Anesthetic management for oocyte retrieval: An exploratory analysis comparing outcome in in vitro fertilization cycles with and without pre-implantation genetic diagnosis

Purpose: To date, there has been no comparison of outcomes in women undergoing anesthesia for in vitro fertilization (IVF) oocyte retrieval for the purpose of pre-implantation genetic diagnosis (PGD) because of their or their partner′s genetic disease relative to the outcome in women requiring IVF because of fertility issues. Materials and Methods: A prospective observational study, wherein all demographic and anesthetic management data were collected from IVF and PGD units′ records for a 6-month period. Descriptive analyses and parametric tests were employed. Results: There were 307 cases IVF and 76 cases PGD: most (97.4% and 99.7%, respectively) received general anesthesia with propofol and fentanyl ± dipyrone (90.5% and 93.3%, respectively) with no adverse effects. The only statistically significant difference between IVF and PGD groups that was potentially clinically significant was post-procedure recovery time (23.0 ± 20.4 vs. 29.4 ± 35.8 min, respectively; P < 0.0001), but is explainable as greater caution by Anesthesiologists for higher-risk PGD cases having autosomal dominant diseases that may impact anesthesia management (myotonic dystrophy, neurofibromatosis, Marfan′s); two of these cases also recovered in the general post-anesthesia care unit, as a precaution for early diagnosis and treatment of potential post-procedural complication. Conclusions: Results of this first-ever survey of anesthesia for PGD compared with IVF cases imply that propofol-and-fentanyl-based anesthesia is safe and can be recommended, bearing in mind that with patients who have autosomal dominant diseases impacting anesthetic management it is prudent to be more cautious post-recovery

Phenyl-imidazolo-cytidine Analogues: Structure–Photophysical Activity Relationship and Ability To Detect Single DNA Mismatch

To expand the arsenal of fluorescent cytidine analogues for the detection of genetic material, we synthesized <i>para</i>-substituted phenyl-imidazolo-cytidine (^PhImC) analogues <b>5a</b>–<b>g</b> and established a relationship between their structure and fluorescence properties. These analogues were more emissive than cytidine (λ_em 398–420 nm, Φ 0.009–0.687), and excellent correlation was found between Φ of <b>5a</b>–<b>g</b> and σ_p^– of the substituent on the phenyl-imidazolo moiety (<i>R</i>² = 0.94). Calculations suggested that the dominant tautomer of ^PhImC in methanol solution is identical to that of cytidine. DFT calculations of the stable tautomer of selected ^PhImC analogues suggested a relationship between the HOMO–LUMO gap and Φ and explained the loss of fluorescence in the nitro analogue. Incorporation of the CF₃-^PhImdC analogue into a DNA probe resulted in 6-fold fluorescence quenching of the former. A <i>17-fold</i> reduction of fluorescence was observed for the <i>G-matched</i> duplex vs <b>ODN­(CF</b>_<b>3</b><b>-</b>^<b>Ph</b><b>ImdC)</b>, while for <i>A-mismatched</i> duplex, only a <i>2-fold</i> decrease was observed. Furthermore, since the quantum yield of <b>ODN­(CF</b>_<b>3</b><b>-</b>^<b>Ph</b><b>ImdC)</b>:<b>ODN­(G)</b> was reduced 17-fold vs that of a single strand, whereas that of <b>ODN­(CF</b>_<b>3</b><b>-</b>^<b>Ph</b><b>ImdC)</b>:<b>ORN­(G)</b> was reduced only 3.8-fold, <b>ODN­(CF</b>_<b>3</b><b>-</b>^<b>Ph</b><b>ImdC)</b> appears to be a DNA-selective probe. We conclude that the <b>ODN­(CF</b>_<b>3</b><b>-</b>^<b>Ph</b><b>ImdC)</b> probe, exhibiting emission sensitivity upon single nucleotide replacement, may be potentially useful for DNA single nucleotide polymorphism (SNP) typing