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Biomedical subjects

A Botchan

Publications and source records attributed to A Botchan.

At least 37 records · Page 2Linked to original sources
PubMed1999

Genetic evaluation of infertile men.

Recently, microdeletions in the azoospermic factor region of the Y chromosome, in addition to chromosomal anomalies, have been detected in men with azoospermia or severe oligozoospermia. In this study we evaluated the molecular and cytogenetic defects of infertile men. The frequency of Y microdeletions among 105 azoospermic, 28 oligozoospermic and 32 fertile men was tested on lymphocyte DNA using a series of 20 sequence-tagged sites. In addition, microdeletions were evaluated on testicular-derived DNA among 26 azoospermic patients who underwent testicular biopsy and in whom no sperm cells could be identified. Karyotype analysis was performed on 72 of the infertile patients. Deletions were detected in 6.7% azoospermic and 3.6% oligozoospermic men. No deletions were identified among the fertile men. Identical results were obtained with DNA derived either from lymphocytes or testicular tissue. The frequency of chromosomal aberrations in the 72 infertile patients tested (62 azoospermic, 10 oligozoospermic) was 16.6%, with a high percentage of gonosome anomalies. Additional andrological parameters (hormone values, cryptorchidism) failed to identify men at risk for having microdeletions before the test. Our findings support the recommendation to perform genetic defect screening among infertile men before their enrollment in an intracytoplasmic injection/in-vitro fertilization programme.

Adult↗
PubMed1998

Expression of mannose-ligand receptors on human spermatozoa: effect of lecithin and association with sperm binding to the zona pellucida.

OBJECTIVE: To evaluate the change in the expression of mannose-ligand receptors and sperm binding capacity after the incubation of sperm cells with lecithin liposomes. DESIGN: A randomized, blinded-controlled experiment. SETTING: Andrology laboratory at the Lis Maternity Hospital. PATIENT(S): Fifteen fertile sperm donors and 10 subfertile men. INTERVENTION(S): Incubation of sperm samples with either control medium or 1 mg/mL of liposomal lecithin for 2 hours. MAIN OUTCOME MEASURE(S): Expression of mannose-ligand receptors as evaluated by mannosylated bovine serum albumin-fluorescein isothiocyanate and sperm binding to the zona pellucida as evaluated by the hemizona assay. RESULT(S): The mean +/- SE percentages of spermatozoa with patterns I, II, and III were 86% +/- 4.8%, 11% +/- 3.4%, and 3% +/- 1.6%, respectively, after treatment with control medium and 71% +/- 5.7%, 22% +/- 3.5%, and 7% +/- 2.5%, respectively, after treatment with lecithin. The same effect of lecithin was observed in the 10 sperm samples from subfertile men. The mean +/- SE numbers of sperm that bound to hemizonae after treatment with control medium or lecithin were 116 +/- 32.4 and 176 +/- 29.6, respectively. Statistically significant correlations were observed between the shift in patterns II and III and the enhancement of sperm binding after lecithin treatment (r = 0.44 and 0.6, respectively). CONCLUSION(S): Lecithin shifts the expression of mannose-ligand receptors to the capacitated and acrosoine-reacted patterns and enhances the binding capacity of the sperm cells.

Adult↗
PubMed1998

Multiple testicular sampling in non-obstructive azoospermia--is it necessary?

Spermatogenesis may be focal in non-obstructive azoospermia. The present study was conducted to determine whether the performance of multiple, rather than a single testicular sample contributes to obtaining spermatozoa in amounts sufficient for fertilization and cryopreservation in non-obstructive, azoospermic patients. Furthermore, the aim was to clarify the significance of location for retrieval from the testis in such cases. Three biopsies were taken from identical locations in 55 testes of 29 men with non-obstructive azoospermia: (i) the rete testis region, ii) the midline, and (iii) the proximal region of the testis. When sperm cells were detected, they were used for intracytoplasmic sperm injection (ICSI), and the remainder were then cryopreserved in as many aliquots as possible (adjusted for ICSI procedure). Spermatozoa were found in 28 testes (50.9%) of 18 men (62.1%). In the testes from which spermatozoa were obtained, they were present in three, two or one locations in 15 (53.6%), five (17.9%) and eight (28.6%) cases respectively. The possibility of finding spermatozoa was not influenced by the location in the testis. Multiple testicular sperm extraction is recommended in cases of non-obstructive azoospermia, since it may enhance diagnostic accuracy of absolute testicular failure and increase the number of sperm cells retrieved.

Adult↗
PubMed1997

Sperm quality in Hodgkin's disease versus non-Hodgkin's lymphoma.

The study was conducted to determine the deleterious effect of lymphoma disease on spermatogenesis and to evaluate the possibility that the disease is mediated primarily by inherent mechanisms in Hodgkin's disease and non-Hodgkin's lymphoma patients. A total of 89 patients with lymphoma disease (Hodgkin's and non-Hodgkin's) were referred for sperm preservation prior to adjuvant treatments. A comparison was made of pre- and post-thaw sperm quality between lymphoma patients and healthy volunteers who applied for sperm donation. This was followed by further assessment of the differences between patients with Hodgkin's disease and non-Hodgkin's lymphoma in terms of sperm variables, clinical parameters and blood hormone concentrations. It was found that patients with lymphoma disease had significantly impaired pre-freeze and post-thaw sperm quality compared with that of healthy volunteers. Patients with non-Hodgkin's lymphoma had spermatozoa of higher quality than patients with Hodgkin's disease. No differences were found in the clinical or hormonal parameters between these two groups. As expected, reduced testicular size and abnormal testicular consistency were correlated with decreased sperm quality. The mere presence of cancer disease has a direct negative effect on spermatogenesis, which is probably not related to incidental side-effects. A variable degree of impairment should be expected with different categories of cancer.

Adolescent↗
PubMed1997

Pregnancy resulting from frozen-thawed embryos achieved by intracytoplasmic injection of cryopreserved sperm cells extracted from an orchidectomized, seminoma-bearing testis, causing obstructive azoospermia.

A clinical pregnancy occurred in a 26-year-old patient after transfer of frozen-thawed embryos had been achieved by intracytoplasmic sperm injection (ICSI) of cryopreserved spermatozoa. These had been obtained from a testis removed due to seminoma. The couple applied to our fertility clinic for sperm cryopreservation before orchidectomy and radiotherapy. Unfortunately the husband was found to be azoospermic upon admission and sperm cells were extracted from the removed testis for use in our ICSI programme. This case represents a new aetiology for obstructive azoospermia that was successfully treated by ICSI. A pregnancy was established, resulting in successful birth.

Adult↗
PubMed1997

Testicular cancer and spermatogenesis.

We retrospectively analysed the characteristics of 54 men with testicular cancer. The group comprised 32 men with pure seminoma and 22 with non-seminoma germ cell tumours (NSGCT). This group was further compared to 190 healthy sperm donor candidates. Sperm quality was found to be higher in the seminoma versus the NSGCT patients in: sperm concentration [50 (0-230) versus 17 (0-288) x 10(6)/ml, P < 0.001], total motile sperm counts (TMC) [57 (0-508) versus 12 (0-854) x 10(6)/ejaculate, P = 0.002], post-thaw forward motile concentration [3 (0-28) versus 1.7 (0-17) x 10(6)/ml, P = 0.003] and motility percentage [20 (0-57) versus 12.5 (0-42) %, P = 0.002]. Serum hormone concentrations did not differ between these two sub-groups, although the follicle stimulating hormone concentrations were higher than normal in both (14.6 +/- 2.5 versus 10.4 +/- 1.4 mIU/ml, P > 0.05). As is well documented, cancer patients were found to have lower sperm quality compared to healthy candidates. The existence of these differences, and the fact that testicular cancer affects spermatogenesis, indicated that the mechanisms involved in the deterioration of sperm quality can, at least partially, be attributed to the type and origin of the malignant cancer. The higher sperm counts in the seminoma group may be related to the fact that the resemblance of the seminoma cells to normal germ cells is greater than that of the NSGCT cells, and therefore they retain a better capacity to function. Due to modern assisted reproductive technologies and micromanipulation achievements, the lower yield of spermatozoa in severe cases is no longer a major obstacle to offering cryopreservation to these patients.

Cryopreservation↗
PubMed1996

Mucocele formation 20 years after an appendiceal uterine transplantation for infertility mistaken for hydrops tubae profluens.

A 56 year old woman was admitted to our hospital with a 9-year history of recurrent, lower abdominal pain and mucoid vaginal discharge 20 years after an appendiceal uterine transplantation. The removal of the uterus and the attached appendix resulted in the disappearance of the symptoms. A mechanism linking the appendiceal mucoid discharge with abdominal pain in this menopausal patient is suggested.

Abdominal Pain↗
PubMed1995

Female age does not affect the capacity of human zona pellucida to bind spermatozoa.

The purpose of this study was to evaluate the effect of female age on the capacity of the zona pellucida to bind spermatozoa. A total of 1008 unfertilized oocytes obtained from 210 women (aged 21-43 years) participating in the in-vitro fertilization programme were tested using a hemizona assay. Spermatozoa taken from a cryopreserved pool of fertile donor specimens served as a control in the hemizona assay, and were used to assess the ability of the zona pellucida to bind spermatozoa. The mean +/- SD number of spermatozoa attached to the hemizona was 107 +/- 42. The binding capacity of different oocytes from the same cohort varied substantially (coefficient of variation = 28%). Age was not found to be correlated with the number of spermatozoa bound to the zona pellucida (r = -0.02; P > 0.1). It was concluded that female age has no role in the ability of the human zona pellucida to bind spermatozoa.

Adult↗
PubMed1995

Pheochromocytoma in pregnancy: case report and review of the literature.

Pheochromocytoma is a rare disease that may occur during pregnancy. Only a few hundred cases have been published in the literature. Manifestations include hypertension with various clinical presentations, possibly resembling those of pregnancy-induced hypertension, or pre-eclamptic toxemia. Differentiation of these conditions is not always feasible, thus creating a serious risk, because fetal and maternal morbidity and mortality are far higher with pheochromocytoma. Biochemical measurements of catecholamines and their metabolites are apparently a convenient way to establish diagnosis during pregnancy, inasmuch as interpretation of radiological evaluation is complicated by the gravid uterus, and might even be potentially dangerous due to the use of ionizing radiation. More sophisticated methods for evaluation are not always practical during pregnancy. Medical treatment aims at controlling symptoms, mandating the use of alpha- and beta-receptors blockade medication. Surgical intervention is the only possible curative method available, but the critical issue is probably to identify the exact timing during the course of pregnancy for such intervention, or the ability to control symptoms until delivery. Although malignant transformation of pheochromocytoma have been reported, it is extremely uncommon. The overall prognosis is mainly affected by early diagnosis, and multidisciplinarian management.

Adrenal Gland Neoplasms↗
PubMed1995

Pentoxifylline improves sperm binding to the zona pellucida in the hemizona assay.

OBJECTIVE: To evaluate the effect of pentoxifylline on sperm binding capacity to zona pellucida (ZP) using the hemizona assay (HZA). DESIGN: The fertility potential of 82 men was evaluated by routine semen analysis. Each ejaculate was incubated with or without pentoxifylline (3 mM) in Ham's F-10 medium (Flow Laboratories, Irvine, Scotland) before the HZA. The effect of the pentoxifylline treatment on sperm-binding capacity to ZP was assessed by the hemizona index. RESULTS: The mean hemizona indexes with medium or pentoxifylline treatment were 23% +/- 2.1% (mean +/- SE) and 41% +/- 3.4%, respectively. Taking into consideration a significant change of the hemizona index on rising above the intra-assay coefficient of variation (+/- 8%) after pentoxifylline treatment, 73.1% of specimens improved, 19.5% deteriorated, and 7.4% remained unchanged. Using a threshold hemizona index of 23% as a discriminator between fertile and infertile specimens, 43.5% of the "pentoxifylline-improved" samples ascended to the fertile zone (> 23%). No correlations were found between sperm variables in the raw semen and the effect of pentoxifylline on sperm binding capacity. CONCLUSION: Pentoxifylline may improve the binding capacity of human spermatozoa. However, this effect is confined to a selected group of patients and cannot be predicted by the basic sperm variables. Thus, to avoid uncertain or damaging effects of pentoxifylline while preparing sperm suspension for assisted reproductive techniques, it is recommended that its effect be tested by the HZA system before its use.

Female↗
PubMed1994

Outcome of donor versus husband insemination in couples with unexplained infertility treated by in vitro fertilization and embryo transfer.

OBJECTIVE: To examine the IVF-ET outcome of couples with unexplained infertility treated by husband versus donor sperm. DESIGN: A retrospective analysis of the IVF-ET outcome of couples with unexplained infertility treated by either husband or donor sperm and in a subgroup of patients treated simultaneously by husband and donor sperm. SETTING: IVF Unit, Serlin Maternity Hospital, Tel Aviv, Israel. PATIENTS: Couples diagnosed as having unexplained infertility underwent IVF at our Unit; included were 96 couples treated by husband insemination (group A), 27 couples who received donor insemination because of azoospermia (group B), and 8 couples who sought donor insemination after having previously failed IVF (group C). RESULTS: No statistically significant difference was found between groups A and B regarding age of the females, duration of infertility, number of IVF cycles, fertilization rate, number of ETs, and pregnancy rate. Oocytes collected in group C were subdivided further into two groups: 45 were incubated with husband sperm and 46 were incubated with donor sperm. Fertilization rates were 46.6% and 50%, respectively. One pregnancy occurred. CONCLUSION: In couples with unexplained infertility who had undergone IVF-ET with husband insemination, the fertilization and pregnancy rates were similar to those of couples who were treated by donor sperm.

Adult↗
PubMed1994

Endometrial receptivity in the light of modern assisted reproductive technologies.

OBJECTIVE: To review the different aspects of endometrial receptivity as it is reflected in the various modalities of modern assisted reproductive technologies. DESIGN: The importance of endometrial receptivity and the factors that affect it such as the type of treatment, age, and ovarian function are discussed in this review. Novel approaches to determine receptivity such as Doppler ultrasonography and molecular biology are considered; assisted hatching is also discussed. CONCLUSIONS: Endometrial receptivity cannot, as yet, be directly assessed. Circumstantial evidence suggests that receptivity declines with age, is adversely affected by controlled ovarian hyperstimulation, and is possibly affected by ovarian function. Future studies will have to focus on molecular cell biology and physiology of the endometrium.

Aging↗
PubMed1994

Analysis of the fourth to eighth in-vitro fertilization treatments after three previously failed attempts.

The fourth to eighth in-vitro fertilization cycles of patients who had previously reached the stage of embryo transfer without conceiving were evaluated. A total of 426 cycles were received in women ranging in age from 25 to 46 years. The patients underwent from four (169 women) to eight (27 women) treatment cycles, using four established protocols for induction of ovulation. There was no statistical difference in the age, aetiology, duration of infertility and distribution of the various protocols among the analysed groups. The pregnancy rates in cycles 4-8 were 19.5, 15.4, 10.8, 16.7 and 11.8% respectively (mean 16.2% per cycle) and were not statistically different. There was no trend of reduced success when the number of attempts increased. The overall live birth rate was 12.4%. The pregnancy rate was comparable between age groups. No protocol proved to be significantly superior to others when pregnancy rate per embryo transfer was assessed. We concluded that the pregnancy rate in cycles 4-8 was stable, including those of patients up to 42 years of age. Continuous efforts are therefore advised for at least up to this age and number of attempts. A change of an induction protocol in subsequent cycles, after repeated failure, is not statistically justified.

Adult↗
PubMed1993

Endometrial receptivity: the age-related decline in pregnancy rates and the effect of ovarian function.

OBJECTIVE: To assess the effect of age and ovarian function on endometrial receptivity. DESIGN: Retrospective comparison between standard IVF and ovum donation in younger and older patients (< 40 and > or = 40 years of age, respectively). PATIENTS: In standard IVF, there were 325 transfer cycles in older patients and 1,103 transfer cycles in younger ones. In ovum donation, there were 236 transfer cycles in older patients and 222 cycles in younger women. Ovum recipients were then redivided into two groups, according to ovarian function: ovarian failure group (219 cycles) and eugonadal group (239 cycles) in patients with retained ovarian function as manifested by regular menstrual cycles and normal gonadotropins. RESULTS: In standard IVF, clinical pregnancy rates (PRs) were significantly lower in older patients (12.9% versus 23.8%, respectively). In ovum donation, clinical PRs were also significantly lower in older patients (21.2% versus 29.3%, respectively). A significantly higher clinical PR (31.1%) was noted in patients with ovarian failure, compared with both eugonadal patients undergoing ovum donation (19.7%) and standard IVF patients (21.3%). CONCLUSIONS: The decrease in endometrial receptivity with age is responsible for the higher rate of implantation failure in older women. Patients with nonfunctioning ovaries do better than eugonadal patients in ovum donation programs.

Adult↗
PubMed1993

When multiple gestational sacs are seen on ultrasound, 'take-home baby' rate improves with in-vitro fertilization.

During a 5.5 year period, 309 clinical pregnancies were recorded in our in-vitro fertilization (IVF) unit. A single gestational sac was identified by early ultrasonography in 233 patients, while in 76 others, multiple gestational sacs were noted. 'Take-home baby' rate, in patients in whom multiple sacs were observed, was higher than that in patients with a single sac. Delivery of at least one live newborn occurred in only 73.8% of patients with a single sac, compared with 93.3% and 91.7% in patients with two and three gestational sacs, respectively. Conversely, the early and late abortion rates were decreased in patients with multiple sacs. Embryonic implantation rate, defined as the ratio of gestational sacs observed to the number of embryos transferred, was found to be a valuable prognostic factor for a live delivery, and can serve as a tool in assaying the prognosis of pregnancy detected by early sonography. The observation of a higher 'take-home baby' rate in cases with multiple sacs identified by ultrasound and with higher embryonic implantation rate, might be the result of a better embryo quality and/or improved uterine receptivity, promoted by a favourable hormonal milieu or by as yet unknown endometrial factors.

Abortion, Spontaneous↗