Intracytoplasmic sperm injection--an assisted reproduction technique that should make us cautious about imprinting deregulation

Effects of enzymolysis and fermentation of Chinese herbal medicines on serum component, egg production, and hormone receptor expression in laying hens

OBJECTIVE

In the present study, we aimed to investigate the effects of enzymolysis fermentation of Chinese herbal medicines (CHMs) on egg production performance, egg quality, lipid metabolism, serum reproductive hormone levels, and the mRNA expression of the ovarian hormone receptor of laying hens in the late-laying stage.

METHODS

A total of 360 Hy-Line Brown laying hens (age, 390 days) were randomly categorized into four groups. Hens in the control (C) group were fed a basic diet devoid of CHMs, the crushed CHM (CT), fermented CHM (FC), and enzymatically fermented CHM (EFT) groups received diets containing 2% crushed CHM, 2% fermented CHM, and 2% enzymatically fermented CHM, respectively.

RESULTS

Compared with crushed CHM, the acid detergent fiber, total flavonoids, and total saponins contents of fermented CHM showed improvement (p<0.05); furthermore, the neutral and acid detergent fiber, total flavonoids, and total saponins contents of enzymatically fermented CHM improved (p<0.05). At 5 to 8 weeks, hens in the FC and EFT groups showed increased laying rates, haugh unit, albumin height, yolk color, shell thickness, and shell strength compared with those in the C group (p<0.05). Compared with the FC group, the laying rate, albumin height, and Shell thickness in the EFT group was increased (p<0.05). Compared with the C, CT, and FC groups, the EFT group showed reduced serum total cholesterol and increased serum luteinizing hormone levels and mRNA expressions of follicle stimulating hormone receptor and luteinizing hormone receptor (p<0.05).

CONCLUSION

These results indicated that the ETF group improved the laying rate and egg quality and regulated the lipid metabolism in aged hens. The mechanism underlying this effect was likely related to cell wall degradation of CHM and increased serum levels of luteinizing hormone and mRNA expression of the ovarian hormone receptor.

Intracytoplasmic spermatid injection and in vitro maturation: fact or fiction?

Intracytoplasmic injection with testicular spermatozoa has become a routine treatment in fertility clinics. Spermatozoa can be recovered in half of patients with nonobstructive azoospermia. The use of immature germ cells for intracytoplasmic injection has been proposed for cases in which no spermatozoa can be retrieved. However, there are low pregnancy rates following intracytoplasmic injection using round spermatids from men with no elongated spermatids or spermatozoa in their testes. The in vitro culture of immature germ cells to more mature stages has been proposed as a means to improve this poor outcome. Several years after the introduction of intracytoplasmic injection with elongating and round spermatids, uncertainty remains as to whether this approach can be considered a safe treatment option. This review outlines the clinical and scientific data regarding intracytoplasmic injection using immature germ cells and in vitro matured germ cells.

Male factor infertility and ART

For years, the management and treatment of male factor infertility has been 'experience' and not 'evidence' based. Although not evidence-based, current clinical practice involves extensive use of assisted reproductive techniques (ART). Where specific treatments are not indicated or have failed, ART have become popular adjunctive treatments for alleviating male factor infertility. According to the limited evidence available, intrauterine insemination (IUI) may be considered as a first-line treatment in a couple in which the female partner has a normal fertility status and at least 1×10(6) progressively motile spermatozoa are recovered after sperm preparation. If no pregnancy is achieved after 3-6 cycles of IUI, optimized in vitro fertilization (IVF) can be proposed. When less than 0.5×10(6) progressively motile spermatozoa are obtained after seminal fluid processing or sperm are recovered surgically from the testis or epididymis, intracytoplasmic sperm injection (ICSI) should be performed. Although the outcome of no other ART has ever been scrutinized as much before, no large-scale 'macroproblems' have as yet been observed after ICSI. Yet, ICSI candidates should be rigorously screened before embarking on IVF or ICSI, and thoroughly informed of the limitations of our knowledge on the hereditary aspects of male infertility and the safety aspects of ART.

Intracytoplasmic sperm injection: An assisted reproductive technique and its outcome to overcome infertility

This review focuses on the outcome, merits and demerits of intracytoplasmic sperm injection (ICSI) for treatment of male factor infertility. Spermatozoa of infertile men are surgically retrieved from the epididymis or testis. Fertilisation and pregnancy rates after ICSI are found to be around 66% and 48%, respectively, with surgically retrieved spermatozoa. Major contributing factors to failed fertilisation after ICSI are the number of metaphase II oocytes retrieved and availability of viable spermatozoa for injection. Children born after ICSI have an increased risk of major congenital deformity as compared with children born naturally. Both paternal and maternal risk factors seem to pose an increased risk of congenital malformations in the offspring born after ICSI. The ICSI technique per se is not an independent risk factor. Qualitative differences in development and social interaction between ICSI and natural children appears to be related to developmental processes of the entire family unit. Parents of ICSI children have a good relationship with their children.

Epigenetic consequences of assisted reproduction and infertility on the human preimplantation embryo

Epigenetic information, which is essential for normal mammalian development, is acquired during gametogenesis and further regulated during preimplantation development. The epigenetic consequences of assisted reproductive technologies (ARTs) and infertility on the health and quality of the human preimplantation embryo are considered in this review. In the zygote, the epigenetic information that is inherited from the sperm and the oocyte intersects and must be appropriately recognized, regulated and then propagated during preimplantation development so as to regulate gene expression in an appropriate manner. A growing body of evidence suggests that ARTs and/or infertility itself may affect these complex processes leading to epigenetic diseases that include disorders of genomic imprinting. The epigenetic safety of human gametes and embryos is of paramount importance. Unfortunately, morphological methods of assessing embryo quality are incapable of detecting epigenetic errors. Further research is therefore critical to resolve these issues.

Fertility and pregnancy: common concerns of the aging cystic fibrosis population

Due to dramatically improved survival, cystic fibrosis (CF) is now considered a chronic disease of adults. Many men and women who have CF are interested in starting families and have questions regarding fertility and pregnancy, making discussion of these issues important in routine CF care. This article addresses key issues of fertility in men and women who have CF and discusses pregnancy, including maternal and fetal outcomes, highlighting advances over the last decade.

Trends in the use of intracytoplasmic sperm injection in the United States

BACKGROUND

Intracytoplasmic sperm injection (ICSI) was initially developed as part of in vitro fertilization (IVF) to treat male-factor infertility. However, despite the added cost, uncertain efficacy, and potential risks of ICSI, its use has been extended to include some patients without documented male-factor infertility.

METHODS

We analyzed national data on assisted reproductive technology reported to the Centers for Disease Control and Prevention, to determine temporal trends in the use of ICSI and IVF in the United States, and we examined differences in the use of ICSI between states with and those without mandated insurance coverage.

RESULTS

From 1995 to 2004, the number of fertility clinics and fresh-embryo cycles and the rates of IVF-related pregnancies and live births increased. The percentage of IVF cycles with the use of ICSI also increased dramatically (from 11.0% to 57.5%), while the percentage of diagnoses of infertility attributed to male-factor conditions remained stable. The ratio of ICSI procedures to diagnoses of male-factor infertility steadily increased each year, suggesting an increasing use of ICSI for conditions other than male-factor infertility. From 1999 to 2004, there was an increasing use of ICSI relative to the percentage of patients with male-factor infertility in states with and those without mandated insurance coverage. For any given year, however, states with insurance coverage had a higher ratio of ICSI use to diagnoses of male-factor infertility than did states without insurance coverage (P<0.001).

CONCLUSIONS

Since 1995, the use of ICSI in the United States has increased dramatically, while the proportion of patients receiving treatment for male-factor infertility has remained stable. State-mandated health insurance coverage for IVF services is associated with greater use of ICSI for infertility that is not attributed to male-factor conditions.