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Biomedical subjects

O Hovatta

Publications and source records attributed to O Hovatta.

At least 73 records · Page 4Linked to original sources
PubMed1996

Cryopreservation of human ovarian tissue using dimethylsulphoxide and propanediol-sucrose as cryoprotectants.

Pieces of ovarian cortical tissue (0.3-2 mm in diameter) were obtained during gynaecological operations by biopsy or as a result of oophorectomy from 19 women aged 19-44 years. The tissue was frozen in a programmable freezer using one of two different cryoprotectants, either 1.5 M dimethylsulphoxide (DMSO), or a combination of 1,2-propanediol (1.5 M) and sucrose (0.1 M). After cryopreservation lasting from 24 h to 5 weeks, the ovarian pieces were thawed and studied histologically. Specimens taken before and after cryopreservation with either protectant showed no signs of tissue necrosis. Follicles at similar developmental stages were found before and after freezing. The proportions of follicles showing signs of atresia, 27% in the non-frozen tissue and 19% in the frozen-thawed tissue, were not significantly different. Oocytes, too, had the same appearance after freezing and thawing with both cryoprotectants as was seen in the specimens taken before freezing. These results suggest that cryopreservation of human ovarian tissue is feasible. However, the normality of the oocytes taken from tissue which has been frozen still needs to be established. Cryopreservation of ovarian tissue would be potentially an excellent method for storage of human oocytes once methods for their maturation in vitro have been developed.

Adult↗
PubMed1996

A randomized comparative study of highly purified follicle stimulating hormone and human menopausal gonadotrophin for ovarian hyperstimulation in an oocyte donation programme.

A randomized comparative study of highly purified human follicle-stimulating hormone (FSH-HP), administered s.c., and human menopausal gonadotrophin (HMG), administered i.m., was carried out in 41 volunteer oocyte donors. The response to ovarian hyperstimulation was similar in both groups. One cycle in both groups was cancelled. The number of oocytes recovered was 16.0 +/- 7.9 (mean +/- SD) following stimulation with 32.8 +/- 10.3 ampoules of FSH-HP (n = 19) over 12.3 +/- 1.7 days. Following stimulation with 29.8 +/- 10.6 ampoules of HMG over 11.5 +/- 1.6 days, the number of oocytes collected was 18.4 +/- 12.7 (n = 20). The oocyte recipients were allocated 9.2 +/- 3.6 oocytes in the FSH-HP group (n = 33) and 9.6 +/- 4.6 oocytes in the HMG group (n = 37). The fertilization rate (2PN/cell) was significantly higher in the HMG group (48%, 170/355) than in the FSH-HP group (36%, 109/304) (P < 0.01). The number of embryos transferred per recipient was 2.0 +/- 0.4 in the FSH-HP and 2.0 +/- 0.3 in the HMG group. The pregnancy rate per embryo transfer was 25% in the FSH-HP (5/20) and 26% (8/31) in the HMG group. Fertile donors with body mass index > or = 25 made up a poor responder group to s.c. FSH-HP, possibly indicating reduced absorption of the drug.

Adult↗
PubMed1996

A placebo-controlled flow cytometric study of the effect of low-dose prednisolone treatment on sperm-bound antibody levels.

In this placebo-controlled study the effect of short term, low-dose prednisolone treatment on sperm-bound antibody levels was investigated using an objective flow cytometric (FCM) measurement. Twenty infertile men, positive for antisperm antibodies by the mixed antiglobulin reaction (MAR) test, were treated with either 20 mg/day prednisolone (n = 10) or placebo (n = 10) for 3 weeks. The two groups were similar with respect to sperm count, motility and antibody levels. The proportion of spermatozoa positive for IgG and IgA antibodies and the antibody load, expressed as the number of IgG and IgA antibody molecules bound per spermatozoa were measured by FCM. The study showed that, overall, the antibody levels measured before and after treatment with low-dose prednisolone or with placebo were not statistically different. However, in the prednisolone group a marked decrease in the proportion of spermatozoa positive for IgG and IgA antibodies was observed in two of the patients. An examination of the FCM data of these two patients revealed that, in their ejaculates, only the spermatozoa with low to moderate amounts of sperm-bound antibodies had responded to prednisolone treatment, while spermatozoa with high levels of sperm antibodies had remained resistant to prednisolone. These results point to the existence of an as-yet-undefined subset of prednisolone-responsive, antibody--positive spermatozoa.

Antibodies↗
PubMed1996

Clinical features of primary ovarian failure caused by a point mutation in the follicle-stimulating hormone receptor gene.

The recent finding that a mutation in the FSH receptor gene causes ovarian dysgenesis prompted the present study to determine the phenotype caused by this mutation. Twenty-two patients with ovarian dysgenesis and a 566C-->T mutation in the FSH receptor gene (designated FSH-resistant ovaries or FSHRO) were compared with 30 clinically similar patients with ovarian dysgenesis (designated ODG) who did not have this mutation. The genealogical studies suggested a founder effect of the FSH receptor gene mutation in Finland. Clinically, both groups of patients were characterized by primary or early secondary amenorrhea, variable development of secondary sex characteristics, and high serum levels of FSH and LH. Notable differences were observed in median adult height (FSHRO patients were shorter) and the occurrence of follicles judged by transvaginal sonography (observed in 6 of 8 FSHRO vs. 1 of 11 ODG) and ovarian histology (present in all 9 FSHRO vs. 1 of 4 ODG). These findings suggest that a subset of ovarian dysgenesis patients with the FSH receptor mutation 566C-->T is pathogenetically distinct, possibly due to residual receptor activity, and that these patients can be tentatively identified by demonstrating the presence of ovarian follicles and confirmed by mutation analysis.

Adolescent↗
PubMed1996

Early treatment of cryptorchidism, semen quality and testicular endocrinology.

PURPOSE: We evaluated the effect of patient age at treatment of cryptorchidism in relation to subsequent semen quality. MATERIALS AND METHODS: Semen analyses and hormonal evaluations were performed in 51 men who were treated for cryptorchidism at ages 10 months to 12 years. RESULTS: Sperm concentration was normal in 90% of the patients with unilateral and 50% with bilateral cryptorchidism. No patient treated before age 4 years had severe sperm defects. Elevated follicle-stimulating hormone levels indicated severe testicular damage. CONCLUSIONS: Fertility is better in patients with bilateral cryptorchidism if treated before age 4 years. Age at treatment did not have a significant effect on semen quality in patients with unilateral cryptorchidism.

Adolescent↗
PubMed1995

Diverse spermatogenic defects in humans caused by Y chromosome deletions encompassing a novel RNA-binding protein gene.

We have detected deletions of portions of the Y chromosome long arm in 12 of 89 men with azoospermia (no sperm in semen). No Y deletions were detected in their male relatives or in 90 other fertile males. The 12 deletions overlap, defining a region likely to contain one or more genes required for spermatogenesis (the Azoospermia Factor, AZF). Deletion of the AZF region is associated with highly variable testicular defects, ranging from complete absence of germ cells to spermatogenic arrest with occasional production of condensed spermatids. We find no evidence of YRRM genes, recently proposed as AZF candidates, in the AZF region. The region contains a single-copy gene, DAZ (Deleted in AZoospermia), which is transcribed in the adult testis and appears to encode an RNA binding protein. The possibility that DAZ is AZF should now be explored.

Amino Acid Sequence↗
PubMed1995

Intra-uterine insemination versus cyclic, low-dose prednisolone in couples with male antisperm antibodies.

A total of 46 couples with male immunological infertility entered the trial at the infertility clinic of the Family Federation of Finland. The men all showed a positive mixed antiglobulin reaction to immunoglobulin G in their semen; 31 men were also tested for sperm-bound IgA immunoglobulins by flow cytometry. Serum antisperm antibodies were checked in a tray agglutination test. The women showed normal reproductive endocrinology and at least one patent Fallopian tube. The couples were randomized to undergo either up to three intra-uterine inseminations (IUI), or timed intercourse with cyclic, low-dose (20 mg) prednisolone therapy of the men. Cross-over was carried out if no pregnancy occurred in the first stage. Timing of ovulation was based on urinary luteinizing hormone assay and transvaginal ultrasonographic measurements. In all, 40 couples either completed the study or the female partner conceived. IUI was significantly better (P = 0.04) with nine pregnancies than timed intercourse with prednisolone (one pregnancy). There were no significant associations between antibody levels, sperm count or motility versus the incidence of pregnancy. In male immunological infertility, well-timed IUI is an effective treatment method: results are obtained rapidly and steroidal side-effects can be avoided.

Adult↗
PubMed1995

Treatment of severe male immunological infertility by intracytoplasmic sperm injection.

A total of 29 infertile couples (group A) with male antisperm antibodies detected by the mixed antiglobulin reaction (MAR) and partly by flow cytometry (n = 21) were treated using an intracytoplasmic sperm injection (ICSI) technique to assist fertilization. In all, 22 of them had shown a poor fertilization rate (6%) in previous in-vitro fertilization (IVF) treatments. The fertilization and cleavage rates in ICSI, 79 and 89% respectively, were similar to those in a MAR-negative group (group B; n = 20) injected because of male infertility (68 and 93% respectively). A third group (group C; n = 37) with male immune infertility was treated by conventional IVF. All these couples had at least one oocyte fertilized, but the overall fertilization rate (44%) in group C was significantly poorer (P < 0.001) than that in the two ICSI groups. However, the embryo quality was lower in group A compared with that in the other groups. A total of 13 pregnancies resulted in group A (46%), of which five ended in miscarriage. None of the six pregnancies (30%) in group B aborted during the first trimester. These results reveal, for the first time, that ICSI offers a good chance of fertilization for couples with male immunological infertility. However, post-fertilization events may compromise these results because of factors not yet clearly understood.

Adult↗
PubMed1995

Low-dose prednisolone does not improve the outcome of in-vitro fertilization in male immunological infertility.

Early reports of male immunological infertility suggested a decline in antisperm antibody concentrations in some patients after even short-term (10 day) therapy with low-dose prednisolone. In the present study, 53 men with positive results in spermatozoal mixed antiglobulin reaction (MAR) and serum tray agglutination tests (TAT), were randomized to receive either 20 mg of prednisolone or placebo daily for 2 weeks prior to in-vitro fertilization (IVF) treatment. The antibody levels were also monitored by flow cytometry (FCM). There were no significant differences between these groups as regards fertilization rates (35% with prednisolone; 39% with placebo) and pregnancy rates (29%; 32%). No significant changes occurred in either MAR or FCM results in relation to therapy. Patients with fertilization rates of < 10% had significantly higher immunoglobulin G (IgG) MAR values compared with those with better fertilization, whereas there was no relationship between IgA levels and fertilization results. As regards FCM, the results were similar, but without statistical significance. In conclusion, IVF is a good course of action in severe male immune infertility, but low-dose prednisolone therapy does not lower the sperm-bound antibody numbers and does not improve the IVF outcome.

Adult↗
PubMed1995

Pregnancy results from a vibrator application, electroejaculation, and a vas aspiration programme in spinal-cord injured men.

In an infertility treatment programme for spinal-cord injured men, vibrator application was primarily used in cases of upper motor neurone lesion and electroejaculation in men with lower lesions, or when vibrator application failed to induce ejaculation. Spermatozoa were obtained by these methods from 29 out of 35 men who desired infertility treatment. No ejaculate was obtained from six men. Three of these men plus two others with very poor sperm quality with electroejaculation underwent micro-surgical sperm aspiration from the vas deferens for invitro fertilization (IVF), and spermatozoa were obtained from all of them. Thus it was possible to obtain spermatozoa from almost every spinal-cord injured man who had ongoing spermatogenesis using these three methods. Insemination was the primary infertility treatment used with all the couples where there was successful ejaculation. In all, 12 pregnancies resulted from home vaginal inseminations, eight from intrauterine inseminations, two from IVF with ejaculated spermatozoa, and two from IVF with spermatozoa aspirated from the vas. Three couples had children from donor inseminations (not counted in the results); 12 are still in the programme. From 24 pregnancies, 22 children have now been born to 18 couples out of the original 35 (51%), and there were four abortions. Hence, overall, infertility treatment of spinal-cord injured men has given good results.

Ejaculation↗
PubMed1995

An oocyte donation program with goserelin down-regulation of voluntary donors.

BACKGROUND: In ovum donation programs oocytes can be requested from infertile women going through an in vitro fertilization cycle. Currently, when embryos can be cryopreserved, these donors have virtually disappeared. Instead, most donors have been healthy fertile volunteers willing to go through an IVF attempt solely for the purpose of donating all oocytes. METHODS: Sixty-four patients had 93 started cycles of oocyte donation from 59 donors. Twenty recipients had primary ovarian failure, 24 had secondary ovarian failure, 15 had had repeated failures in earlier IVF attempts and five were carriers of genetic diseases. The donors were 51 healthy volunteers recruited through the press. Eight patients from an IVF program donated excess oocytes. Donors were not paid and their mean age was 30 years. To minimize discomfort of the treatment, a long-acting GnRH-agonist, goserelin, was used for down-regulation. RESULTS: The pregnancy rate per transfer with fresh embryos was 28.4% (23/81) and with frozen-thawed embryos, 17% (3/18). Twenty-one healthy infants have been born including one set of triplets and three sets of twins. Nine pregnancies ended in abortion and one in intrauterine fetal death. The most common complications of pregnancy were pre-eclampsia and pregnancy-induced hypertension (41.2%, 7/17). Ten of 17 patients delivered by cesarean section (58.8%). CONCLUSION: It was possible, through the press, to obtain highly motivated oocyte donors, who go through IVF treatment solely for altruistic reasons. Oocyte recipients appear to have many complications in their pregnancies. Until more data are available, these patients need a high standard of obstetric care.

Adult↗
PubMed1995

Testicular needle biopsy, open biopsy, epididymal aspiration and intracytoplasmic sperm injection in obstructive azoospermia.

Testicular or epididymal spermatozoa were obtained for in-vitro fertilization and intracytoplasmic sperm injection (ICSI) in 27 cycles out of 33 (in six men the azoospermia proved to have testicular causes). Testicular needle biopsy carried out in addition to surgical open biopsy proved to be an effective method to obtain spermatozoa for ICSI from patients with obstructive azoospermia. Thus it might be possible to replace scrotal operations by simple needle biopsies. Embryos resulting from ICSI with testicular spermatozoa were used in 19 transfers that resulted in six pregnancies. One pregnancy resulted from six embryo transfers from ICSI after microsurgical-epididymal sperm aspiration (MESA). The normal fertilization rates with testicular (37.3%) and MESA spermatozoa (53.7%) did not differ significantly from each other, but with testicular spermatozoa the rate was significantly lower than that obtained with ejaculated spermatozoa and ICSI (59.7%) in the matched couples. The abnormal fertilization of oocytes with one pronucleus was significantly higher with testicular spermatozoa than with ejaculated spermatozoa in the control couples.

Biopsy↗