21/27. triploidy in human abortions.Seven triploid embryos and fetuses, six spontaneously aborted and one resulting from pregnancy interruption are described. A wide range of malformations, from amorphous, nodular embryos, to apparently normal phenotypes were observed. The degree of hydatid degeneration in the placentae ranged from minimal to severe. In several cases large, atypical cells were present in the villous stroma. There was no apparent correlation between the degree of placental lesion and fetal malformations. It is suggested that termination of triploid pregnancies is determined more by the degree of placental damage rather than the severity and type of fetal anomalies.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
22/27. Does primary omental pregnancy exist?Omental pregnancy is a rare form of abdominal pregnancy. In the 5 previously reported cases, primary implantation of the embryo to the omentum has been proposed as its etiology. We present a new case of omental pregnancy in a 31-year-old woman presenting with symptoms of ectopic pregnancy. After careful review of our case and the published literature in view of the accepted definition of primary abdominal pregnancy, we conclude that all reported instances of omental pregnancy are secondary and probably follow tubal or ovarian pregnancy abortion.- - - - - - - - - - ranking = 0.5keywords = embryo (Clic here for more details about this article) |
23/27. Spontaneous resolution of ectopic pregnancy in a surrogate after oocyte donation and frozen embryo transfer.A case of tubal pregnancy in a young and healthy woman participating in a programme of in-vitro fertilization (IVF) gestational surrogacy is reported. The gestational surrogate was the 30 year old fertile sister of a 25 year old patient affected by stage 1 ovarian cancer. After mandatory oncological consultation, the donor was recommended to prospectively undergo controlled ovarian hyperstimulation cycles for embryo banking before being treated by total hysterectomy. Available embryos were cryopreserved and after adequate endometrial preparation using artificial cycles of hormone replacement therapy, three thawed frozen embryos were transferred to the surrogate. At 17 days following embryo transfer the surrogate was noted to have a negative beta-human chorionic gonadotrophin (HCG) serum concentration. All medication was suspended and a few days later normal menstrual bleeding occurred. After 2 weeks, the beta-HCG concentrations, performed as part of routine follow-up evaluation, were showing signs of trophoblast activity (236 mIU/ml). Taking into account the stable condition of the patient, a decision was made to undertake expectant management. At 43 days after embryo transfer, a complete tubal abortion was apparently seen in the posterior cul-de-sac by ultrasound associated with a subtle and short lasting pelvic pain. We stress that this ectopic gestation was able to maintain prolonged viability in conditions of absent corpus luteum and exogenous steroid supplementation.- - - - - - - - - - ranking = 4.5keywords = embryo (Clic here for more details about this article) |
24/27. Spontaneous abortions are reduced after preconception diagnosis of translocations.PURPOSE: Preimplantation genetic diagnosis of translocations has seldom been attempted. Recently, a genetic test based on analyzing polar bodies at the methaphase stage, following fluorescent in situ hybridization with commercially available whole-chromosome painting dna probes has been presented. Here we report the use of this method in seven couples in whom the female was a carrier of one of these balanced translocations: 45,XX,der (13q;14q)(q10;q10) (two cases), 46,XX,t(4;14)(p15.3;q24), 45,XX,der(14q;21q) (q10;q10), 46,XX,t(7;20)(q22;q11.2), 46,XX,t(9,11)(p24;q12), 46,XX,t(14;18)(q22;q11), and 46,XX,t(3;8)(q11;q11). methods: The original method was improved in two ways. First, centromeric probes for one or both chromosomes involved in the translocation were added to avoid misdiagnosis caused by possible confusion of first polar body monovalent chromosomes (with two chromatids each) with single chromatids. Second, for cases with terminal translocations where commercially available probes do not cover telomere sequences, a telomere probe labeling the translocated fragment was added. RESULTS: A total of 26 abnormal, 18 balanced, and 22 normal eggs was detected. Nine normal and seven balanced embryos were transferred, resulting in eight (50%) implanting, of which one spontaneously aborted. To date, the remainder have produced karyotypically normal or balanced babies and ongoing pregnancies. The rate of spontaneous abortions after preimplantation genetic diagnosis (12.5%) was significantly reduced (P < 0.001) compared to natural cycles in the same patients (95%). CONCLUSIONS: With the above improvements, the test can characterize any translocation of maternal origin and produce a high pregnancy rate and an apparently low frequency of spontaneous abortion.- - - - - - - - - - ranking = 11.197440926904keywords = preimplantation, embryo (Clic here for more details about this article) |
25/27. Onset of coeliac disease after a spontaneous miscarriage during a holiday in australia: coincidence or causal relationship?Diarrhoea contracted whilst travelling in a (sub)tropical country often has an infectious cause. However, dietary changes can also be of importance. We describe the case of a 28-year-old woman, who developed severe coeliac disease during a trip in the Australian outback. The nutritional history revealed that the patient's diet contained more wheat products during her trip than she was used to in Holland. Moreover, the onset of symptoms coincided with a spontaneous miscarriage of an 8-week-old embryo. This correlation has been described in several case reports in the literature. However, the pathophysiologic mechanism behind this correlation is unknown. Some speculative mechanisms are proposed here. Further investigations into this relationship could increase our understanding of the immunopathogenesis of coeliac disease.- - - - - - - - - - ranking = 0.5keywords = embryo (Clic here for more details about this article) |
26/27. trisomy 9 in an embryo with spina bifida.The products of a 14 week spontaneous abortion were examined and found to contain an embryo at a developmental age of around 35 days. It had a cystic lumbosacral spina bifida and was trisomic for chromosome 9.- - - - - - - - - - ranking = 2.5keywords = embryo (Clic here for more details about this article) |
27/27. Case report: chromatid exchange and predivision of chromatids as other sources of abnormal oocytes detected by preimplantation genetic diagnosis of translocations.Preimplantation genetic diagnosis of translocations can be performed on first polar bodies (PB) at metaphase stage using FISH with whole-chromosome painting dna probes. Here we report the use of this method in a couple in which the female was a carrier of a balanced translocation 46,XX,t(11;16)(q21;q22). This case unusual in that two polar bodies showed recombination events between the homologue chromosomes of 11 and 16 pairs, resulting in M-II oocytes with monovalent chromosomes having a normal and a derivative chromatid. For this type of case, PGD analysis on polar bodies cannot give a useful result, because, at the second meiotic division, either of these chromatids could remain in the oocyte, resulting in a normal, balanced or unbalanced embryo. PGD analysis on blastomeres can provide a solution. 11 previous cases of PGD of translocations performed by metaphase PB analysis are reviewed.- - - - - - - - - - ranking = 43.289763707616keywords = preimplantation, embryo (Clic here for more details about this article) |
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