Phthalates and Bisphenol A: Presence in Blood Serum and Follicular Fluid of Italian Women Undergoing Assisted Reproduction Techniques.

BACKGROUND: folliculogenesis is a strictly regulated process that may be affected by endocrine disrupting chemicals (EDCs) through sometimes not so clear molecular mechanisms. METHODS: we conducted a multicentric observational study involving six fertility centers across Italy, prospectively recruiting 122 women attending a fertility treatment. Recruited women had age ≤42 years, and normal ovarian reserve. Blood and follicular fluid samples were taken for EDCs measurement using liquid chromatography tandem mass spectrometry and each woman completed an epidemiological questionnaire. RESULTS: The main EDCs found were monobutyl phthalate (MBP) (median blood: 8.96 ng/mL, follicular fluid 6.43 ng/mL), monoethylhexyl phthalate (MEHP) (median blood: 9.16 ng/mL, follicular fluid 7.68 ng/mL) and bisphenol A (BPA) (median blood: 1.89 ng/mL, follicular fluid 1.86 ng/mL). We found that serum MBP concentration was significantly associated with the considered area (p < 0.001, adj. mean: 7.61 ng/mL, 14.40 ng/mL, 13.56 ng/mL; Area 1: Milan-Turin, Area 2: Rome-Naples; Area 3: Catania-Bari, respectively) but negatively with home plastic food packaging (p = 0.004). Follicular MBP was associated with irregular cycles (p = 0.019). No association was detected between EDCs and eating habits and other clinical and epidemiological features. CONCLUSIONS: This study represents the first Italian biomonitoring of plastic EDCs in follicular fluid, laying the basis for future prospective evaluation on oocyte quality before assisted reproduction techniques (ART).

Polarized light microscopy-detectable structures of human oocytes and embryos are related to the likelihood of conception in IVF.

PURPOSE: To clarify if birefringent structures of human oocytes and embryos, measurable by polarized light microscopy, have any value in predicting the chance of pregnancy in human in vitro fertilization and may halp to identify the most competent oocytes and embryos. METHODS: The inner layer of the zona pellucida (IL-ZP) and the meiotic spindle (MS) were analyzed by polarized light microscopy in 258 oocytes and in the 209 embryos deriving from them. Data obtained from 102 ICSI cycles with conception were compared with those obtained in 156 cycles without conception. The retardance and area of the IL-ZP, as well as the retardance, length of the major axis, and area of the MS were measured. Furthermore, polarized light microscopy parameters were related to the embryo morphological score by multiple regression analysis. RESULT(S): The mean area of the IL-ZP of both oocytes and embryos was significantly lower in conception than in non-conception cycles (p = 0.0001 for oocytes and p = 0.002 for embryos). The area of the IL-ZP in embryos was significantly, inversely related to the embryo morphological score (p = 0.011). The area, the major axis length and the retarcance of the MS, as well as the retardance of the IL-ZP in oocytes and embryos were comparable in conception and non-conception cycles. CONCLUSION: The area of the IL-ZP of the human oocytes may represent a marker of oocyte competence, as oocytes with a low IL-ZP area are more frequently obtained in conception cycles. When measured in embryos, a low IL-ZP area identifies embryos with a high chance of implantation.

Slow-freezing-induced changes of birefringent structures in human oocytes are related to responsiveness to ovulation induction.

The slow-freezing method is widely used to freeze human oocytes, both for fertility preservation and in routine IVF programmes. Slow freezing damages some of the cell's structures, including the meiotic spindle (MS) and the zona pellucida (ZP). Polarized light microscopy was used to study the variations induced by slow freezing on the MS and the ZP of human oocytes and to analyse the relationship between slow-freezing effects on the gamete and some clinical characteristics, such as age, body mass index and ovarian responsiveness to ovulation induction (expressed as total follicle-stimulating hormone dose/retrieved oocyte). Both the MS and the ZP (particularly its inner layer) underwent significant changes during slow-freezing procedure. The MS became thinner and structurally less organized (lower retardance) (P<0.001 and P<0.05, respectively), whereas the ZP became thicker and its inner layer lost structural organization (both P<0.05). These morphological changes were unrelated to the patient's age or body mass index, but ZP variations in thickness and retardance were significantly related to ovarian responsiveness (P=0.033 and P=0.026, respectively), suggesting that patients with a higher response to gonadotrophins produce oocytes better able to preserve their characteristics after freezing-thawing.

The pentose phosphate pathway plays an essential role in supporting human sperm capacitation.

In swim-up-selected spermatozoa of 38 normozoospermic patients, capacitated spermatozoa exhibited enhanced pentose phosphate pathway (PPP) activity and increased expression of glucose-6-phosphate dehydrogenase (G6PD). The G6PD inhibitor DHEA and the inhibitors of NADPH oxidase apocynin and diphenylene iodonium (DPI) prevented both superoxide generation and capacitation in human spermatozoa, but whereas DPI and DHEA inhibited PPP, apocynin did not influence it, suggesting that PPP activation during capacitation is not a response to increased oxidative stress but exerts a role by supplying reducing equivalents to oxygen.

Impact of oncostatic treatments for childhood malignancies (radiotherapy and chemotherapy) on uterine competence to pregnancy.

UNLABELLED: Fertility preservation in young girls affected by malignancies has got growing relevance in the last decade due to the improved survival chance of these patients after oncostatic treatments. Most studies have focused on preserving ovarian follicles and avoiding premature ovarian failure, whereas only a few have evaluated the effects exerted by radiotherapy and chemotherapy on the uterus. It is self-evident that fertility preservation after oncostatic therapies must include the maintenance of a functional uterus, and a certain degree of uterine damage must be considered when estimating reproductive prognosis in previously treated, childhood cancer survivors. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader should be able to recall the growing number of children who survive oncostatic treatments, explain the possible effects on future reproductive endeavors, and summarize the possible ways to preserve fertility.

Seasonality and human in vitro fertilization outcome.

Seasonal changes in spontaneous fecundity have been observed in several human populations, but it is not clear whether the same applies to human in vitro fertilization-embryo transfer (IVF) procedures. In the present study, 2067 patients undergoing their first IVF attempt between the years 1998 and 2003 were grouped into four 'seasons' (December-February, March-May, June-August, September-November) according to the day on which they were administered human chorionic gonadotropin. Several parameters known to affect IVF outcome (including ovarian response to gonadotropins, sperm and oocyte quality, fertilization rate, embryo quality, pregnancy and implantation rates) were considered and potential changes among the four seasonal periods were analyzed. Moreover, some confounding variables (sperm quality, age, duration of infertility, indications for IVF) were controlled for. Overall, pregnancy rate per oocyte pick-up and per embryo transfer of 32.5% and 35.8%, respectively, as well as implantation rate of 18.9%, were recorded. None of the observed IVF-related parameters showed any significant change clearly related to a specific seasonal period, their fluctuations throughout the year being randomly determined. Ovarian responsiveness to gonadotropins, quality of gametes and embryos, and fertilization and implantation processes were apparently not significantly affected by seasonality. It is concluded that the results of a good-quality IVF program in humans are not significantly affected by the season of the year in which the IVF attempt is accomplished; therefore, season is not a relevant factor to be considered when planning an IVF treatment.