Three types of defects of preimplantation embryogenesis contribute to the developmental arrest of cleaving human embryos: blastomere fragmentation, abnormal nuclear status and chromosomal disorders. Data concerning the relation and succession of these abnormalities during first mitotic cycles of the human zygote are controversial and mainly empirical at present. In this study we have performed simultaneous evaluation of blastomere fragmentation, nuclear apoptotic changes and the ploidy of four chromosomes (1, 5, 19 and X or 18, 21, X and Y) in 193 human embryos. Another group of 28 embryos was subjected to TUNEL for confirmation of apoptosis in blastomere nuclei. Nuclei with apoptotic chromatin were seen in nearly 1/10 of blastomeres of embryos with good morphology and in more than 1/5 of blastomeres of embryos with more than 20% fragmentation. The correct number of investigated chromosomes was registered in 85.2% of successfully tested embryos. Chromatin apoptotic changes are the only limiting factor for the success of chromosomal FISH tests. Nearly 1/2 of embryos with at least one apoptotic nucleus were chromosomally abnormal. For the embryos that contain only normal nuclei, the rate of ploid normality was more than 89%. The rate of euploidy was higher (66%) in embryos with a significant degree of cell fragmentation. Moderate cell fragmentation was not related to significant increase of chromatin and chromosomal disorders. In a substantial portion of abnormal blastomeres, chromatin damage preceded cell fragmentation. Nuclear destruction in human blastomeres was illustrated by fluorograms of different stages of chromatin lesions.

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The aim of this study was to examine the occurrence of ovarian cysts during the administration of three different gonadotrophin-releasing hormone analogues (GnRHa) in the long protocol as well as their characteristics, management and outcome compared with patients with no cyst formation. A total of 172 in-vitro fertilization (IVF) cycles in which GnRHa was administered at menstruation were analysed. Group B consisted of 72 cycles in which buserelin was used. Of these, 10 (13.9%) were with cysts (group B1) and 62 (86.1%) without cysts (group B2). Group T included 49 cycles in which triptorelin was injected. Of these, seven (14.2%) were with cysts (group T1) and 42 (85.7%) without cysts (group T2). Group L comprised 51 cycles in which leuprolide was administered. Of these, eight (15.7%) were with cysts (group L1) and 43 (84.3%) without cysts (group L2). All women with ovarian cysts had higher serum oestradiol concentrations and all except five underwent cyst aspiration with no complication. No differences were observed in the number of follicles and oocytes between groups B, T and L or between the groups with cysts and those without cysts. The pregnancy rate was similar in all groups. In conclusion, follicle cyst formation does not seem to be related to the use of a specific GnRHa, its short- or long-acting form or to the mode of administration. In addition, follicle cyst aspiration is a safe and successful solution to the problem of functionally active ovarian cysts.

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