Does endometrioma surgery affect assisted reproductive technologies cycle outcome in patients with decreased ovarian reserve diagnosed by Bologna criteria?

Author(s):  
Inci Kahyaoglu ◽  
Cavidan Gülerman ◽  
Nafiye Yılmaz ◽  
Mehmet Ufuk Ceran ◽  
Ayşe Seval Ozgu-Erdinc ◽  
...  

Objectives: Data regarding whether the assisted reproductive technologies (ART) outcome of patients with decreased ovarian reserve (DOR) secondary to an endometrioma surgery differs from that of patients with DOR secondary to other etiologies is limited. The aim of this study was to compare the ART outcomes of DOR patients diagnosed by Bologna criteria secondary to a previous endometrioma surgery with DOR patients without a history of an endometrioma surgery. Methods: This retrospective cohort study was conducted in the assisted reproduction unit of a tertiary research and education hospital. Medical records of the patients with DOR were reviewed retrospectively. Group I included 23 cycles of DOR patients secondary to a previous endometrioma surgery and Group II consisted of 260 cycles of DOR patients without a history of endometrioma surgery. Results: No significant difference was demonstrated between groups regarding demographic features except for the age (32 (24–41) in Group I vs 35 (23–47) in Group II, p = 0.031). The data comparing the controlled ovarian stimulation parameters and ART outcomes showed similar results in both groups. No statistically significant difference was found between groups regarding pregnancy rates per transfer (23% vs 22.2 %) and per cycle (13% vs 15.4%) ( p > 0.05). Conclusion: Cycle outcomes of DOR patients secondary to an endometrioma surgery did not differ from that of DOR without an endometrioma surgery history.

Author(s):  
Dr. Hitesh Kumar Solanki ◽  
Dr. Omnath P Yadav ◽  
Dr. Anita J Gojiya

The study was conducted in department of physiology, B J Medical College, Ahmedabad from Mar. 2012 to Feb. 2013. This was a cross-sectional study to evaluate the effect of smoking on lung   function and serum lipids in asymptomatic smokers   and comparable non   smokers. The mean of the various spirometric parameters were calculated of the subjects for both the groups. The mean FVC in group I and group II was 2.60 ± 0.62 L and 4.10 ± 0.64L respectively. The mean FEV1 in group I was 1.91 ± 0.57L and     3.19 ± 0.77L in group II Group I had mean FEF25% - 75% and PEFR of 1.98 ± 0.67L/sec and 4.50 ± 1.57L/sec respectively. Group II had mean FEF25 – 75% of 4.22 ± 1.23L/sec and a mean PEFR of 7.22 ± 1.42L/sec. In young smokers and asymptomatic, still the spirometric values were significantly deranged as compared to controls. Even smokers with history of less pack years of smoking also had significant abnormalities of lung function. All he spirometric values in the two groups had statistically highly significant difference and were higher in non-smokers as compared to smokers. The spirometric values were reduced in smokers with history of smoking for as low as two pack years. Keywords: Progression, PFT, Asymptomatic & Smokers


Doctor Ru ◽  
2020 ◽  
Vol 19 (8) ◽  
pp. 14-19
Author(s):  
S.V. Barinov ◽  
◽  
O.V. Ostrovskaya ◽  
I.V. Shamina ◽  
Yu.I. Tirskaya ◽  
...  

Study Objective: To optimize pregnancy management and improve delivery outcomes in women with infertility of endocrine origin after the use of assisted reproductive technologies (ART). Study Design: This was an analytical prospective study. Materials and Methods: One hundred and twenty patients with singleton pregnancy were observed: 74 women with infertility of endocrine origin who had undergone in vitro fertilization (IVF) (Group I) and 46 women who became pregnant spontaneously (Group II). The main group (Group I) was divided into subgroup IA (n = 44), in which a comprehensive approach to pregnancy was applied (obstetric pessary and micronized progesterone), and subgroup IB (n = 30) consisting of patients for whom micronized progesterone alone was used. Study Results: Groups I and II differed significantly in miscarriage risk rates: 60.8% and 30.4%, respectively. This complication was most often observed in subgroup IB (80.0%), 2.6 times more often than in Group II (χ2 = 5.700; p = 0,029). There were also statistically significant differences between the groups in the rate of preterm delivery (PD), which was 5.6 times higher in the main group than in the control group (24.3% vs. 4.3%, χ2 = 4.915; p = 0.027). The greatest difference from the control group (9.3 times higher rate) was observed in subgroup IB (χ2 = 10.156; p = 0.004). Conclusion: A comprehensive approach makes it possible to prolong pregnancy, reduce rates of PD by a factor of 2.9 and achieve full-term pregnancies in 86.4% of cases. Keywords: pregnancy, IVF, ART, obstetric complications, perinatal outcomes, Arabin pessary.


Lupus ◽  
2019 ◽  
Vol 28 (7) ◽  
pp. 806-817 ◽  
Author(s):  
D H Attia ◽  
A Mokbel ◽  
H M Haggag ◽  
N Naeem

Several studies have emphasized poor pregnancy outcomes associated with active lupus nephritis at the onset of conception. A few controversial studies have compared pregnancy outcome in patients with inactive lupus nephritis at conception and those without a history of lupus nephritis. This study aimed to find out if quiescent lupus nephritis at the onset of conception carries an increased risk of pregnancy complications compared to pregnancies without a history of lupus nephritis. This is a prospective cohort study carried out at the Rheumatology/Obstetrics Conjoint Clinic of Kasr Al-Ainy Hospital between January 2006 and December 2017. A total of 119 pregnancies were included: 72 pregnancies in group I (with a history of lupus nephritis) and 47 pregnancies in group II (non-renal systemic lupus erythematosus). They were subjected to full history taking, monthly clinical examination and laboratory investigations. In total, 16 (22.2%) renal pregnancies had renal flares at the onset of conception. Maternal complications, specifically renal flares, were reported in 36 (50%) pregnancies in group I and 13 (27.7) pregnancies in group II, with a significant difference ( p = 0.015). No significant differences were found concerning the frequency of pregnancy-related maternal and fetal complications between the two groups. When data were re-analyzed after excluding patients experiencing renal flares during the 6 months preceding pregnancy, there were no significant differences regarding the frequency of maternal and fetal complications between renal and non-renal pregnancies. In conclusion, lupus nephritis, per se, is not a risk factor for poor pregnancy outcome; rather, it is the lupus nephritis activity at the onset of pregnancy.


2018 ◽  
Vol 25 (1) ◽  
Author(s):  
Nicolaus Kresno Harimurti ◽  
Zulfikar Ali ◽  
Trisula Utomo

Objective: Catheter management is conducted to the patients undergoing transurethral resection of the prostate (TURP). There were many arguments between clinical practitioners about bladder training procedure after TURP procedure. This study aims to determine whether there is a relationship between bladder training action and success of spontaneous micturition in post TURP procedure in patients with urinary retention caused by prostate enlargement. Material & methods: Randomized clinical trial was conducted at Kardinah General Hospital, Tegal from October 2015 to February 2016. 44 study participants who underwent TURP were randomly allocated into two groups. In Group I, patient’s Folley catheter was clamped prior to its removal (bladder training group); and in Group II was not clamped (control group). Results: Mean age of patients was 64.48 ± 8.1 years old. There were 23 patients (52.3%) have had history of recurrent urinary retention and 21 patients (47.7%) have had not (p=0.560). There were 4 patients (17.4%) in Group I and 1 patient (4.7%) in Group II who required re-catheterization and discharge with catheter. There was no statistically significant difference in spontaneous micturition rate between bladder training group and control group (p=0.187).  Conclusion: The result of the current study identified that bladder training to patients undergoing TURP procedure had no significant impact in spontaneous micturition.


2021 ◽  
Vol 25 (3 (99)) ◽  
pp. 149-156
Author(s):  
V. Yuzko ◽  
O. Yuzko

Оbjective of the study was to conduct a retrospective comparative characterization of patients with infertility who took or did not take melatonin with assisted reproductive technologies (ART).Materials and methods. In our study, we examined 89 women. The first (control) group included 13 healthy women oocyte donors who got pregnant on their own and gave birth to their own healthy children, the second group - 33 patients with infertility, who took 3 mg of the preparation "Vita-melatonin" produced by "Kyiv Vitamin Plant" at the same time before bedtime, two weeks before and during ovulation stimulation, the third group - 43 patients with infertility who did not take melatonin preparation before and during ovulation stimulation. There were no women who worked night shifts among the patients. Medical documentation of women of the control group and those with infertility, data of gynecological, ultrasound examination, hormones blood were analyzed. Ultrasound examination of the pelvic organs was performed on all patients with the device "Mindray DC-80 X-Insight", and measurements were performed using a transvaginal sensor. The thickness and structure of the endometrium were evaluated, and the number of antral follicles (NAF) ranging in size from 2 to 10 mm was counted in each ovary. All patients were tested for serum levels of the anti-mullerian hormone (AMG), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), progesterone (P), thyroid-stimulating hormone (TSH), triiodothyronine (T4).Results. The average age of women in the first (control) group was 27.08 ± 12.38 years, the second (taking melatonin) - 33.12 ± 8.18 years, the third (not taking melatonin) - 30.95 ± 7.07 years > 0.05), i. e. the age of the patients of the examined groups was equal. It should be noted that in the studied patients of both groups, the occurrence of primary infertility exceeded secondary infertility 2.7 times in the second group (p < 0.05) and 1.7 times in the third (p < 0.05). Infertility factors such as reduced ovarian reserve, habitual miscarriage and infertility of unknown origin were more common in patients of the second group, and endometriosis, tubal factor and male factor in the third, although the difference was not significant. The available extragenital pathology did not differ in the patients of the examined groups. The number of antral follicles was significantly higher in both ovaries of women in the control group compared with patients of the second and third groups. While the thickness of the endometrium did not differ significantly in groups, although in women of the control group it was slightly less. Regarding the study of hormonal status, it should be noted that we did not find a significant difference in the levels of hormones in the blood of women we examined. Exceptionally, there was a significant difference (p < 0.001) in progesterone content between the second (0.62 ± 0.052 nmol/l) and third (181.63 ± 13.87 nmol/l) groups. Also, the patients of the third group had significantly (p < 0.05) higher levels of FSH in blood (8.25 ± 0.63 mUn/ml) compared with the control group (4.93 ± 0.69 mUn/ml).Conclusions. The examined women in the control group, as well as infertility patients who received melatonin two weeks before the expected menstruation and during ovulation stimulation, and infertility patients who did not receive this preparation in similar programs, did not differ in age, occurrence of primary and secondary infertility, the factor that led to infertility, concomitant extragenital pathology, ovarian reserve and hormone levels of the reproductive panel. That is, they were equal in our study.


2020 ◽  
pp. 68-75
Author(s):  
T.G. Romanenko ◽  
◽  
A.D. Haiduk ◽  
S.V. Turbanis ◽  
◽  
...  

The objective: to conduct a clinical and statistical analysis of the characteristics of the somatic and reproductive history in women with repeated unsuccessful attempts of assisted reproductive technologies and to determine significant medical and social factors in the formation of chronic endometritis. Materials and methods. A clinical and statistical analysis of 177 outpatient cards was carried out: Group I – 127 women under the age of 45 with a history of two or more ineffective attempts at in vitro fertilization; Group II – there were 50 healthy women without reproductive disorders. The comprehensive examination included data from anamnesis, general clinical and gynecological examination, laboratory and instrumental methods according to the data of outpatient observation cards at the MC LLC «Isida – IVF». The diagnosis of chronic endometritis was verified by the data of the histological examination of the endometrium obtained by the pipel biopsy method on days 4 –9 of the menstrual cycle. Results. The incidence of inflammatory diseases of the uterine appendages in patients of group I was 47.2%, inflammatory diseases of the endometrium – 41.7%; р1.2<0.01. The incidence of acute endometritis among patients of group I was 6.3%; р1.2>0.05 and was due to the implementation of the infectious process after abortion. In the first group, sexually transmitted infections were noted in 67.7% of patients, р1.2>0.05; bacterial vaginosis was recorded 1.5 times more often – 28.4%; р1.2<0.05. In the first group, one-time artificial termination of pregnancy appeared in 15.0%, twice – in 15.7% (р1.2<0.05). Laparoscopies were previously performed in 59.8% of women, laparotomies – in 62.2%, while operations were repeated in 25.4% of women. Unilateral tubectomy for ectopic pregnancy was performed in 25.4% of women, bilateral in 12.7%. Removal of fallopian tubes due to sactosalpinxes in 25.4% of women, unilateral removal of appendages appeared in patients in 3.9% of cases. The most significant risk factors for the development of chronic endometritis in the studied groups are acute post-abortion endometritis VR (relative risk) = 1.439, p=0.029 and postoperative peritonitis, which was caused by complications of appendectomy – RR=1.430, p=0.084. We did not reveal a significant effect of inflammatory diseases of the uterine appendages on the implementation of chronic endometritis (RR=45.132, CI (6.151-31.167), p=0.001. Analysis of reproductive failures as a risk factor for the development of chronic endometritis in women of group I showed a significant relative risk: with a history of PR RR=1.44, p=0.039, with repeated artifactual abortions RR=1.5, p<0.001, SV RR=1.572, p=0.001. A higher relative risk of developing XE was observed during pregnancy – RR=1.597, p=0.001. Conclusions. Clinical and statistical analysis of the reproductive health of women with repeated unsuccessful attempts at ART has shown that these women have a high frequency of intrauterine interventions, a low frequency of using alternative and safe methods of abortion, and there is no system of health measures after reproductive failures. There is a significant increase in spontaneous abortion in the early stages and the absence of a decrease in premature birth. Preserving the reproductive health of women is an important medical and social problem, the solution of which depends on the joint efforts of state and public organizations and health authorities, as well as on the responsibility of the population for their health. The development and implementation of pregravid health improvement and pregnancy planning programs for women with repeated unsuccessful attempts at ART against the background of chronic endometritis should be a priority in the health care system. Keywords: assisted reproductive technologies, chronic endometritis, ineffective attempts at fertilization, reproductive health, pregnancy.


2021 ◽  
Vol 20 (1) ◽  
pp. 64-70
Author(s):  
A.A. Solomatina ◽  
◽  
L.M. Mihaleva ◽  
I.Z. Khamzin ◽  
O.V. Bratchikova ◽  
...  

Objective. To analyze the significance of the ovarian reserve (OR) in the assessment of endometrial receptivity in patients after cystectomy for ovarian endometriotic cysts (OECs). Patients and methods. We examined 172 patients after organ-sparing surgeries for OECs. The mean patient age was 28.7 ± 4.8 years. Group I included 114 women with low OR. Group II comprised 58 patients with unchanged OR. All study participants underwent pelvic ultrasonography in the middle luteal phase 6 and 12 months postoperatively. We evaluated endometrial thickness and its echostructure, as well as Doppler-angle-independent flow indices, including resistance index, pulsatility index, and systolic/diastolic ratio. Reduced OR was diagnosed according to the ESHRE recommendations (2011 Anti-Müllerian hormone ≤ 0.5–1.1 ng/mL and ≤5–7 antral follicles in one ultrasound section. Results. Impairments in the morphological and functional state of the ovaries were associated with changes of the endometrial thickness, its ultrasonic structure, and hemodynamic parameters in the terminal branches of the uterine arteries (hypovascularization, increased flow indices). Simultaneous use of various methods for the assessment of ovarian tissue and endometrium allowed the detection of a decreased reproductive potential. Patients with a reduced OR after surgeries for OECs demonstrated improvement of both morphological/functional characteristics of ovarian tissue and endometrial receptivity, which allows pregnancy planning. Patients with extremely thin endometrium (3.0–5.0 mm) that does not improve are recommended to resort to assisted reproductive technologies. Key words: ovarian reserve, endometrium, ovarian endometriotic cysts


Somatechnics ◽  
2015 ◽  
Vol 5 (1) ◽  
pp. 88-103 ◽  
Author(s):  
Kalindi Vora

This paper provides an analysis of how cultural notions of the body and kinship conveyed through Western medical technologies and practices in Assisted Reproductive Technologies (ART) bring together India's colonial history and its economic development through outsourcing, globalisation and instrumentalised notions of the reproductive body in transnational commercial surrogacy. Essential to this industry is the concept of the disembodied uterus that has arisen in scientific and medical practice, which allows for the logic of the ‘gestational carrier’ as a functional role in ART practices, and therefore in transnational medical fertility travel to India. Highlighting the instrumentalisation of the uterus as an alienable component of a body and subject – and therefore of women's bodies in surrogacy – helps elucidate some of the material and political stakes that accompany the growth of the fertility travel industry in India, where histories of privilege and difference converge. I conclude that the metaphors we use to structure our understanding of bodies and body parts impact how we imagine appropriate roles for people and their bodies in ways that are still deeply entangled with imperial histories of science, and these histories shape the contemporary disparities found in access to medical and legal protections among participants in transnational surrogacy arrangements.


2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Um-e-Kalsoom ◽  
Sabiha Khan ◽  
Israr Ahmad

Abstract Background Hemodialysis may have serious psychological impact upon patients suffering from chronic kidney diseases. The aim of the present study is to investigate the impact of hemodialysis on the wellbeing of individuals with chronic kidney diseases (CKD). Result A sample consists of (N = 100) CKD patients referred from neurology ward of Leady Reading Hospital Peshawar. Data was collected from both male (50%) and female (50%) in 2017. Participants were divided into two groups on the basis of pre-set criteria. In group I, individuals with 4–5 stage of CKD referred first time for dialysis treatment were recruited. Group II comprised of CKD patients with 1–3 stage. Demographic data sheet, Pakistan Anxiety and Depression, WHO Quality of Life scale, and Perceived Social support scale (PSS) were used to test the hypotheses. Paired sample t test was use to see the difference between pre- and post-analysis of depression, anxiety, QOL, and PSS in group I (experimental group). Results suggests significant difference on depression (p > .001), anxiety (p > .001), and QOL (p > .001), while no significant difference was reported on perceived social support (p <.673). Findings also indicate no significant difference between group I and group II on QOL depression, anxiety, and PSS. Conclusion The findings concluded that patients under hemodialysis treatment suffered from depression, anxiety, and poor quality of life.


Author(s):  
Mahir Tıraş ◽  
Emrah Can ◽  
Şahin Hamilçıkan

Objective This study aimed to assess whether cord blood carboxyhemoglobin (COHb) levels in jaundiced term neonates with and without a positive direct Coombs test (DCT) and in healthy controls could be used as a predictor of severe hyperbilirubinemia. The percentage of cord blood COHb should be higher among neonates with Coombs-positive ABO hemolytic disease than among those with Coombs-negative ABO incompatibility and higher than that of ABO-compatible control neonates. Study Design This cross-sectional descriptive study of 198 term neonates comprised three subgroups: group I featured 68 DCT-positive ABO-incompatible neonates (ABO + DCT), group II featured 60 DCT-negative ABO-incompatible neonates with hyperbilirubinemia (ABO–DCT), and group III featured 70 healthy controls. COHb was determined by an OSM3 hemoximeter. Results Group I differed from groups II and III for cord blood bilirubin, cord blood hemoglobin, and cord blood hematocrit. Groups I and II had higher mean total serum bilirubin (TSB) levels than group III, while there was no difference in the mean TSB levels between groups I and II. There was no significant difference between the COHb group means for groups I, II, and III (p = 0.98). The area under the receiver operating characteristic curve calculated for group I/group III and group II/group III were found to be 0.62 and 0.54, respectively. Conclusion COHb levels did not prove to be superior to the DCT for predicting the risk of developing severe hyperbilirubinemia in term neonates. Key Points


Sign in / Sign up

Export Citation Format

Share Document