We report on a case where late intracytoplasmic sperm injection (ICSI) on unfertilized oocytes after standard in-vitro fertilization (IVF) cycles resulted in a dizygotic twin pregnancy. Fifteen oocytes were harvested from a patient with a history of salpingotomy. After a single cycle of IVF, only one oocyte showed two pronuclei. Subsequently ICSI was performed on six unfertilized metaphase II oocytes, and three of these oocytes showed two pronuclei. Three fertilized embryos were transferred (two derived from ICSI and one from IVF). A normal twin pregnancy resulted, and after delivery of two healthy boys the twins were confirmed to be dizygotic by DNA analysis of several loci. We conclude that at least one of the embryos was derived from the reinsemination by 'second day ICSI'.

The histopathologic features of 855 cervical biopsies were correlated with the presence of human papillomavirus DNA using in situ hybridization (ISH) with biotin labeled type specific probes for Human Papilloma Virus (HPV) types 6, 11, 16, 18, 31, 33 and 51. HPV-DNA was found in 18% (13/72) of cervical intraepithelial neoplasia I (CIN I), 30% (35/115) of CIN II, 28% (57(206) of CIN III, in 84% (21/25) of flat condyloma and in 13% (15/112) of normal cervical tissue. HPV DNA was detectable in 11% (5/46) of cervical adenocarcinoma and in 21% (59/279) of squamous cell carcinoma (SCC) of the cervix. High risk HPV types were identified more often than low risk HPV types in CIN I, CIN II, CIN III and SCC. HPV type 16/18 predominates over HPV types 31/33/51 in CIN I, flat condyloma and in SCC. The prevalence of HPV was strongly associated with the grade of differentiation of SCC. It was identified in 59% (23/39) of well differentiated SCC, in 18% (25/142) of moderately differentiated and in 11% (11/98) of poorly differentiated SCC.

ZusammenfassungFragestellung: Ziel der Untersuchung war es, die Prävalenz von Gerinnungsstörungen bei Patientinnen mit drei oder mehr aufeinander folgenden, spontanen Frühaborten zu evaluieren. Zusätzlich sollte ein möglicher Zusammenhang zwischen dem Vorliegen von Antiphospholipid-Autoantikörpern und einer hereditären Thrombophilie bei Frauen mit habituellen Aborten untersucht werden. Material und Methodik: Bei 20 Patientinnen mit habitueller Abortneigung wurden die folgenden plasmatischen Gerinnungsuntersuchungen durchgeführt: Prothrombinzeit nach Quick, aktivierte Thromboplastinzeit (aPTT), Protein S, Protein C, Antithrombin III, Fibrinogen und Plasminogen. Zusätzlich erfolgte eine molekulargenetische Analyse zum Nachweis der Faktor-V-Leiden-Mutation und der Faktor-II-G20210 A-Mutation sowie eine serologische Untersuchung auf Antiphospholipid-Autoantikörper. Das Kontrollkollektiv bestand aus 20 gesunden Probandinnen ohne Abortanamnese mit mindestens einer unkomplizierten Schwangerschaft. Ergebnisse: Die Prävalenz der untersuchten Gerinnungsstörungen betrug 10% (2/20 Patientinnen) im Studienkollektiv bzw. 15% (3/20 Patientinnen) im Kontrollkollektiv. Für keinen der plasmatischen Gerinnungsparameter konnte ein signifikanter Unterschied zwischen der Studien-und der Kontrollgruppe nachgewiesen werden. Beim Nachweis von Faktor-II-oder Faktor-V-Mutationen zeigte sich kein gehäuftes Auftreten in einem Abstract Purpose: This study was undertaken to evaluate the incidence of haemostatic abnormalities and hypercoagulation mutations in women with a history of three or more consecutive spontaneous abortions and to investigate the influence of the antiphospholipid autoantibody status. Material and Methods: 20 non-pregnant habitual aborters were analysed for prothrombin time, activated partial thromboplastin time, fibrinogen, plasminogen, protein S, protein C, antithrombin III, and antiphospholipid autoantibodies. Genetic analysis was performed to detect factor V Leiden mutation and factor II G20210A mutation. Twenty healthy non-pregnant multigravidae served as controls. Results: The incidence of haemostatic abnormalities or of factor II or V Leiden mutations did not differ significantly between women with a history of recurrent spontaneous abortion and controls. In 9 of 20 women with recurrent spontaneous abortions antiphospholipid autoantibodies (APA) were detectable. APApositive and APA-negative study patients revealed similar results with respect to the investigated coagulation values Conclusion: According to our observations a general screening for hereditary coagulation disorders or hypercoagulation mutations should not be included in the routine work-up of women with a history of recurrent spontaneous abortions unless there is a history of familiar thrombophilia.

The histopathologic features of 855 cervical biopsies were correlated with the presence of human papillomavirus DNA using in situ hybridization (ISH) with biotin labeled type specific probes for Human Papilloma Virus (HPV) types 6, 11, 16, 18, 31, 33 and 51. HPV-DNA was found in 18% (13/72) of cervical intraepithelial neoplasia I (CIN I), 30% (35/115) of CIN II, 28% (57(206) of CIN III, in 84% (21/25) of flat condyloma and in 13% (15/112) of normal cervical tissue. HPV DNA was detectable in 11% (5/46) of cervical adenocarcinoma and in 21% (59/279) of squamous cell carcinoma (SCC) of the cervix. High risk HPV types were identified more often than low risk HPV types in CIN I, CIN II, CIN III and SCC. HPV type 16/18 predominates over HPV types 31/33/51 in CIN I, flat condyloma and in SCC. The prevalence of HPV was strongly associated with the grade of differentiation of SCC. It was identified in 59% (23/39) of well differentiated SCC, in 18% (25/142) of moderately differentiated and in 11% (11/98) of poorly differentiated SCC.