[The efficiency of ART methods for treatment of male infertility in men of age 40 years and older with obstructive azoospermia].

AIM: to evaluate the efficacy of ART methods to treat infertility in men with obstructive azoospermia. MATERIALS AND METHODS: The results of treatment of infertile couples using ART methods during the period from 2009 to 2017 were analyzed. A total of 18 married couples with obstructive azoospermia in men were included in the main group. The control group consisted of 59 married couples in which men had spermatozoa in the ejaculate. Both groups were comparable in age, concomitant gynecological pathology in female partner, protocols of superovulation, fertilization method, days of transfer and the number of transferred embryos into the uterine cavity. The results were evaluated by pregnancy rate (according to the results of determining the level of the -subunit of human chorionic gonadotropin), clinical pregnancy rate (according to the results of the first ultrasound), the number of birth and the number of living children. RESULTS: Pregnancy rate in the main group was 55.6%, compared to 35.6% in the control group (2 with Yeats correction = 1531, p=0.217), while clinical pregnancy rate was 44.4% and 32.2%, respectively (2with Yeats correction = 0.450, p=0.503). In the main group, there were 6 births and 8 children were born (4 with one fetus and 2 twin). In the control group, there were 14 births (2 with Yeats correction=0.168, p=0.683 in comparison with the main group) and 19 children were born (12 one fetus, 2 twins, 1 triplets). The high rates obtained in the main group can be explained by the fact that the obstructive azoospermia doesnt have such a pronounced negative influence on spermatozoa as a non-obstructive azoospermia, and, possibly, as severe oligozoospermia. CONCLUSION: Our data have convincingly established the efficiency of testicular biopsy for the treatment of infertility in men with azoospermia. In addition, spermatozoa obtained from these patients, are suitable for fertilization.

First experience of hematopoietic stem cell transplantation treatment of Shwachman-Diamond syndrome using unaffected HLA-matched sibling donor produced through preimplantation HLA typing.

The only proven cure for Shwachman-Diamond syndrome (SDS) bone marrow failure is allogeneic hematopoietic stem cell transplantation (HSCT). However HSCT with donors other than HLA-identical siblings is associated with high mortality and unfavorable prognosis. This paper presents the first experience of HSCT treatment of SDS using an unaffected HLA-identical sibling produced through preimplantation genetic diagnosis (PGD). The patient was a 6-year-old blood transfusion-dependent SDS baby girl with secondary myelodysplastic syndrome, for whom no HLA-identical donor was available. As a result of PGD, two unaffected HLA matched embryos were identified; one of them was randomly selected for transfer, resulting in a clinical pregnancy and birth of an apparently healthy child. The patient underwent allogeneic transplantation of cord blood hematopoietic stem cells, together with bone marrow from this sibling, resulting in complete hemopoietic recovery. The patient was no longer transfusion-dependent and had normal blood values 160 days after transplantation.