Bipartición embrionaria temprana: descripción de una serie de 9 casos / Early embryo bisection: Nine cases description

Resumen ANTECEDENTES: La tasa de bipartición temprana en concepciones naturales es de 0.4% de los nacimientos. Se ha descrito un aumento de estos casos en tratamientos de reproducción asistida, especialmente durante la transferencia en estadio de blastocisto. CASO CLÍNICO: se describen nueve casos retrospectivos (2014-2016) de pacientes a quienes se transfirió un embrión y se visualizaron dos sacos, o en las que se transfirieron 2 embriones y se visualizaron 3 sacos. En el periodo de estudio se transfirieron 3737 embriones: 1470 en fresco y 827 desvitrificados. Los 9 casos suponen una tasa de bipartición temprana embrionaria de 0.39% del total de las transferencias y 0.86% del total de los embarazos. CONCLUSIONES: no existe relación entre el riesgo de división embrionaria y la eclosión (hatching) asistida, ni entre la edad avanzada ovocitaria y la edad paterna. La transferencia de embrión único es la mejor opción en pacientes que reciben ovocitos de donantes jóvenes o participan en protocolos de FIV-ICSI.

Abstratc BACKGROUND: The cases in which the embryo divides in two identic embryos is causing real concerns in the treatments of assisted reproduction. The percentage of early bisection in natural conception is about 0.4% on life birth. There is noticed an increase of this cases in treatments of the assisted reproduction, especially when transferring in blastocyst stage. CASE REPORT: We have collected series of 9 cases in a retrospective way, between 2014-2016 in which we have transferred 1 embryo and we have visualized 2 sacs, and the cases in which we have transferred 2 embryos and we have visualized 3 sacs. This year we have transferred a total of 3737 embryos, 1470 fresh embryo transfers and 827 frozen embryo transfers. These 9 cases mean the 0.39% of early embryo division and the 0.86% of total of pregnancies. CONCLUSION: We didn't observe a relationship in the risk of embryo division with the hatching. Neither with advanced age of the eggs, non the father's age. The rate of division of the embryos in cycles of the assisted reproduction in our clinic using ICSI increase in comparison with the spontaneous gestations, howbeit it would be necessary to do more studies in order to prove this statement. We consider single embryo transfer the best practice in IVF in young women or donor eggs.

Is trophoblastic thickness at the embryonic implantation site a new sign of negative evolution in first trimester pregnancy?

In this study a new sign to evaluate the evolution of pregnancy is described: the trophoblastic thickness at the embryonic implantation site. A prospective, observational study of 592 normal pregnancies with no known risk factors was carried out from January 1998 to February 1999. Serial ultrasound scans were performed from week 5 to week 12 of pregnancy. Trophoblastic thickness was measured at the embryonic implantation site to determine the significance of a difference in gestational age in weeks and a trophoblastic thickness of >/=3 mm in predicting poor prognosis in pregnancy outcome. The sensitivity of this sign in the prediction of spontaneous abortion was 82%, the specificity was 93%, the positive predictive value was 63% and the negative predictive value was 97%.

An extract of the fern Polypodium leucotomos inhibits human peripheral blood mononuclear cells proliferation in vitro.

An alcoholic extract of the fern polypodium leucotomos (PLE) has been empirically used as an immunosuppressor for the treatment of several autoimmune diseases. In this paper, we investigated the effects of PLE on activation and proliferative responses of peripheral blood mononuclear cells (PBMNC) from healthy donors to T lymphocyte polyclonal mitogens. PLE shows a significant inhibitory effect on the proliferative response of PBMNC to stimulation with phytohaemagglutinin (PHA) or anti CD3 monoclonal antibodies (p < 0.05). In contrast, PLE did not modify the proliferative response of PBMNC to phorbol esters (p > 0.05). The inhibitory effect of PLE upon mitogen induced PBMNC proliferation is time dependent and can be overcome by the exogenous addition of interleukin-2 to the culture medium (p < 0.05). The decreased proliferative response of PBMNC to PHA stimulation in the presence of PLE is not associated with a significant modification of expression of the alpha chain (CD25) of the IL-2 receptor (p > 0.05). In conclusion, PLE shows an inhibitory effect on the polyclonal proliferative response of PBMNC to T lymphocyte mitogens that interact with cytoplasmic membrane molecules.

Assessment with transvaginal ultrasonography of endometrial thickness in women with postmenopausal bleeding.

OBJECTIVE: The aim of this study was to assess the use of transvaginal ultrasonography in measuring endometrial thickness in postmenopausal women with bleeding, thus to determine the least invasive treatment. STUDY DESIGN: We evaluated 168 women with postmenopausal bleeding by transvaginal ultrasonography and histological study of the endometrium. RESULTS: No cancerous or precancerous lesions were found when endometrial thickness was under 10 mm. The mean endometrial thickness in women with cancerous and precancerous lesions was 10.75 +/- 1.63 mm, while in non-pathological lesions it was 1.36 +/- 1.18 mm. CONCLUSIONS: To diagnose endometrial pathology, an endometrial thickness over 6 mm yields a sensitivity of 88.6%, a specificity of 90.6%, a positive predictive value of 92%, with 4.6% of false-positives and 4.6% of false-negatives (six small polyps and one irregular maturation). Although we are waiting for other prospective and multicentric studies, our present experience leads us to believe that Dilatation and Curettage (D&C) can be avoided in postmenopausal bleeding with endometrial thickness under or equal to 6 mm.