Effect of different exposure periods to the infrared 1.48 m diode laser on the inner cell mass and trophectoderm of blastocysts.

This study was carried out to determine the effect of the duration of exposure to an infrared 1.48 mm diode laser, on the number of cells in the inner cell mass and the trophectoderm of blastocysts following laser-assisted embryo biopsy. A total of 102 mouse embryos were used in the study. The embryos were randomly divided into three groups; group A (n = 22), group B (n = 47) and group C (n = 33). The embryos in group A were biopsied using the laser with an exposure of 600 ms, whereas those in group B were biopsied using the same laser with an exposure of 5 ms. The embryos in group C were incubated in culture without any procedures, as a control group. The blastocyst formation rates of group B (46/47, 97.8%) and group C (33/33, 100%) were significantly higher than that of group A (12/22, 54.5%). The number of cells in the inner cell mass, trophectoderm and the total number of cells in the blastocyst in group A (16.1 ฑ 5.1, 35.5 ฑ 10.9, 51.6 ฑ 12.9) were similar to those in group B (14.0 ฑ 5.6, 36.0 ฑ 12.7, 50.0 ฑ 18.3). The number of cells in the inner cell mass, trophectoderm and the total number of cells in the blastocysts in group C (19.1 ฑ 6.5, 45.8 ฑ 14.0, 65.0 ฑ 18.7) was significantly higher than those of the study groups. In conclusion, the longer duration of exposure to the infrared 1.48 mm diode laser might adversely affect blastocyst formation. However, it might not affect the quality of the blastocysts with regard to the number of cells in the inner cell mass and the trophectoderm.

Comparison of EffectiveNESS between Recombinant Follicle Stimulating Hormone and Human Menopausal Gonadotrophin Administration in those with Diminished Ovarian Reserve.

The study was carried out to compare the effectiveness of recombinant follicle stimulating hormone (recombinant FSH) and human menopausal gonadotrophin (HMG) in those with diminished ovarian reserve. A total of 106 ovarian stimulation cycles from 88 poor responders were included in this study. Either recombinant FHS or HMG was administered in order to stimulate the ovary for each cycle. The pregnancy rate of the recombinant FSH group (22.5%) was higher than that of the HMG group (9.1%). The cancellation rate of the recombinant FSH group (10.0%) was lower than that of the HMG group (19.7%). In in vitro fertilisation-embryo transfer (IVF-ET) cycles, the fertilisation rate of the recombinant FSH group (62.8%) was higher than that of the HMG group (51.8%). The pregnancy rate and the implantation rate of the recombinant FSH group (23.0 and 9.1%, respectively) were higher than those of the HMG group (13.6 and 5.9%, respectively). Although this did not achieve statistical significance, only the recombinant FSH group achieved pregnancies using gamete intrafallopian transfer (GIFT). In conclusion, recombinant FSH is probably more effective than HMG in improving the IVF and pregnancy rate in poor responders.

Comparison of human menopausal gonadotrophin and recombinant follicle-stimulating hormone in in-vitro fertilisation and pregnancy outcome.

The study was carried out to compare the effectiveness of human menopausal gonadotrophin (HMG) and recombinant follicle-stimulating hormone (recombinant FSH) in term of in vitro fertilisation (IVF) and pregnancy outcome. A total of 238 patients who underwent IVF for infertility treatment were included in the study. The first attempt of controlled ovarian stimulation was recorded and evaluated. A long protocol of ovarian stimulation was performed with gonadotrophin releasing hormone analogue (GnRH-a) administration. Gonadotrophin, which was either HMG (group A) or recombinant FSH (group B), was administrated to each patient for ovarian stimulation. The results of this study showed no difference in the number of stimulation days, fertilised oocytes, transferred embryos and cycles with embryos available for freezing between the two groups. Although the starting doses of both gonadotrophins were similar, the total dosage of HMG was higher than that of recombinant FSH (48.8ฑ20.8 versus 42.9ฑ20.0, p = 0.03). The number of retrieved oocytes in group A was higher than that in group B (9.5ฑ4.4 versus 8.3ฑ4.3, p = 0.04). The differences in cancellation rate, fertilisation rate, pregnancy rate per cycle and per transfer, as well as implantation rate between the two groups was not statistically significant. In conclusion, patients who underwent ovarian stimulation with GnRH-a long down-regulation still benefit for HMG for their treatment. We did not find any difference in fertilisation rate or pregnancy rate as well as implantation rate between HMG and recombinant FSH. A greater number of oocytes were retrieved in patients treated with HMG. However, more ampoules of HMG were administrated to achieve ovarian stimulation, compared with recombinant FSH.

Preimplantation development of the cleavage stage embryos after laser assisted embryo biopsy.

This study was carried out to determine the effect of the duration of exposure to the infrared 1.48 mm diode laser, on the developmental potential of cleavage stage embryos. A total of 69 mouse embryos were included in the study. Twenty-two of which (group A) were biopsied using the laser with a longer duration of exposure (600 ms), meanwhile 47 (group B) were biopsied using the same laser with a shorter period (5 ms). The blastocyst formation rate of group B (46/47, 97.8%) was significantly higher than that of group A (12/22, 54.4%). There were no grade 1 blastocysts or hatching in group A. In contrast, 35 of 46 (76.0%) blastocysts in group B were grade 1 and the hatching rate of group B was 84.7% (39/46). In conclusion, the infrared 1.48 mm diode laser may be effective and safe with cautious application. A long duration of exposure to the laser can adversely affect the developmental potential of the biopsied embryos. The laser system with a shorter duration of exposure, therefore, is recommended for laser assisted embryo biopsy.

Comparison between hysterosalpingo-contrast sonography ( HyCoSy ) using echovist® and hysterosalpingography ( HSG ) in uterine cavity and tubal patency assessment.

assessment of uterine cavity and tubal patency compare with hysterosalpingography ( HSG ). Thirty four of infertile women undergoing investigation for infertility were enrolled from July 1997 until November 1998 for the current study. HyCoSy using Echovistฎ and HSG were successful carried out during the first half of each patient’s menstrual cycle. The flow of contrast medium through the uterine cavity and each fallopian tube was visualised in real time by transvaginal ultrasonography for HyCoSy. Meanwhile, HSG was performed and reported by consultant radiologists. Regarding the uterine cavity evaluation, 32 of 34 cases ( 94.1 % ) was reported to be normal by both procedures. Only 2 cases were noted with different results. From the 68 fallopian tubes studied, though 47 of 68 tubes were showed patent by the two procedures, HyCoSy could detect occlusion in only 5 of 10 left fallopian tubes and in 5 of 9 right fallopian tubes which were reported to be occluded by HSG. Mean length of time for HyCoSy was 8.7 minutes (range 2-30 minutes, Std. Dev. 5.4) and mild pelvic pain was the only complication incurred. In conclusion, HyCoSy using Echovistฎ is a reliable and safe procedure for outpatient uterine cavity evaluation. However, it does not substitute to HSG for tubal patency assessment in basic infertility investigation.

Tubal patency assessment: A comparison of hysterosalpingo contrast sonography (HyCoSy) and chromolaparoscopy.

Twenty nine fallopian tubes from 15 patients were examined for tubal patency using HyCoSy followed by chromolaparoscopy. The mean volume of contrast medium used was 14.3 ml and the duration of HyCoSy was 8.5 minutes. Concordance, sensitivity, specificity, positive predictive value and negative predictive value were 75.9, 44.4, 90.0, 66.7 and 78.3% respectively. The only adverse effect was mild pelvic pain and this was found in 60%. These results suggest that HyCoSy may become an established method for assessing fallopian tubal patency in the future.

Hypo-osmotic swelling test of washing and swim-up sperm treated with pentoxifylline.

An experimental study was carried out in order to evaluate the effect to of pentoxifylline on the membrane function of washing and swim-up sperm in the process of sperm preparation for assisted reproductive techniques. Normal semen samples were taken according to World Health Organization criterias, from 30 male partners who attended the infertility clinic from November 1996 to January 1997, and divided into two aliquots. In the process of sperm preparation by the washing and swim-up method, pentoxifylline was added in only one aliquot. The hypo-osmotic swelling test was used to evaluate the outcome of both aliquots. From the study, the percentage of sperm that showed swollen tails in the hypo-osmotic solution prepared by the washing and swim-up method and treated by pentoxifylline was higher than that in the group which did not have pentoxifylline added in the process of sperm preparation. However, the difference was not atatistically significant (54.9 and 49.2 percent; P>0.01). It was therefore concluded that pentoxifylline added to washing and swim-up sperm in the process of sperm preparation dose not improve membrane function of spermatozoa. Thus, it may not be necessary to use pentoxifylline in the treatment of male infertility.