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Frequency of aneuploidy in day 3 human embroys
August 2002, Vol. 9, No. 3 Supplement
The Journal of the American Association of Gynecologic Laparoscopists
173. Frequency of Aneuploidy in Day 3 Human Embryos
174. Fertiloscopy in the Early Diagnosis of Pelvic Malignancy RR Syed. St. Vincent's Hospital of Staten Island, Staten Island, New York.
1MW Surrey. 1DL Hill, 21Souter. ~Southern California Reproductive Center, Beverly Hills, California; 2Department of Obstetrics and Gynecology, UCLA School of Medicine, Los Angeles, California.
Objective. To show the utility of tra_nsvaginal hydrolaparoscopy (fertiloscopy) in accurately diagnosing pelvic malignancy. Measurements and Main Results. Fertiloscopy canhulas were used to perform outpatient traaasvaginal hydrolaparoscopy under general anesthesia in an asymptomatic 36-year-old gravida 1, para 1 woman with secondary infertility. Raised, white, plaquelike lesions were scattered on the peritoneal surface, suspicious of neoplasia. Immediate microlaparoscopy confirmed these findings. Biopsies showed welldifferentiated malignant mesothelioma of petitoneum. Total operating time was 15 minutes. No complications occurred and the patient was referred for definitive surgery. She recovered uneventfully after this early diagnosis and surgical treatment. She received no chemotherapy and was able to conserve her ovaties. Additional data are necessary to place fertiloscopy in the diagnostic algorithm of suspected pelvic malignancy. Conclusion. Fertiloscopy can be performed safely as a first-line surgical tool to diagnose suspected pelvic neoplasia with minimal morbidity.
Objective. To assess the frequency of aaaeuploidy in morphologically normal day 3 embryos. Measurements andMain Results. We analyzed 24 IVFET cycles in which preimplaxltation genetic diagnosis (PGD) was performed on day 3, with ET on day 5 or 6. One to two blastomeres were removed from embryos of good morphology (grade A-B) at the 6- to 10-cell stage. Twenty-one cases were analyzed by fluorescence in situ hybridization (FISH) with chromosomespecific probe panels, either 13,18,21,X,Y or 13,16,18,21,22X,Y. In three cases, polar body biopsy was used in conjunction with polymerase chain reaction and embryo biopsy for detection of single gene defects. Twenty-two patients underwent 24 IVF-PGD cycles with 355 oocytes retrieved, 245 (69%) fertilized normally (2PN). Of these, 156 (63.7%) became day 3 embryos considered morphologically suitable for biopsy. No results were obtained from eight blastomeres because the nucleus could not be found. Results from the other 148 blastomeres indicated euploidy at the chromosomes tested for. Embryo transfer with at least one normal embryo was performed in 22 cycles, with a total of 54 embryos being replaced among them. Eleven clinical and four biochemical pregnancies resulted for a clinical pregnancy rate of 50%/ transfer. The rate of pregnancy loss was 18.2% (9.1% if one pregnancy of a trisomy at chromosome 2, detected at 11 weeks gestation, is excluded). Conclusion. During IVF, many day 3 embryos are axleuploid. In older women and women with a history of axleuploid pregnancies or multiple IVF failures with morphologically normal embryos, transfer of PGDevaluated embryos may increase implantation rates per embryo transferred, and reduce the rate of chromosomally unbalanced offspring or pregnancy loss. Expanding indications for transferring PGD-evaluated embryos might reduce the need for repeat IVF-ET cycles, and improve pregnancy rates for patients undergoing IVF-ET.
175. Hysteroscopic Metroplasty Performed with Miniscissors and Resectoscope NM Tabrizi, H Dabirashrafi, K Maharnad, FI Nia, K Zandinejad. Tehran University Medical Science and Health, Dabirashrafi Fertility and Endoscopy Research, Tehran, Iran.
Objective. To compare the effect of miniscissors and resectoscopic loop on hysteroscopy metroplasty in patients with septate uterus. Measurements and Main Results. Twenty-six women were randomly assigned to undergo hysteroscopic metroplasty using miniscissors or resectoscopic loop (13 each group), both performed with D5W as distending medium. Septum length measured by HSG before and after surgery showed no statistical difference between methods (p = 0.843). Conclusion. Both methods of hysteroscopic metroplasy produce similar results, and results of incision
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The Journal of the American Association of Gynecologic Laparoscopists
173. Frequency of Aneuploidy in Day 3 Human Embryos
174. Fertiloscopy in the Early Diagnosis of Pelvic Malignancy RR Syed. St. Vincent's Hospital of Staten Island, Staten Island, New York.
1MW Surrey. 1DL Hill, 21Souter. ~Southern California Reproductive Center, Beverly Hills, California; 2Department of Obstetrics and Gynecology, UCLA School of Medicine, Los Angeles, California.
Objective. To show the utility of tra_nsvaginal hydrolaparoscopy (fertiloscopy) in accurately diagnosing pelvic malignancy. Measurements and Main Results. Fertiloscopy canhulas were used to perform outpatient traaasvaginal hydrolaparoscopy under general anesthesia in an asymptomatic 36-year-old gravida 1, para 1 woman with secondary infertility. Raised, white, plaquelike lesions were scattered on the peritoneal surface, suspicious of neoplasia. Immediate microlaparoscopy confirmed these findings. Biopsies showed welldifferentiated malignant mesothelioma of petitoneum. Total operating time was 15 minutes. No complications occurred and the patient was referred for definitive surgery. She recovered uneventfully after this early diagnosis and surgical treatment. She received no chemotherapy and was able to conserve her ovaties. Additional data are necessary to place fertiloscopy in the diagnostic algorithm of suspected pelvic malignancy. Conclusion. Fertiloscopy can be performed safely as a first-line surgical tool to diagnose suspected pelvic neoplasia with minimal morbidity.
Objective. To assess the frequency of aaaeuploidy in morphologically normal day 3 embryos. Measurements andMain Results. We analyzed 24 IVFET cycles in which preimplaxltation genetic diagnosis (PGD) was performed on day 3, with ET on day 5 or 6. One to two blastomeres were removed from embryos of good morphology (grade A-B) at the 6- to 10-cell stage. Twenty-one cases were analyzed by fluorescence in situ hybridization (FISH) with chromosomespecific probe panels, either 13,18,21,X,Y or 13,16,18,21,22X,Y. In three cases, polar body biopsy was used in conjunction with polymerase chain reaction and embryo biopsy for detection of single gene defects. Twenty-two patients underwent 24 IVF-PGD cycles with 355 oocytes retrieved, 245 (69%) fertilized normally (2PN). Of these, 156 (63.7%) became day 3 embryos considered morphologically suitable for biopsy. No results were obtained from eight blastomeres because the nucleus could not be found. Results from the other 148 blastomeres indicated euploidy at the chromosomes tested for. Embryo transfer with at least one normal embryo was performed in 22 cycles, with a total of 54 embryos being replaced among them. Eleven clinical and four biochemical pregnancies resulted for a clinical pregnancy rate of 50%/ transfer. The rate of pregnancy loss was 18.2% (9.1% if one pregnancy of a trisomy at chromosome 2, detected at 11 weeks gestation, is excluded). Conclusion. During IVF, many day 3 embryos are axleuploid. In older women and women with a history of axleuploid pregnancies or multiple IVF failures with morphologically normal embryos, transfer of PGDevaluated embryos may increase implantation rates per embryo transferred, and reduce the rate of chromosomally unbalanced offspring or pregnancy loss. Expanding indications for transferring PGD-evaluated embryos might reduce the need for repeat IVF-ET cycles, and improve pregnancy rates for patients undergoing IVF-ET.
175. Hysteroscopic Metroplasty Performed with Miniscissors and Resectoscope NM Tabrizi, H Dabirashrafi, K Maharnad, FI Nia, K Zandinejad. Tehran University Medical Science and Health, Dabirashrafi Fertility and Endoscopy Research, Tehran, Iran.
Objective. To compare the effect of miniscissors and resectoscopic loop on hysteroscopy metroplasty in patients with septate uterus. Measurements and Main Results. Twenty-six women were randomly assigned to undergo hysteroscopic metroplasty using miniscissors or resectoscopic loop (13 each group), both performed with D5W as distending medium. Septum length measured by HSG before and after surgery showed no statistical difference between methods (p = 0.843). Conclusion. Both methods of hysteroscopic metroplasy produce similar results, and results of incision
$53