ABSTRACT
BACKGROUND: Preimplantation genetic diagnosis (PGD) for aneuploidy is recommended to couples at risk of generating chromosomally abnormal embryos. The aim of this study was to demonstrate that PGD for aneuploidy has an important role in the prognosis of subsequent treatments. METHODS: A total of 389 couples underwent their first PGD for aneuploidy due to either female age >or=38 years (n = 266) or >or=3 previous unsuccessful cycles (n = 123). After the first PGD followed by an unsuccessful treatment cycle, 141 couples underwent 175 subsequent PGD cycles. These patients were divided into three groups depending on the number of euploid embryos available for transfer in their first PGD cycle: group A included patients where no euploid embryos were diagnosed; group B included patients who had only one euploid embryo; and group C included patients with at least two normal embryos resulting from chromosomal analysis. RESULTS: In subsequent cycles, group A patients underwent significantly fewer transfers (45%) compared with group B (69%, P < 0.05) and group C patients (85%, P < 0.001). The pregnancy rate per transfer was significantly decreased in group A (15%) compared with group B (36%; P < 0.02) and group C (30%; P < 0.03). Accordingly, the live birth rate per patient was significantly lower in group A compared with group C (8.5% versus 30%; P < 0.005). CONCLUSIONS: The outcome of the first PGD for aneuploidy may have a predictive role for subsequent attempts.
Subject(s)
Aneuploidy , Preimplantation Diagnosis , Reproductive Techniques, Assisted , Adult , Birth Rate , Embryo Transfer/statistics & numerical data , Female , Humans , Male , Pregnancy , Pregnancy Rate , PrognosisABSTRACT
BACKGROUND: The aim of this study was to evaluate the concentration of vascular endothelial growth factor (VEGF) in follicular fluid and in granulosa cell cultures in relation to the degree of apoptosis in granulosa cells from patients with different types of ovarian response to controlled ovarian hyperstimulation. METHODS: We studied 30 women who underwent controlled ovarian hyperstimulation and oocyte retrieval. Group A comprised patients with 1-4 follicles (n = 10), group B patients with 5-14 follicles (n = 10) and group C patients with >15 follicles (n = 10). RESULTS: Mean (+/-SD) VEGF concentrations in follicular fluid were 1232 +/- 209, 813 +/- 198 and 396 +/- 103 pg/ml for groups A, B and C respectively (P > 0.01). Concentrations of VEGF in granulosa cell supernatant were 684 +/- 316, 1101 +/- 295 and 1596 +/- 227 pg/ml respectively (P < 0.05). Percentages of apoptotic cells in granulosa cells culture was 55.02 +/- 7.5, 23.98 +/- 4.4 and 14.2 +/- 2.3% respectively (A versus B, P < 0.01, A versus C, P < 0.006, B versus C, NS). CONCLUSIONS: Our findings showed that in patients with decreased ovarian response to controlled ovarian hyperstimulation, follicular fluid VEGF concentration is elevated, the concentration from granulosa cells culture supernatant is decreased and the percentage of apoptotic granulosa cells is increased, while opposite findings occurred in patients with normal or hyper-responses.
Subject(s)
Endothelial Growth Factors/metabolism , Granulosa Cells/physiology , Lymphokines/metabolism , Ovary/physiopathology , Ovulation Induction , Adult , Cells, Cultured , Female , Fertilization in Vitro , Follicular Fluid/metabolism , Humans , Osmolar Concentration , Ovarian Follicle/pathology , Ovary/pathology , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth FactorsSubject(s)
Humans , Female , Adult , Middle Aged , Echocardiography, Doppler , Genital Neoplasms, Female , Neoplasms , UltrasonographySubject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Age Factors , Anal Canal/physiology , Manometry , Pressure/adverse effects , Rectum/abnormalitiesSubject(s)
Humans , Female , Adult , Middle Aged , Diagnostic Errors , Genital Diseases, Female , Genital Neoplasms, Female/pathology , OvarySubject(s)
Humans , Female , Adult , Middle Aged , Urethra/physiopathology , Urinary Incontinence , Urinary Tract Infections/etiologySubject(s)
Humans , Female , Adult , Chromosome Aberrations/diagnosis , Cytogenetics , Infertility/geneticsSubject(s)
Humans , Female , Adult , Middle Aged , Ultrasonography , Echocardiography, Doppler , Neoplasms , Genital Neoplasms, FemaleSubject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Anal Canal/physiology , Pressure/adverse effects , Age Factors , Manometry/methods , Rectum/abnormalitiesSubject(s)
Humans , Female , Adult , Middle Aged , Genital Neoplasms, Female/pathology , Genital Diseases, Female , Ovary , Diagnostic ErrorsSubject(s)
Humans , Female , Adult , Middle Aged , Urethra/physiopathology , Urinary Incontinence , Urinary Tract Infections/etiologySubject(s)
Humans , Female , Adult , Infertility/genetics , Chromosome Aberrations/diagnosis , CytogeneticsABSTRACT
El deterioro de la función de los músculos del piso de la pelvis se incrementa con la edad y se evidencia en las mujeres fundamentalmente durante la posmenopausia, siendo un factor etiopatogénico de gran importancia
Subject(s)
Female , Adult , Abdominal Muscles , Pelvic Floor , Receptors, EstrogenABSTRACT
El deterioro de la función de los músculos del piso de la pelvis se incrementa con la edad y se evidencia en las mujeres fundamentalmente durante la posmenopausia, siendo un factor etiopatogénico de gran importancia
