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621. Animal Reproduction - acrosomal integrity and DNA distributi

05 April 2004 by S.Selvaraju
Can you give details how to assess acrosomal integrity and DNA distribution with photograph?
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622. Should we have a re-thought about the wide spread and indiscriminate use of ICSI? Is there any alternative methods simulating more or less nature?-Opinions sought from IVF experts

29 March 2004 by Alex CV
Do we see any publications in reputed journals on works on how to improve sperm quality of male factor patients and alternatives to ICSI. A technique mostly commercially driven rather than science based. Rather we see a quantum of papers on comparison of IVF, ICSI and statistical datas only.
? Does the technician know what kind of sperm he immobilizes and injects?
? What will be the consequences of a little PVP gone inside the ooplasm, the fine the cyto architecture including microarrays, mytocondrial milieu, the electrical events, signaling pathways, mechanical disturbances to spindle structure by ICSI?
? A four fold increase in numerical sex chromosomal anomalies and de novo balanced translocations have been observed in children born by ICSI.
? Possible increase in neural tube defects, possible increase in childhood neuro ectodermal tumors (Moll et. al, Lancet 2003, 361) and syndromic disorders of genomic imprinting.

What are the possible alternatives to ICSI?
Oligo-astheno-spermic and obstructive azoospermic may benefit from a less invasive methodology.
How many ART labs around the globe go for a possible assessment of improvement in sperm quality of such patients before embarking directly to ICSI by merely seeing a simple semen analysis report.
It is true that all patients do not respond to same mode of therapy. Does it cost much if one want to do trials with invivo and in vitro sperm stimulants and or some time with antioxidants, coenzyme Q etc. The effect of Pentoxiphylline, de-oxy adenosine, platlet activating factor (PAF), tripeptides (p-Glu-Glu-Proamide) have been well documented. A herbal based 'Fast sperm' system have been developed by our laboratory too.
A trial hemi-zona assay is not that laborious or costly. Any IVF lab can cut unfertilized oocytes to halves under stereo-zoom microscope using insulin syringe fitted with needle.
Leave the art of sperm aspiration from azoospermic to an experienced clinical andrologist by microsurgical methods.
Only a few hundred sperm eventually reach the ampulla of Oviduct for fertilization ? hence if one can harvest few hundred robust and motile sperm, a micro-droplet insemination can be chosen, may be combined with removal of cumulus-corona by natural enzymes like coronase (France) rather than using Hyaluronidase.
Initially, ART clinics can go on a 50-50 basis with ICSI and micro insemination. If micro inseminated oocytes develop, culture up to blastocyst and transfer those only.
Microfluidic sperm sorter and IVF in micro-fluidic system are nearly in the final stages of development, which can greatly transform the way we handle human gametes. A genetic diagnosis, assessment of sperm micro-deletion, mutations and possible PGD before ET using DNA micro ray systems are essential in ICSI cases of severe male factor infertility. 'Genetic anticipation'- a micro deletion can not become smaller but expand, hence children born by ICSI using sperm having micro deletion of AZF region will eventually become sterile with total absence of competent sperm cells.
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623. Does off-gassing of so called 'pure' tissue culture wares used in IVF improve embryo quality?.

29 March 2003 by Alex C V
Does off-gassing of so called 'pure' tissue culture wares used in IVF improve embryo quality?
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624. Using HEPES buffered culture medium in human IVF

29 March 2004 by wen feng
May I know how to prepare co2 indepent medium by hepes?

Best Regards,

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625. Unusual patient

29 March 2004 by goolam hussim mohamed
I recently had a very unusual patient and would appreciate some help/ comments.
I had a 24year old female , who I diagnosed as having PCOS and I had started her on the long protocol with a view to ICSI for severe male factor infertility. Downregulation was commenced on leuprolide acetate 200 micrograms daily sc.
When she did not have a withdrawal bleed after 14 days i decided to do a ULTASOUND and was shocked to find about 20 follicles on each side ranging between 15 and 25 mm. I then did a ESTRDIOL etc and the E@ was 44000 pmol/l
the fsh was 0.3miu LH was 5 the bhcg was neg.
I cancelled the cycle and did some ovarian tumor markers .
My question are 1) Should i have emptied those follicles??2) would i have found anything
3) what possibly could be driving those follicles??
4) would a antagonist protocol be better next time?
5) should i use a step instead of a step down protocol???
Your help will be greatly appreciated
Dr GH Mohamed
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626. Globozoospermia, ICSI, and Egg Activation

29 March 2004 by Michael L. Reed
What are the current thoughts, experiences, and so forth, on perfoming ICSI with round-head sperm (globozoospermia), with or without ionophore-induced egg activation? I have a fairly extensive literature review, and I understand that there can be zero or reduced fertilization rate due to egg activation, centrosome dysfunction, and premature chromatin condensation - but what is known about the effects of calcium ionophore on further development - even though there have been births after expsoing oocytes to the ionopore? In addition, there are references to a pattern of heritability associated with this diagnosis, which brings up consents and genetic counseling - any suggestions beyond the obvious?

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627. Oocyte maturity

28 March 2004 by Joe Conaghan
I'm seeing quite a dramatic drop in the percentage of oocytes that are mature at retrieval when comparing the first 2 months of 2004 with 2003. I've talked to one other person, several thousand miles away, who is seeing the same thing. If anyone else is experiencing this problem or is interested in talking about it, please contact me.
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628. Post biopsy embryo development

28 March 2004 by Joe Conaghan
This question is for anyone out there that does a lot of embryo biopsies on day 3 with embryo transfer the next day. I'm trying to establish if our rates of embryo development in the 24h post biopsy are normal or abnormal, but I don't know what the expectation is. I've asked a couple of people that I consider should know the answer to this question and I'm told that if an embryo shows any development (even increasing blastomere number by just one), then the embryo is ok. This is a little vague for me however and I'd like to know if anyone has established criteria for what to expect when looking at embryos on day 4.
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629. Acrosomal integrity and also Chromation condensation

22 March 2004 by S.Selvaraju
How to grade acrosomal integrity and also Chromation condensation by different staining (Light/phase contrast microscopy) procedures.
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630. Oocyte Quality

22 March 2004 by DR.ASHRAF
Sometimes we find almost all the oocytes in certain women to have granular cytoplasm, central pitting, large & small vacoules or having ser.
Could it be related to any particular disease entity or to the hormonal therapy.
We could observe granularity in the perivittaline space to have some correlation to increased use of hmg, also the central vacoules relating to endometriosis.

Your comments please
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