Mineral Oil for in vitro Embryo Production: What We Should Know?

Mineral oil as a barrier can minimize temperature, osmolality, and pH fluctuation of the media in the in vitro embryo production system (IVP). Regardless of these advantages, mineral oil quality is varied and may deteriorate during storage or transport conditions. So, it can affect the IVP outcome by absorbing the essentials factors or realizing the toxic components into the media. Although, some methods have already been developed to reduce these side effects, still there is a big concern about the safety and use of mineral oil in the IVP system. In this review, we provided an overview of the advantages and disadvantages of using mineral oil in the IVP system. We also reviewed available methods for its quality control and finally, we introduced some methods for reducing the side effects of mineral oil.

Polycystic Ovary Syndrome Develops the Complications of Assisted Reproductive Technologies

Ovarian hyperstimulation syndrome (OHSS) is a serious complication that remains a threat to every patient experiencing stimulation of ovulation. Polycystic ovary syndrome (PCOS) appears to be the most important predisposing factor for OHSS. The severity of OHSS is associated with the degree of the follicular response to the ovulation inducing agents. The objective of this study was to investigate the relationship between PCOS with the risk of moderate-to-severe OHSS in intracytoplasmic sperm injection treatment patients. Sixty patients in the reproductive ages (20-38), including OHSS patients and age-matched normoresponders were included in this study. Patients who had larger follicle counts on the day of hCG injection were considered at risk for developing moderate-to-severe OHSS. In addition, oocyte quality was assessed about 20-30 min after oocyte pickup. The incidence of OHSS in PCOS patients increased significantly up to 13.9 times higher than in patients without PCOS (OR=13.900; P=0.007). Moreover, moderate-to-severe OHSS increased significantly (OR=3.860; P=0.043) in patients with primary infertility than those with secondary infertility. In addition, oocyte quality was not affected with the severity of OHSS. In conclusion, the risk of moderate-to-severe OHSS is correlated with PCOS and primary infertility without affecting oocyte quality.

CYP2E1-Catalyzed Oxidation Contributes to the Sperm Toxicity of 1-Bromopropane in Mice1

1-bromopropane (1-BrP) induces dose- and time-dependent reproductive organ toxicity and reduced sperm motility in rodents. The contribution of cytochrome P4502E1 (CYP2E1) to both 1-BrP metabolism and the induction of male reproductive toxicity was investigated using wild-type (WT) and Cyp2e1-/- mice. In gas uptake inhalation studies, the elimination half-life of [1,2,3-(13)C]-1-BrP was longer in Cyp2e1-/- mice relative to WT (3.2 vs. 1.3 h). Urinary metabolites were identified by 13C nuclear magnetic resonance. The mercapturic acid of 1-bromo-2-hydroxypropane (2OHBrP) was the major urinary metabolite in WT mice, and products of conjugation of 1-BrP with glutathione (GSH) were insignificant. The ratio of GSH conjugation to 2-hydroxylation increased 5-fold in Cyp2e1-/- mice relative to WT. After 1-BrP exposure, hepatic GSH was decreased by 76% in WT mice vs. 47% in Cyp2e1-/- mice. Despite a 170% increase in 1-BrP exposure in Cyp2e1-/- vs. WT mice, sperm motility in exposed Cyp2e1-/- mice did not change relative to unexposed matched controls. This suggests that metabolites produced through CYP2E1-mediated oxidation may be responsible for 1-BrP-induced sperm toxicity. Both 1-BrP and 2OHBrP inhibited the motility of sperm obtained from WT mice in vitro. However, only 2OHBrP reduced the motility of sperm obtained from Cyp2e1-/- mice in vitro, suggesting that conversion of parent compound to 2OHBrP within the spermatozoa may contribute, at least in part, to reduced motility. Overall, these data suggest that metabolism of 1-BrP is mediated in part by CYP2E1, and activation of 1BrP via this enzyme may contribute to the male reproductive toxicity of this chemical.

Rated casemix of general practitioner referrals to practice counsellors and clinical psychologists: a retrospective survey of a year's caseload

Although evidence-based guidelines are beginning to be produced as to which psychological therapies might be appropriate for which patients, little is known about how general medical practitioners (GPs) in practice distribute referrals between different psychological therapy services. In a retrospective survey, 19 practice counsellors and 10 clinical psychologists from the same geographical area rated a year's caseload of GP referrals using identical data collection methods. Rated casemix was found to be broadly similar, although practice counsellors rated relationship and bereavement problems as more common in their caseloads (totalling 986 patients), and clinical psychologists rated panic disorder, phobias, and obsessive-compulsive problems as more common in their caseloads (totalling 320 patients). Depression and anxiety reactions were the most common problems rated in both groups, but the clinical psychologist cases of depression were rated as more severe and complex. Where differences were found, they may have reflected the different ways that counsellors and clinical psychologists conceptualize cases rather than actual differences in casemix. The results are discussed in relation to evidence-based guideline recommendations about cases appropriate to be seen by practice counsellors and by clinical psychologists in primary and secondary care, and the need to adapt such guidance to local services and skills of practitioners.

Mental health training needs of primary health care nurses

The primary health care team (PHCT) has a critical role to play in the care of people with mental health problems. However, little attention has been paid to the mental health training and preparation required by primary health care nurses. This paper reports on a training needs assessment undertaken in one London health authority area. The findings indicate that primary health care nurses are undertaking a wide range and increasing volume of mental health work with little preparation and training. Specific training needs include time and space to identify training gaps; basic training in mental health, safe working practices and management of role boundaries; and multidisciplinary training. In addition, NHS trusts, primary care groups and health authorities need to clarify which aspects of nurses' mental health workloads are appropriate to their role and develop policies, procedures and training to support them in undertaking that role.

Relationship between practice counselling and referral to outpatient psychiatry and clinical psychology

BACKGROUND

Although reduction in the use of secondary care mental health services is a suggested benefit of counselling in general practice, there has been little empirical investigation of this relationship.

AIM

To investigate the relationship between the provision of counselling in general practice and the use of outpatient psychiatry and clinical psychology services across a geographical area.

METHOD

Information on referrals to outpatient psychiatry and clinical psychology from all general practices in the London Borough of Islington over one year (October 1993 to September 1994) was collected from the routine information systems of the main hospital departments serving this area. Referral rates per 1000 practice population were compared for practices with and without a practice-based counsellor.

RESULTS

Fifteen (35%) of the 43 practices had a counsellor based in the practice. The median referral rate to clinical psychology was higher in practices with a counsellor (4.1 per 1000) than in practices without a counsellor (0.8 per 1000). There was no relationship between the provision of practice counselling and median referral rates to outpatient psychiatry (1.8 per 1000 with a counsellor, 1.7 per 1000 without a counsellor).

CONCLUSION

Provision of practice counselling in the study was associated with higher referral rates to clinical psychology and no difference in referral rates to outpatient psychiatry. This is in contrast to the hypothesis that counselling reduces the use of secondary care mental health services.