Spermatozoa selection at high magnification before intracytoplasmic sperm injection seems to be positively associated with pregnancy rates after day 3 embryo transfers. The aim was to demonstrate an association between the presence of vacuoles in sperm nuclei and the competence of embryos to develop to day 5. Grading of spermatozoa at x 6000-x 12,500 magnification: grade I, no vacuoles; grade II, or=1 large vacuole; grade IV, large vacuoles with other abnormalities. The outcome of embryo development in a group of 25 patients after sibling oocyte injection with the four different grades of spermatozoa showed no significant difference in embryo quality up to day 3. However, the occurrence of blastocyst formation was 56.3 and 61.4% with grade I and II spermatozoa respectively, compared with 5.1% with grade III and 0% with grade IV respectively (P < 0.001). Spermatozoa selection at high magnification using Nomarski interference contrast is useful to identify more precisely the size and the number of nuclear vacuoles that greatly exert a negative effect on embryo development to the blastocyst stage. These observations confirm previous studies pointing to possible 'early and late paternal effects', both of which may have an impact on early embryonic development.

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Our aim was to observe the frequency of combination therapy using antiepileptic drugs (AEDs) and electroconvulsive therapy (ECT) in Austria and the literature, and to provide rationales and recommendations based on clinical and molecular properties. The responsible ECT leaders of eight Austrian departments were contacted for information about combination therapy. A computerized PubMed database search was performed and supplemented by cross-referencing from papers, review articles and psychiatric manuals. The frequency of combination therapy in Austrian departments ranges between 0 and 85.7%. In 17 studies enrolling a total of 189 patients, 87 (46.0%) patients received combination therapy. Of these 87 patients, nine (10.3%) reported adverse effects. ECT and AEDs show overlapping clinical and molecular properties. Combination therapy is an observed reality and, according to the currently available literature, feasible. A comparison of clinical and molecular properties indicates possible augmentative effects, making combination therapy a promising alternative in treatment-resistant cases. But there is still a clear need for prospective case controlled data concerning side effects, safety profiles and effectiveness until it can be recommended.

Oral communication abstractsrisk for severe complications like recurrent late miscarriage and early growth restriction. Objective: To evaluate intra and interobserver reproducibility of fetal renal volume measurement using three-dimensional ultrasonography (3DUS). Methods: A cross-sectional study was conducted on 11 women between 24 and 34 weeks of a healthy pregnancy. One examiner (GDT) obtained volumetric measurements of both fetal renal volumes using the VOCAL (Virtual Organ Computer-aided AnaLysis) method with a 300 rotation angle (delimitation of 6 sequential planes). A second examiner (ISWB) obtained these measurements on the same patients, without knowledge of the first examiner's results (blinded). Reproducibility was evaluated with Bland-Altman plots. Results: The mean difference between paired measurements obtained by the same examiner was −0.07 cm 3 (CI95% −0.88 to 0.75) for the right kidney and −0.21 cm 3 (CI95% −0.95 to 0.75) for the right kidney; and the mean difference between paired measurements obtained by the two examiners was −0.07 cm 3 (CI95% −1.25 to 1.12) for the right kidney and 0 cm 3 (CI95% −1.53 to 1.53) for the left kidney. Conclusions: The fetal renal volume assessed by 3DUS using the VOCAL method is highly reproducible. Objective: VOCAL measurement of the bladder contour is operator dependant and has inter-observer variations. As well, fetal voiding frequence is not known, as neurologic control is immature. Recently it was demonstrated that two measurements separated 15 to 20 minutes may underestimate diuresis as small voiding may occur in between. Nevertheless, too frequent 3D bladder volume acquisition could produce false diuresis produced just from intra-observer variability. The objective of this study was to estimate this variability and confidence intervals of bladder volume measurement with 3D VOCAL, in order to define the least time interval needed for diuresis measurement. Methods: Prospective study. Normal singleton pregnancies, 20 to 25 weeks of GA were included. Four bladder volume acquisitions in a General Electric E8, RAB 4-9 transducer, were performed during the normal morphologic scan, every 2-5 minutes, decided randomly. Two blinded operators calculated the bladder volume with 3D VOCAL off-line, with 30 • rotation Intraclass correlation coefficient was used. Non satisfactory visualization of bladder border was defined as more than 2/3 in no more than 1 of 6 planes. Results: 79 volume bladder acquisitions in 22 fetuses at 20 to 25w, median time interval of 2 : 42 (range 00 : 15-9 : 22). The intraclass correlation coefficient was 0.81. Bland and Altmann test showed 3.9% (95% CI 109% to −102%, absolute 1.7 to −1.4ml) agreement. When only satisfactory bladder borders were obtained (53/79), ICC was 0.89 and Bland and Altman agreement was −4.4% (95% CI 86% to −95%). The mean diuresis obtained between two consecutive increasing phases was 0.3ml/min. As the 95%CI was 1.7 to −1.4 ml, 5 to 6 minutes interval could demonstrate representative diuresis not due to measurement vari...