels of IFN-γ compared with the control group. CONCLUSION: In women of reproductive age, typical symptoms of UF are associated with reproductive failure with activation of adaptive immunity, angiogenic factors, inflammatory cell reactions, deficit of human antitumor factors, that is why detection of TNF-α, СРБ, IFN-γ in serum is necessary to perform in pregravid preparation of women, including IVF program.

Clinical and laboratory parameters and morphological characteristics of the endometrium in women with impaired fat metabolism and failed IVF attempts.

Objective: To study clinical and laboratory parameters and morphological characteristics of the endometrium in women with impaired fat metabolism and failed IVF attempts. Materials and methods: Clinical examination, laboratory tests, morphological analysis, and immunohistochemistry of the endometrium were conducted in 76 patients with different BMI, followed up with infertility and failed IVF attempts. Patients were divided into four groups by body mass index (BMI): 1 group - 17 women with overweight, BMI = 25.0 - 29.9 kg/m2; 2 group - 15 women with class I obesity, BMI 30.0-34.9 kg/m2; 3 group - 14 women with class II obesity, BMI 35.0-39.9 kg/m2; and the control group of 30 women with normal weight, BMI 18.5-24.9 kg/m2. Results: Clinical and laboratory analysis revealed menstrual irregularities and hormonal imbalance such as hypoestrogenism. Immunohistochemistry of the endometrium found a significant decrease in the expression of ERα and PR receptors in the glands correlated to increasing BMI. Conclusion: Pregravid preparation of women with increased BMI and failed IVF attempts has to include life-style modification and weight reduction program to restore normal hormonal status and expression of estrogen and progesterone receptors, prevention of excessive proliferative processes in the endometrium, and improving endometrial receptivity.