Pituitary adenoma and apoplexy during GnRH agonist treatment for IVF - case report.

In vitro fertilization is commonly used for treating infertility. One stage of this process is controlled hyperstimulation of the ovaries, achieved by administering gonadotropins. There are several stimulation protocols utilized that increase the number of ovarian follicles during IVF. The most common protocol employs desensitization - the inhibition of follicle-stimulating hormone and luteinizing hormone secretion by the pituitary gland. This is achieved by administering a gonadotropin-releasing hormone (GnRH) analog that is agonistic for the GnRH receptor. However the use of a this drug during therapy carries a risk of complications. This case report deals with a rare case of a woman who underwent pituitary tumor growth as a result of the treatment of GnRH analog.

[Prognosis of the IVF ICSI/ET procedure efficiency with the use of artificial neural networks among patients of the Department of Reproduction and Gynecological Endocrinology]. / Prognozowanie skutecznosci procedury IVF ICSI/ET--wsród pacjentek Kliniki Rozrodczosci i endokrynologii ginekologicznej--z wykorzystaniem sieci neuronowych.

OBJECTIVES: Prognosis of pregnancy for patients treated with IVF ICSI/ET methods, using artificial neural networks. MATERIAL AND METHODS: Retrospective study of 1007 cycles of infertility treatment of 899 patients of Department of Reproduction and Gynecological Endocrinology in Bialystok. The subjects were treated with IVF ICSI/ET method from August 2005 to September 2008. RESULTS: Classifying artificial neural network is described in the paper Architecture of the network is three-layered perceptron consisting of 45 neurons in the input layer 14 neurons in the hidden layer and a single output neuron. The source data for the network are 36 variables. 24 of them are nominal variables and the rest are quantitative variables. Among non-pregnancy cases only 59 prognosis of the network were incorrect. The results of treatment were correctly forecast in 68.5% of cases. The pregnancy was accurately confirmed in 49.1% of cases and lack of pregnancy in 86.5% of cases. CONCLUSIONS: Treatment of infertility with the use of in vitro fertilization methods continues to have too low efficiency per one treatment cycle. To improve this indicator it is necessary to find dependencies, which describe the model of IVF treatment. The application of advanced methods of bioinformatics allows to predict the result of the treatment more effectively With the help of artificial neural networks, we are able to forecast the failure of the treatment using IFV ICSI/ET procedure with almost 90% probability of certainty These possibilities can be used to predict negative cases.

[Contemporary methods of treating age-related infertility]. / Wspólczesne metody leczenia nieplodnosci zwiazanej z wiekiem.

Age-related infertility that is caused by diminished reproductive potential is both medical and social problem of a great concern. Changes in modern ways of life make women postpone the decision of starting up a family, what may reduce their chances of having a healthy baby. It is also a problem of subfertile couples who after many years of insufficient treating approach the period where the age imposes on primary causes of infertility, what even more reduces the chance of pregnancy. The main reason of this is increased number of chromosomal abnormalities resulting in lower quality of oocytes. There is a lot of research being held on the reconstruction of gametes by transferring the nucleus or cytoplasm among the oocytes derived from young and older patients. However, it has not brought the expected results so far. The method of preimplantation genetic diagnosis--aneuploidy screening (PGD-AS) in patients older than 35 gives some hope for improving the efficiency of infertility treatment. Nevertheless, oocyte donation still remains the most effective and applied method of assisted reproduction in the group of older patients.

Cystic fibrosis as a cause of infertility.

Cystic fibrosis (CF) is one of the autosomal recessive diseases, caused by mutations in a gene known as cystic fibrosis transmembrane regulator (CFTR). The majority of adult males with CF (99%) is characterized by congenital bilateral absence of vas deferens (CBAVD). CBAVD is encountered in 1-2% of infertile males without CF. Females with CF are found to be less fertile than normal healthy women. In females with CF, delayed puberty and amenorrhoea are common due to malnutrition. CFTR mutations are also associated with congenital absence of the uterus and vagina (CAUV). The National Institutes of Health recommend genetic counseling for any couple seeking assisted reproductive techniques with a CF male or obstructive azoospermia which is positive for a CF mutation.

[Two treatment methods of infertility associated with polycystic ovarian syndrome]. / Porównanie skutecznosci dwóch metod leczenia nieplodnosci zwiazanej z zespolem policystycznych jajników.

OBJECTIVES: 30 patients treated for infertility associated with PCO were analyzed. Anovulatory cycles and US scans of ovaries were taken as criteria for PCO. MATERIALS AND METHODS: Patients were treated either by the laparoscopic electrocauterization (n = 16) of ovaries or by the ultrasonographic punction of follicles (n = 14). Number of ovulatory cycles, cumulative pregnancy rate and hormonal changes were analyzed. RESULTS: We observed the same efficacy of both methods in terms of ovulatory cycles and pregnancy rates. The cumulative pregnancy rate was 37.5% in laparoscopic and 35.7% in ultrasonographic groups during the 3 months' observation. CONCLUSIONS: Ultrasonographic punction has appeared to be easier to do and safer for the patient and have the same pregnancy rate. It also gives opportunity for in vitro culture and maturation of obtained oocytes.