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While most studies focused on the association between the number of oocytes retrieved and LBR, there is lack of analysis highlighting the effect of the number of oocyte retrieved on top quality embryo (TQE) rate in different age groups. We aimed to study the correlations between the number and ratio of TQE, as assessed by morphology only, according to the number of oocytes retrieved, and to evaluate the impact of patients' age. This was a retrospective study that includes 1639 patients who underwent 2263 IVF cycles between 2016 and 2019. Patients were categorized into four groups according to the number of oocytes retrieved: 1-3, 4-9, 10-14, or > 15 oocytes (OPU groups A-D, respectively). Another classification was according to patient's age < 35, 35-40, and > 40 years. Morphologically, TQE (both cleavage stage and blastocyst) was defined as those eligible for transfer or vitrification. TQE was assessed both as a fraction of oocytes retrieved per patients (rate) and the average TQE per number oocytes retrieved category. For all age subgroups, a negative significant association was observed between the number of oocytes retrieved and TQE rate (56.1%, 43.6%, 35.9%, and 34.3% for groups A-D, respectively). The reduction was significant up to 14 oocytes retrieved and plateau thereafter. On the other hand, TQE rate was significantly increased as women age increased, from 36.1% TQE rate in young women (< 35 years) to 40.3% for 35-40 years to 42.5% in older patients (> 40 years). Finally, a linear regression revealed a drop in TQE rate of - 0.5% for every oocyte retrieved, while an increased in TQE rate of + 0.7%, as the women age increased by 1 year. While young women are able to recruit more oocyte, including medium/low quality, older women recruit less oocytes, with good quality, as demonstrated by their higher morphologically TQE rate relative to the number of oocyte retrieved.

We sought to compare ICSI outcomes of cycle using fresh versus thawed TESE spermatozoa obtained during the previous fresh TESE. All consecutive couples undergoing ICSI cycles using fresh TESE spermatozoa, followed by ICSI cycle using cryopreserved sperm remaining from the previous fresh TESE procedure were included. Ovarian stimulation (OS)/laboratory variables and cycle outcome were assessed and compared between those utilising fresh versus thawed TESE spermatozoa. Seventy-five couples were evaluated, with no in-between groups differences in OS nor embryological variables. While implantation and LBR per embryo transfer were nonsignificantly higher in the frozen as compared to the fresh TESE, there was a trend towards higher LBRs per patient in the frozen TESE group. The cumulative miscarriage rate (4% versus 14.7%, p < .022 respectively) was significantly lower and the cumulative LBR (34.7% versus 16%, p < .007 respectively) was significantly higher using frozen TESE spermatozoa. Moreover, significantly higher proportion of frozen TESE sperm samples used pentoxifylline to enhance sperm motility. In conclusion, the results of ICSI cycles using frozen TESE spermatozoa are as good, or even better than using fresh TESE spermatozoa. Further studies are required to explore the factors responsible for the improved ICSI outcome, while using frozen versus fresh TESE sperm samples., (© 2020 Wiley-VCH GmbH.)

We aim to evaluate our experience, comparing intracytoplasmic sperm injection (ICSI) outcomes of cycle using fresh versus thawed electroejaculated spermatozoa. All consecutive couples undergoing ICSI cycles using electroejaculated spermatozoa, during a 16-year period, were evaluated. Embryological/laboratory variables of the ICSI cycles were assessed and compared between those utilising fresh (fresh group) versus thawed (thawed group) electroejaculated spermatozoa. Fifty-seven couples were evaluated, 30 used a fresh electroejaculated spermatozoa in 55 ICSI cycles, while 27 used a thawed sperm sample in 41 ICSI cycles. There were no in-between group differences in the mean numbers of oocytes retrieved per oocyte retrieval nor the percentage of MII oocytes. The fresh group demonstrated significantly higher fertilisation (71.5% vs. 64.1%, respectively, p < .05), top-quality embryos (66.5% vs. 54.9%, respectively, p < .02), clinical pregnancy per transfer (41.3% and 21.2%, respectively, p < .05) and cumulative clinical pregnancy (58.2% vs. 26.8%, respectively, p < .001) rates, as compared to the thawed group. Independent of the source of spermatozoa used, no pregnancy was achieved following ICSI utilising immotile spermatozoa. In conclusion, ICSI cycles using ejaculated spermatozoa of patients suffering from neurologic or psychogenic anejaculation are reassuring. The use of fresh ejaculated spermatozoa retrieved on the day of the female spouse oocyte retrieval might improve outcome. Whenever a thawed electroejaculated spermatozoa yield no motile spermatozoa, emergency electroejaculation is mandatory., (© 2020 Blackwell Verlag GmbH.)

Purpose: Class II dento-facial deformity due to inferior alveolar retrusion may be difficult to treat using conventional surgical procedures. The aim of this study was to report on total mandibular subapical osteotomy (TMSO) to correct inferior alveolar retrusion, to describe its indications, the surgical technique and to analyse the aesthetic, occlusal changes and stability., Materials and Methods: Patients treated with TMSO from January 2004 to December 2014 were included and analysed retrospectively. Delaire's cephalometric analysis was performed before surgery and one year after surgery. Skeletal, occlusal and soft tissue changes were measured comparing lateral cephalographs before and after surgery., Results: From January 2004 to December 2014, 8 patients were treated by TMSO. Six patients were analysed and presented a stable class I occlusion 3 years after surgery with an improvement of the labio-mental sulcus. Mean position of the dental apex of the inferior central incisor (ia) before surgery was -8.5mm corresponding on an inferior alveolar retrusion of -8.5mm. After surgery, mean ia position was -0.25mm showing an average of alveolar advancement of 8.25mm. Regarding the soft tissues movements, the mean labio-mental angle showed a variation from 84.7° to 120.3°, and the deepest point of the labio-mental sulcus (Mli) was advanced with a mean of 9.22mm corresponding to the bone movements., Conclusion: Total mandibular subapical osteotomy may be considered as a stable, safe and ideal procedure for patients having a class II deformity, due to a total inferior alveolar retrusion without mandibular retrognathism, improving labio-mental sulcus and chin shape., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

The treatment of malocclusions can involve orthognathic surgery. Although orthognathic surgery is a safe surgical procedure, low incidences of many complications have been reported such as infections, hemorrhage, nerve injuries, temporomandibular disorders (TMDs), and psychological problems. There are no reports in the literature of orthognathic surgery being associated with postural disorders although the link between dental occlusion and postural disorders is highlighted in numerous recent publications. This report describes the case of a young, healthy patient who presented with sustained spasmodic torticollis following orthognathic surgery. In addition, the physiopathological aspects of this atypical condition are discussed., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Background: Marked class II dentofacial deformity associated with centrofacial protrusion may be difficult to treat successfully. The purpose of this article was to report on Le Fort II setback osteotomy (LIISBO) to correct Naso-Ethmoido-Maxillary Protrusion (NEMP), to describe its indications and surgical techniques, and to analyze aesthetic and occlusal changes., Materials and Methods: From November 2011 to November 2014, patients with NEMP, treated with LIISBO, were included in the study. Cephalometric analysis of Delaire was performed before and 1 year after surgery. Skeletal and soft tissues movements were measured between preoperative and postoperative lateral cephalographs., Results: Fourteen patients were treated in our department by LIISBO. Ten patients were analyzed and presented a stable class I occlusion with reliable aesthetic results. The mean maxillary setback was -2.8 mm at nasopalatal point (Np), -3.1 mm at A point, and -3.7 mm at Pti (inferior pterygomaxilar point). The mean maxillary impaction was -2.4 mm at Np, -3 mm at A point, and -0.6 mm at Pti. The B, mental, and pogonion points showed an advancement with an average of +7.4, +7.9, and +7.7 mm, respectively. Measured soft tissues variations showed a backward movement of the nasal tip, the subnasal point, and the upper lip of -1.5, -1.6, and -0.7 mm, respectively. The lower lip, sublabial point, and the skin pogonion were advanced by +3.2, +5.4, and +6.2 mm, respectively., Conclusions: Le Fort II setback osteotomy may be regarded as the ideal treatment for adult patient presenting a NEMP syndrome.

Almost 2 decades ago, the senior author's (M.T.J.) first article was with our mentor, Dr Leonard B. Kaban, a review article titled "Distraction Osteogenesis: Past, Present, Future." In 1998, many thought it would be impossible to have a remotely activated, small, curvilinear distractor that could be placed using endoscopic techniques. Currently, a U.S. patent for a curvilinear automated device and endoscopic techniques for minimally invasive access for jaw reconstruction exist. With minimally invasive access for jaw reconstruction, the burden to decrease donor site morbidity has increased. Distraction osteogenesis (DO) is an in vivo form of tissue engineering. The DO technique eliminates a donor site, is less invasive, requires a shorter operative time than usual procedures, and can be used for multiple reconstruction applications. Tissue engineering could further reduce morbidity and cost and increase treatment availability. The purpose of the present report was to review our experience with tissue engineering of bone: the past, present, and our vision for the future. The present report serves as a tribute to our mentor and acknowledges Dr Kaban for his incessant tutelage, guidance, wisdom, and boundless vision., (Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Purpose: Deep bone penetration into implanted scaffolds remains a challenge in tissue engineering. The purpose of this study was to evaluate bone penetration depth within 3-dimensionally (3D) printed β-tricalcium phosphate (β-TCP) and polycaprolactone (PCL) scaffolds, seeded with porcine bone marrow progenitor cells (pBMPCs), and implanted early in vivo., Materials and Methods: Scaffolds were 3D printed with 50% β-TCP and 50% PCL. The pBMPCs were harvested, isolated, expanded, and differentiated into osteoblasts. Cells were seeded into the scaffolds and constructs were incubated in a rotational oxygen-permeable bioreactor system for 14 days. Six 2- × 2-cm defects were created in each mandible (N = 2 minipigs). In total, 6 constructs were placed within defects and 6 defects were used as controls (unseeded scaffolds, n = 3; empty defects, n = 3). Eight weeks after surgery, specimens were harvested and analyzed by hematoxylin and eosin (H&E), 4',6-diamidino-2-phenylindole (DAPI), and CD31 staining. Analysis included cell counts, bone penetration, and angiogenesis at the center of the specimens., Results: All specimens (N = 12) showed bone formation similar to native bone at the periphery. Of 6 constructs, 4 exhibited bone formation in the center. Histomorphometric analysis of the H&E-stained sections showed an average of 22.1% of bone in the center of the constructs group compared with 1.87% in the unseeded scaffolds (P < .05). The 2 remaining constructs, which did not display areas of mature bone in the center, showed massive cell penetration depth by DAPI staining, with an average of 2,109 cells/0.57 mm(2) in the center compared with 1,114 cells/0.57 mm(2) in the controls (P < .05). CD31 expression was greater in the center of the constructs compared with the unseeded scaffolds (P < .05)., Conclusion: 3D printed β-TCP and PCL scaffolds seeded with pBMPCs and implanted early into porcine mandibular defects display good bone penetration depth. Further study with a larger sample and larger bone defects should be performed before human applications., (Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Naso-ethmoido-maxillary protrusion (NEMP) is a rare dental and facial dysmorphosis, with excessive growth of basicranium, ethmoid, maxillary, and nasal bones. The clinical presentation includes nasal and upper lip protrusion, telecanthus, a class 2 malocclusion with maxillary protrusion and exoclusion. The craniofacial field is increased in Delaire's analysis. Contrary to isolated maxillary protrusion secondary to membranous ossification dysfunction, NEMP is a constitutional anomaly resulting from an excessive primary growth of the chondrocranium. The therapeutic management of NEMP should take into account these specificities., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Follicular development and ovulation are major processes in the reproductive system. Understanding their complexity is important to female fertility treatments and the control of reproductive processes. Wnt signaling pathway components were shown to be involved in reproduction in animal models. The secreted frizzled-related protein-4 (sFRP4), a potential modulator of Wnt4 signaling pathway, was shown to be induced by LH in rodents and expressed in the corpus lutea, but the pattern of its expression in human ovaries remains unknown. We evaluated the expression pattern of sFRP4 and other sFRP family members in human mural and cumulus granulosa cells (GCs), as well as their regulation by LH/hCG. GCs were obtained from follicles aspirated during in vitro maturation and IVF procedures. GCs were also plated and grown in culture. We showed that the human sFRP4 expression decreases as follicles grows to the preovulatory stage and its expression was higher in cumulus GCs than in mural GCs. Interestingly, LH/hCG stimulation of GCs in vivo and in culture resulted in decreased expression of sFRP4. Of the other sFRP family members, sFRP5 expression was found in mural and cumulus GC in vivo and was shown to be induced by LH/hCG in vitro and in vivo. In summary, sFRP4 is expressed in human GCs and its expression declines during late antral follicular growth. sFRP4 expression is also inhibited by LH/hCG, unlike its rodent homolog. In human GC, sFRP5 may substitute the role of sFRP4 in mouse GC.

ADAM-metallopeptidase with thrombospondin type 1 motifs-1 (ADAMTS-1) null female mice show impaired follicular development and ovulatory processes. However, ADAMTS-1 expression and function in human normal ovulation and folliculogenesis have not yet been determined. The objective of this study is to study the expression patterns of ADAMTS-1 in human granulosa cells (GCs) obtained from follicles aspirated during in vitro maturation (IVM) and in vitro fertilization (IVF) procedures. We found that ADAMTS-1 expression is a luteinizing hormone/human chorionic gonadotropin (LH/hCG)-induced gene whose expression in the mural GCs directly correlated with antral follicular growth. Interestingly, we were able to show a significant correlation between ADAMTS-1 expression in cumulus cells and the fertilization capacity of the related oocyte. In conclusion, human ADAMTS-1 is an ovulatory gene and its expression is LH/hCG- and follicle-size dependent. The correlation between its expression in cumulus GCs and oocyte fertilization capacity suggests a role for ADAMTS-1 in human cumulus function., (Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.)