The effect of timing of oocyte denudation from oocyte retrieval in the total fertilization failure among in vitro fertilization - Intracytoplasmic sperm injection cycles

@#<p>Objective: This study aimed to evaluate the effect of oocyte incubation after retrieval in TFF among IVF-ICSI and identify factors affecting total fertilization failure (TFF).</p><p>Methods: This is a retrospective cohort study, involving 995 IVF cycles using the antagonist protocol that were clustered into three timings of oocyte denudation from retrieval : Group 1: <1 hour, Group 2: ?1 hour to <2hours and Group 3: ?2hours. Other variables considered were etiology of infertility, female age, days of stimulation and total number of oocytes retrieved.</p><p>Results: Overall TFF was 4.5%. TFF among groups were 4.8%, 5.8% and 3.2%, respectively. Multiple logistic regression analysis showed that oocyte incubation prior to denudation for ? 2 hours tend to decrease TFF incidence. Among factors studied, male factor infertility and a low number of oocytes adversely affect TFF.</p><p>Conclusion: Timing of incubation of oocyte did not significantly affect the occurrence of TFF. Among factors studied, male factor infertility and a low number of oocytes adversely affect TFF.</p>

Practice of minimally invasive gynecologic surgery in the Philippines during the COVID-19 Pandemic / Philippine Journal of Obstetrics and Gynecology

Objective@#This study aims to establish baseline information on the practice of minimally invasive gynecologic surgery (MIGS) among Filipino gynecologic endoscopists amid the COVID-19 pandemic. @*Materials and Methods@#MATERIALS AND METHODS: An online survey was conducted among Fellows of the Philippine Society for Gynecologic Endoscopy (PSGE) practicing in private and government hospitals in the Philippines after informed consent. The survey had five subsections: (1) demographic data, (2) impact of COVID-19 pandemic on MIGS practice, (3) changes of practice during the COVID-19 pandemic, and (4) changes in the conduct of surgery and postoperative care. @*Results@#A total of 119 out of 144 PSGE Fellows based in the Philippines participated in the survey, 83% were Fellows in both laparoscopy and hysteroscopy. The majority had more than 15 years of practice and were practicing in the National Capital Region. Surgeries were canceled initially but have since resumed. The majority were hysteroscopy cases, the most common being polypectomy. Majority of the respondents reduced their clinic hours and appointments. Most have used telemedicine for consultations. Use of face masks, face shields, and personal protective equipment (PPE) were the top precautions taken in the clinics. Screening and precautions per guidelines inside the operating room setting were observed. Modifications during surgery include the use of smoke evacuators, minimizing energy device use, and wearing enhanced PPE.@*Conclusion@#The volume of laparoscopy and hysteroscopy cases was greatly reduced during the pandemic. The pandemic has disrupted the practice of MIGS both in the outpatient clinics and the operating rooms. Most of the changes made are congruent to local and international automotive task force guidelines. Precautionary measures and screening procedures must remain in place to reduce the risk of severe acute respiratory syndrome coronavirus 2 transmission to patients and health-care workers.

Primary bilateral tubal pregnancy: A case report and review of literature

@#Ectopic pregnancy is one of the leading causes of maternal morbidity and mortality worldwide, as seen in 9 to 13% and up to 30% of maternal deaths in developed and developing countries, respectively. Bilateral tubal pregnancy is an exceedingly rare condition with an even greater risk of rupture and hemorrhage than that of the unilateral type. This is a case of a 32 yearold G4P3 (4004) who presented with amenorrhea of 5 weeks, vaginal bleeding, and abdominal pain. The triad of symptoms, elevated serum β-HCG levels, along with a transvaginal ultrasound finding of a right adnexal mass led to the impression of a ruptured ectopic pregnancy, probably tubal. Patient underwent laparoscopy and intraoperative findings revealed bilateral tubal pregnancy for which bilateral salpingectomy was done. Oftentimes, as in this case, bilateral tubal pregnancy is diagnosed intraoperatively. However, it is possible, as seen in a review of cases, that a combination of history, symptoms, and clinical findings may point to a probable diagnosis which is imperative in treatment planning. Bilateral tubal pregnancy is rare, but due to a rise in pelvic inflammatory disease, its consequences, and the advent of assisted reproductive techniques, the risk for this condition increases with important clinical implications.

Live birth after intracytoplasmic sperm injection with cryopreserved sperm retrieved from urine in a case of complete retrograde ejaculation: A case report

@#This is a case of a 37-year-old nulliparous woman, and her 53-year-old husband diagnosed with complete retrograde ejaculation and absolute azoospermia, who conceived after transfer of embryos fertilized using cryopreserved sperm retrieved from postejaculatory urine. Four embryos were thawed, then transferred in the blastocyst stage, resulting in a singleton pregnancy and delivery by cesarean section at term to a healthy baby boy weighing 3100 g. This case study shows that cryopreservation of sperm retrieved from postejaculatory urine is feasible for IVF, despite demonstration of low motility. This is more cost-effective and least invasive as the husband may avoid surgical aspiration or extraction of sperm.