Pregnancy achieved by transfer of a single blastocyst selected by time-lapse monitoring

Appropriate selection of a single blastocyst for transfer decreases the risk of multiple gestations. By using a compact time-lapse microscope system placed inside a regular incubator, combined with a microwell embryo culture dish, the development of all the embryos from a patient was continuously monitored by obtaining images at 10 min intervals. The embryos were not moved during the time-lapse observation. The system was switched off completely between image acquisitions in order to avoid exposure to electromagnetic radiation. The analysis of time-lapse records was used to choose a single blastocyst for transfer, which resulted in a singleton pregnancy and birth of a healthy boy on term

Pregnancy achieved by transfer of a single blastocyst selected by time-lapse monitoring

Appropriate selection of a single blastocyst for transfer decreases the risk of multiple gestations. By using a compact time-lapse microscope system placed inside a regular incubator, combined with a microwell embryo culture dish, the development of all the embryos from a patient was continuously monitored by obtaining images at 10 min intervals. The embryos were not moved during the time-lapse observation. The system was switched off completely between image acquisitions in order to avoid exposure to electromagnetic radiation. The analysis of time-lapse records was used to choose a single blastocyst for transfer, which resulted in a singleton pregnancy and birth of a healthy boy on term

Different patterns of aortic wall elasticity in patients with Marfan syndrome: a noninvasive follow-up study

OBJECTIVE: Aortic complications determine the life expectancy of most patients with Marfan syndrome. To find out whether there is heterogenous aortic involvement among patients and, if there is, to characterize aortic patterns and response to long-term beta-blocker therapy, we investigated aortic elastic properties before and during beta-blocker treatment. METHODS: In 46 patients with Marfan syndrome (age, 17.4 +/- 11.1 years) and 46 healthy control subjects, ascending and descending aortic elastic parameters were determined noninvasively before and after 39 +/- 16 months of beta-blocker treatment with atenolol. RESULTS: Aortic diameters and distensibility distinguished Marfan patients and controls with a sensitivity of 85% and a specificity of 87%. Cluster analysis revealed 4 patterns of aortic phenotypic expression: (1) reduced ascending aortic elasticity (46% of patients), (2) diminished ascending and descending aortic elasticity (17%), (3) minimal alterations of ascending and descending aortic elasticity (20%), and (4) reduced descending aortic elasticity (17%). During follow-up, aortic elastic properties improved in 21 (70%) of 30 patients and deteriorated in 9 (30%) irrespective of beta-blocker dosage. Improvement was observed in 100% of patients (n = 7; age, 5.3 +/- 4.2 years) with end-diastolic aortic root diameters between 20 and 30 mm and in 61% of patients (14/23; age, 20.5 +/- 10.0 years) with root diameters between 30 and 52 mm. CONCLUSIONS: Aortic elastic parameters distinguish between patients with Marfan syndrome and healthy controls and show the pattern of regional aortic involvement. Improvement or deterioration during follow-up can influence therapeutic decisions to prevent aortic dissection and rupture. Young age, small root diameter, and high distensibility are favorable prognostic factors

Prediction of in-vitro developmental competence of early cleavage-stage mouse embryos with compact time-lapse equipment

Single blastocyst transfer is regarded as an efficient way to achieve high pregnancy rates and to avoid multiple pregnancies. Risk of cancellation of transfer due to a lack of available embryos may be reduced by early prediction of blastocyst development. Time-lapse investigation of mouse embryos shows that the time of the first and second cleavage (to the 2- and 3-cell stages, respectively) has a strong predictive value for further development in vitro, while cleavage from the 3-cell to the 4-cell stage has no predictive value. In humans, embryo fragmentation during preimplantation development has been associated with lower pregnancyrates and a higher incidence of developmental abnormalities. Analysis of time-lapse records shows that most fragmentation is reversible in the mouse and is resorbed in an average of 9 h. Daily or bi-daily microscopic checks of embryo development, applied routinely in human IVF laboratories, would fail to detect 36 or 72% of these fragmentations, respectively. Fragmentation occurring in a defined time frame has a strong predictive value for in-vitro embryo development. The practical compact system used in the present trial, based on the ‘one camera per patient’ principle, has eliminated the usual disadvantages of time-lapse investigations and is applicable for the routine follow-up of in-vitro embryo development