Desfechos reprodutivos e de sobrevida em adolescente tratada com cirurgia preservadora de fertilidade por tumor borderline de ovário em estádio avançado: relato de caso e revisão da literatura / Reproductive and survival outcomes in an adolescent treated with fertility- sparing surgery for advanced stage borderline ovarian tumor: case report and review of the literature

Existem poucos dados na literatura sobre os resultados obstétricos e oncológicos de adolescentes com tumores borderline de ovário em estádio avançado trata- das com cirurgia preservadora da fertilidade. Uma adolescente de 15 anos com diagnóstico de tumor borderline de ovário estádio IIIc foi inicialmente tratada com tumorectomia ovariana bilateral e quimioterapia adjuvante com esquema de platina/taxano (seis ciclos). Durante o seguimento, foi submetida a outras três tumorectomias devido a tumor borderline de ovário (duas vezes) e cistadenoma ovariano (uma vez). Outra recidiva de tumor borderline de ovário ocorreu seis anos após o diagnóstico inicial, quando ela estava grávida; foi tratada com tumorecto- mia realizada durante a cesariana. Em sua última consulta ambulatorial, a mulher de 27 anos não apresentava evidência da doença e tinha um filho saudável. Mesmo em estádio avançado, a cirurgia de preservação da fertilidade foi segura e factível nessa paciente com tumor borderline de ovário.

There are few data in the literature regarding obstetric and oncological outcomes of adolescents with advanced-stage borderline ovarian tumors treated with fertility spa- ring surgery. A 15 years old adolescent who was diagnosed with a stage IIIc borderline ovarian tumor, was treated with bilateral ovarian tumorectomies and adjuvant chemotherapy with platinum/taxane regimen (six cycles). During follow up she was submitted to other three tumorectomies due to borderline ovarian tumor(twice) and ovarian cysta- denoma (once). Another borderline ovarian tumorrecurren- ce occurred six years after initial diagnosis, when she was pregnant; treated with tumorectomy performed during ce- sarean section. At her last outpatient visit, the 27-year-old woman had no evidence of disease and a had healthy child. Even at an advanced stage, fertility sparing surgery was safe and feasible in this patient with borderline ovarian tumor.

Quiste gigante de ovario / Giant cyst of ovary

Introducción: Los tumores de gran tamaño han sido descritos a través de la historia, entre ellos los ginecológicos y los de ovario cuando pesan más de 12 kg constituyen una rareza médica. Las masas tumorales en hemiabdomen inferior son causas frecuentes de consulta en cirugía general. Dentro de estas, los quistes de ovarios son los que con más frecuencia se diagnostican. Objetivo: Describir el caso de un quiste gigante de ovario en una paciente que fue atendida en consulta de cirugia general por aumento de tamaño en el abdomen de varios años de evolución. Caso clínico: Se expone el caso de una paciente femenina, con antecedentes de salud, que acude al servicio de cirugía general por aumento de volumen del abdomen, progresivo, insidioso de 2 años de evolución. Se diagnostica masa quística dependiente de ovario y en el transoperatorio se constata una tumoración quística del ovario que en el análisis histopatológico informa un cistoadenoma seroso de ovario. Conclusión: Los tumores del ovario no son tan frecuentes como los del útero y los de la mama, pero constituyen el tercer grupo de tumores benignos y malignos de la mujer. Se presentó el caso por lo infrecuente que resulta, la escasa frecuencia de reporte de estos casos lo cual aporta conocimiento a la comunidad médica sobre el tema(AU)

Introduction: Large tumors have been described throughout history, including gynecological tumors, and ovarian tumors when they weigh more than 12 kg constitute a medical rarity. Tumor masses in lower hemiabdomen are frequent causes of consultation in general surgery. Within these, ovarian cysts are the most frequently diagnosed. Objective: To describe the case of a giant ovarian cyst in a patient who was treated in a general surgery consultation due to an increase in abdomen size of several years of evolution. Clinical case: The case of a female patient, with a history of health, which goes to the general surgery service due to an increase in abdomen volume, progressive, insidious of 2 years of evolution, is presented. Ovarian-dependent cystic mass is diagnosed and a cystic tumor of the ovary is found in the transoperative period, which in the histopathological analysis reports a serous ovarian cystadenoma. Conclusion: Ovarian tumors are not as frequent as those of the uterus and those of the breast, but they constitute the third group of benign and malignant tumors of women. The case was presented because of the infrequent result, the low frequency of reporting these cases, which brings knowledge to the medical community on the subject(AU)

Ultrasound evaluation of female reproductive system in free ranging Giant Anteater (Myrmecophaga tridactyla): case report / Avaliação ultrassonográfica do sistema reprodutor feminino em tamanduá-bandeira de vida livre (Myrmecophaga tridactyla): relato de caso

An adult, female, 31kg body weight, free range Myrmecophaga tridactyla was referred for medical consultation due to apathy, dehydration, intense flatulence and fetid stools. The animal was submitted to chemical restraint and physical examination, blood count, fecal analysis, and vaginal cytology and abdominal ultrasonography were performed. Good nutritional status and clinical variables within the normal range were observed at physical examination. At vaginal cytology leukocytes, spermatozoa and a large proportion of cornified cells (superficial) were observed, indicating estrus and recent copula. At ultrasound examination it was possible to locate, identify, evaluate and measure the ovaries and the uterine structures, cervix, body, lumen, myometrium and endometrium, a fact never reported in the literature for this species. These data can be used as reference for clinical evaluation of the reproductive tract in Myrmecophaga tridactyla females considered vulnerable species, for the diagnosis of reproductive pathologies, biotechnologies application or estrous cycle evaluation.(AU)

Uma fêmea, com 31kg de peso corporal, de Myrmecophaga tridactyla, de vida livre, foi apresentada para consulta médica em razão de apatia, desidratação, flatulência intensa e fezes fétidas. O animal foi submetido à contenção química e foram realizados exame físico, hemograma, análise fecal, citologia vaginal e ultrassonografia abdominal. Ao exame físico, foi determinado bom estado nutricional e variáveis clínicas dentro da faixa de normalidade. Na citologia vaginal, foram observados leucócitos, espermatozoides e uma grande proporção de células cornificadas (superficiais), indicando estro e cópula recente. No exame ultrassonográfico, foi possível localizar, identificar, avaliar e mensurar os ovários e as estruturas uterinas, o colo do útero, o corpo do útero, o lúmen, o miométrio e o endométrio, fato nunca relatado na literatura para essa espécie. Esses dados podem ser utilizados como referência para avaliação clínica do trato reprodutivo de fêmeas de Myrmecophaga tridactyla considerada espécie vulnerável, para o diagnóstico de patologias reprodutivas, aplicação de biotecnologias ou avaliação do ciclo estral.(AU)

Ultrasound monitoring of the uterus and ovaries of dominant and subordinate females of yellow-breasted capuchin (Sapajus xanthosternos) and robust tufted capuchin (Sapajus robustus) in captive colonies during the ovarian cycle and anestrus periods / Acompanhamento ultrassonográfico do útero e ovários de fêmeas dominantes e subordinadas de macacos-prego-do-peito-amarelo (Sapajus xanthosternos) e macacos-prego-de-crista (Sapajus robustus) em colônias cativas, durante o ciclo ovariano e períodos de anestro

The yellow-breasted capuchin (Sapajus xanthosternos) and robust tufted capuchin (Sapajus robustus) are endangered species due to destruction of their natural habitat and predatory chase. However, it is still necessary to elucidate some details of their reproductive physiology in order to obtain better indices in the assisted reproduction of these species. This study aimed to evaluate the ovarian cycle of 13 dominant and subordinate females of S. xanthosternos (n=8) and S. robustus (n=5) using sagittal and transversally scanned ultrasound of their uterus and ovaries. Sonograms were performed every seven days for two months. The ovarian cycle phase and anestrous condition were confirmed by colpocytology. Our results showed different uterine parameters (craniocaudal diameter, dorso-ventral diameter, and transverse diameter) (P<0.05) between anestrous subordinate females and other ovarian cycle phases and social classes. The mean of uterine volume was higher in dominant females than subordinate females in all cycle phases (P<0.05), except in follicular phase. During anestrus, endometrial width was smaller in subordinate females than in dominant females (P<0.05). Subordinate females showed differences in endometrial measures (P<0.05) between anestrous period and follicular and luteal periods. Ovarian measures in dominant females were higher than in subordinate females only during anestrus (P<0.05). In the subordinate females, ovarian parameters were different (P<0.05) between anestrus and follicular and luteal phases. Dominant females showed higher volume of right ovary compared to volume of the left ovary during anestrus and follicular phase (P<0.05). Follicles and corpus luteum were distinguished by ultrasonography in most exams (86.11%). During anestrus, measurable ovarian structures were not observed in both ovaries in dominant and subordinate females. In conclusion, the methodology used in this study allowed to evaluate the ovarian cycle in S. xanthosternos e S. robustus females and that cycle phase/anestrus and social class of the female influenced the size of the uterus and ovaries.(AU)

O macaco-prego-do-peito-amarelo (Sapajus xanthosternos) e o macaco-prego-de-crista (Sapajus robustus) encontram-se em risco de extinção devido a destruição do seu habitat e a caça predatória. Porém, ainda necessita-se elucidar alguns detalhes de sua fisiologia reprodutiva, para obterem-se melhores índices por meio de reprodução assistida. Sendo assim, o objetivo deste trabalho foi acompanhar o ciclo ovariano de 13 fêmeas dominantes e subordinadas de S. xanthosternos (n=8) e S. robustus (n=5) por meio de cortes ultrassonográficos sagitais e transversais do útero e dos ovários. Estas fêmeas foram examinadas uma vez por semana durante dois meses. A fase do ciclo ovariano/anestro foi confirmada pela colpocitologia. Os resultados da pesquisa demonstrou diferença significativa (P<0,05) relacionada ao diâmetro crânio-caudal, diâmetro dorso-ventral e diâmetro transversal entre as fêmeas subordinadas em anestro com todas as outras fases do ciclo ovariano e classes sociais. A média do volume uterino foi maior nas fêmeas dominantes que nas subordinadas em todas as fases do ciclo (P<0,05) a exceção da fase folicular. A largura endometrial, durante o período de anestro, foi menor nas fêmeas subordinadas quando comparada às dominantes (P<0,05). Nas fêmeas subordinadas, houve diferenças (P<0,05) nas mensurações endometriais entre o período de anestro e das fases folicular e lútea. Quanto aos ovários, as médias das medidas observadas nas fêmeas dominantes foram superiores as das subordinadas durante o anestro (P<0,05). As médias das medidas das variáveis ovarianas das fêmeas subordinadas apresentaram diferenças entre o anestro e as fases folicular e lútea (P<0,05). Nas fêmeas dominantes o volume do ovário direito foi maior que o do ovário esquerdo durante o anestro e na fase folicular (P<0,05). Folículos e corpos lúteos foram diferenciados pela ultrassonografia na maioria das coletas (86,11%). Durante o anestro não foram observadas estruturas ovarianas mensuráveis nos ovários em ambas as classes sociais. Concluiu-se que a metodologia empregada neste estudo permitiu o acompanhamento do ciclo ovariano das fêmeas S. xanthosternos e S. robustus e que as fases do ciclo/anestro e a classe social das fêmeas influenciaram as medidas do útero e ovários.(AU)

Rare case of sarcomatoid squamous cell carcinoma arising in an ovarian mature teratoma / Caso raro de carcinoma espinocelular sarcomatoide que surge em um teratoma ovariano maduro

Abstract Although mature cystic teratoma (MCT) is benign, malignant transformation (MT) occurs in ~ 1% to 2% of all cases, and usually consists of squamous cell carcinoma (SCC), which accounts for ~ 80% of the cases. Spindle-cell (sarcomatoid) carcinoma (SCSC) is an uncommon type of SCC, comprising up to 3% of all cases. The lack of characteristic symptoms and specific imaging findings may lead to preoperative misdiagnosis. Moreover, the clinicopathologic characteristics, the treatment, the prognostic factors and the mechanism of MT have not yet been well understood due to the rarity of such tumors, especially in women of reproductive age. The authors present a case of a 34- year-old patient with 14 weeks of gestation who was diagnosed with an adnexal mass suggestive of ovarian teratoma. A laparoscopy salpingo-oophorectomy was performed after 6 months of delivery, and the histological exam revealed a sarcomatoid SCC in the MCT.

Resumo Embora o teratoma cístico maduro (MCT) seja benigno, a transformação maligna (MT) ocorre em cerca de 1% a 2% dos casos, e geralmente apresenta-se sob a forma de carcinoma espinocelular (CEC), responsável por cerca de 80% dos casos. O carcinoma (sarcomatoide) de células fusiformes (CSCF) é um tipo incomum de CEC, compreendendo até 3% de todos os casos. A falta de sintomas característicos e achados imagiológicos específicos pode levar a erros diagnósticos pré-operatórios. Além disso, as características clinico-patológicas, o tratamento, os fatores prognósticos e o mecanismo da MT ainda não são bem compreendidos devido à raridade de tais tumores, principalmente em mulheres em idade reprodutiva. Os autores apresentam um caso de uma paciente de 34 anos com 14 semanas de gestação que foi diagnosticada comumamassa anexial sugestiva de teratoma do ovário. A anexectomia laparoscópica foi realizada após 6 meses do parto, e o exame histológico revelou um CEC sarcomatoide tendo como origem um MCT.

Dolor pélvico crónico secundario a síndrome de congestión pélvica: resultados del tratamiento endovascular de la insuficiencia venosa pelviana y várices genitales / Embolization of insufficient pelvic veins for pelvic congestion syndrome: analysis of 17 cases

Background: Pelvic venous insufficiency may cause pelvic congestion syndrome that is characterized by chronic pelvic pain exacerbated by prolonged standing, sexual activity or menstrual cycle. It may be treated by embolizing the dysfunctional pelvic venous drainage and sometimes resecting vulvar, perineal and thigh varices. Aim: To assess the results of embolization of insufficient pelvic or ovarian veins on pelvic congestion syndrome. Material and Methods: Analysis of 17 female patients aged 32 to 53 years, who underwent subjected to a selective coil embolization of insufficient pelvic and/or ovarian veins through the jugular, basilic or cephalic veins. In the preoperative period, all patients had a lower extremity venous duplex pelvic ultrasound examination and some had an abdominal and pelvic CT angiogram. Results: The technical success of the procedure was 100% and no complications were registered. During a 32 month follow up, no patient had symptoms of pelvic venous insufficiency or relapse of vulvar or thigh varices. Conclusions: Embolization of insufficient pelvic and ovarian veins is a safe and successful procedure for the treatment of pelvic venous insufficiency or vulvar varices.

Avaliação da reserva ovariana na predição do mau prognóstico reprodutivo: quando e como investigar / Ovarian reserve evaluation in the prediction of poor reproductive prognosis: when and how to investigate?

Muitas vezes, torna-se um grande desafio para o ginecologista a identificação daquelas com maior ou menor chance de concepção. Vários marcadores laboratoriais e ultrassonográficos, conhecidos conjuntamente como testes de avaliação da reserva ovariana, são estudados há décadas com a intenção de se buscar uma ferramenta para a predição do potencial reprodutivo. E, embora ainda se busquem os marcadores ideais para aplicação clínica, mais difícil do que os definir é definir quando eles estão indicados. Este artigo de atualização, assinado pela Comissão Nacional Especializada em Ginecologia Endócrina da Febrasgo, pretende oferecer ao leitor as ferramentas necessárias para o uso racional dos testes de avaliação da reserva ovariana no cotidiano.(AU)

Often, it becomes a great challenge for the gynecologist to identify women with a greater or lesser chance of conception. Several laboratory and ultrasound markers, known jointly as ovarian reserve evaluation tests, have been studied for decades with the intention of seeking a tool for the prediction of reproductive potential. And, while the ideal markers for clinical application are still sought, defining them is as harder as defining when they are indicated. This update article, signed by the National Specialized Committee on Gynecologic Endocrinology, Febrasgo, intends to offer the reader the necessary tools for the rational use of ovarian reserve evaluation tests in daily practice.(AU)

Evaluation of embolization for periuterine varices involving chronic pelvic pain secondary to pelvic congestion syndrome

OBJECTIVES: To evaluate the clinical response and success rate after periuterine varices embolization in patients with chronic pelvic pain secondary to pelvic congestion syndrome and to report the safety of endovascular treatment and its rate of complications. METHODS: Retrospective cohort of patients undergoing endovascular treatment of pelvic congestion syndrome in our department from January 2012 to November 2015. Data were analyzed based on patient background, imaging findings, embolized veins, rate of complications, and clinical response as indicated by the visual analog pain scale. RESULTS: We performed periuterine varices embolization in 22 patients during the study, four of which required a second embolization. Seventeen patients reported a reduction in pelvic pain after the first embolization and three patients reported a reduction in pelvic pain after the second embolization. Minor complications were observed in our patients, such as postural hypotension, postoperative pain, and venous perforation during the procedure, without clinical repercussion. CONCLUSION: Periuterine varices embolization in patients with chronic pelvic pain secondary to pelvic congestion syndrome appears to be an effective and safe technique.

Feasibility of laparoscopic cytoreduction in patients with localized recurrent epithelial ovarian cancer / 부인종양

OBJECTIVE: To assess the feasibility of laparoscopic cytoreduction in patients with localized recurrent epithelial ovarian cancer (EOC) by comparing its outcomes to those of laparotomy. METHODS: We performed retrospective analysis in 79 EOC patients who had a localized single recurrent site, as demonstrated by computed tomography (CT) scan, magnetic resonance imaging, or positron emission tomography/CT scan; had no ascites; were disease-free for 12 or more months prior; and who had undergone secondary cytoreduction (laparoscopy in 31 patients, laparotomy in 48 patients) at Samsung Medical Center between 2002 and 2013. By reviewing the electronic medical records, we investigated the patients' baseline characteristics, surgical characteristics, and surgical outcomes. RESULTS: There were no statistically significant differences between laparoscopy and laparotomy patients in terms of age, body mass index, cancer antigen 125 level, tumor type, initial stage, grade, recurrence site, type of procedures used in the secondary cytoreduction, adjuvant chemotherapy, and disease-free interval from the previous treatment. With regards to surgical outcomes, reduced operating time, shorter hospital stay, and less estimated blood loss were achieved in the laparoscopy group. Complete debulking was achieved in all cases in the laparoscopy group. CONCLUSION: The laparoscopic approach is feasible without compromising morbidity and survival in selected groups of patients with recurrent EOC. The laparoscopic approach can be a possible treatment option for recurrent EOC.

Estrus cycle monitoring of captive collared peccaries (Pecari tajacu) in semiarid conditions / Monitoramento de ciclo estral em catetos (Pecari tajacu) criados em cativeiro em condições semiáridas

Collared peccaries (Peccary tajacu) are among the most hunted species in Latin America due the appreciation of their pelt and meat. In order to optimize breeding management of captive born collared peccaries in semiarid conditions, the objective was to describe and correlate the changes in the ovarian ultrasonographic pattern, hormonal profile, vulvar appearance, and vaginal cytology during the estrus cycle in this species. During 45 days, females (n=4) were subjected each three days to blood collection destined to hormonal dosage by enzyme immunoassay (EIA). In the same occasions, evaluation of external genitalia, ovarian ultrasonography and vaginal cytology were conducted. Results are presented as means and standard deviations. According to hormonal dosage, six estrous cycles were identified as lasting 21.0 ± 5.7 days, being on average 6 days for the estrogenic phase and 15 days for the progesterone phase. Estrogen presented mean peak values of 55.6 ± 20.5 pg/mL. During the luteal phase, the high values for progesterone were 35.3 ± 4.4 ng/mL. The presence of vaginal mucus, a reddish vaginal mucosa and the separation of the vulvar lips were verified in all animals during the estrogenic peak. Through ultrasonography, ovarian follicles measuring 0.2±0.1 cm were visualized during the estrogen peak. Corpora lutea presented hyperechoic regions measuring 0.4±0.2 cm identified during luteal phase. No significant differences (P>0.05) between proportions of vaginal epithelial cells were identified when comparing estrogenic and progesterone phases. In conclusion, female collared peccaries, captive born in semiarid conditions, have an estral cycle that lasts 21.0±5.7 days, with estrous signs characterized by vulvar lips edema and hyperemic vaginal mucosa, coinciding with developed follicles and high estrogen levels.(AU)

Os catetos (Peccary tajacu) estão entre as espécies mais caçadas na América Latina devido a apreciação de seu couro e carne. No intuito de otimizar o manejo produtivo de catetos nascidos em cativeiro sob condições semiáridas, o objetivo foi descrever e correlacionar as modificações verificadas no padrão ultrassonográfico ovariano, o perfil hormonal, a aparência vulvar, e a citologia vaginal durante o ciclo estral nesta espécie. Durante 45 dias, fêmeas (n=4) foram submetidas a coleta de sangue destinado a dosagem hormonal por meio de teste imuno-enzimático (EIA). Na mesma ocasião, foram conduzidas a avaliação da genitália externa, a ultrassonografia ovariana e a citologia vaginal. Os resultados são apresentados com média e desvio padrão De acordo com a dosagem hormonal, foram identificados seis ciclos estrais, com duração 21,0±5,7 dias, sendo em média 6 dias de fase estrogênica e 15 dias de fase progesterônica. O estrógeno apresentou valores médios de pico de 55,6±20,5pg/mL. Durante a fase luteal, os valores mais altos alcançados pela progesterona foram 35,3±4,4ng/mL. A presença de muco vaginal, mucosa vaginal hiperêmica e separação dos lábios vulvares foi identificada em todos os animais durante o pique estrogênico. Por meio da ultrassonografia, folículos ovarianos medindo 0,2±0,1cm foram visualizados durante o pique estrogênico. Corpos lúteos apresentando regiões hiperecóicas medindo 0,4±0,2 cm foram identificados na fase luteal. Nenhuma diferença significativa (P>0,05) entre as proporções de células epiteliais vaginais foram identificadas quando comparadas as fases estrogênica e progesterônica. Em conclusão, fêmeas de cateto, nascidas em cativeiro sob condições semiáridas, apresentam um ciclo estral que dura 21,0±5,7 dias, com sinais de estro caracterizados por edema de lábios vulvares e hiperemia da mucosa vaginal, coincidindo com desenvolvimento de folículos ovarianos e elevados níveis de estrógeno.(AU)

Tubo-ovarian Actinomycosis: A case report with brief review of literature.

Pelvic actinomycosis is an uncommon condition, often associated with the use of intrauterine contraceptive device (IUCD). Pelvic actinomycosis is rare accounting for 3% of all human actinomycotic infections. Ovarian actinomycosis is even rarer. Here, we present a 24-year-old woman using an IUCD for 3 1 / 2 years with right-sided adnexal mass, which was diagnosed postoperatively as tubo-ovarian actinomycosis. Many times, an appropriate management is overlooked or delayed due to its non-specific and variable clinical and radiological features. Sometimes, it can even mimic an advanced pelvic malignancy. Therefore, the gynecologist should consider the possibility of this infection to spare the patient from morbidity of radical surgical procedure.

Effect of ovarian morphology on in vitro oocyte recovery and quality, and certain follicular fluid steroids hormones concentrations in ewes

The present study was conducted to investigate the effects of ovarian morphology on oocyte quantity and quality, as well as on follicular fluid steroid hormones concentrations. Fifty pairs of ovaries were collected from Barbari ewes and grouped into right, left, CL bearing and non-CL bearing ovaries. The weight, length, width and thickness of the right, left, CL bearing and non-CL bearing ovaries were recorded. The follicles were classified according to their diameter into 3 groups; small [<2mm], medium [2-4mm] and large [>4mm] follicles. Oocytes were classified according to their morphology into 3 grades; COCS [Compact cumulus oocyte complexes], POCS [Partially invested with less than three layers of cumulus cells] and DO [denuded oocyte]. The concentrations of progesterone and estradiol 17 beta in the follicular fluid were estimated. Results indicated that, dimensions of both right and left ovaries were not significantly differed. However, the ovarian dimensions as well as their weights were significantly [P < 0.05] affected by the presence of CL, being higher in the CL bearing ovary. The average number of large follicles were significantly [P < 0.05] increased in the right ovary when compared to the left one. The recovered COCs number was found to be significantly higher [P < 0.05] in the right than left ovaries. A greater number of vesicular follicles and aspirated COCS were found in the non-CL bearing ovary than in the CL bearing ovary. The non CL bearing ovaries provide larger numbers as well as higher quality of COCs when compared to CL bearing ovaries and that the former can be used to collect good quality COCs for in vitro production of sheep embryos. The progesterone concentration of follicular fluid was significantly higher in CL- and non-CL bearing ovaries [27.75 and 12.33 ng/ml; P < 0.05, respectively]. Non-CL bearing ovaries had significantly [P < 0.05] higher concentration of estradiol 17beta than those found in CL bearing ovaries [22.10 vs.8.43 pg/ml, respectively]. It can be concluded that non-CL bearing ovaries provide a higher number as well as superior quality of COCs than those obtained from ovaries bearing CL suggesting that the ovaries without CL can be used to collect good quality of COCs in view of in vitro production of sheep embryos [IVP]

Review of gray-scale ultrasonographic findings: a valuable guide to suspect adnexal torsion

To report preoperative gray-scale sonographic characteristics of adnexal Torsion. In a retrospective multi-centric study in 20 hospitals, 148 out of 3303 adnexal mass operations, proved histopathologically as Adnexal Torsion, were reviewed regarding age, involved side and gray-scale abdominal sonographic findings. Torsion occurred in 5% of benign adnexal surgeries. Mean age was 29 [SD=12], Mean mass diameter was 9 cm and they mostly revealed a cystic pattern [84%]. Free peritoneal fluid was seen in 29%. Right-sided involvement was shown in 62%. Gray-scale sonographic findings are valuable besides clinical findings to suspect adnexal Torsion

Sonographic Quantification of Ovarian Volumes in an Adult Nigeria Population

This study was conducted to establish the normal values of ovarian volumes in this locality. A convenience sample of 141 apparently and gynecologically healthy and non pregnant females was studied using transabdominal sonography. The length; width and anteroposterior dimensions of both the right and left ovaries were measured. Volumes of the ovaries were determined using the prolate ellipsoid formula. The mean ovarian volumes were found to be a 9.5cm3 and 10.cm3 for the right and left ovaries respectively. A mean ovarian volume (Right and left) was 9.9cm3. A mean (right and left) range of 5.3cm3 to 13.9cm3 was also established. Significant correlations were noted between ovarian volumes and age (r=0.93; p0.05) and between ovarian volumes and body weight (r

effect of LH and GnRH analogues on induction ovulation in Bactrian camel [Camelus bactrianus]

Ovarian follicle response and corpus luteum formation following induction of ovulation using gonadotropin-releasing hormone [GnRH] analogues and luteinizing hormone [LH] in Bactrian camel were characterized. Bactrian camels with a mature follicle [13-19.6 mm] received: 1] natural porcine LH [25 mg, IV, n = 4], 2] Buserelin [20 microg, IV, n = 4] and 3] Alarelin [25 microg, IM, n = 4]. Daily ultrasonography and blood samplings were conducted between day -3 and +15 of the experiment [day 0 = Induction of ovulation]. Data were analyzed by univariat analysis with repeated measures analysis included in the model. Following treatment, mature follicle ovulated within 2 days and a new follicle wave emerged after 2-3 days. New mature follicle reached a size of 13.5 +/- 0.14 mm by day 12. Corpus luteum was detected on day 6 and reached the maximum size of 19.73 +/- 0.81 mm on day 9. Progesterone concentration initiated to increase on day 5, reached maximum concentration on day 9 and decreased significantly on day 11. In conclusion, due to the lack of significant difference among treatment groups [P>0.05], Alarelin may be considered as a drug of choice for inducing ovulation in Bactrian camel because of its effectiveness, simple route of administration [IM vs. IV], lower price, and local availability

Assessment and protection of ovarian function in young females undergoing cytotoxic chemotherapy

Infertility with its psychological and social implications is one of the side effects of chemotherapy especially in young females with various malignant diseases. This study was conducted to assess ovarian function and test the effect of oral contraceptive pills and GnRH a[gnadotrophine releasing hormone agonist] in the protection of ovarian function in cancer cases. Fifty seven young female patients with early stages of malignant diseases were enrolled in this study. Their age ranged between 20-35 years. All patients received alkylating agent based chemotherapy as a chemotherapy for their disease. They were divided into 3 groups. Group [1] included 15 patients who received GnRH agonist 3.6 mg IM monthly. Group [2] included 18 patients who received oral contraceptive pills continuously for the entire duration of the their chemotherapy cycles Group [3] included 24 cases received only chemotherapy. Pre and 6 months post chemotherapy serum hormonal assay which included FSH, estradiol [E2], anti mullerian hormones [AMH], and inhibin-B were carried out for all patients. Ultrasound ovaries was also done. Analysis of the results showed that the use of either GnRH agonist or oral contraceptive pills almost equally helps in the protection of ovarian function in young female patients receiving alkylating agent based regimen. But contraceptive pills are significantly less costly in comparison to GnRH agonists. However, in spite of the apparent short term benefits of these drugs in preserving gonadal function, the hormone derangement which was noticed post chemotherapy may cause premature ovarian failure. The hormonal study AMH and lnhibin-B as well as the ultrasound study to count the number of antral follicles pre and post chemotherapy, are very effective tools to evaluate the condition of the ovaries pre and post treatment

Non-interventional and interventional transvaginal ultrasound in present day infertility practice.

The diagnosis of cause and targeted management of infertility has emerged in leaps and bounds over the last few decades. Here the author has described the non-interventional (eg, vascular study in ovulation, ultrasound study in polycystic ovarian disease and other pelvic pathological conditions) and interventional transvaginal ultrasound as evident in infertility practice today. She concluded with the few points as the possible future directions in infertility management.

Sonographic findings of uterus and ovaries in normal pre- and post-menopausal women.

To investigate the significant findings of ultrasonography before hormonal replacement therapy (HRT) was given in normal pre- and post-menopausal women. Sixty eight Thai pre- and post-menopausal women with no previous HRT were recruited into the study, They were divided into 22 pre-menopausal women (group I), 28 post-menopausal women of < or = 5 years (group II) and 18 post-menopausal women of > 5 years (group III). Their mean age was 48.2, 50.2 and 57.3 years, respectively. Myoma uteri was found in 10 (45.5%), 2 (7.1%) and 1 (5.6%) in group I, II and III. There were 2 (9.1%), 3 (10.7%), 3 (16.7%) cases of ovarian tumor in these three groups respectively. The detection rate of ovaries from ultrasound was 90.7 per cent in group I, 89.1 per cent in group II and III. The corpus to cervix ratio in the three groups was 2.3, 2.4 and 2.3, respectively. Uterine volume in nulliparous and multiparous pre-menopausal women was 56.6 ml and 74.2 ml, but in group II and III were 60.1 ml and 37.1 ml respectively. Endometrial thickness was significantly different in group I, II and III (7.2, 4 and 2.9 mm.) Left and right ovarian volume of group I was significantly larger than that of group II and group III. In conclusion, the ultrasonography is highly recommended to detect uterine and ovarian abnormalities before HRT is given in pre- and post-menopausal women.

Transvaginal ultrasound - guided needle aspiration of ovarian cysts

The aim of this work was to try the therapeutic ultrasound guided transvaginal approach using this technique. Six premenopausal women with the age range of 15-35 years all having simple unilateral ovarian cysts were subjected to transvaginal US guided total fine needle [22 G] aspiration. Certain criteria were established for the selection of the cases including premenopausal age, clear content and thin wall of the cysts with no solid component. The procedure was carried out in the theater under i.v. Analgesia with the needle mounted to the intravaginal probe using a special device. The total time of the procedure was 15 minutes. The procedure was well-tolerated by all the patients. Prophylactic hospital stay was 24 hours. Cytological examination of the aspirate was follicular cyst in three cases and corpus luteum cyst in the other three. Only one out of five cases showed recurrent cyst in a period of three months follow up. It was concluded that, when certain criteria for selection of the cases are fulfilled, the transvaginal approach for US-guided therapeutic needle aspiration of ovarian cysts is a safe and useful therapeutic alternative to reduce the number of laparotomies performed in these cases