Aneuploid embryo transfer: clinical policies and provider opinions at United States fertility clinics.

OBJECTIVE: To describe institutional clinical policies and individual provider opinions regarding aneuploid embryo transfer (aET). DESIGN: A survey about clinical policies was electronically sent to Society for Assisted Reproductive Technology (SART) member laboratory directors, and a separate survey about personal opinions was electronically sent to all SART members. SETTING: Not applicable. PATIENTS: Patients pursuing preimplantation genetic testing for aneuploidy (PGT-A). INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Current clinical policies about aET were described. Individual provider opinions about aET in the context of specific aneuploidies and mosaicism were also described. RESULTS: A total of 48 laboratory directors and 212 individual providers responded to their respective surveys. Twelve (25%) clinics report that they do not have a policy regarding aET, but clinics performing PGT-A in >100 cycles per year were more likely to have a policy. Half of the individual providers agree that an embryo with trisomy 21 should be available for aET, but most disagreed with aET of embryos with other aneuploidies and most were either unsure about or unwilling to transfer embryos with mosaicism. Those who worked in primarily patient-facing roles held more agreeable opinions regarding aET. CONCLUSION: There is no consensus regarding ideal clinical policies for aET. The wide range of current clinical practices and individual provider opinions regarding under what circumstances, if any, aET should be available to patients indicates that this is a divisive issue among ART providers, and there is a clear need for specific professional guidelines to address this issue.

A longitudinal study of very young children's vowel production.

PURPOSE: Ecologically realistic, spontaneous, adult-directed, longitudinal speech data of young children were described by acoustic analyses. METHOD: The first 2 formant frequencies of vowels produced by 6 children from different American English dialect regions were analyzed from ages 18 to 48 months. The vowels were from largely conversational contexts and were classified according to dictionary pronunciation. RESULTS: Within-subject formant frequency variability remained relatively constant for the span of ages studied. It was often difficult to detect overall decreases in the first 2 formant frequencies between ages 30 and 48 months. A study of the movement of the corner vowels with respect to the vowel centroid showed that the shape of the vowel space remained qualitatively constant from 30 through 48 months. CONCLUSIONS: The shape of the vowel space is established early in life. Some aspects of regional dialect were observed in some of the subjects at 42 months of age. The present study adds to the existing data on the development of vowel spaces by describing ecologically realistic speech.