ABSTRACT
CFTR protein regulates electrolyte and fluid transport in almost all tissues with exocrine function, including male reproductive tract. Mutation of CFTR gene causes cystic fibrosis (CF), which affects the function of several organs, and impairs male fertility. The role of CFTR protein in different compartments of male reproductive tract (testis, epididymis, sperm) as well as an impact of CFTR mutation(s) on male fertility phenotype is discussed in relation with the choice of optimal technique for Assisted Reproductive Techniques (ART) management.
Subject(s)
Cystic Fibrosis Transmembrane Conductance Regulator/genetics , Fertility/genetics , Infertility, Male/genetics , Sperm Injections, Intracytoplasmic/methods , Animals , Cystic Fibrosis Transmembrane Conductance Regulator/metabolism , Genetic Counseling/methods , Humans , Infertility, Male/pathology , Infertility, Male/therapy , Male , Mutation , Spermatozoa/metabolism , Treatment OutcomeABSTRACT
Sperm and embryos cryopreservation is a commonly applied technique for several years. Recently authorized in France, vitrification tends to replace gradually the conventional technique of slow freezing, so upsetting the practices in the management of patients. It allows from now on the cryopreservation of oocytes and opens new perspectives in egg donation either still in fertility preservation. This review thus attempted to examine the contribution of vitrification in the freezing of oocytes and human embryos at various stages of development. If obviously vitrification appears as the current method of choice for the cryopreservation of oocytes as well as blastocysts, the results are less cut as regards embryos to early stages. No increase in adverse obstetric and perinatal outcomes in children conceived from vitrified oocytes or embryos is noted in the literature.
Subject(s)
Cryopreservation/methods , Embryo, Mammalian/physiology , Oocytes/physiology , Reproductive Techniques, Assisted , Vitrification , France , Humans , Reproductive Techniques, Assisted/adverse effectsABSTRACT
Oocyte donation, initially proposed in agonadal women, saw indications expand to ovarian deficiencies and failures of in vitro fertilization (IVF), resulting in a significant increasing demand. The recruitment of oocyte donors is a critical issue for all countries that have allowed this practice. The French legislation, with the laws of bioethics, is clearly the most restrictive of European countries, imposing an absolute free gift from mother. The different solutions in the neighboring countries are analysed and in particular the interpretations made in respect of gratuity and compensation. Motivating donors (spontaneous, relational, or by reciprocity), but also motivating the medical teams can organize a program of oocyte donation in France. The authors present their results of three years experience, demonstrating that this system is possible in the current legislative framework.
Subject(s)
Oocyte Donation/ethics , Oocyte Donation/legislation & jurisprudence , Confidentiality/ethics , Embryo Disposition/ethics , Female , Fertilization in Vitro/ethics , Fertilization in Vitro/legislation & jurisprudence , France , Humans , Pregnancy , Reproductive Techniques, Assisted/ethics , Tissue and Organ ProcurementABSTRACT
In 2005-2006, 905 punctures of oocytes were realised in the Assisted Reproductive Technology Centre of Rennes' Hospital in France, the source of 173 pregnancies after fresh embryos transfers and 185 pregnancies after frozen embryos transfers. The single-embryo transfer (SET) was proposed in all patients aged less than 38 years with at least two embryos type I or II on the first two cycles. Sixty-three percent of patients (n=293 cycles) chose the SET with 21.5% pregnancies through fresh embryo transfer. The SET with frozen embryos has been completed on 708 cycles with 16.8% of pregnancies per transfer. The cumulative rate of pregnancies by puncture is 39% and the overall risk of multiple pregnancies has dropped to 12%. The SET associated with an effective embryo cryopreservation therefore allows to reduce the risk of multiple births while maintaining a satisfactory pregnancy cumulative rate.
