Suboptimal trophectoderm mitochondrial DNA level is associated with delayed blastocyst development.

PURPOSE: To provide a comprehensive analysis of mtDNA quantity in D5 and D6 blastocysts, as well as a further insight to the origin of delayed blastocyst development. METHODS: A retrospective cohort analysis of 829 D5 and 472 D6 blastocysts from 460 patients who underwent in vitro fertilization (IVF) with next-generation sequencing (NGS)-based preimplantation genetic testing for aneuploidy (PGT-A). The quantity of trophectoderm mtDNA was extrapolated from the NGS data, followed by the analysis of mean mtDNA levels between D5 and D6 blastocysts of the same ploidy (aneuploid/euploid) and transfer outcomes (positive/negative clinical pregnancy). RESULTS: D5 blastocysts had significantly higher euploidy rate and clinical pregnancy rate when compared with D6 blastocysts. The proportion of blastocysts derived from patients ≧ 40 years old were similar between the D5 and D6 cohorts. When blastocysts with identical ploidy were analyzed, the D5 cohorts all had significantly higher mean mtDNA levels than their D6 counterparts. Similarly, when embryo transfers with identical outcome were analyzed, the D5 cohorts also had significantly higher mean mtDNA levels than the D6 cohorts. Trophectoderm mtDNA level was independent of maternal age and blastocyst morphology grades. CONCLUSIONS: Our data provided further evidence D5 blastocysts contained significantly greater mtDNA quantity than D6 blastocysts, and mtDNA quantity could be a key factor that affects the development rate of blastocysts. Furthermore, one must avoid using an arbitrary threshold when incorporating mtDNA quantity into the embryo selection criteria, as the observed value may have vastly different clinical implication when blastulation rate is also considered.

Inflammatory pseudotumor of the spleen: CT and MRI findings.

Inflammatory pseudotumors rarely occur in the spleen. We report such a case with characteristic computed tomography (CT) and magnetic resonance imaging (MRI) findings. A CT scan showed an isodense nodular mass with gradual mild enhancement on delayed-phase contrast-enhanced images. MRI showed a mass with isointense signal on T1-weighted images and hypointense signal on T2-weighted images. The tumor mass showed progressive inhomogeneous enhancement on gadolinium-enhanced images. The patient received splenectomy, and histologic diagnosis was compatible with inflammatory pseudotumor.

Successful treatment of ovarian pregnancy with laparoscopy-assisted local injection of etoposide.

OBJECTIVE: To present a case of ovarian ectopic pregnancy successfully treated with laparoscopy-assisted local injection of etoposide. DESIGN: Case report. SETTING: University-affiliated teaching hospital. PATIENT(S): A 33-year-old woman with the diagnosis of an ovarian pregnancy. INTERVENTION(S): Laparoscopically assisted local injection of etoposide. MAIN OUTCOME MEASURE(S): Successful treatment of the ovarian ectopic pregnancy, with preservation of the ovary. RESULT(S): The patient was successfully treated, and she had normal menstruation after surgery. CONCLUSION(S): Treatment of ovarian ectopic pregnancy with a laparoscopy-assisted local injection of etoposide might be a less invasive choice that can circumvent the systemic side effects of the medication.