No abstract

Urinary tract anomalies are common. Prenatal diagnosis is important and enables either special obstetric management or termination of pregnancy and probably in the future, intrauterine intervention. Transvaginal sonography (TVS) allows visualization of the normal and anomalous fetal urinary tract at an early stage. One thousand nine hundred and forty women were examined via TVS at an early stage of pregnancy between 10 and 16 weeks from the last menstrual period (LMP) and 35 anomalies (1.8 per cent) were clearly identified: 29 cases of low urinary tract obstruction, 2 cases of multicystic dysplastic kidney, 2 cases of polycystic kidney (infantile type), 1 case of double collecting system, and 1 case of horseshoe kidney. Potter syndrome could be ruled out in three patients who had delivered fetuses suffering from this anomaly in previous pregnancies. The concise and early identification of anomalies makes TVS an important aid in the hands of the obstetrician, ultrasonographer, and neonatologist.

The administration of hCG to women undergoing in vitro fertilization and embryo transfer (IVF/ET) results in the meiotic maturation of cumulus-oocyte complexes (COC). Sometimes oocytes being aspirated for IVF/ET fail to resume meiosis in vivo and even after a subsequent 20-h incubation in vitro and are thus defined as meiotic competence failure (MCF) oocytes. The relationship between the proportion of MCF oocytes and other IVF/ET outcomes was studied over 3 years in 703 tested cycles of 487 women. Women yielding one or more MCF oocytes in at least one menstrual cycle represented 8.6% of this population and were defined as MCF women. Cumulus state in the MCF oocyte population was characterized as mature in 57.4 +/- 6.7%, intermediate in 13.9 +/- 4.0%, immature in 24.1 +/- 8.7%, and atretic in 4.6 +/- 2.7%. These values differed significantly, by 0.6-, 2.9-, 7.1-, and 4.6-fold, respectively, as compared to the corresponding COC aspirated from women yielding only meiotically competent (MC) oocytes. In a menstrual cycle yielding both MC and MCF oocytes, the IVF/ET variables were evaluated in the MC oocytes. Thus, in such cases the incidence of fertilization or cleavage and the number of blastomeres per embryo were significantly reduced concomitant with the increase in percentage of MCF oocytes. When the percentage of MCF oocytes was 25% or more, no pregnancy was achieved. Various follicular parameters and serum 17 beta-estradiol (E2) and progesterone (P4) levels were compared in MC and MCF women over the four days preceding day of aspiration.(ABSTRACT TRUNCATED AT 250 WORDS)

We attempted to correlate distinct morphological data on cumulus cells to oocyte and cumulus cell activity. Oocyte/cumulus-corona cell complexes, which were mature 4 h after aspiration, were divided into four subgroups designated according to the type of cumulus culture morphology after 3 days of culture: type A, compact clumps; type B, partially spread clumps; type C, nonhomogeneously spread cells; and type D, homogeneously spread cells. Fertilization and cleavage rates of mature oocytes appeared to differ according to their prospective cumulus culture morphology. Fertilization and cleavage rates were 81.5 and 62.6%, respectively, in oocyte/cumulus-corona cell complexes yielding type D cumulus cells, versus 54 and 34%, respectively, in those yielding type A cumulus cells. Basal secretion of progesterone in type A cumulus cells was 105.2 +/- 10.3 ng/ml compared to 231.8 +/- 22.5 ng/ml in type D cumulus cells (p less than 0.001). Testosterone and estradiol secretion exhibited a significant difference as well: testosterone was 293 +/- 10 pg/ml in type A cumulus cells versus 224 +/- 11 pg/ml in type D cumulus cells (p less than 0.001), and estradiol was 4.6 +/- 0.4 ng/ml in type A cumulus cells versus 3.5 +/- 0.3 ng/ml in type D cumulus cells (p less than 0.05). The present study demonstrated by indirect means that oocyte/cumulus-corona cell complexes, characterized as mature a few hours after aspiration, are composed of a heterogeneous population and differ in their potential for fertilization and consequent cleavage.