Objective: Since not all women wish to conceive a child through aggressive treatment, we investigated the usefulness of modified repeated intracyclic clomiphene citrate (CC) therapy (repeated CC therapy) as a newly de...Objective: Since not all women wish to conceive a child through aggressive treatment, we investigated the usefulness of modified repeated intracyclic clomiphene citrate (CC) therapy (repeated CC therapy) as a newly devised administration method. Methods: We evaluated the effects of CC administration on menstrual cycle length and retrospectively compared ovulation and pregnancy in 220 women who received CC at our hospital. Patients in the conventional method group received 50 mg per day for five days, starting on the fifth day of menstruation (withdrawal bleeding). Groups with and without menstrual cycle shortening after conventional CC administration were compared. The repeated CC therapy group was also compared with the non-shortened group. Repeated CC therapy was administered for the first five days as in the conventional method, and a second five-day repeat treatment was administered after an interval of five to seven days. Pregnancy rates, including indirect pregnancies, were evaluated by three different methods. Results: Ovulation and pregnancy rates were significantly better in the shortened group than in the non-shortened group (P < 0.001 and P = 0.010, respectively). Even in the non-shortened group, ovulation and pregnancy rates including indirect pregnancies were significantly improved when ovulation was observed with repeated CC therapy (P < 0.001 and P = 0.022, respectively). Conclusions: For patients whose menstrual cycle was not improved or shortened, repeated CC therapy as the newly devised CC administration method is useful as the next step after the conventional CC administration method.展开更多
Background: The purpose of this study was to compare the effectiveness of Letrozole versus Clomiphene citrate for ovulation induction in polycystic ovarian syndrome (PCOS) with infertility. Methods: This was a prospec...Background: The purpose of this study was to compare the effectiveness of Letrozole versus Clomiphene citrate for ovulation induction in polycystic ovarian syndrome (PCOS) with infertility. Methods: This was a prospective randomized trial involving 150 women with PCOS attending the Infertility Clinic at three hospitals in Malaysia. During the initial visit, anthropometric measurements and baseline investigations were performed. Patients were randomized to 5.0 mg Letrozole daily (75 patients) or 100 mg Clomiphene citrate daily (75 patients) from the fifth until the ninth day of menstruation. Serial transvaginal scans were performed to see the dominant follicles, endometrial thickness and number of follicles. Transvaginal scans were performed serially to look for evidence of ovulation. Results: The subjects were homogenously distributed. The difference between Letrozole and Clomiphene citrate for ovulation rate was 59 (78.7%) versus 40 (53.3%). Patients taking Letrozole exhibited a mean endometrial thickness (ET) at mid cycle of menses (Day 11-D14) of9.2 mm(SD ± 2.3) versus8.4 mm(SD ± 2.2) for patients taking Clomiphene citrate, and these differences were statistically significant展开更多
Heterotopic pregnancy is an uncommon clinical entity in Nigeria even though some of the risk factors are highly prevalent in the population. We report a case of heterotopic pregnancy following ovulation induction with...Heterotopic pregnancy is an uncommon clinical entity in Nigeria even though some of the risk factors are highly prevalent in the population. We report a case of heterotopic pregnancy following ovulation induction with clomiphene citrate. A favourable outcome resulting in live twin birth was recorded despite the presence of poor clinical features that affects pregnancy and foetal outcome.展开更多
BACKGROUND Ovarian pregnancy after assisted reproductive technology treatment has rarely been reported;ovarian pregnancy following intrauterine insemination(IUI)is even rarer,and only nine cases have previously been r...BACKGROUND Ovarian pregnancy after assisted reproductive technology treatment has rarely been reported;ovarian pregnancy following intrauterine insemination(IUI)is even rarer,and only nine cases have previously been reported.CASE SUMMARY We report a case of ovarian pregnancy rupture after ovulation induction and IUI.The patient presented with bilateral lower abdominal pain and was referred to the emergency department.Ultrasound examination revealed ovarian pregnancy and intraperitoneal bleeding.Laparoscopy revealed an ovarian pregnancy with hemoperitoneum,which was subsequently removed.Pelvic adhesions were detected intraoperatively,which were treated immediately.The patient spontaneously conceived an intrauterine pregnancy 3 mo later,which was ongoing at the time of writing this study.CONCLUSION Close attention should be paid to any history of pelvic inflammatory disease before commencing IUI treatment,and patients with such a history should be closely followed up after IUI.Early measurement of serumβ-human chorionic gonadotropin levels and ultrasonic examination are essential for timely diagnosis of ovarian pregnancy after ovulation induction and IUI to avoid more serious complications.展开更多
BACKGROUND Hepatocellular adenoma(HCA) is a rare benign liver tumor usually affecting young women with a history of prolonged use of hormonal contraception.Although the majority is asymptomatic, a low proportion may h...BACKGROUND Hepatocellular adenoma(HCA) is a rare benign liver tumor usually affecting young women with a history of prolonged use of hormonal contraception.Although the majority is asymptomatic, a low proportion may have significant complications such as bleeding or malignancy. Despite responding to the hormonal stimulus, the desire for pregnancy in patients with small HCA is not contraindicated. However, through this work we demonstrate that intensive hormonal therapies such as those used in the treatment of infertility can trigger serious complications CASE SUMMARY A 33-year-old female with a 10-year history of oral contraceptive use was diagnosed with a hepatic tumor as an incidental finding in an abdominal ultrasound. The patient showed no symptoms and physical examination was unremarkable. Laboratory functional tests were within normal limits and tests for serum tumor markers were negative. An abdominal magnetic resonance imaging(MRI) was performed, showing a 30 mm × 29 mm focal lesion in segment VI of the liver compatible with HCA or Focal Nodular Hyperplasia with atypical behavior. After a total of six years of follow-up, the patient underwent ovulation induction treatment for infertility. On a following MRI, a suspected malignancy was warned and hence, surgery was decided. The surgical specimen revealed malignant transformation of HCA towards trabecular hepatocarcinoma with dedifferentiated areas. There was non-evidence of tumor recurrence after three years of clinical and imaging follow-up.,CONCLUSION HCAs can be malignant regardless its size and low-risk appearance on MRI when an ovultation induction therapy is indicated.展开更多
Background: The response of ovaries during controlled ovarian stimulation is the most important factor for evaluating the pregnancy outcome in assisted reproductive techniques. Aim: The study is to assess the role of ...Background: The response of ovaries during controlled ovarian stimulation is the most important factor for evaluating the pregnancy outcome in assisted reproductive techniques. Aim: The study is to assess the role of a nurse in giving induction of ovulation medications at assisted reproduction university center versus home medications by private In Vitro Fertilization and infertility center on clinical outcomes and patient satisfaction. Subjects and Methods: Case-control research design, conducted at two centers (Banon private center for IVF and Assisted Reproductive Unit at Women health hospital, Assiut University) during the period from February 2018 to November 2018. The sample size included 150 women undergoing IVF for each group. Results: There is no statistically significant difference between women given IVF medications by the nurse at the public IVF center and women take IVF medication in the home at Banon IVF center as regards the outcome of IVF. Majority of infertile patients are satisfied with the care, they received and nearly third of them are satisfied with outcome of IVF in both groups, and there is statistically significant difference between satisfaction in public IVF center and satisfaction in private center in relation to information provided about IVF procedure, staff willingness to listen carefully and help patients;regular progress update on condition is in place with p value (0.000, 0.005, 0.003) respectively. Conclusion: IVF outcome isn’t significantly related to where induction medication was taken either at IVF center or at the home because infertile couples are keen to comply with all instructions on how to take medications with correct route, correct dose and on time. Recommendations: Empower the role of nurse as a health educator for women undergoing IVF about importance of stage of induction and take medications with correct route, correct dose and on time on outcome of IVF;other studies should also be conducted in other centers to further investigate the issue.展开更多
This is a review paper of some effective recipes of Chinese traditional medicine usedin ovulation induction and treatment of gynecological diseases. Some clinical results bygynecologists using Chinese traditional medi...This is a review paper of some effective recipes of Chinese traditional medicine usedin ovulation induction and treatment of gynecological diseases. Some clinical results bygynecologists using Chinese traditional medicine in combination with western medicineand results from research on traditional medicine with modern technology are presented.A list of frequently used traditional medicine for ovulation induction are selected from the famous Compendium of Materica Medica(本草纲目)by Li Shi-zhen(李时珍).展开更多
Adult rice field eels with 125.52±27.99 g body weight corresponding to 44.79±5.93 cm in length were maturity cultured in a 5 m^2 cement tank without mud for three months with density 30 eels/m^2.Eel broodsto...Adult rice field eels with 125.52±27.99 g body weight corresponding to 44.79±5.93 cm in length were maturity cultured in a 5 m^2 cement tank without mud for three months with density 30 eels/m^2.Eel broodstocks were fed with three types of food including:sea fish(T1),commercial pellet food(T2)and mixed food—50%sea fish and 50%commercial pellet food(T3).Result showed that the maximum gonadosomatic index(GSI)of female eels fed by sea fish(2.89%±0.67%)was higher than both commercial pellet food(1.62%±0.62%)and mixed food(2.03%±0.82%)(P<0.05),while,GSI of male eels was 1.27%±0.31%,0.68%±0.23%and 1.14%±0.41%(P>0.05).Maturity rate of female fed by sea fish(88.91%±9.64%)was higher than commercial pellet food(61.12%±9.64%)(P<0.05).The maturity rate of male eels was rather low and there was not significantly different among treatments(P>0.05).Then.the eels were induced for spawning with two kinds of hormones,including T1:human chorionic ganadotropin(HCG)at 1,500 IU/kg,T2:luteinzing hormone-releasing hormone(LHRH-a)at 150μg/kg and domperidon 10 mg/kg,and T3:control without hormone.The results of spawning induction methods showed that the reproduction rate of female eels induced by LHRH-a and HCG hormones were higher than that by natural reproduction method(P<0.05).Others,the survival rate of fry eels after 5 d using natural reproduction method(92.65%±2.54%)was higher than both using LHRH-a(67.77%±1.91%)and HCG(68.65%±1.23%)hormones(P<0.05).The average diameter of eggs was 3.40-3.41 mm and the length of newly hatched eels was 1.72±0.19 cm.展开更多
Malignancy is a serious disease that can lead to serious morbidity and mortality. However, the survival rates for women with cancers have increased significantly during the past decades, reflecting improved diagnosis ...Malignancy is a serious disease that can lead to serious morbidity and mortality. However, the survival rates for women with cancers have increased significantly during the past decades, reflecting improved diagnosis and treatment. With the increased survival in young women with cancer, more attention is being paid to preservation of fertility, which is potentially jeopardized by chemotherapy and radiation therapy, aiming to limit the devastating sequelae of this serious illness by providing these young women with a hope for motherhood. In vitro fertilization with oocyte or embryo cryopreservation has emerged as an astounding method to preserve fertility. It entails induction of ovulation to produce oocytes, the number and quality of which are imperative factors predicting the potential efficacy of the fertility preservation procedure. The aim of this review is to discuss ovarian stimulation for fertility preservation in women with gynecological cancer.展开更多
目的研究剖宫产史对人工授精助孕临床妊娠率的影响。方法回顾性分析2012年2月—2022年6月在厦门大学附属妇女儿童医院生殖医学科接受夫精人工授精(artificial insemination by husband,AIH)治疗的至少有1次活胎分娩史的不孕患者336例,共...目的研究剖宫产史对人工授精助孕临床妊娠率的影响。方法回顾性分析2012年2月—2022年6月在厦门大学附属妇女儿童医院生殖医学科接受夫精人工授精(artificial insemination by husband,AIH)治疗的至少有1次活胎分娩史的不孕患者336例,共560个周期,其中瘢痕子宫组203个周期,阴道分娩组357个周期。比较2组年龄、身体质量指数(body mass index,BMI)、输卵管盆腔因素、内膜异位症占比、治疗方案及助孕结果等。结果2组的年龄、高龄占比(>35岁)、不孕年限、输卵管盆腔因素、内膜异位症占比比较,差异无统计学意义(P>0.05)。瘢痕子宫组患者BMI为(22.30±3.27)kg/m^(2),高于阴道分娩组的(21.67±2.76)kg/m^(2)(P<0.05)。瘢痕子宫组BMI>23 kg/m^(2)的比例为36.9%,高于阴道分娩组的29.7%,差异无统计学意义(P=0.078)。瘢痕子宫组诱导排卵方案占比为53.7%(109/203),高于经阴道分娩组的44.3%(158/357),差异有统计学意义(P<0.05)。瘢痕子宫组临床妊娠率为15.3%,阴道分娩组为16.5%,差异无统计学意义(P=0.853)。结论通过适当的干预与筛选,可以提高有剖宫产史妇女的宫腔内人工授精临床妊娠率。展开更多
文摘Objective: Since not all women wish to conceive a child through aggressive treatment, we investigated the usefulness of modified repeated intracyclic clomiphene citrate (CC) therapy (repeated CC therapy) as a newly devised administration method. Methods: We evaluated the effects of CC administration on menstrual cycle length and retrospectively compared ovulation and pregnancy in 220 women who received CC at our hospital. Patients in the conventional method group received 50 mg per day for five days, starting on the fifth day of menstruation (withdrawal bleeding). Groups with and without menstrual cycle shortening after conventional CC administration were compared. The repeated CC therapy group was also compared with the non-shortened group. Repeated CC therapy was administered for the first five days as in the conventional method, and a second five-day repeat treatment was administered after an interval of five to seven days. Pregnancy rates, including indirect pregnancies, were evaluated by three different methods. Results: Ovulation and pregnancy rates were significantly better in the shortened group than in the non-shortened group (P < 0.001 and P = 0.010, respectively). Even in the non-shortened group, ovulation and pregnancy rates including indirect pregnancies were significantly improved when ovulation was observed with repeated CC therapy (P < 0.001 and P = 0.022, respectively). Conclusions: For patients whose menstrual cycle was not improved or shortened, repeated CC therapy as the newly devised CC administration method is useful as the next step after the conventional CC administration method.
文摘Background: The purpose of this study was to compare the effectiveness of Letrozole versus Clomiphene citrate for ovulation induction in polycystic ovarian syndrome (PCOS) with infertility. Methods: This was a prospective randomized trial involving 150 women with PCOS attending the Infertility Clinic at three hospitals in Malaysia. During the initial visit, anthropometric measurements and baseline investigations were performed. Patients were randomized to 5.0 mg Letrozole daily (75 patients) or 100 mg Clomiphene citrate daily (75 patients) from the fifth until the ninth day of menstruation. Serial transvaginal scans were performed to see the dominant follicles, endometrial thickness and number of follicles. Transvaginal scans were performed serially to look for evidence of ovulation. Results: The subjects were homogenously distributed. The difference between Letrozole and Clomiphene citrate for ovulation rate was 59 (78.7%) versus 40 (53.3%). Patients taking Letrozole exhibited a mean endometrial thickness (ET) at mid cycle of menses (Day 11-D14) of9.2 mm(SD ± 2.3) versus8.4 mm(SD ± 2.2) for patients taking Clomiphene citrate, and these differences were statistically significant
文摘Heterotopic pregnancy is an uncommon clinical entity in Nigeria even though some of the risk factors are highly prevalent in the population. We report a case of heterotopic pregnancy following ovulation induction with clomiphene citrate. A favourable outcome resulting in live twin birth was recorded despite the presence of poor clinical features that affects pregnancy and foetal outcome.
文摘BACKGROUND Ovarian pregnancy after assisted reproductive technology treatment has rarely been reported;ovarian pregnancy following intrauterine insemination(IUI)is even rarer,and only nine cases have previously been reported.CASE SUMMARY We report a case of ovarian pregnancy rupture after ovulation induction and IUI.The patient presented with bilateral lower abdominal pain and was referred to the emergency department.Ultrasound examination revealed ovarian pregnancy and intraperitoneal bleeding.Laparoscopy revealed an ovarian pregnancy with hemoperitoneum,which was subsequently removed.Pelvic adhesions were detected intraoperatively,which were treated immediately.The patient spontaneously conceived an intrauterine pregnancy 3 mo later,which was ongoing at the time of writing this study.CONCLUSION Close attention should be paid to any history of pelvic inflammatory disease before commencing IUI treatment,and patients with such a history should be closely followed up after IUI.Early measurement of serumβ-human chorionic gonadotropin levels and ultrasonic examination are essential for timely diagnosis of ovarian pregnancy after ovulation induction and IUI to avoid more serious complications.
文摘BACKGROUND Hepatocellular adenoma(HCA) is a rare benign liver tumor usually affecting young women with a history of prolonged use of hormonal contraception.Although the majority is asymptomatic, a low proportion may have significant complications such as bleeding or malignancy. Despite responding to the hormonal stimulus, the desire for pregnancy in patients with small HCA is not contraindicated. However, through this work we demonstrate that intensive hormonal therapies such as those used in the treatment of infertility can trigger serious complications CASE SUMMARY A 33-year-old female with a 10-year history of oral contraceptive use was diagnosed with a hepatic tumor as an incidental finding in an abdominal ultrasound. The patient showed no symptoms and physical examination was unremarkable. Laboratory functional tests were within normal limits and tests for serum tumor markers were negative. An abdominal magnetic resonance imaging(MRI) was performed, showing a 30 mm × 29 mm focal lesion in segment VI of the liver compatible with HCA or Focal Nodular Hyperplasia with atypical behavior. After a total of six years of follow-up, the patient underwent ovulation induction treatment for infertility. On a following MRI, a suspected malignancy was warned and hence, surgery was decided. The surgical specimen revealed malignant transformation of HCA towards trabecular hepatocarcinoma with dedifferentiated areas. There was non-evidence of tumor recurrence after three years of clinical and imaging follow-up.,CONCLUSION HCAs can be malignant regardless its size and low-risk appearance on MRI when an ovultation induction therapy is indicated.
文摘Background: The response of ovaries during controlled ovarian stimulation is the most important factor for evaluating the pregnancy outcome in assisted reproductive techniques. Aim: The study is to assess the role of a nurse in giving induction of ovulation medications at assisted reproduction university center versus home medications by private In Vitro Fertilization and infertility center on clinical outcomes and patient satisfaction. Subjects and Methods: Case-control research design, conducted at two centers (Banon private center for IVF and Assisted Reproductive Unit at Women health hospital, Assiut University) during the period from February 2018 to November 2018. The sample size included 150 women undergoing IVF for each group. Results: There is no statistically significant difference between women given IVF medications by the nurse at the public IVF center and women take IVF medication in the home at Banon IVF center as regards the outcome of IVF. Majority of infertile patients are satisfied with the care, they received and nearly third of them are satisfied with outcome of IVF in both groups, and there is statistically significant difference between satisfaction in public IVF center and satisfaction in private center in relation to information provided about IVF procedure, staff willingness to listen carefully and help patients;regular progress update on condition is in place with p value (0.000, 0.005, 0.003) respectively. Conclusion: IVF outcome isn’t significantly related to where induction medication was taken either at IVF center or at the home because infertile couples are keen to comply with all instructions on how to take medications with correct route, correct dose and on time. Recommendations: Empower the role of nurse as a health educator for women undergoing IVF about importance of stage of induction and take medications with correct route, correct dose and on time on outcome of IVF;other studies should also be conducted in other centers to further investigate the issue.
文摘This is a review paper of some effective recipes of Chinese traditional medicine usedin ovulation induction and treatment of gynecological diseases. Some clinical results bygynecologists using Chinese traditional medicine in combination with western medicineand results from research on traditional medicine with modern technology are presented.A list of frequently used traditional medicine for ovulation induction are selected from the famous Compendium of Materica Medica(本草纲目)by Li Shi-zhen(李时珍).
文摘Adult rice field eels with 125.52±27.99 g body weight corresponding to 44.79±5.93 cm in length were maturity cultured in a 5 m^2 cement tank without mud for three months with density 30 eels/m^2.Eel broodstocks were fed with three types of food including:sea fish(T1),commercial pellet food(T2)and mixed food—50%sea fish and 50%commercial pellet food(T3).Result showed that the maximum gonadosomatic index(GSI)of female eels fed by sea fish(2.89%±0.67%)was higher than both commercial pellet food(1.62%±0.62%)and mixed food(2.03%±0.82%)(P<0.05),while,GSI of male eels was 1.27%±0.31%,0.68%±0.23%and 1.14%±0.41%(P>0.05).Maturity rate of female fed by sea fish(88.91%±9.64%)was higher than commercial pellet food(61.12%±9.64%)(P<0.05).The maturity rate of male eels was rather low and there was not significantly different among treatments(P>0.05).Then.the eels were induced for spawning with two kinds of hormones,including T1:human chorionic ganadotropin(HCG)at 1,500 IU/kg,T2:luteinzing hormone-releasing hormone(LHRH-a)at 150μg/kg and domperidon 10 mg/kg,and T3:control without hormone.The results of spawning induction methods showed that the reproduction rate of female eels induced by LHRH-a and HCG hormones were higher than that by natural reproduction method(P<0.05).Others,the survival rate of fry eels after 5 d using natural reproduction method(92.65%±2.54%)was higher than both using LHRH-a(67.77%±1.91%)and HCG(68.65%±1.23%)hormones(P<0.05).The average diameter of eggs was 3.40-3.41 mm and the length of newly hatched eels was 1.72±0.19 cm.
文摘Malignancy is a serious disease that can lead to serious morbidity and mortality. However, the survival rates for women with cancers have increased significantly during the past decades, reflecting improved diagnosis and treatment. With the increased survival in young women with cancer, more attention is being paid to preservation of fertility, which is potentially jeopardized by chemotherapy and radiation therapy, aiming to limit the devastating sequelae of this serious illness by providing these young women with a hope for motherhood. In vitro fertilization with oocyte or embryo cryopreservation has emerged as an astounding method to preserve fertility. It entails induction of ovulation to produce oocytes, the number and quality of which are imperative factors predicting the potential efficacy of the fertility preservation procedure. The aim of this review is to discuss ovarian stimulation for fertility preservation in women with gynecological cancer.
文摘目的研究剖宫产史对人工授精助孕临床妊娠率的影响。方法回顾性分析2012年2月—2022年6月在厦门大学附属妇女儿童医院生殖医学科接受夫精人工授精(artificial insemination by husband,AIH)治疗的至少有1次活胎分娩史的不孕患者336例,共560个周期,其中瘢痕子宫组203个周期,阴道分娩组357个周期。比较2组年龄、身体质量指数(body mass index,BMI)、输卵管盆腔因素、内膜异位症占比、治疗方案及助孕结果等。结果2组的年龄、高龄占比(>35岁)、不孕年限、输卵管盆腔因素、内膜异位症占比比较,差异无统计学意义(P>0.05)。瘢痕子宫组患者BMI为(22.30±3.27)kg/m^(2),高于阴道分娩组的(21.67±2.76)kg/m^(2)(P<0.05)。瘢痕子宫组BMI>23 kg/m^(2)的比例为36.9%,高于阴道分娩组的29.7%,差异无统计学意义(P=0.078)。瘢痕子宫组诱导排卵方案占比为53.7%(109/203),高于经阴道分娩组的44.3%(158/357),差异有统计学意义(P<0.05)。瘢痕子宫组临床妊娠率为15.3%,阴道分娩组为16.5%,差异无统计学意义(P=0.853)。结论通过适当的干预与筛选,可以提高有剖宫产史妇女的宫腔内人工授精临床妊娠率。
