RESUMEN
BACKGROUND: In the present study, we report that D-aspartic acid (D-Asp) occurs in human ovarian follicular fluid and that a relationship may exist between the concentration of this amino acid and oocyte quality. METHODS: Samples of pre-ovulatory follicle fluid were obtained from 20 patients undergoing an IVF programme. The concentration of D-Asp was measured by using specific high-performance liquid chromatography (HPLC) combined with a d-aspartate oxidase. RESULTS: D-Asp occurs in human follicular fluid at a mean concentration of 14.98 +/- 4.51 nmol/ml. A significant difference in the content of this amino acid in the follicular fluid in relation to patient's age exists. In younger women aged 22-34 years (group A), D-Asp was found at a concentration of 19.11 +/- 1.91 nmol/ml, whereas in patients aged 35-40 years (group B), it decreased to 10.86 +/- 1.22 nmol/ml (P < 0.01). In addition, this amino acid was linked to oocyte quality; a relationship exists between D-Asp follicular concentration and the percentage of good quality metaphase II oocytes (P < 0.01), as well as the fertilization rate. CONCLUSIONS: In human follicular fluid, D-Asp is present at a relatively higher concentration in younger women than in older patients and there appears to be a relationship between the concentration of d-Asp and fertility outcome parameters. These findings suggest that follicular D-Asp concentration may be considered as an alternative or additional biochemical marker for oocyte quality in patients undergoing IVF programmes.
Asunto(s)
Ácido D-Aspártico/metabolismo , Fertilización In Vitro/métodos , Líquido Folicular/metabolismo , Fase Folicular/metabolismo , Oocitos/metabolismo , Adulto , Factores de Edad , Biomarcadores/metabolismo , Cromatografía Líquida de Alta Presión , Ácido D-Aspártico/aislamiento & purificación , Femenino , HumanosRESUMEN
Palmer s point must be considered a safe alternative site to insert the Verres needle and the primary trocar. It s possible, also, to perform adhesiolysis by this way before to insert the bigger trocar in umbilical site. Our experience shows that this technique can avoid intestinal, omental, injury if the trocar was inserted directly using the umbilical site: that in patients with previous surgery.