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Effect of age on testicular function in adult males with sickle cell anemia
112
Citations
from
the literature
/International
Journal
Practical evoh~tioo aad applic~tioa of direct intracytoplasmic sperm iajectiaa for male factor and idiopathic fertilization faihwe iafertiBtica
Tucker M.J.; Wright G.; Morton P.C.; Mayer M.P.; lngargiola P.E.; Jones A.E. USA
FERTIL STERIL 1995 63/4 (820-827) Objective: To analyze the introduction of a new assisted fertilization technique for the treatment of severe male factor and idiopathic fertilization failure infertilities. Design: Retrospcctive analysis of 16-month clinical application of IVF-ET where insemination was performed solely by direct intracytoplasmic sperm injection. Setting: Clinical IVF-ET program. Patients: Ninety-two couples undergoing 105 cycles of sperm injection. Results: One hundred embryo transfers yielded 28 viable pregnancies (28%) from which eight normal deliveries have occurred to date. Complete cleavage arrest or fertilization failure occurred in four cycles, and one couple had all embryos cryopreserved. One thousand one hundred forty-three eggs were injected of which 173 (15%) degenerated. Four hundred seventy-nine of the surviving 970 eggs became normally fertilized (49%), and 381 of these zygotes (79.5%) developed suitably for cryopreservation or for transfer. Thirty-four of 310 embryos transferred implanted, yielding an implantation rate of 11%. Both testicular and epididymal sperm were used successfully to achieve fertilization and pregnancies, as was sperm retrieved by electroejaculation. Older women and couples suffering from prior idiopathic fertilization failure had a markedly poorer outcome. Conclusions: These results confirm that the intracytoplasmic sperm injection technique is a successful form of assisted fertilization that can he applied to a wide range of couples at significant risk from fertilization failure. Factors of important gram of iatracytoplasmic fertility
for tbe establishment of a successful prosperm injection treatment for male in-
Svalander P.; For&erg A.-S.; Jakobsson A.-H.; Wikland M. SWE
FERTIL STERIL 1995 6314 (828-837) Objective: To establish an intracytoplasmic sperm injection treatment program for couples with male infertility and to determine those factors important for success.Design: A retrospective analysis of 171 consecutive cycles of intracytoplasmic sperm injection concerning 145 infertile couples. Setting: Infertility clinic in a private hospital associated with a university hospital. Patients: Couples with infertility in the male partner whose sperm parameters were unaccept able for conventional IVF or in whom fertilization by conventional IVF failed repeatedly. Interventions: One hundred seventy-one transvaginal oocyte retrievals were completed after superovulation with GnRH agonist and gonadotropins. Main Outcome Measures: The parameters evaluated included fertilization, cleavage, implantation, pregnancy, and spontaneous abortion in relation to patient indications and improved procedures. Results: After intracytoplasmic sperm injection, normal fertilization occurred in 45% of the oocytes (n = 1,499). Of 171 treatment cycles,93% of the couples had fertilization and 86%
of Gynecology
& Obstetrics
52 (19%)
105- I14
had ET. Thirty-six pregnancies were achieved. During the period studied, the mean fertilization rate increased from 21.3% during the first 17 weeks to 67.8% during the last 13 weeks, and the pregnancy rate (PR) per started cycle increased from 12.8%, to 31.3%. Conclusions: Technical factors critical for achieving high rates of fertilization and pregnancy were the use of standardized intracytoplasmic sperm injection pipettes, the immobilization of sperm before injection, and the aspiration of a minimal amount of ooplasm before reinjection with the sperm. Intracytoplasmic sperm injection appears to be superior to other micromanipulation methods for alleviating male infertility. Randomized
trial of partial
zona dissection
for male infertility
Tummon IS.; Gore-Langton R.E.; Daniel S.A.J.; Squires P.M.; Koval J.J.; Alsalili M.B.; Martin J.S.B.; Kaplan B.R.; Nisker J.A.; Yuzpe A.A. CAN
FERTIL STERIL 1995 63/4 (842-848) Objectives: To compare IVF rates using partial zona dissection versus zona intact insemination in couples with male infertility. To analyze pregnancy rates relative to sperm characteristics, fertilization rates, and treatment. Design: Randomized prospective comparison of fertilization in sibling oocytes. Transfer of the three best quality embryos from one or both treatments. Setting: Department of Gynaecology and Reproductive Medicine, University Hospital, London, Ontario, Canada. Participants: Thirty-two couples undergoing IVF with a principal diagnosis of male infertility. Intervention: Treatment with partial zona dissection. Main Outcome Measures: Fertilization and pregnancy. Results: Fertilization rates were 26% and 9% after partial zona dissection and IVF, respectively. Polyspermy was < 1% in each treatment. There were five singleton pregnancies in 29 completed cycles, three in cycleswith fertilization only by partial zona dissection and two in cycleswith both partial zona dissection and IVF fertilization. There were no pregnancies after fertilization by IVF only. Stepwise logistic regression analysis indicated that pregnancy was related to partial zona dissection, initial sperm concentration, and total acrosin activity. Conclusion: Partial zona dissection was associated with minimal polyspermic fertilization and higher normal fertilization rates than sibling oocytes treated by modified IVF. Pregnancy occurred only after transfer of embryos from partial zona dissection or combined partial zona dissection and IVF. Effect of age on testicular anemia
function
in adult males with sickle cell
Modebe 0.; Ezeh U.O. SAU
FERTIL STERIL 1995 63/4 (907-912) Objectives: To detetmine the effect of age on testicular function and fertility profile of adult males with homozygous sickle cell disease. Design: A comparative cross sectional study. Setting: A university teaching hospital in Nigeria. Participants: Twenty two adult males with homozygous sickle ceil disease and 20 healthy adult males with normal hemoglobin genotype.
Citations
from
the literature/International
Journal
Main Outcome Measures: Seminal indexes, serum concentration of reproductive hormones, body mass index (BMI), testicular volume index, and span height difference of patients with homozygous sickle cell disease and normal subjects were compared. Also significant differences were sought between two age groups among patients and control subjects: those 4 25 years old and those > 25 years of age. Results: The mean BMI, testicular volume index, serum T concentration, and indexes of semen quality of the patients with homozygous sickle cell disease were significantly lower than the values for the control subjects. In contrast, there was no significant difference in the mean concentration of FSH, LH, PRL, and mean span-height difference between both groups. Also, although no significant age-related effect on serum T concentration, testicular volume index, and sperm density was found in the subjects I8 to 40 years of age with normal hemoglobin genotype, patients > 25 years old with homozygous sickle cell disease had significantly higher mean serum T concentration and mean testicular volume index than those 5 25 years old; their sperm density was also substantially higher. Conclusion: Fertility is impaired in adult males with homozygous sickle cell disease probably as a result of abnormal hypothalamic or pituitary function. There is a significant amelioration of the hypogonadism, abnormal sexual function, and poor semen protile with increasing age. Admioisbstion of human chorionic gonadotropin for in vitro fertilizatiowmbfyo transfer based on the serum luteinizing hormone (LH) concentration: The importance of synchronization with endngenous LH rises Jinno M.; Ubukata Y.; Hanyu I.; Satou M.; Yoshimura Y.; Nakamura Y. JPN FERTIL STERIL 1995 63/4 (859-865) Objective: To examine whether synchronized administration of hCG at the onset of the endogenous LH rise promotes successful IVF. Design: A prospective randomized study. Setting: In vitro fertilization program at a university hospital. Patients: A total of 208 IVF cycles in 148 patients. Interventions: Serum LH concentrations were measured daily and hMG was administered daily. Independent of follicle size and Ez concentration, hCG was administered as soon as the LH concentration exceeded the J level, defined as the minimum value + (the day 3 value-the minimum value) x l/3(5 group). Alternatively, hCG was administered when the serum LH concentration turned to increase but was still less than the J level, or I day after the serum LH concentration exceeded the J level (non-J group). Results: The rates of total and ongoing pregnancy per cycle were significantly higher in the J group (35.6% and 26.0%, respectively, R = 104) than in the non-J group (21.2% and 12.5%, respectively, n = 104). Pregnancies in the J group were achieved over a wide range of dominant follicle diameters (I3 to 25 mm), E, levels (198 to 1,700 pg/ml; conversion factor to SI units, 3.671), and E, level per follicle 2 I2 mm (24 to 225 pg/ml per follicle) recorded on the day of hCG administration. Conclusion: Synchronized administration of hCG in accordance with endogenous LH rises produces a high rate of pregnancy in IVF.
of Gynecology
& Obstetrics
52 (19%)
105-I
14
113
Endomehun preparation with exogenous estradiol and progesternne for the transfer of cryopwserved Mastocysts Lelaidier C.; De Ziegler D.; Freitas S.; Olivennes F.; Hazout A.; Frydman R. FRA FERTIL STERIL 1995 6314 (919-921) Objective: To determine the implantation rates of cryopreserved blastocysts using controlled Ez and P replacement cycles in women with functioning ovaries. Design: Retrospective clinical study. Setting: University teaching hospital. Patients: Infertile women with eryopreserved blastocysts obtained from previous IVF attempts. Interventions: Exogenous E, was administered orally from cycle day I and P was started transvaginally from day 15. Blastocysts were transferred on the 5th day of endometrial exposure to P (day 19). Main Outcome Measures: Blastocyst implantation rate and pregnancy rate (PR). Results: Ninety-eight percent of blastocysts survived thawing: 67 were transferred in 42 women. Eight pregnancies occurred giving a PR of 19% per ET and I 1.9% per blastocyst. Conclusion: The high PR observed after transferring blastocysts on the 5th day of endometrial exposure to P in controlled E, and P replacement cycles speaks for a forward slide of the window of transfer in case of blastocysts.
Preimplantation gewtic diagnosis for Tay-Sachs disease: Successful pregnancy after pre-embryo biopsy and gene amplification by polymerase chain reaction Gibbons W.E.; Gitlin S.A.; Lanzendorf SE.; Kaufman R.A.; Slotnick R.N.; Hodgen G.D. USA FERTIL STERIL 1995 6314 (723-728) Objective: To determine the ability to apply preimplantation genetic diagnostic techniques to screen for and prevent TaySachs disease (TSD). Design: A couple, both carriers for the 4 base pair (bp) insertion in exon I I of the r@&hexosaminidase A gene, which results in TSD, underwent IVF, pre-embryo biopsy, polymerase chain reaction (PCR) DNA amplification of the biopsied blastomeres, and pre embryo transfer. One to two blastomeres were aspirated using a biopsy pipette that was inserted through an opening in the zona formed with acidified phosphate buffer. Polymeras chain reaction was performed on the individual blastomeres for 20 cycles followed by an additional 30 cycles using nested primers. This yielded amplified DNA products of 272 and 276 bp for the normal and mutant gene, respectively. Heteroduplex formation was used for identification of normal, homozygous affected, and heterozygous preembryos. Results: Seven of I3 oocytes fertilized normally and were biopsied at the four- to eight-cell stages. Deoxyribonucleic acid amplification occurred in four of seven pre embryos (one homozygous affected and three homozygous normal pre embryos). The three normal pre-embryos that continued to cleave after biopsy were transferred on the evening of day 3 after retrieval. Subsequently, a single gestational sac was observed and the genetic diagnosis was confirmed at amniocentesis. Conclusion: A successful pregnancy and birth were accomplished after preimplantation genetic diagnostic screening for the prevention of TSD.
Citations
from
the literature
/International
Journal
Practical evoh~tioo aad applic~tioa of direct intracytoplasmic sperm iajectiaa for male factor and idiopathic fertilization faihwe iafertiBtica
Tucker M.J.; Wright G.; Morton P.C.; Mayer M.P.; lngargiola P.E.; Jones A.E. USA
FERTIL STERIL 1995 63/4 (820-827) Objective: To analyze the introduction of a new assisted fertilization technique for the treatment of severe male factor and idiopathic fertilization failure infertilities. Design: Retrospcctive analysis of 16-month clinical application of IVF-ET where insemination was performed solely by direct intracytoplasmic sperm injection. Setting: Clinical IVF-ET program. Patients: Ninety-two couples undergoing 105 cycles of sperm injection. Results: One hundred embryo transfers yielded 28 viable pregnancies (28%) from which eight normal deliveries have occurred to date. Complete cleavage arrest or fertilization failure occurred in four cycles, and one couple had all embryos cryopreserved. One thousand one hundred forty-three eggs were injected of which 173 (15%) degenerated. Four hundred seventy-nine of the surviving 970 eggs became normally fertilized (49%), and 381 of these zygotes (79.5%) developed suitably for cryopreservation or for transfer. Thirty-four of 310 embryos transferred implanted, yielding an implantation rate of 11%. Both testicular and epididymal sperm were used successfully to achieve fertilization and pregnancies, as was sperm retrieved by electroejaculation. Older women and couples suffering from prior idiopathic fertilization failure had a markedly poorer outcome. Conclusions: These results confirm that the intracytoplasmic sperm injection technique is a successful form of assisted fertilization that can he applied to a wide range of couples at significant risk from fertilization failure. Factors of important gram of iatracytoplasmic fertility
for tbe establishment of a successful prosperm injection treatment for male in-
Svalander P.; For&erg A.-S.; Jakobsson A.-H.; Wikland M. SWE
FERTIL STERIL 1995 6314 (828-837) Objective: To establish an intracytoplasmic sperm injection treatment program for couples with male infertility and to determine those factors important for success.Design: A retrospective analysis of 171 consecutive cycles of intracytoplasmic sperm injection concerning 145 infertile couples. Setting: Infertility clinic in a private hospital associated with a university hospital. Patients: Couples with infertility in the male partner whose sperm parameters were unaccept able for conventional IVF or in whom fertilization by conventional IVF failed repeatedly. Interventions: One hundred seventy-one transvaginal oocyte retrievals were completed after superovulation with GnRH agonist and gonadotropins. Main Outcome Measures: The parameters evaluated included fertilization, cleavage, implantation, pregnancy, and spontaneous abortion in relation to patient indications and improved procedures. Results: After intracytoplasmic sperm injection, normal fertilization occurred in 45% of the oocytes (n = 1,499). Of 171 treatment cycles,93% of the couples had fertilization and 86%
of Gynecology
& Obstetrics
52 (19%)
105- I14
had ET. Thirty-six pregnancies were achieved. During the period studied, the mean fertilization rate increased from 21.3% during the first 17 weeks to 67.8% during the last 13 weeks, and the pregnancy rate (PR) per started cycle increased from 12.8%, to 31.3%. Conclusions: Technical factors critical for achieving high rates of fertilization and pregnancy were the use of standardized intracytoplasmic sperm injection pipettes, the immobilization of sperm before injection, and the aspiration of a minimal amount of ooplasm before reinjection with the sperm. Intracytoplasmic sperm injection appears to be superior to other micromanipulation methods for alleviating male infertility. Randomized
trial of partial
zona dissection
for male infertility
Tummon IS.; Gore-Langton R.E.; Daniel S.A.J.; Squires P.M.; Koval J.J.; Alsalili M.B.; Martin J.S.B.; Kaplan B.R.; Nisker J.A.; Yuzpe A.A. CAN
FERTIL STERIL 1995 63/4 (842-848) Objectives: To compare IVF rates using partial zona dissection versus zona intact insemination in couples with male infertility. To analyze pregnancy rates relative to sperm characteristics, fertilization rates, and treatment. Design: Randomized prospective comparison of fertilization in sibling oocytes. Transfer of the three best quality embryos from one or both treatments. Setting: Department of Gynaecology and Reproductive Medicine, University Hospital, London, Ontario, Canada. Participants: Thirty-two couples undergoing IVF with a principal diagnosis of male infertility. Intervention: Treatment with partial zona dissection. Main Outcome Measures: Fertilization and pregnancy. Results: Fertilization rates were 26% and 9% after partial zona dissection and IVF, respectively. Polyspermy was < 1% in each treatment. There were five singleton pregnancies in 29 completed cycles, three in cycleswith fertilization only by partial zona dissection and two in cycleswith both partial zona dissection and IVF fertilization. There were no pregnancies after fertilization by IVF only. Stepwise logistic regression analysis indicated that pregnancy was related to partial zona dissection, initial sperm concentration, and total acrosin activity. Conclusion: Partial zona dissection was associated with minimal polyspermic fertilization and higher normal fertilization rates than sibling oocytes treated by modified IVF. Pregnancy occurred only after transfer of embryos from partial zona dissection or combined partial zona dissection and IVF. Effect of age on testicular anemia
function
in adult males with sickle cell
Modebe 0.; Ezeh U.O. SAU
FERTIL STERIL 1995 63/4 (907-912) Objectives: To detetmine the effect of age on testicular function and fertility profile of adult males with homozygous sickle cell disease. Design: A comparative cross sectional study. Setting: A university teaching hospital in Nigeria. Participants: Twenty two adult males with homozygous sickle ceil disease and 20 healthy adult males with normal hemoglobin genotype.
Citations
from
the literature/International
Journal
Main Outcome Measures: Seminal indexes, serum concentration of reproductive hormones, body mass index (BMI), testicular volume index, and span height difference of patients with homozygous sickle cell disease and normal subjects were compared. Also significant differences were sought between two age groups among patients and control subjects: those 4 25 years old and those > 25 years of age. Results: The mean BMI, testicular volume index, serum T concentration, and indexes of semen quality of the patients with homozygous sickle cell disease were significantly lower than the values for the control subjects. In contrast, there was no significant difference in the mean concentration of FSH, LH, PRL, and mean span-height difference between both groups. Also, although no significant age-related effect on serum T concentration, testicular volume index, and sperm density was found in the subjects I8 to 40 years of age with normal hemoglobin genotype, patients > 25 years old with homozygous sickle cell disease had significantly higher mean serum T concentration and mean testicular volume index than those 5 25 years old; their sperm density was also substantially higher. Conclusion: Fertility is impaired in adult males with homozygous sickle cell disease probably as a result of abnormal hypothalamic or pituitary function. There is a significant amelioration of the hypogonadism, abnormal sexual function, and poor semen protile with increasing age. Admioisbstion of human chorionic gonadotropin for in vitro fertilizatiowmbfyo transfer based on the serum luteinizing hormone (LH) concentration: The importance of synchronization with endngenous LH rises Jinno M.; Ubukata Y.; Hanyu I.; Satou M.; Yoshimura Y.; Nakamura Y. JPN FERTIL STERIL 1995 63/4 (859-865) Objective: To examine whether synchronized administration of hCG at the onset of the endogenous LH rise promotes successful IVF. Design: A prospective randomized study. Setting: In vitro fertilization program at a university hospital. Patients: A total of 208 IVF cycles in 148 patients. Interventions: Serum LH concentrations were measured daily and hMG was administered daily. Independent of follicle size and Ez concentration, hCG was administered as soon as the LH concentration exceeded the J level, defined as the minimum value + (the day 3 value-the minimum value) x l/3(5 group). Alternatively, hCG was administered when the serum LH concentration turned to increase but was still less than the J level, or I day after the serum LH concentration exceeded the J level (non-J group). Results: The rates of total and ongoing pregnancy per cycle were significantly higher in the J group (35.6% and 26.0%, respectively, R = 104) than in the non-J group (21.2% and 12.5%, respectively, n = 104). Pregnancies in the J group were achieved over a wide range of dominant follicle diameters (I3 to 25 mm), E, levels (198 to 1,700 pg/ml; conversion factor to SI units, 3.671), and E, level per follicle 2 I2 mm (24 to 225 pg/ml per follicle) recorded on the day of hCG administration. Conclusion: Synchronized administration of hCG in accordance with endogenous LH rises produces a high rate of pregnancy in IVF.
of Gynecology
& Obstetrics
52 (19%)
105-I
14
113
Endomehun preparation with exogenous estradiol and progesternne for the transfer of cryopwserved Mastocysts Lelaidier C.; De Ziegler D.; Freitas S.; Olivennes F.; Hazout A.; Frydman R. FRA FERTIL STERIL 1995 6314 (919-921) Objective: To determine the implantation rates of cryopreserved blastocysts using controlled Ez and P replacement cycles in women with functioning ovaries. Design: Retrospective clinical study. Setting: University teaching hospital. Patients: Infertile women with eryopreserved blastocysts obtained from previous IVF attempts. Interventions: Exogenous E, was administered orally from cycle day I and P was started transvaginally from day 15. Blastocysts were transferred on the 5th day of endometrial exposure to P (day 19). Main Outcome Measures: Blastocyst implantation rate and pregnancy rate (PR). Results: Ninety-eight percent of blastocysts survived thawing: 67 were transferred in 42 women. Eight pregnancies occurred giving a PR of 19% per ET and I 1.9% per blastocyst. Conclusion: The high PR observed after transferring blastocysts on the 5th day of endometrial exposure to P in controlled E, and P replacement cycles speaks for a forward slide of the window of transfer in case of blastocysts.
Preimplantation gewtic diagnosis for Tay-Sachs disease: Successful pregnancy after pre-embryo biopsy and gene amplification by polymerase chain reaction Gibbons W.E.; Gitlin S.A.; Lanzendorf SE.; Kaufman R.A.; Slotnick R.N.; Hodgen G.D. USA FERTIL STERIL 1995 6314 (723-728) Objective: To determine the ability to apply preimplantation genetic diagnostic techniques to screen for and prevent TaySachs disease (TSD). Design: A couple, both carriers for the 4 base pair (bp) insertion in exon I I of the r@&hexosaminidase A gene, which results in TSD, underwent IVF, pre-embryo biopsy, polymerase chain reaction (PCR) DNA amplification of the biopsied blastomeres, and pre embryo transfer. One to two blastomeres were aspirated using a biopsy pipette that was inserted through an opening in the zona formed with acidified phosphate buffer. Polymeras chain reaction was performed on the individual blastomeres for 20 cycles followed by an additional 30 cycles using nested primers. This yielded amplified DNA products of 272 and 276 bp for the normal and mutant gene, respectively. Heteroduplex formation was used for identification of normal, homozygous affected, and heterozygous preembryos. Results: Seven of I3 oocytes fertilized normally and were biopsied at the four- to eight-cell stages. Deoxyribonucleic acid amplification occurred in four of seven pre embryos (one homozygous affected and three homozygous normal pre embryos). The three normal pre-embryos that continued to cleave after biopsy were transferred on the evening of day 3 after retrieval. Subsequently, a single gestational sac was observed and the genetic diagnosis was confirmed at amniocentesis. Conclusion: A successful pregnancy and birth were accomplished after preimplantation genetic diagnostic screening for the prevention of TSD.