1/15. broad ligament twin pregnancy following in-vitro fertilization.We report the first case of an ectopic twin pregnancy in the broad ligament following in-vitro fertilization and embryo transfer in a patient with a previous ipsilateral (left) salpingo-oophorectomy. The previous surgery was for endometriosis. We discuss the possible contribution of the embryo transfer technique, limitations of preventive measures and importance of transvaginal ultrasound in establishing the diagnosis.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
2/15. Sigmoid endometriosis and ovarian stimulation.In-vitro fertilization (IVF) and ovarian stimulation are frequently performed in patients with endometriosis. Although endometriosis is a hormone-dependent disease, the rate of IVF complications related to endometriosis is low. We report four cases of severe digestive complications due to the rapid growth of sigmoid endometriosis under ovarian stimulation. In three patients, sigmoid endometriosis was diagnosed at laparoscopy for sterility. Because of the absence of digestive symptoms or repercussion on the bowel, no bowel resection was performed before ovarian stimulation. All patients experienced severe digestive symptoms during ovarian stimulation, and a segmental sigmoid resection had to be performed. Analysis of endoscopic and radiological data demonstrated that bowel lesions of small size may rapidly enlarge and become highly symptomatic under ovarian stimulation. At immunohistochemistry, these infiltrating lesions displayed high populations of steroid receptors and a high proliferative index (Ki-67 activity), suggesting a strong dependence on circulating ovarian hormones and a potential for rapid growth under supraphysiological oestrogen concentrations. Clinicians should be aware of this rare but severe digestive complication of ovarian stimulation. The early diagnosis of such lesions may help the patients to avoid months of morbidity falsely attributed to ovarian stimulation side effects. Further experience is necessary to determine the optimal attitude when diagnosing a small and asymptomatic endometriotic bowel lesion before ovarian stimulation.- - - - - - - - - - ranking = 0.2keywords = fertilization (Clic here for more details about this article) |
3/15. live birth after treatment of a heterotopic cornual pregnancy with fetal intrathoracic KCI. A case report.BACKGROUND: Heterotopic pregnancy, in which an ectopic gestation coexists with an intrauterine one, occurs more frequently following in vitro fertilization than with spontaneous conception. However, it is rare to find an ectopic gestation in the interstitial (or cornual) portion of the fallopian tube. This scenario poses challenges in diagnosis as well as difficulties in managing the cornual pregnancy while maintaining the viability of the intrauterine gestation. CASE: A 29-year-old nulligravida with stage IV endometriosis completed in vitro fertilization for primary infertility. A heterotopic pregnancy involving the right interstitial portion of the fallopian tube as well as a viable singleton intrauterine pregnancy was diagnosed using serial ultrasound. Successful termination of the cornual pregnancy was accomplished by transabdominal fetal intrathoracic injection of KCl under ultrasound guidance. CONCLUSION: pregnancy reduction of a heterotopic cornual gestation using KCl is a treatment alternative for this uncommon but potentially devastating complication of in vitro fertilization.- - - - - - - - - - ranking = 0.6keywords = fertilization (Clic here for more details about this article) |
4/15. endometriosis--a missed malady.endometriosis is a disease that affects approximately 5.5 million girls and women in their reproductive years in the united states and canada. During the menstrual cycle, the endometrial lining of the uterus thickens in preparation to receive a fertilized egg. If fertilization does not occur, this lining sloughs off during menstruation. Endometrial tissue can migrate out of the fallopian tubes and grow outside of the uterus as endometrial implants. This can result in severe pain. endometriosis is very difficult to detect because most women become accustomed to painful menstrual cycles at an early age. The disease often will go undiagnosed because even with extensive endometriosis it is possible to have minimal symptoms or none at all. physicians have few diagnostic tools to detect the scars and growths of endometriosis. The only way to confirm the diagnosis and stage of endometriosis is by laparoscopy. Treatment options include hormone therapy and surgery. In the past, the most successful treatment was open laparotomy with excision of the endometrial implants. This article discusses the use of the ultrasonic scalpel to resect endometrial implants through the laparoscope. The patient's perioperative course also is discussed.- - - - - - - - - - ranking = 0.2keywords = fertilization (Clic here for more details about this article) |
5/15. Clear cell ovarian carcinoma in a pregnant woman with a history of infertility, endometriosis and unsuccessful IVF treatment.Ovarian cancer in pregnancy is a very rare event. We present here the case of a 37-year-old woman in whom a clear cell ovarian carcinoma was diagnosed in the first trimester of pregnancy. This patient had a history of infertility, endometriosis and two previous unsuccessful attempts of in vitro fertilization. Transvaginal sonography at six gestational weeks revealed a 6 x 4 cm ovarian cyst with an internal papillary excrescence. The cyst persisted throughout the first trimester, whereas the initial CA 125 value of 226 U/ml dropped to 61 U/ml at 12 gestational weeks. Exploratory laparotomy and cystectomy was performed at 14 weeks and the disease was classified as Stage Ic, arising in endometriosis. The couple decided to continue with pregnancy and the woman was followed by serial sonographic, MRI and CA 125 examinations. A cesarean section, hysterectomy, bilateral salpingo-oophorectomy and omentectomy was performed at 34 weeks. histology and cytology were negative for recurrence. Four months later the woman and baby are doing well. We review cases of ovarian clear cell carcinoma diagnosed during pregnancy and discuss the association of endometriosis, infertility, infertility drugs and ovarian cancer.- - - - - - - - - - ranking = 0.2keywords = fertilization (Clic here for more details about this article) |
6/15. Spontaneous uterine rupture of a twin pregnancy after a laparoscopic adenomyomectomy: a case report.Adenomyomectomy is a treatment option to preserve fertility and reduce symptoms associated with adenomyosis. Although this procedure is reasonably expected to increase the risk of uterine rupture during pregnancy, reports on this issue are scarce. We recently encountered a 33-year-old nulliparous woman with a twin pregnancy who experienced a spontaneous uterine rupture at 30 weeks' gestation. This patient was the first to conceive after undergoing laparoscopic adenomyomectomy at our institution. Her pregnancy was established with in vitro fertilization-embryo transfer 12 months after laparoscopic adenomyomectomy. The uterine rupture was heralded by a sudden onset of severe abdominal pain while she was receiving intravenous ritodrine. This case reinforces that pregnancy after adenomyomectomy should be closely monitored with respect to uterine rupture.- - - - - - - - - - ranking = 0.2keywords = fertilization (Clic here for more details about this article) |
7/15. pregnancy following transvaginal sonographic guided aspiration of endometrioma.A 30-year-old infertile women with stage IV endometriosis was treated initially with endoscopic surgery, danazol and intrauterine insemination to no avail. Before starting ovulation induction for in vitro fertilization, transvaginal sonographic guided aspiration of endometrioma was performed. One month after the procedure the patient became pregnant and delivered a normal child at term.- - - - - - - - - - ranking = 0.2keywords = fertilization (Clic here for more details about this article) |
8/15. endometriosis-associated infertility treated by long-term gonadotropin-releasing hormone agonist administration and assisted fertilization.Two patients with long-lasting infertility associated with moderate and severe symptomatic endometriosis were treated with long-term GnRH-agonist suppression of ovarian function. Both patients were relieved of their endometriosis-related abdominal pains during the first treatment month. After an additional treatment period of 3 to 5 months, assisted fertilization was performed, resulting in an ongoing pregnancy for both patients.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
9/15. Heterotopic pregnancy after in vitro fertilization and embryo transfer.We have presented a second case of heterotopic pregnancy after IVF-ET. The most likely cause is direct extrusion of embryos through the tubal ostia by the hydrostatic pressure associated with ET. The diagnosis of ectopic pregnancy must be suspected clinically and not ruled out on the sonographic demonstration of an intrauterine pregnancy. early diagnosis is essential for the prevention of significant maternal morbidity and mortality after IVF-ET.- - - - - - - - - - ranking = 0.8keywords = fertilization (Clic here for more details about this article) |
10/15. Infected endometriotic cysts secondary to oocyte aspiration for in-vitro fertilization.Two weeks after oocyte aspiration for in-vitro fertilization, a 38-year-old woman with a history of endometriosis presented with abdominal pain and fever. On exploratory laparotomy, both ovaries were enlarged and contained seropurulent fluid. Unilateral oophorectomy and drainage of the other ovary were performed. Pathological examination revealed infected endometriotic cysts.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
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