[Influence of hCG glycosylation on its functions in female reproduction]. / Vliv glykosylace hCG na jeho funkce v zenské reprodukci.

OBJECTIVE: To review contemporary knowledge of the hCG molecule, its isoforms and the importance of glycosylation. Biologic variants and glycoforms of hCG have different biological activities and functions related to the control of menstrual cycle, conception, gestation as well as gynaecologic and non-gynaecologic malignancies. DESIGN: A review. SETTING: Department of Obstetrics and Gynaecology, University Hospital Olomouc. METHODS: To present own experience and an overview of recent literature in molecular biology, clinical biochemistry and clinical practice. CONCLUSION: Recent knowledge of the role of hCG glycosylation in physiologic and pathologic events in female organism will provide a better understanding of regulation of processes like ovulation (co-operation of pituitary hCG with LH), implantation and hemochorial placentation (invasivity of hyperglycosylated hCG). Some biologic variants and isoforms of hCG are important for the prediction of certain pathologies of pregnancy, prenatal screening of inborn errors (free beta hCG) as well as in the treatment of infertility.

Increased lipid peroxidation and abnormal fatty acid profiles in seminal and blood plasma of normozoospermic males from infertile couples.

BACKGROUND: Reactive oxygen species (ROS) are essential for sperm function. However, excessive ROS production can impair sperm function and might be a factor contributing to male infertility. METHODS: We investigated the levels of arachidonic acid (AA) and docosahexaenoic acid (DHA) as well as lipid peroxidation, as represented by thiobarbituric acid reactive species (TBARS), in blood and seminal plasma of 38 normozoospermic males from infertile couples (NSI-males), compared with that of 17 fertile volunteers (FV-males). RESULTS: TBARS levels in blood and seminal plasma were higher in NSI-males than in FV-males (P < 0.0002, P < 0.0003, respectively), as were AA levels (P < 0.0003, P < 0.00004, respectively). On the contrary, the blood and seminal plasma levels of DHA were lower in NSI-males than in FV-males (P < 0.02 and P < 0.05, respectively). The AA/DHA ratios in blood and seminal plasma were higher in NSI-males than in FV-males (P < 0.003, P < 0.0007, respectively). Significant correlations between seminal and blood plasma levels of TBARS (P < 0.0001, r = 0.548), AA (P < 0.0001, r = 0.571) and DHA (P < 0.0001, r = 0.506) were found. CONCLUSIONS: Our data provide new insight into lipid metabolism in male infertility and indicate that systemic oxidative stress resulting in increased lipid peroxidation and an altered fatty acid profile may be, at least in part, responsible for infertility even in normozoospermic males.

[Comparison of reactive oxygen species production in neat semen and washed spermatozoa]. / Porovnání produkce reaktivních kyslíkových cástic v nativním ejakulátu a v suspenzi spermií.

OBJECTIVE: To determine Reactive Oxygen Species (ROS) production in neat semen and spermatozoa suspension using chemiluminescence and to examine correlation between both methods. SUBJECT: Prospective laboratory study. SETTING: Department of Obstetric and Gynecology, University Hospital, Olomouc. METHODS: The study included fertile volunteers (FV, n = 17), men from infertile couples (NM, n = 19) and men with idiopathic infertility (NMI, n = 15). ROS levels were determined by the same method in neat and washed semen samples. RESULTS: The ROS production in neat semen was lower than that in spermatozoa suspension. There was no significant diference in ROS production between volunteers and males from infertile couples. There was a significant correlation between log ROS in neat semen and in spermatozoa suspension in studied groups (FV r = 0.85, p = 1.5 x 10(-5); NM r = 0.76, p < 2 x 10(-4); NMI r = 0.75, p < 1.5 x 10(-3)). CONCLUSIONS: Measurement of ROS in neat semen is simpler, faster and better reflecting the actual level of oxidative stress than the same measurement in spermatozoa suspension. The implementation of this method can complement the algorithm of diagnostics and treatment of male infertility and be helpful in selection of patients for antioxidant or antibiotic treatment.

[Oxidative stress in diagnosis and treatment of idiopathic male infertility]. / Oxidacní stres v diagnostice a lécbe idiopatické muzské neplodnosti.

OBJECTIVE: To summarize available data concerning reactive oxygen species in sperm physiology and male infertility. DESIGN: Review article. SETTING: Dept. of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc. METHODS: Compilation of published data from scientific literature. CONCLUSIONS: The article describes the importance of reactive oxygen species and their role in male reproductive health.

[Lycopene therapy in male infertility]. / Lykopen v terapii muzské neplodnosti.

OBJECTIVE: To summarize available data concerning lycopene and male infertility treatment. DESIGN: Review article. SETTING: Dept. of Obstetrics and Gynecology, University Hospital Olomouc. METHODS: Compilation of published data from scientific literature. CONCLUSIONS: The article describes occurrence, biochemistry, metabolism of lycopene and its role in male reproductive health.

[Embryo quality evaluation according to the speed of the first cleavage after conventional IVF]. / Kvalita embryí po klasickém IVF v závislosti na rychlosti nástupu prvního bunecného delení.

OBJECTIVE: To evaluate morphological parametres of embryos obtained in the process of conventional IVF. DESIGN: A prospective study. SETTING: Centre of Assisted Reproduction, Dept. of Obstetrics and Gynecology, Palacký University Medical School, Olomouc. METHODS: In the present study 549 embryos developing after conventional IVF in the period of 2001-2004 were evaluated. The beginning of the mitotic cleavage was assessed within the interval of 24 - 27 hours after insemination. The embryos were divided into three groups according to the speed of their division as early cleavage (EC) embryos, where two blastomeres were present at the time of assessment, break down pronuclei stage (BDPN) where the pronuclei had already disappeared, and pronuclei (PN) embryos, where both pronuclei were still present. In these groups the degree of fragmentation was evaluated on day two of cultivation and embryos were divided into four categories as: A - with regular blastomeres, without fragmentation, B - with irregular blastomeres or with fragmentation below 30%, C - with fragmentation 30-50%, D - with fragmentation above 50%. The speed of further cleavage and average number of blastomeres were evaluated on days two and three of cultivation. Statistical analysis was preformed in the Palacký University Computer Centre. The chi-square test and t test for independent samples were used. RESULTS: EC embryos were found in 45.5%, BDPN in 33.5% and PN in 21.0%. EC embryos were less fragmented (p = 0.000), had more blastomeres at the time of evaluation (p = 0.000) and their speed of cleavage was faster (p = 0.000). The cleavage of EC embryos was faster in comparisson with the PN group (p = 0.000), but there were no significant differences between the EC and BDPN groups on day two of cultivation. On day three significant difference was found also between the EC and BDPN groups (p = 0.000). CONCLUSION: The speed of the first cell cleavage is a useful additional criterion for the embryo selection for ET. EC embryos usually have better morphology and more blastomeres that the BPDN and PN ones.

[Embryo quality evaluation according to the speed of the first cleavage after IntraCytoplasmic Sperm Injection (ICSI)]. / Kvalita embryí po ICSI v závislosti na rychlosti nástupu prvního bunecného delení.

OBJECTIVE: To evaluate morphological parameters of embryos obtained in the process of ICSI. DESIGN: A prospective study. SETTING: Centre of Assisted Reproduction, Dept. of Obstetrics and Gynecology, Palacký University Medical School, Olomouc. METHODS: In the present study 1116 embryos developing after ICSI (IntraCytoplasmic Sperm Injection) procedure in the period of 2001-2004 were evaluated. The beginning of the mitotic cleavage was assessed within the interval of 22-27 hours after insemination. The embryos were divided into three groups according to the speed of their division as Early Cleavage (EC) embryos, where two blastomeres were present at the time of assessment, Break Down ProNuclei stage (BDPN) where the pronuclei had already disappeared, and ProNuclei (PN) embryos, where both pronuclei were still present. In these groups the degree of fragmentation was evaluated on day two of cultivation and embryos were divided into four categories as: A--regular blastomeres, without fragmentation, B--irregular blastomeres or fragmentation below 30%, C--fragmentation 30-50%, D--fragmentation above 50%. The speed of further cleavage and average number of blastomeres were evaluated on day two and three of cultivation. Statistical analysis was preformed at the Palacky University Computer Centre. The chi2 test and t-test for independent samples were used. RESULTS: EC embryos were found in 37.4%, BDPN in 33.1% and PN in 29.5%. The degree of fragmentation between evaluated groups of embryos were statistically significant (p = 0.000). EC embryos were less fragmented (p = 0.000), had more blastomeres at the time of evaluation (p = 0.000) and their speed of cleavage was faster (p = 0.000). The cleavage of EC embryos was faster in comparison with the PN group (p = 0.000), but there were no significant differences between the EC and BDPN groups on day two of cultivation. On day three significant differences were found also between the EC and BDPN groups (p = 0.000). The embryonic developmental arrest was found only in PN embryos. CONCLUSION: The speed of the first cell cleavage is a useful additional criterion for the embryo selection for embryotransfer. EC embryos usually have better morphology and more blastomeres than the BPDN and PN ones.

[SHBG--new possibilities of diagnostic use in obstetrics and gynecology]. / SHBG--nové moznosti diagnostického vyuzití v zenském lékariství.

Recent literature review is suggesting the need to renew the traditional concept of SHBG as only a transport protein. The new role of SHBG relates to the evidence of its specific receptor on the cell membrane and an alternative signal pathway for sexual steroids. This review points to the importance of simultaneous measurements of SHBG along with determinations of the total sexual steroid concentration and informs of some new areas where SHBG can be used in laboratory diagnostics. In obstetrics the low levels of SHBG in the first half of pregnancy were reported as a promising early risk marker of the later development of preeclampsia.

[Protein bcl-2 expression in the secretory endometrium after oral estrogen-progesterone replacement]. / Exprese proteinu bcl-2 v sekrecním endometriu po perorální estrogen-progesteronové substituci.

OBJECTIVE: To compare the changes of the protein bcl-2 expression, regulatory mechanism in the process of apoptosis, in the secretory endometrium throughout natural and artificial (estrogen-progesterone substitution) cycles in the same group of patients. DESIGN: A prospective study. SETTING: Dept. of Obstetrics and Gynecology, University Hospital Olomouc, Dept. of Histology and Embryology, Faculty of Medicine, Palacký University in Olomouc, Dept. of Obstetrics and Gynecology, Bata Hospital, Zlín. METHODS: Endometrial samples (n=56) were obtained on days 5 and 7 after ovulation, progesterone addition, resp. Patients (n=14) included in the study had regular menstrual cycle, age under 40, BMI range 20-32 and basal FSH level range 5-9 IU/l. The collected samples were processed routinely and bcl-2 was estimated by indirect three level imunohistochemic method. RESULTS: We demonstrated the bcl-2 expression in all evaluated layers (epithelial surface, stroma, glands) of the mid-secretory endometrium in both cycles. No difference was found in bcl-2 expression between days 5 and 7 in the secretory phase of the natural cycle. In artificial cycles higher bcl-2 expression was found only in epithelial surface (p<0.05) between days 5 and 7. On day 7 higher bcl-2 expression was found in the artificial cycle in the endometrial epithelial surface (p<0.001) as well as in spongy layer (p<0.01) and compact layer (p<0.05) comparing to day 7 of the natural cycle. CONCLUSION: The bcl-2 expression in the mid-secretory endometrium is significantly higher in the cycle with estrogen-progesterone substitution comparing to the natural cycle. These changes were more significant in endometrial and glandular epithelium than in stromal cells.

[The analysis of preliminary spermatological parameters in potential donors of semen]. / Analýza spermiologických parametru vstupního vysetiení potenciálních dáircu spermí.

OBJECTIVE: To contribute to the contemporary discussion on the male factor infertility through the evaluation of the basic spermatological parameters in men recruiting for semen donation. DESIGN: A retrospective demographic study. SETTING: Dept. of Obstetrics and Gynaecology, Dept. of Biology, Faculty of Medicine, Palacký University, Olomouc. METHODS: A total of 108 men aged 18 to 35 years came to the preliminary examination for the potential semen donors between January 2000 and April 2004. Spermatological analysis of the fresh ejaculates obtained by masturbation was performed according to WHO guidelines. The following parameters were evaluated: the volume of ejaculate, sperm concentration and total percent motility. RESULTS: Normospermia was found in only 46 men (42.6%). Three males (2.8%) were azoospermic. The most frequent problem was asthenospermia, which was documented in 49 (46.6%) men. CONCLUSION: The analysis of the obtained data may suggest a marked semen quality decline in the Czech male population. In our opinion, further multicentric epidemiological studies concerning fertility potential in Czech male population seem highly needed.

Changes in the development of uterine pinopodes in steroid hormone supplemented cycles.

The endometrium acquires the ability to implant a hatched blastocyst only within a specific time termed the receptive phase. Ovarian steroid hormones are essential for structural and functional changes that prepare the endometrium to be receptive. Pinopodes have been suggested to be markers of uterine receptivity. The aim of this study was to compare the pinopode expression and serum levels of ovarian steroid hormones in the mid-luteal phase of the natural cycle and in a "mock" cycle in the same subject. Sequentional endometrial biopsies within 48 hours were obtained from women in the mid-luteal phase (ovulation +5, ovulation +7) of the natural cycle and in the "mock" cycle (progesterone supplementation +5 and +7). Biopsies were examined under a scanning electron microscope for pinopode detection. The expression of pinopodes was similar in both cycles, where pinopodes covered about 5 % of the endometrial surface. The developmental stages were also similar with a slight increase of fully developed pinopodes in both samples in the "mock" cycles. Our findings suggest that hormonal preparation of the endometrium do not change the timing of pinopode expression.

[Reduced serum dehydroepiandrosterone levels in postmenopausal osteoporosis]. / Snízené hladiny sérového dehydroepiandrosteronu u postmenopauzální osteoporózy.

The decline of the production of several hormones with age has been recently linked to several degenerative processes related to aging including osteoporosis. The aim of our study was to confirm the observations published in 1994 suggesting that postmenopausal women with DHEAS levels below a certain limit have a much higher risk of osteoporosis than those with the levels above this limit. The DHEAS levels were measured by RIA and compared to our own age-adjusted reference ranges. The values lower than 25th quantile were considered "subnormal". More than 500 postmenopausal subjects were included in our study. In those with "subnormal" levels bone mineral density (BMD) was measured on DEXA (Lunar or Hologic). Decreased BMD ranging from osteopenia to severe osteoporosis was found in 86% of 74 women with "subnormal" DHEAS, while the expected frequency in our postmenopausal population may be about 30%. In the following period the serum DHEAS levels were compared with DEXA findings in another 134 postmenopausal women. The DHEAS levels in all stages of decreased BMD were significantly lower than those in the group with normal BMD. The clinical sensitivity and specificity of DHEAS as a marker of increased risk of osteoporosis has been calculated for a cut-off limit of 0.5 MoM. In the light of these findings we believe that the robust and relatively cheap DHEAS determination could help us to identify women who are at higher risk of osteoporosis. Also, in the future, only the women with evidently deficient DHEA production might possibly become candidates for eventual DHEA substitution.

[Correlation of umbilical artery erythropoietin levels during labor with traditional indicators of neonatal hypoxia]. / Korelace hladiny pupecníkového erytropoetinu pri porodu s tradicními ukazateli porodní hypoxie.

OBJECTIVE: To assess a correlation between the erythropoietin (Epo) level in umbilical blood during delivery and three "classical" markers of hypoxia: the Apgar score, pH in the umbilical artery and lactate concentration. MATERIAL AND METHODS: The above parameters were assessed in 109 deliveries divided into three groups-normal deliveries, deliveries with neonatal pathology at term and premature deliveries. RESULTS: Based on calculation of Spearman correlations which seemed most suitable with regard to the nature of the experimental data no significant relations were found between Epo and any of the mentioned parameters, while the mutual correlations between the Apgar score, pH of the umbilical artery and lactate were highly significant. CONCLUSION: Epo is an independent marker of foetal hypoxia and supplementation of "classical" markers by this examination could be an asset to the evaluation of the prognosis of postnatal development.

[EUROPOP--European Programme of Occupational Risks and Pregnancy Outcome--part II]. / EUROPOP--European Programme of Occupational Risks and Pregnancy Outcome--cást II.

As continuation of their previous paper the authors submit the results of the European study EUROPOP pertaining to the effect of occupation on the course and outcome of pregnancy. The paper contains the first part of results where the authors compare groups of women with premature deliveries (22nd-36th week of pregnancy) with control groups 1/10 deliveries in term (> or = 37 weeks). The groups of abortions in the second trimester which were studied by the authors were relatively small (Czech Republic 49 and in the all-European study 229). To keep the study within a reasonable limits the tables are not presented. Comparison of results describing home work, living conditions of pregnant women, prenatal care and medical problems as well as data on the outcome of pregnancy are presented in part III.

[EUROPOP--European Programme of Occupational Risks and Pregnancy Outcome--part III]. / EUROPOP--European Programme of Occupational Risks and Pregnancy Outcome--cást III.

As continuation of the previous paper ther authors submit the second part of the results of the European programme EUROPOP which evaluates the relationship between work, living conditions of pregnant women, prenatal care and medical data on the outcome of pregnancy. The authors compare groups of women, who had premature deliveries (22nd-36 week of gestation) with control groups 1/10 deliveries in term (> or = 37 weeks). Groups of abortions in the second trimester which were investigated were relatively small (Czech Republic 49 and all-European study 229). To keep the paper within reasonable limits the tables are not presented.

[The EUROPOP Project. European Programme of Occupational Risks and Pregnancy Outcomes]. / Projekt EUROPOP. European Programme of Occupational Risks and Pregnancy Outcome.

Efforts to obtain an objective view of the working and living conditions of European women and in particular the influence of these conditions on the course of pregnancy were the reason why in 1994 within research activities of the EC a project EUROPOP (European Programme of Occupational Risk and Pregnancy Outcome) was adopted and started. Seventeen countries incl. the Czech Republic were asked to participate. The research proper was conducted in 57 maternity institutions. In the Czech Republic the Olomouc region was selected with the Gynaecological and Obstetric Clinic in Olomouc as the coordinating centre. All 13 gynaecological and obstetric departments of the Olomouc catchment area were included in the trial.

[Effect of early cleavage of embryos after intracytoplasmic sperm injection (ICSI) into oocytes on results of fertilization in vitro (IVF) and embryo transfer (ET)]. / Vliv casného nástupu prvního bunecného delení u embryí po vpichu spermie do cytoplazmy oocytu (ICSI) na výsledky IVF + ET.

OBJECTIVE: To evaluate the influence of early cleavage in embryos obtained using ICSI on the success rate of IVF-ET. DESIGN: A prospective study. SETTING: Centre of Assisted Reproduction, Department of Obstetrics and Gynecology, Medical Faculty, Palacký University, Olomouc. METHODS: The rate of the first cleavage of embryos was checked between 23 to 26 hours after ICSI in 115 cycles IVF-ET. "Early Cleavage" (EC) embryos which were already cleaved were cultivated separately from the "slow" (No Early Cleavage, NEC) embryos. After 3 days cultivation, no more than three 6- to 8-cell embryos were transferred. Only EC embryos were transferred in 43 cycles and only NEC embryos were transferred also in 43 cycles. The remaining 29 cycles, where both EC and NEC embryos had to be transferred, were not evaluated. In both groups the following entry parameters were compared: age of the patient, number of fertilized oocytes, fertilization rate (FR), number of frozen and evaluated embryos, number of EC embryos recorded and number of transferred embryos. The outcome parameters compared were: pregnancy rate (PR), number of gestational sacs with heart beats per number of transferred embryos (implantation rate, IR), abortions (AB) and the frequency of multiple pregnancy. Statistical evaluation was performed by t-test, chi 2 test and by Sheffe analysis. RESULTS: EC embryos were found in 57% of cycles (n = 66) after ICSI. Early cleavage was observed in 198 of 563 embryos (35%). Among entry parameters the only statistically significant differences (P < 0.05) were found in the number of retrieved oocytes as well as in the ratio of frozen embryos which were higher in the cycles with the transfer of only EC embryos. FR was the same (74%) in both types of transfer. Outcome parameters in the transfer of only EC versus NEC embryos were higher in PR (40% vs. 33%), about equal in IR (27% vs. 25%) and lower in AB (2% vs. 5%). Moreover, multiple pregnancies were less frequent in the transfer of only EC embryos: 65% of singleton pregnancy, 35% of twins and no triplet versus 36%, 57% and 7%, resp., in the transfer of only NEC embryos. The differences in outcome parameters are not statistically significant (P > 0.05) because of small numbers. CONCLUSION: The speed of the first cell cleavage is a useful additional criterion for better evaluation of quality and viability of embryos.

[Does grapefruit juice increase the bioavailability of orally administered sex steroids?]. / Zvysuje grapefruitová stáva dostupnost orálne podaných sexuálních steroidu?

OBJECTIVE: To verify if and to which extent the interaction with grapefruit juice can increase bioavailability of orally administered sexual steroids. DESIGN: Pilot pharmacokinetics study. SETTING: Department of Obstetrics and Gynecology and Institute of Pharmacology, Medical Faculty, Palacký University, Olomouc; Department of Nuclear Medicine, University Hospital, Olomouc. METHODS: 2 mg of estradiol valerate and 100 mg of micronized progesterone were given to eight healthy postmenopausal volunteers. Blood samples were collected at time 0, 2, 3, 5 and 24 hours after tablets application. The same trial was repeated a week later but tablets were swallowed with 200 ml of grapefruit juice. Serum levels of estradiol and progesterone were measured by RIA. Results were statistically evaluated using the Wilcoxon's nonparametric paired test. RESULTS: Though grapefruit juice on average slightly increased serum levels of estradiol (E2) and progesterone, this increase reached statistical significance only for the E2 level 24 hours after application of tablets. The mean area under curve (AUC) of estradiol rose significantly to 117%. The even greater increase in the mean AUC of progesterone (to 125%) was not statistically significant because of marked individual variability of response. CONCLUSIONS: Our results suggest that grapefruit juice may increase bioavailability of orally administered estradiol and progesterone. The response varies markedly between individuals. This observation may be of some importance also for users of OC and HRT.

[Sonographic evaluation of endometrial preparation with oral estrogen-progesterone substitution before cryogenic embryo transfer]. / Sonografické hodnocení prípravy endometria orální estrogen-progesteronovou substitucí pred kryoembryotransferem.

OBJECTIVE: To compare the changes of sonographic features of endometrium throughout natural and artificial cycles in which oral estrogen-progesterone substitution were used in the same group of patients and discuss their clinical significance. DESIGN: A prospective study. SETTING: Dept. of Obstetrics and Gynaecology, University Hospital, Olomouc. METHODS: In 24 women with regular menstrual cycle ovulation was detected (LH, sonography) and the following sonographic features: endometrial thickness, echogenity and pulsatility index (PI) of uterine artery were evaluated in the late proliferative, early and mid secretory phase. The same sonographic examination was performed in the artificial cycle with oral estrogen-progesterone substitution used for endometrial preparation for transfer of cryopreserved-thawed embryos. RESULTS: In the late proliferative phase of the natural cycle the thickness of endometrium was higher than in the arteficial cycle (p=0.05). Triple-line echogenity prevailed in both cycles. The PI in natural cycle was lower (p=0.01) on the side of the growing Graafian follicle compared to the other side and lower (p=0.05) than in the artificial cycle. In the secretory phase there were no differences in endometrial thickness within cycles. Homogenous hyperechoic endometrium prevailed in both cycles and the lowest PI was found on the 7th day both after ovulation and after initiation of progesterone substitution. CONCLUSION: Progesterone addition after endometrial preparation with estrogen should be instituted when the endometrium thickness reached at least 9mm and isoechoic or triple line echogenity is found.

[Early cleavage embryos and their effect on the results of standard in vitro fertilization]. / Embrya s casným delením (early cleavage) a jejich vliv na výsledky klasického IVF.

OBJECTIVE: To assess if early cleavage embryo is an additional indicator of embryo quality that could be used to increase the efficiency of IVF and ET. DESIGN: A prospective study. SETTING: Centre for Assisted Reproduction, Department of Gynecology and Obstetrics, Medical Faculty, Palacký University, University Hospital, Olomouc. METHODS: The study evaluates 62 cycles of conventional IVF in our Centre during 2001 to 2002. All embryos were observed for the presence or absence of "early cleavage" (EC), i.e. with completed first mitotic division 25 to 26 hours after insemination. The EC embryos were cultivated separately from the so called "late cleavage" or no early cleavage (NEC) embryos. After the three-day cultivation a maximum of three embryos were transferred in 6-8 cells stage. EC embryos were transferred in 28 cycles, NEC embryos in 18 cycles. The remaining 16 patients with "combined" transfer of EC + NEC embryos were excluded from the evaluation. The following parameters have been compared: age, number of fertilized oocytes, fertilization rate (FR), number of cryopreserved embryos, number of embryos assessed for EC, number of EC embryos found, number of transferred embryos, pregnancy rate (PR), implantation rate (IR), spontaneous abortions (AB). Statistical analysis was performed by Student's t-test, chi 2 test and Sheffe analysis. RESULTS: EC embryos were found in 71% of conventional IVF (n = 44). There were no significant differences in the entry parameters (age, number of fertilized and fertilizing oocytes, number of cryopreserved, assessed and transferred embryos) between the group with EC embryos versus the group with NEC embryos. When EC embryos were transferred, the following parameters were higher: PR (61% vs. 56%), IR (38% vs. 33%), compared to NEC group, while pregnancy loss was lower after EC (4% vs. 11%) compared to NEC. Due to small numbers in the subgroups the results, though suggestive, are not statistically significant (p > 0.05). CONCLUSIONS: The assessment of early cleavage embryo is one of the criteria for evaluation and selection of suitable embryos prior to transfer which could help in the process of selection to choose the best embryos between embryos of the same morphology on the day of transfer.