No abstract

Introduction: Ever since the first successful in vitro conception was made, the selection of the most competent embryos for transfer was the primary focus of research in this domain. The main cause of implantation failure and pregnancy loss is the presence of aneuploidy. It has been proposed that the performance of the in vitro fertilization (IVF) can be improved by selection and transfer of the embryo without chromosomopathy. This method is known as Preimplantation Genetic Screening (PGS). Aim: The aim of our study was to determine the clinical significance of the array comparative genomic hibridization (array CGH) within the PGS and the possibility of routine application of PGS to determine the existence of aneuploidy within the embryos obtained in IVF procedure. Material and methods: We performed partly both retrospective and prospective study on 25 patients who underwent an IVF with PGS in the Clinic for Gynaecology and Obestetrics, Clinical Center of Vojvodina, from March 2015 to Februrary 2016. Embryo biopsy was done first, and then the samples were sent to the Institute for Health Protection of Children and Youth of Vojvodina, where array CGH method was performed. Results: From 109 analyzed samples, 63 were successfully amplified, while 46 were not. From those successfully amplified, 26.98% (17/63) were euploid and 73.02% (46/63) aneuploid. The percentage of aneuploidy was highest in patients in the age group 31-36 years (50%; 23/46). Patients with tubal infertility had the highest rate of aneuploidy (36.9%; 17/46). Conclusion: In our study, aneuploidies were present in a high proportion in patients with tubal sterility and in patients in the age group 31-36 years, which significantly reduces the chance of a successful IVF procedure. Routine screening of embryos for aneuploidies in an IVF procedure would significantly reduce emotional, financial and time losses.

1. Služba opšte medicine, Dom zdravlja, Jagodina 2. Služba opšte medicine, Dom zdravlja, Rekovac 3. Visoka medicinska škola strukovnih studija, Ćuprija 4. Služba za kućno i palijativno lečenje i negu, Dom zdravlja, Jagodina RECEIVED 29. 07.201407. . ACCEPTED 11.11.2014. SAŽETAKOsteoporoza je sistemska skeletna bolest koja se karakteriše niskom koštanom masom i pogoršanjem koštane mikoroarhitekture, što dovodi do povećane koštane fragilnosti i za posledicu ima povećani rizik od frakture. Procenjeno je da 22 miliona žena i 5,5 miliona muškaraca u Evropskoj uniji ima osteoporozu. Osteoporoza je asimptomatska bolest, simptomi su znak uznapredovalog oboljenja i posledica nastalih fraktura. Dijagnoza osteoporoze se postavlja na osnovu merenja mineralne koštane gustine (BMD) metodom dvostruke apsorpcije X zraka (DEXA), na lumbalnoj kičmi i na proksimalnom femuru. BMD se opisuje kao T skor i Z skor. T skor predstavlja odstupanje BMD pacijenta od srednje vrednosti BMD za odgovarajući pol i konstituciju, osobe 20-30 godina starosti,, izraženo u standardnim devijacijama (SD) . Osteoporoza postoji kada je BMD 2,5 SD ili više, ispod prosečne vrednosti za mlade zdrave žene (T skor < -2,5 SD). .Skrining vrši kod žena starijih od 65. godina i muškaraca starijih od 70. godina, zatim kod starijih od 50. godina sa frakturom na minimalnu traumu, kao i kod odabranih postmenopauzalnih žena i muškaraca sa faktorima rizika za nastanak preloma. Osteoporoza se može prevenirati i lečiti. Prevencija obuhvata sprečavanje padova, adekvatan dnevni unos kalcijuma i vitamin D. U tretmanu osteoporoze koriste se sledeće kategorije medikamenata: antiresorptivni lekovi koji usporavaju gubitak kosti-bisfosfonati, kalcitonin, denosumab, estrogen i selektivni modulatori estrogenskih receptora (SREM), anabolički lekovi koji povećavaju formiranje kosti-teriparatide kao i lekovi koji istovremeno imaju i antiresorptivni i anabolički efekat-stroncijum ranelat. . Neophodno je vršiti procenu terapije, merenjem BMD-a prvi put nakon 24 meseca Ključne reči: osteoporoza, mineralna koštana gustina, T skor, faktori rizika, prevencija, lečenje ABSTRACTOsteoporosis is a systemic skeletal disease characterized by low bone mass and deterioration of bone microarchitecture, which leads to bone fragility and resulting in an increased risk of fractures. It is estimated that 22 million women and 5.5 million men in the European Union have osteoporosis. Osteoporosis is asymptomatic disease, the symptoms are a sign of advanced disease and the consequences of fractures. The diagnosis of osteoporosis is based on the measurement of bone mineral density (BMD) using dual X-ray absorption (DEXA) at the lumbar spine and proximal femur. BMD is described as a T score and the Z score. T score represents the deviation of BMD from the mean BMD of the appropriate for gender and constitution, in persons 20-30 years of age, expressed in standard deviations (SD). Osteoporosis occurs when the BMD is -2.5 SD or more below the average value for young healthy women (T score <-2.5 SD). Skrining ...

No abstract

Introduction. Numerical aberrations (whole chromosomal aneuploidy) have been considered one of the most important factors leading to implantation failure and early miscarriages in patients undergoing assisted reproductive procedures. Embryo selection is mainly based on morphological assessment; however, embryos produced from aneuploid gametes cannot be distinguished from euploid based on morphological characteristics. Detection of aneuploidy in human embryos. Thanks to the introduction of molecular-genetic screening of embryos, it is possible to identify aneuploid embryos via preimplantation genetic screening/diagnosis and thus select the best embryos based on their ploidy. Array comparative genomic hybridization is a molecular technique which allows ploidy analysis of the entire genome amplification from a single cell, within 24 hours after polar body, blastomere or trophectoderm cell biopsy. Trophectoderm cell biopsy is considered the most reliable screening approach given the lower mosaicism appearance at the blastocyst stage. Conclusion. This paper points to the importance and necessity of molecular analysis in embryo selection. Further investigations and improvements are required, because this technology has only recently become available in clinical practice in the in vitro fertilization procedure.

Introduction. Progress in the field of cancer treatment has led to increased survival rate of cancer patients. Chemotherapy and surgical treatment may be the consequence of decreased fertility in both genders. Fertility Preservation. Some of the prominent techniques for fertility preservation, cryopreservation of gametes and embryos, are efficient and safe techniques in clinical practice, while cryopreservation of gonadal tissue and cells is considered experimental, and it is not used in everyday practice yet. Conclusion. Timely and complete information about the effects of cancer treatment on fertility, as well as information about the potential techniques for fertility preservation, should be available to all patients.

No abstract