Polycystic ovary syndrome and ovarian autoimmunity--assessment of ovarian antibodies by EIA.

There are conflicting reports of an association of ovarian antibodies, detected by immunofluorescence, with polycystic ovary syndrome (PCOS). The objective of this study was to evaluate the association of ovarian autoimmunity with PCOS. A validated immunoassay for ovarian antibodies was used to assess serum from women with PCOS and with menopause and normal cycling women as controls. The frequency of ovarian antibodies was similar (25%) among the controls and PCOS. Thus, unlike the association of ovarian antibodies detected with this test in patients with unexplained infertility and premature menopause, the prevalence of ovarian antibody in patients with PCOS is not significantly different to controls.

Morphologic changes in offspring of female mice exposed to ethanol before conception.

OBJECTIVE: Our purpose was to evaluate the mutagenic effects of preconceptional ethanol exposure by use of the mouse model. STUDY DESIGN: Fifty-three adult female CF-1 mice were divided into one of five groups with or without an ethanol diet for 28 days. Mice were then superovulated and mated. On day 14 of gestation all mice were killed and fetuses removed and examined for abnormalities. RESULTS: The mutation index for the study and mutagen groups was similar (48% vs 41%). The percentage of any anatomic abnormality in any treatment group were between 50% and 100%. Anomalies of the abdominal wall were most commonly seen in the mutagenic groups. CONCLUSIONS: Chronic ethanol exposure in the female mouse before conception yields anatomic abnormalities in the offspring. These mutagenic effects may be variable in that they may result in a dominant lethal mutation or a delayed interference with organogenesis. Ethanol consumption, whether before or after conception, poses an unfavorable outcome in the offspring produced.

Optimizing tubal epithelial cell growth promotes mouse embryo hatching in coculture.

PURPOSE: This study investigates the relationship between human tubal epithelial cell growth characteristics and mouse embryonic development to determine which cellular requirements should be preferentially provided in a coculture system. METHODS: Cell growth and viability were assessed for 5 days in alpha-minimal essential medium or human tubal fluid supplemented with 10% human serum or 10% synthetic serum. Two-cell mouse embryo development to blastocyst and hatching blastocyst stages was also assessed with or without coculture. RESULTS: Both epithelial cell growth and embryo development were dependent on serum supplementation with better cell viability and growth rates in human serum and better blastocyst development in synthetic serum. The highest proportion of hatching blastocysts was found in alpha-minimal essential medium and human serum with coculture. CONCLUSIONS: Culture conditions which improve tubal epithelial cell growth also improve the hatching rate of mouse embryos in coculture. This indicates that by meeting the metabolic and nutritional demands for epithelial cell growth, the beneficial effects of coculture on embryo development may be optimized.

Evaluation of co-culture and alternative culture systems for promoting in-vitro development of mouse embryos.

The goal of this study was to compare mouse embryo development in a defined synthetic medium (human tubal fluid) against the same medium supplemented with a defined synthetic serum (SS), co-culture on human tubal epithelium (TECC), and culture on human fibronectin (FN) with and without SS. After 48 h, TECC, SS and FN + SS cultures demonstrated accelerated development with > 70% achieving > or = 8-cell stage. After 72 h, these culture conditions also significantly increased the proportion of embryos reaching the blastocyst stage but only TECC significantly increased the number of hatching blastocysts. Nuclei of the trophectoderm of unhatched and hatched blastocysts were stained with propidium iodide before fixing and labelling both the trophectoderm and inner cell mass with bisbenzimide. Blastocysts from the TECC contained a significantly higher total cell number (TCN) and trophectoderm and inner cell mass cell numbers than all other groups. These findings indicate equivalent improvements in mouse embryo development to the blastocyst stage in response to TECC, SS and FN and an enhanced number of cells and rate of hatching found only with TECC.

Human chorionic gonadotropin levels in conception cycles after uterine and tubal embryo transfer.

OBJECTIVE: To describe the rate of rise of beta-hCG levels in normal single gestations after uterine and tubal embryo transfer. DESIGN: A prospective study from 1991 through 1992 in which infertility patients who conceived after ovulation induction and ET were monitored with serum beta-hCG levels. SETTING: Infertility unit at Rush-Presbyterian-St. Luke's Medical Center in Chicago, Illinois. PATIENTS: Ninety-eight women conceived after ovarian stimulation and ET. This study included only patients who conceived after uterine ET (n = 12) and tubal ET (n = 25) and had an exponential rise of beta-hCG levels and sonographic evidence of an intrauterine gestation. RESULTS: The rate of rise of mean beta-hCG levels after ET preceded that of tubal ET by 24 hours until day 14 when the two approximate each other. CONCLUSION: There appears to be a unique interaction between the trophoblast and endometrial surface that may account for the early detection of beta-hCG after uterine versus tubal ET.

Hormonal profiles of early gestations with abnormal karyotype.

OBJECTIVE: To describe the hormonal profiles of chromosomally abnormal pregnancies during the first trimester. DESIGN: A prospective study from 1984 through 1990 in which infertility patients who conceived were monitored weekly with serum E2, P, and beta-hCG levels. SETTING: The infertility practice at Rush-Presbyterian-St. Luke's Medical Center in Chicago, Illinois. PATIENTS: Study included 15 women who had dilatation and curettage for first trimester fetal losses with confirmed abnormal karyotype, 6 women with chromosomally normal male abortuses, and 60 consecutive women whose pregnancies yielded normal term infants. RESULTS: After natural conception, E2 demonstrated a moderate rise in both normal and chromosomally abnormal pregnancies to approximately 300 pg/mL by day 29 (6 weeks of gestation). In normal gestations, E2 continued a steady increase to exceed the level of 1,000 pg/mL by day 64 (11 weeks of gestation). In chromosomally abnormal pregnancies, the mean E2 plateaued and remained at approximately 200 pg/mL until fetal demise was noted. In stimulated conceptions, the rise of E2 was sharp and early (1,200 pg/mL by day 29); in normal pregnancies, E2 steadily increased to an average of 1,400 pg/mL by the end of the first trimester, whereas in karyotypically abnormal gestations, E2 declined to approximately 200 pg/mL by day 64. In pregnancies yielding a male abortus, a sharp decline and plateau at 800 pg/mL by day 56 (10 weeks of gestation) was observed. In both natural and stimulated normal pregnancies, hCG levels first demonstrated a linear rise, followed by a curvilinear increase from day 29 until day 56, with a peak of approximately 110,000 mIU/mL. The beta-hCG in chromosomally abnormal pregnancies, as well as in pregnancies yielding a male abortus, was characterized by a slow and gradual rise to a maximum of 40,000 mIU/mL, which remained relatively linear until day 64 when fetal demise was detected in all cases. Progesterone level data were excluded from analysis because of frequent P supplementation. CONCLUSIONS: There were significant differences in the hormonal profiles of chromosomally normal and abnormal pregnancies. Serial measurements of serum E2 and beta-hCG from the 6th week of gestation may be useful in predicting an abnormal karyotype sooner than other current diagnostic tests.

Human immunodeficiency virus-1 infection in an infertile population.

OBJECTIVE: The aim of our study was to determine the prevalence of human immunodeficiency virus-1 (HIV-1) in an infertile population. DESIGN: The study design included a retrospective anonymous survey of clinical data and screening for HIV-1 antibody by enzyme-linked immunoabsorbent assay (ELISA) in stored sera. Samples that were ELISA-positive were further tested by Western blot assay. Frequency distributions were analyzed by Fisher's exact test. SETTING: University tertiary care center. PARTICIPANTS: Based on availability of stored frozen sera, the total study population included 182 of 304 consecutively registered infertile couples. RESULTS: Seventy-five percent of the study population were found to have one or more risk factors for HIV infection. Of the 252 sera tested, 10 were repeatedly reactive by ELISA, and Western blot testing confirmed HIV-1 infection in one woman and two men. CONCLUSIONS: This relatively high HIV-1 seroprevalence (male: 2.6%; female: 0.6%) in a low-middle class infertile population emphasizes the urgent need to implement on-site HIV-infection counseling aimed at preventing the spread of disease to the healthy partner and fetus and to discuss therapeutic and reproductive options.