1/9. 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 = fertilization (Clic here for more details about this article) |
2/9. 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 = 4keywords = fertilization (Clic here for more details about this article) |
3/9. Uterine incarceration in a 9-week multifetal pregnancy resulting from in vitro fertilization. A case report.BACKGROUND: Although retroversion of the uterus is a common finding, incarceration of the gravid uterus is a rare complication. It occurs usually between the 12th and 16th weeks of gestation and can lead to severe complications. No case of incarceration has been reported before in a multifetal gestation resulting from in vitro fertilization. CASE: A 35-year-old woman with a triplet pregnancy presented at 9 weeks' gestation with acute urinary retention and was diagnosed with uterine incarceration. This diagnosis was confirmed by ultrasound and was resolved using transvaginal pressure under epidural anesthesia. CONCLUSION: This is the first reported case of uterine incarceration in a triplet pregnancy that resulted from in vitro fertilization. There is no universal protocol for treatment of incarceration, but several techniques have been described.- - - - - - - - - - ranking = 6keywords = fertilization (Clic here for more details about this article) |
4/9. Osseous metaplasia: case report and review.OBJECTIVE: To discuss, through the experience of a case report and extensive literature review, the best practices for the diagnosis and treatment of osseous metaplasia, which is the cause of secondary infertility. DESIGN: Case report. SETTING: in vitro fertilization unit in Athens. PATIENT(S): A 40-year-old woman with a 10-year history of secondary infertility. INTERVENTION(S): Hysteroscopic diagnosis and removal of the bony fragment. MAIN OUTCOME MEASURE(S): Elimination of secondary infertility caused by osseous metaplasia. RESULT(S): After treatment, the woman underwent an IVF program and a healthy neonate was born with cesarean section. CONCLUSION(S): hysteroscopy remains the best practice for the diagnosis and removal of endometrial ossifications, causing secondary infertility.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
5/9. 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 = 1keywords = fertilization (Clic here for more details about this article) |
6/9. uterine rupture during pregnancy after laparoscopic myomectomy.A 31 year old patient presenting with primary infertility underwent an operative laparoscopy for the treatment of bilateral hydrosalpinges, during which a myomectomy was also performed. The uterus was repaired using interrupted sutures. At follow-up laparoscopy seven weeks later, a uterine fistula was diagnosed and was oversewn using a single 'figure of eight' suture. One year later the patient became pregnant through in-vitro fertilization. At 34 weeks gestation, she required an emergency laparotomy for acute abdominal pain and the presence of fetal bradycardia. The operative findings revealed a uterine rupture at the site of the previous myomectomy scar. This was then enlarged with a scalpel and a live baby was delivered. The uterus was repaired in two layers. The postoperative period for both mother and baby was satisfactory. This complication raises the problem of the quality of uterine repair following laparoscopic myomectomy, together with the question of how to prevent this type of life-threatening situation.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
7/9. 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 = 1keywords = fertilization (Clic here for more details about this article) |
8/9. Benign gynecologic conditions associated with a CA-125 level > 1,000 U/mL. A case report.BACKGROUND: CA-125 was initially investigated as a marker of ovarian cancer. However, various studies have noted that it can be minimally elevated in benign conditions. CASE: A case of CA-125 > 1,000 U/mL was associated with benign gynecologic conditions. A 37-year-old woman with a history of endometriosis and premature ovarian failure underwent hormonal therapy for donor in vitro fertilization. After an unsuccessful cycle, severe dysmenorrhea developed. Investigation revealed a CA-125 level of 1,036 U/mL and a uterine mass. On exploratory laparotomy, cystic adenomyosis and uterine endometriosis was found. After excision of these areas, the CA-125 levels returned to normal. In this case, cystic adenomyosis and endometriosis of the uterine serosa were responsible for the elevated CA-125 level. CONCLUSION: Very high levels of CA-125 are not always associated with a malignant process.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
9/9. 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 = 1keywords = fertilization (Clic here for more details about this article) |