1/15. exercise-induced ovarian torsion in the cycle following gonadotrophin therapy: case report.The incidence of ovarian torsion has been reported to be increased during controlled ovarian hyperstimulation. In this report we describe exercise-induced ovarian torsion in an ovary with a persistent cyst, following a failed gonadotrophin-stimulated intra-uterine insemination cycle. This report suggests that the risk of ovarian torsion persists beyond the treatment cycle and that patients should be instructed to refrain from exercise or strenuous activity if regression to normal ovarian size has not been documented. Ovarian torsion should be high in the differential diagnosis in patients experiencing abdominal pain with a history of recent gonadotrophin stimulation.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
2/15. Empty follicle syndrome in two sisters with three cycles: case report.Empty follicle syndrome (EFS) is characterized by a lack of retrieved oocytes in the presence of multiple follicle development, in both natural and stimulated cycles. The aim of the present case report is to point out the possibility of genetic factors that could be responsible for some occurrences of EFS. Two sisters with moderate deafness underwent controlled ovarian hyperstimulation and IVF/ICSI cycles at the same centre. During all three cycles there were normal follicular development, estradiol levels and bio-available hCG plasma levels, but no oocytes and cumulus-corona complexes were retrieved, despite second hCG injections. These cases may represent an inherited condition of EFS with hearing loss with genetic factors affecting both the aetiology of EFS and the hearing loss.- - - - - - - - - - ranking = 1.1666666666667keywords = cycle (Clic here for more details about this article) |
3/15. Successful treatment of empty follicle syndrome by triggering endogenous LH surge using GnRH agonist in an antagonist down-regulated IVF cycle.To date, empty follicle syndrome (EFS) has only been reported in GnRH agonist down-regulated IVF cycles. Some cases have been successfully treated by changing the batch, or by repeating the dose of hCG. A case of EFS was observed in both GnRH antagonist and GnRH agonist down-regulated IVF cycles when final oocyte maturation was triggered using urinary hCG (u-hCG). Failure to retrieve oocytes occurred, despite administration of a further dose of u-hCG from a different batch and a delayed repeated oocyte recovery performed in the second GnRH agonist down-regulated cycle. A successful oocyte recovery cycle was achieved after triggering of an endogenous gonadotrophin surge using GnRH agonist in an antagonist down-regulated cycle. Nine oocytes were readily retrieved from 10 follicles, at 36 h after GnRH agonist administration, and eight of these fertilized normally. Two good quality embryos were used for fresh transfer and four were cryopreserved for future use. EFS can occur in GnRH antagonist down-regulated IVF cycles, and can be successfully treated by triggering a natural gonadotrophin surge using GnRH agonist in the absence of any response to previous treatment methods. This represents a novel therapeutic modality for this uncommon but frustrating condition.- - - - - - - - - - ranking = 1.6666666666667keywords = cycle (Clic here for more details about this article) |
4/15. Pericentric inversion of chromosome 2 in a patient with the empty follicle syndrome: case report.The empty follicle syndrome (EFS) is defined as a lack of retrieved oocytes from follicles, at the time of repeated aspiration and flushing, following ovulation induction. The actual mechanism responsible for the EFS is still unknown. The aim of this study was to offer more information regarding the possible connection of this syndrome with pericentric inversion of chromosome 2. We give a case report of a patient who had multiple failed IVF attempts, due to the absence of oocyte and granulosa cells in the follicular fluid, following oocyte retrieval in both stimulated and natural cycles. Chromosomal analysis showed the presence of a pericentric inversion of chromosome 2: 46,XX,inv(2)(p11q21) in the female partner karyotype, while the male partner had a normal karyotype. Our case showed possible genetic factor influence in the aetiology of EFS.- - - - - - - - - - ranking = 0.16666666666667keywords = cycle (Clic here for more details about this article) |
5/15. Ovarian hyperstimulation caused by gonadotroph cell adenoma: a case report and review of the literature.OBJECTIVE: We present a case of spontaneous ovarian hyperstimulation caused by pituitary gonadotroph macroadenoma, and include a review of the literature. CASE REPORT: A 27-year-old woman presented with irregular menstruation and bilateral multicystic enlargement of the ovaries. serum estradiol (E(2)) levels were marginally elevated for the follicular phase but within the physiological range. serum luteinizing hormone (LH) was extremely low, follicle-stimulating hormone (FSH) was normal, and prolactin (PRL) was high. magnetic resonance imaging disclosed a pituitary macroadenoma. Immunohistochemical examination of the surgically removed adenoma showed intense reactivity for FSH and LH. After the operation, E(2), LH and PRL levels were normalized, the ovaries returned to a normal morphology, and regular menstrual cycles were resumed. CONCLUSION: A review of the literature showed that ovarian hyperstimulation caused by pituitary gonadotroph adenoma is not always accompanied by elevated FSH levels. High PRL and E(2) and low LH were reported in the majority of the cases, but E(2) may stay within the range observed in normal menstrual cycles.- - - - - - - - - - ranking = 0.33333333333333keywords = cycle (Clic here for more details about this article) |
6/15. Simultaneous bilateral ovarian torsion in the follicular phase after gonadotropin stimulation.OBJECTIVE: To present and discuss the first report of follicular phase bilateral ovarian torsion following a cancelled IVF cycle. DESIGN: Case report. SETTING: University-based assisted reproductive technology program. PATIENT(S): A 41-year-old nulligravid patient on day 3 of her menses following a cancelled IVF cycle. INTERVENTION(S): Gonadotropin ovulation induction; laparoscopy with detorsion of left and right ovaries; aspiration of cysts. RESULT(S): Ovarian torsion resolved; follicular development in the following natural cycle. CONCLUSION(S): This is a unique case of simultaneous bilateral ovarian torsion following a cancelled IVF cycle and presenting in the ensuing follicular phase. physicians should be aware of this unusual risk related to persistently enlarged ovaries in the cycle following gonadotropin stimulation. Furthermore, management of the infertility patient should be conservative and focused on ovarian preservation whenever feasible. Early surgical intervention can permit reperfusion and salvage of the affected adnexa.- - - - - - - - - - ranking = 0.83333333333333keywords = cycle (Clic here for more details about this article) |
7/15. Internal jugular vein thrombosis after ovulation induction with gonadotropins.An unusual case of ovarian hyperstimulation syndrome complicated by internal jugular vein and mediastinal thrombosis is presented. Hemoconcentration and perhaps immobilization appear to be the most probable causative factors. The patient was successfully treated with heparin anticoagulation. An uneventful twin pregnancy resulted from the stimulation cycle.- - - - - - - - - - ranking = 0.16666666666667keywords = cycle (Clic here for more details about this article) |
8/15. Pseudocorpus luteum insufficiency: a local defect of progesterone action on endometrial stroma.A 23-yr-old woman whose initial complaint was infertility demonstrated glandular stromal dissociation with failure of the endometrial stroma to undergo pseudodecidualization in repeated endometrial biopsies taken late in the luteal phase. As the clinical presentation was consistent with the inadequate corpus luteum syndrome, hormone measurements were performed. The endometrial biopsy was abnormal during cycles in which the serum pattern of progesterone, estradiol, FSH, and LH was normal. Exogenous progesterone did not correct the abnormality. The patient, by in vitro studies, has approximately one half the number of high affinity progesterone-binding sites in the cytosol fraction of her endometrium compared to preparations from two normal control subjects. Since her cytosol-binding protein was qualitatively identical to two control subjects, the incomplete maturation of her endometrial stroma may represent an absence or reduced number of stromal cytosol receptors and/or a resistance to specific hormone action in an individual target tissue.- - - - - - - - - - ranking = 0.16666666666667keywords = cycle (Clic here for more details about this article) |
9/15. Ovarian hyperstimulation complicating the clinical presentation of a pre-existing ectopic pregnancy.A 32-year-old nulliparous woman underwent hMG induction of superovulation, started on the third day of "menses." The presence of hyperstimulation confused the clinical picture of ectopic pregnancy conceived during the previous cycle. This case illustrates that (1) the clinical findings of hyperstimulation may mask those of ectopic pregnancy; (2) the ovary is not refractory to hMG in the presence of circulating hCG; and (3) an inappropriately high beta-hCG value is suggestive of gestation initiated during a previous cycle.- - - - - - - - - - ranking = 0.33333333333333keywords = cycle (Clic here for more details about this article) |
10/15. Spontaneous pregnancy in a patient with hypergonadotrophic ovarian failure.A 27-year-old woman was referred to the gynaecological endocrine clinic because of infertility and secondary amenorrhoea. serum luteinizing hormone and follicle stimulating hormone levels were raised and oestradiol concentrations were subnormal. In spite of these findings, spontaneous resumption of menstrual cycles associated with a fall of gonadotrophin concentrations was followed by a normal pregnancy.- - - - - - - - - - ranking = 0.16666666666667keywords = cycle (Clic here for more details about this article) |
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