Surgical sperm retrieval(SSR)is currently one of the most common procedures in in vitro fertilization(IVF).However,a gap between the guidelines and routine clinical practice regarding antibiotic use in sSR,which might...Surgical sperm retrieval(SSR)is currently one of the most common procedures in in vitro fertilization(IVF).However,a gap between the guidelines and routine clinical practice regarding antibiotic use in sSR,which might lead to antibiotic resistance,is a challenging problem worldwide.A cross-sectional survey was conducted from May 1,2021,to July 15,2021,to investigate antibiotic usage by medical professionals when performing SSR in IVF centers in Vietnam.The confidential questionnaire comprised 12 items,including characteristics of the study population,awareness of antimicrobial resistance,attitude toward prescribing antibiotics,and current practice of prescribing antibiotics when performing SSR.Surveys were completed by 30 of 45 registered IVF centers(66.7%).Among 67 physicians working at those centers,the age and work-experience years(mean±standard deviation[s.d.])were 38.6±6.6 years and 11.2±7.0 years,respectively.Over 60%of them held a degree in Obstetrics and Gynecology,and over four-fifths were men.Most respondents"often/very often/always"raised awareness of antimicrobial resistance to their patients(83.3%),but only half of them"often/occasionally"prescribed antibiotics to patients with SSR in cases where the prescription would be optional.About one-tenth of respondents followed the recommendation from the American Urological Association using"prophylaxis only"for SSR patients.For more invasive SSR,physicians tended to prescribe more complicated and sometimes inappropriate regimens.In conclusion,antibiotic usage in SSR was not always appropriate among IVF centers.Further studies may define specific recommendations for regimens,intervention strategies,and programs to promote appropriate antibiotic use for SSR patients among IVF specialists.展开更多
Objective: To investigate the effect of coasting on IVF outcome in GnRH agonist cycles.Design: Retrospective ana-lysis. Setting: Private IVF center.Patient(s): Infertile couples undergoing IVF/intracytoplasmic sperm i...Objective: To investigate the effect of coasting on IVF outcome in GnRH agonist cycles.Design: Retrospective ana-lysis. Setting: Private IVF center.Patient(s): Infertile couples undergoing IVF/intracytoplasmic sperm injection (ICSI) treatment (normal responders [control], hyper- responders [coasting]- groups).Intervention(s): Coasting to reduce the risk of ovarian hyperstimulation syndrome (OHSS) among hyper- responders.Main Outcome Measure(s): Stimulation, embryology parameters, and pregnancy rate (PR).Result(s): The average length of coasting was 2.2 days.Age and baseline FSH were comparable to control cycles.There were more follicles and oocytes in the coasting group, but the number of fertilized oocytes and embryos transferred were similar.Implantation rate (22.4% vs.13.9% ) was higher in the control group but the PRs were comparable (45.1% vs.38.5% ).Within the coasting group, baseline, stimulation, and embryology parameters were comparable between successful and unsuccessful cycles.Pregnancy rates were comparable after 1, 2, and 3 or more days of coasting (36.3% vs.38.4% vs.40% ). Pregnancy rates were also comparable (28.5% vs.35.7% vs.44.4% ) when groups were compared based on change in E2 ( < 25% , 25% ～ 50% , > 50% ).Conclusion(s): Coasting for 3 days can be used successfully in the management of the hyper- responding patients during IVF.展开更多
Objective:To investigate and analyze the prevalence and risk factors of infertility in a Mongolian population.Methods:We conducted a population-based cross-sectional study between September 2016 and November 2021.Our ...Objective:To investigate and analyze the prevalence and risk factors of infertility in a Mongolian population.Methods:We conducted a population-based cross-sectional study between September 2016 and November 2021.Our study population of 1919 participants consisted of residents of Ulaanbaatar city and four regions of Mongolia.A pretested standardized and structured questionnaire was used to gather data from the participants.Our questionnaire comprised categories influencing infertility,such as socioeconomic status,lifestyle factors,health,reproductive history,present status,and sexual function.In addition,trained staff conducted face-to-face interviews with the participants.Results:Our study showed an infertility incidence of 8.2%,with primary infertility at 2.76%and secondary infertility at 5.47%.Compared with the urban area of Ulaanbaatar,the prevalence of infertility was significantly higher amongst the rural population(P<0.001).Risk factors of infertility included advanced age(35-39 years,OR 1.8,95%CI 1.99-6.55;>40 years,OR 2.1,95%CI 2.62-8.55),living rural region(aOR 2.4,95%CI 1.62-3.69),alcohol consumption(aOR 1.6,95%CI 1.11-2.44),chronic diseases(aOR 1.6,95%CI 1.20-2.38),reproductive disease(aOR 2.6,95%CI 1.86-3.88),gynecological operative history(aOR 2.1,95%CI 1.38-3.21),ovarian cyst(aOR 4.2,95%CI 2.70-6.40),gonorrhea(aOR 2.4,95%CI 1.01-6.16),non-malignant uterine cancer(aOR 2.9,95%CI 1.40-6.70),and endometriosis(aOR 4.7,95%CI 1.41-15.62).Conclusions:In Mongolia,the average infertility rate is 8.2%,similar to the average worldwide and is significantly higher in rural communities.Our study shows the most significant risk factors for infertility are age,alcohol consumption,and rural living.In addition,an unfavorable gynecological history and some diseases also pose a risk to fertility.展开更多
We report the successful outcome of intracytoplasmic sperm injection （ICSI） treatment in two siblings with familial globozoospermia. After controlled ovarian hyperstimulation and oocyte pick-up, retrieved oocytes we...We report the successful outcome of intracytoplasmic sperm injection （ICSI） treatment in two siblings with familial globozoospermia. After controlled ovarian hyperstimulation and oocyte pick-up, retrieved oocytes were mechanically activated before ICSI and a fertilization rate of 33.3% was achieved in the first case. The second couple underwent ICSI without oocyte activation and a 9.1% fertilization rate was obtained. The transfer of two grade I embryos in the first couple and one grade I embryo in the second couple resulted in clinical pregnancies with healthy livebirths. It was concluded that the main problem of cases with globozoospermia is a low fertilization rate, and even though ICSI and oocyte activation can increase this rate it is not necessarily needed to achieve a pregnancy. （Asian J Androl 2008 Mar; 10： 332-336）展开更多
Embryo cryopreservation（CP） has became a very important part of the clinical use of in vitro fertilization. Oocyte CP offers more advantages compared with embryo freezing with regard to less ethical, legal and moral...Embryo cryopreservation（CP） has became a very important part of the clinical use of in vitro fertilization. Oocyte CP offers more advantages compared with embryo freezing with regard to less ethical, legal and moral problems. However, the efficiency of this procedure is still low, which prevents its clinical application in wide range. The aim of our paper is to review the basic principles, technical and safety aspects and current status of oocyte cryopreservation in human assisted reproduction.展开更多
Varicocele has been implicated as a cause in 35%-50% of patients with primary infertility and up to 81% of men with secondary infertility. Although a large number of reports have shown improvement in the semen paramet...Varicocele has been implicated as a cause in 35%-50% of patients with primary infertility and up to 81% of men with secondary infertility. Although a large number of reports have shown improvement in the semen parameters after correction of varicocele, other studies have suggested no benefit. We report the first case of azoospermia after surgery in a young infertile male patient with left-sided varicocele and severe oligozoospermia undergoing laparoscopic varicocelectomy. A pregnancy was only achieved with assisted reproductive technology because semen cryopreservation was performed before surgery. In the light of the above, the deterioration of sperm count after varicocele repair in patients with severe oligozoospermia could be due to irreversible impairment of spermatogenesis of such patients, together with the possible temporary damage of the surgical repair. This possible complication could therefore turn the severe oligozoospermia into an indication to perform cryopreservation before surgery, on both clinical and medico-legal grounds. Further research is needed before drawing definitive conclusions regarding the management of varicocele-related severe oligozoospermia.展开更多
Objective: This study assessed blood C-reactive protein (CRP), fibrinogen, procalcitonin, and CA125 levels and determined whether they have an effect on pregnancy. Material & Methods: Between Feb. and Sep. 2018, 5...Objective: This study assessed blood C-reactive protein (CRP), fibrinogen, procalcitonin, and CA125 levels and determined whether they have an effect on pregnancy. Material & Methods: Between Feb. and Sep. 2018, 50 consecutive women who had their first frozen embryo transfer at a tertiary referral IVF center in Turkey were included in the study. Serum samples were collected on the second day of the cycle and on the transfer day. The women were divided into two groups based on the results of pregnancy outcome: pregnant (group 1) and non-pregnant (group 2). Blood CRP, fibrinogen, procalcitonin, and CA125 levels were compared between the groups. Results: There were no statistically significant differences between the groups according to CA125, CRP, fibrinogen, and procalcitonin levels at the beginning of the cycle and on the transfer day. In comparison with levels at the beginning of the cycle and on the transfer day, fibrinogen and CRP were significantly higher on the transfer day than at the beginning of the cycle. Procalcitonin was significantly higher on the transfer day than at the beginning of the cycle in group 1. However, there was no statistically significant difference between the transfer day and the beginning of the cycle in group 2. Conclusions: However, the fibrinogen, CRP and procalcitonin levels were significantly higher on the transfer day than at the beginning of the cycle. The results indicated that acute phase reactants or CA125 should not be used to determine the time of embryo transfer or predict pregnancy.展开更多
Objective: This study was designed to compare the exogenous FSHovarian reserve test(EFORT) versus the clomiphene citrate challenge test(CCCT), basal FSH, and basal inhibin B, with respect to their ability to predict p...Objective: This study was designed to compare the exogenous FSHovarian reserve test(EFORT) versus the clomiphene citrate challenge test(CCCT), basal FSH, and basal inhibin B, with respect to their ability to predict poor and/or hyperresponders in an IVF population. Design: Prospective randomized controlled trial. Setting: Fertility center of a university hospital. Patient(s): One hundred ten patients undergoing their first IVF cycle, randomized into two groups. Intervention(s): Fifty-six patients underwent a CCCT, and 54 patients underwent an EFORT. In all patients, the test was followed by an IVF treatment. Main Outcome Measure(s): Ovarian response, expressed by the total number of retrieved oocytes. Result(s): Univariate logistic regression showed that the best predictor for poor response is the CCCT(area under receiver operator characteristic curve [ROCAUC] =0.87),with maximal accuracy of 0.89. Multiple logistic regression analysis did not produce a better model in terms of improving the prediction of poor response. For hyper response, univariate logistic regression showed that the best predictor is the inhibin B increment in the EFORT(ROC-AUC=0.92) but with a low maximal accuracy of 0.78. Again, multiple logistic regression analysis did not produce a better model in terms of predicting hyper response. Conclusion(s): Our study, the first which compares the CCCT with the EFORT for the prediction of poor and hyperresponders, shows that the CCCT is superior for identification of low responders. The EFORT(inhibin B increment) is superior for prediction of hyper response at the cost of a high rate of false positives. Neither of the two tests seems adequate to act alone for identification of both poor and hyperresponders.展开更多
Prior studies suggested sperm with damaged DNA permits fertilization but may lead to failure of embryo implantation following blastocyst formation. Quantitative correlations between DNA damage and risk of implantation...Prior studies suggested sperm with damaged DNA permits fertilization but may lead to failure of embryo implantation following blastocyst formation. Quantitative correlations between DNA damage and risk of implantation failure have, however, so far not been performed. The aim of this study was to investigate two FSHR gene polymorphisms G919A (Ala307Thr) and A2039G (Asn680Ser) in Eastern Ukrainian Caucasian men with abnormally low fertility. The molecular genetic analysis was performed by real-time PCR, with the level of DNA fragmentation measured by the sperm chromatin dispersion (SCD) method. The relationship between DNA fragmentation in sperm and these genetic polymorphisms was estimated. Compared to homozygotes, the risk of high-level DNA fragmentation (>20%) increased in men up to age 35 years 16-fold for heterozygotes GA of polymorphic variant G919A, 28-fold for homozygotes AA of polymorphic variant G919A;and 16-fold for heterozygotes GG of polymorphic variant A2039G. A statistically significant positive correlation between number of alternative alleles of the FSHR gene in genotype and degree of DNA fragmentation is proved (r<sub>s</sub> = 0.70, P < 0.01).展开更多
Multiplex polymerase chain reaction （PCR） has been widely used to detect Y-chromosome micredeletions, which is one of the major causes of male infertility. Both the European Academy of Andrology （EAA） and the Euro...Multiplex polymerase chain reaction （PCR） has been widely used to detect Y-chromosome micredeletions, which is one of the major causes of male infertility. Both the European Academy of Andrology （EAA） and the European Molecular Genetics Quality Network （EMQN） have recommended the use of sY84 and sY86 markers for the detection of azoospermia factor a （AZFa） microdeletion during DNA testing for male infertility. In this study, a large-scale analysis of AZF microdeletion in a total of 630 Chinese males, including healthy semen donors （n=200）, infertile males with normal sperm count （n=226） and patients with either nonobstructive azoospermia or severe oligozoospermia （n=204）, was performed. A series of nine sequence-tagged site （STS） markers from the AZF region of the Y chromosome was used to detect microdeletions. All primers were designed based on the recommendations of the National Center for Biotechnology Information. An unusually high incidence （73/630, 11.6%） of sY84-absent but sY86-present genotypes was observed in the AZFa microdeletion screening. Sequencing the sY84-flanking region revealed a total of 73 patients with sY84-absent but sY86-present genotypes have a T-to-G transversion at the fifth base from the 5＇ end of the reverse sY84 primer. These prevalent false positives, which were not only observed in infertile men, but also observed in donors, resulted from a single-nucleotide polymorphism （SNP） named rs72609647 in the targeting sequence of the reverse sY84 primer. Our study suggests that a pre-screening of existence of rs72609647 polymorphism can prevent the frequent false positive results of AZFa microdeletions detection in the infertile Chinese males. Given the SNP rs72609647 was recently found in a deep sequencing of a Chinese individual, the current EAA and EMQN standards may need to be scrutinized among different populations to avoid the potential genetic variations in the primer binding sequences.展开更多
Objective: The incidence of placenta previa (PP) has been increasing due to the rise in cesarean rates. The aim of this study is to determine the success of lower uterine segment compression suture and bakri balloon a...Objective: The incidence of placenta previa (PP) has been increasing due to the rise in cesarean rates. The aim of this study is to determine the success of lower uterine segment compression suture and bakri balloon applications in patients diagnosed with placenta previa. Materials and Methods: 257 patients who underwent cesarean section due to placenta previa totalis (PPT) between the years of 2010-2018 in Ondokuz Mayis University were screened retrospectively. The patients were evaluated in four groups according to their treatment method: medical treatment, bakri balloon application, compression suture and hysterectomy. Results: In the study, between the years 2010-2015, postpartum hysterectomy was performed in the cases of adherent placenta previa, and hysterectomy was performed in 33 patients. Between the years of 2015-2018, first, bakri balloon or compression suture was applied;and if bleeding control was not achieved despite these, then, hysterectomy was performed. Between 2015 and 2018, a total of 27 patients underwent compression suture and 1 patient had a hysterectomy after all. The success rate was 96.3% with compression suture and 91.7% for bakri balloon application. Totally, 24 patients were treated with bakri balloon and yet, two patients underwent hysterectomy. When all the cases were examined, complications caused by urinary bladder and ureteral injury were seen in 5.6% of patients, and all of these complications were also seen in hysterectomy patients. Conclusion: Lower uterine segment transverse suture technique and bakri balloon application should be considered as a good alternative to prevent hysterectomy in patients with placenta previa totalis. In addition, they are effective treatment methods that can be used without increasing maternal morbidity.展开更多
文摘Surgical sperm retrieval(SSR)is currently one of the most common procedures in in vitro fertilization(IVF).However,a gap between the guidelines and routine clinical practice regarding antibiotic use in sSR,which might lead to antibiotic resistance,is a challenging problem worldwide.A cross-sectional survey was conducted from May 1,2021,to July 15,2021,to investigate antibiotic usage by medical professionals when performing SSR in IVF centers in Vietnam.The confidential questionnaire comprised 12 items,including characteristics of the study population,awareness of antimicrobial resistance,attitude toward prescribing antibiotics,and current practice of prescribing antibiotics when performing SSR.Surveys were completed by 30 of 45 registered IVF centers(66.7%).Among 67 physicians working at those centers,the age and work-experience years(mean±standard deviation[s.d.])were 38.6±6.6 years and 11.2±7.0 years,respectively.Over 60%of them held a degree in Obstetrics and Gynecology,and over four-fifths were men.Most respondents"often/very often/always"raised awareness of antimicrobial resistance to their patients(83.3%),but only half of them"often/occasionally"prescribed antibiotics to patients with SSR in cases where the prescription would be optional.About one-tenth of respondents followed the recommendation from the American Urological Association using"prophylaxis only"for SSR patients.For more invasive SSR,physicians tended to prescribe more complicated and sometimes inappropriate regimens.In conclusion,antibiotic usage in SSR was not always appropriate among IVF centers.Further studies may define specific recommendations for regimens,intervention strategies,and programs to promote appropriate antibiotic use for SSR patients among IVF specialists.
文摘Objective: To investigate the effect of coasting on IVF outcome in GnRH agonist cycles.Design: Retrospective ana-lysis. Setting: Private IVF center.Patient(s): Infertile couples undergoing IVF/intracytoplasmic sperm injection (ICSI) treatment (normal responders [control], hyper- responders [coasting]- groups).Intervention(s): Coasting to reduce the risk of ovarian hyperstimulation syndrome (OHSS) among hyper- responders.Main Outcome Measure(s): Stimulation, embryology parameters, and pregnancy rate (PR).Result(s): The average length of coasting was 2.2 days.Age and baseline FSH were comparable to control cycles.There were more follicles and oocytes in the coasting group, but the number of fertilized oocytes and embryos transferred were similar.Implantation rate (22.4% vs.13.9% ) was higher in the control group but the PRs were comparable (45.1% vs.38.5% ).Within the coasting group, baseline, stimulation, and embryology parameters were comparable between successful and unsuccessful cycles.Pregnancy rates were comparable after 1, 2, and 3 or more days of coasting (36.3% vs.38.4% vs.40% ). Pregnancy rates were also comparable (28.5% vs.35.7% vs.44.4% ) when groups were compared based on change in E2 ( < 25% , 25% ～ 50% , > 50% ).Conclusion(s): Coasting for 3 days can be used successfully in the management of the hyper- responding patients during IVF.
基金funded by the Mongolian National University of Medical Sciences’Science and Technology Support Fund’s“Domestication of IVF technology in Mongolia project”(Fund protocol number:2016/01).
文摘Objective:To investigate and analyze the prevalence and risk factors of infertility in a Mongolian population.Methods:We conducted a population-based cross-sectional study between September 2016 and November 2021.Our study population of 1919 participants consisted of residents of Ulaanbaatar city and four regions of Mongolia.A pretested standardized and structured questionnaire was used to gather data from the participants.Our questionnaire comprised categories influencing infertility,such as socioeconomic status,lifestyle factors,health,reproductive history,present status,and sexual function.In addition,trained staff conducted face-to-face interviews with the participants.Results:Our study showed an infertility incidence of 8.2%,with primary infertility at 2.76%and secondary infertility at 5.47%.Compared with the urban area of Ulaanbaatar,the prevalence of infertility was significantly higher amongst the rural population(P<0.001).Risk factors of infertility included advanced age(35-39 years,OR 1.8,95%CI 1.99-6.55;>40 years,OR 2.1,95%CI 2.62-8.55),living rural region(aOR 2.4,95%CI 1.62-3.69),alcohol consumption(aOR 1.6,95%CI 1.11-2.44),chronic diseases(aOR 1.6,95%CI 1.20-2.38),reproductive disease(aOR 2.6,95%CI 1.86-3.88),gynecological operative history(aOR 2.1,95%CI 1.38-3.21),ovarian cyst(aOR 4.2,95%CI 2.70-6.40),gonorrhea(aOR 2.4,95%CI 1.01-6.16),non-malignant uterine cancer(aOR 2.9,95%CI 1.40-6.70),and endometriosis(aOR 4.7,95%CI 1.41-15.62).Conclusions:In Mongolia,the average infertility rate is 8.2%,similar to the average worldwide and is significantly higher in rural communities.Our study shows the most significant risk factors for infertility are age,alcohol consumption,and rural living.In addition,an unfavorable gynecological history and some diseases also pose a risk to fertility.
文摘We report the successful outcome of intracytoplasmic sperm injection （ICSI） treatment in two siblings with familial globozoospermia. After controlled ovarian hyperstimulation and oocyte pick-up, retrieved oocytes were mechanically activated before ICSI and a fertilization rate of 33.3% was achieved in the first case. The second couple underwent ICSI without oocyte activation and a 9.1% fertilization rate was obtained. The transfer of two grade I embryos in the first couple and one grade I embryo in the second couple resulted in clinical pregnancies with healthy livebirths. It was concluded that the main problem of cases with globozoospermia is a low fertilization rate, and even though ICSI and oocyte activation can increase this rate it is not necessarily needed to achieve a pregnancy. （Asian J Androl 2008 Mar; 10： 332-336）
文摘Embryo cryopreservation（CP） has became a very important part of the clinical use of in vitro fertilization. Oocyte CP offers more advantages compared with embryo freezing with regard to less ethical, legal and moral problems. However, the efficiency of this procedure is still low, which prevents its clinical application in wide range. The aim of our paper is to review the basic principles, technical and safety aspects and current status of oocyte cryopreservation in human assisted reproduction.
文摘Varicocele has been implicated as a cause in 35%-50% of patients with primary infertility and up to 81% of men with secondary infertility. Although a large number of reports have shown improvement in the semen parameters after correction of varicocele, other studies have suggested no benefit. We report the first case of azoospermia after surgery in a young infertile male patient with left-sided varicocele and severe oligozoospermia undergoing laparoscopic varicocelectomy. A pregnancy was only achieved with assisted reproductive technology because semen cryopreservation was performed before surgery. In the light of the above, the deterioration of sperm count after varicocele repair in patients with severe oligozoospermia could be due to irreversible impairment of spermatogenesis of such patients, together with the possible temporary damage of the surgical repair. This possible complication could therefore turn the severe oligozoospermia into an indication to perform cryopreservation before surgery, on both clinical and medico-legal grounds. Further research is needed before drawing definitive conclusions regarding the management of varicocele-related severe oligozoospermia.
文摘Objective: This study assessed blood C-reactive protein (CRP), fibrinogen, procalcitonin, and CA125 levels and determined whether they have an effect on pregnancy. Material & Methods: Between Feb. and Sep. 2018, 50 consecutive women who had their first frozen embryo transfer at a tertiary referral IVF center in Turkey were included in the study. Serum samples were collected on the second day of the cycle and on the transfer day. The women were divided into two groups based on the results of pregnancy outcome: pregnant (group 1) and non-pregnant (group 2). Blood CRP, fibrinogen, procalcitonin, and CA125 levels were compared between the groups. Results: There were no statistically significant differences between the groups according to CA125, CRP, fibrinogen, and procalcitonin levels at the beginning of the cycle and on the transfer day. In comparison with levels at the beginning of the cycle and on the transfer day, fibrinogen and CRP were significantly higher on the transfer day than at the beginning of the cycle. Procalcitonin was significantly higher on the transfer day than at the beginning of the cycle in group 1. However, there was no statistically significant difference between the transfer day and the beginning of the cycle in group 2. Conclusions: However, the fibrinogen, CRP and procalcitonin levels were significantly higher on the transfer day than at the beginning of the cycle. The results indicated that acute phase reactants or CA125 should not be used to determine the time of embryo transfer or predict pregnancy.
文摘Objective: This study was designed to compare the exogenous FSHovarian reserve test(EFORT) versus the clomiphene citrate challenge test(CCCT), basal FSH, and basal inhibin B, with respect to their ability to predict poor and/or hyperresponders in an IVF population. Design: Prospective randomized controlled trial. Setting: Fertility center of a university hospital. Patient(s): One hundred ten patients undergoing their first IVF cycle, randomized into two groups. Intervention(s): Fifty-six patients underwent a CCCT, and 54 patients underwent an EFORT. In all patients, the test was followed by an IVF treatment. Main Outcome Measure(s): Ovarian response, expressed by the total number of retrieved oocytes. Result(s): Univariate logistic regression showed that the best predictor for poor response is the CCCT(area under receiver operator characteristic curve [ROCAUC] =0.87),with maximal accuracy of 0.89. Multiple logistic regression analysis did not produce a better model in terms of improving the prediction of poor response. For hyper response, univariate logistic regression showed that the best predictor is the inhibin B increment in the EFORT(ROC-AUC=0.92) but with a low maximal accuracy of 0.78. Again, multiple logistic regression analysis did not produce a better model in terms of predicting hyper response. Conclusion(s): Our study, the first which compares the CCCT with the EFORT for the prediction of poor and hyperresponders, shows that the CCCT is superior for identification of low responders. The EFORT(inhibin B increment) is superior for prediction of hyper response at the cost of a high rate of false positives. Neither of the two tests seems adequate to act alone for identification of both poor and hyperresponders.
文摘Prior studies suggested sperm with damaged DNA permits fertilization but may lead to failure of embryo implantation following blastocyst formation. Quantitative correlations between DNA damage and risk of implantation failure have, however, so far not been performed. The aim of this study was to investigate two FSHR gene polymorphisms G919A (Ala307Thr) and A2039G (Asn680Ser) in Eastern Ukrainian Caucasian men with abnormally low fertility. The molecular genetic analysis was performed by real-time PCR, with the level of DNA fragmentation measured by the sperm chromatin dispersion (SCD) method. The relationship between DNA fragmentation in sperm and these genetic polymorphisms was estimated. Compared to homozygotes, the risk of high-level DNA fragmentation (>20%) increased in men up to age 35 years 16-fold for heterozygotes GA of polymorphic variant G919A, 28-fold for homozygotes AA of polymorphic variant G919A;and 16-fold for heterozygotes GG of polymorphic variant A2039G. A statistically significant positive correlation between number of alternative alleles of the FSHR gene in genotype and degree of DNA fragmentation is proved (r<sub>s</sub> = 0.70, P < 0.01).
基金ACKNOWLEDGMENTS This research was supported by the Major State Basic Research Development Program of China （973 Program, Noso 2006GB504005 and 2009CB941700）, the National Natural Science Foundation of China （No. 30872765） and the Basic Research Key Program of Shanghai （10]C1410800）. Shi-Wei Duan is sponsored partly by the K. C. Wong Magna Fund of Ningbo University. Wethank Dr Ching-Ling Chen for kind suggestions regarding English in drafting this paper.
文摘Multiplex polymerase chain reaction （PCR） has been widely used to detect Y-chromosome micredeletions, which is one of the major causes of male infertility. Both the European Academy of Andrology （EAA） and the European Molecular Genetics Quality Network （EMQN） have recommended the use of sY84 and sY86 markers for the detection of azoospermia factor a （AZFa） microdeletion during DNA testing for male infertility. In this study, a large-scale analysis of AZF microdeletion in a total of 630 Chinese males, including healthy semen donors （n=200）, infertile males with normal sperm count （n=226） and patients with either nonobstructive azoospermia or severe oligozoospermia （n=204）, was performed. A series of nine sequence-tagged site （STS） markers from the AZF region of the Y chromosome was used to detect microdeletions. All primers were designed based on the recommendations of the National Center for Biotechnology Information. An unusually high incidence （73/630, 11.6%） of sY84-absent but sY86-present genotypes was observed in the AZFa microdeletion screening. Sequencing the sY84-flanking region revealed a total of 73 patients with sY84-absent but sY86-present genotypes have a T-to-G transversion at the fifth base from the 5＇ end of the reverse sY84 primer. These prevalent false positives, which were not only observed in infertile men, but also observed in donors, resulted from a single-nucleotide polymorphism （SNP） named rs72609647 in the targeting sequence of the reverse sY84 primer. Our study suggests that a pre-screening of existence of rs72609647 polymorphism can prevent the frequent false positive results of AZFa microdeletions detection in the infertile Chinese males. Given the SNP rs72609647 was recently found in a deep sequencing of a Chinese individual, the current EAA and EMQN standards may need to be scrutinized among different populations to avoid the potential genetic variations in the primer binding sequences.
文摘Objective: The incidence of placenta previa (PP) has been increasing due to the rise in cesarean rates. The aim of this study is to determine the success of lower uterine segment compression suture and bakri balloon applications in patients diagnosed with placenta previa. Materials and Methods: 257 patients who underwent cesarean section due to placenta previa totalis (PPT) between the years of 2010-2018 in Ondokuz Mayis University were screened retrospectively. The patients were evaluated in four groups according to their treatment method: medical treatment, bakri balloon application, compression suture and hysterectomy. Results: In the study, between the years 2010-2015, postpartum hysterectomy was performed in the cases of adherent placenta previa, and hysterectomy was performed in 33 patients. Between the years of 2015-2018, first, bakri balloon or compression suture was applied;and if bleeding control was not achieved despite these, then, hysterectomy was performed. Between 2015 and 2018, a total of 27 patients underwent compression suture and 1 patient had a hysterectomy after all. The success rate was 96.3% with compression suture and 91.7% for bakri balloon application. Totally, 24 patients were treated with bakri balloon and yet, two patients underwent hysterectomy. When all the cases were examined, complications caused by urinary bladder and ureteral injury were seen in 5.6% of patients, and all of these complications were also seen in hysterectomy patients. Conclusion: Lower uterine segment transverse suture technique and bakri balloon application should be considered as a good alternative to prevent hysterectomy in patients with placenta previa totalis. In addition, they are effective treatment methods that can be used without increasing maternal morbidity.
