"Oncofertility" procedures in children and adolescents.

One of the most important elements associated with increase in oncological outcome in children is fertility preservation for future. It is obvious that chemo and radio therapy used in cancer treatment aim to destroy tumor cells, but they also impact healthy tissues. The nega-tive influence of these types of therapy can be observed in every patient's organ. One of the most serious complication of oncological treatment is reproductive impairment. This determinates directly mental and social state of the patient as well as quality of life after the treatment, particularly in adolescent. Commonly used methods of fertility preservation in female children are: freezing ovarian tissue or unfertilized oocytes. Among male children freezing of testicular tissue or ejaculated sperm are conducted. Described methods of fertility preservation among children and adolescents are on the experimental stage and none of them provide 100% effectiveness.

[Influence of naloxone on uterine contractions in patients with primary dysmenorrhea]. / Wplyw naloksonu na czynnosc skurczowa macicy u pacjentek z pierwotnym zespolem bolesnego miesiaczkowania.

UNLABELLED: Dysmenorrhea is a common condition among women in childbearing age. An increased uterine contractions, resulting among others from increased vasopressin and oxitocin secretion, is considered as a main cause of the primary dysmenorrhea. The endogenous opioids play the important role in the control of oxytocin and vasopressin release from the pituitary gland. Naloxone is a selective opioid receptor antagonis. So far, there is not much data on naloxone effect on uterine contractions. The aim of study was to determine the influence of naloxone on uterine contractions in patients with primary dysmenorrhea. MATERIAL AND METHODS: There were 10 female patients with primary dysmenorrhea included into the study. The uterine contractions had been recorded for 30 minutes before and 2 hours after injection of naloxone at the first day of menstruation. RESULTS: The intrauterine pressure recordings revealed a severe spontaneous uterine contractions, with high frequency and amplitude, at the time of dysmenorrhea. An intravenous administration of naloxone decreased uterine contractile activity and pain intensity. CONCLUSIONS: Naloxone acting on central nervous system decreases the uterus contractions in the patients suffering from dysmenorrhea. Unexplained mechanisms and multiple factors involved in the pathogenesis of primary dysmenorrhea indicates a need for the further studies on this subject.

[Etiopathogenesis of dysmenorrhea]. / Etiopatogeneza zespolu bolesnegomiesiaczkowania.

Dysmenorrhea is a common and frequently disabling condition among women of childbearing age. Based on results of large epidemiological studies, it is estimated that over a half of the population of young women suffers from dysmenorrhea. In spite of such a high frequency of this condition, its literature. Pain and lower abdominal cramps are among the most common causes for gynecological referral. Dysmenorrhea is sometimes associated with nausea, vomiting, diarrhea, fatigue, fever, headache, back pain, and dizziness. The exact cause of the disorder is not completely understood. However, there are many known factors that play significant roles in the pathogenesis of dysmenorrhea. The most important are: excessive uterine contractility, disturbances in uterine blood supply, synthesis of prostaglandins and anatomical abnormalities of the female reproductive tract. Primary dysmenorrhea refers to painful menstrual bleedings in the absence of any detectable underlying pathology. Secondary dysmenorrhea represents the clinical situation where menstrual pain can be related to an underlying disease, disorder, or structural abnormality either within or outside the uterus. Unexplained mechanisms and multiple factors involved in the pathogenesis of primary dysmenorrhea indicate a vivid need for further studies on this subject.

Pressure induced nucleus DNA fragmentation.

PURPOSE: The present study was designed to investigate the impact of pressure on nuclear DNA integrity in viable cells of mouse blastocysts. METHODS: The blastocysts of hybrid F1 females [(C57Bl/10 J × CBA-H);N = 15] aged 2-3 months were exposed into the pressure impulse lasting ~0.021 s and characterized by a positive pressure peak of ~76 mmHg. The nuclear DNA fragmentation index of mouse blastocysts was assessed by TUNEL assay within 60 s after exposure to pressure impulse. RESULTS: The mean nuclear DNA fragmentation index was significantly higher in the experimental group (83%) than in the control group (19.7%); p < 0.001. CONCLUSION(S): A low magnitude pressure impulse can induce nuclear DNA fragmentation in mouse blastocysts. The compression and decompression forces appearing during pressure fluctuations are responsible for the observed DNA shearing.

Influence of embryo transfer on blastocyst viability.

OBJECTIVE: To investigate the impact of injection speeds of the transferred load on embryo viability. DESIGN: Laboratory model for in vitro simulation of embryo transfer (ET). SETTING: Academic research institutes of reproduction biotechnology and private centers of reproductive medicine. ANIMAL(S): Mouse hybrid F1 females, C57bl/10J × CBA-H (N = 15), aged 2 to 3 months. INTERVENTION(S): In vitro exposure of mouse blastocysts to either fast ET with an ejection speed of the transferred load of >1 m/s or slow ET with an ejection speed of <0.1 m/s. MAIN OUTCOME MEASURE(S): Morphologic changes and apoptotic index of blastocysts. RESULT(S): Morphologic changes in response to ET were most prevalent in blastocysts exposed to fast ET. The mean apoptotic index was 52% in the group exposed to fast ET, 25% in the group exposed to slow ET, and 12.8% in control group. CONCLUSION(S): Fast ejection of the transferred load can trigger both morphologic changes and apoptosis in mouse blastocysts. A reduction of the ejection speed of the transferred load minimizes injury to the embryos. Therefore, embryos should be transferred at the lowest possible speed.

Pressure changes during embryo transfer.

OBJECTIVE: To investigate the pressure changes in the transferred load during mock ET. DESIGN: Experimental setup. SETTING: Academic Research Institute of Mechanical Engineering and private centers of reproductive medicine. PATIENTS(S): None. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Laboratory simulations of ET into a rigid transparent uterine model equipped with a pressure sensor. RESULT(S): Injection of a transferring load during mock ET could increase pressure locally up to 155 mm Hg in <0.1 seconds. The recorded pressure increase slope reached values as high as 72,000 mmHg/s, and the pressure decrease slope reached 144,000 mmHg/s. The pressure buildup in the transferred liquid was proportional to the ejection speed of the transferred load. CONCLUSION(S): ET can cause rapid pressure fluctuations in the transferred liquid. Therefore, it is advisable to transfer the embryo gently with minimum ejection speed, to avoid exposing the embryo to the steep pressure gradient.

Vitrification vs. slow cooling protocol using embryos cryopreserved in the 5th or 6th day after oocyte retrieval and IVF outcomes.

Modifying cryopreservation protocols may be seen as a way to simplify cryobanking procedure and increase satisfying outcomes. The aim of the study was to evaluate the influence of slow cooling protocol and vitrification on IVF outcomes using embryos preserved in the 5th or 6th day after oocyte retrieval. The study compared 2 groups of human embryos underwent slow cooling protocol (n=189) and vitrification (n=58). All embryos were cryopreserved in the 5th or 6th day after oocyte retrieval. Pre- and postfreezing embryo evaluation was performed in 2 or 3 steps scale, respectively. The study evaluates the effectiveness of two freezing methods and influence of the freezing day, pre- and postfreezing embryo grading on clinical pregnancy rate. Study showed higher pregnancy rate after vitrification (50.4%) than slow cooling protocol (25.9%). Significantly higher pregnancy rate was observed, when embryo preserved in the 5th day after oocyte retrieval (50.3%) than in the 6th day (22.7%). Postfreezing embryos evaluation showed that high quality blastocysts gave nearly four times better pregnancy outcomes than the ones evaluated as poor quality, and three times better than the ones evaluated as moderate. Prospective trials are needed to evaluate pregnancy and neonatal outcomes after vitrification. The number of controlled studies concerning vitrification has not been large enough, yet.