Immunophenotypic profiles of peripheral blood lymphocytes on the day of embryo transfer in women undergoing in vitro fertilization.

Evaluation of different types of lymphocyte subpopulations in the peripheral blood has unknown and controversial significance in diagnosis of infertility. The aim of the study was to evaluate selected blood lymphocytes in patients treated with intracytoplasmic sperm injection (ICSI).MATERIALS AND METHODSwomen were divided into three groups: (1) control fertile group (n=18), (2) infertile women that achieved (n=32), and (3) did not achieve a pregnancy after ICSI (n=26). The following types of leukocytes were analyzed by three-colour flow cytometry by detection of specific CD antigens: lymphocytes T (CD3+), B (CD19+ and CD5+CD19+), T and B (CD5+), NK cells (CD56+CD16-, CD56-CD16+, CD56+CD16+, CD56brightCD16-, CD56dimCD16+). Additionally, the antigen of early activation (CD69) was evaluated on T, B and NK cells. The results were presented as a percentage and total counts of all lymphocytes.RESULTSThe percentage of total NK cells (CD56+CD16+, CD56+CD16- and CD56-CD16+) did not differ between pregnant and non pregnant women and was lower comparing to control group. Fractions of CD56-CD16+ cells were higher in pregnant vs. non-pregnant women. The percentages of CD56brightCD16- NK cells were higher in control group comparing to both ICSI treated groups. Other fractions of lymphocyte subpopulations, including activated cells (with CD69 expression) did not differ between the analyzed groups. Total counts of CD56-CD16+ cells were higher in pregnant vs. non-pregnant group, and the CD56brightCD16- cells was more abundant in control group vs. women with unsuccessful ICSI.CONCLUSIONSTesting of peripheral blood NK cells and the others lymphocytes has limited value as a prognostic factor in ICSI treated patients. The antigen of early lymphocytic activation (CD69) has not any predictive value in prognosis of ICSI outcome

Biotechnological and clinical outcome of in vitro fertilization in non-obese patients with polycystic ovarian syndrome.

INTRODUCTIONPolycystic ovarian syndrome (PCOS) is a hormonal and metabolic disorder which poses problems with controlled ovarian stimulation (COH). It has been also postulated that PCOS patients have oocytes and embryos with poorer quality which affects IVF results.AIMTo verify IVF outcome in non-obese patients with PCOS.MATERIALS AND METHODSIVF results of 71 non-obese PCOS patients with 243 non-obese non-POCS patients, regardless of stimulation protocol, from years 2004-2006 were compared.RESULTSBiotechnological results of PCOS patients in opposition to non-PCOS patients were respectively as follows: higher average number (10.19 vs. 7.61; p=0.001) and percentage (82.34% vs. 76.25%; p=0.025) of retrieved mature M2 oocytes; similar (77.01% vs. 76.75%; p=0.835) fertilization rate with higher average number of embryos (7.633 vs. 5.650 p=0.003); higher average number (4.830 vs. 3.304; p=0.001) and percentage (65.66% vs. 60.57%; p=0.006) of embryos with optimal Z1 and Z2 pronuclei pattern according to Scott; higher average number of class Aembryos (3.57 vs. 2.34; p=0.001). Similar number of embryos were transferred in both groups (2.408 vs. 2.485, p=0.552). Clinical results in PCOS and non-PCOS patients were as follows: similar stimulation duration (10.53 days vs. 10.31 days; p=0.639) with significant less gonadotropin total usage (1866.54 IU vs. 2276.18 IU; p=0.001). Also clinical pregnancy per transfer (57.75% vs. 41.98%; p=0.021) and delivery per transfer (45.07% vs. 32.51%; p=0.066) were more often in PCOS patients with comparable miscarriages (12,68% vs. 6,58%; p=0.131) and ectopic pregnancy (0.00% vs. 2.06%; p=0.591) rates, respectively.CONCLUSIONPCOS in non-obese patients is linked with good biotechnological and clinical IVF outcome

Immunophenotypic profiles of peripheral blood lymphocytes on the day of embryo transfer in women undergoing in vitro fertilization.

Evaluation of different types of lymphocyte subpopulations in the peripheral blood has unknown and controversial significance in diagnosis of infertility. The aim of the study was to evaluate selected blood lymphocytes in patients treated with intracytoplasmic sperm injection (ICSI).<br /><br /><strong>MATERIALS AND METHODS</strong><br />women were divided into three groups: (1) control fertile group (n=18), (2) infertile women that achieved (n=32), and (3) did not achieve a pregnancy after ICSI (n=26). The following types of leukocytes were analyzed by three-colour flow cytometry by detection of specific CD antigens: lymphocytes T (CD3+), B (CD19+ and CD5+CD19+), T and B (CD5+), NK cells (CD56+CD16-, CD56-CD16+, CD56+CD16+, CD56brightCD16-, CD56dimCD16+). Additionally, the antigen of early activation (CD69) was evaluated on T, B and NK cells. The results were presented as a percentage and total counts of all lymphocytes.<br /><br /><strong>RESULTS</strong><br />The percentage of total NK cells (CD56+CD16+, CD56+CD16- and CD56-CD16+) did not differ between pregnant and non pregnant women and was lower comparing to control group. Fractions of CD56-CD16+ cells were higher in pregnant vs. non-pregnant women. The percentages of CD56brightCD16- NK cells were higher in control group comparing to both ICSI treated groups. Other fractions of lymphocyte subpopulations, including activated cells (with CD69 expression) did not differ between the analyzed groups. Total counts of CD56-CD16+ cells were higher in pregnant vs. non-pregnant group, and the CD56brightCD16- cells was more abundant in control group vs. women with unsuccessful ICSI.<br /><br /><strong>CONCLUSIONS</strong><br />Testing of peripheral blood NK cells and the others lymphocytes has limited value as a prognostic factor in ICSI treated patients. The antigen of early lymphocytic activation (CD69) has not any predictive value in prognosis of ICSI outcome.<br /><br /&gt

Ciężki, izolowany wysięk w jamie opłucnej z zaburzeniami oddychania poprzedzony infekcja dróg oddechowych Haemophilus influenzae jako główny objaw zespołu hiperstymulacji jajników

Introduction: An isolated unilateral pleural effusion as the only presentation of ovarian hyperstimulation syndrome (OHSS) is very rare. This case is an unusual presentation of OHSS after a confirmed respiratory tract infection, with no other coexisting risk factors identified for this syndrome. We also imply that the presence of Haemophilus influenzae in bronchial fluid can increase local reaction to vasoactive cytokines. Case Report: A 32-year-old woman presented at the Department of Reproductive Medicine and Gynaecology of the Pomeranian Medical University after 10 years of infertility with diagnosed hyperprolactinemia followed by bromocriptine treatment. The patient had three IUIs but no pregnancy was achieved. Therefore, ICSI was proposed. After an ovarian hyperstimulation, oocyte aspiration gave 8 oocytes. Although ICSI was performed in all of the oocytes there were 3 fertilizations. The ET of 3 embryos was carried out following 3 days of culture. Three weeks before the gonadotropin administration and a week before GnRH administration the patient had a respiratory tract infection with the most typical syndromes. The infection was treated successfully with over-the-counter medications and antibiotic .Three days after ET the patient was admitted to the ICU with signs of severe dyspnoea. The chest Xray showed a large pleural effusion over the right lung. Upon admission, thoracocentesis was preformed and 1600 ml of clear fluid was aspirated. The bronchial aspirate showed evidence of Haemophilus influenzae and leukocytes. After three days of standard treatment the chest X-ray revealed no pathology. The patient was discharged asymptomatic on the 4th day of treatment. Serum beta-hCG level was negative on day 12 after ET. Conclusions: This case suggest that respiratory tract infection prior to stimulation may constitute a new independent risk factor for OHSS. However, the true relation between the respiratory tract infection and susceptibility to OHSS still awaits explanation. Recent or existing respiratory tract infection may be a relative contraindication for starting COH.Wstęp: Izolowany jednostronny wysięk opłucnowy jako jedyna manifestacja zespołu hiperstymulacji jajników (OHSS) występuje niezwykle rzadko. Prezentowany przypadek jest kazuistycznym opisem wystąpienia zespołu OHSS po potwierdzonej infekcji układu oddechowego i wykluczeniu innych czynników ryzyka dla tego zespołu. Sugerujemy także, że obecność Haemophilus influenzae w płynie oskrzelowym może wzmacniać lokalna reakcję na wazoaktywnę cytokiny. Opis przypadku: 32-letnia pacjentka zgłosiła się do Kliniki Rozrodczości i Ginekologii PAM po 10 latach starań o dziecko, leczeniu hiperprolaktynemii bromokryptyna i 3 nieskutecznych wewnątrzmacicznych inseminacjach nasieniem męża. Pacjentkę zakwalifikowano do programu zapłodnienia pozaustrojowego z bezpośrednim podaniem plemnika do komórki jajowej (ICSI/ET). Na tydzień przed podaniem agonistycznego analogu GnRH, na trzy tygodnie przed rozpoczęciem podawania gonadotropin pacjentka przeszła typową infekcję dróg oddechowych, która została skutecznie wyleczona antybiotykami. W wyniku kontrolowanej hiperstymulacji jajników otrzymano 8 oocytów. A w rezultacie ICSI 3 zapłodnienia. Na trzeci dzień hodowli do jamy macicy przeniesiono trzy zarodki. Trzy dni po transferze zarodków pacjentka zgłosiła na Izbę Przyjęć z objawami ciężkiej duszności. Prześwietlenie RTG klatki piersiowej wykazało rozległy naciek opłucnowy nad prawym płucem. W zaaspirowanym w trakcie torakocentezy płynie oskrzelowym stwierdzono obecność Haemophilus influenzae i leukocytów. Po trzech dniach standardowego leczenia obraz RTG klatki piersiowej nie wykazywał zmian patologicznych. Pacjentkę bez objawów duszności wypisano do domu czwartego dnia leczenia. Poziom beta-hCG w surowicy krwi na 12 dzień po transferze zarodków nie wykazał obecności ciąży. Wnioski: Infekcja dróg oddechowych poprzedzająca stymulację może stanowić nowy niezależny czynnik ryzyka dla OHSS. Związek pomiędzy infekcja dróg oddechowych a podatnością na OHSS wymaga dalszych badań. Świeżo przebyta infekcja dróg oddechowych może stanowić względne przeciwwskazanie do rozpoczęcia kontrolowanej hiperstymulacji jajników

Biotechnological and clinical outcome of in vitro fertilization in non-obese patients with polycystic ovarian syndrome.

<strong>INTRODUCTION</strong><br />Polycystic ovarian syndrome (PCOS) is a hormonal and metabolic disorder which poses problems with controlled ovarian stimulation (COH). It has been also postulated that PCOS patients have oocytes and embryos with poorer quality which affects IVF results.<br /><br /><strong>AIM</strong><br />To verify IVF outcome in non-obese patients with PCOS.<br /><br /><strong>MATERIALS AND METHODS</strong><br />IVF results of 71 non-obese PCOS patients with 243 non-obese non-POCS patients, regardless of stimulation protocol, from years 2004-2006 were compared.<br /><br /><strong>RESULTS</strong><br />Biotechnological results of PCOS patients in opposition to non-PCOS patients were respectively as follows: higher average number (10.19 vs. 7.61; p=0.001) and percentage (82.34% vs. 76.25%; p=0.025) of retrieved mature M2 oocytes; similar (77.01% vs. 76.75%; p=0.835) fertilization rate with higher average number of embryos (7.633 vs. 5.650 p=0.003); higher average number (4.830 vs. 3.304; p=0.001) and percentage (65.66% vs. 60.57%; p=0.006) of embryos with optimal Z1 and Z2 pronuclei pattern according to Scott; higher average number of class Aembryos (3.57 vs. 2.34; p=0.001). Similar number of embryos were transferred in both groups (2.408 vs. 2.485, p=0.552). Clinical results in PCOS and non-PCOS patients were as follows: similar stimulation duration (10.53 days vs. 10.31 days; p=0.639) with significant less gonadotropin total usage (1866.54 IU vs. 2276.18 IU; p=0.001). Also clinical pregnancy per transfer (57.75% vs. 41.98%; p=0.021) and delivery per transfer (45.07% vs. 32.51%; p=0.066) were more often in PCOS patients with comparable miscarriages (12,68% vs. 6,58%; p=0.131) and ectopic pregnancy (0.00% vs. 2.06%; p=0.591) rates, respectively.<br /><br /><strong>CONCLUSION</strong><br />PCOS in non-obese patients is linked with good biotechnological and clinical IVF outcome.<br /><br /&gt

The influence of a change in the meniscus cross-sectional shape on the medio-lateral translation of the knee joint and meniscal extrusion.

The purpose of this study was to evaluate the influence of a change in the meniscus cross sectional shape on its position and on the biomechanics of a knee joint.One main finite element model of a left knee joint was created on the basis of MRI images. The model consisted of bones, articular cartilages, menisci and ligaments. Eight variants of this model with an increased or decreased meniscus height were then prepared. Nonlinear static analyses with a fixed flexion/extension movement for a compressive load of 1000 N were performed. The additional analyses for those models with a constrained medio-lateral relative bone translation allowed for an evaluation of the influence of this translation on a meniscus external shift.It was observed that a decrease in the meniscus height caused a decrease in the contact area, together with a decrease in the contact force between the flattened meniscus and the cartilage. For the models with an increased meniscus height, a maximal value of force acting on the meniscus in a medio-lateral direction was obtained. The results have shown that the meniscus external shift was approximately proportional to the meniscus slope angle, but that relationship was modified by a medio-lateral relative bone translation. It was found that the translation of the femur relative to the tibia may be dependent on the geometry of the menisci.The results have suggested that a change in the meniscus geometry in the cross sectional plane can considerably affect not only the meniscal external shift, but also the medio-lateral translation of the knee joint as well as the congruency of the knee joint