The presence of sERCs is associated with lower chances of successful pregnancy, even in sERC-negative oocytes from the same cohort that are transferred along with the sERC-positive oocytes. High estradiol levels could be one of the causes of sERC formation.

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Objective: To study clinical outcomes for different uterine wall incision directions, comparing vertical incision and transverse incision in laparoscopic myomectomy of the intramural myoma.Methods: Laparoscopic myomectomies were performed on 50 women with intramural myomas. Using a table of random numbers, they were randomly divided into a vertical incision group (25 women) and a transverse incision group (25 women) according to the direction of incisions in the uterine wall. The numbers of enucleated myoma, operation duration, amount of bleeding, and numbers of sutures were compared. The Mann-Whitney U-test was used for analysis.Results: For the transverse incision group, the amount of bleeding (137.6 ± 88.1 mL) was a significantly lower value (P = 0.0426) than for the vertical incision group (235.8 ± 169.4 mL). In addition, in cases where the maximum myoma nucleus diameter was 7 cm or larger, operation duration (129.0 ± 32.5 min) and amount of bleeding (158.9 ± 87.1 mL) showed significantly lower values (P = 0.0067 and P = 0.0002, respectively) for the transverse incision group than did operation duration (362.3 ± 147.3 min) and amount of bleeding (362.3 ± 147.3 mL) for the vertical incision group. Conclusion:Transverse incision of the uterine wall is useful to reduce the amount of bleeding in the laparoscopic myomectomy of the intramural myoma. Transverse incision also shortens operation duration in cases where the myoma nuclei are large. (Reprod Med Biol 2004; 3: 33-37)

Effects of protease inhibitors on development of mouse blastocysts and fibrinolytic activity of trophoblast were examined by growing embryos on monolayers of decidual cells in the presence of inhibitors. Nitrophenol-p-guanidino benzoate (NPGB) was the most effective inhibitor; 10(-4) M NPGB inhibited attachment and trophoblast outgrowth by 24% and 66%, respectively, and inhibited the fibrinolytic activity of trophoblast by 86%. The effects of NPGB were reversible, as demonstrated by the embryos' ability to attach and resume normal development when transferred to NPGB-free medium. Soybean trypsin inhibitor and epsilon-aminocaproic acid were less effective than NPGB in inhibiting blastocyst development. When 10(-4) M NPGB and 350 microgram/ml of soybean trypsin inhibitor were added together, blastocyst development and fibrinolytic activity were inhibited more severely than when either inhibitor was added alone. We suggest that at least two types of proteolytic activities in mouse blastocysts are involved in implantation, attachment requiring trypsin-like activity, and trophoblast outgrowth requiring both plasminogen activator and trypsin-like activity.