Objective: To evaluate the incidence of congenital malformations among offspring of mothers who conceived with clomiphene citrate(CC) or with letrozole treatment for infertility. Design: Retrospective study. Setting: ...Objective: To evaluate the incidence of congenital malformations among offspring of mothers who conceived with clomiphene citrate(CC) or with letrozole treatment for infertility. Design: Retrospective study. Setting: 5 fertility centers in Canada. Patients: 911 newborns from women who conceived following CC or letrozole treatment. Interventions: Examination of medical files of both mother and newborn, and cross-checked with the parents by telephone calls. Main Outcome Measures: Identified major and minor congenital malformations, birth weight, age of the mother, and type of treatment that led to the conception. Results: Overall, congenital malformations and chromosomal abnormalities were found in 14 of 514 newborns in the letrozole group(2.4%) and in 19 of 397 newborns in the CC group(4.8%). The major malformation rate in the letrozole group was 1.2%(6/514) and in the CC group was 3.0%(12/397). One newborn in the letrozole group was found to have a ventricular septal defect(0.2%)-compared to 4 newborns in the CC group(1.0%). In addition, the rate of all congenital cardiac anomalies was significantly higher(P: 0.02) in the CC group(1.8%) compared to the letrozole group(0.2%). Conclusion: There was no difference in the overall rates of major and minor congenital malformations among newborns from mothers who conceived after letrozole or CC treatments. However, it appears that congenital cardiac anomaly is less frequent in the letrozole group. The concern that letrozole use for ovulation induction could be teratogenic is unfounded based on our data.展开更多
Eighty- eight infertile patients undergoing laparoscopy were randomized to undergo chromopertubationwith lipiodol orwith normal saline. The cumulative probability of conception at 1, 3, and 6 months following laparosc...Eighty- eight infertile patients undergoing laparoscopy were randomized to undergo chromopertubationwith lipiodol orwith normal saline. The cumulative probability of conception at 1, 3, and 6 months following laparoscopy was not statistically different between the lipiodol group (21% , 31% , and 43% , respectively) and the saline group (18% , 21% , and 33% , respectively).展开更多
OBJECTIVE:To summarize management of interstitial pregnancy and its outcome among 32re ported cases in the world METHODS:From 1999to 2002,32c ases of inter-stitial pregnancy were reported to t he registry of the Socie...OBJECTIVE:To summarize management of interstitial pregnancy and its outcome among 32re ported cases in the world METHODS:From 1999to 2002,32c ases of inter-stitial pregnancy were reported to t he registry of the Society of Reproductive Surgeons.The participants completed a five -page questionnaire regarding when and how diagnosis was made,the characteristics of the pregnancy,treatment modalities,and subsequent reprodu ctive outcome.RE-SULTS:History of ipsilateral salpi ngectomy was encoun-tered in 37.5%of patients,and the di agnosis was made by ultrasound in 71.4%of the patients.Eight women were treated with methotrexate either sy stemically(n =4),lo-cally under ultrasound guidance(n =2),or under la-paroscopic guidance(n =2).Eleven patients were treated by laparoscopy and 13by laparotomy.Three patients failed systemic methotrexate treatment an d subsequently required surgery.Persistently elevated serumβhuman chorionic gonadotropin levels were found in on e patient after laparo-scopic cornual excision,and she was successfully treated with methotrexate.Fourteen cases(43.7%)of rupture of interstitial pregnancy were found.This included five cases(15.6%)of heterotopic pregnancy;all were t he results of in vitro fertilization,and all rupt ured at the time of diag-nosis.Subsequent pregnancywas ach ieved in ten patients.No uterine rupture was encountered d uring pregnancy or labor.CONCLUSION:Ipsilateral salpingectomy,previous ectopic pregnancy,and in vitro fertilization are predispos-ing factors for interstitial pregnancy.Contrary to previous belief,rupture of interstitial pre gnancy occurs relatively early in pregnancy.In selected patients,laparoscopiccornual excision is a viable treatme nt option.展开更多
No nerve fibers are found in endometr iomasor in the en-dometrioma-containing ovaries.These findings are con-sistent with our previous report that no correlation exists between the presence of nerve fibers and endomet...No nerve fibers are found in endometr iomasor in the en-dometrioma-containing ovaries.These findings are con-sistent with our previous report that no correlation exists between the presence of nerve fibers and endometriosis.展开更多
文摘Objective: To evaluate the incidence of congenital malformations among offspring of mothers who conceived with clomiphene citrate(CC) or with letrozole treatment for infertility. Design: Retrospective study. Setting: 5 fertility centers in Canada. Patients: 911 newborns from women who conceived following CC or letrozole treatment. Interventions: Examination of medical files of both mother and newborn, and cross-checked with the parents by telephone calls. Main Outcome Measures: Identified major and minor congenital malformations, birth weight, age of the mother, and type of treatment that led to the conception. Results: Overall, congenital malformations and chromosomal abnormalities were found in 14 of 514 newborns in the letrozole group(2.4%) and in 19 of 397 newborns in the CC group(4.8%). The major malformation rate in the letrozole group was 1.2%(6/514) and in the CC group was 3.0%(12/397). One newborn in the letrozole group was found to have a ventricular septal defect(0.2%)-compared to 4 newborns in the CC group(1.0%). In addition, the rate of all congenital cardiac anomalies was significantly higher(P: 0.02) in the CC group(1.8%) compared to the letrozole group(0.2%). Conclusion: There was no difference in the overall rates of major and minor congenital malformations among newborns from mothers who conceived after letrozole or CC treatments. However, it appears that congenital cardiac anomaly is less frequent in the letrozole group. The concern that letrozole use for ovulation induction could be teratogenic is unfounded based on our data.
文摘Eighty- eight infertile patients undergoing laparoscopy were randomized to undergo chromopertubationwith lipiodol orwith normal saline. The cumulative probability of conception at 1, 3, and 6 months following laparoscopy was not statistically different between the lipiodol group (21% , 31% , and 43% , respectively) and the saline group (18% , 21% , and 33% , respectively).
文摘OBJECTIVE:To summarize management of interstitial pregnancy and its outcome among 32re ported cases in the world METHODS:From 1999to 2002,32c ases of inter-stitial pregnancy were reported to t he registry of the Society of Reproductive Surgeons.The participants completed a five -page questionnaire regarding when and how diagnosis was made,the characteristics of the pregnancy,treatment modalities,and subsequent reprodu ctive outcome.RE-SULTS:History of ipsilateral salpi ngectomy was encoun-tered in 37.5%of patients,and the di agnosis was made by ultrasound in 71.4%of the patients.Eight women were treated with methotrexate either sy stemically(n =4),lo-cally under ultrasound guidance(n =2),or under la-paroscopic guidance(n =2).Eleven patients were treated by laparoscopy and 13by laparotomy.Three patients failed systemic methotrexate treatment an d subsequently required surgery.Persistently elevated serumβhuman chorionic gonadotropin levels were found in on e patient after laparo-scopic cornual excision,and she was successfully treated with methotrexate.Fourteen cases(43.7%)of rupture of interstitial pregnancy were found.This included five cases(15.6%)of heterotopic pregnancy;all were t he results of in vitro fertilization,and all rupt ured at the time of diag-nosis.Subsequent pregnancywas ach ieved in ten patients.No uterine rupture was encountered d uring pregnancy or labor.CONCLUSION:Ipsilateral salpingectomy,previous ectopic pregnancy,and in vitro fertilization are predispos-ing factors for interstitial pregnancy.Contrary to previous belief,rupture of interstitial pre gnancy occurs relatively early in pregnancy.In selected patients,laparoscopiccornual excision is a viable treatme nt option.
文摘No nerve fibers are found in endometr iomasor in the en-dometrioma-containing ovaries.These findings are con-sistent with our previous report that no correlation exists between the presence of nerve fibers and endometriosis.
