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We present a case of a 46,XY der(13;14) Robertsonian translocation carrier whose spermatozoa were karyotyped after injection into mouse oocytes. Fresh semen samples as well as recovered samples were used. There was no significant difference in the survival rate of mouse oocytes (fresh: 78.1% versus frozen: 81.7%), activation rate (fresh: 84.0% versus frozen: 90.6%), fertilization rate (fresh: 72.0% versus thawing of frozen: 76.5%) between fresh or frozen spermatozoa. Metaphase chromosome spreads from 45 spermatozoa were analysed. The frequency of spermatozoa that were chromosomally unbalanced with respect to the translocation was 8.9%, and the frequency of abnormalities unrelated to translocation was 4.4%. An excess of spermatozoa with balanced chromosomes was observed: compared with normal, 23 (51.1%) versus 16 (35.6%) respectively; but this segregation difference was not statistically significant (chi(2) = 0.9, P > 0.3). After genetic counselling with the carrier and his partner, intracytoplasmic sperm injection treatment was performed. Healthy female and male infants were delivered at 36 weeks gestation via a Caesarean section. Both babies were carriers for the balanced Robertsonian translocations detected for prenatal diagnosis at 16 weeks gestation. The present study demonstrates that patients can be given further information about the proportion of the spermatozoa which carry a chromosomal abnormality.

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We investigated prospectively the clinical efficacy of a newly developed continuous autotransfusion system of ascites (CATSA) without protein supplement in patients with severe ovarian hyperstimulation syndrome (OHSS). Peritoneovenous shunting was used to recirculate ascites. The CATSA was performed for 5 h at a rate of 100-200 ml/h once a day. Eighteen patients were treated with the CATSA (CATSA group) and 36 were treated with an intravenous 37.5 g/day of albumin supplement (albumin group). Hospital stay was significantly shorter in the CATSA group than in the albumin group (10.0 +/- 5.7 versus 13.9 +/- 6.2 days, P < 0.01). Haematocrit value reached <40% significantly earlier in the CATSA group (on hospital days 3.9 +/- 3.2 versus 5.9 +/- 2.5, P < 0.01). Using a single procedure, haemoconcentration, urinary output and pulse pressure were markedly improved in the CATSA group compared with the albumin group. Discomfort due to massive ascites diminished promptly and did not recur in nine of 18 CATSA group patients, whereas it persisted in all 36 patients in the albumin group. The serum concentration of protein was maintained in the CATSA group, whereas it did not increase in the albumin group despite daily supplementation with 37. 5 g of albumin. Apparent adverse effects of each procedure were not observed in either group. The mean values of several parameters in the serum pertinent to the coagulation-fibrinolysis system did not change significantly in either group after the procedure. It was concluded that the CATSA procedure expanded circulating plasma volume without exogenous albumin and appeared to lead to a prompt recovery from severe conditions of OHSS.

To assess changes in the serum uric acid level in the third trimester of twin pregnancies, a total of 152 consecutive women with twin pregnancies were examined. Serum uric acid levels were analyzed in the women at varying gestational weeks in the presence or absence of preeclampsia. A receiver operating characteristic curve was used to determine the optimal cutoff value of serum uric acid between 30 and 31 weeks of gestation predicting subsequent development of preeclampsia. Forty-four women (29%) developed preeclampsia (preeclampsia group) at 33.2 ± 1.9 weeks (mean ± SD) and gave birth at 35.4 ± 1.5 weeks of gestation. The remaining 108 women (71 %) gave birth at 35.6 ± 1.7 weeks of gestation (control group without preeclampsia). Serum uric acid levels rose gradually with advancing gestation in both groups. In the preeclampsia group, they were already increased at 30–31 weeks of gestation and corresponded to those seen in the control group at 37 weeks. The cutoff value at 30–31 weeks was 5.5 mg/dl, with a sensitivity of 73% and a specificity of 74%. These results suggest that an elevation in serum urate preceded the onset of preeclampsia. Determination of the serum level of uric acid between 30 and 31 weeks of gestation was useful for detecting a higher risk of late-onset preeclampsia in twin pregnancies.

This case report illustrates the successful use of assisted reproductive technologies (ARTs) in a patient receiving conservative treatment for endometrial adenocarcinoma. A 31-year-old infertile woman, diagnosed as FIGO stage Ia endometrial adenocarcinoma (grade 1), received oral medroxyprogesterone acetate 400 mg/day for 12 weeks. Endometrial curettage was performed and the absence of endometrial carcinoma was confirmed. A single pregnancy was achieved with in vitro fertilization and embryo transfer. A healthy female infant was born via cesarean section at 42 weeks’ gestation. The carcinoma has not recurred, and the patient now desires a second child. We conclude that ART combined with progesterone treatment might be a powerful option for the treatment of infertile patients with early stage, well-differentiated endometrial adenocarcinoma.

Human elongated spermatids from azoospermic patients were inserted into mouse oocytes by intracytoplasmic sperm injection (ICSI). The injection resulted in survival rates of 46.5% (180 out of 387) and activation rates of 36.1% (65 out of 180). The rate of two pronuclear (2PN) formation was 35.4% (23 out of 65). Only 34.8% (eight out of 23) metaphase chromosome spreads from 2PN zygotes could be analysed; however, all were of normal karyotype. Cytogenetic analysis at the first metaphase revealed that human elongated spermatid chromosomes were able to undergo replication in a heterogeneous environment.

Background: Ovarian hyperstimulation syndrome (OHSS) appears to be caused by increased capillary permeability in the vascular endothelial cells. Such cells secrete excess amounts of von Willebrand factor (vWF), a large adhesive glycoprotein.Methods: We retrospectively evaluated the circulating levels of vWF and of vascular endothelial growth factor (VEGF) twice, on the days of oocyte retrieval and embryo transfer, in 46 women who developed early-onset OHSS. Results: Nineteen, 14, and 13 women developed mild, moderate, and severe OHSS, respectively. Inconsistent changes were observed in the VEGF during oocyte retrieval and embryo transfer. However, the net increase in serum vWF during that period showed an increase in absolute value at the time of embryo transfer that paralleled an increase in the severity of OHSS. That is, in mild OHSS, the serum vWF increased from 140 ± 44 to 164 ± 28%; in moderate OHSS, it increased from 113 ± 47 to 186 ± 22%; and in severe OHSS, it increased from 120 ± 35 to 274 ± 63%. All 9 women with a vWF level >230% at embryo transfer developed severe OHSS, while 9 of 13 women with severe OHSS exhibited a vWF >230% at embryo transfer. Conclusion:The results suggest that a rise of the serum level of vWF occurs prior to clinical manifestation of OHSS in patients with severe OHSS but not in patients with mild OHSS.