The aim of this study was to investigate whether the sperm chromatin structure assay （SCSA） results after swim-up are related to fertilization rates, embryo quality and pregnancy rates following in vitrofertilizati...The aim of this study was to investigate whether the sperm chromatin structure assay （SCSA） results after swim-up are related to fertilization rates, embryo quality and pregnancy rates following in vitrofertilization （IVF）. A total of 223 couples undergoing IVF in our hospital from October 2008 to September 2009 were included in this study. Data on the IVF process and sperm chromatin structure assay results were collected. Fertilization rate, embryo quality and IVF success rates of different DNA fragmentation index （DFI） subgroups and high DNA stainability （HDS） subgroups were compared. There were no significant differences in fertilization rate, clinical pregnancy or delivery rates between the DFI and HDS subgroups. However, the group with abnormal DFI had a lower good embryo rate. So, we concluded that the SCSA variables, either DFI or HDS after swim-up preparation, were not valuable in predicting fertilization failure or pregnancy rate, but an abnormal DFI meant a lower good embryo rate following IVF.展开更多
The aim of this study was to compare the in vitro fertilization (IVF) cycles ended by miscarriage with subsequent IVF cycles in relation to various IVF cycle parameters and pregnancy termination modalities. Comparison...The aim of this study was to compare the in vitro fertilization (IVF) cycles ended by miscarriage with subsequent IVF cycles in relation to various IVF cycle parameters and pregnancy termination modalities. Comparison of pre-miscarriage to post-miscarriage IVF cycles parameters demonstrated that lower peak E2 levels (1087 ± 593 versus 1237 ± 676 pg/ml, respectively;p p p p p p < 0.05), and an increase in the conception rate (34.7% versus 42.2%, respectively) at the second post-miscarriage IVF cycle.展开更多
Poor ovarian response (POR)—retrieval of 3 or fewer eggs, is a challenging issue in IVF. A retrospective study included POR women who underwent 386 IVF cycles. The data were classified in four groups according to wo...Poor ovarian response (POR)—retrieval of 3 or fewer eggs, is a challenging issue in IVF. A retrospective study included POR women who underwent 386 IVF cycles. The data were classified in four groups according to women’s age (years) during the treatment cycle: 1) 20 - 34 (n = 133), 2) 35 - 39 (n = 133), 3) 40 - 42 (n = 78), 4) 43 - 47 y (n = 42), and correlated with the characteristics of the population. The clinical pregnancy rates for groups 1, 2, 3, and 4 were: 23.3%, 12%, 2.6%, 4.8%, respectively. It was found to be significantly higher (p < 0.001) comparing group 1 with group 3 patients. The “take home baby” rate was much lower (p < 0.001) in group 3;there were no deliveries in group 4. Delivery rates for groups 1, 2, 3, and 4 were: 19.5%, 10.5%, 1.3% and 0%, respectively. Intraabdominal adhesions were more common (p = 0.005) as the cause of infertility in group 3 women compared to groups 2 and 1: 24.4% compared with 9% and 9.8%, respectively. According to multivariate regression analysis, the parameters that negatively reflect on the pregnancy rate in POR women are intraabdominal adhesions, POR in the past, and increased age. We suggest encouraging young POR patients to pursue IVF treatments since the “take home baby” rates are reasonably good.展开更多
Introduction: The effect of Body Mass Index (BMI), which reflects the woman’s obesity, in IVF treatment cycle, remains unclear. In 1997, the World Health Organization (WHO) provided authoritative refinements to the o...Introduction: The effect of Body Mass Index (BMI), which reflects the woman’s obesity, in IVF treatment cycle, remains unclear. In 1997, the World Health Organization (WHO) provided authoritative refinements to the over-weight terminology and BMI cutoffs [1]. Objective: To verify the relationship between BMI and ovarian response in IVF treatment cycle. Design: Retrospective study. Materials & Methods: The study includes 2625 IVF treatment cycles performed in our IVF center in the period of 4 years. Patients were divided into five groups using the WHO criteria according to their BMI [2]. Cancellation rate, mean last E2 before hCG administration, mean endometrial thickness, mean duration of stimulation, number of eggs retrieved, fertilization rate, pregnancy and abortion rates were analyzed. The unpaired t-test was used in statistical analysis. Results: There was statistically significant less mean oestradiol level prior to hCG, less endometrial thickness and less number of simulation days as BMI gets higher. In contrast, there was a positive relationship between cancellation rate and higher BMI except with BMI >39 which was not, possibly due to lower number of patients available. But if we look at the cause of cancellation, it was 100% due to insufficient number of follicles obtained for this group (BMI >39). Also, days of stimulation are significantly lower for the same group of patients in comparison with the other groups. Retrieval, fertilization and pregnancy rates were not significant between all groups. Abortion rate gets significantly higher as BMI increased. Conclusion: Overweight affects ovulation, if we consider the cause of cancellation being insufficient number of follicles reflects the poor response. The fertilization and pregnancy rate were not affected once oocytes retrieved. The reduction of weight is an important part of infertility treatment in obese women with regards to the ovarian response and abortion rate in IVF cycle.展开更多
Infertility,affecting one in six couples,is often related to the male partner’s congenital and/or environmental conditions or complications postsurgery.This retrospective study examines the link between orchiopexy fo...Infertility,affecting one in six couples,is often related to the male partner’s congenital and/or environmental conditions or complications postsurgery.This retrospective study examines the link between orchiopexy for undescended testicles(UDT)and testicular torsion(TT)in childhood and adult fertility as assessed through sperm analysis.The study involved the analysis of semen samples from 7743 patients collected at Soroka University Medical Center(Beer Sheva,Israel)between January 2009 and December 2017.Patients were classified into two groups based on sperm concentration:those with concentrations below 5×10^(6)sperm per ml(AS group)and those above(MN group).Medical records and surgical histories were reviewed,categorizing orchiopexies by surgical approach.Among 140 individuals who had undergone pediatric surgery,83(59.3%)were placed in the MN group and 57(40.7%)in the AS group.A higher likelihood of being in the MN group was observed in Jewish compared to Arab patients(75.9%vs 24.1%,P=0.006).In cases of childhood UDT,45(78.9%)patients exhibited sperm concentrations below 5×10^(6)sperm per ml(P<0.001),and 66(76.7%)had undergone unilateral and 18(20.9%)bilateral orchiopexy.Bilateral orchiopexy was significantly associated with lower sperm concentration,total motility,and progressive motility than unilateral cases(P=0.014,P=0.001,and P=0.031,respectively).Multivariate analysis identified UDT as a weak risk factor for low sperm concentration(odds ratio[OR]:2.712,P=0.078),with bilateral UDT further increasing this risk(OR:6.314,P=0.012).Jewish ethnicity and TT diagnosis were associated with a reduced risk of sperm concentrations below 5×10^(6)sperm per ml.The findings indicate that initial diagnosis,surgical approach,and ethnicity markedly influence male fertility outcomes following pediatric orchiopexy.展开更多
Women have been increasingly delaying the start of motherhood in recent decades. The same trend is seen also for men. The influence of maternal age on fertility, chromosomal anomalies, pregnancy complications, and imp...Women have been increasingly delaying the start of motherhood in recent decades. The same trend is seen also for men. The influence of maternal age on fertility, chromosomal anomalies, pregnancy complications, and impaired perinatal and post-natal outcome of offspring, has been thoroughly investigated, and these aspectsare clinically applied during fertility and pregestational counseling. Male aging and reproductive outcome has gained relatively less attention. The purpose of this review is to evaluate updated and relevant literature on the effect of paternal age on reproductive outcome.展开更多
This study investigated the effects of varicocele on semen parameters in infertile men based on the new 2010 World Health Organization laboratory manual for the examination of human semen. Semen analysis results （vol...This study investigated the effects of varicocele on semen parameters in infertile men based on the new 2010 World Health Organization laboratory manual for the examination of human semen. Semen analysis results （volume, sperm count, motility, and morphology） were the primary outcomes. An electronic search to collect the data was conducted using the Medline/PubMed, SJU discover, and Google Scholar databases. We searched articles published from 2010 to August 2015, i.e., after the publication of the 2010 WHO manual. We included only those studies that reported the actual semen parameters of adult infertile men diagnosed with clinical varicocele and contained a control group of either fertile men or normozoospermic men who were not diagnosed with varicocele. Ten studies were included in the meta-analysis, involving 1232 men. Varicocele was associated with reduced sperm count （mean difference： -44.48 x 106 ml-1; 95% Ch -61.45, -27.51 x 106 ml-1; P〈 0.001）, motility （mean difference： -26.67%; 95% Ch -34.27, -19.08; P 〈 0.001）, and morphology （mean difference： -19.68%; 95% Ch -29.28, -10.07; P 〈 0.001） but not semen volume （mean difference： -0.23 ml; 95% CI： -0.64, 0.17）. Subgroup analyses indicated that the magnitude of effect was influenced by control subtype but not WHO laboratory manual edition used for semen assessment. We conclude that varicocele is a significant risk factor that negatively affects semen quality, but the observed pooled effect size on semen parameters does not seem to be affected by the WHO laboratory manual edition. Given most of the studies published after 2010 still utilized the 1999 manual for semen analysis, further research is required to fully understand the clinical implication of the 2010 WHO laboratory manual on the association between varicocele and semen parameters.展开更多
Neurodevelopmental disorders are characterized by an abnormal development of the central nervous system, leading to a myriad of symptoms and diseases, including intellectual disability, attention deficits, impairments...Neurodevelopmental disorders are characterized by an abnormal development of the central nervous system, leading to a myriad of symptoms and diseases, including intellectual disability, attention deficits, impairments in learning and memory, speech disorders and repetitive behavior （Telias and Ben-Yosef, 2014）. Common major neurodevelopmental disorders include autism and autism spectrum disorders （ASDs）, fragile X syndrome （FXS）, Down syndrome （DS）, and Rett syndrome （RTT）. They can be collectively described as disorders in which the plasticity of the brain has been severely impaired. The concept of plasticity refers to the brain＇s ability to adapt to and process new information and react accordingly, and it can be classified into three categories： a） molecular plasticity, whenever specific receptors, ion channels, enzymes,展开更多
The irreversible transformation of androgens into oestrogens is catalysed by cytochrome P450 aromatase. In the present study, we explored the contribution of the （TTTA）n polymorphism in the aromatase gene （CYP19） ...The irreversible transformation of androgens into oestrogens is catalysed by cytochrome P450 aromatase. In the present study, we explored the contribution of the （TTTA）n polymorphism in the aromatase gene （CYP19） to sperm concentration and motility. Ninety normozoospermic and 60 oligospermic men were examined during infertility examinations. DNA was extracted from spermatozoa, and the CYP19（TTTA）n polymorphism was genotyped by PCR. Genotype analysis revealed six CYP19（TTTA）n alleles with 7-12 repeats. The allelic distribution of the CYP19（TTTA）n polymorphism differed between normozoospermic and oligospermic men （P〈0.01）. Oligospermic men less frequently had long CYP19 alleles than did normozoospermic men （25 and 37.8%, respectively; P〈0.02）. The higher frequency of short CYP19alleles in oligospermic men compared to normozoospermic men （43.3 and 28.3%, respectively; P〈0.01） was primarily due to the distribution of the CYP19 （TTTA）7 allele. The CYP19 （TTTA）7 allele was associated with lower sperm concentration in normozoospermic men {P〈0.01） and in the total study population {P〈0.01）; it was also associated with lower sperm motility in normozoospermic men （P〈0.05） and in the total study population （P〈0.01）. In conclusion, the CYP19 （TTTA）7 allele probably impairs aromatase activity, which in turn alters aromatase and oestrogen levels in the testis, leading to decreased sperm concentration and motility. These findings support the significance of cytochrome P450 aromatase in human spermatogenesis and consequently in semen quality.展开更多
Choline is a crucial factor in the regulation of sperm membrane structure and fluidity, and this nutrient plays an important role in the maturation and fertilizing capacity of spermatozoa. Transcripts of phosphatidyle...Choline is a crucial factor in the regulation of sperm membrane structure and fluidity, and this nutrient plays an important role in the maturation and fertilizing capacity of spermatozoa. Transcripts of phosphatidylethanolamine N-methyltransferase （PEMT） and choline dehydrogenase （CHDH）, two basic enzymes of choline metabolism, have been observed in the human testis, demonstrating their gene expression in this tissue. In the present study, we explored the contribution of the PEMTand CHDHgene variants to sperm parameters. Two hundred oligospermic and 250 normozoospermic men were recruited. DNA was extracted from the spermatozoa, and the PEMT -774G〉C and CHDH ＋432G〉T polymorphisms were genotyped. The genotype distribution of the PEMT-774G〉C polymorphism did not differ between oligospermic and normozoospermic men. In contrast, in the case of the CHDH ＋432G〉T polymorphism, oligospermic men presented the CHDH432GIG genotype more frequently than normozoospermic men （62% vs. 42%, P〈0.001）. The PEMT774GIG genotype was associated with a higher sperm concentration compared to the PEMT774GIC and 774C/C genotypes in oligospermic men （12.5±5.6× 10^6 spermatozoa m1-1 vs. 8.3±5.2×10^6 spermatozoa m1-1, P〈0.002） and normozoospermic men （81.5±55.6×10^6 vs. 68.1±44.5×10^6 spermatozoa m1-1, P〈0.006）. In addition, the CHDH432G/G genotype was associated with higher sperm concentration compared to CHDH432G.T and 432T/T genotypes in oligospermic （11.8±5.1×10^6 vs. 7.8±5.3×10^6 spermatozoa m1-1, P〈0.003） and normozoospermic men （98.6±62.2×10^6 vs. 58.8±＋33.6×10^6 spermatozoa m1-1, P〉0.001）. In our series, the PEMT-774G〈C and CHDH ＋432G〈T polymorphisms were associated with sperm concentration. This finding suggests a possible influence of these genes on sperm quality.展开更多
Variations in Vascular Endothelial Growth Factor (VEGF) levels were prospectively evaluated in 18 young women undergoing in vitro fertilization treatments according to the “Long Protocol” and a typical pattern of VE...Variations in Vascular Endothelial Growth Factor (VEGF) levels were prospectively evaluated in 18 young women undergoing in vitro fertilization treatments according to the “Long Protocol” and a typical pattern of VEGF levels was recorded. A significant increase in VEGF concentrations was observed only when the follicles reached a mean diameter of 15.3 mm in concurrence with mature oocyte retrieval. Since an increase in VEGF levels is related to follicular vascularity and oocyte developpment, our study supports the approach that oocyte retrieval may be performed when follicles > 15 mm in diameter appear. Anticipating egg retrieval in young patients with an optimal ovarian reserve may decrease the incidence of severe ovarian hyperstimulation, without compromising the treatment results.展开更多
Objective: Since little is known about the actual incidence and fate of vacuoles at different stages of development this preliminary study was set up to accurately measure vacuoles and track them to day 5. Design: Pro...Objective: Since little is known about the actual incidence and fate of vacuoles at different stages of development this preliminary study was set up to accurately measure vacuoles and track them to day 5. Design: Prospective study. Setting: Women’s General Hospital in Austria. Patient(s): A total of 223 consecutive IVF and intracytoplasmic sperm injection (ICSI) cycles (206 patients). Intervention(s): Accurate measurement of vacuoles. Affected gametes and embryos were cultured individually and tracked until day 5. Main Outcome Measure(s): Size and number of vacuoles, fertilization rate, blastocyst formation rate, blastocyst quality. Result(s): There was a significant relationship between size of the vacuole (cutoff value 14 μ m) and fertilization (P< .05). At zygote stage the incidence of vacuoles was higher (P< .01) in ICSI (11.6% ) than in IVF (5.3% ). Only 32.2% of affected ICSI- embryos reached blastocyst stage on day 5 compared with 53.0% of the normal ones (P< .001). In terms of blastocyst formation vacuolization on day 4 (P< .001) turned out to be the most severe one. At blastocyst stage inner cell mass was affected less frequently than the trophectoderm (P< .05). Conclusion(s): Three types of vacuoles could be identified: (1) those already present at oocyte collection, which develop during maturation (day 0); (2) those artificially created by ICSI (day 1); and (3) those accompanied with developmental arrest (day 4). The later that vacuoles arose, the more detrimental their effect on blastocyst formation.展开更多
Objective: To investigate whether hypnosis during ET contributes to successful IVF/ET outcome. Design: Case-control clinical study. Setting: Academic Fertility and IVF Unit, Soroka Medical Center, Beer-Sheva, Israel. ...Objective: To investigate whether hypnosis during ET contributes to successful IVF/ET outcome. Design: Case-control clinical study. Setting: Academic Fertility and IVF Unit, Soroka Medical Center, Beer-Sheva, Israel. Patient(s): Infertile couples undergoing IVF. Intervention(s): Ninety-eight IVF/ET cycles with hypnosis during the ET procedure were matched with 96 regular IVF/ET cycles. Main Outcome Measures: Comparison of clinical pregnancy and implantation rates between the two groups. Result(s): We obtained 52 clinical pregnancies out of 98 cycles (53.1% ) with an implantation rate of 28% among hypnosis IVF/ET cycles, and 29 out of 96 (30.2% ) clinical pregnancies and an implantation rate of 14.4% in the control cycles. Our overall IVF program pregnancy rate for the same period was 32.1% . Logistic regression analysis was performed emphasizing the positive contribution of hypnosis to the IVF/ET conception rates. Conclusion(s): This study suggests that the use of hypnosis during ET may significantly improve the IVF/ET cycle outcome in terms of increased implantation and clinical pregnancy rates. Furthermore, it seems that the patients’ attitude to the treatment was more favorable.展开更多
Backg</span><span style="font-family:Verdana;">round: Obstetric sonography is one of the prenatal tests offered to most pregnant women and an essential tool that helps health care providers to es...Backg</span><span style="font-family:Verdana;">round: Obstetric sonography is one of the prenatal tests offered to most pregnant women and an essential tool that helps health care providers to establish fetal condition and growth. The Objective: to assess the knowledge, attitudes, and practice about obstetric sonography among women at KAUH in Jeddah, Saudi Arabia. Method: A cross-sectional study was co</span><span style="font-family:Verdana;">nducted during 2018-2019 among 367 women. It included all women </span></span><span style="font-family:Verdana;">that </span><span style="font-family:""><span style="font-family:Verdana;">attend the OB/GYN outpatient clinic at KAUH in Jeddah. The data was collected through </span><span style="font-family:Verdana;">interview</span></span><span style="font-family:Verdana;">ing</span><span style="font-family:Verdana;"> questionnaire. The questionnaire consisted of 5 items to assess their knowledge, attitude, practice, and sociodemographic characteristics. Data were entered into a Microsoft Excel 2014 sheet, and statistical analysis was performed using IBM SPSS Statistics.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Result: The mean knowledge score about obstetric sonography was 13.9</span><span style="font-family:""> </span><span style="font-family:Verdana;">±</span><span style="font-family:""> </span><span style="font-family:Verdana;">1.7, where 343 (93.0%) had good knowledge, and only 26 (7.0%) had poor knowledge. The result revealed that the third</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">fourth</span><span style="font-family:Verdana;">s</span><span style="font-family:""><span style="font-family:Verdana;"> of the women 291 (78.9%) believed that obstetric sonography is safe, and 309 (83.8%) believed that obstetric sonogr</span><span style="font-family:Verdana;">aphy doesn</span></span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">t lead to a congenital anomaly. There was a difference in the knowledge score regarding education level, occupation, monthly income, and those with higher education, those who worked, and those with higher monthly payment had a higher knowledge score. Also, there was a positive correlation</span><span style="font-family:Verdana;"> between knowledge score and both gravidity and parity.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Conclusion: Women</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s knowledge, attitude, and practice about the purpose of the obstetric sonography were good. So, the primary health care providers should be advised to focusing more on providing health education on obstetric sonography to all pregnant women during their ANC visits.展开更多
Congenital Nephrotic Syndrome Type 1 (Congenital Nephrotic Syndrome of the Finnish Type—CNF) is an autosomal recessive disorder encoding by nephrin gene mutation which is a (transmembrane protein 1-homolog—NPHS1) st...Congenital Nephrotic Syndrome Type 1 (Congenital Nephrotic Syndrome of the Finnish Type—CNF) is an autosomal recessive disorder encoding by nephrin gene mutation which is a (transmembrane protein 1-homolog—NPHS1) structural component of the slit diaphragm responsible for the proper functioning of the renal filtration barrier. In NPHS1 kidneys there is an effacement of the foot processes of the podocytes and impaired glomerular filtration barrier leading to antenatal manifestations and end-renal stage of disease after birth. We present a case of this disease where sonographic appearance of the fetal kidneys had alerted the experts for further genetic investigation for congenital nephrotic syndrome.展开更多
<strong>Background:</strong><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span styl...<strong>Background:</strong><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Answering the question of what is the optimal protocol for monitoring controlled ovarian stimulation (COS) still remains a challenge. The rapid introduction of new diagnostic methods and various components of telemedicine makes it possible to reduce the number of patient visits during ovarian stimulation, which will reduce the loss of time, costs, and risk for the patient from COVID-like situations. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods:</span></b></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">The different COS monitoring protocols are examined, thus proposing a new approach consisting of two successive phases. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> In the first phase, E3G in urine samples is being examined, which is performed by the patient themselves with a small portable analyzer. Based on the results, the specialist prescribes the doses for stimulation. The second phase involves one single determination of the size and number of follicles at the end of stimulation, using TVUS, as well as the dynamics of serum levels of P4 and E2. This proves to be in many cases sufficient. </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusions:</span></b></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">It is of our opinion that on the basis of new diagnostic tests such as E3G in urine and telemedicine, patients are able to independently and actively participate in the treatment process. This new approach to COS monitoring can be successfully implemented in different protocols for ovarian stimulation.</span></span></span>展开更多
Capsule: Although embryos with synchronous blastomere cleavage showed higher post-thaw survival rates, pregnancy rates did not differ. Thus, embryos with all cleavage patterns may be safely cryopreserved. Objective: T...Capsule: Although embryos with synchronous blastomere cleavage showed higher post-thaw survival rates, pregnancy rates did not differ. Thus, embryos with all cleavage patterns may be safely cryopreserved. Objective: To compare post-thaw embryo survival, pregnancy and live birth rates of embryos with synchronous vs asynchronous blastomere cleavage in frozen embryo transfer (FET) cycles. Design: Retrospective study. Setting: University-affiliated IVF unit. Patients: One thousand and sixty FET cycles performed from 2004-2006. Interventions: Cycles were divided into 3 groups: 1: cycles in which only embryos with synchronous blastomere cleavage were frozen;2: cycles in which only embryos with asynchronous blastomere cleavage were frozen;3: cycles in which both embryos with synchronous and asynchronous blastomere cleavage were frozen. Clinical and laboratory data were recorded and analyzed. Main Outcome Measures: Post-thaw embryo survival, morphologic grading, pregnancy and live birth rates. Results: A total of 1863 embryos were analyzed. Synchronous embryos had higher blastomere survival rates and morphological grading at thawing. Pregnancy and birth rates did not differ among groups. In a multivariant logistic regression analysis, a number of transferred embryos and embryo morphological grading at thawing were the only parameters that affected pregnancy and live birth rates. Conclusions: Embryos with both synchronous and asynchronous blastomere cleavage can be selected by classical embryo grading and safely cryopreserved.展开更多
Objective: To describe a successful in vitro fertilization (IVF)- twin pregnancy in a patient with complete uterine septum who underwent partial correction during cesarean section. Design: Case report. Setting: An IVF...Objective: To describe a successful in vitro fertilization (IVF)- twin pregnancy in a patient with complete uterine septum who underwent partial correction during cesarean section. Design: Case report. Setting: An IVF unit at a university hospital. Patient(s): A 29- year- old female patient with complete uterine septum undergoing IVF- intracytoplasmic sperm injection. Intervention(s): In vitro fertilization- intracytoplasmic sperm injection with single embryo transfer to each uterine cavity. Main Outcome Measure(s): Pregnancy course and outcome. Result(s): Both transferred embryos underwent implantation, resulting in twin pregnancy with a single embryo in each hemiuterus. Cesarean section was performed at 34 weeks’ gestation. Two healthy neonates were born. Resection of the uterine septum by electrocauterization was attempted during cesarean section. Diagnostic hysteroscopy performed 6 months later demonstrated the presence of the uterine septum reaching approximately 40% of the cavity. Conclusion(s): Whether prophylactic metroplasty should be performed in patients with uterine septae without prior history of miscarriage or pregnancy complications is still under debate. Successful implantation and fetal development might occur without prior metroplasty, as described in our case report. Metroplasty during cesarean section might be only partly successful because part of the septum might be confined in the stretched gravid uterus.展开更多
In a study of the possible inter-relationship among müllerian anomalies,hearing loss,and connexin 26 mutations,we evaluated all women in whom müllerian anomalies were diagnosed on hysterosalpingography durin...In a study of the possible inter-relationship among müllerian anomalies,hearing loss,and connexin 26 mutations,we evaluated all women in whom müllerian anomalies were diagnosed on hysterosalpingography during a 6-year period (n=24/519). Audiometric testing revealed five (22.7%) with unrecognized sensorineural hearing loss; however,on genetic evaluation,none harbored a connexin 26 mutation.展开更多
Thirty-five pregnancies were inadvertently conceived during the midluteal application of the long-acting gonadotropin-releasing hormone agonist triptorelin acetate before ovarian stimulation for in vitro fertilization...Thirty-five pregnancies were inadvertently conceived during the midluteal application of the long-acting gonadotropin-releasing hormone agonist triptorelin acetate before ovarian stimulation for in vitro fertilization. Most of the conceptions occurred before the first or second IVF trial, and were associated with a significantly increased tendency to develop gestational diabetes. No increase in pregnancy wastage or appearance of congenital malformations occurred.展开更多
基金ACKNOWLEDGMENTS This study was supported by grants from the Natural Science Foundation of Shanghai （No. 10JC1410800）. The support of Jian-Bin Liu in collecting the patient data is gratefully acknowledged.
文摘The aim of this study was to investigate whether the sperm chromatin structure assay （SCSA） results after swim-up are related to fertilization rates, embryo quality and pregnancy rates following in vitrofertilization （IVF）. A total of 223 couples undergoing IVF in our hospital from October 2008 to September 2009 were included in this study. Data on the IVF process and sperm chromatin structure assay results were collected. Fertilization rate, embryo quality and IVF success rates of different DNA fragmentation index （DFI） subgroups and high DNA stainability （HDS） subgroups were compared. There were no significant differences in fertilization rate, clinical pregnancy or delivery rates between the DFI and HDS subgroups. However, the group with abnormal DFI had a lower good embryo rate. So, we concluded that the SCSA variables, either DFI or HDS after swim-up preparation, were not valuable in predicting fertilization failure or pregnancy rate, but an abnormal DFI meant a lower good embryo rate following IVF.
文摘The aim of this study was to compare the in vitro fertilization (IVF) cycles ended by miscarriage with subsequent IVF cycles in relation to various IVF cycle parameters and pregnancy termination modalities. Comparison of pre-miscarriage to post-miscarriage IVF cycles parameters demonstrated that lower peak E2 levels (1087 ± 593 versus 1237 ± 676 pg/ml, respectively;p p p p p p < 0.05), and an increase in the conception rate (34.7% versus 42.2%, respectively) at the second post-miscarriage IVF cycle.
文摘Poor ovarian response (POR)—retrieval of 3 or fewer eggs, is a challenging issue in IVF. A retrospective study included POR women who underwent 386 IVF cycles. The data were classified in four groups according to women’s age (years) during the treatment cycle: 1) 20 - 34 (n = 133), 2) 35 - 39 (n = 133), 3) 40 - 42 (n = 78), 4) 43 - 47 y (n = 42), and correlated with the characteristics of the population. The clinical pregnancy rates for groups 1, 2, 3, and 4 were: 23.3%, 12%, 2.6%, 4.8%, respectively. It was found to be significantly higher (p < 0.001) comparing group 1 with group 3 patients. The “take home baby” rate was much lower (p < 0.001) in group 3;there were no deliveries in group 4. Delivery rates for groups 1, 2, 3, and 4 were: 19.5%, 10.5%, 1.3% and 0%, respectively. Intraabdominal adhesions were more common (p = 0.005) as the cause of infertility in group 3 women compared to groups 2 and 1: 24.4% compared with 9% and 9.8%, respectively. According to multivariate regression analysis, the parameters that negatively reflect on the pregnancy rate in POR women are intraabdominal adhesions, POR in the past, and increased age. We suggest encouraging young POR patients to pursue IVF treatments since the “take home baby” rates are reasonably good.
文摘Introduction: The effect of Body Mass Index (BMI), which reflects the woman’s obesity, in IVF treatment cycle, remains unclear. In 1997, the World Health Organization (WHO) provided authoritative refinements to the over-weight terminology and BMI cutoffs [1]. Objective: To verify the relationship between BMI and ovarian response in IVF treatment cycle. Design: Retrospective study. Materials & Methods: The study includes 2625 IVF treatment cycles performed in our IVF center in the period of 4 years. Patients were divided into five groups using the WHO criteria according to their BMI [2]. Cancellation rate, mean last E2 before hCG administration, mean endometrial thickness, mean duration of stimulation, number of eggs retrieved, fertilization rate, pregnancy and abortion rates were analyzed. The unpaired t-test was used in statistical analysis. Results: There was statistically significant less mean oestradiol level prior to hCG, less endometrial thickness and less number of simulation days as BMI gets higher. In contrast, there was a positive relationship between cancellation rate and higher BMI except with BMI >39 which was not, possibly due to lower number of patients available. But if we look at the cause of cancellation, it was 100% due to insufficient number of follicles obtained for this group (BMI >39). Also, days of stimulation are significantly lower for the same group of patients in comparison with the other groups. Retrieval, fertilization and pregnancy rates were not significant between all groups. Abortion rate gets significantly higher as BMI increased. Conclusion: Overweight affects ovulation, if we consider the cause of cancellation being insufficient number of follicles reflects the poor response. The fertilization and pregnancy rate were not affected once oocytes retrieved. The reduction of weight is an important part of infertility treatment in obese women with regards to the ovarian response and abortion rate in IVF cycle.
文摘Infertility,affecting one in six couples,is often related to the male partner’s congenital and/or environmental conditions or complications postsurgery.This retrospective study examines the link between orchiopexy for undescended testicles(UDT)and testicular torsion(TT)in childhood and adult fertility as assessed through sperm analysis.The study involved the analysis of semen samples from 7743 patients collected at Soroka University Medical Center(Beer Sheva,Israel)between January 2009 and December 2017.Patients were classified into two groups based on sperm concentration:those with concentrations below 5×10^(6)sperm per ml(AS group)and those above(MN group).Medical records and surgical histories were reviewed,categorizing orchiopexies by surgical approach.Among 140 individuals who had undergone pediatric surgery,83(59.3%)were placed in the MN group and 57(40.7%)in the AS group.A higher likelihood of being in the MN group was observed in Jewish compared to Arab patients(75.9%vs 24.1%,P=0.006).In cases of childhood UDT,45(78.9%)patients exhibited sperm concentrations below 5×10^(6)sperm per ml(P<0.001),and 66(76.7%)had undergone unilateral and 18(20.9%)bilateral orchiopexy.Bilateral orchiopexy was significantly associated with lower sperm concentration,total motility,and progressive motility than unilateral cases(P=0.014,P=0.001,and P=0.031,respectively).Multivariate analysis identified UDT as a weak risk factor for low sperm concentration(odds ratio[OR]:2.712,P=0.078),with bilateral UDT further increasing this risk(OR:6.314,P=0.012).Jewish ethnicity and TT diagnosis were associated with a reduced risk of sperm concentrations below 5×10^(6)sperm per ml.The findings indicate that initial diagnosis,surgical approach,and ethnicity markedly influence male fertility outcomes following pediatric orchiopexy.
文摘Women have been increasingly delaying the start of motherhood in recent decades. The same trend is seen also for men. The influence of maternal age on fertility, chromosomal anomalies, pregnancy complications, and impaired perinatal and post-natal outcome of offspring, has been thoroughly investigated, and these aspectsare clinically applied during fertility and pregestational counseling. Male aging and reproductive outcome has gained relatively less attention. The purpose of this review is to evaluate updated and relevant literature on the effect of paternal age on reproductive outcome.
文摘This study investigated the effects of varicocele on semen parameters in infertile men based on the new 2010 World Health Organization laboratory manual for the examination of human semen. Semen analysis results （volume, sperm count, motility, and morphology） were the primary outcomes. An electronic search to collect the data was conducted using the Medline/PubMed, SJU discover, and Google Scholar databases. We searched articles published from 2010 to August 2015, i.e., after the publication of the 2010 WHO manual. We included only those studies that reported the actual semen parameters of adult infertile men diagnosed with clinical varicocele and contained a control group of either fertile men or normozoospermic men who were not diagnosed with varicocele. Ten studies were included in the meta-analysis, involving 1232 men. Varicocele was associated with reduced sperm count （mean difference： -44.48 x 106 ml-1; 95% Ch -61.45, -27.51 x 106 ml-1; P〈 0.001）, motility （mean difference： -26.67%; 95% Ch -34.27, -19.08; P 〈 0.001）, and morphology （mean difference： -19.68%; 95% Ch -29.28, -10.07; P 〈 0.001） but not semen volume （mean difference： -0.23 ml; 95% CI： -0.64, 0.17）. Subgroup analyses indicated that the magnitude of effect was influenced by control subtype but not WHO laboratory manual edition used for semen assessment. We conclude that varicocele is a significant risk factor that negatively affects semen quality, but the observed pooled effect size on semen parameters does not seem to be affected by the WHO laboratory manual edition. Given most of the studies published after 2010 still utilized the 1999 manual for semen analysis, further research is required to fully understand the clinical implication of the 2010 WHO laboratory manual on the association between varicocele and semen parameters.
文摘Neurodevelopmental disorders are characterized by an abnormal development of the central nervous system, leading to a myriad of symptoms and diseases, including intellectual disability, attention deficits, impairments in learning and memory, speech disorders and repetitive behavior （Telias and Ben-Yosef, 2014）. Common major neurodevelopmental disorders include autism and autism spectrum disorders （ASDs）, fragile X syndrome （FXS）, Down syndrome （DS）, and Rett syndrome （RTT）. They can be collectively described as disorders in which the plasticity of the brain has been severely impaired. The concept of plasticity refers to the brain＇s ability to adapt to and process new information and react accordingly, and it can be classified into three categories： a） molecular plasticity, whenever specific receptors, ion channels, enzymes,
文摘The irreversible transformation of androgens into oestrogens is catalysed by cytochrome P450 aromatase. In the present study, we explored the contribution of the （TTTA）n polymorphism in the aromatase gene （CYP19） to sperm concentration and motility. Ninety normozoospermic and 60 oligospermic men were examined during infertility examinations. DNA was extracted from spermatozoa, and the CYP19（TTTA）n polymorphism was genotyped by PCR. Genotype analysis revealed six CYP19（TTTA）n alleles with 7-12 repeats. The allelic distribution of the CYP19（TTTA）n polymorphism differed between normozoospermic and oligospermic men （P〈0.01）. Oligospermic men less frequently had long CYP19 alleles than did normozoospermic men （25 and 37.8%, respectively; P〈0.02）. The higher frequency of short CYP19alleles in oligospermic men compared to normozoospermic men （43.3 and 28.3%, respectively; P〈0.01） was primarily due to the distribution of the CYP19 （TTTA）7 allele. The CYP19 （TTTA）7 allele was associated with lower sperm concentration in normozoospermic men {P〈0.01） and in the total study population {P〈0.01）; it was also associated with lower sperm motility in normozoospermic men （P〈0.05） and in the total study population （P〈0.01）. In conclusion, the CYP19 （TTTA）7 allele probably impairs aromatase activity, which in turn alters aromatase and oestrogen levels in the testis, leading to decreased sperm concentration and motility. These findings support the significance of cytochrome P450 aromatase in human spermatogenesis and consequently in semen quality.
文摘Choline is a crucial factor in the regulation of sperm membrane structure and fluidity, and this nutrient plays an important role in the maturation and fertilizing capacity of spermatozoa. Transcripts of phosphatidylethanolamine N-methyltransferase （PEMT） and choline dehydrogenase （CHDH）, two basic enzymes of choline metabolism, have been observed in the human testis, demonstrating their gene expression in this tissue. In the present study, we explored the contribution of the PEMTand CHDHgene variants to sperm parameters. Two hundred oligospermic and 250 normozoospermic men were recruited. DNA was extracted from the spermatozoa, and the PEMT -774G〉C and CHDH ＋432G〉T polymorphisms were genotyped. The genotype distribution of the PEMT-774G〉C polymorphism did not differ between oligospermic and normozoospermic men. In contrast, in the case of the CHDH ＋432G〉T polymorphism, oligospermic men presented the CHDH432GIG genotype more frequently than normozoospermic men （62% vs. 42%, P〈0.001）. The PEMT774GIG genotype was associated with a higher sperm concentration compared to the PEMT774GIC and 774C/C genotypes in oligospermic men （12.5±5.6× 10^6 spermatozoa m1-1 vs. 8.3±5.2×10^6 spermatozoa m1-1, P〈0.002） and normozoospermic men （81.5±55.6×10^6 vs. 68.1±44.5×10^6 spermatozoa m1-1, P〈0.006）. In addition, the CHDH432G/G genotype was associated with higher sperm concentration compared to CHDH432G.T and 432T/T genotypes in oligospermic （11.8±5.1×10^6 vs. 7.8±5.3×10^6 spermatozoa m1-1, P〈0.003） and normozoospermic men （98.6±62.2×10^6 vs. 58.8±＋33.6×10^6 spermatozoa m1-1, P〉0.001）. In our series, the PEMT-774G〈C and CHDH ＋432G〈T polymorphisms were associated with sperm concentration. This finding suggests a possible influence of these genes on sperm quality.
文摘Variations in Vascular Endothelial Growth Factor (VEGF) levels were prospectively evaluated in 18 young women undergoing in vitro fertilization treatments according to the “Long Protocol” and a typical pattern of VEGF levels was recorded. A significant increase in VEGF concentrations was observed only when the follicles reached a mean diameter of 15.3 mm in concurrence with mature oocyte retrieval. Since an increase in VEGF levels is related to follicular vascularity and oocyte developpment, our study supports the approach that oocyte retrieval may be performed when follicles > 15 mm in diameter appear. Anticipating egg retrieval in young patients with an optimal ovarian reserve may decrease the incidence of severe ovarian hyperstimulation, without compromising the treatment results.
文摘Objective: Since little is known about the actual incidence and fate of vacuoles at different stages of development this preliminary study was set up to accurately measure vacuoles and track them to day 5. Design: Prospective study. Setting: Women’s General Hospital in Austria. Patient(s): A total of 223 consecutive IVF and intracytoplasmic sperm injection (ICSI) cycles (206 patients). Intervention(s): Accurate measurement of vacuoles. Affected gametes and embryos were cultured individually and tracked until day 5. Main Outcome Measure(s): Size and number of vacuoles, fertilization rate, blastocyst formation rate, blastocyst quality. Result(s): There was a significant relationship between size of the vacuole (cutoff value 14 μ m) and fertilization (P< .05). At zygote stage the incidence of vacuoles was higher (P< .01) in ICSI (11.6% ) than in IVF (5.3% ). Only 32.2% of affected ICSI- embryos reached blastocyst stage on day 5 compared with 53.0% of the normal ones (P< .001). In terms of blastocyst formation vacuolization on day 4 (P< .001) turned out to be the most severe one. At blastocyst stage inner cell mass was affected less frequently than the trophectoderm (P< .05). Conclusion(s): Three types of vacuoles could be identified: (1) those already present at oocyte collection, which develop during maturation (day 0); (2) those artificially created by ICSI (day 1); and (3) those accompanied with developmental arrest (day 4). The later that vacuoles arose, the more detrimental their effect on blastocyst formation.
文摘Objective: To investigate whether hypnosis during ET contributes to successful IVF/ET outcome. Design: Case-control clinical study. Setting: Academic Fertility and IVF Unit, Soroka Medical Center, Beer-Sheva, Israel. Patient(s): Infertile couples undergoing IVF. Intervention(s): Ninety-eight IVF/ET cycles with hypnosis during the ET procedure were matched with 96 regular IVF/ET cycles. Main Outcome Measures: Comparison of clinical pregnancy and implantation rates between the two groups. Result(s): We obtained 52 clinical pregnancies out of 98 cycles (53.1% ) with an implantation rate of 28% among hypnosis IVF/ET cycles, and 29 out of 96 (30.2% ) clinical pregnancies and an implantation rate of 14.4% in the control cycles. Our overall IVF program pregnancy rate for the same period was 32.1% . Logistic regression analysis was performed emphasizing the positive contribution of hypnosis to the IVF/ET conception rates. Conclusion(s): This study suggests that the use of hypnosis during ET may significantly improve the IVF/ET cycle outcome in terms of increased implantation and clinical pregnancy rates. Furthermore, it seems that the patients’ attitude to the treatment was more favorable.
文摘Backg</span><span style="font-family:Verdana;">round: Obstetric sonography is one of the prenatal tests offered to most pregnant women and an essential tool that helps health care providers to establish fetal condition and growth. The Objective: to assess the knowledge, attitudes, and practice about obstetric sonography among women at KAUH in Jeddah, Saudi Arabia. Method: A cross-sectional study was co</span><span style="font-family:Verdana;">nducted during 2018-2019 among 367 women. It included all women </span></span><span style="font-family:Verdana;">that </span><span style="font-family:""><span style="font-family:Verdana;">attend the OB/GYN outpatient clinic at KAUH in Jeddah. The data was collected through </span><span style="font-family:Verdana;">interview</span></span><span style="font-family:Verdana;">ing</span><span style="font-family:Verdana;"> questionnaire. The questionnaire consisted of 5 items to assess their knowledge, attitude, practice, and sociodemographic characteristics. Data were entered into a Microsoft Excel 2014 sheet, and statistical analysis was performed using IBM SPSS Statistics.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Result: The mean knowledge score about obstetric sonography was 13.9</span><span style="font-family:""> </span><span style="font-family:Verdana;">±</span><span style="font-family:""> </span><span style="font-family:Verdana;">1.7, where 343 (93.0%) had good knowledge, and only 26 (7.0%) had poor knowledge. The result revealed that the third</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">fourth</span><span style="font-family:Verdana;">s</span><span style="font-family:""><span style="font-family:Verdana;"> of the women 291 (78.9%) believed that obstetric sonography is safe, and 309 (83.8%) believed that obstetric sonogr</span><span style="font-family:Verdana;">aphy doesn</span></span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">t lead to a congenital anomaly. There was a difference in the knowledge score regarding education level, occupation, monthly income, and those with higher education, those who worked, and those with higher monthly payment had a higher knowledge score. Also, there was a positive correlation</span><span style="font-family:Verdana;"> between knowledge score and both gravidity and parity.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Conclusion: Women</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s knowledge, attitude, and practice about the purpose of the obstetric sonography were good. So, the primary health care providers should be advised to focusing more on providing health education on obstetric sonography to all pregnant women during their ANC visits.
文摘Congenital Nephrotic Syndrome Type 1 (Congenital Nephrotic Syndrome of the Finnish Type—CNF) is an autosomal recessive disorder encoding by nephrin gene mutation which is a (transmembrane protein 1-homolog—NPHS1) structural component of the slit diaphragm responsible for the proper functioning of the renal filtration barrier. In NPHS1 kidneys there is an effacement of the foot processes of the podocytes and impaired glomerular filtration barrier leading to antenatal manifestations and end-renal stage of disease after birth. We present a case of this disease where sonographic appearance of the fetal kidneys had alerted the experts for further genetic investigation for congenital nephrotic syndrome.
文摘<strong>Background:</strong><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Answering the question of what is the optimal protocol for monitoring controlled ovarian stimulation (COS) still remains a challenge. The rapid introduction of new diagnostic methods and various components of telemedicine makes it possible to reduce the number of patient visits during ovarian stimulation, which will reduce the loss of time, costs, and risk for the patient from COVID-like situations. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods:</span></b></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">The different COS monitoring protocols are examined, thus proposing a new approach consisting of two successive phases. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> In the first phase, E3G in urine samples is being examined, which is performed by the patient themselves with a small portable analyzer. Based on the results, the specialist prescribes the doses for stimulation. The second phase involves one single determination of the size and number of follicles at the end of stimulation, using TVUS, as well as the dynamics of serum levels of P4 and E2. This proves to be in many cases sufficient. </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusions:</span></b></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">It is of our opinion that on the basis of new diagnostic tests such as E3G in urine and telemedicine, patients are able to independently and actively participate in the treatment process. This new approach to COS monitoring can be successfully implemented in different protocols for ovarian stimulation.</span></span></span>
文摘Capsule: Although embryos with synchronous blastomere cleavage showed higher post-thaw survival rates, pregnancy rates did not differ. Thus, embryos with all cleavage patterns may be safely cryopreserved. Objective: To compare post-thaw embryo survival, pregnancy and live birth rates of embryos with synchronous vs asynchronous blastomere cleavage in frozen embryo transfer (FET) cycles. Design: Retrospective study. Setting: University-affiliated IVF unit. Patients: One thousand and sixty FET cycles performed from 2004-2006. Interventions: Cycles were divided into 3 groups: 1: cycles in which only embryos with synchronous blastomere cleavage were frozen;2: cycles in which only embryos with asynchronous blastomere cleavage were frozen;3: cycles in which both embryos with synchronous and asynchronous blastomere cleavage were frozen. Clinical and laboratory data were recorded and analyzed. Main Outcome Measures: Post-thaw embryo survival, morphologic grading, pregnancy and live birth rates. Results: A total of 1863 embryos were analyzed. Synchronous embryos had higher blastomere survival rates and morphological grading at thawing. Pregnancy and birth rates did not differ among groups. In a multivariant logistic regression analysis, a number of transferred embryos and embryo morphological grading at thawing were the only parameters that affected pregnancy and live birth rates. Conclusions: Embryos with both synchronous and asynchronous blastomere cleavage can be selected by classical embryo grading and safely cryopreserved.
文摘Objective: To describe a successful in vitro fertilization (IVF)- twin pregnancy in a patient with complete uterine septum who underwent partial correction during cesarean section. Design: Case report. Setting: An IVF unit at a university hospital. Patient(s): A 29- year- old female patient with complete uterine septum undergoing IVF- intracytoplasmic sperm injection. Intervention(s): In vitro fertilization- intracytoplasmic sperm injection with single embryo transfer to each uterine cavity. Main Outcome Measure(s): Pregnancy course and outcome. Result(s): Both transferred embryos underwent implantation, resulting in twin pregnancy with a single embryo in each hemiuterus. Cesarean section was performed at 34 weeks’ gestation. Two healthy neonates were born. Resection of the uterine septum by electrocauterization was attempted during cesarean section. Diagnostic hysteroscopy performed 6 months later demonstrated the presence of the uterine septum reaching approximately 40% of the cavity. Conclusion(s): Whether prophylactic metroplasty should be performed in patients with uterine septae without prior history of miscarriage or pregnancy complications is still under debate. Successful implantation and fetal development might occur without prior metroplasty, as described in our case report. Metroplasty during cesarean section might be only partly successful because part of the septum might be confined in the stretched gravid uterus.
文摘In a study of the possible inter-relationship among müllerian anomalies,hearing loss,and connexin 26 mutations,we evaluated all women in whom müllerian anomalies were diagnosed on hysterosalpingography during a 6-year period (n=24/519). Audiometric testing revealed five (22.7%) with unrecognized sensorineural hearing loss; however,on genetic evaluation,none harbored a connexin 26 mutation.
文摘Thirty-five pregnancies were inadvertently conceived during the midluteal application of the long-acting gonadotropin-releasing hormone agonist triptorelin acetate before ovarian stimulation for in vitro fertilization. Most of the conceptions occurred before the first or second IVF trial, and were associated with a significantly increased tendency to develop gestational diabetes. No increase in pregnancy wastage or appearance of congenital malformations occurred.
