Early pronuclear breakdown is a good indicator of embryo quality and viability.

OBJECTIVE: To examine whether the timing of pronuclear breakdown can be a predictor of embryo quality and viability. DESIGN: Retrospective comparison of the development and quality of early and late developing zygotes. SETTING: Infertility and endocrinology unit in a university hospital. PATIENT(S): One thousand seven hundred eighty-two zygotes obtained in 383 consecutive IVF cycles. INTERVENTION(S): Culture of all fertilized embryos. MAIN OUTCOME MEASURE(S): Number of fertilized zygotes showing early pronuclear breakdown at 22-25 hours postinsemination, embryo quality, pregnancy rates (PR), implantation rates. RESULT(S): Early pronuclear breakdown embryos had a significantly higher cell number (4.4 +/- 1.2) compared with the late pronuclear breakdown embryos (3.6 +/- 1.4). When comparing the frequency of the early pronuclear breakdown embryos according to the method of fertilization, we failed to find any significant difference between the IVF (37.1%) and the intracytoplasmic sperm injection (ICSI) (41.1%) groups. The transfer of early pronuclear breakdown embryos resulted in a significantly higher clinical pregnancy rate than those with late pronuclear breakdown (48.3% vs. 27.3%). The implantation rate was higher in the early pronuclear breakdown group than in the late pronuclear breakdown group (26.5% vs. 15.1%). CONCLUSION(S): Early pronuclear breakdown is a strong indicator of embryo viability, and may be used as an additional criterion in the selection of embryos for transfer.

Catheter type does not affect the outcome of intrauterine insemination treatment: a prospective randomized study.

OBJECTIVE: To compare the main outcome of IUI with the Gynetics catheter (Gynetics Medical Products, Hamont-Achel, Belgium) or the Makler cannula (Sefi-Medical Instruments, Haifa, Israel). DESIGN: Prospective, randomized study. SETTING: Infertility and endocrinology unit in a university hospital. PATIENT(S): Two hundred fifty-one infertile couples undergoing 784 consecutive IUI treatments. INTERVENTION(S): Patients were randomly assigned to undergo IUI treatment with either the Gynetics catheter (124 patients) or the Makler cannula (127 patients). MAIN OUTCOME MEASURE(S): Primary outcome measures were pregnancy and cumulative pregnancy rates. Secondary outcome measures were the ease of introduction of the catheter, the presence of bleeding, and semen regurgitation after removal of the catheter. RESULT(S): The use of the Gynetics catheter resulted in similar pregnancy (10.4% vs. 9.7%) and cumulative pregnancy rates (27.9% vs. 26.4%) as compared with the Makler cannula. Difficult introduction of the catheter was more frequent in the Gynetics group than in the Makler group (19.4% vs. 8.0%, respectively), but the frequency of bleeding did not differ between groups. Sample regurgitation was observed more often in the Makler group than in the Gynetics group (49.9% vs. 17.9%, respectively). CONCLUSION(S): A lower frequency of sperm regurgitation and a higher frequency of difficult introduction was observed when the Gynetics catheter was used. However, there was no significant difference in pregnancy rates with use of either the Gynetics catheter or the Makler cannula.