More than fifty percent of normal 46, XX results of early miscarriage samples analyzed by traditional karyotype, are due to maternal cell contamination (Lathi et al. 2014). This error is eliminated by SNP microarrays with Parental Support™ (Natera). We sought to review the incidence, type, and origin of chromosomal abnormalities detected by SNP microarray technology in patients who experienced first trimester miscarriage. Retrospective analysis. A total of 150 first-trimester miscarriage samples were analyzed by SNP microarray at a single fertility clinic between January of 2012 and March of 2014. Miscarriage samples were obtained by suction dilatation and curettage under ultrasound guidance in the operating room. The products were paired with a sample of maternal blood and or a paternal blood, and sent for analysis. Patients were divided into four age groups <30, 30-34, 35-39, and ≥ 40. In addition, pregnancies were divided into whether they were spontaneous or via assisted reproductive technologies (ART). The overall rate of chromosomal abnormalities was 54%. Of the remaining specimens 34% were normal and 12% had maternal cell contamination (MCC). The aneuploidies were 86% maternal and 14% paternal in origin. ART pregnancies had similar rates of chromosomal abnormalities as spontaneous pregnancies, 51.5% vs. 59.6% respectively (X2=1.2, P=0.53). The rates of abnormalities in the four age groups were 42.3% vs. 59.3% vs. 57.1% vs. 84.4% respectively, with a significant increase above age 40 (X2=11.5, P=0.009). The most common abnormalities were trisomies 16 and 22. To our knowledge this is the largest study investigating the rate of chromosomal abnormalities detected by SNP microarrays in early pregnancy loss. Our study found that the rate of chromosomal abnormalities is similar between miscarriages in spontaneous pregnancies vs. those achieved by ART. Furthermore, we noted a significant increase in the rate of chromosomal abnormalities above maternal age of 40.

To compare the clinical and multiple pregnancy rates in patients undergoing minimal-stimulation (mini-stim) with clomiphene citrate (CC) followed by a single injection of gonadotropin, to those receiving either CC or gonadotropin alone prior to intrauterine insemination (IUI). Retrospective chart review of 1,692 infertile couples that underwent ovulation induction between 2008 and 2011 in a single fertility clinic. Included were all women undergoing infertility treatment with ovarian stimulation followed by IUI. Ovarian stimulation protocols included daily 100 mg of CC alone, 100 mg of CC for 5 days followed by one 150 IU of gonadotropins (mini-stim), or daily gonadotropin injections. Couples were limited to a single treatment arm, and underwent between one and three cycles. Clinical and multiple pregnancies were defined by sonographic evidence of fetal cardiac activity. Pearson's ChiSquared was used to test for association between treatment protocols and outcome. The distribution of patients undergoing one, two, or three IUI cycles was similar irrespective of the treatment type. In patients younger than 35, the pregnancy rates for CC, mini-stim, and gonadotropins were 18.1%, 27.6%, and 31.7%, respectively (X2(2)=13.9, P=.0009). Patients aged 35-37 had pregnancy rates of 15.1%, 19.8%, and 15.0% (X2(2)=1.22, P=.5425). Patients between 38-40 of age had pregnancy rates of 8.7%, 17.6%, and 17.0% (X2(2)=2.63, P=.2677). Those older than 40 had pregnancy rates of 6.6%, 8.5%, and 5.3% (X2(2)=0.99, P=.6). Moreover, gonadotropins protocol had a significantly higher multiple pregnancy rate (25.6%) than both mini-stim (15.0%) and CC (11.7%), (X2(2)=7.29, P=.026). A mini-stim protocol with IUI achieves pregnancy rates similar to gonadotropins with IUI. In addition, mini-stim with IUI and CC with IUI protocols, had significantly lower multiple pregnancy rates than that of gonadotropins with IUI, in patients undergoing infertility treatments.

It is well established that chromosomes occupy distinct positions within the interphase nuclei, conferring a potential functional implication to the genome. In addition, alterations in the nuclear organisation patterns have been associated with disease phenotypes (e.g. cancer or laminopathies). The human sperm is the smallest cell in the body with specific DNA packaging and the mission of delivering the paternal genome to the oocyte during fertilisation. Studies of nuclear organisation in the sperm have postulated nonrandom chromosome position and have proposed a chromocentre model with the centromeres facing toward the interior and the telomeres toward the periphery of the nucleus. Most studies have assessed the nuclear address in the sperm longitudinally predominantly using centromeric or telomeric probes and to a lesser extent with whole chromosome paints. To date, studies investigating the radial organisation of human sperm have been limited. The purpose of this study was to utilise whole chromosome paints for six clinically important chromosomes (18, 19, 21, 22, X, and Y) to investigate nuclear address by assessing their radial and longitudinal nuclear organisation. A total of 10,800 sperm were analysed in nine normozoospermic individuals. The results have shown nonrandom chromosome position for all chromosomes using both methods of analysis. We present novel radial and polar analysis of chromosome territory localization within the human sperm nucleus. Specifically, a hierarchical organisation was observed radially with chromosomes organised from the interior to the periphery (chromosomes 22, 21, Y, X, 19, and 18 respectively) and polar organisation from the sperm head to tail (chromosomes X, 19, Y, 22, 21, and 18, respectively). We provide evidence of defined nuclear organisation in the human sperm and discuss the function of organisation and potential possible clinical ramifications of these results in regards to male infertility and early human development.

To evaluate the post-thaw survival and the pregnancy outcomes of vitrified human blastocysts, a retrospective analysis was performed. A total of 213 blastocysts were thawed and transferred to 81 patients with 83% post-thaw survival, 31% clinical pregnancy, and 23% implantation rate per embryo. The clinical application of blastocyst vitrification with the cryoloop technique is effective based on the post-thaw survival and the pregnancy outcome.

Commercially obtained Buffalo rat liver (BRL) cells were grown in monolayer culture. The effect of BRL cell co-culture with assisted hatching on embryo development, implantation and pregnancy was investigated in a population of 200 'first-time' in-vitro fertilization (IVF) patients, subdivided into three groups according to the methods of fertilization [IVF; intracytoplasmic sperm injection (ICSI); ICSI/IVF]. Assisted hatching was performed on all embryos chosen for transfer. Following co-culture, the overall embryo quality, implantation rate and pregnancy rates were not significantly different from the controls. However, when grouped according to fertilization method, co-culture was found to have an impact on pregnancy and implantation rates in the group undergoing conventional IVF. Using co-culture with assisted hatching, we were able to achieve a 58% (38/65) clinical pregnancy rate with a 49% (32/65) live birth rate and a 26% (60/235) implantation rate. No changes in the pregnancy and implantation rates were apparent in ICSI or ICSI/IVF subgroups. This is the first prospective, randomly controlled study which reports the use of BRL cell co-culture for human IVF for a large number of patients undergoing IVF for the first time.

Videocinematography and image analysis procedures were utilized to evaluate the effect of conventional and coculture methodologies on morphological parameters in human embryos derived from in-vitro fertilization (IVF). Following 24-30 h of in-vitro development, cocultured embryos had more acceptable morphological features and less fragmentation present than embryos cultured in medium alone. Cocultured embryos were more advanced at the time of replacement when compared with conventionally cultured embryos. Zona pellucida variation (> or = 20%) also occurred more frequently in cocultured embryos. The morphological characteristic most enhanced after coculture was blastomere expansion. Patients who became pregnant across both culture treatments had a higher proportion of morphologically normal embryos replaced than patients who failed to achieve an ongoing pregnancy. Clinical pregnancy rate for patients following coculture was 49%, which was greater (P < 0.05) than the 29% detected for patients with embryos in the conventional culture group.

Videocinematography and image analysis procedures were utilized to evaluate the effect of conventional and coculture methodologies on morphological parameters in human embryos derived from in-vitro fertilization (IVF). Following 24-30 h of in-vitro development, cocultured embryos had more acceptable morphological features and less fragmentation present than embryos cultured in medium alone. Cocultured embryos were more advanced at the time of replacement when compared with conventionally cultured embryos. Zona pellucida variation (> or = 20%) also occurred more frequently in cocultured embryos. The morphological characteristic most enhanced after coculture was blastomere expansion. Patients who became pregnant across both culture treatments had a higher proportion of morphologically normal embryos replaced than patients who failed to achieve an ongoing pregnancy. Clinical pregnancy rate for patients following coculture was 49%, which was greater (P < 0.05) than the 29% detected for patients with embryos in the conventional culture group.