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Herlyn-Werner-Wunderlich syndrome is characterized by a triad of uterine didelphys, obstructed hemivagina, and ipsilateral renal agenesis. The syndrome should be suspected in any young woman with abdominal pain or cyclic dysmenorrhea, and radiologic evidence of müllerian duct and renal anomalies. Herein is presented the case of a 25-year-old woman with a rare variant of Herlyn-Werner-Wunderlich syndrome, characterized by an anomalous connection between the 2 endocervical canals, who underwent hemivaginal septum resection to relieve progressively worsening dysmenorrhea. The right hemivaginal septum was resected medially from the left cervix and laterally off the right vaginal wall. Hydrodissection between the hemivaginal septum and right cervix facilitated surgical resection. After resection of the hemivaginal septum there was complete resolution of dysmenorrhea and no recurrence of hematometra or hematocolpos.

Objective To determine any beneficial effects of preimplantation genetic screening (PGS) of all chromosomes by array comparative genomic hybridization (aCGH), with either day 3 or blastocyst biopsy, for idiopathic recurrent pregnancy loss (RPL) patients compared with their expected loss rate. Design Case series report. Setting Multiple fertility centers. Patient(s) A total of 287 cycles of couples with idiopathic RPL (defined as two or more losses). Intervention(s) PGS was done with day 3 biopsy (n = 193) or blastocyst biopsy (n = 94), followed by analysis with aCGH. Main Outcome Measure(s) Spontaneous abortion rate, euploidy rate. Result(s) A total of 2,282 embryos were analyzed, of which 35% were euploid and 60% were aneuploid. There were 181 embryo transfer cycles, of which 100 (55%) became pregnant with an implantation rate of 45% (136 sacs/299 replaced embryos) and 94 pregnancies (92%) were ongoing (past second trimester) or delivered. The miscarriage rate was found to be only 6.9% (7/102), compared with the expected rate of 33.5% in an RPL control population and 23.7% in an infertile control population. Conclusion(s) Current PGS results with aCGH indicate a significant decrease in the miscarriage rate of idiopathic RPL patients and high pregnancy rates. Furthermore, this suggests that idiopathic recurrent miscarriage is mostly caused by chromosomal abnormalities in embryos.

OBJECTIVE: To determine if vitrification (Vit) can provide improved survival and pregnancy rates compared to a modified slow freeze protocol that had proven very successful for 2PN and multi-cell embryos over the years. DESIGN: Prospective comparison with Vit. performed 3 set days each week vs. 4 for slow freeze. MATERIALS AND METHODS: Vit. protocol: Irvine media, 6-10 minutes in equilibration solution and 90 seconds in vitrification solution at room temperature then loaded onto High security vitrification (HSV) highsecurity straw in

blastocyst biopsy. The practice of biopsying all non-arrested D5 embryos provides the opportunity to have genetic information on all embryos eligible for fresh transfer on D6, potentially adding to the pool of embryos available for transfer. Biopsy of non-arrested D5 embryos may also avoid the need to cryopreserve developmentally competent embryos without ploidy information at the time of transfer.

Purpose A laser is commonly used to remove a blastomere from an embryo for genetic testing. The laser uses intense heat which could possibly disrupt embryo development. It is the goal of this study to test the effects of different laser pulse lengths (and consequently heat) on the embryo biopsy procedure and embryo development. Methods Each embryo biopsy was performed randomly utilizing laser pulse lengths of 0.604mS (group I), 0.708mS (group II), and 1.010mS (group III). Results For groups I, II, and III, 83, 86, and 71 embryos were biopsied, respectively. There was no difference in day 5 embryoqualityorlysedblastomeresbetweengroups.Average number of blastomeres biopsied between group I (1.0±0.0), II (1.0±0.2), and III (1.1±0.2) was significant (0.0001). Conclusion Our data demonstrates that laser pulse length does not influence the embryo biopsy procedure or embryo development.