scholarly journals An unusual case of interstitial pregnancy: a case report

2021 ◽  
Vol 10 (3) ◽  
pp. 1229
Author(s):  
Nikhil Sebastian ◽  
Abhishek Radhakrishnan ◽  
Vennila Murugesan
Keyword(s):  
Age Groups ◽  
Uterine Cavity ◽  
Reproductive Age ◽  
Interstitial Pregnancy ◽  
Vitro Fertilization ◽  
Beta Human Chorionic Gonadotropin ◽  
Life Threatening ◽  
Threatening Situation ◽  
The Right

Ectopic pregnancy (EP) has been found to be a common cause of morbidity, and on occasion, mortality among women in the reproductive age groups. The incidence of EP is 1-2% of all pregnancies. 93-97% of EP are tubal with the interstitial type consisting only 3-4%. A 31-year-old female patient with primary infertility underwent IVF (In Vitro Fertilization). Pregnancy was confirmed by βHCG (beta human chorionic gonadotropin). Her ultrasonography reported a mass in the right cornual region. The uterine cavity was empty. Laparoscopy was performed followed by resection of the right cornua with tubes. Histopathology report confirmed the diagnosis of Interstitial Pregnancy (IP). The patient had an uneventful post-operative period and was discharged the next day. EP is a common complication seen in cases undergoing IVF, and IP is a rare form of EP. Hence, early diagnosis and prompt intervention is required to avoid a potentially life-threatening situation.

Caution with bilateral salpingectomy and consideration of tubal stump ectopic in IVF

2020 ◽  
Vol 13 (11) ◽  
pp. e235893
Author(s):  
Swee Lin Yip ◽  
Shahul Hameed Mohamed Siraj ◽  
Jerry Kok Yen Chan
Keyword(s):  
Ectopic Pregnancy ◽  
Cystic Mass ◽  
In Vitro Fertilisation ◽  
Beta Human Chorionic Gonadotropin ◽  
Life Threatening ◽  
History Of ◽  
Bilateral Salpingectomy ◽  
Ectopic Pregnancies ◽  
The Right

We report a 35-year-old female patient with a history of bilateral salpingectomy from ectopic pregnancies presenting with a positive serum beta-human chorionic gonadotropin (bhCG) result following in vitro fertilisation (IVF) treatment. Apart from per vaginal spotting, she remained asymptomatic. Initial ultrasound showed an empty uterus with a cystic mass on the right side of the uterus. Serum beta-hCG was trended. A follow-up pelvic ultrasound 1 week later showed a live pregnancy in the right adnexa. A diagnostic laparoscopy was performed, which revealed an unruptured right stump ectopic pregnancy that was successfully removed. As a stump ectopic pregnancy can be a potentially life-threatening occurrence, we emphasise caution with salpingectomy and the consideration of tubal stump ectopic pregnancies following IVF treatment.

scholarly journals Heterotopic pregnancy after in vitro fertilization and embryo transfer: A case report

2012 ◽  
Vol 140 (7-8) ◽  
pp. 511-514 ◽  
Author(s):  
Radmila Sparic ◽  
Snezana Buzadzic ◽  
Rajka Argirovic ◽  
Danijela Bratic ◽  
Darko Plecas
Keyword(s):  
Abdominal Pain ◽  
In Vitro Fertilization ◽  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Reproductive Age ◽  
Heterotopic Pregnancy ◽  
Vitro Fertilization ◽  
Life Threatening ◽  
In Pregnancy

Introduction. Heterotopic pregnancy is a life-threatening complication of pregnancy defined as coexistent intrauterine and ectopic gestation. Its diagnosis is frequently overlooked and delayed. Case Outline. A 28-year-old woman experienced acute abdominal pain in pregnancy achieved by in vitro fertilization. Since all previous checkups indicated a normal course of pregnancy, the ectopic pregnancy was not suspected on admission. However, due to persistent hypotension, this diagnosis was also considered. Transvaginal ultrasound performed by an experienced obstetrician revealed an adnexal mass highly indicative of ectopic pregnancy. No fetal heart beats were visualized and the diagnosis of a missed abortion was made. A prompt laparotomy revealed a ruptured right ampullary pregnancy, and salpingectomy was performed. Conclusion. Although rare, heterotopic pregnancy should be considered in the differential diagnosis of abdominal pain in pregnancy. Every physician treating women of reproductive age should bear in mind the possibility of heterotopic pregnancy not only in patients with predisposing risk factors but also in those without them.

scholarly journals COT-05 Experience of fertility preservation in 3 male cases and 1 female case with high-grade glioma

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii21-ii21
Author(s):  
Noriyuki Nakayama ◽  
Tetsuya Yamada ◽  
Hirohito Yano ◽  
Yuki Kato ◽  
Toru Iwama
Keyword(s):  
Survival Rate ◽  
In Vitro Fertilization ◽  
Fertility Preservation ◽  
High Grade Glioma ◽  
Reproductive Age ◽  
High Grade ◽  
Partial Removal ◽  
Vitro Fertilization ◽  
The Right

Abstract High-grade glioma (HGG) has a low survival rate, and fertility preservation (FP) has rarely been discussed in the field of Japanese neurosurgery. We report on 4 reproductive patients, including 2 male patients who became biological fathers. Case 1 was a 23-year-old man with anaplastic oligodendroglioma (AO) of the right frontal lobe. Temozolomide maintenance therapy (TMZ-MT) was completed 42 courses after the initial surgery for economic reasons. 21 months later, a local recurrent lesion appeared, so TMZ-MT was restarted after removal this lesion. When he married at 32 years old, the couple wished a desire for childbearing. The TMZ-MT was stopped at 47 courses from the resumption and they aimed for spontaneous pregnancy. At 5 months after discontinuation of TMZ-MT, Gd-enhanced lesions increased again, so we changed the course to in vitro fertilization and resumed TMZ-MT. The couple had a biological baby at his 33 years and 10 months old. Case 2 was a 33-year-old married man with AO of the right parietal lobe. After partial removal, the FP information was explained and cryopreservation of sperm was performed. As of 23 months after the first operation, he became a biological father by in vitro fertilization. Case 3 was a 31-year-old married man with diffuse midline glioma (H3K27M mutant) in the cervical spinal cord. After partial removal, we provided FP information in the same manner, but the couple did not chose cryopreservation of sperm due to his mRS 5. Case 4 was a 24-year-old female with anaplastic astrocytoma of the brain stem. FP information was provided after stereotactic biopsy, but she chose to start radiochemotherapy without cryopreservation of eggs. Patients of reproductive age with HGG, especially oligodendroglial tumors who have a higher survival rate than astrocytic tumors, should be positively informed about FP before treatment begins.

New in a diagnosis and treatment of chronic endometritis at infertility

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (1) ◽  
pp. 14-18
Author(s):  
Klara G Serebrennikova ◽  
Igor I Babichenko ◽  
Narina A Arutyunyan ◽  
Sergey N Katsalap ◽  
Albina S Akateva
Keyword(s):  
Low Dose ◽  
Uterine Cavity ◽  
Reproductive Age ◽  
High Tech ◽  
Comprehensive Treatment ◽  
Chronic Endometritis ◽  
Vitro Fertilization ◽  
Group 2 ◽  
Group 1

Background. Chronic endometritis is one of the causes of infertility, miscarriage, failed in vitro fertilization and embryo transfer attempts. Treatment of chronic endometritis is quite complicated due to a multifactorial nature of endometrium morpho-functional disorders. There are lots of approaches to a comprehensive treatment of chronic endometritis which indicates a lack of a single algorithm for a management of such patients to date. One of the modern, perspective and high-tech methods for treatment of chronic endometritis is photodynamic therapy (PDT). Aim. To study chronic endometritis treatment efficacy in patients with infertility when using the method of PDT and low doses of 17b-estradiol. Materials and methods. 85 female patients of reproductive age with chronic endometritis were examined and treated. All patients were divided into 2 groups: group 1 (43 patients) got treated by a method of intravenous PDT with low-dose transdermal 17b-estradiol; group 2 (42 patients) received low-dose transdermal therapy with 17b-estradiol. Clinical examination and laboratory tests, pelvic ultrasound, endometrial aspiration biopsy followed by pathomorphlogical and immunohistochemical examination were carried out to all patient. Results. Ultrasound examination revealed an increase in endometrium thickness at 12th day following PDT session in group 1 and following transdermal therapy with 17b-estradiol in group 2 resulting in endometrium state improvement almost 2 times compared with baseline values before treatment. Conclusions. PDT is a minimally invasive, gentle and safe treatment method. Due to a diffuser design laser radiation is evenly distributed in the uterine cavity. PDT reliably restores receptor function to progesterone in the endometrial glands.

Thickness of endometrium: predictor of the effectiveness of IVF/ICSI programs (literature review)

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 113-116
Author(s):  
L A Bagdasaryan ◽  
I E Korneyeva
Keyword(s):  
Assisted Reproductive Technologies ◽  
Endometrial Thickness ◽  
Molecular Genetic ◽  
Uterine Cavity ◽  
Reproductive Technologies ◽  
Genetic Characteristics ◽  
Vitro Fertilization ◽  
Need To Evaluate ◽  
The Relationship

The aim of the study is to systematically analyze the data available in the modern literature on the relationship between endometrial thickness and the frequency of pregnancy in the program of assisted reproductive technologies (ART). Materials and methods. The review includes data from foreign and domestic articles found in PubMed on this topic. Results. The article presents data on the relationship between the thickness of the endometrium and the frequency of pregnancy in ART programs. The greatest number of studies is devoted to the evaluation of the relationship between the thickness of the endometrium and the frequency of pregnancy on the day of the ovulation trigger. Data are presented on the existence of a correlation between the thickness of the endometrium measured on the day of the ovulation trigger and the frequency of clinical pregnancy, as well as data on the need to evaluate the structure of the endometrium and the state of subendometric blood flow. The importance of multilayered (three-layered) endometrium as a prognostic marker of success in in vitro fertilization/intracytoplasmic sperm injection programs in the ovum is emphasized. The conclusion. The thickness of the endometrium can not be used as an argument for canceling the cycle or abolishing embryo transfer to the uterine cavity. Further studies in this direction are needed with a study of the morphological and molecular genetic characteristics of the endometrium, which in the future will allow us to evaluate the relationship between the thickness of the endometrium and the probability of pregnancy.

scholarly journals Successful live birth after heterotopic ruptured cornual pregnancy with twin intrauterine gestation in an in vitro fertilization conception

2019 ◽  
Vol 8 (12) ◽  
pp. 5057
Author(s):  
Venus Bansal ◽  
Muskaan Chhabra ◽  
Rahul Chopra ◽  
Pooja Prajapati
Keyword(s):  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Omental Patch ◽  
Vitro Fertilization ◽  
Ultrasound Findings ◽  
Life Threatening ◽  
Intraperitoneal Bleeding ◽  
High Index Of Suspicion ◽  
Preterm Rupture Of Membranes

Heterotopic pregnancies, especially in the cornual region which were a rarity till recent times, have become a more common occurrence due to increasing practice of assisted reproduction. Optimal management of such cases is imperative to manage the risk of hypotension and shock in case of rupture and to judiciously preserve the intrauterine pregnancy. Here we are reporting a case of IVF conception of twin intrauterine pregnancy with a cornual heterotopic pregnancy. Patient presented to the emergency department with features of acute abdomen, haemoperitoneum and shock. Ultrasound findings were suggestive of rupture of cornual heterotopic pregnancy, 1500 ml haemoperitoneum with live twin intrauterine gestation. Patient was resuscitated with iv fluids blood transfusion. Immediate laparotomy was done and cornual site repaired and covered with an omental patch while preserving the intrauterine gestations. Thereafter, pregnancy was carefully monitored with a high index of suspicion for rupture of site of cornual repair with advancing gestational age. Patient was readmitted at 24 weeks with pain abdomen and cornual site was found to be 4mm in thickness. She was managed conservatively till 27 weeks when she had preterm rupture of membranes and emergency LSCS was done. She delivered healthy twin male babies, 780 gmb and 795 gm respectively. This case demonstrates that cornual heterotopic pregnancy is a diagnosis which may be easily missed and can present as a life-threatening complication if it ruptures and significant intraperitoneal bleeding occurs. However, it is possible to successfully manage these cases with timely intervention, proper uterine reconstruction and monitoring of intrauterine gestation.

The scattered puzzle effect: implantation disorders in chronic endometritis

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 93-100
Author(s):  
Victor E. Radzinsky ◽  
Mekan R. Orazov ◽  
Liliia R. Toktar ◽  
Liudmila M. Mihaleva ◽  
Pavel A. Semenov ◽  
...  
Keyword(s):  
Uterine Cavity ◽  
Special Role ◽  
Inadequate Response ◽  
Chronic Endometritis ◽  
Vitro Fertilization ◽  
Endometrial Cells ◽  
Adverse Pregnancy ◽  
Relationship Of

Chronic endometritis (CE) is defined as a state of inflammation localized in the endometrium, accompanied by edema, dissociated maturation of epithelial cells and fibroblasts, increased stromal density and the presence of plasma cell infiltrate in it. The connection between chronic inflammation in the endometrium and infertility deserves special attention. Inadequate response of immunocompetent endometrial cells, including impaired synthesis of proinflammatory cytokines, dysreceptiveness, disorders of proliferation and differentiation processes are the main links in the formation of infertility in patients with CE. Despite the fact that the presence of a normocenosis of the uterine cavity today is not in doubt this is a physiological norm, persistent bacterial infection of the endometrium is still called the main etiopathogenetic factor of CE and, therefore, the main point of application of therapeutic agents. Nevertheless, a number of works have emphasized the special role of not bacterial, but viral etiology of endometritis, especially in the context of infertility developing against this background. It seems that the role of viral endometrial infection in adverse pregnancy outcomes and in vitro fertilization programs is underestimated. Further research is needed to clarify the relationship of viral infection as a trigger of implantation failure in infertile women with CE.

Achieving pregnancy at a late reproductive age in a patient with a history of multiple failed in vitro fertilization attempts

2021 ◽  
Vol 7_2021 ◽  
pp. 202-209
Author(s):  
Kirienko K.V. Kirienko ◽  
Osina E.A. Osina ◽  
Apryshko V.P. Apryshko ◽  
Voloshanenko V.V. Voloshanenko V ◽  
Yakovenko S.A. Yakovenko S ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Reproductive Age ◽  
Vitro Fertilization ◽  
History Of
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