SpainFertility

Analyzing the influence of age and basal levels of follicle stimulating hormone on the risk for aneuploidy in women undergoing IVF.
The risk of embryonic aneuploidy in women undergoingIVF is significantly influenced by age but not by follicle stimulating hormone (FSH) levels, say scientists.

Researchers from the Lister Fertility Clinic in London, UK, note the decline in fecundity seen in women of advanced maternal age “is attributed to reduction of ovarian reserve and deterioration of oocyte quality.

However, they point out: “There is an ongoing debate regarding the etiology of the reduction of fecundity for women who have elevated basal FSH… and regarding whether this etiology is associated either with poorer oocyte quality or lower ovarian reserve.”

To investigate, Meen-YauThumand team measured basal FSH levels in 151 women undergoing IVF.

Genetic screening revealed that aneuploid embryos were as common in women with basal FSH levels of 10 IU/L or above as in those with FSH levels below this point, at rates of 50.0 percent and 50.2 percent, respectively.

In contrast, the risk of aneuploid embryos was significantly higher in women aged 38 years or more than in younger women, at 56.2 percent versus 37.5 percent. This difference was independent of differences in basal FSH concentrations, the team notes.

Based on these findings, the authors reason: “A delay in treating women with elevated basal FSH is counterproductive, because the oocyte number and genetic quality will deteriorate as maternal age increases.”

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Evaluating whether patients with polycystic ovary syndrome are at increased risk for gestational diabetes during pregnancy.

Demonstrating a link between polycystic ovary syndrome (PCOS) and gestational diabetes remains problematic because of differences between the various studies conducted, say researchers.

“In pregnant women with PCOS, the increasing tissue resistance to insulin adds to the pre-existing insulin resistance, which may accompany the syndrome,” explain KonstantinosToulis (Papageorgiou General Hospital, Thessaloniki, Greece) and co-researchers.

“This pathogenic mechanism could lead to hyperglycemia, reflected in a higher incidence of gestational diabetes,” the investigators note. “However, studies on the prevalence of gestational diabetes in women with PCOS gave conflicting results, probably because of the heterogeneity of studies conducted so far.”

To clarify links between PCOS and gestational diabetes,Touliset al undertook a random-effects meta-analysis and systematic review of studies, which, importantly, controlled for sources of heterogeneity between trials.

They combined data from 15 studies for a total of 721 women with PCOS and 4572 control individuals without the condition.

Overall, women with PCOS were almost three times as likely (odds ratio [OR] = 2.89) to develop gestational diabetes as women without PCOS.

Despite the significance of this finding, further investigation showed that it was dependent on the type of study and the patients’ baseline risk.

The authors conclude that further investigation is necessary before preventive diabetes treatment is routinely given to women with PCOS.

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High pregnancy and delivery rates after IVF-ICSI can be achieved using cryopreserved sperm from patients with malignant cancer, researchers have reported.

The specialists from centers in Tel-Hashomer and Tel-Aviv, Israel, and New York, USA, performed a retrospective study of 118 consecutive couples who had undergone IVF-ICSI using sperm that had been banked before the male partner underwent treatment for malignant cancer (the sperm had been collected and cryopreserved immediately after the cancer diagnosis was made). The couples were identified from reviewing records relating to the 11-year period from January 1994 to April 2005.

The three most frequent types of cancer experienced by the male partners were testicular cancer (40 percent of the men in the study), lymphomas (31 percent), and prostate cancer (8.5 percent). The mean age at diagnosis was 31.4 years (range 11.9-68.8 years).

The 118 couples underwent a total of 169 IVF-ICSI cycles using pretreatment cryopreserved sperm. The mean sperm count before cancer treatment was 66.5 x 1000000/mL; after thawing the mean sperm count was 40.9 x 1000000/mL. The average motility was 45.6 percent before treatment; after thawing the average motility was 14.2 percent.

Overall, the clinical pregnancy rate was 56.8 percent per retrieval – a total of 96 pregnancies from the 169 cycles. These led to 126 births and 11 spontaneous abortions.

The researchers observed that the clinical pregnancy rate was lowest when the male partner had prostate cancer, rather than other malignancies. The clinical pregnancy rate was 18.2 percent in couples where the male partner had prostate cancer, compared with 58.0 percent with testicular cancer and 60.7 percent with other malignancies. Prostate cancer was also associated with lower pre-freezing semen parameters such as volume, sperm count and motility, compared with the other types of malignancy.

Discussing their results in a paper due to be published in the journal Fertility and Sterility, the researchers (Hourvitz et al) note that the achieved overall clinical pregnancy rate of 56.8 percent is similar to the average pregnancy rate achieved with other male-factor patients.

They suggest that it is of “crucial importance” that all newly diagnosed cancer patients be advised to cryopreserve their sperm as early as possible, and certainly before starting treatment.

Concluding, the researchers write: “Our 11 years’ experience with ICSI in male cancer survivors shows great promise. The high success rate achieved with cryopreserved-thawed sperm should encourage all physicians involved in cancer care to offer cryopreservation to all men of reproductive age before initiating anti-neoplastic therapy.”

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Evaluating whether patients with polycystic ovary syndrome are at increased risk for gestational diabetes during pregnancy.

Demonstrating a link between polycystic ovary syndrome (PCOS) and gestational diabetes remains problematic because of differences between the various studies conducted, say researchers.

“In pregnant women with PCOS, the increasing tissue resistance to insulin adds to the pre-existing insulin resistance, which may accompany the syndrome,” explain KonstantinosToulis (Papageorgiou General Hospital, Thessaloniki, Greece) and co-researchers.

“This pathogenic mechanism could lead to hyperglycemia, reflected in a higher incidence of gestational diabetes,” the investigators note. “However, studies on the prevalence of gestational diabetes in women with PCOS gave conflicting results, probably because of the heterogeneity of studies conducted so far.”

To clarify links between PCOS and gestational diabetes,Touliset al undertook a random-effects meta-analysis and systematic review of studies, which, importantly, controlled for sources of heterogeneity between trials.

They combined data from 15 studies for a total of 721 women with PCOS and 4572 control individuals without the condition.

Overall, women with PCOS were almost three times as likely (odds ratio [OR] = 2.89) to develop gestational diabetes as women without PCOS.

Despite the significance of this finding, further investigation showed that it was dependent on the type of study and the patients’ baseline risk.

The authors conclude that further investigation is necessary before preventive diabetes treatment is routinely given to women with PCOS.

ORGYN.com