scholarly journals Experience of performing radical trachelectomy with uterine transposition in organ-preserving treatment of stage IB-II invasive cervical cancer

2021 ◽  
Vol 67 (1) ◽  
pp. 85-90
Author(s):  
Alyena Chernyshova ◽  
Vitaly Аntipov ◽  
Larisa Коlomiets ◽  
Vladimir Chernov ◽  
Victor Gyunter ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Assisted Reproductive Technologies ◽  
Invasive Cervical Cancer ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Treatment Modalities ◽  
Combined Modality Treatment ◽  
Radical Trachelectomy ◽  
Stage Ib

The development and implementation of organ-preserving treatment modalities is the priority trend in the current cancer treatment of patients of the reproductive age. Methods of expanding indications for organ-preserving treatment in cancer patients are becoming relevant. We present our experience in performing radical trachelectomy with uterine transposition in patients with stage IB-II cervical cancer. Our surgical technique allows the preservation of the uterus and adnexa in patients with invasive cervical cancer, who need to receive combined modality treatment including extended surgery followed by chemotherapy or radiation therapy to the pelvis. Transposition of the uterus and adnexa after radical abdominal or laparoscopic trachelectomy allows the movement of the uterus and ovaries out of the radiation field. After completion of radiation therapy, the uterus with adnexa is repositioned into the pelvis and uterine-vaginal anastomosis is formed using an implant made of titanium nickelide. Independent pregnancy and the use of assisted reproductive technologies are permitted after passing the time when distant metastases are most likely to develop.  

scholarly journals Successful Pregnancy following Myomectomy Accompanied with Abdominal Radical Trachelectomy for an Infertile Woman with Early Cervical Cancer: A Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Yuji Kamei ◽  
Ai Miyoshi ◽  
Nao Wakui ◽  
Takeya Hara ◽  
Serika Kanao ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Infertile Woman ◽  
Radical Trachelectomy ◽  
Significant Past Medical History ◽  
Successful Pregnancy ◽  
Early Cervical Cancer

Women in the reproductive age group diagnosed with cervical cancer can receive radical trachelectomy in case they wish to preserve fertility. However, the indication for this procedure in infertile women with cervical cancer is controversial depending on the underlying cause of infertility. Here, we present a case of a successful pregnancy following myomectomy accompanied with abdominal radical trachelectomy for an infertile woman with early cervical cancer. The patient was a 38-year-old nulliparous woman with a significant past medical history of infertility of unknown origin. She had been undergoing treatment with assisted reproductive technologies including artificial insemination and in vitro fertilization for over four years. During her treatment for infertility, she was diagnosed with stage IB1 cervical squamous cell carcinoma. She received abdominal radical trachelectomy and abdominal myomectomy in the same surgical procedure. Six months after the surgery, she went for the first embryo transfer and became pregnant. At 26 weeks of pregnancy, a male baby weighing 980 g was delivered with an Apgar score of 3/5/7 by cesarean section due to chorioamnionitis. The baby has received general care in a neonatal intensive care unit for four months and weighed 4520 g when discharged.

scholarly journals Assisted Reproductive Technologies for Women with Polycystic Ovarian Syndrome

2021 ◽  
Vol 14 (3) ◽  
pp. 1305-1308
Author(s):  
Muhjah Falah Hassan ◽  
Pallav Sengupta ◽  
Sulagna Dutta
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Fetal Loss ◽  
Reproductive Technologies ◽  
Fertilization Rate ◽  
Reproductive Age ◽  
Treatment Modalities ◽  
Reproductive Techniques ◽  
Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is the most common cause of anovulatory fertility problems in women of reproductive age, with a prevalence as high as 40% to 75%. There are different treatment modalities for increasing the chance of pregnancy in PCOS patients. Since most of the PCOS patients suffer from ovulatory problems, therapeutic efforts are focused mainly towards restoring normal ovulation. However, even after pharmacological interventions to ameliorate ovulatory irregularities, women with polycystic ovary are still at high risk of fetal loss. Thus, assisted reproductive techniques (ARTs) have become popular approaches which significantly increase the chances of successful pregnancy in these women, bypassing the conditions of PCOS. The present mini-review ‘pinpoints’ on the suitability of ARTs for PCOS patients who fail to ovulate following the conventional infertility treatment. The article also briefly explains how intracytoplasmic sperm injection (ICSI), the most effectiveART, correlates with better biological parameters, fertilization rate and better quality of embryos in PCOS women.

RADICAL TRACHELECTOMY: A 10-YEAR EXPERIENCE OF TOMSK CANCER RESEARCH INSTITUTE

2019 ◽  
Vol 65 (5) ◽  
pp. 715-720
Author(s):  
Alena Chernyshova ◽  
Larisa Kolomiets ◽  
Viktor Gyunter ◽  
Yekaterina Marchenko
Keyword(s):  
Cervical Cancer ◽  
Invasive Cervical Cancer ◽  
Nickel Titanium ◽  
Reproductive Age ◽  
Dysfunctional Uterine Bleeding ◽  
Radical Trachelectomy ◽  
Cancer Research Institute ◽  
Menstrual Dysfunction ◽  
Mesh Implant

The article summarizes and presents 10 years of experience in the organ-preserving treatment of invasive cervical cancer in patients of reproductive age in the amount of radical trachelectomy. The study included 68 patients with cervical cancer (T1a1NxM0 - T2aNxM0), the average age was 34.1 ± 8.4 years. Of these, 39 patients underwent radical trachelectomy with transabdominal access, 29 - with laparoscopic. During the operation, a mesh implant with a shape memory, woven into a stocking of super-elastic nickel-titanium filament with subsequent fixation with separate sutures along the perimeter, was used to form the locking apparatus of the uterus and strengthen the utero-vaginal anastomosis. It has been shown to be highly effective for providing a “locking” effect of the cervix. Of all the patients treated, 15 (22%) spontaneous pregnancies were registered, 9 after PAT and 6 after RT with laparoscopic access, of which 3 had operative delivery in terms of 29, 31 and 38 weeks. One currently has a prolongation of pregnancy (33 weeks), 2 (13.3%) had spontaneous miscarriages, the rest interrupted the pregnancy for various reasons. The onset of pregnancy was noted in patients after laparoscopic RT within a shorter period after surgery from 3 to 18 months. Menstrual dysfunction after surgery was observed in 4% and 19%, respectively. Dysfunctional uterine bleeding prevailed. The median follow-up was 69 months; 1 relapse was detected (1.4%). Overall survival rate of 100%.

CLINICAL CASE OF SUCCESSFUL TREATMENT OF INFERTILITY IN A PATIENT WITH FAILURE IVF RESULTS IN ANAMNESIS

2020 ◽  
pp. 61-67
Author(s):  
Kalinkina O.B. ◽  
Tezikov Yu.V. ◽  
Lipatov I.S. ◽  
Aravina O.R.
Keyword(s):  
Assisted Reproductive Technologies ◽  
Transvaginal Ultrasound ◽  
Clinical Manifestations ◽  
Reproductive Function ◽  
Abnormal Uterine Bleeding ◽  
Clinical Situation ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Deficiency Anemia ◽  
Number Of Publications

Genital endometriosis is a disease of women of reproductive age, accompanied by infertility in 50% [1]. Adenomyosis can be considered as an endometriosis of the uterus. Histologically, this process is represented by ectopic, non-tumor endometrial glands, and stroma surrounded by hypertrophic and hyperplastic myometrium [2]. Adenomyosis is accompanied by pelvic pain of varying intensity as well as menstrual disorders [1]. The disease is accompanied by significant violations of reproductive function (infertility, unsuccessful attempts at pregnancy and miscarriage, abnormal uterine bleeding). Adenomyosis can be accompanied by a violation of the function of adjacent organs (such as the bladder, rectum). Often, one of the clinical manifestations of adenomyosis is the development of sideropenic syndrome, which is also caused by the development of chronic post-hemorrhagic iron deficiency anemia. This is accompanied by a deterioration in the general condition of patients, a decrease in their ability to work. Despite a large number of publications in Russian and foreign scientific sources devoted to this problem, reproductive doctors and obstetricians-gynecologists often underestimate the role of adenomyosis in pregnancy planning using assisted reproductive technologies. Without interpreting the anamnesis data obtained through an active survey, doctors do not prescribe additional methods for diagnosing this pathology, which is not complex and expensive. To confirm the diagnosis, a transvaginal ultrasound examination of the pelvic organs during the premenstrual period is sufficient. In cases that are difficult to diagnose, the MRI method of the corresponding anatomical area can be used. Underestimation of the clinical picture and under-examination of the patient did not allow prescribing timely correction of the pathology and led to unsuccessful attempts to implement the generative function using assisted reproductive technologies. The conducted examination with clarification of the cause of IVF failures and the prescribed reasonable treatment made it possible to achieve regression of endometriosis foci in this clinical situation, followed by the patient's ability to realize generative function.

scholarly journals Review of Gynaecological Diagnoses and Surgeries Performed at a Tertiary Health Facility in Niger-Delta of Nigeria from 2012-2017: Implications for Healthcare Planning and Budgeting

2020 ◽  
pp. 1-10
Author(s):  
P. A. Awoyesuku ◽  
D. A. MacPepple ◽  
B. O. Altraide ◽  
D. H. John
Keyword(s):  
Health Facility ◽  
Uterine Fibroid ◽  
Assisted Reproductive Technologies ◽  
Descriptive Analysis ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
University Teaching ◽  
Common Cause ◽  
Healthcare Planning ◽  
Pelvic Malignancies

Background: Gynaecological disorders are a particularly common cause of morbidity and mortality among women of reproductive age and a common cause of hospital presentation/admission and surgery. Objective: This study sought to review gynaecological diagnoses and surgeries performed in a tertiary health facility from 2012 to 2017 and its implication for healthcare planning and budgeting. Methodology: This was a retrospective review of all gynaecological diagnoses and surgeries seen in the Rivers State University Teaching Hospital (RSUTH) from 2012 to 2017. Data were retrieved using a proforma comprising of year, gynaecological diagnosis and gynaecological surgeries. Data obtained was entered into Microsoft Excel for descriptive analysis. Results: The proportion of clinic attendees declined from an average of 23% in the first three years (2012-2014) to about 10% in the last three years (2015-2017). The most common gynaecological diagnosis were uterine fibroid (33.3%), infertility 28.1% (primary 5.7%, secondary 22.4%), PID (5.9%), ovarian tumour (4.2%), secondary amenorrhea (3.4%) and pelvic malignancies (3.4%). The commonest major surgeries were myomectomy 441(33.7%), salpingectomy 345(26.4%), hysterectomy 168(12.8%) and cervical cerclage 122(9.3%). The commonest minor surgeries were manual vacuum aspiration 314(41.0%), examination under anaesthesia and biopsy 110(14.3%) and adhesiolysis for synechiae 97(12.6%). The duo of uterine fibroid and infertility made up 50%-70% of all gynaecological diagnoses. Conclusion: This study showed that there has been a steady decline in gynaecological consultations over the years. However, the duo of uterine fibroid and infertility made up half to three-quarter of all gynaecological diagnoses over the 6 years. Infertility and uterine fibroids have a long cause and effect association. Healthcare policies and budgeting should be increased towards tackling these conditions, especially the setting up of a fertility center to provide assisted reproductive technologies and laparoscopy to improve practice and patient outcome.

REPRODUCTIVE POTENTIAL OF WOMEN WITH PREMATURE OVARIAN INSUFFICIENCY

2021 ◽  
pp. 41-48
Author(s):  
Spiridenko G.Yu. ◽  
Petrov Yu.A. ◽  
Palieva N.V.
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Assisted Reproductive Technologies ◽  
Hormone Replacement ◽  
Reproductive Potential ◽  
Reproductive Technologies ◽  
Pathological Process ◽  
Reproductive Age ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency

Infertility is currently a priority problem for women of reproductive age. One of the reasons for this condition may be premature ovarian insufficiency. This is a pathological process causes by primary hypogonadism that occurs in women under 40 years of age. Its prevalence varies from 1:10,000 at the age of 20 to 1:100 at an older age. The absence of specific clinical manifestations of the disease complicates its early diagnosis and timely treatment. This pathological process manifests itself as secondary oligo-or amenorrhea, infertility. Less often, before the onset of reproductive disorders, there are manifestations of estrogenic insufficiency - vasomotor disorders - hot flashes, hyperhidrosis, cephalgia, tachycardia, arterial hypertension, emotional and vegetative disorders-irritability, asthenic manifestations, anxiety, depression, hypo - thymia, decreased libido. The lack of accurate data on etiological factors makes it harder to find methods for preventing this disease. The main direction of treatment is hormone replacement therapy, aimed at eliminating the insufficiency of natural estrogens in the woman's body. The chances of successful realization of the reproductive potential depend on the value of the follicle-stimulating hormone, since its high concentration affects the mitotic activity of granulosa cells of the follicle, which confirms the validity of hormone replacement therapy. The non-occurrence of pregnancy after therapy forces the patient to use assisted reproductive technologies using donor embryos and oocytes, while the effectiveness of in vitro fertilization does not exceed 58%. To prevent this outcome, if a woman has risk factors for developing premature ovarian insufficiency, it is necessary to timely assess the ovarian reserve with the preservation of her own oocytes for subsequent assisted reproductive technologies.

scholarly journals Effects of Inositol(s) in Women with PCOS: A Systematic Review of Randomized Controlled Trials

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Vittorio Unfer ◽  
John E. Nestler ◽  
Zdravko A. Kamenov ◽  
Nikos Prapas ◽  
Fabio Facchinetti
Keyword(s):  
Systematic Review ◽  
Insulin Resistance ◽  
Randomized Clinical Trials ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Pathological Condition ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Industrialized Nations

Polycystic ovary syndrome (PCOS) is a common endocrine disorder, with complex etiology and pathophysiology, which remains poorly understood. It affects about 5–10% of women of reproductive age who typically suffer from obesity, hyperandrogenism, ovarian dysfunction, and menstrual irregularity. Indeed, PCOS is the most common cause of anovulatory infertility in industrialized nations, and it is associated with insulin resistance, type 2 diabetes mellitus, and increased cardiovascular risk. Although insulin resistance is not included as a criterion for diagnosis, it is a critical pathological condition of PCOS. The purpose of this systematic review is the analysis of recent randomized clinical trials of inositol(s) in PCOS, in particular myo- and D-chiro-inositol, in order to better elucidate their physiological involvement in PCOS and potential therapeutic use, alone and in conjunction with assisted reproductive technologies, in the clinical treatment of women with PCOS.

Abdominal radical trachelectomy for invasive cervical cancer: A case series and literature review

2008 ◽  
Vol 111 (3) ◽  
pp. 555-560 ◽  
Author(s):  
Rene Pareja F. ◽  
Pedro T. Ramirez ◽  
Mauricio Borrero F. ◽  
Gonzalo Angel C.
Keyword(s):  
Cervical Cancer ◽  
Literature Review ◽  
Invasive Cervical Cancer ◽  
Case Series ◽  
Radical Trachelectomy

Thromboembolic events in patients treated with definitive chemotherapy and radiation therapy for invasive cervical cancer

2005 ◽  
Vol 96 (2) ◽  
pp. 470-474 ◽  
Author(s):  
Geraldine M. Jacobson ◽  
Reena S. Kamath ◽  
Brian J. Smith ◽  
Michael J. Goodheart
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Invasive Cervical Cancer ◽  
Thromboembolic Events

Infecundity and Infertility

2019 ◽  
Author(s):  
Marie Thoma ◽  
Carie Cox ◽  
Jasmine Fledderjohann ◽  
Rudolph Kantum Adageba
Keyword(s):  
Public Health ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Assisted Reproductive Technologies ◽  
Significant Proportion ◽  
Well Being ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Increased Risk ◽  
Global Epidemiology

This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Global Public Health. Please check back later for the full article. Infertility remains a neglected area in sexual and reproductive health, yet its consequences are staggering. Infertility is estimated to impact about 15% (estimates range from 48 million to 180 million) of couples of reproductive age worldwide. It is associated with adverse physical and mental health outcomes, financial distress, severe social stigma, increased risk of domestic abuse, and marital instability. While men and women are equally likely to be infertile, women often bear the societal burden of infertility, particularly in societies where a woman’s identity and social value is closely tied to her ability to bear children. Despite these consequences, disparities in access to infertility treatment between low- and high-income populations persist, given the high cost and limited geographic availability of diagnostic services and assisted reproductive technologies. In addition, a significant proportion of infertility arises from preventable factors, such as smoking, sexually transmitted infections, pregnancy-related infection or unsafe abortion, and environmental contaminants. Accordingly, programs that address the equitable prevention and treatment of infertility are not only in keeping with a reproductive rights perspective, but can also improve public health. However, progress on infertility as a global concern in the field of sexual and reproductive health and rights is stymied by challenges in understanding the global epidemiology of infertility, including its causes and determinants, barriers to accessing quality infertility care, and a lack of political will and attention to this issue. Tracking and measurement of infertility is highly complex, resulting in considerable ambiguity about its prevalence and stratification of reproduction globally. A renewed global focus on infertility epidemiology, risk factors, and access to and receipt of quality of care will support individuals in trying to reach their desired number and spacing of children and improve overall health and well-being.

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