Journal of Reproduction & Infertility
Year:2000 | Volume:1 | Issue:3 (3)|Papers Count:11

The objective of this study was to evaluate the effect of albumin on inhibition of severe ovarian hyperstimulation syndrome (OHSS) in women at high risk .A prospective, interventive and randomized study was planned and performed at the IVF department of the Royan Research Center .Ninety high risk patients from moderate to serere OHSS who were undergoing IVF ICSI cycles, were divided in two groups .57 patients in the study group and 33 in the control group .At the time of oocyte recovery, 50gr human albumin in 500 ml of normal saline (N.S) was injected to the study group .The control group only received 500 ml N.S .All patients in study and control groups were matched for age, number of oocytes, level of Estradiol at the time of hCG injection, duration of Follicular phase, amount of hMG used and the number of the transferred embryos .Of the 57 patients in the study group, one had OHSS, while in the control gourp, 4 OHSS patient was found in 33 patients (1/8% versus 2%, p<0.05) .We conclude that prophylactic infusion of human serum albumin can reduce or mitigate severe OHSS in patients at high risk.

Cervical cancer is one of the most frequently found cancers in women and appears to have a viral aetiology. Certain types of the human papillomavirus (HPV) are well established as the primary causes of cervical cancer. Clinical follow-up data; histopathologic diagnosis, Insitu hybridization (ISH) and HPV DNA typing were available from 60 patients .ISH technique was performed with commercial biotinylated probes. The presence of 7 high risks HPV was evaluated in 60 cervical biopsies with squamous cell carcinoma (SCC) and Cervical Intraepithelial neoplasia (CIN) of different degrees by ISH. We analyzed 60 biopsies from Iranian women. 42 of 60 (70%) carcinoma specimens were positive for HPV-DNA. HPV 31/33/51 (25%) was most frequently found, followed by HPV 16/18 (23.33%) and HPV 6/11 (21.66%) while HPV negative cases were 18(30%).High risk HPV types appear to be most frequently associated with SCC and CIN. ISH is a sensitive test in the detection and typing of HPV DNA both in clinical and latent infections.

The objective of this study was to evaluate the outcome of late (one and two days) Intracytoplasmic sperm injection (ICSI) after total fertilization failure in IVF. 35 IVF cycles that were part of our regular IVF program and showed no evidence of fertilization 16-46 hours after insemination (oocytes were observed at 16-18 hours and again 42-44 hours after the IVF procedures), were assigned to two treatment groups. Assisted fertilization with ICSI was carried out at 24 and 48 hours after oocyte retrieval. Group I (injected-day 1), consisted of 21 patients with 72 failed-fertilized metaphase II oocytes injected 1 day after ovum pick-up; and group II (injected-day 2), included 14 patients with 45 failed-fertilized metaphase II oocytes injected 2 days after ovum pickup. A single spermatozoon from the patient's husband (same as that used for insemination in IVF program) was injected into the cytoplasm of each of these oocytes. Resultant embryos were transferred 72 and 96 hours after oocyte retrieval in group I and II, respectively. Fertilization was achieved with ICSI in most patients with fertilization failure. In group I, (80.5%) oocytes fertilized, whereas in group II, 46.6% of oocytes fertilized. Cleavage rate was 79.3% of injected oocytes in group I, and 42.8% in group II. Finally, in group one 19 of 21 (94%) embryos well transferred. The transfer rate for group two was 11 of 14 (78%). These results indicate significant differences between fertilization and cleavage rates in both groups. One of the singleton pregnancies resulted from transfer of the embryos in group II, and none in group I. This is the first known pregnancy achieved from late (two days) ICSI and late transferred embryos, after failed IVF. In conclusion, late (24 and 48 hours) ICSI after complete failed fertilization in IVF, can give good fertilization and good cleavage rates. This method can be used as an ideal protocol in IVF programs, to increase chance of pregnancy in infertile couples using the advantages of two main assisted reproductive treatments including IVF and ICSI.

There are generally three factors involved in male infertility: low count, weak motility, and abnormal morphology of spermatozoa. Currently, it is impossible to improve the quality of sperm count and morphology in vitro. However, it may become possible to improve the sperm motility with the application of motility enhancer medicine. The objective of this study was to evaluate the effect of pentoxifylline (PX) on sperm motility and morphology of asthenozoospermic epididymal and testicular samples. The specimen's a sperm extraction (TESE) from men with obstructive azoospermia. A total of 40 PESA and 40 TESE samples were allocated to this prospective study. Following preliminary evaluation, each sample was processed with swim up procedure and then divided into two aliquots of control (non – PX) and PX (3.5 mM PX). Following 45 min of incubation at 37°C, the percentages of motility and normal morphology of spermatozoa were evaluated using Meckler chamber and papaniclau staining technique, respectively. The mean sperm counts in the PESA and TESE groups were 7.4±7.3×106 and 2.43±1.3×106, respectively. The percentages of normal morphology in the above groups were 22.67±11.6 and 14.9±9.2 which were respectively changed to 23.2±15.7 and 9.5±1.9 with PX incubation. In addition, the percentage of control progressive motility in the PESA and TESE samples were 13.9±4.2% and 0.26±0.6% which were increased to 20.1±9.7% (p<0.001) and 0.95±0.03% (p<0.05). These results strongly suggest that PX was successful in enhancing sperm motility particularly in the PESA group. It also did not have any significant side effect on sperm morphology. PX is considered to be safe and cheap, with easy application which may be used for improving the male infertility treatment program. With its dual role as motility enhancer and vitality detector of spermatozoa, it can be used safely for the ICSI treatment of severe cases of asthenozoospermia.

There are a limited number of infertile males with obstructive azoospermia, at present; spermatozoa can be aspirated with a simple technique called, percutaneous epididymal sperm aspiration (PESA). It is also possible to repeat PESA to aspirate spermatozoa for intracytoplasmic sperm injection (ICSI) cycles. The objective of this study was to evaluate whether of not repeated PESA would cause any obstruction, scars, or defects on sperm parameters. Eighty–nine azoospermic cases were admitted to the university infertility center. A total of 235 PESA who underwent 199 ICSI cycles were selected for this retrospective study. Sperm concentration, motility, and normal morphology, as well as the fertilization rates were statistically evaluated for each time. Sperm concentration (×106/ml) in first to forth PESA was 37.68, 45.58, 35.62, and 19.13, respectively. Sperm motility in the above groups was 24.95%, 23.10%, 23.24%, and 25.71%, respectively. Also, fertilization rate (FR) was 66.36, 68.35, 71.89, and 74.70 percent, respectively, for the same groups. There was not any significant difference in sperm parameters and FR in patients undergoing 1 to 4 PESA In additions, neither obstruction nor scars were reported in PESA. Cases. We conclude that repeated PESA is safe and reliable, and does not cause any significant defects in sperm parameters. Also, this technique can be repeated in individuals with obstructive azoospermia to aspirate sperm for a treatments regimen.

During transit of spermatozoa through the epididymis, where develop its capacity to fertilize oocytes, several new antigenic determinants appear on surface of spermatozoa. Many of these are proteins and glycoproteins with epididymal origin. The aim of this study was evaluation the role of epididymal secretory proteins on fertilizing ability of spermatozoa. In This study, epithelial cells from proximal portion of rat epididymis were cultured in RPMI medium supplemented with growth factors and androgens. To identify epididymal secretory proteins, pulse labeling with [35S] - (Met, Cys) was used. Labeled conditioned medium recovered and subjected to SDSPAGE and flurography. Antiserums against 8 secretory proteins were produced in Rabbits. The immunogens were lyophilized narrow strip of polyacrylamide gel from preparative electrophoresis with ultrapure proteins. Incubation of intact rat spermatozoa with these antisera was revealed secretory proteins on surface of spermatozoa. The effects of these antisera on in vitro fertilization were evaluated. The results showed that epithelial cells secreted about 20-30 proteins in culture medium. High titer antisera for 8 secretory proteins were produced. Three antisera were reacted with surface of rat spermatozoa (20, 24 & 72 kD proteins), and only 20 kD protein antiserum decreased fertilization rate. (28% in treatment group against 89% for control group). In Conclusion, the epididymal maturation process of spermatozoa was associated with the secretion of a number protein by epididymal epithelial cells, many of these proteins bound to plasma membrane of spermatozoa. Only secreted 20 kD protein has a critical role in fertilizing ability of spermatozoa.

In this study morphology of testicular and epididymal sperm was assessed. Morphology of sperms was assessed by using Tygerbery strict criteria. TESE and PESA were done by conventional method under local anesthesia. A percentage of normal and abnormal sperm was studied. The percentage of normal testicular sperm (6.2%) differed significantly from the percentage of normal epididymal sperm (18.6%). percentage of abnormal form of head and tail differs in two groups but Percentage of midpiece abmormalities was not significantly different between the two groups. To assess the predictive value of Tygerberg strict criteria for determining morphology of testicular sperms we need a healthy control group.