Histopathology of ipsilateral and contralateral ovaries and plasma interleukin 6 levels after unilateral ovarian torsion.

OBJECTIVE: The aim of the present study was to evaluate the time-dependent histopathologic changes in both ovaries and to determine the time-dependent levels of plasma interleukin 6 (IL-6) after unilateral ovarian torsion. MATERIALS AND METHODS: An experimental animal study included 48 female Sprague-Dawley rats which were distributed to six groups: control group (Group 1), sham-operated control group (Group 2), and four unilateral ovarian torsion groups with torsion duration of three, six, 12, and 24 hours (Group 3, 4, 5, and 6, respectively). Histopathologic criteria (follicular degeneration, vascular congestion, hemorrhage, inflammatory cell infiltration, and total tissue damage score) were evaluated in both ovaries, and plasma IL-6 levels were measured. RESULTS: At 24 hours after torsion began, mean total tissue damage score was similar between ovaries that had torsion and contralateral ovaries. Mean plasma IL-6 level did not change during the 24 hours after torsion began (p = 0.584). CONCLUSIONS: In addition to ovaries that had torsion, histopathologic abnormalities also occurred in contralateral ovaries. These results suggest that contralateral ovaries are not quiescent after unilateral ovarian torsion. Plasma IL-6 levels did not change significantly during the 24 hours after ovarian torsion began, resulting in a limitation of its diagnostic use in the early course of the disease.

Does ischemia-reperfusion injury affect ovarian reserve and follicle viability in a rat model with adnexal torsion?

OBJECTIVE(S): To evaluate the effect of ischemia-reperfusion on follicle count and viability of follicles in a rat model with adnexal torsion. STUDY DESIGN: A total of 24 female adult Wistar albino rats were included in the study. In the first laparotomy, right ovaries were twisted at 720° in the counterclockwise for a duration of two (n=12), four (n=6) or 16 hours (n=6), whereas contralateral sites were kept as controls. In the second laparotomy, the right ovaries were detorsioned. Twenty-eight days after the detorsion, both ovaries were retrieved with the third laparotomy and placed in formaldehyde for subsequent examination under light microscopy and immunohistochemistry for proliferating cell nuclear antigen (PCNA). Besides histological evaluation by only using a standard scoring system, the viability of the follicles was also assessed by PCNA with immunohistochemical staining. RESULTS: Macroscopically, after two, four and 16 hours of torsion, all the twisted ovaries had enlarged and demonstrated a dark, dusky appearance. However, under light microscopy with 10X magnification, the mean primordial+primary follicle count was comparable in twisted and control sides (26.7±7.6 vs. 28.1±5.9 respectively). In terms of the means of total tissue damage, only the loss of cohesion was found to be significantly different compared to the control sides (2.78±0.86 vs. 2.17±0.86, p=0.017). Immunohistochemical staining revealed significantly lower PCNA counts in the 16-hour torsion group only. CONCLUSION(S): Even though ovarian reserves, reflected by primordial and primary follicle count, are similar between torsioned and contralateral ovaries, the viability of the remaining follicles might be affected by a long-standing ischemia-reperfusion phenomenon. Follicle count may reflect an idea of fertility potential, but immunohistochemical staining using viability markers such as PCNA confirms the viability of the counted follicles and appears to be a more precise approach necessary for demonstrating the functional status.

Histologic changes caused by nonabsorbable sutures after ovarian suspension.

PURPOSE: To evaluate intraovarian histologic changes caused by polypropylene and silk sutures that commonly are used in ovarian suspension. MATERIALS AND METHODS: Twenty-four female rats were randomly allocated to three study groups: a sham group receiving no ovarian suspension; the other two groups that had right ovarian suspension with polypropylene and silk sutures. At 90 days after surgery, the histologic changes and ovarian weight reduction in the suspended ovaries and severity of pelvic adhesions were evaluated. RESULTS: There were no differences between study groups in focal inflammation, cystic structures, or vascularity. Adhesion severity and ovarian weight reduction in suspended ovaries and cysts around the suspended ovary were significantly greater in the silk than sham group. The frequency of hematoma within the suspended ovary was significantly greater in the polypropylene than sham group. CONCLUSIONS: Polypropylene suture caused less adhesion severity or ovarian weight reduction than silk suture. This suggests that polypropylene suture may be the better suture for ovarian suspension procedures.

ICSI outcome of patients with severe oligospermia vs. non-obstructive azoospermia.

OBJECTIVE: To compare the results of intracytoplasmic sperm injection (ICSI) and embryo transfer (ET) cycles in men with severe oligoospermia and non-obstructive azoospermia. MATERIALS AND METHODS: This study included 91 ICSI cycles performed due to male factor infertility. Patients are divided into two groups according to source of spermatozoa. Group 1 consisted of 38 cycles in which sperm was obtained from testicles (cases with non-obstructive azoospermia). In Group 2, 53 consecutive cycles were included in which ejaculated sperm was available for ICSI in spite of severe oligospermia (< 100,000/ml). Fertilization, embryo quality and clinical pregnancy rates were compared between the groups. RESULTS: Although, the female age and mean number of oocytes retrieved were similar among the two groups, fertilization rate was significantly lower in the non-obstructive azoospermia (34.6%) group compared to group in which patients underwent ICSI with ejaculate spermatozoa (55.3%) (p < 0.05). However, there were no differences regarding mean number of available grade 1 embryos on day 3 and pregnancy rate between the two groups. CONCLUSION: Testicular sperm from non-obstructive azoospermia patients had significantly lower fertilization rates than the ejaculated spermatozoa from severe oligospermia patients in ICSI cycles. However, it did not bring about improved pregnancy rate.

Effect of sperm morphology on clinical outcome parameters in ICSI cycles.

OBJECTIVE: To assess the effect of isolated teratozoospermia with a normal sperm count and total motility by means of the fertilization rates, embryo quality and clinical pregnancy rate only in ICSI cycles. MATERIALS AND METHODS: We retrospectively analyzed the records of patients who underwent ICSI at Hacettepe University, Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Fertility and Reproductive Endocrinology between July 2001 and January 2010. Only patients with normal sperm count and total motility were recruited. The remaining cycles were further divided into two groups according to their sperm morphology with respect to Kruger's strict criteria. In Group 1, 537 consecutive cycles were enrolled whose sperm morphology was <4%. In Group 2, 118 cycles were identified with a morphology of > or = 4%. RESULTS: A total of 655 ICSI cycles were included in the final analysis. The fertilization rates were 72.0% and 70.8% in Groups 1 and 2, respectively. There were no differences regarding embryo quality, clinical pregnancy and implantation rates between the two groups. CONCLUSION: Our data suggest that detection of morphology defect has no value in the prediction of fertilization, embryo quality and clinical pregnancy in ICSI cycles.