Blastulation of a zygote to a hatched blastocyst without any clear cell division: an observational finding in a time-lapse system after in vitro fertilization.

PURPOSE: To describe an interesting not previously described morphokinetic finding. METHODS: Retrospective case report of a couple undergoing controlled ovarian stimulation (COS) followed by in vitro fertilization and blastocyst transfer. RESULTS: We identified a unique finding of blastulation of a fertilized human zygote after conventional in vitro fertilization. The fertilized zygote did not show any clear cytokinesis until approximately 107 h post insemination, when it started dividing into a blastocyst. By 113 h post insemination, inner cell mass and trophectoderm cells could be clearly distinguished and the blastocyst was completely hatched by 136 h post insemination. CONCLUSION: Time-lapse systems offer more detailed observations of embryonic development. Here, we report an atypical development of an embryo that was not described previously. We hope to become an insightful discussion among peers and incentive the publication of such findings in the future.

Serial CEA and CA 15-3 measurements during follow-up of breast cancer patients.

OBJECTIVE: CEA and CA 15-3 are adequate parameters for the early diagnosis of metastases in breast cancer patients. During the last years serial marker measurements have been discussed controversely and moreover accused of frightening breast cancer patients in the sense of a tumor marker terror. Therefore we evaluated the acceptance and practicability of an intense follow-up program including monthly measurements of CEA and CA 15-3. MATERIALS AND METHODS: Between 1985 and 1995. 547 breast cancer patients were asked to give blood samples every four weeks for CEA and CA 15-3 measurements. In a field research study using a half-standardized interview by telephone we evaluated the acceptance of serial marker measurements in defined aspects: personal acceptance, blood sampling intervals, form of information, role of the home practitioner, motivation. RESULTS: 280 patients could be analyzed for the acceptance of this follow-up program. 52% of this patient group accepted serial tumor marker measurements, while 48% did not. 99% of the participating patients agreed to monthly blood sampling intervals compared to only 41% of the non-participating patients. 64% of the analyzed patients would have preferred both written and personal information about the role of CEA and CA 15-3 and this kind of follow-up program. Only in 6% of the participating patients the home practitioner had a negative attitude towards monthly tumor marker measurements compared to 36% in non-participating patients. Moreover serial marker measurements led to a feeling of security and reassurance in 85% of the patients. CONCLUSION: CEA and CA 15-3 measurements are adequate and accepted instruments for the follow-up and early diagnosis of metastases in breast cancer patients. If patients got detailed information and support from their home practitioner, serial CEA and CA 15-3 measurements could lead to a feeling of security in most of the patients.