Achieved pregnancy with the delivery of a healthy child by TESE-ICSI 7 years after bilateral adult orchidopexy: a case report.

We report pregnancy with the delivery of a healthy child by TESE-ICSI 7 years after bilateral adult orchidopexy. A 29-year-old patient presented with infertility and previous bilateral cryptorchidism, but no surgical treatment had ever been performed. His partner had been assessed by a gynaecologist, and no contributing female factors were detected. Orchidopexy and conventional testicular sperm extraction (TESE) were performed and microdissection TESE 10 months after orchidopexy. The second microdissection TESE with intracytoplasmic sperm injection (ICSI) was performed 7 years after orchidopexy. The couple achieved pregnancy with the delivery of a healthy child by TESE-ICSI. It is concluded that bilateral orchidopexy in adulthood progresses spermatogenesis gradually, and microdissection TESE may succeed after a certain period of time following treatment.

Functional characterization of human organic anion transporting polypeptide B (OATP-B) in comparison with liver-specific OATP-C.

PURPOSE: To assess the functional characteristics of human organic anion transporter B (OATP-B) in comparison with those of the known, liver-specific OATP-C. METHODS: OATP-B or -C was expressed in HEK293 cells or Xenopus oocytes, and uptakes of estradiol-17beta-glucuronide and estrone-3-sulfate were measured using radiolabeled compounds. RESULTS: OATP-C transported both estrone-3-sulfate and estradiol-17beta-glucuronide, whereas OATP-B transported only the former. OATP-C-mediated uptake of estrone-3-sulfate exhibited biphasic saturation kinetics, whereas transports of estradiol-17beta-glucuronide by OATP-C and estrone-3-sulfate by OATP-B followed single-saturation kinetics. Inhibition kinetics showed that only the high-affinity site for estrone-3-sulfate on OATP-C was shared with glucuronide conjugates. Uptake of [3H]estrone-3-sulfate by OATP-B was inhibited by sulfate conjugates but not by glucuronide conjugates, whereas its uptake by OATP-C was inhibited by both types of conjugates. CONCLUSIONS: OATP-B accepted sulfate conjugates of steroids but not glucuronide conjugates, whereas OATP-C transported both types of steroid conjugates. Transport of estrone-3-sulfate by OATP-B and -C followed single- and biphasic-saturation kinetics, respectively, and the high-affinity site on OATP-C was the same as that for estradiol-17beta-glucuronide. Other OATPs, OATP-A and OATP-8, reportedly exhibit different preferences for steroid conjugates, and the specific recognition of sulfate conjugates seems to be unique to OATP-B.

Assisted reproduction technology for patients with congenital bilateral absence of vas deferens.

PURPOSE: We investigate the frequency of cystic fibrosis transmembrane conductance regulator gene mutations in Japanese patients with congenital bilateral absence of the vas deferens, and assess treatment outcomes of assisted reproduction interventions. MATERIALS AND METHODS: In 10 Japanese patients with bilateral congenital absence of the vas deferens genetic analysis was performed for known frequent mutations of the cystic fibrosis transmembrane conductance regulator gene using polymerase chain reaction amplification followed by dot-blot hybridization with the allele-specific oligonucleotide probes and direct sequencing. Intracytoplasmic sperm injection using spermatozoa retrieved from the testes was performed in 7 of the couples. RESULTS: No known mutations of the gene were detected in the patients. However, analysis of the polythymidine tract polymorphism in intron 8 revealed 30% allele frequency of 5T. Pregnancy was achieved in 7 cycles of intracytoplasmic sperm injection using spermatozoa retrieved from the testes. CONCLUSION: The 5T variant in intron 8 polythymidine tract was identified with high allelic frequency in Japanese patients with congenital bilateral absence of the vas deferens, suggesting that the disease in Japan is also partially caused by this particular mutation of the cystic fibrosis transmembrane conductance regulator gene. Modern assisted reproduction technology offers an important option for patients with congenital bilateral absence of the vas deferens.

[Midluteal progesterone/estradiol ratio as an indicator of pregnancy potential].

In an effort to determine the reliability of the midluteal progesterone(P)/estradiol(E2) ratio as an index of the potential for conception, we measured the midluteal P and E2 levels in 76 infertile women who had been treated at our infertility clinic. This parameter in conception cycles was compared with that in non-conception cycles. Eighty cycles of the 76 women were classified into two groups, depending upon whether pregnancy occurred or not. Group 1 and group 2 were composed of 31 conception cycles and 49 drug-induced cycles, respectively. Midluteal concentrations of P and E2 did not show any significant differences between the two groups. The P/E2 ratios were 106.4 +/- 71.3 (mean +/- SD) and 71.5 +/- 44.16, respectively. This difference was statistically significant (p less than 0.05). Discriminant function analysis showed that the smallest probability of misclassification between the two groups decreased from 44% when using P only to 36% when using the combined P and E2. The following equation: Y = 0.0727X1 - 0.00456X2 - 0.130 was obtained (when X1 = P, X2 = E2). These results suggest that the midluteal P/E2 ratio gives clinicians the best indication of luteal function for the achievement of pregnancy.

Inhibition of ovulation in PMSG/hCG-treated immature rats by rotenone, a specific inhibitor of mitochondrial oxidation.

Immature Wistar rats were induced to ovulate by treatment with PMSG and hCG. Control animals ovulated 43.5 +/- 0.36 ova/rat. Intraperitoneal injection of rotenone doses of 0.125, 0.25 and 0.50 mg/kg reduced the ovulation rate to 24.0 +/- 3.08, 8.0 +/- 0.88 and 1.5 +/- 0.44 ova/rat, respectively. The rotenone significantly reduced ovarian cytochrome oxidase activity and progesterone production, but not production of oestradiol or testosterone. Thyroxine treatment at a dose of 5 mg/kg s.c. reversed the rotenone inhibition of ovulation. The results suggest that an increase in mitochondrial respiration is an essential feature of the ovulation process in mammals.

Thyrotropin-releasing hormone and gonadotropin-releasing hormone test to predict effectiveness of bromocriptine therapy in infertile women.

Sixty-four infertile women presenting with luteal phase defect, anovulatory cycle, and secondary amenorrhea were compared with 15 normal cycling women with bolus injections of thyrotropin-releasing hormone (TRH) and gonadotropin-releasing hormone (GnRH) before bromocriptine (BCPT) therapy. All of the women had normal baseline prolactin (PRL), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) concentrations. Responses of PRL, LH, and FSH levels were measured. PRL responses in BCPT responders were markedly greater than in controls and nonresponders. A better responder rate to BCPT therapy was observed in patients with apparent (88.9%) or borderline (69.2%) exaggerated responses of PRL to TRH than in normal patients (41.7%). Further, in patients with normal PRL responses, the inappropriately enhanced LH responses were seen in BCPT responders but not in nonresponders. These findings suggest that TRH and GnRH tests are worthwhile in predicting the outcome of BCPT therapy in infertile patients.

[Effect of rotenone on rabbit ovulation and histochemical activities of cytochrome oxidase and 3 beta-hydroxysteroid dehydrogenase of the follicle].

Various doses of rotenone, an inhibitor of respiratory chain, were administered to mature female rabbits concomitantly with an ovulatory dose of hCG. The effect of rotenone on ovulation was studied by counting the ovulated stigma under a dissecting microscope. Histochemical studies on the activities of 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD) and cytochrome oxidase (CYO) in follicles at various intervals after hCG-rotenone injections were also performed to investigate the role of mitochondrial oxidation in the ovulatory process. Rotenone inhibited the hCG-induced ovulation in a dose respondent manner and reduced the sudden hCG-induced increase in the histochemical activities of 3 beta-HSD and CYO of granulosa cells. It is suggested that the activation of mitochondrial oxidation in the ovulating follicle is mandatory for ovulation and the induction of steroidogenic enzymes in granulosa cells.

[A histochemical study of the respiratory system in rabbit ovarian follicles during ovulation].

Histochemical studies on the activities of 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD), succinate dehydrogenase (SDH) and cytochrome oxidase (CY-O) in rabbit ovarian follicles at various times after the administration of hCG were performed to investigate the relationship between the activities of steroid biosynthesis and the respiratory system. The activities of 3 beta-HSD and SDH were studied by using the tetrazolium salt and CY-O activities by the method of Seligman with prefixation. On the granulosa cell layer prior to the administration of hCG, no activities of 3 beta-HSD and CY-O were detectable, while slight activities of SDH were observed. These three enzymes showed intense activities on the granulosa cell layer 3 hours after the administration of hCG, which were maintained till the time of ovulation. The results indicated that increased activities of steroid biosynthesis in the granulosa cell layer after LH-surge were accompanied by the accelerated TCA cycle and respiratory chain. Energy from accelerated glycolysis may be utilized for steroid biosynthesis in preovulatory granulosa cells. Increased O2 consumption due to accelerated aerobic glycolysis is in accordance with hyperactivity of perifollicular capillaries, which finally leads to rapid follicular expansion and ovulation.

Scanning electron microscopy study on corrosion cast of rat uterine vasculature during the first half of pregnancy.

Vascular changes in the rat uterus during the first half of pregnancy were studied by the microcorrosion casting/scanning electron microscope method. Arterioles supplying the endometrium were divided into two groups according to differences in their shape, distribution, and development. Circular impressions indicative of the presence of vascular sphincters were observed around the casts of each group of arterioles. Resin leakage, suggesting an increase in vascular permeability, was observed from capillaries composing the sub-epithelial plexus and the glandular 'baskets'. Although leakage was noted throughout the endometrium before implantation, it tended to be localised around each blastocyst after the onset of implantation. The present results suggest the existence of a special control mechanism of the uterine blood flow, and that the uterine vasculature is affected by the conceptus from the beginning of implantation.