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Altered male: female ratio
• Chang (2009) reported a male : female ratio of 1.29 (95% CI 1.10 – 1.51).
• Several reports suggested the same findings.
Reasons of adverse perinatal outcome
• A possible explanation could be that extended culture may trigger genetic and epigenetic changes in trophodermal cells that can lead to abnormal placentation and implantation.
(Rizos et al., 2002)
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