Search

Objective To report a case of ureterovaginal fistula secondary to transvaginal oocyte retrieval (TVOR). Design Case report. Setting IVF Center IN a private hospital. Patient(s) A 31-year-old woman presented immediately after TVOR with right lower abdominal pain with irradiation to the suprapubic area and vaginal discharge. Intervention(s) Vaginal examination, creatinine dosage in plasma and vaginal discharge, excretory urography. A double-J catheter was inserted under general anesthesia. Main Outcome Measure(s) Clinical follow-up. Result(s) Vaginal leakage ceased a few hours after catheter insertion. Transfer of two embryos was performed 3 days after TVOR, but no pregnancy occurred. The double-J catheter was removed 21 days after its placement. Imaging studies done 6 weeks later demonstrated a normal urinary tract morphology. Conclusion(s) Given the elective nature of TVOR and IVF, patients should be informed about all potential complications, including ureterovaginal fistula.

Premature ovarian failure occurs in approximately 1:1000 women before 30 years, 1:250 by 35 years and 1:100 by the age of 40. It is characterized by primary or secondary amenorrhea and cannot be considered as definitive because spontaneous conception may occur in 5 to 10% of cases. In 95% of cases, premature ovarian failure is sporadic. The known causes of premature ovarian failure include chromosomal defects, autoimmune diseases, exposure to radiation or chemotherapy, surgical procedures, and certain drugs. Frequently, however, the etiology is not clear and these cases are considered to be idiopathic. Premature ovarian failure is defined by gonadal failure and high serum follicle-stimulating hormone (FSH) levels. Clinical approach includes emotional support, hormonal therapy with estrogens and progesterone or progestogens, infertility treatment, and prevention of osteoporosis and potential cardiovascular risk.

Objective To assess the results obtained in our clinic with intracytoplasmic sperm injection (ICSI) in severe male factor infertility and failed fertilization and to determine if the age of the female has any impact on those results. Design Retrospective study. Setting Private high-complexity Human Reproduction Center. Patients One hundred five couples with a total of 114 procedures. Eighty-six were classified as severe male factor and 19 were classified as previous failed fertilization. Interventions Treatment was performed by ICSI. Main Outcome Measure Normal fertilization, cleavage, and implantation, total, term, and ongoing pregnancy rates in the total population and in different age brackets. Results Excellent fertilization, cleavage, and implantation rates were obtained with this procedure (78%, 85%, and 13.5%, respectively). The total pregnancy rates were 43% and 46% per cycle and per transfer and 31.5% and 33.6% in terms of term and ongoing pregnancy rates. A significant reduction in implantation and total, and term and ongoing pregnancy rates was seen after the age of 35 years. Conclusions The results obtained with ICSI are quite satisfactory with proper equipment and careful training. The age of the female is an important parameter in determining prognosis and treatment outcome.