Posterior fossa abnormalities are sonographically diagnosable in the fetus. Anomalies of this region include Dandy‐Walker malformation, enlarged cisterna magna, and arachnoid cyst. Despite prenatal diagnosis, the uncertainties related to natural history and neurodevelopmental outcome in survivors make patient counseling difficult. The purposes of this study were to determine the accuracy of prenatal diagnosis of these lesions and elucidate long‐term neurodevelopmental outcome in survivors in prenatally diagnosed posterior fossa abnormalities. Fifteen cases of posterior fossa abnormalities were reviewed. Antenatal diagnoses of Dandy‐Walker malformation was made in 13 of these cases, arachnoid cyst in one case, and enlarged cisterna magna in one case. Hydrocephalus was present in 66% of patients. The sonographic diagnosis was concordant with the pathologic or neonatal radiologic diagnosis in 13 of 15 cases. Seven fetuses (47%) exhibited additional cranial or extracranial anomalies. A karyotypic abnormality (trisomy 18) was found in one of 15 cases of posterior fossa abnormalities. Neurodevelopmental delay was present in 80% of survivors with follow‐up study to 4 years of age. Prenatal diagnosis of posterior fossa abnormalities is highly accurate, yet the differential diagnosis can be challenging. Cognitive and psychomotor developmental delays remain commonplace despite early diagnosis and treatment. The approach with families in cases of prenatal diagnosis of posterior fossa abnormalities should include a search for additional central nervous system and extra‐central nervous system anomalies in the fetus and counseling of parents regarding potential adverse outcome for survivors.

Background:Given the importance of timing of denudation and oocyte injection during assisted reproductive technology cycles, a study was undertaken of the impact of timing on the outcome of intracytoplasmic sperm injection in a cohort of patients from a private in vitro fertilization center.Methods:The study included patients who underwent fresh intracytoplasmic sperm injection-embryo transfer by a single embryologist and gynecologist over a two-year period (January 2008 to March 2010). The primary outcome measure was the number of mature oocytes, and clinical pregnancy was the secondary outcome measure.Results:There was no significant difference between the three groups with respect to female age, but Group 3 showed a higher mean number of cumulus oopherus (14.46 versus 14.19), mature oocytes at time of denudation (12.72 versus 11.71), metaphase II injected (13.04 versus 11.85), and fertilized oocytes (9.75 versus 8.25) than Group 2. Group 2 showed a higher number of cumulus oopherus (14.19 versus 13.11), mature oocytes at time of denudation (11.71 versus 9.37), metaphase II injected (11.85 versus 9.7), and fertilized oocytes (8.25 versus 6.86) than Group 1. The maturation index, as well as positive clinical pregnancies, was significantly higher in Group 2 than Group 1 and in Group 3 compared with Group 1. Comparing Group 2 and Group 3, there was no significant difference regarding clinical pregnancy rates.Conclusion:It is preferable to allow an interval between oocyte retrieval and sperm injection.

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