• Title/Summary/Keyword: ectopic pregnancy

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Stimulated intrauterine insemination in women with unilateral tubal occlusion

  • Yi, Gwang;Jee, Byung Chul;Suh, Chang Suk;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.39 no.2
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    • pp.68-72
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    • 2012
  • Objective: To investigate the value of stimulated intrauterine insemination (IUI) in women with unilateral tubal occlusion. Methods: Superovulation and IUI was performed during 2003-2010 and the medical records were reviewed retrospectively. Thirty-seven infertile women (52 cycles) with unilateral tubal occlusion diagnosed by hysterosalpingography and without other causes of infertility were selected. One-hundred fourteen patients with unexplained infertility served as a control group (182 cycles). The main outcome was the clinical pregnancy rate per cycle. Results: The pregnancy rate per cycle was similar, 17.3% for the unilateral tubal occlusion group and 16.5% for the unexplained infertility group. The rate of miscarriage (11.1% vs. 23.3%) and ectopic pregnancy (11.1% vs. 6.7%) was similar between the two groups. The pregnancy rate was higher in patients with proximal occlusion (25.0%) compared with distal occlusion (13.9%) or unexplained infertility, but not statistically significant. Conclusion: Stimulated IUI can be suggested as the initial treatment option in women with unilateral proximal or distal tubal occlusion.

Laparoscopic management of early primary peritoneal pregnancy: a case report

  • Koo, Hwa-Seon;Bae, Ju-Youn;Kang, Inn-Soo;Koong, Mi-Kyoung;Kim, Hye-Ok;Cha, Sun-Hwa;Choi, Min-Hye;Kim, Ji-Young;Yang, Kwang-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.38 no.2
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    • pp.109-114
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    • 2011
  • Peritoneal pregnancy is an implantation in the peritoneal cavity exclusive of tubal, ovarian, or intra-ligamentary implantations. This is a rare obstetric complication with high maternal mortality and even higher perinatal mortality, and secondary type was most common. Risk factors for peritoneal pregnancy are previous history of extrauterine pregnancy or tubal surgery pelvic post-inflammatory status or presence of an intrauterine device. As it is a life-threatening condition, expectant management carries a risk of sudden life-threatening intra-abdominal bleeding and a generally poor fetal prognosis. So, when it is recognized, immediate termination of pregnancy is usually recommended. Early diagnosis of peritoneal pregnancy is difficult, but is important by their life threatening progress course to patients. Recently, we experienced primary peritoneal pregnancy which meets both the original and modified criteria. In this paper, we reported the case of early diagnosed and successfully treated peritoneal pregnancy despite of their diagnosis was incidentally.

Prediction of The Course of Early Pregnancy after In Vitro Fertilization by Placental Proteins (체외수정 후 태반단백들을 이용한 초기임신의 예후 추정)

  • Kim, Hak-Soon;Moon, Shin-Yong;Chang, Yoon-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.17 no.1
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    • pp.45-56
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    • 1990
  • Maternal serum ${\beta}$-specific human chorionic gonadotropin(${\beta}$-hCG) and pregnancy-specific ${\beta}_1$-glycoprotein($SP_1$) levels were determined more than one per week during 11-41 days post embryo transfer(ET) in 21 consecutive pregnancies after in vitro fertilization(IVF), which included 8 normal singleton pregnancies, 3 twin pregnancies, 4 clinical abortions, 1 ectopic pregnancy, and 5 preclinical abortions. The sensitivity of serum ${\beta}$-hCG and $SP_1$ radioimmunoassays was 3mIU/ml and 0.7ng/ml relatively. At the 7th to 8th week of gestation, ultrasonographic confirmation of fetal pole and fetal heartbeat was performed. Both serm ${\beta}$-hCG and $SP_1$ levels showed logarithmic increase, but log[$SP_1$] had more steep rising curve and had wider variation than log[${\beta}$-hCG] in normal singleton pregnancies. In 3 twin pregnancies and one ectopic pregnancy, both serum ${\beta}$-hCG and $SP_1$ levels located within the 95% confidence interval of the mean levels of 8 normal singleton pregnancies(normal range). In 2 clinical abortions which had a fetal pole without heartbeat, serum ${\beta}$-hCG level showed lower limit of the normal range or just below, but all $SP_1$ levels showed within the normal range. In other 2 clinical abortions which were diagnosed as blighted ovum, both serum ${\beta}$-hCG levels from 11 days post-ET and serum $SP_1$ levels from later days compared with ${\beta}$-hCG were below the normal range. In 5 preclinical abortions, serum $SP_1$ levels were within the normal range but serum ${\beta}$-hCG levels were far below the normal range. In conclusion, both serum ${\beta}$-hCG and $SP_1$ levels increased exponentially with similar pattern in normally conceived pregancy after IVF-ET. Both serum ${\beta}$-hCG and $SP_1$ levels could predict outcome of early pregnancy to a certain degree, but log[${\beta}$-hCG] levels had more significant correlation with outcome of pregnancy compared with log[$SP_1$] levels. In addition, ultrasonographic examination of fetal poles and fetal heartbeats gives very important clinical information and prognosis.

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Clinical Experiences of Gamete Intrafallopian Transfer (GIFT) Procedure (Gamete Intrafallopian Transfer(GIFT)방법의 임상체험에 관한 고찰)

  • Song, J.S.;Park, Y.S.;Kye, Y.S.;Kim, E.I.;Hur, K.O.;Han, C.W.;Mok, Y.J.
    • Clinical and Experimental Reproductive Medicine
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    • v.17 no.2
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    • pp.145-151
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    • 1990
  • This study was carried out to elevating the pregnancy rate in infertile patient by Gamete intrafallopian transfer (GIFT). The GIFT program was performed from July 1988 to June 1990. Of the 131 cycles, the mean age of patient was 31.6 years and the mean duration of infertility was 5.3 years. 41 patients became pregnant, for a pregnancy rate of 31.3%. 5 preclinical abortions and 6 clinincal abortion was occured. 2 ectopic pregnanices and 1 combined pregnancy were occured. 7 twin pregnancies and 1 triplet were occured (multiple pregnancy rate;22.2%). 11 pregnancies were term delivered, 17 are ongoing pregnancies. GIFT may be considered as an alternative to in vitro fertilazation in infertility cases in which at least one fallopian tube is patent.

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Influence of Herbal Medicine and Acupuncture Treatment on the Pregnancy Rate in Infertile Women before In Vitro Fertilization-Embryo Transfer (체외수정 시술 전 한방치료가 여성 불임 환자의 임신성공율에 미치는 영향)

  • Park, Young-Sun;Baek, Jung-Han
    • The Journal of Korean Medicine
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    • v.32 no.5
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    • pp.25-40
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    • 2011
  • Objectives: This study was performed to assess whether herbal medicine and acupuncture before in vitro fertilizationembryo transfer (IVF-ET) is effective on clinical pregnancy. Methods: From May 2010 to January 2011, a prospective analysis study was performed in 38 patients planning to undergo IVF-ET after taking herb medicine and acupuncture treatment. This study investigated the pregnancy rate and analyzed the change of dysmenorrhea by visual analog scale (VAS), body heat and condition of premenstrual syndrome (PMS), vaginal discharge and menstruation status. Results: 1. During herbal medicine and acupuncture treatment, five patients (13.16%) naturally became pregnant and six patients (15.79%) withdrew. After treatment, 15 patients (39.47%) received IVF-ET, 12 patients (31.58%) did not. 2. The biochemical pregnancy rate was 26.67%, the clinical pregnancy rate 26.67%, miscarriage rate 25% and ectopic pregnancy rate was 0%. 3. After treatment, PMS, dysmenorrhea and dysmenorrhea VAS was significantly decreased and the overall menstrual status improved. 4. After treatment, temperature difference of CV17-CV12 and CV4-CV12 increased, but it was not a statistically significant difference. 5. After treatment, decrease of hemoglobin and protein and increase of total bilirubin and creatinine were statistically significant. All the blood test results were within normal levels which proves safety of treatment. Conclusions: This study suggests that herbal medicine and acupuncture treatment before IVF-ET shows similar pregnancy rates with existing rates, but contributes to increasing the possibility of natural pregnancy.

Heterotopic Pregnancy in Polycystic Ovary Syndrome Woman Conceived after Ovulation Induction by Clomiphene Citrate: A Case of Bilateral Tubal Pregnancies and Intrauterine Twin Pregnancy (클로미펜을 이용한 배란 유도 후 임신된 다낭성 난소 증후군 여성에서 발견된 병합임신: 양측 난관임신 및 쌍태아 임신 1예)

  • Woo, Jang-Hwan;Choi, Kyu-Hong;Kim, Bong-Seok;An, Gye-Hyeong;Kim, Yun-Young;Chae, Young-Hwa
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.3
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    • pp.261-266
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    • 2010
  • Diagnosis of heterotopic pregnancy could be delayed because of insufficient clinical symptoms. Many clinician mistook the symptoms associated with ectopic pregnancy for the symptoms of complicated normal intrauterine pregnancy. The incidence of heterotopic pregnancies has been increased because of the use of various ovulation induction and assisted reproductive technologies. We experienced a case of bilateral tubal pregnancies and intrauterine twin pregnancy in polycystic ovary syndrome woman conceived after ovulation induction by clomiphene citrate. We report this case with a brief review of the literatures.

A Clinical Review of Ectopic Pregnancy (자궁외임신의 임상적 고찰)

  • Hwang, Tai-Young;Nah, Yong-Yun;Kim, Jong-Wook;Park, Wan-Seok;Lee, Tae-Hyung;Lee, Sung-Ho;Chung, Wun-Yong
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.229-235
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    • 1985
  • This study was undertaken for the clinical evaluation and statistical analysis on the 88 women with histopathologically confirmed ectopic pregnancies who were admitted and treated from grand opening on May-28, 1983 to Sept.-30, 1985. Incidence of ectopic pregnancy was 1 in 22.2 deliveries and the most common age group was in 30~34 years of age. There was tendency of decreasing incidencies as the gravidity, panty or artificial abortion were over 3. The most common etiologic factor was pelvic inflammatory disease and procedures for family planning were the next common. Common symptoms were lower abdominal pain (85.2%) and vaginal spotting (56.8%). At the admission, hemoglobin level under 10gm% were 44.3%, 69.5% of urine HCG tests were positive. Culdocentesis was positive only in 75.9%. Termination was frequent at 6 ~ 7 weeks of gestation mostly with rupture or abortion. Free blood in the abdominal cavity was averaged 1,224 ml. 4 cases of clinicobiochemically suspected ectopic pregnancies with spontaneous regression were excluded, and there was no fatal case treated in hospital.

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Intramural Pregnancy after in vitro Fertilization and Embryo Transfer (체외수정 시술 후 발생한 자궁벽내 임신 1예)

  • Cha, Sun-Hwa;Park, Chong-Taik;Kim, Hae-Suk;Song, Hyun-Jung;Kang, Eun-Hee;Song, Hyun-Jin;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.31 no.4
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    • pp.273-277
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    • 2004
  • Intramural pregnancy is an unusual ectopic gestation located within the uterine wall, completely surrounded by myometrium and separate from the uterine cavity, fallopian tube, or round ligament. It is known to be difficult to diagnose, and associated with a high rate of uterine rupture. We report a case of intramural pregnancy in which early diagnosis was made and successful treatment was done by dilatation and curettage. Diagnostic laparoscopy confirmed the absence of uterine rupture during the procedure. Therefore, conservation of fertility can be possible with early diagnosis of intramural pregnancy. To our knowledge, this is the first case report of intramural pregnancy following IVF-ET in Korea.

Success Rate of Tubal Sterilization Reversal (정부지원 난관복원수술의 성공율에 관한 연구)

  • Bai, Byoung-Choo;Park, Chan-Moo;Kwak, Hyun-Mo;Whang, Young-Whan
    • Clinical and Experimental Reproductive Medicine
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    • v.20 no.1
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    • pp.79-85
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    • 1993
  • Five hundred and fory-four women were provided government funded sterilization reversal services with technique of microsurgery at 15 reversal institutions designated by the Korean Association for Voluntary Sterilization since the inception of Female Reversal Program in 1981. A large majority of reasons for requesting reversal surgery was a loss of children, comprising 87.3%, and the mean interval between sterilization and reversal was 33.6 months. Two hundred and ninty-one of 418 women who were post-operatively followed up with the length of 11 months to 11 years, have experienced term dilivery or ,intra-uterine pregnancy, represented 69.6%. Eight cases have experienced ectopic pregnancy and 9 cases spontaneous abortion. The largest number of reversal clients were sterilized by the laparoscopic unipolar coagulation technique and the next largest group was sterilized by the laparoscopic banding technique, representing 59.8% and 28.9% respectively. The highest pregnancy rate, 80.9%, was shown in clients who had undergone laparoscopic banding technique while the lowest, 61.8%, was the group of laparoscopic bipolar coagulation. The most common site of the anastomosis was isthmic-ampullary portion and the next was isthmic-isthmic portion. The highest success rate, 77.8 %, was marked in the isthmic-isthmic anastomosis and the lowest was in the ampullary-ampullary anastomosis, representing 50.0%. A more than 60% of the clients became pregnant within 6 months of their reversal surgery, with the shortest interval being 1 month, the longest 39 months, and the mean 7.6 months. A large majority of the successful cases were pregnancy within 1 year of their reversal surgery, representing 82.1 %. The higher rate of pregnancy, 73.5%, was in the clients undergone reversal surgery within 36 months of their sterilization and the lower pregnancy rate, 64.1 %, was in the clients undergone reversal surgery longer than 37 months of their sterilization.

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