For whom the egg thaws: insights from an analysis of 10 years of frozen egg thaw data from two UK clinics, 2008-2017.

PURPOSE: To better understand the characteristics of patients who returned to thaw their frozen eggs to attempt conception and their outcomes. METHODS: A retrospective analysis of clinical records for all own egg thaw patients in two UK fertility clinics across 10 years, 2008-2017. RESULTS: There were 129 patients who returned to thaw their eggs, of which 46 had originally frozen their eggs for social reasons and 83 for a variety of clinical, incidental, and ethical reasons (which we have called "non-social"). Women who had frozen their eggs for social reasons were single at time of freeze, with an average age of 37.7. They kept their eggs in storage for just under 5 years, returning to use them at the average age of 42.5. 43.5% were single at time of thaw, and 47.8% used donor sperm to fertilise their eggs. Women whose eggs were frozen for non-social reasons were almost all (97.6%) in a relationship at both time of freeze and thaw. They had an average age of 37.2 at first freeze and 37.6 at thaw, having kept their eggs in storage for an average of 0.4 years. Overall, there was a 20.9% success rate among women attempting conception with frozen-thawed eggs. CONCLUSIONS: Despite widespread assumptions, many women attempting conception with thawed eggs had not initially frozen them for social reasons. Women who froze their eggs for social reasons presented distinctly and statistically different characteristics at both time of freeze and thaw to women whose eggs were frozen for non-social reasons.

Novel automated three-dimensional genome scanning based on the nuclear architecture of telomeres.

Telomeres, the end of chromosomes, are organized in a nonoverlapping fashion and form microterritories in nuclei of normal cells. Previous studies have shown that normal and tumor cell nuclei differ in their 3D telomeric organization. The differences include a change in the spatial organization of the telomeres, in telomere numbers and sizes and in the presence of telomeric aggregates. Previous attempts to identify the above parameters of 3D telomere organization were semi-automated. Here we describe the automation of 3D scanning for telomere signatures in interphase nuclei based on three-dimensional fluorescent in situ hybridization (3D-FISH) and, for the first time, define its sensitivity in tumor cell detection. The data were acquired with a high-throughput scanning/acquisition system that allows to measure cells and acquire 3D images of nuclei at high resolution with 40 × or 60 × oil and at a speed of 10,000-15,000 cells h(-1) , depending on the cell density on the slides. The automated scanning, TeloScan, is suitable for large series of samples and sample sizes. We define the sensitivity of this automation for tumor cell detection. The data output includes 3D telomere positions, numbers of telomeric aggregates, telomere numbers, and telomere signal intensities. We were able to detect one aberrant cell in 1,000 normal cells. In conclusions, we are able to detect tumor cells based on 3D architectural profiles of the genome. This new tool could, in the future, assist in patient diagnosis, in the detection of minimal residual disease, in the analysis of treatment response and in treatment decisions.

The early pregnancy assessment project: the effect of cooperative care in the emergency department for management of early pregnancy complications.

BACKGROUND: Early pregnancy assessment clinics (EPAC) have been introduced and accepted as the gold standard for management of early pregnancy problems (EPP). However, EPAC are not universally available and management of EPP within the emergency department (ED) can result in prolonged waiting times, inappropriate use of resources and no clear treatment or follow-up plan being implemented. AIM: To assess the effect of an early pregnancy assessment protocol (EPAP) in the ED, designed to create a cultural change among doctors in relation to EPP in order to minimise use of resources, improve treatment times for patients and establish a clear management plan where dedicated EPAC services are not available. METHODS: An intervention, the EPAP was introduced to the ED and retrospective and prospective audits of the patients were carried out to assess the effect. RESULTS: Implementation of the EPAP decreased treatment time by 55%, representations by 48%, pathology blood tests by 56% and formal imaging services by 85%. Gynaecological consultation increased by 37% for each patient visit to the ED and by 9% for each EPP. Total direct cost saving was 63% per patient and no adverse outcomes were recorded. CONCLUSION: Introduction of the EPAP was successful in creating cultural change and delivering clinical and financial benefits to the hospital, patients and staff. Early gynaecological consultation and bedside ultrasound scanning within the ED were key factors. Similar benefits could be reproduced in other institutions and for other clinical scenarios where a need has been identified.

Selective rotation pulses calculated with an inverse scattering algorithm.

Selective rotation pulses cause magnetization within a given frequency range (or slice) to undergo a specified rotation, about a specified axis. Magnetization outside this slice remains unaffected if it is initially along the z axis. It has previously been shown that the design of such pulses can be reduced to the design of selective "point-to-point" pulses, which rotate magnetization within the slice from the y axis. By decomposing the point-to-point pulses into two sub-pulses, it is shown that an inverse scattering algorithm for selective pulse design can be used to calculate selective rotation pulses with any desired spinor response, subject to the constraint that the second spinor component have constant phase across the slice. The design of selective refocusing pulses can be treated specially, requiring the calculation, by the same inverse scattering algorithm, of a single sub-pulse.

Two-level systems with relaxation.

A method is presented for the coherent control of two-level systems when T2 relaxation is significant. The Bloch equations are rewritten as an equation of motion of the stereographic projection, Gamma, of the spin vector. This allows a Schur-type iteration used for the design of shaped pulses in magnetic resonance and coherent optics to be extended to include the effect of T2. In general, the effect of T2 on Gamma cannot be completely compensated for, although in practice it can be to a high degree. An example is presented of a driving field that produces a coherent superposition (no on-diagonal elements of the density matrix) over a chosen band of frequencies, in the presence of relaxation.