Various hormones have been studied as regards prediction of pregnancy outcome after infertility treatment, but no ideal candidate has been found. Folate and genetic variations in folate metabolism have also been associated with infertility, but it remains unclear how these factors affect IVF pregnancy outcome. It is known that infertility is associated with active folic acid supplement use, but the effect of socioeconomic and lifestyle factors on folic acid supplement use in infertile women has not been well investigated. The overall aim of this work was to obtain information on the prediction of live birth, and to study factors affecting the role of folate and folic acid intake in relation to IVF pregnancy outcome. Infertile women with various infertility diagnoses were studied. Healthy, fertile non-pregnant women were used as controls in three of the studies. Blood samples were taken for assay of eight different hormones, folate and homocysteine, and for genomic DNA extraction. A questionnaire was used to assess background data and use of folic acid supplements. Twenty-four-hour recall interviews were performed for validation of the questionnaire. The studied hormones were not good predictors of live birth. The best predictor was age of the women, together with ovulatory menstrual cycles, and thyroid-stimulating hormone and anti-Müllerian hormone (AMH) status. Well-educated women, high-status employed women, and married and infertile women used the most folic acid supplements. Infertile women had better folate status than fertile women. However, pregnancy outcome after infertility treatment was not dependent on folic acid intake, folate status, genetic variation of 5,10-methylenetetrahydrofolate reductase or socioeconomic status. In conclusion, AMH levels vary less than those of other hormones during the menstrual cycle, and AMH could be used as a predictive marker of live birth together with age and ovulation. Folate might play a minor role in IVF pregnancy outcome, but the importance of folate as regards other health perspectives should not be forgotten.

Master of Science in Medicine (by research) / Assisted reproductive technologies (ARTs) are very efficient in producing embryos, however many of these embryos have poor viability. No more than 50% of IVF embryos complete preimplantation development (Hardy et al. 2001). The poor viability is manifested as a reduced rate of cell proliferation and increased rates of apoptosis in the early embryo, resulting in high rates of embryo mortality (Hardy et al. 2001). The reduced viability occurs as a response to a range of cellular stressors that are a consequence of embryo culture (Hardy et al. 2001). The stress of culture disrupts some survival signalling pathways, metabolism of substrates and induces redox stress (Hardy et al. 2001). The cellular stress sensor p53 is expressed in the early embryo but is normally kept at very low levels (Li et al. 2005). This latency may be breached in IVF embryos following culture of zygotes in vitro for 96 hours, resulting in the up-regulation and nuclear accumulation of p53 (Li et al. 2005). Activation of the p53 stress-sensing pathway in the early mouse embryo by culture in vitro causes a marked loss of their developmental competence (Li et al. 2005). This study aimed to establish whether benefits could be obtained by culturing mice IVF embryos in the presence of p53 protein inhibitors. IVF zygotes were cultured individually in 10µl drops of 1.25, 2.5, 5 or 10µM Pifithrin-a (PFTa) in 0.05% DMSO for 96 hours. On day 5 the development stage was assessed. Embryos reaching the blastocyst stage were fixed and stained with Hoechst 33342 for total cell count and the proportion of nuclei with normal and abnormal morphology. There was an increase in the blastocyst rate, total cell count and the proportion of nuclei in a blastocyst with normal nuclei in 10µM-treated embryos. This study also aimed to determine whether benefits could be obtained by incubating mouse IVF sperm with p53 protein inhibitors during IVF. IVF sperm was treated with 1.25, 2.5, 5 or 10µM of PFTa in 0.05% DMSO during incubation with oocytes for 6 hours. Resulting zygotes were cultured for 96 hours individually in 10µl drops of MODHTFM. On day 5 the development stage was assessed. Embryos reaching the blastocyst stage were fixed and stained with Hoechst 33342 for total cell count and the proportion of nuclei with normal and abnormal morphology. There was a reduction in the proportion of fragmented nuclei in blastocysts derived from 1.25 and 10µM-treated sperm. 10µM treated sperm increased the total cell count, the proportion of normal nuclei in a blastocyst and the blastocyst development rate. IVF sperm incubated with 1.25µM PFTa during insemination of oocytes increased the fertilisation rate. Another aim of this study was to establish whether p53 siRNA could inhibit p53 mRNA in mice IVF embryos and if so, whether this would improve embryo viability in culture. IVF zygotes were transfected with 15nM p53 small inhibiting RNA (siRNA) and 0.8% Oligofectamine Reagent immediately, 24 h, 48 h and 72 h after IVF then cultured individually in 10µl drops of MOD-HTFM for a total of 96 hours. On day 5 the blastocyst rate was assessed and immunofluorescence performed probing for p53. There was no significant reduction in p53 expression and no improvement in blastocyst rate at any of the transfection times. However, there was a decrease in the proportion of nuclei which expressed p53 when p53 siRNA was transfected 72 hours after IVF. Also, it was determined that siRNA was efficiently being delivered into the preimplantation embryo with Oligofectamine Reagent. Lastly, this study aimed to determine whether mice sperm with p53 gene deletions have a selective advantage in fertilising the oocyte compared to their wild-type counterparts. p53+/- males were mated with p53+/+ females and the resulting zygotes genotyped after 24 hours of culture. More than 50% of offspring had a p53+/+ genotype. There was no selective advantage for p53 null sperm to fertilise the oocyte, there was actually a disadvantage. The selective disadvantage for p53 null sperm to fertilise the F1 hybrid oocyte in IVF compared to its wild-type counterparts may imply that p53 null sperm are not as viable and may have a survival disadvantage. The reduction in fertility of p53 null sperm in vitro infers that p53 function may be important for the fertility of the mouse sperm in vitro. The results of this thesis could establish means of improving human embryo viability in ART, some examples being P53 protein inhibition in preimplantation embryos during culture prior to transfer to the uterus, or P53 protein inhibition in IVF sperm. The use of the new technology, p53 siRNA was not effective in inhibiting p53 expression, although the build-up experiments determined that siRNA is efficiently delivered into the preimplantation embryo with Oligofectamine Reagent. The demonstration that p53 null sperm has a selective disadvantage in fertilising the oocyte compared to their wild-type counterparts does not indicate a positive selection pressure for naturally occurring mutations to this gene. And so, there is no concern regarding the genetic and epigenetic risks to progeny arising from assisted reproductive technologies with respect to sperm.

Over the past five years an often emotive and controversial public debate has emerged in Australia over access to reproductive technologies such as in vitro fertilisation and donor insemination. The debate was in part prompted by a policy announcement made by the Federal Government who aimed to effectively bar single and lesbian women from accessing these technologies on the basis of marital status. The resulting public debate has centred around questions concerning which ‘types’ of women should be allowed to access reproductive technologies and therefore reproduce. The debate was a highly salient one and the issues have been widely discussed amongst the public, within parliament and through the media, thereby creating a forum where ideas of just what constitutes ‘valid’ motherhood are publicly and privately contested. The purpose of this thesis is to examine the discursive construction of categories of motherhood identity, using the public policy debate around access to reproductive technologies in Australia as a research site. I specifically investigate the designation of particular identities of motherhood as ‘good’ and therefore acceptable, and others as deviant and therefore undeserving of access to the full range of social services available. The research is situated within the field of critical social policy and utilises theories of governmentality, feminism, sexuality and motherhood. The use of theories of governmentality, as developed by Michel Foucault [1979] and implemented by Mitchell Dean (1999), is primary within the research because they enable a consideration of the techniques and discourses through which the identity of the mother is governed and through which individual women act upon and construct their own identities. The analysis engendered by the use of governmentality is educated by an understanding of the socially constituted and inscribed body highlighted within feminist and postmodern approaches. The use of a critical social policy approach situates the research within an epistemological paradigm which offers an analysis that is able to conceptualise the operations of power and the marginalisation and manipulation of particular identities. Theories of sexuality and motherhood are utilised in order to critique these central aspects of women’s experiences which have been largely disregarded in much ‘traditional’ social policy analysis. file:///C|/Documents%20and%20Settings/uqlclayt/Desktop/01front.txt (4 of 17)23/03/2006 1:16:06 PM file:///C|/Documents%20and%20Settings/uqlclayt/Desktop/01front.txt The methodology employed in this research is influenced by an understanding of the functioning of discourse as a device through which social processes and identities are questioned and transformed. I therefore utilise discourse analysis in order to investigate the construction of motherhood identities within the debate around access to reproductive technologies. The specific methodology that I use is critical discourse analysis as developed by Norman Fairclough (1992, 1995, 2003) and Ruth Wodak (2001). In order to investigate the construction of motherhood identities within the study site I conduct a critical discourse analysis of the media texts from two major newspapers which relate to the debate. I also analyse the parliamentary debate which considered the introduction of legislation aimed at allowing individual Australian State governments to restrict access to reproductive technologies. I compare and contrast this analysis with an examination of the mother identities expressed in the narratives of individual single and lesbian women who engage with the reproductive technologies discussed in the debate. In essence this thesis identifies, in the public policy debate around reproductive technologies, a moment of problematisation where the practices of governing involved in the production of motherhood identities are made apparent. I use an analysis of this moment in order to identify and question the construction of motherhood which takes place within policy debates and how individual women construct their own identities as mothers both in relation to and separate from this. The newspaper and parliamentary texts are found to govern women’s behaviour through the identification and promulgation of narrow ‘good’ mother and ‘good’ citizen identities which constrain the range of mother identities deemed to be acceptable. The women’s narratives are found to reject the negative characterisation of their identities within popular discourses and construct a mothering persona for themselves which paradoxically also serves to highlight and enforce many of the characteristics of the idealised ‘good’ mother identity.

La FSH est une hormone qui joue un rôle central dans la fonction de reproduction. De ce fait, elle est utilisée en assistance médicale à la procréation (AMP) afin de recruter un pool de follicules et de l’amener jusqu'à l'ovulation. La FSH agit sur un récepteur spécifique (RFSH) qui active des voies de signalisation par l'intermédiaire des protéines G et des β-arrestines. L'étude in vitro d’un mutant et de variants du RFSH décrits chez l’homme nous a permis de mettre en évidence différents mécanismes conduisant à des biais de signalisation de ce récepteur. Ces altérations génétiques, en modifiant l'équilibre qui existe entre les différentes voies de signalisation activées par le RFSH, conduisent à des manifestations cliniques. En parallèle, nous avons mené une étude clinique sur le polymorphisme N680S du RFSH, qui nous a permis de confirmer et de prolonger les résultats de la littérature tout en corrélant les résultats obtenus in vitro à la signalisation des récepteurs N680 et S680. L’ensemble de nos résultats ouvre des perspectives pour le développement de nouvelles stratégies en AMP. / FSH is a hormone which is centrally involved in reproduction. For this reason, FSH is extensively used in in vitro fertilization (IVF) to recruit and lead a pool of follicle to ovulation. FSH acts on its cognate receptor (FSHR) which activates signaling pathways through the canonical G-protein pathways as well as through β-arrestin-dependent transduction mechanisms. In vitro studies of a mutant and of variants of the FSHR identified in patients allowed us to highlight different mechanisms leading to bias in the signaling pathways triggered by this receptor. These genetic alterations, by modifying the equilibrium that exists between the different signaling pathways activated by the FSHR, lead to clinical consequences. In parallel, we have carried out a clinical study centered on the N680S polymorphism of the FSHR. Our results confirm and extend previous studies from the literature while correlating the results we obtained in vitro with the functional consequences of the N680S polymorphism of the FSHR. Together, our results open new avenues for developing new strategies in IVF.

This research examined how men and women experience stress and coping during the early stages ofIVF, focusing on time, gender and couples. Both members of three heterosexual couples took part separately in two or three semi-structured interviews over a six-month period, producing fourteen accounts. Interpretative Phenomenological Analysis was used to preserve participants' unique experiences alongside interpretation and generation of broader themes by the researcher. Infertility and fertility treatment were not always seen as stressful, but often as a problem to be tackled in the best way, both emotionally and practically. Stress arose from specific, time-limited issues. Participants' emotional responses were shaped by perceptions of the effect of stress on fertility, a desire to stay positive, and downward comparison with other fertility patients who were perceived to be coping poorly. Participants emphasised their choices as logical, careful decisions, weighing up multiple factors including alternatives like adoption, and temporal and financial investments. Over time, perceptions of IVF changed from a precise, technical process to one subject to luck-and chance, although the process itself was perceived as becoming easier with experience. The study was originally positioned within the transactional stress and coping model, but a self-regulatory perspective provided a better fit for the data The fmdings are linked to each model where appropriate, and the implications suggest use of the transactional model to understanding specific, time- limited events, and a self-regulatory framework to explore general fertility treatment experiences. Suggestions for future work include greater use of the self-regulatory framework to study infertility and fertility treatment; paying attention to couples' willingness to adopt in shaping infertility experiences; conducting interviews at different times during treatment cycles, and during different treatment cycles; and using alternative data gathering methods including Internet Mediated Research.

The aim of the diploma thesis is to evaluate the position of the Czech Republic in the field of health tourism, particularly assisted reproduction. The theoretical chapters include the definitions of the following topics: health tourism, organization of tourist agents and tour operators, marketing methods and the issue of assisted reproduction. In the analytic part, the offer of the Czech Republic in this field is described, the survey investigating customer behaviour of the patients as tourists is evaluated and SWOT analysis of the Czech Republic and of its offer in the field of assisted reproduction is conducted. In the last part of the thesis, a tourism product including a fertility treatment is created and some distribution channels are suggested.

The subject of my thesis is to analyze the evolution of the reproductive behavior of the Czech population to assess changes over time, especially after 1989 and to analyze the success of assisted reproduction in the Czech Republic in the period 2007 to 2013. It is divided into several parts. The first theoretical part describes the change in reproductive behavior after 1989, risk factors and causes of female and male infertility, possible tratments of diagnosed infertility and various methods of assisted reproduction. Another analytical part is dedicated to the evolution of fertility and the phenomenon of childlessness of young women. Some indicators are compared with selected European countries for an overall assessment. Subsequently are analyzed in detail the most widely used methods of assisted reproduction IVF, ICSI and kryoembryotransfer and of using indicators Pregnancy rate and Take-home baby rate is assessed their effectiveness. The thesis is supplemented by own research reproductive and family behavior on a selected sample of the Czech population.

Anti-Müllerian hormone appears to play central role in regulation of oocyte recruitment and folliculogenesis. Serum AMH concentration was found to be one of the best predictors of ovarian performance in IVF treatment. Consequently many fertility centres have introduced AMH for the assessment of ovarian reserve and as a tool for formulation of ovarian stimulation strategies in IVF. However published evidence on reliability of AMH assay methods and the role of AMH-tailored individualisation of ovarian stimulation in IVF appear to be weak. Consequently, I decided to conduct a series of studies that directed towards an improvement of the scientific evidence in these areas of research. The studies on performance of Gen II AMH assay revealed the assay suffers from significant instability and provides erroneous results. Consequently, the manufacturer introduced a modification on assay method. In view of the observed issues with Gen II assay, I conducted a critical appraisal of all published research on the previous and current assay methods that reported AMH variability, assay method comparison and sample stability. The literature indicated clinically important variability between AMH measurements in repeated samples, which was reported to be more significant with Gen II assay. The studies on between-assay conversion factors derived conflicting conclusions. Correspondingly, the review of studies on sample stability revealed conflicting reports on the stability of AMH under normal storage and processing conditions, which was reported to be more significant issue in Gen II assay. In view of above findings, we concluded that AMH in serum may exhibit pre-analytical instability, which may vary with assay method. Therefore robust, international standards for the development and validation of AMH assays are required. In the analysis of determinants of ovarian reserve, I evaluated the effect of ethnicity, BMI, endometriosis, causes of infertility and reproductive surgery on AMH, AFC and FSH measurements using data on a large cohort of infertile patients. Using robust multivariable regression analysis in a large cohort of IVF cycles, I established the effect of age, AMH, AFC, diagnosis, attempt, COS protocol changes, gonadotrophin type, USOR operator, regime and initial dose of gonadotrophins on oocyte yield. Then, I examined effect of gonadotrophin dose and regime on total and mature oocyte numbers. The study found that, after adjustment for all above variables, there was no increase in oocyte yield with increasing gonadotrophin dose categories beyond the very lowest doses. This suggests that there may not be significant direct dose-response effect and consequently strict protocols for tailoring the initial dose of gonadotrophins may not necessarily optimize ovarian performance in IVF treatment. In summary, studies described in this thesis have revealed instability of Gen II assay samples and raised awareness of the pitfalls of AMH measurements. These studies have also demonstrated the effect of clinically measurable factors on ovarian reserve and provided data on the effect of AMH, other patient characteristics and treatment interventions on oocyte yield in cycles of IVF. Furthermore, a robust database and statistical models have been developed, which can be used in future studies on ovarian reserve and IVF treatment interventions.

Perdas embrionárias e alterações gestacionais são frequentemente observadas em prenhezes de embriões bovinos manipulados in vitro. Sabe-se que tais anormalidades são resultantes de alterações epigenéticas ocasionadas pela manipulação dos gametas e/ou do embrião durante as técnicas de reprodução assistida (ARTs), com destaque para as técnicas de fecundação in vitro (FIV) e da clonagem por transferência nuclear de células somáticas (SCNT). Tais alterações resultam em distúrbios no desenvolvimento do concepto em algum momento crítico entre a fertilização e o parto, fornecendo bons modelos de estudos sobre a fisiopatologia de perdas embrionárias e dos distúrbios de desenvolvimento. Caracterizam-se como momentos críticos após a transferência do embrião (TE) o desenvolvimento embrionário no útero, o reconhecimento materno da gestação, a placentação e o desenvolvimento da placenta e do feto, os quais tem de ser transpassados sem nenhuma falha, permitindo um desenvolvimento normal do concepto até o termo. Sendo assim, o presente trabalho abordou três fases distintas do amplo período gestacional em prenhezes por ARTs. O Estudo 1 foi realizado durante o período peri-reconhecimento materno da gestação e objetivou descrever a abundância de expressão de genes estimulados pelo interferon tau (ISGs) de células mononucleares do sangue periférico (PBMCs) maternas em gestações oriundas de ARTs no primeiro mês de gestação; o Estudo 2 compreendeu os primeiros 35 dias de gestação e objetivou descrever as mudanças morfológicas e vasculares do complexo útero-concepto-ovário e o estímulo à expressão de ISGs em PBMCs em gestações de conceptos clonados por SCNT com diferentes fenótipos de desenvolvimento, sendo esses denominados gestação anembrionada e CL persistente; e o Estudo 3 foi conduzido durante o período pré-parto e objetivou descrever as alterações na produção de esteroides sexuais e corticosteroides em gestações produzidas por ARTs. Três hipóteses foram testadas: (1) Gestações de conceptos clonados por SCNT apresentam uma baixa e mais tardia estimulação de ISGs em PBMCs maternas quando comparadas com gestações de conceptos produzidos por FIV e IA; (2) O concepto clonado por SCNT apresenta um menor estímulo sobre mudanças morfológicas e vasculares do complexo útero-ovário e ISGs em PBMCs maternas durante os primeiros 35 dias de gestação, quando comparado com conceptos oriundos de IA; e (3) Gestações de embriões oriundos de ARTs apresentam alterações na dinâmica esteroidogênica no pré-parto quando comparados com gestações de IA. No estudo 1 foram coletadas amostras de sangue de gestações produzidas por inseminação artificial (IA), FIV e clonagem por SCNT, nos dias 15, 18, 20, 22, 24, 26, 28 e 31 pós-ovulação e foi realizada mensuração da abundância de transcritos de ISGs (OAS1 e ISG15) em PBMCs maternas. No estudo 2, gestações produzidas por IA e clonagem por SCNT, foram submetidas a escaneamentos ultrassonográficos dos ovários, útero e concepto a cada 3 dias do dia 14 ao 35 (dia 0 = ovulação) e amostras de sangue foram coletadas nos dias 15, 18, 20, 22, 24, 26, 28 e 31 para mensuração da abundância de transcritos de ISGs (OAS1 e ISG15) em PBMCs maternas. No estudo 3, foram coletadas amostras de sangue no último mês em gestações naturais, oriundas de FIV e de clonagem por SCNT para análise hormonal de 10 esteroides utilizando o método de espectrometria de massas multi-hormonal de alta resolução LC-MS/MS. O primeiro estudo mostrou semelhanças na expressão de genes estimulados pelo IFNT em gestações oriundas de ARTs e produzidas por IA. Entretanto, a estimulação nas gestações oriundas de ARTs aparentou ser quatro dias mais prolongada, sugerindo uma maior funcionalidade do trofectoderma em conceptos oriundos de ARTs. O segundo estudo demonstrou um aumento na expressão de ISGs em PBMCs maternas tanto em gestações de conceptos normais quanto em anormais, justificando a manutenção da função luteal mesmo na ausência de detecção do concepto por ultrasonografia. No terceiro estudo, demonstrou-se alterações na esteroidogênese nas gestações de embriões FIV e clonados no último mês de gestação, sendo essas compatíveis com a hiperativação da enzima aromatase durante todo o último mês de gestações oriundas de FIV e hiperativação das enzimas P450C11 e P450C21 trinta dias antes do parto em gestações oriundas de clonagem por SCNT. O presente estudo concluiu que conceptos oriundos de FIV e clonagem por SCNT apresentam um prolongamento no estímulo de ISGs pelo IFNT, conceptos clonados anormalos apresentam estímulo de ISGs, o que justifica a manutenção da função luteal, e, por fim, a cascata esteroidonênica que culmina com o parto apresenta-se alterada em gestações oriundas de FIV e clonagem por SCNT. / Pregnancy losses and gestational abnormalities are frequently observed in pregnancies from in vitro produced embryos in bovines. It is known that these abnormalities are due to epigenetic changes from the manipulation of gametes and/or embryo during the use of assisted reproduction techniques (ARTs), especially for the in vitro fertilization (IFV) and cloning by somatic cells nuclear transfer (SCNT). These changes results in disturbances of conceptus development in any critical stage between the fertilization and parturition, which provides good models for the study of physiopathology of embryo losses and disturbances of development. Critical stages after the embryo transfer (ET) to the uterus are characterized as the maternal recognition of pregnancy, placentation, and fetal-placental development, which needs to be surpassed without failures, in order to develop a normal conceptus until term. Therefore, the present work approached three distinct phases of the wide gestational period in pregnancies from ARTs. The Study 1 was conducted during the maternal peri-recongnition of pregnancy period and aimed to describe the expression of interferon stimulated genes (ISGs) in maternal peripheral blood mononuclear cells (PBMCs) in pregnancies derived of ARTs; the Study 2 comprise the first 35 days of pregnancy and aimed to describe morphological and vascular changes of the complex uterus-ovaries-conceptus, as well as the expression of ISGs in maternal PBMCs in pregnancies of conceptus cloned by SCNT with different phenotypes of development, denominated as anembryonic gestation and persistent CL; the Study 3 was conducted during the pre-partum period and aimed to describe changes in the production of sexual steroids and corticosteroids during the last month of pregnancies derived of ARTs. Three hypothesis were tested: (1) Pregnancies of conceptus cloned by SCNT presented a decrease and delay in the stimulation of ISGs in maternal PBMCs when compared with conceptuses produced by IFV and AI; (2) Stimulus from the conceptus for changes in the morphology and vasculature of the the uterus-ovarian complex, detected by ultrasonography in B and Doppler modes, and the stimulation of ISGs in maternal PBMCs during the first 35 days of pregnancy of conceptus cloned by SCNT are less intense when compared with conceptus derived from AI; and (3) Pregnancies derived of ARTs present changes in the steroidogenic dynamics in the pre-partum, when compared with pregnancies derived from AI. In Study 1 blood samples were collected from pregnancies produced by AI, IVF, and cloning by SCNT, at days 15, 18, 20, 22, 24, 26, 28, and 31 post-ovulation for the measurement of abundance of transcripts of ISGs (OAS1 and ISG15) in maternal PBMCs. In Study 2, pregnancies derived of AI and cloning by SCNT, were submitted to ultrasonographic scans for the evaluation and description of morphological and vascular changes in ovaries, uterus, and conceptus every 3 days from day 14 to 35 (day 0 = ovulation) and blood samples were collected on days 15, 18, 20, 22, 24, 26, 28 e 31 for the measurement of the abundance of transcripts of ISGs (OAS1 and ISG15) in maternal PBMCs. In Study 3, blood samples were collected during the last month of pregnancies naturally conceived, derived of IVF, and cloned by SCNT for the analysis of 10 steroids using the method of mass spectrometry high resolution LC-MS/MS. The first study showed similarities in the ISGs expression stimulation in pregnancies derived of ARTs and AI. However, the stimulation in the ART derived pregnancies was apparently 4 days longer, suggesting a greater placental function in conceptus derived of ARTs. The second study showed an increase in ISG expression in both normal and abnormal conceptus development, which justifies the maintenance of CL in the absence of a conceptus structure detected by ultrasonography. In the third study, was detected changes in the steroidogenesis of pregnancies derived of IFV and cloning by SCNT during the last month of pregnancy, which are compatible with the hyperactivation of the aromatase enzyme during the last month of IFV derived pregnancies, and hyperactivation of the enzymes P450C11 and P450C21 thirty days before parturition in pregnancies derived of cloning by SCNT. The present study concludes that conceptus derived of IFV and cloning by SCNT present a prolonged stimulus of ISGs, cloned conceptus with anomalous development presents a stimulus of ISGs, which justifies the CL function maintenance, and, ultimately, the steroidogenic cascade that culminates with the term is altered in pregnancies derived from IFV and cloning by SCNT.

Clinical Assisted Reproductive Technology (ART) practices seek to make improvements in embryo quality and resultant procedural success rates. There is a significant variance in live birth rates among clinics nationwide. The goal of this thesis is make comparisons of embryo quality among clinics and understand these differences. This analysis focuses on the stage between egg retrieval and embryo transfer. Because the currently accepted embryo scoring methods are not directly proportional to performance, a new scoring methodology is proposed and applied. Data provided by the Society for Assisted Reproductive Technology (SART) consisting of 36,836 patient cycles from 40 anonymous clinics nationwide is considered. After necessary reductions are made, the data is anatomized to link each embryo transferred to an implantation probability. A score is generated for each morphology grouping based on the average implantation rate of that group. This score is used as the basis for clinic comparisons. Top-performing clinics (in terms of live birth rates in patients agedold) are then shown to both produce embryos of higher score and achieve better results from embryos of identical morphology.