Peter De Loecker

Higher Implantation Rate Using Modified Quarter Laser-Assisted Zona Thinning in Repeated Implantation Failure

Background/Aims: Some embryo implantation problems in patients with recurrent implantation failure may be explained by the inability of the embryo to hatch out of its zona pellucida. In this case-control study, a study group which had received modified quarter laser-assisted zona thinning (mQLAZT) was compared with a control group which had not received mQLAZT with respect to reproductive outcome. Methods: Cycles from patients with a 4th fresh embryo transfer (ET) after 3 previously failed ET cycles (no β-hCG detected) were included. Cases (group A, n = 53) included ET cycles from patients who received a 4th ET with fresh embryos after mQLAZT. Controls (group B, n = 86) included ET cycles from patients who had a 4th ET without mQLAZT. The clinical implantation rate and live birth rate per embryo transferred were measured. Results: The clinical implantation rate with positive fetal heart beat per embryo transferred was significantly higher (p = 0.035) in group A (22/107 or 21%) than in group B (18/166 or 11%). Conclusion: The data of this case-control study suggest that mQLAZT can be effective in the treatment of patients with recurrent implantation failure, but need to be confirmed by randomized trials.

The effects of cryopreservation on protein synthesis and membrane transport in isolated rat liver mitochondria.

Protein synthesizing activity and membrane transport were examined in fresh and cryopreserved isolated rat liver mitochondria. In the presence of 0.6, 1.2, and 1.8 M final concentrations of dimethyl sulfoxide (Me2SO), both metabolic parameters were considerably inhibited in the fresh samples and even more inhibited in the cryopreserved specimens. However, simple exposure to this penetrating cryoprotectant, followed by its subsequent removal by washing, did not seem to affect significantly the examined functions. When different freeze-thaw regimes were investigated, it was observed that optimal recovery of protein synthesis and membrane transport functions were obtained when fast freezing took place in the absence of Me2SO.

Is There a Correlation between the Number of Follicular Flushings, Oocyte/Embryo Quality and Pregnancy Rate in Assisted Reproductive Technology Cycles? Results from a Prospective Study

Objective: To determine the mean number of follicular flushings needed to retrieve the maximal number of oocytes and to investigate the correlation between the number of flushings and oocyte/embryo quality as well as reproductive outcome. Methods: This prospective study included 154 oocyte retrieval cycles in 138 patients undergoing assisted reproductive technology treatment. During oocyte retrieval, aspirate and flushes were collected in four separate collections (A, F1, F2, F3) and inspected for the presence of an oocyte-cumulus complex (OCC). Outcome variables included oocyte recovery rate, percentage of mature oocytes, fertilization rate, day 2/day 3/day 5 embryo quality and clinical pregnancy rate/live birth rate. Results: Out of 1,495 OCCs collected, 91% were obtained in collections A or F1. Significantly more mature oocytes were obtained in collection A (p = 0.03). The fertilization rate was similar for oocytes obtained in the four separate collections (p = 0.50). The proportion of good-quality day 2/day 3/day 5 embryos was similar (p = 0.93, p = 0.85 and p = 0.14, respectively). Clinical pregnancy rate and live birth rate were not significantly affected by the first two flushes. No live birth emanated from oocytes obtained from the third flush onwards. Conclusion: More than 90% of all recovered OCCs were obtained after follicular aspiration followed by follicular flushing up to two times (collections A and F1). Follicular flushing may increase the oocyte recovery rate and does not have a negative influence on fertilization rate, day 2/day 3/day 5 embryo quality or pregnancy rate.

Fertiliteit na behandeling van volwassen patiënten met hemato-oncologische aandoeningen en borstkanker Recente inzichten en therapeutische ontwikkelingen

Abstract Fertility and treatment of adults withhaematological malignancies and breastcancer Lymphoma, leukaemia and breast cancer are of themost common cancers during reproductive life. Theiroutcome has improved dramatically over the lastdecades. Infertility is a severe side-effect of a cur-ative cancer treatment exerting a considerableimpact on the quality of life.Given the present-day tendency of women to post-pone their first pregnancy, the preservation of fer-tility remains an essential part of the managementof these cancers. The efficacy of fertility preserva-tion techniques depends largely on an early recog-nition of the problem.In this manuscript we present an overview of ourcurrent multidisciplinary approach in this field.Literatuur 1. M EIROW D. Reproduction post-chemotherapy in young cancerpatients. Mol Cell Endocrinol 2000; 169 : 123-131.2. L EE SJ, S CHOVER LR, P ARTRIDGE AH, et al. American Society ofClinical Oncology recommendations on fertility preservation incancer patients. J Clin Oncol 2006;