The successful use of hatched blastocysts in assisted reproductive technology.

This retrospective study was undertaken to determine the value of blastocyst culture and transfer as a tool in assisted reproductive technology. Six hundred and fifty-five cycles in patients undergoing IVF treatment for infertility were involved. All patients were aged < 40 years. Day-2 embryos were transferred to 427 (group 1) and day-6 embryos (blastocysts) were transferred to 228 patients (group 2). Pronucleate oocytes obtained from IVF were cultured in vitro for 2 or 6 days. One to five embryos were transferred. A total of 10,146 oocytes were retrieved, 6,105 oocytes were fertilized, 2,222 embryos were transferred and 197 clinical pregnancies were achieved in all groups. Blastocystes were transferred to almost 90% of group 2 patients. The pregnancy rate per cycle and implantation rate per transferred embryo was 42.1% and 19.4%, respectively, in the blastocyst group compared to 23.6% and 8.6%, respectively, when embryos were transferred on day 2. Even though in the blastocyst group there was an increased number of oocytes fertilized at the same time there was a significant reduction in the number of embryos being replaced (3.2 vs 3.8). This study demonstrate that transfer of blastocysts increases the success of IVF when compared with day-2 transfers and reduces the number of embryos to be transferred.

Cryopreservation of embryos, blastocysts, and pregnancy rates of blastocysts derived from frozen-thawed embryos and frozen-thawed blastocysts.

PURPOSE: To evaluate the development of cryopreserved embryos when thawed and subsequently cultured to the blastocyst stage in comparison to transferring cryopreserved blastocysts. METHODS: In this retrospective clinical study, we have evaluated 170 cycles in patients undergoing IVF treatment for infertility. Cryopreserved embryos were thawed and were subsequently cultured and transferred at the blastocyst stage. Cryopreserved blastocysts (Day 6) were thawed and transferred immediately. RESULTS: Five hundred and sixty embryos and 444 blastocysts have been thawed. In the embryos group, the survival rate was 89% while in the blastocyst group the survival rate was 56%. In the embryos group the blastocyst development rate was 24.5%. The implantation rate in the embryos group was 20.6% per group blastocyst transferred compared to 5.3% in the blastocyst group. CONCLUSIONS: The ability of cryopreserved embryos to develop to blastocysts and their implantation potential does not seem to be greatly affected by the cryopreservation procedure.

Immunohistochemical analysis of nm23-H1 expression in human cervical lesions.

Reduced expression of the metastasis suppressor gene nm23-H1 has been previously correlated with high tumor metastatic potential and fatal clinical outcome in several types of human carcinomas. The aim of the study was to identify the expression of nm23-H1 in a variety of premalignant and malignant cervical lesions. The study comprised 106 cervical biopsies obtained from 106 women ranging in age from 23 to 68 (median 42) years. Histologic slides stained with H&E were evaluated blindly by two pathologists and a consensus diagnosis was established for each case. In addition, immunohistochemical stain was employed and a monoclonal antibody against nm23-H1 (YLEM Rome, Italy) was used. Twenty-five of the cervical biopsies showed changes of mild dysplasia (CIN I), whereas 28 demonstrated features of moderate dysplasia (CIN II) and 28 severe dysplasia (CIN III). In 25 cases infiltrating squamous cell carcinoma was identified. Expression of nm23-H1 was evident in 9/25 (36%) CIN I, 13/28 (46%) CIN II, 22/28 (78.5%) CIN III and 17/25 (68%) infiltrating carcinoma biopsies. Statistically significant differences were observed between CIN II and CIN III (p=0.003), and CIN II and infiltrating carcinoma (p=0.002) groups. Expression of the nm23-H1 gene in premalignant and malignant cervical lesions indicates that this gene may play a substantial role in carcinogenesis and tumor progression.

Vulvar neoplasia and search for human papillomavirus 16 and 18 genetic information. Short communication.

The presence of HPV 16 and 18 is frequent in cases with vulvar carcinomas and intraepithelial neoplasias.

Denoising of the fetal heart rate signal with non-linear filtering of the wavelet transform maxima.

The fetal heart rate (FHR) signal provides valuable information for fetal development and well-being. However, the FHR traces derived from present-day ultrasound cardiotocographs are not of the desired quality. The paper applies the wavelet transform (WT) in order to denoise effectively the FHR signal. The denoising procedure analyses the evolution of the WT maxima across scales. The singularities of the signal create wavelet maxima with different properties from those of the induced noise. Since it is difficult to formulate precise rules that distinguish between the wavelet maxima of the FHR signal from those of the noise we have trained a neural network for this classification task. The neural network draws out successfully the noise induced wavelet maxima. An improved FHR signal can be obtained from the coarser wavelet approximation signal component and the filtered wavelet maxima by means of the inverse dyadic wavelet transform. Also, feature extraction and processing algorithms can be defined on the denoised wavelet coefficients (instead of on the original signal).

The performance and reliability of wavelet denoising for Doppler ultrasound fetal heart rate signal preprocessing.

The present paper deals with the performance and the reliability of a Wavelet Denoising method for Doppler ultrasound Fetal Heart Rate (FHR) recordings. It displays strong evidence that the denoising process extracts the actual noise components. The analysis is approached with three methods. First, the power spectrum of the denoised FHR displays more clearly an 1/fa scaling law, i.e. the characteristic of fractal time series. Second, the rescaled scale analysis technique reveals a Hurst exponent at the range of 0.7-0.8 that corresponds to a long memory persistent process. Moreover, the variance of the Hurst exponent across time scales is smaller at the denoised signal. Third, a chaotic attractor reconstructed with the embedding dimension technique becomes evident at the denoised signals, while it is completely obscured at the unfiltered ones.

Prevalence of Toxoplasma gondii antibodies in gravidas and recently aborted women and study of risk factors.

Two hundred seventeen parturients and eighty six recent aborters were screened for IgM and IgG toxoplasma antibodies. Age, profession, educational level, residence (urban/rural), presence of cat and other domestic animals were recorded for each subject. None of the subjects was IgM-positive. Prevalence of IgG positivity was 52.3% in the parturients and 50.2% in the recently aborted women. None of the personal or social characteristics investigated could be related to IgG positivity. However, the frequency of toxoplasma antibodies was found to be higher in recent aborters from rural areas where contact with soil is common regardless of whether cats are kept as pets or not. This study confirms other investigators' conclusion on the importance of soil contact as a risk factor for infection.

Prevalence of asymptomatic carriers of Chlamydia trachomatis among pregnant and non-pregnant women in south-western Greece.

One-hundred-ninety-three pregnant and seventy five non-pregnant women, aged 18-35 years, were examined for endocervical infection with Chlamydia trachomatis using an enzyme immunoassay technique on cervical specimens. Chlamydia trachomatis was discovered in 7.2% of the pregnant women and in 10.6% of the non-pregnant ones. There was no correlation between chlamydia infection and either previous vulvovaginitis, previous pregnancies or pregnancy outcome. However, younger, more highly educated women with high sexual promiscuity tended to be more frequently colonized.

Toxoplasma antibodies and spontaneous abortion.

One hundred and fifty-two women with spontaneous abortion were investigated by hemagglutination (HA) and immunofluorescence antibody (IFA) tests for toxoplasmosis. In 48 cases, quantitive immunoglobulin (Ig) studies and mouse inoculation with gestational material were performed. Positive toxoplasma antibody titers were observed in 62 cases (40.8%) using HA and in 52 cases (38.2%) using IFA. This prevalence was significantly higher than that observed in 80 normal women who served as controls. Toxoplasma gondii was isolated in two cases. No correlation was found between antibody titers and IgG, IgM or IgA levels. We conclude that toxoplasmosis should be considered as the cause of abortion when a patient's antibody titer exceeds 1:256.