Aim was to determine whether there is any difference in the sex ratio, body length, and body weight of 2,456 deliveries after transfer of 9,624 embryos derived using in vitro culture under static and mechanical microvibration conditions. Pronuclear embryos from 4435 patients were cultured in vitro under two different conditions: without (n=4821) and with mechanical agitation (n=4803). Sex ratio, body length, and weight of 2,456 live-birth deliveries after transfer of 9,624 embryos were noted. The proportion of males at birth was significantly associated with mode of in vitro culture of embryos only among women aged 40 years and older. The rate “body length” was significantly associated with mode of in vitro culture of embryos only among women aged 29 and younger. In the same time, among twins, this ratio positively associated with in vitro culture of embryos under microvibration only among women aged 30–34 years as well as ≥40 years and negatively among women aged 35–39 years. It was concluded that birth weight of infants was positively associated with mode of in vitro culture of embryos under microvibration among women of all age groups. This trial registration number is ISRCTN13773904, registered 6 April 2016.

In natural conditions the oocyte and embryo are subjected to ever-changing dynamic processes. However, the routine assisted reproductive technologies today involve the use of static in vitro culture systems. The objective was to determine whether there is any difference in the viability of embryos after in vitro culture under static and mechanical microvibration conditions. The viability of embryonic cells (9,624 embryos) generated from 4,436 couples after in vitro culture was evaluated. For groups ≤29, 30-34, 35-39, and ≥40 years, the following rates of high-quality embryos without fragmentation (two to four blastomeres on day 2; six to eight blastomeres and compacting morula on day 3; blastocyst, expanded and hatching blastocyst on day 5) were detected (static vs. vibration, respectively): 65% versus 71%, 44% versus 69%, 67% versus 76% (for statistically significant differences between respective rates in these three groups, p <0.05), and 67% versus 66% (p > 0.1). The following baby-take-home rates were determined for groups ≤29, 30-34, 35-39, and ≥40 years (static vs. vibration, respectively): 30% versus 31% (p > 0.1, increasing only on the level of tendency), 28% versus 37%, 23% versus 29%, and 9% versus 15% (differences between respective rates in these three groups with p < 0.05). It was concluded that in vitro culture of embryos under microvibration (with a mimic of conditions in nature whereby oviductal fluid is mechanically agitated by the epithelial cilia) significantly increases the baby-take-home rate for patients 30 years and older.

The aim of this work is to establish the relationship between the morphology of Intracytoplasmic Morphologically Selected Sperm Injection (IMSI)-selected spermatozoa and their DNA integrity. The 45 ejaculates were randomly distributed into three treatment groups: normozoospermic, oligoasthenozoospermic and oligoasthenotheratozoospermic samples. The evaluation of DNA integrity was performed using the sperm chromatin dispersion test. It was established that DNA integrity of spermatozoa is strongly dependent on ejaculate quality (P < 0.05). The count of spermatozoa with nonfragmented DNA in normozoospermic samples was high and independent from IMSI-morphological classes (Class 1 versus Class 3, respectively) (P > 0.1). With decreased ejaculate quality, the percentage of spermatozoa with nonfragmented DNA decreased significantly (P < 0.05) independent from morphological class. Nevertheless, the rate of IMSI-selected spermatozoa with fragmented DNA within of Class 1 in normozoospermic (Group 1), in oligoasthenozoospermic (Group 2) and in oligoasthenotheratozoospermic (Group 3) samples was 21.1%, 31.8% and 54.1%, respectively. In conclusion, there is a direct relationship between morphological parameters of spermatozoa and their DNA integrity. However, the IMSI technique alone is not enough for the selection of spermatozoa with intact nuclei.

The in-vitro culture of human embryos in a medium subjected to regular short intervals of mechanical agitation leads to increased development rates. This type of treatment tries to mimic conditions in nature whereby oviductal fluid is mechanically agitated by the epithelial cilia. This phenomenon can be explained by the fact that an embryo developing in vivo is naturally exposed to constant vibrations of around 6Hz with the periodically repeating increase to 20Hz. This review covers the history of this question and in this light offers an explanation through biological concept for one of the most recent developments in this area: in-vitro culture of human embryos with mechanical micro-vibration. The effect of mechanical micro-vibration on embryos during their in-vitro culture was examined. Pregnancy rates after the transfer of embryos in the group with in-vitro culture under mechanical vibration were increased.

In this study we intend to evaluate the effect of electro-acupuncture on the pregnancy outcome in the infertility women undergoing ART, and to observe a temperature gradients change of stimulation points and during electro-acupuncture by medical infrared imaging.

Objective: To evaluate the ultramorphologic sperm features of idiopathic infertile men after acupuncture therapy.Design: Prospective controlled study.Setting: Christian-Lauritzen-Institut, Ulm, IVF center Munich, Germany, and Department of General Biology, University of Siena, Siena, Italy.Patient(s): Forty men with idiopathic oligospermia, asthenospermia, or teratozoospermia,Intervention(s): Twenty eight of the patients received acupuncture twice a week over a period of 5 weeks. The samples from the treatment group were randomized with semen samples from the 12 men in the untreated control group.Main Outcome Measure(s): Quantitative analysis by transmission electron microscopy (TEM) was used to evaluate the samples, using the mathematical formula based on submicroscopic characteristics.Result(s): Statistical evaluation of the TEM data showed a statistically significant increase after acupuncture in the percentage and number of sperm without ultrastructural defects in the total ejaculates. A statistically significant improvement was detected in acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibers of sperm organelles. However, specific sperm pathologies in the form of apoptosis, immaturity, and necrosis showed no statistically significant changes between the control and treatment groups before and after treatment.Conclusion(s): The treatment of idiopathic male infertility could benefit from employing acupuncture. A general improvement of sperm quality, specifically in the ultrastructural integrity of spermatozoa, was seen after acupuncture, although we did not identify specific sperm pathologies that could be particularly sensitive to this therapy, (c) 2005 by American Society for Reproductive Medicine.

No AccessJournal of UrologyAdult urology1 Feb 2006Quantitative Evaluation of Spermatozoa Ultrastructure After Acupuncture Treatment for Idiopathic Male Infertility J. Pei, E. Strehler, U. Noss, M. Abt, P. Piomboni, B. Baccetti, and K. Sterzik J. PeiJ. Pei More articles by this author , E. StrehlerE. Strehler More articles by this author , U. NossU. Noss More articles by this author , M. AbtM. Abt More articles by this author , P. PiomboniP. Piomboni More articles by this author , B. BaccettiB. Baccetti More articles by this author , and K. SterzikK. Sterzik More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)00443-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Quantitative Evaluation of Spermatozoa Ultrastructure After Acupuncture Treatment for Idiopathic Male Infertility." The Journal of Urology, 175(2), pp. 663–664 Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China© 2006 by American Urological AssociationFiguresReferencesRelatedDetails Volume 175Issue 2February 2006Page: 663-664 Advertisement Copyright & Permissions© 2006 by American Urological AssociationMetricsAuthor Information J. Pei More articles by this author E. Strehler More articles by this author U. Noss More articles by this author M. Abt More articles by this author P. Piomboni More articles by this author B. Baccetti More articles by this author K. Sterzik More articles by this author Expand All Advertisement PDF downloadLoading ...

Fragestellung: Die uterine Perfusion stellt eine bedeutende Einflussgröße für den Erfolg der assistierten Reproduktion dar. Der Phosphodiesteraseinhibitor Sildenafil verbesserte zwar die Durchblutung des Uterus sowie das Endometriumwachstum, jedoch mit beträchtlichen Nebenwirkungen. Der Extrakt des chinesischen Ginkgo-Baumes ist für seine durchblutungsfördernden Eigenschaften bei guter Verträglichkeit bekannt, wurde allerdings auf dem Gebiet der Reproduktionsmedizin bislang nicht untersucht.

enough, single embryo transfer (SET) is an ultimate method to prevent them.If an effective cryopreservation is available, transfer embryo one by one, which means repeating SET, is more effective than doing it at once.The aim of this study is to evaluate the efficacy of the repeating SET with cryopreserved surplus embryos.Materials and methods: From August to October in 2003, 66 patients (34.1± 3.0 years old; mean± SD) underwent SET.The Ovarian stimulation was done by the Clomiphene cycle with hMG.Clomiphene was initiated on d3 by 50mg/day and continued until the flare up of LH, caused by spraying 300µ g of GnRHa.hMG was initiated on d8 by 150IU and continued every other day until the day before the flare up of LH.The mean dosage of total hMG was 375± 141 IU.SET was applied for the patients whoes past history of four-cell stage ET was less than two times, and who had more than three good four-cell stage embryos.The best was transferred first.The surplus embryos were cultured into blastocysts by Blastocyst-medium (Irvine Scientific).When they grew into expanded blastocysts, they were immediately cryopreserved by vitrification using the Cryotop method (Kuwayama et al, 2000).If the first transfer resulted in failure, single vitrified-thawed blastocyst was transferred in a following natural cycle or a hormone-replacement cycle.We repeated this SET until finishing the stock of the cryopreserved surplus blastocysts. Results:The number of retrieved oocytes was 5.4± 2.0 and the number of cleaved cells was 4.1± 1.3.The pregnancy rate in the first SET was 44.9%.The surplus 207 four-cell stage embryos were cultured into blastocysts.The blastocyst rates per cell was 67.3% (141 expanded blastocysts), and per patient was 97.0%, respectively.All the blastocysts were successfully cryopreserved by vitrification (100% post-thaw survival).Twenty-nine patients, who resulted in failure in the first SET, underwent single blastocyst transfer.The pregnancy rates per transfer was 72.4% and per cycle was 87.5%, respectively.Conclusion: As long as more than three good four-cell stage embryos were obtained in the Clomiphene cycle, increasing the number of transferred embryos does not increase pregnancy rate more than expected, but rather increases multiple pregnancy rate.In such cases, our SET protocol was very effective in increasing pregnancy rate per cycle with preventing multiple pregnancies.

Zu den Risiken einer kindlichen Entwicklungsstörung nach intrazytoplasmatischer Spermieninjektion (ICSI) liegen nach wie vor widersprüchliche Aussagen vor.

Aim: To evaluate the possible links between ultrastructural sperm quality and the clinical pregnancy rate in infertile males treated with FSH before intracytoplasmic sperm injection (ICSI). Methods: Forty-four infertile males with idiopathic oligo-asthenozoospermia were randomly allocated to the treated (n=24) and non-treated (control, n=20) groups. Semen analysis was carried out by light and transmission electron microscopy (TEM) before and 12 weeks after FSH therapy. ICSI was performed in all couples. Results: TEM revealed a significant improvement in sperm quality after FSH treatment, particularly in men with their partners achieving clinical pregnancy. The pregnancy rate was 33% in the treated group and 20% in the control. Conclusion: Results highlight a positive role of FSH therapy in infertile males before ICSI, which was correlated with an increased pregnancy rate in treated couples. We believe that improved sperm ultrastructure after FSH therapy could positively influence the quality and early stage of embryo development, thereby increasing the probability of embryo implantation.

ObjectiveThe importance of nitric oxide (NO) as an intra- and intercellular modulator has been recognized in many biological processes. Nitric oxide, formed in vivo from L-arginine, may play a key role in follicular maturation and ovulation. Enhanced vascularization appears to be important for follicular selection and maturation in both spontaneous and stimulated IVF cycles. This study investigated the association between plasma L-arginine concentrations and ovarian response in patients with recurrent failures of IVF or ICSI treatment.DesignRetrospective analysis of patients with recurrent failure of ART.Materials and methods103 patients with at least two failed cycles of IVF or ICSI treatment after gonadotropin stimulation in down-regulated cycles were included in this study at our tertiary care infertility clinic. The reason for infertility was tubal or male factor. Blood samples were taken from each patient in the middle of the cycle after failed ART therapy. Quantitative and qualitative analysis of plasma amino acid profiles was performed in all patients using high-performance liquid chromatography. The average number of aspirated oocytes per cycle was compared between patients with low and normal L-arginine levels by statistical evaluation (Mann-Whitney test).ResultsIn 90 patients (87%) a decreased level of plasma L-arginine was measured (normal range: 70−130 μmol/l). The proportion of L-arginine in the aminogram was also reduced below the 5th percentile (2.22%) in 60 patients (58%). The average number of aspirated oocytes per cycle was significantly lower in patients with decreased absolute and relative levels of plasma L-arginine (4.00 vs 6.75 oocyctes per cycle, p=0.01; 4.34 vs 6.75 oocytes per cycle, p=0.028).ConclusionPlasma L-arginine levels may play a role in patients suffering from recurrent failure of ART especially by poor response. ObjectiveThe importance of nitric oxide (NO) as an intra- and intercellular modulator has been recognized in many biological processes. Nitric oxide, formed in vivo from L-arginine, may play a key role in follicular maturation and ovulation. Enhanced vascularization appears to be important for follicular selection and maturation in both spontaneous and stimulated IVF cycles. This study investigated the association between plasma L-arginine concentrations and ovarian response in patients with recurrent failures of IVF or ICSI treatment. The importance of nitric oxide (NO) as an intra- and intercellular modulator has been recognized in many biological processes. Nitric oxide, formed in vivo from L-arginine, may play a key role in follicular maturation and ovulation. Enhanced vascularization appears to be important for follicular selection and maturation in both spontaneous and stimulated IVF cycles. This study investigated the association between plasma L-arginine concentrations and ovarian response in patients with recurrent failures of IVF or ICSI treatment. DesignRetrospective analysis of patients with recurrent failure of ART. Retrospective analysis of patients with recurrent failure of ART. Materials and methods103 patients with at least two failed cycles of IVF or ICSI treatment after gonadotropin stimulation in down-regulated cycles were included in this study at our tertiary care infertility clinic. The reason for infertility was tubal or male factor. Blood samples were taken from each patient in the middle of the cycle after failed ART therapy. Quantitative and qualitative analysis of plasma amino acid profiles was performed in all patients using high-performance liquid chromatography. The average number of aspirated oocytes per cycle was compared between patients with low and normal L-arginine levels by statistical evaluation (Mann-Whitney test). 103 patients with at least two failed cycles of IVF or ICSI treatment after gonadotropin stimulation in down-regulated cycles were included in this study at our tertiary care infertility clinic. The reason for infertility was tubal or male factor. Blood samples were taken from each patient in the middle of the cycle after failed ART therapy. Quantitative and qualitative analysis of plasma amino acid profiles was performed in all patients using high-performance liquid chromatography. The average number of aspirated oocytes per cycle was compared between patients with low and normal L-arginine levels by statistical evaluation (Mann-Whitney test). ResultsIn 90 patients (87%) a decreased level of plasma L-arginine was measured (normal range: 70−130 μmol/l). The proportion of L-arginine in the aminogram was also reduced below the 5th percentile (2.22%) in 60 patients (58%). The average number of aspirated oocytes per cycle was significantly lower in patients with decreased absolute and relative levels of plasma L-arginine (4.00 vs 6.75 oocyctes per cycle, p=0.01; 4.34 vs 6.75 oocytes per cycle, p=0.028). In 90 patients (87%) a decreased level of plasma L-arginine was measured (normal range: 70−130 μmol/l). The proportion of L-arginine in the aminogram was also reduced below the 5th percentile (2.22%) in 60 patients (58%). The average number of aspirated oocytes per cycle was significantly lower in patients with decreased absolute and relative levels of plasma L-arginine (4.00 vs 6.75 oocyctes per cycle, p=0.01; 4.34 vs 6.75 oocytes per cycle, p=0.028). ConclusionPlasma L-arginine levels may play a role in patients suffering from recurrent failure of ART especially by poor response. Plasma L-arginine levels may play a role in patients suffering from recurrent failure of ART especially by poor response.

As there are still conflicting results concerning the developmental outcome of children born after IVF or ICSI treatment, this study evaluates the follow-up of children born after IVF or ICSI treatment up to the age of 12 months. controlled cohort study. 434 children born after ICSI therapy and 356 children born after IVF therapy were followed up by pediatricians up to the age of twelve months at our fertility center. Moreover the birth weight of these children was compared with a control group of 363 infants naturally conceived. The proportion of multiple pregnancies did not differ significantly between the ICSI and the IVF group: 296 (68.2%) vs. 246 (69.1%) singletons, 120 (27.7%) vs 104 (29.2%) twins and 18 (4.1%) vs. 6 (1.7%) triplets were included. Comparing the birth weight of singleton pregnancies after IVF and ICSI with the control group of naturally conceived singletons there was a slight but significant increase of growth retardation after ART with a relative risk of 1.67 after IVF (95% confidence interval: 1.05 − 2.64) and 1.57 after ICSI (95% confidence interval: 1.03 − 2.39). The gestational age at birth did not differ between the study groups (median: 39 weeks). Up to the age of 12 months major malformations were diagnosed in 11 (3.1%) vs 17 (3.9%) children, minor malformations in 18 (5.1%) vs 20 (4.6%) cases and developmental retardation in 20 (5.3%) vs 23 (5.6%) infants comparing the IVF group with the ICSI group. The total rate of anomalies (13.8%, n=49/356 vs n=60/434) did not differ (Chi-square test) between the IVF and the ICSI group up to the age of 12 months. At the age of one year the somatogram revealed no difference in the ratio of length and weight of the children: 45 children (12.6%) of the IVF group vs. 48 children (11.1%) of the ICSI group did not reach the third percentile. The outcome of the offspring did not differ between the IVF and ICSI group, neither at birth nor at the age of 12 months. In comparison with a control group after natural conception birth weight of singleton pregnancies was significantly decreased after ART.