Deciduosis in a cesarean scar

Endometriosis is the term used to describe the presence of endometrial tissue at sites other than the uterus. It may rarely arise from scar tissue due to previous abdominal surgery such as cesarean section or episiotomy and may present with some histological features of decidual change, fibrosis, hyperplasia, metaplasia and calcifications. Here we present a case report of a 34 years old gravida who had a nodular thickening of previous surgical scar and it was diagnosed as a case of deciduosis

Immunoglobulin therapy in recurrent pregnancy loss

Recurrent pregnancy loss is a global issue. This study was planned in order to evaluate the effects of high dose intravenous immunoglobulin [IVIg] in primary and secondary unexplained miscarriages in patients of recurrent pregnancy loss. Total 168 couples having history of primary or secondary recurrent pregnancy loss were included in the study. They were divided into IVIg group and control group. IVIg group was given 50 gm of IVIg on monthly basis. Control group was provided with normal saline drip at same intervals. Statistical package for social sciences 19 [SPSS 19] was used to analyze the data. Women receive IVIg treatment [primary + secondary recurrent pregnancy loss] shows significantly higher percentage of live birth as compare to control group [81%; p < 0.000]. Percentage of full term live birth is also significantly increased in IVIg group in comparison with control group [76.2%; p < 0.000]. In primary recurrent pregnancy loss total percentage of live births and full term live births were 85.3 and 79.4% in IVIg group while in control group it was 26.9% and 19.2% [p < 0.000]. In secondary recurrent pregnancy loss percentage of total number of live birth and full term live births in IVIg group is 78% and 74% in comparison with control group 32% and 26% respectively [p < 0.000]. High dose intravenous immunoglobulin has a beneficial role in patients of primary and secondary recurrent miscarriages

Histopathological patterns of testicular biopsies in male infertility

To evaluate histopathological patterns of testicular biopsy specimens from infertile males and to categorize each case according to Modified Johnson scoring system. Male infertility contributes to about 20% of infertility cases. Testicular biopsy is important in categorizing patients with Azoospermia and provides useful information and guidelines for further treatment. Histopathological findings of testicular biopsies are of significant importance in making decision for selection of cases for Intracytoplasmic sperm injection [ICSI] in patients with non obstructive azoospermia. Testicular biopsies from male patients with history of infertility and azoospermia were included in this study. All biopsies were received in 10% formalin fixative and routinely processed and stained with Hematoxylin and Eosin [H and E]. Clinical data was obtained and recorded on a proforma. All cases were examined microscopically and various histological patterns were evaluated and categorized according to the histopathological patterns and Modified Johnson scoring was performed. A total 53 cases of testicular biopsies from azoospermic males were evaluated. Mean age was 28 years and range was from 24-56 years. Most frequent pattern was of Sertoli cell only syndrome [30.18%], further categorized as Johnson score 2. The second most frequent was hypospermatogenesis [18.86%], further categorized as Johnson score 7. There were 5 cases that showed mixed pattern and 1 case showed discordant pattern. This study outlines the different histopathological patterns of testicular biopsies in cases of male infertility in our setup and identifies Sertoli cell only syndrome as the most common pathological finding amongst various histopathological patterns

Uterine leiomyomata -unusual number managed with conservation of uterus

Uterine leiomyomata are the commonest neoplasms of female reproductive tract. On an average there are six to seven fibroids in the affected uterus. These neoplasms may lead to symptoms like menorrhagia, dysmenorrhea, pressure effects, urinary frequency, pelvic pain, infertility and pelvic mass. Here we present a case report of 34 years old nulliparous women having an unusual number [48] of fibroids. As she was nulliparous and wanted to conceive, her uterus was conserved and all the fibroids were surgically removed

Role of female age in determining causes of infertility and predicting outcome of in vitro fertilization

To look into various causes of infertility according to increasing age, differences in percentage of pregnancy rate after IVF in different age groups and role of various infertility parameters in determining pregnancy rate among these patients. A total of 206 infertile couples were selected and divided into two groups according to female age: Group I [<35 years, n=108] and Group II [>/= 35 years, n=98]. Diagnostic hysterosalpingography or laproscopy was done in order to rule out the tubal blockage and endometriosis. Ovarian dysfunction was excluded on the basis of hormonal analysis, IVF treatment following a long protocol for use of GnRH agonist was given to infertile couple. Analysis was done using SPSS 19 and MedCal software 12. Male causes were frequent in both groups without any significant difference [33%; p=0.882]. Tubal factor was significantly raised in older group [33%; p=0.000], whereas ovarian dysfunction was significantly higher in younger patients [33%; p=0.000]. Number of embryos transferred and pregnancy rate after IVF were significantly decreased in older couples [p

Endometrial histological findings in infertile women

Infertility is a global health problem and in Pakistan frequency of subfertility is 21.9%. The fact that cyclical histological changes in the endometrium correlate with fluctuating biorhythms of various hormone levels enables histological appearance of the endometrium to be a reliable parameter to evaluate the cause of infertility. To discern the histological patterns of endometrium in infertile women. This study was carried out at the clinic of one of the authors. The study included 120 consecutive cases of infertile women seeking Assisted Reproductive Treatment. D and C was performed to obtain the endometrial biopsy. The biopsy specimen was then fixed, processed and sectioned. Haematoxylin and Eosin staining was performed. Histological sections were examined under the microscope for evaluation of morphological features. The results were analyzed and percentages calculated. In the present study majority of patients [46.6%] belonged to 26-30 years age group. Amongst the morphological patterns observed, the percentage of cases in secretory phase was the maximum. There were 17 [14%] cases of cystic hyperplasia and the feature of intraluminal tufting was noted in 65 [54%] cases. Additionally, there were 4 [3.3%] cases of non specific endometritis and 1 [0.8%] case of tuberculous endometritis. In majority of the cases [46.7%] there was sporadic lymphocytic infiltration. Endometrial biopsy give information about hormone response of endometrium as well as the local factors of endometrium concerning non-specific and specific infections, tuberculous endometritis, hyperplasias and anovulatory cycle.