[Results and experiences after 1000 IVF cycles at the Clinic for Gynecology and Obstetrics in Novi Sad]

INTRODUCTION

Infertility affects 15-17% of reproductive age couples in our country, and 10-15% of couples worldwide. The aim of this paper was to present results and experience gained after the first 1000 cycles of the national In Vitro Fertilization (IVF) program, to offer professional standard of work in our country and to compare it with results obtained in Europe and worldwide.

MATERIAL AND METHODS

The study prospectively included 1000 women who had undergone national In Vitro Fertilization program from October 2006 until November 2009 at the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina, Novi Sad.

RESULTS

The analysis included 1000 in vitro fertilization cycles. Male factor infertility was the leading cause (56.9%) followed by tubal factor (45.9%). The classic method of in vitro fertilization constituted 72.3% of all cycles, while intracytoplasmic sperm injection (ICSI) method was used in 27.7% of all cycles. The average number of embryos transferred was 2.67. The cycle cancellation rate was 14.10% and the aspiration rate was 94.40%. The clinical pregnancy and live birth rate were 33.41% and 26.78% per embryo transfer respectively.

DISCUSSION AND CONCLUSION

The results in our study showed that in our setting there are far less intracytoplasmic sperm injection cycles compared with the European average of 66.5% of all fresh cycles, and that we transferred more embryos on average. Our success rates are comparable with those in other European countries where the clinical pregnancy rates per aspiration and per transfer for in vitro fertilization were 29 and 32.4%, respectively in the period of observation. For intracytoplasmic sperm injection, the corresponding rates were 29.9 and 33%.

[Labour after intracytoplasmic sperm injection]

INTRODUCTION

The aim of our study was to describe labour characteristics after intracytoplasmic sperm injection programme. This is the first study of those deliveries at the Department of Gynecology and Obstetrics in Novi Sad.

PATIENTS AND METHODS

Subjects were 73 parturients and their babies from the intracytoplasmic sperm injection programme (48 singletons, 22 twins and 3 triplets), delivered from January 1st, 2001 to December 31st, 2006.

RESULTS

At the Department of Gynecology and Obstetrics in Novi Sad, 0.65% of all deliveries are those from assisted reproductive programmes. 30.67% of all labours after assisted reproductive programmes are after intracytoplasmic sperm injection. One half of all labours after intracytoplasmic sperm injection are twins. The mean age of women is 33-34. More than 95% of all babies were delivered by Cesarean section.

DISCUSSION

The most frequent pathologies in labours after intracytoplasmic sperm injection are hypertensive disorders and premature rupture of membranes. There is still a matter of debate what is a real cause for those pathologies, especially for hypertension (age of woman, laboratory factors and or induction of ovulation).

CONCLUSION

At the Department of Gynecology and Obstetrics in Novi Sad, one third of all deliveries after assisted reproductive programme are after intracytoplasmic sperm injection. The most frequent pathologies after intracytoplasmic sperm injection are hypertensive disorders, which is similar to findings of other authors. The mean age of women is also similar to the mean European age of women after intracytoplasmic sperm injection.

[Effect of prolactin on the regulation of osmotic processes across the fetoplacental membranes in vitro]

INTRODUCTION

The aim of this investigation was to point to the influence of minerals and total osmolality on regulation and secretion of prolactin in decidual tissue of the placenta and the role of prolactin in regulation of osmotic processes across the fetoplacental membrane.

MATERIAL AND METHODS

Explants for the tissue culture have been obtained from pregnant women with normal pregnancy and delivery, between the 277 and 282 days of gestation. The investigation consisted of 4 repeated experiments. The parietal decidua and the corresponding chorion were separated from the amnion, rinsed in salt solution and cut into explants 0.2 g of weight. After a 2-hour period of preincubation in the control medium, 12 explants were incubated in the media of altered mineral and osmotic properties, whereas the 13-th in the control medium. Concentrations of prolactin following the 3-hour incubation in the medium was estimated by immunoenzymologic procedures.

RESULTS

During the 3-hour incubation, the control explants secreted on average 75.4 +/- 5.23 micrograms/l of prolactin in the experiment repeated 4 times. The changes of Na+, Cl-, K+, Mg++, P- and HCO3- concentrations and of the total osmolality have not significantly influenced the synthesis of prolactin. In the medium with no Ca++, the value of secreted prolactin was 26.7 +/- 3.34 micrograms/l (p < 0.001); increase of the Ca++ concentration has not influenced the synthesis of prolactin. In the medium with increased concentration of H+ (pH = 7.00), the prolactin concentration was 50.9 +/- 2.9 micrograms/l (p < 0.001).

CONCLUSION

The minerals--Na+, Cl-, K+, Mg++, P-, HCO3- and the total osmolality do not significantly influence the synthesis of prolactin in decidual-chorionic tissue. Certain quantities of Ca++ and optimal concentration of H+ are necessary for the synthesis of prolactin (PRL).