Amel Zhioua

Healthy Birth Resulting from in Vitro Matured Oocyte Fertilized with TesticularSpermatozoa

This case report describes a live birth resulting from intracytoplasmic sperm injection (ICSI) of spermatozoa retrieved by microdissection testicular sperm extraction (micro-TESE) into in vitro matured oocyte produced from controlled ovarian hyperstimulation cycle. A total of 11 oocytes (4 atretic and 7 immature oocytes) were retrieved. Following IVM, all immature oocytes had matured. A total of 5 oocytes were fertilized after ICSI with the husbands micro-TESE spermatozoa and 2 embryos were transferred into the uterus on day 2. A healthy girl weighing 3650 g was born at 38 weeks of gestation.

Seminal vesicle agenesis: An uncommon cause of azoospermia

Seminal vesicle malformations are a rare cause of obstructive azoospermia, often associated with other internal genitalia and upper urinary tract birth defects. We report 5 new cases of seminal vesicle agenesis in men presenting with hypospermia and azoospermia. Imaging showed seminal vesicle unilateral agenesis in all patients. The remaining seminal vesicle was hypoplastic in 3 cases, dilated in 1 case and with abnormally thick content in another case. Vas deferens agenesis was observed unilaterally in 2 patients and bilaterally in 2 other patients. No renal malformations were detected. Genetic study showed in all cases a 46 XY karyotype without any microdeletions. A single heterozygous cystic fibrosis transmembrane regulator gene mutation was diagnosed in 1 man, but not found in his partner. Intracytoplasmic sperm injection using sperm from a testicular biopsy was performed in 3 couples, without success.

Perurethral transvesical route for oocytes retrieval: an old technique for a new indication in oncofertility

We aimed to evaluate the safety and efficiency of the peruretheral transvesical oocyte retrieval in oncofertility. We conducted a retrospective comparative study in our assisted reproductive technologies center. STUDY GROUP 28 pubertal young women affected by malignancies, referred for fertility preservation and refusing transvaginal (TV) procedure. CONTROL GROUP 28 infertile patients, aged less than 25 years, who have undergone in vitro fertilization with TV oocyte retrieval. The ovarian stimulation was significantly longer on the study group. There was no difference between the two groups regarding mean number of collected metaphase II oocytes. One patient of the study group had a transient dysuria. These preliminary data suggest that, in oncofertility, peruretheral transvesical oocyte retrieval is an alternative when the TV route is refused or not feasible.

Progesterone for Luteal Phase Support in in Vitro Fertilization: Comparison of Vaginal and Rectal Pessaries to Vaginal Capsules: A Randomized Controlled Study:

BACKGROUND In IVF, Luteal phase support is usually performed using vaginal progesterone. A part of patients using this route reports being uncomfortable with this route. We tried to study whether the rectal route could be an effective alternative and associated with less discomfort. PATIENTS AND METHODS A prospective randomized controlled study. All patient were eligible for IVF treatment for infertility. After oocyte pickup, 186 patients were allocated to one the following protocols for luteal phase support: (i) rectal pessaries group: natural progesterone pessaries administered rectally 200 mg three times a day, (ii) vaginal pessaries group: natural progesterone pessaries administered vaginally 200 mg three times a day), and (iii) vaginal capsules group: natural micronized progesterone capsules administered vaginally 200 mg three times a day. On the day of pregnancy test, patients were asked to fill in a questionnaire conducted by an investigator in order to assess the tolerability and side effects of the LPS treatment taken. The primary endpoint was the occurrence of perineal irritation. RESULTS Fifty eight patients were assigned to the rectal pessaries group, 68 patients to the vaginal pessaries group, and 60 patients to the vaginal capsules group. All patients adhered to their allocated treatment. Implantation and clinical pregnancy rates per transfer did not differ between the three groups. Perineal irritation, which was our primary endpoint, was the same for all the three groups (respectively 1.7 % versus 5.9 % versus 11.7%). Regarding the other side effects, more patients experienced constipation and flatulence with the rectal route, whereas more patients reported vaginal discharge in the vaginal capsules group. CONCLUSION Rectal administration for luteal phase support is effective and well accepted alternative to vaginal route.