1/591. Rare delivery complication caused by an undiagnosed uterine septum. The role of a uterine septum, and thus, metroplasty in an infertile woman is a debatable issue. A rare complication of fetal malpresentation and impaction in the uterine cavity due to undiagnosed uterine septum in a 24-year-old primigravida who conceived after 3 years of primary infertility is reported. This case highlights that uterine anomalies should be looked for in patients with infertility and reproductive failures, and should be corrected before conception by metroplasty in order to improve reproductive outcome. ( info) |
2/591. Endometrial ossification associated with secondary infertility. A patient with secondary infertility and endometrial ossification after a spontaneous is described. The aetiology and pathogenesis of endometrial ossification are discussed. ( info) |
3/591. A new approach to hysteroscopic cannulation of the fallopian tube. Hysteroscopic cannulation of the fallopian tube has become an essential part of the treatment of interstitial fallopian tube obstruction. This report describes the use of a flexible instrument that can be introduced through a rigid hysteroscope for the purpose of hysteroscopic tubal cannulation. ( info) |
4/591. Diagnostic difficulty in polycystic ovary syndrome due to an LH-beta-subunit variant. We initially failed to confirm a case of polycystic ovary syndrome (PCOS) because underestimation of LH concentrations due to a variant form of this hormone resulted in a misleadingly low LH/FSH ratio. A 26-year-old woman presented to our hospital with infertility. Given the presence of bilateral polycystic ovaries, oligomenorrhea and hirsutism. PCOS was suspected, but a normal LH/FSH ratio as measured by RIA led to diagnostic problems. When we remeasured LH and FSH using a chemical luminescence enzyme immunoassay (CLEIA), the ratio of the LH concentration measured by RIA to that measured by CLEIA was 0.29, and the ratio of LH to FSH measured by CLEIA was 3.3 compared with 0.81 measured by RIA. We then diagnosed PCOS. The point mutations Trp8 to Arg8 and Ile15 to Thr15 in the LH subunit were detected in the corresponding gene. The patient's LH status represented variant and wild-type LH equally. She was therefore diagnosed as heterozygous for the mutant LH-beta. Histologic assessment of ovarian tissue after laparoscopic biopsy was compatible with a polycystic ovary. ( info) |
5/591. Hysteroscopic cervical canal shaving: a new therapy for cervical stenosis before embryo transfer in patients undergoing in vitro fertilization. OBJECTIVE: To report a case of cervical stenosis repaired by hysteroscopic cervical shaving that created a smooth passage for ET in a patient undergoing IVF. DESIGN: Case report. SETTING: University-based IVF program. PATIENT(S): A woman with a history of multiple failed IVF attempts in whom ET was extremely difficult. INTERVENTION(S): Operative hysteroscopy with creation of a cervical tract. MAIN OUTCOME MEASURE(S): Ease of postoperative ET and outcome of IVF treatment after the hysteroscopic procedure. RESULT(S): Easy performance of ET and a resulting triplet pregnancy. CONCLUSION(S): This novel hysteroscopic repair of cervical stenosis resulted in a markedly easier ET and a viable pregnancy. ( info) |
6/591. Triplet pregnancy in a subfertile woman treated with clomiphene citrate. A 26-year-old subfertile woman with a history of abortions at the 7-9th week was treated with Clomid, 50 mg for 5 days. A pregnancy resulted, which ended in the premature birth of a set of alive triplets that sex and blood-group determinations showed to be trizgotic. It is suggested that this production of a multiple ovulation in a woman with luteal deficiency be the result of excessive dosage of Clomid. ( info) |
7/591. A new case of NSAID-induced infertility. A 38-year-old woman on piroxicam for hip osteoarthritis secondary to hip dysplasia developed secondary sterility. Ova collected for in vitro fertilization were immature and failed to fertilize. A further attempt done after piroxicam discontinuation produced seven mature ova that fertilized, allowing embryo implantation. Nonsteroidal antiinflammatory drugs may induce infertility by reducing the production of prostaglandins, most notably via inhibition of the enzyme cyclooxygenase 2. The impact of nonsteroidal antiinflammatory drug therapy on reproductive function needs to be evaluated. ( info) |
8/591. Long-term consequences following conservative management of epithelial ovarian cancer in an infertile patient. A 35-year-old woman with primary infertility underwent an ovarian cystectomy for a 5 x 4 cm left adnexal mass. There was no macroscopic evidence of metastatic disease. The final pathology report revealed a poorly differentiated serous cystadenocarcinoma. Because the patient desired to retain child-bearing capacity, she refused a surgical staging of her ovarian cancer. She elected to receive combination chemotherapy. This was then followed by a negative reassessment laparotomy. The patient was diagnosed with recurrent, metastatic ovarian carcinoma 10 years later. ( info) |
9/591. pregnancy following the laparoscopic bipolar electrocoagulation of polycystic ovaries resistant to medicamentous ovulation induction--a case report. The case of a primarily infertile patient with polycystic ovaries (PCOS) resistant to medicamentous ovulation induction is presented. The preoperative condition, laparoscopic ovarian drilling using an original technique of bipolar electrocoagulation and consecutive spontaneous pregnancy and delivery are described. This case suggests that bipolar forceps with jaws 1 mm wide could be a useful instrument for laparoscopic ovarian drilling. ( info) |
10/591. Large empty sella with an intrasellar herniation of an elongated third ventricle. Case report. A 73-year-old female presented with a large empty sella with herniation of an elongated third ventricle concomitant with herniation of the surrounding subarachnoid space into the sella, manifesting as visual impairment and amenorrhea without galactorrhea. magnetic resonance imaging and computed tomography cisternography clearly showed the large empty sella, without evidence of either hydrocephalus or benign intracranial hypertension, which is extremely rare. ( info) |