Metabolic imaging of human embryos is predictive of ploidy status but is not associated with clinical pregnancy outcomes: a pilot trial.

Study Question: Does fluorescence lifetime imaging microscopy (FLIM)-based metabolic imaging assessment of human blastocysts prior to frozen transfer correlate with pregnancy outcomes?

Summary Answer: FLIM failed to distinguish consistent patterns in mitochondrial metabolism between blastocysts leading to pregnancy compared to those that did not.

What Is Known Already: FLIM measurements provide quantitative information on NAD(P)H and flavin adenine dinucleotide (FAD+) concentrations. The metabolism of embryos has long been linked to their viability, suggesting the potential utility of metabolic measurements to aid in selection.

Utilization of Cryopreserved Oocytes in Patients With Poor Ovarian Response After Planned Oocyte Cryopreservation.

Importance: Poor ovarian response (POR) to stimulation may impact patients' desire or need to utilize cryopreserved oocytes for family building in the future. These findings, captured by Society for Assisted Reproductive Technology (SART) national data, underscore the need for tailored counseling and further research into the decision-making processes influencing oocyte utilization.

Objective: To examine the association of ovarian response to stimulation and the number of vitrified oocytes with the likelihood and timing of patients returning for oocyte utilization following planned oocyte cryopreservation (OC).

The timescales of word learning in children with language delays: In-the-moment mapping, retention, and generalization.

Learning new words and, subsequently, a lexicon, is a time-extended process requiring encoding of word-referent pairs, retention of that information, and generalization to other exemplars of the category. Some children, however, fail in one or more of these processes resulting in language delays. The present study examines the abilities of children who vary in vocabulary size (including both children with normal language (NL) and late talking (LT) children) across multiple timescales/processes - known and novel word mapping, novel word retention, and novel noun generalization.

Routine ketorolac at oocyte retrieval decreases postoperative narcotic use by more than 50.

Objective: To study the impact of routine ketorolac administration during oocyte retrieval on the proportion of patients who require postoperative narcotics for analgesia.

Design: Retrospective cohort study.

Setting: Single, university-affiliated infertility clinic.

Blasts from the past: is morphology useful in PGT-A tested and untested frozen embryo transfers?

Research Question: Day of cryopreservation, inner cell mass (ICM) grade, trophectoderm grade and blastocyst expansion grade have been associated with differences in live birth rate in frozen embryo transfer (FET) cycles. This study sought to examine the likelihood of live birth and whether the morphological grade of the blastocyst is more or equally useful in FET cycles among preimplantation genetic testing for aneuploidies (PGT-A) tested and untested blastocysts.

Design: This was a retrospective cohort study of 6271 vitrified-warmed, autologous, single-embryo transfer cycles among patients undergoing IVF from July 2013 to December 2017 at a single, university-affiliated infertility practice.

Non-invasive imaging of mouse embryo metabolism in response to induced hypoxia.

Purpose: This study used noninvasive, fluorescence lifetime imaging microscopy (FLIM)-based imaging of NADH and FAD to characterize the metabolic response of mouse embryos to short-term oxygen deprivation. We investigated the response to hypoxia at various preimplantation stages.

Methods: Mouse oocytes and embryos were exposed to transient hypoxia by dropping the oxygen concentration in media from 5-0% over the course of ~1.

Double trouble? Clinic-specific risk factors for monozygotic twinning.

Objective: To investigate clinic-specific risk factors for monozygotic twinning (MZT) using a large, electronic database.

Design: Retrospective case-control study.

Setting: Infertility clinics.

Choice of statistical model in observational studies of ART.

Analyzing data on ART presents unique and sometimes complicated challenges related to choosing the unit(s) of analysis and the statistical model. In this commentary, we provide examples of how these challenges arise and guidance for overcoming them. We discuss the implications of different ways to count treatment cycles, considering the perspectives of research questions, data management and analysis and patient counseling.

Prepregnancy Genetic Carrier Screening in Recipients of Hematopoietic Stem Cell Transplants.

Background: Genetic carrier screening of individuals with a history of hematopoietic stem cell (HSC) transplant is not always straightforward.

Case: We present the case of a couple who underwent prepregnancy genetic screening before fertility treatment. The genetics laboratory flagged the male partner's blood sample because there was a discrepancy between the sex of the patient and the sex chromosome markers, ultimately leading to the discovery of a prior HSC transplant.

To test or not to test? A framework for counselling patients on preimplantation genetic testing for aneuploidy (PGT-A).

Study Question: What is the treatment path and cumulative live birth (CLB) rate from a single oocyte retrieval of patients who intend to pursue PGT-A at the start of an IVF cycle compared to matched controls?

Summary Answer: The choice of PGT-A at the start of the first IVF cycle decreases the CLB per oocyte retrieval for patients <38 years of age, however patients ≥38 years of age benefit significantly per embryo transfer (ET) when live birth (LB) is evaluated.

What Is Known Already: PGT-A has been shown to reduce the practice of transferring multiple embryos and to confer a higher live birth rate per transfer.

Study Design, Size, Duration: This is a retrospective cohort study from December 2014 to September 2016, involving 600 patients: those intending PGT-A for their first IVF cycle (N = 300) and their matched controls.

Will noninvasive methods surpass invasive for assessing gametes and embryos?

The need to identify the most viable embryo following in vitro fertilization (IVF) was established early in the history of human IVF. The stalwart of identifying the best embryos has been morphology. Other techniques have however seen wide acceptance, including the use of preimplantation genetic screening, even though concerns exist over the invasive nature of the technique.

Metabolic Determinants of Mitochondrial Function in Oocytes.

Mitochondrial production of cellular energy is essential to oocyte function, zygote development and successful continuation of pregnancy. This review focuses on several key functions of healthy oocyte mitochondria and the effect of pathologic states such as aging, oxidative stress and apoptosis on these functions. The effect of these abnormal conditions is presented in terms of clinical presentations, specifically maternal obesity, diminished ovarian reserve and assisted reproductive technologies.

Effect of Age at Diagnosis on Chronic Quality of Life and Long-Term Outcomes of Individuals with Psoriasis.

Psoriasis is a skin disorder that frequently begins in the pediatric and young adult population but imposes physical and psychosocial burdens over a lifetime. The objective of this retrospective cohort study was to evaluate the effect of age at diagnosis on the lifetime outcomes of psoriasis patients. Individuals with psoriasis (N = 114) completed a questionnaire regarding disabilities, relationships, education, finances, and medical outcomes.

Supply-and-demand discrepancy in academic pigmented lesion clinics: a case for a new health care delivery model.

Importance: There is an increasing demand for a limited number of pigmented lesion clinic (PLC) visits at dermatology centers.

Objective: To determine the proportion of visits to PLCs that are more frequent ("additional screening") than the recommended ("standard") follow-up schedule and to determine if certain patient characteristics correlate with the demand for these visits.

Design, Setting, And Participants: A retrospective medical chart review of all PLC visits at an academic dermatology center from October 2010 to January 2012.

A measure of chronic quality of life predicts socioeconomic and medical outcomes in psoriasis patients.

Background: Psoriasis is a chronic skin disorder that detracts from quality of life, including elements of physical, psychological and social functioning.

Objective: This study investigated whether retrospective questions about chronic quality of life (CQoL) were better predictors of poor socioeconomic and medical outcomes than the current Dermatology Life Quality Index (DLQI).

Methods: One hundred fourteen participants answered the 10 questions used in the standard DLQI for 'over the last week', 'over the last year' and 'over your lifetime with psoriasis'.

Is non-alcoholic steatohepatitis a predisposing factor to porphyria cutanea tarda?

Porphyria cutanea tarda (PCT) is a disease caused by a deficiency of the fifth enzyme of the heme biosynthetic pathway in the liver that manifests in the skin as blistering and fragility of predominantly sun-exposed skin. It occurs in individuals with environmental and/or genetic risk factors such as estrogen use, hepatitis C infection and hemochromatosis gene mutations. This report highlights a case of PCT which manifested in an individual with non-alcoholic fatty liver disease (non-alcoholic steatohepatitis; NASH).

The relative impact of psoriasis and obesity on socioeconomic and medical outcomes in psoriasis patients.

Background: Psoriasis is a chronic, inflammatory skin disorder that is associated with obesity. Independently, both psoriasis and obesity likely impose impressive physical and psychosocial burdens on affected patients.

Objective: The purpose of this study was to evaluate the relative impact of body mass index (BMI) on the socioeconomic status, medical co-morbidities, and current and chronic quality of life of psoriasis patients.

Effectiveness of Novel Borane-Phosphine Complexes In Inhibiting Cell Death Depends on the Source of Superoxide Production Induced by Blockade of Mitochondrial Electron Transport.

Central neurons undergo cell death after axotomy. One of the signaling pathways for this process is oxidative modification of one or more critical sulfhydryls in association with superoxide generation within mitochondria. Agents that reduce oxidized sulfhydryls are neuroprotective of axotomized retinal ganglion cells, and we hypothesized that this occurs via reversal of the effects of mitochondrial-produced superoxide.

Meta-analysis comparing efficacy of benzoyl peroxide, clindamycin, benzoyl peroxide with salicylic acid, and combination benzoyl peroxide/clindamycin in acne.

Background: Comparative efficacy of the multiple treatments containing benzoyl peroxide (BPO) and clindamycin (CL) is not established.

Objective: We compared the efficacy of topical 5% BPO, 1% to 1.2% CL, 5% BPO with salicylic acid (SA) preparation, and combination BPO/CL in acne lesion reduction.

Cell-autonomous generation of mitochondrial superoxide is a signal for cell death in differentiated neuronal precursor cells.

The vast majority of optic neuropathies result from retinal ganglion cell (RGC) axonal injury. This induces cell death and is associated with a burst of mitochondria-generated superoxide within the soma. It is unclear whether there is a clear causal relationship between superoxide generation and cell death.

Long-term safety of biologics in dermatology.

The use of biologics in dermatology has increased rapidly. Although most are relatively safe when correctly used and monitored, there are known side effects and adverse events that occur. Selection of patients should be done on a case-by-case basis.

Characteristics of Sleep-Related Obstructive Respiratory Disturbances in Childhood.

Sleep-related obstructive respiratory disturbances in childhood differ significantly from the adult's obstructive sleep apnea syndrome (OSAS). In contrast to adults, in children with OSAS the disturbance of the macrostructure of sleep, the increase of the number of apneas and hypopneas, and the diminution of oxygen saturation are not so prominent. Restlessness of the sleep, as reflected by movement arousals together with cortical (electroencephalograph-recorded) arousals, is important.