Cases reported "Anovulation"

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1/10. Anovulatory infertility: a report of four cases and literature review.

    Four cases of anovulatory/dysovulatory infertility encountered in Ilorin, nigeria are presented and the literature extensively reviewed on the up-to-date management of this aspect of infertility. All the patients had bilateral tubal patency on hysterosalpingography (HSG) and their husbands had normal seminal fluid analysis. The first case, 30 years of age, had hyperprolactinaemia with galactorrhoea, treated with bromocriptine given 2.5 mg twice daily. Another case, aged 27 years, had polycystic ovarian syndrome with hyperprolactinaemia but no galactorrhea This was treated with clomiphene citrate 100 mg daily. The third case, 34 years old, had hypothyroidism with hyperprolactinaemia and galactorrhea and was treated with thyroxine. The last case, aged 32 years, had hyperprolactinaemia and was treated with bromocriptine and clomiphene citrate. None of the patients had demonstrable pituitary adenoma. After the appropriate treatment, ovulatory menses were restored in all the patients; two have been pregnant, while the other two have not yet achieved pregnancy but have having regular ovulatory menses. All the patients are Nigerians.
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ranking = 1
keywords = polycystic
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2/10. Quintuplet pregnancy and third degree ovarian hyperstimulation despite withholding human chorionic gonadotrophin.

    A patient who suffered from polycystic ovarian disease and anovulation, was treated with pure follicle stimulating hormone for induction of ovulation. The treatment was stopped and human chorionic gonadotrophin was not administered because of high serum oestradiol levels and multiple follicular development. Ovulation occurred 11 days after pure follicle stimulating hormone was discontinued, the patient developed third-degree ovarian hyperstimulation syndrome and conceived with a quintuplet pregnancy.
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ranking = 1
keywords = polycystic
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3/10. A syndrome of hyperandrogenism, insulin resistance, and acanthosis nigricans associated with polycystic ovary syndrome: clinical and laboratory features.

    We describe an adolescent Japanese girl with acanthosis nigricans and irregular anovulatory menstruation following menarche. serum LH levels were elevated, whereas serum FSH levels were within normal range. An exaggerated response to LHRH was observed. Further, serum androstenedione levels were markedly elevated. Ultrasonogram revealed bilateral polycystic changes of ovaries. She had a mild degree of insulin resistance. Insulin binding studies using erythrocytes demonstrated a decreased binding capacity of insulin. From the above findings, this patient presents the syndrome consisting of hyperandrogenism, insulin resistance, and acanthosis nigricans and also has clinical and biochemical features compatible with polycystic ovary syndrome.
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ranking = 533.54435189121
keywords = polycystic ovary syndrome, ovary syndrome, polycystic ovary, polycystic, ovary
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4/10. acanthosis nigricans in a patient with streak gonads.

    acanthosis nigricans (ACN) is associated with ovarian disorders or abnormalities of carbohydrate metabolism. We saw a 21-year-old woman who had primary amenorrhea and ACN. Results of endocrine studies showed anovulation and low serum estradiol levels with increased gonadotropin concentrations. Laparoscopic examination disclosed bilateral streak gonads; the ovaries were completely replaced by fibrous tissue. Cultures of peripheral lymphocytes, skin fibroblasts, and the right and left ovaries demonstrated normal female karyotype 46XX in all mitoses studied. An autoimmune disorder was excluded by the absence of antithyroid and antiadrenal antibodies. Specific antibodies against ovarian proteins were also absent. A glucose tolerance test demonstrated fasting hyperinsulinemia and exaggerated serum insulin response to the glucose load. The observations in this patient exclude a primary pathogenic role for the ovary in the production of ACN; they also lend further support to a connection between the cutaneous disorder and insulin resistance.
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ranking = 0.1240453534404
keywords = ovary
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5/10. A new therapeutic method for climacteric disorders.

    At the present time the administration of an exogeneous estrogen for the treatment of climacteric disorders is generally accepted both in japan and foreign countries. However, there have been several reports to show that estrogen will promote carcinogenecity. With special attention to this point, the author performed the endocrinological treatment without estrogen for climacteric disorders. The author would like to propose the reactivation method on functionally declining ovary by the approach of induction of ovulation. In this paper the author describes a successful case treated by the new method of hormone therapy.
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ranking = 0.1240453534404
keywords = ovary
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6/10. anovulation presumably due to the gonadotrophin-resistant ovary syndrome.

    The clinical syndrome of the resistant ovary is described in a 24-yr-old woman (XX genotype) with secondary amenorrhea and primary infertility. She presented an increased secretion of gonadotrophins with a decreased secretion of estrogens. In the ovarian tissue only primary ovarian follicles and a thickened tunica albuginea were found. The elevated serum gonadotrophins could be further increased by the administration of exogenous LHRH and incompletely suppressed by exogenous estrogens (50 micrograms ethynylestradiol daily). However, serum LH concentration started with a further rise (positive feedback?) during this estrogen administration. Results of treatment with Cyclocur and ethynylestradiol (100 micrograms daily) in higher dosages are presented. Following discontinuation of the estradiol therapy regular menses resumed, which became ovulatory. The patient became pregnant 23 months after stopping the estradiol therapy.
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ranking = 137.78917444814
keywords = ovary syndrome, ovary
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7/10. Reversal of persistent anovulation in polycystic ovarian disease by administration of chronic low-dose follicle-stimulating hormone.

    Low doses of follicle-stimulating hormone (FSH) were administered once daily to two consecutive patients with polycystic ovarian disease (PCOD) for therapy of infertility. Serial blood samples were obtained for gonadotropins and ovarian steroid determinations during the period of FSH administration. Exogenous FSH resulted in an initial and concomitant decrease in serum androstenedione (A), estrone (E1), and luteinizing hormone (LH), with an increase in estradiol (E2) and FSH. Subsequent changes in the above-mentioned hormonal levels were typical of a normal ovulatory cycle, with the exception of FSH, which continued to rise in the second half of the follicular phase. This was attributed to the exogenous administration of FSH. Both patients became pregnant in their first induced ovulatory cycle by administration of chronic low-dose FSH. These preliminary data demonstrate (1) a correction of the biochemical imbalance characteristic of PCOD, (2) successful ovulation induction, and (3) restoration of fertility in PCOD treated with chronic low-dose FSH.
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ranking = 5
keywords = polycystic
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8/10. Sclerosing stromal tumor of the ovary.

    This case study of a sclerosing stromal tumor of the ovary in a 29-year-old woman demonstrates that the tumor was a functioning lesion that secreted estradiol, progesterone, and testosterone. Clinically, there was anovulation with resultant infertility, which was resistant to therapy with clomiphene citrate. Removal of the tumor was followed by reversal of these abnormalities.
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ranking = 0.62022676720198
keywords = ovary
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9/10. Two cases of ovarian tumours in women who had undergone multiple ovarian stimulation attempts.

    Concerns have been raised recently about the possible association between superovulation and ovarian cancer. In order to contribute to the limited literature on this important issue, two cases of ovarian tumours in women who had undergone multiple ovulation inductions are presented. In the first case, the patient had secondary anovulatory infertility. She was treated with human menopausal gonadotrophin (HMG) alone and in combination with clomiphene citrate or buserelin for six cycles. She then underwent ovarian stimulation with buserelin/HMG in the long protocol for in-vitro fertilization (IVF) and embryo transfer. In preparation for a new IVF/embryo transfer attempt, 8 months later, the screening ultrasound revealed a cystic formation of the left ovary and an enlargement of the right. During laparotomy, both ovaries were found to bear large tumours (approximately 6 x 5 x 4 cm) which were removed. Histological examination showed that they were epithelial tumours (serous-papillary cystadenomas) of borderline malignancy. The patient conceived spontaneously 1.5 years after the operation. In the second case, the patient presented with secondary anovulatory infertility. She underwent ovulation induction with clomiphene/HMG and with buserelin/HMG in the long protocol, and intra-uterine insemination with husband's spermatozoa and conceived (singleton pregnancy). She was delivered by Caesarean section, during which a cystic tumour of the left ovary was removed. Histological examination revealed a benign mucous cystadenoma of the ovary.(ABSTRACT TRUNCATED AT 250 WORDS)
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ranking = 0.37213606032119
keywords = ovary
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10/10. Bilateral simultaneous tubal pregnancies after ovulation induction with clomiphene-menotropin combination.

    A case is presented of bilateral simultaneous tubal pregnancy after ovulation induction with a clomiphene-menotropin combination. Although extremely rare in the general population, the entity of simultaneous pregnancies is far more common with ovulation induction. Care must be taken not to mistake an extrauterine pregnancy for a hyperstimulated ovary.
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ranking = 0.1240453534404
keywords = ovary
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