Résumé
Oocyte in vitro maturation (IVM) is an assisted reproductive technology in which oocytes are retrieved from the antral follicles of unstimulated or minimally stimulated ovaries. IVM of human oocytes has emerged as a promising procedure. This new technology has advantages over controlled ovarian stimulation such as reduction of costs, simplicity, and elimination of ovarian hyperstimulation syndrome. By elimination or reduction of gonadotropin stimulation, IVM offers eligible infertile couples a safe and convenient form of treatment, and IVM outcomes are currently comparable in safety and efficacy to those of conventional in vitro fertilization. IVM has been applied mainly in patients with polycystic ovary syndrome or ultrasound-only polycystic ovaries, but with time, the indications for IVM have expanded to other uncommon situations such as fertility preservation, as well as to normal responders. In this review, the current clinical experiences with IVM will be described.
Sujets)
Femelle , Humains , Caractéristiques familiales , Préservation de la fertilité , Fécondation in vitro , Gonadotrophines , Techniques de maturation in vitro des ovocytes , Infertilité , Ovocytes , Syndrome d'hyperstimulation ovarienne , Ovaire , Induction d'ovulation , Syndrome des ovaires polykystiques , Techniques de reproduction assistéeRésumé
OBJECTIVE: To evaluate the pregnancy outcomes of women with congenital uterine anomaly exceeding 20 weeks of gestation. METHODS: We reviewed retrospectively the birth records of the Seoul National University Hospital between January 1, 1990, and December 31, 2005. We grouped congenital uterine anomalies into five classes, namely bicornuate, didelphys, septate, arcuate, and unicornuate uterus. We compared the pregnancy outcomes with each anomaly. RESULTS: We found 106 cases of congenital uterine anomaly within a given period of time. There were 63 cases of bicornuate uterus, 19 cases of didelphys, 16 cases of septate uterus, 5 cases of arcuate uterus, and 3 cases of unicornuate uterus. The overall preterm delivery rate was 22.6% (24/106) and cesarean section rate was 74.5% (79/106). A high cesarean section rate was due to metroplasty, abnormal fetal presentation, and uterine anomaly itself. The preterm delivery rate and cesarean section rate of each uterine anomaly did not differ statistically from one another. Five fetuses were stillborn, and one fetus died after birth because of a placenta abruption. The overall take-home baby rate was 94.3% (100/106). There was no maternal mortality and only one case was suffered from postpartum bleeding. CONCLUSION: Our results suggest that the most of women with uterine anomaly exceeding 20 weeks of gestation may take their baby home.
Sujets)
Femelle , Humains , Grossesse , Grossesse , Certificats de naissance , Césarienne , Foetus , Hémorragie , Présentation foetale , Mortalité maternelle , Travail obstétrical prématuré , Parturition , Placenta , Période du postpartum , Issue de la grossesse , Études rétrospectives , Séoul , UtérusRésumé
OBJECTIVE: To evaluate one-year outcomes of tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence (SUI). METHODS: From 2002 to 2005, all patients with stress urinary incontinence undergoing the TVT procedure were enrolled in this retrospective study. All cases were diagnosed as SUI by the evidences in history, physical examination, and urodynamic study. Outcomes and post-operative complications were investigated from review of medical records and interview during post-operative follow-up. RESULTS: Totally 164 cases were enrolled in this study. The success rates (cure or improved) of two-month and one-year after the TVT procedure were 94.5% and 87.9%, and the failure rates were 5.5% and 3.0%, respectively. The follow-up loss rate in one-year was 9.1%. There was no serious complication related to the procedure in one-year follow-up. CONCLUSION: This preliminary report indicates that the TVT procedure is a safe treatment modality for female SUI. Further investigation with long term follow-up is required to estimate cumulative success rate and late complications.
Sujets)
Femelle , Humains , Études de suivi , Dossiers médicaux , Examen physique , Études rétrospectives , Bandelettes sous-urétrales , Incontinence urinaire , UrodynamiqueRésumé
Torsion of the fallopian tube is an uncommon cause for acute low abdominal pain in female that is difficult to diagnose. Because it has no pathognomonic clinical symptoms or laboratory findings, a high index of suspicion is important when there is history of pelvic pathologic conditions or surgery. The early diagnosis and surgical treatment of the disease are mandatory to preserve oviduct.