1/263. Hysteroscopic cervical canal shaving: a new therapy for cervical stenosis before embryo transfer in patients undergoing in vitro fertilization.OBJECTIVE: To report a case of cervical stenosis repaired by hysteroscopic cervical shaving that created a smooth passage for ET in a patient undergoing IVF. DESIGN: Case report. SETTING: University-based IVF program. PATIENT(S): A woman with a history of multiple failed IVF attempts in whom ET was extremely difficult. INTERVENTION(S): Operative hysteroscopy with creation of a cervical tract. MAIN OUTCOME MEASURE(S): Ease of postoperative ET and outcome of IVF treatment after the hysteroscopic procedure. RESULT(S): Easy performance of ET and a resulting triplet pregnancy. CONCLUSION(S): This novel hysteroscopic repair of cervical stenosis resulted in a markedly easier ET and a viable pregnancy.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/263. Triplet pregnancy in a subfertile woman treated with clomiphene citrate.A 26-year-old subfertile woman with a history of abortions at the 7-9th week was treated with Clomid, 50 mg for 5 days. A pregnancy resulted, which ended in the premature birth of a set of alive triplets that sex and blood-group determinations showed to be trizgotic. It is suggested that this production of a multiple ovulation in a woman with luteal deficiency be the result of excessive dosage of Clomid.- - - - - - - - - - ranking = 2.5keywords = pregnancy (Clic here for more details about this article) |
3/263. pregnancy following the laparoscopic bipolar electrocoagulation of polycystic ovaries resistant to medicamentous ovulation induction--a case report.The case of a primarily infertile patient with polycystic ovaries (PCOS) resistant to medicamentous ovulation induction is presented. The preoperative condition, laparoscopic ovarian drilling using an original technique of bipolar electrocoagulation and consecutive spontaneous pregnancy and delivery are described. This case suggests that bipolar forceps with jaws 1 mm wide could be a useful instrument for laparoscopic ovarian drilling.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
4/263. 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.- - - - - - - - - - ranking = 4keywords = pregnancy (Clic here for more details about this article) |
5/263. 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.- - - - - - - - - - ranking = 0.024565365289114keywords = gestation (Clic here for more details about this article) |
6/263. Ectopic pregnancy after transmyometrial embryo transfer: case report.OBJECTIVE: To report a case of ectopic pregnancy after transvaginal transmyometrial ET. DESIGN: Case report. SETTING: University-based IVF program. PATIENT(S): A woman with tubal subfertility and a history of difficult ETs. INTERVENTION(S): Transvaginal transmyometrial ET performed to avoid a difficult transcervical ET. MAIN OUTCOME MEASURE(S): Expected improvement in the pregnancy rate in a selected group of patients. RESULT(S): Tubal pregnancy. CONCLUSION(S): Transmyometrial ET is an attractive alternative to difficult transcervical ET but is not free of complications.- - - - - - - - - - ranking = 3.5keywords = pregnancy (Clic here for more details about this article) |
7/263. Clinical management of a quadruplet pregnancy combining a triplet pregnancy with a classical hydatidiform mole: case report and review of literature.A 28-year-old Taiwanese woman who had received ovulation induction by clomiphene citrate (CC), follicular-stimulating hormone (FSH), and human chorionic gonadotrophin (hCG) treatment was diagnosed with a quadruplet pregnancy containing a hydatidiform mole and three fetuses at nine weeks' gestation. Expectant management failed to achieve any viable neonate due to massive antepartum haemorrhage and preterm delivery at 25 weeks' gestation. Five other cases previously reported involving quadruplets or triplets with a complete hydatidiform mole and two or three fetuses are reviewed. All cases ended as premature non-viable fetuses. Analysis of the clinical features, management, and outcome both in our patient and these reports suggest that more efficacious treatment planning, such as selective feticide, should be considered in order to improve the likelihood of attaining an advanced gestational age for a single fetus.- - - - - - - - - - ranking = 4.5736960958673keywords = pregnancy, gestation (Clic here for more details about this article) |
8/263. Recovery of spermatogenesis and successful conception after bone marrow transplant for acute leukaemia: case report.A case is presented of a young adult male diagnosed with acute myeloid leukaemia who was treated with busulphan and cyclophosphamide, but not total body irradiation, with subsequent bone marrow transplantation. After surviving for 5 years, he and his wife experienced a period of infertility. Interestingly, the problem was found to be with the female partner and the man's sperm evaluation seemed normal. A successful pregnancy ensued following the surgical removal of a large endometrioma and treating a luteal phase deficiency. Though this may be the fifth case of proven parentage in cases of bone marrow conditioning and bone marrow transplantation in a male for control of leukaemia, we believe it is the first documented case showing a normal semen analysis despite treatment. Further studies are needed to see if chemical conditioning with busulphan and cyclophosphamide preserve the chances of sperm production better than total body irradiation.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
9/263. The use of gonadotrophin-releasing hormone antagonists in polycystic ovarian disease.Polycystic ovarian disease (PCOD) is characterized by anovulation, eventually high luteinizing hormone (LH) levels, with increased LH pulse frequency, and hyperandrogenism. As the aetiology of the disease is still unknown, gonadotrophin-releasing hormone (GnRH) antagonists, competitive inhibitors of GnRH for its receptor, are interesting tools in order to study and treat the role of increased LH levels and pulse frequency in this disease. Their administration provokes a rapid decrease in bioactive and immunoactive LH followed by a slower decrease in follicle-stimulating hormone (FSH). In patients with PCOD, the suppression of gonadotrophin secretion eradicates the symptoms of the disease as long as the treatment lasts. Several authors have suggested that increased plasma LH levels have deleterious effects on the fertility of women with PCOD. Indeed, fewer spontaneous pregnancies with more miscarriages are observed when plasma LH levels are high. Assisted reproduction techniques such as in vitro fertilization (IVF) have provided other clues to the role of the LH secretory pattern in women with PCOD. The number of oocytes retrieved, the fertilization rate and the cleavage rate are lower in PCOD patients undergoing IVF and this is inversely correlated with FSH:LH ratio. These abnormalities are corrected when endogenous secretion of LH is suppressed. On the other hand, implantation and pregnancy rates after IVF are similar to those observed in control women. New GnRH antagonists are devoid of side effects and suppress LH secretion within a few hours without a flare-up effect. This action lasts for 10-100 hours. When GnRH antagonists are associated with i.v. pulsatile GnRH, this combination both suppresses the effect of endogenous GnRH and because of the competition for GnRH receptors restores a normal frequency of LH secretion. We have studied two women with PCOD, administering first 10 mg s.c. every 72 hours for 7 days of the GnRH antagonist Nal-Glu, then adding on top i.v. pulsatile GnRH: 10 micrograms/pulse every 90 minutes for 15 days. We thus succeeded in normalizing LH secretion pattern and observed a significant decline in testosterone levels. We failed to induce appropriate ovarian response and ovulation. In conclusion, the combination of GnRH antagonist and GnRH pulsatile treatment can re-establish normal LH secretory pattern in patients with PCOD. The failure to induce ovulation with this regimen suggests the existence of an inherent ovarian defect in women with PCOD.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
10/263. Subsequent successful pregnancy and delivery after intracytoplasmic sperm injection in a patient with XY gonadal dysgenesisms.Report of a rare case of subsequent twin delivery after intracytoplasmic sperm injection (ICSI) into donated oocytes in a 30-year-old woman with a diagnosis of XY dysgenesis, who underwent a gonadectomy at the age of 13 years. Her husband suffers from severe oligo-astheno-terato-spermia.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
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