11/19. Surrogate human fallopian tubes for overcoming tubal infertility.A procedure has been devised in order to establish a pregnancy in a patient with severe, untreatable tubal infertility who had unsuccessfully undergone tubal reconstructive surgery and repeated in-vitro fertilization procedures. This technique, which involves a volunteer, fertile woman, results from the combination of two infertility treatments: namely gamete intra-Fallopian transfer and uterine flushing. The gametes of the infertile couple were introduced into the distal tube of a synchronized volunteer woman; after 5 days, the embryos, recovered by lavage of the volunteer's uterus, were transferred into the patient's uterus with a resulting pregnancy and delivery.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
12/19. Successful in vitro fertilization and embryo transfer after limited surgical treatment for tubal adenocarcinoma.A 29-year-old woman with tubal adenocarcinoma stage IA was treated only with bilateral salpingectomy, pelvic lymphadenectomy, and omentectomy. Two years later the patient successfully underwent in vitro fertilization and embryo transfer, and at 39 weeks gave birth to a healthy son by cesarean section. The result of oncologic follow-up 3 years after surgery is negative.- - - - - - - - - - ranking = 5keywords = fertilization (Clic here for more details about this article) |
13/19. Tuboovarian abscess following transvaginal oocyte retrieval for in vitro fertilization: imaging appearance.All physicians participating in the workup of an infertile patient should be aware of the nonspecificity of the computed tomographic or sonographic finding of a complex adnexal cystic lesion occurring following transvaginal oocyte retrieval for in vitro fertilization. Persistent fever and leukocytosis in conjunction with such lesions should lead to an early presumptive diagnosis of tuboovarian abscess with prompt administration of antibiotic therapy.- - - - - - - - - - ranking = 5keywords = fertilization (Clic here for more details about this article) |
14/19. Multiple follicular development associated with herbal medicine.After three endocrinologically normal cycles while undergoing unstimulated in-vitro fertilization treatment, a woman took a herbal medicine (vitex agnus castus) at the beginning of a fourth unstimulated IVF treatment cycle. In this fourth cycle, her serum gonadotrophin and ovarian hormone measurements were disordered. One embryo resulted from the three eggs collected but a pregnancy did not ensue. She had symptoms suggestive of mild ovarian hyperstimulation syndrome in the luteal phase. Two subsequent cycles were endocrinologically normal. We do not advocate the use of this herbal medicine to promote normal ovarian function.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
15/19. An unexpected guest in follicular fluid.Parasitic infection as the only or concomitant cause of infertility in Caucasian women is rare. A parasitic infection may also present itself quite unexpectedly as a coincidental finding as shown with this case report. Moving microfilariae of mansonella perstans were found in the aspirated follicular fluid of a patient who underwent in-vitro fertilization (IVF) with embryo transfer because of tubal pathology due to chlamydia trachomatis. The patient also appeared to have a schistosoma infection. To our knowledge, the presence of parasites in follicular fluid has never been reported before. We expect that infertility physicians may be confronted with parasitic infections more often, not only in patients originating from tropical countries but also in Western women as a result of a tendency to travel more frequently to exotic and (sub)tropical countries.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
16/19. recurrence of hydrosalpinges after transvaginal aspiration of tubal fluid in an IVF cycle with development of a serometra.The presence of hydrosalpinges has been shown to be deleterious in infertility treatment. Pregnancy rates after in-vitro fertilization (IVF) with embryo transfer decline considerably. This study concerns a patient who developed bilateral hydrosalpinges during controlled ovarian stimulation in preparation for IVF treatment. Transvaginal aspiration of the tubal fluid was unsuccessful as the tubes refilled within 2 days. Additionally, on the day of embryo transfer a serometra developed which could not be seen on the day of oocyte retrieval. The uterine cavity was evacuated via an embryo transfer catheter and three embryos were transferred. The serometra reappeared 3 days after embryo transfer. A pregnancy could not be achieved. The accumulation of fluid in the uterine cavity during an IVF/embryo transfer cycle is a rare complication of hydrosalpinges. However, the retrograde flow of tubal fluid may disturb intrauterine embryo development. This study suggests that the aspiration of hydrosalpinges and intrauterine fluid accumulation during an IVF cycle is not beneficial, as the underlying pathology is not cured. Cancellation of the treatment cycle or cryopreservation of oocytes in the pronucleate stage and transfer of the cryopreserved oocytes after surgical correction of the tubes may be better options.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
17/19. Endometrial fluid collection in women with hydrosalpinx after human chorionic gonadotrophin administration: a report of two cases and implications for management.The impact of hydrosalpinx (HSPX) on in-vitro fertilization (IVF) outcome has recently been the subject of intense debate. Most, but not all, studies have reported decreased implantation and pregnancy rates and increased early pregnancy loss in HSPX patients. This has led to prophylactic salpingectomies prior to IVF in HSPX patients despite the lack of any prospective studies to suggest that any improvement will occur. women with HSPX constitute a heterogeneous population because some conceive easily with IVF while others do not until after surgical correction. HSPX also increases in size with ovarian stimulation, and can cause implantation failure by fluid reflux into the uterine cavity. Careful assessment of the endometrial lining is mandatory in HSPX to rule out fluid reflux from the HSPX. We present two case reports of patients whose HSPX enlarged with ovarian stimulation, causing fluid reflux into the uterine cavity which was only noted after human chorionic gonadotrophin (HCG) administration.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
18/19. Sonographic diagnosis of triplet tubal pregnancy after in vitro fertilization and embryo transfer.Ectopic pregnancy (EP) after in vitro fertilization and embryo transfer (IVF/ET) is not rare, but triplet tubal pregnancy after IVF/ET is very rare. We describe a patient with hydrosalpinx in whom a triplet tubal pregnancy occurred on the same side as the hydrosalpinx. Close hormonal and sonographic monitoring of pregnancies achieved through IVF is recommended to ensure the early diagnosis of EP and to avert complications. A triplet tubal EP was considered highly probable after 3 gestational sacs were observed outside the uterus during sonography performed at 6 weeks' gestation. Therapeutic laparoscopy was then performed because methotrexate treatment failed. Appropriate management strategies are discussed.- - - - - - - - - - ranking = 5keywords = fertilization (Clic here for more details about this article) |
19/19. Laparoscopic fimbrioplasty: an evaluation of 35 cases.The aim of this prospective study was to assess the value of laparoscopic treatment of severe fimbrial occlusions. During a period of 52 months infertile patients with fimbrial lesions were treated by operative laparoscopy. Only those patients requiring incision of the tubal serosa (salpingostomy) were included, representing the most severe lesions. The most frequent cases, those patients requiring simple adhesiolysis and deagglutination of the fringes, were excluded. All tubal lesions were documented carefully. Positive chlamydia trachomatis (CT) serology was found in 65.7% of the patients. All the patients were followed up for at least 2 years. Three patients lost to follow-up were defined as failures. The global conception rate was 74.3%. The intrauterine pregnancy rate was 51.4%, and the 'take home baby rate' was 37.1% (only the first pregnancy being taken into account). The ectopic pregnancy rate was 22.9%. A positive CT serology was found to have a significant influence on the outcome. It can be concluded that the laparoscopic approach provides results similar to those obtained by microsurgery for the treatment of severe fimbrial occlusions, and represents an acceptable alternative to in-vitro fertilization (IVF) in selected cases.- - - - - - - - - - ranking = 1.0181311243234keywords = fertilization, conception (Clic here for more details about this article) |
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