Despite recent advancements in reproductive medicine, recurrent implantation failure and habitual abortion remain ongoing issues. One of the most important aspects of successful implantation is the intricate immune response and regulation necessary for the acceptance of the hemiallogenic embryo. The most numerous immune cells in the decidua are uterine natural killer cells (uNK). Studies suggest that changes in the uNK count and physiology may be responsible for the aforementioned pathological conditions. Thus, testing for uNK may provide valuable insights into their pathogenesis. The study compared Pipelle endometrial sampling with conventional curettage to find out whether the less invasive Pipelle method is a viable alternative of tissue collection. Tissue samples from 14 patients obtained by both methods were examined. The average size of tissue samples obtained with Pipelle was 17 mm2, samples obtained with curettage had on average 34 mm2. Using immunohistochemical visualization of CD56 (NK cells) and granzyme B antigens (serine protease-expressing activation state of NK cells), it was found that the average total count of CD56 / mm2 was for Pipelle 115 and 120 for curettage, respectively. The study also proved a correlation between granzyme B positivity and identification of NK cells clusters. The results indicated that Pipelle endometrial sampling seems a suitable method of tissue harvesting for the purpose of uNK cells examination. Pipelle endometrial sampling is safe, cost-effective and can be performed on an outpatient basis without the need of anesthesia or analgesia. Several issues remain yet to be solved: how to standardize the subsequent uNK testing, how to interpret the results and finally yet importantly, how to use this knowledge in personalized treatment protocols.
- MeSH
- buňky NK MeSH
- endometrium * patologie MeSH
- granzymy MeSH
- habituální potrat * diagnóza patologie MeSH
- lidé MeSH
- těhotenství MeSH
- uterus patologie MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Štúdia popisuje retrospektínu analýzu patológie spermiogramu z pohľadu asistovanej reprodukcie, teda andrologického faktora. Analyzujeme vekové rozpätie pacientov podstupujúcich cyklus in vitro fertilizácie na našom pracovisku za posledných 10 rokov, vplyv veku na patológiu spermiogramu a vplyv veku mužov na úspešnosť cyklov asistovanej reprodukcie. Centrá asistovanej reprodukcie sa neustále snažia zvyšovať úspešnosť cyklov in vitro fertilizácie. V súčasnosti sa pozornosť obracia na podrobnejšiu analýzu vplyvu mužského faktora na úspešnosť asistovanej reprodukcie. Dizajn: retrospektívna analýza andrologického faktora z hľadiska vplyvu veku na parametre spermiogramu a úspešnosť asistovanej reprodukcie. Metódy: porovnali sme vek partnerov pacientok podstupujúcich asistovanú reprodukciu z roku 2007 a 2017. Hodnotili sme jednotlivé parametre spermiogramu našich pacientov vzhľadom na vek. Analyzovali sme celkovú koncentráciu spermií, motilitu a morfológiu spermií. Taktiež sme hodnotili vplyv veku na DNA fragmentáciu spermií. Keďže sme potrebovali minimalizovať vplyv ženského vekového faktoru v ďalšej analýze sme obmedzili výber respondentov len na program darovaných oocytov a hodnotili sme vplyv veku mužov na úspešnosť metódy IVF‑ICSI u párov podstupujúcich asistovanú reprodukciu. Výsledky: Vek sa zdá byť určujúcim faktorom na kvalitu spermiogramu pri hodnotení "normospermikov" klasickými parametrami spermiogramu. Pokles normospermikov vzhľadom na vek je signifikantný. A naopak s vekom rastie kombinácia patológii v spermiograme. Pri hodnotení jednotlivých parametrov ako je celková koncentrácia spermií, motilita a morfológia spermií signifikantný rozdiel nepozorujeme. V hodnotení úspešnosti metódy IVF‑ICSI sú závery kontroverzné, obzvlášť pri vyššie uvedenej selekcii pacientov. Rozdiel v úspešnosti donorského programu, však môžeme pripísať reparačnej schopnosti "mladého" oocytu darkyne.
The study describes a retrospective analysis of spermiogram pathology from assisted reproduction perspective. We analyze the age range of patients undergoing the in vitro fertilization cycle at our workplace over the last 10 years, the effect of age on spermiogram pathology, and the influence of age on the success rate of assisted reproduction cycles. Centres of assisted reproduction are continually trying to increase the success of in vitro fertilization cycles. Attention is now focusing on a more detailed analysis of the influence of male factor on the success of assisted reproduction treatment. Design: The retrospective analysis of the andrological factor in accordance with the age effects on spermiogram parameters and the success rate of assisted reproduction cycles. Methods: We compared the age of patients undergoing assisted reproduction cycles from the years 2007 and 2017. We evaluated the individual sperm parameters of our patients in accordance with their age. The total sperm concentration, motility and sperm morphology as well as the influence of age on sperm DNA fragmentation were analyzed. Because we needed to minimize the influence of female factor, we made a restriction in the consecutive analysis and selected only respondents from the oocyte donation program. We evaluated the influence of age of males on the success of IVF-ICSI method in couples undergoing assisted reproduction. Results: Age seems to be a determining factor of the quality of spermiogram in the group of normospermics evaluated by classical spermiogram parameters. The decrease of normospermics in accordance with the age is significant. On the contrary, combinations of the pathologies in spermiogram increase with age. When assessing individual parameters such as total sperm concentration, motility and sperm morphology, there is no significant difference. The conclusions in the analysis of the success of IVF‑ICSI method are controversial, especially with the selection of respondents. However, the difference in the success of the donor program can be attributed to the reparative ability of the "young" donor oocyte.
- Klíčová slova
- andrologický faktor,
- MeSH
- analýza spermatu * MeSH
- asistovaná reprodukce * MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužská infertilita MeSH
- poškození DNA MeSH
- retrospektivní studie MeSH
- spermie patologie MeSH
- úspěšnost MeSH
- věkové faktory MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
Prehľadový článok je zameraný na ultrazvukové hodnotenie placenty a pupočníka počas jednotlivých období gravidity. Autori sa venujú ultrazvukovému obrazu pri najčastejších abnormalitách placenty a pupočníka a ich klinickému významu. Zdôrazňuje sa nevyhnutnosť podrobného ultrazvukového vyšetrenia placenty počas celej gravidity.
The review article is focused on ultrasound evaluation of placenta and umbilical cord during particular periods of pregnancy. The authors pay attention to the ultrasound image in the most common abnormalities of placenta and umbilical cord and their clinical importance. The inevitability of detailed ultrasound examination of the placenta during the whole time of pregnancy is emphasised.
