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J Lornage

Publications and source records attributed to J Lornage.

34 records · Page 2Linked to original sources

Six year follow-up of cryopreserved human embryos.

In 1987, we became aware of the importance of remaining in contact with couples whose embryos had been cryopreserved for > 1 year. As a result, a questionnaire was designed to follow the fate of these embryos. Of 407 couples with cryopreserved embryos, 262 couples opted to use them within 1 year with the intention of fulfilling a parental plan. The remaining 145 couples were questioned by six successive questionnaires sent out between 1987 and 1992. By the end of the study, 336 of the 407 couples (82.5%) had chosen to utilize their embryos in a parental plan. In most cases, the maximum delay of response (5 years according to the Council of State) was respected. The remaining 71 couples (17.5%) either abandoned the parental plan or had not given any information by the end of the study. Initially, anonymous donation to another couple was chosen in preference to destroying the surplus embryos (32 versus 18 couples, P < 0.05). Latterly, however, these differences have balanced out (24 versus 28, not significant). Only those couples who initially opted to donate embryos to another couple changed their attitude in later years. In the long run, 62 couples decided not to pursue their parental plan; of these, 24 couples chose to make a gift to another couple, 28 couples opted for destruction, and 10 chose to make a gift to research. Nine couples (out of 71) declined to make a decision, but they had all achieved a pregnancy during an in-vitro fertilization (IVF) attempt. Three of these were lost to follow-up, i.e. 0.7% of all couples benefiting from the freezing technique.

Cryopreservation↗

Cumulative conception rate following intrauterine artificial insemination with husband's spermatozoa: influence of husband's age.

This paper presents the analysis of 901 cycles of intrauterine artificial insemination with the husband's spermatozoa (AIHIU) in 274 couples who obtained 80 pregnancies. The cumulative pregnancy rate after three cycles of AIHIU was 22% and reached 39% after six cycles. Univariate analysis disclosed two factors of poor prognosis: duration of infertility > 3 years (P = 0.01) and husband's age (P = 0.03). Multivariate analysis revealed that the most significant factor contributing to a decreased likelihood of pregnancy was the age of the husband (P = 0.01), then duration of infertility and dysovulation. The wife's age > or = 35 years did not appear to be of poor prognostic value when taking into consideration the three other factors.

Adult↗

Motility and fertilizing capacity of epididymal human spermatozoa in normal and pathological cases.

OBJECTIVE: To investigate different factors involved in the outcome of in vitro fertilization (IVF) with epididymal spermatozoa in cases of vas deferens agenesis, with particular emphasis on sperm movement parameters. DESIGN: Prospective study in which sperm movement characteristics, level of puncture, and sperm preparation technique were studied relative to the outcome of IVF. SETTING: Département de Gynécologie, Oncologie Gynécologique, Sénologie, Médecine de la Reproduction, Hôpital Edouard-Herriot, Lyon France. PATIENTS: Thirteen couples underwent 15 IVF cycles. In 14 cycles (12 patients) epididymal spermatozoa could be recovered by surgical punctures. Epididymides were taken from 10 subjects in state of cerebral death to study epididymal spermatozoa under physiological status of the epididymis. RESULTS: The cleavage rate in IVF was low (25/158: 15.8%). In seven cases, embryo transfer was possible, leading to two twin pregnancies (4 infants born). Fertilization could be achieved with spermatozoa from the epididymis caput. Motility was paradoxically higher in the proximal epididymis than in the distal epididymis. In healthy epididymides, spermatozoa collected from the caput did not exhibit any progressive motility, whereas progressive motility was always present in the epididymis corpus. CONCLUSIONS: Our study showed that forward motility could be observed in the epididymis caput in patients with congenital absence of the vas deferens and that fertilization and ongoing pregnancies could be obtained from caput spermatozoa. On the other hand, in physiological status of the epididymis, forward motility was observed only as from the corpus area, confirming observations in other species.

Adult↗

Transfers of frozen-thawed human embryos in cycles stimulated by HMG.

A total of 130 transfers of frozen-thawed (F-T) human embryos was carried out after moderate ovarian stimulation with human menopausal gonadotrophin (HMG). Embryos were replaced 3 days after the spontaneous luteinizing hormone (LH) surge or 4 days if ovulation was induced by human chorionic gonadotrophin (HCG). Embryos were thawed a few hours prior to transfer. One-hundred-and-twenty-three transfers were effective and 23 pregnancies were achieved. The rate of ongoing pregnancies per transfer was 17.9% (22/123). The survival rate of embryos originating from cycles stimulated by a combination of an LHRH analogue and HMG in a long protocol (LA-HMG protocol) was significantly lower when compared with the rate of embryos retrieved from clomiphene citrate-HMG (CC-HMG protocol) stimulated cycles (52 versus 67%, P less than 0.05). When fresh embryos originated from cycles stimulated with an LHRH analogue and HMG in a short protocol (SA-HMG protocol), the survival rate was not affected (59 versus 67%, NS). Although the difference was not significant, the ongoing pregnancy rate per transfer according to the three protocols from which the embryos originated seemed to be better with the SA-HMG protocol: 16% with the CC-HMG protocol, 14.5% with the LA-HMG protocol versus 27.6% with the SA-HMG protocol. The success rate was independent of the number of F-T transferred embryos if at least one embryo with 100% intact blastomeres was replaced.

Cryopreservation↗

Improvement of survival and fertilizing capacity of human spermatozoa in an IVF programme by selection on discontinuous Percoll gradients.

Two techniques for the separation of spermatozoa were compared: swim-up migration (SUM) and centrifugation on a discontinuous Percoll gradient (CPG). Their respective effects on sperm motility were analysed by computer-assisted videomicrography in either normal or asthenozoospermic groups. In both groups, there was no difference in any of the motion parameters between the two treatments after 1-h incubation. However, a clear difference was observed after 24 h when excellent motility was retained only in the CPG-treated group. A total of 350 ejaculates were produced by the husbands of women undergoing oocyte retrieval in an IVF programme. Spermatozoa were treated by CPG when the infertility was due to poor quality spermatozoa (n = 91), when there was a known previous history of semen infection (n = 73) or when frozen semen, originating from a donor, was used (n = 36). In all other cases (n = 150), spermatozoa were treated by SUM. The cleavage rates obtained were 32.2, 70.1, 60.9 and 68.6% respectively in the four categories. The clinical pregnancy rates per oocyte retrieval were 19.8, 31.5, 22.2 and 18.0% respectively. Forty-eight births occurred in the CPG group: 28 boys and 20 girls, all normal. We conclude that CPG is useful, both in cases of poor semen quality and in tubal infertility, in which the clinical pregnancy rate increased significantly from 18.0 to 31.5%.

Cell Survival↗

Stimulation of motility and energy metabolism of spermatozoa from asthenozoospermic patients by 17 beta-estradiol.

Spermatozoa from nine asthenozoospermic patients were incubated for 3 h in Krebs Phosphate Ringer (KRP), supplemented or not with 17 beta-estradiol. 17 beta-estradiol increased the mean velocity and maintained the percentage of motility during the first 2 h of incubation. Oxydative metabolism and intracellular ATP concentrations were enhanced, too, whereas glycolysis remained unchanged.

Cell Survival↗

[Therapeutic use of LH-RH analogs].

The development of GnRH analogues enabling a hypophyseal desensitization with suppression of the gonadotrophic activity has opened new therapeutic possibilities in early puberty of central origin, metastatic prostate and breast cancers, endometriosis, fibromyomas and the syndrome of polycystic ovaries. This retrospective study concerning 93 cycles of in vitro fertilization between March and June 1987, compares the results of the combination of a GnRH agonist (busereline 0.3 mg s.c. x 2 days) with HMGs according to a "long protocol" or a "short protocol". For a mean stimulation time by HMG equivalent (13 days), the number of HMG vials is higher in case of a long protocol (40 vs 30). The mean estradiol level, on the morning of the induction is identical (2,096 pg/ml), as well as the mean number of ovocytes collected (6/tap). The segmentation rate appears to be better in case of long protocol (70% vs 45% in female indications), but there is no significant difference between the pregnancy rates (20 to 30%). The short protocol, less costly and simpler, seems therefore interesting in FIV, with patients without SOPK.

Adult↗

[Separation of spermatozoa using Percoll gradients: value for in vitro fertilization].

Male infertility can be successfully treated by In Vitro Fertilization (IVF) and Embryo Transfer. However in case of oligo asthenospermia it is often difficult to select enough spermatozoa with good motility for the oocytes insemination. To cope with this problem, in 27 IVF cycles, sperm selection was performed by centrifugation on discontinuous Percoll density gradient. This method was demonstrated to be more efficient than swim-up migration to select motile sperm. The cleavage rate (63%) and the pregnancy rate per cycle (22%) were both satisfying. Centrifugation on discontinuous Percoll gradient was also found to be highly efficient for the removal of bacterial contaminants from semen (20 IVF cycles); the cleavage rate (66%) and the pregnancy rate per cycle (35%) were also quite satisfying. It can be concluded that centrifugation on discontinuous Percoll gradient is a useful method for sperm preparation in IVF in case of oligo-asthenospermia and in case of bacterial contamination in semen.

Cell Separation↗

In vitro behavior of human nonfertile semen in isoosmotic and hyperosmotic media.

High-ionic-strength media are known to favor rapid capacitation and acrosome reaction of spermatozoa in vitro. The influence of isoosmolar (N-BWW) and hyperosmolar (H-BWW) media on the percent motility, forward progression, and zona-free hamster egg penetration has been investigated for 148 semen from patients consulting for male or idiopathic sterility. After 15 h of incubation, the hyperosmotic medium had no significant detrimental effect on the percent motility of spermatozoa, although the forward progression was better maintained in the isoosmolar medium. In general egg penetration was increased when spermatozoa were treated with the hypertonic medium, and in particular 5 patients whose semen showed no penetration when treated with N-BWW scored greater than 12% when treated with H-BWW. For the 23 subjects who had an IVF at the same period, a good agreement with zona-free egg penetration was found in 70% of the cases.

Animals↗

Effects of estradiol and its antagonist tamoxifen on motility and metabolism of human spermatozoa.

An investigation was conducted to evaluate the motility and metabolism of human spermatozoa incubated at 37 degrees Celsius for 3 hours in a krebs phosphate Ringer solution containing different concentrations of 17beta-estradiol and tamoxifen. 17beta-estradiol (17beta E2) stimulated significantly the motility of human spermatozoa. The oxidative metabolism and the intracellular ATP concentrations are enhanced with 10-20 mcg/ml of 17beta E2; the lactate production remains unchanged however. Tamoxifen, an antiestrogen, inhibited the motility of spermatozoa, and was toxic at high concentrations. Its effects on the energetic metabolism is dose-dependent; it increases the oxidative metabolism and decreases the lactate production and intracellular ATP at 3 mcg/ml.

Biology↗

Glycolytic activity of human spermatozoa in normospermic men and in men with abnormal spermograms.

The glycolytic activity of human spermatozoa was studied in samples from supposed fertile and infertile subjects. The quantity of L-lactate produced during the first hour of incubation in an enriched medium was measured. There was no difference between the oligozoospermic subjects and the volunteer donors constituting the control group. Lactate production was considerably decreased in men consulting for sterility but with a normal sperm examination, as well as in asthenozoospermic men. In oligoasthenozoospermic men abnormally high quantities of lactate were present in samples from certain individuals or it was unexpected, reflecting extensive metabolic disturbances. Positive correlations were noted between motility and glycolysis only in the controls. A negative correlation was noted between the concentration of spermatozoa and their metabolic activity, especially evident in oligoasthenozoospermic men.

Glycolysis↗

Influence of cations and albumin on human spermatozoa.

The effects of potassium, calcium and magnesium cations, and albumin on motility of spermatozoa, were tested after 15 min, 4 hr, and 24 hr of incubation using laser Doppler velocimetry. The optimal concentration of K+ was found to be 11 mM; higher values decreased motility more severely than did lower ones, even when K+ was completely removed. Motility was increased in the presence of small amounts of calcium (from 0.8-1.7 mM) but was depressed by magnesium concentrations above 0.8 mM. Moderate concentrations of albumin (0.5-1%) improved motility, but the protecting effect of this compound--leading to a best sperm survival--appeared with higher concentrations (4%). In conclusion we observed that optimal ionic conditions presently found were corresponding well to the tubal environment in preovulatory phase.

Albumins↗

Effect of spermatozoa selection on a simplified Percoll gradient in case of asthenozoospermia.

Two methods for preparing semen (Swim-up migration and centrifugation on a two step density Percoll gradient) were tested in 21 cases of asthenozoospermia (motility less than 30%). The parameters of sperm movement were studied through automated videomicrographic analysis. In 9 cases out of 21 swim-up migration failed while centrifugation on a Percoll gradient failed in only 1 case out of 21.

Cell Separation↗

Variability of the response to pentoxifylline in vitro in infertile normozoospermic and asthenozoospermic patients.

The in vitro effect on the motility of spermatozoa of the methylxanthine pentoxifylline was studied in 30 patients consulting for infertility (13 normozoospermic and 17 asthenozoospermic). After separation by centrifugation on Percoll gradient, the spermatozoa were incubated for 30 min in pentoxifylline (3.6 mM), then the pentoxifylline was removed by washing and centrifugation. The residual effect of pentoxifylline was studied by computer-assisted videomicrographic analysis of the sperm motion parameters. In both groups of patients a decrease in the percentage of motile spermatozoa after exposure to pentoxifylline was observed, as compared with a control group. The effect on the motion parameters varied according to the time of observation (30, 120, 240 min). In the asthenozoospermic patients, the curvilinear velocity (VCL) was not modified in a statistically significant manner. In the normozoospermics, the VCL was increased after exposure to pentoxifylline at 120 min (p = .03) and 240 min (p = 10(-5)); similarly, the amplitude of the lateral head displacement (ALH) was greater in this group at 120 and 240 min (p = .01 for maximum ALH). However, a heterogeneity was noted in the response between individuals, which required that the statistical analyses take into account these differences.

Humans↗

[In vitro fertilization failures related to a sperm hyperactivation defect: indication for microinjection?].

Development of hyperactivated motility is considered as necessary for penetration through zona pellucida. In a study concerning 114 IVF attempts, we could not establish a significant correlation between fertilization rate and hyperactivation rate (HA). On the contrary, most fertilization failures (16/21) we found for HA values < 10%. 10 of such couples could benefit of ICSI for the next attempt: fertilization rates were strictly similar to the general rate observed for ICSI in our group (48%).

Female↗