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Are there any differences in viability, spindle abnormalities and mitochondrial and other organelle structures amongst embryos biopsied on day 3 versus day 5 before and after vitrification?A total of 240 day 3 biopsied embryos that developed to blastocysts but were rejected for transfer following preimplantation genetic testing for monogenic/single gene defects (PGT-M) (n = 115) or for aneuploidies (PGT-A) (n = 125) were divided into two groups: (i) 120 blastocysts treated for viability, spindle/chromosome configuration (SCC) analysis and transmission electron microscopy (TEM) analysis (fresh n = 20, n = 20, n = 20 and following vitrification/warming n = 20, n = 20, n = 20); (ii) 120 embryos were re-biopsied at the blastocyst stage and treated for viability, SCC and TEM analysis (fresh n = 20, n = 20, n = 20 and following vitrification/warming n = 20, n = 20, n = 20). Also, 60 vitrified blastocysts biopsied only on day 5 that were rejected for transfer following PGT-M (n = 6) or PGT-A (n = 54) were treated following warming for viability (n = 20), SCC (n = 20) and TEM analysis (n = 20).No differences were observed in SCC and ultrastructure between embryos biopsied on day 5 and day 3 but following vitrification higher numbers of abnormal spindles, distension of mitochondria, multivesicular bodies, lipofuscin droplets, altered cell junctions and occasionally excessive accumulation of glycogen granules were evident. The fresh day 3 biopsied group also had a lower incidence of damaged (propidium iodide-stained) cells compared with the fresh day 3+5 (P = 0.02) and the vitrified day 5 (P = 0.001) biopsied groups.Biopsies on day 5 and day 3 do not adversely affect embryo viability, SCC or ultrastructure, although following vitrification minimal embryo quality-dependent increases in spindle abnormalities and cell damage are observed.

Η παρούσα διδακτορική διατριβή πραγματεύεται την πρόταση της ανάπτυξης των Μικρομεσαίων Επιχειρήσεων με τη μορφή συνεργατικών σχηματισμών μέσα από τη στήριξη που μπορούν να παρέχουν τα πανεπιστημιακά και τεχνολογικά ιδρύματα της Ελλάδας. Η απορρόφηση της τεχνογνωσίας τους από τις ΜΜΕ (Μικρομεσαίες Επιχειρήσεις) και η εφαρμογή της στην πραγματική οικονομία μπορεί να επιφέρει σημαντικά αποτελέσματα, που θα οδηγήσουν στην ανάπτυξη της οικονομίας, ειδικά κατά την περίοδο της ελληνικής κρίσης χρέους. Επίσης, η διατριβή αναφέρεται στην ύπαρξη ενός ενδιάμεσου, μη κερδοσκοπικού φορέα, που με τη μορφή Venture Capital θα μπορούσε να διαδραματίσει έναν ιδιαίτερα σημαντικό ρόλο, καθώς θα αποτελούσε το συνδετικό κρίκο μεταξύ ακαδημαϊκού και επιχειρηματικού χώρου. Η εφαρμογή της προαναφερόμενης πρότασης προϋποθέτει όμως και την ύπαρξη ενός ξεκάθαρου κανονιστικού πλαισίου από πλευράς ελληνικού κράτους, έτσι ώστε να υπάρξει σταθερότητα της αναπτυξιακής πολιτικής και να μειωθούν στο ελάχιστο τα σημερινά σημαντικά εμπόδια που ανακόπτουν την ανάπτυξη κάθε είδους επιχειρηματικής πρωτοβουλίας, όπως για παράδειγμα η απουσία ενός σταθερού φορολογικού καθεστώτος, η σκιώδης οικονομία και η διαφθορά. Το πρώτο μέρος της παρούσας διδακτορικής διατριβής στηρίχθηκε σε επιστημονική βιβλιογραφία, ελληνική και ξένη, ενώ στο δεύτερο συμπεριλήφθηκε έρευνα πεδίου. Ακολουθήθηκε η διερευνητική μέθοδος, ενώ η έρευνα στον επιχειρηματικό χώρο ήταν ποσοτική, μέσω συστηματικής δειγματοληψίας και η συλλογή στοιχείων πραγματοποιήθηκε με τη μέθοδο αποστολής δομημένων ερωτηματολογίων. Επίσης, η βασική στατιστική μέθοδος στηρίχτηκε στην παραγοντική ανάλυση με τη χρήση του στατιστικού προγράμματος SPSS 22.0. Τη βάση δεδομένων αποτέλεσαν ο Ελληνικός Οικονομικός Οδηγός της ICAP 2012 και τα Επιμελητήρια.

Congenital malformations of the female genital tract affect 4-7% of the female population. They are mainly detected at reproductive age during the investigation for infertility. Accurate classification is vital for the effective management. In need of a more detailed description of these anomalies, clinical usefulness and simplicity ESHRE and ESGE introduced in 2013 the new classification system and further in 2016, at the Thessaloniki consensus they introduced guidance on proper diagnosis with the use of the available diagnostic procedures. In the current review the most important key points of both consensuses are described.

Study question What is the prevalence of leiomyosarcomas and atypical leiomyomas after laparoscopic morcellation of fibroids in reproductive age women? Summary answer No case of leiomyosarcomas but seven atypical leiomyomas were found in 1216 subjects. What is known already Although uterine sarcoma is a rare entity affecting usually older peri- or post-menopausal women, the Food and Drug Administration discourages use of laparoscopic power morcellation of uterine fibroids. Study design, size, duration Retrospective review of data extracted from a single center database of 1216 consecutive women who underwent laparoscopic morcellation of 2582 unsuspicious leiomyomas between June 2003 and December 2015 and were followed-up until December 2016. Participants/materials, settings, methods A total of 1216 women, aged 18-45 years, underwent laparoscopic morcellation of 2582 apparently benign leiomyomas by the same surgeon and all specimen slides were examined by the same experienced pathologist. Main results and the role of chance The prevalence of leiomyosarcomas and atypical leiomyomas was 0% (95% CI: 0-0.3%) and 0.6% (95% CI: 0.23-1.18%) (six atypical-bizarre and one mitotically active leiomyoma) respectively. In addition, there were identified 34 cases of adenomyomas, 45 leiomyomas with infarcts, 81 cellular leiomyomas and 133 degenerated leiomyomas. No morcellator-associated complication was recorded and none of the patients included in this study required conversion to laparotomy. Limitations, reasons for caution Retrospective and single referral center study design. Wider implications of the findings Laparoscopic morcellation of unsuspicious leiomyomas after careful preoperative work up seems to be safe in women of reproductive age. Study funding/competing interest(s) None.

Sex hormone-binding globulin (SHBG), androgen receptor (AR), LH beta polypeptide (LHB), progesterone receptor membrane component 1 (PGRMC1) and progesterone receptor membrane component 2 (PGRMC2) regulate follicle development and maturation. Their mRNA expression was assessed in peripheral blood mononuclear cells (PBMC) of normal and poor responders, during ovarian stimulation.Fifty-two normal responders and 15 poor responders according to the Bologna criteria were enrolled for IVF and intracytoplasmic sperm injection and stimulated with 200 IU of follitrophin alpha and gonadotrophin-releasing hormone antagonist. HCG was administered for final oocyte maturation. On days 1, 6 and 10 of stimulation, blood samples were obtained, serum hormone levels were measured, RNA was extracted from PBMC and real-time polymerase chain reaction was carried out to identify the mRNA levels. Relative mRNA expression of each gene was calculated by the comparative 2Differences between mRNA levels of each gene on the same time point between the two groups were not significant. PGRMC1 and PGRMC2 mRNA levels were downregulated, adjusted for ovarian response and age. Positive correlations between PGRMC1 and AR (standardized beta = 0.890, P0.001) from day 1 to 6 and PGRMC1 and LHB (standardized beta = 0.806, P0.001) from day 1 to 10 were found in poor responders. PGRMC1 and PGRMC2 were positively correlated on days 6 and 10 in normal responders.PGRMC1 and PGRMC2 mRNA are significantly decreased during ovarian stimulation, with some potential differences between normal and poor responders.

STUDY QUESTION Does pretreatment with transdermal testosterone increase the number of cumulus-oocyte complexes (COCs) retrieved by more than 1.5 in poor responders undergoing intracytoplasmic sperm injection (ICSI), using recombinant follicle stimulating hormone (FSH) and gonadotrophin releasing hormone agonists (GnRHa)? SUMMARY ANSWER Testosterone pretreatment failed to increase the number of COCs by more than 1.5 as compared with no pretreatment in poor responders undergoing ICSI (difference between medians: 0.0, 95% CI: -1.0 to +1.0). WHAT IS KNOWN ALREADY Androgens are thought to play an important role in early follicular development by enhancing ovarian sensitivity to FSH. In a recent meta-analysis, testosterone pretreatment resulted in an increase of 1.5 COCs as compared with no pretreatment. However, this effect was based on the analysis of only two randomized controlled trials (RCTs) including 163 patients. Evidently, there is a need for additional RCTs that will allow firmer conclusions to be drawn. STUDY DESIGN, SIZE, DURATION The present RCT was designed to detect a difference of 1.5 COCs (sample size required = 48 patients). From 02/2014 until 04/2015, 50 poor responders fulfilling the Bologna criteria have been randomized (using a randomization list) to either testosterone pretreatment for 21 days ( ITALIC! n = 26) or no pretreatment ( ITALIC! n = 24). PARTICIPANTS/MATERIALS, SETTING, METHODS All patients underwent a long follicular GnRHa protocol. Recombinant FSH stimulation was started on Day 22 following GnRHa initiation. In the testosterone pretreatment group, a daily dose of 10 mg of testosterone gel was applied transdermally for 21 days starting from GnRHa initiation. Results are expressed as median (interquartile range). MAIN RESULTS AND THE ROLE OF CHANCE No differences in baseline characteristics were observed between the two groups compared. Testosterone levels [median (interquartile range)] were significantly higher in the testosterone pretreatment on the day of initiation of FSH stimulation [114 (99.5) ng/dl versus 20 (20) ng/dl, respectively, ITALIC! P < 0.001]. Duration of FSH stimulation [median (interquartile range)] was similar between the groups compared [12.5 (3.0) days versus 12 (3.0) days, respectively, ITALIC! P = 0.52]. The number of COCs retrieved [median (interquartile range)] was not different between the testosterone pretreatment and the no pretreatment groups [3.5 (4.0) versus 3.0 (3.0), 95% CI for the median: 2.0-5.0 versus 2.7-4.3, respectively; difference between medians: 0.0, 95% CI: +1.0 to -1.0). Similarly no differences were observed regarding fertilization rates [median (interquartile range)] [66.7% (32.5) versus 66.7% (42.9), respectively, ITALIC! P = 0.97] and live birth rates per randomized patient (7.7% versus 8.3%, respectively, rate difference: -0.6%, 95% CI: -19.0 to +16.9). LIMITATIONS, REASONS FOR CAUTION The study was not powered to detect differences less than 1.5 COCs, although it is doubtful whether these differences would be clinically relevant. Moreover, due to sample size restrictions, no conclusions can be drawn regarding the probability of live birth. WIDER IMPLICATIONS OF THE FINDINGS The results of this randomized clinical trial, suggesting that pretreatment with 10 mg of transdermal testosterone for 21 days does not improve ovarian response by more than 1.5 oocytes, could be used to more accurately consult patients with poor ovarian response. However, an improvement in IVF outcome using a higher dose of testosterone or a longer pretreatment period cannot be excluded. STUDY FUNDING/COMPETING INTEREST The study was partially funded by a Scholarship from the Academy of Athens. C.A.V. reports personal fees and non-financial support from Merck, Sharp and Dome, personal fees and non-financial support from Merck Serono, personal fees and non-financial support from IPSEN Hellas S.A., outside the submitted work. B.C.T. reports grants from Merck Serono, grants from Merck Sharp & Dohme, personal fees from Merck Serono, personal fees from Merck Sharp & Dohme, personal fees from IBSA & Ferring, outside the submitted work. TRIAL REGISTRATION NUMBER NCT01961336. TRIAL REGISTRATION DATE 10 October 2013. DATE OF FIRST PATIENT'S ENROLLMENT 02/2014.

The aim of this working paper is to present the valuable role of Venture Capital Organization which can be a “guarantee” for the collaboration between Small and Medium Enterprises (SMEs) and Universities. In case SMEs want to absorb university know-how so as to implement it in the real market with the aim to be self-sponsored, a Venture Capital Organization is absolutely necessary,given that the business and academic site have many different features, and as a result, serious problems arise many times in their collaboration. A questionnaire has been made and through personal interviews with businessmen and professorsresearchers we may now present the data from 150 answered (108 from businessmen and 42 from professors-researchers). The main conclusion is that an organization Venture Capital is considered innovative and indispensable so as the collaboration between SMEs and Universities continues through the time without any problems.

Sao Paulo State Univ UNESP, Ctr Human Reprod Prof Franco Jr, Paulista Ctr Diag Res & Training, Dept Gynecol & Obstet,Botucatu Med Sch, Ribeirao Preto, Brazil

Aim: To investigate a possible relationship between tibolone therapy and recurrence or mortality in breast cancer survivors. Methods: In a retrospective study, data from files of 247 patients who had been treated for breast cancer were analyzed. Twenty women were treated with tibolone because of menopausal symptoms (Group 1: mean duration of tibolone use 37.1 months). One hundred and one women who did not take tibolone were selected as the control group (Group 2). All women were followed up in our Department on our standard protocol (mean follow up: 73.4 months in Group 1, 67.4 months in Group 2). Comparison of the survival curves was applied with the Wilcoxon (Gehan) statistic. Cox regression analysis was also applied in order to identify significant coefficients in the survival curve. Results: Recurrence of breast cancer was observed in two (10%) Group 1 women versus 21 (21%) Group 2 women (P = NS). Two Group 1 women died (one from breast cancer recurrence) versus 15 Group 2 women (14 from breast cancer recurrence). Conclusions: Despite of the inherent limitations of this small retrospective study, it seems that tibolone does not reveal an apparent negative impact on breast cancer outcome when given to breast cancer survivors.