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Background: Failure to achieve conception after 12 months of regular unprotected intercourse is defined as infertility. The aim of this study was evaluating SIS done under high pressure (SIStreat) as a treatment procedure, for relieving simple tubal obstruction and on cumulative pregnancy rate in infertile women.Methods: A prospective, interventional trial was done (October 2017 - November 2018) on 106 eligible women. All patients performed SIS. Patient with tubes patent under low pressure were assigned as control group, the rest of them were subjected to SIStreat, this group was farther divided into Group 2-a (patent under high pressure) and Group 2-b (occluded under high pressure). All patients had regular intercourse for 6 months. Pregnancy was confirmed by serum B-HCG.Results: we compared patients who performed conventional SIS (n = 100 cases) to patients who performed SIStreat afterwards (n = 84) according to the number of patent tubes. There was a high statistically significant difference in favor of SIStreat group (p < 0.001). Also, there was no significant difference in pregnancy rate between control group 62.5% and Group 2-a 45.7% (p = 0.226).Conclusions: SIStreat is a whole new procedure for opening fallopian tubes (diagnosed occluded by SIS). Patients who were successfully treated by SIStreat had cumulative pregnancy rate comparable to patients who were diagnosed to have patent tubes using conventional SIS.
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Objective To investigate how to optimize the protocol of embryo cryopreservation to improve the success of frozen-thawed embryo transfer (FET), reduce multiple pregnancy rate and increase the cumulative pregnancy rate from one oocyte retrieval process. Methods The clinical data of 1 166 FET cycles were retrospectively analyzed and separated into different groups:445 for vitrification and 721 for slow-freezing. The vitrification group was divided into single embryo (28 cy?cles), double embryos (71 cycles) and triple embryos (346 cycles). 0-1 optimal embryo was called O0-1 group (235 cycles), 2 optimal embryos were called O2 group (80 cycles), 3 optimal embryos were called O3 group (130 cycles). The difference preg?nancy outcomes (implantation rate, clinical pregnancy, abortion rate and live-birth rate) were compared between groups. Results (1) There were significantly higher embryo survival rate(98.3%vs 73.1%), embryo recovery rate without damaging (83.3%vs 62.1%), implantation rate(36.8%vs 29.9%), clinical pregnancy(57.1%vs 44.0%) and live-birth rate(47.9%vs 34.5%) in vitrification group than those of slow freezing group(P0.05). Conclusion Vitrification technology can improve the clinical pregnancy and live-birth rate, and decrease multiple preg?nancy rate. Two optimal embryos in one tube are supposed to be the preferred method for embryo cryopreservation.
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Se presenta la evaluación reproductiva, a través del método de las tablas de vida, aplicado a una cohorte de 16 pacientes tratadas con metotrexato parenteral por embarazo ectópico, en el período comprendido entre julio de 1993 y julio de 2002. Estudio realizado en el Instituto de Investigaciones Materno-Infatil, Universidad de Chile y Servicio de Ginecología. Hospital San Borja-Arriarán e Integramédica, división Ginecología. Todas las pacientes negativizaron la gonadotrofina coriónica. La permeabilidad tubaria fue evaluada en 12 de 16 pacientes, siendo permeable la trompa ipsilateral en 75% de los casos. La tasa acumulativa de embarazo intrauterino a los 24 meses fue de un 57%, con una fecundabilidad de 2%. En los casos con trompa única, la tasa acumulativa de embarazo normal fue de 40%, con una fecundabilidad de 1,6% a los dos años. Al evaluar la recidiva de embarazo ectópico, encontramos una tasa acumulativa de 48% a los 24 meses. Los resultados obtenidos en esta serie en términos de permeabilidad tubaria y embarazo intrauterino son satisfactorios. La recidiva de embarazo ectópico y la baja fecundabilidad se asociarían al daño tubario previo. El tratamiento médico del embarazo ectópico es una alternativa válida en casos bien seleccionados, con resultados reproductivos aceptables.
Our group performed a survival analysis of fertility after pregnancy of 16 patients treated with intramuscular methotrexate, between july 1993 and july 2002, in the Instituto de Investigaciones Materno-Infantil, Obstet Gynecol Dept., San Borja-Arriarán Hospital, University of Chile and a private health center; Integramédica, división of Gynecology. All cases normalized chorionic gonadotropin. Tubal patency has been evaluated in 12 of 16 patients; 75% of the cases had patent tube in the involved side. The cumulative intrauterine pregnancy rate was 57% at 2 years with a fecundity of 2%. In the cases with a single tube, the cumulative intrauterine pregnancy rate was 40% with a 1.6% fecundity at 24 months. The ectopic pregnancy recurrence had a cumulative pregnancy rate of 48% at 2 years. The results in terms of tubal and intrauterine pregnancy obtained in this series are adequate. The ectopic pregnancy recurrence and low fecundity are probably associated to previous tubal damage. Medical treatment of ectopic pregnancy is a valid choice in selected cases with an acceptable reproductive outcome.
Subject(s)
Humans , Female , Pregnancy , Adult , Pregnancy, Ectopic/drug therapy , Abortifacient Agents, Nonsteroidal/therapeutic use , Methotrexate/therapeutic use , Survival Analysis , Prospective Studies , Follow-Up Studies , FertilityABSTRACT
OBJECTIVE: To evaluate the cumulative pregnancy rate(CPR) of in vitro fertilization and embryo transfer(IVF-ET) with intracytoplasmic sperm injection(ICSI). METHODS: Medical records of 260 infertile patients undergoing 519 cycles of IVF-ET with ICSI from January, 1994 to December, 1999 were retrospectively reviewed. The CPR beyond 12 weeks of gestation was estimated by Kaplan-Meier method. The CPRs were compared by log-rank test between groups divided by age of patients, indication of ICSI, and method of sperm retrieval for ICSI. RESULTS: As 70 patients achieved an on-going pregnancy after IVF-ET with ICSI, the PR was 26.9% per patient and 13.5% per cycle. The overall CPR was 54.9% after 6 cycles of IVF-ET with ICSI. As expected, age had a significant strong effect on the CPR; CPRs afer 4 cycles of ICSI were 61.8% in the age group of 30 years(n=81), 43.7% in 31-35 years(n=106), and 15.3% in 36 years(n=73). There was no significant difference in the CPR between abnormal semen analysis group(n=184) and prior low fertilization rate group(n=66). In abnormal semen analysis group, the CPR of surgically retrieved sperm subgroup(n=60) was not significantly different from that of ejaculated sperm subgroup(n=124). CONCLUSIONS: The CPR of IVF-ET with ICSI was presented, and it could be of much help in the clinical counseling of IVF-ET patients. ICSI technique could be used successfully for IVF-ET in infertile couples who had the male factor infertility or the past history of low fertilization rate in the previous cycles.