Prognostic implication of apoptosis in human luteinized granulosa cells during IVF-ET

PURPOSE

To investigate the prognostic significance of apoptosis in granulosa cells recovered from patients participating in IVF-ET.

METHODS

Seventy-three women underwent ovarian hyperstimulation for IVF and embryo transfer. After follicle aspiration, recovered granulosa cells were stained by BCL2 monoclonal antibody with FITC and propidium iodide (PI). Fluorescence was detected by flowcytometry, then the apoptotic index (Al) and BCL2 positivity were assessed.

RESULTS

The pregnant group showed a significantly lower apoptotic index in granulosa cells compared with the nonpregnant group (p < 0.0001). Patient's age, basal serum FSH concentration, serum E2 concentrations at hCG day, number of retrieved oocytes, fertilization rates. number of embryos transferred, and BCL2 positivity were not different between the two groups. Linear regression analysis of AI to serum basal FSH showed a positive correlation. Al in granulosa cells of 6.14% or below could predict a successful pregnancy with a sensitivity of 87.5% and a specificity of 73.7%.

CONCLUSION

Our results indicate that apoptotic analysis within granulosa cells can be used as a prognostic indicator for IVF success.

Clinical significance of transvaginal color Doppler ultrasonography of the ovarian artery as a predictor of ovarian response in controlled ovarian hyperstimulation for in vitro fertilization and embryo transfer

PURPOSE

Our purpose was to verify whether the blood flow impedance of the ovarian stromal artery in transvaginal color Doppler ultrasonography can predict the in vitro fertilization and embryo transfer (IVF-ET) outcomes.

METHODS

Transvaginal color Doppler ultrasonographic examinations were performed in 99 patients undergoing controlled ovarian hyperstimulation (COH) for IVF-ET. The pulsatility index (PI) was evaluated in the bilateral ovarian stromal arteries on the starting day of COH (PI1) and the day of hCG administration (PI2). The patients were classified into three groups by the mean PI1, PI2, and API (PI1 - PI2), respectively, and the IVF-ET outcomes were analyzed and compared.

RESULTS

There were no significant differences in the duration of COH, the total dosage of gonadotropins used for COH, the serum E2 concentration on day of hCG administration, the number of follicles on the day of hCG administration, the number of oocytes retrieved or fertilized in vitro, and the number of embryos transferred between their respective PI1, PI2, and API values. However, the pregnancy rate was significantly lower in the higher PI1 and PI2 groups than in the lower groups (p < 0.05, p < 0.05). Significant positive correlations were also found between PI1 and PI2 and the total dosage of gonadotropins for COH (Y= 0.483X + 27.1, r = 0.052, p < 0.05; Y = 0.877X + 26.6, r = 0.075, p < 0.05).

CONCLUSIONS

Our results showed that the lower PI in the ovarian stromal artery during COH is associated with the higher the pregnancy rate and the smaller amount of gonadotropins used for effective COH. This study suggests that the color Doppler ultrasonographic index (PI) of the ovarian stromal artery during COH may be useful for predicting the success of IVF-ET in infertile patients.

Seasonal influences on in vitro fertilization and embryo transfer

PURPOSE

The study was aimed to investigate the influence of time factors (day, week, month) on pregnancy rates and in vitro fertilization (IVF) and embryo transfer (ET) parameters.

METHODS

8,184 IVF-ET cycles, taking place in two IVF centers from 1992 to 1999, were analyzed. Multiple logistic and linear regression methods were performed as statistical analyses.

RESULTS

Oocyte pickup on Tuesdays achieved a significantly higher mean number of oocytes (median: 7) and the highest pregnancy rate (PR) (33.4%) per ET There was a significant variation over the year, with the lowest PR/ET in July (25.71%) and the highest in December (35.5%). Concerning outcomes, the age factor and the number of embryos transferred had the highest significant (p < 0.0001) influence.

CONCLUSIONS

The observed weekly rhythm for oocyte pick-ups is certainly due to preprogrammed ovarian stimulation used in our IVF programs. Age as well as the number of embryos transferred are the main influencing factors on a positive outcome and more predictive than seasonal aspects.