Gonadotropin stimulation for in vitro fertilization and embryo transfer in insulin-dependent diabetics: Follicular response, oocyte quality, embryo development, and follicular environment

Citations from the Literature bioassay in 98 men subgrouped into normospermic, oligospermit, and azoospermic. Bioactivity of FSH was determined using in vitro cultures of granulosa cells utilizing progesterone measurements for assessing FSH activity. Results of FSH levels obtained by both methods correlated well (r = 0.55, P < 0.01) within themselves, and both correlated negatively and significantly with sperm concentration. The ratio between bioactivity and immunoreactivity of FSH did not correlate with sperm density. Thus, the decrease in sperm concentration and other sperm variables resulting from a germinal epithelial dysfunction was not mediated or associated with low biological activity of FSH. The application of this method can be of clinical value in cases where a discrepancy is found between serum RIA-FSH levels and sperm quality. Gonadotropin stimulation for in vitro fertiliition and embryo transfer in insulindependent diabetics: Follicular response, oocyte quality, embryo development, and follicular environment

Oehninger S; Hofmann GE; Kreiner D; Acosta AA; Muasher SJ Jones Institute for Reproductive Medicine, 826 Fairfax Avenue, Norfolk, VA 23507, USA FERTIL STERIL 1990,53/4 (741-743) Two IDD patients were stimulated with gonadotropins for IVF and ET. Both patients had high E, response and 2 5 preovulatory oocytes retrieved, normal fertilization and cleavage rates, and transfer; neither conceived. Follicular fluid showed levels of E,, P, A, hCG, and PRL similar to non-IDD. Epiderma1 growth factor could not be detected in FF. Insulin-dependent diabetes patients can undergo gonadotropin stimulation for IVF with customary responses. Their follicular milieu resembles that of non-IDD patients except for a lack of EGF. Immunosuppression

supports implantation

of zona pellucida

dissected human embryos

Cohen J; Malter H; Elsner C; Kort H; Massey J; Mayer MP Center for Reproductive Medicine and Infertility, Cornell University Medical College, 505 East 70 Street, New York, NY 10021, USA FERTIL STERIL 1990,53/4 (662-665) The effect of low dose immunosuppression with methylprednisolone during the first 4 days after oocyte retrieval on potential immune cell invasion of partially zona dissected embryos in utero was investigated in alternate in vitro fertilization patients (n = 32). The incidence of pregnancy was significantly higher in patients receiving methylprednisolone (7 of 18, 39%) than in control patients (1 of 14, 7%). Twenty-eight percent (11 of 39) of the embryos replaced in the corticosteroid treated patients implanted, whereas only 7% (2 of 31) of embryos in control patients had a fetal heart beat. There were no side effects reported in any of the patients receiving corticosteroids. It can be concluded that methylprednisolone supports implantation of embryos with small holes in their zonae. However, the actual mechanisms of corticosteroid support on the interaction between immune cells and micromanipulated embryos are not well understood.

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Relationship of bacteriologic characteristics to semen indices in men attending an infertility clinic

Hillier SL; Rabe LK; Muller CH; Zarutskie P; Kuzan FB; Stenchever MA Department of Obstetrics and Gynecology, University of Washington, Seattle, WA 98195, USA OBSTET GYNECOL 1990,75/5 (800-804) Bacteria can be isolated from most seminal fluid samples, but the significance of these microorganisms is uncertain because most men lack symptoms associated with bacterial infection of the reproductive tract. We obtained semen samples from 37 men attending a Special Infertility Clinic and assessed the relationship between seminal fluid microorganisms and seminal fluid analysis including sperm motility, morphology, and concentration; the numbers of polymorphonuclear leukocytes and other white blood cells; and the hamster zona-free oocyte sperm penetration assay. Aerobic and/or anaerobic bacteria were recovered from 36 of the 37 samples. One hundred eighty-eight isolates (113 aerobes, 74 anaerobes, and one yeast) were recovered, with a mean of 5.2 isolates per semen specimen. The microorganisms recovered from the samples included: coagulase-negative staphylococci (89%), viridans streptococci (65%), diphtheroids (8601o),Peptostreptococcus sp (62%), Bacteroides sp (27%), Gardnerella vaginalis (19%), Lactobacillus sp (16S), Actinomyces sp (16Oro), Enterococcus (11qo), and Veillonella (11%). Other microorganisms including group B streptococcus, Hemophilus, Escherichia coli, Mobiluncus, and Clostridium were each recovered from fewer than 10% of the specimens. When the microbiology of seminal fluid specimens with or without polymorphonuclear leukocytes was compared, the presence of polymorphonuclear leukocytes in the semen was not associated with the isolation of staphylococci (33 versus 25%), viridans streptococci (33 versus 28%), Bacteroides sp (17 versus 37%), or Peptostreptococcus (31 versus 33%) (P > .05 for each comparison). The proportion of semen samples yielding bacterial isolates was similar after categorization by normal motility (more than 6Os/‘o),pyospermia (six or more leukocytes per 100 sperm), sperm concentration, morphology, and a normal sperm penetration assay (11% or more). Likewise, the median numbers of isolates per specimen were similar for each group. These observations suggest that bacteriospermia is not associated with either pyospermia or abnormal sperm function and probably represents bacterial colonization rather than active infection.

GYNECOLOGICAL ENDOCRINOLOGY Pbarmacokinetics of estrogen

Stumpf PC Department of Obstetrics and Gynecology, Jersey Shore Medical Center, 1945 Corlies Avenue, Neptune, NJ07754, USA OBSTET GYNECOL 1990,75/4 SUPPL (9S-14s) The main types of pharmacologic therapy used to treat the hormone deficiency of menopause are parenteral and oral administrations of estrogen. Parenteral administration results Int J Gynecol Obstet 33