Congenital Malformations

Lb, Holmes

doi:10.1056/nejm197607222950406

Cited by 65 publications

(13 citation statements)

References 8 publications

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“…Malformations with surgical or functional impairment requiring a surgical intervention were considered major; while all others that did not impair daily function were considered minor [28] . A minor anomaly was distinguished from a normal variation if it occurred in <4% of the infants in the same racial group [29] . For the 20% of neonates born at our institution, a detailed physical examination was performed at birth.…”

Section: Methodsmentioning

confidence: 99%

Intracytoplasmic Sperm Injection (ICSI) in Extreme Cases of Male Infertility

Palermo¹,

Neri

Schlegel

et al. 2014

PLoS ONE

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IntroductionSeverely compromised spermatogenesis typical of men with virtual azoospermia or non-obstructive azoospermia requires an extreme search for spermatozoa. Our goal was to evaluate the usefulness of a meticulous search carried out in ejaculated or surgically retrieved specimens in achieving pre- and post-implantation embryo development.Patients and MethodsIn a retrospective cohort study carried out in an academic institution, intracytoplasmic sperm injection (ICSI) outcomes were reviewed as a function of length of microscopic sperm search in ejaculated and surgically retrieved specimens. Couples whose male partner presented with either virtual or non-obstructive azoospermia were treated by ICSI and categorized according to the time spent in identifying and retrieving enough spermatozoa to inject all the oocyte cohort. Semen parameter, fertilization, pregnancies, deliveries, and child welfare in relation to increasing search time were analyzed and compared.Result(s)The maternal and paternal ages were comparable in both ejaculated and testicular sperm extraction (TESE) groups along with the oocytes retrieved. The fertilization rates for both ejaculated and TESE progressively decreased with increasing time (P<0.0001). Clinical pregnancies in the ejaculated cohort remained satifactory. In the TESE cohort, there was a decrease in pregnancy rate with increasing time, from 44% to 23%. In a limited number of cases, offspring health was evaluated in both semen sources and appeared reassuring.Conclusion(s)An extensive and at time exhaustive sperm quest yields kinetically and morphologically impaired spermatozoa without apparent impact on embryo developmental competence. Retrieval of spermatozoa from the seminiferous tubules provided more consistent fertilization and pregnancy outcomes than those retrieved from the ejaculate. A trend indicated that pregnancy rate decreased as search time increased in the TESE group. The utilization of the scarce and unselected spermatozoa did not obviously impair embryo development or cause post-implantation errors.

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Section: Methodsmentioning

confidence: 99%

Intracytoplasmic Sperm Injection (ICSI) in Extreme Cases of Male Infertility

Palermo¹,

Neri

Schlegel

et al. 2014

PLoS ONE

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“…Anomaly and malformation were considered synonymous with a structural abnormality. 23,24 Statistical Analysis 2 tests were performed using SAS (Statistical Analysis System, Cary, NC). Statistical procedures were carried out by 2 tests as one tailed using a 5% level of significance to evaluate all hypotheses.…”

Section: Methodsmentioning

confidence: 99%

ICSI and Its Outcome

Palermo¹,

Neri²,

Hariprashad³

et al. 2000

Semin Reprod Med

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Since its introduction in 1992, intracytoplasmic sperm injection (ICSI) has become a popular assisted fertilization technique proved very efficient in treating male factor infertility. Many healthy children have been born worldwide from this procedure, and their physical and mental development appears to be within the normal limits. However, because of the peculiarity of the technique and the poor characteristics of the spermatozoa used, concern about the safety of ICSI still exist. In this article, we analyze the in vivo development of embryos conceived after ICSI as well as the obstetric outcome, occurrence of chromosomal abnormalities, and rate of congenital malformations in neonates born as a result of this treatment. A total of 2435 couples were studied in whom the male partners were presumed to be the cause of repeated failed attempts at in vitro fertilization (IVF) or had semen parameters that were unacceptable for conventional IVF treatment. Pregnancies resulting from 3573 ICSI cycles were analyzed; pregnancy outcome data were obtained from the records of obstetrician-gynecologists and/or pediatricians. The overall clinical pregnancy (fetal heartbeat) rate was 44.8% with a resultant delivery rate of 39.2% per ICSI cycle (n = 1388). In 37 of the 77 miscarriages for which cytogenetic data were available, an autosomal trisomy was found in each and 29 additional pregnancies were terminated because of a chromosomal abnormality revealed by prenatal diagnosis. There was an equal distribution of vaginal deliveries and cesarean sections (n = 682 and n = 658, respectively). Of the 2059 neonates resulting from ICSI treatment, 38 (1.8%) presented with congenital abnormalities (22 major and 16 minor). When the frequency of miscarriages and congenital malformations was analyzed in terms of semen origin, the outcome was no different between ICSI and IVF. The course of pregnancies and occurrence of congenital malformations following treatment by ICSI are within the ranges obtained following conventional IVF.

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“…3 La etiología de los DTN es multifactorial y éstos son la consecuencia de la interacción de factores ambientales, nutricionales, genéticos, étnicos o de causa desconocida . [4][5][6][7][8] De los estudios hechos, la mayoría son de tipo descriptivo y de muestras de centros hospitalarios. Los DTN representan un riesgo para el producto de la gestación, de enfermedad con secuela o bien la muerte.…”

Section: Introductionunclassified