11/16. Ovarian hyperstimulation presenting as acute hydrothorax after in vitro fertilization.Ovarian hyperstimulation that occurs with an isolated hydrothorax as the only symptom has previously been reported. We describe the second such case, the first to occur after in vitro fertilization and embryo transfer.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
12/16. Ruptured tubo-ovarian abscess complicating transcervical cryopreserved embryo transfer.OBJECTIVE: To present a rare infectious complication related to transcervical ET, without prior transvaginal puncture. DESIGN: Case report. SETTING: Hadassah University Hospital, IVF-ET unit. PATIENT: One patient undergoing cryopreserved-thawed ET. INTERVENTIONS: Artificial preparation of the endometrium with E2 and P, followed by transcervical intrauterine cryopreserved-thawed embryo transfer. RESULTS: After ET, severe pelvic inflammatory disease (PID) with ruptured tubo-ovarian abscess was diagnosed and treated. CONCLUSIONS: Severe PID including tubo-ovarian abscess formation should be considered a potential complication after ET, even without transvaginal oocyte aspiration.- - - - - - - - - - ranking = 5keywords = embryo (Clic here for more details about this article) |
13/16. Unilateral tuboovarian autoamputation.Six cases of unilateral tuboovarian absence are reviewed. In four, the peritoneal cavity contained a separate ovoid structure. In two of these, the pathologist could identify the remnant as a phagocytized ovary. In a third patient, the ovoid body was seen fixed to the contralateral ovary during laparoscopy. Subsequently, it was identified radiologically as a calcific density. In the fourth case, an intact ovary was separated from the uterus and engulfed by omentum. If a total embryogenic error or selective dysgenesis of the urogenital fold occurs, ipsilateral anomalies usually involve adjacent structures of both the urinary and genital systems. Howerver, no anomalies of the uterus and urinary structures appeared evident in any reviewed case. Therefore, adnexal torsion with subsequent infarction necrosis and autoamputation represents the most likely explanation for this phenomenon.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
14/16. Late manifestation of pelvic abscess following oocyte retrieval, for in vitro fertilization, in patients with severe endometriosis and ovarian endometriomata.PURPOSE: Our purpose was to study the unusual and rare late manifestation of severe pelvic abscess, following oocyte pickup (OPU), for in vitro fertilization and embryo transfer (IVF-ET). patients: The patients were three infertile women with stage IV endometriosis and ovarian endometriomata, as the sole reason for their infertility. Medical and surgical modalities to treat endometriosis and infertility proved to be unsuccessful. INTERVENTIONS: All patients were prepared for IVF-ET employing a long GnRH-a and hMG protocol. Transvaginal OPU was performed under ultrasound guidance. Intravenous (i.v.) prophylactic antibiotic was routinely administered. RESULTS: All women underwent ET, and one conceived. Forty, 24, and 22 days after OPU, respectively, these patients presented with acute symptoms of severe pelvic inflammatory disease (PID) and were found to have pelvic abscess. Broad-spectrum i.v. antibiotics were employed in all cases, however, two patients did not respond and bilateral adnexectomy was eventually performed. CONCLUSIONS: Severe endometriosis with ovarian endometriomata seems to be a significant risk factor for pelvic abscess development, following transvaginal OPU for IVF-ET. Prophylactic IV cefazolin does not seem to prevent this complication. Late manifestation of pelvic abscess supports the notion that the presence of old blood in an endometrioma provides a culture medium for bacteria to grow slowly after transvaginal inoculation.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
15/16. Pelvic abscess after ultrasound-guided aspiration of endometrioma: a case report.A 31-year-old female with four years of infertility due to endometriosis and severe pelvic adhesions underwent transvaginal ultrasound-guided aspiration of an ovarian endometrioma before ovulation induction for in vitro fertilization (IVF) and embryo transfer. Seven days following the aspiration, the patient developed acute abdominal pain; diagnostic laparoscopy was performed at a local medical center, revealing a right tubo-ovarian abscess. Exploratory laparotomy ensued and right salpingo-oophorectomy was performed. A combination regimen of three antibiotics was administered and the patient was transferred to the intensive care unit of the Cathay General Hospital two days after surgery for further care. Her postoperative condition was uneventful and she recovered quickly. The patient then continued with further IVF treatment.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
16/16. Ovarian prostatic tissue originating from hilar mesonephric rests.Nonteratoid prostatic differentiation in the ovary of a parous, phenotypically normal, postmenopausal woman is reported for the first time, to the authors' best knowledge. The patient was a 70-year-old woman who underwent bilateral oophorectomy following pelvic ultrasound examination that showed enlargement of the left ovary and an equivocally abnormal Doppler signal. Histologic examination showed a normal right ovary and a left ovary enlarged by hilar cystic dilatation related to a proliferation of mesonephric remnants exhibiting various types of epithelial metaplasia, including hyperplastic rete and epididymal-like and clear cell epithelia resembling the lining of the seminal excretory system. These were closely associated, occasionally even merging, with a discrete area of prostatic acinar and smooth muscle differentiation in the cyst wall. The identity of the prostatic tissue was confirmed immunohistochemically by positive staining with prostate specific antigen and prostatic acid phosphatase. The lesion was associated with an incidental, microscopic hemangioma. A developmental malformative origin of this abnormality cannot satisfactorily be explained by current embryologic concepts. A hypothesis of a metaplastic induction of prostatic tissue by mesonephric remnants is proposed, since complex metaplastic changes coexisted within the cysts and even showed epithelial transitions with the prostatic acini.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
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