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First-trimester combined screening for trisomies 21, 18 and 13 by maternal age, fetal NT thickness, fetal heart rate and maternal serum-free (beta)-hCG and pregnancy-associated plasma protein-A indicated that as a beneficial side effect of screening for trisomy 21, 
95% of trisomy 13 and 18 fetuses can be detected with a small 0.1% increase in the false positive rate (p. 1968).
A randomized controlled study comparing slow freezing and vitrification was done on 466 donated Day 3 embryos from patients who did not want their embryos cryopreserved (p. 1976). Embryos were vitrified using ethylene glycol and 1,2-propanediol as cryoprotectant in a cryoloop system. Embryos survived better after vitrification than after slow freezing; a higher metabolic rate (higher pyruvate uptake) was consistent with this higher survival. The vitrified Day 3 embryos also had a higher rate of blastocyst formation on Day 5. The good clinical results of vitrification in a separate cohort of 73 patients await confirmation in a properly conducted randomized clinical trial. Only then will the question be answered whether (singleton) delivery rate is higher after the transfer of vitrified or conventionally frozen embryos.
A small randomized placebo-controlled trial with infliximab, an anti-TNF-(alpha) monoclonal antibody in patients with deep-endometriosis, indicated no effect on pain severity (p. 2017). However, the treatment was associated with an important placebo effect; in the placebo and infliximab groups, pain severity decreased by 30% following the treatment.
Elective single embryo transfer (eSET) is the only procedure to eradicate the iatrogenic epidemic of multiple IVF pregnancies including twins (p. 2036). To understand the resistance to more widespread use of eSET, interviews were conducted among 19 Dutch IVF professionals and 20 IVF patients. For both IVF professionals and patients, numerous factors were identified which prevented the use of eSET in clinical practice.
The role of treatment strategy on the decision of couples to drop-out of IVF was investigated in a prospective cohort study in the Netherlands (p. 2050). Although the treatment was fully covered, 66 out of 384 couples discontinued treatment. A mild ovarian stimulation protocol reduced the drop-out rate, whereas the presence of severe male subfertility and failure to have embryo transfer enhanced the drop-out rate. Efforts to reduce the burden of the treatment may reduce the drop-out rate and enhance the efficacy and cost-effectiveness of IVF.
There is a lack of information concerning the prevalence of depressive and anxiety disorders in infertile men and women. A prospective study was carried out in Sweden on 1090 female and male patients (545 infertile couples) using the ‘Primary Care Evaluation of Mental Disorders’ as a diagnostic tool for mood and anxiety disorder assessment (p. 2056). A high prevalence of mood disorders was noticed in both women and men undergoing IVF treatment, which in the majority of circumstances had gone undiagnosed or treated.
A Belgian population-based retrospective study compared perinatal outcome of twin pregnancies in 240 primiparae aged 35 or older to that of twin pregnancies in 940 primiparae aged 25–29 years (p. 2145). A more favourable outcome (lower incidence of preterm birth and low birthweight) was observed in primiparae aged 35 and over.
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