EXPERIENCE OF SURGICAL STIMULATION OF OVULATION IN INFERTILE WOMEN WITH SYNDROME OF POLYCYSTIC OVARIES AND OBESITY

Background: Infertility leads to considerable personal suffering and disruption of family life. According to United Nations "Reproductive health is a state of complete physical mental and social well-being and not merely the absence of disease or infirmity in all matters relating to the reproductive system and to its functions and processes". The objective of present study was to find out different causes of female infertility with diagnostic laparoscopy and their comparative frequency in primary and secondary infertility.Methods: It is a prospective study conducted on all infertile women and they underwent diagnostic laparoscopy for primary and secondary infertility during the study period. Couples who had not lived together for at least 12 months, and those with male factor infertility were excluded. Data were collected on a proforma, and analyzed on SPSS package for windows version 10. Frequencies were calculated for laparoscopic findings regarding primary and secondary infertility.Results: Fifty infertile women underwent laparoscopy during the study period, 35 (70%) had primary infertility while 15 (30%) secondary infertility. 10 (28.5%) patients with primary and 3 (20%) patients with secondary infertility had no visible abnormality. The common finding was tubal blockage in 10 (28.5%) and 5 (33.3%) cases of primary and secondary infertility respectively. 9 (25.7%) cases of primary infertility were detected as polycystic ovaries (PCO) and 2 (13.3%) in cases of secondary infertility. Endometriosis was found in 1 case with primary infertility and 2 (13.3%) cases with secondary infertility. Fibroid was found in 3 (8.57%) and 1 (6.6%) cases of primary and secondary infertility respectively.Conclusions: Most common causes responsible for infertility were tubal occlusion and polycystic ovary. Infertile couple should be thoroughly investigated. Laparoscopy in infertility can be used for a definitive diagnosis.

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Hysterolaparoscopy in the evaluation and management of female infertility

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174423 ◽

2017 ◽

Vol 6 (10) ◽

pp. 4454

Author(s):

Ramalingappa C. Antaratani ◽

Harsha B.

Keyword(s):

Retrospective Study ◽

Therapeutic Modality ◽

Pelvic Endometriosis ◽

Polycystic Ovaries ◽

Medical Sciences ◽

Septate Uterus ◽

Infertile Women ◽

Uterine Anomaly ◽

Case Files

Background: To study the role of hysterolaparoscopy in the evaluation and management of female infertility.Methods: A retrospective study of the 677 case files of all the patients who underwent diagnostic hysterolaparoscopy for infertility between January 2011 to December 2016 at Karnataka Institute of Medical Sciences, Hubli and Sushruta Multispeciality hospital, Hubli. These infertile women were confirmed to have normal ovulatory cycles, hormonal assays and seminogram report. Dye studies as well as inspection for abnormal pelvic and intrauterine pathology and necessary therapeutic interven-tions were done during the procedure. Abnormal pelvic and intrauterine pathology by hysterolaparoscopy were categorized.Results: Out of 677 cases, 74% patients had primary, 26% patients had secondary infertility. As a whole pelvic pathology was confirmed in 59.5% and intrauterine pathology in 22.3% patients by hysteroscopy. The most common laparoscopic abnormality detected was Polycystic ovaries (27.1%), followed by pelvic adhesions (18.7%). Tubal block comprised 8.1% whereas distorted uterus by fibroid in 6.2% and pelvic endometriosis in 8.7%. In hysteroscopy, the incidence of uterine anomaly was 54 (7.9%). Septate uterus is the most common with a mean incidence of approximately 37 (67.8%).Conclusions: Diagnostic hysterolaparoscopy is an effective diagnostic and therapeutic modality for certain significant and correctable abnormalities in pelvis, tubes and uterus which are missed by other imaging modalities.

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Impaired Uterine Receptivity in Infertile Women over Age 40 having Oocyte Donation and Correction with Increased Progesterone Replacement

Reproduction Fertility and Development ◽

10.1071/rd9920689 ◽

1992 ◽

Vol 4 (6) ◽

pp. 689 ◽

Cited By ~ 5

Author(s):

DR Meldrum ◽

B Marr ◽

C Stubbs ◽

A Wisot ◽

l Yeo ◽

...

Keyword(s):

Animal Studies ◽

Oocyte Donation ◽

Similar Group ◽

Uterine Receptivity ◽

Infertile Women ◽

Normal Women ◽

Stimulation Of

Significantly fewer ongoing and delivered pregnancies occurred in infertile women aged >40 years receiving oocyte donation from young normal women (8%, P<0.02) than in a similar group of younger recipients receiving identical treatment (43%). A significant improvement (46Yo ongoing and delivered, P<0.01) was achieved in another group of women over 40, treated with a doubled dose of progesterone. The results are consistent with those observed in animal studies and suggest an effect of ageing on uterine receptivity that is at least partly correctable by augmented progesterone stimulation of the endometrium.

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STUDY OF LAPAROSCOPIC EVALUATION OF FEMALE FACTORS IN INFERTILITY AT ANMMCH, GAYA, BIHAR

10.36106/ijsr/2733535 ◽

2021 ◽

pp. 60-62

Author(s):

Pankaj Kumar Chaudhary ◽

Anupam Chaurasia ◽

Lata Shukla Dwivedy ◽

Debarshi Jana

Keyword(s):

Diagnostic Laparoscopy ◽

Polycystic Ovaries ◽

Male Factor ◽

Secondary Infertility ◽

Infertile Women ◽

Medical College ◽

Primary Infertility ◽

Common Causes ◽

Tubal Blockage ◽

Laparoscopic Evaluation

Objective:To nd out different causes of female infertility with diagnostic laparoscopy and their comparative frequency in primary and secondary infertility. Study Design:Acase series. Place and Duration of Study: Department of Obstetrics and Gynaecology, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, August 2018 to July 2019. Methodology:All infertile women underwent diagnostic laparoscopy for primary and secondary infertility during the study period were included. Couples who had not lived together for at least 12 months, and those with male factor infertility were excluded. Data were collected on a proforma, and analysed on SPSS package for windows version 10. Frequencies were calculated for laparoscopic ndings regarding primary and secondary infertility. Results: Fifty infertile women underwent laparoscopy during the study period, 32 (64%) had primary infertility while 18 (36%) secondary infertility. Eight (25.0%) patients with primary and 2 (11.1%) patients with secondary infertility had no visible abnormality. The common nding was tubal blockage in 7 (21.9%) and 6 (33.3%) cases of primary and secondary infertility respectively. Five (15.6%) cases of primary infertility were detected as polycystic ovaries (PCO) which was not found in cases of secondary infertility. Endometriosis was found in 4 (12.5%) cases with primary infertility and 2 (11.1%) cases with secondary infertility. Pelvic inammatory disease (PID) was found in 1 (3.1%) and 2 (16.7%) cases of primary and secondary infertility respectively. Peritubal and periovarian adhesions were detected in 2 (6.3%) cases with primary infertility and 4 (22.2%) cases with secondary infertility. Fibriod was found in 2 (6.3%) and 1 (5.6%) cases of primary and secondary infertility respectively. Ovarian cyst detected in 2 (6.3%) cases with primary infertility while none was found in cases of secondary infertility. Conclusion: Most common causes responsible for infertility were tubal occlusion, endometriosis, peritubal and periovarian adhesions. Ovarian causes were seen in primary infertility only

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Ovarian response patterns to human menopausal gonadotropin in mixed hyperandrogenemia

Acta Endocrinologica ◽

10.1530/acta.0.1230598 ◽

1990 ◽

Vol 123 (6) ◽

pp. 598-602

Author(s):

Miklos Hamori ◽

Attila Török ◽

Manfred Zwirner ◽

Hans-Rudolf Tinneberg

Keyword(s):

Follicular Development ◽

Ovarian Response ◽

Human Menopausal Gonadotropin ◽

Response Patterns ◽

Polycystic Ovaries ◽

Ovarian Volume ◽

Wide Range ◽

Suppression Test ◽

Dexamethasone Suppression ◽

Stimulation Of

Abstract. Twenty-eight hyperandrogenemic women suffering from infertility owing to chronic anovulation were treated with hMG. Only 7 patients exhibited the typical polycystic ovarian appearance of multiple subcortical cysts, however, a wide range (6-15 cm3) of ovarian volume was observed. The LH/FSH ratio was consistently lower than 2.5 and circulating androgens of both ovarian and adrenal origin were elevated. The 4 days dexamethasone suppression test showed more than 80% suppression of dehydroepiandrosterone-sulphate and a variable (40-60%) reduction of testosterone and androstenedione levels. Two different patterns of follicular development were observed in response to hMG. Sixteen patients exhibited polycystic ovarian reaction, whereas 12 women had a follicular growth pattern similar to that seen in hMG-stimulated normo-ovulatory subjects. Patients with polycystic ovarian reaction showed a significantly increased androstenedione response to hMG when compared with the other group. Moreover, the non-stimulated ovarian volume was found to be markedly greater than in subjects without polycystic reaction. Thus, ovarian stimulation of patients with mixed hyperandrogenemia may elucidate the presence of borderline polycystic ovaries; furthermore the increased accumulation of androstenedione may suggest an inherent ovarian failure.

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Clinical and sonohysterography evaluation of infertile women

Journal of Chitwan Medical College ◽

10.3126/jcmc.v10i1.28073 ◽

2020 ◽

Vol 10 (1) ◽

pp. 58-63

Author(s):

Upendra Pandit ◽

Lekhnath Baral

Keyword(s):

Multinomial Logistic Regression ◽

Polycystic Ovaries ◽

Chi Square ◽

Endometrial Polyps ◽

Multinomial Logistic Regression Analysis ◽

Tubal Patency ◽

Infertile Women ◽

Modern Technique ◽

Combined Test ◽

Chi Square Test

Background: Hysterosalpingography (HSG) is an integral part of the Conventional clinical evaluation of infertile women. Now a day, Sonohysterography is a modern technique widely used in the clinical evaluation. The objective of this study was to identify pelvic pathology; compare the effect and findings of tubal patency test between Sonohysterosalpingography and single film HSG radiograph. Methods: This is a prospective evaluation of infertile women who attended the infertility unit of the gynecology department from 2017 March to 2018 October. Women 220 clients were subjected to clinical including SHSG evaluation followed by a single film HSG radiograph on the single sitting. The Chi-square test, multinomial logistic regression analysis was done using IBM SPSS statistics version 20. Results: Women had bilateral tubal patency 181(82.2%) in SHSG and conformed the same number later by HSG. SHSG showed bilateral tubal occlusion in 33 (15%) whereas HSG conformed only in 22(10%) and block was seen in 18(8.18%) only by HSG. The pathological findings were polycystic ovaries in 33 (15%), Fibroid uterus 11 (5%), ovarian cysts 5(2%), endometrial polyps in 2 cases, endometriotic cyst with hydrosalpinx 8(4%). Procedural side effects were no pain in 69(31.1%), mild pain 125(56.3%), Moderate pain 21(9.5%), vasovagal symptoms 7(3.1%). Conclusions: The outcome of the Sonohysterosalpingraphy (SHSG) test for tubal patency is significantly synergized by concurrent HSG in the same sitting. The combined test is best indicated if SHSG alone is not able to demonstrate the sign of tubal patency.

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Stimulation of Liver Regeneration Using a Titanium Nickelide Implant (Experimental Study)

Acta biomedica scientifica ◽

10.29413/abs.2020-5.1.11 ◽

2020 ◽

Vol 5 (1) ◽

pp. 78-83

Author(s):

I. R. Vesir ◽

G. Ts. Dambaev ◽

V. E. Gunter ◽

E. A. Gereng ◽

A. N. Vusik ◽

...

Keyword(s):

Experimental Study ◽

Liver Regeneration ◽

Titanium Nickelide ◽

Specific Pressure ◽

Pharmacological Agents ◽

Laboratory Rats ◽

Marginal Part ◽

Liver Changes ◽

Surgical Stimulation ◽

Stimulation Of

Currently, morbidity and mortality from chronic diffuse diseases of the liver and cirrhosis continue to increase worldwide. The difficulty of stabilizing the process with pharmacological agents, lots of restrictions for liver transplantation, the palliative character of the surgical correction of complications determine the urgency of finding various ways to stimulate liver regeneration, including surgical ones. Most of the known methods of surgical stimulation of regeneration are quite traumatic, and their stimulating effect is short-lived. The methods associated with cellular technologies are mostly expensive, ineffective, or poorly understood. In the experimental study, the effect on the parenchyma of a healthy and cirrhotic liver clips for clamping parenchymal organs exerting different unit pressure on the tissue was studied. The object of the study was laboratory rats with a healthy liver and animals with simulated cirrhosis. The animals were operated on with the imposition of titanium nickelide clips on the liver. Changes in the liver were studied 3, 7, 14, and 28 days after the surgery by histological examination of various parts of the liver. It was established that the clip with a lower specific pressure did not cause tissue necrosis, led to atrophy of the marginal part of the liver, also increased hepatocytes and binuclear hepatocytes were observed in the bulk of the liver. A decrease in the proportion of connective tissue was also observed in groups with liver cirrhosis. Thus, we consider it possible to use clips with a certain specific pressure on the tissue as a method of stimulating the reparative properties of the liver in chronic diffuse diseases and cirrhosis of the liver

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Surgical stimulation of uveoscleral outflow is an alternative to cyclodestructive procedures

Clinical ophthalmology ◽

10.32364/2311-7729-2021-21-1-9-13 ◽

2021 ◽

Vol 21 (1) ◽

pp. 9-13

Author(s):

E.A. Korchuganova ◽

◽

A.Yu. Kazantzeva ◽

Keyword(s):

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Secondary Glaucoma ◽

Open Angle ◽

Uveoscleral Outflow ◽

Surgical Stimulation ◽

Diode Laser Cyclophotocoagulation ◽

Stimulation Of

Aim: to assess clinical efficacy and safety of surgical scleral rejection (SSR) vs. transscleral diode laser cyclophotocoagulation (TSCPC) in primary open-angle glaucoma (POAG) and secondary glaucoma (SG). Patients and Methods: study (prospective) group included 84 patients with POAG and SG after SSR. Control (retrospective) group included 80 patients after TSCPC. In addition, the patients were distributed by age and the stage and type of glaucoma, i.e., 128 patients were diagnosed with POAG and 36 patients were diagnosed with secondary thrombotic glaucoma. Follow-up was 24 to 36 months. IOP measurements, tonography (to assess the coefficient outflow facility / COF), ultrasound biomicroscopy of the anterior segment, visual acuity measurement, and visual field testing were performed. Results: no complications after SSR were reported in patients with POAG and SG. In contrast, postoperative complications (choroidal effusion, hyphema, and uveitis) were reported in 14% of patients after TSCPC. Long-term IOP-lowering efficacy of both procedures was similar (87% after SSR and 89% after TSCPC). In POAG, greater IOP reduction was seen after TSCPC (by 39.11%) compared to SSR (by 31.58%) (p<0.05). Meanwhile, in patients with SG, treatment outcomes were similar (IOP reduced by 36.78% after TSCPC and by 35.26% after SSR). In longterm follow-up, PVF reduced by 10.76% vs. baseline after TSCPC but increased by 11.19% vs. baseline after SSR (p≤0.05). Surgery resulted in the improvement or stabilization of visual functions. Ultrasonography has demonstrated that outflow pathways (intrascleral space and filtering bleb) remain functional after SSR in long-term follow-up. Conclusion: SSR is an alternative to cyclodestructive procedures in POAG and SG. Sclera being the final point of the uveoscleral outflow is a perspective entity to develop surgical approaches to glaucoma treatment. Keywords: surgical scleral resection, uveoscleral outflow, sclera, primary open-angle glaucoma, secondary glaucoma, glaucoma surgery, transscleral diode laser cyclophotocoagulation. For citation: Korchuganova E.A., Kazantzeva A.Yu. Surgical stimulation of uveoscleral outflow is an alternative to cyclodestructive procedures. Russian Journal of Clinical Ophthalmology. 2021;21(1):9–13. DOI: 10.32364/2311-7729-2021-21-1-9-13.

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