scholarly journals Analysis of the Clinical Efficacy of Laparoscopy and Hysteroscopy in the Treatment of Tubal-Factor Infertility

2021 ◽  
Vol 8 ◽  
Author(s):  
Lei Nian ◽  
De-Hong Yang ◽  
Jie Zhang ◽  
Han Zhao ◽  
Cai-Fen Zhu ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Pregnancy Rate ◽  
Fallopian Tube ◽  
Clinical Efficacy ◽  
Pregnancy Outcomes ◽  
Fallopian Tubes ◽  
Tubal Factor Infertility ◽  
Tubal Factor ◽  
Ectopic Pregnancies ◽  
The Impact

Objective: This study aims to investigate the clinical efficacy of laparoscopy and hysteroscopy in the treatment of tubal-factor infertility (TFI) to provide a basis for predicting postoperative pregnancy rates.Methods: The clinical data of 336 patients who underwent laparoscopy and hysteroscopy for TFI between February 2018 and December 2018 in the Department of Reproductive Gynecology at the First People's Hospital of Yunnan were retrospectively analyzed. After implementing the inclusion and exclusion criteria, 278 patients were included in the study. The patients were grouped according to pelvic adhesions, hydrosalpinx, twisted fallopian tubes, and fimbriae structure. The impact of the extent of fallopian tube diseases on postoperative pregnancy outcomes was analyzed.Results: Of the 278 patients, 129 got pregnant (pregnancy rate = 46.4%). Pelvic adhesions, hydrosalpinx, twisted/folded fallopian tubes, and damage to the fimbriae of the fallopian tubes were found to affect the natural pregnancy rate after surgery, and it decreased significantly with the aggravation of the disease (P < 0.001). Of the 129 patients who had natural pregnancies, 29 had ectopic pregnancies (ectopic pregnancy rate = 22.48%). Twisted/folded fallopian tubes and damage to the fimbriae structure significantly increased the incidence of postoperative ectopic pregnancy (P < 0.001).Conclusion: Laparoscopy and hysteroscopy are effective treatments for TFI. Pelvic adhesions, twisted/folded fallopian tubes, hydrosalpinx, and damage to the fimbriae of the fallopian tubes can affect postoperative pregnancy outcomes and lead to failure of a natural pregnancy after the operation. The incidence of ectopic pregnancy increases with the degree of fallopian tube twisting/folding and the degree of damage to the fimbriae of the fallopian tubes.

scholarly journals Ectopic Pregnancy in Two Cats

2018 ◽  
Vol 46 ◽  
pp. 5
Author(s):  
Jia-San Zheng ◽  
Zheng Wang ◽  
Jia-Ren Zhang ◽  
Shuang Qiu ◽  
Ren-Yue Wei ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Clinical Symptoms ◽  
Abdominal Cavity ◽  
Scar Tissue ◽  
Tubal Pregnancy ◽  
Abdominal Pregnancy ◽  
Fallopian Tubes ◽  
Gestational Sac ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy mainly refers to tubal pregnancy and abdominal pregnancy. Tubal pregnancy presents as an implanted embryo that develops in the fallopian tubes, and is relatively common in humans. In animals, tubal pregnancy occurs primarily in primates, for example monkeys. The probability of a tubal pregnancy in non-primate animals is extremely low. Abdominal pregnancy is a type of ectopic pregnancy that occurs outside of the uterus, fallopian tube, ovary, and ligament(broad ligament, ovarian ligament, suspensory ligament).This paper describes two cases of ectopic pregnancy in cats.Cases: Cat 1. The presenting sign was a significant increase in abdominal circumference. The age and immune and sterilization status of the cat were unknown. On palpation, a 4 cm, rough, oval-shaped, hard mass was found in the posterior abdomen. Radiographic examination showed three high-density images in the posterior abdomen. The fetus was significantlycalcified and some feces was evident in the colon. The condition was preliminarily diagnosed as ectopic pregnancy. Cat 2. The owner of a 2-year-old British shorthair cat visited us because of a hard lump in the cat’s abdomen. The cat had a normal diet and was drinking normally. Routine immunization and insect repulsion had been implemented. The cat had naturally delivered five healthy kittens two months previous. Radiographs showed an oval-shaped mass with a clear edge in the middle abdominal cavity. Other examinations were normal. The case was preliminarily diagnosed as ectopic pregnancy, and the pregnancy was surgically terminated. The ectopic pregnancies were surgically terminated. During surgery, the structures of the uterus and ovary of cat 1 were found to be intact and the organs were in a normal physiological position.Cat 1 was diagnosed with primary abdominal pregnancy. In cat 2, the uterus left side was small and the fallopian tube on the same side was both enlarged and longer than normal. Immature fetuses were found in the gestational sac. Thus, cat 2 was diagnosed with tubal ectopic pregnancy based on the presenting pathology.Discussion: Cats with ectopic pregnancies generally show no obvious clinical symptoms. The ectopic fetus can remain within the body for several months or even years. Occasionally, necrotic ectopic tissues or mechanical stimulation of the ectopic fetus can lead to a systemic inflammatory response, loss of appetite, and apathy. The two cats in our reportshowed no significant clinical symptoms. To our knowledge, there have been no previous reports of the development of an ectopic fetus to maturity, within the abdominal cavity of felines, because the placenta of cats cannot support the growth and development of the fetus outside of the uterus. Secondary abdominal ectopic pregnancy, lacking any signs of uterine rupture is likely associated with the strong regenerative ability of uterine muscles. A damaged uterus or fallopian tube can quickly recover and rarely leaves scar tissue. In the present report, cat 1 showed no apparent scar tissue, nor signs of a ruptured ovary or fallopian tubes. It was diagnosed with primary ectopic abdominal pregnancy, which could arise from the descent of the fertilized egg from the fallopian tube into the abdominal cavity. There was an abnormal protrusion in left of the fallopian tubes in cat 2, to which the gestational sac was directly connected. Based on pathological examination of the uterus, fallopian tubes, and gestational sac, the cat was diagnosed with a tubal pregnancy. Placental tissues and signs of fetal calcification were observed in both the fallopian tube and gestational sac.Keywords: tubal pregnancy, abdominal pregnancy, feline, ectopic fetus, fallopian tube, gestational sac.

TUBAL FACTOR INFERTILITY: POSSIBLE OPTIONS OF REPRODUCTIVE FUNCTION RESTORATION

2020 ◽  
pp. 56-62
Author(s):  
L. N. Shсherbakova ◽  
K. B. Bugerenko ◽  
A. E. Bugerenko ◽  
N. V. Ivanova ◽  
E. V. Fotina ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Fallopian Tube ◽  
Reproductive Function ◽  
Fallopian Tubes ◽  
Tubal Factor Infertility ◽  
Reproductive Techniques ◽  
History Of ◽  
Tubal Factor ◽  
Reconstructive Plastic Surgery

Relevance. Despite the assisted reproductive techniques being widely used in modern gynaecology, the challenge of restoring fallopian tube patency in patients with hydrosalpinx, distal tubal occlusion, peritubal and periovarial adhesions remains relevant.Objective. The aim of this study was to evaluate the effectiveness of laparoscopic surgery in restoring fertility in patients with tubal factor infertility.Materials and methods. We included 99 patients, who underwent laparoscopic surgery for tubal factor infertility. During the follow-up we assessed the rate of spontaneous pregnancy and pregnancy after IVF.Results. Pregnancy occurred in 41 (41.4%) patients with a history of tubal factor infertility. Moreover, after reconstructive plastic surgery on the fallopian tubes out of 66 patients, in 17 cases (25.8%) pregnancy occurred spontaneously. In 33 patients tubectomy was performed due to impossibility of adequate fallopian tube reconstruction. In 24 (24.2%) patients, pregnancy occurred after IVF (after salpingo-ovariolysis or after tubectomy). The frequency of pregnancy after IVF in these patients was 1,5 times higher than in patients that underwent IVF in the same medical institution during the same period (42.5% and 27.8%, respectively).Conclusion. In patients with tubal factor infertility younger than 35 with preserved ovulation and the absence of pathospermia in a partner, laparoscopy is an effective method for restoring patency of the fallopian tubes. If a severe falopian tube lesions are present in patients with infertility, bilateral tubectomy should be considered, since bilateral tubectomy in such patients increases the effectiveness of IVF.

A ruptured seventeen weeks’ ectopic pregnancy: a case report

2020 ◽  
pp. 1-8
Author(s):  
Usama Shabbir ◽  
Jamal Anwar ◽  
Mohammad Sohail Asghar ◽  
Balakh Sher Zaman ◽  
Ameer Afzal ◽  
...  
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Uterine Cavity ◽  
Fallopian Tubes ◽  
Common Condition ◽  
Crown Rump Length ◽  
Proper Management ◽  
Timely Diagnosis ◽  
Ectopic Pregnancies

Abstract Ectopic pregnancy is a common condition with a prevalence of 2% in all pregnancies. Implantation of the developing blastocyst outside the uterine cavity leads to ectopic pregnancy. About 95% of ectopic pregnancies occur in the different segments of the fallopian tubes. Usually, an ectopic pregnancy grows up to 1.5–3.5 cm and any size greater than this leads to rupture. We present a case of ruptured ectopic pregnancy in which the foetus had a crown–rump length(CRL) of 12 cm was retrieved. To our knowledge, this is the largest foetus recovered from a ruptured ectopic pregnancy at the ampulla of fallopian tube reported in the literature. Timely diagnosis and proper management is the key to reduce morbidity associated with it. Keywords: Ectopic pregnancy Hemoperitoneum Implantation Continuous...

Chlamydial Serology Among Patients with Tubal Factor Infertility and Ectopic Pregnancy in Alexandria, Egypt

1995 ◽  
Vol 22 (5) ◽  
pp. 317-321 ◽  
Author(s):  
MOHAMMED T.R. MEHANNA ◽  
MOHAMAD A. RIZK ◽  
NAGWA YOUSSEF ◽  
MOHAMAD RAMADAN ◽  
SOAD A. ZAKI ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Tubal Factor Infertility ◽  
Tubal Factor

scholarly journals Role of Activins and Inducible Nitric Oxide in the Pathogenesis of Ectopic Pregnancy in Patients with or without Chlamydia trachomatis Infection

2009 ◽  
Vol 16 (10) ◽  
pp. 1493-1503 ◽  
Author(s):  
Bassem Refaat ◽  
Majedah Al-Azemi ◽  
Ian Geary ◽  
Adrian Eley ◽  
William Ledger
Keyword(s):  
Nitric Oxide ◽  
Immune Response ◽  
Chlamydia Trachomatis ◽  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Enzyme Linked Immunosorbent Assay ◽  
Type Ii ◽  
Fallopian Tubes ◽  
Human Fallopian Tube ◽  
Inducible Nitric Oxide

ABSTRACT Chlamydia trachomatis infection can lead to pelvic inflammatory disease, ectopic pregnancy (EP), infertility, and chronic pelvic pain in women. Activins and inducible nitric oxide synthase (iNOS) are produced by the human fallopian tube, and we speculate that tubal activins and iNOS may be involved in the immune response to C. trachomatis in humans and their pathological alteration may result in tubal pathology and the development of EP. Blood and fallopian tubes were collected from 14 women with EP. Sera were analyzed by enzyme-linked immunosorbent assay to detect antibodies against chlamydial heat shock protein 60 (chsp60) and the major outer membrane protein of C. trachomatis. Confirmation of C. trachomatis serology was made using the microimmunofluorescence test. The patients were classified into three groups according to their serological results, and immunohistochemistry and quantitative reverse transcription-PCR were performed to investigate the expression of candidate molecules by tubal epithelial cells among the three groups. This is the first study to show an increase in the expression of activin βA subunit, type II receptors, follistatin, and iNOS within the human fallopian tube of EP patients who were serologically positive for C. trachomatis. A similar expression profile was observed in the fallopian tubes with detectable antibodies only against chsp60. These results were shown at the mRNA and protein levels. We suggest that tubal activin A, its type II receptors, follistatin, and NO could be involved in the microbial-mediated immune response within the fallopian tube, and their pathological expression may lead to tubal damage and the development of EP.

scholarly journals Ectopic pregnancy as a complication after assisted reproductive techniques. Case report

2021 ◽  
pp. 548-551
Author(s):  
Marina A. Kiyok ◽  
Keyword(s):  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Assisted Reproductive Techniques ◽  
Highly Qualified ◽  
Vitro Fertilization ◽  
Abdominal Bleeding ◽  
Precise Diagnosis ◽  
Reproductive Techniques ◽  
Ectopic Pregnancies

Ectopic pregnancy (EP) is a rare and severe complication of assisted reproductive techniques (ART). A specific feature of EP after ART is a high frequency of rare atypical forms of EP, the absence of a specific clinical picture and a high probability of recurrent EP, which makes certain difficulties in terms of diagnosis. Interstitial pregnancies occur in 1–6% of all ectopic pregnancies and in 7.3% cases of EB which were the results of in vitro fertilization programs (IVF). The anatomical features of the blood supply in the intramural segment of the fallopian tube provide favorable conditions for the progression of pregnancy on the average up to 10 weeks of gestation, simulating the intra-uterine pregnancy. Chorionic villi, growing into the thickness of the myometrium, create a high risk of profuse intra-abdominal bleeding. The article presents a clinical case of a rare form of ectopic pregnancy in the interstitial segment of the fallopian tube after IVF. The patient had previously undergone a bilateral salpingectomy by tubal pregnancies. This clinical example shows the meaning of precise diagnosis and timely provision of highly qualified specialized medical care.

scholarly journals Impact of SARS-Cov-2 on ectopic pregnancies management in the United Kingdom: a multicentre paired observational study

2020 ◽  
Author(s):  
Sophie Platts ◽  
Jeewantha Ranawakagedon ◽  
Reeba Oliver ◽  
Sayantana Das ◽  
Phalguni Kotabagi ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Expectant Management ◽  
Complication Rates ◽  
University Hospitals ◽  
Length Of Treatment ◽  
Hospital Visits ◽  
Ectopic Pregnancies ◽  
The Impact ◽  
Pregnancy Registry

Objective: to describe the impact of COVID-19 on the management of patients with ectopic pregnancy. Design: a multicentre study comparing outcomes from a prospective cohort during the pandemic [Covid-ectopic pregnancy registry (CEPR)] compared to an historical pre-pandemic cohort [non-Covid ectopic pregnancy registry (NCEPR)]. Setting: five London university hospitals. Population and Methods: consecutive patients diagnosed clinically and/or radiologically with ectopic pregnancy (March/2020-Aug/2020) were entered into the CEPR and an exploratory matched analysis was performed comparing results to NCEPR patients (January/2019-June/2019). Main outcome measures: patient demographics, management (expectant, medical and surgical), length of treatment, number of hospital visits (non-surgical management), length of stay (surgical management) and 30-day complications. Results: 341 patients met inclusion: 162 CEPR and 179 NCEPR. A significantly higher percentage of women underwent non-surgical management versus surgical management in the CEPR versus NCEPR (58.6% [95/162] vs 72.6% [130/179]; p= 0.0084]. Amongst patients managed with expectant management the CEPR had a significantly lower mean number of hospital visits compared to NCEPR [3.6 [SD 1.4] vs 13.7 [SD 13.4], p= 0.0053]. Amongst patients managed with medical management, the CEPR had a significantly lower mean number of hospital visits [NCEPR 6.4 [SD 2.3] vs 8.8 [SD 3.9], p= 0.0014]. There was no observed difference in complication rates between cohorts. Conclusion: women were found to undergo significantly higher rates of non-surgical management during COVID-19 first wave vs NCEPR cohort. Women managed non-surgically in CPER cohort were also managed with fewer hospital attendances. This did not lead to an increase in observed complications rates.

scholarly journals Screening of Chlamydia trachomatis and Waddlia chondrophila Antibodies in Women with Tubal Factor Infertility

2020 ◽  
Vol 8 (6) ◽  
pp. 918 ◽  
Author(s):  
Wies T.M. van Dooremalen ◽  
Stephan P. Verweij ◽  
Janneke E. den Hartog ◽  
Carole Kebbi-Beghdadi ◽  
Sander Ouburg ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Intracellular Pathogen ◽  
Serum Samples ◽  
Tubal Factor Infertility ◽  
Fertility Clinic ◽  
Tubal Factor ◽  
Adverse Pregnancy

Waddlia chondrophila is an emerging intracellular pathogen belonging to the order of Chlamydiales, and was previously associated with adverse pregnancy outcomes, as well as tubal factor infertility (TFI). In this study, we investigate the link between both W. chondrophila and Chlamydia trachomatis IgG seropositivity and TFI. Antibodies against both bacteria were measured in 890 serum samples of women visiting a fertility clinic. After a hysterosalpingography and/or laparoscopy, they were classified as either TFI-negative (TFI−) or TFI-positive (TFI+). The total seroprevalence was 13.4% for C. trachomatis and 38.8% for W. chondrophila. C. trachomatis antibodies were present significantly more often in the TFI+ group than in the TFI− group, while for W. chondrophila no difference could be observed. In conclusion, our study confirms the association between C. trachomatis seropositivity and TFI, but no association was found between W. chondrophila seropositivity and TFI. The high percentage of W. chondrophila seropositivity in all women attending a fertility clinic does, however, demonstrate the need for further research on this Chlamydia-like bacterium and its possible role in infertility.

scholarly journals Predictive value of a modified classification of fallopian tube status on prognosis of tubal factor infertility after laparoscopic surgery

Medicine ◽  
2019 ◽  
Vol 98 (13) ◽  
pp. e14952 ◽  
Author(s):  
Lin Yuan ◽  
Huang Jingying ◽  
Chen Xiujuan ◽  
Lian Chengying ◽  
Huang Xiaochen ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Fallopian Tube ◽  
Predictive Value ◽  
Tubal Factor Infertility ◽  
Tubal Factor
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