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Objective:To investigate the biochemical markers such as nitric oxide (NO), malondialdehyde (MDA) and reduced glutathione (GSH), indicators of the oxidative status of the follicle, to predict the outcome of in vitro fertilization. Material and Methods: Follicular aspirates of dominant follicleswere collected during oocyte retrieval. Biochemical analyses of NO, MDA and GSH were performed on all aspirates. Results:When the successful and unsuccessful pregnancy groups were compared in terms of NO, MDA and GSH, follicular fluid MDA was significantly higher (p=0.001) and follicular fluid NO level was significantly lower (p=0.039) in the pregnant group. Correlation analysis between oxidative stress and IVF parameters showed that MDA had a positive weak correlation with the number of grade 1 embryos (r=0.271, p=0.033) and fertilization rate (r=0.263, p=0.039). ROC curve analysis found that malondialdehyde has an area under the curve of 0.74 and can predict pregnancy with high sensitivity. Conclusion:As malondialdehyde was significantly different in pregnant and non-pregnant women and had a good sensitivity profile in predicting pregnancy, it may be considered a marker for predicting IVF success. (J Turkish-German Gynecol Assoc 2013; 14: 136-41) Key words: Follicular fluid, malondialdehyde, nitric oxide, glutathione, in vitro fertilization, pregnancy Received: 22 April, 2013 Accepted: 21 May, 2013 Amaç: Folikül oksidatif durumunun belirteci olan nitrik oksit (NO), malondialdehit (MDA) ve redükte glutatyon (GSH) gibi kimyasal belirteçlerin in vitro fertilizasyon başarısına etkisinin araştırılması. Gereç ve Original Investigation 136 IntroductionInfertility is defined as the inability to conceive for at least one year despite having regular sexual intercourse without using any contraception method. There are different causes of infertility. Nearly 40-50% of infertility problems are estimated to be of female origin and approximately 30% of cases are of male origin. A further 20-25% of couples suffer from unexplained factors (1). The pathophysiology of unexplained infertility is still a scientific question (2). In order to find some answers for unexplained cases, several investigators are trying to develop new, non-invasive biochemical markers that may affect gamete and embryo quality. Oxidative stress is being investigated as a causative marker in this manner. Studies on the pathophysiology of unexplained infertility have indicated that oxidative stress may be involved as an underlying factor (3, 4). The maintenance of homeostasis in cells requires a complex interaction between prooxidants and antioxidants. Oxidative stress occurs as a result of a shift in this balance between prooxidants and antioxidants towards excess free radical formation (5 Abstract Özet is malondialdehyde (MDA). Since it is a stable end product, it can be used as a cumulative measure of lipid peroxidation (6). Nitric oxide (NO) is an inorganic, short-lived free radical gas that is synthesized from L-arginine via NO synthases. It has various ...

The outcomes of the embryos based on the dynamic score do not comply with the results of the preconstructed model. Each IVF laboratory is unique based on its practice. Therefore, we suggest that each IVF laboratory should determine its own embryo selection criteria based on its own data instead of using a preconstructed model.

Recurrent implantation failure leads to a reduced pregnancy rate. The expression patterns of trophinin and dipeptidyl peptidase IV (CD26) indicate the involvement of embryo implantation and early placental development. The purpose of the present study was to evaluate endometrial co‑culture cells in the presence of embryo with trophinin and CD26 immunofluorescence staining. Patients with recurrent implantation failure were enrolled in the present study. The patients were aged between 26 and 36 years. Co‑cultures were prepared from endometrial biopsies for each patient. Controlled ovarian hyperstimulation was performed on each of the patients. Certain embryos were maintained in a conventional culture environment (n=80), and others in an endometrial co‑culture environment (n=25). Following embryo transfer, the co‑culture cells were examined under an inverted wide‑field fluorescence microscope. The ratio of a successful pregnancy was 0.38 in the present study (n=5/13 pregnancies). The average age of the successful group (28±3.54 years) was younger compared with the unsuccessful (32.67±2.81) group (P≤0.05). The number of trophinin (+) endometrial cells in the presence of an embryo was significantly lower (P=0.046) in the successful group on the first day. No significant difference between the groups was observed in terms of the number of CD26 (+) cells on the first to the fourth days (P≤0.05). Trophinin and CD26 immunostaining is important in the early period of pregnancy, and it will be beneficial in terms of providing the deficit of conventional culture medium in performed studies with the endometrial co‑culture medium. The co‑culture may be important, particularly in the early period, in patients with recurrent implantation failure in terms of enabling a connection between the cells belonging to the endometrium and the embryo.

In vitro maturation (IVM) is a promising technique that is used for the maturation of immature oocytes in laboratory conditions and preferred for use in patients with a diagnosis of polycystic ovary syndrome (PCOS) as an alternative to conventional in vitro fertilization (IVF) treatment. In this report, we present a case who surprisingly showed insufficient response to gonadotrophin stimulation during IVF treatment and whose cycle was retrieved from cancellation by using the in vitro maturation technique. As a result, we conclude that IVM may be a good option not only for PCOS patients, but also for poor responders. (J Turkish-German Gynecol Assoc 2013; 14: 235-7)