HPV infection in male partners of infertile couples seems to not affect seminal parameters

[P-057] HPV infection in male partners of infertile couples seems to not affect seminal parameters A.M. Brucculeri1, G. Ruvolo1, L. Giovannelli2, R. Schillaci3, E. Cittadini1, G. Scaravelli4, A. Perino3. 1Centro di Biologia della Riproduzione, Centro di Biologia della Riproduzione, Palermo, Italy; 2University of Palermo, Dipartimento di Scienze per la Promozione della Salute, Palermo, Italy; 3University of Palermo, Dipartimento Materno Infantile, Palermo, Italy; 4Istituto Superiore di Sanità, Istituto Superiore di Sanità, Roma, Italy Introduction: Human papilloma viruses (HPV) are agents of the most common sexually transmitted disease. This small DNA viruses induce epithelial cell prolifera…

Gamete intrafallopian transfer in the treatment of infertility: the first series at the University of Palermo

Twenty-six couples with unexplained infertility (UI), nine women with repeated failures of artificial insemination with donor semen (AID), three women with mild endometriosis, three with periadnexal adhesions, one with hostile (not immunologic) cervical mucus, and one couple in which the male partner was affected by asthenospermia were treated by the gamete intrafallopian transfer (GIFT) technique. Three different protocols for controlled ovarian hyperstimulation were used, and an adequate follicular growth and oocyte maturation were achieved in all cases. Seventeen pregnancies were obtained, for a global pregnancy rate of 38.6%. Two pregnancies (11.7%) ended in clinical abortions, and one …

Oocyte Quality According to Protocols for Controlled Ovarian Hyperstimulation and Patients’ Age

In in vitro fertilization (IVF) and embryo transfer (ET), the induction of multiple follicular growth represents the first and necessary step for the efficient performance of the technique.

Morte cellulare programmata in oociti umani dopo ICSI

Selection of the best three oocytes for intracytoplasmic sperm injection (ICSI) using apoptotic analysis of cumulus cells

Introduction: We studied the apoptosis rate of the cumulus cells of individual cumulus-oocyte complex (COC), to verify a relationship with clinical outcomes, in terms of pregnancy and implantation rates. Usually oocytes are selected using morphological criteria. We tried to verify if cumulus cell apoptotic rate could be used as a molecular criteria in selecting oocytes with higher implantation potentiality. Material and Methods: The study design consisted in two different trials: in the first we investigated apoptosis rate in cumulus cells of the three selected oocytes, according to Italian law, to be fertilized by intracytoplasmic sperm injection (ICSI). In a second trial, average apoptosi…

Hysteroscopy for metroplasty of uterine septa: report of 24 cases

Lower apoptosis rate in human cumulus cells, after r-LH administration in ovarian stimulation for IVF procedure

Pollution exposure and high DNA fragmentation index in human sperms: a case-control study

Study question: Could pollution exposure play a key role on sperm quality, in terms of DNA fragmentation index (DFI)? Summary answer: Patients exposed to high level of pollution show an higher percentage of sperm DNA fragmentation index in contrast with patient from control group. What is known already: Taranto area is characterized by a number of steel factories and petrochemical industries. Data about the detrimental effects of environmental pollution are alarming. Pollution coming from the industrial plants causes health and fertility risks, mainly due to the exposure to several pollutant (PM10, heavy metals, etc). Toxic substances can affect DNA directly or indirectly, through oxidative…

Successful in vitro fertilization and embryo transfer after limited surgical treatment for tubal adenocarcinoma.

A 29-year-old woman with tubal adenocarcinoma stage IA was treated only with bilateral salpingectomy, pelvic lymphadenectomy, and omentectomy. Two years later the patient successfully underwent in vitro fertilization and embryo transfer, and at 39 weeks gave birth to a healthy son by cesarean section. The result of oncologic follow-up 3 years after surgery is negative.

Effects of work exposure to electromagnetic waves and organic compounds on sperm DNA fragmentation in patients undergoing ICSI

Apoptosi in oociti umani non fecondati dopo ICSI

A Short History of Oocyte Pick-up

Before talking about the history of ovarian pick-up, it is important to have a look at the history of the medicine, especially to take into account the part concerning female reproductive system anatomy. The anatomical and physiological description of the ovary, the most important reproductive organ, takes place in a recent historical period with respect to other human organs. Before the fourteenth century, the ovary was considered as a female testis and the uterus as an empty penis.

Reproductive outcomes in couples affected by human papillomavirus infection undergoing in vitro fertilization procedures

Reproductive outcomes in couples affected by human papillomavirus infection undergoing in vitro fertilization procedures G. Ruvolo1, L. Giovannelli2, R. Schillaci3, P. Alimondi3, A. Pane1, A. Perino3, E. Cittadini1 1Centro di Biologia della Riproduzione, Centro di Biologia della Riproduzione, Palermo, Italy 2Dipartimento di Scienze per la Promozione della Salute, Dipartimento di Scienze per la Promozione della Salute, Palermo, Italy 3Dipartimento Materno Infantile University of Palermo, Dipartimento Materno Infantile University of Palermo, Palermo, Italy Introduction: Genital human papillomavirus (HPV) infection is the most common sexually transmitted viral infection worldwide, and has been…

Lower sperm DNA fragmentation after r-FSH administration in functional hypogonadotropic hypogonadism

Abstract PURPOSE: An observational clinical and molecular study was designed to evaluate the effects of the administration of recombinant human FSH on sperm DNA fragmentation in men with a non-classical form of hypogonadotropic hypogonadism and idiopathic oligoasthenoteratozoospermia. METHODS: In the study were included 53 men with a non-classical form of hypogonadotropic hypogonadism and idiopathic oligoasthenoteratozoospermia. In all patients, sperm DNA fragmentation index (DFI), assessed by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate (dUTP) in situ DNA nick end-labelling (TUNEL) assay, was evaluated before starting the treatment with 150 IU of recombinant hum…

L'apoptosi nelle cellule del cumulo ooforo dopo somministrazione di r-LH.

Tromboprofilassi in gravidanza in donne con aborto ricorrente precoce “inspiegato”:esiti del trattamento con basse dosi di aspirina versus aspirina ed eparina”

Apoptosis in Human Cumulus Cells

Lower apoptosis rate in human cumulus cells after administration of recombinant luteinizing hormone to women undergoing ovarian stimulation for in vitro fertilization procedures.

Objective: To investigate the effects of recombinant (r-) LH supplementation in “low responder” patients undergoing ovarian stimulation with r-FSH for an IVF program. The apoptosis rate in cumulus cells was used as an indicator of oocyte quality. Design: Comparison of the rate of DNA fragmentation and caspase-3 activity in cumulus cells in women stimulated with r-LH and r-FSH, versus patients treated with r-FSH alone (control). Setting: In vitro fertilization (IVF) laboratory. Patient(s): Forty patients undergoing assisted fertilization programs treated with a GnRH agonist, or r-FSH treatment begun on day 3 of the cycle (control). In the r-LH group, from day 8 of gonadotropin stimulation, 1…

Apoptosis in human unfertilized oocytes after ICSI

Apoptosis rate of human cumulus cells from single oocytes in infertile patients as criteria for the selection of oocytes to be treated by intracytoplasmic sperm injection (ICSI).

FSH administration reduces significantly sperm apoptosis only in the case of high DFI value: a study in idiopathic dispermic patients

Introduction: In the last decades sperm DNA quality has been recognized as one of the most important markers of male reproductive potential (Lewis and Aitken, 2005; Ozmen, 2007; Tarozzi, 2007), in contrast to standard semen parameters as sperm density, motility and morphology, which do not act as powerful discriminators between fertile and infertile men. DNA damage in the male germ line is a major contributor to infertility, miscarriage and birth defects in the offspring. In animal models, it has been unequivocally demonstrated that the genetic integrity of the male germ line plays a major role in determining the normality of embryonic development. In humans, many studies showed that sperm …

Evaluation of DNA damage in human spermatozoa: a sperm quality assay.

Several studies have demonstrated the relationship between gonadotrophine serum levels and the apoptosis rate in germinal cells. In human, lower FSH serum levels are associated with reduced Sperm Standard Parameters in term of concentration, motility and morphology and higher sperm DNA fragmentation. Hypogonadotrope hypogonadism is a clinical condition associated with male infertility, characterized by low serum levels of gonadotrophins. In this pilot study we investigated the spermatozoa quality of 11 patients with development of hypogonadotrope hypogonadism urdergoing in vitro fertilization programs. Recombinant-FSH administered to improve the sperm parameters, apoptosis rate, aiming to i…

Apoptosis in human unfertilized oocytes after intracytoplasmic sperm injection

Objective To investigate the presence of programmed cell death in unfertilized oocytes after intracytoplasmic sperm injection (ICSI), assuming that previous apoptotic events could be correlated with the fertilization failure. Design Comparison of the rate of DNA fragmentation in human oocytes at different stages of maturation soon after pick-up (control) and in unfertilized oocytes after ICSI treatment. Setting In vitro fertilization (IVF) laboratory with extensive ICSI experience. Patient(s) Sixty-three patients undergoing assisted fertilization by ICSI. Intervention(s) Terminal deoxynucleotidyl transferase-mediated digoxigenin-dUTP nick-end labeling (TUNEL) assay and anticaspase-3 cleaved…

Sludge and stones in gallbladder after pregnancy

Summary The prevalence of sludge and stones in the gallbladder of 298 women in the immediate post-partum period was ultrasonographically assessed. We have investigated some risk factors for the development of sludge or stones in these patients and followed up most of these patients by ultrasonography to detect the presence of sludge and/or stones in the year following their discovery. We found sludge in 80 (26.2%) and gallstones in 16 (5.2%) of these patients. Age, obesity and months of oral contraceptive use were risk factors only for the presence of gallstones. After 1 year of follow-up only 2 out of 45 patients with sludge but 13 out of 15 patients with gallstones still had abnormal ultr…

Concomitant gonadotropin-releasing hormone agonist and menotropin treatment for the synchronized induction of multiple follicles.

In an effort to overcome possible interference by endogenous gonadotropin-ovarian hormone dynamics, desensitization of the pituitary gonadotropins by a gonadotropin-releasing hormone agonist (GnRHa) was achieved in 12 women with repeatedly failed attempts at multiple follicular stimulation. Eight women were scheduled for in vitro fertilization (IVF) and embryo transfer (ET), and 4 for gamete intrafallopian transfer (GIFT). Stimulation failure was characterized by premature luteinization, poor estradiol (E2) response, or inadequate follicular growth. The agonist was administered by nasal spray 500 to 600 micrograms/day beginning on days 21 to 23 of the menstrual cycle. A rapid desensitizatio…

Thanatophoric dysplasia in monozygotic twins discordant for cloverleaf skull: Prenatal diagnosis, clinical and pathological findings

We present male monozygotic twins with thanatophoric dysplasia (TD) type I concordant for long bone abnormalities and discordant for cloverleaf skull. The twins were the product of the second pregnancy of unrelated parents, with advanced paternal age. Prenatal diagnosis and postmortem examination showed severe rhizomelic shortness of limbs, bowing of the long bones with "telephone-receiver" femora in both twins, and cloverleaf skull and hydrocephalus in one of them. It is now accepted that most of cases of TD, such as in the present report, represent an autosomal dominant mutation with a high new mutations rate.

Total laparoscopic hysterectomy versus total abdominal hysterectomy: an assessment of the learning curve in a prospective randomized study.

The present randomized study was undertaken in order to compare the short-term results between total laparoscopic hysterectomy and abdominal hysterectomy in a centre with experience in laparoscopic surgery. From January 1997 to September 1998 inclusive, 102 women aged 44-71 years were randomly assigned to either total laparoscopic hysterectomy (n = 51 patients) or abdominal hysterectomy (n = 51 patients). The patients' demographic characteristics were similar in both groups. Average intra-operative blood loss was lower in laparoscopic hysterectomy than in abdominal hysterectomy (P </= 0. 001). The average time employed for laparoscopic hysterectomy was 104.1 +/- 26.98 min; according to the …

A new method to select the best three oocytes to be treated for intracytoplasmic sperm injection (ICSI)

The endometrium in human assisted reproduction.

Initial experience of a new linear everting falloposcopy system in comparison with hysterosalpingography

Objective To assess the endolumenal portion of the fallopian tube from ostium to fimbria using a specially designed linear everting catheter and microendoscope. The study compared falloposcopy results with those obtained with hysterosalpingography (HSG) in the same patients and explored the system's ability to classify internal tubal conditions. Design A prospective study of a new diagnostic technique, falloposcopy, versus conventional means of evaluating tubal status. Setting A tertiary university infertility center. Patients Eighteen infertile patients with a previous history of infertility of at least 2 years duration. Intervention Diagnostic falloposcopy was performed on a total of 31 t…

Ovarian function following radiation and chemotherapy for cancer

High-dose chemotherapy and radiotherapy have increased the long-term survival of young patients with cancer; nevertheless, the toxic effects on ovarian function causing amenorrhoea, premature menopause and infertility, are still severe.

Endoscopic management of a case of 'complete septate uterus with unilateral haematometra'

Endoscopy and ultrasound was used to diagnose a 13 year old virgin girl who presented with dysmenorrhoea and suspected right side adnexal tumescence. The girl was found to have a complete septate uterus with non-communicating right hemicavity and haematometra, an exceptional type of Mullerian anomaly. After pretreatment with buserelin, hysteroscopic metroplasty was successfully performed.

IVF/ET and GIFI in andrology

Improvement in both in-vitro fertilization/embryo transfer (IVF/ET) and gamete intra-Fallopian transfer (GIFT) procedures have led to a progressive extension of their use far beyond the indications represented by tubal problems. One of the most important examples of this is in the field of male infertility. Some researchers claim that IVF/ET is more efficient on the basis of the 'fertilization evidence', while others prefer the GIFT technique, stressing that as its results are clearly so much better that it should be used in all cases.

Successful gamete intrafallopian transfer following failed artificial insemination by donor: evidence for a defect in gamete transport?

Gamete intrafallopian transfer (GIFT) was offered as an alternative treatment to 48 women who failed to conceive after artificial insemination with donor semen (AID) in numerous attempts (9 to 24 cycles). The evaluation of these women showed no major cause of infertility as evidenced by normal endocrine, cervical, uterine, and tubal factor studies. Their partners were either azoospermic or severely oligoasthenospermic. During the GIFT cycle, follicular development was induced with (1) clomiphene citrate (days 3 to 7) plus human menopausal gonadotropins (hMG) from day 6 on or (2) human follicle-stimulating hormone (days 3 to 4) plus hMG (day 5 on), until ultrasound revealed 2 follicles 16 mm…

Conservative treatment of ectopic pregnancies using a single echo-guided injection of methotrexate into the gestational sac

The authors describe the possibility of the conservative treatment of five early ectopic pregnancies. A single injection of methotrexate into the tubal gestational sac was performed under vaginal ultrasound guidance. In all five cases, a clear ectopic gestational sac could be visualized. The pregnancies dated from the 5th to the 7th week of amenorrhea. Strict ultrasound follow-up following injection showed a gradual reduction in the size of the tubal gestational sac. At the same time, plasma beta-hCG gradually decreased to zero after a maximum time period of 25 days. Subsequent hysterosalpingography performed on all of the women demonstrated bilateral normal patent tubes. It is concluded th…

New molecular markers for the evaluation of gamete quality.

Purpose: Only 30 % of IVF cycles result in a pregnancy, so that multiple embryos need to be replaced, per treatment cycle, to increase pregnancy rates, resulting in a multiple gestation rate of 25 %. The use of new markers in the gamete selection, could reduce the number of the oocytes to be fertilized and embryos to be produced, but the tools to evidence the gamete competence remain unavailable and more studies are needed to identify bio-markers to select the best oocyte and sperm to produce embryos with higher implantation potentiality. Methods: To define oocyte competence, the apoptosis of the surrounding cumulus cells and the oxygen consumption rates for individual oocytes before fertil…

r-lh administration in multiple follicular stimolation for ivf: effects of apoptosis in cumulus cells, oocytes quality and clinical outcome

Il fallimento della fecondazione: un evento predeterminato?

Effect of ovarian stimulation with recombinant LH/ FSH, recombinant FSH and human menopausal gonadotrophin (hMG) in reducing apoptosis rate in cumulus cells of patients undergoing ICSI. a pilot study

Role of leuprolide acetate depot in hysteroscopic surgery: a controlled study.

Objective To evaluate leuprolide acetate (LA) depot (Enantone Depot, Takeda, Italy) when administered preoperatively in hysteroscopic surgery. Design Prospective, comparative study. Setting University Clinic of Obstetrics and Gynecology. Patients One hundred ninety-three patients (114 pretreated with LA depot and 79 controls) who underwent hysteroscopic surgery for uterine septa (group A), submucous fibroids (group B), and abnormal uterine bleeding (group C). Results In groups B and C there was a significant reduction in the operating time, bleeding during the operation, and the amount of distention medium required after LA depot administration, but no significant differences in surgical fe…

Tromboprofilassi in gravidanza in donne con aborto ricorrente precoce "inspiegato": esiti del trattamento con basse dose di aspirina versus aspirina ed eparina

L'aborto ricorrente spontaneo (ARS), sindrome caratterizzata dal ripetersi di tre o più aborti consecutivi precoci( I trimestre)complicanti gravidanze opttenute con lo stesso partner, interessa l'1-5% delle coppie ed ha etiopatogenesi in gran parte ancora sconosciuta.Infatti, a dispetto degli studi a riguardo,solo in pochi casi si può stabilire un rapporto causa-effetto tra un fattore riscontrato in corso di indagini e la perdita embrio-fetale e, nonostante gli accertamenti cui la coppia viene sottoposta, il 40-50% dei casi rimane inspiegato. E' problematica la gestione di una nuova gravidanza in queste donne che, anche se informate della possibilità di essere vittime di un evento casuale p…