Current Issue : April - June Volume : 2019 Issue Number : 2 Articles : 7 Articles
Background: Premature ovulation occurs at a high rate in natural-cycle in vitro fertilization (IVF), and cycle cancellation\nfurther hampers the overall efficiency of the procedure. While lower levels of estradiol (E2) are observed in preovulatory\nfollicles, it is unclear whether declines in E2 can be used as an effective marker of premature ovulation.\nMethods: This retrospective analysis includes 801 natural/unstimulated IVF/ICSI cycles undergoing scheduled ovum\npick-up (OPU) and 153 natural/unstimulated IVF/ICSI cycles undergoing emergency OPU at a university IVF center from\nMay 2014 to February 2017.\nResults: Among the 801 IVF/ICSI cycles undergoing scheduled OPU, preovulatory E2 levels increased by more\nthan 10% in 403 (50.31%) cycles of the sample (Group A), while 192 (23.97%) cycles experienced a plateau\n(increased or decreased by 10%; Group B), and 206 (25.72%) cycles decreased by more than 10% (Group C).\nGroup C had more patients who experienced premature LH surges, premature ovulation, as well as the fewest\noocytes retrieved, frozen embryos, and top-quality embryos. A multivariate logistic regression analysis indicated\nthat premature ovulation was associated with preovulatory E2/-1E2 ratio and premature LH surge. Moreover,\npreovulatory E2/-1E2 ratio served as a valuable marker for differentiating premature ovulation, with an AUC\n(area under the receiver operating curve) of 0.708 and 0.772 in cycles with premature LH surges and cycles\nwithout premature LH surges, respectively. Emergency OPU resulted in a significantly decreased rate of premature\novulation and increased number of frozen embryos.\nConclusion: Decreases in preovulatory serum E2 was a valuable marker for premature ovulation in natural/unstimulated\nIVF cycle. Emergency OPU based on the preovulatory E2/-1E2 ratio decreased the rate of premature ovulation in cycles\nthat experienced E2 decreases....
Background: The rate of prematurity in twin pregnancies is higher than 50%.\nDue to its multifactorial nature, different strategies are necessary to reduce\nthe incidence of premature birth or to increase the gestational age at birth of\npregnancies at risk. In this context, cervical pessary may be indicated in twin\npregnancies with short cervix. Methods: In this case series, we describe six\ntwin pregnancies that were considered as high-risk for preterm labor due to\nshort cervix (CL < 30 mm) at second trimester and multiple risk factors for\nprematurity. Several strategies were associated for the goal of delaying gestational\nage at birth. The main strategies were: removal of labor activities,\ntreatment of infections, vaginal micronized progesterone 400 mg/day and vaginal\npessary insertion (Ingamed_ Brazil). Results: The gestational age of insertion\nof the pessary ranged from 16 to 24 weeks. The gestational age of birth\nranged from 26 to 34 weeks. Three of the pregnancies were delivered due to\nspontaneous onset of labor, and three were delivered due to medical reasons.\nThe mean length of pregnancy since pessary insertion to birth was 9 weeks\n(range 2 to 17 weeks). All infants without severe fetal malformation were\ndischarged from the hospital without major sequelae. Conclusion: The use of\ncervical pessaries associated to micronized progesterone at a dose of 400\nmg/day may be an option in the management of twins at risk for preterm\nbirth. More controlled studies are needed to evaluate the simultaneous use of\ncervical pessary and progesterone on twin pregnancies....
Background: It has been shown â?? mostly in animal models - that circadian clock genes are expressed in granulosa\ncells and in corpora luteum and might be essential for the ovulatory process and steroidogenesis.\nObjective: We sought to investigate which circadian clock genes exist in human granulosa cells and whether their\nexpression and activity decrease during aging of the ovary.\nStudy design: Human luteinized granulosa cells were isolated from young (age 18â??33) and older (age 39â??45)\npatients who underwent in-vitro fertilization treatment. Levels of clock genes expression were measured in these\ncells 36 h after human chorionic gonadotropin stimulation.\nMethods: Human luteinized granulosa cells were isolated from follicular fluid during oocyte retrieval. The mRNA\nexpression levels of the circadian genes CRY1, CRY2, PER1, PER2, CLOCK, ARNTL, ARNTL2, and NPAS2 were analyzed by\nquantitative polymerase chain reaction.\nResults: We found that the circadian genes CRY1, CRY2, PER1, PER2, CLOCK, ARNTL, ARNTL2, and NPAS2, are expressed in\ncultured human luteinized granulosa cells. Among these genes, there was a general trend of decreased expression in\ncells from older women but it reached statistical significance only for PER1 and CLOCK genes....\nConclusions: This preliminary report indicates that molecular circadian clock genes exist in human luteinized\ngranulosa cells. There is a decreased expression of some of these genes in older women. This decline may\npartially explain the decreased fertility and steroidogenesis of reproductive aging....
Background: Pelvic tuberculosis is a rare form of extrapulmonary tuberculosis. It commonly involves the fallopian\ntubes and the uterus from a lympho-hematogeneous spread. The presentation of pelvic tuberculosis as an isolated\novarian abscess is extremely rare and is reported only twice.\nCase presentation: a 25 yrs. old para III mother in the post partum period undergone laparotomy for suspected\ntuboovarian abscess/ovarian tumor after presenting with abdominal pain, pelvic mass and fever. Intra-operatively,\nIsolated right ovarian mass with caseation in the cavity but no significant pelvic adhesions was detected and right\noophorectomy was done. Post operative Histopathology of surgical specimens revealed tuberculous leision and\npatient recovered well after anti-tuberculosis treatment.\nConclusion: Isolated ovarian tuberculosis is a very rare form of Genital Tuberculosis which should always be\nconsidered in the evaluation of a woman presenting with any adnexal mass in highly prevalent areas....
Luteolin, a polyphenolic flavone, has been demonstrated to exert anti-tumor activity in various cancer types.\nCisplatin drug resistance is a major obstacle in the management of ovarian cancer. In the present study, we\ninvestigated the chemo-sensitizing effect of luteolin in both cisplatin-resistant ovarian cancer cell line and a mice\nxenotransplant model. In vitro, CCK-8 assay showed that luteolin inhibited cell proliferation in a dose-dependent\nmanner, and luteolin enhanced anti-proliferation effect of cisplatin on cisplatin-resistant ovarian cancer CAOV3/DDP\ncells. Flow cytometry revealed that luteolin enhanced cell apoptosis in combination with cisplatin. Western blotting\nand qRT-PCR assay revealed that luteolin increased cisplatin-induced downregulation of Bcl-2 expression. In\naddition, wound-healing assay and Matrigel invasion assay showed that luteolin and cisplatin synergistically\ninhibited migration and invasion of CAOV3/DDP cells. Moreover, in vivo, luteolin enhanced cisplatin-induced\nreduction of tumor growth as well as induction of apoptosis. We suggest that luteolin in combination with cisplatin\ncould potentially be used as a new regimen for the treatment of ovarian cancer....
Mullerian adenosarcomas are rare mixed tumors with low malignant potential,\nand occur mainly in the uterus. Primary adenosarcomas arising in vaginal\nendometriosis are even more rarely reported. We report a very rare case\nwith Müllerian adenosarcoma arising from vaginal endometriosis. A\n43-year-old nulliparous woman has a history of endometriosis. Due to two\nparallel fistulas in cervix, severe endometriosis and adenosarcoma, she has\nundergone radical and multiple surgeries. After the surgery, persistent vaginal\nvault masses were noticed, and eight resections of the polyps at vaginal stump\nwere performed. For the first six resections, all the pathological examinations\nshowed endometriosis. And the last two resections demonstrated vaginal\nadenosarcoma. Transition between Müllerian adenosarcoma and endometriosis\nwas gradual. Finally, adenosarcoma associated with endometriosis was\ndiagnosed from recurrent vaginal masses. To our knowledge, this report is\nthe sixth case that primary adenosarcomas arising in vaginal endometriosis.\nBut chemo-therapy and radiation therapy were not taken and the patient remained\nin a good condition throughout the 9-year follow-up period. In addition,\nwe present a review of the literature. The diagnosis and treatment of the\ntumor are also discussed....
Introduction: Severe preeclampsia is a frequent cause of maternal death, and\nalso a frequent indication for caesarean deliveries when faced with the need to\nexpedite delivery. We sought complications specific to caesarean deliveries in\npatients with severe preeclampsia. Methods: It was a case-control study carried\nout over 6 months, from December 1st, 2015 to May 31st, 2016 at the\nYaounde Central and the Yaounde Gynaeco-Obstetric and Paediatric Hospitals.\nWe evaluated 159 women undergoing a caesarean delivery to assess the\nrisk of maternal and foetal postoperative complications in patients with severe\npreeclampsia. Significance level was set at 0.05. Results: The incidence of\npostoperative complications stood at 26.4%. Maternal and foetal complications\nwere more frequent in preeclamptic women at 54.5% versus 11.5% (p <\n0.05) and 47.3% versus 27.9% (p < 0.05) respectively. The incidence of adverse\nevents was greater in women with preeclampsia: pruritus and limb pain\n(RR = 2.96; p < 0.001), the persistence of high blood pressure (RR = 4.51, p <\n0.001), maternal death (RR = 2.93, p < 0.001), postpartum convulsions (RR =\n3, p < 0.001) headaches resistant to first-line analgesics (RR = 3, p < 0.001),\nDisseminated Intravascular Coagulation (DIC) (RR = 2.92, p < 0.001), a cute\npulmonary oedema (RR = 2.92, p < 0.001), prematurity (RR = 4.43, p <\n0.001), neonatal asphyxia (RR = 2.93, p < 0.001), and hyaline membrane disease\n(RR = 2.93, p < 0.001). Conclusion: Severe preeclampsia is associated with an increased risk of postoperative complications....
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