Simultaneous serous cyst adenoma and ovarian pregnancy in an infertile woman

Ovarian pregnancy is a rare form of extra uterine pregnancy. Serous cyst adenoma is a benign variant of epithelial cell tumors of ovary. The coexistence of a cyst adenoma with an ovarian pregnancy in the same ovary is extremely rare. Some studies suggested that infertility or ovulation-inducing drugs can be involved in increased risk of ovarian tumors and ovarian pregnancies. A 28-year-old infertile woman presented with a ruptured ovarian pregnancy following ovulation induction with metformin. She had a concurrent benign serous cyst adenoma in the same ovary. Resection of both ovarian pregnancy and tumoral mass were performed. The ovary was preserved. Removal of gestational tissue and preservation of the involved ovary are the best options for management of ovarian pregnancy in young patient. Although there is an association between infertility/ovulation inducting medications and ovarian gestation, their connections with serous cyst adenoma are undetermined

[Factors affecting pregnancy and abortion rates following intra cytoplasmic sperm injection in the obstructive and non-obstructive azoospermic men]

Intracytoplasmic sperm injection [ICSI] has revolutionized the treatment of azoospermic men. The aim of this study was to evaluate the factors interfering in the success of ICSI, including sperm collection method, testicular histology, age and hormonal assay of the couple, the number of retrieved oocytes, and the number of transferred embryos. In this retrospective cohort study, 246 azoospemic men [52 with obstructive azoosprmia [OA] and 194 with non obstructive azoospermia [NOA]] who were underwent sperm retrieval with PESA or TESE and ICSI protocol were studied. By long protocol of ovarian stimulation, oocytes were retrieved 36h after hCG administration. After 48h, cleaved embryos were replaced in the uterine cavity. Clinical pregnancy rates [21.1% in OA versus 10.8% in NOA] was significantly correlated with sperm origin [P<0.05]. Female partner's age and serum FSH significantly influenced pregnancy rates in both groups [p<0.001] and also pregnancy rates was significantly influenced by number of retrieved oocytes and transferred embryos in NOA groups [P<0.05]. ICSI can make a chance for fertility in azoospermic men. Higher success rates in OA patients can be related to better quality of sperm. The value of male hormonal assay and testicular biopsy was not remarkable.

Pathogenesis and causes of premature ovarian failure: an update

Premature ovarian failure [POF] affects 1% of young women. This condition has significant psychological sequelae and major health implications. POF seriously interferes with fertility and family planning. Diverse etiologies are associated with POF. Literature review related to the causes and pathogenesis of POF, cited between the year 1900 and May 2010.POF may be either spontaneous or induced. The known causes include:-Genetic disorders, which could involve the X chromosome or autosomes. However, the growing body of literature demonstrates a list of newly discovered mutations that may be responsible for causing POF. Most of these mutations are extremely rare, and most cases of POF are still considered to be idiopathic. -Autoimmune causes; there is some evidence of an association of POF with lymphocytic oophoritis and other autoimmune disorders. Antiovarian antibodies are reported in POF, but their specificity and pathogenic role are obscure. -Iatrogenic causes; chemotherapy, radiotherapy and pelvic surgery can lead to POF. -Infectious Causes; some viral and microbial infections can be followed by POF. -Environmental toxins, such as cigarette smoking are reported as risk factors of spontaneous POF. -Idiopathic; in most cases, no identifiable etiology can be recognized after complete evaluation

Controlled ovarian hyperstimulation and intrauterine insemination cycles in patients with unilateral tubal blockage diagnosed by hysterosalpingography

Controlled ovarian hyperstimulation and intrauterine insemination [IUI] cycle is an ideal protocol for some subfertile patients. So, we decided to try this therapeutic protocol for the patients with unilateral tubal blockage diagnosed by hysterosalpingography [HSG]. To evaluate the effect of unilateral tubal blockage diagnosed by HSG on cumulative pregnancy rate [CPR] of the stimulated IUI cycles. A cross-sectional analysis was performed between October 2006 and October 2009 in an academic reproductive endocrinology and infertility center. Two groups of patients undergoing stimulated IUI cycles were compared. Sixtyfour infertile couples with unilateral tubal blockage diagnosed by HSG as the sole cause of infertility in the group [I], and two hundred couples with unexplained infertility in the group [II]. The patients underwent 3 consecutive ovarian hyperstimulation [Clomiphen citrate and human menopausal gonadotropin] and IUI cycles. The main outcome measurements were the CPRs per patients for 3 consecutive stimulated IUI cycles. Cycle characteristics were found to be homogenous between the both groups. CPRs were similar in group I [26.6%] and group II [28%] [p=0.87; OR=1.075; 95% CI: 0.57 -2.28]. Unilateral tubal blockage [diagnosed on HSG] has no effect on success rate of stimulated IUI cycles, so COH and IUI could be recommended as the initial therapeutic protocol in these patients

case report of spontaneous pregnancy during hormonal replacement therapy for premature ovarian failure

Premature ovarian failure [POF] is a common condition; its incidence is estimated to be as great as 1 in 100 by the age of 40 years. Physiologic replacement of ovarian steroid hormones seems rational until the age of normal menopause. Temporary return of ovarian function and pregnancy may occur rarely in women with POF. We report a case of POF who conceived during hormone replacement therapy. A 30 years-old woman with confirmed POF after pelvic surgery and sever emotional stress conceived spontaneously. Return of ovarian function and achievement of pregnancy is possible in women with POF