No abstract

The present study is the proof of the concept that GnRH-agonist triggering of final oocyte maturation in combination with elective cryopreservation of 2 PN oocytes offers OHSS risk patients a good chance of pregnancy achievement, while reducing the risk of moderate and severe OHSS.

There are only scarce data on the incidence of spontaneous pregnancy in infertility patients. Contraception after infertility treatment is another topic that has been neglected so far. Therefore, a questionnaire was sent to 1614 couples with a child conceived by intracytoplasmic sperm injection (ICSI) aged 4-6 years. A total of 899 couples responded (response rate 55.7%). A total of 10.9% of couples had used contraception. Of the couples that had actively tried to conceive, 20.0% had conceived spontaneously, resulting in a live-birth rate of 16.4%. 74.5% of these pregnancies were conceived within 2 years after delivery. A further 26.6% of couples conceived again by ICSI, with a live-birth rate of 20.9%. Maternal age was the only prognostic factor for spontaneous conception. Parents of multiples after ICSI did not have a higher chance of spontaneous conception than parents of singletons. Couples can be counselled that one out of five couples conceive spontaneously after successful ICSI. Even when assuming that none of the families that were lost to follow-up had conceived spontaneously, one out of eight couples would have conceived spontaneously. Therefore, it is important to counsel patients about the possibility of natural conception and necessity to use contraception despite their history of subfertility.

Overall, by the long-term follow-up of 77 children with prenatal SVES we could show that prenatal SVES has a good prognosis. However, 30% of children develop arrhythmia postpartum and 31% of children present with cardiac anomalies. These children still have a worse prognosis than children with isolated prenatal SVES.

Intracytoplasmic sperm injection (ICSI) is used to overcome severe male-factor infertility where males are azoospermic or have poor quality spermatozoa. Perturbations of finger length (short finger length adjusted for height and high second-to-fourth digit ratio, or 2D:4D) have been described in azoospermic men and men who are rated as having low sexual attractiveness. High 2D:4D has been described in women with high fecundity. Such perturbations may be related to endocrine regulation of some homeobox genes. This study compared finger length and 2D:4D in singleton children conceived with the help of ICSI with those in naturally conceived singleton controls. Participants were recruited from centres in Germany and the UK. There were 211 children conceived by ICSI and 195 controls. Finger length was measured from photocopies of the ventral surface of the hand. In comparison to controls, male and female ICSI children had shorter fingers after correction for height. There was also evidence that female ICSI children may have higher 2D:4D than female controls. Perturbations in finger length in ICSI children may be inherited from their fathers and, in the case of boys, could be associated with lower fertility and reduced sexual attractiveness. For ICSI females, increased 2D:4D may be associated with increased fertility.