ABSTRACT
Deletions of Y chromosome AZF locus were analyzed during a large-scale andrological and genetic examination of 810 infertile men. The search for Yq microdeletions was carried out according to the standard EAA/EMQN guidelines. The breakpoints were mapped for the deletions in AZF locus. The Y chromosome macro- and microdeletions were detected in 61 (7.5%) infertile men. The frequencies of AZF deletions during azoospermia and severe oligozoospermia amounted to 12.2 and 8.1 %, respectively. On the whole, the frequencies of Yq microdeletions and the genophenotypic correlations characteristic of various AZF deletion types comply with the relevant published data. However, spermatozoids in the ejaculate sediment of men with completely deleted AZFa region or AZFb+c deletions (from solitary spermatozoids to several dozens) were detected for the first time. It was demonstrated that the breakpoints were localized between AZFa and AZFb regions proximally to AZFb+c microdeletions for the majority of cytogenetically detectable deletions in the Y chromosome long arm. This indicates that the mechanisms underlying Yq macro- and microdeletions are somewhat different. The issues related to the role of Y chromosome deletions in the origins of monosomy for X chromosome and X/XY mosaicism are discussed.
Subject(s)
Chromosome Deletion , Chromosomes, Human, Y/genetics , Oligospermia/genetics , Humans , Infertility, Male/genetics , Male , Physical Chromosome MappingABSTRACT
Since 1996 the authors have examined and treated 42 infertile married couples (the husbands had azoospermia). To obtain spermatozoa directly from the testes or epididymis and subsequent ICSI, 42 patients underwent 53 interventions: TESE (n = 38), PESA (n = 10), MESA (n = 5). Spermatozoa were obtained from 32(76.1%) of 42 patients, fertilization occurred in 21(50%) cases, 10(23.8%) wives got pregnant. Assisted reproductive technologies expand potentialities of correcting severe forms of male infertility including azoospermia. The armory of the operative procedures in male infertility was replenished with MESA, TESE, PESA.
Subject(s)
Infertility, Male/therapy , Reproductive Techniques, Assisted , Adult , Female , Fertilization in Vitro , Humans , Insemination, Artificial , Male , Oligospermia/therapy , Pregnancy , Sperm Injections, IntracytoplasmicABSTRACT
Three patients with idiopathic sterility were treated by transferring the gametes into uterine tubes. Clomiphene+ citrate stimulation of superovulation was employed. Preovulatory oocytes were obtained via the laparoscopic approach. Two oocytes with capacitated spermatozoa were placed into the tube of patient 1, four cells into one tube of the second patient, and two cells into each tube of the third patient. Pregnancy started in two cases, uterine in one, eventuating in 12-13 weeks in spontaneous abortion, and tubal in the other, eventuating in tubectomy. These data evidence the possibility of transferring gametes into uterine tubes to sterile patients, in whom sterility is not caused bu tubal diseases.
Subject(s)
Gamete Intrafallopian Transfer/methods , Infertility, Female/surgery , Pregnancy/physiology , Adult , Female , HumansABSTRACT
To decrease the cost of determining estrogens by the High Estrotex (Mochida Pharmaceutica, Japan) method, the authors have modified it, thus reducing the usage of expensive reagents four times. The modified method was applied to evaluate estrogens in 27 infertile patients when stimulating superovulation. The findings were in agreement with the results obtained by foreign special clinics engaged in treating infertility with extracorporeal fertilization followed by embryonal transfer. The pregnancy rate in the females was 15% on an embryonal transfer basis. The modified High-Estrotex method is easy-to-use, rapid, and cost-effective in the measurement of daily urinary estrogen levels. It may be employed both in extracorporeal fertilization and embryonal transfer and in cases which require daily multiple and reliable evaluation of an ovarian response to ovulation inducers.
Subject(s)
Estradiol Congeners/pharmacology , Infertility, Female/prevention & control , Ovary/drug effects , Ovulation Induction/methods , Adult , Estradiol Congeners/administration & dosage , Female , Humans , Infertility, Female/physiopathology , Ovary/physiologyABSTRACT
Laparoscopy was employed to treat extrauterine pregnancy in 16 patients aged 19 to 38 years. An operation was the continuum of diagnostic laparoscopy in 3 patients, but it was emergency in 13 after the diagnosis was established by other methods. Tubectomy was performed in 15 patients, conservative removal of the fetal ovum from the tubal lumen was made in 1 patient. No complications were observed. The operation duration was 12 to 20 minutes. The postoperative period ran significantly easier than that after tubectomies conducted by laparotomy.
Subject(s)
Fallopian Tubes/surgery , Pregnancy, Tubal/surgery , Adult , Female , Humans , Intraoperative Care , Laparoscopy , Ligation/methods , Pregnancy , Pregnancy, Tubal/diagnosis , Preoperative CareABSTRACT
Outpatient in vitro insemination has been performed in 609 infertile couples in 1145 menstrual cycles. Age of the women ranged from 19 to 44 years and their history of infertility, from 2 to 17 years. Tubal infertility was present in 439 patients and one or both tubes were patent in 170 patients. Superovulation was induced with anti-estrogens and gonadotropins (Humegon and Neopergonal). Preovulatory oocytes were retrieved using transvaginal follicular puncture guided by transvaginal ovarian ultrasonography. A total of 942 punctures yielded 2177 oocytes (2.3 per puncture). The incidence of conception was 63.3% of the entire population and 75.2% of the mature oocyte population. Division was documented in 1176 zygotes (85.2%). Embryo transfers were undertaken in 498 cycles (2.4 embryos per transfer). There were 80 conceptions (16.1% of transfers); 19 (23.7%) of them were "biochemical" and 10 (12.5%) ended in spontaneous abortion; pregnancy was ectopic in 5 (6.3%) patients. As of March 1, 1990, 46 (57.5%) women gave birth to 51 normal infants (5 twins). The therapeutic results are consistent with experience of world clinics.
Subject(s)
Embryo Transfer/methods , Fertilization in Vitro/methods , Infertility, Female/therapy , Insemination, Artificial, Homologous/methods , Oocytes/transplantation , Adult , Female , Humans , Male , Oocytes/growth & developmentABSTRACT
During October 1987 to June 1989, 609 infertile couples have been treated using in vitro fertilization and embryo transfer (IVF-ET). Of 78 conceptions (15.7% of transferred embryos), 6 (7.7%) pregnancies were ectopic (5 tubal and 1 ovarian). After diagnosis of ectopic pregnancy all the patients were operated; the ovary was resected in 1 patients and tubectomies were done in 5 patients (laparoscopically in 1). All the diagnoses were confirmed histologically. Since prevention of ectopic pregnancy in IVF-ET is not reliable, the patients enrolled for IVF-ET should be considered to be at risk and closely followed up.
Subject(s)
Embryo Transfer/adverse effects , Fertilization in Vitro , Infertility, Female/therapy , Pregnancy, Ectopic/etiology , Adult , Female , Humans , Ovary , Pregnancy , Pregnancy, Ectopic/diagnosis , Pregnancy, Tubal/diagnosis , Pregnancy, Tubal/etiologyABSTRACT
Menstrual cycles of 274 women have been analyzed in order to decide on possibility of follow-up of follicular growth and development using echography and retrieval of preovulatory oocytes using sonographically guided transvaginal access during in vitro fertilization and embryo transfer (IVF-ET). Transvaginal echography proved to be a very efficient tool in monitoring follicle growth during an IVF-ET program and outpatient oocyte retrieval with a minimal injury.