Ovarian Stem Cells for Women's Infertility: State of the Art.

Today, women's infertility is considered a social disease in females, occurring not only as an effect of POF (premature ovarian failure) but also as CTRI (cancer treatment-related infertility) in oncologic patients. Several procedures for FP (fertility preservation) are currently adopted to prevent this condition, mostly based on utilization of retrieved eggs from the patients with subsequent IVF (in vitro fertilization) or cryopreservation. However, great interest has recently been devoted to OSCs (ovarian stem cells), whose isolation from female ovaries, followed by their in vitro culture, led to their maturation to OLCs (oocyte-like cells), namely, neo-oocytes comparable to viable eggs suitable for IVF. Translation of these data to FP clinical application creates new hope in the treatment of infertility. Thus, in line with the significant progress in using stem cells in the regenerative medicine field, neo-oogenesis via OSCs, which is currently unapplicable in fertility preservation procedures, will provide novel possibilities for young and adult females in motherhood programs in the future.

[Perinatal results of intrauterine open fetal surgery of fetuses diagnosed with myelomeningocoele--the clinical report of ten cases]. / Wyniki perinatalne wewnatrzmacicznej operacji zamkniecia przepukliny oponowo-rdzeniowej plodu. Raport kliniczny 10 przypadków.

The purpose of the study was to demonstrate our approach to qualification for open fetal surgery (OFS) and surgery techniques. We also tried to determinate the outcome of fetal surgical treatment. OFS was performed in 10 out of 15 cases with prenataly diagnosed myelomeningocele. Patients were qualified for the surgery on the basis of precisely determined inclusion criteria and after assessment by multidisciplinary team of specialists. Surgery was performed between 22nd and 29th week of pregnancy. Fist and second surgery were performed in 29th and 27th week of pregnancy, some patients have undergone the surgery before 26th week of pregnancy. Babies were delivered by cesarean section. Gestational age by the time of the delivery ranged from 25th and 37th and a half week of pregnancy. In two cases the delivery was at term. Main complications included: PROM, placental ablation and vaginal bleeding. In half of all the cases we did not observe hydrocephalus increase after the surgery. OFS can be beneficial but it can also carry certain amount of risk both for the fetus and the mother. Therefore, further randomized research deems necessary to better comprehend and determine the safety and effectiveness of such procedures.

Ultrasonographic assessment of fetal nuchal translucency (NT) at 11th and 14th week of gestation--Polish multicentre study.

UNLABELLED: THE AIMS OF THE STUDY WERE: To evaluate range and median values of NT in a large, unselected Polish population; to determine the value of the 95th percentile and the median values for NT for given weeks of late 1st trimester pregnancy and to determine the level of chromosomal aberration risk corresponding to the values of the 95th percentile in the examined groups; to examine the possible correlation between CRL, NT width as well as the mother's age with the risk of the most frequent chromosomal aberrations. MATERIAL & METHODS: We have retrospective analyzed 7,866 pregnant women. All fetuses of this women had NT measurement performed, as well as CRL and assessed of the most frequent chromosomal abnormalities. The group of pregnant women was divided into 2 subgroups: until and above 35 years old. All population group was divided into 3 subgroups depending on gestational age (11, 12 and above 13th weeks of gestation). RESULTS: The median of NT in all population group was 1.5 mm and 95th percentile was 2.4 mm, whilst in group with low risk median of NT and 95th percentile were the same and in group with high risk of chromosomal abnormalities respectively 1.5 mm and 2.5 mm. There were strong correlations between maternal age and the risk of most frequent chromosomal abnormalities from NT. CONCLUSIONS: The obtained results of median values and the 95th percentiles of NT in the examined group and the age groups under 35 and 35 plus are similar to these quoted by FMF. The risk levels of trisomy of 21st chromosome were similar to the reference values used by FMF. With gestational age, NT value increases in a non-linear way, therefore it is incorrect to use the term "a normal value" for NT, therefore, only the risk level calculated with the dedicated software using NT and CRL measurements with maternal age should be stated.

[Correlation between amniotic fluid index (AFI) and glucose concentration in amniotic fluid, glycaemia, glycosylated haemoglobin concentration during normal pregnancy and pregnancy complicated by insulin-dependent diabetes mellitus]. / Korelacja pomiedzy wartoscia indeksu plynu owodniowego (AFI) a stezeniem glukozy w plynie owodniowym, glikemia, stezeniem hemoglobiny glikowanej podczas ciazy prawidlowej oraz powiklanej cukrzyca insulinozalezna.

INTRODUCTION: In spite of confirming an association between type I diabetes of pregnancy with hydramnios, in the most recent studies there is still no clarity about which of the maternal or foetal metabolic parameters linked with amniotic fluid volume play the most important role. AIM: To determine which of the maternal or foetal metabolic parameters has the closest association with amniotic fluid volume. MATERIAL AND METHODS: The research was performed in two groups: normal healthy pregnant women (n=43) and group of pregnant women with insulin-dependent diabetes mellitus (n=17) and their newborns. We measured: amniotic fluid index, glucose level in serum and in amniotic fluid, in newborn serum, HbA1c level in serum of women and newborns. RESULTS: We found statistically significant higher values of amniotic fluid index 16.3 +/- 5.2 cm (p<0.01), glucose level in amniotic fluid 2.7 +/- 0.3 mmol/l (p<0.01), serum glucose level before delivery 8.4 +/- 1.6 mmol/l (p<0.001), glycosylated haemoglobin in serum levels 7.9 +/- 0.4% (p<0.05), levels of glucose and glycosylated haemoglobin in serum newborns 3.4 +/- 0.3 mmol/l (p<0.05), 7.7 +/- 0.4% (p<0.001) in patients with insulin-dependent diabetes mellitus as compared with these values in the group of healthy parturient women and their newborn infants. Performed correlation study shows statistical correlation between amniotic fluid index and glycosylated hemoglobin serum levels in the group of women with insulin-dependent diabetes mellitus (p<0.05), t=0.56. CONCLUSION: We conclude that long hyperglycemia or increased HbA1c level have an important role in amniotic fluid index increase in patients with insulin-dependent diabetes mellitus.

[Comparison of the efficacy of ICSI using either spermatozoa aspired microsurgically from the epididymis (MESA-ICSI) or obtained from the ejaculation]. / Porównanie skutecznosci ICSI z uzyciem plemników pobranych na drodze mikrochirurgicznej aspiracji z najadrza (MESA-ICSI) oraz ICSI przy uzyciu plemników uzyskanych z ejakulatu.

OBJECTIVE: Microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection (MESA-ICSI) is a viable alternative to the treatment of couple sterility caused by obstructive azoospermia. Because there are structural differences between epididymal and ejaculated spermatozoa and it is not univocally stated, if this fact influences positively or negatively the results of ICSI, it was decided to compare the efficacies of ICSI using both the kinds of spermatozoa at the same setting. DESIGN: Retrospective comparative analysis. MATERIALS AND METHODS: The MESA group consisted of 27 couples and the control ICSI group of 154 couples--both matched in age, duration of sterility, health status, stimulation protocols and luteal supplementation. The trial was performed at the same period in one center, keeping the same laboratory and personal conditions in both the groups. RESULTS: In the MESA group the fertilization rate was 53.9%, the cleavage rate 87.6% and pregnancy rates 37.0% per microinjection and 43.5% per embryotransfer. In the control group the corresponding values were 50.1%, 90.0%, 28.0% and 31.7%. The differences between the groups were insignificant. CONCLUSIONS: It may be concluded, that the structural differences between epididymal and ejaculated spermatozoa do not significantly influence the efficacy of ICSI, however further investigations are still needed.

[Results of amnioinfusion in pregnancies with oligohydramnios and non-ruptured fetal membranes]. / Wyniki leczenia malowodzia technika amnioinfuzji u ciezarnych z zachowanym pecherzem plodowym.

Authors analysed results of amnioinfusion in the group of 65 pregnant women with oligohydramnios and non-ruptured fetal membranes. Amnioinfusions were the most efficient in the pregnancies with oligohydramnios and asymmetric hypotrophy, idiopathic oligohydramnios or oligohydramnios with pathological FCG. The group with oligohydramnios and fetal malformations showed the worst results of the treatment. The findings confirm mainly the diagnostic character of the method before the end of 25 week of pregnancy because during period the oligohydramnios usually occurs together with lethal fetus malformations. The amnioinfusion in the cases of fetal hypotrophy and pregnancy-induced hypertension seems to be the prophylactic procedure.