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Stuckey B.G.A.,Keogh Institute for Medical Research | Stuckey B.G.A.,University of Western Australia | Yeap D.,Fertility Specialists of Western Australia | Turner S.R.,Hollywood Fertility Center
Fertility and Sterility | Year: 2010

Objective: Our objective is to report observed changes in thyroid-stimulating hormone (TSH) in two patients undergoing super-ovulation for IVF. Design: Case report. Setting: Private assisted reproduction practices. Patient(s): Two hypothyroid women taking thyroxine replacement therapy undergoing super-ovulation for IVF. Intervention(s): Laboratory records for TSH taken during ovulation induction cycles were retrieved retrospectively for six cycles and measured prospectively for one cycle each in both women. Main Outcome Measure(s): To document changes in thyroid status during super-ovulation. Result(s): Despite being euthyroid at the start of the super-ovulation cycle, both patients demonstrated a rise in TSH to hypothyroid levels during ovulation induction, even in the absence of ongoing pregnancy. Conclusion(s): High circulating E2 during super-ovulation for IVF induces increased thyroxine-binding globulin binding of thyroxine. In women taking thyroxine replacement therapy, hypothyroidism develops during a superovulation cycle. Whether such acute biochemical hypothyroidism is a hindrance to ovum quality, fertilization, conception, or ongoing pregnancy and whether thyroxine dose adjustment during a super-ovulation cycle would improve IVF outcomes requires further study. These case studies identify a potential management gap in assisted reproduction for women taking thyroxine therapy. © 2010 by American Society for Reproductive Medicine.

Zuvela E.,Fertility Specialists WA | Junk S.,Fertility Specialists WA | Moska N.,Hollywood Fertility Center | Matson P.,Fertility North | Matson P.,Edith Cowan University
Reproductive Biology | Year: 2011

The usefulness of latex beads of defined concentration was assessed as a substitute for sperm in the performance of External Quality Assurance (EQA) and Internal Quality Control (IQC) of semen analysis. Within the EQA programme, mean±SEM bias (%) was significantly reduced in 2007 compared to 2002 for both specialist (6.0%±5.4% vs. 55.0%±5.9%) and non-specialist (18.4%±5.9% vs. 90.9%±13.4%) laboratories (both p<0.0001), indicating improved accuracy over time. Within the IQC programme, the beads were used in the appraisal of two scientists, one experienced and one inexperienced, against a known standard. Beads were also used to calibrate eleven counting chambers, resulting in one old chamber being discarded due to its poor performance. The present study has shown that the use of a defined concentration of beads is an excellent adjunct to IQC and EQA programmes enabling the performance of both people and equipment to be assessed in an objective manner.

Rebollar-Lazaro I.,Hollywood Fertility Center | Matson P.,Hollywood Fertility Center | Matson P.,Murdoch University
Reproductive Biology | Year: 2010

The effect of cleavage-stage group culture (CGC; embryos cultured in groups of three or more for the first 3 days and then individually to blastocyst) was compared to extended single embryo culture (ESC; embryos cultured individually to the blastocyst stage). While implantation and ongoing pregnancy rates were similar between groups, the blastocyst utilization rate (number of blastocysts suitable for freezing and thawing/total number of embryos cultured to Day 5 and 6) was significantly higher when embryos were cultured in CGC for women <35 yrs thereby increasing the number of embryos available for clinical use for the younger women. This strategy of group culture to Day 3 would seem an ideal protocol to capitalize on an overall embryo quality in two particular settings, namely programmes wishing to (i) undertake Day 3 transfers, and (ii) keep embryos separate from Day 3 to Day5/6 for the purposes of selection. The culture system can also be applied to the embryos of older women without adverse effect, enabling the same system to be used for all embryos. © 2010 by the Society for Biology of Reproduction.

Moska N.,Hollywood Fertility Center | Murray E.,Hollywood Fertility Center | Wakefield P.,Hollywood Fertility Center | Matson P.,Murdoch University
Reproductive Biology | Year: 2011

The dark staining of human sperm heads by Diff Quik is significantly correlated with abnormal sperm head morphology (r=0.51, p<0.0001), but is not associated with changes in sperm chromatin detected by a sperm chromatin structure assay (SCSA; r=0.18, p>0.09). Whilst valuable in the assessment of head morphology, it is concluded that Diff Quik staining is not a useful substitute for the SCSA to assess human sperm chromatin. © 2011 by the Society for Biology of Reproduction.

Grubb J.,Hollywood Fertility Center | Grubb J.,Murdoch University | Muramoto O.,Oregon Health And Science University | Matson P.,Hollywood Fertility Center | Matson P.,Murdoch University
Human Fertility | Year: 2011

Four Jehovah's Witness couples were treated between 2000 and 2009 using in vitro fertilization or intracytoplasmic sperm injection. A review of the issues encountered during their treatment, and the options chosen, was made in an attempt to provide effective treatment without compromising the moral views of the individuals concerned. Considerations specific to the Jehovah's Witness faith were identified that required departure from the standard operating procedures used in the clinic, and the development of modified protocols prior to treatment is recommended to minimize the stress and anxiety of patients and staff alike. Issues raised included the collection of semen by masturbation, the use of donor gametes, the number of oocytes inseminated, the discard of poor quality embryos conventionally thought unsuitable for transfer or embryo cryopreservation. A common request was the avoidance of blood products as a culture medium supplement. The use of recombinant human albumin circumvented this, although a recent shift by the Watchtower Bible and Tract Society of Pennsylvania in the interpretation of the Bible opens the possibility of using blood fractions if not whole blood, and so the use of standard culture medium containing human serum albumin is now acceptable to some Jehovah's Witnesses. © 2011 The British Fertitlity Society.

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