1/22. salpingectomy for unilateral hydrosalpinx may improve in vivo fecundity.The objective of this study was to determine whether unilateral salpingectomy for hydrosalpinx could improve fecundity in women with an apparently normal contralateral tube. Two women with unilateral hydrosalpinx and with an apparently normal contralateral tube, and a long history of infertility, including failure to conceive despite several cycles of in vitro fertilization (IVF), had unilateral salpingectomies prior to considering subsequent IVF cycles. Case 1 conceived after 1 month following surgery and case 2 after 8 months without the use of assisted reproductive technology. Though the ensuing pregnancies may have been fortuitous, the possibility exists that in cases of unilateral hydrosalpinx, the performance of salpingectomy may improve fecundity without the need for IVF. Hopefully the outcome of these 2 case reports may generate interest in a larger cooperative prospective study. copyright copyright 1999 S. Karger AG, Basel- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
2/22. Chronic cough and infertility: a report of two cases.OBJECTIVE: To report two cases of infertility caused by primary ciliary dyskinesia in patients who presented with an associated complaint of a chronic cough. DESIGN: Case report. SETTING: University teaching hospital.Patient(s): Two patients presenting with unexplained infertility and an associated history of long-term chronic cough. INTERVENTION(s): patients underwent a nasal mucosal biopsy by an otolaryngologist. Electron microscopy (EM) examination of biopsy specimens was performed. MAIN OUTCOME MEASURE(s): diagnosis and appropriate treatment for functional tubal factor infertility. RESULT(s): Both patients were diagnosed with primary ciliary dyskinesia based on EM of the nasal biopsy specimens. Given this diagnosis, they immediately underwent IVF-ET. Both patients became pregnant with their first IVF-ET cycle. CONCLUSION(s): Other investigators have shown that almost 20% of patients with a chronic cough will have EM evidence of ciliary dyskinesia. patients presenting with idiopathic infertility and an associated unexplained chronic cough should be referred for nasal biopsy with EM evaluation to rule out primary ciliary dyskinesia. infertility in these cases, which is due to a functional tubal factor, is best treated with IVF-ET rather than superovulation and intrauterine insemination treatments.- - - - - - - - - - ranking = 0.5keywords = cycle (Clic here for more details about this article) |
3/22. salpingectomy improves outcome in the presence of a unilateral hydrosalpinx in a donor oocyte recipient: a case report.PURPOSE: To determine if unilateral salpingectomy for hydrosalpinx can improve fecundity in a woman with many cycles of failure to conceive despite the fertilization of donor oocytes and subsequent embryo transfer. methods: salpingectomy performed after failure to conceive despite IVF-ET with the patient's own oocytes (n=5) or transfer of donor embryos (n=2) or embryo transfer cycles as a donor oocyte recipient (n=5). RESULTS: The patient conceived three of four times following salpingectomy. Transfer of four frozen-thawed donor embryos and two frozen-thawed embryos of her own led to a successful delivery. In one of two cycles as a donor oocyte recipient she had a successful delivery and subsequently, the transfer of cryopreserved/thawed embryos from a previous donor oocyte cycle led to a chemical pregnancy. CONCLUSION: Unilateral hydrosalpinx can be a cause of recalcitrant failure to conceive despite assisted reproductive technology. salpingectomy can restore fecundity.- - - - - - - - - - ranking = 2keywords = cycle (Clic here for more details about this article) |
4/22. Abnormal cervicovaginal smears due to endometriosis: a continuing problem.endometriosis may be challenging when identified on cervicovaginal smears (CVS), leading to an incorrect interpretation of high-grade squamous intraepithelial lesion (HSIL), or atypical glandular cells of undetermined significance (AGUS) including adenocarcinoma in situ (AIS). awareness of cervical endometriosis, particularly in predisposed patients, is crucial for a correct diagnosis. While cervical endometriosis has been reported to be a diagnostic pitfall of glandular abnormalities, its characteristic features are still not well-established. This may partially be attributed to the varied cytomorphologic features endometriosis shows, depending on menstrual cycle hormonal changes. We describe our experience with three examples where CVS were interpreted as either AGUS or HSIL, which led to a hysterectomy in 2 of 3 patients. Cervical endometriosis needs to be considered with other well-known benign conditions that mimic glandular abnormalities, including cervicitis, tubal metaplasia, lower uterine segment sampling, and microglandular hyperplasia. Published series and our own experience lead us to suggest that these smears will continue to present diagnostic difficulties.- - - - - - - - - - ranking = 0.5keywords = cycle (Clic here for more details about this article) |
5/22. Limited polyarteritis nodosa of the male and female reproductive systems: diagnostic and therapeutic approach.BACKGROUND: polyarteritis nodosa (PAN) is a multisystem necrotising small and medium sized vasculitis that when left untreated carries a grave prognosis, with a five year survival of 10-15%. Prolonged immunosuppressive treatment with cyclophosphamide and steroids leads to high remission rates while carrying the risk of life threatening complications. The diagnostic and therapeutic approach for patients with isolated genital tract PAN is not well defined. OBJECTIVE: To present the management and follow up of two patients with limited PAN localised to the male and female reproductive system. case reports: A 26 year old man presented with an "acute scrotum". He was afebrile and had no other sign or symptom. Laboratory tests, including complete blood count, erythrocyte sedimentation rate, liver and renal function tests, C reactive protein, antinuclear antibody, cryoglobulins, complement levels, antineutrophil cytoplasmic antibodies, and hepatitis b surface antigen, were all normal. His left testis was excised. Histopathology disclosed PAN of medium sized arteries with testicular infarction but no signs of torsion or infection. The other patient was a 51 year old woman who had had a total hysterectomy for a uterine myoma; incidentally PAN of the uterus and fallopian tubes was discovered. Neither patient received any immunosuppressive treatment after surgical removal of the affected organ. On prolonged follow up (clinical and laboratory evaluation) both patients are healthy with no sign of local recurrence or systemic PAN.- - - - - - - - - - ranking = 0.00096236431561091keywords = life (Clic here for more details about this article) |
6/22. Torsion of the fallopian tube in an adolescent female: a case report.BACKGROUND: Torsion of the fallopian tube is an infrequent but significant cause of acute lower abdominal pain in adolescent females that is difficult to recognize preoperatively, although prompt diagnosis and timely surgical treatment are vital to salvage the oviduct. CASE REPORT: A 17-yr-old virgin presented with sudden and severe right-sided lower abdominal pain with guarding and tenderness, fever, nausea, and vomiting at mid-cycle. Ultrasound scan showed a right ovarian cyst measuring 3 cm in diameter and a normal appendix. There was no leucocytosis. Presumptive diagnosis was a cystic ovarian follicle with ovulatory pain. Her condition improved but did not resolve with supportive treatment. At laparotomy, the right fallopian tube was twisted completely, distended with blood, and necrotic, with a small fimbrial cyst. The left tube, ovaries, appendix, and uterus were normal. Right salpingectomy was performed. Histologic examination revealed diffuse hemorrhagic infarction of the tube and a cyst of the hydatid of Morgagni. She remains well at follow-up. CONCLUSION: Unless a high index of suspicion is maintained for torsion of the fallopian tube in adolescent females, this disorder may not be detected until after tubal destruction.- - - - - - - - - - ranking = 0.5keywords = cycle (Clic here for more details about this article) |
7/22. Mullerian papilloma-like proliferation arising in cystic pelvic endosalpingiosis.This report describes an unusual epithelial proliferation occurring in pelvic cystic endosalpingiosis. A cyst mass lined by a layer of ciliated epithelial cells involved the posterior surface of the cervix and vagina. The epithelial proliferation within the wall resembled a mullerian papilloma with fibrous and fibrovascular cores lined by bland cuboidal epithelial cells. Other areas had a microglandular growth pattern resembling cervical microglandular hyperplasia, and focally there was a solid growth pattern. Foci of typical endosalpingiosis involved the surface of both ovaries and pelvic soft tissues. The cystic lesion recurred after partial cystectomy and drainage and was followed up radiologically and with periodic fine-needle aspiration. Part of the wall of the cyst removed 11 years after the original surgery showed an identical epithelial proliferation. MIB1 staining showed a proliferation index of less than 5%, contrasting with the higher proliferation index of a typical serous borderline tumor. The differential diagnosis is discussed. As far as we are aware, this is the first report of such a benign epithelial proliferation involving cystic endosalpingiosis.- - - - - - - - - - ranking = 0.0096236431561091keywords = life (Clic here for more details about this article) |
8/22. Heterotopic pregnancy in a natural conception cycle presenting with tubal rupture: a case report and review of the literature.BACKGROUND: Heterotopic pregnancy is a potentially fatal condition, rarely occurring in natural conception cycles. CASE: We report such a case in a 28-year old para 0, gravida 1 woman with no known risk factors. The ectopic pregnancy was diagnosed after rupturing at 11 weeks, 4 weeks after diagnosis of the intrauterine pregnancy, and resected via laparotomy. A healthy baby was delivered without complications at 40 weeks gestation. CONCLUSION: Heterotopic pregnancy is possible with natural conception and the survival of the intrauterine fetus is feasible.- - - - - - - - - - ranking = 2.5keywords = cycle (Clic here for more details about this article) |
9/22. peritonitis after a ruptured left pyosalpinx in a patient undergoing in vitro fertilization.OBJECTIVE: To report acute abdomen in a young woman with infertility due to small asymptomatic bilateral hydrosalpinges who was on the 12th day of an IVF cycle. DESIGN: Case report. SETTING: Private IVF clinic. PATIENT(S): A 35-year-old woman with asymptomatic bilateral hydrosalpinges. INTERVENTION(S): Abdominal laparoscopy. MAIN OUTCOME MEASURE(S): Pus and a ruptured left pyosalpinx. RESULTS: The patient suddenly developed acute abdomen while lifting a disabled person at a nursing home where she worked as a nurse. About 200 mL of pus was aspirated, and the patient had a ruptured left pyosalpinx. Bilateral salpingectomy was done by laparoscopy; the patient's postoperative recovery was uneventful. CONCLUSION: We report a rare case of acute abdomen due to peritonitis after a ruptured pyosalpinx in an IVF patient who lifted a disabled person.- - - - - - - - - - ranking = 0.5keywords = cycle (Clic here for more details about this article) |
10/22. Tumor-like cystic endosalpingiosis of the uterus with florid epithelial proliferation. A case report.Mass-like cystic endosalpingiosis is very rare. The author reports such a lesion with histologic features of endosalpingiosis of the uterus with florid epithelial proliferation in a 51-year-old female who complained of lower abdominal pain. Preoperatively, it was considered to be left-sided ovarian cancer. Intraoperatively, a subserosal, sessile polypoid mass with multiple cysts in the uterine fundus measuring 12 x 6.5 x 5.5 cm was found. Histologically, it was composed of multiple cysts lined by benign-appearing tubal epithelium and bland smooth muscular and myofibromatous stroma. Part of the epithelium exhibited marked papillarity and tufting. Features of conventional endometriosis were present focally. Pathologists and clinicians should be aware of the existence of this type of non-neoplastic lesion, mass-like cystic endosalpingiosis, and should avoid overdiagnosis and overtreatment.- - - - - - - - - - ranking = 0.0048118215780545keywords = life (Clic here for more details about this article) |
| | Next -> |