Effect of the estrus cycle stage on the establishment of murine endometriosis lesions

Background: Establishment of a standardized animal endometriosis model is necessary for evaluation of new drug effects and for explaining different ethological aspects of this disease. For this purpose, we need a model which has more similarity to human endometriosis

Objective: Our objective was to establish an autologous endometriosis mouse model based on endogenous estrogen level and analyze the influence of estrus cycle on the maintenance of endometriotic lesions

Materials and Methods: In this experimental study, endometriotic lesions were induced in 52 female NMRI mice by suturing uterine tissue samples to the abdominal wall. The transplantation was either performed at proestrus/estrus or at metestrus/diestrus cycles. Urine-soaked beddings from males and also male vasectomized mice were transferred to the cages to synchronize and maintenance of estrus cycle in female mice. The mice were sacrificed after different transplantation periods [2, 4, 6 or 8 wk]. The lesions size, macroscopic growth, model success rate, histological and immune-histochemical analyses were assessed at the end

Results: From a total of 200 tissue samples sutured into the peritoneal cavity, 83 endometriotic lesions were confirmed by histopathology [41.5%]. Model success rate for proestrus/estrus mice was 60.7% vs. 79.2% for metestrus/diestrus mice. The endometriotic lesions had similar growth in both groups. Number of caspase-3, Ki67-positive cells and CD31-positive micro vessels were also similar in endometriotic lesions of two groups

Conclusion: If we maintain the endogenous estrogen levels in mice, we can induce endometriosis mouse model in both proestrus/estrus and metestrus/diestrus cycle without any significant difference

Impact of the endometrioma on ovarian response and pregnancy rate in in vitro fertilization cycles

Our objective was to evaluate the effect of ovarian endometrioma on ovarian stimulation outcomes in in vitro fertilization cycles [IVF]. In this prospective cohort study, we followed 103 patients who underwent intra-cytoplasmic sperm injection [ICSI] procedures over a 24-months period. The study group consisted of 47 infertile women with either unilateral or bilateral ovarian endometrial cysts of less than 3 cm. The control group consisting of 57 patients with mild male factor infertility was candidate for ICSI treatment during the same time period as the study groups. Both groups were compared for number of oocytes retrieved, grades of oocytes, as well as embryo quantity and quality. Our results showed similar follicle numbers, good embryo grades [A or B] and pregnancy rates in the compared groups. However, patients with endometrioma had higher gonadotropin consumption than the control group. The mean number of retrieved oocytes in patients with endometrioma was significantly lower than control group [6.6 +/- 3.74 vs. 10.4 +/- 5.25] [p<0.001]. In addition, patients with endometrioma had significantly lower numbers of metaphase II [MII] oocytes [5 +/- 3.21] than controls [8.2 +/- 5.4] [p<0.001]. In patients with unilateral endometrioma, there were no significant differences in main outcome measures between normal and involved ovaries in the patients with endometrioma. Patients with ovarian endometrioma had poor outcome. They showed poor ovarian response with lower total numbers of retrieved oocytes and lower MII oocytes during the stimulation phase; however, it does not affect the total number of embryos transferred per patient, quality of embryos, and pregnancy rate per patient

Comparison of easy and difficult embryo transfer outcomes in in vitro fertilization cycles

The aim of this study was to compare the effects of easy and difficult embryo transfers [ET] on implantation and pregnancy rates. In this prospective study, we analyzed the results of 706 ET procedures over a 12-month period. An easy ET was defined as a transfer that occurred without the use of force or other instrumentation. A difficult ET was defined as the use of force for catheter placement, and/or the use of additional instruments, and/or manipulation. Pregnancy rate was compared between patients with easy or difficult ETs. There was a significantly higher implantation rate in the easy group [21.7%] compared to the difficult group [12.1%, p<0.05].The easy group had a higher pregnancy rate [38.1%] compared to patients who had difficult ETs [21.4%; p<0.05]. Any uterine manipulation during ET adversely affects in vitro fertilization [IVF]. Precaution should be taken to identify possibly difficult ET cases in advance

Hysteroscopic findings in patients with a history of two implantation failures following in vitro fertilization

This study was designed to evaluate the incidence of uterine pathologies in infertile women with a history of two implantation failures after in vitro fertilization [IVF] and estimate the effect of hysteroscopic correction on achieving a pregnancy in these patients. The retrospective study population included 238 infertile women attended the outpatient infertility clinic between November 2007 and December 2008. Patients with at least two previous IVF failures were eligible for this study. All patients had normal findings on hysterosalpingography performed prior their first attempt for IVF. Standard transvaginal ultrasonography and diagnostic hysteroscopy were performed in patients before the subsequent IVF attempt. Out of 238 patients with previous IVF failure who underwent hysteroscopic evaluation, 158 patients [66.4%] showed normal uterine cavity. Abnormal cavity was found in 80 patients [33.6%]. We found polyp as the most common abnormality [19.7%] in the patients with previous history of IVF failure. The pregnancy rate was similar between IVF failure patients who treated by hysteroscopy for a detected uterine abnormality [24.6%] and similar patients with normal uterine cavity [21.2%] in hysteroscopic examinations. The intrauterine lesions diagnosed by hysteroscopy in patients with previous IVF failure ranges from 0.8%-19.7%. Correction of abnormalities such as myoma and polyp showed good outcome, similar to that achieved in patients with a normal hysteroscopy

pregnancy outcomes of day 2 versus day 3 embryo transfer: a cross-sectional study

The objective was to evaluate whether extending the embryo culture period from 2 to 3 days would yield a more optimal selection of viable embryos, thereby increasing the pregnancy rate. We have retrospectively analyzed pregnancy rates in the patients who had embryo transfer either on day 2 [582 patients] or on day 3 [387 patients] post-insemination over a 10-month period. The relationship between the quality score of day 2 and day 3 embryos and their respective pregnancy rates was also analyzed. The demographic and clinical characteristics were similar in both groups. Embryos transferred on day 2 or day 3, were similar morphologically and we found no difference in the distribution of grades between patients who became pregnant and those who failed to become pregnant. Pregnancy rates were slightly higher in patients who had embryo transfer on day 3 [40.72%] than patients who had transferred on day 2 [38.96%], but this difference was not significant. proportion of embryos with 2-3 cells, four cells, and 5-7 cells, which selected for transfer, showed significant difference between day 2 and day 3 [p<0.05]. There was also significant difference between pregnant and non-pregnant women based on embryo cell numbers on day two [p<0.011]. Extending the embryo culture period from 2 to 3 days had no adverse effect on pregnancy rate. Embryo transfer could be done on days 2 or 3 according to the convenience of the patient and the medical team