The approach of immediately retransferring retained embryos does not solve the problem of reduced pregnancy rates in FFA cases. It is suggested that ET should be repeated 1 day later in FFA cases in an attempt to improve pregnancy rates.

and Key wordsEjaculated, density purified, human spermatozoa were exposed to 900 MHz GSM mobile phone radiation at two specific absorption rate levels (SAR 2.0 and 5.7 W/kg) and examined at various time points post exposure. Change in sperm mitochondrial membrane potential was analyzed using flow cytometry. Sperm motility was determined by computer assisted sperm analysis (CASA). There was no effect of 900MHz GSM radiation on mitochondrial membrane potential. This was also the case for all kinematic parameters assessed at SAR of 2.0 W/kg. However, two kinematic parameters (VSL and BCF) were statistically significantly altered after the exposure at SAR 5.7 W/kg. Effects seen cannot be ascribed to heating, as the temperature did not increase by more than 0.3ºC. A thorough investigation at lower SAR levels is required to determine the extent of the influence of RF-EMF on human sperm motility.

A prospective randomized study was conducted to assess the prognostic value of sperm morphology in an in-vitro fertilization (IVF) programme, using strict criteria. The first group (T, teratozoospermic) included 32 couples with an isolated teratozoospermia in the male partner (morphology < 9% normal). The second group (C, control) contained 36 couples with normal semen parameters, including morphology (> 9% normal, strict criteria). In both groups, 50 IVF cycles were performed. Patients were matched for indication for IVF. There was no difference between the two groups regarding age, duration of infertility, stimulation protocol, catheter used for embryo transfer and different sperm parameters. A statistically significant difference between the T and C groups respectively was observed regarding the fertilization rate (69.2 and 79.4%, P < 0.05), pregnancy rate per cycle (12.0 and 42%, P < 0.001), the pregnancy rate per transfer (13.9 and 42.0%, P < 0.01) and per embryo transferred (6.1 and 14.8%, P < 0.05). No pregnancy occurred in the poor prognosis group (morphology < 5% normal). In cases of moderate teratozoospermia, the fertilization rate appeared normal (78.6%) but the conception rate remained low. We concluded that the use of strict criteria in the assessment of sperm morphology is useful in predicting fertilization and pregnancy rate in the human in-vitro model.

Semen samples from 183 consecutive unselected men participating in an in vitro fertilization program were retrospectively studied to determine the bacterial and fungal contamination rate before and after antibiotic treatment. To ascertain the influence of semen preparation (wash and swim-up method) on the incidence of microorganisms, semen from 102 male patients was studied before and after swimup. Antimicrobial treatment by prescription of antibiotics decreased the incidence of pathogens by 16.3% (P less than 0.0001). Semen processing was more effective by ridding 57.4% of semen samples of microbial contaminants (P less than 0.0001). When infection of culture media was observed during routine microscopy, all infected oocytes were degenerated, without evidence of fertilization or pronuclei.

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This study examined the seasonal variation in three semen parameters (total sperm count, % grade a progressive motility and sperm morphology according to strict criteria) with an identical abstinence period of 24 h. A total of 340 spermiograms of 107 different men enrolled in an intrauterine insemination (IUI) program were examined. To reduce variation due to interindividual disparities in semen quality, differences of each test result from the mean value obtained for that individual were analyzed. Mean values resulted from at least 3 observations during different IUI cycles. Using ANOVA and spectral analysis, no differences in semen parameter results in function of the month of the year were observed. The lack of any significant periodicity may be explained by the large biological variation for individual semen parameters and/or the lack of significant differences regarding light exposure and temperature between summer and winter months in moderate climates.

The cumulative embryo score system involves three aspects of relevance in pregnancy achievement during in-vitro fertilization (IVF) and embryo transfer: cleavage rates, morphological qualities and the number of embryos transferred. The scores of 602 IVF/embryo transfer trials were calculated and analysed to determine the system's relationship to pregnancy rate, pregnancy outcome and the incidence of twin and triplet pregnancies. The system was also applied to cycles where endotoxins were either present in or absent from culture medium, in order to evaluate its validity in quality control analyses. Pregnancy rates were found to increase from 4%, with scores between 1 and 10, to 35% in the 41-50 group. The score of 20 was the criterion for separating patients into poor and good pregnancy prognosis groups (P = 0.00001). Biochemical abortions occurred more frequently with scores < 20 (P = 0.00978), but a similar relationship was not found in clinical abortion rates (P = 0.62206). Birth rates below and above a score of 20 (2.8 and 19.2%, respectively) differed significantly (P = 0.0005). The scores of twins overlapped extensively with those of singleton births, but those of all triplets were > 40. The system did not reflect a correlation between embryo quality and the presence of endotoxins in culture medium.

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