Anat Porat-Katz

At what age can human oocytes be obtained

OBJECTIVE To determine whether oocyte retrieval and in vitro maturation (IVM) is effective in girls undergoing fertility preservation before cancer treatment. DESIGN Cohort study. SETTING Tertiary university medical center. PATIENT(S) Patients <or=20 years old before gonadotoxic chemotherapy undergoing ovarian cortex cryopreservation. INTERVENTION(S) Before ovarian cortex cryopreservation, oocytes in all observed follicles were aspirated, matured in vitro, and cryopreserved. MAIN OUTCOME MEASURE(S) Maturation of oocytes. RESULT(S) One hundred seventy-nine oocytes were detected in 17/19 patients (89%) aged 5-20 years. We found 7, 8, and 17 oocytes in patients 5, 8, and 10 years old, respectively. The median number of oocytes per patient was 9 (0-37). Maturation rate was 45/133 oocytes (34%). In total, 81 oocytes were cryopreserved. We cryopreserved 4 of 12 detected, 4 of 9 detected, 1 of 8 detected, and 4 of 9 detected IVM oocytes for patients aged 5-10, 11-14, 15-17, and 18-20 years old, respectively. CONCLUSION(S) Patients undergoing ovarian cryopreservation could benefit from supplementary oocyte aspiration from the cortex. Surprisingly, oocytes were detected even in young premenarcheal girls. The number of oocytes detected, matured, and cryopreserved was not age dependent. Retrieved oocytes can be matured in vitro and cryopreserved. Because no pregnancy has yet resulted from this procedure it should be considered to be experimental. We describe the youngest patients to undergo ovum collection, IVM, and oocyte cryopreservation.

Hyaluronic acid can successfully replace albumin as the sole macromolecule in a human embryo transfer medium.

OBJECTIVE To examine the effect on pregnancy and implantation rates when highly purified, fermentation-based hyaluronic acid was the only macromolecule supplement to the transfer medium in a human IVF program. DESIGN Prospective randomized study. SETTING In vitro fertilization center in an academic medical institution. PATIENT(S) Eighty patients were included in this prospective randomized double blind study. Inclusion criteria were age </=35 years, the availability of at least three embryos eligible for transfer on day 3 after fertilization, and no more than three previous embryo transfer attempts. INTERVENTION(S) All embryos were cultured in P1 medium containing 10% synthetic serum substitute (SSS) until day 3. Patients were randomly allocated to two groups; in treatment group A (40 patients), embryos were transferred to P1 medium supplemented with 0.5 mg/mL hyaluronic acid for 5-10 min before their intrauterine transfer. In the control group B (40 patients), embryos were transferred, as routinely performed, in P1 medium containing 10% SSS. MAIN OUTCOME MEASURES Clinical pregnancy and implantation rates. RESULT(S) The mean age of the female partner was 28.7 +/- 3.3 years and 29.7 +/- 3.8 years for groups A and B, respectively. In group A, 103 embryos were transferred and in group B, 97 embryos were transferred for a similar mean number of 2.6 +/- 0.6 and 2.4 +/- 0.5 embryos/transfer, respectively. Twenty-five pregnancies were achieved in group A, and 21 pregnancies in group B. This led to a comparable clinical pregnancy and implantation rates of 62.5% and 34% as compared to 52% and 26.8% for groups A and B, respectively. CONCLUSION(S) Hyaluronic acid can successfully replace albumin as a sole macromolecule in a human embryo transfer medium and result in high pregnancy and implantation rates. The use of this supplement is an important step in the development of human embryo culture media free of blood-derived additives.

The effect of using complementary medicine on the infertility-specific quality of life of women undergoing in vitro fertilization

To evaluate associations between the use of complementary medicine, quality of life (QoL), and lifestyle habits among women undergoing in vitro fertilization (IVF).

Use of complementary medical therapies by Israeli patients undergoing in vitro fertilization

To evaluate the prevalence and characteristics of complementary medical therapy (CMT) use among Israeli couples undergoing in vitro fertilization (IVF).

Using propensity score matching to evaluate the effect of complementary medicine on clinical and embryologic outcomes of in vitro fertilization

To evaluate associations between using complementary medical therapies (CMTs) and embryologic and clinical outcomes of in vitro fertilization (IVF).OBJECTIVE To evaluate associations between using complementary medical therapies (CMTs) and embryologic and clinical outcomes of in vitro fertilization (IVF). METHODS The present prospective questionnaire-based cohort study enrolled women aged 18-44 years undergoing their first, second, or third IVF cycle using their own oocytes at a large IVF clinic in Israel between February 1, 2013, and July 31, 2015. Clinical and embryologic data were obtained from patient records and patients completed a self-administered questionnaire that included details of any CMTs used to treat infertility. Propensity score matching was used and the proportion of top-quality embryos was compared between CMT users and non-users. RESULTS The study enrolled 400 participants and 134 (33.5%) reported using CMT to treat infertility. In an unmatched analysis, reduced endometrium thickness was observed among CMT users (P=0.020); differences were not observed for embryologic or other clinical parameters. Following propensity score matching, reduced endometrial thickness (P=0.046), and a lower proportion (P=0.046) and number (P=0.040) of top-quality embryos were observed among CMT users in comparison with patients who did not use CMTs. CONCLUSIONS Using CMTs was associated with inferior clinical and embryologic outcomes; using CMTs during IVF treatment could contribute to adverse outcomes. This article is protected by copyright. All rights reserved.