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Assisted Reproduction of Pretreatment with Laparoscopic “Core-pulling” Salpingectomy for Patients with hydrosalpinx before in vitro Fertilization Embryo Transfer

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Journal of Reproduction and Contraception 2010年第3期21卷 147-154页

作者： Hong-chu BAO Cui-fang HAO Mei-mei WANG Li-li ZHUANG Xin-rong WANG Reproductive Medicine Center of Provincial Hospital Affiliated to Shandong University School of Medicine Jinan 250021 China Reproductive Medicine Center of Yantai Yuhuangding Hospital Affiliated to Qingdao University School of Medicine Yantai 264000 China

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 *** 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 *** 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 responsi

关键词： fertilization,in vitro embryo transfer hydrosalpinx salpingectomy

Ultrasound Causes of Female Infertility at the Fertilia Medical Clinic in Bamako

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Open Journal of Medical Imaging 2023年第3期13卷 107-113页

作者： Mamadou Dembele Alassane Kouma Ilias Guindo Zoumana Cheick Berete Souleymane Sanogo Mamadou N'diaye Brahima Doumbia Oncoumba Diarra Ousmane Traore Issa Cisse Aboubacar Sidiki N’ Diaye Badiougou Doucoure Youssouf Yalcouye Adama Diaman Keita Siaka Sidibe Radiology Department Faculty of Medicine and Odonto-Stomatology of Bamako (FMOS) Bamako Mali Radiology Unit Fertilia Medical Clinic Bamako Mali Department of Education and Research in Public Health (DERSP) FMOS Bamako Mali

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.

关键词： Ultrasound Female Infertility Myomas Polycystic Ovaries hydrosalpinx

Full-term pregnancy in breast cancer survivor with fertility preservation: A case report and review of literature

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World Journal of Clinical Cases 2019年第1期7卷 58-68页

作者： Marta Garrido-Marín Pedro Maria Argacha Luís Fernández Florencia Molfino Fina Martínez-Soler Avelina Tortosa Pepita Gimenez-Bonafé Department of Physiological Sciences Physiology Unit Faculty of Medicine and Health Sciences Bellvitge Campus Universitat de BarcelonaIDIBELL L’Hospitalet del Llobregat Hospital Universitari General de Catalunya Servicio de Oncología Médica Consorcio Corporación Sanitaria Parc Taulí Instituto de Reproducción Cefer Department of Basic Nursing Faculty of Medicine and Health Sciences Universitat de Barcelona IDIBELL L’Hospitalet del Llobregat

A 43-year-old woman with an associated history of gynecological pathology and breast cancer with only one cryopreserved embryo wished to be a *** factors that influenced the success of the pregnancy in this case were analyzed. Favorable factors included: triple positive breast cancer [positive hormone receptors and positive human epidermal growth factor receptor 2],which is more hormosensitive and chemosensitive; absence of metastasis; correct endometrium preparation; and the patient's optimistic attitude and strict health habits. In contrast, the factors against success were: breast cancer; adjuvant breast cancer therapy gonadotoxicity; the age of the patient(> 40-year-old);endometriosis; ovarian cyst; hydrosalpinx; submucosal fibroids and the respective associated surgery done for the above-mentioned pathology(all resolved prior to the embryo transfer); and a low quantity of ovules(low ovarian reserve) after ovarian stimulation. This is a very special clinical case of a patient with theoretically low pregnancy success probability due to the consecutive accumulation of gynecological and oncological pathologies, who nonetheless became pregnant and delivered a full-term infant and was able to provide adequate breastfeeding.

关键词： Breast cancer Fertility preservation Gonadotoxicity Pregnancy In vitro fertilization hydrosalpinx Endometriosis Case report

Hysterosalpingography Profile of Utero-Tubal Lesions in Female Infertility in Mopti (Mali, West Africa)

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Open Journal of Medical Imaging 2022年第2期12卷 67-72页

作者： Souleymane Sanogo Mamadou N’Diaye Alassane Kouma Nana Dembélé Issa Cissé Ouncoumba Diarra Ilias Guindo Mahamadou Diallo Medical Imaging Department Sominé Dolo Hospital Mopti Mali Medical Imaging Department Mother-Child Luxembourg University Hospital Center Bamako Mali Army Medical Imaging Center Central Directorate of Armed Forces Services Bamako Mali Medical Imaging Department Municipal III Reference Health Center Bamako Mali Medical Imaging Department The University Hospital Center of Kati Bamako Mali Medical Imaging Department The University Hospital Center Gabriel Touré Bamako Mali

Introduction: Infertility is the inability to achieve pregnancy after 12 months of regular, unprotected sexual intercourse by a couple of childbearing age. It is a real public health problem because of its high prevalence in both developed and developing countries. Female infertility occupies a prominent place in reproductive health in Africa such as in our country Mali. The objective of this work was to determine the hysterosalpingography profile of utero-tubal lesions in the etiological research of female infertility in Mopti. Materials and Method: This was a cross-sectional descriptive study covering a period of one year from January 2019 to December 2019 in the radiology department of Sominé Dolo Hospital in Mopti. The variables analyzed were patient age and hysterosalpingography results. The hysterosalpingography examination was performed 3 or 4 days after menstruation on a remote-controlled table under fluoroscopic control. Data analysis was done with the aid of SPSS version 22 and Excel 2016 software. Results: During the study period, 9012 patients were seen in the imaging department, including 115 patients, or 1.3% for infertility assessment. The 25 - 29 age group was the most represented with 34 patients or 29.6%. The mean was 30.39 ± 6.96 years with extremes of 17 and 46 years. Tubal abnormalities represented 45 cases or 39.1%. hydrosalpinx was the most prevalent with 26 cases or 36.6%. Conclusion: Tubal lesions were the most observed, especially hydrosalpinx following. Hysterosalpingography remains the first choice in the radiological assessment of female infertility in our context.

关键词： Infertility Hysterosalpingography hydrosalpinx Mopti Hospital

Use of Trans-Vaginal Ultrasound to Diagnose and Treat Infertility and Its Performance

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Open Journal of Radiology 2023年第3期13卷 167-183页

作者： Sonia Rahman Combined Military Hospital Saidpur Bangladesh

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 4

关键词： Endometriomas hydrosalpinx PID Adnexal Cyst PCOD Contraception

Bilateral hydrosalpinges,what to do:Salpingectomy or salpingoplasty?Result of a 480 cases continuous series

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Gynecology and Obstetrics Clinical Medicine 2021年第1期1卷 5-8页

作者： Antoine Watrelot Jing Guan Centre lyonnais de l'endometriose Hôpital Natecia 22 avenue Rockefeller69008LyonFrance Peking University People's Hospital 11#Xizhimen StreetBeijing100044China

Background hydrosalpinx is the most common lesion of the distal part of the *** is well known to have deleterious effect on *** Two options are doable in case of hydrosalpinx:radical treatment(salpingectomy)or conservative treatment(salpingoneostomy).Results This work demonstrates that in experienced hands and with an acute selection,salpingoneostomy gives results comparable to those obtained after *** cuff salpingoneostomy technique is much better than racket form salpingoneostomy and should be preferred whenever it is *** Conservative treatment should be discussed in infertile patients having hydrosalpinx after a careful selection.

关键词： Tubal infertility hydrosalpinx Salpingoneostomy In vitro fertilization

A Case of Benign Mature Cystic Teratoma of Left Fallopian Tube Along with Right Endometrial Ovarian Cyst

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Journal of Reproduction and Contraception 2014年第1期25卷 55-59页

作者： Min YAO Xiao-fei SHI Bei-lei GE Shanghai First Maternity and Infant Hospital Tongji University School of Medicine

Objective To report a case of benign mature cystic teratoma of fallopian tube along with endometrial ovarian cyst, occasionally found during the operation. Methods A 30-year-old patient complained of mild dysmenorrhea and gradual enlargement of bilateral adnexal cysts in the past one year. At the age of 27 she had undergone a laparoscopic right ovarian endometrial cyst ablation. Before the second operation, pelvic ultrasound revealed recurrence of bilateral cysts in the adnexal regions, as well as serum concentrations of CA19-9 and CA125 above normal limits. Laparotomy revealed a 7 cm cystic mass of the right ovary, tightly adhesive to the lateral pelvic; a 10 cm-large mass on the left adnexal region embedded among intestines. The left adnexal mass appeared to be attached to the fimbriated end of the left fallopian tube with the ipsi-lateral ovary. However the left fallopian tube was obscure because of severe synechia. After separating the adhesion, we found the left hydrosalpinx. Results During laparotomy, both the cyst on the right ovary and the left fallopian tube were removed. Grossly, it revealed enlargement of the left fallopian tube in diameter 1.3 cm, with 2 neoplasms, in diameter 0.6 cm and off-white and smooth appearance. This mass was considered to be a mature solid teratoma arising in the left fallopian tube. At the same time it indicated left hydrosalpinx. Conclusion Although mature cystic teratomas are derived from ovarian germ cells （in proportion of 16%-20%）, mature teratoma of the fallopian tube is very rare. Once diagnosis, the operation will be recommended. This case was revealed during the laparotomy accidentally. The prognosis was good.

关键词： benign mature cystic teratoma fallopian tube endometrial ovarian cyst hydrosalpinx

Hysterosalpingographic Findings among Patients Undergoing Infertility Work-Up in Kisangani, Democratic Republic of the Congo

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Open Journal of Obstetrics and Gynecology 2019年第2期9卷 267-277页

作者： Jean-Didier Bosenge Nguma Antoine Modia O’yandjo Jeanot Juakali Sialikyolo Gaston Litalema Liogo Antoine Molua Aundu Roger Amisi Kitoko Gédeon Katenga Bosunga Department of Gynecology-Obstetrics Faculty of Medicine and Pharmacy University of Kisangani Kisangani DRC Department of Medical Imaging Radiology Unit Kisangani University Hospital Kisangani DRC Department of Medical Imaging Unit of Imaging of Women University of Kinshasa Kinshasa DRC Department of Surgery Faculty of Medicine and Pharmacy University of Kisangani Kisangani DRC

Introduction: Hysterosalpingography is an important tool in the investigation of the causes of female infertility. In developing countries such as the Democratic Republic of Congo, the HSG is the basic tool for performing first-line anatomical (pelvic) assessment. The aim of this study is to determine the prevalence of the different lesions observed in hysterosalpingography carried out during the assessment of infertile women monitored in Kisangani. The study set also out to look for differences in these lesions according to the type of infertility. Methods: This cross-sectional study was conducted in Kisangani from June 2016 to December 2018. The 130 cases of hysterosalpingography performed for female infertility assessment during the study period were included, of which 33.07% for primary infertility and 66.93% for secondary infertility. Results: The mean age of the patients was 33.52 ± 6.01 years;the history of pelvic inflammatory disease was noted with a predominance for secondary infertility (11% vs. 4.65%). Using hysterosalpingography, 7 (5.38%) patients had a normal result;94 (72.31%) had tubal obstruction;25 (19.23%) had hydrosalpinx;11 (8.46%) had uterine fibroids;pelvic adhesions were suspected in 12.64% of cases. There was no obvious association between all these lesions and the type of infertility. Conclusion: We found that tubal obstructions were the most prevalent lesions in this study, regardless of the type of infertility. These lesions would reflect the high prevalence of septic abortions and sexually transmitted infections in developing countries such as the Democratic Republic of the Congo.

关键词： Hysterosalpingography Female Infertility Tubal Obstruction hydrosalpinx Pelvic Adhesion Uterine Fibroids