Associations of fertility parameters with fatty acids and DNA methylation in Mexican women undergoing in vitro fertilization.

BACKGROUND: Fatty acids (FA) likely affect human fertility at multiple levels, as deviations from physiological FA profiles are obesogenic, and FA can modify DNA methylation (DNAm). Yet, the interplay of follicular fluid (FF) and serum FA with BMI and percentage body fat (PBF) in human fertility is not completely understood. Also, associations of DNAm with fertility are largely unexplored. METHODS: Reproductive parameters ranging from retrieved oocyte number to infant birth weight, were recorded in Mexican women undergoing in vitro fertilization (n = 88). Multiple regression analysis sought BMI-adjusted and age-adjusted associations. Receiver operating characteristic analysis tested for discrimination between outcomes. RESULTS: Associations of FF and serum FA were markedly distinct. While various FF FA (C16:1, C18:0, C20:2, C20:3, arachidonic acid) were significantly and inversely associated only with retrieved oocyte number, selected serum FA were associated with a broad range of pre-fertilization and post-fertilization parameters. Associations of BMI and FF FA were complex, as arachidonic acid was inversely associated with both BMI and retrieved oocyte number, while oleic acid (OA) was directly associated with BMI and PBF. Ultrasound-assessed clinical pregnancy outcome (CP) was directly associated with serum OA but inversely with its trans isomer elaidic acid (EA) and with BMI. Compounded BMI, serum EA and OA discriminated CP well (AUC = 0.74). Whole blood DNA methylation was significantly associated with and a moderate predictor (AUC = 0.66) of percent fertilized oocytes. CONCLUSIONS: Overall FF FA pool composition rather than FA identity may impact oocyte production and cellular memory of FF FA is lost as the oocyte exits the follicular environment. The contrasting associations of BMI, FF OA and arachidonic acid suggest that the control of oocyte homeostasis by FF FA is uncoupled from BMI. Further studies are warranted to assess the potential of compounding BMI with serum EA and OA to predict CP.

Repetición de la biopsia ante una falla en la amplificación / Repeat biopsy in case of amplification failure

Resumen OBJETIVO: Analizar los posibles factores asociados con las fallas en la amplificación, los desenlaces de la euploidia y clínicos entre los embriones con repetición de la biopsia y los de una sola (grupo control). MATERIALES Y MÉTODOS: Estudio retrospectivo y multicéntrico de análisis de biopsias de blastocistos practicadas en 22 centros de reproducción asistida (noviembre 2017 a febrero 2022). Se analizaron 4,106 blastocistos procedentes de 1,007 ciclos de ICSI con prueba genética para aneuplidias previa a la implantación. En los blastocistos reportados con falla en la amplificación se analizó el Centro donde se practicó la biopsia, el día en que ésta se tomó, la calidad embrionaria y la incidencia de complicaciones durante el procedimiento. Los resultados se compararon con la prueba genética para aneuploidias previa a la implantación y los desenlaces clínicos entre los embriones con repetición de la biopsia y el grupo control. RESULTADOS: En el 96.0% (3,942) de los embriones se obtuvo resultado y en el 4.0% (n = 164) se reportó falla en la amplificación. La biopsia se repitió en las 99 fallas en la amplificación y se obtuvo resultado en el 83.8% de los casos. Las tasas de euploidia fueron similares entre embriones con repetición de la biopsia y los controles (34.9 en comparación con 39.7%; p > 0.05). El Centro fue el único factor que mostró diferencias en las tasas de falla en la amplificación (p < 0.05). No se observaron diferencias en el día de la biopsia o la calidad embrionaria. Las tasas de embarazo (51.0 en comparación con 58.3%), implantación (63.9 en comparación con 61.5%) y aborto (16.9 en comparación con 28.6%) fueron similares entre embriones con una sola biopsia o repetición de ésta, respectivamente. CONCLUSIONES: El Centro fue el principal factor que influyó en las fallas en la amplificación. Las tasas de euploidia y los desenlaces clínicos no difirieron entre el grupo control y los embriones con repetición de la biopsia; por consiguiente, se recomienda repetir la biopsia en los embriones con falla en la amplificación.

Abstract OBJECTIVE: To analyze possible factors associated with amplification failures, euploidy and clinical outcomes between repeat and single biopsy embryos (control group). MATERIALS AND METHODS: Retrospective multicenter study involving 4,106 blastocysts from 1,007 ICSI cycles with preimplantation genetic testing for aneuploidy performed by next generation sequencing. In case of DNA amplification failure, the IVF center where biopsies were performed, the day of biopsy, the embryo quality and the incidence of complications during biopsy were analyzed. Preimplantation genetic testing for aneuploidy results and clinical outcomes were compared between re-biopsied embryos and the control group. RESULTS: Of the 4,106 blastocysts included in this study, 96.0% (3,942) obtained a result while 4.0% (164) had an amplification failure. Ninety-nine embryos with amplification failure were re-biopsied and 83.8% resulted in an informative diagnosis. Euploidy rates were equivalent between re-biopsied and control blastocysts (34.9% vs 39.7%, P>0.05). The only factor significantly affecting the amplification failure rates was the IVF center. No differences were observed between biopsy days or embryo quality. Pregnancy (51.0% vs 58.3%), implantation (63.9% vs 61.5%) and miscarriage rates (16.9% vs 28.6%) were similar between single and repeat biopsied embryos, respectively. CONCLUSIONS: The centre was the main factor influencing amplification failures. Euploidy rates and clinical outcomes did not differ between the control group and repeat biopsied embryos; therefore, repeat biopsy is recommended for embryos with amplification failure.

An Extremely Low-Frequency Vortex Magnetic Field Modifies Protein Expression, Rearranges the Cytoskeleton, and Induces Apoptosis of a Human Neuroblastoma Cell Line.

Homogeneous extremely low-frequency electromagnetic fields (ELF-EMFs) alter biological phenomena, including the cell phenotype and proliferation rate. Heterogenous vortex magnetic fields (VMFs), a new approach of exposure to magnetic fields, induce systematic movements on charged biomolecules from target cells; however, the effect of VMFs on living systems remains uncertain. Here, we designed, constructed, and characterized an ELF-VMF-modified Rodin's coil to expose SH-SY5Y cells. Samples were analyzed by performing 2D-differential-gel electrophoresis, identified by MALDI-TOF/TOF, validated by western blotting, and characterized by confocal microscopy. A total of 106 protein spots were differentially expressed; 40 spots were downregulated and 66 were upregulated in the exposed cell proteome, compared to the control cell proteome. The identified spots are associated with cytoskeleton and cell viability proteins, and according to the protein-protein interaction network, a significant interaction among them was found. Our data revealed a decrease in cell survival associated with apoptotic cells without effects on the cell cycle, as well as evident changes in the cytoskeleton. We demonstrated that ELF-VMFs, at a specific frequency and exposure time, alter the cell proteome and structurally affect the target cells. This is the first report showing that VMF application might be a versatile system for testing different hypotheses in living systems, using appropriate exposure parameters.© 2022 Bioelectromagnetics Society.

Pasado presente y futuro de la estimulación ovárica en el tratamiento de la infertilidad / Past, present and future of ovarian stimulation in infertility treatment

La mejor comprensión de la fisiología reproductiva y la disponibilidad de más y mejores recursos diagnóstico/terapéuticos permiten individualizar la estimulación ovárica y hacerla más efectiva (mejores resultados), eficiente (en menos tiempo y con dosis más bajas), segura (con menos y más leves complicaciones), cómoda (menos molestias y autonomía) y accesible (para más personas, a menores costos). Con tecnología de ADN recombinante se dispone ahora de todas las gonadotrofinas e incluso algunas con formas moleculares modificadas para aumentar la duración de acción y disminuir el número de inyecciones. El esquema más utilizado es el de FSH recombinante junto con antagonistas de GnRH. Hay indicaciones específicas para agregar LH o coadyuvantes como hGH o andrógenos transdérmicos. La estimulación ovárica, además de infertilidad, se usa para la preservación de la fertilidad. Cada vez se implementan más estrategias como acumulación de óvulos, esquemas no convencionales (random start, DuoStim y otros) junto a vitrificación ovular, estudio genético preimplantatorio, transferencias embrionarias diferidas y la investigación continúa. Se pronostican mejoras en un futuro próximo, entre otras antagonistas por vía oral y estudio genético de pacientes para diagnosticar mutaciones o polimorfismos de gonadotrofinas y sus receptores. Aunque ya es factible individualizar la estimulación y volverla más efectiva, segura y amigable, así como ofrecer otras opciones a pacientes de mal pronóstico.

Due to an increased understanding of reproductive physiology and to the availability of more and better diagnostic/therapeutic agents, ovarian stimulation through individualization, has become more effective (improved results), efficient (shorter span and lower doses), safe (less and milder complications), comfortable (less discomfort and dependance) and affordable (for more people at lower cost). All gonadotrophins are now available by recombinant DNA technology, including some modified compounds for specific purposes such as longer action and fewer injections. The most popular ovarian regime uses recombinant FSH and GnRH antagonist. There are precise indications for adding LH or adjuncts like hGH or transdermal androgens. Besides infertility, ovarian stimulation is also indicated for fertility preservation. Strategies like oocyte accumulation, non-conventional stimulation protocols (random start, DuoStim and others), oocyte vitrification, preimplantation genetic testing, freeze-all, deferred embryo transfer for particular cases are becoming popular, and the research still goes on. Future advances like oral GnRH antagonists, and the study of mutations and polymorphisms for gonadotropins and its receptors are foreseen. Today through individualization, ovarian stimulation is safe, effective and friendly, also we can offer good options to bad prognosis patients

Preservación de la fertilidad: opinión de grupo de expertos en México / Fertility preservation: an expert taskforce opinion

La preservación de la fertilidad es la aplicación de estrategias médicas y de laboratorio para preservar la descendencia genética parental en adultos o niños en riesgo de esterilidad. El cáncer es la principal indicación de preservación de fertilidad en pacientes en edad reproductiva. En las últimas décadas ha incrementado la incidencia de cáncer en adolescentes. Los tratamientos oncológicos también han mejorado significativamente, por lo que hoy es posible la curación en un amplio porcentaje de pacientes. La mayoría de los niños y adolescentes con cáncer se convierten en sobrevivientes a largo plazo, lo que aumenta el interés en los efectos del tratamiento del cáncer sobre la fertilidad. Las condiciones sociales, económicas y culturales también son determinantes para decidir el momento que una pareja busque promover su fertilidad. Además, otras patologías o incluso fármacos para prevención del rechazo de órganos trasplantados pueden afectar la fertilidad y, por tanto, tales pacientes son susceptibles de orientación sobre preservación de la fertilidad. El éxito en los programas de reproducción asistida y en los tratamientos oncológicos brindan alternativas para preservar la fertilidad. En esta primera Opinión de Grupo de Expertos Mexicanos en Preservación de la Fertilidad hemos evaluado pacientes oncológicas que son candidatas a preservación de fertilidad: jóvenes con riesgo de compromiso de su fertilidad por el tratamiento oncológico, pero con reserva ovárica suficiente y pronóstico vital aceptable. También se consideraron casos especiales como la preservación social, en casos de conceptualización sexual diferente, así como los aspectos legales y éticos básicos

Fertility preservation is the application of medical and laboratory strategies to preserve parental genetic offspring in adults or children at risk of sterility. Cancer is the main indication of fertility preservation in patients of reproductive age. In recent decades, the incidence of cancer in adolescents has increased. Cancer treatments have also improved significantly, making cure possible today in a large percentage of patients. Most children and adolescents with cancer become long-term survivors, increasing interest in the effects of cancer treatment on fertility. Social, economic and cultural conditions are also decisive in deciding when a couple seeks to promote their fertility. Furthermore, other pathologies or even drugs for the prevention of rejection of transplanted organs can affect fertility and, therefore, such patients are susceptible to guidance on fertility preservation. Success in assisted reproduction programs and cancer treatments provide alternatives to preserve fertility. In this first Opinion of the Group of Mexican Experts on Fertility Preservation, we have evaluated oncological patients who are candidates for fertility preservation: young people at risk of compromising their fertility due to oncological treatment, but with sufficient ovarian reserve and acceptable vital prognosis. Special cases such as social preservation were also considered, in cases of different sexual conceptualization, as well as the basic legal and ethical aspects

Oocyte maturation arrest produced by TUBB8 mutations: impact of genetic disorders in infertility treatment.

Oocyte maturation defect is a challenging situation in the management of infertility, the etiology may be related to endocrine causes, protocols used in ovarian stimulation, oocyte intrinsic defects or procedures in embryology laboratory. We report three Mexican females in treatment for primary infertility with non-mature oocytes after ovary stimulation and oocyte capture in whom a genetic diagnosis of TUBB8-oocyte maturation defect was revealed by exome sequencing. Two couples achieved pregnancies though oocyte donation after establishing the genetic etiology. Our results expand the role of TUBB8-disorders in patients of non-Asian ethnicity. Oocyte maturation defects of monogenic origin are a growing group of disorders that endocrinologists and reproductive medicine specialists should be aware in order to provide referral to genetics for establish a correct and opportune diagnosis.

Natural-cycle in vitro fertilization (IVF) combined with in vitro maturation in infertile patients with polycystic ovarian syndrome (PCOS) requiring IVF.

OBJECTIVE: In this study, we report an experience of 59 natural-cycle IVF combined with in vitro oocyte maturation (IVF/M) cycles in patients with PCOS requiring IVF recruited based on limitations to afford a conventional IVF treatment in a 9-years period. Results of IVF/M were compared with 164 cycles of IVF in PCOS patients. MATERIAL AND METHODS: In IVF/M cycles only hCG priming was used before oocyte recovery, with in vitro maturation of immature oocytes in a commercial medium. In conventional IVF group, recombinant FSH (rFSH) and GnRH agonist/antagonist for ovarian stimulation were used. In both groups, fertilization was achieved by intracytoplasmic sperm injection (ICSI) of mature oocytes and fresh embryos transferred at day 2 or day 3. RESULTS: In all IVF/M cycles oocytes and transferable quality embryos were obtained, only in 6 IVF/M cycles mature oocytes were obtained at oocyte capture day. Clinical pregnancy rate per cycle was 39.0% vs 53.6% (p = 0.0682) and delivery rate per cycle was 30.5% vs 42.6% (p = 0.1209) in IVF/M and conventional IVF respectively. Patients with ovarian hyperstimulation syndrome (OHSS) were 0% in IVF/M vs 6.7% in conventional IVF (p = 0.0399). CONCLUSION: Our experience in a private clinic in Mexico suggests that IVF/M can be a useful initial strategy to treat PCOS patients requiring IVF with comparable delivery rates to conventional IVF and a decreased risk of ovary hyperstimulation. IVF/M may be indicated to patients with limited resources paying without insurance for their infertility treatment.

[Combined Preimplantation Genetic Testing for Aneuploidy and Monogenic Disease in a Mexican Family Affected by X-linked Hypohidrotic Ectodermal Dysplasia].

Background: Hypohidrotic ectodermal dysplasia (HED) is a genetic skin condition presenting as hypohidrosis, hypodontia, and hypotrichosis, resulting in an important burden for affected families. The most common form of HED has an X-linked inheritance and female carriers have the option of prenatal or preimplantation genetic testing (PGT) to avoid transmission of the disease. A combined PGT for a mutation in EDA gene and aneuploidies in a Mexican carrier of X-linked HED is reported. Materials and Methods: Ovarian stimulation and assisted reproduction procedures were performed in a private academic medical center. PGT for a novel c.707-1G>A (rs886039466) mutation in EDA gene and chromosomal aneuploidies was performed by massive parallel and Sanger sequencing. Results: In the first PGT, the transfer of two blastocysts did not result in a pregnancy. An accumulative stimulation approach was decided to improve pregnancy chances for a second PGT procedure. Three ovarian stimulations were performed and 10 blastocysts coming from fresh and vitrified oocytes were genetically analyzed. A single embryo transfer produced a healthy non-carrier euploid girl. Discussion: PGT combining aneuploidy and mutation analyses is an alternative for female carriers of X-linked and other Mendelian disorders in Latin-American countries. In the era of genomic and personalized medicine, medically assisted reproduction techniques, such as PGT, are shifting from only infertility to preventive genetics.

A human reproductive approach to the study of infertility in chimpanzees: An experience at Leon's Zoological Park, Mexico.

Great apes are mammals close to humans in their genetic, behavioral, social and evolutionary characteristics and new genomic information is revolutionizing our understanding of evolution in primates. However, all these species are endangered. While there are many global programs to protect these species, the International Union for Conservation of Nature (IUCN) projects that in a near future the wild populations will decrease significantly. Nowadays, the relevance of captive populations of great apes is becoming critical for research and understanding of pathophysiology of diseases. In this report, the evaluation of infertility in a group of captive chimpanzees maintained at Leon's Zoological Park using a human infertility protocol is described. Our results suggested that infertility in this group was due to low hormonal levels and sperm alterations in the male characterized by hormonal assessment and a sperm sample obtained by electroejaculation and cryopreserved using human protocols. In the females, it was demonstrated that it is possible to follow the follicular cycle using non-invasive methods based on morphological changes in genitalia, detection of blood in urine and measurement of hormones in saliva samples; concluding that fertility in females was normal. Also, we demonstrate that human artificial insemination procedures may be applied. Our human approach was successful in finding the infertility cause in this group of captive chimpanzees. In countries with limited resources, collaboration of zoos with human infertility clinics can be beneficial for research and management of reproductive aspects of great apes.

Birth after human chorionic gonadotropin-primed oocyte in vitro maturation and fertilization with testicular sperm in a normo-ovulatory patient.

In this report, we present a case of in vitro maturation (IVM) with surgical retrieved testicular sperm in a normo-ovulatory female. Human chorionic gonadotropin-primed IVM, testicular biopsy for sperm retrieval and intracytoplasmic sperm injection with fresh sperm were performed. Fourteen cumulus-oocyte complexes were obtained in germinal vesicle or metaphase I stage, eight oocytes reached metaphase II, seven presumptive zygotes were obtained, and three cleavage stages embryos in day 2 were transferred producing a singleton pregnancy. A single healthy newborn was obtained. Our results suggest that IVM may be an alternative for in vitro fertilization in normo-ovulatory women even if surgical retrieval of sperm is needed. Further research is required to depict contributing factors to the success of IVM in indications different from polycystic ovaries syndrome and the role of male gamete.

[Impact of laser-assisted hatching (quarter technique) in poor prognosis patients]. / Impacto de la eclosión asistida con láser (técnica en cuartos) en pacientes con pobre pronóstico reproductivo.

BACKGROUND: Poor implantation rates continue to be the determinant factor for results in assisted reproductive techniques; many factors are thought to be involved including embryo quality, endometrial receptivity and embryo transfer. Assisted hatching has been proposed as a technique to improve implantation rates in selected groups of patients, especially with poor prognosis. OBJECTIVE: To evaluate the impact of the laser assisted hatching performed with quarter technique in patients with poor prognosis. MATERIAL AND METHODS: Prospective, controlled and randomized clinical study. The study group included patients with poor prognosis: maternal age ≥ 38 years, basal FSH ≥ 12.0 mUl/mL, two or more previous FIV/ ICSI failures. The control group don't received neither assisted reproductive techniques. RESULTS: We registered 303 cycles: n=1 54 in study group (laser assisted hatching) and n = 149 in control group. Clinical pregnancy (40.1 vs 19.7%) and implantation (17.5 vs 8.3%) rates were significant higher in laser assisted hatching group, there were not significant differences between multiple pregnancy (13.11 vs 10%) and miscarriage (14.7 vs 17.2) rates. CONCLUSION: Laser assisted hatching with quarter technique improves pregnancy and implantation rates in poor prognosis patients.

Y chromosome microdeletions in Mexican males of couples with idiopathic recurrent pregnancy loss.

AIM: To analyze the presence of Y chromosome microdeletions in males of Mexican couples with idiopathic recurrent pregnancy losses (RPL). METHODS: Seventy-one males from couples with RPL and 66 fertile males as controls were studied. DNA was isolated from peripheral lymphocytes and used to run multiplex polymerase chain reactions. Regions AZFa (sY84, sY86), AZFb (sY127, sY134) and AZFc (sY254, sY255) of the Y chromosome were analyzed according to valid guidelines recommended by the European Academy of Andrology and the European Molecular Genetics Quality Network. Also, the sequence tagged sites (STSs): DYS262 (sY67), DYS220 (sY129), DYF85S1 (sY150), DYF86S1 (sY152) and DYF87S1 (sY153) were included in order to analyze STSs previously reported as deleted. A power analysis to support our simple size was performed. RESULTS: Results show an absence of Y chromosome microdeletions in males of couples with RPL and controls with an acceptable statistical power. CONCLUSION: The study did not show an association of recurrent pregnancy loss and Y chromosome microdeletions in Mexican male partners. Based on the results, the study of Y chromosome microdeletions in couples with RPL is not considered clinically relevant.

Revival of extinct species using nuclear transfer: hope for the mammoth, true for the Pyrenean ibex, but is it time for "conservation cloning"?

Recent accomplishments in the fields of nuclear transfer and genomics, such as the cloned offspring production from frozen mouse cells, cryopreserved at not too low temperatures without cryoprotectors; or the sequencing of wooly mammoth genome, have opened the opportunity for the revival of extinct species. As expected, they are receiving a lot of publicity in the media and also scientific attention. Furthermore, it was recently published the "revival" of the first extinct subspecie: the Pyrenean ibex (Capra pyrenaica pyrenaica), a wild goat extinct in 2000. This strengthens the field of cloning as it had been tarnished by induced pluripotent stem cells (iPS) and other methods of reprogramming. However, for biological conservation purposes, cloning is not generally accepted as an alternative for animal conservation, and there is an ongoing debate between reproductive scientists and conservation specialists. Although we believe that nuclear transfer technologies have an opportunity in conservation efforts for some species that are on the brink of extinction and that population status, geographical isolation, reproductive characteristics, and human pressure create a situation that is almost unsustainable. In this article we discuss the barriers in cloning mammoths and cloning controversies in conservation from a zoological perspective, citing the species that might benefit from nuclear transfer techniques in the arduous journey so as not to disappear forever from this, our world.

Genetic screening in infertile Mexican men: chromosomal abnormalities, Y chromosome deletions, and androgen receptor CAG repeat length.

In our study, we analyzed chromosomal abnormalities, Y chromosome deletions, androgen receptor CAG repeat length and their association with defective spermatogenesis in infertile Mexican men. Eighty-two infertile patients and 40 controls were screened for karyotypic abnormalities, Y chromosome microdeletions, and CAG repeats. Nine infertile males (11%) carried chromosomal abnormalities and 10 (12.2%) presented Y chromosome microdeletions. The mean CAG repeat length was 21.6 and 20.88 base pairs in idiopathic infertile males and controls, respectively. Our results suggest that chromosomal aberrations and Y-chromosomal microdeletions are related to male infertility in Mexican men. In addition, expansion of the CAG repeat segments of the androgen receptor is not correlated with male idiopathic infertility.

[Gestation in sheep after autotransplantation with cryopreserved ovarian tissue: evidence for oocyte viability after the freezing and transplantation procedures]. / Gestaciones en ovejas autotrasplantadas con tejido ovárico criopreservado: evidencia de viabilidad ovocitaria posterior al proceso de congelación y trasplante.

UNLABELLED: Freezing ovarian tissue is acquiring a greater significance due to the increase in oocyte long term survival rates, which provides young women with malignancies an alternative to preserve their fertility. OBJECTIVES: 1. Assessing the physiological viability of ovarian tissue auto-transplants. 2. Determining possible differences between the two cryoprotectors that were used: dimethyl sulfoxide (DMSO) and propanediol (PROH). DESIGN: Experimental and prospective study assessing ovarian tissue viability after freezing and auto-transplantation in eight female sheep. MATERIALS AND METHODS: A bilateral oophorectomy was performed on the sheep under general anesthesia. The ovarian cortex was dissected and frozen using either DMSO (1.5 M) or PROH (1.5) with saccharose. The thawed tissue was auto-transplanted within the following one to six months, and weekly progesterone measurements were carried out in order to assess ovarian tissue functionality. Once ovulation levels were obtained, the female sheep were continuously exposed to the male in order to obtain the gestation process. RESULTS: Ovulation activity was recovered in seven of the eight female sheep (87.5%) submitted to auto-transplants within an average period of time of 62.8 +/- 9.1 days, as evidenced by serum progesterone levels. These findings were obtained regardless of the cryoprotector used. Two gestations were obtained, and these are evolving normally, as assessed by ultrasonic methods. CONCLUSIONS: The present study shows that ovarian function is adequately restored in oophorectomized sheep using ovarian tissue auto-transplantation, and produced the first pregnancies obtained through this technique in Latin America. It is possible to assume that these results can be reproduced in women.

[Y chromosome micro-deletion identification in infertile males]. / Identificación de microdeleciones en el cromosoma Y en pacientes con infertilidad masculina.

UNLABELLED: Identifying the genetic causes of male infertility is very important, considering they account for 30-50% of reproductive problems among couples. Genetic abnormalities, among which Y chromosome microdeletions are found, are commonly detected in patients with non-obstructive azoospermia (0-4.3%). Most of these patients are eligible for intracytoplasmic sperm injection (ICSI) and this genetic defect can be inherited by male children. OBJECTIVE: Determining the prevalence of microdeletions in the Y chromosome in a group of Mexican patients presenting azoospermia and oligospermia, under treatment in the Infertility Clinics. MATERIALS AND METHODS: This study included 52 infertile men (cases): 36 with non-obstructive azoospermia, and 16 with oligospermia; and 50 men (controls) whose fertility had been validated. The genomic DNA of each individual was obtained from his EDTA and heparin treated blood, and the corresponding karyotype determined. The karyotype was analyzed using G banding techniques. Eighteen markers (STS) corresponding to the chromosome Y long arm (AZFa, b, c, and d zones) were amplified in each DNA sample in all cases--azoospermic, oligospermic and controls--using the PCR method. RESULTS: No chromosomal alterations were detected in the patients, and no Y chromosome microdeletions were detected in control cases. Five azoospermic patients (13.9%) presented microdeletions corresponding to the AZFb, c, and d zones, while no microdeletions were found in oligospermic patients. The frequency of microdeletions found in this study is very similar to that reported for other populations. CONCLUSIONS: This research not only reports the frequency of microdeletions in the Y chromosome in our population, but also contributes to the integration of a DNA bank for patients with idiopathic male infertility, which will be of great use in the search for the causes of this affection.

Efecto de la reducción de peso en la condición clínica y hormonal de mujeres anovulatorias obesas / Neight reduction effect in clinical and hormonal condition of obese anovulatory women

La obesidad se asocia a una gran variedad de trastornos endocrinos hipotálamo-hipófisio-ováricos que pueden llevar a una anovulación persistente. La reducción de peso puede mejorar el perfil hormonal y por lo tanto recuperar la función ovulatoria. El objetivo del presente estudio fue valorar el efecto de la reducción de peso en la condición clíonica y hormonal de mujeres anovulatorias obesas en el Instituto de Medicina Reproductiva del Bajío en el Hospital Aranda de la Parra de la ciudad de León, Guanajuato. Se analizaron un total de 30 pacientes entre 18 y 35 años de edad con obesidad, anovulación crónica y sin patología tiroidea. Previo y posterior a un tratamiento de reducción de peso, con pérdida de al menos 5 por ciento de peso inicial, se analizaron hormona luteinizante (LH), hormona folículo estimulante (FSH), estradiol, prolactina, testosterona, dihidroepiandrostendiona-sulfato (DEA-S), curva de tolerancia oral a la glucosa y progesterona en día 21, peso, IMC, relación cintura/cadera y porcentaje de grasa por suma de pliegues. La pérdida media de peso fue de 9.5 ñ 4.3 kg. lo que representa una pérdida de peso de 10.96 por ciento con respecto al inicial. Se presentó ovulación espontánea en 26 pacientes (86.6 por ciento). Hubo una reducción significativa en los niveles basales de LH, estradiol, testoterona, DHEA-S, así como un aumento en los niveles de progesterona. De 12 pacientes con curva de tolerancia a la glucosa alterada, nueve (75 por ciento) observaron mejoría la final del tratamiento. Los resultados obtenidos demuestran que la disminución de peso y de porcentaje corporal de grasa puede mejorar el perfil hormonal y la función ovulatoria de pacientes anovulatorias obesas por lo que estas mujeres deberían someterse a un tratamiento de reducción de peso antes de comenzar con inductores de ovulación

Embarazo gemelar mediante la técnica de donación de ovocitos en una mujer con síndrome de Turner / Twin pregnancy by oocyte donation technique in a woman with Turner's syndrome

Es extremadamente raro que ocurra un embarazo espontáneo en pacientes con síndrome de Turner, y en caso de presentarse este correrá un gran riesgo de pérdidas fetales y malformaciones congénitas en el recién nacido, especialmente del cromosoma sexual. La donación de ovocitos es actualmente la técnica de elección para solucionar los deseos reproductivos de estas mujeres. Se presenta el caso de una mujer con síndrome de Turner, cariotipo 45, XO, a la cual se le realiza donación de ovocitos y transferencia intrauterina de embriones, logrando un embarazo gemelar, el cual transcurrió sin complicaciones, se efectuó una cesárea obteniendo dos productos completamente sanos