Ectopic pregnancies with unusual location and an angular pregnancy: Report of eight cases.

Objective: The increased use of assisted reproduction techniques has been accompanied by an increase in ectopic pregnancies with unusual location being associated with significant maternal morbidity and mortality. This article reports on seven cases of ectopic pregnancies with unusual location and an angular pregnancy. Diagnostic and therapeutic strategies are discussed and a brief review of literature is presented.

Age-related distribution of basal serum AMH level in women of reproductive age and a presumably healthy cohort.

In this study, day 1 to 4 serum anti-Müllerian hormone (AMH) level was analyzed in 2,741 patients attending our department for reproductive medicine or reproductive surgery, including a subgroup of 1,105 women who attended an assisted reproductive technology program because of a male factor as a presumably healthy subgroup. Day 1 to 4 serum AMH levels showed an age-dependent distribution and there is a wide range of AMH in each year of age analyzed, showing that even young women are at a risk of reduced ovarian reserve.

Anti muellerian hormone serum levels in women with endometriosis: a case-control study.

Objective: To compare the anti muellerian hormone (AMH) serum levels in women with and without endometriosis.

Design: A case-control study

Setting: Women's General Hospital, Linz, Austria.

Patient(s): Our study included a total of 909 patients undergoing in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) treatment or consulting our specific endometriosis unit.

Cryopreserved blastocysts have a lower implantation but an equal live birth rate as compared to fresh blastocysts of the same quality - a case-control study.

The purpose of this case-control study was to compare implantation, pregnancy, and live birth rate of cryopreserved embryos with that of fresh embryos. A total of 1,488 assisted reproductive technology (ART) trials including 188 cryopreserved embryo replacement trials were reviewed. After proofing the exclusion criteria, 112 patients undergoing a cryopreserved embryo replacement (study group) were matched with 112 patients undergoing a fresh embryo transfer (control group).

The role of mode of conception in the outcome of twin pregnancies.

Artificial reproductive techniques (ART) have become a routine and successful treatment of infertility. Twin pregnancies are more frequent after ART compared to spontaneous conception. Varying findings have been reported for the obstetric and perinatal outcome of ART twin pregnancies as compared to spontaneously conceived twin pregnancies.

Morphological analysis at compacting stage is a valuable prognostic tool for ICSI patients.

In terms of treatment outcome, little prognostic power is attributed to day-4 morphology. A day-4 score was applied to 56 patients separating non-compacting embryos from compacting (some areas of compaction) and fully compacted embryos. The latter were further subdivided according to the morphology of compaction.

Risk in twin pregnancies after the use of assisted reproductive techniques.

Objective: To analyze whether there is an increased perinatal risk for twin pregnancies after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).

Study Design: The medical files of 216 twin pregnancies (group 1) conceived through IVF/ICSI and 377 spontaneously conceived twin pregnancies (group 2) were assessed retrospectively. Data on gestational age at delivery, mode of delivery, birth weight, neonatal intensive care unit admission, duration of hospitalization, perinatal mortality and malformations were recorded.

Blood clots in the cumulus-oocyte complex predict poor oocyte quality and post-fertilization development.

Assessment of oocyte maturity and quality (morphological appearance) at the time of retrieval is difficult as the egg is obscured by a large cumulus mass that hinders adequate scoring. Since no data are available on the possible relationship between the cumulus-oocyte complex (COC) and oocyte morphology, this prospective intracytoplasmic sperm injection study was set up in 87 consecutive patients. COC were grouped according to expansion of both corona radiata and cumulus matrix.

Developmental fate of ovoid oocytes.

Background: Irregularities in composition, thickness and/or color of the zona pellucida may impair optimal function and result in reduced outcome. Anomalies of oocyte shape have not been investigated in detail in this respect.

Methods: Therefore, all patients attending our clinic within a period of 1 year were screened for the presence of ovoid gametes and the corresponding developmental potential was evaluated.

Birth weight is lower for survivors of the vanishing twin syndrome: a case-control study.

Objective: To compare the outcome of singleton pregnancies originating from a twin gestation with singleton pregnancies originating from a single gestation.

Design: Case-control study.

Setting: Women's general hospital in Austria.

[Multiple pregnancies after ART: problems and possible solutions].

Multiple pregnancies following an assisted reproduction technique (ART) should be seen as a complication, and for that reason they should be avoided. In contrast to singleton pregnancies following ART, the multiple pregnancies are associated with a higher prenatal, neonatal and maternal risk; furthermore this results in a financial burden for the health care system. This paper gives an overview of the latest literature and different attempts of European countries, trying to reduce the multiple pregnancy rate.

Incomplete denudation of oocytes prior to ICSI enhances embryo quality and blastocyst development.

Background: Granulosa cells are essential mediators of oocyte maturation and fertilization. Because of the denudation of oocytes in preparation for ICSI, any potential positive effect of surplus cumulus cells (CCs) on further development would be unable to exert further effect. In order to evaluate the actual influence of adhering cumulus cells on further preimplantation development, this prospective study was carried out.

Basal level of anti-Müllerian hormone is associated with oocyte quality in stimulated cycles.

Background: Serum anti-Müllerian hormone (AMH) levels provide a powerful means for predicting ovarian response, which is reflected not only by the size of the primordial follicle pool but also by the quality of the oocytes. Considering a mutual interdependence between AMH-expressing somatic cells and gametes, this prospective morphological study was set up to evaluate whether extreme AMH levels represent diminished oocyte quality and developmental incompetence.

Methods: A total of 141 consecutive ICSI patients were subdivided into three groups using the 25th and 75th percentiles of the serum AMH levels (cycle day 3).

Cytoplasmic pitting has a negative influence on implantation outcome.

Purpose: Since cytoplasmic pitting is a morphological phenomenon discussed controversially, this study was set up in order to assess the actual influence of cytoplasmic pitting on treatment outcome.

Methods: Four hundred and one patients undergoing 484 consecutive treatment cycles were evaluated retrospectively in order to assess the actual influence of pitting on treatment outcome.

Results: Pitting was found to be reduced in single culture as compared to group culture (p < 0.

Occurrence and developmental consequences of vacuoles throughout preimplantation development.

Objective: Since little is known about the actual incidence and fate of vacuoles at different stages of development this preliminary study was set up to accurately measure vacuoles and track them to day 5.

Design: Prospective study.

Setting: Women's General Hospital in Austria.

Premature rupture of membranes with oligo- or anhydramnios before 24 weeks of gestation and the chances of fetal survival.

Unlabelled: Rupture of the membranes before the fetus has achieved viability within the womb is an event of enormous importance for both mother and physician. The potential outcome ranges from fetal death, a frequent occurrence, to a severely disabled life or a happy (but rare) birth without any mental or physical retardation for the child. The aim of the present investigation was to provide the consulting physician with valid data, enabling him/her to make a realistic assessment of the risks and to inform the patient accordingly.

Assisted vaginal delivery versus caesarean section in breech presentation.

Background: The Term Breech Trial (TBT), a well-known study conducted by Hannah and published in the Lancet, revealed a better outcome for neonates after primary caesarean section compared with attempted vaginal delivery. The aim of the present study was to determine whether the results of TBT have to be taken into account when counseling pregnant women in central Europe.

Methods: We investigated 882 women who had delivered infants in breech presentation over a period of 11 years.

Complete oocyte activation failure after ICSI can be overcome by a modified injection technique.

Background: Complete fertilization failure after ICSI is a rare event, and it may happen repeatedly even in cases of normal sperm parameters and good ovarian response. In these cycles, alternative ICSI techniques may prove useful.

Methods: Our modified ICSI (mICSI) is characterized by aspiration close to the opposite membrane (the region of the mitochondria with a high inner mitochondrial membrane potential) which is followed by central deposition of the sperm.

Laser-assisted zona pellucida thinning prior to routine ICSI.

Background: In MII oocytes showing difficult oolemma breakage, ICSI can cause an increase in the degeneration rate. This may be overcome by laser-assisted ICSI using a 5-10 micro m opening in the zona pellucida for injection. However, such a small opening might impair the hatching process, especially if assisted hatching is applied in addition.

Presence, but not type or degree of extension, of a cytoplasmic halo has a significant influence on preimplantation development and implantation behaviour.

Background: Since there is considerable disagreement in grading cytoplasmic haloes, this prospective study was set up to evaluate if certain subtypes of haloes are related to further development.

Methods: Out of a total of 152 patients, 713 zygotes could be checked for the formation of a halo. Where present, haloes were subdivided into concentric (symmetric) and polar (asymmetric) types.

Selection based on morphological assessment of oocytes and embryos at different stages of preimplantation development: a review.

In contrast to IVF, in ICSI the surrounding cumulus and corona cells must be removed completely, as only denuded oocytes can be successfully manipulated by the holding pipette. This ancillary effect of ICSI allows us to focus on the morphology of preimplantation development from the earliest stages. Early prognosis regarding the developmental fate of oocytes would help to limit a negative impact of culture conditions.

Developmental competence of oocytes showing increased cytoplasmic viscosity.

Background: The objective of the study was to investigate the developmental fate of oocytes with increased cytoplasmic viscosity as assessed by the persistence of the injection funnel after withdrawal of the ICSI pipette.

Methods: For this purpose, 1008 oocytes showing a characteristic injection funnel during ICSI were subdivided into two groups according to the oocyte's ability to restore its spherical shape within 2-3 min after ICSI. Fertilization and further development was evaluated in both groups.

The potential of preoperative beta-hCG and progesterone levels to predict failure of laparoscopic linear salpingostomy in ectopic pregnancies.

Study Objective: To estimate the association between preoperative beta-human chorionic gonadotropin (hCG) and progesterone levels, and success of linear salpingostomy in treatment of tubal pregnancy.

Design: Retrospective case control study (Canadian Task Force classification II-1).

Setting: Women's general hospital.

[Sonographic measurement of endometrium thickness as a predictive value for pregnancy through IVF].

Aim: This prospective study was performed to evaluate the predictive value of endometrium thickness in patients undergoing IVF-ET.

Method: Measurements of endometrium thickness as well as pattern assessments were performed in 936 cycles (722 patients) on the day of administering human chronic gonadotropin (HCG).

Results: The overall pregnancy rate was 31.