Asian Pacific Journal of Reproduction

206-213

Authors: Ho Lee Mee, de Souza Nurun Nisa, Lee Shaw Ni, Yu Su Ling

Objective: To explore the potential predictors of a live birth (LB) outcome among subfertile couples of Asian ethnicity undergoing the first fertility treatment cycle; to assess the cumulative live birth rates after successive cycles; and to determine the incidence rate of spontaneous conception (SC). Methods: Subfertile couples were grouped according to treatment modalities at the first fertility treatment cycle: intrauterine insemination (IUI), in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) and no treatment, and were followed-up for duration up to seven years. Multivariable logistic regression analysis was used for statistical analyses. Results: Age of female subjects [35-38 years, odds ratio (OR): 0.39; ≥39 years, OR: 0.14], uterine factor subfertility (OR: 5.24), and treatment modalities (ORs: IUI 0.25, IVF 2.33 and ICSI 1.91) significantly predicted a LB outcome (P<0.05). The cumulative live birth rates were 11.7% IUI, 41.5% IVF, 27.5% ICSI and 22.6% from frozen embryo transfer cycles. The cumulative SC rate was 24.6% in the non-treated group and 10.7% in the treated group. All LBs from IVF cycles were delivered by the second cycle and within four years, compared to SC delivery of within five years in the non-treated group and six years in the treated group. Conclusions: Age of female subject, uterine factor and modalities of treatment are significant predictors for LB outcome at the first cycle. Higher delivery rates could be achieved following fewer successive IVF cycles and within a shorter duration compared to SC.

220-224

Authors: Samaa M Galal, Mohamed Fathi, Ismail ST, ElBelely MS, Faten F Mohamed

Objective: To describe the breed predisposition, clinical diagnosis, pathological findings and the surgical approach through excision of the hyperplasic mass from the vagina. Methods: Twenty five bitches of different breeds suffering from a protruded mass from the vulva were examined clinically, blood samples were collected to ensure the phase of estrus that were determined by evaluating the exfoliative vaginal epithelium, and a histopathological examination of the hyperplastic mass was done after its surgical excision. Results: The current work revealed that the maximum value of estradiol 17-B was in Alabai breed while the maximum value of progesterone was in Pit bull breed. And Pit bull breed showed cornification and stratification of the vaginal mucosa with abundant eosinophilic cytoplasm and regular round nuclei. Conclusions: As the vaginal hyperplasia is a crucial gynaecological problem that affects different breeds of bitches, the current work provides a comprehensive diagnosis of the case and illustrates the surgical interference for its excision.

229-235

Authors: Işıl Aydemir, Mahmud M. Özkut, Fatma Fırat, Alican Gümürüdü, Dila Hatun Sal, Kübra Erdoğan, Aslı Göker, Mehmetİbrahim Tuğlu

Objective: To investigate the effects of bone marrow derived mesenchymal stem cell (BMSC) application into the rat endometrium on oxidative stress, cell proliferation and apoptosis. Methods: The female rats selected in estrous cycle were divided into three groups (saline, media and BMSC group). The intrauterine and intraperitoneal injections were performed using the saline (200 µL), culture media (200 µL) and 1伊10 6 BMSCs/200 µL culture media, and then they were mated with male rats. On the 7th day of the pregnancy, uterine samples were harvested and dyed with heamatoxylin-eosin histochemically, anti-endothelial nitric oxide synthase and anti-inducible nitric oxide synthase, and anti- proliferating cell nuclear antigen immunohistochemically, with terminal deoxynucleotidyl transferas dUTP nick end labeling for apoptosis. The stainings were evaluated by H-score and the results were analyzed using one-way ANOVA test statistically. Results: It was found that BMSCs increased the endometrial thickness, endometrial epithelium thickness and number of endometrial glands compared to control and sham groups. The intrauterine BMSC application decreased both anti-endothelial nitric oxide synthase and anti-inducible nitric oxide synthase immunoreactivities and the number of apoptotic cells compared to the intraperitoneal applications whereas the immunoreactivity of proliferating cell nuclear antigen was increased. Conclusions: In current study, we define that stem cells do not cause any structural damages. Also they change the distribution of oxidative stress and cell proliferation marker. These findings support the reliability of stem cells in clinical use in the case of infertility.

239-240

Authors: Manjushri Kothekar, Richa Jagtap

We are reporting a case of monozygotic twinning after donor egg intracytoplasmic sperm injection (ICSI). A 34-year-old lady presented to our centre with primary infertility due to severe endometriosis and low egg reserve. ICSI with donor eggs was planned. A 24 years old voluntary oocyte donor was investigated and stimulated under antagonist protocol. Total 21 eggs and all in metaphase Ⅱ were retrieved. These eggs were injected with the patient’s husband sperms by ICSI. Patient’s endometrial lining was prepared under hormonal replacement therapy protocol. Two expanded blastocysts were transferred on day 5 of progesterone. Beta human chorionic gonadotropin was positive after 10 days. The first antenatal scan at 6 weeks could pick up only two sacs indicating twin conception. Repeat scan at 12 weeks revealed tri-amniotic triplet conception with two foetuses sharing the same placenta (triamniotic pregnancy with monochorionic twins). The patient was counselled about risks associated with triplet conception and was advised of embryo reduction. Two mono chorionic twins were reduced under ultrasonography guidance. Single pregnancy continued till 21 weeks after which the patient miscarried spontaneously. It is difficult to identify the subset of patients at risk for monozygotic twinning; hence, all patients should be counselled about possibility of monozygotic twinning while deciding the number of embryos to be transferred.