Chronic ectopic pregnancy mimicking pelvic malignancy

Ectopic pregnancy is a common complication of early pregnancy. We present a very atypical case of an ectopic gestation in a woman who presented with a negative pregnancy test, a large pelvic mass, weight loss and bowel obstruction.

Effects of blood pathological changes before TAI on pregnancy of dairy cows with anestrus and estrus

ABSTRACT The objective of this study was to investigate the influence of plasma pathological changes before timed artificial insemination (TAI) on pregnancy of cows. The contents of estrogen (E2), progesterone (P4), glucose (Glu), selenium (Se), brain-derived neurotrophic factor (BDNF), and histamine (HIS) in plasma of 48 Holstein cows were measured before TAI. According to the estrus detection, the cows were divided into estrus (E) and anestrus (A) groups. After pregnancy testing at 28 d after TAI, two groups of E and A were divided into positive pregnancy of E group (EP+), negative pregnancy of E group (EP-), positive pregnancy of A group (AP+), and negative pregnancy of A group (AP-). The contents of E2, P4, Glu, Se, BDNF and hIS significantly differed among the four groups (P<0.01). The ROC analysis was used to determine the risk of negative pregnancy test (-) after TAI was increased when plasma E2 was less than 46.45 pmol/L in cows before TAI. The changes in E2, P4,hIS, Glu, and BDNF in the blood of natural estrus and natural anestrus cows affected the pregnancy after TAI. the level of E2 in plasma may be used to assess the risk of negative pregnancy after TAI.

Assessment of cervical cytomorphological changes in infertile women undergoing IVF/ICSI

The aim of this study is to assess cervical cytomormophological changes in cervical smears taken from infertile women undergoing IVF/ICSI compared with normal fertile women. A case-control study of 100 cases were included, 50 infertile group and 50 normal fertile control group both in age range between (20-44), Pap smear taken prior to ova pickup in case group and in preovulatory day in control group. The mean age for case group was 28.9 ±5.6 year; and the mean age of control group was 29.7 ±5.5 years with no significant difference between them t=1.99, p=0.5, the most frequent cause of infertility is polycystic ovaries or with polycystic ovarian syndrome which diagnosed in (36%) of patients then (28%) of patients diagnosed with unexplained infertility. Case group has (22%) diagnosed with atypical squamous cells with undetermined significance (ASC-US) while control group has just 1 case (2%) with ASC-US and this affects pregnancy test result since (18%) out of (22%) of patient with (ASC-US) pap smear report has negative pregnancy test. Statistical analysis shows significant correlation between positive cervicitis and negative pregnancy test (P value = 0.04) because (52%) out of (66%) with positive cervicitis has negative pregnancy test.beside a significant relation between positive infection in pap smear report and negative pregnancy test because (30%) out of (34%) with positive infection in pap smear has negative pregnancy test. In Conclusions, infertile women eligible for IVF are more probable to have ASC-US when compared with normal fertile women, ASC-US worsen pregnancy test results in women undergoing IVF/ICSI because (18%) out of (22%) of patient with (ASC-US) have negative pregnancy test.

Morphometric analysis of human embryos to predict developmental competence

Morphometric and morphokinetic approaches toward embryo quality assessment have for many years been difficult due to technical limitations. Today, with improvements in laboratory techniques and subsequent quality, we have a better understanding of the morphometric and kinetics of embryo development. Fertility clinics are moving from “sensing” embryo quality to measuring embryo quality – and this is happening every day in fertility clinics all over the world. However, we cannot select for something that is not there. In daily clinical life it is almost never a question of selecting the optimal embryo, but rather choosing and prioritising between the available embryos. Data suggest that only approximately 5% of aspirated human oocytes have the competence to implant and develop into a child and that, in most treatment cycles, there is no oocyte capable of implanting. The most likely outcome is a negative pregnancy test, no matter what we choose in the laboratory. Still, both with the increasing complexity of infertile patients treated today and the important focus on reducing multiple pregnancies, it becomes increasingly important to improve our ability to predict the developmental competence of each embryo. This involves an improved understanding of the basic biology controlling early embryonic development and, over the years, many groups have tried to identify parameters reflecting embryonic competence.