A thin-layer isoelectric focusing method for the separation of proteins in follicular fluid and seminal plasma

The detection of blood contamination in human follicular fluid

PURPOSE

The aim of this study was to compare the reliability of the methods conventionally used to identify low levels of blood contamination in human follicular fluid (hFF) as applicable in the clinical environment.

METHODS

Follicular fluid (n = 339) and plasma samples (n = 20) were collected from patients (n = 138) attending the Centre for Fertility Studies, HF Verwoerd Hospital, University of Pretoria, South Africa. hFF blood contamination was assessed by means of (a) visual inspection, (b) hematocrit (Hct), (c) spectrophotometric analysis, (d) spectrophotometric hemoglobin kit, and (e) Combur-9-test urine sticks.

RESULTS

(1) Neither hematocrit nor spectrophotometry provided reliable detection at low levels of blood contamination. (2) Visual inspection presented with a better discriminatory ability than either Hct or spectrophotometry. (3) Combur-9-test sticks identified up to 50% of blood-contaminated fluids. (4) Spectrophotometrically determined hemoglobin levels presented with weak discriminatory abilities for detecting blood-contaminated fluids.

CONCLUSIONS

Visual inspection as performed in this study provides a fast and relatively reliable method for the determination of blood-contaminated hFFs. In a laboratory environment, however, it would be recommended that a combination of visual inspection, Hct, and spectrophotometric evaluation be employed for the selection of blood-free fluids.

Spectrophotometric absorbance of follicular fluid: a selection criterion

PURPOSE

The aim of this study was to ascertain the absorbance profiles of uncontaminated follicular fluids (FF) vs blood and medium contaminated FF, and to test the hypothesis that blood contamination alters the biochemical status of FF.

METHODS

FF (n = 655) from 230 patients were scanned spectrophotometrically during an ongoing in vitro fertilization (IVF) program. Based on spectrophotometric evaluation, blood contaminated and uncontaminated FF (n = 39 patients/FF) were analyzed for electrolyte content, inorganic phosphate, glucose, creatine, urate, total protein, albumin, bilirubin, cholesterol, alkaline phosphatase, gamma-glutamyltransferase, alanine aminotransferase, aspartate transaminase, and lactate dehydrogenase by means of a SMAC analyzer.

RESULTS

Laparoscopic aspiration resulted in the collection of significantly more clear FF compared to the transvaginal procedure (P = 0.001). Uncontaminated fluid depicted a single mean absorbance at 458.0 nm. Blood contaminated FF could be identified by spectrophotometry and revealed three peaks at 418.12, 540.13, and 575.32 nm, respectively, according to the degree of blood contamination. Follicular fluid diluted with Earles Balanced Salt Solution (EBSS) displayed an additional mean peak at 561.4 nm. Potassium, glucose, and all of the above mentioned enzymes revealed significantly higher levels in blood contaminated FF (P < 0.05).

CONCLUSIONS

From this study, it is concluded that blood contamination and dilution with culture medium influence the biochemical composition as well as the absorbance spectrum of follicular fluids. This procedure is advocated as a prerequisite before quantifying FF content.

Prediction of outcome in human in vitro fertilization based on follicular and stimulation response variables

Since in vitro fertilization (IVF) pregnancy rates have reached a plateau in recent years, there is need for a system of assessment, which could provide a guide for improvements. The follicular characteristics, the response to stimulation, the quality of sperm used for insemination, and the embryonic human chorionic gonadotropin production of 222 women who had undergone routine IVF treatment have been analyzed. Models, predictive of IVF outcome, have been developed using these parameters in various combinations. The results have shown that follicular health and maturity are critical to IVF outcome and that certain patterns of response to ovarian stimulation are associated with the more frequent occurrence of oocytes capable of normal embryonic development after fertilization.

Follicular characteristics associated with viable pregnancy after in vitro fertilization in humans

The aim of this study has been the development of a noninvasive method of predicting the pregnancy potential of human oocytes and embryos intended for in vitro fertilization and embryo replacement. A multifactorial system which distinguishes, with a high degree of accuracy, between normal pregnancy, abnormal pregnancy, and non-pregnancy-producing embryos is reported. The variables included are (1) follicular fluid proteins alpha 1-antitrypsin, complement C3, immunoglobulin IgG2, and total protein, and total proteoglycan level separated by isoelectric focusing; (2) follicular volume; and (3) an embryo appearance rating. The study group consisted of (1) follicles which produced embryos of known performance after transfer (a) when the number of embryos transferred = the number of implantations and, (b) where one embryo transferred = no pregnancy; (2) follicles which produced oocytes which did not cleave after insemination; and (3) follicles from which no oocyte was aspirated. Canonical discriminant analysis of follicular fluid variables and follicular volume has been used to characterize the oocyte performance groups. Correct classification was achieved in 69% of normal pregnancy, 70% of abnormal pregnancy, 33% of no pregnancy, and 47% of no cleavage oocytes. An embryo appearance rating was included with the above variables for a separate discriminant analysis of only those oocytes which had formed embryos after insemination. Correct classification was achieved in 81% of normal-pregnancy, 70% of abnormal-pregnancy, and 70% of no-pregnancy embryos.