RESUMO
OBJECTIVE: The present study aimed to evaluate reproductive outcomes and determine the predictors of clinical pregnancy and live birth in women with elevated baseline follicle-stimulating hormone (FSH) levels, who have undergone intracytoplasmic sperm injection (ICSI) treatment. METHODS: This retrospective study included 1011 ICSI cycles of women with high baseline FSH levels (> 10 IU/L), from a tertiary university IVF center between 2010 and 2015. Logistic regression analysis was performed to evaluate the prognostic factors of clinical pregnancy and live birth. RESULTS: Among the 1011 ICSI cycles, the clinical pregnancy and live birth rates per oocyte retrieval were 19.5% and 14.3%, respectively. The live birth rates were 21.1% and 1.7% in women aged ≤30 years and those aged ≥40 years, respectively. In addition, the live birth rate was 1.47-fold higher in women from whom >3 oocytes were retrieved, compared to those from whom ≤3 oocytes were retrieved (p=0.047). Logistic regression analysis indicated that the age categories ≤30y, 36-39y and ≥40y, level of baseline FSH (≥20 IU/L) and the ovarian response (≤3 or >3 oocytes retrieved) were significantly associated with live birth. CONCLUSIONS: Our study indicated that age, baseline FSH level, and ovarian response are independent predictive factors for clinical pregnancy and live birth among women with baseline FSH levels >10 IU/L.
Assuntos
Hormônio Foliculoestimulante , Feminino , Fertilização in vitro , Humanos , Indução da Ovulação , Gravidez , Taxa de Gravidez , Estudos RetrospectivosRESUMO
Bilateral tubal ectopic pregnancy is a very rare form of ectopic pregnancy. The incidence is higher in women undergoing assisted reproductive techniques or ovulation induction. We report the case of bilateral tubal ectopic pregnancy. The patient was 30 years old and had a 3-year history of infertility; she was referred to the in-vitro fertilization (IVF) program because of tubal factor infertility. A pregnancy resulted from the transfer of two embryos during an artificial cycle. Despite the increase in ß-hCG values during the follow-up, 22 days after the embryo transfer, the ß-hCG levels were 2,408 U/L and the serum progesterone (P4) level was 10.53 ng/ml. After application with methotrexate, ß-hCG levels did not decrease effectively. Moreover, the sonographic screening revealed a suspicious bilateral tubal focus for ectopic pregnancy. A mini-laparotomy was performed and a bilateral tubal pregnancy was found. In the case of unilateral tubal pregnancy after the transfer of two embryos, the situation of the other tube should be systematically checked and ß-hCG levels should be monitored.
Assuntos
Transferência Embrionária , Gravidez Tubária/diagnóstico , Diagnóstico Pré-Natal , Injeções de Esperma Intracitoplásmicas , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Gravidez , Gravidez Tubária/sangue , Gravidez Tubária/diagnóstico por imagem , Ultrassonografia Pré-NatalRESUMO
Abstract Bilateral tubal ectopic pregnancy is a very rare form of ectopic pregnancy. The incidence is higher in women undergoing assisted reproductive techniques or ovulation induction. We report the case of bilateral tubal ectopic pregnancy. The patient was 30 years old and had a 3-year history of infertility; she was referred to the in-vitro fertilization (IVF) program because of tubal factor infertility. A pregnancy resulted from the transfer of two embryos during an artificial cycle. Despite the increase in β-hCG values during the follow-up, 22 days after the embryo transfer, the β-hCG levels were 2,408 U/L and the serum progesterone (P4) level was 10.53 ng/ml. After application with methotrexate, β-hCG levels did not decrease effectively. Moreover, the sonographic screening revealed a suspicious bilateral tubal focus for ectopic pregnancy. A mini-laparotomy was performed and a bilateral tubal pregnancy was found. In the case of unilateral tubal pregnancy after the transfer of two embryos, the situation of the other tube should be systematically checked and β-hCG levels should be monitored.
Assuntos
Humanos , Feminino , Gravidez , Adulto , Gravidez Tubária/diagnóstico , Diagnóstico Pré-Natal , Injeções de Esperma Intracitoplásmicas , Transferência Embrionária , Gravidez Tubária/sangue , Gravidez Tubária/diagnóstico por imagem , Ultrassonografia Pré-Natal , Diagnóstico DiferencialRESUMO
We report a case of right adnexal torsion during the embryo implantation period of an IVF/ICSI cycle. A 26-yearold woman who diagnosed as primary infertility was included in an IVF/ICSI program. In the following period right adnexal torsion occurred at the sixth day of the embryo transfer. Laparoscopic detortion was successfully performed with preserving the adnexia. The patient had positive pregnancy test in the subsequent week.