COMPARISON OF SPERM MOTILITY AND FERTILISATION IN VITRO

SAŽETAK Cilj: Cilj ovog rada bio je ispitati povezanost kompjutorske analize spermija (engl. computer-aided sperm analysis, CASA), posebno parametara koncentracije i pokretljivosti progresivnih spermija, s postizanjem oplodnje in vitro. Metode: Analiza kvalitete sjemena napravljena je pomoću CASA sistema. Analizirano je 36 bolesnika kod kojih je napravljena in vitro oplodnja (engl. in vitro fertilization, IVF) i embrio transfer (ET). Karakteristike spermija prije i nakon ‘swim up’ metode pročišćavanja uspoređene su između 23 ciklusa s oplodnjom ≤ 50% i 13 ciklusa bez oplodnje. Rezultati i zaključak: Ispitivanje pokazuje da parametri brzine i pokretljivosti spermija iz nativnog sjemena i spermija pročišćenih ‘swim up’ metodom koreliraju s oplodnjom in vitro, što ukazuje da ovi parametri mogu biti dobar pokazatelj ishoda oplodnje.ABSTRACT Aim: The aim of this study was to investigate the relationships between computer-aided sperm analysis (CASA), especially the concentration and movement characteristics of progressively motile spermatozoa and fertilization rates in vitro. Methods: Analysis of semen quality was performed using CASA in 36 in vitro fertilization – embryo transfer (IVF-ET) cycles with at least 2 oocytes collected. Sperm quality before and after swim-up procedure was compared between 23 cycles with fertilization rate ≤50% and 13 cycles without fertilization. Results and conclusion: Our study demonstrated that velocity parameters and motility characteristics of sperms from freshly obtained semen and those after swim up procedure correlated with fertilization rates, indicating that these parameters could be good predictors of the fertilization outcome

Synergetic effects of K, Ca, Cu and Zn in human semen in relation to parameters indicative of spontaneous hyperactivation of spermatozoa

We have observed that sperm quality parameters indicative of spermatozoa hyperactivation such are lower “ linearity ” and “ straightness ” , and as showed by this research “ elongation ” , were more pronounced in patients with normal spermiogram compared to the group of men with reduced sperm motility who were undergoing routine in vitro fertilisation. The research encompassed 97 men diagnosed with normozoospermia (n = 20), asthenozoospermia (n = 54) and oligoasthenozoospermia (n = 23). The findings indicate that sperm quality of patients with normal spermiogram diagnosed according to WHO criteria, may be compro- mised by showing premature spontaneous hyperactivation which can decrease the chances of natural conception. We assessed synergistic effects of multiple chemical ele- ments in ejaculated semen to find if premature spontaneous hyperactivation of spermato- zoa can be a sign of imbalanced semen composition especially of elements K, Ca, Cu and Zn. Human semen samples showing low or high baseline status of chemical elements con- centrations were found in samples from all three diagnostic groups. However, correlation of K/Ca and Cu/Zn ratios, taking into account samples from all three groups of men, were neg- ative at statistical significance level p = 0.01. We tested if the negative correlation between K/Ca and Cu/Zn ratio works for greater number of semen samples. We found the negative correlation to be valid for 175 semen samples at statistical significance of p = 0.00002. The ratio of K/Ca and Cu/Zn, i.e. increased concentrations of K and Zn in comparison to concen- trations of Ca and Cu, were associated with a decrease of “ straightness ” in the group of men with normal spermiogram and pronounced spontaneous hyperactivation of spermato- zoa, implying that these elements act in synergy and that the balance of elements and not their absolute concentrations plays the major role in premature spermatozoa hyperactiva- tion in ejaculated semen

Nemjerljiva razina serumskog anti-müllerova hormona u žene sa sindromom hiperstimulacije jajnika tijekom in vitro fertilizacije i uspješan ishod trudnoće: prikaz slučaja

We report a unique case of undetectable serum levels of anti-müllerian hormone (AMH) in women with polycystic ovary syndrome (PCOS) who developed ovarian hyperstimulation syndrome (OHSS) during in vitro fertilization (IVF). A case is described of a 28-year-old woman with clinical symptoms of PCOS and AMH serum level below analytical sensitivity (<1.0 pmol/L). After undergoing controlled ovarian stimulation, the patient developed OHSS. After follicle aspiration, seven oocytes were recovered. Three of them were used for intracytoplasmic sperm injection (ICSI) and fertilized, but with unsuccessful pregnancy outcome. A successful pregnancy was achieved in the second IVF/ICSI cycle with six oocytes retrieved and three embryos transferred. At 39 weeks of gestation, the patient delivered a healthy baby weighing 3930 g and 50 cm long. In conclusion, although AMH is considered a useful tool in ovarian reserve assessment and in predicting response to controlled ovarian hyperstimulation, the case presented shows that AMH should not be used as an independent ovarian marker.Opisan je jedinstven slučaj nemjerljive serumske razine anti-Müllerova hormona (AMH) u žene sa sindromom policističnih jajnika (PCOS) koja je razvila sindrom hiperstimulacije jajnika (OHSS) tijekom in vitro oplodnje (IVF). Prikazujemo slučaj 28-godišnje žene s kliničkim simptomima PCOS-a i razine AMH u serumu ispod analitičke osjetljivosti (<1,0 pmol/L). Nakon što je prošla kroz kontroliranu stimulaciju jajnika, bolesnica je razvila OHSS. Aspiracijom folikula dobiveno je sedam jajnih stanica. Tri su oplođene metodom intracitoplazmatskog ubrizgavanja spermija (ICSI), ali s neuspješnim ishodom trudnoće. Do trudnoće je došlo u drugom ciklusu IVF/ICSI sa šest oocita i tri prenesena zametka. U 39. tjednu trudnoće žena je rodila zdravo dijete teško 3930 g i dugo 50 cm. U zaključku, iako se AMH smatra korisnim testom u procjeni rezerve jajnika i u predviđanju odgovora na kontroliranu hiperstimulaciju jajnika, ovaj slučaj pokazuje da se AMH ne smije rabiti kao samostalan test procjene rezerve jajnika

CROATIAN SOCIETY OF CLINICAL EMBRYOLOGISTS – GUIDELINES ON THE EPIDEMIOLOGICAL FRAMEWORK FOR THE IMPLEMENTATION OF MEDICALLY ASSISTED REPRODUCTION (MAR) PROCEDURES DURING THE COVID-19 PANDEMIC REGARDING THE SAFETY OF PATIENTS AND MEDICAL HEALTH WORKERS

Due to the high virulence of the SARS-CoV-2 virus, the infection rate in the community has led to a state of pandemic, leading to the introduction of new emergency measures all over the world. With the aim of controlling and preventing the SARS-CoV-2 viral epidemic, the health institutions performing medically assisted reproduction (MAR) suspended any new MAR treatments in order to reduce the burden on the health care system and implement current social distancing recommendations. Considering the favorable epidemiological situation in Croatia, our perspective is that it is time to conceive, plan and bring forth guidelines for restarting work in MAR centres, taking into account the selection of patients and organization of good laboratory and clinical practices with emphasis on the safety of patients and health workers. In regard to epidemiological knowledge, it is important to establish the reorganization of work in MAR centres including epidemiological measures of reducing unnecessary stays in closed spaces, the usage of protective gear by patients and health workers and disinfection of the working spaces and equipment

ART in Europe, 2017: results generated from European registries by ESHRE

© The Author(s) 2021. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.Study question: What are the data on ART and IUI cycles, and fertility preservation (FP) interventions reported in 2017 as compared to previous years, as well as the main trends over the years? Summary answer: The 21st ESHRE report on ART and IUI shows the continual increase in reported treatment cycle numbers in Europe, with a decrease in the proportion of transfers with more than one embryo causing an additional slight reduction of multiple delivery rates (DR) as well as higher pregnancy rates (PR) and DR after frozen embryo replacement (FER) compared to fresh IVF and ICSI cycles, while the number of IUI cycles increased and their outcomes remained stable. What is known already: Since 1997, ART aggregated data generated by national registries, clinics or professional societies have been gathered and analyzed by the European IVF-monitoring Consortium (EIM) and communicated in a total of 20 manuscripts published in Human Reproduction and Human Reproduction Open. Study design size duration: Data on European medically assisted reproduction (MAR) are collected by EIM for ESHRE on a yearly basis. The data on treatments performed between 1 January and 31 December 2017 in 39 European countries were provided by either National Registries or registries based on personal initiatives of medical associations and scientific organizations. Participants/materials setting methods: Overall, 1382 clinics offering ART services in 39 countries reported a total of 940 503 treatment cycles, including 165 379 with IVF, 391 379 with ICSI, 271 476 with FER, 37 303 with preimplantation genetic testing (PGT), 69 378 with egg donation (ED), 378 with IVM of oocytes, and 5210 cycles with frozen oocyte replacement (FOR). A total of 1273 institutions reported data on 207 196 IUI cycles using either husband/partner's semen (IUI-H; n = 155 794) or donor semen (IUI-D; n = 51 402) in 30 countries and 25 countries, respectively. Thirteen countries reported 18 888 interventions for FP, including oocyte, ovarian tissue, semen and testicular tissue banking in pre- and postpubertal patients. Main results and the role of chance: In 21 countries (20 in 2016) in which all ART clinics reported to the registry, 473 733 treatment cycles were registered for a total population of approximately 330 million inhabitants, allowing a best-estimate of a mean of 1435 cycles performed per million inhabitants (range: 723-3286).Amongst the 39 reporting countries, the clinical PR per aspiration and per transfer in 2017 were similar to those observed in 2016 (26.8% and 34.6% vs 28.0% and 34.8%, respectively). After ICSI the corresponding rates were also similar to those achieved in 2016 (24% and 33.5% vs 25% and 33.2% in 2016). When freeze all cycles were removed, the clinical PRs per aspiration were 30.8% and 27.5% for IVF and ICSI, respectively.After FER with embryos originating from own eggs the PR per thawing was 30.2%, which is comparable to 30.9% in 2016, and with embryos originating from donated eggs it was 41.1% (41% in 2016). After ED the PR per fresh embryo transfer was 49.2% (49.4% in 2016) and per FOR 43.3% (43.6% in 2016).In IVF and ICSI together, the trend towards the transfer of fewer embryos continues with the transfer of 1, 2, 3 and ≥4 embryos in 46.0%, 49.2%, 4.5% and in 0.3% of all treatments, respectively (corresponding to 41.5%, 51.9%. 6.2% and 0.4% in 2016). This resulted in a reduced proportion of twin DRs of 14.2% (14.9% in 2016) and stable triplet DR of 0.3%. Treatments with FER in 2017 resulted in a twin and triplet DR of 11.2% and 0.2%, respectively (vs 11.9% and 0.2% in 2016).After IUI, the DRs remained similar at 8.7% after IUI-H (8.9% in 2016) and at 12.4% after IUI-D (12.4.0% in 2016). Twin and triplet DRs after IUI-H were 8.1% and 0.3%, respectively (in 2016: 8.8% and 0.3%) and 6.9% and 0.2% after IUI-D (in 2016: 7.7% and 0.4%). Amongst 18 888 FP interventions in 13 countries, cryopreservation of ejaculated sperm (n = 11 112 vs 7877 from 11 countries in 2016) and of oocytes (n = 6588 vs 4907 from eight countries in 2016) were the most frequently reported. Limitations reasons for caution: As the methods of data collection and levels of reporting vary amongst European countries, interpretation of results should remain cautious. Some countries were unable to deliver data about the number of initiated cycles and deliveries. Wider implications of the findings: The 21st ESHRE report on ART, IUI and FP interventions shows a continuous increase of reported treatment numbers and MAR-derived livebirths in Europe. Being already the largest data collection on MAR in Europe, efforts should continue to optimize data collection and reporting with the perspective of improved quality control, transparency and vigilance in the field of reproductive medicine. Study funding/competing interests: The study has received no external funding and all costs are covered by ESHRE. There are no competing interests.info:eu-repo/semantics/publishedVersio

Oocyte and ovarian tissue cryopreservation in European countries : statutory background, practice, storage and use

STUDY QUESTION: What is known in Europe about the practice of oocyte cryopreservation (OoC), in terms of current statutory background, funding conditions, indications (medical and ‘non-medical’) and specific number of cycles? SUMMARY ANSWER: Laws and conditions for OoC vary in Europe, with just over half the responding countries providing this for medical reasons with state funding, and none providing funding for ‘non-medical’ OoC. WHAT IS ALREADY KNOWN: The practice of OoC is a well-established and increasing practice in some European countries, but data gathering on storage is not homogeneous, and still sparse for use. Ovarian tissue cryopreservation (OtC) is only practiced and registered in a few countries. STUDY DESIGN, SIZE, AND DURATION: A transversal collaborative survey on OoC and OtC, was designed, based on a country questionnaire containing information on statutory or professional background and practice, as well as available data on ovarian cell and tissue collection, storage and use. It was performed between January and September 2015. PARTICIPANTS/MATERIALS, SETTING AND METHODS: All ESHRE European IVF Monitoring (EIM) consortium national coordinators were contacted, as well as members of the ESHRE committee of national representatives, and sent a questionnaire. The form included national policy and practice details, whether through current existing law or code of practice, criteria for freezing (age, health status), availability of funding and the presence of a specific register. The questionnaire also included data on both the number of OoC cycles and cryopreserved oocytes per year between 2010 and 2014, specifically for egg donation, fertility preservation for medical disease, ‘other medical’ reasons as part of an ART cycle, as well as for ‘non-medical reasons’ or age-related fertility decline. Another question concerning data on freezing and use of ovarian tissue over 5 years was added and sent after receiving the initial questionnaire. MAIN RESULTS AND THE ROLE OF CHANCE: Out of 34 EIM members, we received answers regarding OoC regulations and funding conditions from 27, whilst 17 countries had recorded data for OoC, and 12 for OtC. The specific statutory framework for OoC and OtC varies from absent to a strict frame. A total of 34 705 OoC cycles were reported during the 5-year-period, with a continuous increase. However, the accurate description of numbers was concentrated on the year 2013 because it was the most complete. In 2013, a total of 9126 aspirations involving OoC were reported from 16 countries. Among the 8885 oocyte aspirations with fully available data, the majority or 5323 cycles (59.9%) was performed for egg donation, resulting in the highest yield per cycle, with an average of 10.4 oocytes frozen per cycle. OoC indication was ‘serious disease’ such as cancer in 10.9% of cycles, other medical indications as ‘part of an ART cycle’ in 16.1%, and a non-medical reason in 13.1%. With regard to the use of OoC, the number of specifically recorded frozen oocyte replacement (FOR) cycles performed in 2013 for all medical reasons was 14 times higher than the FOR for non-medical reasons, using, respectively, 8.0 and 8.4 oocytes per cycle. Finally, 12 countries recorded storage following OtC and only 7 recorded the number of grafted frozen/thawed tissues. LIMITATIONS, REASONS FOR CAUTION: Not all countries have data regarding OoC collection, and some data came from voluntary collaborating centres, rather than a national authority or register. Furthermore, the data related to use of OoC were not included for two major players in the field, Italy and Spain, where numbers were conflated for medical and non-medical reasons. Finally, the number of cycles started with no retrieval is not available. Data are even sparser for OtC. WIDER IMPLICATIONS OF THE FINDINGS: There is a need for ART authorities and professional bodies to record precise data for practice and use of OoC (and OtC), according to indications and usage, in order to reliably inform all stakeholders including women about the efficiency of both methods. Furthermore, professional societies should establish professional standards for access to and use of OoC and OtC, and give appropriate guidance to all involved. STUDY FUNDING/COMPETING INTEREST(S): The study was supported by ESHRE. There are no conflicts of interest.peer-reviewe

Usporedba Pokretljivosti Sjemena i Oplodnje In Vitro

Aim: The aim of this study was to investigate the relationships between computer-aided sperm analysis (CASA), especially the concentration and movement characteristics of progressively motile spermatozoa and fertilization rates in vitro. Methods: Analysis of semen quality was performed using CASA in 36 in vitro fertilization – embryo transfer (IVF-ET) cycles with at least 2 oocytes collected. Sperm quality before and after swim-up procedure was compared between 23 cycles with fertilization rate ≤50% and 13 cycles without fertilization. Results and conclusion: Our study demonstrated that velocity parameters and motility characteristics of sperms from freshly obtained semen and those after swim up procedure correlated with fertilization rates, indicating that these parameters could be good predictors of the fertilization outcome.Cilj: Cilj ovog rada bio je ispitati povezanost kompjutorske analize spermija (engl. computer-aided sperm analysis, CASA), posebno parametara koncentracije i pokretljivosti progresivnih spermija, s postizanjem oplodnje in vitro. Metode: Analiza kvalitete sjemena napravljena je pomoću CASA sistema. Analizirano je 36 bolesnika kod kojih je napravljena in vitro oplodnja (engl. in vitro fertilization, IVF) i embrio transfer (ET). Karakteristike spermija prije i nakon &apos;swim up&apos; metode pročišćavanja uspoređene su između 23 ciklusa s oplodnjom ≤ 50% i 13 ciklusa bez oplodnje. Rezultati i zaključak: Ispitivanje pokazuje da parametri brzine i pokretljivosti spermija iz nativnog sjemena i spermija pročišćenih &apos;swim up&apos; metodom koreliraju s oplodnjom in vitro, što ukazuje da ovi parametri mogu biti dobar pokazatelj ishoda oplodnje