Acta Europaea fertilitatis最新文献

The aim of the present study is to compare the outcome of GnRH analog treatment versus expectant management in infertile patients with minimal and mild endometriosis. From January 1987 to December 1990, 14 patients with stage I and II endometriosis underwent a six-month course of the GnRH analog buserelin, whereas 38 patients underwent expectant management. The two groups were comparable as to mean age of the patients, mean length of infertility prior to diagnosis and mean scores of endometriosis. No major tubal or male factor of infertility was present in any patient. Cumulative pregnancy rates at 12 months were comparable in the two groups (48% for GnRH analog treatment and 42% for expectant management). Expectant management should therefore be considered the most cost-effective option in the management of mild endometriosis-associated infertility.

Nearly homogeneous preparations of stromal cells derived from human proliferative endometrium can be obtained by treating endometrial fragments with collagenase in order to disperse stromal elements, filtering the mixture a 25 microns opening sieve to separate them from gland, and incubating the dispersed cells to culture dishes. Exposure of stromal cell cultures to db-cAMP, 8-Br-cAMP or forskolin in RPMI 1640 medium containing 2% ct-FCS and 0.1 U/ml insulin induces the expression of prolactin (PRL), evident from 1) its secretion to the culture medium, measured by radioimmunoassay and by Western blot analysis, 2) the incorporation of 35S-methionine in a protein precipitated with a PRL antibody and co-migrating with authentic PRL during electrophoresis, and 3) the synthesis of PRL mRNA determined by Northern blot analysis. The cAMP effect on PRL production is enhanced by progestins, which by themselves are weak PRL inducers under similar experimental conditions. As expected from previous findings in our laboratory, showing that addition of PRL to the culture medium induces decidualization of endometrial stromal cells, cAMP derivatives not only induce PRL but also provoke differentiation of the fibroblast-like stromal cells to the decidual phenotype, as evident from morphologic changes and by the expression of products characteristic of decidual cells, e.g. IGFBP-1, desmin, hsp 27 and laminin. These findings suggest a PRL-mediated, progesterone-enhanced decidualization mechanism initiated by physiologic agents increasing cAMP levels in stromal cells.

Whatever the culture medium, embryo culture generally leads to a major loss of viability in mouse, rabbits even if the morphological development of the embryo is preserved. Moreover, Embryo metabolism is commonly depressed in culture media. The protein turnover is accelerated and the quality of the metabolites transport systems is impaired. Various coculture systems have been designed to avoid this loss of viability and in some animal species, to overcome the so called "embryo developmental arrest" usually observed at the approximate time of genomic activation. Moreover, it is clear now that cocultured embryos have usually higher cells numbers than those observed for embryos cultured in classical culture media. In the human, the problems seem less complicated because embryos can be transferred into the uterus on the second day post fertilization, at a time when they would normally be in the Fallopian tube: this is not possible in animal species. Also, blastocysts can be obtained, even at low rates, in conventional culture media and there is no apparent block of development. In this paper, we will present an overview of Cocultures in different species. Then, we will focus on the Human including the blastocyst formation rate and freezing at the Blastocyst stage. At the beginning of the Story, For coculturing, 2 ideas were put forward: The use of embryonic tissue (trophoblast) to help the embryo through an autocrine effect. The use of female genital tract cells, to assist the embryo through a paracrine effect.