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Objective: To evaluate the patterns of chromosome abnormalities in embryos derived from intracytoplasmic sperm injection (ICSI) in microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in comparison to embryos that are derived from naturally ejaculated (EJAC) patients. Materials and methods: Male partners with azoospermia who required MESA or TESE for ICSI were studied for chromosomal abnormalities. The ICSI patients with EJAC sperm served as the control group. Preimplantation genetic diagnosis (PGD) was performed by fluorescence in situ hybridization (FISH). Chromosome abnormalities were categorized as polyploidy, haploidy, aneuploidy, and complex abnormality (which involves more than two chromosomes). Fertilization, embryo development, and patterns of chromosome abnormalities were accessed and evaluated. Results: There was no difference between the MESA, TESE, and EJAC patient groups in the rates of fertilization and pregnancy and the percentages of euploid embryos. In all three groups, less than one-half of the embryos for each group were normal (41 ± 31%, 48 ± 38%, and 48 ± 31% in MESA, TESA, and EJAC, respectively). Complex chromosomal abnormality was significantly more frequent in the MESA group than in the EJAC group (48.3% vs. 26.5%, respectively; p

Accurate and early prediction of the outcome of an in vitro fertilization (IVF) treatment is important for both patients and physicians. The most common question asked by IVF patients is ''What are my chances of conceiving?'' The answer to this difficult question typically considers patient age, day 3 serum follicle stimulating hormone (FSH) levels, and infertility diagnosis. However, many more parameters are known to affect IVF outcome. It is difficult for the clinician to recognize trends and intuitively decide how to optimize success rates for each infertile couple. This paper presents a hybrid intelligence method which integrating genetic algorithm and decision learning techniques for knowledge mining of an IVF medical database. The proposed method can not only assist the IVF physician in predicting the IVF outcome, but also find useful knowledge that can help the IVF physician tailor the IVF treatment to the individual patient with the aim of improving the pregnancy success rate. The twenty-eight most significant attributes for determining the pregnancy rate (e.g., patient's age, number of embryo transferred, number of frozen embryos, and culture days of embryo) and their combinative relationships (represented by if-then rules) were identified through the proposed method. The knowledge discovered in this study is currently accepted as an interesting discovery from the viewpoint of domain experts. For the results from this study to be conveniently accessed by IVF physicians and patients, an expert system tool equipped with the proposed IVF outcome prediction model was built.

A single early quantitative hCG measurement 16 to 18 days after timed insemination has prognostic value with regard to pregnancy outcome in an asymptomatic, infertile population. Further, there is a statistically significant difference in the predictive value for hCG levels in patients less than or equal to 35 years compared with patients greater than 35 years of age. Interestingly, the same age-dependent phenomenon was observed when analyzing the predictive value of sonographically detected fetal heart motion at 5 weeks post-ovulation. We suggest that any investigation on pregnancy outcome, or its prediction should consider the impact of maternal age as a potentially significant covariate.

To assess the predictive value of a single serum human chorionic gonadotropin (hCG) measurement obtained on day 14, 15, or 16 after transfer in in vitro fertilization or gamete intrafallopian transfer pregnancies.Retrospective.Assisted reproductive technology (ART) programs.One hundred thirty-four consecutive pregnancies from two ART programs were reviewed.The incidence of livebirth was only 6% when day 14 to 16 hCG values were less than 100 mIU/mL, but increased to 82% with levels greater than 100 mIU/mL (P less than 0.001). The incidence of livebirth and multiple birth correlated with rising hCG levels. Only 1% (1/71) of pregnancies with serum hCG values greater than 100 mIU/mL was ectopic, and this case was a bilateral (double) ectopic.A single serum hCG measurement obtained 14 to 16 days after embryo or gamete transfer not only is diagnostic but also has good predictive value for pregnancy outcome.