Purpose Blastocysts contain a large amount of fluid in the blastocoel, which may pose a risk for ice crystal formation during vitrification. This study aimed to evaluate the effectiveness of laser-induced artificial shrinkage of blastocoel before vitrification on clinical outcome. Methods Patients were divided into two groups: a control group with untreated, expanded blastocysts (n = 115) and a study group with blastocoel artificially eliminated by a laser pulse prior to vitrification (n = 309). Blastocyst survival, clinical pregnancy, and implantation rates were compared. Result(s) The survival rate was significantly higher in the study group compared with the control group (97.3 and 74.9 %, respectively; p > 0.01). The clinical pregnancy and implantation rates of the study group were significantly higher (p < 0.01) than that of the control group (clinical pregnancy, 67.2 vs. 41.1 %; implantation, 39.1 vs. 24.5 %. Conclusion(s) This study demonstrated that the removal of blastocoel fluid before vitrification by laser pulse of in vitroproduced human blastocysts significantly improves blastocyst survival, clinical pregnancy, and implantation rates.

Artificial oocyte activation (AOA) has been previously suggested as a means to overcome the problem of total fertilization failure, which affects about 1-3% of the intracytoplasmic sperm injection (ICSI) cycles. A preliminary study on the application of chemical AOA was conducted using A23187 Ca(2+) ionophore to improve embryonic development in four women with a history of complete fertilization arrest and inability to transit to cleavage stage during previous ICSI trials. Data indicated that activated oocytes resulted in better fertilization, embryonic development and clinical pregnancy in one of the four couples. Therefore, ICSI combined with AOA using Ca(2+) ionophore may be useful in selected patients with cleavage failure, and may help the zygotes to reach more advanced developmental stages.

Severe oligoasthenoteratozoospermia (OAT) refers to impaired count, motility and abnormal sperm morphology of infertile men associated with high chromosomal abnormalities. The objective of the present study was to define a management protocol for severe OAT cases and discover new routes to improve their basic semen parameters. We have applied a therapeutic treatment protocol in a cohort of 210 infertile men diagnosed with extreme severe idiopathic OAT. This therapeutic treatment based on modifying the lifestyle factors combined with antioxidant treatment for 6 months in severe OAT to study its effect on basic semen parameter. Basic semen parameters were assessed before and after applying the therapeutic treatment strategy. Sperm concentration, percentage of total motility and progressive motility were significantly increased after applying the therapeutic treatment (p = .006, p = .001 and p = .001 respectively). On the other hand, abnormal sperm morphology was significantly reduced after therapy (p < .01). In conclusion, the present results suggested that antioxidative supplement in combination with modifying the lifestyle factors in a cumulative treatment period significantly improves the basic semen parameters.

AIM:The aim of this work was to assess the frequency of spontaneous bacterial empyema in cirrhotic patients with ascites and determine the possible associated risk factors of spontaneous bacterial empyema in those patients. MATERIALS AND METHODS: 322 cirrhotic patients with ascites and pleural effusion were enrolled. Spontaneous bacterial empyema was diagnosed by positive pleural fluid culture or, if negative, a pleural fluid PMNL count >500 cells/mm3 without radiographic evidence of pneumonia or a contiguous infection process on chest radiography. RESULTS: The frequency of spontaneous bacterial empyema (SBEM) among cirrhotic patients with ascites and hepatic hydrothorax was 14.3% (46 out of 322 cirrhotic patients). E.Coli was the commonest organism (54.8%) responsible for SBEM in positive culture cases. CONCLUSION: SBEM was recognized in 14.3% of cirrhotic patients with ascites and hepatic hydrothorax. So, it is a frequent but underdiagnosed complication of hepatic hydrothorax and has a poor prognosis.

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