Résumé
Objective: To compare outcomes among good-prognosis patients undergoing in vitro fertilization and intracytoplasmic sperm injection followed by embryo transfer (IVF/ ICSI-ET) in GnRH-agonist (GnRH-a) and GnRH-antagonist (GnRH-ant) regimens. Methods: Retrospective analysis of 434 IVF/ICSI-ET cycles performed in a private center, in women aged up to 40: GnRH-a (n = 291) and GnRH-ant (n = 143). Pregestational, gestational and perinatal outcomes were evaluated. Statistical analysis was performed by unpaired t-test, Mann-Whitney test and Fisher’s exact test. Significance was set at p < 0.05. Results: GnRH-a regimen was associated with higher amounts of total oocytes (10.7 ± 5.7 vs 9.3 ± 5.7, p < 0.001), mature oocytes (8.2 ± 4,5 vs 6.8 ± 4.4, p < 0.001) and good quality embryos transferred (1.7 ± 0.8 vs 1.5 ± 0.9; p < 0.05). Rates of fertilization, embryo implantation and live births were also higher in GnRH-a (72.8%, 27.6% and 48.8%, respectively) compared to GnRH-ant (65.3%, 14.7% and 26.6%, respectively; p < 0.0001). There were no significant differences between rates of preterm delivery or low birth weight, comparing the two groups. Conclusion: Our results suggest that the long GnRH-a regimen is the one that offers the best reproductive outcomes among in women aged up to 40 undergoing IVF/ICSI-ET.
Résumé
O tumor estromal esclerosante de ovário é uma neoplasia benigna extremamente rara, mais frequente em mulheres jovens e sem sintomas específicos na maioria dos casos. Menos de 150 casos foram descritos, dos quais 8 diagnosticados durante a gestação. Neste relato, documentamos a associação entre tumor estromal esclerosante de ovário, síndrome de Meigs e elevação dos níveis de CA-125 em gravidez a termo.
The sclerosing stromal tumor of the ovary is an extremely rare benign tumor more common in young women and without specific symptoms in most cases. Less than 150 cases have been described, of which 8 were diagnosed during pregnancy. In this report, we describe the association between sclerosing stromal tumor of the ovary, Meigs' syndrome and elevated levels of CA-125 in term pregnancy.
Sujets)
Adolescent , Femelle , Humains , Grossesse , Syndrome de Meigs/complications , Syndrome de Meigs/diagnostic , Tumeurs de l'ovaire/complications , Tumeurs de l'ovaire/diagnostic , Complications de la grossesse/diagnostic , Tumeurs des cordons sexuels et du stroma gonadique/complications , Tumeurs des cordons sexuels et du stroma gonadique/diagnostic , /sang , Syndrome de Meigs/sang , Tumeurs de l'ovaire/sang , Complications de la grossesse/sang , Tumeurs des cordons sexuels et du stroma gonadique/sangRésumé
Osteoporose é a primeira causa de fraturas com colapso do corpo vertebral, responsável por até 700 mil casos, com 150 mil internações por ano somente nos Estados Unidos. O quadro clínico é caracterizado por dor intensa, restrição à deambulação, baixa estima e depressão com limitação para as atividades diárias. Dentre as opções de tratamento destaca-se a vertebroplastia, uma técnica de acesso percutâneo ao corpo da vértebra no qual se injeta cimento acrílico. Este método é indicado no tratamento de fraturas vertebrais compressivas espontâneas secundárias à osteoporose ou a tumores vertebrais. Consiste em um procedimento cirúrgico minimamente invasivo, resultando na maioria dos casos em alívio imediato da dor e relativa estabilização vertebral