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1/43. Successful pregnancy in an infertile patient with conservatively treated endometrial adenocarcinoma after transfer of embryos obtained by intracytoplasmic sperm injection.

    A rare case of successful pregnancy in a woman with early-stage endometrial adenocarcinoma conservatively treated is presented. The patient, having polycystic ovaries, was initially diagnosed with hyperplasia of the endometrium and treated with several cycles of ovulation induction following intrauterine insemination. Then dilatation and curettage were carried out when hysteroscopy was performed. The histology report identified a well-differentiated adenocarcinoma of the endometrium. After repeated endometrial curettage, in-vitro fertilization and embryo transfer were introduced for immediate treatment of the patient's infertility in order to avoid the risk of recurrence of neoplastic endometrial lesions by oestrogens. A single pregnancy was achieved after transfer of the embryos obtained after intracytoplasmic sperm injection. This was performed due to the poor semen characteristics (asthenozoospermia). The patient delivered a healthy normal male infant at term. A transvaginal ultrasound examination 2 months after delivery showed a smooth, linear endometrium. Moreover, the histology report after endometrial biopsy was free of any malignancies. The patient now desires another pregnancy. We conclude that conservative treatment of early-stage endometrial adenocarcinoma in young women wishing to preserve fertility should be considered in carefully selected cases. Assisted reproductive technologies may be helpful for immediate achievement of pregnancy in such patients.
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keywords = fertilization
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2/43. Twin delivery after myomectomy, in vitro fertilization, and embryo reduction in an infertile woman.

    A 28-year-old patient had metroplasty performed because of necrosis of a uterine fibroid. During follow-up, the left adnexa were removed because of a recurrent left ovarian cyst. The triplet gestation achieved by in vitro fertilization was reduced to twins. The living premature newborns were delivered abdominally.
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keywords = fertilization
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3/43. Recurrent leiomyomatosis peritonealis disseminata exacerbated by in vitro fertilization.

    leiomyomatosis peritonealis disseminata is a rare disease that is most often discovered during pregnancy or in patients with a history of oral contraceptive use. We report the first case of a patient with the disease who conceived by in vitro fertilization and the complications that occurred.
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keywords = fertilization
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4/43. Course and outcome of pregnancy in a patient with mild, asymptomatic, primary hyperparathyroidism diagnosed before conception.

    Primary hyperparathyroidism (PHP) during pregnancy is well known to confer an increased risk of complications to both the mother and the fetus. However, the risks and optimal management of patients with mild, asymptomatic disease during pregnancy are much less clear. We observed a patient with mild, asymptomatic PHP who was diagnosed before conception through pregnancy. The patient remained asymptomatic through the first 22 weeks of pregnancy, and her calcium levels remained under 11 mg/dL. This occurred despite a dramatic elevation in the level of 1,25-dihydroxyvitamin D and marked hypercalciuria. Parathyroid surgery was performed at 22 weeks of gestation and a parathyroid adenoma was removed. Postoperatively, the patient's calcium level normalized and the rest of the pregnancy was uncomplicated. The patient delivered a healthy baby at 40 weeks of gestation. The neonatal course was unremarkable. We conclude that mild, asymptomatic PHP during early pregnancy is compatible with normal fetal development and an uncomplicated pregnancy and that the serum calcium level in such patients can remain stable with medical management alone, despite the marked changes in maternal calcium metabolism that characterize normal pregnancy.
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ranking = 2.8924042989151
keywords = conception
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5/43. pregnancy in a woman with a y chromosome after removal of an ovarian dysgerminoma.

    BACKGROUND: It appears to be a general belief that pregnancy might be impossible in women with the XY karyotype. Therefore, it is recommended that patients with dysgerminoma of the ovary associated with the XY karyotype should undergo a bilateral salpingo-oophorectomy. CASE: We report an extremely rare case of a true hermaphrodite with a 20% 46,XX/80% 46,XY karyotype who became pregnant after removal of an ovarian dysgerminoma. The patient had a completely normal female phenotype. A dysgerminoma with ovotestis was found in the right ovary. Two courses of chemotherapy following a right salpingo-oophorectomy were carried out. Nine months later she became pregnant and delivered a healthy male infant. CONCLUSION: A unilateral salpingo-oophorectomy followed by combination chemotherapy can be the treatment of choice for any woman who wishes to preserve her capacity for conception at the time of operation for dysgerminoma of the ovary.
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ranking = 0.57848085978303
keywords = conception
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6/43. Spontaneous conception in the presence of stage IIIC endometrioid ovarian cancer.

    OBJECTIVE: To describe a rare case of spontaneous conception in a patient with a preexisting metastatic ovarian cancer. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 39-year-old Asian woman who conceived while undergoing an evaluation for primary infertility and newly detected bilateral adnexal masses. INTERVENTION(S): Staging laparotomy and total abdominal hysterectomy and bilateral salpingo-oophorectomy. MAIN OUTCOME MEASURE(S): Anatomic pathology diagnosis. RESULT(S): Blighted ovum and stage IIIC endometrioid adenocarcinoma of ovary. CONCLUSION(S): Metastatic ovarian cancer does not prevent either spontaneous ovulation or spontaneous conception.
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ranking = 3.4708851586982
keywords = conception
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7/43. craniopharyngioma presenting during pregnancy 4 years after a normal magnetic resonance imaging scan: case report.

    OBJECTIVE AND IMPORTANCE: Craniopharyngiomas, epithelial tumors of the hypothalamic and pituitary region, are thought to have congenital origins. It has been postulated that hormonal influences may stimulate growth in adults. This report describes a case and reviews the literature. CLINICAL PRESENTATION: The case is discussed of a 39-year-old woman who experienced symptoms from a craniopharyngioma diagnosed during a pregnancy that resulted from in vitro fertilization. A magnetic resonance imaging scan performed 4 years previously had disclosed nothing abnormal. INTERVENTION: The patient underwent a right frontotemporal craniotomy with total resection of the suprasellar tumor, which was dissected from the pituitary stalk. CONCLUSION: This case suggests a possible link in the adult patient between the growth of this supposedly congenital tumor and hormonal stimulation.
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keywords = fertilization
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8/43. Metastases to the products of conception from a maternal bronchial carcinoma. A case report and review of literature.

    The association of mother's malignancy with metastases to the products of conception is rarely reported. We present 8th case reported in the literature of oat-cell lung carcinoma complicated by an aggressive clinical course and documented placental metastases. review of all published cases of lung cancer metastasizing to the placenta is also presented. A 44-year-old white pregnant woman at an estimated gestational age of 30 weeks presented with cervical incompetence symptoms and multiple tumors of 2-4 cm in diameter located in the subcutaneous tissue of the chest, including both breasts. The biopsy revealed a metastatic oat-cell carcinoma. cesarean section was performed immediately. During the procedure, micronodular metastatic infiltration of the liver was noted. Microscopic examination of placenta showed clusters of oat-cell carcinoma calls within the intervillous spaces; no infiltration of villi themselves was noted. The malignant cells were morphologically identical as those of the subcutaneous metastases. The woman succumbed to cancer and died on the 16th postoperative day. lung cancer metastasizing to the placenta is relatively rarely reported. In all cases only placental metastases were found; the fetus in all cases was spared. Only in one out of 8 reported cases outcome of mother was not fatal. It should be emphasized that not in all cases of maternal malignancy the histological examination of the placental was made Therefore it is possible that the incidence of placental involvement is more often than it is reported.
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ranking = 2.8924042989151
keywords = conception
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9/43. Maternal pulmonary adenocarcinoma metastatic to the fetus: first recorded case report and literature review.

    We report the first maternal pulmonary adenocarcinoma metastatic to the fetus as well as an updated literature review. review of the literature revealed that there have been only 67 cases of maternal malignancy metastatic to the products of conception. These were mostly malignant melanoma and hematopoietic tumors. A 46-year old multiparous woman with metastatic pulmonary adenocarcinoma, diagnosed at 23 weeks gestation, delivered a male infant who appeared normal at birth. The mother died 2 days after delivery. The child developed multiple scalp tumors a 2 weeks of age. The tumors recurred rapidly after initial resection. Wide local excision of the involved scalp and skin graft coverage was performed at 14 weeks of age. Histopathology of these tumors was identical to that of the maternal tumor. The maternal origin of these tumors was confirmed by fluorescence in situ hybridization (FISH). The child is now 5 years old and free of disease.
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ranking = 0.57848085978303
keywords = conception
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10/43. A case of twin pregnancy with complete hydatidiform mole and coexisting fetus following IVF-ET.

    Twin pregnancy consisting of complete hydatidiform mole (H-mole) and a coexisting fetus occurs with an estimated incidence of 1 per 22,000-100,000 pregnancies. The incidence of this unusual twin pregnancy with complete H-mole and a coexisting fetus after in vitro fertilization and embryo transfer (IVF-ET) is not thought to be greater than that of general population. We present an unusual twin pregnancy with complete H-mole and a coexisting fetus that occurred following IVF-ET, which was terminated at 21 weeks of gestation and developed into nonmetastatic gestational trophoblastic tumor.
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ranking = 1
keywords = fertilization
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