Assisted reproduction and Coronavirus in Italy.

OBJECTIVE: A novel type of Coronavirus was identified in China in December 2019. The first cases of a form of pneumonia of unknown etiology were detected at the beginning of that month in Wuhan. The virus is believed to have emerged at the Wuhan Huanan Seafood Market, where transmission of a zoonotic pathogen to humans occurred. PATIENTS AND METHODS: Some studies conducted in China during the epidemic report small numbers of pregnant women infected with SARS-CoV-2 and some pregnancy complications in patients with COVID-19. However, they fail to document the transplacental passage of the virus from mother to fetus. RESULTS: Following the COVID-19 outbreak, guidelines for couples who are undergoing treatments of assisted reproduction have been issued by the International Federation for Fertility Societies (IFFS), the American Society for Reproductive Medicine (ASRM), the European Society of Human Reproduction and Embryology (ESHRE) and the Latin American Network of Assisted Reproduction (REDLARA). They recommend couples to discuss assisted reproduction with their doctors while those at risk or with SARS-CoV-2 should consider freezing oocytes or embryos and retransferring them later. CONCLUSIONS: Other than the US, Italy is the country with the highest number of cases (197675 positives, 26644 deaths) (updated on April 26). The Italian National Transplant Centre and the Higher Institute of Health advised on March 17 to complete the cycles already started and not to start new cycles. Phase 2 will begin on 4 May with an increase in freedom of action and fertilization treatments will start again. The Society that brings together embryologists (SIERR) has issued the guidelines to be followed when this happens.

Common medium versus advanced IVF medium for cryopreserved oocytes in heterologous cycles.

Granulocyte-macrophage colony-stimulation factor plays different crucial roles during embryo implantation and subsequent development. Here we aimed to evaluate the effects of embryo cell culture medium, with the inclusion of granulocyte-macrophage colony-stimulation factor (GM-CSF), on embryo development and pregnancy rate. To this end, we took advantage of our retrospective observational study to correlate the outcomes from two different culture media. We included in this study 25 unselected patient from our IVF Center that underwent heterologous IVF cycle with crypreserved oocytes. We analyze the fertilization rate, pregnancy rate, and embryo quality at different day of transfer obtained from two different media composition. Our results show that the rate of fertilization and the pregnancy rate were increased using medium added with this particular type of cytokines (GM-CSF).

Secondary solid cancer following hematopoietic cell transplantation in patients with thalassemia major.

Hematopoietic cell transplant (HCT) recipients have a substantial risk of developing secondary solid cancers (SSCs). The aim of this retrospective study was to compare the incidence of SSC in a monocentric cohort of thalassemia major (TM) patients (n=122) who received HCT versus an hematopoietic cell donor monocentric cohort (n=122) and versus a large multicenter cohort of age- and sex-matched TM patients (n=244) who received conventional therapy. With a median follow-up of 24 years, 8 transplanted patients were diagnosed with SSC at a median of 18 years after HCT and at a median age of 33 years. Three patients died of cancer progression and 5 are living after a follow-up ranging from 10 months to 16 years after SSC diagnosis. The 30-year cumulative incidence of developing SSC was 13.24%. The occurrence of solid cancers in the hematopoietic cell donor cohort was limited to only one case for a significantly lower cumulative incidence (3.23%, P=0.02) and to 3 cases in the cohort of nontransplant patients for a significantly lower cumulative incidence (1.32%, P=0.005). This study shows that the magnitude of increased risk of SST is fourfold to sixfold for patients treated with HCT as compared with hematopoietic cell donors and nontransplant patients.

Recombinant luteinizing hormone priming in multiple follicular stimulation for in-vitro fertilization in downregulated patients.

Follicle development is controlled amongst other factors by pituitary gonadotropins follicle-stimulating hormone (FSH) and luteinizing hormone (LH) that act in synergy in completing follicle maturation. Exogenous gonadotropins, combined with gonadotropin-releasing hormone agonists, have been successfully used in patients with ovulatory disorders undergoing assisted reproduction. There is some evidence of a beneficial role of androgens or LH administration before FSH stimulation. This study was designed to verify whether the addition of LH in the early follicular phase, in downregulated patients undergoing follicular stimulation for assisted reproduction, would add benefits in terms of general outcomes and pregnancy rates. We compared two groups of patients one of which was treated with recombinant FSH (rFSH) alone and the other with rFSH plus recombinant LH (rLH), in the early follicular phase only. The number of eggs recovered was higher in the group treated with FSH only; however, the number of embryos available at transfer was similar in the two groups and, more importantly, the number of Grades I and II embryos was higher in the group pretreated with LH. Similarly, although biochemical pregnancy rate and clinical pregnancy rates were similar in both groups, a beneficial role of LH priming was demonstrated by the higher implantation rate achieved in these patients.

Temperature-controlled poly(propylene) glycol hydrophobicity on the formation of inclusion complexes with modified cyclodextrins. A DSC and ITC study.

The study highlighted the main forces driving the formation of hydroxypropyl-cyclodextrins (HP-CDs) + poly(propylene) glycol 725 g mol(-1) inclusion complexes. The temperature parameter was chosen as the variable to modulate the hydrophobicity of the polymer, and consequently ITC experiments as functions of temperature as well as DSC measurements were done in a systematic way. The polymer is not included into HP-α-CD, it is strongly bound to HP-ß-CD and it is floating in HP-γ-CD. The stability of the inclusion complexes is entropy controlled. The gain of the entropy is a unique result compared to the opposite literature findings for inclusion complexes based on polymers and CDs. This peculiarity is ascribable to the removal of water molecules from cages during complexation and this effect compensates the entropy loss due to constraints caused by the CD threading. In spite the host-guest van der Waals contacts are optimized, the enthalpies for the inclusion complex formation are positive and reveal the large heat required for dehydrating the propylene oxide units. All the macrocycles enhanced the polymer solubility in water. Increasing the affinity of the macrocycle to the macromolecule makes more expanded the one-phase area of the binodal curve. A new thermodynamic approach was proposed to predict quantitatively the binodal curve as well as the dependence of the enthalpy of separation phase on the macrocycle composition. The agreement between the experimental data and the computed values was excellent.

The assessment of human health impact caused by industrial and civil activities in the Pace Valley of Messina.

The impact of industrial and civil activities on an agricultural and residential area is presented in a detailed and global analysis. The examined area is the Pace river valley situated in the northern zone of Messina (Italy). The sources of pollution present in the area are: a Municipal Solid Waste Incinerator operating since 1979, a disused urban solid waste landfill which was used for 30 years, an urban solid waste treatment facility with heavy vehicles traffic, and two open pits for the production of bitumen. Large quantities of toxic, carcinogenic substances and criteria pollutants are released into the environment and represent potential hazards to human health. The analysis is performed using the EHHRA-GIS tool which employs an integrated, multimedia, multi-exposure pathways and multi-receptor risk assessment model that is able to manage all the steps which constitute the human health risk analysis in a georeferenced structure. The transport of pollutants in different environmental media is assessed applying models (AERMOD, GMS, CALINE) that take into account the particular three-dimensional morphology of the terrain. The results obtained, combined with a probabilistic risk assessment and a sensitivity analysis of calculation parameters, are a comprehensive assessment of the total human health risk in the area. Finally human health risks caused by toxic and carcinogenic substances are compared with acceptable legal limits in order to support environmental managers' decisions.

Aqueous laponite clay dispersions in the presence of poly(ethylene oxide) or poly(propylene oxide) oligomers and their triblock copolymers.

The effect of polyethylene oxide (PEO) or polypropylene oxide (PPO) oligomers of various molecular weight (Mw) as well as of triblock copolymers, based on PEO and PPO blocks, on aqueous laponite RD suspensions was studied with small-angle neutron scattering (SANS). The radius of gyration (RG) increases for low M w whereas the opposite occurs for larger Mw. This behavior is explained on the basis that an effective R G is given by two contributions: (1) the size of the particles coated with the polymer and (2) the interactions between the laponite RD particles which are attractive for small and repulsive for large polymers. The SANS curves in the whole Q-range are well described by a model of noninteracting polydisperse core+shell disks, where the thickness of the polymer layer increases with the Mw. The adsorbed polymer is in a more compact conformation compared to a random coil distribution while the fraction of the polymer in the shell formed around the laponite RD particles is nearly independent of Mw. For increasing laponite RD amounts, at a given polymer composition, the thickness of the polymer slightly changes. In some cases, where also gelation is sped up, a structure factor with attractive interaction was employed which allowed to evaluate the attractive forces between the laponite RD particles. The gelation time was determined for mixtures at fixed copolymer and laponite RD concentrations. Surprisingly, it is observed that gels are formed despite the fact that the binding sites of the laponite RD particles are almost covered but the polymer size is too small to prevent aggregation. The gelation rate is correlated to structure and thermodynamics of these systems. Namely, when the balance between the steric forces and the depletion attractive forces undergoes an abrupt change the gelation time also undergoes a sharp variation. For lower and comparable Mw, PPO speeds up the gelation more efficiently than PEO while for higher Mw the gelation kinetics is slowed down again. Interestingly, copolymers of PEO and PPO blocks do not induce gelation in the time-window where the homopolymers do.

Polystyrene nanoparticles in the presence of (ethylene oxide)13(propylene oxide)30(ethylene oxide)13, N,N-dimethyloctylamine-N-oxide and their mixtures. A calorimetric and dynamic light scattering study.

Polystyrene nanoparticles were synthesized by emulsion polymerization of styrene. They were functionalized using the conventional surfactant N,N-dimethyloctylamine-N-oxide (ODAO), the tri-block copolymer (ethylene oxide)(13)(propylene oxide)(30)(ethylene oxide)(13) (L64) and their mixtures. To this purpose, dynamic light scattering and calorimetric experiments were carried out and provided information consistent to each other. The L64 adsorption is Langmuir-type in the copolymer dilute regime and generates complex structures at larger concentrations. In the region where ODAO is in the unimeric state, the adsorption process is cooperative leading to hemi-micelle formation at the polystyrene nanoparticle/water interface. In the concentrated region (above the critical micellar concentration), ODAO forms micelles which interact with the solid substrate most likely through ion-dipole forces. The ODAO addition to the dispersion containing polystyrene particles already wrapped by L64 creates an ODAO thickness around the dispersed particles the size of which is equal to that in the absence of the copolymer, but is built at much lower concentrations. A plausible interpretation of this behavior is that the adsorbed L64 confers to the nanoparticles surface novel properties which enhance the attractive forces with the ODAO molecules.

Aqueous block copolymer-surfactant mixtures and their ability in solubilizing chlorinated organic compounds. A thermodynamic and SANS study.

Within the topic of surfactant enhanced solubilization of additives sparingly soluble in water, volumetric, solubility, conductivity, and small-angle neutron scattering (SANS) experiments on mixtures composed of alpha,omega-dichloroalkane, surfactant, copolymer, and water were carried out at 298 K. The triblock copolymers (ethylene oxide)132(propylene oxide)50(ethylene oxide)132 (F108) and (ethylene oxide)76(propylene oxide)29(ethylene oxide)76 (F68) were chosen to investigate the role of the molecular weight keeping constant the hydrophilic/hydrophobic ratio. The selected surfactants are sodium decanoate (NaDec) and decyltrimethylammonium bromide (DeTAB) with comparable hydrophobicity and different charged heads. The alpha,omega-dichloroalkanes were chosen as contaminant prototypes. For the water + surfactant + copolymer mixtures, both the volume and the SANS results straightforwardly evidenced that (1) monomers of NaDec and copolymer unimers generate small mixed aggregates, (2) monomers of DeTAB combined with copolymer unimers do not form aggregates, and (3) unimeric copolymer is solubilized into NaDec and DeTAB micelles. The alpha,omeaga-dichloroalkanes presence induces the F108 aggregation even at very low copolymer composition. The addition of surfactant disintegrates the F108 aggregates and, consequently, the additive is expelled into the aqueous phase. Once F108 is in the unimeric state, it forms copolymer-micelle aggregates which incorporate the oil. In the case of F68 both the volumetric and the SANS data reveal that the additive does not alter the copolymer unimeric state. Moreover, they show that for the aqueous DeTAB-F68 system the additive trapping in both the copolymer-micelle aggregate and the pure micelles takes place being enhanced in the former aggregate in agreement with solubility experiments. For the NaDec-F68 mixtures, an additional solubilization process in the premicellar copolymer-surfactant microstructures occurs. SANS and conductivity data show that the additive incorporation into the mixed and the pure micelles does not essentially influence the structural properties of the aggregates.

Aqueous nonionic copolymer-functionalized laponite clay. A thermodynamic and spectrophotometric study to characterize its behavior toward an organic material.

The affinity of functionalized Laponite clay toward an organic material in the aqueous phase was explored. Functionalization was performed by using triblock copolymers based on ethylene oxide (EO) and propylene oxide (PO) units that are EO(11)PO(16)EO(11) (L35) and PO(8)EO(23)PO(8) (10R5). Phenol (PhOH) was chosen as organic compound, which represents a contaminant prototype. To this purpose, densities and enthalpies of mixing as well as PhOH UV-absorption spectra were determined. The enthalpy and the spectrophotometry revealed PhOH-Laponite interactions whereas the volume did not. It emerged that the area occupied by PhOH on the Laponite surface is equal to that computed from the partial molar volume of PhOH in water, corroborating the insensitivity of the experimental volumes to the adsorption process. The situation where both PhOH and copolymer are simultaneously present in the aqueous Laponite suspension was also investigated. It turned out that the copolymer replaces PhOH from the water/Laponite clay interface, resulting in L35 being the more efficient. Moreover, the lateral copolymer-phenol interactions enhance the anchoring of PhOH to the solid surface. The reverse copolymer exercises the most important relevant effect. The UV-absorption spectra of PhOH in the water + copolymer + Laponite mixtures provided information that is consistent with those given by the calorimetric experiments. In conclusion, the aqueous copolymer-functionalized Laponite presents surface properties very different from the bare Laponite, favoring the removal of the organic compound from the solid surface.

A thermodynamic study to evidence the alpha,omega-dichloroalkane/ block copolymer mixed aggregates formation: effect of the copolymer architecture.

The thermodynamics of alpha,omega-dichloroalkanes in aqueous solutions of (ethylene oxide)(11)(propylene oxide)(16)(ethylene oxide)(11) (L35) and (propylene oxide)(8)(ethylene oxide)(23)(propylene oxide)(8) (10R5) was determined at 298 and 305 K. Modeling the experimental data allowed to calculate the standard free energy (DeltaG(D)(o)/w) and the volume (DeltaV(D)/w) for the additive-copolymer mixed aggregates formation per additive molecule. DeltaG(D)(o)/w for Cl(2)CH(2) and Cl(2)(CH(2))(2) evidenced that the process is controlled by the forces exercising between the chlorine atoms and the OH groups of the copolymer micelles protruded into the aqueous phase. Cl(2)(CH(2))(3) experiences both the hydrophilic and hydrophobic domains into the aggregates. The hydrophobic interactions are more significant in 10R5 whereas the hydrophilic ones are more significant in L35. Temperature increase does not influence DeltaG(D)(o)/w in 10R5, whereas, it does influence DeltaG(D)(o)/w in L35, enhancing the ability of the aggregate to extract the chlorinated compounds from the aqueous phase. The DeltaV(D)/w values are consistent with the free energy results. These insights agree with those predicted by the Flory liquid lattice theory. The calculations extended to several alpha,omega-dichloroalkanes showed that Cl(2)CH(2) and Cl(2)(CH(2))(2) prefer poly(ethylene oxide) (PEO), Cl(2)(CH(2))(3) exhibits the same affinity for both PEO and poly(propylene oxide) (PPO), whereas the more hydrophobic additives show a preference for PPO. The copolymer architecture plays a relevant role in the alpha,omega-dichloroalkane solubilization into the polymeric aggregates.

Adsorption of triblock copolymers and their homopolymers at laponite clay/solution interface. Role played by the copolymer nature.

The adsorption thermodynamics of copolymers, based on ethylene oxide (EO) and propylene oxide (PO) units, at the laponite (RD) clay/liquid interface was determined at 298 K. The copolymer nature was tuned at molecular level by changing the hydrophilicity, the architecture and the molecular weight (Mw) keeping constant the EO/PO ratio. Polyethylene (PEGs) and polypropylene (PPGs) glycols with varying Mw and their mixture were also investigated to discriminate the role of the EO and the PO segments in the adsorption process. Enthalpies of transfer of RD, at fixed concentration, from water to the aqueous macromolecule solutions as functions of the macromolecule molality were determined. They were treated quantitatively by means of a model based on two equilibria: (1) one-to-one binding between the macromolecule and the site on the solid and (2) two-to-one binding following which one macromolecule interacts with another one adsorbed onto the solid. The good agreement between the equilibrium constants obtained from calorimetry and those determined from kinetic experiments confirmed the reliability of the experimental and theoretical approaches. Almost all of the systems investigated are highlighted by the one-to-one binding; the L35 and 10R5 systems present both equilibria. The insights provided by the thermodynamics of adsorption of their homopolymers onto RD were fruitful in obtaining detailed information on the nature of the forces involved between RD and the copolymers. The data obtained in the present work clearly evidenced that for comparable polymer Mw, PPG is more suitable in building up a steric barrier around the RD particles and, indeed, exhibits several advantages and no drawbacks. Moreover, the parent copolymers may properly functionalize the RD surface by exploiting both their high affinity to the solid surface and the ability to self-assemble onto it as L35 and 10R5 clearly showed.

Heat capacity of transfer of (Ethylene oxide)13-(propylene oxide)30-(ethylene oxide)13 from water to the aqueous anionic surfactant solutions at 298 K. A quantitative treatment.

Heat capacities of transfer (DeltaCpt) of unimeric (ethylene oxide)13-(propylene oxide)30-(ethylene oxide)13 from water to the aqueous surfactant solutions as functions of the surfactant concentrations (mS) were determined at 298 K. The surfactants investigated are sodium hexanoate, sodium heptanoate, sodium octanoate, sodium undecanoate, and sodium dodecanoate. For short alkyl chain surfactants, the profiles of the DeltaCpt versus mS curves show maxima and minima; for long alkyl chain surfactants, the maximum becomes sharper and moved to lower mS values whereas the minimum tends to disappear. These experimental trends are different from those of the enthalpy in agreement with the fact that heat capacity, being the derivative of enthalpy with respect to temperature, reflects additional terms generated by temperature change on the equilibria in solution. On the basis of a thermodynamic model recently proposed by us for properties first derivatives of Gibbs free energy, a quantitative treatment of the experimental data was done. Such an approach assumes that even in the dilute surfactant region monomers of surfactant associate with unimeric copolymer generating surfactant-copolymer aggregation complexes and, whenever the surfactant achieves the conditions for the micellization, the formation of copolymer-micelle mixed aggregates takes place. The equation derived for the heat capacity of transfer is more complex than that for the enthalpy because it contains five additional terms due to the shift of the equilibria induced by the temperature change. It turned out that these contributions, evaluated by using the equilibrium constants and the associated enthalpies, cannot be neglected for a quantitative treatment of the experimental data. The minimizing procedure provided the heat capacity changes for the formation of the surfactant-copolymer aggregation complexes and the copolymer-micelle mixed aggregates.

Mitigating nutrient leaching with a sub-surface drainage layer of granulated tires.

Markets for scrap tires have expanded since the early 1990s with the development of value-added applications such as tire-derived fuel and crumb-rubber-amended asphalt. Granulated tires have also displayed the ability to adsorb volatile organic compounds, indicating that the rubber material can be a useful filter media. Sand-based root zones, typically used for golf course putting green and athletic field construction, lack sufficient cation exchange capacity to restrict nitrogen and phosphorus migration through the root zone and into sub-surface drainage systems. Therefore, the adsorptive properties of tire rubber for retaining nitrogen and phosphorus were studied when applied as a distinct sub-surface drainage or intermediate layer in golf course putting greens. A statistically significant reduction in the concentration of nitrate in leachate was achieved by replacing traditional pea gravel with equally sized granulated tires for the drainage layer media, although the mechanism of nitrate mitigation remains unclear. The results indicate that using granulated tires as a drainage layer or fill material beneath sand-based root zones does not compromise the function of the profile or quality of the vegetation while creating an environmentally beneficial and value-added option for scrap tire reuse.

Use of recombinant LH in a group of unselected IVF patients.

The aim of this study was to evaluate the use of recombinant luteinizing hormone (rLH) supplementation in an unselected group of IVF patients undergoing follicular stimulation with recombinant follicle stimulating hormone (rFSH) after pituitary down-regulation. Group A comprised 122 cycles administered rFSH and rLH while group B included 331 cycles using rFSH only during the same period of treatment. There was no significant difference in any of the endocrine, embryological and outcome parameters measured. The implantation rate of 14.2% for group A compared with 9.8% for group B showed a positive trend (P = 0.055), but for patients in whom LH concentration was <1.0 IU/l at down-regulation or required excessive FSH stimulation, there was an increased incidence of implantation if rLH was supplemented. It was concluded that the addition of exogenous rLH to an unselected group of 'down-regulated' patients stimulated with rFSH appears to offer little benefit, but in the event of profound LH down-regulation or requirement for excessive exogenous FSH (>2500 IU), the rate of implantation might be improved.

A novel human homologue of the SH3BGR gene encodes a small protein similar to Glutaredoxin 1 of Escherichia coli.

Glutaredoxins (GRXs) are ubiquitous GSH-dependent oxidoreductases, which catalyze the reduction of protein-glutathionyl-mixed disulfides and are considered to play an important role in the enzymatic regulation of redox-sensitive proteins. In this paper, we describe the identification and characterization of a new human homologue of the SH3BGR gene, named SH3BGRL3 (SH3 domain binding glutamic acid-rich protein like 3). SH3BGRL3 is widely expressed and codes for a highly conserved small protein, which shows a significant similarity to Glutaredoxin 1 (GRX1) of Escherichia coli and is predicted to belong to the Thioredoxin Superfamily. However, the SH3BGRL3 protein lacks both the conserved cysteine residues, which characterize the enzymatic active site of GRX. This structural feature raises the possibility that SH3BGRL3 could function as an endogenous modulator of GRX biological activity. EGFP-SH3BGRL3 fusion protein expressed in COS-7 cells localizes both to the nucleus and to the cytoplasm. The SH3BGRL3 gene was mapped to chromosome 1p34.3-35.

Use of recombinant FSH and recombinant LH in multiple follicular stimulation for IVF: a preliminary study.

Twelve patients (17 cycles) who needed >3000 IU of recombinant FSH (rFSH) on previous follicular stimulation attempts for IVF using rFSH (group A) underwent further attempts (a total of 12 cycles) using rFSH supplemented with rLH from day 7 of stimulation (group B). There was no significant difference in the total quantitative administration of rFSH (mean: 4759 versus 4800 IU rFSH), days of stimulation (14.0 versus 12.6), number of M2 oocytes per patient (3.76 versus 4.17) or embryo morphology between group A and group B respectively. However, there was a significant increase in the incidence of fertilization (60.9 versus 86.0%; P = 0.006) and clinical (ongoing) pregnancies (1 versus 6; P = 0.022). The higher incidence of fertilization increased the mean number of embryos transferred per patient, although in this small group the data was not significant (1.75 versus 2.71). This preliminary clinical trial suggests that in poor responders superimposing rLH upon a down-regulated cycle stimulated with rFSH improves relevant outcome data; and this preliminary trial has encouraged the need for a larger and more detailed study.

An atrioventricular canal domain defined by cardiac troponin I transgene expression in the embryonic myocardium.

During early cardiac development the atrial myocardium is continuous with the ventricular myocardium throughout the atrioventricular canal. The atrioventricular canal undergoes complex remodelling involving septation, formation of atrioventricular valves and insulation between atria and ventricles except at the level of the atrioventricular node. Understanding of these processes has been hampered by the lack of markers specific for this heart region. We have generated transgenic mice expressing beta-galactosidase under the control of the cardiac troponin I gene that show transgene expression mainly confined to the atrioventricular canal myocardium during early embryonic development. With further development beta-galactosidase positive cells are observed in the atrioventricular node and in the lower rim of both right and left atria, supporting the view that atrioventricular canal myocardium contributes to the atrioventricular node and is in part incorporated into the lower rim of the atria. These results identify the atrioventricular canal myocardium as a distinct transcriptional domain.

Should ICSI be the treatment of choice for all cases of in-vitro conception?

The objective of this study was to examine different clinical scenarios of in-vitro conception, viz. fertilization with conventional IVF, IVF with high insemination concentration (HIC) and intracytoplasmic sperm injection (ICSI), and assess on a sibling oocyte comparison the hypothesis that ICSI should be performed in all cases requiring in-vitro conception. ICSI with husband's spermatozoa had a higher incidence of fertilization as compared with IVF or IVF with HIC with donor spermatozoa (if previous failure of fertilization had occurred) for unexplained infertility. Similarly, ICSI with husband's spermatozoa had as high an incidence of fertilization as IVF with donor spermatozoa for patients with severe oligozoospermia, asthenozoospermia and/or teratozoospermia, even when the spermatozoa were not selected for their morphology. Two studies were performed to assess ICSI in potential oocyte-related failure of IVF, viz. when fertilization occurred in >50% of oocytes for one group of patients, and in <50% of oocytes in a second group. In both of these studies a significant proportion of the oocytes that failed to fertilize with conventional IVF eventually fertilized after ICSI. The overall conclusion was that ICSI as a first option offers a higher incidence of fertilization, maximizes the number of embryos and minimizes the risk of complete failure of fertilization for all cases requiring in-vitro conception. However, among other concerns, current knowledge of ICSI as an outcome procedure does not provide the confidence to use this process in all cases of IVF for the time being.

Gender differences in advanced mathematical problem solving.

Strategy flexibility in mathematical problem solving was investigated. In Studies 1 and 2, high school juniors and seniors solved Scholastic Assessment Test-Mathematics (SAT-M) problems classified as conventional or unconventional. Algorithmic solution strategies were students' default choice for both types of problems across conditions that manipulated item format and solution time. Use of intuitive strategies on unconventional problems was evident only for high-ability students. Male students were more likely than female students to successfully match strategies to problem characteristics. In Study 3, a revised taxonomy of problems based on cognitive solution demands was predictive of gender differences on Graduate Record Examination-Quantitative (GRE-Q) items. Men outperformed women overall, but the difference was greater on items requiring spatial skills, shortcuts, or multiple solution paths than on problems requiring verbal skills or mastery of classroom-based content. Results suggest that strategy flexibility is a source of gender differences in mathematical ability assessed by SAT-M and GRE-Q problem solving.