RESUMO
BACKGROUND: Intracytoplasmic sperm injection (ICSI) is highly effective for the control of male factor infertility. The sperm selected for ICSI may have structural abnormalities undetectable to 400x as nuclear vacuoles, decreasing rates of pregnancy and implantation. Recent studies show that with intracytoplasmic morphologically selected sperm injection (IMSI), at higher magnification (> 6,600x), increases pregnancy and implantation rates in patients with repeated failure to ICSI. OBJECTIVE: To compare the results of the injection of selected motile sperm organelle morphology examination (MSOME) for IMSI, instead of the use of ICSI in patients with repeated failure to ICSI. PATIENTS AND METHOD: Prospective, observational cohort study. Since February 1, 2010 was administered IMSI to couples with at least two failed cycles of ICSI, and analyzed the first 30 cycles in patients under 38 years of good ovarian reserve. This study group was compared with the last 30 cycles of ICSI performed before that date, in patients with similar clinical characteristics. The IMSI was performed with a magnification of 7,676 increases for evaluation and sperm selection. RESULTS: The groups had similar clinical characteristics. The pregnancy rate with IMSI was better than with ICSI (63 vs. 50%), the difference was not significant for the size of the sample, although the trend is clear and clinically significant in favor to IMSI. The implantation rate with IMSI (44.8%) showed statistically significant differences vs. ICSI (29.7%). No significant differences in abortion rates. CONCLUSIONS: IMSI significantly improves the implantation rate in patients with repeated failure to ICSI.
Assuntos
Injeções de Esperma Intracitoplásmicas/métodos , Espermatozoides/ultraestrutura , Adulto , Distinções e Prêmios , Separação Celular , Estudos de Coortes , Implantação do Embrião , Feminino , Ginecologia , Humanos , Masculino , México , Obstetrícia , Gravidez , Taxa de Gravidez , Estudos Prospectivos , Espermatozoides/anormalidades , Falha de TratamentoRESUMO
In our study, we analyzed chromosomal abnormalities, Y chromosome deletions, androgen receptor CAG repeat length and their association with defective spermatogenesis in infertile Mexican men. Eighty-two infertile patients and 40 controls were screened for karyotypic abnormalities, Y chromosome microdeletions, and CAG repeats. Nine infertile males (11%) carried chromosomal abnormalities and 10 (12.2%) presented Y chromosome microdeletions. The mean CAG repeat length was 21.6 and 20.88 base pairs in idiopathic infertile males and controls, respectively. Our results suggest that chromosomal aberrations and Y-chromosomal microdeletions are related to male infertility in Mexican men. In addition, expansion of the CAG repeat segments of the androgen receptor is not correlated with male idiopathic infertility.
Assuntos
Aberrações Cromossômicas , Cromossomos Humanos Y/genética , Infertilidade Masculina/genética , Receptores Androgênicos/genética , Expansão das Repetições de Trinucleotídeos/genética , Adulto , Análise Citogenética , Testes Genéticos , Humanos , Masculino , MéxicoRESUMO
UNLABELLED: Identifying the genetic causes of male infertility is very important, considering they account for 30-50% of reproductive problems among couples. Genetic abnormalities, among which Y chromosome microdeletions are found, are commonly detected in patients with non-obstructive azoospermia (0-4.3%). Most of these patients are eligible for intracytoplasmic sperm injection (ICSI) and this genetic defect can be inherited by male children. OBJECTIVE: Determining the prevalence of microdeletions in the Y chromosome in a group of Mexican patients presenting azoospermia and oligospermia, under treatment in the Infertility Clinics. MATERIALS AND METHODS: This study included 52 infertile men (cases): 36 with non-obstructive azoospermia, and 16 with oligospermia; and 50 men (controls) whose fertility had been validated. The genomic DNA of each individual was obtained from his EDTA and heparin treated blood, and the corresponding karyotype determined. The karyotype was analyzed using G banding techniques. Eighteen markers (STS) corresponding to the chromosome Y long arm (AZFa, b, c, and d zones) were amplified in each DNA sample in all cases--azoospermic, oligospermic and controls--using the PCR method. RESULTS: No chromosomal alterations were detected in the patients, and no Y chromosome microdeletions were detected in control cases. Five azoospermic patients (13.9%) presented microdeletions corresponding to the AZFb, c, and d zones, while no microdeletions were found in oligospermic patients. The frequency of microdeletions found in this study is very similar to that reported for other populations. CONCLUSIONS: This research not only reports the frequency of microdeletions in the Y chromosome in our population, but also contributes to the integration of a DNA bank for patients with idiopathic male infertility, which will be of great use in the search for the causes of this affection.
Assuntos
Deleção Cromossômica , Cromossomos Humanos Y/genética , Infertilidade Masculina/genética , Adulto , Estudos de Casos e Controles , DNA/análise , Humanos , Masculino , Reação em Cadeia da PolimeraseRESUMO
Introducción: la ingesta adecuada de folatos puede reducir el riesgo para cáncer de colon. La enzima metilentetrahidrofolato reductasa (MTHFR) juega un papel importante en el metabolismo del folato. El papel de la mutación 677T del gen MTHFR en el riesgo del cáncer de colon es controversial. Recientemente se reportó que la población mexicana presenta una de las frecuencias alélicas más altas del mundo para esta mutación, por lo que resulta interesante analizar si ésta influye en el riesgo de cáncer colorrectal en nuestra población. Objetivo: determinar la frecuencia de la mutación 677T del gen MTHFR en un grupo de pacientes con cáncer de colorrectal y adenomas vs. un grupo control en una muestra de la población en el noreste de México. Método: se procesaron 74 muestras de cáncer colorrectal, 32 adenomas y 110 muestras de controles apareados por edad y sexo. Se realizó extracción de DNA y análisis de la mutación 677T mediante PCR-RFLPs. Resultados: al comparar sujetos portadores de la mutación (homocigotos T/T y heterocigotos C/T) vs. portadores de alelos normales (C/C) se obtiene un riesgo relativo de 1.81 (IC 95 por ciento 0.97 a 3.3), con ? 2 = 3.5 y p = 0.06. Conclusiones: los individuos portadores de la mutación presentan una tendencia hacia un riesgo aumentado para cáncer de colon, lo que sería congruente con el concepto que la deficiencia de folatos contribuye con la patogenia del cáncer colorrectal. La carencia de significancia estadística en este reporte se puede explicar por el tamaño de muestra.