scholarly journals Silicone Plate for the Prevention of Postoperative Adhesions in Patients with Asherman Syndrome

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Maho Miyagi ◽  
Keiko Mekaru ◽  
Sugiko Oishi ◽  
Chiaki Urasoe ◽  
Kozue Akamine ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Uterine Cavity ◽  
Silicon Plate ◽  
Intrauterine Adhesions ◽  
Endometrial Polyps ◽  
Healthy Baby ◽  
Hysteroscopic Adhesiolysis ◽  
History Of ◽  
Thawed Embryo Transfer

Purpose. Re-adhesion rates following hysteroscopic adhesiolysis have remained high. Accordingly, we present a case involving temporary placement of an intrauterine silicone plate to prevent re-adhesions following hysteroscopic adhesiolysis in a 36-year-old woman with Asherman syndrome. Methods. After hysteroscopic adhesiolysis, a silicone plate molded to the uterine cavity’s shape was inserted into the uterine cavity and left in place for 1 month. Results. The patient had a history of endometrial curettage for endometrial polyps. After the procedure, she developed amenorrhea and experienced infertility for 5 years despite four cycles of in vitro fertilization and embryo transfer. Following admission to our hospital, hysteroscopic examination showed a wide area of intrauterine adhesions for which hysteroscopic adhesiolysis and silicone plate insertion were performed. The silicone plate was removed after 1 month. No intrauterine adhesions were observed during the subsequent hysteroscopic examination. After a thawed embryo transfer, the patient became pregnant and delivered a healthy baby. Conclusions. A silicon plate may be considered a useful tool for preventing re-adhesion following hysteroscopic adhesiolysis without serious complications.

scholarly journals Comparative Study Between Mock Embryo Transfer Prior To The Treatment Cycle and Real Embryo Transfer In In Vitro Fertilization

KnE Medicine ◽  
2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Hilma Putri Lubis
Keyword(s):  
In Vitro Fertilization ◽  
Embryo Transfer ◽  
Treatment Cycle ◽  
Uterine Cavity ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Vitro Fertilization ◽  
Significant Difference ◽  
Clinical Pregnancy Rates

<p><strong>Introduction</strong><strong></strong></p><p>A trial or mock embryo transfer (ET) may influence pregnancy rates and it performed prior to ET allows the clinician to assess the uterine cavity and the utero-cervical angle. The aim of this study is to compare the consistency of the type of ET in mock ET with real ET.</p><p><strong>Material &amp; Methods</strong></p><p>A retrospective comparative analysis of  patients who underwent in vitro fertilization or ICSI cycle from January 2014 to December 2014 in Halim Fertility Center was done. The type of transfer was divided into two groups: ‘easy’ or ‘difficult’. An easy ET was defined as a transfer that occurred without the use of manipulation or other instrumentation and difficult ET was considered when additional instrumentation was required.</p><p><strong>Results</strong></p><p>From the study, 103 patients who underwent Mock-ET, we  found 58 patients (56.3%) with easy ET and 45 patients (43.7%) with difficult ET, which with hard catheter ET in 17 patients (16.5%), with osfander assistance in 20 patients (19.4%) and with stylet in 8 patients (7,8%). 58 patients with Easy Mock ET group were entirely easy real ET (100%) and 45 patients with difficult Mock ET group also entirely were difficult real ET (100%). The Statistical analysis shows no significant difference between the mock ET and real ET groups (p&gt;0,05). In easy real ET, clinical pregnancy rates were 32.8% and in difficult real ET, clinical pregnancy rates were 26.7% with no significant difference between the  groups (p&gt;0,05).</p><p><strong>Conclusion:</strong></p><p>Mock ET prior to the treatment cycle is consistent with real ET.</p>

scholarly journals Successful pregnancy for primary amenorrhea and recurrent implantation failure and the role of hysteroscopic adhesiolysis: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Zakwan Khrait
Keyword(s):  
Uterine Cavity ◽  
Factor V Leiden ◽  
Estradiol Valerate ◽  
Primary Amenorrhea ◽  
Factor V ◽  
Reproductive Techniques ◽  
History Of ◽  
The Right

Abstract Background Infertility continues to be an enigmatic and emerging problem. Although in vitro fertilization has proved to be revolutionary and immensely beneficial to many people, it is far from perfect, and many women experience recurrent in vitro fertilization failures. There can be a multitude of factors involved in recurrent in vitro fertilization failures. The aim of this report was to explore the role of hysteroscopy in determining potential causes of in vitro fertilization failure and how the relevant hysteroscopic findings can address the issue of infertility in terms of a subsequent successful in vitro fertilization. Case presentation A 37-year-old white Arab woman with a history of eight in vitro fertilization failures and one curettage performed for a blighted ovum presented to our hospital because of inability to conceive. Her past medical history was significant for hypothyroidism and positive factor V Leiden. She underwent hystero contrast sonography, which revealed a normal uterine cavity with irregular fillings in the right corner. To explore this further, hysteroscopy was performed, which showed dense adhesions in the right upper corner and first-degree adhesions in the lower half of the uterus. After undergoing adhesiolysis and a cycle of estradiol valerate and progesterone, the patient successfully conceived twins. Conclusions Hysteroscopy may play an important role before or in conjunction with assisted reproductive techniques to help infertile women and couples achieve their goals of pregnancy and live birth of a child.

Pituitary hyperplasia with Sertoli cell-only and 47,XYY syndromes: an uncommon triad

2020 ◽  
Vol 13 (5) ◽  
pp. e233100
Author(s):  
Amelle Geurim Ra ◽  
Paul Jeffrey Evans ◽  
Anshu Awasthi ◽  
Upendram Srinivas-Shankar
Keyword(s):  
Sertoli Cell ◽  
Semen Analysis ◽  
Follicle Stimulating Hormone ◽  
Testicular Biopsy ◽  
In Vitro Fertilisation ◽  
Donor Sperm ◽  
Healthy Baby ◽  
Pituitary Hyperplasia ◽  
History Of

We report the case history of a 32-year-old man with no phenotypical abnormalities who presented with infertility. Semen analysis revealed azoospermia and testicular biopsy confirmed Sertoli cell-only (SCO) syndrome. Karyotyping revealed 47,XYY and pituitary hyperplasia was found on MRI pituitary. In our patient, 47,XYY karyotype is likely to have given rise to SCO syndrome that in turn resulted in pituitary hyperplasia. The patient was evaluated by various members of the multidisciplinary team including the pituitary surgeon, endocrinologist and andrologist. The patient’s partner successfully delivered a healthy baby via in vitro fertilisation with donor sperm. This triad of diagnoses (SCO syndrome, 47,XYY karyotype and pituitary hyperplasia) has not been reported previously. SCO syndrome should be considered in the presence of azoospermia, elevated follicle-stimulating hormone, low inhibin-B and normal testosterone levels. Our case report also highlights the importance of excluding genetic causes of infertility even when the patient has no phenotypical abnormalities.

scholarly journals Evaluation of Uterine Cavity Abnormality using Saline Infusion Sonohysterography Before In Vitro Fertilization

2021 ◽  
Vol 9 (B) ◽  
pp. 917-920
Author(s):  
Ichwanul Adenin ◽  
Hilma Putri Lubis ◽  
Binarwan Halim
Keyword(s):  
In Vitro Fertilization ◽  
Treatment Success ◽  
Uterine Cavity ◽  
Saline Infusion ◽  
Infertile Woman ◽  
Success Rates ◽  
Endometrial Polyps ◽  
Vitro Fertilization ◽  
Saline Infusion Sonohysterography

BACKGROUND: Some studies suggested that saline infusion sonohysterography (SIS) has been used to detect uterine cavity abnormalities before in vitro fertilization (IVF) cycles to improve treatment success rates and decrease the number of cycle cancellations and embryo implantation failures. Some of the factors contributing to the dissemination and acceptance of the technique include the fact that it is a simple, less painful, less expensive, less invasive, and well-tolerated procedure when compared to hysteroscopy. AIM: The aim of the study is to evaluate uterine cavity abnormality with SIS performed before IVF. METHODS: A descriptive retrospective study involving 551 female partners who had SIS before IVF/ICSI treatment at private Halim Fertility Center from January 2014 until December 2017. Five hundred and fifty-one infertile woman was included in this study before IVF/ICSI cycles. Patients agreed to have an ultrasound assessment of the uterine cavity with the use of saline as the contrast medium. SIS procedure was scheduled postmenstrual period in the early-mid follicular phase and 1-3 months before starting IVF/ICSI treatment. RESULTS: From 551 patients, we found 527 (94.4%) cases with the normal uterine cavity. The uterine cavity abnormalities were detected in 5.56% of cases included in this study (28 (5.02%) cases with endometrial polyps, two (0.36%) cases with intrauterine adhesions, and one (0.18%) case with Müllerian duct anomalies). CONCLUSION: SIS before IVF treatment could be a good option for evaluating uterus cavity before IVF to improve success rates of pregnancy.

Successful delivery in 17,20-lyase Deficiency

2021 ◽  
Author(s):  
Zeev Blumenfeld ◽  
Ilana Koren
Keyword(s):  
Embryo Transfer ◽  
Ovarian Stimulation ◽  
Controlled Ovarian Stimulation ◽  
Embryo Cryopreservation ◽  
High Dose ◽  
Human Menopausal Gonadotropin ◽  
Lyase Deficiency ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Objective To study and describe the achievement of successful pregnancy and delivery in a patient with 17,20-lyase deficiency. Design Controlled ovarian stimulation (COS) and In Vitro fertilization (IVF), cryopreservation of embryos and frozen-thawed embryo transfer (ET). Setting IVF clinic. Patient A 24 years old, infertile patient with 17,20-lase deficiency. Interventions Controlled ovarian stimulation, follicular aspiration- egg retrieval, IVF, embryo cryopreservation, thawed ET. Main Outcome Measures Clinical pregnancy, successful delivery. Results Isolated 17,20-lyase deficiency is caused by mutations in the CYP17A1 gene (coding for cytochrome P450c17), POR (coding for cytochrome P450 oxidoreductase) and CYB5A (coding for microsomal cytochrome b5) genes. A 24 yo patient with 17,20-lyase deficiency had undergone IVF with gonadotropin releasing hormone agonist (GnRHa) protocol, prednisone, and gonadotropins. After human chorionic gonadotropin (hCG) trigger 37 oocytes were retrieved, 25 ova fertilized, and 17 embryos cryopreserved. After menstrual bleeding, the endometrium was stimulated with oral estradiol, under progesterone suppression with long acting GnRHa and prednisone. When endometrial width of 8.5 mm was reached, vaginal progesterone was added, while gradually decreasing prednisone. On the fourth day of progesterone supplement, two thawed embryos were transferred. After 11 days of human menopausal gonadotropin (hMG), estradiol concentration moderately increased, but progesterone levels remained high, therefore, no fresh ET was performed. Twelve days after thawed ET, hCG was positive, and seven days later, an intrauterine gestational sac was detected, but the pregnancy ended in missed abortion. After two months, another frozen-thawed embryo transfer (FET) was performed, generating a normal gestation, which ended in successful delivery. Conclusion Pregnancy can be achieved in patients with 17,20-lyase deficiency, by IVF, freezing all embrya, and ET in a subsequent cycle, while suppressing endogenous ovarian progesterone with a GnRHa and adrenal suppression with high dose glucocorticoids.

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