1/8. Endometrial fluid collection in women with PCOS undergoing ovarian stimulation for IVF. A report of four cases.BACKGROUND: The presence of endometrial fluid collections' developing during ovarian-stimulation was previously reported to occur in women with hydrosalpinx. We report on the occurrence of endometrial fluid collections in four women with polycystic ovary syndrome (PCOS) undergoing ovarian stimulation for in vitro fertilization. CASES: Four women developed endometrial fluid collections during ovarian stimulation. These fluid collections were noted as early as day 5 of stimulation. The reproductive outcome when fluid collections were noted on the day of human chorionic gonadotropin (hCG) or of embryo transfer (ET) was poor. One of three women with fluid collection on the day of hCG conceived but had a missed abortion. One patient with fluid on the day of ET failed to conceive. Three of four patients who underwent repeat cycles conceived when no fluid collections were seen on day of hCG or ET. CONCLUSION: Abnormal endometrial milieu could be an underlying defect in some women with PCOS and chronic anovulation who fail to conceive with ovulation-induction agents. This is the first report of endometrial fluid collections in patients with PCOS in the absence of hydrosalpinx. Continuous monitoring of the endometrial lining during ovulation induction is mandatory to rule out any abnormality in endometrial development. Cryopreserving all embryos may be considering in cycles with fluid collections noted on the day hCG or ET.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
2/8. Ultrasound detection of pyometra at the time of embryo transfer after ovum retrieval for in vitro fertilization.OBJECTIVE: To report the detection of pyometra after ovum retrieval for IVF with the routine use of ultrasound-guided embryo transfer. DESIGN: Case report. SETTING: Tertiary fertility center. patients: A 29-year-old woman who developed pyometra after ovum retrieval for IVF detected at the time of ultrasound-guided embryo transfer. INTERVENTION(S): Cancellation of the embryo transfer, cryopreservation of the embryos, treatment of the pyometra, and a successful frozen-embryo transfer. MAIN OUTCOME MEASURE(S): Normal uterine cavity after treatment and a delivered twin pregnancy. RESULT(S): A successful delivered twin pregnancy. CONCLUSION(S): Routine use of ultrasound-guided embryo transfer resulted in the rescue of the patient's embryos for cryopreservation, with a resulting ongoing pregnancy.- - - - - - - - - - ranking = 5.5keywords = embryo (Clic here for more details about this article) |
3/8. Rapid reaccumulation of hydrometra after drainage at embryo transfer in patients with hydrosalpinx.OBJECTIVE: To report the occurrence and management of hydrometra at the time of scheduled embryo transfer in two patients who underwent drainage of hydrosalpinges at oocyte retrieval. DESIGN: Case report.University IVF clinic. PATIENT(S): Two patients with hydrosalpinges visible on ultrasonography who deferred tubal surgery.Although no fluid was seen at the time of oocyte retrieval, hydrometra was noticed and drained before planned embryo transfer (ET). MAIN OUTCOME MEASURE(S): Reoccurrence of hydrometra after drainage. RESULT(S): Rapid reaccumulation of hydrometra despite drainage was seen in both patients, one of whom had reoccurrence in 1 hour. embryo transfer was deferred until after tubal surgery, and all embryos were cryopreserved. CONCLUSION(S): In patients with hydrosalpinges, ultrasonography before ET is useful to detect newly developed hydrometra. Aspiration of the uterine fluid is unlikely to help because of rapid reaccumulation of hydrometra. cryopreservation of the embryos for future transfer after the hydrosalpinx is removed or ligated is recommended.- - - - - - - - - - ranking = 4keywords = embryo (Clic here for more details about this article) |
4/8. Heterotopic Caesarean scar pregnancy combined with intrauterine pregnancy successfully treated with embryo aspiration for selective embryo reduction: case report.Ectopic pregnancy situated in a Caesarean section scar is a rare but potentially life-threatening event. Because of its rarity, there are no universal treatment guidelines to manage this condition. We report a case of IVF-induced triplet heterotopic pregnancy of early gestational age that included one Caesarean scar pregnancy diagnosed as early as 6 weeks gestation. Treatment with embryo aspiration under vaginal ultrasonography for selective embryo reduction was given and the concurrent intrauterine twin pregnancy was preserved successfully.- - - - - - - - - - ranking = 5keywords = embryo (Clic here for more details about this article) |
5/8. Spontaneous uterine rupture of a twin pregnancy after a laparoscopic adenomyomectomy: a case report.Adenomyomectomy is a treatment option to preserve fertility and reduce symptoms associated with adenomyosis. Although this procedure is reasonably expected to increase the risk of uterine rupture during pregnancy, reports on this issue are scarce. We recently encountered a 33-year-old nulliparous woman with a twin pregnancy who experienced a spontaneous uterine rupture at 30 weeks' gestation. This patient was the first to conceive after undergoing laparoscopic adenomyomectomy at our institution. Her pregnancy was established with in vitro fertilization-embryo transfer 12 months after laparoscopic adenomyomectomy. The uterine rupture was heralded by a sudden onset of severe abdominal pain while she was receiving intravenous ritodrine. This case reinforces that pregnancy after adenomyomectomy should be closely monitored with respect to uterine rupture.- - - - - - - - - - ranking = 0.5keywords = embryo (Clic here for more details about this article) |
6/8. Hydrometrocolpos in neonate due to distal vaginal atresia.hydrocolpos is the result of vaginal obstruction and can become an emergency in the newborn period. The treatment of imperforate hymen is well defined, but the treatment of vaginal atresia is more complex. We encountered two cases of hydrocolpos secondary to distal vaginal atresia, that were operated on in the first days of life. One baby had distal atresia without persistance of urogenital sinus. Surgery combining abdominal perineal approaches and a posterior vaginoplasty was carried out. The second baby had hydrocolpos with persistance of urogenital sinus. drainage through the sinus was unsuccessful because the baby developed sepsis by trapping urine in the uterus. Finally an abdominoperineal vaginal pull-through was successfully done. The embryology and literature are reviewed. The classification, indications and surgical technique are discussed.- - - - - - - - - - ranking = 0.5keywords = embryo (Clic here for more details about this article) |
7/8. uterine rupture following hysteroscopic lysis of synechiae due to tuberculosis and uterine perforation.A patient with genital tuberculosis who conceived with in-vitro fertilization and embryo transfer following hysteroscopic synechiolysis complicated by a fundal uterine perforation subsequently presented with uterine rupture at 36 weeks gestation. Immediate Caesarean section and repair of the ruptured uterus were performed. women with a history of uterine perforation should be counselled regarding the risk of uterine rupture during their subsequent pregnancies.- - - - - - - - - - ranking = 0.5keywords = embryo (Clic here for more details about this article) |
8/8. recurrence of hydrosalpinges after transvaginal aspiration of tubal fluid in an IVF cycle with development of a serometra.The presence of hydrosalpinges has been shown to be deleterious in infertility treatment. pregnancy rates after in-vitro fertilization (IVF) with embryo transfer decline considerably. This study concerns a patient who developed bilateral hydrosalpinges during controlled ovarian stimulation in preparation for IVF treatment. Transvaginal aspiration of the tubal fluid was unsuccessful as the tubes refilled within 2 days. Additionally, on the day of embryo transfer a serometra developed which could not be seen on the day of oocyte retrieval. The uterine cavity was evacuated via an embryo transfer catheter and three embryos were transferred. The serometra reappeared 3 days after embryo transfer. A pregnancy could not be achieved. The accumulation of fluid in the uterine cavity during an IVF/embryo transfer cycle is a rare complication of hydrosalpinges. However, the retrograde flow of tubal fluid may disturb intrauterine embryo development. This study suggests that the aspiration of hydrosalpinges and intrauterine fluid accumulation during an IVF cycle is not beneficial, as the underlying pathology is not cured. Cancellation of the treatment cycle or cryopreservation of oocytes in the pronucleate stage and transfer of the cryopreserved oocytes after surgical correction of the tubes may be better options.- - - - - - - - - - ranking = 3.5keywords = embryo (Clic here for more details about this article) |