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A prospective study investigating whether levels of the homocysteine pathway are associated with pregnancy rate in in vitro fertilization (IVF). Prior to initiate treatments, women gave a blood sample to test serum and red blood cell (RBC) folates, homocysteine and vitamin B12. The main outcome was cumulative clinical pregnancy rate according to basal levels of serum and RBC folates, homocysteine and vitamin B12. Two-hundred-nine women were selected, of whom 56 achieved a clinical pregnancy (27%). Median [interquartile range] levels of RBC and serum folate in women who did and did not become pregnant were 328 and 263 ng/ml (p = 0.018) and 13.6 and 9.4 ng/ml (p = 0.001), respectively. The adjusted ORs (95%CI) of pregnancy in women with RBC and serum folate concentrations in the upper tertile of the distributions were 2.6 (1.4–5.1) and 1.9 (1.0–3.7), respectively. Women undergoing IVF treatments with higher levels of folate have a higher chance of clinical pregnancy

Background Improving in vitro fertilization success is an unmet need. Observational studies have suggested that women with deficient or insufficient vitamin D have lower chances of in vitro fertilization success, but whether supplementation improves clinical pregnancy rate remains unclear. Objective This study aimed to determine whether oral vitamin D3 supplementation improves clinical pregnancy in women undergoing an in vitro fertilization cycle. Study Design The “supplementation of vitamin D and reproductive outcome” trial is a 2-center randomized superiority double-blind placebo-controlled trial. Subjects were recruited between October 2016 and January 2019. Participants were women aged 18 to 39 years with low vitamin D (peripheral 25-hydroxyvitamin D of 0.5 ng/mL and starting their first, second, or third treatment cycle of conventional in vitro fertilization or intracytoplasmic sperm injection. The primary outcome was the cumulative clinical pregnancy rate per cycle. Pregnancies obtained with both fresh or frozen embryo transfers were included. Clinical pregnancy was defined as an intrauterine gestational sac with a viable fetus. The primary analysis was performed according to the intention-to-treat principle and could also include natural conceptions. Secondary outcomes included total dose of gonadotropins used, embryologic variables (number of oocytes retrieved, number of suitable oocytes retrieved, fertilization rate, and rate of top-quality embryos), and clinical outcomes (miscarriage rate and live birth rate). Results Overall, 630 women were randomized 2 to 12 weeks before the initiation of the in vitro fertilization cycle to receive either a single dose of 600,000 IU of vitamin D3 (n=308) or placebo (n=322). Interestingly, 113 (37%) and 130 (40%) women achieved a clinical pregnancy in the treatment and placebo groups, respectively (P=.37). The risk ratio of clinical pregnancy in women receiving vitamin D3 was 0.91 (95% confidence interval, 0.75–1.11). Compared with the placebo, vitamin D3 supplementation did not improve the rate of clinical pregnancy. Exploratory subgroup analyses for body mass index, age, indication to in vitro fertilization, ovarian reserve, interval between drug administration and initiation of the cycle, and basal levels of 25-hydroxyvitamin D failed to highlight any clinical situation that could benefit from the supplementation. Conclusion In women with normal weight with preserved ovarian reserve and low vitamin D levels undergoing in vitro fertilization cycles, a single oral dose of 600,000 IU of vitamin D3 did not improve the rate of clinical pregnancy. Although the findings do not support the use of vitamin D3 supplementation to improve in vitro fertilization success rates, further studies are required to rule out milder but potentially interesting benefits and explore the effectiveness of alternative modalities of supplementation.

The clinical management of women with deep peritoneal endometriosis remains controversial. The debate focuses mainly on the precise role of hormonal medical treatment and surgery and on the most suitable surgical technique to be used. In particular, considering the risks of second-line surgery, prevention of recurrences after first-line surgery is a priority in this context. Post-surgical medical therapy has been advocated to improve the effectiveness of surgery and prevent recurrences. However, adjuvant therapy, i.e. a short course of 3-6 months of hormonal therapy after surgery, has been proven to be of limited or no benefit for endometriosis in general and for deep peritoneal endometriosis in particular. On the other hand, two cohort studies suggest a beneficial effect of prolonged hormonal therapy after surgery for deep endometriosis. Even if this evidence is too weak to confidently advocate systematic administration of prolonged medical therapy after surgery, we argue in favour of this approach because of the strong association of deep endometriosis with other disease forms. In fact, women operated on for deep endometriosis may also face recurrences of endometriomas, superficial peritoneal lesions and pelvic pain in general. The demonstrated high effectiveness of prolonged postoperative therapy for the prevention of endometriomas' formation and dysmenorrhea recurrence should thus receive utmost consideration in the decision-making process.

This systematic review of the literature reports on the use and effectiveness of sperm banking programmes for cancer patients. Thirty studies with 11798 patients were included. The aggregated rate of use of cryopreserved semen was 8% (95% CI 8 to 9%). A statistically significant correlation emerged between the mean and median duration of follow-up and the rate of use (R(2) = 0.46; P = 0.03). The rate of patients discarding their frozen sample was reported in 11 studies. The aggregated rate was 16% (95% CI 15 to 17%). The rate of patients who used their frozen semen and achieved parenthood was reported in 19 papers. The aggregated rate was 49% (95% CI 44 to 53%). The rate of patients achieving parenthood with the use of frozen sperm is low and, from an economical perspective, the effectiveness of programmes of sperm banking might therefore be questioned. On the other hand, the low rate of patients discarding their frozen samples and the correlation between rate of use and duration of follow-up suggest that the calculated 8% rate of use may be an under-estimation and that cumulative rate of use may be substantially higher. Specific studies are, however, required to clarify this issue.

Research on the effect of adenomyosis on the rate of success of IVF is controversial. Differences in study design, study power, criteria and instrument used to diagnose adenomyosis and choice of controls may explain these discrepancies. To establish whether embryo implantation is impaired in women with adenomyosis, women scheduled for IVF were prospectively evaluated for the presence of adenomyosis and whether this condition affected embryo implantation. Forty-nine women with adenomyosis diagnosed at transvaginal ultrasound with no abnormal uterine bleeding were recruited. They were matched for study period, age, day of embryo transfer and number of transferred embryos to 49 controls without the disease. In women with adenomyosis, 24 out of 76 embryos transferred implanted (32%); this occurred in 16 out of 76 (21%) in unaffected controls. The crude odds ratio of implantation in affected women was 1.73 (95% CI 0.83 to 3.60). The odds ratio adjusted for body mass index (the unique variable found to differ at univariate analysis) was 1.78 (95% CI 0.85 to 3.77). In conclusion, implantation rate is not impaired in asymptomatic women who are diagnosed with adenomyosis at transvaginal sonography. Affected women can be reassured about the effect of this condition on their chances of success.

Parthenogenesis is a reproductive strategy typical of lower species where a female gives birth to offsprings without a paternal contribution. On the contrary, parthenogenesis is not a form of natural reproduction in mammals even if mammalian oocytes, under appropriate stimuli, can undergo to parthenogenetic activation. This review describes the biological mechanisms regulating parthenogenetic activation in mammals and illustrates the fundamental differences between embryos and parthenotes. Ethical, legal and political concerns on the value of human embryos regulate and limit human embryological studies founded on the widespread belief that human embryos should not be created and studied for research purposes only. Based on the differences between parthenotes and embryos the use of parthenogenesis is proposed as an experimental tool to investigate embryo development which may solve many of the ethical concerns associated with the use of human embryos for experimental purposes. Examples of the possible uses of parthenotes in many field of research such as in vitro assays aimed to study some aspects of assisted reproductive technologies (ART), toxicology or stem cell are described and their validity is discussed.

The implementation of the European Water Framework Directive requires new tools for predicting the effect of expected measures taken in the watershed on water quality at the scale of large regional river systems. In the Seine basin, four models, developed in a research context, have been chained to each other to simulate water quality and biogeochemical functioning of the hydrosystem from headwater streams to the coastal marine area. All four models are based on a similar deterministic approach and share a common description of the biogeochemical processes, allowing them to exchange information. Each model differently represents the hydro-sedimentological processes, and uses different time and space resolution, in order to tackle with the specific problematic of each sub-system. This cascade of models has been used for testing a prospective scenario of water resources management at the horizon of 2015, established by Water Authorities of the Seine-Normandy district. The simulation predicts a general improvement of water quality concerning those variables linked to point sources of pollution (ammonium, oxygen, phosphate), even if, locally, this improvement can be insufficient for meeting the expected quality standards. The predicted improvement of the quality of the Seine River downstream from Paris and its estuary is large. However, the predicted very significant drop of phosphate contamination, although beneficial for limiting the problems of coastal marine eutrophication, does not lead to a significant control of phytoplankton development in the rivers upstream from Paris. The simulation also predicts a general increase in nitrate contamination mainly linked to diffuse sources from agricultural areas.

Objective To compare directly in vitro developmental competence between parthenogenetically activated and intracytoplasmic sperm injection (ICSI)-fertilized oocytes. Design For each patient, three metaphase II oocytes were randomized to the ICSI procedure, while n−3 were allocated to parthenogenetic activation. Setting University hospital infertility unit. Patients Thirty-eight patients, aged 35.2 ± 3.3 years (mean ± SD) selected for ICSI. Interventions After 1 hour from denudation, oocytes were either fertilized by ICSI (n = 114) or chemically activated (n = 104). Fertilized and activated oocytes were cultured for up to 3 and 5 days, respectively. Main Outcome Measures Development rate, cell number, and morphological grade during culture. Results The two groups showed no significant differences between rates of fertilization and parthenogenetic activation, development, and blastomere number on days 2 and 3 of culture. However, parthenotes showed a lower morphological grade, and a significantly lower proportion went on cleaving to day 3, when only activated rather than total numbers of oocytes were considered. On day 5 after activation, nine oocytes (8.6%) reached the blastocyst stage, representing 12.9% of parthenotes. Conclusions Since most parameters examined in this study were similar between activated and fertilized oocytes, parthenogenetic activation may be a useful tool for the preclinical evaluation of experimental procedures.

To evaluate the influence of IVF on the dimension of leiomyomas, we selected 72 women with small intramural or subserosal leiomyomas and assessed the size of these lesions before and after the treatment cycle. The mean ± SD diameters of the tumors at these two time points were 20.5 ± 9.5 and 20.6 ± 10.2 mm, respectively, thus supporting the conclusion that IVF does not influence the growth of these lesions.

The normal contact between two nominally flat, parallel rough surfaces is analysed on the microgeometric scale from a theoretical point of view. The microgeometry is described using a probabilistic model based on the quantification of the variability in the summit altitude and the asperity radius. This model takes for its basic data six standardised parameters for roughness and waviness defects measured on both surfaces in contact. For a given separation between two surfaces, this model allows us to determine the number of asperities in contact and their respective indentations. For each asperity in contact, realistic indentation laws are developed taking into account either elastic, elasto-plastic or plastic deformation. The continuous sum of the loads at each asperity gives the global load at the contact and the force transmitted through elastic, elasto-plastic or fully plastic deformed asperities. The theoretical analysis of classical surfaces possessing various mechanical characteristics confirms the combined influence of microgeometry (roughness and waviness parameters) and mechanical characteristics (Young's modulus, Poisson's ratio and yield stress) on load transmission. The association of these parameters into a classical index for plasticity confirms previous predictions. The last necessary parameter is the normal load applied through the contact. This parameter does not appear in previous theories for the plasticity index but can drastically change the degree of plasticity in the contact. The main contribution of our research consists in the quantification of the proportion of plastification in the contact at a given normal load.

several vacuoles greater than 25%. Selected spermatozoa (by ICSI pipette) were assessed for DNA fragmentation (TUNEL) by immunofluorescence. Statistical analysis was performed by ANOVA. RESULTS: The mean age was: 35 4.5(group 1), 36 3.5 (group 2) and 36 3.0 (group 3). Progressive sperm motility was 59 22 (1), 55 18 (2), 60 18 (3). The average of Kruger was: 16.2 2 (1), 7.5 2.5 (2) and 1.2 1.4 (3). A total of 818 spermatozoa were selected and evaluated for TUNEL. The comparison between sperm populations are shown in table 1.