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E-mail: vansteirteghema{at}humanreproduction.co.uk
Worldwide, hepatitis B is the most prevalent viral liver infection and the question arises as to how best to prevent infection of the unaffected partner and the future child when ART is used. Some countries advise against the use of ICSI because of the unknown risks and affects of chromosomal integration of hepatitis B virus (HBV) DNA in the fetus. The scientific evidence for the risk of introducing HBV into the oocyte is reviewed and the question whether or not to do IVF and ICSI is put forward as the start of a possible discussion forum (p. 2676).
As part of an ongoing debate in this journal "What next for preimplantation genetic screening?", high mitotic chromosome instability was demonstrated in early human embryos by applying genome-wide array comparative genome hybridization screening of all chromosomes. As many as 90% of all embryos were found to be imbalanced. This chromosome instability may provide a biological basis explaining the low success rate of PGS using FISH for a limited number of chromosomes (p. 2679).
Aetiology and treatment of recurrent miscarriage remain enigmatic. In women with unexplained recurrent miscarriage, an RCT was carried out comparing granulocyte colony-stimulating factor (G-CSF) or placebo; more women treated with G-CSF delivered a healthy baby. Further studies are needed to confirm the effectiveness of this treatment in women with unexplained recurrent miscarriage who are refractory to conventional treatment (p. 2703).
Potency of 4-cell stage human embryos was investigated by splitting two 4-cell embryos into 16 blastomeres. After culture for 2 days, the blastomere-derived embryos were plated on mouse embryonic fibroblasts. Two human stem cell lines could be derived and characterized; one had a normal karyotype and one was a mosaic normal/abnormal. This indicates that at least one blastomere of the 4-cell stage embryos is pluripotent (p. 2709).
ART terminology differs in different settings but the need for standardization is important for benchmarking the outcomes of ART. The combined efforts of ICMART and the WHO resulted in the publication of a first glossary of ART terminology in 2006. After a further gathering of basic scientists, clinicians, epidemiologists and social scientists in Geneva in 2008, an update to the glossary was agreed upon. Once again, a joint collaboration with our US counterpart Fertility and Sterility sees its simultaneous publication in the two journals this month (p. 2683).
In patients with anovulatory polycystic ovary syndrome, serum concentrations of anti-Müllerian hormone before treatment by laparoscopic ovarian diathermy or clomiphene citrate may be a useful in predicting outcome of treatment (p. 2760).
After orthotopic transplantation of ovarian tissue in patients with ovarian failure after cancer treatment the study of oocytes and embryos revealed a high frequency of empty follicles, abnormal or immature oocytes and few embryos for transfer (dep289). In sheep autotransplantation of cryopreserved whole embryos demonstrated successful partial restoration of ovarian function. Inability to restore full ovarian function was related to loss of primordial follicles (p. 2845).
A prospective cohort study of signs of depression in women and men who had unsuccessful infertility treatment indicated a higher frequency of severe depression in women than in men. Strain in relationships may have a negative impact. Clinical staff should be aware of these consequences of unsuccessful infertility treatment (p. 2810).
In a pilot RCT, recombinant FSH was replaced by low-dose hCG (200 IU) in the late follicular phase of GnRH-antagonist controlled ovarian stimulation cycles. In the hCG group, less FSH was needed and, following ICSI, the number of oocytes retrieved and ongoing pregnancy rate was comparable to the traditional regime (p. 2910).
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