RESUMEN
The proportions of good, fair, and poor embryos in 13 women with bilateral endometriomas were compared with those of 39 women without endometriomas and were found to be similar (47.2% vs. 41.1%, 28.3% vs. 32.8%, and 24.3% vs. 26.0%, respectively). Therefore, it appears that the presence of bilateral endometriomas during IVF treatment is not associated with reduced embryo quality.
Asunto(s)
Fase de Segmentación del Huevo , Endometriosis/complicaciones , Fertilidad , Fertilización In Vitro , Infertilidad Femenina/terapia , Enfermedades del Ovario/complicaciones , Adulto , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Implantación del Embrión , Transferencia de Embrión , Endometriosis/diagnóstico por imagen , Endometriosis/fisiopatología , Femenino , Humanos , Infertilidad Femenina/diagnóstico por imagen , Infertilidad Femenina/etiología , Infertilidad Femenina/fisiopatología , Modelos Logísticos , Oportunidad Relativa , Enfermedades del Ovario/diagnóstico por imagen , Enfermedades del Ovario/fisiopatología , Embarazo , Índice de Embarazo , Quebec , Estudios Retrospectivos , Resultado del Tratamiento , UltrasonografíaRESUMEN
BACKGROUND: Women who undergo uterine artery embolization (UAE) and subsequently have heavy vaginal bleeding require assessment to establish the cause. Endometrial sampling in such women should not necessarily carry more than the usual risk. CASES: Two women who had undergone UAE presented with recurrence of heavy vaginal bleeding. In order to rule out possible endometrial malignancy, we performed an endometrial biopsy. Both patients had large and necrotic intramural myomas adjacent to the endometrium. They developed septic uterus shortly after endometrial biopsy and each required a hysterectomy. The postoperative course in the first case was complicated by deep vein thrombosis and enterovaginal fistula. CONCLUSION: Because of the high risk of infection, women with a history of UAE and necrotic myoma adjacent to the endometrium should not undergo endometrial biopsy. We recommend evaluation of the relation of myomas to the endometrium.
Asunto(s)
Absceso/etiología , Embolización Terapéutica/efectos adversos , Enfermedades Uterinas/etiología , Hemorragia Uterina/terapia , Útero/irrigación sanguínea , Absceso/diagnóstico , Absceso/patología , Biopsia/efectos adversos , Endometrio/patología , Femenino , Humanos , Leiomiomatosis/complicaciones , Leiomiomatosis/patología , Imagen por Resonancia Magnética , Persona de Mediana Edad , Necrosis , Sepsis , Enfermedades Uterinas/diagnóstico , Enfermedades Uterinas/patología , Hemorragia Uterina/etiología , Neoplasias Uterinas/complicaciones , Neoplasias Uterinas/patología , Útero/patologíaRESUMEN
In vitro fertilization (IVF) with ovarian stimulation is an effective treatment for couples needing treatment with assisted reproductive technologies (ART) where polycystic ovary syndrome (PCOS) is coexisting. However, it is also associated with an increased risk of ovarian hyperstimulation syndrome. In vitro maturation (IVM) avoids the risks and side effects of ovarian stimulation by retrieving immature oocytes from unstimulated ovaries. These immature oocytes are then cultured, matured, and fertilized in vitro. Embryos are then selected for transfer in the same manner as conventional IVF. Although there has been significant progress in terms of improving clinical pregnancy and live-birth rates after IVM, there remains much to learn in terms of what controls maturation, fertilization, and implantation rates. This review is intended as an update on the most recent advances and directions of ongoing research in IVM in patients with PCOS.
Asunto(s)
Infertilidad Femenina/terapia , Oogénesis , Inducción de la Ovulación , Síndrome del Ovario Poliquístico/complicaciones , Transferencia de Embrión , Femenino , Fertilización In Vitro , Humanos , Infertilidad Femenina/etiología , Oogénesis/efectos de los fármacos , Inducción de la Ovulación/efectos adversos , Inducción de la Ovulación/métodos , Inducción de la Ovulación/tendencias , Embarazo , Resultado del Embarazo , Resultado del TratamientoRESUMEN
OBJECTIVE: To compare the ability of the fasting plasma glucose (FPG) level with the ability of the 2-hour oral glucose tolerance test (OGTT) to identify women with any form of glucose intolerance within the first six postpartum months. METHODS: In a retrospective, observational analysis, the predictive ability of the FPG level was compared with that of the 2-hour OGTT in 275 women followed for gestational diabetes who returned for postpartum testing. RESULTS: With use of the FPG level alone, 4.4% of the women were found to have an FPG 7.0 mmol/L, identifying diabetes mellitus (DM); 2.5% had an FPG in the range 6.1-6.9 mmol/L, identifying impaired fasting glucose (IFG); and 93% had an FPG 6.0 mmol/L, i.e., within the normal range. Using the 2-hour 75g OGTT, 5% of women were found to have either an FPG 7.0 mmol/L or a 2-hour plasma glucose (PG) 11.1 mmol/L, identifying DM; 2.5% had an FPG of 6.1-6.9 mmol/L, identifying IFG; and 32% had a 2-hour PG of 7.8-11.0 mmol/L, identifying impaired glucose tolerance (IGT). Of the women with any glucose abnormality postpartum, an FPG level alone detected 15.8%, the post-glucose load level detected 97.5%, and an OGTT detected 100% of the women. An FPG level alone in 39% of cases failed to detect either IGT or DM and in 54% of cases, type 2 DM. CONCLUSION: In view of the potential for early, effective prevention of DM, the optimal method for detecting glucose abnormalities in women within six months post partum is a 2-hour OGTT.