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Objective: To determine the relationship between platelet-activating factor acetylhydrolase (PAFah) content in semen and sperm motility. Design: The PAFah levels in semen were measured and correlated with sperm motility. Setting: Clinical laboratory in a private assistant reproductive technology clinic. Patient(s): Three hundred and twelve men seeking diagnosis and treatment of infertility. Intervention(s): Semen samples were collected from 312 healthy mature men seeking infertility treatment. Sperm motility and PAFah activity were measured in seminal plasma. Data was analyzed by Student’s t test and regression analysis. Main Outcome Measure(s): PAFah activity and sperm motility. Result(s): Seminal PAFah content ranged from a low of 179 IU/L to a high of 2,457 IU/L. The overall mean PAFah content in semen was 780.59 IU/L. Linear regression analysis revealed a significant (R 2 = 0.655) and negative relationship between PAFah content in semen and sperm motility. Semen specimens with high percent motility (≥50%) had significantly lower PAFah concentrations (442.03 ± 14.37 IU/L) than those with the lower percent sperm motility (<50%) (882.16 ± 18.45 IU/L). Conclusion(s): The data confirm the presence of PAFah in human semen and that activity is significantly and negatively correlated with sperm motility. The PAFah is proven to be a candidate for sperm decapacitation factors, whereas PAF is qualified to be a candidate for sperm capacitation factors. [Copyright &y& Elsevier]

Objective: To evaluate the results of a novel protocol that allows to rescue IVF unfertilized oocytes by intracytoplasmic sperm injection (ICSI). Design: Prospective clinical trial. Setting: Private reproductive medical center. Patient(s): Thirty patients undergoing IVF. Intervention(s): Controlled ovarian stimulation (COS), conventional IVF, rescue ICSI, embryo culture, and embryo transfer. Main Outcome Measure(s): Identification of unfertilized IVF oocytes 6 hours after insemination and fertilization, and developmental rates of those oocytes after rescue microinjection, as well implantation and pregnancy rates (PR). Result(s): All oocytes (392) from 30 patients were inseminated with standard IVF 3 hours after ovum pick-up. Polar body (PB) status was checked at decumulation and rechecked 3 hours later. Eighty-two oocytes were fertilized after IVF alone and 184 nonactivated oocytes (failed fertilization) were rescue microinjected and 166 of them fertilized (20 patients). Cleavage stage on day 2 was significantly more advanced and embryo grade was higher after standard IVF fertilization than after rescue ICSI. Eight of the 30 embryos transferred were implanted in the IVF-only patients (27%) and 8 of 68 embryos in the rescue ICSI patients (12%). Conclusion(s): Rescue ICSI of unfertilized IVF oocytes 6 hours after insemination (9 hours after egg retrieval) can provide normal fertilization, embryo development, and pregnancy; however, corresponding outcome parameters tend to be impaired in comparison to the standard IVF fertilization results. [Copyright &y& Elsevier]

Objective: To evaluate the effect of degenerated (lysed) blastomere removal on implantation and pregnancy rates in cleavage-stage cryo–embryo transfer (ET) cycles. Design: Randomized clinical trial. Setting: Private reproductive medical center. Patient(s): A total of 88 patients who received frozen–thawed ET, divided into two groups. Intervention(s): Embryo freezing and thawing; opening of the zona pellucida and removal of cryodamaged blastomeres (in the study group), followed by same-day ET. Main Outcome Measure(s): Extent of survival of cleavage-stage embryos after the freeze–thaw procedure; embryo implantation and clinical pregnancies. Result(s): Oocyte number per patient, fertilization rate, embryo development rate (and quality), and freezing rates were similar in the two groups in the fresh cycle. In the control group, a total of 55 embryos (25%) of the 217 thawed remained fully intact, and 53 (26%) of the 207 in the study group remained intact. The average number of embryos transferred per group was similar (control, 3.4 ± 0.9; study, 3.3 ± 0.9). Implantation rates were 12% and 26% in the control and study groups, respectively. The clinical pregnancy rate was 23% in the control group and 64% in the study group when lysed cell removal was performed. Conclusion(s): The results show that pregnancy and implantation rates are higher in the study group; therefore, the removal of degenerated blastomeres may be beneficial to all patients who undergo cleavage-stage, frozen–thawed ET. [Copyright &y& Elsevier]

Objective: The aim of this study was to determine, with a bovine model, the appropriate interval for xenografted adult and newborn ovarian tissue to develop gonadotropin-responsive follicles. Design: Controlled experiment. Setting: Academic research laboratory. Animal(s): Male non-obese diabetic (NOD) severe combined immunodeficient (SCID) mice (n = 20) were hosts of bovine ovarian tissue. Two dairy calves and one adult beef cow were donors of ovarian tissue. Intervention(s): Newborn and adult bovine ovarian cortical pieces were transplanted to the SC space of intact male NOD SCID mice. Grafts were recovered after euthanasia at intervals after transplantation. Main Outcome Measure(s): Microscopic examination of histologic sections to determine proportions of growing follicles. Result(s): There was an increase in the proportion of primary and secondary follicles on day 55 after surgery for the cow and on day 124 after surgery for calf tissue compared with nongrafted and xenografted ovarian tissues recovered at previous intervals. These observed increases were accompanied by decreases in proportions of primordial follicles. Results suggest a sudden increase in the proportion of primary and secondary follicles due to progressive development of primordial follicles. Conclusion(s): In the NOD SCID mouse, bovine follicles survived xenotransplantation and underwent development. A longer interval was required for ovarian follicular development in calf tissues compared with that in adult cow ovarian tissues after xenotransplantation. [Copyright &y& Elsevier]

Objective: To determine the efficacy of treating semen specimens with platelet-activating factor (PAF) before IUI.Design: Prospective randomized double-blinded study of PAF treatment of sperm for patients with a history of infertility undergoing IUI.Setting: Private infertility center.Intervention(s): Patients had ovulation induction therapy with clomiphene citrate (CC) or gonadotropin, two IUIs per month with PAF treatment.Main outcome measure(s): Clinical pregnancy rates.Result(s): There was a significant difference in IUI pregnancy rates per cycle between control (10/56; 17.9%) and PAF (14/47; 29.8%) treatment groups in the normal male study arm. There was a significant difference in cumulative IUI pregnancy rates between control (10/35; 28.6%) and PAF (14/26; 53.9%) patient groups in the normal male study arm. There was no significant difference in IUI pregnancy rates per cycle between control (12/124; 9.7%) and PAF (14/119; 11.8%) treatment groups in the male factor study arm. There was no significant difference in cumulative IUI pregnancy rates between control (12/46; 26.1%) and PAF (14/38; 36.8%) patient groups in the male factor study arm. There was a significant difference in overall cumulative IUI pregnancy rates between control (21/81; 25.9%) and PAF (27/64; 42.2%) patient groups.Conclusion(s): The inclusion of PAF into the IUI sperm wash procedure significantly improves pregnancy rates. However, the significant improvement can only be shown to affect men presenting with normal semen parameters. [Copyright &y& Elsevier]

: ObjectiveTo study the response of human ovarian xenografts to transplantation into different sites and in different host conditions.: DesignControlled experiment.: SettingAcademic research laboratory.: Patient(s)Donated ovarian tissue from two young women.: Intervention(s)Human ovarian cortical pieces were transplanted either under the kidney capsule or to the subcutaneous space of intact or castrated male nonobese diabetic (NOD) severe combined immune-deficient (SCID) mice. Grafts were recovered after euthanasia.: Main outcome measure(s)Microscopic examination of histologic sections to determine proportions of growing follicles, and serum estradiol concentration measurements.: Result(s)Six months after transplantation, ovarian grafts transplanted under the kidney capsule of intact male mice had significantly higher proportions of growing follicles compared with those recovered from the castrated/kidney capsule and intact/subcutaneous groups. However, no difference was detected between the intact/kidney capsule and the castrated/subcutaneous groups. Mean estradiol concentrations in serum were nonsignificantly increased in mice with ovarian grafts compared with those in mice without a graft.: Conclusion(s)Follicular development in xenotransplanted human ovarian tissue is influenced by the site of transplantation and the condition of the host. [Copyright &y& Elsevier]