Birth after TESE-ICSI in a man with hypogonadotropic hypogonadism and congenital adrenal hypoplasia linked to a DAX-1 (NR0B1) mutation

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C. Frapsauce1, C. Ravel1, M. Legendre2, M. Sibony3, J. Mandelbaum1, B. Donadille4, J.C. Achermann5, J.-P. Siffroi2,6 and S. Christin-Maitre4,6,*

1UPMC, AP-HP, Hôpital Tenon, Service de Biologie de la Reproduction, 75020 Paris, France

2AP-HP, Hôpital Trousseau, Service de Génétique et d'Embryologie Médicales, 75012 Paris, France

3AP-HP, Hôpital Tenon, Service d'Anatomopathologie, 75020 Paris, France

4Service d'Endocrinologie, Hôpital Saint-Antoine, AP-HP, Centre de maladies endocriniennes rares de la croissance CMERC, 75012 Paris, France

5Developmental Endocrinology Research Group, Clinical & Molecular Genetics, UCL Institute of Child Health, University College London, London WC1N 1EH, UK

6ER9, génétique de la reproduction, Faculté de médecine Pierre et Marie Curie, University Paris VI, France *Correspondence address. Service d'Endocrinologie, Hôpital Saint-Antoine, AP-HP, Centre de maladies rares de la croissance (CMERC), 184 rue du faubourg Saint-Antoine, ER-9 Université Paris VI, 75012 Paris, France. Tel: +33-1-49-28-24-00; Fax: +33-1-49-28-31-95; E-mail: sophie.christin-maitre{at}sat.aphp.frReceived July 4, 2010. Revision received November 30, 2010. Accepted December 3, 2010. DAX1/NR0B1 mutations are responsible for X-linked congenital adrenal hypoplasia (AHC) associated with hypogonadotropic hypogonadism (HH). Few data are available concerning testicular function and fertility in men with DAX1 mutations. Azoospermia as well as failure of gonadotrophin treatment have been reported. We induced spermatogenesis in a patient who has a DAX1 mutation (c.1210C>T), leading to a stop codon in position 404 (p.Gln404X). His endocrine testing revealed a low testosterone level at 1.2 nmol/l (N: 12–40) with low FSH and LH levels at 2.1 IU/l (N: 1–5 IU/l) and 0.1 IU/l (N: 1–4 IU/l), respectively. Baseline semen analysis revealed azoospermia. Menotropin (Menopur®:150 IU, three times weekly) and human chorionic gonadotrophin (1500 IU, twice weekly) were used. After 20 months of treatment, as azoospermia persisted, bilateral multiple site testicular biopsies were performed. Histology revealed severe hypospermatogenesis. Rare spermatozoa were extracted from the right posterior fragment and ICSI was performed. Four embryos were obtained and, after a frozen–thawed single-embryo transfer, the patient's wife became pregnant and gave birth to a healthy boy. We report the first case of paternity after TESE–ICSI in a patient with DAX1 mutation, giving potential hope to these patients to father non-affected children. Furthermore, this case illustrates the fact that patients with X-linked AHC have a primary testicular defect in addition to HH.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.5), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

This ArticleHum. Reprod. (2011) 26 (3): 724-728. doi: 10.1093/humrep/deq372 First published online: January 11, 2011

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Effects of electric field on early preimplantation development in vitro in mice and rats

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Elena Popova, Michael Bader* and Alexander Krivokharchenko

Max-Delbrück Center for Molecular Medicine (MDC), Robert-Rössle-Str. 10, D-13125 Berlin-Buch, Germany *Correspondence address. Fax: +49-30-9406-2110; E-mail: mbader{at}mdc-berlin.deReceived October 6, 2010. Revision received November 30, 2010. Accepted December 7, 2010. BACKGROUND Exposure of cells to electric fields is a commonly used technique for parthenogenesis, cloning and tetraploid embryo production. However, little is known about possible detrimental effects of electric fields on embryos and their development. The aim of this study was to investigate the effects of electric fields on early preimplantation development in mice and rats.

METHODS Mouse and rat metaphase II (MII) and pre-activated oocytes, zygotes and 2-cell stage embryos were treated with electric fields with increasing voltage. Cleavage rate, morula and blastocyst formation were evaluated by in vitro cultivation. The effects of electric fields on embryos were investigated by measurement of reactive oxygen species (ROS) content and microtubule and microfilament distributions using fluorescence staining.

RESULTS Pre-activated oocytes at the pronuclear stage and zygotes are more resistant to electric exposure than freshly isolated oocytes at MII stage in both studied species. Rat zygotes treated with electric fields of increasing voltage showed higher cleavage rates compared with the mouse and some of them developed beyond 4-cell stage in vitro. Embryos blocked at the 2-cell stage after in vitro cultivation of zygotes exposed to electric fields demonstrated increased level of ROS but normal distributions of microtubules and microfilaments. In both species, embryos at the 2-cell stage were more resistant to electric fields because they formed tetraploid embryos after electric field-induced blastomere fusion and these embryos could develop in vitro until the blastocyst stage.

CONCLUSIONS There are stage-dependent and species-specific differences in sensitivity to electric fields in mouse and rats.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (3): 662-670. doi: 10.1093/humrep/deq379 First published online: January 11, 2011

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Serum anti-Mullerian hormone levels are negatively related to Follicular Output RaTe (FORT) in normo-cycling women undergoing controlled ovarian hyperstimulation

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V.K. Genro1,2,3,4, M. Grynberg1,2,3, J.B. Scheffer1,2,3, I. Roux1,2,3, R. Frydman1,2,3 and R. Fanchin1,2,3,*

1Service de Gynécologie-Obstétrique et Médecine de la Reproduction, AP-HP, Hôpital Antoine Béclère, 157, rue de la Porte de Trivaux, Clamart F-92141, France

2Univ Paris-Sud, Clamart F-92140, France

3INSERM, U782, Clamart F-92140, France

4Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Porto Alegre, Brazil *Correspondence address. Tel: +33-1-45-37-40-53; Fax: +33-1-45-37-49-80; E-mail: renato.fanchin{at}abc.ap-hop-paris.frReceived August 25, 2010. Revision received November 9, 2010. Accepted November 24, 2010. BACKGROUND Since in rodents anti-Müllerian hormone (AMH) has been shown to inhibit antral follicle responsiveness to FSH, we aimed at verifying whether a relationship exists between serum AMH levels and antral follicle responsiveness to exogenous FSH in normo-cycling women.

METHODS Serum AMH, estradiol (E2) and FSH levels were prospectively measured on cycle day 3 in patients undergoing controlled ovarian hyperstimulation (COH) with a time-release GnRH agonist and standardized FSH doses. In 162 patients, follicles were counted after pituitary suppression and before FSH administration (baseline; small antral follicles; 3–8 mm), and on the day of hCG (dhCG; pre-ovulatory follicles; 16–22 mm). Antral follicle responsiveness to FSH was estimated by the Follicular Output RaTe (FORT), determined by the ratio pre-ovulatory follicle count on dhCG × 100/small antral follicle count at baseline.

RESULTS Serum AMH levels were positively correlated with the number of small antral follicles at baseline (r = 0.59; P < 0.0001) and pre-ovulatory follicles on dhCG (r = 0.17; P < 0.04). Overall, FORT was 47.5 ± 1.4% and failed to be influenced by the woman's age, BMI or basal E2 and FSH level. Conversely, multiple regression analysis showed that FORT was negatively correlated with AMH levels (r = -0.30; P < 0.001), irrespective of duration of COH and total FSH dose.

CONCLUSIONS The percentage of follicles that effectively respond to FSH by reaching pre-ovulatory maturation is negatively and independently related to serum AMH levels. Although the mechanisms underlying this finding remain unclear, it is in keeping with the hypothesis that AMH inhibits follicle sensitivity to FSH.

© The Author 2010. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (3): 671-677. doi: 10.1093/humrep/deq361 First published online: December 21, 2010

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Sperm and oocyte donors' experiences of anonymous donation and subsequent contact with their donor offspring

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V. Jadva1,*, T. Freeman1, W. Kramer2 and S. Golombok1

1Centre for Family Research, Faculty of Politics, Psychology, Sociology and International Studies, Free School Lane, University of Cambridge, Cambridge CB2 3RF, UK

2Donor Sibling Registry, PO Box 1571, Nederland, CO 80466, USA *Correspondence address. Fax: +44-1223-330574; E-mail: vj227{at}cam.ac.ukReceived July 15, 2010. Revision received November 19, 2010. Accepted November 26, 2010. BACKGROUND This study examined the motivations and experiences of anonymous donors who decide to make themselves open to contact with their donor offspring.

METHODS Online questionnaires were completed by 63 sperm donors and 11 oocyte donors recruited via the Donor Sibling Registry (http://www.donorsiblingregistry.com/), a US-based international registry that facilitates contact between donor-conceived offspring and their donors.

RESULTS Donors' main reasons for donating were financial payment and wanting to help others. Sperm donors had donated between 1 and 950 times (median = 100) and oocyte donors had donated between 1 and 5 times (median = 2). The majority of sperm donors and more than one-third of oocyte donors expressed concerns about having donated. These concerns were mainly about the well-being of any children conceived using their gametes and not being able to make contact with them. Most sperm and oocyte donors felt that it was important to know how many offspring had been born using their donation, and 51% of sperm donors and 46% of oocyte donors wanted identifying information. All of the donors who had contact with their donor offspring reported positive experiences and the majority continued to have regular contact.

CONCLUSIONS Although the sample may not be representative of all anonymous donors, this study highlights the importance of donors having access to information about their donor offspring and the positive consequences that may arise when contact is made.

© The Author 2010. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (3): 638-645. doi: 10.1093/humrep/deq364 First published online: December 21, 2010

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Decisional conflict and the disposition of frozen embryos: implications for informed consent

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A.D. Lyerly1,2,*, S. Nakagawa3 and M. Kuppermann3

1Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA

2Center for Bioethics, University of North Carolina, Chapel Hill, NC, USA

3Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA, USA *Correspondence address. University of North Carolina at Chapel Hill, School of Medicine, CB#7240, 333 South Columbia Street, MacNider Hall, Chapel Hill, NC 27599-7240, USA. Tel: +1-919-962-6735; Fax: +1-919-962-2154; E-mail: alyerly{at}email.unc.eduReceived September 17, 2010. Revision received November 1, 2010. Accepted November 29, 2010. BACKGROUND Fertility patients often struggle with decisions about disposition of embryos remaining after fertility treatment. We aimed to identify predictors and correlates of decisional conflict among patients facing these decisions.

METHODS We analyzed results from a survey of 2210 patients from nine geographically diverse US fertility clinics. The main outcome measure was decisional conflict about embryo disposition, as measured by the decisional conflict scale (DCS).

RESULTS Of 1244 respondents who returned the survey, 1005 with cryopreserved embryos and DCS scores were included in the analysis. Of the respondents, 39% reported high decisional conflict (DCS = 37.5). Thoughts about future childbearing were associated with high decisional conflict: respondents who were either uncertain about whether to have a baby in the future or sure they did not want to have a baby were at higher odds of high decisional conflict than participants who desired a baby [adjusted odds ratio (aOR) = 3.93, P < 0.001 and aOR = 1.69, P = 0.04, respectively]. Also associated with high decisional conflict were being likely to have embryos thawed and discarded (aOR = 2.08, P < 0.001), donated for research (aOR = 1.66, P = 0.01) or frozen ‘forever’ (aOR = 1.90, P = 0.01); being likely to choose compassionate transfer if it were available (aOR = 1.65, P = 0.03); attributing high, but not full, moral status to human embryos; not having enough information; and not being satisfied with the informed consent process.

CONCLUSIONS Decisional conflict about frozen embryo disposition differs according to reproductive preferences that may vary according to stage of treatment. Informed consent for embryo disposition should be revisited periodically, with serious discussions about disposition after childbearing is complete.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (3): 646-654. doi: 10.1093/humrep/deq368 First published online: January 7, 2011

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Advanced glycation end-products accumulation compromises embryonic development and achievement of pregnancy by assisted reproductive technology

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Masao Jinno1,*, Masayoshi Takeuchi2, Aiko Watanabe1, Koji Teruya3, Jun Hirohama1, Noriko Eguchi1 and Aiko Miyazaki4

1Women's Clinic Jinno, 3-1-39-201 Kokuryou-chou, Choufu City, Tokyo 182-0022, Japan

2Department of Life Pharmacy, Faculty of Pharmaceutical Sciences, Hokuriku University, Kanazawa City, Ishikawa, Japan

3Department of Public Health, School of Health Sciences, Kyorin University, Hachioji City, Tokyo, Japan

4HUSHIMI Pharmatheuticals, Kagawa, Japan *Correspondence address. Tel: +81-424-80-3105; Fax: +81-424-80-3105; E-mail: mjinno{at}s9.dion.ne.jpReceived August 20, 2010. Revision received December 2, 2010. Accepted December 10, 2010. BACKGROUND Advanced glycation end-products (AGE) are pivotal in aging and diabetes. Aging and polycystic ovary syndrome, a diabetes-associated disease, often cause infertility. We examined how AGE accumulation affects assisted reproductive technology (ART) outcomes.

METHODS In this retrospective analysis, toxic AGE (TAGE), pentosidine (Pent) and carboxymethyl lysine (CML) in blood and follicular fluid (FF) were measured in 157 ART-patients. We analyzed associations of AGE with ART outcomes and pre-ART clinical factors.

RESULTS TAGE, Pent and CML in FF and TAGE in serum, showed significant negative correlations with estradiol and numbers of follicles larger than 12 mm in diameter, retrieved oocytes, fertilized oocytes and embryos. AGE, Pent in FF and TAGE in serum showed significant negative correlations with ongoing pregnancy. Areas under receiver-operating characteristic curves for AGE (0.709), Pent in FF (0.686) and TAGE in serum (0.667) were significantly larger than for the reference (0.5). Women with serum TAGE above 7.24 U/ml showed decreased oocyte numbers and ongoing pregnancy rates, even with younger age or lower Day-3 FSH. Serum TAGE correlated positively with leptin (R = 0.51), BMI, low-density lipoprotein, triglyceride, glucose, homeostasis model assessment-insulin resistance and insulin.

CONCLUSIONS Serum TAGE and FF Pent accumulations correlated highly with poor follicular and embryonic development and with a lower likelihood of ongoing pregnancy. Serum TAGE predicts poor ART outcomes independent of age and Day-3 FSH.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (3): 604-610. doi: 10.1093/humrep/deq388 First published online: January 12, 2011

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Social age deadlines for the childbearing of women and men

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F.C. Billari1,*, A. Goisis1,2, A.C. Liefbroer3,4, R.A. Settersten5, A. Aassve1, G. Hagestad6 and Z. Spéder7

1Department of Decision Sciences, Carlo F. Dondena Centre for Research on Social Dynamics and IGIER, Bocconi University, Roentgen 1, 20136 Milan, Italy

2Department of Social Policy, The London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK

3Netherlands Interdisciplinary Demographic Institute, PO Box 11650, 2502 AR The Hague, The Netherlands

4Department of Social Research Methodology, VU University Amsterdam, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands

5Department of Human Development and Family Sciences, Oregon State University, Corvallis, OR 97331, USA

6NOVA/ Norwegian Social Research, PO Box 3223 Elisenberg, 0208 Oslo, Norway

7Demographic Research Institute HCSO, Buday László 1-3, H-1024 Budapest, Hungary *Correspondence address. E-mail: billari{at}unibocconi.itReceived August 2, 2010. Revision received November 9, 2010. Accepted November 24, 2010. BACKGROUND This study examines whether social age deadlines exist for childbearing in women and men, how they vary across countries, whether they are lower than actual biological deadlines and whether they are associated with childbearing at later ages and the availability of assisted reproduction techniques (ARTs).

METHODS This study is based on the European Social Survey, Round 3 (2006–2007), which covers 25 countries. Data were gathered on social age deadlines for childbearing in women (21 909 cases) and men (21 239 cases) from samples of representative community-dwelling populations aged 15 and older.

RESULTS Social age deadlines for childbearing were perceived more frequently for women than men. These deadlines are often lower than actual biological limits, and for women and men alike: 57.2% of respondents perceived a maternal social age deadline =40 years of age; 46.2% of the respondents perceived a paternal social age deadline =45 years of age. There is also considerable variability in deadlines across countries, as well as within them. At the country level, the presence of social age deadlines for the childbearing of women was negatively associated with birth rates at advanced ages and the prevalence of ART, and later deadlines were positively associated with these factors.

CONCLUSIONS It is important to understand the factors that increase and limit late fertility. While biological factors condition fertility, so do social expectations. These findings provide widespread evidence across Europe that social limits exist alongside biological ones, though both sets of factors are more binding for women.

© The Author 2010. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.5), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

This ArticleHum. Reprod. (2011) 26 (3): 616-622. doi: 10.1093/humrep/deq360 First published online: December 15, 2010

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A pilot study assessing art therapy as a mental health intervention for subfertile women

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Edward G. Hughes* and Alicia Mann da Silva

Department of Obstetrics and Gynecology, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5*Correspondence address. hughese{at}mcmaster.caReceived August 13, 2010. Revision received October 13, 2010. Accepted November 15, 2010. BACKGROUND Subfertility is a common but hidden source of anxiety, depressive symptoms and hopelessness. Counselling reduces this emotional burden and may even enhance the likelihood of pregnancy. Art therapy may be a useful intervention, because it facilitates the expression of feelings, both visually and verbally, and may ease emotional distress.

METHODS Weekly 2-h art therapy group courses were held for a total of 21 subfertile women. The impact of subfertile women's support systems and barriers to coping were all explored. The effectiveness of art therapy was assessed using Beck Hopelessness, Depression and Anxiety Inventories, administered before and after participation, as well as a qualitative exit questionnaire.

RESULTS The mean age of participants was 35.7 (SD 2.1) years and duration of infertility was 64 (12.0) months. Mean Beck Hopelessness Scale fell from 6.1 (3.8) to 3.5 (3.1, P = 0.01) after therapy. Beck Depression Inventory-II Score fell from 19.8 (11.0) to 12.5 (10.2, P = 0.01) and Beck Anxiety Inventory Score changed from 12.4 (8.4) to 8.4 (5.2, P = 0.3). Based on the exit questionnaire, women felt the course was insightful, powerful and enjoyable.

CONCLUSIONS Art therapy is an inexpensive, non-pharmacological intervention, which was associated with decreased levels of hopelessness and depressed mood in subfertile women. It also provides insight into the meaning and emotional implications of subfertility for patients and caregivers. This pilot study highlights the need for further research in this field.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (3): 611-615. doi: 10.1093/humrep/deq385 First published online: January 18, 2011

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Clinical grade vitrification of human ovarian tissue: an ultrastructural analysis of follicles and stroma in vitrified tissue

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Mona Sheikhi1,*, Kjell Hultenby2, Boel Niklasson1, Monalill Lundqvist1 and Outi Hovatta1

1Division of Obstetrics and Gynaecology, Department of Clinical, Science, Technology and Intervention, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden

2Division of Clinical Research Centre, Department of Laboratory Medicine, Karolinska Institutet, SE 141 86 Stockholm, Sweden *Correspondence address. Tel: +46-8-5858-0000; Fax: +46-8-58587250; E-mail: mona.sheikhi{at}karolinska.seReceived March 17, 2010. Revision received November 10, 2010. Accepted November 22, 2010. BACKGROUND Cancer therapy is one of many conditions which may diminish the ovarian reserve. Banking of human ovarian tissue has become an option for the preservation of female fertility. We have shown that vitrification is an excellent method to cryopreserve ovarian tissue. To carry out vitrification in a clinical setting, we have developed a clinical grade closed system to avoid direct contact of ovarian tissue with liquid nitrogen.

METHODS Ovarian tissue was obtained by biopsy from 12 consenting women undergoing Caesarean section. Tissues were vitrified in cryotubes, using dimethyl sulphoxide, 1,2-propanediol, ethylene glycol and polyvinylpyrrolidon as cryoprotectants. Non-vitrified and warmed-vitrified tissue was compared by light and electron microscopic morphology of the follicles within the tissues.

RESULTS We did not see any differences in the light or electron microscopic ultrastructure of oocytes between non-vitrified and vitrified tissues. No irreversible subcellular alterations in vitrified tissues were seen.

CONCLUSIONS The ultrastructure of follicles within the vitrified human ovarian tissue was well preserved using cryotube in a closed vitrification system to avoid direct contact of liquid nitrogen. The system is compatible with the European tissue directive.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.5), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

This ArticleHum. Reprod. (2011) 26 (3): 594-603. doi: 10.1093/humrep/deq357 First published online: January 8, 2011

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The effects of timing of intrauterine insemination in relation to ovulation and the number of inseminations on cycle pregnancy rate in common infertility etiologies

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Mohamad E. Ghanem1,*, Nagwa I. Bakre2, Mohamad A. Emam1, Laila A. Al Boghdady1, Adel S. Helal1, Abdel Gawad Elmetwally1, Mohamad Hassan3, Ibrahim A. Albahlol3 and Mostafa M. Elzayat1

1Mansoura Integrated Fertility Center, Mansoura, Egypt

2Department of Dermatology and Andrology, Mansoura University Students Hospital, El Gomhoria Street, Mansoura, Egypt

3Department of Obstetrics and Gynecology, Mansoura Faculty of Medicine, El Gomhoria Street, Mansoura, Egypt *Correspondence address. E-mail: meghanem87{at}hotmail.comReceived August 31, 2010. Revision received October 21, 2010. Accepted October 25, 2010. BACKGROUND Controlled ovarian hyperstimulation with intrauterine insemination (COH/IUI) is an established tool in medically assisted conception for many infertility factors. However, the proper timing of IUI after hCG trigger and the frequency of IUI are still debated. We aimed to examine the association between the cycle pregnancy rate (CPR) and: (i) single IUI timed at 36 ± 2 h post-hCG (pre- or post-ovulation) (ii) the number of IUI (single or double) for pre-ovulatory cases both aims in male, anovulatory and unexplained infertility.

METHODS The study included a total 1146 first-stimulated cycles in infertile couples due to male factor, anovulation or unexplained infertility. Cycles were stimulated by clomiphine citrate (CC) or sequential CC–hMG or hMG and monitored by transvaginal ultrasound. When the leading follicle reached =18 mm mean diameter, 10000 IU hCG was given to trigger ovulation and IUI was timed for 36 ± 2 h later. Semen was processed and ovulation was checked at the time of IUI. Post-ovulatory cases received single IUI, while pre-ovulatory cases were sequentially randomized to receive either single or double IUI. The end-point of the cycle was CPR.

RESULTS Overall CPR in the whole cohort was 10.1%. When ovulation was present before IUI, CPR was 11.7% compared with 6.7% when ovulation was absent [OR (95% CI): 1.85 (1.12–3.06), P = 0.015]. When this OR was computed according to infertility etiology, it was 1.26 (0.52–2.95) (P =0.82) for male factor infertility and 2.24 (1.23–4.08) (P = 0.007) for non-male factor infertility. Comparing the CPR for double versus single IUI in pre-ovulatory cases, the OR for all cycles was 1.9 (0.76–4.7) (P = 0.22), but according to etiology, it was 4.667 (0.9–24.13) (P = 0.06) in male factor and 1.2 (0.43–3.33) (P = 0.779) for non-male factors.

CONCLUSIONS Single IUI timed post-ovulation gives a better CPR when compared with single pre-ovulation IUI for non-male infertility, whereas for male factors, pre-ovulation, double IUI gives a better CPR when compared with single IUI.

© The Author 2010. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (3): 576-583. doi: 10.1093/humrep/deq362 First published online: December 21, 2010

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Physicians underestimate the importance of patient-centredness to patients: a discrete choice experiment in fertility care

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Inge W.H. van Empel1,*†, Eline A.F. Dancet1,2,3,†, Xander H.E. Koolman4, Willianne L.D.M. Nelen1, Elly A. Stolk5, Walter Sermeus3, Thomas M. D'Hooghe2 and Jan A.M. Kremer1

1Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands

2Leuven University Fertility Centre, Leuven University Hospital, Leuven, Belgium

3Centre for Health Services & Nursing Research, Catholic University Leuven, Brussels, Belgium

4IPSE studies, Delft University of Technology, Delft, The Netherlands

5Department of Health Policy & Management, Erasmus Medical Centre, Rotterdam, The Netherlands *Correspondence address. E-mail: i.vanempel{at}obgyn.umcn.nl?† These authors contributed equally to this work.

Received September 17, 2010. Revision received December 6, 2010. Accepted December 13, 2010. BACKGROUND High-quality healthcare should be effective, safe and patient-centred. How important patient-centredness is in relation to effectiveness of fertility care has never been investigated. This study aimed to determine and compare the importance of patient-centredness, relative to pregnancy rates, to patients and physicians.

METHODS A discrete choice experiment (DCE) was designed. Participants had to choose between hypothetical fertility clinics differing in following attributes: travel time; pregnancy rate (effectiveness); physicians' attitude; information on treatment; and continuity of physicians (the latter three represent patient-centredness). A total of 1378 patients and 268 physicians from eight Dutch and Belgian fertility clinics received the DCE-questionnaire. The attributes' relative importance was analysed using multinomial logistic regression. Additionally, patients' actual choice behaviour was investigated.

RESULTS In total, 925 patients and 227 physicians participated. Pregnancy rates were relatively more important to physicians. Patients assigned more value to patient-centredness (P< 0.001) and were willing to trade-off a higher pregnancy rate for patient-centredness than physicians recommended them to do (P< 0.05). For example, patients considered pregnancy rates 1.5 times as important as an interested physician's attitude, whereas physicians considered this 2.4 times as important (P< 0.001). The willingness to trade-off pregnancy rate for this attitude was 9.8% for patients and 6.3% for physicians (P< 0.001). A lack of patient-centredness was the most cited non-medical reason for changing fertility clinics.

CONCLUSIONS Patients and physicians put considerable value on pregnancy rates. However, physicians significantly undervalue the importance of patient-centredness to patients. Clinics aiming to optimize the quality of their services should be aware of the substantial importance their patients assign to patient-centredness.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (3): 584-593. doi: 10.1093/humrep/deq389 First published online: January 12, 2011

Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.

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Reduced plasma fibrinolytic potential in patients with recurrent implantation failure after IVF and embryo transfer

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M. Angeles Martínez-Zamora1, Montserrat Creus1, Dolors Tassies2, Juan Carlos Reverter2, Salvadora Civico1, Francisco Carmona1 and Juan Balasch1,*

1Institut Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain

2Hemotherapy and Hemostasis Unit, Faculty of Medicine-University of Barcelona, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain *Correspondence address. Tel: +34-932275436; Fax: +34-932279325; E-mail: jbalasch{at}ub.eduReceived September 18, 2010. Revision received October 21, 2010. Accepted November 26, 2010. BACKGROUND Recurrent implantation failure (RIF) following embryo transfer (ET) is a major continuing problem in IVF. Women with haemostatic defects may be at increased risk of miscarriage and preclinical pregnancy loss. The fibrinolytic system is considered, at present, the key to new thrombotic pathogenic mechanisms. Patients with unexplained recurrent miscarriage have an impairment of fibrinolysis, as demonstrated by prolonged clot lysis time (CLT) in association with increased plasma levels of thrombin-activatable fibrinolysis inhibitor (TAFI). In this study, we investigated fibrinolytic potential in patients with RIF.

METHODS Three groups of patients were studied: 30 women with RIF (RIF group), 60 patients undergoing a first successful IVF–ET cycle (IVF group) and 60 healthy fertile women (FER group). Plasma CLT was measured using a global fibrinolysis assay. TAFI antigen plasma levels and polymorphisms in the TAFI gene (+505A/G and +1542C/G) were analysed using enzyme-linked immunosorbent assay and allele-specific PCR, respectively.

RESULTS CLT was significantly longer (P< 0.0001 and P< 0.0009, respectively) and TAFI antigen levels were significantly higher (both P< 0.0001) in the RIF versus the IVF and FER groups. A direct relationship between CLT and TAFI antigen levels (r = 0.40; P = 0.001) was detected in the whole study population. There were no differences in distribution of TAFI polymorphisms between groups.

CONCLUSIONS Patients with RIF have reduced plasma fibrinolytic potential, as shown by a prolonged CLT, and this may be explained, at least in part, by increased TAFI antigen levels.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (3): 510-516. doi: 10.1093/humrep/deq369 First published online: January 7, 2011

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Reducing the incidence of twins from IVF treatments: predictive modelling from a retrospective cohort

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Stephen A. Roberts1,*, Linda McGowan2, W. Mark Hirst1, Andy Vail1, Anthony Rutherford3, Brian A. Lieberman4,5,6, Daniel R. Brison4 and the towardSET collaboration†

1Health Sciences—Methodology, University of Manchester, Manchester Academic Health Science Centre (MAHSC), Manchester M13 9WL, UK

2School of Nursing, Midwifery and Social Work, University of Manchester, MAHSC, Manchester M13 9WL, UK

3Leeds Centre for Reproductive Medicine, Leeds Teaching Hospitals NHS Trust, Seacroft Hospital, Leeds LS14 6UH, UK

4University of Manchester, MAHSC, St Mary's Hospital, Manchester, UK

5Department of Reproductive Medicine, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK

6Manchester Fertility Services, 120 Princess Road, Manchester M15 5AT, UK *Correspondence address. E-mail: steve.roberts{at}manchester.ac.uk?† Jan Hogg (The Leeds Centre for Reproductive Medicine); Steve Troup and Natalie Scott (The Hewitt Centre for Reproductive Medicine, Liverpool); Cheryl Fitzgerald and Helen Hunter (St Marys Hospital, Manchester); Debbie Falconer and Brian Lieberman (Manchester Fertility Services); Jane Saxton (Centre for Reproductive Medicine and Fertility, Sheffield).

Received July 14, 2010. Revision received October 15, 2010. Accepted October 26, 2010. BACKGROUND IVF treatments carry a high risk of twin pregnancy which confers a higher risk to the mother and child than singletons. Increased use of elective single embryo transfer (eSET) can reduce this twin rate. We aimed to utilize a previously published data set and statistical model based on routinely collected clinical data to predict the outcomes of policies that increase the proportion of eSET.

METHODS The models allow simultaneous prediction of outcomes from double embryo transfer (DET) and SET. These models were used to predict outcomes for different scenarios using SET in both the initial (fresh) transfer and over a complete cycle (transfer of all embryos created, with cryopreservation). A total of 16 096 cycles (12 487 fresh and 3609 frozen) from 9040 couples treated between 2000 and 2005 were included in the final analyses.

RESULTS For any transfer, SET has about a one-third lower live birth rate relative to DET: this can be partially mitigated by appropriate patient and treatment cycle selection, with several realistic policies performing similarly. However, if we consider complete cycles with embryo cryopreservation, it is possible for repeat SET to produce more live births per egg retrieval than repeat DET.

CONCLUSIONS All patients receiving SET would have a higher chance of successful treatment in that cycle if they received DET. The selection of appropriate patients for SET can partially ameliorate the overall loss. For complete cycles, repeat SET could produce more live births per egg retrieval than repeat DET. All treatments involving SET will increase the number of treatments required to achieve a successful outcome and this extra treatment burden will be a significant barrier to the implementation of such treatments.

© The Author 2010. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (3): 569-575. doi: 10.1093/humrep/deq352 First published online: December 16, 2010

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Efficiency of polarized microscopy as a predictive tool for human oocyte quality

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B. Heindryckx*, S. De Gheselle, S. Lierman, J. Gerris and P. De Sutter

Department for Reproductive Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium *Correspondence address. Tel: +32-9-332-4748; Fax: +32-9-332-4972; E-mail: bjorn.heindryckx{at}ugent.beReceived September 1, 2010. Revision received October 29, 2010. Accepted December 3, 2010. BACKGROUND Conflicting results have been reported regarding the use of polarized microscopy as a predictive tool for human oocyte quality.

METHODS Oocytes from 121 ICSI cycles were analysed with polarized microscopy. Both qualitative (spindle presence) and quantitative (retardance) data were correlated to the key assisted reproduction technology outcome parameters. Second, polarized microscopy was applied on in vitro matured (IVM) oocytes from germinal vesicle oocytes that matured after 24 or 48 h and from metaphase I oocytes matured after 3 or 24 h. These data were correlated with confocal analysis of spindle-chromosome complex.

RESULTS Spindles were detected in 82% of in vivo matured oocytes and in 64% adjacent to the first polar body (PB). Fertilization rate was higher in oocytes with a visible spindle (P = 0.0002). In patients aged over 35 years, the percentage of a visible spindle and mean spindle retardance was lower than in younger patients (P < 0.03). A higher number of spindles were located adjacent to the first PB in IVM matured oocytes (94%) versus in vivo matured oocytes (P < 0.0001). Confocal imaging revealed that spindle absent IVM metaphase II (MII) oocytes had a higher degree of aberrant spindle and chromosomal configurations versus IVM MII oocytes with a visible spindle (P = 0.002).

CONCLUSIONS Oocytes with absent spindles were associated with lower fertilization rates and advanced female age. Other important outcome parameters (embryo quality, pregnancy rates) were not correlated to spindle nor zona inner layer analysis. Interestingly, confocal imaging showed that polarized microscopy might be used as a qualitative predictive tool of human oocyte quality but no correlation could be demonstrated with quantitative polarized microscopy.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (3): 535-544. doi: 10.1093/humrep/deq376 First published online: January 12, 2011

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Cellular and genetic analysis of oocytes and embryos in a human case of spontaneous oocyte activation

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Catherine M.H. Combelles1,*, William G. Kearns2, Janis H. Fox3 and Catherine Racowsky3

1Biology Department, Middlebury College, Middlebury, VT 05753, USA

2Shady Grove Center for Preimplantation Genetics, Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA

3Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA *Correspondence address. E-mail: ccombell{at}middlebury.eduReceived October 4, 2010. Revision received November 18, 2010. Accepted November 25, 2010. Unusual and consistent defects in infertility patients merit attention as these may indicate an underlying genetic abnormality, in turn necessitating tailored management strategies. We describe a case of repeated early pregnancy loss from in vivo conceptions, followed by cancelled embryo transfers after one IVF and one ICSI/PGD cycle. Following the unexpected presence of cleaved embryos at the fertilization check in the first IVF attempt, oocytes and embryos were subsequently analyzed in an ICSI/PGD case. Part of the oocyte cohort was fixed at retrieval for a cellular evaluation of microtubules, microfilaments and chromatin. The remaining oocytes were injected with sperm, and resultant embryos were biopsied for genetic analysis by fluorescence in situ hybridization (FISH), single-nucleotide polymorphism (SNP) microarray for 23 chromosome pairs, as well as with PCR for sex chromosomes. The presence of interphase microtubule networks and pronuclear structures indicated that oocytes were spontaneously activated by the time of retrieval. FISH revealed aneuploidy in all seven blastomeres analyzed, with all but two lacking Y chromosomes. Microarray SNP analysis showed an exclusively maternal origin of all blastomeres analyzed, which was further confirmed by PCR. From our multi-faceted analyses, we conclude that spontaneous activation, or parthenogenesis, was probably the pathology underlying our patient's recurrent inability to maintain a normal pregnancy. Such analyses may prove beneficial not only in diagnosing case-specific aberrations for other patients with similar or related failures, but also for furthering our general understanding of oocyte activation.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (3): 545-552. doi: 10.1093/humrep/deq363 First published online: January 11, 2011

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Differential actions of glycodelin-A on Th-1 and Th-2 cells: a paracrine mechanism that could produce the Th-2 dominant environment during pregnancy

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Cheuk-Lun Lee1,2,3,†, Philip C.N. Chiu1,3,*†, Kevin K.W. Lam1, Siu-On Siu2, Ivan K. Chu2, Riitta Koistinen4, Hannu Koistinen4, Markku Seppälä4, Kai-Fai Lee1,3 and William S.B. Yeung1,3

1Department of Obstetrics and Gynaecology, University of Hong Kong, Pokfulam Road, Hong Kong, China

2Department of Chemistry, University of Hong Kong, Pokfulam Road, Hong Kong, China

3Centre for Reproduction, Development and Growth, University of Hong Kong, Pokfulam Road, Hong Kong, China

4Department of Clinical Chemistry, Helsinki University Central Hospital and University of Helsinki, 00029 HUS Helsinki, Finland *Correspondence address. Tel: +852-28199388; Fax: +852-28161947; E-mail: pchiucn{at}hkucc.hku.hk?† Contributed equally to the report.

Received June 24, 2010. Revision received November 29, 2010. Accepted December 6, 2010. BACKGROUND The maternal–fetal interface has a unique immunological response towards the implanting placenta. It is generally accepted that a T-helper type-2 (Th-2) cytokine prevailing environment is important in pregnancy. The proportion of Th-2 cells in the peripheral blood and decidua is significantly higher in pregnant women in the first trimester than in non-pregnant women. Glycodelin-A (GdA) is a major endocrine-regulated decidual glycoprotein thought to be related to fetomaternal defence. Yet the relationship between its immunoregulatory activities and the shift towards Th-2 cytokine profile during pregnancy is unclear.

METHODS GdA was immunoaffinity purified from human amniotic fluid. T-helper, T-helper type-1 (Th-1) and Th-2 cells were isolated from the peripheral blood. The viability of these cells was studied by XTT assay. Immunophenotyping of CD4/CD294, cell death and GdA-binding were determined by flow cytometry. The mRNA expression, surface expression and secretion of Fas/Fas ligand (FasL) were determined by quantitative polymerase chain reaction, flow cytometry and ELISA, respectively. The activities of caspase-3, -8 and -9 were measured. The phosphorylation of extracellular signal-regulated kinases (ERK), p38 and, c-Jun N-terminal kinase was determined by western blotting.

RESULTS Although GdA bound to both Th-1 and Th-2 cells, it had differential actions on the two cell-types. GdA induced cell death of the Th-1 cells but not the Th-2 cells. The cell death was mediated through activation of caspase -3, -8 and -9 activities. GdA up-regulated the expression of Fas and inhibited ERK activation in the Th-1 cells, which might enhance the vulnerability of the cells to cell death caused by a trophoblast-derived FasL.

CONCLUSIONS The data suggest that GdA could be an endometrial factor that contributes to the Th-2/Th-1 shift during pregnancy.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (3): 517-526. doi: 10.1093/humrep/deq381 First published online: January 11, 2011

Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.

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Intrafamilial medically assisted reproduction

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ESHRE Task Force on Ethics and Law including, G. de Wert*, W. Dondorp, G. Pennings, F. Shenfield, P. Devroey, B. Tarlatzis, P. Barri and K. Diedrich

Department of Health, Ethics and Society, Research Institutes CAPHRI and GROW, Maastricht University, Maastricht, The Netherlands *Correspondence address. E-mail: g.dewert{at}maastrichtuniversity.nl?† ESHRE pages' content is not externally peer-reviewed.

Received December 3, 2010. Revision received December 3, 2010. Accepted December 8, 2010. For different motives, couples in need of third party assisted reproduction sometimes prefer the help of a family member over an unrelated collaborator. Quantitative (frequency) and qualitative (experience) data about this practice are lacking or scarce. Forms of intrafamilial medically assisted reproduction (IMAR) are different with respect to (i) familial closeness between the collaborator and the person whose reproductive contribution he or she replaces and whether assistance would be intra- or intergenerational, (ii) the relationship between the collaborator and the fertile partner (this relationship may or may not be consanguineous) and (iii) with regard to the material (sperm and oocytes) that is donated and the services (surrogacy) that are offered. This document aims at providing guidance to the professional handling of requests for IMAR. It briefly sketches the background of this practice and discusses a variety of relevant normative aspects.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (3): 504-509. doi: 10.1093/humrep/deq383 First published online: January 19, 2011

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Constitutional change of Italian legislation on assisted reproduction technology improves pregnancy rate especially in older patients

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Paola Scaruffi1, Maria Rita Primavera1, Luiza Helena Abbamonte1, Shanti Levi1, Caterina De Leo2, Annamaria Nicoletti1 and Paola Anserini1,*

1Center of Physiopathology of Human Reproduction, Department of Obstetrics and Gynecology, ‘San Martino’ Hospital, L.go R. Benzi, 10, 16132 Genova, Italy

2Department of Obstetrics and Gynecology, University of Genova, Genova, Italy *Correspondence address. Tel: +39-010-5555843; Fax: +39-010-5556909; E-mail: paola.anserini{at}hsanmartino.itSir,

In February 2004, the Italian Parliament approved a law (namely 40/2004) regulating assisted reproduction technology ( Benagiano and Gianaroli, 2004). This law imposed many limitations on Italian reproductive specialists. The most important of these restrictions was the provision that no more than three oocytes could be fertilized at one time during an IVF treatment, since all embryos obtained had to be transferred simultaneously. On May 2009, the Italian Constitutional Court outlawed some restrictions set out in the 40/2004 law ( Benagiano and Gianaroli, 2010). The most important point of the ruling is that embryo protection is limited by the imperative to ensure a concrete possibility to achieve a successful pregnancy. The Court also strongly reaffirmed the supremacy of the physician's judgment in carrying out a full evaluation and a personalized treatment plan for each woman and couple. Therefore, Italian reproductive specialists can now define an individualized optimal number of embryos to give the best chance of achieving a pregnancy while limiting the number of cryopreserved embryos.

The recently published article by Levi Setti et al. (2010) reported a retrospective analysis of 3274 IVF cycles, comparing fresh cycles before and after the 40/2004 law was modified. No significant difference was found between the two groups in terms of patients’ age, basal FSH levels, …

This ArticleHum. Reprod. (2011) 26 (4): 959-961. doi: 10.1093/humrep/der014 First published online: February 11, 2011

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Zillow Releases Free BlackBerry App for Home Shoppers

 

I am not sure how many of you are familiar with Zillow but it is an awesome resource for home shoppers. When you are looking for a new house Zillow provides you with a ton of vital information about each property. They just announced today that they have released a BlackBerry app for their service that allows you to view a aerial map of your location using GPS displaying

Zestimate home valuationshomes for salehomes for rentRent ZestimatesMake Me Move listingsand recently sold data on the homes around them. Additional features on the

The Zillow BlackBerry App also allows you to have:

Multiple search filters that include price, number of bedrooms and bathrooms and other valuable home-related information.Homes viewable on a map with high-resolution satellite and street view.Home search by location or by typing in a city, ZIP code or address.Full-screen color photos of homes.

The Zillow app is totally free and you can pick it up at zillow.com/blackberry/ or in App World by searching for Zillow. It supports OS 5.0+ so it should cover most users.

Check out a video demo of Zillow for BlackBerry below:

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Where is the BlackBerry PlayBook Advertisement Blitz?

Now that RIM has officially set the BlackBerry PlayBook launch date for April 19th along with opening up preorders I keep wondering one thing. Where are all the BlackBerry PlayBook ads. RIM has really stepped up their game with BlackBerry smartphone ads but I have yet to see one ad for the BlackBerry PlayBook. No billboards, web ads, nothing…

So I have to wonder if we are in the quiet before the storm? Will we suddenly see the floodgates open in the next three weeks? What do you think RIM’s game plan is?

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What is that Icon in the BlackBerry Touch Leak – Speculate!

I didn’t notice it until Marc Paradise pointed it out but anybody notice something funny about the BlackBerry Touch pictures leaked by the BoyGenius? They have a black box over one of the icons on the homescreen. While Marc thought that points to it being a controlled “leak”, Jonathan (aka BoyGenius) confirmed in the comments when Afrolion also pointed it out that:

Stuff we blurred that isn’t quite ready to be public yet! Well, you know, besides the phone and all that.

So I thought I would throw the question to all of you. What do you think could be hidden behind door black icon #1? A icon for the Apple App Store? A Tardis? A BlackBerry Music Store? Let us know what you think!

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Poll: Does your BlackBerry Knowledge Influence the People Around You?

I was out at the mall yesterday, and happened to run in to an old classmate from college at the Bell store, and saw him looking at a 9780 and an Atrix.  I immediately had to go and talk to him and ask what his needs and wants were for the phone, and whipped out my 9700.  I obviously told him about all the pro’s and how I have had my 9700 since release and it’s been flawless, and the 9780 was an upgraded version of my great phone.  How OS6 has made the BlackBerry a more competitive smartphone, and the push technology makes them excellent communication devices.  Now the Atrix is a good phone as well, but showing him hands on how my 9700 worked helped him seeing the phone first hand.

I didn’t stick around to see what his decision was, but later on Facebook I got a pm with his PIN, and with this I am asking, has your BlackBerry knowledge and addiction influenced people around you to get a BlackBerry, theme, apps or accessories?  I know that I now have siblings, friends, and extended family addicted… do you?

Also, with the launch of the PlayBook, have you swayed people to hold off on a tablet purchase? Have you examined the strengths and weaknesses of the PlayBook versus the Ipad (1 and 2) as well as the many Android tablets becoming available. Have you adapted to the mentality that the PlayBook is for everyone, even though RIM is pushing it as the first business oriented tablet, seeing how many of us adopted BlackBerry’s for personal devices while they are mainly business oriented.

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RIM Foo Fighters Garage Tour Contests End Today! (US & Canada)

I am not sure how we missed this but RIM has a Foo Fighters contest and sweepstakes going on with a grand prize of trip for two to see the Foo Fighters or a private performance by them in your garage. The sweepstakes for the trip to see the Foo Fighters in concert ends today and its really simple to enter compared to the Best Buy version. You need to fill out the form at http://www.foofightersgaragetour.com/ and the contest is open to US and Canadian residents except for Quebec.

The contest on the other hand is a bit more complicated but also ends today. You need to submit a photo of YOUR garage and in 25 words or less tell RIM why the Foo Fighters should play in your garage. You enter that contest at this link.

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Where is the BlackBerry PlayBook Advertisement Blitz?

Now that RIM has officially set the BlackBerry PlayBook launch date for April 19th along with opening up preorders I keep wondering one thing. Where are all the BlackBerry PlayBook ads. RIM has really stepped up their game with BlackBerry smartphone ads but I have yet to see one ad for the BlackBerry PlayBook. No billboards, web ads, nothing…

So I have to wonder if we are in the quiet before the storm? Will we suddenly see the floodgates open in the next three weeks? What do you think RIM’s game plan is?

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OS 6.1.0.44 Leaks for Unreleased Torch 2 9850 and Bold Touch 9930

For all of you sporting unreleased BlackBerry Torch 2 9850’s or BlackBerry Bold Touch 9930s we have an OS leak for you! If you don’t have one of those devices simply jump in your Tardis (that’ makes 3 @DrewCPU) and pick one up from the “future you.” All of those leaked apps were extracted by this new OS 6.1.0.44 that has been leaked by the Driphter team courtesy of ALKi3. You can see how early of a release it is based on the numbering but still it might be fun to download if you want to tinker and create a “frankenOS” hybrid.

You can pick up the OS at the links below:

Thanks to everyone who sent this in! (image credit AussieGall)

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AGF Ballistic Built For BlackBerry PlayBook Case

Recently I reviewed the GRT Shell case for the BlackBerry 9800  from AGF  and yesterday they let us know that they have cases for the 8500 and 9300 curves. The one thing that interested me the most though was the mention of the Ballistic Tough Jacket (TJ) for the soon to be released PlayBook. We know that RIM is releasing some cases and other accessories for the PlayBook but is is nice to see other 3rd party vendors working on them too.  This means that early adopters of the PlayBook won’t have much problems finding accessories for it. That is one of the main problems I usually ran into when there is a new device in the market.

Note: The case is not yet available but you can sign up here for updates.

Product description:

The Ballistic Hardcore (HC) The Ballistic Tough Jacket (TJ) offers three layers of advanced protection.  It includes a rigid screen cover that also doubles as a kickstand to provide the optimal viewing position.

Ballistic is proud to introduce our Ballistic TJ (Tough Jacket) Series Case for the BlackBerry Playbook, with not one, not two… but THREE layers of protection! The first and outermost layer is made of soft TPU which will help absorb the shock of a drop. In addition, this first layer, is co-molded onto layer number 2, which is made of a tough impact resistant polycarbonate. Layer number three, which is the inner-most layer, made of a soft silicone. This layer also includes our Ballistic Corners™ which means all four corners have extra shock absorption where you need it the most! Also included with this amazing case is a front cover attachment to help protect the screen during travel. The cover can also be removed and placed on the back of your case to be used as a kickstand for your Playbook!

Advanced three layer protectionInner silicone layer absorbs shockImpact resistant hard plastic protects the phoneSoft rubber on the back of the plastic adds to the durabilityThicker Ballistic Corners for drop protectionRemovable screen cover that can also be used on the back as a kickstand

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Leaked BlackBerry Enterprise Software Roadmap for 2011

RIM is really shaking up their enterprise offerings the past year or so. They threw in BES Express for free, worked with Google Apps, and are rolling out a “Cloud BES” solution. Lucas @N4BB scored a slide showing what is supposed to be the Enterprise Roadmap for BlackBerry solutions in 2011. We don’t have much confirmation on the rumor beyond the releases that already happened but some things are interesting:

SharePoint 1.0 general availability is “on hold since Nov RTM” whatever that meansBES 5.0.3 is still showing a late March or April releaseBES Express 5.0.3 seems to be coming later in late May 2011Some sort of BES for Google Apps is coming in the beginning of September which looks like part of the “Cloud BES” we have heard of beforeA unknown Contrail 1.0 rel;ease is scheduled for sometime in November. No idea what it is but it may be something to do with the cloud BES solution

Here are two product slides to accompany the roadmap:

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Zinio Bringing Popular Magazines to the BlackBerry PlayBook?

Yesterday we pointed out a picture on RIM’s BlackBerry PlayBook site showing a then unknown app with popular magazines featured. Having no idea what the app was I decided to open up to floor to our readers to figure out what it was and it looks like we have it figured out. The BlackBerry PlayBook render of the app looks exactly like Zinio.

In case you have never heard of Zinio (I hadn’t) they offer up popular digital magazines and books through their service. From what I can tell Zinio offers National Geographic, Rolling Stones, Harvard Business Review, and Popular Mechanics which are shown in the rendering on RIM’s site. What really clinches it is that their latest Zinio Reader4 beta is built on Adobe AIR which should be super easy for them to port to the BlackBerry PlayBook.

So it looks like we will probably hear an announcement about the PlayBook getting Zinio soon. What do you think?

Thanks to Tenniscpa and Michael for pointing this out!

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