OBJECTIVE: The present study describes the isolation of "implantation-related" uterine cDNA clones. It further describes their temporal and spatial expression and their identification as the messengers for two ribosomal proteins: RP2 and RS25. METHODS: Libraries of cDNA, representing spayed rats treated with progesterone for 3 consecutive days and with estrogen for either 12 or 36 hours, were screened using homologous and heterologous probes. Two cDNA clones showing differential intensity of the signal were sequenced, the timing of their expression was analyzed by Northern analysis, and their spatial expression was visualized by in situ hybridization. RESULTS: The steady-state level of RP2 mRNA was temporally and spatially controlled by estrogen and progesterone. Whereas estrogen, alone or in combination with progesterone, stimulated this gene, the spatial distribution of the activation was different. Estradiol alone directed RP2 expression to the endometrial-myometrial border, whereas combined treatment increased epithelial staining and directed heavy expression to the stratum vasculare. In normal pregnancy, during the implantation-window period, RP2 was mainly expressed on the mesometrial side, with much less staining on the antimesometrial side. The steady-state levels of the RS25 messenger were elevated by estrogen alone or in combination with progesterone and were confined to the uterine epithelium. RS25 mRNA was evenly distributed throughout the uterine stroma during implantation. CONCLUSION: A developmental pattern of expression of RP2 is reported that corresponds temporally with the primary decidual response but is spatially expressed at the site of the secondary response.

Amino Acid Sequence↗

PubMedDate not supplied

Probability of sperm detection in nonobstructive azoospermic men undergoing testicular sperm extraction procedures unrelated to clinical parameters.

The study was conducted to evaluate the significance of preoperative clinical parameters for detection of mature testicular sperm cells in nonobstructive azoospermic men. Sixty-five consecutive men with nonobstructive azoospermia underwent testicular sperm extraction procedures. Testicular samples were analyzed histologically with patterns classified as mature spermatogenesis (normal or partial), arrest of spermatogenesis, and Sertoli cell only. Testicular sperm cells were isolated for use in an IVF/ICSI program. Histologic patterns and detection rate of sperm cells were correlated to clinical characteristics. Mature sperm cells were found in all levels of serum FSH. The men were divided into 3 groups based on their clinical characteristics (serum FSH level and testicular size). The distribution of the different testicular histologic patterns, as well as detection rate of sperm cells, was similar in all groups. No correlation was found between serum levels of FSH, LH, prolactin, or testosterone and sperm presence. None of these parameters, nor the testicular size and consistency, can serve as predictive variables of the histological pattern or the presence of mature sperm cells in the testicular biopsies in cases of nonobstructive azoospermia. Until an effective predictive tool is available, a trial of sperm retrieval is recommended for all azoospermic men independent of their clinical characteristics.

Adult↗

PubMedDate not supplied

The expression of mannose-ligand receptor is correlated with sperm morphology.

The objective of the present study was to evaluate the association between the expression of sperm mannose-ligand receptors and sperm morphology. Sperm samples were obtained from 45 men, 30 fertile sperm donors and 15 infertile men. Sperm concentration, motility and morphology were evaluated and then incubated with control medium (Ham's F-10 + 1% HSA) for 4 h. Expression of mannose-ligand receptors was evaluated by mannosylated-BSA-FITC (subdivided into 3 patterns: I, for uncapacitated sperm; II, for capacitated; and III, for acrosome-reacted sperm). The mean (+/- SE) frequencies of sperm cells of the total sperm population that expressed patterns I, II, and III were 88 +/- 2.1%, 7 +/- 1.6%, and 5 +/- 0.8%, respectively, for fertile men, and 90 +/- 2.1%, 7 +/- 1.3%, and 3 +/- 0.5%, respectively, for infertile men. The rate of pattern III expression of mannose-ligand receptors was significantly higher in the fertile group compared to the infertile patients (p <.01). A poor but significant correlation was observed between the rate of pattern III and the percentage of normal-forms sperm cell in the ejaculate (r =.35, p =.018). Fertile sperm samples express more advanced patterns of mannose-ligand receptors compared to infertile men. This phenomenon is related to the morphology of human sperm cell in the ejaculate more than to any other basic sperm characteristics.

Humans↗

PubMedDate not supplied

Improvement in the cervical mucus penetration test by using standard sperm control.

The objective of the present experiments was to establish an acceptable standard for the cervical mucus penetration test (CMPT) by determining the minimal progressive motile spermatozoa concentration (PMSC) that will yield the highest score for proven fertile donor sperm specimens. For this purpose, fresh and frozen-thawed samples were used. Semen was obtained from 29 fertile donors and different PMSC (8, 10, and 14 x 10(6)/mL) were prepared for each sample. The same mucus specimen was used for testing each sperm sample in the three different dilutions. No difference in the scoring of the CMPT between the fresh vs. frozen-thawed groups was found. When PMSC of 14 x 10(6)/mL was used, almost all specimens scored the highest rank. The present study revealed that only semen samples with a minimal PMSC of 14 x 10(6)/mL cells can be used in the CMPT. The information that the freeze-thaw process does not affect the CMPT results supports the concept of cryopreservation of pooled fertile donor specimens in aliquots with adequate concentration of progressive motile spermatozoa for later use as a CMPT control.

Cervix Mucus↗

PubMedDate not supplied

The interrelationship between coping strategies and sexual functioning in in vitro fertilization patients.

This study examined the correlation between various coping strategies and sexual functioning and the likelihood of conception from in vitro fertilization (IVF). Self-reported questionnaires were distributed randomly among the 102 women enrolled in an IVF program, 96 of whom were recruited. Of the studied parameters, positive reinterpretation, and growth, and active coping strategies were found to be positively associated with sexual functioning, while there was a significantly (p < .05) adverse influence of planning and self-restraint. Being sexually active during the IVF-treatment period was found to be positively associated (p < .05) with the likelihood of conception and with adaptive coping strategies.

Adaptation, Psychological↗

PubMedDate not supplied

Combined vulvar vestibulitis syndrome with vaginismus: which to treat first?

The common approach to vulvar vestibulitis syndrome (VVS) combined with vaginismus is to treat the VVS before the vaginismus. Our study initially ignored the VVS and instead treated the vaginismus first.

Dyspareunia↗

PubMedDate not supplied

Mediterranean lymphoma -- an unusual course.

A case of Mediterranean lymphoma with an unusual short and stormy course complicated by spontaneous perforation of the small bowel in a 32-year-old Jewish Moroccan-born male is presented. Such a course has not been described previously. Literature pertinent to the subject is reviewed.

Adult↗

PubMedDate not supplied

Cryptorchidism: incidence and sperm quality in infertile men.

In a population of 8500 men attending the andrology outpatient clinic, 200 men (2.35%) were recorded as having some disturbances with the descent of the testes into the scrotum. Medical history of the patients revealed that 51 underwent unilateral orchidopexy; 40 bilateral orchidopexy; and 24 were treated with human chorionic gonadotropin in order to induce descent of their testes. In addition, 6 patients reported spontaneous descent of the testes, and 13 others were found to be unilaterally cryptorchid upon physical examination. Results of semen analysis, hormonal profile, testes position, and testicular volume were compared to those of 105 proven fertile men. The major finding of this study shows that post-partum undescended testes suffer from primary Sertoli cell malfunction as reflected by elevated serum follicle stimulating hormone levels. Serum luteinizing hormone and testosterone levels were within the normal range. Surgical descent of the testes did not improve sperm production, proved by low sperm quality of all the study groups, compared to the cryptorchid group. Among the patients who were operated on, no correlation was found between age at operation and semen variables. All groups showed poor sperm quality which can be defined as oligoteratoasthenozoospermia. The degree of spermatogenic damage was in the following order of diagnosis or treatment: bilateral orchidopexy greater than cryptorchid testes greater than hormonal treatment greater than unilateral orchidopexy greater than late spontaneous descent of the testes. Thus, it is advisable to postpone surgical treatment of cryptorchidism and apply this only after a waiting period, and if the hormonal approach has failed to descend the testis.

Adolescent↗

PubMedDate not supplied

Advanced methods for evaluation of sperm quality.

Routine semen analysis includes measurements of sperm concentration, motility, and morphology. In our study, three additional tests were evaluated in relation to fertilization rate in an in vitro fertilization program: the freezing and hypo-osmotic swelling tests that evaluate the functional integrity and stability of the sperm membrane under extreme osmotic conditions, and migration sedimentation test that isolates high-quality motile sperm cells. The study was performed on semen delivered by men of couples treated at the In Vitro Fertilization Unit, and men who served as semen donors (fresh or cryopreserved semen). No correlation was found between the sperm fertilization rate, and the decrease in motility percent following the freezing-thawing process. Thus, the freezing test cannot be used to predict semen fertilization capacity. The hypo-osmotic swelling test was applied on semen given by a similar population of men. While the hypo-osmotic swelling test values carried out with fresh semen was found to have good correlation with fertilization, no correlation was found when frozen thawed semen was used. Post-migration sedimentation test sperm characteristics, and especially the recovery rate of the motile sperm, were significantly better in in vitro fertilization cycles with fertilizations. Both the hypo-osmotic swelling test and migration sedimentation test can assist in evaluating semen quality, judged by the fertilization rate in an in vitro fertilization program.

Female↗

PubMedDate not supplied

Separation of sperm cells by sedimentation technique is not suitable for in vitro fertilization purposes.

Two methods of sperm preparation for in vitro fertilization were compared: the swim-up technique vs. the migration-sedimentation technique. The study comprised fresh semen samples obtained from 25 couples treated in the In Vitro Fertilization Unit. Oocytes aspirated in a single cycle were divided into two groups, each inseminated by sperm prepared by one of these techniques. Motility, degree of motility, and normal morphology were improved by both methods. The improvement was greater when the migration-sedimentation technique was applied. However, fertilization rate was significantly higher after the swim-up technique. In order to clarify this contradiction, an additional group of 26 semen samples was divided and then prepared by the swim-up or migration-sedimentation techniques. Sperm quality was examined up to 72 h after separation. Compared with the swim-up technique, sperm characteristics were better after separation by the migration-sedimentation technique. However, this difference abated after 24 h. The better results of the swim-up technique in the "survival experiment' may explain its improved performance in in vitro fertilization, despite lower separation capacity. Thus, the migration-sedimentation technique is not recommended for sperm preparation in in vitro fertilization.

Cell Separation↗

PubMedDate not supplied

Correlation between sperm penetration into the human zona pellucida and in vitro fertilization rates.

Sperm penetration into the zona pellucida of unfertilized oocytes, and its correlation with in vitro fertilization rates of the sibling oocytes, were assessed. This was performed in order to evaluate the prediction rate of the sperm penetration test into the zona pellucida. Unfertilized oocytes (n = 1872) from 371 cycles were pipetted through a microcapillary, and the remaining sperm cells penetrating the zona pellucida were counted. The mean (+/- SD) number of spermatozoa that penetrated the zona pellucida of unfertilized oocytes was 12.9 +/- 16.37. A significant correlation was found between the fertilization rate and the mean number of spermatozoa that penetrated into the zona pellucida of the unfertilized sibling oocytes (r = 0.48; P < 0.001), or the percent of unpenetrated zonae pellucidae in a cohort (r = -0.43; P < 0.001). However, a distinct variation in the number of spermatozoa that penetrated into the zona pellucida was detected. A step-wise regression analysis proved the number of spermatozoa penetrating the zona pellucida to be more predictive for fertilization rates than the variable of percent of unpenetrated zonae pellucidae. The results imply that although there is interdependence between penetration into the zona pellucida and fertilization rate, the predictive value of sperm penetration test for prognosis and future management after the first in vitro fertilization attempt, is limited.

Cohort Studies↗

PubMedDate not supplied

Effect of sperm preparation with TEST yolk buffer on sperm-binding capacity under hemizona assay conditions.

The study was conducted to evaluate the diverse effect and clinical significance of TEST yolk buffer treatment on sperm samples of 128 infertile men. Sperm samples were incubated with TEST yolk buffer and control medium (Ham's F-10) at room temperature for 2 h. The hemizona indices (mean +/- SE) of the TEST yolk buffer and medium-treated sperm samples were 29 +/- 2.3% and 22 +/- 1.6%, respectively. Inspection of the individual response of each sperm sample to TEST yolk buffer revealed that 63 samples (49%) improved (double the interassay variation = 28%) their binding to zona pellucida, 36 (28%) remained unchanged, whereas the binding capacity of 29 samples (23%) decreased. Furthermore, TEST yolk buffer treatment of 24 samples (19%) resulted in an increased binding beyond the hemizona index threshold set up at 23%. This level was previously shown to be the cut-off point between fertile and infertile sperm samples. It was concluded that when applied to an unselected group of infertile men, TEST yolk buffer significantly increased sperm binding capacity to the zona pellucida. However, only 19% of the sperm samples showed improvement with clinical significance. The other sperm samples may have improved, remained unchanged or even deteriorated independently on basic sperm variables. Thus, the effect of TEST yolk buffer treatment on sperm binding should be tested prior to its clinical use to avoid possible damage to certain sperm samples.

Buffers↗

PubMedDate not supplied

The possible association between in vitro fertilization treatments and cancer development.

The objective of this paper is to assess whether ovarian hyperstimulation and in vitro fertilization (IVF) are associated with increased risk of cancer development, using an historical cohort analysis of infertile women who attended the IVF unit, Lis Maternity Hospital Tel Aviv Medical Center, Tel Aviv, Israel. One thousand and 82 women participated in the IVF treatment program between 1984 and 1992. Cancer incidence rates were determined through the National Cancer Registry and were compared to the expected rates with respect to appropriate age and continent of birth. Twenty-one cases of cancer were observed as compared to 11 that were expected (SIR 1.91; 95% CI 1.18-2.91). When cancer cases that were diagnosed within one year of the IVF treatment were excluded from the analysis (SIR = 1.46; 95% CI 0.83-2.36), no significant excess risk of cancer was noted. We conclude that in this cohort of infertile women, the higher than expected cancer rate could not be attributed to IVF treatments. Special attention should be made to women who may be diagnosed with cancer during or shortly after IVF treatment.

Adult↗

PubMedDate not supplied

Intracardiac echogenic focus: no apparent association with structural cardiac abnormality.

OBJECTIVE: The aim of our study was to evaluate whether intracardiac echogenic foci (ICEFs) may be associated with increased risk for structural cardiac anomalies in the low-risk population. METHODS: During a 24-month period, 3,744 low-risk patients were prospectively screened for ICEFs by prenatal sonography. The study group was composed of 138 fetuses (3.7%) with ICEF. The control group was composed of 167 fetuses without ICEF. In all fetuses a complete echocardiographic evaluation was performed. RESULTS: Among the 138 fetuses in the study group, 108 (78%) ICEFs were found in the left ventricle, 25 (18%) were found in the right ventricle, and 5 (4%) were found to be bilateral. No statistically significant difference was found between the study and the control group regarding the presence of cardiac anomalies. Only 1 case (0.7%) of pulmonic stenosis was found in the study group, compared to 1 case (0.6%) of bicuspid aortic valve in the control group. CONCLUSIONS: We conclude that ICEFs found in low-risk patients are not associated with a significant increase in the risk of cardiac anomalies.

Adult↗