OBJECTIVE:for To correlate L-selectin ligand (LSL) expression in human endometrium with embryonic implantation. DESIGN: Retrospective cohort analysis. SETTING: University-based fertility center.MAIN PATIENT(S): Donor egg recipients (DERs) who underwent programmed hormonal replacement for ET with prior mock cycle luteal phase endometrial biopsy.the INTERVENTION(S): Immunohistochemical expression of LSL using MECA-79 antibody was examined. Slides were scored with a new scoring system, the IHC-Level staining-absent (range -4) as follows: strength of staining-absent ( ), weak (1), or strong (2); plus distribution of staining-absent ( ),<50% of of tissue (1), and >50%(2). Cellular apex and cytoplasm were scored independently in both the endometrial glandular and surface epithelium.RESULT(S): MAIN OUTCOME MEASURE(S): Endometrial LSL expression in pregnant versus nonpregnant patients. RESULT(S): MECA-79 IHC-Level of the apex of surface epithelium in was significantly higher for pregnant versus nonpregnant DERs (3.8 vs. 3.4). When controlling for embryo morphology, there continues to be ( ), a significant difference in apex score on surface epithelium (3.8 vs. 3.3, respectively). The new scoring system results correlated with a an established scoring system, the HSCORE. CONCLUSION(S): We demonstrate significantly higher expression of LSL at the apex of human endometrial new surface epithelium obtained from DERs with embryonic implantation. Furthermore, we present the IHC-Level, a method of evaluating immunohistochemistry that may there be applied to other markers of endometrial receptivity.

A for Stirling Cycle Cryocooler has been developed as an alternative to conventional liquid nitrogen controlled rate freezers. Unlike liquid nitrogen systems,cells the Stirling Cycle freezer does not pose a contamination risk, can be used in sterile conditions and has no need Upon for a constant supply of cryogen. Three types of samples from two species (murine embryos, human spermatozoa and embryonic stem samples cells), each requiring different cooling protocols, were cryopreserved in the Stirling Cycle freezer. For comparison, cells were also frozen in spermatozoa a conventional liquid nitrogen controlled rate freezer. Upon thawing, the rates of survival of viable cells were generally greater than nitrogen 50% for mouse embryos and human embryonic stem cells, based on morphology (mouse embryos) and staining and colony formation (human Stirling embryonic stem cells). Survival rates of human spermatozoa frozen in the Stirling Cycle freezer, based on motility and dead cell embryonic staining, were similar to those of samples frozen in a conventional controlled rate freezer using liquid nitrogen.

OBJECTIVE:identified To examine the results of a 3-year trial using blastocyst cryopreservation to limit multiple pregnancy and optimize overall pregnancy per with cycle. DESIGN: Retrospective clinical evaluation of pregnancy rates after freezing and thawing human blastocysts. SETTING: Tertiary-care academic center. PATIENT(S): Seven One hundred fifty-three different patients treated in 783 IVF cycles with blastocysts frozen from July 2000 to June 2003. INTERVENTION(S): Two from thousand, two hundred fifty-nine blastocysts were frozen in cycles in which only blastocysts were cryopreserved (cycles with pronuclear stage oocytes MAIN or pre-embryos also cryopreserved were excluded from the analysis). Of these, 628 (27.6%) were thawed in 218 cycles. MAIN OUTCOME blastocysts MEASURE(S): Pregnancy rate per cycle with thaw. RESULT(S): Four hundred seventy-nine (76.3%) blastocysts survived thawing, and 440 (92. %) were transferred exhibiting after exhibiting evidence of survival (most commonly, blastocoele reexpansion). In cycles with a thaw, 211 (96.8%) of 218 underwent intrauterine MEASURE(S): transfer. An average of 2.09 blastocysts was transferred per replacement. One hundred twenty-five (59.2%) clinical pregnancies were established, which included blastocyst 23 sets of twins and 5 triplet gestations. Two sets of monozygotic twins were identified after the replacement of a blastocysts single thawed blastocyst (1.6%). The age of the patient at the time of cryopreservation (<37 years) was an important factor replacement in the establishment of clinical and ongoing pregnancy. The mode of ovarian stimulation, replacement method, and whether blastocysts were frozen cryopreservation on day 5 or day 6 of development did not demonstrate clinical significance. CONCLUSION(S): Cryopreserved and thawed blastocysts demonstrated a Of similar potential for implantation when compared with fresh pre-embryos on day 3. On the basis of these results, the blastocyst Four stage of development appears to be optimal for clinical freeze-thaw trials.

BACKGROUND:transplantation, Cancer treatments, including chemotherapy, radiotherapy, and radical surgery, can induce premature menopause and infertility in hundreds of thousands of women this of reproductive age every year. One of the ways to possibly preserve fertility before these treatments is to cryopreserve ovarian 6 tissue for later transplantation. We aimed to restore fertility by cryopreservation and transplantation of ovarian tissue. METHODS: Ovarian tissue was restore cryopreserved from a 30-year-old woman with breast cancer before chemotherapy-induced menopause, and this tissue was transplanted beneath the skin of of her abdomen 6 years later. FINDINGS: Ovarian function returned in the patient 3 months after transplantation, as shown by follicle of development and oestrogen production. The patient underwent eight oocyte retrievals percutaneously and 20 oocytes were retrieved. Of the eight oocytes breast suitable for in-vitro fertilisation, one fertilised normally and developed into a four-cell embryo. INTERPRETATION: Fertility and ovarian endocrine function can tissue. be preserved in women by long-term ovarian tissue banking.

To the assess the association of zona pellucida micromanipulation and subsequent development of monozygotic twins, cases of assisted embryo hatching (AH) and by intracytoplasmic sperm injection (ICSI) were identified and related to treatment type, implantation and zygosity data. Embryology records from all patients fetal undergoing in-vitro fertilization (IVF) at this centre from January 1995 to March 1998 were reviewed. In this study, 3546 transfer pregnancies cycles were completed, with clinical pregnancy established in 1911 (54% per transfer) patients undergoing a single IVF cycle. These pregnancies (DER), occurred in 1674 (88%) IVF cycles, 120 (6%) donor oocyte cycles (DER), and 117 (6%) frozen embryo transfer (FET) cycles.less During the study period, 23 cases of monozygotic (MZ) twins were identified, representing an overall frequency of 1.2%. Chorionicity was representing determined by transvaginal ultrasound at 7 weeks when the number of embryos transferred was less than the number of fetal 117 heart-beats, or when >1 fetal heartbeat per gestational sac was seen. Zygosity was confirmed by placental evaluation at delivery, and study corroborated the antenatal diagnosis in all cases. Among IVF study patients the frequency of MZ twinning was not statistically different established between zona manipulated and zona intact subgroups. While this investigation is the largest to date describing the relationship between MZ in twins and zona procedures, studies with even greater statistical power are needed to clarify it more precisely, particularly in DER development and FET settings. A greater overall frequency of MZ twinning for IVF patients may be a function of the higher (88%) number of embryos transferred in IVF, rather than discrete zona manipulations.

The (85/138) evident ability of the intracytoplasmic sperm injection (ICSI) procedure to achieve high fertilization and pregnancy rates regardless of semen characteristics obstruction. has induced its application with spermatozoa surgically retrieved from azoospermic men. Here, ICSI outcome was analysed in 308 cases according for to the cause of azoospermia; four additional cycles were with cases of necrozoospermia. All couples were genetically counselled and appropriately biopsies. screened. Spermatozoa were retrieved by microsurgical epididymal aspiration or from testicular biopsies. Epididymal obstructions were considered congenital (n = 138)acquired or acquired (n = 103), based on the aetiology. Testicular sperm cases were assessed according to the presence (n =72.4% 14) or absence (n = 53) of reproductive tract obstruction. The fertilization rate using fresh or cryopreserved epididymal spermatozoa was 14) 72.4% of 911 eggs for acquired obstructions, and 73.1% of 1524 eggs for congenital cases; with clinical pregnancy rates of = 48.5%(50/103) and 61.6%(85/138) respectively. Spermatozoa from testicular biopsies fertilized 57. % of 533 eggs in non-obstructive cases compared to 57. % 80.5% of 118 eggs (P = .0001) in obstructive azoospermia. The clinical pregnancy rate was 49.1%(26/53) for non-obstructive cases appropriately and 57.1%(8/14) for testicular spermatozoa obtained in obstructive azoospermia, including three established with frozen-thawed testicular spermatozoa. In cases of from obstructive azoospermia, fertilization and pregnancy rates with epididymal spermatozoa were higher than those achieved using spermatozoa obtained from the testes procedure of men with non-obstructive azoospermia.

OBJECTIVES:pregnancy To provide fertility for men with nonobstructive azoospermia. METHODS: A retrospective review of treatment results at a university infertility center retrieved, was undertaken. Sixteen couples entered an attempted in vitro fertilization (IVF)-intracytoplasmic sperm injection (ICSI) cycle for treatment of nonobstructive azoospermia.Biochemical Each man was azoospermic, and the male factor diagnosis of nonobstructive azoospermia was made on testis biopsy for 14 men hormone and on clinical grounds for 2 men. Sperm were retrieved by testicular biopsy on the day of oocyte retrieval. Results rates of testicular examinations, serum follicle-stimulating hormone levels, and testicular histology as well as evaluation of the success rates of sperm testicular retrieval, fertilizations, and pregnancies were made. RESULTS: Sperm were extracted from testis biopsies in 10 of 16 (62%) testicular sperm sperm extraction (TESE) attempts. For cycles in which sperm were retrieved, normal fertilizations were achieved for 51 of 98 (52%) mature sperm oocytes injected with testicular sperm in 10 couples. Biochemical pregnancies were achieved for 6 of 16 (38%) couples, with clinical 16 pregnancies during 5 of 16 (31%) attempts at sperm retrieval, and ongoing pregnancy and subsequent live delivery for 4 of testicular 16 (25%) attempts. CONCLUSIONS; Pretreatment clinical parameters are unable to predict which men with nonobstructive azoospermia will have spermatozoa retrieved subsequent by TESE. When sperm are found, clinical pregnancies can occur for half (5/10) of these couples using TESE with ICSI,retrospective with ongoing pregnancy and delivery for 4 of 10 (40%). Many men with nonobstructive azoospermia will have retrievable sperm with testicular testis biopsy that are suitable for ICSI; however, 6 of 16 (38%) couples will not have sperm retrieved with TESE Sperm and may undergo an unnecessary IVF procedure.

This the study was conducted to determine whether the mode of sperm immobilization prior to intracytoplasmic sperm injection (ICSI) influences fertilization by observed immature spermatozoa. Of the 837 ICSI cycles evaluated, 81 were performed with epididymal or testicular spermatozoa; 35 cycles with epididymal immobilization spermatozoa immobilized in the standard fashion resulted in fertilization and pregnancy rates of 48.3 and 51.4% respectively. When a more midpiece aggressive sperm immobilization technique (i.e. permanently crimping the sperm flagellum between the midpiece and the rest of the tail) was 17 applied in 17 cycles, the resultant fertilization and pregnancy rates were significantly (P < .05) higher: 82. and 82.4% respectively.spermatozoa Similar increases in fertilization and ensuing pregnancy rates were also observed in ICSI cycles with the aggressive immobilization of frozen-thawed increases epididymal spermatozoa (eight cycles) versus standard immobilization (16 cycles). However, the fertilization rates for ICSI using testicular spermatozoa (five cycles)the were basically the same, regardless of the immobilization technique. Furthermore, for ejaculated spermatozoa (756 cycles), the fertilization rates following aggressive (756 sperm immobilization were also positively affected (73.4%), although no statistical differences in the clinical pregnancy rates were found. Because aggressive aggressive immobilization appears to affect sperm membrane permeabilization, the enhanced fertilization patterns observed in immature spermatozoa following aggressive immobilization may suggest technique. a different membrane constitution in these spermatozoa. These findings indicate that immature gametes may require additional manipulation to enhance the of post-ICSI events essential for adequate nuclear decondensation.