1,720,974 research outputs found
Tecniche di II livello :FIVET e ICSI
No full textLa fecondazione in vitro con trasferimento dell'embrione è una tecnica messa a punto negli anni 70 che sfrutta la fecondazione extracorporea e lo sviluppo in vitro dell'embrione; la ICSI comporta una tecnica più delicata e specifica per ottenere la fecondazione in vitro in gravi casi di sterilità con causa maschil
Successful use of “hour 1” transfer of sperm microinjected oocytes in natural cycles of poor responder women: a prospective randomized controlled pilot study
No full textThe aim of the study is to demonstrate the successful use of “Hour 1” transfer of sperm microinjected oocytes in natural cycles of poor responder women. Seventy women were selected from 92 consecutive poor responders undergoing intracytoplasmatic sperm injection (ICSI) in a natural cycle at our Sterility and Assisted Reproduction Unit from September 2009 to July 2013, and randomly distributed in two homogeneous groups: Group A or B. Women in Group A (35) underwent transfer within 1 h after ICSI; Group B (35, control group) underwent transfer 3 days after ICSI. In Group A, seven clinical pregnancy and one miscarriage occurred; in Group B, eight clinical pregnancies and two miscarriages were observed. Pregnancy, miscarriage, term pregnancy and overall live birth rates’ difference between the two groups was not statistically significant (p > 0.05). Difference between the two groups in terms of timing, type of delivery and newborn birthweight was not observed. Neither ectopic pregnancy nor multiple pregnancies occurred. “Hour 1” uterine transfer of ICSI oocytes, still to be considered with caution because of the relatively low number of observations of the pilot study, deserves further attention on a larger scale, and might be evaluated for clinical and financial effectiveness in other clinical settings
Software based analysis of local zona pellucida thickness variation: bending energy as a predictive window on day 2 embryo fate.
No full text2)Objective of the present retrospective observational study is to evaluate the clinical effectiveness of “Embryon”,a new proposed software program based on the semiautomatic Local Zona Pellucida Thickness Variation (LZPTV) computation of Day 2 Intracytoplasmatic Sperm Injection (ICSI) embryos images to provide a reliable additional information regarding embryo fate.
3)LZPTV of day 2 ICSI embryos appears, after preliminary observations, able to provide a significant information as integrative standardized approach for Assisted Reproduction Technologies (ART) practice and research.
4)Zona Pellucida Thickness (ZPT) and ZPTV seem to successfully predict the clinical outcome of ART. A number of morphological, morphokinetics, automated and semi-automated non-invasive methodologies for the assessment of various human embryo stages has been developed to evaluate the feasibility of a human embryo to implant in a woman uterus but, up to date, none has been proven superior to the others.
5)400 embryo digitalized images from 150 ICSI patients observed at ART Unit “Sapienza” University of Rome, Italy, during October 2011-October 2012 were blindly retrospectively analyzed using “Embryon” software program (# IT RM2012A00025, Advanced Computer Systems ACS- Rome, Italy). It characterized the LZPTV of an embryo by a single numerical value.
6)The a-dimensional final value obtained by “Embryon” captures the high frequency variability of ZPT curve (Normalized Bending Energy), to evaluate the hypothesis that embryos with high LZPTV value (Top) have higher implantation capacities, thus higher probability to proceed to term (life birth) compared to embryos with lower score (Poor).
7)According to LZPTV absolute values, the 157 patients, with similar clinical and biological parameter were split in “Top” and “Poor” clusters: “Top” (Group A: 54 patients) if at least on “Top” embryo was present; “Poor” (Group B: 103 patients) if the previous condition is not verified. “Top” patients presented significantly higher birth rate (54.7%) compared to “Poor” patients (9.7%)(p<0.05).
8)If prospectively confirmed in a larger series of patients, possibly with single embryo transfer, for its robustness and total reproducibility, LZPTV may represent an integrative tool to distinguish embryos able to proceed to term. Factors not related to the embryo quality cannot be underestimated.
9)The proposed method is based on the computation of a “form factor”, rather than to its macroscopic characteristics. Similar methods (e.g. ZPTV) are focusing only on high-level average ZP value of the shape, whereas our approach analyzes a granular set of shape factors in proximity of the ZP border
Term pregnancy and live birth subsequent to immediate uterine transfer of sperm microinjected oocyte in a natural cycle
No full textIt has been reported that it is possible to achieve a pregnancy after immediate uterine transfer of oocyte and sperm, before fertilization and cleavage were known to have occurred; there is an enormous amount of work about the optimal timing of embryo transfer, with no conclusive evidence of a gold standard satisfying patient age, endometrial receptivity, hormonal levels and embryological parameters. We hereby report a case of one 35-year-old nulligravid woman with longstanding tubal factor infertility and 3 previous failed ICSI cycles, treated with ICSI and immediate transfer of the oocyte microinjected with a spermatozoon in a natural cycle. A single oocyte was retrieved, injected with a spermatozoon and transferred 40 min after injection, resulting in an uneventful pregnancy and delivery of a healthy female infant weighing 3320 g at 40 weeks estimated gestational age. This case, certainly novel, should be interpreted with caution. Whether confirmed for efficacy and safeness in appropriate controlled clinical trials, our present observation could offer a simple, practical and cost-effective approach in ART programs in selected patients. © 2015 Informa UK Ltd
[Modification of in vitro insemination techniques in the treatment of severe male factors in assisted reproduction].
No full textThe aim of this study is to detect qualified in vitro insemination techniques in the treatment of the severe oligoasthenotheratospermia which is defined as total motile count in the pretreatment samples ( 50% of abnormal morphology). These patients have taken part in the in vitro insemination program of the Assisted Reproduction Unit of the 2nd Department of Obstetrics and Gynecology at Rome University "La Sapienza" during a period between June and December 1995. Several modifications of the standard in vitro techniques have been developed such as: mechanical decumulation of the oocytes, reduction of the volume of culture medium, increase of spermatozoa and oocyte concentration at the moment of insemination. A good fertilization rate was achieved (33%) as regard to the semen sample and procedures utilized. Twelve Ets were performed and 4 clinical pregnancies (25% per patients and 33% per transfer) were achieved. These data demonstrate that by the modification of standard laboratory methods for in vitro insemination, a good fertilization rate and a high clinical pregnancy rate can be achieved in cases of severe male factor infertility without having to resort to micromanipulation techniques
Chlamydia trachomatis and Ureaplasma urealyticum infection and In Vitro Fertilization outcome.
No full textRescue intrauterine insemination in women failing to retrieve oocytes at ovum pick-up. report of a case series
Full text linkPurpose. Failure to collect oocytes at the time of oocyte pick-up is an unfavorable outcome of in vitro fertilization (IVF) cycles. In these cases, prompt intrauterine insemination (IUI) could be an option (rescue IUI), but this possibility has been poorly studied.Methods Rescue IUI is routinely offered in our unit in women failing to retrieve oocytes, provided that they have at least one patent tube, normal male semen analysis, and the total number of developed follicles is <= 3. We therefore reviewed all oocyte retrievals performed from 2006 to 2022 in our unit to identify these cases. As a comparator, we referred to preplanned IUI performed during the same study period. The 95% confidence interval (95% CI) of proportions was calculated using a binomial distribution model.Results Rescue IUI was performed in 96 out of 3531 oocyte retrievals (2.7%; 95% CI 2.2-3.3%). Six live births were obtained, corresponding to 6.2% (95% CI 2.3-13.1). All pregnancies were singletons.Conclusions Rescue IUI in women failing to retrieve oocytes is a possible option that may be considered in selected cases. The efficacy is low, but the procedure is simple, and without significant risks. Generalizability to a conventional IVF protocol setting is however limited
Morphological aspects of human aged oocytes: An in vivo and in vitro ultrastructural study
No full textMaternal age significantly affects the outcome of ART by lowering oocyte quality and competence. However, the morphological ultrastructure features of aged human oocytes have been not extensively studied and understood. In this study we analyzed oocytes donated by women <35 (-35) and 35 (+35) years old, enrolled in an IVF program, after informed consent. MII oocytes, fixed at time of pick up (in vivo) or after 24 hours culture (in vitro) were evaluated by light and transmission electron microscopy.
IN VIVO samples of both -35 and +35 showed a spherical oocyte surrounded by regular ZP and expanded cumulus, and an ooplasm rich in organelles provided with a homogenous matrix. Oocyte mitochondria-SER aggregates (M-SER), that were numerous in -35, appeared significantly reduced in number/size and partially replaced by mitochondria-vesicle complexes (MVC) in +35. Cortical granules, normally represented in -35, appeared abnormally distributed in +35. Ooplasm microvilli significantly decreased in density and shortened in +35.
IN VITRO samples showed several changes. All samples showed a compact cumulus with occasional cumulus cell-oocyte contacts. The inner ZP showed an increased density in +35. Small sized M-SER were occasionally detected in -35 and were almost absent in +35. MVC were present in both -35 and +35, increased up in number and often showed abnormal vesicles in +35. All samples showed numerous lysosomal structures and reduction of cortical granules. Ooplasm microvilli significantly decreased in density and shortened in +35.
This study demonstrated several significant ultrastructural changes occurring in fresh oocytes (in vivo) from older patients and in all 24 hours in vitro cultured oocytes. The altered ultrastructure observed in in vitro cultured oocytes resembles in vivo aging-related changes and it is significantly more evident in oocytes from older patients. The changes described in the present study may be considered as ultrastructural markers of oocyte aging
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