1/32. ovarian hyperstimulation syndrome and benign intracranial hypertension in pregnancy after in-vitro fertilization and embryo transfer: case report.ovarian hyperstimulation syndrome (OHSS) is a dangerous and sometimes life-threatening complication of ovulation induction with exogenous gonadotrophins. While many complications of severe OHSS are recognized we have only identified one review detailing neurological problems. This report concerns a 32-year-old patient with bilateral tubal blockage who achieved her first pregnancy following in-vitro fertilization (IVF) and embryo transfer. Shortly after embryo transfer she developed clinical signs of moderate OHSS with symptoms which were later diagnosed as benign intracranial hypertension (BIH). The BIH was treated effectively using repeated lumbar puncture and diuretics. Spontaneous labour and delivery occurred at 40 weeks' gestation. There was no neurological sequel and no recurrence of the BIH 2 years after the pregnancy. The possible link between OHSS and BIH is discussed as well as the risks of further pregnancy.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
2/32. ovarian hyperstimulation syndrome and its effect on renal function in a renal transplant patient undergoing IVF treatment: case report.ovarian hyperstimulation syndrome (OHSS) in a renal transplant patient undergoing assisted conception treatment is reported. A couple with infertility secondary to tubal blockage and pelvic endometriosis received IVF treatment. Ovarian enlargement secondary to OHSS resulted in obstruction in the transplanted kidney and deterioration of renal function. No other systemic manifestations of OHSS were evident. Conservative management was successful and a twin live birth was later achieved by replacement of two frozen-thawed embryos.- - - - - - - - - - ranking = 0.16666666666667keywords = embryo (Clic here for more details about this article) |
3/32. Complications of triple pregnancy following intracytoplasmic sperm injection: a case report.A case is presented of pregnancy and delivery of triplets following intracytoplasmic sperm injection (ICSI) therapy. Although the outcome was satisfactory, with the birth of normal children free from any malformation, most of the obstetric and particularly the neonatal complications that can be associated with this therapy are illustrated in this case. In addition, from point of view of medical costs, concerns are raised about the current policy of multiple embryo transfer which is directly responsible for the high rate of multiple gestations observed in the IVF/ICSI programme. The authors consequently recommend a policy of transferring not more than two embryos per treatment cycle.- - - - - - - - - - ranking = 0.33333333333333keywords = embryo (Clic here for more details about this article) |
4/32. Cortical vein thrombosis misinterpreted as intracranial haemorrhage in severe ovarian hyperstimulation syndrome: case report.A case of cortical vein thrombosis presenting as intracranial haemorrhage is described in a patient with ovarian hyperstimulation syndrome (OHSS) after IVF and embryo transfer. Veno-occlusive disease of the brain could appear as a haemorrhagic lesion on magnetic resonance imaging (MRI) and this made the initial diagnosis of cortical vein thrombosis difficult. The patient developed deep vein thrombosis 2 weeks after the intracranial event and the diagnosis of cortical vein thrombosis was made at that time on MRI study after the resolution of the haemorrhage. This patient actually developed generalized thrombosis as a complication to OHSS. Although the initial MRI picture may be misleading, the diagnosis of thrombosis should always be kept in mind, as it is the commonest cause of intracranial lesions after OHSS.- - - - - - - - - - ranking = 0.16666666666667keywords = embryo (Clic here for more details about this article) |
5/32. A case of forearm amputation after ovarian stimulation for in vitro fertilization-embryo transfer.OBJECTIVE: To report a case of forearm amputation after ovarian stimulation for IVF-ET. DESIGN: Case report. SETTING: A university hospital. PATIENT(S): A 41-year-old woman, who had coagulation disorder as a result of an ovarian hyperstimulation syndrome (OHSS) for IVF-ET. INTERVENTION(S): Retrospective evaluation of angiographic studies and surgical treatment. MAIN OUTCOME MEASURE(S): Medical follow-up after forearm amputation due to OHSS. RESULT(S): The patient underwent many cycles of IVF-ET with administration of purified FSH (75 IU 10 times per day, for 12 days) and chorionic gonadotropin (5,000 IU). The patient had a coagulation disorder as a result of OHSS, with thrombosis of the axillary vein, recurring after thromboarterectomy and leading to the paradoxical result of the amputation of an arm. CONCLUSION(S): An ethical evaluation of this case is mandatory, since the desire for pregnancy, the role of medical science, health, and human life itself are all factors involved.- - - - - - - - - - ranking = 0.66666666666667keywords = embryo (Clic here for more details about this article) |
6/32. Hepatic dysfunction associated with moderate ovarian hyperstimulation syndrome. A case report.BACKGROUND: liver dysfunction is a rare complication of severe ovarian hyperstimulation syndrome (OHSS). Based on a medline search from 1966 to September 2000, we report the second case of liver dysfunction associated with moderate OHSS. In addition, this is the first report of moderate OHSS with serum progesterone levels during the first trimester of pregnancy higher than the upper limit of normal for a third-trimester gestation. CASE: A 33-year-old nulligravida with a history of infertility had previously undergone three failed cycles of assisted reproduction. During her fourth attempt at in vitro fertilization and intracytoplasmic sperm injection, she developed moderate OHSS 11 days after embryo transfer. She was managed on an outpatient basis. Her serum progesterone and liver enzyme levels were significantly elevated, as is unusual for the moderate picture of OHSS in this patient. CONCLUSION: Hepatic dysfunction is not limited to the severe forms of OHSS. liver function should be analyzed even in moderate cases. Further study is needed to understand the role of elevated liver function tests and serum progesterone in the pathogenesis of OHSS.- - - - - - - - - - ranking = 0.16666666666667keywords = embryo (Clic here for more details about this article) |
7/32. blastocyst development and pregnancies after IVF of mature oocytes retrieved from unstimulated patients with PCOS after in-vivo HCG priming.A major side-effect of controlled ovarian stimulation (COS) in patients with polycystic ovarian syndrome (PCOS) is the risk of ovarian hyperstimulation syndrome (OHSS). In-vitro maturation (IVM) of immature oocytes represents a potential alternative for the fertility treatment of these patients. Two patients at high risk of OHSS were primed with 10,000 IU HCG 36 h before oocyte retrieval. After retrieval, oocyte maturity was evaluated. oocytes considered to be mature at the time of collection were inseminated by IVF or ICSI, and the resulting embryos were cultured to blastocysts. Transfer of these blastocysts resulted in pregnancy in both patients. Immature oocytes were cultured in YS medium supplemented with 30% human follicular fluid, 1 IU/ml rFSH, 10 IU/ml HCG and 10 ng/ml epidermal growth factor (rhEGF). After in-vitro maturation of the oocytes, ICSI was performed. Two and five expanded blastocysts were obtained after 5 day culture and were cryopreserved. This report indicates that mature oocytes can be collected at the time of retrieval using only in-vivo HCG priming in women with PCOS, and clinical pregnancy can be established by transfer of blastocysts derived from the mature oocytes. This approach opens a potential for a new dimension in the management of patients with PCOS.- - - - - - - - - - ranking = 0.16666666666667keywords = embryo (Clic here for more details about this article) |
8/32. Three-dimensional power Doppler in the diagnosis of ovarian torsion.Recent advances in ultrasound technology have enabled the diagnosis of overall tissue vascularization by three-dimensional (3D) power Doppler. This case report describes 3D power Doppler characteristics of unilateral ovarian torsion 2 weeks after embryo transfer in a pregnant patient with bilateral hyperstimulated ovaries. Before laparoscopic treatment the twisted right ovary showed the following 3D power Doppler indices: mean grayness index, 15.66; vacularization index, 0.24; flow index, 21.99; vascularization flow index, 0.05. One hour after laparoscopic treatment 3D power Doppler indices of the untwisted ovary were as follows: mean grayness index, 25.61; vacularization index, 3.81; flow index, 42.800; vascularization flow index, 1.63. The resistance index of the ovarian vessels before and after laparoscopy showed no significant difference (5.1 vs. 5.2). The diagnosis of ovarian torsion can be better made with 3D power Doppler sonography than with two-dimensional Doppler sonography.- - - - - - - - - - ranking = 0.16666666666667keywords = embryo (Clic here for more details about this article) |
9/32. Heterotopic triplet pregnancy with bilateral tubal and intrauterine pregnancy after IVF.Heterotopic pregnancy in a spontaneous cycle is rare, but the incidence increases with the introduction of assisted reproductive technologies. This report describes a case of combined bilateral tubal and intrauterine pregnancy after IVF and embryo transfer. The diagnostic and therapeutic problems will be discussed both in terms of the case report and the literature. Heterotopic pregnancies after IVF and resulting problems are further reasons to encourage the transfer of only one embryo. This could be difficult to achieve without simultaneously decreasing pregnancy rates, as embryo selection is not permitted in germany.- - - - - - - - - - ranking = 0.5keywords = embryo (Clic here for more details about this article) |
10/32. Excessive follicular response to controlled ovarian stimulation in a woman with menopausal FSH levels: case report.A suspected poor responder to controlled ovarian stimulation (COS), with menopausal levels of follicular phase serum FSH, required coasting due to an excessive ovarian response. A 27 year old woman was referred to our Fertility Centre for ovum donation following repeated elevated, early follicular phase FSH levels (34.3, 27.1, 20.3 IU/l). Further investigations revealed the presence of antiovarian antibodies and a trial of COS, with the additional use of prednisolone, was proposed in view of her regular 28 day cycle. As 23 follicles were noted and an oestradiol level of 10,461 pmol/l following 7 days of stimulation with 450 IU of recombinant FSH per day, gonadotrophins were withheld for 9 days. Ten oocytes were retrieved and two grade I embryos were transferred. pregnancy did not occur and she developed mild ovarian hyperstimulation syndrome. During a second cycle, multiple follicular development was again observed with an oestradiol level >13,200 pmol/l, despite a lower dose of gonadotrophin, and coasting was required for 4 days. Nineteen oocytes were collected, of which nine fertilized and cleaved. Two grade I embryos were replaced, leading to a singleton pregnancy. This patient subsequently had a vaginal delivery of a normal male baby at term. Young women with regular menstrual cycles and grossly elevated FSH levels may benefit from further investigation of autoantibodies and their ovarian response to exogenous gonadotrophins.- - - - - - - - - - ranking = 0.33333333333333keywords = embryo (Clic here for more details about this article) |
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