Cytogenetic analysis of the retained products of conception (POC) is the most effective test for identifying miscarriage causes. However, there has been no large-scale study limited to blastocyst transfer. This study retrospectively reports the findings of 1030 cases in which POC analysis was performed after missed abortion following single blastocyst transfer performed at the Shinbashi Yume Clinic. We identified 19.4% as normal karyotypes and 80.6% as aneuploid. These cases broke down into: 62.3% trisomy; 7.8% double trisomy; 0.5% triple or quadruple trisomy; 1.3% monosomy 21; 3.2% monosomy X; 0.1% 47,XXY; 1.0% polyploidy; 1.0% mixed; 1.1% embryonic mosaicism; and 2.4% structural anomalies. In samples with normal karyotypes, 49.5% were female while 50.5% were male. The occurrence of trisomy and double trisomy were both significantly more frequent in the ≥38 years group than in the ≤37 years group (P < 0.01). Trisomy was significantly more frequently associated with fetal heartbeat (P < 0.01); double trisomy, polyploidy and normal karyotype were significantly more frequent with no fetal heartbeat (P < 0.01). There was no significant difference in the frequency of chromosomal abnormalities between the number of miscarriages or blastocyst quality. Thus, POC cytogenetic testing is highly valuable for ascertaining the cause of miscarriage.

A pituitary tumor can be located at the various positions of the optic chiasm. Visual field defects are produced by lesions at the anterior angle, body, posterior angle, or lateral aspect of the chiasm. A pituitary tumor frequently causes bitemporal hemianopia by compressing the optic chiasm initially. Visual field defects are thought to be due to the direct compression or the effect on the blood supply of the optic chiasm. These visual field defects can be detected by manual perimetry, 1 and by automated static perimetry. 2-5Automated perimetry can find as many or more abnormalities in chiasmal lesions as can Goldmann perimetry. Automated static perimetry expresses numeric values as sensitivity and decreased values as depression. Vertical step or decreased value along the midline are known to be the initial findings of bitemporal hemianopia.5 However, these findings are not quantitatively determined. It is not yet known how many dB of differences in sensitivity between midlines could be significant. We also need to determine how many dB of decreased sensitivity in the temporal area lead to initial change. Magnetic resonance imaging (MRI) demonstrates compression to the optic chiasm by the tumor. Compression of the optic chiasm by the tumor can induce visual field loss. We studied the visual field by automated perimetry in patients with asymptomatic pituitary tumor demonstrated by MRI and determined the criteria of detecting temporal hemianopia. Patients and methodsFifteen patients (five men and 10 women) with pituitary tumor detected by MRI had no

This procedure is an effective treatment for CP or CSP that could be used in place of conventional surgical interventions and medical treatment using MTX.

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