Infertility is defined as the inability for a couple to have children without any contraceptive methods within 1 year.Tubal factors are responsible for 25％ to 35％ of female reasons,and these have been proven to be a...Infertility is defined as the inability for a couple to have children without any contraceptive methods within 1 year.Tubal factors are responsible for 25％ to 35％ of female reasons,and these have been proven to be a major cause of female infertility.Hydrosalpinx is a special type of tubal occlusion in which fluid accumulates inside the hymen of the tube.This adversely affects fallopian function,and hydrosalpinx fluids have a toxic effect on the quality of the embryos and endometrial receptivity.Currently,reconstructive surgery still plays a role in female infertility for tubal factors and has not been totally replaced by assisted reproductive technology in developing countries and districts.Keywords：infertility; hydrosalpinx; laparoscopy; pregnancy; ectopic pregnancy rate展开更多
Objective To investigate the reproduction-assisting effects of laparoscopic ＂corepulling＂ salpingectomy for patients with hydrosalpinx on ovarian reserve,responsiveness to stimuli and outcomes of in vitro fertilizat...Objective To investigate the reproduction-assisting effects of laparoscopic ＂corepulling＂ salpingectomy for patients with hydrosalpinx on ovarian reserve,responsiveness to stimuli and outcomes of in vitro fertilization and embryo transfer（IVF-ET）.Methods Infertile females receiving treatment in Reproductive Medicine Center of Yantai Yuhuangding Hospital due to fallopian tube disorders（n=214） were enrolled from July 2006 to December 2007 and further divided into three groups.＂Core-pulling＂ procedure group（group A） consisted of patients receiving pretreatment with ＂corepulling＂ salpingectomy due to hydrosalpinx in our center（n=31）,wherein 16 patients received IVF-ET.Conventional procedure group（group B） consisted of patients receiving conventional salpingectomy for hydrosalpinx or ectopic pregnancy in our center or other institutes prior to IVF-ET（n=59）.Control group（group C） consisted of patients receiving IVF-ET without the history of previous hydrosalpinx or salpingectomy（n=124）.Results At baseline,the antral follicle count of group B was significantly less than that of groups A and C（8.6±2.5 vs 8.3±2.0 vs 9.8±2.4）.The mature oocytes retrieved numbered less than the other two groups,in a statistically significant manner compared with group C（13.1±5.7 vs 10.6±5.0 vs 12.0±6.2）.Patients of groups A and B received more gonadotropin while the dosage of group B differed significantly from group C（31.0±17.7 vs 37.6±8.3 vs 30.0±4.6）.E2 level on hCG injection day was slightly lower in group B than in the other two groups,statistically significant compared with that of group C,but not compared with that of group A.After receiving IVF-ET,patients of group A showed significantly higher conception rate than groups B and C（62.5% vs 43.6% vs 39.2%）.Conclusion Compared with the conventional procedure,laparoscopic ＂core-pulling＂ salpingectomy should be recommended for patients with hydrosalpinx intending to receive IVF-ET,which did not interfere with the ovarian reserve or responsiveness but improve the conception rate in clinical practice.展开更多
Aims: Infertility is a major problem in our current societies and the Fertilia medical clinic in Bamako is a center for medical assistance in procreation (MAP) where there is an increasingly growing demand for ultraso...Aims: Infertility is a major problem in our current societies and the Fertilia medical clinic in Bamako is a center for medical assistance in procreation (MAP) where there is an increasingly growing demand for ultrasound. The objective of our study was to investigate the ultrasound causes likely to prevent the occurrence of pregnancy in a group of infertile and subfertile women. Subjects and Methods: This was a 5-year cross-sectional and prospective study, between January 2017 and January 2022, which involved 250 women wishing to become pregnant (infertile or subfertile), who came for pelvic ultrasound or follicular monitoring and who agreed to participate in our study. The parameters used were ultrasound reports including uterine, ovarian and tubal pathologies. It should be noted that in some cases no ultrasound cause of infertility was found. Data were entered and analyzed in SPSS. Results: 250 women were recruited into our. The average age was 32 years with extremes ranging from 17 to 51 years. 179 patients or 71.6% were between 17 and 35 years old. 139 patients or 55.6% had secondary infertility against 44.4% primary infertility. 202 patients or 80.8% had at least one ultrasound lesion and 48 patients or 19.2% had no significant ultrasound abnormality. The most represented ultrasound lesions were of uterine origin with 72.20%, 23.7% ovarian lesions and 04% tubal lesions. Uterine lesions were dominated by myomas, adenomyosis, endometrial polyps, uterine malformations and synechiae. As for ovarian lesions we noted cysts, polycystic ovary syndrome (PCOS), ovarian endometriosis, non-follicular ovaries and tubal ultrasound lesions showed unilateral or bilateral hydrosalpinx. Conclusion: In our study, ultrasound was an invaluable contribution to the diagnosis of the causes likely to explain subfertility and infertility in our respondents. She highlighted uterine, ovarian and tubal lesions, some of which could be corrected and pregnancies ensued.展开更多
The use of trans-vaginal ultrasound (TVU) has become increasingly popular in diagnosing and treating infertility. TVU allows for a detailed examination of the female reproductive organs and can aid in identifying abno...The use of trans-vaginal ultrasound (TVU) has become increasingly popular in diagnosing and treating infertility. TVU allows for a detailed examination of the female reproductive organs and can aid in identifying abnormalities that may be contributing to infertility [1]. Additionally, TVU can assist in monitoring fertility treatments, such as in vitro fertilization. By TVS diagnosis of focal intrauterine lesions, uterine malformations and leiomyomas are easily delineated and nearly approaches the sensitivity of hysteroscopy. Abnormality of uterine cavity may affect fertility by inhibiting implantation [2]. TVS seems very accurate in the diagnosis of presence or extension of frank pelvic inflammatory disease and also promising in augmenting the outpatient diagnosis of PID among patients referred for lower abdominal pain. In addition to these conditions trans-vaginal sonography has also been described in the diagnosis of pelvic abscesses, pelvic mass, endometriomas, hydrosalpinx, intra uterine adhesions (Asherman’s syndrome), uterine hypoplasia and other developmental anomalies like mullerian or vaginal agenesis associated with infertility. In this study, it was established transvaginal sonography as a new and reliable diagnostic method by which was able to proceed accurately with more confidence in diagnosing infertility. The Study was a cross sectional study which was conducted at Combined Military Hospital (CMH), Cumilla. During the ultrasound exam, the Study physician evaluated 45 patients by TVS. Among 45 Patients, 8.89% of Leiomyoma, 11.11% of endometrioma, 6.67% of developmental abnormalities i.e. absent uterus, rudimentary uterus, ovarian agenesis, vaginal agenesis and short vagina. 15.56% of bulky uterus with PID, 24.44% of PCOD, 4.44% of retroverted uterus, 6.67% have adnexal cyst and 2.22% are found to have hydrosalpinx. The study found 20% (9 cases) of normal findings of pelvis. We found correlation between clinical findings and TVS findings subsequently 44.44% of leiomyoma, 71.43% of Endometrioma, 60% of Developmental anomaly, 69.23% of Normal Study, 77.78% of Bulky uterus with PID, 84.62% of PCOD, 66.67% of Retroverted Uterus, 60% of adnexal Cyst.展开更多
文摘Infertility is defined as the inability for a couple to have children without any contraceptive methods within 1 year.Tubal factors are responsible for 25％ to 35％ of female reasons,and these have been proven to be a major cause of female infertility.Hydrosalpinx is a special type of tubal occlusion in which fluid accumulates inside the hymen of the tube.This adversely affects fallopian function,and hydrosalpinx fluids have a toxic effect on the quality of the embryos and endometrial receptivity.Currently,reconstructive surgery still plays a role in female infertility for tubal factors and has not been totally replaced by assisted reproductive technology in developing countries and districts.Keywords：infertility; hydrosalpinx; laparoscopy; pregnancy; ectopic pregnancy rate
文摘Objective To investigate the reproduction-assisting effects of laparoscopic ＂corepulling＂ salpingectomy for patients with hydrosalpinx on ovarian reserve,responsiveness to stimuli and outcomes of in vitro fertilization and embryo transfer（IVF-ET）.Methods Infertile females receiving treatment in Reproductive Medicine Center of Yantai Yuhuangding Hospital due to fallopian tube disorders（n=214） were enrolled from July 2006 to December 2007 and further divided into three groups.＂Core-pulling＂ procedure group（group A） consisted of patients receiving pretreatment with ＂corepulling＂ salpingectomy due to hydrosalpinx in our center（n=31）,wherein 16 patients received IVF-ET.Conventional procedure group（group B） consisted of patients receiving conventional salpingectomy for hydrosalpinx or ectopic pregnancy in our center or other institutes prior to IVF-ET（n=59）.Control group（group C） consisted of patients receiving IVF-ET without the history of previous hydrosalpinx or salpingectomy（n=124）.Results At baseline,the antral follicle count of group B was significantly less than that of groups A and C（8.6±2.5 vs 8.3±2.0 vs 9.8±2.4）.The mature oocytes retrieved numbered less than the other two groups,in a statistically significant manner compared with group C（13.1±5.7 vs 10.6±5.0 vs 12.0±6.2）.Patients of groups A and B received more gonadotropin while the dosage of group B differed significantly from group C（31.0±17.7 vs 37.6±8.3 vs 30.0±4.6）.E2 level on hCG injection day was slightly lower in group B than in the other two groups,statistically significant compared with that of group C,but not compared with that of group A.After receiving IVF-ET,patients of group A showed significantly higher conception rate than groups B and C（62.5% vs 43.6% vs 39.2%）.Conclusion Compared with the conventional procedure,laparoscopic ＂core-pulling＂ salpingectomy should be recommended for patients with hydrosalpinx intending to receive IVF-ET,which did not interfere with the ovarian reserve or responsiveness but improve the conception rate in clinical practice.
文摘Aims: Infertility is a major problem in our current societies and the Fertilia medical clinic in Bamako is a center for medical assistance in procreation (MAP) where there is an increasingly growing demand for ultrasound. The objective of our study was to investigate the ultrasound causes likely to prevent the occurrence of pregnancy in a group of infertile and subfertile women. Subjects and Methods: This was a 5-year cross-sectional and prospective study, between January 2017 and January 2022, which involved 250 women wishing to become pregnant (infertile or subfertile), who came for pelvic ultrasound or follicular monitoring and who agreed to participate in our study. The parameters used were ultrasound reports including uterine, ovarian and tubal pathologies. It should be noted that in some cases no ultrasound cause of infertility was found. Data were entered and analyzed in SPSS. Results: 250 women were recruited into our. The average age was 32 years with extremes ranging from 17 to 51 years. 179 patients or 71.6% were between 17 and 35 years old. 139 patients or 55.6% had secondary infertility against 44.4% primary infertility. 202 patients or 80.8% had at least one ultrasound lesion and 48 patients or 19.2% had no significant ultrasound abnormality. The most represented ultrasound lesions were of uterine origin with 72.20%, 23.7% ovarian lesions and 04% tubal lesions. Uterine lesions were dominated by myomas, adenomyosis, endometrial polyps, uterine malformations and synechiae. As for ovarian lesions we noted cysts, polycystic ovary syndrome (PCOS), ovarian endometriosis, non-follicular ovaries and tubal ultrasound lesions showed unilateral or bilateral hydrosalpinx. Conclusion: In our study, ultrasound was an invaluable contribution to the diagnosis of the causes likely to explain subfertility and infertility in our respondents. She highlighted uterine, ovarian and tubal lesions, some of which could be corrected and pregnancies ensued.
文摘The use of trans-vaginal ultrasound (TVU) has become increasingly popular in diagnosing and treating infertility. TVU allows for a detailed examination of the female reproductive organs and can aid in identifying abnormalities that may be contributing to infertility [1]. Additionally, TVU can assist in monitoring fertility treatments, such as in vitro fertilization. By TVS diagnosis of focal intrauterine lesions, uterine malformations and leiomyomas are easily delineated and nearly approaches the sensitivity of hysteroscopy. Abnormality of uterine cavity may affect fertility by inhibiting implantation [2]. TVS seems very accurate in the diagnosis of presence or extension of frank pelvic inflammatory disease and also promising in augmenting the outpatient diagnosis of PID among patients referred for lower abdominal pain. In addition to these conditions trans-vaginal sonography has also been described in the diagnosis of pelvic abscesses, pelvic mass, endometriomas, hydrosalpinx, intra uterine adhesions (Asherman’s syndrome), uterine hypoplasia and other developmental anomalies like mullerian or vaginal agenesis associated with infertility. In this study, it was established transvaginal sonography as a new and reliable diagnostic method by which was able to proceed accurately with more confidence in diagnosing infertility. The Study was a cross sectional study which was conducted at Combined Military Hospital (CMH), Cumilla. During the ultrasound exam, the Study physician evaluated 45 patients by TVS. Among 45 Patients, 8.89% of Leiomyoma, 11.11% of endometrioma, 6.67% of developmental abnormalities i.e. absent uterus, rudimentary uterus, ovarian agenesis, vaginal agenesis and short vagina. 15.56% of bulky uterus with PID, 24.44% of PCOD, 4.44% of retroverted uterus, 6.67% have adnexal cyst and 2.22% are found to have hydrosalpinx. The study found 20% (9 cases) of normal findings of pelvis. We found correlation between clinical findings and TVS findings subsequently 44.44% of leiomyoma, 71.43% of Endometrioma, 60% of Developmental anomaly, 69.23% of Normal Study, 77.78% of Bulky uterus with PID, 84.62% of PCOD, 66.67% of Retroverted Uterus, 60% of adnexal Cyst.
