Euploidy rates are not affected when embryos are cultured in a continuous (CCM) or sequential culture medium (SCM): a sibling oocyte study

Journal of Assisted Reproduction and Genetics - To determine if euploidy rates and embryo development differ when blastocysts are cultured in CCM or SCM. A single-center retrospective observational...     

Different CO2 settings (6.0% vs 7.0%) do have an impact on extracellular pH of culture medium (pHe) and euploidy rates rather than on blastocyst development: a sibling oocyte study

Journal of Assisted Reproduction and Genetics - To determine whether euploidy rates and blastocyst development differ in a continuous culture medium under different CO2 concentrations. A...     

Segmental duplications and monosomies are linked to in vitro developmental arrest

Journal of Assisted Reproduction and Genetics - To verify which genetic abnormalities prevent embryos to blastulate in a stage-specific time. A single center retrospective study was performed...     

Endometriosis infiltrativa profunda

We present a case of deeply infiltrating endometriosis and describe its management. The patient had previously undergone surgery for ovarian endometriosis. The patient’s symptoms were the main indicator of disease progression and imaging techniques were essential for accurate diagnosis and surgical management.     

Evolution of serum progesterone levels in the very early luteal phase of stimulated IVF/ICSI cycles post hCG trigger: a proof of concept study

Journal of Assisted Reproduction and Genetics - Studies have suggested that controlled ovarian hyperstimulation adversely affects endometrial receptivity due to advanced endometrial maturation....     

Hormonoterapia como primer tratamiento en pacientes no subsidiarias de cirugía en cáncer de mama

Objectives

To analyze the response to hormonotherapy and survival in non-surgical breast cancer patients.

Material and methods

We performed a retrospective study of 153 patients with inoperable breast carcinoma due to advanced disease, advanced age, severe comorbidity or refusal to accept conventional therapy, who were treated with hormonotherapy. Initial tumoral stage, response, overall survival and causes of death were evaluated.

Results

The mean age was 79 ± 7 years with a mean follow-up of 42.6 months (range: 0-180). At diagnosis, stage T4 tumors were found in 22%, clinical nodal involvement was found in 47% and metastasis in 16%. Tamoxifen was administered in 87.7% of the patients and aromatase inhibitors or megestrol in the remainder. Successive treatments were required in 22%. Complete response occurred in 5.8% and partial response in 31.8%. Of the remaining patients, 34.4% remained stable and 9.7% showed disease progression. The first event occurred at 35.7 ± 33 months of follow-up. Overall mortality was 68.7% and breast cancer mortality was 57.3%.

Conclusions

Because of its efficacy and scarce adverse effects, hormonotherapy may be an effective treatment in non-surgical patients with breast carcinoma.     

Luteal phase serum progesterone levels after GnRH-agonist trigger - how low is still high enough for an ongoing pregnancy?

In the past years, individualization of assisted reproductive technique (ART)-treatment is increasingly common to customize the treatment protocol to the patient’s specific conditions. The use of GnRH-agonist for final oocyte maturation in a gonadotropin-releasing hormone (GnRH)-antagonist protocol is the best approach to reduce the risk for ovarian hyperstimulation in high responder patients. However, due to severe luteolysis, the reproductive outcome with this approach in combination with the use of vaginal progesterone as luteal phase support, was poor. Cycle segmentation as alternative to a fresh transfer requires embryo freezing which might not be applicable to all patients due to various reasons. The concept of luteal coasting monitors the progesterone-level closely and human chorionic gonadotropin (hCG) for rescue of the corpora lutea is administered when the progesterone-level drops below a certain threshold. However, the lower range of progesterone levels in the early luteal phase after GnRH-agonist trigger, which is compatible with achieving and maintaining a pregnancy, is unknown. This case-series demonstrates, that ongoing pregnancies can be achieved even with a progesterone-level below 15?ng/ml in the early luteal phase with the timely administration of an hCG-rescue bolus. With the concept of luteal coasting, individualization of the luteal phase support according to the patient’s specific luteolysis pattern is possible.     

Situs ambiguo asociado a cardiopatía e interrupción de la vena cava inferior con continuidad de la ácigos

There is a spectrum of heterotaxic syndromes between normal organ distribution (situs solitus) and congenital conditions in which major organs are mirrored from their normal position (situs inversus). The two main modalities are left isomerism (with polysplenia) and right isomerism (with asplenia). Heterotaxic defects involve ciliary dyskinesia, hampering migration of embryonic organs and leading to malposition of thoracic and abdominal organs, complex cardiac defects, and other malformations. We present a case of prenatal echographic diagnosis of levocardia, with left-sided liver, asplenia, congenital heart disease, and interruption of the inferior vena cava with azygos continuation. Because of the malformations frequently associated with heterotaxy, the position of fetal organs should form part of routine ultrasonographic examination.