1/6. Successful treatment of cervical stenosis with hysteroscopic canalization before embryo transfer in patients undergoing IVF: a case series.The course of the transfer catheter through the cervical canal is one of the most important issues for a successful embryo transfer (ET) during in vitro fertilization (IVF) cycles. Technically difficult ETs due to cervical stenosis are associated with reduced chance of pregnancy after assisted reproductive procedures. In the current case series, we report on three patients with cervical stenosis who underwent IVF-ET cycles. These three patients, in whom ET was classified as "difficult," failed to conceive with previous ET attempts. An intervention to create a cervical tract was performed with operative hysteroscopy under general anesthesia before transcervical ET. After the hysteroscopic shaving procedure, we observed quite an improvement in access to the endometrial cavity during ET procedure. These patients had significantly easier ET procedures compared with previous attempts and achieved clinical pregnancies. Hysteroscopic revision of the cervical canal results in easier ET and improves pregnancy rates in patients with cervical stenosis and histories of difficult ET.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
2/6. abscess formation of a Gartner's duct cyst with cervical communication in a case of bicornuate uterus associated with an ipsilateral renal agenesis.One case of abscess formation of a Gartner's duct cyst communicating with the cervix of a bicornuate uterus is presented in a case of ipsilateral renal agenesis. The embryonic origin and the incidence of associated genital and urologic malformations are discussed. Marsupialization is recommended as an adequate method of treatment.- - - - - - - - - - ranking = 0.2keywords = embryo (Clic here for more details about this article) |
3/6. Diffuse laminar endocervical glandular hyperplasia.A case is reported of diffuse laminar endocervical glandular hyperplasia, which is very rare among pseudoneoplastic endocervical glandular lesions. The patient was a 54 year old woman who had been suffering from watery vaginal discharge for about 7 years, and the lesion was found in the cervix of the hysterectomy specimen. Microscopically, the lesion showed a diffuse, laminar proliferation of hyperplastic endocervical glands, sharply demarcated from the underlying stroma. The significant nuclear atypia was absent. Inflammatory response was mild. Immunohistochemically, carcinoembryonic antigen was negative. Differential diagnosis from other non-neoplastic conditions and well differentiated adenocarcinoma is discussed.- - - - - - - - - - ranking = 0.2keywords = embryo (Clic here for more details about this article) |
4/6. Florid deep glands of the uterine cervix. Another mimic of adenoma malignum.Two cases of florid deep glands of the uterine cervix, a lesion which mimics adenoma malignum are reported. One case was misdiagnosed as adenoma malignum, and the patient was treated with adjuvant radiotherapy. In contrast to the majority of cases of adenoma malignum in which there is preoperative evidence of a cervical abnormality, the lesion described in both cases was an incidental microscopic finding in hysterectomy specimens. The architectural pattern in both these cases was strikingly similar, showing diffusely scattered endocervical glands within the endocervical stroma extending to the outer third of the cervical wall. However, the variability in size and shape of the glands, which were typically round to oval, was less than observed in adenoma malignum. Additionally, there was no cytologic atypia, which is observed focally in most cases of deeply invasive adenoma malignum. The lack of a desmoplastic stromal reaction, vascular and perineural invasion also may help distinguish florid deep glands from adenoma malignum. Finally, in both cases of florid deep glands, there was no cytoplasmic immunoreactivity for carcinoembryonic antigen, which is in contrast to what is seen in adenoma malignum.- - - - - - - - - - ranking = 0.2keywords = embryo (Clic here for more details about this article) |
5/6. Successful pregnancies with the use of laminaria tents before embryo transfer for refractory cervical stenosis.OBJECTIVE: To determine whether laminaria tents are a safe and effective method of cervical dilatation in patients with a history of cervical stenosis and difficult ET. DESIGN: case reports describing two patients. SETTING: Tertiary care, assisted reproduction practice. PATIENT(S): Two patients with cervical stenosis and a history of multiple failed cycles of IVF. INTERVENTION(S): laminaria tents were placed intracervically before ET. MAIN OUTCOME MEASURE(S): Presence of a gestational sac and fetal heartbeat on ultrasound. RESULT(S): Successful clinical pregnancies occurred in both patients after laminaria placement and ET. CONCLUSION(S): laminaria tent cervical dilatation appears to be a safe and effective option to assist ET in patients with a history of cervical stenosis.- - - - - - - - - - ranking = 0.8keywords = embryo (Clic here for more details about this article) |
6/6. Laparoscopic transabdominal cervicoisthmic cerclage.OBJECTIVE: To report a laparoscopic technique for placement of a transabdominal cervicoisthmic cerclage. DESIGN: Detailed case report of one of three patients undergoing described procedure. SETTING: University hospital. PATIENT: A 39-year-old infertile patient with a history of cervical adenocarcinoma in situ and two cone biopsies, resulting in an essentially absent exocervix. INTERVENTION(S): Laparoscopic transabdominal cervicoisthmic cerclage placement, as an interval procedure, followed by ET of cryopreserved donor oocyte-derived embryos. MAIN OUTCOME MEASURE(S): Clinical outcome. RESULT(S): Establishment of a pregnancy delivered at 38 1/2 weeks of gestation by elective cesarean section. CONCLUSION(S): patients believed to require a transabdominal cerclage may undergo a laparoscopic interval procedure, obviating the need for a laparotomy before or during pregnancy.- - - - - - - - - - ranking = 0.2keywords = embryo (Clic here for more details about this article) |