No abstract

Discontinuation is a problem in fertility clinics. Many couples discontinue assisted reproductive technologies (ART) without achieving a live birth for reasons other than poor prognosis or the cost of treatment. Discontinuation has been attributed to the burden of treatment. The causes of burden can be broadly classified according to whether they originate in the patient, clinic or treatment. Interventions to alleviate these burdens include provision of comprehensive educational material, screening to identify highly distressed patients, provision of tailored coping tools and improvements in the clinic environment and medical interventions. Practical interventions to reduce the different causes of burden in ART exist, but further development and evaluation of the efficacy of these interventions requires more precise definition of terms and theory. In this paper, we propose a general integrated approach to cover different perspectives in dealing with burden in ART clinics. We firstly describe the integrated approach and present common sources of burden. We then describe interventions that could help reduce the burden in ART. Our paper is aimed at fertility clinic staff because of their day-to-day involvement with patients. However, this discussion should also be relevant to companies that develop treatments and to psychosocial experts. Reducing the burden of treatment should lead to improved outcomes, namely better quality of life during treatment and lower discontinuation rates.

No abstract

No abstract

matured MII or IVM-MII oocytes were collected and processed rapidly. RNA was extracted and amplified using a 2-round in vitro transcription procedure, then labeled and hybridized to Applied Biosystems Human Genome Survey Microarrays. This array interrogates 29,098 genes. Up-or down-regulated genes were classified according to the molecular function, biological process, or pathway in which they participate. Statistical analysis was employed to compare each class of genes between samples.RESULTS: The in vitro transcription protocol generated an average of 12 mg of RNA per sample. GV, in vivo matured-MII and IVM-MII oocytes expressed 14,188, 16,402 and 18,299 genes, respectively. There was extensive overlap in the genes expressed by each group, but also some significant differences. Samples showing the least similarity in expression profile were GV and in vivo MII oocytes. IVM-MIIs also displayed significant differences in expression when compared to in vivo MII oocytes, indicating that the process of in vitro maturation does not perfectly mimic that achieved in vivo. A disproportionate number of genes for storage proteins displayed down-regulation in IVM-MII oocytes (relative to in vivo MII). A reduction in expression was also seen for genes involved in processes of homeostasis. Significant up-regulation of gene expression for the ubiquitin proteasome pathway was observed in both IVM-MII and GV samples.CONCLUSIONS: This study provided a detailed insight into gene expression of human oocytes, assessing virtually every gene in the genome. GV oocytes were highly active for processes related to transcription, RNA processing and early stages of protein synthesis, whereas MII oocytes were active for pathways involved in processing of mature proteins. The results suggest that although IVM-MII oocytes closely resemble in vivo-MII oocytes for pathways related to nuclear maturity, a number of those associated with cytoplasmic functions continue to be expressed in a GV-like manner. Additionally, IVM-MII oocytes have significant differences in the expression of genes related to cellular storage and homeostasis. The pathways abnormally expressed during IVM highlight specific deficiencies in culture media and point the way to further optimization of IVM protocols.

This paper compares results of rigorous calculations of light scattering by a distribution of coated spheres with the measured light scattering of marine Chlorella. The elastic scattering properties of any organism are described completely by the 16-element scattering matrix that gives all the intensity and polarization information as a function of angle. Fitting the angular dependence of several matrix elements affords a much more stringent test of scattering calculations than does fitting only one, such as the phase function or linear polarization. The added requirements of this test significantly narrow the range of acceptable optical models and thereby permit better characterization of the scattering medium. Measurements of several elements of the scattering matrix of laboratory cultures of Chlorella were obtained with a scanning polarization-modulation nephelometer. The results for these elements were best fit by calculations based on a model of a Gaussian distribution of spheres with a relative complex refractive index of l.OS(t-0.005)-0.05i(~0.005) and a 60-nm coating of index1.13(+0.005)-0.04i(f0.005) to approximate the cell membrane. Good agreement was obtained for only a very narrow range of particle parameters. Experimental results were broken into spherical and nonspherical contributions to evaluate the effects of nonsphericity.Particles in the oceanic water column scatter and absorb light to alter its intensity, spectrum, and polarization state. The polarization of light in the ocean has long been known to affect the behavior of marine organisms (Waterman 1954). Measurement of the intensity and polarization of light scattered by particles in the water as a function of angle can be used to investigate the nature of the particles and to predict the propagation of light in the ocean. To better understand light scattering in the ocean, we AcknowledgmentsWe thank Richard Spinrad, Eric Hartwig, and Pat Wilde for discussions and support.

No abstract

No abstract