Does cryopreservation of sperm affect icsi fertilization rates in patients with non-obstructive azoospermia or cryptozoospermia?
RESULTS: The patient’s hormone levels remained menopausal until August
2011 when a peak estradiol level of 1166 pmol/L and FSH of 10.2 IU/L and LH
morphology alone drives the current practice to transfer multiple embryos
of 15.3 IU/ L was recorded indicating ovarian function. A decision was then
to patients to maximize the chances of pregnancy. Unfortunately, this
made to proceed with an IVF cycle and the patient was stimulated with an aro-
practice leads to a high rate of multiple births and associated complica-
matase inhibitor, letrozole, at 2.5mg from day 2 to 6 of a natural menstruation
tions for both mothers and children. Recently, time-lapse imaging has
with antagonist starting at day 5. Two oocytes were subsequently collected on
proven useful to find quantitative parameters predictive of viability. How-
25th October 2012, one of which was mature. Fertilisation was achieved
ever, existing techniques are limited to 2D imaging and parameter extrac-
through Intracytoplasmic sperm Injection (ICSI) and the embryo was subse-
tion. Our improved system enables automated 3D imaging of developing
quently transferred on day 3 at 10 cell stage. Fifteen days post VPU, bHCG
embryos that, together with novel image processing tools, may reveal new
of 259 IU/L and a progesterone of 71.6 nmol/L were measured. A vaginal ultra-
parameters for accurate, early prediction of viability not obtainable with
sound was performed at 6 weeks 3 days on dates (November 26th, 2012), and a
viable intrauterine pregnancy was confirmed with a fetal heart of 120 bpm.
MATERIALS AND METHODS: Developing embryos were imaged
over several days using a custom-built microscope with an integratedlow coherence interferometer and stage-top incubator. Computer vision-
based image processing tools are used to extract parameters such ascell shape, degree of fragmentation, nucleus position, and speed of cyto-
HYSTEROSCOPIC MYOMECTOMY AND REPRODUCTIVE
plasmic streaming. Blastocyst formation is used as a proxy measure of
OUTCOMES. E. Mu~noz, M. Martınez, B. Martınez, J. Aguilar,
S. Portela, I. Fernandez. Reproductive Medicine, IVI Vigo, Vigo, Ponteve-
RESULTS: Images of live, developing 2PN mouse embryos and ar-
rested 3PN human embryos show clear visualization of cell nuclei.
Future work will image more cells and track nuclear positions
OBJECTIVE: Submucous myomas (SM) decrease fertility, and their
through later stages of development to correlate them with measures of
removal increases it to baseline rates. Literature concernig resection of my-
omas in IVF is limited. Our aim is to evaluate the reproductive outcome in
CONCLUSION: We present a novel optical technique for 3D imaging of
patients undergoing assisted reproductive techniques (ART) after a hystero-
developing embryos. Imaging human embryos through to the blastocyst stage
could suggest a new method for early prediction of viability with implica-
DESIGN: Retrospective comparative study.
tions for clinical practice and standard of care.
MATERIALS AND METHODS: We studied 51 patients who underwent
Supported by: The Center for Biomedical Imaging at Stanford.
96 cycles of ART after a HM and compared them to 61 controls who did107 cycles of ART between February 2005 and January 2013. Myomasand the submucous component of an intramural myoma (IM) distorting uter-
ine cavity (UC) were resected in SM and IM patients. Patients had two men-strual cycles after IVF. Controls were patients with normal UC evaluated by
DOES CRYOPRESERVATION OF SPERM AFFECT ICSI
hysteroscopy after an abnormality in a transvaginal ultrasound.
FERTILIZATION RATES IN PATIENTS WITH NON-OBSTRUC-
RESULTS: We analyzed 32 IVF cycles, 30 oocyte donations and 34
TIVE AZOOSPERMIA OR CRYPTOZOOSPERMIA? I. Har-V
frozen-thawed cycles after myomectomy and compared them to 19 IVF cy-
N. SchachterM. FrigerA. Zeadna,E. E. LeaFertility
cles, 40 oocyte donations and 48 frozen-thawed cycles in controls. No differ-
and IVF Unit, Department of Obstetrics and Gynecology, Soroka University
ences were found in age, number of retrieved or received oocytes in cases of
Medical Center, Beer-Sheva, Israel; bDepartment of Epidemiology Faculty
oocyte donation, endometrial thickness or number of transferred embryos,
of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
neither in pregnancy or miscarriage rates between groups.
OBJECTIVE: Our aim was to compare ICSI outcomes in patients with
non-obstructive azoospermia or cryptozoospermia using fresh or frozen
ejaculated or testicular sperm in order to determine possible differences.
DESIGN: A retrospective cohort study.
MATERIALS AND METHODS: Two hundred seventy four patients were
evaluated from 1999-2011: One hundred twenty two TESE procedures were
We compared ICSI outcomes during the first cycle in each technique per-
formed according to the sperm origin (testicular/ejaculated) and processing
(frozen/fresh): group 1a: frozen testicular (48 cycles), group 1b: fresh testic-
ular (22 cycles), group 2a: frozen ejaculated (66 cycles) and group 2b: fresh
ejaculated (138 cycles). The statistical analyses used were Kruskal Wallis
RESULTS: In 76 of the TESE cycles (62%) sperm cells were found. No
statistical significant difference was found in fertilization rate using fresh
testicular or frozen testicular sperm (49.2% vs 52.7% respectively). The
fertilization rate was significantly higher when ejaculated sperm cells were
used (61.5%) in comparison to testicular sperm (50.3%), P¼0.002. Further-more, fresh ejaculated sperm were found to have better fertilization rates(64%) than frozen ejaculated (55.8%), P¼0.025, or frozen testicular sperm
CONCLUSION: In women undergoing ART, resection of SM or the
(49%), P¼0.002. More oocytes were injected with motile sperm in the fresh
submucous component of IM restored fertility like the infertile controls’
ejaculated group (96.4%) than in the frozen ejaculated groups (87.9%)
p¼0.03. Fertilization rates were significantly higher when motile spermswere used (62.5%) compared to immotile (30%), P¼0.001, regardless the
CONCLUSION: In cases of cryptozoospermia frozen ejaculated sperm is
inferior to fresh ejaculated sperm. In cases of non obstructive azoospermia
we would recommend uncoupled TESE/OPU if no back up donor sperm is
an option, since no major differences in fertilization rates were found, and
A. K. Ellerbee.aDepartment of Electrical Engineering, Stanford University,
therefore unnecessary ovarian stimulation and OPU can be prevented in cases
Stanford, CA; bDepartment of Obstetrics and Gynecology, Stanford
University, Stanford, CA; cStanford Photonics Research Center, StanfordUniversity, Stanford, CA.
OBJECTIVE: We constructed a high-resolution optical imaging system to
acquire 3D images of live embryos and identify novel biomarkers of viability
IMPROVEMENT IN OVERALL SEMINAL QUALITY BY
Yr Adran Iechyd a Gwasanaethau Cymdeithasol Cyfarwyddwr Cyffredinol • Prif Weithredwr, GIG Cymru Department for Health and Social Services Director General • Chief Executive, NHS Wales Darren Millar AMChairPublic Accounts CommitteeNational Assembly for WalesCardiff BayCardiff GOVERNANCE ARRANGEMENTS AT BETSI CADWALADR UNIVERSITY LOCAL HEALTH BOARD During my appearance before th
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