Irreparable obstructive azoospermic patients can be treated successfully with microsurgical epididymal sperm aspiration(MESA) o. testicular sperm extraction (TESE) by intracytoplasmic sperm injection(ICSI). Obstructive azoospermic patients generally have normal spermatogenesis. The aim of this study was to see if any spermatozoa could be retrieved from non-obstructive azoospermia and to assess the efficacy of ICSI with TESE in germinal failure. 42 non-obstructive azoospermic patients revealed no spermatozoa at all in their ejaculates, even after centrifuge. The histology of 42 patients revealed 15 Sertoli cell only Syndrome, 4 maturation arrest and 23 severe hypospermatogenesis. All patients underwent extensive multiple testicular biopsy for sperm retrieval. These patients were scheduled for ICSI using testicular spermatozoa. In 25 out of 42 non-obstructive azoospermic patients, spermatozoa were recovered from multiple testicular biopsy specimen and 11 ongoing pregnancies were achieved. There are usually some tiny foci of spermatogenesis which allow TESE with ICSI in non-obstructive azoospermia. Also these patients may have sufficient sperm in the testes for ICSI, despite extremely high FSH level and small testes.
Azoospermia* ; Biopsy ; Humans ; Male ; Oligospermia ; Pregnancy ; Sertoli Cell-Only Syndrome ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Spermatogenesis ; Spermatozoa ; Testis

PURPOSE: The cisplatin and etoposide had been reported to be an effective anti-tumor drug for small cell lung cancer, ovarian cancer, breast cancer and so on. The aim of this study was to evaluate the stability of cisplatin and etoposide in aqueous solution. MATERIALS AND METHODS: Cisplatin 200 microgram/ml was prepared in 0.9% sodium chloride and stored in either glass bottle or polyvinyl chloride (pvc) bag and protected from light or exposed to fluorescent light. Etoposide solution was prepared in 0.9% sodium chloride, and contained in glass bottle. Precipitating concentration was achieved using 200 microgram/ml, 400microgram/ml, 600 microgram/ml, and 1000 microgram/ml of etoposide solution. Samples were stored at room temperature and visually inspected and assayed for etoposide and cisplatin content by high-performance liquid chromatography after 15 minutes, 2, 4, 8, 12, 16 and 24 hours of storage. RESULT: 1) Cisplatin concentration decreased less than 10% from initial concentration for 24 hours of storage, both in glass bottle and pvc bag. Stability of cisplatin 200 microgram/ml in both container were not different. and Condition of light exposure did not have significant effect on stability of cisplatin 200 microgram/ml in glass bottle. 2) The etoposide 200 microgram/ml was not precipitated and stable for 24 hours, but we could find the precipitates of etoposide with the concentration of 400 microgram/ml or higher for 24 hours. CONCLUSION: Cisplatin 200 microgram/ml and etoposide 200 microgram/ml in 0.9% sodium chloride were stable at room temperature under room fluorescent light for 24 hours.
Breast Neoplasms ; Chromatography, Liquid ; Cisplatin* ; Etoposide* ; Glass ; Ovarian Neoplasms ; Polyvinyl Chloride ; Small Cell Lung Carcinoma ; Sodium Chloride

OBJECTIVE: To identify the factors affecting the complete fetal loss following multifetal pregnancy reduction (MFPR). DESiGN: Retrospective clinical study. METHODS: A total of 256 consecutive treatments of MFPR in iVF-ET cycles performed between 1992 through 2000 in Samsung Cheil hospital were analyzed. MFPR was done around 8 weeks of gestation by transvaginal ultrasono-guided aspiration in multiple pregnancies and reduced to singleton or twins. Stepwise logistic regression was performed to identify the factors affecting the final outcome of pregnancy after MFPR. Dependent variable was complete fetal loss and the independent variables were maternal age, paternal age, initial number of gestational sac (iGSNO), initial number of fetal heart beat, the number of remaining live fetus after MFPR, and chorionicity. RESULTS: The total survival rate was 87.9%, and total fetal loss rate after MFPR was 12.1%. Total fetal loss occurred within four weeks from MFPR procedure was 1.95%. Total loss occurred after four weeks of procedure and before 24 gestational weeks was 8.2%. Seventy nine percent (202/256) of pregnancies delivered after 34 weeks of gestation. The survival rate of pregnancies reduced to singleton was significantly higher than that of pregnancies reduced to twins (93.5% vs. 86.7%, p<0.05). The mean (+/-SEM) gestational age at delivery was 36.2+/-1.0 and 34.1+/-0.5 weeks for pregnancies reduced to singletons and twins, respectively (p=0.065). Logistic regression analysis revealed that the maternal age, the number of initial gestational sac (iGSNO), and the number of remaining live fetus after MFPR significantly affected the rate of total fetal loss (Z = 0.174'age + 0.596'iGSNO + 1.324'remaining fetuses-12.07), (p<0.05). CONCLUSiONS: MFPR seems to be a relatively safe and efficient method to improve the obstetric outcome in high order multiple pregnancy. Because the maternal age, the number of initial gestational sac and the remaining live fetuses after MFPR affect the total fetal loss rate, restriction of the number of transferred embryos according to the age and MFPR to singleton fetus could be considered for the better obstetric outcome in iVF pregnancy.
Chorion ; Embryonic Structures ; Female ; Fetal Heart ; Fetus ; Gestational Age ; Gestational Sac ; Humans ; Logistic Models ; Maternal Age ; Paternal Age ; Pregnancy ; Pregnancy Reduction, Multifetal* ; Pregnancy, Multiple ; Retrospective Studies ; Survival Rate