RESUMO
In women with endometriosis, including those with endometriomas, 6 to 8 weeks of continuous use of oral contraception (OC) before assisted reproduction treatment (ART) maintains ART outcomes comparable with the outcomes of age-matched controls without endometriosis. In contrast, ART outcomes are markedly compromised in endometriosis patients who are not pretreated with OC. Ovarian responsiveness to stimulation was not altered by 6 to 8 weeks' use of pre-ART OC, including in poor responders with endometriomas.
Assuntos
Anticoncepcionais Orais/administração & dosagem , Endometriose/terapia , Técnicas de Reprodução Assistida , Doenças Uterinas/terapia , Adulto , Terapia Combinada , Esquema de Medicação , Endometriose/complicações , Feminino , Hormônio Liberador de Gonadotropina/agonistas , Humanos , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/etiologia , Infertilidade Feminina/terapia , Indução da Ovulação/métodos , Gravidez , Prognóstico , Resultado do Tratamento , Pamoato de Triptorrelina/administração & dosagem , Doenças Uterinas/complicaçõesRESUMO
OBJECTIVE: To examine sperm meiotic segregation in men with paracentric inversions. DESIGN: Cases reports, literature review. SETTING: Departments of reproductive biology, cytogenetics, gynaecology, and obstetrics. PATIENT(S): Two patients referred for infertility, heterozygous for a paracentric inversion. INTERVENTION(S): Fluorescence in situ hybridization (FISH) with specific probes and X/Y/18 centromeric probes on 1,000 spermatozoa for the 2 patients and 10 controls. MAIN OUTCOME MEASURE(S): Sperm aneuploidy frequency. RESULT(S): The FISH analysis using the specific probes for the paracentric inversion indicated low disequilibrium (0.4% and 0.5%). The FISH analysis using X/Y/18 centromeric probes indicated aneuploidy frequencies (0.3% and 1.1%), identical to those of control patients with the same sperm parameters. CONCLUSION(S): Paracentric inversion seems to be associated with a very low risk of aneuploidy. A larger study is necessary to explore all chromosome inversions.
Assuntos
Inversão Cromossômica/genética , Cromossomos Humanos X/genética , Cromossomos Humanos Y/genética , Infertilidade Masculina/genética , Aberrações dos Cromossomos Sexuais , Espermatozoides/anormalidades , Espermatozoides/ultraestrutura , Adulto , Predisposição Genética para Doença/genética , Humanos , MasculinoRESUMO
BACKGROUND: Using fluorescence imaging, an a posteriori multiparametric analysis was performed of human oocytes which failed to give pronucleated zygotes after IVF in cases of very low rates of fertilization or complete fertilization failure. METHODS: The analysis included: (i) the state of the maternal and paternal chromatin; (ii) quality of the metaphase II oocytes; and (iii) cortical granule (CG) distribution. RESULTS: Most oocytes were arrested in metaphase II, but they were abnormal in 50% of cases. The incidence of spindle and chromosome aberrations was strongly influenced by maternal age (69% for 40- to 45-year-old women versus 35% for 26- to 33-year-olds), and sperm chromatin was always condensed in immature oocytes, and fully decondensed only in normal metaphase II. The migration of CGs appeared to be associated with achievement of nuclear maturation at the time of puncture. CONCLUSIONS: These factors, when analysed on a complete set of oocytes from the same patient, provided information about potential causes of IVF failure, and also represented part of an 'oocyte quality evaluation' to select the assisted fertilization technique most suitable for each patient. For example, when the majority of oocytes were judged non-fertilizable at a first attempt, no pregnancy was registered at any subsequent attempt.
Assuntos
Aberrações Cromossômicas , Fertilização in vitro , Infertilidade Feminina/patologia , Oócitos/patologia , Distribuição por Idade , Cromatina/patologia , Feminino , Humanos , Incidência , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/genética , Masculino , Metáfase , Microtúbulos , Gravidez , Interações Espermatozoide-Óvulo , Espermatozoides , Falha de TratamentoRESUMO
In vitro maturation of human oocytes at the germinal vesicle (GV) stage could offer an alternative in several cases of female infertility. It however rests on a better knowledge of the quality of human oocyte. Using fluorescence imaging of DNA and of the transcription sites, combined with electron microscopy, we show that human oocytes follow size-dependent changes in chromatin configuration, transcription sites distribution and nuclear ultrastructure that follow those observed in mouse GV oocytes. We thus analyzed in mouse GV oocytes the phosphorylation dependence of the transcriptional activity. We show by Western blot that, while active GV oocytes have approximately the same proportion of hypo- and hyperphosphorylated forms of the RNA polymerase II (RNAP II), the hyperphosphorylated form is almost absent from inactive oocytes. We also show that (1) RNAP II-dependent transcription is much less sensitive to various kinase inhibitors in mouse oocytes than in somatic cells or mouse one-cell embryos, although the phosphorylation equilibrium of RNAP II was largely shifted towards the hypo-phosphorylated form upon treatment with these inhibitors (2) RNAP I is completely insensitive to kinase inhibitors in GV oocytes.
