Correlação entre a taxa de fertilização e o fuso meiótico em oócitos humanos: Uma meta-análise

Objective: To investigate the relationship between the presence of meiotic spindle in human oocytes and fertilization rates in ICSI cycles. Methods: Search strategies included online surveys of databases from 1990 to 2008. Nine trials fulfilled the inclusion criteria Results: According to the meta-analysis, the results showed statistically significant higher fertilization rate (p<0.0001) when the meiotic spindle was viewed than when it was not. There was heterogeneity in this comparison. Conclusion: The presence of a birefringent meiotic spindle in human oocytes can predict a higher fertilization rate. This observation has clinical relevance mainly in countries where there is a legal limit on the number of oocytes to be fertilized. Copyright - SBRA - Sociedade Brasileira de Reprodução Assistida.

Análise morfológica dos folículos primordiais de ovários de ovino criopreservados em EG, DMSO e sua associaçã o

Objective: Compare the cryoprotectants Dimethyl Sulphoxide (DMSO), Ethylene Glycol (EG) and their association for cryopreservation of sheep ovarian cortex. Methodology: Fragments collected from ovaries were divided into 3 parts. 1. One part from sample was destined for analysis of fresh material. 2. The second part was incubated with solution of freezing having 1,5M EG or 1,5M DMSO or 1,5MEG + 1,5M DMSO and washed for dilution of the cryoprotectants. 3. The third part was submitted to cryopreservation using the same cryoprotectans (EG 1,5M; DMSO 1,5M and EG + DMSO 1,5M) and cryopreserved. In all groups, one part of sample was submitted to pre-antral follicles isolation and the remainder was destined to ultra-structural analysis. Results: After isolation of fresh primordial follicles (control), the percentage of viable follicles was 78,9%. The percentage of viable follicles only exposed to cryoprotectants 1,5M EG, 1,5M DMSO and 1,5M EG + 1,5M DMSO was 77,1%, 68,4% and 60,7% respectively. After cryopreservation were 75%, 60% and 55,6% respectively. Ultra-structural analysis of the primordial follicles derived from fresh ovarian fragments or from fragments just exposed to the cryoprotectants showed similar morphology. However, in frozen samples, alterations of mitochondria were observed in all groups. Despite this, the integrity of the remained organelles was preserved in follicles cryopreserved with EG, while that in others groups (DMSO and association) an excess of vacuolizaton in cytoplasm of oocytes and swelling of nuclear membrane was observed indicating degeneration. Conclusion: The Ehilene Glycol seems to be the cryoprotector more adequated for cryopreservation of sheep ovarian tissue.

Técnicas de correlação no delineamento de feições rodoviárias em imagens de baixa e média resolução

This paper presents a method for the sequential road feature delineation from digital images. It is based on a feedback loop between extrapolation and refinement steps of a given road centerline point, using in both steps correlation techniques. Firstly, a previously extracted road centerline point is linearly extrapolated, resulting in an approximate position. Secondly, this approximate position is corrected by comparing gray level profiles extracted perpendicularly to the extrapolation direction. This strategy is then repeated to allow the entire road centerline to be extracted or a stop point to be found. In order to initialize the extraction process, the operator needs to supply a starting point plus direction and width. Experimental results obtained from the application of the method to real image data are presented and discussed in this paper.

Geração de dados GPS de pseudodistância para uma estação virtual: Métodos, implementação e análise dos resultados

This paper aims to evaluate the quality of the pseudorange observables generated for a Virtual Reference Station (VRS). In order to generate the VRS data three different approaches were implemented and tested. In the first one, raw data from the reference station network were used while in the second it was based on double difference reference station corrections. Finally, in the third approach atmospheric models (ionosphere and troposphere) were used to create the VRS data. Sao Paulo State Network stations were used in all experiments. The VRS data were generated in a reference station position of known coordinates (real file). In order to validate the approaches, the VRS data were compared with the real data file. The results were quite similar, reaching the decimeter or centimeter level, depending on the approach applied.

A síndrome do hiperestímulo ovariano não influencia os resultados clínicos após ciclos de descongelamento de embriões provenientes de ciclos de ICSI

Objective: The objective of this study was evaluate if the embryos cryopreservation from OHSS patients Intracytoplasmic Sperm Injection (ICSI) cycles could be influence the clinical outcomes when compared to patients who receive oocytes from donors but the endometrium was not prepared and the embryos were cryopreserved. Methods: Fifty eight couples submitted to ICSI cycles in which 26 with OHSS clinical manifestation (OHSS group) and 32 couples who have received oocytes from donors (control group). The embryos were frozen on day+2 or +3of development. All patients included in this study had embryos crypreserved before the transfer, and in the thawing cycle, only the endometrium preparation was performed. The embryo survival, implantation, pregnancy and miscarriage rates were evaluated in the embryo thawing cycle. Results: There was no difference among the groups in relation to fertilization rate (OHSS: 71.89% ± 15.45, Control: 79.75% ± 21.68, p= 0.234), survival embryos rate (OHSS: 68.85 ± 21.10, Control: 59.53 ± 36.79, p= 0.233), high quality embryos rate (OHSS: 25.20 ± 23.90, Control: 27.40 ± 30.30, p= 0.760), implantation rate (OHSS: 17.9 ± 26.9, Control: 12.5 ± 23.7, p= 0.435), pregnancy rate (OHSS: 38.50, Control: 28.60, p= 0.441) and miscarriage rate (OHSS: 40.00, Control: 25.00, p= 0.332). Conclusion: Our findings suggest that clinical outcomes in freeze and thawing cycles were not affected by the presence of ovarian hyperstimulation syndrome clinical manifestation after controlled ovarian stimulation.

Fatores preditivos do sucesso da inseminação intrauterina: A morfologia espermática de acordo com o novo manual de laboratório da Organização Mundial de Saúde

Objective: The aim of our study was to assess the likelihood of IUI success as a function of the previously described predictive factors, including sperm morphology according to the new reference values defined by WHO. Material and Methods: This retrospective study enrolled 300 couples which underwent IUI. Regression analyses were used to correlate maternal age, number of preovulatory follicles on the day of hCG administration, number of inseminated motile sperm, and normal sperm morphology with clinical pregnancy. Results are expressed as odds ratio (OR) with 95% of confidence intervals (CI). Results: Women older than 35 years showed a lower pregnancy rate (6.5% vs 18.2%, p=0.017). Logistic regression models confirmed the lower chance of pregnancy occurrence for older women (OR: 0.39; CI: 0.16-0.96; p=0.040). The presence of two or more preovulatory follicles on the day of hCG administration resulted in higher pregnancy rate when compared to cases in which only one preovulatory follicle was present (18.6% vs 8.2%, p=0.011). The regression model showed a more than two fold increase on probability of pregnancy when two or more preovulatory follicles were detected (OR: 2.58; CI: 1.22-5.46, p=0.013). The number of inseminated motile sperm positively influenced pregnancy occurrence (OR: 1.47; CI: 0.88-3.14, p=0.027). Similar pregnancy rates were observed when semen samples were classified as having normal or abnormal morphology (10.6% vs 10.2%, p=0.936). Conclusion: Our results demonstrate that sperm morphological normalcy, according to the new reference value, has no predictive value on IUI outcomes. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.

Seleção de espermatozoides para ICSI

The application of assisted reproduction techniques has provided help to many men seeking to father a child, although the current success of these procedures remains suboptimal. Today some protocols allow sperm to be selected according to their ultrastructural morphology or surface molecular characteristics. On the other hand, successful human reproduction relies partly on the inherent integrity of sperm DNA. Therefore, it is now necessary to improve the safety of the sperm selection method. It is urgent to optimize procedures to isolate spermatozoa for ICSI with low risk of DNA damage. In recent years, two technologies have attracted the attention of specialists as methods capable of identifying a spermatozoon with low risk of DNA damage: Ultrastructural morphology sperm selection at high magnification and sperm head birefringence selection. This review analyses these two technologies. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.

Compartimentação fisiográfica do município de peruíbe, litoral de São Paulo - uma abordagem metodológica como subsídio à avaliação geotécnica de terrenos

This paper presents a method applied to the seacoast town of Peruibe, São Paulo State, Brazil. The method encompasses the application of remote sensing interpretation techniques and field survey to obtain geotechnical data and thus generate cartographic products composed of easily grouped units that work as database objects and can de used to assist geotechnical zoning. The so-called Compartmentalization Basic Units (CBUs) show the smallest land surface analyzed from its physiographic elements and have in their cores the same geotechnical properties, making it easier to analyze the potentialities and the fragilities of the physical environment and its susceptibility to the action of natural and anthropic processes. In the study area, sixty-eight units were individualized in which geotechnical properties were inferred by photo interpretation criteria, using textural properties of the image adjusted with field observations. The method proved to be easily reproducible, and is especially useful in regions where the absence of basic maps makes it impossible to establish homogeneous zones through traditional overlay of different topic informations.

Classificação de áreas de favelas a partir de imagens IKONOS: Viabilidade de uso de uma abordagem orientada a objeto

The growth of large cities is usually accelerated and disorganized, which causes social, economical and infrastructural conflicts and frequently, occupation in illegal areas. For a better administration of these areas, the public manager needs information about their location. This information can be obtained through land utilization and land cover maps, where orbital images of remote sensing are used as one of the most traditional sources of data. In this context, the present work tested the applicability of the object-based classification to categorize two slum areas, taking into account the structure of the streets, size of the huts, distance between the houses, among other parameters. These area combinations of physical aspects were analyzed using the image IKONOS II and the software eCognition. Slum areas tend to be, to the contrary of the planned areas, disarranged, with narrow streets, small houses built with a variety of materials and without definition of blocks. The results of land cover classification for slum areas are encouraging because they are accurate and little ambiguous in the classification process. Thus, it would allow its utilization by urban managers.

Relevância do assited hatching com laser em um programa de ovo-doação utilizando banco de óvulos criopreservados: Um estudo prospectivo randomizado

Objective: This prospective randomized trial evaluated if there is an improvement in clinical outcomes when assisted hatching is performed in embryos derived from vitrified oocytes in an ovum donation program. Methods: Sixty oocyte recipients undergoing donation program using egg-cryobanking were randomly allocated to the assisted hatched (AH, n=30) or control group (n=30). Pregnancy and implantation rates were compared between the groups. Vitrification and warming procedure were carried out according to the Cryotopmethod. Immediately before embryo transfer, embryos undergoing laser-assisted hatching had the zona pellucida thinned using a 1.48 μm wavelength diode laser. Results: A total of 288 vitrified MII oocytes were warmed for the 60 recipients (4.8 oocytes per recipient). Out of 288 vitrified oocytes, 273 (94.8%) survived. All surviving oocytes were sperm injected and 228 displayed 2 pronucleus 16-18h after injection (83.5%). There were 172 good quality embryos transferred. Twenty four patients achieved clinical pregnancy (total pregnancy rate of 40%). The clinical pregnancy rate did not differ between AH and control groups (44.4% and 33.3%, respectively, p=0.1967), however AH resulted in a significant higher implantation rate (31.6% and 18.4%, p=0.0206). These findings were confirmed by the regression models either for pregnancy (OR = 1.14; IC 95% = 0.80-.72; p= 0.766), as for the implantation rate (RC:19.45, P=0.041). Conclusions: Our evidences demonstrated the effectiveness of the AH in embryos derived from warmed oocytes and suggest that oocyte cryopreservation is a valuable tool to provide successful outcomes in an egg donor program. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.

Locus no cromossomo 19 influencia positivamente o número de oócitos recuperados em ciclos estimulados

Objective: To evaluate if identified loci associated with normal age of menopause variation and early menopause can account for the poor response to controlled ovarian stimulation. Methods: A total of 71 patients, with age ≤ 35 years old, undergoing intracytoplasmic sperm injection were tested for three of the four newly identified genetic variants associated with normal variation in menopausal age and early menopause. Patients were divided into two groups: poor responder group (PR group, n=21) and normoresponder group (NR group, n=50). The influence of risk allele frequency on the response to controlled ovarian stimulation (COS) was evaluated. Logistic regression models were used. Results: There was no significant difference in the incidence of the genetic variants between NR and PR group. The risk allele for chromosome 19 variant (rs4806660) demonstrated a protective effect. The presence of a risk allele, either in homozygosis or in heterozygosis, was associated with an increased response to COS, resulting in an elevated number of follicles (Coef: 2.54, P= 0.041) and retrieved oocytes (Coef: 1.41, P= 0.041). Conclusions: Genetic variants rs244715, rs9379896 and rs4806660 are not risk factors for poor ovarian response. Instead, rs4806660 is associated with higher number of follicles and retrieved oocytes. It could be hypothesized that rs4806660 is associated with an increased response to gonadotrophin stimulus. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.

Valor preditivo do potencial de implantação embrionário pela análise do perfil químico de meios de cultivo por espectrometria de massas (ESI-Q-ToF)

Objective: This case-control study analyzed mass spectrometry fingerprinting patterns of culture media samples used for embryo culture to predict embryo implantation. Methods: The culture medium harvested after embryo transfer of 22 embryos from 13 patients was used for the experiments. After embryo transfer, the remaining culture media were collected and samples were split in positive (n=8) and negative (n=14) implantation groups according to implantation outcomes (100% or 0% of implantation). Samples were individually diluted and injected directly to the Electrospray ionization (ESI) MS coupled to a Quadrupole Time-of-flight MS (Q-ToF-MS).Ions relative intensities of each spectrum were considered. Data analysis was conducted in MatLab 7.0 version using Partial Least Squares - Discriminant Analysis toolbox. Results: There were 3027 observed ions at 100% and 0% implantation groups by ESI-Q-ToF-MS. The statistical model could categorize the samples in two clusters, based on their positive and negative implantation outcomes. Less intense ions present in the mass spectra with statistical significance have contributed to the major differences to group distinction. Conclusions: Positive and negative implantation embryos showed a specific biochemical pattern present in culture media, which could be detected as a fast, simple and non-invasive way. This biochemical profile could help the selection of the most viable embryo, improving single embryo transfer and thus eliminating the risk and undesirable outcomes of multiple pregnancies. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.

Vasectomia no sistema público de saúde: Características dos candidatos e variáveis associadas

Objective: This study aimed to characterize candidates undergo vasectomy in the public health system, Araçatuba- SP and to study related variables. Methods: We surveyed 300 medical patients and vasectomized contacted by telephone to assess several characteristics. The variables analyzed for the study were age, marital status, education, religion, monthly family income and per capita, number of living children, reason for seeking treatment method, contraceptive use, marital relationship quality, decision time (date of intent to perform the procedure) and not because of the procedure. Data were pooled for the analysis of results. Results: The age of the candidates ranged from 23 to 65 years (mean 36.86 years) and average 2.56 living sons. The average monthly family income was R$ 1.079,15, with average per capita income of R$ 249,07. The couple's contraception before the procedure was on account of the woman who used oral anti-conception (84%). The complication rate with the method was around 6.04%, the biggest complication was dehiscence (77.7% of cases of complications), these being mainly during the first 100 cases. Conclusion: Vasectomy is a very effective contraceptive method, with low complication rate and low cost, should be encouraged by the public health system as a means of family planning policy.

Adjuvant therapy with GnRH agonists/tamoxifen in breast cancer should be a good council for patients with hormone receptor-positive tumours and wish to preserve fertility

Infertility represents one of the main long-term consequences of combination chemotherapy used for the treatment of breast cancer. Approximately 60%-65% of breast cancers express the nuclear hormone receptor in premenopausal women. Adjuvant endocrine therapy is an integral component of care for patients with hormone receptor-positive (HR+) tumours. The GnRH agonist (GnRHa) alone or in combination with tamoxifen produces results at least similar to those obtained with the different chemotherapy protocols in patients with HR+ tumors with respect to recurrence-free survival and overall survival, Presentation of the hypothesis: It is time to indicate adjuvant therapy with GnRHa associated with tamoxifen for patients with breast cancer (HR+ tumours) if they want to preserve their reproductive function. Testing the hypothesis: Assessment of ovarian reserve tests: follicle stimulating hormone (FSH), anti-Mullerian hormone (AMH), inhibin B, antral follicle count (AFC) and ovarian volume 6 months, and 1 year after the end of therapy with GnRHa/tamoxifen. The recurrence-free survival and overall survival should be analysed. Implications of the hypothesis: The major implication will be to avoid adjuvant chemotherapy for patients with breast cancer (HR+ tumours) that request fertility preservation. It is expected that ovarian function should not be altered in almost all cases. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.

Caules permineralizados de Tietea e Psaronius na Bacia do Paraná (Formação Corumbataí, Permiano)

PERMINERALIZED STEMS OF TIETEA AND PSARONIUS OF THE PARANÁ BASIN, CORUMBATAÍFORMATION, PERMIAN. Silica permineralized stem fragments from six municipalities of São Paulo, Brazil, belonging to the Passa Dois Group, Corumbataí Formation (Guadalupian, Permian), were analysed. Morpho-anatomic characteristics of the stems and steles, observed on petrographic slides or polished sections, have permitted the classification of many specimens as Tietea cf. Tietea singularis. A stem piece from the region of Casa Branca, determined as Psaronius cf. Psaronius arrojadoi, corresponds to the first true record of this genus in the Paraná Basin. A generic/specific identification was not possible for radicular mantle samples having no preserved steles. Despite the strong influence of taphonomic factors on the record, all known Marattiales fossils from the Paraná Basin in Brazil present relatively small steles and meristeles, and that may be related to hydric stress. Taphonomic, paleoecological and biogeographical aspects of the analysed fossils are discussed as well.