Pregnancy management and outcome after uterus transplantation.

Uterus transplantation is a novel approach in women whose uterus is absent or severely abnormal. However, it is still an experimental procedure that poses risks to both mother and baby. To date, 32 live births after uterus transplantation have been reported in peer-reviewed journals, with several maternal, fetal and neonatal complications. The most common complications were preterm delivery, hypertensive disorders and placenta previa. Four patients experienced episodes of transplant rejection during pregnancy. The appropriate management of complicated and non-complicated pregnancies following uterus transplantation is still unresolved. In this review, obstetric outcomes after uterus transplantation and optimal management during pregnancy are discussed in light of the available data. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

Number of embryos biopsied as a predictive indicator for the outcome of preimplantation genetic diagnosis by fluorescence in situ hybridisation in translocation cases.

This study aimed to investigate the optimum number of embryos to be biopsied in order to increase the likelihood of obtaining a balanced/normal embryo following preimplantation genetic diagnosis (PGD) by fluorescence in situ hybridisation (FISH) for translocation carriers. Patients with low number of fertilised oocytes (≤5) or low number of embryos available for PGD (<7) underwent multiple hormonal stimulation cycles and their embryos from each cycle were vitrified and accumulated to obtain at least three embryos for PGD. Fifty-seven PGD cycles were performed for translocation carriers by FISH on day 3 of embryo development. PGD and pregnancy outcomes were examined according to the number of embryos biopsied. The cancellation rates of embryo transfer for the reciprocal translocation carriers were 40% when more than eight embryos were biopsied and it was as high as 78% when low number of embryos (less than nine) were biopsied. For Robertsonian translocation carriers, when more than eight embryos were biopsied, there were no embryo transfer cancellations. This study showed that when there are more than nine embryos biopsied for PGD, the likelihood of obtaining a balanced embryo and positive pregnancy outcome is significantly higher (P < 0.05) in such the overall pregnancy rate was 63% for reciprocal and 86% for Robertsonian carriers. This was reduced to only 7% for reciprocal and 14% for Robertsonian translocation carriers when less than nine embryos were biopsied. One of the limitations of this study was that the analysis was performed by FISH and more studies should investigate the outcomes of embryo accumulation following comprehensive chromosome analysis.

Poor embryo development and preimplantation genetic diagnosis outcomes of translocations involving chromosome 10: Do we blame genetics?

Balanced reciprocal translocation carriers are usually phenotypically normal. Although the reproductive risk of these carriers varies, they generally have a lower chance to produce normal or balanced gametes. Preimplantation genetic diagnosis (PGD) is offered to these patients to increase their chances of becoming pregnant by selecting a balanced embryo for transfer. This study aimed to analyse the development and the PGD outcome of the embryos obtained from reciprocal translocation carriers focusing on ones with chromosome 10 rearrangements. In total, 27 reciprocal translocation carriers underwent 31 cycles of PGD. PGD was performed using multicolour fluorescence in situ hybridisation for 298 embryos and of these 136 were obtained from couples carrying translocations involving chromosome 10 rearrangements. Carriers of translocations involving chromosome 10 rearrangements have a lower chance of producing normal or balanced embryos compared with the carriers with other rearrangements. The development of embryos obtained from the patients with chromosome 10 rearrangements was impaired and only a limited number of embryos developed to the blastocyst stage.

A Rare Association of Monosomy 18p Syndrome and Polyglandular Autoimmune Syndrome Type IIIA.

We report a monosomy 18p syndrome in a male patient with polyglandular autoimmune syndrome (PAS) type IIIA. A 34-year-old mentally retarded diabetic male patient with short stature, wide earlaps, old-looking face, straight nasal bone, atrophic mouth, drooping cheeks, full teeth loss, and soft, weak and sparse white hair was admitted to the outpatient endocrinology clinic. Chromosome analysis of the patient revealed 46,XY,del(18)(p11.2). He was also diagnosed with autoimmune thyroiditis, primary hypothyroidism and diabetes mellitus type 1. We concluded that monosomy 18p syndrome may be associated with autoimmune diseases and if this is suspected, patients should be examined for an endocrine deficiency.

A case series of Bardet-Biedl syndrome in a large Turkish family and review of the literature.

BACKGROUND AND AIM: Bardet-Biedl syndrome (BBS) is a rare autosomal recessive genetic disorder. We aimed to report a case series of Bardet-Biedl syndrome in a Turkish family and review the literature. PATIENTS AND METHODS: This family had 3 females and 4 males, totally 7 alive; 2 children (1 female and 1 male) had died. Parents were consanguineous. The first was a birth of twins and female sibling of these twins had congenital anal atresia and died when she was three-month old. Third (30 yr), 4th (28 yr) and 9th (19 yr) alive siblings were obese, blind and diabetic. We detected truncal obesity, postaxial polydactyly, cognitive impairment and hypogonadism. Rod-cone dystrophy was detected in ophthalmic examination. With these typical clinical findings, BBS was diagnosed. There was also a male member of the family which shared the same features of his affected brothers but he had died while he was eight months old. Marked glycosuria was determined and urine density was 1021 g/cm3. There was not any further endocrinological abnormality. Fasting blood glucose levels were changing between 290 and 452 mg/dl and the last glycated hemoglobine levels (A1c) were 9.3%, 11.2% and 12.8%, respectively. Diabetes mellitus and obesity were treated with diet, exercise, multiple daily insulin injections and metformine at the dose of 2000 mg/d. CONCLUSIONS: Although it is an infrequent condition due to autosomal recessive transmission, consanguineous marriage may increase the risk of emergence of BBS. Genetic counseling is a very important issue in the family of patients with BBS, in order to prevent new cases.

N-terminal pro-brain natriuretic peptide in newly diagnosed acromegaly.

INTRODUCTION AND AIM: The mechanisms of acromegalic cardiomyopathy are not clearly understood. Brain natriuretic peptide (BNP) and N-terminal fragment of its pro-hormone (NT-proBNP) are released by the cardiac ventricles and increase in heart failure. In the present study, we aimed to evaluate serum NT-proBNP levels in acromegalic patients and determine a relationship between NT-proBNP levels and echocardiographic parameters. SUBJECTS AND METHODS: Twenty-two newly diagnosed acromegalic patients [mean age 38.85 ± 11.06 yr; body mass index (BMI): 28.51 ± 3.48 kg/m2] and 26 age- and BMI-matched healthy control subjects (mean age 32.9 ± 12.6 yr; BMI: 26.2 ± 5.3 kg/m2) were included in the study. Standard oral glucose tolerance test (OGTT) was performed. Serum NT-proBNP and GH were measured at the beginning of the OGTT (0 min). Body fat analyses were measured by bioelectrical impedance. Echocardiography was used in cardiac evaluations. RESULTS: The mean NT-proBNP level in the acromegalic group was not significantly different from the control subjects (55.89 ± 46.64 pg/ml in acromegaly vs 28.76 ± 22.13 pg/ml in control subjects). There were no correlations between the serum NTproBNP, GH, and IGF-I levels. Echocardiography revealed significantly increased left ventricular end-diastolic diameter (p=0.008), interventricular septum thickness (p=0.009), left atrium (p=0.029), and right ventricle diameter (p=0.027) in the acromegalic group. CONCLUSION: NT-proBNP levels were found to be slightly higher in acromegalic patients as an indicator of heart failure, but the increase was not statistically significant. Although these cardiac structural changes in newly diagnosed acromegalic patients are present, the normal level of NT-proBNP shows that NT-proBNP may not be a good indicator in acromegaly.

Ovulation triggering with GnRH agonist vs. hCG in the same egg donor population undergoing donor oocyte cycles with GnRH antagonist: a prospective randomized cross-over trial.

OBJECTIVE: To compare fertilization, implantation and pregnancy rates in donor oocyte cycles triggered for final oocyte maturation with either human chorionic gonadotropin (hCG) or gonadotropin releasing hormone (GnRH) agonist in the same donor population in two sequential stimulation cycles. DESIGN: Prospective randomized cross-over trial. SETTING: Private infertility clinic. PATIENT(S): Eighty-eight stimulation cycles in 44 egg donors. INTERVENTIONS: Controlled ovarian hyperstimulation (COH) with GnRH antagonist protocol triggered with hCG or GnRH agonist (leuprolide acetate 0.15 mg) in the same egg donors in two consecutive cycles. MAIN OUTCOME MEASURE(S): The primary outcome measure was the proportion of mature and fertilized oocytes per donor cycle. Secondary outcome measures were implantation and pregnancy rates in the recipients and incidence of ovarian hyperstimulation syndrome (OHSS) in oocyte donors. RESULT(S): The proportion of mature oocytes, fertilized oocytes and mean embryo scores were comparable between the two triggering agents. While implantation (36.53% vs, 32.93%), pregnancy (69.08% vs. 68.81%) and clinical pregnancy (41.3% vs. 40.2%) rates were comparable for the groups, the incidence of OHSS was significantly lower in GnRH than in hCG triggered cycles. CONCLUSION(S): Fertilization, implantation and pregnancy rates from donor oocytes stimulated with GnRH antagonist protocol were identical for donor cycles triggered with hCG and GnRH agonist. GnRH antagonist triggering in egg donors was associated with lower rates of OHSS.

Outcome of assisted reproduction treatment in patients with endometrial thickness less than 7 mm.

Endometrial thickness is one of the parameters contributing to the outcome of assisted reproduction treatment. The aim of the current study was to investigate the pregnancy rate and the outcome when the endometrial thickness was <7 mm during a treatment cycle. Treatments conducted between January 2000 and December 2004 at the German Hospital in Istanbul were reviewed retrospectively. A total of 175 embryo transfer cycles with an endometrial thickness of <7 mm on the day of oocyte retrieval were assessed. The 175 oocyte retrieval-embryo transfer cycles resulted in 53 pregnancies (30%), of which 11% were biochemical pregnancies, 26% were miscarriages and 58% were delivered. The clinical pregnancy rate was 26%, miscarriage rate was 31% and live birth rate was 17%. However, the results were quite good when the patient age was <35 years or the number of oocytes retrieved was over five or the number of available embryos to transfer was three or more. In conclusion, when the endometrial thickness is <7 mm during an treatment cycle, the couple should be informed about the chance of pregnancy and the outcome. In a young normoresponder woman with at least three embryos available for transfer, transfer could be carried out, otherwise embryo freezing should be recommended.

The association between high parity and obesity in women living in South-eastern Turkey.

BACKGROUND AND AIM: One of the major public health problems in Turkey is the high prevalence of obesity, which is particularly frequent among women. As it has been reported that parity affects body fat and BMI, the aim of this study was to evaluate the association between parity number, socioeconomic status and obesity. SUBJECTS AND METHODS: The study involved 286 married or divorced women aged 28- 80 years (mean age: 46.7+/-9.7), who were divided into two groups depending on whether they had experienced three or fewer pregnancies (group 1) or four or more pregnancies (group 2). We measured their body weight and height, and waist and hip circumferences, calculated their BMI, and determined their body fat percentage and fat mass by means of bioelectric impedance. RESULTS: The women in group 2 had a higher BMI, a greater fat percentage and fat mass, a larger waist circumference and higher waist/hip ratio values than those in group 1, and their mean age and illiteracy ratio were also higher. There was a significant correlation between parity number and body weight, BMI and hip circumference. CONCLUSIONS: Among other risk factors, a high parity number and socioeconomic indices may be associated with obesity in women.

The correlation between adiposity and adiponectin, tumor necrosis factor alpha, interleukin-6 and high sensitivity C-reactive protein levels. Is adipocyte size associated with inflammation in adults?

OBJECTIVE: Hypertrophic obesity correlates with metabolic complications of obesity. We evaluated adipocyte volume and its relationship with tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), adiponectin and high sensitivity C-reactive protein (hs-CRP) levels. SUBJECTS AND METHODS: Patients were divided into 4 groups; lean healthy controls [body mass index (BMI): 24.2+/-1.4 kg/m2], non-diabetic obese patients (30.2+/-2.9), obese (30.1+/-3.2) and non-obese (22.2+/-1.5) Type 2 diabetic patients. TNF-alpha, hs-CRP, adiponectin and IL-6 levels were measured preoperatively and sc fat specimens were obtained during operation. Semi-thin sections were stained with toluidine-blue and evaluated by light microscopy. Fat volumes were calculated by Goldrick's formulation. RESULTS: Mean adipocyte volumes were higher in obese diabetic patients than in other groups (p<0.0001). Mean TNF-alpha, hs-CRP and IL-6 levels were higher in obese diabetic patients than in control subjects, obese non-diabetic and non-obese diabetic patients (p<0.0001, p<0.02 and p<0.01, respectively). Mean TNF-alpha levels of non-diabetic obese patients were higher than the control group (p<0.05). Mean IL-6 levels of diabetic and non-diabetic obese patients were higher than control subjects (p<0.02 and p<0.0001, respectively). Mean adiponectin levels of control subjects were higher than non-diabetic obese, non-obese diabetic and obese-diabetic subjects (p<0.0001). Mean adiponectin levels of obese diabetic patients were lower than non-diabetic obese subjects (p<0.008). Mean hs-CRP levels were higher in diabetic patients whether they were obese or not. There was a positive correlation between adipocyte size and TNF-alpha (p<0.01), IL-6 (p<0.03) and hs-CRP levels (p<0.004), and negative correlation between adipocyte size, adiponectin levels (p<0.0001). CONCLUSIONS: TNF-alpha, IL-6 and hs-CRP levels were positively, adiponectin negatively correlated with adipocyte size. Therefore, adiposity may be an inflammatory condition.

Necrotizing (malignant) otitis externa: an unusual localization of mucormycosis.

Malignant otitis externa (MOE) is a severe infection of external auditory canal and skull base. A 17-year-old diabetic girl was admitted with diabetic ketoacidosis. Cellulitis of her right ear occurred on the second day of hospitalization and a black necrotic scar in the same region appeared on the next day. The lesion rapidly invaded to right side of neck and surrounding tissue of the patient. Therefore, antimycotic therapy was started. Unfortunately the patient died on seventh day of hospitalization because of probably extensive fungal invasion. Physicians should suspect MOE connected to mucormycosis especially in patients with cutaneous lesions of ear unresponsive to antibiotic therapy.

A simple way to estimate mean plasma glucose and to identify Type 2 diabetic subjects with poor glycaemic control when a standardized HbA1c assay is not available.

AIMS: To evaluate the relationship between HbA(1c) and fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) levels, and to estimate the mean plasma glucose (mPG) derived from FPG and PPG that would predict Type 2 diabetic subjects with poor glycaemic control. METHODS: FPG, PPG and HbA(1c) values from 565 Type 2 diabetic patients (247 men and 318 women) were recorded. Linear regression analysis and Pearson's correlation was used to determine the relationship between HbA(1c), FPG and PPG. FPG and PPG were included as explanatory variables of HbA(1c) in linear regression analysis. RESULTS: The American Diabetes Association's objective of achieving an HbA(1c) level < 7.0% was obtained in 26.2% of the patients. The coefficients of FPG and PPG which determined HbA(1c) were similar. Therefore, mPG was calculated using the equation (FPG + PPG)/2. Pearson's correlation coefficient for HbA(1c) and FPG, PPG and mPG were 0.723 (P < 0.0001), 0.734 and 0.761 (P < 0.0001), respectively. A mPG cut-off value of 10 mmol/l predicted an HbA(1c) > 7% in the whole population, with a sensitivity of 84.2% and specificity of 80.4%. The area was high (0.90) in receiver-operating characteristic (ROC) curve analysis performed to examine the performance of mPG to predict HbA(1c) > 7%. CONCLUSIONS: The mPG derived from FPG and PPG correlates strongly with HbA(1c). We therefore suggest that using a cut-off of 10 mmol/l for mPG may be appropriate in diabetes management in the primary-care setting, where most management of Type 2 diabetes occurs.

Is serum C-reactive protein concentration correlated with HbA1c and insulin resistance in Type 2 diabetic men with or without coronary heart disease?

BACKGROUND AND AIMS: C-reactive protein (CRP) is an inflammatory marker that predicts coronary heart disease (CHD) risk. Diabetes mellitus (DM) counts as a CHD risk equivalent. We aimed to compare serum high sensitivity CRP (hs-CRP) levels in Type 2 diabetic (T2DM) men without CHD, non-diabetic CHD patients and T2DM patients with CHD. SUBJECTS AND METHODS: Four groups were formed; Group 1 [DM(+), CHD(-), no.=25], Group 2 [DM(-), CHD(+) no.=25], Group 3 [DM(+), CHD(+), no.=25], and Group 4 (controls, no.=30). Serum hs-CRP, insulin, glucose, total, HDL-, LDL- and VLDL-cholesterol, triglyceride levels and homeostasis model assessment for insulin resistance (HOMA-IR) index were determined. RESULTS: Mean hs-CRP level of Group 1 (0.6+/-0.29) was not different statistically from Group 2 (1.44+/-0.97). Mean hs-CRP levels were higher in men with CHD, whether they were diabetic (Group 3; 3.83+/-2.01 mg/dl) or non-diabetic (Group 4), than in control subjects (0.16+/-0.15; p=0.0001 and p<0.004, respectively). Mean hs-CRP level of Group 3 was also higher than Group 2 (p=0.0001). There was a positive correlation between serum hs-CRP and glycated hemoglobin (HbA1c; r=0.277, p<0.01), fasting insulin (r=0.336, p<0.02) and HOMA-IR (r=0.348, p<0.02) in T2DM men with or without CHD. CONCLUSIONS: T2DM men without CHD had similar CRP levels with non-diabetic CHD patients, whereas CRP levels of T2DM men with CHD were higher than non-diabetic men with CHD. Because of a positive correlation between serum hs-CRP and HbA1c, fasting insulin and HOMA-IR, inflammation, insulin resistance and hyperglycemia jointly contribute to the cardiovascular risk in T2DM men.

The comparison of insulin sensitivity in non-diabetic hemodialysis patients treated with and without recombinant human erythropoietin.

BACKGROUND: Patients with end-stage renal disease (ESRD) are known to have insulin resistance. Treatment with EPO is associated with improvement in insulin sensitivity in uremic patients. The aim of this study was to compare insulin sensitivity and pancreatic B cell function in adult non-diabetic uremic hemodialysis patients treated with or without rHuEPO. SUBJECTS AND METHODS: Three groups of subjects were included to the study: hemodialysis patients treated with rHuEPO [EPO(+) group] or without rHuEPO [EPO(-) group], and healthy controls. Anthropometrical parameters, lipid levels, fasting glucose and insulin levels were measured in all subjects. Homeostasis Model Assessment (HOMA) was used to compare insulin sensitivity. ANOVA, independent t-test, and Pearson correlation were used for statistical analysis. RESULTS: Mean insulin level of control group (20.04 +/- 7.2 pmol/l) was significantly lower than EPO(+) group (p < 0.04) and EPO(-) group (p < 0.0001). HOMA-(%B) levels in the EPO(+) group were significantly lower than in the EPO(-) group (106 +/- 42, 140 +/- 63 respectively, p < 0.02). HOMA-(%B) levels in the control group (66 +/- 17) were significantly lower than in the EPO(+) and EPO(-) group (p < 0.005 and p < 0.0001 respectively). HOMA-(%S) levels in the EPO(+) groups was significantly higher than in the EPO(-) group (91 +/- 40, 56 +/- 26, respectively; p < 0.01). HOMA-(%S) levels of control group (125 +/- 24 ) was significantly higher than EPO(+) and EPO(-) groups (p < 0.02, p < 0.0001 respectively). We found a positive correlation between duration of erythropoietin treatment and insulin sensitivity (r = 0.484, p < 0.002). CONCLUSIONS: Firstly, patients treated with EPO are insulin sensitive compared to patients not treated with EPO. Secondly, duration of erythropoietin treatment is positively correlated with insulin sensitivity in hemodialysis patients.

Impact of oxygen concentration on embryonic development of mouse zygotes.

The aim of the present study was to examine the effect of culture under 5 and 20% oxygen on the development, differentiation and viability of zygotes and in-vivo-produced embryos at the 2-cell and 8-cell stages of development. First, zygotes collected in a common pool were cultured in 20% O2 for 0, 23, 46 and 95 h. Zygotes and in-vivo-produced embryos at the 2-cell and 8-cell stages of development were then cultured in 5 or 20% O2. The proportion of embryos reaching the compaction and blastocyst stages of development did not differ between groups regardless of the period of time embryos were cultured in 20% O2 or the stage at beginning of culture. Duration of culture under 20% O2 had a significant effect on total number of blastocyst cells. A stage-specific effect was observed on total and trophectoderm cell numbers in blastocysts resulting from the culture of zygotes and in-vivo-produced embryos under 20% O2. ICM and percent ICM development was significantly decreased by culture in 20% O2 at all stages examined. Oxygen concentration had no effect on implantation rate and fetal weights upon embryo transfer. However, transfer of zygotes grown to the blastocyst stage in 20% O2 resulted in a dramatic decrease in fetal development per blastocyst and fetal development per implantation. These results demonstrate that culture of F1 mouse zygotes in 20% O2 compromises the developmental potential of resultant blastocysts, which appear to be normal on morphological assessment.

Serum prostate specific antigen levels in women with polycystic ovary syndrome and the effect of flutamide+desogestrel/ethinyl estradiol combination.

BACKGROUND: Prostate-specific antigen (PSA) is expressed in many female tissues and its concentrations were higher in hirsute subjects. We aimed to determine serum PSA level in hirsute women and evaluate the effect of flutamide+desogestrel/ethynil estradiol combination. SUBJECTS AND STUDY DESIGN: Thirty patients with polycystic ovary syndrome (PCOS) and 30 healthy controls were studied. Hirsutism was defined by modified Ferriman-Gallwey score (FGS). Free androgen index (FAI) was used for hyperandrogenism. Patients received flutamide (500 mg/d) and oral contraceptive (desogestrel+ethinyl estradiol) for 9 months. RESULTS: Mean FGS (p<0.0001), insulin (p<0.01), FAI (0.0001), androstenedione (p<0.0001), LH (p<0.05), and free testosterone (p<0.003) levels of patients with PCOS were higher than the control group. Mean serum total and free PSA level of PCOS patients were higher than the control group (p<0.0001 and p<0.0001). We found a positive correlation between total PSA levels and FGS (r=0.568, p<0.001), FAI and FGS (r=0.456 and p<0.01). There was also a positive correlation between FAI and total PSA (r=0.503 and p<0.005). At the end of treatment, FGS, androstenedione, free and total testosterone, FAI, serum PSA and LH levels decreased significantly [serum total PSA was 0.0208 +/- 0.0178 ng/ml at baseline and 0.0061 +/- 0.0044 ng/ml after treatment (p<0.0001)]. CONCLUSIONS: 1. Serum prostate specific antigen level is higher in patients with PCOS; 2. There is a positive correlation among FGS, FAI and PSA levels; 3. Serum PSA levels decrease with antiandrogen treatment; 4. Serum PSA measurement might be a marker for hirsutism.

The results of cytogenetic analysis with regard to intracytoplasmic sperm injection in males, females and fetuses.

OBJECTIVES: To determine the incidence of chromosome abnormalities among couples for whom intracytoplasmic sperm injection (ICSI) treatment was indicated and fetuses conceived through the ICSI procedure. METHODS: All cytogenetic results were evaluated retrospectively. Patients undergoing ICSI (n = 508) were classified according to the referring indications as: (1) males with severe infertility (87 azoospermia and 34 oligoasthenoteratozoospermia, OAT), (2) prior to ICSI (56 males and 61 females), and (3) following an unsuccessful ICSI procedure (132 males and 138 females). Fetuses conceived through ICSI (n = 475) were also classified into 4 groups according to the additional risk factors for chromosome abnormalities: ICSI (n = 185), ICSI + advanced maternal age (AMA, n = 215), ICSI + positive triple test result (TT, n = 50), and ICSI + abnormal ultrasound findings (USG, n = 25). RESULTS: An abnormal karyotype was found in 31.03% of males with azoospermia and 14.71% of males with OAT, in 3.57% of males and 1.64% of females in the group prior to ICSI, and in 5.30 and 5.07%, respectively, in the group following unsuccessful ICSI treatment. Gonosomal aneuploidies were predominant in males with azoospermia and autosomal rearrangements in males with OAT, while low-level sex chromosome mosaicism was found in females. The overall frequency of chromosome abnormalities in fetuses was 4.42% and varied in the different groups from 1.62% in ICSI, 2.79% in ICSI + AMA, 10.0% in ICSI + TT to 28.0% in ICSI + USG. The frequencies of the different types of chromosome abnormalities were as follows: balanced 1.05%, unbalanced 3.37%, familial 0.84%, de novo 3.37%, autosomal 3.58%, gonosomal 0.84%, numerical 1.89%, structural abnormalities 2.53%, and mosaicism 1.26%. CONCLUSION: Our results indicate that cytogenetic investigations of the ICSI parents and fetuses are essential for the families, genetic counselors and also reproductive centers. In fetal karyotyping, de novo structural chromosome abnormalities and mosaicism should be taken into consideration.