We conclude that 1,2-propanediol can be used with success in oocyte cryopreservation, although the issue of parthenogenecity is still to be resolved. Oocyte's with intact cumulus survive cryostorage better than those without it.

In this study, we report an alternative method of management of patients at a potential risk of ovarian hyperstimulation syndrome (OHSS) in an in-vitro fertilization (IVF) programme, by the use of gonadotrophin releasing hormone analogue (GnRHa). Thirty eight women considered at risk of this syndrome, having serum oestradiol greater than 4000 pg/ml following ovarian stimulation, received a GnRHa nasal spray for induction of the preovulatory endogenous luteinizing hormone surge for follicular maturation prior to oocyte recovery. Oocyte recovery (mean oocytes per cycle 18.60 +/- 4.79; range 15-35) and IVF were successfully completed in 27 cycles. Twenty six women had embryos replaced and 11 pregnancies occurred (28.9% per operation, 42.3% per replacement cycle). None of the patients developed OHSS. Where there is a risk of OHSS, the use of GnRHa to induce the preovulatory surge of endogenous luteinizing hormone for final follicular maturation provides a successful and more economical alternative to cancellation of cycles.

No abstract

Although caffeine has been reported to enhance spermatozoon motility as well as fertilizing ability, its use in clinical practice has remained sparse. We report here the results carried out to assess the effect of exposing normal human spermatozoa to different concentrations of caffeine on their motility, their ability to fertilize oocytes, and the subsequent development of resulting embryos. Mature human oocytes were inseminated with spermatozoa washed and capacitated in 1.25, 2.5, and 5 mM caffeine. The fertilization rates were compared with control oocytes inseminated with untreated spermatozoa. While caffeine was observed to improve significantly various motility parameters in a dose-dependent manner, it did not lead to an improvement in the fertilization rates. At the highest concentration, 5 mM, it adversely affected the fertilization rate: 38%, compared with 78% in controls. Embryonic development was also observed to be retarded at the lower concentrations, while it was virtually inhibited in the 5 mM concentration group. Our results suggest that while a definite improvement in motility may occur when spermatozoa are exposed to caffeine, this improvement did not translate into enhanced fertilizing ability and subsequent embryonic development. We are therefore of the opinion that the use of caffeine as a spermatozoon motility enhancer requires further studies prior to wider clinical use in assisted pregnancy programs.

The outcome of in vitro fertilization treatment in male-factor infertility is generally poor, due mainly to poor fertilization rate and hence fewer available embryos for replacement. This study was carried out to assess the value of asthenospermic sperm exposure to a motility enhancing agent, 2-deoxyadenosine (2-DXA), on our in vitro fertilization program in couples undergoing repeat treatment after previous failed fertilization. Following sperm wash and incubation in 2-DXA-supplemented medium, marked significant improvements were observed in the sperm motility pattern and the number of recoverable sperms as compared to control unexposed samples. There was also a significantly better fertilization rate and higher number of replaceable embryos available following sperm wash in 2-DXA as compared to those washed without it. Following embryo transfer, pregnancy rate was comparable to the generally reported pregnancy rates for routine in vitro fertilization and embryo transfer treatment. Three normal babies were born. Our results indicate that 2-DXA enhances fertilization rate in some asthenospermic patients and that it has no adverse effect on embryonic development.