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(sz) In order to reduce complications associated with the conventional IVF procedure, modified natural cycle IVF (mnc-IVF) and mild IVF (m-IVF) cycles have been adopted. However, there is speculation that the pregnancy and live birth rates may be lower with both these approaches compared to conventional cycles, probably due to the lower use of medicines and shorter treatment duration. Now, a 10-year Swedish study published in the journal, Reproductive BioMedicine Online highlights that mnc-IVF and m-IVF have comparable pregnancy rates to conventional cycles.
Arthur Aanesen and coworkers from the IVF Unit, Queen Sophia Hospital, Stockholm, conducted the study on 43 patients (129 cycles) and 145 couples (250 cycles) undergoing mnc-IVF and m-IVF, respectively, between 1996 and 2007. The results were compared to patients who underwent conventional IVF cycles during the same period. The study findings are listed in the table given below.[...]
It was also found that in comparison to the least expensive conventional IVF cycle, the medication costs were lower by 97.5% and 96.3% in the mnc-IVF and m-IVF groups, respectively. Based on the analysis, the researchers noted the following with respect to the two approaches when compared to conventional cycles.
• Acceptable pregnancy rates per embryo transfer
• Reduced medication cost
• Substantially decreased risk of complications
• Psychologically more acceptable to patients
Similar findings on the efficacy of mnc-IVF and m-IVF were reported in several other studies. In one such randomized open-label prospective trial, Heijnen et al (Nederlands Tijdschrift voor Geneeskunde, 2008) divided 404 subjects to receive either of the two:
• m-IVF: gonadotrophin releasing hormone (GnRH) antagonist for ovarian stimulation in combination with single embryo transfer
• standard treatment: prolonged stimulation using a GnRH agonist along with the transfer of two embryos. more…

From: »IVF News.Direct!«

(wz) Scientists from University of Michigan have developed a novel device that could one day lead to significantly higher IVF success rates in humans. They built a device that imitates the motion that embryos experience in the body as they make their way down a mammal’s oviduct (a woman’s Fallopian tube) to the uterus.
Currently in IVF, eggs are fertilized with sperm and left to grow for several days in a culture dish that remains still. Then the embryos are transferred to the uterus.
“By making the cells feel more at home, we get better cells, which is key to having better infertility treatment,” said Shu Takayama, an associate professor in the Department of Biomedical Engineering and in macromolecular science and engineering. The study showed that by gently rocking embryos while they grow during in vitro fertilization (IVF) improves pregnancy rates in mice by 22 percent.
Lead researchers Takayama and Gary Smith revealed that their device holds early-stage embryos, which are about half the size of the period at the end of this sentence, in a thimble-sized funnel. The bottom of the funnel is lined with microscopic channels that allow fresh nutrient-rich fluid to flow in and waste products out.
The funnel sits on rows of Braille pins that are programmed to pulse up and down, pushing the fluids in and out of the channels. The current the Braille pins generate simulates flows that occur in the body due to muscle contractions and the motion of hair-like projections called cilia that line the oviducts. In the body, these motions help to push fertilized eggs to the uterus and flush out eggs” waste products. more…

From: »The Times Of India«

(cz) The European Society of Human Reproduction and Embryology (ESHRE) has published a position statement on the impact of the life style factors obesity, smoking and alcohol consumption on natural and medically assisted reproduction.
In a literature study the ESHRE Task Force on Ethics and Law summarised the negative effects of obesity, smoking and drinking on the natural reproductive potential of patients, on IVF results, pregnancy complications and outcomes and finally on the health of the future child. The paper is published online on 19 January 2010 in the journal Human Reproduction. The group made five recommendations.
1) In view of the risks for the future child, fertility doctors should refuse treatment to women used to more than moderate drinking and who are not willing or able to minimize their alcohol consumption.
2) Treating women with severe or morbid obesity required special justification. The available data suggested that weight loss would incur in a positive reproductive effect, although more data was needed to establish whether assisted reproduction should be made conditional upon prior life-style changes for obese and smoking females. more…

From: »Science Daily«

(sz) The success of any IVF cycle is known to be multifactorial, although there is no consensus about the factors that influence the outcome. Now, a new retrospective study elucidates the negative effect of certain key recipient-related parameters, such as increased body mass index (BMI >30 kg/m2), endometrial thickness (<8 mm), and pituitary down-regulation, on IVF outcome in donor oocyte cycles, independent of the age of the recipient. The study results have been published in the current issue of Human Reproduction.
Lionel Dessolle from the Service de Gynécologie Obstétrique et Médecine de la Reproduction, Hôpital Tenon, France, investigated 450 frozen-thawed embryo transfers to identify the predictive factors of treatment success. The study considered IVF cycles carried out using donor oocytes in 198 infertile recipients with a mean age of 35.7 years (±4.5) during the period, January 1992 to December 2006. The mean number of transferred embryos was 1.65±0.5 (range=1-3) and the overall implantation, clinical pregnancy, and delivery rates noted during the analysis were 18%, 30%, and 23%, respectively.
The findings of the univariate analysis showed that the rate of pregnancy was substantially higher in subjects with the following characteristics:
• <35 years of age
• BMI of <30 kg/m2
• Endometrial thickness of ≥8 mm
• Amenorrhea
• Not used gonadotropin releasing hormone (GnRH) analogue for pituitary down-regulation prior to endometrial priming
Based on the study results, the researchers concluded that some of the negative determinants of IVF outcome in oocyte donor cycles include obesity, endometrial thickness of <8 mm, and the administration of GnRH analogue before priming of the endometrium. more…

From: »IVF News.Direct!«

(sz) The role of androgen in regulating the expression of male phenotype, and the onset and maintenance of spermatogenesis has been well established through several studies. However, there persists uncertainty regarding the cell types mediating the androgen regulation of spermatogenesis. A recent study published in The FASEB Journal reports that androgen exerts its action via peritubular myoid (PTM) cells in order to regulate the normal spermatogenesis and male fertility. The study, claiming to provide the first direct evidence on the significance of stromal-epithelial interactions driven by androgen, holds great implications in developing strategies for male contraception, as well as treatment of male infertility.
Michelle Welsh, from the Medical Research Council Human Reproductive Sciences Unit, The Queen’s Medical Research Institute, Edinburgh, UK, and coworkers, conducted the study on peritubular myoid cell-specific androgen receptor-knockout (PTM-ARKO) mice. Although the researchers observed a gross reproductive development in the animal models, the PTM-ARKO male mice were infertile and azoospermic. Further analysis of the affected subjects showed a reduction in testicular weight beyond puberty, and an 86% decrease in the number of germ cells by adulthood when compared to wild-type littermates. The study ruled out the effect of decreased testosterone, luteinizing hormone, or follicle-stimulating hormone levels in contributing to the above changes.
The decline in the expression of androgen-dependent Sertoli cell (SC) genes, as well as the secretion of seminiferous tubule fluid indicated impaired functioning of SC in PTM-ARKO males. Based on the study findings, the researchers concluded that the action of androgen through PTM cells is crucial for the normal testicular functioning, spermatogenesis, and fertility.
PTM cells, the mesenchymal cells forming the outer lining of the seminiferous tubules, has been reported to play a substantial role in male fertility. Expressing a high percentage of androgen receptors (AR) from fetal life through adulthood, the cells regulate germ cell development based on androgen signaling. The peritubular myoid cells are also found to be significant in eliciting peristalsis-like movements and impulses in the tubules to facilitate the transport of sperm and fluid through the tubular lumen into the epididymis. more…

From: »IVF News.Direct!«

(wz) A new strategy that researchers believe provides a more comprehensive screening of the entire chromosomal makeup of an embryo shows tremendous promise in the field of preimplantation genetic screening (PGS) according to a study published in the December issue of Fertility and Sterility.
Forty-five infertile couples participated in the study with an average age of 37.7 years. Using a novel screening approach, researchers biopsied several cells from embryos five days after fertilization, also known as the blastocyst stage. The patients underwent comparative genomic hybridization (CGH) screening, which researchers say allows for a more comprehensive look at the chromosomal health of the cell.
Results show successful biopsy in close to 100 percent of the embryos using CGH. Of these embryos, more than half (51.3 percent) were diagnosed as abnormal. The remaining embryos with normal chromosome counts were implanted and of the CGH group, 68.9 percent produced a fetus.
Reprogenetics, LLC, in Livingston, New Jersey, performed the genetic diagnosis. Its president, Santiago Munne, says the CGH screening results could provide the answers to challenges that IVF researchers have faced for years. more…

From: »Earthtimes« (press release)

(sz) The molecular interaction of the sperm with the zona pellucida (ZP) is an important event that precedes fertilization, and also relates to various sperm functions, such as capacitation completion and ligand-induced acrosome reaction. In clinical practice, defective sperm-ZP interactions are a relatively common cause of fertilization disorders. Sperm-ZP binding tests help in detecting subtle abnormalities in the sperm, which cannot be identified by semen analyses. A recent prospective study provided further credence to the effectiveness of such tests in selecting competent sperm for improved ICSI outcome. The findings of the study have been published in the recent issue of the journal, Reproductive Bio Medicine Online.
Daniela Paes de Almeida Ferreira Braga and coworkers from the Assisted Fertilization Center Av. Brigadeiro Luis Antonio, Brazil, conducted the study to assess the ability of the sperm-ZP tests in choosing sperms with high fertilization potential and high rate of successful embryo development. Conventionally selected sperm were injected into 50% of the metaphase II (MII) oocytes in each patient (controls; n=194), while the remaining eggs were inserted with ZP-bound sperm (ZP binding group; n=194). The two groups were compared with respect to the rates of fertilization, high-quality embryo, and embryo transfer. more…

From: »IVF News.Direct!«

(cz) Screening IVF embryos for genetic defects increases the death risk of multiple birth babies five times, a study has found.
But the procedure, known as pre-implantation genetic diagnosis (PGD), appears to be harmless for singletons.
PGD involves removing one or two cells from an embryo to test it for abnormalities and diseases.
There have been concerns the test might itself adversely affect babies created through In-Vitro Fertilisation (IVF).
The largest and longest running study of children born after PGD suggests that such fears are unfounded, for singletons at least. However researchers found in the case of multiple pregnancies, PGD increased the risk of death around the time of birth five-fold.
The findings were published yesterday in the journal Human Reproduction. more…

From: »The Belfast Telegraph«

(cz) An embryo screening test called pre-implantation genetic diagnosis (PGD) is safe for the children of singleton pregnancies, Belgian researchers say.
They looked at 581 children born at one Belgian centre over 13 years who had been screened using the PGD technique.
They found that rates of birth defects and deaths were similar to those of children born using other IVF methods.
However, significantly more deaths just after or before the birth were seen in multiple pregnancies following PGD.
The findings come after concerns that the PGD screening technique, which involves removing some of the embryo’s cells at an early stage, could lead to problems.
But the researchers, writing in the journal Human Reproduction, found no significant difference in birth defect rates when compared to 2,889 children born using IVF but who did not undergo the screening.
In total, 2.13% of PGD children had birth defects compared with 3.38% of the other children.
The perinatal death rate - the period immediately before and after birth - was also similar at just over 1% for singleton children in both groups.
However, for multiple pregnancies there was a difference. In the PGD group it was 11.73%, whereas among the others it was 2.54%.
Professor Inge Liebaers, head of the centre for medical genetics at the University Hospital Brussels, said:”At present, we don’t have an explanation for why the perinatal death rate (for multiple pregnancies) should be so much higher in the PGD children, and we need to be careful about drawing firm conclusions from these observations as they may be biased due to low numbers. more…

From: »The BBC«

(sz) The usefulness of ovarian reserve tests (ORT) in evaluating IVF outcomes in infertile women aged ≤35 years is still debatable. Now, a recent retrospective database study reports that it may be beneficial for women of this age group to have their ovarian reserve tested for abnormal follicle-stimulating hormone (FSH) levels and antral follicle counts (AFC) before undergoing IVF treatment. The study findings were presented at the 65th American Society for Reproductive Medicine (ASRM) Annual Meeting held at Atlanta, from October 17th to 21st, 2009.
Todd Deutch and Richard Sherbahn, reproductive endocrinologists and infertility specialists at the Advanced Fertility Center of Chicago, Illinois, reviewed 1,380 IVF cycles in order to estimate the occurrence of abnormal FSH and/or AFC levels in women aged ≤35 years, undergoing IVF treatment. Treatment outcomes were also assessed in cycles with one or more abnormal ORTs. Based on the recorded AFC and FSH levels collected from the IVF database, four groups were formed, as listed in the table below. Using statistical tests such as z- and t-tests, IVF outcomes in groups with a minimum of one abnormal ORT were compared to the normal group; the results reported as follows:
[table]
The findings demonstrated poor treatment outcomes in cycles with at least one abnormal ORT. Although both abnormal FSH and AFC levels were found in a relatively small percentage (2.5%) of the cycles, there existed a significantly high rate of pregnancy loss and an extremely low pregnancy rate in this group, despite their young age; thereby signifying the importance of ORT in young women seeking infertility treatment.
Earlier, El-Toukhy et al (Human Reproduction, 2002) conducted a study to assess IVF success rates in young women with depleted ovarian reserve. more…

From: »IVF News.Direct!«