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March 7, 2002 Vol. 346 No. 10
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Intracytoplasmic sperm injection and in vitro fertilization are being used increasingly to treat infertility. It is not known whether infants conceived with these types of technology have a higher risk of birth defects than infants conceived naturally. This study found that infants conceived with intracytoplasmic sperm injection or in vitro fertilization had a risk of a major birth defect diagnosed by one year of age that was twice as high as that in naturally conceived infants. These increased risks persisted after adjustment for potentially confounding factors and did not appear to be attributable to increased surveillance for birth defects among these infants.
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The increased risk of low birth weight among infants conceived with assisted reproductive technology has been attributed in large part to the higher rate of multiple gestations associated with this technology. This study used population-based data to compare the rates of low birth weight in infants from singleton and multiple gestations conceived with this technology with the rates in the general population. Infants conceived with assisted reproductive technology accounted for 0.6 percent of all infants born in the United States to mothers 20 years of age or older in 1997, but they accounted for 3.5 percent of low-birth-weight and 4.3 percent of very-low-birth-weight infants.
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Male cells were sought in biopsy specimens of liver, skin, and gastrointestinal tract from six women who received a transplant of peripheral-blood stem cells from a brother. In all three types of tissue, small numbers of epithelial cells or hepatocytes containing the Y chromosome were seen. With double staining, cytokeratin (a marker of epithelial cells) and the Y chromosome appeared to be present in the same cell.
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This report describes four patients with pneumococcal pneumonia in whom empirical treatment with levofloxacin failed. In these patients, the isolates of Streptococcus pneumoniae were resistant to levofloxacin, and in two of them the resistance appeared to have been acquired during the current course of treatment with fluoroquinolones.
At birth this baby girl was found to have left pneumohydrothorax and marked pulmonary hypoplasia that was treated with mechanical ventilation. After continued deterioration, she received high-frequency oscillatory ventilation. Her intraarterial pressure wave form dampened, and surgical exploration revealed air, but no blood, in the carotid artery.
The antiphospholipid syndrome is an autoimmune disorder of hypercoagulability characterized by the presence of autoantibodies to various phospholipids or phospholipid-binding proteins. The autoantibodies include anticardiolipin antibodies, lupus anticoagulant antibodies, and antibodies to β2-glycoprotein I (a phospholipid-binding protein). These autoantibodies have both procoagulant and anticoagulant effects, but the procoagulant effects predominate, resulting in syndromes of venous and arterial thrombosis and pregnancy loss.
Ooplasmic transfer is a novel approach to the treatment of infertility due to recurrent failure of oocyte implantation after in vitro fertilization. To restore oocyte viability, ooplasm from a normal donor is removed with a micropipette and injected into an oocyte from the infertile woman. The resulting oocyte, which is fertilized by intracytoplasmic sperm injection, contains mitochondrial DNA from both women. The author discusses the potential benefits and risks, as well as the ethical aspects, of this new approach to the treatment of infertility.
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