Bilateral megalocystic ovaries following in vitro fertilization detected during cesarean section: a case presentation

The article presents a personal observation of the course of pregnancy and childbirth in a patient with a typical form of gonadal dysgenesis (ShereshevskyTurner syndrome, karyotype 45,X0/46,XY in the ratio of clones 1:1). The diagnosis was established at 12 years of age during an examination for growth retardation and lack of signs of puberty. Given the presence of a 46,XY clone in the karyotype, a high risk of malignization of dysgenetic gonads, laparoscopy and gonadectomy were performed at 12 years of age. Pregnancy occurred after preparation of the endometrium with estrogens and progestogens, as a result of the first in vitro fertilization attempt with a donor egg and her husbands sperm, occurred against the background of hormonal support with the threat of termination of pregnancy and hypercoagulation. At 34 weeks, there was a premature detachment of placenta, in connection with which she was delivered by cesarean section.

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Rare Case of Metastatic Ovarian Clear Cell Carcinoma With an In Vitro Fertilization Pregnancy

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz113.036 ◽

2019 ◽

Vol 152 (Supplement_1) ◽

pp. S51-S52

Author(s):

Arati Inamdar ◽

Abraham Loo

Keyword(s):

In Vitro Fertilization ◽

Cesarean Section ◽

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Definitive Treatment ◽

Ovarian Clear Cell Carcinoma ◽

Vitro Fertilization ◽

The Right

Abstract The risk of ovarian malignancy is rare in pregnancy with a reported incidence of approximately 1 in 50,000. Ovarian clear cell carcinoma (OCCC) accounts for 5% to 10% of all ovarian carcinomas with mean age of 50 to 55 years and is often associated with endometriosis. We present a case of 38-year-old G2P1 Asian female with an in vitro fertilization pregnancy and history of endometriosis who presented with the right adnexal mass. The transvaginal ultrasound performed during the early pregnancy was suggestive of endometrioma or desmoid tumor. At 32 weeks, the patient presented to the emergency department with preeclampsia and severe headache. An emergency cesarean section was performed due to worsening of the patient’s condition. An ovarian mass arising from the right ovary and with a friable and hemorrhagic internal surface was excised, which weighed 63 g and measured 14.0 × 10.5 × 3.0 cm. Its external surface was smooth, hemorrhagic, but without any excrescences. The serial sectioning revealed multiple cystic lesions filled with necrotic material overall occupying 80% of the mass. Microscopically, the viable ovarian tissue demonstrated tubulocystic/papillary architecture lined by hyperchromatic hobnail cells along with focal areas of solid sheets of tumor cells displaying clear cytoplasm. Immunohistochemical stains for Wilm’s tumor 1 and p53 were negative while positive for PAX8. These findings were indicative of OCCC without overexpression of wild-type p53. The PET scan performed few weeks after delivery showed widespread metastasis. We present a unique case of metastatic OCCC removed at the time of cesarean section in the late-preterm period. Our case not only emphasizes the need for definitive treatment option for endometriosis but also a close imaging surveillance of all masses diagnosed during pregnancy in women with risk factors such as endometriosis and Asian ethnicity. Furthermore, our study advocates the need for possible guidelines for management of such rare cases.

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In Vitro Fertilization and Vasa Previa: A Report of Two Cases

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0039-1683354 ◽

2019 ◽

Vol 41 (05) ◽

pp. 348-351

Author(s):

Ana Lúcia Isotton ◽

Cristiano Caetano Salazar ◽

Cleisson Fábio Andrioli Peralta ◽

Juliana Moysés Leite Abdalla ◽

Janete Vettorazzi

Keyword(s):

Risk Factor ◽

Prenatal Diagnosis ◽

In Vitro Fertilization ◽

Cesarean Section ◽

Apgar Score ◽

Transvaginal Ultrasound ◽

Caucasian Woman ◽

Vitro Fertilization ◽

Vasa Previa

AbstractVasa previa (VP) is a dangerous obstetric condition associated with perinatal mortality and morbidity. In vitro fertilization (IVF) is a risk factor for VP due to the high incidence of abnormal placentation. The diagnosis should be made prenatally, because fetal mortality can be extremely high. We report two cases to demonstrate the accuracy of transvaginal ultrasound in the prenatal diagnosis of VP. A 40-year-old primiparous Caucasian woman with IVF pregnancy was diagnosed with VP at 29 weeks of gestation and was hospitalized for observation at 31 weeks of gestation. She delivered a male newborn weighing 2,380 g, with an Apgar score of 10 at 5 minutes, by elective cesarean section at 34 weeks + 4 days of gestation, without complications. A 36-year-old primiparous Caucasian woman with IVF pregnancy was diagnosed with placenta previa, bilobed placenta increta and VP. The cord insertion was velamentous. She was hospitalized for observation at 26 weeks of gestation. She delivered a female newborn weighing 2,140 g, with an Apgar score of 9 at 5 minutes, by emergency cesarean section at 33 weeks + 4 days of gestation due to vaginal bleeding. The prenatal diagnosis of VP was associated with a favorable outcome in the two cases, supporting previous observations that IVF is a risk factor for VP and that all IVF pregnancies should be screened by transvaginal ultrasound.

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A case of scarred uterine rupture at 11 weeks of gestation having a uterine scar places induced by in vitro fertilization-embryo transfer

Clinics and Practice ◽

10.4081/cp.2018.1038 ◽

2018 ◽

Cited By ~ 2

Author(s):

Akiko Takashima ◽

Naoki Takeshita ◽

Toshihiko Kinoshita

Keyword(s):

In Vitro Fertilization ◽

Cesarean Section ◽

Uterine Rupture ◽

Early Recognition ◽

Placenta Previa ◽

Lower Abdominal Pain ◽

Vitro Fertilization ◽

Increased Risk ◽

Uterine Scar

Having a uterine scar places a woman at increased risk of complications, such as Cesarean scar pregnancy (CSP), uterine rupture, placenta previa, and placenta accreta, in subsequent pregnancies. We report a case of uterine rupture at 11 weeks of gestation in a woman with a previous Cesarean section. A 43-year-old woman with a history of abdominal myomectomy and Cesarean section had her pregnancy induced by in vitro fertilization with donor eggs. The exact location of the gestational sac was identified on her first day of hospitalization, and her pregnancy was suspected to be a CSP. The following day, the patient complained of sudden lower abdominal pain. A uterine scar rupture was diagnosed, and an emergency surgery was required. It may be that first-trimester screening could allow the early recognition of patients at risk for these perinatal complications.

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Repeat in vitro fertilization success rates are lower in patients who deliver via cesarean section when using embryos from the same cohort

Fertility and Sterility ◽

10.1016/j.fertnstert.2016.07.149 ◽

2016 ◽

Vol 106 (3) ◽

pp. e48

Author(s):

M.K. Hayes ◽

P.A. Bergh ◽

C.M. Bergh ◽

T.A. Molinaro

Keyword(s):

In Vitro Fertilization ◽

Cesarean Section ◽

Fertilization Success ◽

Success Rates ◽

Vitro Fertilization

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ОСОБЛИВОСТІ ПЕРЕБІГУ ВАГІТНОСТІ ТА РОЗРОДЖЕННЯ ЖІНОК З ЕКСТРАКОРПОРАЛЬНИМ ЗАПЛІДНЕННЯМ З ГРУПИ ВИСОКОГО РИЗИКУ ПО ВИНИКНЕННЮ ПЕРЕДЧАСНИХ ПОЛОГІВ

The Medical and Ecological Problems ◽

10.31718/mep.2021.25.5-6.05 ◽

2021 ◽

Vol 25 (5-6) ◽

pp. 20-23

Author(s):

Я.В. Шиманська

Keyword(s):

Preterm Birth ◽

High Risk ◽

In Vitro Fertilization ◽

Cesarean Section ◽

Pregnant Women ◽

Preventive Treatment ◽

Study Group ◽

Vitro Fertilization ◽

Group A

The article is a part of the research project at the Department of Obstetrics and Gynecology No.2 of Higher Education Institution Poltava State Medical University "The role of chronic infection of the uterus and lower genital tract in the formation of obstetric and gynecological pathology" (state registration No. 0117U005276, implementation period 2017-2022). In modern reproductive medicine, infertility in marriage is considered a problem of particular importance. That is why modern assisted reproductive technologies are chosen as a method of treatment for many married couples, and their increased application necessitates intensive monitoring of the course of pregnancy and delivery. Pregnant women after in vitro fertilization programs are at high risk of miscarriage and preterm birth. The aim of the research was to study the features of pregnancy, childbirth and the condition of newborns in women after in vitro fertilization, which are classified as high risk for preterm birth. Women were included in the study at 18-20 weeks 6 days of pregnancy. We examined 85 women who became pregnant after in vitro fertilization (study group A: 37 pregnant women who refused preventive treatment and received medications in accordance with regulations; study group B: 48 pregnant women who have received the proposed treatment since their inclusion in the study. The control group included 20 apparently healthy pregnant women with its natural pregnancy onset. In pregnant women of study group A, pregnancies ended in premature birth by 1.7 times more often, and most of them occurred before 34 weeks; during pregnancy, there was a greater risk of preterm birth, which required enhanced correction in addition to conservative measures: suturing the cervix and the use of obstetric unloading pessary; the frequency of delivery by cesarean section prevailed by 1.3 times. Moreover, only in this group, pathological bleeding was observed, surgery was performed and perinatal mortality was recorded. Pregnant women who agreed to preventive treatment developed fewer preterm births after 34 weeks. Complications of pregnancy and childbirth were much less common in these women. Surgical intervention in childbirth and the frequency of delivery by cesarean section were also much less common.

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