11/78. Uncomplicated pregnancy and normal singleton delivery after surgical excision of heterotopic (cornual) pregnancy following in vitro fertilization/embryo transfer.A 39 year-old woman with previous salpingectomy developed a symptomatic heterotopic right cornual pregnancy identified by transvaginal ultrasonography at six weeks' gestation. The patient had previously undergone an ipsilateral partial salpingectomy, and the conception was established four months later after one cycle of controlled ovarian hyperstimulation, in vitro fertilization (IVF) and embryo transfer. We performed immediate surgical excision of the ectopic implantation with conservation of the intrauterine pregnancy. progesterone was administered as 200 mg/d lozenge (troche) plus 200 mg/d rectal suppository, maintained from day of embryo transfer through the perioperative period and until 11th gestational week. Following an uneventful obstetrical course, a healthy male infant was delivered by cesarean at term. In this report, we review the incidence and significance of heterotopic gestation in the context of IVF/embryo transfer. risk factors for complex intra- and extra-uterine pregnancies are also outlined. Additionally, the clinical management of heterotopic pregnancy, including a novel approach to progesterone supplementation, is discussed.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
12/78. Triplet cervical pregnancy treated with intraamniotic methotrexate.BACKGROUND: Multifetal cervical pregnancy is very rare. We are reporting a case of a triplet cervical pregnancy that was treated with direct intraamniotic instillation of methotrexate. CASE: A young multiparous woman was diagnosed as having three gestational sacs in her uterine cervix with embryonic cardiac activity observed within one of the sacs. She became pregnant by natural ovulation and coitus. After initial failure with a single-dose intramuscular injection, the patient was successfully treated with an intra-amniotic methotrexate injection under the guidance of transvaginal ultrasonography. Her reproductive capability was preserved. CONCLUSION: Direct intraamniotic injection can be considered as treatment for multifetal cervical pregnancy.- - - - - - - - - - ranking = 0.14285714285714keywords = embryo (Clic here for more details about this article) |
13/78. Ectopic pregnancy without therapy despite previous failure with in vitro fertilization and a male partner with an extremely low hypoosmotic swelling test score: case report.PURPOSE: To record an ectopic pregnancy achieved through natural intercourse despite previous implantation failure following in vitro fertilization-embryo transfer (IVF-ET) with a male partner who had an extremely low hypoosmotic swelling test (HOST) score. methods: A hypoosmotic swelling test was performed for the first time on the semen of a male partner who was advised previously that his sperm specimen was perfectly normal. RESULTS: The standard semen parameters except normal morphology with strict criteria were normal. The HOST score was 33%. CONCLUSIONS: The HOST score of 33% was the lowest level recorded in anyone achieving a pregnancy. The fact that it resulted in an ectopic pregnancy in a woman with apparently normal tubes and failure to achieve an intrauterine pregnancy despite transfer of 13 embryos with good morphology may suggest that the low HOST score inhibits the blastocyst from implanting in the uterus rather than from failure to develop a blastocyst from a multi-cell embryo.- - - - - - - - - - ranking = 0.42857142857143keywords = embryo (Clic here for more details about this article) |
14/78. Heterotopic pregnancy: successful management with aspiration of cornual/interstitial gestational sac and instillation of small dose of methotrexate.OBJECTIVES: Terminating a corneal pregnancy without jeopardizing a coexistent intrauterine pregnancy. methods: A 29-year-old woman with a 4-year history of primary infertility became pregnant after in-vitro fertilization and embryo transfer. A heterotopic pregnancy with a left cornual and intrauterine sacs was confirmed by early transvaginal scan examinations. The ectopic sac was aspirated under ultrasound guidance followed by local injection of 12.5 mg methotrexate. This was followed by serial ultrasound scans and serum betahCG assays. RESULTS: The fetal pole in the ectopic pregnancy disappeared following the procedure. She had no significant vaginal bleeding or any other unusual symptoms. The intrauterine pregnancy progressed satisfactorily until spontaneous onset of labour and vacuum extraction delivery at 39 weeks. The baby weighed 2.9 kg. CONCLUSIONS: Local injection of low-dose methotrexate following aspiration of a cornual pregnancy proved effective in halting the ectopic trophoblasts' growth without adversely affecting a coexistent intrauterine pregnancy. The injected ectopic trophoblasts resolved quickly despite the small dose of methotrexate used. This technique avoided a more costly surgical treatment with its associated risks in subsequent pregnancies.- - - - - - - - - - ranking = 0.14285714285714keywords = embryo (Clic here for more details about this article) |
15/78. Two consecutive ectopic pregnancies after in-vitro fertilization and embryo transfer. Case report.Ectopic pregnancy is a known complication of in vitro fertilization and embryo transfer (IVF/ET). The overall incidence of ectopic pregnancy after IVF is 4.4-5.8% of clinical pregnancies. The risk factors associated with ectopic pregnancies are complex. We present a patient with two consecutive ectopic pregnancies after IVF/ET.- - - - - - - - - - ranking = 0.71428571428571keywords = embryo (Clic here for more details about this article) |
16/78. An unexpected quadruplet heterotopic pregnancy after bilateral salpingectomy and replacement of three embryos.OBJECTIVE: To report a case of combined intrauterine and interstitial twin pregnancies after bilateral salpingectomy and IVF with replacement of three embryos. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 31-year-old woman known to have bilateral salpingectomy for ectopic pregnancies who underwent IVF. INTERVENTION(S): laparotomy. MAIN OUTCOME MEASURE(S): Postoperation intrauterine monozygotic twins survival and birth. RESULT(S): After removing the interstitial monozygotic twin pregnancy, the patient had an uneventful postoperative course and delivered two healthy girls by cesarean section at 38 weeks' gestation. CONCLUSION(S): Heterotopic pregnancy can still occur in women treated by IVF after bilateral salpingectomy. The early sonography follow-up of IVF pregnancy would be of value because of the reported higher incidence of pathological pregnancies and especially monozygotic twinning.- - - - - - - - - - ranking = 0.71428571428571keywords = embryo (Clic here for more details about this article) |
17/78. Combined cornual pregnancy and intrauterine twin pregnancy after in vitro fertilization and embryo transfer: report of a case.A case of combined cornual pregnancy and intrauterine twin pregnancy after in vitro fertilization (IVF) and transfer of six embryos is presented. The case was diagnosed as intrauterine triplets ultrasonographically at seven weeks of gestation. Unfortunately, the patient suffered from severe lower abdominal pain and hypovolemic shock at 10 weeks of gestation, and an emergent laparotomy was done. During the operation, a ruptured cornual pregnancy with accompanying hemoperitoneum was found. Because fetal heart beats were not detected by intraoperative ultrasonography in the other two intrauterine fetuses, evacuation of the gestational contents through the uterine defect was done, and the rupture site was repaired. The incidence, mechanism and management of heterotopic pregnancies after in vitro fertilization and embryo transfer are discussed.- - - - - - - - - - ranking = 0.85714285714286keywords = embryo (Clic here for more details about this article) |
18/78. Aspiration of ectopic pregnancy under guidance of vaginal ultrasonography.This case report describes the treatment of tubal pregnancy by aspiration of the gestational sac content and injection of methotrexate by transvaginal sonographic guidance. The confirmation of the embryo aspiration as indicated by disappearance of the embryo with its heart beat and the resulting 46,XY karyotype, raises the question whether methotrexate injection is necessary.- - - - - - - - - - ranking = 0.28571428571429keywords = embryo (Clic here for more details about this article) |
19/78. Ovarian ectopic pregnancy after intracytoplasmic sperm injection.A ruptured primary ovarian pregnancy occurred following ovulation induction, intracytoplasmic sperm injection (ICSI) and embryo transfer (ET). The exact mechanism of ovarian pregnancy after intracytoplasmic sperm injection is unclear, but, it is possible that there may be an association between blastocyst transfer and ovarian pregnancy in infertile patients who underwent ICSI, prolonged in vitro culture and fifth day embryo transfer at blastocyst stage.- - - - - - - - - - ranking = 0.28571428571429keywords = embryo (Clic here for more details about this article) |
20/78. Cornual heterotopic pregnancy: conservative treatment with transvaginal embryo reduction.OBJECTIVE: The objective was to discuss a case of heterotopic cornual pregnancy managed with transvaginal embryo reduction. methods: A 22-year-old woman with heterotopic cornual pregnancy was treated with ultrasonographically guided transvaginal injection of potassium chloride into the thorax of ectopic fetus. RESULTS: Sixteen days after the procedure, the patient presented with pelvic pain and miscarriage ensued. Control examination 1 month and 3 months later revealed normal uterine cavity and partially resorbed ectopic material. CONCLUSION: This minimally invasive approach in a hemodynamically stable patient can be considered in the management of a first trimester heterotopic cornual pregnancy. However the patient must be informed for the risk of abortion related to the procedure. Nevertheless this approach can be a treatment option in cornual pregnancies without a simultaneous intrauterine gestation.- - - - - - - - - - ranking = 0.71428571428571keywords = embryo (Clic here for more details about this article) |
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