Digit ratio (2D:4D) in women and men with lung cancer

A prenatal sex steroid environment of high prenatal testosterone and low prenatal oestrogen inhibits lung development and may predispose individuals to be vulnerable to lung disease in later life. Therefore, the aim of this report was to investigate whether there is an association between right and left 2D:4D (biomarker of prenatal sex steroids exposure) and primary lung cancer in women and men. Also, we considered the relationship between right–left 2D:4D (Δ2D:4D, a negative correlate of high prenatal testosterone and low prenatal oestrogen) and the age of lung cancer diagnosis. The study included 109 patients (61 men) with lung cancer and 197 controls (78 men). In the study we found that: (i) women with lung cancer have lower 2D:4D compared to controls (the effect was independent of smoking), (ii) among women with cancer, age at diagnosis was positively related to 2D:4D, i.e. women with masculinized 2D:4D present earlier with the cancer than women with feminized 2D:4D, (iii) among men with lung cancer, those with the most aggressive form (small-cell lung cancer) had masculinized (low) Δ2D:4D compared to those with the less aggressive form (non-small cell lung cancer). The data suggests that masculinized right 2D:4D and Δ2D:4D are associated with a predisposition to lung cancer and/or the more aggressive forms of lung cancer.

Electric-field-induced weakly chaotic transients in ferroelectric liquid crystals

Nonlinear dynamics induced in surface stabilized ferroelectric liquid crystals by strong alternating external electric fields is studied both theoretically and experimentally. As has already been shown, molecular reorientations induced by sufficiently strong fields of high-enough frequencies can reveal a long transient behavior that has a weakly chaotic character. The resulting complex dynamics of ferroelectric liquid crystals can be considered not only as a consequence of irregular motions of particular molecules but also as a repercussion of a surface-enforced partial decorrelation of nonlinear molecular motions within smectic layers. To achieve more insight into the nature of this phenomenon and to show that the underlying complex field-induced behavior of smectic liquid crystals is not exceptional, ranges of system parameters for which the chaotic behavior occurs are determined. It is proved that there exists a large enough set of initial phase trajectory points, for which weakly chaotic long-time transitory phenomena occur, and, thereby, it is demonstrated that such a chaotic behavior can be regarded as being typical for strongly field-driven thin liquid crystal systems. Additionally, the influence of low-amplitude random noise on the duration of the transient processes is numerically studied. The strongly nonlinear contribution to the electro-optic response, experimentally determined for liquid crystal samples at frequencies lower than the actual field frequency, is also analyzed for long-time signal sequences. Using a statistical approach to distinguish numerically response signals of samples from noise generated by measuring devices, it is shown that the distribution of sample signals distinctly differs from the device noise. This evidently corroborates the occurrence of the nonlinear low-frequency effect, found earlier for different surface stabilized liquid crystal samples.

Strongly nonlinear dynamics of ferroelectric liquid crystals

Molecular reorientation processes induced in thin ferroelectric liquid crystal systems by strong alternating external electric fields are studied both by solving numerically the equation of reorientation motion of molecules and by measuring the electro-optic response of thin samples. It is shown that the occurrence of a wide band in nonlinear response spectra above the Goldstone-mode frequency is a consequence of complex partially uncorrelated molecular reorientations enforced within smectic layers by sufficiently high fields of high enough frequencies. Such nonlinear reorientational motions of molecules are argued to have a character of weakly chaotic long-lasting transients, related to almost periodic modulations of the amplitude of rotational oscillations performed by molecules with the field frequency. These modulations have been numerically proved to proceed with lower frequencies than the field frequency and with space-dependent depths of temporal changes. The occurrence of the modulations has experimentally been confirmed by registering distinct contributions to electro-optic response spectra at frequencies less than the running frequency of the applied electric field.

Solitons induced by alternating electric fields in surface-stabilized ferroelectric liquid crystals

Propagation of solitary waves activated in thin ferroelectric liquid crystal cells under external, sinusoidally alternating electric fields is investigated using the electro-optic technique. It is shown that solitons give contributions only to the loss component of the response spectrum, within rather narrow ranges of frequencies and in sufficiently strong fields. The limit frequency, at which the amplitude of the velocity of the solitary waves is greatest, is found to be related to material constants of liquid crystals. Measuring this threshold frequency provides the capability to determine the elastic constant of surface stabilized liquid crystalline materials in the bookshelf or chevron layer geometries.

Behavior of the helix in some chiral smectic-C* liquid crystals

In spite of numerous papers dedicated to the subject, the behavior of the helical pitch in the smectic C* phase near the smectic A phase is still controversial. In particular, it is not clear to what extent the measured pitch values are influenced by surface effects. In order to shed light on this problem, careful pitch measurements have been performed using different methods and sample preparations. We have found that the diffraction of light on planar-oriented samples may give incorrect pitch results because of strong influence of the surfaces and possibly of the sample texture on the helical structure. We have demonstrated that using appropriate preparation of samples the bulk properties of the helix can be determined. It has been found that a maximum of pitch can indeed occur but then only when very close to the transition point smectic C*-->smectic A (about 0.1 K). The results of helical pitch measurements have been compared with predictions of theories.

Orientational order of difluorinated liquid crystals: a comparative 13C-NMR, Optical, and dielectric study in nematic and smectic B phases

Structural and orientational order properties of 3Cy2CyBF2 and of 5CyCy2BF2 have been investigated by means of (13)C-NMR, optical, and dielectric spectroscopy methods. In the case of NMR, order parameters have been independently obtained from the analysis of either (13)C-(19)F dipolar couplings or (13)C chemical shift anisotropies, both measured from (13)C-{(1)H} NMR static spectra. The assignment of the (13)C resonances has been carried out thanks to the comparison with solution state spectra and DFT calculations, and the relevant geometrical parameters and (13)C chemical shift tensors needed to derive orientational order parameters have been calculated by DFT methods. In the analysis of (13)C-(19)F dipolar couplings, empirical corrections for vibrations and anisotropic scalar couplings have been included. Dielectric measurements have been performed over a broad frequency range for two orientations of the nematic director with respect to the measuring field. At low frequencies (static case) a positive dielectric anisotropy has been determined, which has enabled the calculation of the order parameters according to a well-tested procedure. At high frequencies the dielectric anisotropy changes its sign, a property which can be useful in designing a dual addressing display. The nematic order parameter determined from optical, dielectric, and NMR methods have been compared: their trends with temperature are very similar, apart from some slight shifts, and were analyzed by Haller and Chirtoc models. The differences among the results obtained by the four methods have been discussed in detail, also with reference to the assumptions and approximations used in each case, and to the results recently reported for similar fluorinated nematogens. The presence of a non-negligible order biaxiality has been related to the presence of a CH2CH2 bridging group, linking one cyclohexylic unit with either the other cyclohexyl or the phenyl ring.

Dielectric relaxation in chevron surface stabilized ferroelectric liquid crystals

The dielectric response of surface stabilized ferroelectric liquid crystals with chevron layer structure is studied within low and intermediate frequency ranges, characteristic for collective molecular excitations. By analytically solving the dynamic equation for collective molecular fluctuations under a weak alternating electric field, it is demonstrated that chevron cells stabilized by both nonpolar and polar surface interactions undergo at medium frequencies two Debye relaxation processes, connected with two chevron slabs, on opposite sides of the interface plane. This result is confirmed, experimentally, making use of the electro-optic technique. Based on qualitative arguments supported by microscopic observations of zigzag defects at different frequencies and amplitudes of the external electric field, it is shown that, at low frequencies, the electro-optic response of chevron samples is determined by three kinds of motions of zigzag walls. The first two dynamic categories are related to collective relaxation processes at weak fields, within smectic A layers forming zigzag walls, and drift or creep motions of thick walls occurring at stronger field amplitudes. Dynamic processes of the third kind correspond to sliding of zigzag walls, which appear at yet stronger field amplitudes, but below the switching threshold.

Determination of piezoelectric and flexoelectric polarization in ferroelectric liquid crystals

A method of determining the local polarization in chiral smectic liquid crystals is proposed. The method consists of simultaneous measurement of the electric permittivity and depth of electro-optic modulation in a helical liquid crystal using weak ac electric field. The spontaneous polarization of a single smectic layer determined in this way contains both the flexoelectric and piezoelectric component. On the other hand, the polarization measured using strong electric fields in a switching experiment contains the piezoelectric component only. The comparison of polarization obtained using strong and weak fields makes it possible to determine the value of flexoelectric polarization. This kind of measurement has been performed for two ferroelectric liquid crystals having quite small absolute values of the spontaneous polarization (few nC/cm2). It turned out that in both cases, the flexoelectric polarization is of the same order of magnitude as the piezoelectric one.

Rescue ICSI of unfertilized oocytes after IVF

BACKGROUND

Failed fertilization after IVF occurs in 10-20% of cycles. Conflicting results of rescue fertilization by ICSI have been reported. We therefore compared the success rate in terms of fertilization and pregnancy of cycles in which rescue ICSI was performed with those from a matched control group of primarily ICSI cycles.

METHODS

Unfertilized oocytes from IVF cycles with total fertilization failure where at least four metaphase II oocytes were available were treated by ICSI (group I; n = 120). A matched control group was established with patients undergoing ICSI during the same period (group II; n = 280).

RESULTS

Both fertilization rate and the proportion of embryos with four blastomeres on day 2 after ICSI were significantly higher in the control group (P < 0.05). Embryo quality, however, was comparable in both groups. The pregnancy rate in the control group was 25.3% whereas in group I with rescue ICSI, no pregnancy was obtained.

CONCLUSIONS

Although unfertilized oocytes after IVF can be fertilized by ICSI, the developmental potential of the ensuing embryos is very poor. Therefore, rescue ICSI after total failure of fertilization is not recommended.

[Intracytoplasmic sperm injection (ICSI): the Białystok experience]

OBJECTIVE

To present a complete results of Intracytoplasmic Sperm Injection Program (ICSI) performed at IVF Unit in Bialystok, Poland.

DESIGN

Retrospective data analysis.

MATERIALS AND METHODS

A total of 2593 cycles of ICSI treatment were analyzed. The results of controlled ovarian hyperstimulation (COH), parameters of fertilization, early embryo development and clinical pregnancy rates were compared depending on the type of COH used.

RESULTS

Overall, for 16708 MII oocytes microinjected, the 2 pronuclear fertilization rate was 54%. Embryo transfer was performed in 94% of started cycles and 629 clinical pregnancies were recorded, giving a clinical pregnancy rate of 24% per cycle and 26% per transfer. No influence of COH on embryological and clinical results was noted.

CONCLUSION

Intracytoplasmic sperm injection can be used successfully to treat couples with male factor infertility and those who have failed standard IVF. Precisely adapted protocol of ovarian hyperstimulation for every patient could diminish the costs of treatment without negative influence on ICSI results.

The outcome of intracytoplasmic injection of fresh and cryopreserved ejaculated spermatozoa--a prospective randomized study

BACKGROUND

The overall aim of this prospective, randomized study was to compare the reproductive potential of fresh and frozen-thawed ejaculated spermatozoa from oligoasthenoteratozoospermic patients in an intracytoplasmic sperm injection (ICSI) procedure.

METHODS

All patients consenting to participate in this study had a sperm sample frozen prior to the start of a cycle. Patients were randomized using a random number table to undergo ICSI with either fresh (group A, n = 118) or frozen-thawed (group B, n = 122) spermatozoa. All prognostic variables were equally distributed among the two groups.

RESULTS

The pregnancy rate per started cycle was 29.7% in group A and 38.5% in group B, P > 0.05. A significant difference was observed in the rate of ongoing pregnancies between group A (23.7%) and group B (35.2%), P < 0.05.

CONCLUSION

From our data we can conclude that cryopreservation of spermatozoa from men with poor sperm quality does not negatively affect fertilization and pregnancy rates after ICSI. A larger study will be needed to investigate whether the use of cryopreserved spermatozoa can be helpful in selecting the most vital spermatozoa for ICSI.

Correctly timed coasting reduces the risk of ovarian hyperstimulation syndrome and gives good cycle outcome in an in vitro fertilization program

One hundred and twelve severely overstimulated in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) patients were treated with coasting when estradiol concentration was > 3000 pg/ml and the leading follicles had attained > or = 18 mm in diameter. Gonadotropin withholding was offered to them as a promising method for the prevention of both cycle cancellation and complications associated with severe ovarian hyperstimulation syndrome (OHSS). The duration of prolonged coasting prior to human chorionic gonadotropin (hCG) administration ranged from 2 to 9 days (mean 3.5). hCG was administered when the serum estradiol dropped to < 3000 pg/ml and at least three growing follicles > or = 20 mm in diameter were present. Fertilization failure was noted in six couples and in another 10 cases freezing of all embryos was decided, therefore embryo transfer was performed on 96 patients. There were 31 clinical pregnancies (five twins) giving a pregnancy rate per patient and per embryo transfer of 30.4% and 32.3%, respectively, with an implantation rate of 18.1%. With regard to all 112 coasted patients, six developed moderate and two severe OHSS. This study shows that withholding gonadotropin administration in high-risk IVF patients results in a good cycle outcome and a very low risk of severe OHSS, and also demonstrates the importance of both the timing of coasting initiation and the timing of hCG administration.

[Electroejaculation--effectiveness in a patient after retroperitoneal lymph node dissection--case report]

Semen was obtained by transrectal electrostimulation from male patient after retroperitoneal lymph node dissection who had not ejaculated since time of operation. Vibratory stimulation was unsuccessful. electroejaculation was done under general anaesthesia. A silicone catheter was used to tamponade the bladder neck and antegrade ejaculations were collected. The semen underwent seminological assessment and then was diluted 1:1 in egg yolk substrate containing 15% glycerol, equilibrated, divided into straws and frozen in nitrogen. The straws were then placed for storage in liquid nitrogen until the insemination.

[Enzymatic assisted hatching in the infertile couple after failed attempts of IVF ET]

The study was conducted on the patients who had attempted and failed previous IVF procedures. The aim of this study was to determinate effectiveness sequential culture of embryos to blastocyst and assisted hatching by zona pellucida digestation by pronase. In this group the pregnancy rate was 24.1% compared to control 17.8%. The implantation rate was higher in study group than control one. It suggests that the culture embryos to balstocyste stage and assisted hatching by digestation by pronase is safe and effective mode of treatment of infertile couple after failed attempts IVF ET.

[Reinsemination of oocytes by intracytoplasmic sperm injection after the failure of conventional fertilization. Early embryonal development]

OBJECTIVE

To analyze the influence of intracytoplasmic sperm injection (ICSI) on early embryo development used for reinsemination of unfertilized 1-day-old oocytes.

DESIGN

Prospective observational study.

MATERIALS AND METHODS

A total of 126 embryos resulted from reinsemination by ICSI were analyzed with regard for the time course of cleavage and the quality of embryos at 48 hours after injection. Results were compared with those obtained in 698 embryos obtained after routine ICSI program.

RESULTS

It has been shown that embryos derived from reinsemination developed slower in comparison with those obtained after regular ICSI program. At 48 hours after microinjection 50% of embryos achieved 4 blastomeres stage and 37% remained on 2 cells stage. 71% of regular ICSI embryos at this same time showed 4 blastomere or more, only 16% remained on 2 blastomeres stage. The quality of embryos was similar in two compared groups, however those obtained following reinsemination at 4 blastomere stage were significantly poorer quality.

CONCLUSION

Embryos derived from reinsemination of 1-day old oocytes unfertilized after conventional IVF developed slower and the quality of embryos at 4 blastomere stage was poorer comparing to regular ICSI embryos.

[Prolonged desensitization pretreatment for in vitro fertilization in women with polycystic ovary]

OBJECTIVE

To analyse the outcome of intracytoplasmic sperm injection (ICSI) in women with severe polycystic ovary disease (PCD), stimulated after prolonged pituitary desensitization in comparison with regular long protocol therapy.

MATERIALS AND METHODS

The results of controlled ovarian hyperstimulation (COH), fertilization rate, early embryo development parameters and clinical pregnancy rates were compared depending on the duration of pituitary desensitization before gonadotropin administration. A total of 60 patients with severe PCOD were desensitized with GnRH agonist up to 30 days before COH. The results were compared with the group of 213 patients with mild PCOD treated with regular long protocol (control).

RESULTS

We observed a slightly higher rate of mature oocytes MII as well as the number of embryos obtained in the control group, however the pregnancy rate in the group with prolonged desensitization was significantly higher (50%) in comparison to the control group (33.8%).

CONCLUSION

The prolonged pituitary desensitization before controlled ovarian hyperstimulation gives better chance for obtaining pregnancy in patients with severe PCOD. It could be recommended facing previous treatment failure.

[Pregnancy and delivery after the transfer of one blastocyst with enzymatically removed zona pellucida]

OBJECTIVES

The embryonic development up to the blastocyst stage and hatching from zona pellucida are prerequisites for implantation and successful pregnancy. It is suggested that one of the possibilities limiting the implantation rate is impaired hatching. To overcome this problem an artificial alteration of the zona pellucida have been carried out in many laboratories.

DESIGN

The report of the first pregnancy in Poland obtained after the transfer of enzymatically zona removed blastocyst.

MATERIALS AND RESULTS

The patient was previously treated three times in in vitro fertilisation program without success. In the fourth program the embryos were cultured in co-culture of Vero cells to the blastocyst stadium. On the day 5 after insemination the zona of cavitating and expanding blastocyst was removed by pronase. The zona free blastocyst was transferred to the uterus. As a result of implanted blastocyst the ongoing pregnancy developed normally and the patient delivered healthy baby.

CONCLUSION

Enzymatic zona pellucida hatching probably increases the rate of implantation. It is simple, safe and economic techniques.

Good results of milder form of ovarian stimulation in an in vitro fertilization/intracytoplasmic sperm injection program

In a prospective study, we compared two protocols of ovulation stimulation, the clomiphene citrate and human menopausal gonadotropin (hMG) versus D-triptorelin, a long-acting gonadotropin-releasing hormone (GnRH) agonist and hMG in 324 couples having their first in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) program, in terms of pregnancy rates and cost-effectiveness of drugs used. The GnRH agonist/hMG group was characterized by a greater mean number of ampoules of hMG used (31.7 versus 10.2), a larger number of oocytes collected (10.4 versus 4.2), and a larger number of embryos obtained (5.8 versus 2.9). With the policy of transferring only two of the best quality embryos, the mean number of embryos replaced were comparable (1.8 in clomiphene citrate/hMG and 1.9 in GnRH agonist/hMG group). The percentage of patients reaching embryo transfer was lower in the clomiphene citrate/hMG than in the GnRH agonist/hMG group (84.1% versus 93.1%, respectively). However, the combined results of the IVF and ICSI procedure in terms of pregnancy rate, both per patient and per embryo transfer were better, though not significantly in the clomiphene citrate/hMG than in GnRH agonist/hMG group (25.0% and 29.7% versus 23.7% and 25.5%, respectively). Similarly, the implantation rate was better (19.0% versus 13.5%, respectively). With the use of clomiphene citrate/hMG, a fivefold less costly drug regimen, we obtained pregnancy rates equivalent to those gained using GnRH agonist/hMG in our IVF/ICSI program.

[The comparison of efficiency of supplement of the second phase in the program IVF-ET by dydrogesterone and progesterone]

The retrospective study was carried out to compare effectiveness of progesteron and dydrogesteron luetal phase support following in vitro fertilisation and embryo transfer. Two hundred and fifty eight patients undergoing IVF ET received progesteron in itramuscular injections. Two hundred sixty patients received dydrogesteron three times daily p.o. There were no differences in stimulation protocols, indications for IVF and IVF procedures. Pregnancy rate, implantation rate and spontaneous abortion rate were similar in both groups. The effectiveness of luteal phase support in patients undergoing IVF ET program by dydrogesteron and progesteron is similar with significantly lower costs for the last one.

[Monozygotic pregnancy after the treatment for infertility by transfer of frozen-thawed embryos]

OBJECTIVES

It has been suggested that monozygotic pregnancies occur more frequently after in vitro fertilisation. This phenomenon is attributed to a number of factors including in vitro culture conditions, malformation of the zona pellucida due to manipulation on the oocytes and artificial opening of the zona pellucida.

DESIGN

Retrospective analysis of monozygotic pregnancies in an IVF-ET procedures and obstetrical these pregnancies outcome.

MATERIALS AND METHODS

A total of 2254 IVF-ET procedures were analysed. Three protocols were used for ovarian stimulation: short or long protocols with gonadotropins releasing hormone analogue or clomiphene citrate with hMG. In 811 cases male factor was diagnosed and intracitoplasmatic sperm injections were performed.

RESULTS

549 clinical pregnancies were achieved in analysed group. In six cases ultrasound examination 5 weeks after embryo transfer showed a greater number of foetus than the number of embryo transferred. In three of those cases the embryos were obtained after ICSI. Age and average thickness of zona pellucida were similar in group of patients with monozygotic pregnancies when compared with all pregnant patients after IVF treatment.

CONCLUSIONS

The incidence of monozygotic pregnancy is increased in group pregnancies resulting from IVF ET. No single risk factor can explain this phenomena. This type of pregnancy needs special obstetrical attention.

[The use of a vibrator for the stimulation of ejaculation in men with spinal cord injury]

Authors have presented results of vibratory stimulation in 20 anejaculatory spinal cord injury men. In 17 of 20 patients who had not ejaculated since their injuries, application of a vibrator to the penis caused ejaculation. Three of them had retrograde ejaculation. All patients with upper thoracic lesions received nifedipin. Side effects of vibratory stimulation were not reported. Semen can be used for assisted reproductive techniques.

[Electroejaculation and lower motor neuron lesion: a report of cases]

Semen was obtained by transrectal electrostimulation from two spinal injured men who had not ejaculated since their injuries. Vibratory stimulation was unsuccessful. Side effect-pain, was reported in one of the patient. A silicone catheter was used to tamponade the bladder neck and antegrade ejaculations were collected with no incidences of urine contamination and no sperm were seen in post ejaculatory urine.

[Seasonal changes in donor's sperm motility: CASA parameters]

Computer assisted semen analysis was employed to find out whether there are some changes in movement parameters between autumn-winter and spring-summer time. 473 sperm specimens obtained from 12 sperm donors were analyzed. Statistically significant percentage of motile spermatozoa was higher during spring-summer time.

Prevention of high-order multiple gestations in an in vitro fertilization program

The aim of this study was to assess the benefits of the transfer of only two of the best quality embryos, three if a woman was over 35 years of age, in terms of pregnancy rate and the incidence of multiple gestations. In 1993-94, when we were replacing three embryos when available and up to five when the woman was over 35 years of age, 217 clinical pregnancies were obtained (25% per embryo transfer). Among them there were 34 (15.6%) twins and 8 (3.7%) triplet pregnancies. Eighty-one patients had surplus embryos cryopreserved. In 1995, with the new policy of transferring only two embryos and three when the woman was over 35 years of age, 170 patients became pregnant (23.9% per embryo transfer). There were 31 (18.2%) twins and no triplet pregnancies. One hundred and forty-four patients had surplus embryos cryopreserved. Although limiting the number of transferred embryos slightly decreases the pregnancy rate, this small reduction can be considered acceptable if the social, health and financial problems associated with high-order multiple gestations are taken into account.

The outcome of an in vitro fertilization program in women with polycystic ovary syndrome

The objective of this study was to examine the efficacy of D-triptorelin in the long protocol and follicle-stimulating hormone (FSH) in an IVF-embryo transfer program in a group of patients with polycystic ovary syndrome (PCOS) who had earlier failed to respond or did not conceive after clomiphene citrate (CC)/human menopausal gonadotropin (hMG) or 'flare up' gonadotropin-releasing hormone agonist (GnRHa)/hMG stimulation. Eighty-nine women with PCOS (based on typical ultrasound criteria) had 1-3 treatment cycles without success. The stimulation protocol was changed to D-triptorelin given in midluteal phase and when pituitary desensitization was achieved, FSH administration was started. The clinical pregnancy rate per transfer in this 'negatively selected' group of PCOS patients was 29%. This was the same as the rate for a group of women with tubal factor, as was the spontaneous miscarriage rate. Although the use of GnRH agonists in the long protocol increases the costs of treatment, the number of cancelled cycles is reduced. The pregnancy rate increased in this group of women with PCOS.

Nonenzymatic antioxidant activity of human seminal plasma

OBJECTIVE

To examine the nonenzymatic antioxidant properties of human seminal plasma.

DESIGN

Determination of total (peroxyl) radical-trapping antioxidant parameter and malondialdehyde concentration in seminal plasma of 112 men attending IVF-ET or intracytoplasmic sperm injection (ICSI) programs.

SETTING

University-based center for reproductive medicine.

PATIENT(S)

Normozoospermic men, ages 25 to 50 years, of fertility proved by a pregnancy resulting from IVF-ET, and men ages 25 to 50 years with negative IVF-ET or ICSI outcome, distinguished by their smoking status.

INTERVENTION(S)

Seminal plasma was obtained from ejaculates collected for IVF-ET or ICSI procedures.

MAIN OUTCOME MEASURE(S)

Total (peroxyl) radical-trapping antioxidant parameter and malondialdehyde concentrations.

RESULT(S)

No significant differences for total (peroxyl)-radical-trapping antioxidant parameter were observed between normozoospermic IVF-ET or asthenozoospermic ICSI patients; neither was a difference revealed for pregnancy-positive or -negative couples within those groups. Age, smoking status, or increased leukocyte count had no effect on total (peroxyl) radical-trapping antioxidant parameter or malondialdehyde concentrations in seminal plasma.

CONCLUSION(S)

Nonenzymatic antioxidant activity in seminal plasma does not reflect sperm fecundity ability.

[Cryopreservation of embryos in an in vitro fertilization program(IVN-ET)--preliminary results]

The authors present preliminary results of cryopreservation of embryos in IVF-ET programme in the Institute of Obstetrics and Gynecology in Białystok. The method of slow cooling embryos with 1, 2 propanediol and saccharose were used. In the group of 136 patients with excess embryos after the transfer of two fresh embryos 29 pregnancies (21.3%) were obtained. After the transfer of frozen/thawed embryos up till now 5 pregnancies have been obtained (one child born, 3 pregnancies ongoing, 1 abortion).

["Long protocol" for ovarian stimulation using D-Trp6 LHRH (Triptorelin Depot) and menopausal gonadotropin in the IVF-ET program]

39 patients (age 35-40, anovulation, previous failures in the IVF-ET programme) were superovulated using GnRH analogue (Decapeptyl-Depot) in the long protocol and hMG 97 embryos were transferred and 109 were cryopreserved. The clinical pregnancy and implantation rates were 31.6% and 13.4%. The long protocol gives better results in the IVF-ET programme but increases the costs of treatment.

Use of GnRH analog for induction of the ovulatory surge of gonadotropins in patients at risk of the ovarian hyperstimulation syndrome

A total of 32 patients undergoing in vitro fertilization (IVF) and 16 treated for ovulatory disturbances were stimulated with clomiphene citrate and human menopausal gonadotropin. Gonadotropin releasing hormone (GnRH) analog was used for induction of the ovulatory surge of gonadotropins, because of the risk of ovarian hyperstimulation syndrome. In four patients after IVF-embryo transfer and four patients after ovulation induction, single pregnancies were obtained. None suffered from ovarian hyperstimulation syndrome. The authors suggest that the use of GnRH analog for induction of the gonadotropin ovulatory surge prevents the development of ovarian hyperstimulation syndrome.

[In vitro studies for evaluating the influence of recombinant interleukin-11 on human erythropoiesis. Potential clinical implications]

According to the experimental data that IL-11 costimulates the proliferation of human hematopoietic progenitors in vitro the first clinical trials in vivo have been performed. Surprisingly, the patients treated with recombinant Il-11 display decrease in the hematocrit values. This finding is contradictory to previous experimental studies in vitro, where IL-11 was found to be a potent costimulator of eytrhopoiesis. Therefore in order to obtain our own data the influence of IL-11 on human erythropoiesis in vitro has been reevaluated. In performed studies we did not observed any influence of IL-11 on the cloning efficiency of human erythropoietic progenitors in vitro. Our results demonstrate on one side that clinical use of IL-11 in order to stimulate erythropoiesis is not enough theoretically grounded and on the other that the decrease of hematocrit values observed after in vivo treatment with recombinant IL-11 could not be explained simply by the fact of the possibility of the direct inhibition of erythroid colonies formation by Il-11.

The results of an in vitro fertilization program: two regimens of superovulation

Gonadotropin-releasing hormone (GnRH) agonists are increasingly used in ovarian hyperstimulation protocols in in vitro fertilization (IVF) programs. From March 1992 to June 1993, 565 patients attending our Institute underwent superovulation in 1104 IVF program cycles. Of these cycles, 650 were stimulated with clomiphene citrate and gonadotropins (human menopausal gonadotropin/hMG), and 454 with the GnRH agonist buserelin and hMG in a group of patients who had earlier failed to respond or did not conceive after clomiphene citrate/hMG stimulation. The ovarian response was similar in both groups, however, with the use of buserelin more oocytes were recovered -4.9 +/- 3.2 and 3.5 +/- 2.3 oocytes, respectively. The clinical pregnancy rate per transfer in the group of patients superovulated with buserelin/hMG was twice that of the clomiphene citrate/hMG group (21.0% vs. 10.4%). The relatively high pregnancy rate with the buserelin/hMG regimen in the group of 'poor responders' may be connected with GnRH agonist-induced pharmacological hypophysectomy and the sequelae thereof: normalization of some endocrinopathies, absence of an endogenous luteinizing hormone (LH) surge and better endometrium receptivity, oocytes and embryo quality.

[Use of an GnRH analogue for induction of gonadotrophin ovulatory surge in cycles stimulated with clomiphene citrate and menopausal gonadotropin in an in vitro fertilization program]

In 23 women treated for sterility by the in vitro fertilization method the gonadotropins ovulatory surge was stimulated by applying a GnRH analogue (Buserelin). The authors showed that a single injection of GnRH analogue in the cycles stimulated with clomiphene citrate and menopausal gonadotropin causes pituitary output of both LH and FSH which is sufficient for morphological and functional maturity of the oocytes. After such treatment two patients conceived and delivered healthy babies.

[Stimulation of human megakaryopoiesis in vitro with different growth factors. Potential clinical applications]

The stimulation of platelets production by human hemopoietic growth factors, became an interesting alternative in the treatment of thrombocytopenic patients. Because the lineage specific Colony Stimulating Factor of Megakaryocytes (CSF-Meg) has not yet been discovered, the aim of our study was to compare the stimulatory potential of different hemopoietic growth factors influencing megakaryocytic colony formation in vitro. According to our results the best strategy to stimulate human megakaryocytopoiesis in vivo seems to be simultaneous or sequential use of the mixture of several cytokines including: interleukin-3, interleukin-6, erythropoietin or kit ligand. The best stimulatory effect we have obtained however, using recently developed by molecular biology means recombinant fusion protein composed of joined by peptide bridge interleukin-3 and erythropoietin molecules. The data presented in this paper, could find application in the near future by elaborating more effective clinical protocols for treatment of thrombocytopenia using hemopoietic growth factors.

[Diagnostic laparoscopy in the gynecology clinic at the academy of medicine in Białystok during the years 1989-91]

The authors present the results of 1056 diagnostic laparoscopies carried out from 1989 to 1991 in the Clinic of Gynecology of Medical School in Białystok. Sterility was the leading indication for diagnostic laparoscopies in 92.7% of patients. Suspicion of ectopic pregnancy was the reason of 44 laparoscopies. 46.5% of diagnosed infertile women had adhesions in pelvis post inflammation or surgery. 10.6% of them had massive pelvic adhesions and the tubes were damaged without any chance for surgical correction. The endometriosis was found in 15% of infertile women, and 17% of patients had no pelvic pathology.

[Use of GnRH analog for induction of gonadotropin ovulatory surge in cycles stimulated by clomiphene citrate and menopausal gonadotropin in an in vitro fertilization program]

In 23 women treated for sterility by the in vitro fertilization method the gonadotropins ovulatory surge was stimulated by applying a GnRH analogue (Busereline). The authors showed that a single injection of GnRH analogue in the cycles stimulated with clomiphene citrate and menopausal gonadotropin causes pituitary output of both LH and FSH which is sufficient for morphological and functional maturity of the oocytes. After such treatment two patients conceived and delivered healthy babies.

[Plasma fibrinolytic activity after gynecologic surgery]

Fibrinolytic activity and fibrinolytic potential has been estimated in women submitted of gynecologic operations. Results was referred to age, extension of the operation and character of illness. Elevation of fibrinolytic activity immediately after operation and fibrinolytic potential five days later have been stated.

[Treatment of infertility by in vitro fertilization (IVF-ET)]

The authors survey available publications dealing with the indications for in vitro fertilization, ovary stimulation technique, control of the ovary stimulation, oocytes collection, and transfer of the embryo in human. The authors personal experience with in vitro fertilization is also discussed.

[In vitro culture of fibroblasts from pubic skin of women in diagnosis of androgen hypersensitivity]

Intracellular metabolism of testosterone was studied in in vitro cultured skin fibroblasts obtained from women with idiopathic hirsutism. A significantly higher rate of conversion of testosterone into 5-alpha-dihydrotestosterone was found in these women (4.78 +/- 2.08 fmol/microgram DNA/hour) as compared to that obtained for skin cultures of women without symptoms of androgenization (0.98 +/- 0.37 fmol/microgram DNA/hour). These results demonstrate that fibroblast culture may be useful in diagnosing the causes of hyperandrogenization in women with normal androgen secretion.