Von: "Highlights" Datum: Don, 20. Sep 2001 16:44 Uhr An: Betreff: Ferti.Net Highlights Issue 19 FERTI.NET HIGHLIGHTS Issue 19 - Week 38 - Volume 3 - 2001 Ferti.Net Highlights Archive This fortnightly news service brings you the latest news on Assisted Reproduction Techniques as they have been reported in the media. Sources include on-line media, medical data bases, original press releases, trade journals, national daily newspapers and broadcasts reports, as well as peer-reviewed publications. It also keeps you up-to-date with the latest issue of the Ferti.Net Magazine. -------------------------------------------------------------------------------- Index a.. Ultrasound-guided embryo transfer maximizes the IVF results on day 3 and day 4 embryo transfer but has no impact on day 5 b.. Pathophysiology of varicoceles in male infertility c.. Identification of a Y chromosome haplogroup associated with reduced sperm counts d.. Global gene expression analysis to identify molecular markers of uterine receptivity and embryo implantation e.. Y-chromosome microdeletion and phenotype in cytogenetically normal men with idiopathic azoospermia f.. Sperm chromosome abnormalities in men with severe male factor infertility who are undergoing in vitro fertilization with intracytoplasmic sperm injection g.. Differential production of reactive oxygen species by subsets of human spermatozoa at different stages of maturation h.. The questionable use of albumin for the prevention of ovarian hyperstimulation syndrome in an IVF programme: a randomized placebo-controlled trial -------------------------------------------------------------------------------- Ultrasound-guided embryo transfer maximizes the IVF results on day 3 and day 4 embryo transfer but has no impact on day 5 Prapas Y, Prapas N, Hatziparasidou A, Vanderzwalmen P, Nijs M, Prapa S, Vlassis G. 4th Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki Greece, Iakentro Fertility Center, Thessaloniki, Greece and. SIMAF, Van Helmont Hospital, Vilvoorde, Belgium. BACKGROUND: The use of ultrasound-guided embryo transfer has been reported to affect success rates in some centres but not others. In a prospective study, we examined the influence of ultrasound guidance in embryo transfer performed on different days after oocyte retrieval. METHODS: Two different methods of embryo transfer were evaluated in 1069 consecutive transfers. The ultrasound-guided embryo transfer was used in 433 cases, whereas 636 embryo transfers were performed with the tactile assessment ('clinical feel') method. RESULTS: Ultrasound-guided embryo transfer yielded a higher overall pregnancy rate than the 'clinical feel' approach, 47 versus 36% (P < 0.001). This difference was statistically significant where embryos were transferred after 3 or 4 days of culture, 45.9 versus 37.1% (P = 0.001) and 42.3 versus 27% (P = 0.035) respectively but not significant (P = 0.112) on day 5 embryo transfer (56.3 versus 45.7%). Likewise, the implantation rate was significantly different between the two groups on day 3 and 4 embryo transfer, 23.3 versus 15.8% (P < 0.01) and 21.6 versus 15.7% (P < 0.05%) respectively but no statistical difference was noted on day 5 embryo transfer, 26.7 versus 23.6%. CONCLUSION: Ultrasound assistance in embryo transfer on day 3 and 4 significantly improved pregnancy rates in IVF but had no impact on day 5. Hum Reprod 2001 Sep;16(9):1904-1908 Source: humrep.oupjournals.org Back to Top -------------------------------------------------------------------------------- Pathophysiology of varicoceles in male infertility Naughton CK, Nangia AK, Agarwal A. Center for Advanced Research in Human Reproduction and Infertility, Department of Urology, The Cleveland Clinic Foundation, Ohio 44195, USA. Varicoceles are found in 19 to 41% of infertile men, and is one treatable form of male infertility. The mechanism by which varicoceles cause the variable effect on male infertility and spermatogenesis is still unknown. Experimental animal models play a useful (but limited) role due to the sudden and variable iatrogenic nature of the varicoceles and the duration of the studies. Much of the human data are derived by the characterization of associated differences in measurable parameters between men with and without varicoceles. The role of hyperthermia, testicular blood flow and venous pressure changes, reflux of renal/adrenal products, hormonal dysfunction, autoimmunity, defects in acrosome reaction, and oxidative stress, in the pathophysiology of varicocele will be discussed. Hum Reprod Update 2001 Sep;7(5):473-481 Source: www.ncbi.nlm.nih.gov Back to Top -------------------------------------------------------------------------------- Identification of a Y chromosome haplogroup associated with reduced sperm counts Krausz C, Quintana-Murci L, Meyts ER, Jorgensen N, Jobling MA, Rosser ZH, Skakkebaek NE, McElreavey K. Immunogenetique Humaine, INSERM E021, Institut Pasteur, Paris, France, Andrology Unit, University of Florence, Florence, Italy, University Department of Growth and Reproduction, Rigshospitalet, 9, Blegdamsvej, DK-2100, Copenhagen, Denmark and Department of Genetics, University of Leicester, Leicester, UK. In man, infertility is associated with microdeletions of specific regions of the long arm of the Y chromosome. This indicates that factors encoded by the Y chromosome are necessary for spermatogenesis. However, the majority of men with either idiopathic azoospermia or oligozoospermia have grossly intact Y chromosomes and the underlying causes of their infertility are unknown. We hypothesized that some of these individuals may carry other rearrangements or sequence variants on the non-recombining region of the Y chromosome that may be associated with reduced spermatogenesis. To test this hypothesis, we typed the Y chromosome in a group of Danish men with known sperm counts and compared the haplotype distribution with that of a group of unselected Danish males. We found that one class of Y chromosome, referred to as haplogroup 26+, was significantly overrepresented (27.9%; P < 0.001) in the group of men with either idiopathic oligozoospermia (defined as <20 x 10(6 )sperm/ml) or azoospermia compared to the control Danish male population (4.6%). This study defines, for the first time, a class of Y chromosome that is at risk for infertility in a European population. This observation suggests that selection may be indeed active on the Y chromosome, at least in the Danish population, raising the possibility that it could alter the pattern of Y chromosome haplotype distribution in the general population. Hum Mol Genet 2001 Sep 1;10(18):1873-1877 Source: hmg.oupjournals.org Back to Top -------------------------------------------------------------------------------- Global gene expression analysis to identify molecular markers of uterine receptivity and embryo implantation Reese J, Das SK, Paria BC, Lim H, Song H, Matsumoto HM, Knudtson KL, DuBois RN, Dey SK. Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS 66160. Infertility and spontaneous pregnancy losses are an enduring problem to women's health. The establishment of pregnancy depends on successful implantation, where a complex series of interactions occur between the heterogeneous cell types of the uterus and blastocyst. Although a number of genes are implicated in embryo-uterine interactions during implantation, genetic evidence suggests that only a small number of them are critical to this process. To obtain a global view and identify novel pathways of implantation, we used a dual screening strategy to analyze the expression of nearly 10,000 mouse genes by microarray analysis. Comparison of implantation and interimplantation sites by a conservative statistical approach revealed 36 upregulated genes and 27 downregulated genes at the implantation site. We also compared the uterine gene expression profile of progesterone-treated, delayed implanting mice to that of mice in which delayed implantation was terminated by estrogen. The results show upregulation of 128 genes and downregulation of 101 genes after termination of the delayed implantation. A combined analysis of these experiments showed specific upregulation of 27 genes both at the implantation site and during uterine activation, representing a broad diversity of molecular functions. In contrast, the majority of genes that were decreased in the combined analysis were related to host immunity or the immune response, suggesting the importance of these genes in regulating the uterine environment for the implanting blastocyst. Collectively, we identified genes with recognized roles in implantation, genes with potential roles in this process and genes whose functions have yet to be defined in this event. The identification of unique genetic markers for the onset of implantation signifies that genome-wide analysis coupled with functional assays is a promising approach to resolve the molecular pathways required for successful implantation. J Biol Chem 2001 Sep 10 [epub ahead of print] Source: www.jbc.org Back to Top -------------------------------------------------------------------------------- Y-chromosome microdeletion and phenotype in cytogenetically normal men with idiopathic azoospermia Fujisawa M, Shirakawa T, Kanzaki M, Okada H, Arakawa S, Kamidono S. Division of Urology, Department of Organ Therapeutics, Kobe University Graduate School of Medicine, Kobe, Japan Objective: To determine the prevalence of microdeletions of the long arm of chromosome Y within the AZFa, AZFb, and AZFc subregions in patients with idiopathic azoospermia, and then correlate the microdeletions with clinical phenotypes to determine the most important subregion for screening.Design: Controlled clinical study.Setting: Male infertility clinic, Kobe University Hospital.Patient(s): Among 89 consecutive azoospermic patients, those whose infertility was related to known hereditary, endocrine, or obstructive causes or a cytogenetic abnormality were excluded; 54 remaining patients were studied using a polymerase chain reaction (PCR). Of these patients, 33 had Sertoli cell only syndrome, 10 had maturation arrest, and 11 had hypospermatogenesis.Intevention(s): Blood and semen samples and testicular biopsies were obtained from all of the participants.Main Outcome Measure(s): We performed semen analysis, polymerase chain amplification of 28 DNA loci on the long arm of the Y chromosome involving the DAZ (deleted in azoospermia), and measured the plasma FSH, LH, testosterone, prolactin, and estradiol levels.Result(s): Microdeletions were detected in 14 of the 54 patients (nine with Sertoli cell only, three with maturation arrest, and two with hypospermatogenesis). Most microdeletions involved AZFb or AZFc. Patients with hypospermatogenesis or maturation arrest showed deletion only in AZFc. The DAZ gene was deleted in four patients with Sertoli cell only and one patient with maturation arrest. The RBM gene was deleted in two patients with Sertoli cell only who had particularly large deletions, but in no patients with arrest or hypospermatogenesis.Conclusion(s): Cytogenetically azoospermic patients should be examined for microdeletions before undertaking assisted reproduction. AZFc may be the most important subregion to screen. In addition, intact AZFa and AZFb subregions may be important for the presence of germ cells. Fertil Steril 2001 Sep;76(3):491-495 Source: www.ncbi.nlm.nih.gov Back to Top -------------------------------------------------------------------------------- Sperm chromosome abnormalities in men with severe male factor infertility who are undergoing in vitro fertilization with intracytoplasmic sperm injection Levron J, Aviram-Goldring A, Madgar I, Raviv G, Barkai G, Dor J. IVF Unit, Division of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Tel-Hashomer, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Objective: To investigate the potential paternal contribution to the risk of fetal chromosomal anomalies after intracytoplasmic sperm injection (ICSI).Design: Spermatozoa isolated from testicular tissue and ejaculated specimens of consenting patients undergoing testicular biopsy and ICSI were analyzed for chromosomes X, Y, and 18 by FISH.Setting: Assisted reproductive technology program.Patient(s): Consenting patients undergoing testicular biopsy and ICSI, severe oligozoospermic patients, and normal fertile donors.Intervention(s): None.Main Outcome Measure(s): The rate of chromosome abnormalities in testicular sperm with regard to the type of azoospermia and ejaculated sperm compared to healthy men.Result(s): The mean serum levels of FSH in the groups with nonobstructive azoospermia (n = 9), obstructive azoospermia (n = 10), severe oligozoospermia (n = 9), and the normal donors (n = 6) were 17.5 +/- 8.2 (P<.05), 3.5 +/- 2.6, 14.6 +/- 3.5 (P<.05), and 3.1 +/- 0.4 IU/mL, respectively. The corresponding rates of sperm chromosome abnormalities among these groups were 19.6% (P<.001), 8.2% (P<.001), 13.0% (P<.001), and 1.6%, respectively. The corresponding rates of disomy among these groups were 7.8% (12 of 153 spermatozoa), 4.9% (18 of 367), 6.2% (109 of 1,751), and 1% (5 of 500 spermatozoa), respectively. Errors in chromosomes X and Y were significantly more common than in chromosome 18.Conclusion(s): The present findings demonstrate a linkage between gonadal failure (high serum FSH levels) and the occurrence of sperm chromosome aneuploidies. Our findings may explain the increased incidence of sex chromosome abnormalities found after IVF in the severe male factor patient population. Genetic screening during pregnancy or before embryo replacement should be considered carefully. Fertil Steril 2001 Sep;76(3):479-484 Source: www.ncbi.nlm.nih.gov Back to Top -------------------------------------------------------------------------------- Differential production of reactive oxygen species by subsets of human spermatozoa at different stages of maturation Gil-Guzman E, Ollero M, Lopez MC, Sharma RK, Alvarez JG, Thomas AJ Jr, Agarwal A. Center for Advanced Research in Human Reproduction and Infertility, Urological Institute, The Cleveland Clinic Foundation, Cleveland, OH and. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. BACKGROUND: Reactive oxygen species (ROS)-mediated damage to human spermatozoa has been implicated in the pathogenesis of male infertility. Although ROS production by human spermatozoa has been extensively studied, the cell-to-cell variation in ROS production by spermatozoa at different stages of maturation has never been investigated. METHODS: In this study, we determined ROS production by subsets of human spermatozoa at different stages of maturation isolated by density gradient centrifugation of ejaculated spermatozoa obtained from healthy donors and from patients attending a clinic for infertility screening. RESULTS: Four different fractions were obtained. ROS production was highest in immature spermatozoa with abnormal head morphology and cytoplasmic retention and lowest in mature spermatozoa and immature germ cells (P < 0.01). ROS production was highest in immature spermatozoa from males with abnormal semen parameters compared with donors (P < 0.0001) or patients with normal semen parameters (P = 0.015). ROS production by immature spermatozoa was inversely correlated with the recovery of motile, mature spermatozoa in the high density fraction 4 (P = 0.01). CONCLUSIONS: The results of this study indicate that there is significant cell-to-cell variation in ROS production in subsets of spermatozoa at different stages of maturation and that oxidative damage of mature spermatozoa by ROS-producing immature spermatozoa during sperm migration from the seminiferous tubules to the epididymis may be an important cause of male infertility. Hum Reprod 2001 Sep;16(9):1922-1930 Source: humrep.oupjournals.org Back to Top -------------------------------------------------------------------------------- The questionable use of albumin for the prevention of ovarian hyperstimulation syndrome in an IVF programme: a randomized placebo-controlled trial Ben-Chetrit A, Eldar-Geva T, Gal M, Huerta M, Mimon T, Algur N, Diamant YZ, Margalioth EJ. IVF Unit, Department of Obstetrics and Gynaecology, Shaare Zedek Medical Centre, Ben-Gurion University, Jerusalem 91031, Israel. BACKGROUND: The role of intravenous (IV) albumin administration in the prevention of ovarian hyperstimulation syndrome (OHSS) and in the improvement of IVF conception outcomes was evaluated in a prospective, randomized, placebo-controlled double blind study. METHODS: Ninety-eight women were enrolled in the study and were consecutively assigned to either a treatment group or a control group. Eleven patients were lost to follow-up after assignment. Of the remaining 87 women, 46 received albumin on the day of oocyte retrieval, and 41 received 0.9% sodium chloride solution as a placebo control. Outcome measures included OHSS incidence rates and pregnancy rates in the two trial groups. RESULTS: Four of the 46 patients in the study group developed severe OHSS and six developed moderate OHSS. In the control group, one of the 41 developed severe OHSS and five developed moderate OHSS. The difference in OHSS incidence rates between the two groups was not statistically significant [relative risk (RR) = 1.49, 95% CI = 0.59-3.73]. Fourteen patients (30%) in the intervention group conceived, compared with 16 patients (39%) in the control group. The difference in conception rates between the two groups was not statistically significant (RR = 0.78, 95% CI = 0.44-1.39). CONCLUSIONS: Albumin appears to have no positive effect on OHSS or conception rates, while its use carries the risk of undesirable side effects, including exacerbation of ascites in OHSS, nausea, vomiting, febrile reaction, allergic reaction, anaphylactic shock and risk of virus and prion transmission. We suggest that this form of treatment should not be included in the prevention of OHSS. Hum Reprod 2001 Sep;16(9):1880-1884 Source: humrep.oupjournals.org Back to Top -------------------------------------------------------------------------------- By subscribing you agree to the terms and conditions set forth in the D I S C L A I M E R Feel free to send your questions or comments to: thian@benecke.nl. Subscribe / Unsubscribe through website Visit our website for easy subscription/unsubscription, or do the following: Subscribe / Unsubsribe by e-mail To subscribe, send an email to fnhigh-request@infopress.nl Leave the subject empty, and type in the body: SUBSCRIBE fnhigh followed by your-email-address (e.g. SUBSCRIBE fnhigh gerven@benecke.nl) Do not add any other text. To unsubscribe, send an email to fnhigh-request@infopress.nl Leave the subject empty, and type in the body: UNSUBSCRIBE fnhigh followed by your-email-address (e.g. UNSUBSCRIBE fnhigh gerven@benecke.nl) Do not add any other text.