Abstract Study question Does inheritance of FMR1 pre mutant allele affect embryos morphokinetic development? Summary answer Embryos that inherit the FMR1 pre-mutant allele are of a lower morphokinetic quality at the blastocyte stage compared to those with the normal allele. What is known already Previous studies suggest lower oocyte yield and blastulation rate in FMR1 premutation carriers undergoing preimplantation genetic testing for monogenic diseases (PGT-M). Yet, data is lacking concerning embryo morphokinetic development in this group. Study design, size, duration Retrospective analysis, on 529 embryos from 126 in vitro fertilization (IVF)- PGT-M cycles of 39 FMR-1 premutation women carriers. Participants/materials, setting, methods Morphological and morphokinetic parameters acquired by the time-lapse monitoring system were compared between embryos carrying the FMR-1 permutated allele (FMR1 group n = 271) to those who inherited the normal allele (Normal group n = 258). Outcomes measures were embryos morphokinetic parameters up to day 3, the start of blasulation time (tSB) for day 5 embryos, and the rate of top-quality embryos at days 3 and 5. Main results and the role of chance No differences were found between the groups in all morphokinetic parameters from the time of ICSI until biopsy on day 3. Blastulation rate was comparable between the groups. However, FMR1 embryos exhibited delayed start of blastulation compared to the genetically normal embryos (median tSB 104.2 hrs (99.3-110.3) vs 101.6 hrs (94.5-106.7), P = 0.01) and had lower top quality embryo rate (25.6% vs 38.8%, P = 0.04). Limitations, reasons for caution This study is limited by its retrospective design and inability to assess CGG expansion in the embryo. Wider implications of the findings This study offers new insight into the impact of permutated FMR1 gene in the early stages of embryo development. Further studies are needed in order to apply these results in clinical decision-making. Trial registration number not applicable

Superconducting fault current limiters (SFCLs) are very attractive devices which require to increase its robustness against the destructive hot spots. The use of sapphire substrates to grow YBa2Cu3O7 (YBCO) films is a very attractive approach due to its high thermal conductivity. This article reports the growth of microcrack-free, epitaxial YBCO layers by chemical solution deposition (CSD) on Ce1−x Zr x O2 (CZO)/yttrium-stabilized zirconia/r-cut barely polished sapphire (BPS) substrates which can be produced in long lengths at low cost. The surface quality of the r-cut sapphire and its role on the epitaxy of CZO and YBCO layers is discussed. The issue of the microcrack generation in YBCO layers is investigated in relation to the film thickness, the growth process and the oxygenation annealing step. We demonstrate that microcracks formation is related to the in-plane tensile stress generated during the oxygenation step instead of the differential thermal expansion effects and thus it can be minimized through an adapted oxygenation process. We have shown that CSD growth of YBCO films with thicknesses up to 400 nm and attractive superconducting properties (J C ∼ 1.9 MA cm−2 at 77 K) can be achieved on BPS substrates which can be used at moderate cost for SFCL devices.

STUDY OBJECTIVE:To assess the clinical course and surgical and fertility outcomes of patients diagnosed with tubo-ovarian abscess (TOA) after fertility treatment.DESIGN:Parallel case series over 10 consecutive years (Canadian Task Force classification II-2).SETTING:Tel Aviv Sourasky Medical Center, a tertiary university-affiliated hospital.PATIENTS:Thirty-seven women who were diagnosed with TOA after fertility treatments (in vitro fertilization and intrauterine insemination) were compared with 313 women who were diagnosed with TOA not associated with fertility treatments during the same time period.INTERVENTION:Medical records search, chart review, and phone survey were used to assess clinical course and surgical and reproductive outcomes.MEASUREMENTS AND MAIN RESULTS:Women with TOA after fertility treatments had significantly higher inflammatory markers upon admission compared with the nonfertility treatment group (mean white blood cell count, 16.1 × 1000/mm3 [standard deviation [SD], ±4.3] vs 13.8 × 1000/mm3 [SD, ±6.3], p = .001, respectively; and mean C-reactive protein, 149 mg/L [SD, ±78.3] vs 78.2 mg/L [SD, ±68.5], p = .001, respectively). In addition, TOA after fertility treatments was associated with a significantly higher surgical intervention rate and a more complicated clinical course, as evidenced by a shorter time interval from admission to surgery (2.1 days vs 3.2 days, p = .01), higher rates of antibiotic failure, higher conversion rate from laparoscopy to laparotomy (14.2% vs 3.2%, p = .005), increased perioperative complications rate (25.0% vs 3.8%, p = .0001), and a longer hospitalization stay (7.2 days vs 4.8 days, p = .01). Clinical pregnancy rate per cycle in women with TOA after fertility treatments was 9%, and 1 case of live birth was recorded.CONCLUSIONS:Our data indicate that TOA after fertility treatment has a substantial effect on the clinical course and surgical outcome. Prophylactic antibiotic treatment before ovum retrieval and deferral of embryo transfer should be considered in patients at risk of infection.

Objective: To assess the clinical course, surgical and fertility outcomes of patients diagnosed with TOA following fertility treatments.

Objective: Pre-implantation genetic diagnosis (PGD) is required in order to screen and diagnose embryos of patients at risk of having a genetically affected offspring. A biopsy to diagnose the genetic profile of the embryo may be performed either before or after cryopreservation. The aim of this study was to determine which biopsy timing yields higher embryo survival rates.Study design: Retrospective cohort study of all PGD patients in a public IVF unit between 2010 and 2013. Inclusion criteria were patients with good-quality embryos available for cryopreservation by the slow freezing method. Embryos were divided into two groups: biopsy before and biopsy after cryopreservation. The primary outcome was embryo survival rates post thawing.Results: Sixty-five patients met inclusion criteria. 145 embryos were biopsied before cryopreservation and 228 embryos were cryopreserved and biopsied after thawing. Embryo survival was significantly greater in the latter group (77% vs. 68%, p < 0.0001).Conclusion: Cryopreservation preceding biopsy results in better embryo survival compared to biopsy before cryopreservation.

To investigate the changes in the coagulation system during the course of an IVF cycle from baseline to the initial β-human chorionic gonadotropins (hCG) test. prospective study. Patients: Twenty-three women that underwent controlled ovarian stimulation with gonadotropins for IVF. Interventions: The elastic properties of blood clots were measured by thromboelastogram (TEG), providing global assessment of homeostatic function. TEG indices, estradiol (E2), progesterone, PT and PTT were evaluated at four time points: 1. At the beginning of the cycle (corresponding to the lowest levels of E2), 2. Day of hCG administration (maximal stimulation with highest E2 levels), 3. At the day of ovum pickup and 4. At the first β-hCG test (approximately 14 days after ovum pickup). Main outcome measures: TEG indices including R-time: Time until initial fibrin formation. K-time: Time until a 20 mm. amplitude is achieved. α angle: The rate of clot formation. Maximum Amplitude: Strength of the fibrin clot. Coagulation Index (CI): Calculated overall indicator of coagulation. LY30: The percentage decrease in graph amplitude. Comparison of the different time points showed that R, K, alpha, MA and CI at the time of the first pregnancy test and before hCG administration were significantly higher compared to the baseline measurement before gonadotropins administration, whereas no difference in LY30 was recorded. No correlation was found between E2 and TEG indices. Our results demonstrate that ovarian stimulation is associated with increased coagulability that extends well after the time of maximal ovarian stimulation. The lack of association between E2 levels and TEG indices suggest that additional factor may have a role in the pathogenesis of increased coagulability in women with ovarian stimulation.

To evaluate the role of beta human chorionic gonadotropin (β-hCG) change in the 48 hours prior to Methotrexate treatment as a predictor for treatment success.

A Mott transition in granular Al films is observed by probing the increase of the spin-flip scattering rate of conduction electrons as the nanosize metallic grains are being progressively decoupled. The presence of free spins in granular Al films is directly demonstrated by mu SR measurements. Analysis of the magnetoresistance in terms of an effective Fermi energy shows that it becomes of the order of the grains electrostatic charging energy at a room temperature resistivity rho(300) (K) approximate to 50000 mu Omega cm, at which a metal to insulator transition is known to exist. As this transition is approached the magnetoresistance exhibits a heavy-fermion-like behavior, consistent with an increased electron effective mass.

To investigate the clinical presentation, intra and post-operative outcome in post-menopausal women who were diagnosed with adnexal torsion.

Objective: To evaluate the role of beta-hCG levels on days 1, 4, and 7 after methotrexate as predictors for second-dose requirement and success.Design: Retrospective cohort study.Setting: Tertiary university-affiliated hospital.Patient(s): A total of 1,703 patients were admitted because of ectopic pregnancy. Four hundred nine received methotrexate, of whom 73 women required a second dose.Intervention(s): The "single-dose" methotrexate protocol with 50 mg/m(2) was administered to patients with progressing ectopic pregnancy. Surgical intervention was performed in cases of methotrexate second-dose treatment failure.Main Outcome Measure(s): Methotrexate second-dose requirement and success according to beta-hCG levels on days 1, 4 and 7.Result(s): Second-dose methotrexate was successful in 58 patients (79.4%, success group), whereas 15 patients (20.6%) failed treatment and required surgical intervention (failure group). The medians of b-hCG levels on days 1, 4, and 7 were significantly higher in the "failure group" (1,601 vs. 2,844, 2,164 vs. 3,225, and 1,915 vs. 3,745 mIU/mL, respectively). Logistic regression analysis demonstrated that day-1 b-hCG levels were the only significant independent variable for second-dose treatment outcome. The receiver operating characteristic curve for beta-hCG levels on day 1 was 0.727, and at a cutoff value of 2,234 mIU/mL the sensitivity and specificity reached the optimum for treatment success (77.5% and 73.3%, respectively).Conclusion(s): Day-1 beta-hCG levels were the only predictors for methotrexate second-dose requirement and treatment success. The cutoff value of b-hCG on day 1 with the optimal treatment results was found to be 2,234 mIU/mL. (C) 2014 by American Society for Reproductive Medicine.

non-parametric comparisons by STATA 11.1.Cycles resulting in a multiple gestation were excluded.Natural cycle IVF (NCIVF) was performed without the use of exogenous ovarian stimulation but included hCG trigger prior to oocyte retrieval.RESULTS: Maternal age, parity and history of prior ART cycles were comparable between the groups.Infertility diagnoses were similar except greater prevalence of PCOS in the stimulated group (16.7 vs. 0.88%, p<0.001).Time to retrieval was shorter in the NCIVF group (11.0 vs. 12.8 days, p<0.001).While gestational age at delivery was comparable between groups, preterm and very preterm birth was significantly reduced in the NCIVF group.CONCLUSION: Our study is the first to investigate birth outcomes of singleton pregnancies in NCIVF compared to stimulated IVF.Infants conceived by NCIVF had a lower prevalence of preterm and very preterm birth, with a trend toward lower prevalence of low birth weight.We propose the impact on preterm delivery rates may be due to effects of superovulation on oocyte quality or a supraphysiological estrogen milieu during implantation.In this study the data suggests improved perinatal outcomes in NCIVF versus stimulated IVF, notably a lower incidence of preterm birth with natural cycle IVF.

To evaluate the accuracy of diagnostic hysteroscopy in detecting abnormal uterine findings in symptomatic and asymptomatic patients and compare it to that of TVUS and operative hysteroscopy.