Development of the prosencephalic structures, ganglionic eminence, basal ganglia and thalamus at 11 + 3 to 13 + 6 gestational weeks on 3D transvaginal ultrasound including normative data.

OBJECTIVES: To show the development of ganglionic eminence, basal ganglia and thalamus/hypothalamus in week 11 + 3 to 13 + 6 by transvaginal 3D ultrasound. METHODS: To visualize the prosencephalic structures surrounding the 3rd ventricle, 285 three-dimensional ultrasound volume blocks from 402 fetuses examined were selected in a prospective transvaginal 3D study to compare ultrasound images of ganglionic eminence, basal ganglia, thalamus/hypothalamus with embryological sections. In addition, measurements of the described structures were made in 104 fetuses to quantify the embryological development. RESULTS: The sonomorphologic characteristics of ganglionic eminence, basal ganglia and thalamus/hypothalamus are described in 71% of the fetuses examined. Measurements of the structures in 57% of the fetuses, show the following results: axGE ap = 0.17 + 0.112*CRL; axGE/I = 0.888 + 0.048*CRL; axGE/BG = 0.569 + 0.041*CRL; coGE/BG = 0.381 + 0.048*CRL; coTh lat = - 0.002 + 0.135*CRL; coTh/HyT = 3.68 + 0.059*CRL; co3.V lat = 0.54 + 0.008*CRL. CONCLUSION: Transvaginal 3D neurosonography allows visualization and measurement of normal structures in the fetal prosencephalon at 11 + 3 to 13 + 6 weeks of gestation (GW) including details of ganglionic eminence (GE), basal ganglia (BG), and thalamus/hypothalamus (Th/HyT). Further scientific work is needed before using the results to decide on pathological changes in patients.

Good-quality blastocysts derived from vacuolized morulas show reduced viability.

OBJECTIVE: To study whether late spontaneous vacuolization on day 4 is an artefact or an alternate means of blastocele formation and to analyze its impact on pregnancy outcome and live birth. DESIGN: Prospective observational study. SETTING: University teaching hospital. PATIENT(S): A total of 424 patients who fulfilled inclusion criteria were subgrouped according to the spontaneous vacuolization on day 4: Group 1 had all morulas affected, group 2 showed no signs of vacuoles, and group 3 was mixed (some day 4 embryos had vacuoles and others did not). INTERVENTION(S): Screening for the presence of vacuoles on day 4 and fresh single-blastocyst transfer. MAIN OUTCOME MEASURE(S): Morula and blastocyst scoring, utilization rate, pregnancy and live birth rates. RESULT(S): Patients of group 1 had a reduced blastocyst formation rate on day 5 (P<.01) and significantly fewer good-quality blastocysts for usage (P<.05). In addition, pregnancy (P<.001) and live birth (P<.01) rate were significantly worse in group 1 compared with groups 2 and 3. CONCLUSION(S): Late onset of vacuolization around compaction stage is a negative predictor of blastocyst formation and outcome.