Investigation of the association between the outcomes of sperm chromatin condensation and decondensation tests, and assisted reproduction techniques.

The main purpose of this prospective study is to examine possible influences of abnormalities of sperm nuclear condensation and chromatin decondensation with sodium dodecyl sulphate (SDS)-EDTA on outcomes of intrauterine insemination (IUI) or intracytoplasmic sperm injection (ICSI) cycles. Semen samples from 122 IUI and 236 ICSI cycles were evaluated. Before semen preparation for IUI or ICSI, basic semen analysis was performed and a small portion from each sample was spared for fixation. The condensation of sperm nuclear chromatin was evaluated with acidic aniline blue, followed by sperm chromatin decondensation by SDS-EDTA and evaluation under light microscope. Ongoing pregnancy rate was 24% and 26.2% in the IUI and ICSI groups respectively. The chromatin condensation rate was significantly higher in the ongoing pregnancy-positive group compared to the negative group, both in IUI (P = 0.042) and ICSI groups (P = 0.027), and it was positively correlated with ongoing pregnancy rate in both IUI and ICSI groups (P = 0.015, r = 0.214 and P = 0.014, r = 0.312 respectively). Chromatin decondensation rates were not significantly different in neither of the groups. These results indicate that IUI and ICSI outcome is influenced by the rate of spermatozoa with abnormal chromatin condensation. Sperm chromatin condensation with aniline blue is useful for selecting assisted reproduction techniques (ART) patients.

Comparison of follitropin alfa and urinary gonadotropins in IVF cycles.

AIM: The aim of this study was to compare human menopausal gonadotropins with recombinant follicle stimulating hormone-follitropin alpha following a long down-regulation protocol in intra cytoplasmic sperm injection cycles in our clinic, and to review the outcomes in the light of preceding studies. METHODS: This was a retrospective study. Among a total number of 2798 patients who had undergone IVF/ICSI applications, 579 eligible patients were included, and their data were evaluated retrospectively. Three hundred eighteen patients were treated with follitropin alpha and 255 patients were treated with hMG. Total units of follitropin alpha preparations used in ovulation induction, total number of meiois-2 phase oocytes, total number of used oocytes in ICSI cycle, fertilization rate and clinical pregnancy rates of both groups were analyzed. RESULTS: Mean duration of stimulation was longer in the group of patients treated with rFSH-α compared to the second group of patients treated with hMG (8.88 days and 8.55 days, respectively; P<0.05). The number of transferred embryos were 3.08 and 2.68 for patients treated with follitropin alpha and hMG, respectively (P<0.05). Clinical pregnancy rates were %28 and %33 in the groups of patients treated with follitropin alpha and hMG, respectively. Even though a greater clinical pregnancy rate was noted in the hMG group, there was no statistically significant difference between the two groups (P>0.05). CONCLUSION: Our results indicate that there is no statistically significant difference between follitropin alpha and human menopausal gonadotropin in terms of the clinical pregnancy rates.

Sperm selection based on motility in polyvinylpyrrolidone is associated with successful pregnancy and embryo development.

The aim of this study was to investigate whether spermatozoon motility in polyvinylpyrrolidone (PVP) is associated with better embryo development and pregnancy rates in ICSI cycles. A total of 123 primary ICSI treatment cycles were included in this study. Semen samples were tested for motility before ICSI procedure in PVP. Within 3 min, the presence or absence of motility was recorded. Sperm functions were examined by the aniline blue (AB) chromatin condensation test and the hypoosmotic swelling test, and the chromatin stability was evaluated by inducing its decondensation with sodium dodecyl sulphate and ethylenediaminetetraacetic acid (EDTA). Fertilisation and embryo scoring were evaluated. Fifty (64%) of 78 women conceived in the PVP (+) group; and 12 (26%) of 45 women conceived in the PVP (-) group; the pregnancy rate was significantly higher in the PVP (+) group (P = 0.003). Semen parameters were observed to be similar in both groups. The mean number of total embryos obtained in ICSI procedure and transferred grade 1 embryos were significantly higher in PVP (+) group (P = 0.01 and P = 0.003 respectively). The presence of sperm motility in PVP is associated with increased pregnancy rate, higher percentage of good quality embryos, sperm chromatin condensation and decondensation.

Significance of yolk sac measurements with vaginal sonography in the first trimester in the prediction of pregnancy outcome.

BACKGROUND: The purpose of this prospective clinical study was to determine and evaluate the prognostic value of secondary yolk sac diameter of the embryo on pregnancy outcome. METHODS: One hundred and thirty pregnant women in the first trimester were included in the study. Crown-rump length (CRL) and yolk sac diameters were measured in every patient and the outcome of the pregnancies were compared with the measurements. Intact normal pregnancy (group A), threatened abortion (group B) and missed abortion (group C) were diagnosed in 67, 43 and 20 pregnancies, respectively. RESULTS: We detected a significant linear correlation between secondary yolk sac diameter and gestational age in group A (r = 0.5085; p < 0.0001) and a moderate correlation in group B (r = 0.4048; p = 0.007) and C patients (r = 0.3478; p = 0.1333). When the groups were evaluated irrespective of gestational age, a significant difference in secondary yolk sac diameters among the groups was noted (p = 0.037). When confidence intervals for secondary yolk sac diameters of intact normal pregnancies (group A) were calculated by linear regression, two patients in group B were below the 5% confidence interval. However, in group C patients, the yolk sac diameter of six patients were detected below the 5% confidence interval, while two of the measurements were above 95% confidence interval. Therefore, eight measurements (40%) of group C patients were outside the 5-95% confidence interval. CONCLUSION: In the first trimester, when discrepancy is detected between secondary yolk sac diameter and gestational age, additional sonographic investigation should be performed one or two weeks later, in order to estimate the pregnancy outcome.