Concordance of vitamin D peripheral levels in infertile couples' partners.

A large number of evidence supports the role of vitamin D insufficiency in both women and men infertility. However, no studies have evaluated the rate of concordance of vitamin D status between the partners. This finding might open new scenarios in the interpretation of the available data linking vitamin D insufficiency and infertility. In the present cross-sectional study, 103 consecutive infertile couples were recruited between April and May 2014. Both partners concomitantly provided a serum sample for the assessment of 25-hydroxy-vitamin D [25-(OH)-D]. Vitamin D insufficiency was defined as serum 25-(OH)-D <20 ng/ml. One hundred-fifty subjects (73 women and 77 males) were 25-(OH)-D insufficient, corresponding to a rate of 73%. Overall, concordance was observed in 73 couples (71%), thus higher than the expected 61% (0.732 + 0.272) based on chance (p = 0.007). The Pearson coefficient of correlation R2 between the partners of the couples was 0.52 (p < 0.001). No statistically significant differences emerged when evaluating the rate of 25-(OH)-D insufficiency according to the causes of infertility. Serum 25-(OH)-D correlates within the partners of infertile couples. Further evidence is warranted to determine the clinical relevance and possible clinical applications of this finding.

The impact of Alpha/ESHRE consensus regarding oocytes with aggregates of smooth endoplasmic reticulum (SERa) on in vitro fertilization outcome.

PURPOSE: The present study aimed to gather information on the impact of Alpha/European Society of Human Reproduction and Embryology (ESHRE) consensus regarding oocytes with aggregates of smooth endoplasmic reticulum (SERa) on in vitro fertilization outcome. In particular, we investigated if patients undergoing intracytoplasmic sperm injection (ICSI) and whose oocytes are discarded due to SERa have a higher chance of embryo transfer cancellation compared to patients without SERa oocytes. METHODS: This is a nested case-control study drawn from the cohort of women referring for in vitro fertilization with ICSI. Cases were patients showing at least one oocyte with SERa at the time of injection. Controls were subsequent patients showing no SERa oocytes and matched ratio 1:1 for age, clinical indication to in vitro fertilization (IVF), and body mass index. The main outcome was the rate of embryo transfer cancellation. RESULTS: The percentage of women experiencing a transfer cancellation (absence of suitable oocytes or viable embryos) in their ICSI cycle were significantly higher in cases (18 %) compared to controls (8 %) (p = 0.02); however, adjusted odds ratio for FSH and number of SERa oocytes, of follicles, of retrieved oocytes, and of inseminated oocytes were not statistically significant. CONCLUSIONS: We have shown that the exclusion of SERa oocytes from ICSI cycles causes an increased frequency of transfer cancellation. This effect is mostly due to the reduced number of available oocytes after exclusion of SERa oocytes.

Intrafollicular iron and ferritin in women with ovarian endometriomas.

OBJECTIVE: To evaluate whether iron contained in ovarian endometriomas can diffuse through the cyst wall and negatively affect ovarian function. DESIGN: Prospective case series. SETTING: Infertility unit in an academic setting. POPULATION: Thirty-nine infertile women with unilateral endometriomas who underwent in vitro fertilization. METHODS: Iron and ferritin assessments in pools of follicular fluids obtained from affected and contralateral intact gonads. MAIN OUTCOME MEASURES: Iron and ferritin concentrations. RESULTS: Follicular fluid iron content did not differ between the two gonads. The median [interquartile range (IQR)] follicular concentrations in the affected and unaffected ovaries were 59 (IQR 44-74) and 59 (IQR 47-73) µg/dL, respectively (p = 0.77). Conversely, ferritin concentration was significantly higher in affected gonads. The median (IQR) concentrations of ferritin in the affected and unaffected ovaries were 57 (IQR 31-146) and 33 (IQR 23-67) µg/mL, respectively (p = 0.026). When considering together the 78 studied ovaries, no significant correlations emerged between follicular iron and ferritin and variables reflecting ovarian responsiveness and oocyte developmental competence. CONCLUSIONS: Iron may diffuse from ovarian endometriomas into the adjacent ovarian tissue. However, this phenomenon does not appear to markedly affect ovarian function. Some effective biological mechanisms such as ferritin storage may effectively sequester free iron, so limiting its detrimental effects.

Can we use incubators with atmospheric oxygen tension in the first phase of in vitro fertilization? A retrospective analysis.

PURPOSE: Aim of the present study was to compare two culture strategies used in our routine in vitro fertilization program. METHODS: This is a retrospective analysis. Two culture systems were used in parallel and analysed retrospectively: 1) Use of atmospheric oxygen tension (~20 %) until insemination followed by use of low (~5 %) oxygen concentration; 2) Exclusive use of low oxygen concentration. Main outcome was the utilization rate defined as the number of transferred + vitrified embryos per inseminated oocytes. Secondary outcomes were clinical pregnancy and live birth rates. RESULTS: A total of 402 in vitro fertilization cycles were analyzed. Demographic and clinical data of patients belonging to the two culture systems were not significantly different. Utilization rate, cumulative clinical pregnancy rate and cumulative live birth rate per cycle was similar using two different oxygen concentration compared to exclusive use of low oxygen tension (37 % versus 39 %; 30 % versus 30 %; 23 % versus 28 %, respectively). CONCLUSIONS: The use of a culture system with atmospheric oxygen tension from recovery of oocytes until insemination followed by culture in low oxygen gives results similar to exclusive use of low oxygen concentration.

The strategy of group embryo culture based on pronuclear pattern on blastocyst development: a two center analysis.

PURPOSE: To compare two embryo grouping strategies. METHODS: Retrospective time-course analysis in two different centres. Two culture protocols were used at the zygote stage: "Random Group" in which zygotes were randomly grouped and "Definite Group" in which zygotes were grouped based on pronuclear pattern. Embryo culture was extended to blastocyst stage. Primary and secondary outcomes were respectively the blastulation rate and the cumulative clinical pregnancy and implantation rates. RESULT(S): A similar blastulation rate [42 and 41% day (5 + 6) blastocysts] was obtained in the two groups. Conversely, after adjusting for baseline and cycle variables, cumulative pregnancy [adjusted Odds Ratio = 2.10 (95%CI: 1.08-4.07)] and implantation [adjusted Odds Ratio = 1.78 (95%CI: 1.06-2.97)] rates were significantly higher in the "Random Group" compared to the "Definite Group". CONCLUSION(S): Two strategies of group culture gave similar results in terms of blastulation rate but the random grouping of zygotes improves pregnancy and implantation rates in IVF-cycles.