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Objective: To evaluate the risk of monozygotic splitting with embryo biopsy during in vitro fertilisation (IVF).Design: A cohort study.Setting: Anonymised assisted reproductive technology national data from the Human Fertilisation and Embryology Authority, UK.Population: Women undergoing single-embryo transfer (SET) following either pre-implantation genetic testing (PGT) involving embryo biopsy or IVF without PGT.Methods: Data on women undergoing SET either following PGT and non-PGT IVF treatment in 2000-2016 were analysed to compare the risk of zygotic splitting and monozygotic twining. Logistic regression analysis was performed adjusting for potential confounders.Main Outcomes: Monozygotic spitting, monozygotic twin birth.Results: Data comprising a total of 207 697 SET cycles (4544 following PGT and 203 153 following non-PGT IVF) were analysed. The live birth rate per embryo transfer was 31.9% (95% confidence interval [CI] 30.5-33.2%) following PGT and 26.9% (95% CI 26.7-27.1%) following non-PGT IVF. The incidence of zygotic splitting following PGT was 2.4% (95% CI 1.7-3.3%) versus 1.5% (95% CI 1.4-1.6%) following non-PGT IVF. There was a significantly higher risk of zygotic splitting with PGT versus non-PGT IVF cycles (odds ratio [OR] 1.64, 95% CI 1.19-2.27). The higher risk of zygotic splitting with PGT cycles remained significant after adjusting for potential confounders (adjusted OR 1.51, 95% CI 1.06-2.15).Conclusions: The present study demonstrated an increased risk of monozygotic splitting with embryo biopsy. Given the current sparse literature, it is important to accumulate further evidence to validate the findings.Tweetable Abstract: A likely increased risk of monozygotic splitting following embryo biopsy. [ABSTRACT FROM AUTHOR]

Objectives: To explore whether non-tuberculous mycobacteria (NTM) are associated with tubal disease leading to infertility.Design: Prospective observational study.Setting: Teaching hospital.Population: Women with tubal factor infertility.Methods: In all, 173 infertile women with tubal disease were investigated for genital tuberculosis, Chlamydia trachomatis and Neisseria gonorrhoeae using polymerase chain reaction, culture and histopathological examination. On culture, NTM were grown in 23.7% of endometrial samples. The mycolic characteristics of these organisms were analysed.Main Outcome Measure: Whether NTM are associated with tubal disease leading to infertility.Results: The organisms identified in association with tubal disease were Mycobacterium tuberculosis in 30%, gonococci in 1.7%, Chlamydia in 7.5% and NTM in 23.7% of cases. Mycobacterium chelonae was the predominant organism identified by high-performance liquid chromatography. In ten women, for whom there was laparoscopic evidence of tubal disease, the only organism that was grown was NTM, and the tests for other organisms were negative. Tests for possible environment (theatre, instruments) contamination was reported negative.Conclusion: While evaluating infertile women for tubal disease, culture studies revealed a high prevalence of NTM in the endometrium. In the absence of M. tuberculosis, gonococci and Chlamydia infection, the presence of NTM suggests the possibility that these organisms may be responsible for tubal damage leading to infertility.Tweetable Abstract: On evaluating the causes of tubal disease, NTM were associated with tubal disease. [ABSTRACT FROM AUTHOR]

The article discusses the use of diagnostic biomarkers for prediction of adverse early pregnancy outcomes. Topics mentioned include the use of a biomarker for reduction of clinical burden of pregnancy of unknown location cases, the controversies surrounding the use of biomarkers, such as human chorionic gonadotrophin and progesterone, and the categorization of biomarkers in early pregnancy based on their biological origin.

Background: Fallopian tube occlusion is a common cause of infertility, but the effect of unilateral tubal block (UTB) on pregnancy rates (PR) after controlled ovarian hyperstimulation and intrauterine insemination (COH-IUI) remains controversial.Objective: To evaluate PR after COH-IUI among infertile women with proximal and distal UTB diagnosed by hysterosalpingogram (HSG), compared against women with bilateral patent tubes experiencing unexplained infertility.Search Strategy: We searched EMBASE, MEDLINE, Google Scholar, Cochrane Library, and PUBMED from inception to 14 January 2018.Selection Criteria: Studies that report PR/cycle or cumulative PR among women with UTB and controls were included.Data Collection and Analysis: Two authors independently selected and extracted study characteristics and data. Methodological quality was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines.Main Results: Among 2965 patients and 5749 IUI cycles across ten studies, no significant difference in PR/cycle (odds ratio, OR = 0.88; 95% confidence interval, 95% CI = 0.69-1.12) and cumulative PR (OR = 0.80, 95% CI = 0.62-1.04) was observed. Patients with proximal UTB demonstrated similar PR/cycle (OR = 1.06, 95% CI = 0.68-1.66) and cumulative PR (OR = 1.10, 95% CI = 0.75-1.62), compared with controls, whereas patients with distal UTB had significantly lower cumulative PR (OR = 0.49, 95% CI = 0.25-0.97, P = 0.04). Patients with proximal block also demonstrated significantly improved cumulative PR, compared with patients with distal block (OR=2.41, 95% CI = 1.37-4.25, P = 0.002).Conclusion: Infertile patients with proximal UTB diagnosed by HSG can expect similar pregnancy rates after COH-IUI, compared with those with bilateral tubal patency and unexplained infertility, whereas patients with distal UTB have lower odds of pregnancy. These differences may reflect inherent diagnostic limitations of HSG or differences in underlying pathologies.Tweetable Abstract: Meta-analysis evaluates pregnancy outcomes after COH-IUI in women with unilateral tubal block diagnosed by HSG. [ABSTRACT FROM AUTHOR]

The article presents a comment to a systematic review and meta-analysis about unilateral tubal block at hysterosalpingogram (HSG). It discusses the results of the systematic review and meta-analysis which attempted to combine the current knowledge about unilateral tubal obstruction on HSG in patients undergoing intrauterine insemination (IUI) without prior surgical treatment for tubal block.

The article focuses on an observation of changes in evolution of ovarian cancer with analysis of fallopian tube epithelial as origin of the high-grade serous carcinoma (HGSC). Topics discussed include hypothesis of surgeon Thomas Spencer Wells over ovarian surface epithelial cells as origin of ovarian epithelial cancer; incorporation of prophylactic salpingectomy for reduction of the disease's risk; and significance of clinical trials regarding salpingectomy for reduction in cancer risk.