Does EmbryoGlue transfer medium affect embryo transfer success rate?

OBJECTIVE: Verification of the effect of EmbryoGlue (EG) transfer medium enriched with hyaluronan on the embryo transfer success rate. DESIGN: A prospective study. SETTING: Fertimed, Fertility Treatment Centre, Olomouc. METHODS: 484 patients undergoing IVF + ET were engaged who were divided according to the medium used during transfer: Sage or Vitrolife culture medium (n = 135) and EG transfer medium (n = 349). The influence of other factors was also evaluated: age, number of received oocytes, percentage of fertilised oocytes, endometrium height on the day of transfer, number of preserved embryos, number of transferred embryos and the length of cultivation (48, 72, 96, 120 h). These factors were considered quantitative variables while the method of hormone stimulation, the type of culture medium and the application of EG were considered qualitative (categorical) variables. RESULTS: With the use of EG the chances of conception increased by approximately 9%. The negative effect of higher age on implantation proportion and the positive effect of cultivation prolongation were proven. The effect of EG on miscarriages was not proven. The probability of miscarriage diminished with higher oocyte fertilisation. The culture medium used (Sage or Vitrolife) before the application of EG does not affect the gravidity result. CONCLUSION: Using the transfer medium of EmbryoGlue before embryo transfer affects the pregnancy rate (PR) in a positive manner. The influence on pregnancy loss with the application of EG was not proven.

HCG level after embryo transfer as a prognostic indicator of pregnancy finished with delivery.

OBJECTIVE: To examine patients after embryo transfer for predictive influence of the human chorionic gonadotropin (hCG) level on the probability of finishing pregnancy with delivery. DESIGN: Retrospective study. SETTING: Fertimed, Fertility Treatment Centre, Olomouc. METHODS: 490 patients pregnant after IVF + ET treat-ment placed in the study. The influence of other factors: age (patients 20-50), number of transferred embryos (one, two and more) and the length of cultivation on the probability of finishing pregnancy with delivery or loss and the possibility to predict multiple pregnancy was also related to the known hCG value. The transferred embryos were divided into two groups - early (cultivation 48 and 72 hrs) and prolonged cultivation (PC 96 and 120 hrs). The answer here, therefore, is a multinomial variable with four levels. For that reason the data was analysed through a multinomial logistic model vs. multinomial distribution of a mistake and generalised logistic link function. RESULTS: The hCG level grows exponentially in the course of the 9th to 17th day after an embryo transfer (ET). The probability of one child delivery after the transfer of one embryo overdue after prolonged cultivation (96 or 120 hrs) grows with the average and above-average hCG values on the day of the draw. The hCG value was 678 (564-815) IU/l1 on the 14th day after ET in pregnancy ended in delivery, 321 (216-477) IU/l on average in abortion, 82 (51-132) IU/l in biochemical pregnancy and 1070 (737-1554) IU/l in multiple pregnancy. The probability of multiple pregnancy increased with hCG values greatly above the average and on the other hand, below-average values indicated abortion or biochemical pregnancy. The patients age was not proven to be of significant influence, the hCG level slightly decreased with higher age. On the contrary, an increasing frequency of abortions depending on the increasing age of the mother was once again confirmed. CONCLUSION: The measured hCG values are considerably different depending on the pregnancy result, which is why this value is considered a quality predictive factor of the pregnancy result.

Triple pregnancy with mixed chorionicity following in vitro fertilization: is fetal reduction neccesary?

OBJECTIVE: The increasing incidence and management of monozygotic twinning in patients undergoing in vitro fertilization (IVF) has been the subject of much debate. Here, we describe the management and outcome of two triple pregnancies with mixed chorionicity with a monochorionic-diamniotic twin pair and a singleton following the transfer of two embryos during IVF treatment. DESIGN: Case report. SETTING: Department of Obstetrics and Gynaecology, Palacký University Hospital, Olomouc, Czech Republic. METHODS: This study involved Patient A (30 years of age; 0 para) and Patient B (32 years of age; I Para), both with triplets of mixed chorionicity following the transfer of two embryos during IVF treatment, and treated in The Fetal Medicine Centre, Palacky University Olomouc. Detailed counselling led to the deployment of different management strategies for each case. RESULTS: The monochorionic twin component of Patient A was terminated by fetal reduction in the 15th week of gestation, while the remaining single pregnancy was delivered at term without complication. Patient B opted for expectant management. However, the pregnancy was complicated by severe maternal morbidity and was terminated in the 28th week of gestation following the death of one fetus. CONCLUSION: Fetal reduction should be offered as a management tool to patients carrying triplets in order to improve perinatal survival. In triplets with mixed chorionicity, the reduction of monochorionic twins is particularly advisable in preventing the additional risk posed by a shared placenta.

[Aspiration of functional ovarian cyst]. / Ambulantní miniinvazivní lécba funkcních cyst ovaria.

OBJECTIVE: The study was designed to prove the safety of simple cyst aspiration instead of the current treatment by laparoscopy. DESIGN: Retrospective analysis. SETTING: Fertimed Olomouc, Infertility Center. METHODS: We are presenting our experience with the aspiration of follicles (group A) and a functional cyst (group B, C). We are evaluating a number of complications in all groups, anaesthesia versus analgesia in group B, C and the cytological examination of fluid from the function cyst in group C. RESULTS: In 2,744 aspirations we detected 0.0004% small complications (vaginal wall bleeding) and 0.0004% major complications (laparoscopy, cystoscopy). No single cytological examination was suspect in the simple ovarian function cyst. CONCLUSION: Aspiration of a simple functional cyst is the first step of the treatment. It is a simple procedure. For patients it is comfortable and safe. In a simple cyst, we do not find suspect cells.

[Recurrent implantation failure and thrombophilia]. / Opakované selhání implantace embrya a trombofilie.

OBJECTIVE: Bring a comprehensive overview of the available knowledge about the importance of thrombophilic mutations in patients with recurrent implantation failure and summary of therapeutic options. DESIGN: Overview study. SETTING: Department of Obstetric and Gynecology, University Hospital Olomouc. METHODS: Analysis of literary sources and databases Ovid, Medline. CONCLUSION: Failure of implantation in the context of assisted reproduction is associated with impaired endometrial receptivity. In women with normal anatomy may affect the implantation of embryos during stimulation hormonal changes, immunological factors or thrombophilic mutations. Recurrent implantation failure patients should be tested for the presence of thrombophilic mutations. Subsequently, these patients should be individually consulted and low molecular weight heparin should be used only in indicated cases. According to the available data treatment is recommended only in patients with known acquired or inherited thrombophilic disorder.

Low-level 45,X/46,XX mosaicism is not associated with congenital heart disease and thoracic aorta dilatation:prospective magnetic resonance imaging and ultrasound study.

OBJECTIVE: To establish the prevalence of risk factors for aortic dissection, such as bicuspid aortic valve, aortic coarctation and ascending aorta dilatation, in women with low-level 45,X/46,XX mosaicism undergoing an in-vitro fertilization (IVF) procedure. METHODS: The study group comprised 25 women with low-level 45,X/46,XX mosaicism (ranging from 3.3% to 10.0%) who were referred to two reproductive medicine units between 2009 and 2013 because of infertility and who underwent subsequent karyotyping. In accordance with the recommendation of the Practice Committee of the American Society for Reproductive Medicine for patients with Turner syndrome (TS), prior to the IVF procedure, all women underwent careful cardiovascular screening for congenital heart disease and thoracic aorta dilatation, including standard cardiac examination, echocardiography and non-contrast cardiac magnetic resonance imaging. Aortic size index (ASI, diameter of the ascending aorta normalized to body surface area) and the prevalence of coarctation of the aorta and of bicuspid aortic valve were compared with findings previously reported in women with TS and the general population. RESULTS: Bicuspid aortic valve without any stenosis or regurgitation was found in one woman in the study group with low-level 45,X/46,XX mosaicism, a statistically significantly lower prevalence of bicuspid aortic valve than that reported in women with TS. Aortic coarctation was not identified in any individual. The ASI was below the 95th percentile in all cases and the mean value was significantly lower than the mean reference values for both the general population and women with TS. CONCLUSION: Compared with the general population, the prevalence of risk factors for aortic dissection was not found to be higher in women with low-level 45,X/46,XX mosaicism without any noticeable features except infertility.

Coastal sediments in the Gulf of Bothnia as a source of dissolved PCDD/Fs and PCBs to water and fish.

High levels of PCDD/Fs and PCBs in Baltic Sea biota have been a matter of great concern during the last decades. We measured the freely dissolved concentrations of PCDD/Fs and PCBs in sediment pore water and bottom water in eight areas along the Swedish coast of the Gulf of Bothnia, by using state-of-the-art passive samplers. Chemical activity ratios (calculated from freely dissolved concentrations in pore water and bottom water based on chemical activity ratios) for PCDD/Fs were higher than 1 at all stations (PCDD/Fs average 27; stdev 22). High activity ratios suggest that the sediments have a potential to act as a source of dissolved PCDD/Fs to the water column. Activity ratios for PCBs varied between 0.3 and 17 (average 2; stdev 4). The concentrations of PCDD/Fs and PCBs in bottom water were significantly correlated with concentrations in sediment pore water (p<0.00001 to p=0.03) as well as with concentrations in juvenile perch caught in the same areas (p<0.00001 to p=0.02). To our knowledge, this is the first study demonstrating a correlation between in-situ measured freely dissolved PCDD/F concentrations and lipid-normalized contents in stationary fish. Our results confirm that freely dissolved concentrations should be used as chemical predictors of bioaccumulation. The results from this study imply that continued efforts to reduce levels of PCDD/Fs and PCBs in coastal sediments will have positive effects on concentrations of these contaminants in lower trophic levels of Baltic Sea ecosystems.

In the shadow of the Cosmetic Directive--inconsistencies in EU environmental hazard classification requirements for UV-filters.

UV-filters are chemicals with potentially environmental hazardous properties. In the European Union (EU), UV-filters contained in sunscreen products are currently regulated by the Cosmetic Directive (from July 2013 by the Cosmetic Products Regulation). Environmental hazard classifications according to the regulation on classification, labelling and packaging of substances and mixtures (CLP) must be determined for UV-filters contained in industrial chemical products, whereas UV-filters contained in sunscreens are exempted from CLP. In this study we determined the potential environmental hazard classifications of UV-filters and sunscreen products if the CLP regulation was to be required for cosmetic products. Two sunscreen products were evaluated in accordance with the aquatic environmental hazard criteria for mixtures. The results highlight that the inconsistencies in the current EU regulation of UV filters hamper the risk management of environmental hazards of UV filters used in cosmetic products. Almost 50% of the investigated UV-filters approved for use in cosmetic products on the European market according to the current Cosmetic Directive were identified to meet the CLP classification as being hazardous to the aquatic environment. Assuming a worst-case scenario, the two examined sunscreens could both be classified as hazardous to the aquatic environment with long-lasting effects according to CLP classification criteria. Hence, if the CLP regulation was applicable to sunscreen products, both brands could potentially be labelled with the environmental hazard pictogram and associated hazard and precautionary statements. Including cosmetic products, and thereby sunscreens, in the CLP regulation would contribute to a more harmonized and transparent regulation of potentially hazardous substances on the EU market.

[Prevalence of Chlamydia trachomatis infection in patients treated for infertility]. / Výskyt Chlamydia trachomatis pri lécbe neplodnosti.

AIM OF THE STUDY: To determine the prevalence of Chlamydia trachomatis infection in patients treated for infertility. STUDY TYPE: A retrospective analysis. SETTING: Fertimed, infertility treatment center, Olomouc. METHOD: At Fertimed, we used DNA detection of Chlamydia trachomatis by the PCR method of the company GeneProof to examine, between 2009-2011, 785 women undergoing one of the infertility treatment methods and their 113 partners. In the second group, we examined 121 oocyte donors and 30 men before sperm donation. We appraised the frequency of Chlamydia trachomatis detection in the specific groups and the clinical impact of the infection on the female reproductive organs. RESULTS: In the group of women treated for infertility, we detected 20 (2.5%) women with an active infection. After treatment, 9 of them underwent an examination of Fallopian tube patency using the UTHL (ultrasonographically guided transvaginal hydrolaparoscopy) method. In 7 cases, we indicated a bilateral salpingectomy due to a sactosalpinx and in one case severe pelvic adhesions were found (88.9%), and in one patient, the result was normal. In the control group of 43 PCR-negative women who were examined for Fallopian tube patency, 9.3% rate of tubal pathology was found (p<0.001). In the oocyte donor group, we detected the presence of Chlamydia trachomatis in 12 (9.9%) women, and in the sperm donor group, in 7.6% men. Treatment with 500 mg of Sumamed (azithromycin), given in 3 doses, was successful in all of the positive patients. CONCLUSION: We found that Chlamydia trachomatis detection was lower in the women treated for infertility than in the female donor group. Women with a confirmed infection had a high prevalence of inflammatory changes in the Fallopian tubes compared with women devoid of a confirmed infection. The treatment with azithromycin is effective.

Is there a declining trend in ovarian function among infertility clinic patients?

BACKGROUND: There is a growing body of evidence that testicular function has decreased rapidly over the last 50 years. However, much less is known about corresponding trends in ovarian function. Herein, we examine the temporal changes in ovarian function in a large sample of infertile patients from the Czech Republic over a period of 14 years. METHODS: In a retrospective study, we analysed a large body of data from women, 20-40 years of age, undergoing IVF/ICSI treatment between 1995 and 2008. We defined ovarian function using five variables: basal FSH level, estradiol (E2) level on the day of HCG administration, dose of gonadotrophins used for ovarian stimulation, number of retrieved oocytes and dose of gonadotrophins per oocyte. Controlling simultaneously for temporal changes in patient age and stimulation protocol, we applied generalized additive models to describe the temporal trends. RESULTS: During the study period the mean age of the study population increased by 2.7 years. Whereas the basal FSH and gonadotrophin dose did not change over time, the E2 level and oocyte retrieval declined, and the dose of FSH per oocyte increased during the study period. CONCLUSIONS: The results are indicative of a small, but detectable decrease in ovarian function over a period of 14 years, which is not causally related to the ageing population.

[The age of women treated for infertility increases]. / Vek zen podstupujících lécbu neplodnosti roste.

OBJECTIVE: The age of women at first child in the Czech Republic increases. We investigated whether this trend translates into the group of patients treated for infertility by IVF. SETTING: Fertimed, infertility centre, Olomouc. METHODS: We summoned data from 4689 women treated for infertility in our centre. We investigated the age of the patient, FSH levels, E2 levels, number of FSH units needed for ovarian stimulation, number of oocytes and embryos. We analysed the results by the method of regression analysis. RESULTS: We found that the mean age increased from 28.7 to 32 years in a period of 10 years. We also demonstrated that the increasing age was accompanied by a decrease in ovarian function. CONCLUSION: Women older than 32 years should be informed about the decreased ability to conceive. The treatment of women for infertility can be complicated by the growing age of patients in coming decades.

The effect of carprofen on selected markers of bone metabolism in dogs with chronic osteoarthritis.

The purpose of this study was to investigate the effect of the nonsteroidal anti-inflammatory drug carprofen on bone turnover and to monitor the progress of chronic osteoarthritic dogs by measuring different bone markers and radiographic evalutation of the corresponding joints. For this purpose 20 dogs of different ages and weight were devided into 2 groups. Ten dogs were assigned to Group R, treated with carprofen, and ten dogs to Group C, which had no treatment. Radiographs of the affected joints were reviewed initially and six months later at the end of the experiment. Blood was taken 8 times from each dog. Four bone markers (Osteocalcin (OC), bone-specific alkaline phosphatase (bAP), carboxyterminal telopeptide of type I collagen (ICTP), serum CrossLaps (CTX) as well as 1,25-(OH)2-Vitamin D and parathyroid hormone (PTH) were monitored for 6 months. No significant group effects on bone markers were notied. In Group R a decrease in ICTP concentrations during the first three months and a significant decrease in CTX concentrations in the first two months of the study were observed. The bone formation marker bAP revealed a significant decrease throughout the experiment. Three dogs of Group C and one dog of Group R showed osteoarthritic progression in the radiographs. The significant decrease of CTX indicates that carprofentreatment could have a retarding effect on the progression of osteoarthritis. Radiological findings suggest that carprofen may delay osteophyte formation. The monitoring of focal metabolic processes as in bone of a osteoarthrotic joint is difficult, since the bone mass is very active and metabolic processes may have an influence on the monitoring.

[Transvaginal hydrolaparoscopy and ultrasonographically guided transvaginal hydrolaparoscopy--two outpatient methods of pelvis examination]. / Transvaginální hydrolaparoskopie a ultrazvukove asistovaná hydrolaparoskopie--dve ambulantní metody vysetrení zenské pánve.

OBJECTIVE: The aim of this study is to describe transvaginal hydrolaparoscopy (THL) and ultrasonographically guided transvaginal hydrolaparoscopy (UTHL) used in the examination of the female pelvis in patients treated for infertility. Emphasis was placed on the safety of both procedures. SETTING: Fertimed, Infertility centre, Olomouc. METHODS: Transvaginal hydrolaparoscopy is an outpatient method for the examination of the female pelvis. Optics are inserted via the posterior vaginal wall and the tuboovarian complex is examined in saline solution. In ultrasonographically guided transvaginal hydrolaparoscopy, ultrasound is used during whole examination. The control of position of ultrasound instruments during the whole procedure increases the safety of the procedure and decreases difficulty of the method. RESULTS: 9 patients were examined with transvaginal hydrolaparoscopy. In 2 patients, (22%), insertion of the needle was complicated by bowel injury. Based on the experience with transvaginal hydrolaparoscopy we developed a modified version: Ultrasonographically guided transavaginal hydrolaparoscopy. With this method we examined 460 patients. Access to the abdominal cavity was successful in 100%. In 1.7%, the examination was not done due to a lack of fluid in Douglas space. Bowel injury was not detected. Visualisation of both adnexa was similar in both methods (94.5%). Small asymptomatic periovarial adhesions were found in 16%. In 5.2%, we found grade I endometriosis. Laparoscopy was recommended in 15.7% due to tubarian obstruction, severe adhesions, or poor adnexal visibility. Surgical intervention was necessary in 86.2% of those patients. CONCLUSIONS: Transvaginal hydrolaparoscopy and ultrasonographically guided transvaginal hydrolaparoscopy are new methods for examination of tuboovarian complex. Ultrasonographically guided transvaginal hydrolaparoscopy ensures safer and easier access to the abdominal cavity with low complication rate.

Observations of the PCB distribution within and in-between ice, snow, ice-rafted debris, ice-interstitial water, and seawater in the Barents Sea marginal ice zone and the North Pole area.

To evaluate the two hypotheses of locally elevated exposure of persistent organic pollutants (POPs) in ice-associated microenvironments and ice as a key carrier for long-range transport of POPs to the Arctic marginal ice zone (MIZ), dissolved and particulate polychlorinated biphenyls (PCBs) were analyzed in ice, snow, ice-interstitial water (IIW), seawater in the melt layer underlying the ice, and in ice-rafted sediment (IRS) from the Barents Sea MIZ to the high Arctic in the summer of 2001. Ultra-clean sampling equipment and protocols were specially developed for this expedition, including construction of a permanent clean room facility and a stainless steel seawater intake system on the I/B ODEN as well as two mobile 370 l ice-melting systems. Similar concentrations were found in several ice-associated compartments. For instance, the concentration of one of the most abundant congeners, PCB 52, was typically on the order of 0.1-0.3 pg l(-1) in the dissolved (melted) phase of the ice, snow, IIW, and underlying seawater while its particulate organic-carbon (POC) normalized concentrations were around 1-3 ng gPOC(-1) in the ice, snow, IIW, and IRS. The solid-water distribution of PCBs in ice was well correlated with and predictable from K(ow) (ice log K(oc)-log K(ow) regressions: p<0.05, r2=0.78-0.98, n=9), indicating near-equilibrium partitioning of PCBs within each local ice system. These results do generally not evidence the existence of physical microenvironments with locally elevated POP exposures. However, there were some indications that the ice-associated system had harbored local environments with higher exposure levels earlier/before the melting/vegetative season, as a few samples had PCB concentrations elevated by factors of 5-10 relative to the typical values, and the elevated levels were predominantly found at the station where melting had putatively progressed the least. The very low PCB concentrations and absence of any significant concentration gradients, both in-between different matrices and over the Eurasian Arctic basin scale, suggest that ice is not an important long-range transport purveyor of POPs to the Arctic MIZ ecosystem.

[Importance of genetic testing in couples with reproductive disorders]. / Význam genetického vysetrení u páru s poruchami reprodukce.

OBJECTIVE: To determine the prevalence of chromosomal aberrations in infertile couples undergoing in vitro fertilization (IVF). DESIGN: Cytogenetic analysis of peripheral blood lymphocytes in the group of patients undergoing IVF. Detection of chromosomal aberrations in the fetuses after IVF. SETTING: Department of Medical Genetics and Fetal Medicine, Medical Faculty, Palacký University and the University Hospital, Olomouc. METHODS: Cultivation of peripheral blood lymphocytes or fibroblasts of amniotic fluid. Using fluorescent in situ hybridization in cases of mosaicism. RESULTS: Out of 638 patients undergoing treatment for male or female infertility, 595 had normal karyotype and 43 (6.8%) had abnormal karyotype. There were detected 9 (1.4%) cases of balanced chromosomal rearrangements, 2 (0.31%) cases of deletion of Y chromosome, 2 (0.31%) cases of inversion, 2 (0.31%) cases of marker chromosome, 5 (0.78%) cases of gonosomal aneuploidy (47,XXY) and 23 (3.65%) cases of gonosomal mosaicism--out of the 22 (3.5%) cases of low-level mosaicism. In the small group of pregnant patients after IVF investigated for the risk of genetic disorders included in our study (n = 60) the frequency of chromosomal abnormalities was 9 (15%). CONCLUSIONS: Our data show that a high number of infertile couples is affected by chromosomal aberrations which occur more frequently in females than in males. It is caused by high frequency of low-level gonosomal mosaicism in the group of infertile women. Chromosomal analyses are highly recommended before each IVF procedure.

[Chromosome Y microdeletions in Czech men with severe reproductive disorders]. / Mikrodelécie chromozómu Y u ceských muzov s t'azkou poruchou reprodukcie.

BACKGROUND: The Y chromosome microdeletions belong to the frequent genetical causes of male infertility. The aim of our study was to introduce reliable molecular genetic diagnosis of Y chromosomal microdeletions and to determine the prevalence of Y chromosomal microdeletions in Czech males with serious reproductive disorders. METHODS AND RESULTS: The Y chromosome microdeletions were screened in 198 Czech men with serious reproductive disorders with decreased sperm count. The Y chromosome microdeletions were disclosed in 8/198 (4.0%) examined males. The AZFc deletion type was revealed in 62.5% (5/8) and the combined AZFc + b microdeletion in 37.5% (3/8) of cases. Neither isolated AZFb nor AZFa microdeletion were found in any subject of the investigated group. CONCLUSIONS: Incidence of individual types of Y chromosomal microdeletions in Czech males with serious reproductive disorders was assessed. The standardised molecular genetic diagnosis of Y chromosomal microdeletions was introduced into the practice.

[Treatment of infertility in nonobstructive azoospermia using the TESE method (testicular sperm extraction)--clinical results]. / Lécba neplodnosti u neobstrukcní azoospermie metodou TESE (Testicular Sperm Extraction)--klinické výsledky.

Sperm was found in 56.6% of TESE cycles in 27 men with non-obstructive azoospermia. Using testicular sperm, 30% oocytes were fertilized. Embryos were transferred in 11 cycles. Twins were delivered in the 34th week of pregnancy. Two further pregnancies are ongoing. The pregnancy rate was 27% per ET. Testicular biopsy in all azoospermic men is recommended in special IVF centers not only for histological examination but also for ICSI procedure with testicular sperm which could be provided at the same time.

[Treatment of male infertility after oncologic therapy: preventive autologous sperm preservation versus testicular biopsy and oocyte fertilization with testicular spermatozoa]. / Lécba neplodnosti muzu po onkologické lécbe: preventivní autokonzervace versus biopsie varlete a oplodnení oocytu testikulárními spermiemi (TESE).

The prognosis of oncological therapy of some malignancies is favourable. Unfortunately the majority of young patients remain sterile. Sperm cryopreserved before treatment was successfully used in IVF-ICSI (in vitro fertilization-intracytoplasmic sperm injection) cycles. Testicular biopsy (TESE) was performed after successful oncological treatment in three men without previous sperm cryopreservation. No spermatozoa were found for oocyte fertilization. TESE could not ensure sperm recovery in all patients after oncological treatment. Sperm cryopreservation should be highly recommended to all patients before any treatment is offered.

[Treatment of infertility in non-obstructive azoospermia using the TESE (testicular sperm extraction) method--clinical study]. / Lécba neplodnosti u neobstrukcní azoospermie metodou TESE--klinická vysetrení.

Testicular sperm extraction (TESE) was performed in 27 men in 30 cycles. All men were examined for genetics, serum hormonal status, biochemical status of semen samples. All men were examined by an urologist. No prognostic evaluation able to provide information about the prognosis of TESE procedure was found. Even a high FSH level, testicular hypotrophy or previous histological examination cannot exclude any patient from testicular biopsy.

Biochemical findings in the ejaculate of men with non-obstructive azoospermia.

In men with non-obstructive azoospermia, testicle biopsy can provide isolated sperm which can be used for fertilization of an oocyte. The male seminal plasma was examined for adequate biochemical parameters and then tested as potential diagnostic parameters for prediction of sperm presence in non-obstructive azoospermia. Sperm was obtained by preparation of the testicular tissue. Biochemical parameters in men with found sperm were compared to findings obtained from men without sperm in the testicular tissue. The following parameters were analysed: fructose, lactate dehydrogenase, total acid phosphatase, Zn, K, Na, Cl, pH. No statistically significant differences were found in both groups under study. Biochemical examination of the ejaculate cannot provide any prediction of sperm retrieval in non-obstructive azoospermia.