Macroscopic characteristics of 100 fetal adnexae from pregnancies obtained by in-vitro fertilization and embryo transfer (IVF-ET) were compared with data for normal pregnancies taken from the literature. Material was obtained from 63 singleton, 15 twin, one triplet and one quadruplet pregnancies. The fetal and placental weights as well as the fetal:placental weight ratio were within the normal range for gestational age. Whilst placental morphology was normal, the insertion of the umbilical cord was frequently abnormal. Marginal (15%) and velamentous (14%) insertions of the umbilical cord were found more frequently than in a general obstetrical population (6% and 1% respectively). Excluding placentae from multiple pregnancies (which are known to have a higher incidence of abnormal cord insertion) the frequency did not decrease and remained significantly higher than in a normal population (P less than 0.01 and P less than 0.001, for marginal and velamentous insertion respectively). Abnormal insertion of the cord is of major clinical importance because of its association with vasa praevia and fetal haemorrhage (Benkiser Syndrome). Since this condition is thought to be caused by disturbed orientation of the blastocyst at implantation it is probably related to the IVF-ET procedure.

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The incidence of in vitro fertilizationwas analyzed with respect to the degree of cumulus dissociation (expansion) at the time of oocyte recovery and also the semen quality.Of the oocytes surrounded by perfectly ("++") or moderately ("+") p<0.ool.

A new FOATIaRVS (Foci-Ovarian endometrioma-Adhesion-Tubal endometriosis-Inflammation-adenomyosis-Recto Vaginal Space) endometriosis classification is proposed to replace the ASRM (American Society Reproductive Medicine) classification. FOATIaRVS is descriptive, complete, precise, simple and easy-to-use. All endometriotic implants are described through the use of a formula. The attribution of coefficients for each endometriotic site is very simple: 0, 1 or 2. A coefficient of 2 is attributed if the lesion is substantial and could cause infertility or pain. The description of the endometriosis covers not only the usual appearance of the implants but also their functional repercussion for tubal and ovarian function. It also includes results of the most recently developed explorations. The formula is clearly of value for providing information on the progression or the regression of each endometriotic site and on the efficacy of the therapy for each location. It has a predictive value and can provide indications for the choice of therapy.

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