Trophectoderm biopsy protocols can affect clinical outcomes: time to focus on the blastocyst biopsy technique.

Objective: To compare two different blastocyst biopsy protocols.

Design: Retrospective single-center cohort study.

Settings: Private in vitro fertilization center.

Controlled ovarian hyperstimulation (COH) parameters associated with euploidy rates in donor oocytes.

Although oocyte donors are young and are expected to provide a high rate of euploid oocytes, significant differences of euploidy rates for donor embryos exist between different IVF centers (1). Laboratory conditions can lead to differences of euploidy (2,3,4,5,6,7); but, the role of COH has not been investigated. In this study, we investigated whether euploidy rates in the embryos created from donor oocytes are influenced by controlled ovarian hyperstimulation parameters used during assisted reproduction.

Impact of a prior cesarean delivery on embryo transfer: a prospective study.

Objective: To determine whether a history of prior cesarean delivery (CD) makes ET more difficult and impacts pregnancy outcomes.

Design: Prospective cohort study.

Setting: Tertiary care military facility.

Utility of antimüllerian hormone level obtained for infertility assessment for alerting to ovarian tumor.

Background: Antimüllerian hormone is a marker of ovarian reserve and is now routinely measured in women seeking infertility treatment.

Case: A 42-year-old woman, gravida 1, abortus 1, presented with secondary infertility. Obtained originally for assessment of ovarian reserve, an antimüllerian hormone of more than 160 ng/mL raised suspicion for a granulosa cell tumor.

Falsely elevated testosterone due to heterophile antibodies.

Background: Falsely elevated testosterone is a rare phenomenon that may result from heterophile antibodies. Similar to patients with heterophile antibodies for β-hCG, incorrect management may result in unnecessary testing or therapy.

Case: A previously healthy postmenopausal woman presented with a falsely elevated total testosterone level due to interference consistent with heterophile antibodies, with subsequent normal levels detected by liquid chromatography-mass spectrometry.

Characterization of tissue biomechanics and mechanical signaling in uterine leiomyoma.

Leiomyoma are common tumors arising within the uterus that feature excessive deposition of a stiff, disordered extracellular matrix (ECM). Mechanical stress is a critical determinant of excessive ECM deposition and increased mechanical stress has been shown to be involved in tumorigenesis. Here we tested the viscoelastic properties of leiomyoma and characterized dynamic and static mechanical signaling in leiomyoma cells using three approaches, including measurement of active RhoA.

Insurance mandates, embryo transfer, outcomes--the link is tenuous.

To examine the relationship between state insurance mandate status and the number of embryos transferred in assisted reproductive technology cycles, we conducted a retrospective analysis of clinics reporting to the publicly available national Society for Assisted Reproductive Technology registry. We found that clinics in states with comprehensive mandates transferred between 0.210 and 0.

Why leiomyomas are called fibroids: the central role of extracellular matrix in symptomatic women.

Uterine leiomyomas are highly prevalent and symptomatic tumors of women in their reproductive years. The morbidity caused by these tumors is directly related to increasing size. Leiomyoma cells do not rapidly proliferate; instead, the tumors grow primarily due to excessive production of disorganized extracellular matrix (ECM).

Use of F 18-fluoro-D-glucose-positron emission tomography-computed tomography to localize a hilar cell tumor of the ovary.

Objective: To describe provocative testing and alternative imaging strategies used to localize an androgen-producing tumor in a 58-year-old woman with severe hirsutism.

Design: Case report.

Setting: Clinical Research Center.

Conversion from assisted reproductive technology to intrauterine insemination in low responders: is it advantageous?

Objective: To examine cycle outcomes among patients demonstrating an attenuated ovarian response that proceeded to oocyte retrieval to those converted to intrauterine insemination (IUI).

Design: Retrospective cohort study.

Setting: Large private fertility center.

Transforming growth factor beta3 regulates the versican variants in the extracellular matrix-rich uterine leiomyomas.

Uterine leiomyoma are common, benign tumors that are enriched in extracellular matrix. The tumors are characterized by a disoriented and loosely packed collagen fibril structure similar to other diseases with disrupted Transforming growth factor beta (TGF-beta) signaling. Here we characterized TGF-beta3 signaling and the expression patterns of the critical extracellular matrix component versican in leiomyoma and myometrial tissue and cell culture.

Management of uterine fibroids in the patient pursuing assisted reproductive technologies.

Uterine leiomyomas are present in 30-70% of women of reproductive age. In addition to causing menstrual disorders and pain, uterine fibroids negatively affect fertility and pregnancy outcome for patients pursuing assisted reproduction. The two questions that have to be addressed are: which fibroids should be treated and how should they be treated? Submucosal fibroids are associated with a 70% reduction in delivery rate.

Labial fusion: a rare complication of chronic graft-versus-host disease.

Background: Hematopoetic stem cell transplantation may be complicated by genital graft-versus-host (GVH) disease and may uncommonly result in labial fusion.

Case: A 22-year-old woman with a history of Ewing's sarcoma and acute myelogenous leukemia received chemotherapy and total-body irradiation followed by a matched, unrelated donor hematopoetic stem cell transplantation. After transplantation, she developed chronic GVH disease involving the skin, eyes, mouth, and joints.

Low serum osteoprotegerin levels in premenopausal infertile women with low bone density: an association of relevance?

Objective: To evaluate if the levels of the central regulators of osteoclast activity, osteoprotegerin (OPG) and receptor activator for nuclear factor kappaB-ligand (RANk-L), correlate with bone mineral density (BMD) parameters in premenopausal infertile women.

Design: Cross-sectional study.

Setting: Academic infertility practice.

Mechanical homeostasis is altered in uterine leiomyoma.

Objective: Uterine leiomyoma produce an extracellular matrix (ECM) that is abnormal in its volume, content, and structure. Alterations in ECM can modify mechanical stress on cells and lead to activation of Rho-dependent signaling and cell growth. Here we sought to determine whether the altered ECM that is produced by leiomyoma was accompanied by an altered state of mechanical homeostasis.

Vasomotor symptoms in infertile premenopausal women: a hitherto unappreciated risk for low bone mineral density.

Objective: To identify the prevalence of vasomotor symptoms (VMS) in a population of premenopausal infertile women and to determine whether VMS is associated with enhanced bone turnover and low bone mineral density (BMD).

Design: Cross-sectional study.

Setting: Academic infertility practice.

Simple tools for assessment of ovarian reserve (OR): individual ovarian dimensions are reliable predictors of OR.

Objective: To determine the association between individual ovarian dimensions, advancing age, and declining ovarian reserve (OR) in an infertile population.

Design: An ongoing prospective observational study.

Setting: Academic infertility practice.

Total knee arthroplasty in hemophilic arthropathy.

Background: Arthropathy of the knee frequently develops in patients with hemophilia, who may require a total knee arthroplasty at a young age. Hemophilic patients, who require regular intravenous replacement of coagulation factor, have a higher prevalence of human immunodeficiency virus (HIV) infection, which can compromise the outcome of the arthroplasty. The purpose of this study was to evaluate prosthetic survival following total knee arthroplasty and identify factors associated with failures of the arthroplasties in hemophilic patients.