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In clinical practice, an ovarian pregnancy is considered one of the most challenging diagnoses faced by an obstetrician/gynecologist. In this article, we report a 31-year-old Asian-Pakistani female, who presented to the ObsGynae clinic with 8 weeks of amenorrhea, a positive urine pregnancy test, and very high serum ?-hCG levels. Transvaginal ultrasonography ruled out a tubal pregnancy, and the patient was sent for repeat ?-hCG levels. The patient was hemodynamically stable and displayed no characteristic signs and symptoms of an ectopic pregnancy. Upon repeat scans and ?-hCG levels, a diagnosis of ovarian ectopic pregnancy was made. The patient was managed on medication; a single dose of I/M 50 mg/m2 methotrexate was administered and the resultant decline in ?-hCG levels proved the success of conservative treatment in this case. An ovarian ectopic can present as a life-threatening condition, and a high index of suspicion can prevent morbidity as well as mortality. Ovarian pregnancy, without any alarming signs despite very high ?-hCG levels, as reported in this case, is one of the rarest clinical cases observed.
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Molar pregnancy is one of the classifications of GTD and sometimes can be associated with hyperthyroidism. The classic features are irregular vaginal bleeding, hyper emesis and large uterus for gestational age. Though incidence of uterine fibroid with pregnancy is 1% to 10% but encountered with molar pregnancy is rare. Here we reported a case of complete molar pregnancy with posterior uterine fibroid who initially presented with 3-month amenorrhea and had a complaint of spotting per vagina occasionally with ultrasonography report suggestive of molar pregnancy and post uterine fibroid with raised beta-hCG with low TSH suggestive of hyperthyroidism.
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Successfully managing an unruptured ectopic pregnancy necessitates prioritizing the preservation of fertility as the primary objective. Medical management is traditionally considered to be more successful at lower �- human chorionic gonadotropin (HCG) values. However, there is emerging evidence that successful treatment can be achieved with modification of dosage regimen in the presence of high ?-HCG value. We reported the successful management of a case of unruptured repeat ectopic pregnancy in a patient with high ?-HCG. Mrs PA is a 25-year-old G4P0+3 with previous right salpingectomy due to ruptured ectopic gestation who presented with an ultrasound diagnosis of unruptured left tubal ectopic gestation at a gestational age of 6 weeks. The pre-treatment quantitative ?-HCG level was 7066 IU/l. She had multiple dose methotrexate therapy which was well tolerated with normalization of ?-HCG levels within 44 days. Hysterosalpingography done six (6) months post-treatment demonstrated patent left fallopian tube. She subsequently had spontaneous conception of an intrauterine pregnancy 16-months post-treatment. The pregnancy was carried to term and culminated in successful delivery at term. Multiple-dose chemotherapy was successful in this patient with high ?-HCG level with no reported adverse effect.
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Objective To investigate the role of variation trend of pre-treatment blood beta human chorionic gonadotropin(β-HCG)in predicting the efficacy of tubal pregnancy(TP)treated by drug therapy.Methods Clinical data of 380 TP patients treated by drug therapy at the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2017 to June 2022 were collected.The patients were divided into 271 cases in the pure Chinese medicine(CM)treatment group(shortened as pure CM group)and 109 cases in the combination of Chinese medicine and western medicine group(shortened as combination group)according to the therapy.The relevant factors that may affect the outcomes of the therapy were analyzed,and logistic regression analysis was used for the control of confounding factors.The influences of pre-treatment β-HCG on the outcomes of TP treated by various therapies were investigated,and the value of variation trend of pre-treatment β-HCG in predicting the efficacy of TP treated by drug therapy was assessed using the receiver operating characteristic curve(ROC curve).Results(1)The results of univariate analysis showed that the initial value of blood β-HCG,the variation trend of β-HCG and the difference value of β-HCG detected for 2 times before treatment were correlated with the treatment outcomes in the pure CM group and the combination group,and the differences were all statistically significant(P＜0.05 or P＜0.01).(2)The results of multivariate regression analysis showed that in the pure CM group,the blood β-HCG values and the variation trend of β-HCG detected for 2 times before treatment were correlated with the treatment outcomes,and the differences were all statistically significant(P＜0.05 or P＜0.01);in the combination group,the menopausal time and blood β-HCG value detected at the second time before treatment were correlated with the treatment outcomes,and the differences were all statistically significant(P＜0.05).(3)After controlling for the confounding factors,the variation trend of pre-treatment β-HCG in the pure CM group was correlated with the treatment outcomes,and the difference was statistically significant(OR=3.35,95%CI being 1.69-6.65,P = 0.001).However,the variation trend of pre-treatment β-HCG in the combination group did not affect the treatment outcomes,and the difference was not statistically significant(P＞0.05).(4)The ROC curve analysis showed that the area under the curve(AUC)in the pure CM group was 0.74,the cutoff value was-0.14,the sensitivity was 71.3%and the specificity was 67.8%.The AUC in the combination group was 0.67,the cutoff value was 0.10,the sensitivity was 73.6%and the specificity was 60.7%.Conclusion The variation trend of pre-treatment blood β-HCG can effectively predict the efficacy of Chinese medicine for the treatment of TP,but has no value for predicting the efficacy of the combination of Chinese medicine and western medicine in treating TP.The variation value of pre-treatment blood β-HCG can be used as a valuable reference indicator for the early prediction of the outcomes of TP treated by drug therapy.
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Abstract Aim miR-141-5p expression in patients with Early Spontaneous Abortion (ESA) and its correlation with hormone levels during pregnancy were investigated. Methods A total of 70 pregnant women with ESA were selected as the research group, and 70 normal pregnant women who chose abortion for non-medical reasons were selected as the Con group. Serum β-HCG, Progesterone (P), and Estrogen (E2) were detected by enzyme-linked immunosorbent assay. Differentially expressed miRNAs were screened by miRNA microarray analysis. miR-141-5p expression was detected by RT-qPCR, and its correlation with serum β-HCG, P, and E2 levels was analyzed. The diagnostic value of miR-141-5p for ESA was evaluated by the ROC curve. Results Serum β-HCG, P, and E2 were decreased and serum miR-141-5p was increased in patients with ESA. Pearson correlation analysis showed that serum β-HCG, P, and E2 levels were negatively correlated with miR-141-5p expression levels. ROC curve showed that miR-141-5p had a diagnostic value for ESA. Conclusions miR-141-5p is related to hormone levels during pregnancy and is expected to become a new candidate diagnostic marker for ESA.
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Abstract Background: Aortic Dissection (AD) is a vascular disease with a high mortality rate and limited treatment strategies. The current research analyzed the function and regulatory mechanism of lncRNA HCG18 in AD. Methods: HCG18, miR-103a-3p, and HMGA2 levels in the aortic tissue of AD patients were examined by RT-qPCR. After transfection with relevant plasmids, the proliferation of rat aortic Vascular Smoothing Muscle Cells (VSMCs) was detected by CCK-8 and colony formation assay, Bcl-2 and Bax was measured by Western blot, and apoptosis was checked by flow cytometry. Then, the targeting relationship between miR-103a-3p and HCG18 or HMGA2 was verified by bioinformation website analysis and dual luciferase reporter assay. Finally, the effect of HCG18 was verified in an AD rat model induced by β-aminopropionitrile. Results: HCG18 and HMGA2 were upregulated and miR-103a-3p was downregulated in the aortic tissues of AD patients. Downregulating HCG18 or upregulating miR-103a-3p enhanced the proliferation of VSMCs and limited cell apoptosis. HCG18 promoted HMGA2 expression by competing with miR-103a-3p and restoring HMGA2 could impair the effect of HCG18 downregulation or miR-103a-3p upregulation in mediating the proliferation and apo-ptosis of VSMCs. In addition, down-regulation of HCG18 could improve the pathological injury of the aorta in AD rats. Conclusion: HCG18 reduces proliferation and induces apoptosis of VSMCs through the miR-103a-3p/HMGA2 axis, thus aggravating AD.
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Ectopic pregnancies comprise 1-2% of all the first trimester pregnancies. Out of this, 95% are tubal in origin and only 5% are non-tubal. We report a rare type of intramyometrial ectopic pregnancy for which less than 50 cases have been reported so far. A case of intramyometrial pregnancy in 35-year-old primigravida with no previous history of uterine trauma, which is thought to be the main culprit behind its pathophysiology. Effective management in this case preserved the uterus for future pregnancies. Follow up was done till ?- HCG levels returned to undetectable state.
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Background: Hypertensive disorders of pregnancy pose significant risks to maternal and fetal health, contributing to global morbidity and mortality. Despite extensive research, these disorders remain a public health concern, necessitating the identification and prediction of associated risks for effective prevention and management.Methods: A prospective observational study was conducted in a hospital setting, involving 200 antenatal women visiting the Department of Obstetrics and Gynecology for routine checkups over a six-month period. Sample size calculation was based on expected sensitivity and prevalence rates. Inclusion criteria were defined, and clinical examinations were performed on the participants.Results: Higher serum ?-HCG levels were significantly associated with hypertensive disorders of pregnancy. Low levels correlated with 12 out of 122 cases, while high levels correlated with 59 out of 78 cases. Two deaths were linked to hypertensive disorders. Age did not show a significant association, but variations were observed among religious groups.Conclusions: This study concludes that higher serum ?-HCG levels are significantly associated with the development of hypertensive disorders of pregnancy. Age did not show a significant association with these disorders, suggesting the involvement of other contributing factors. The findings provide valuable insights for clinical management and further research in this field, contributing to a better understanding of the etiology and predictors of hypertensive disorders of pregnancy.
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Background: Hypertensive disorders of pregnancy pose significant risks to maternal and fetal health, contributing to global morbidity and mortality. Despite extensive research, these disorders remain a public health concern, necessitating the identification and prediction of associated risks for effective prevention and management.Methods: A prospective observational study was conducted in a hospital setting, involving 200 antenatal women visiting the Department of Obstetrics and Gynecology for routine checkups over a six-month period. Sample size calculation was based on expected sensitivity and prevalence rates. Inclusion criteria were defined, and clinical examinations were performed on the participants.Results: Higher serum ?-HCG levels were significantly associated with hypertensive disorders of pregnancy. Low levels correlated with 12 out of 122 cases, while high levels correlated with 59 out of 78 cases. Two deaths were linked to hypertensive disorders. Age did not show a significant association, but variations were observed among religious groups.Conclusions: This study concludes that higher serum ?-HCG levels are significantly associated with the development of hypertensive disorders of pregnancy. Age did not show a significant association with these disorders, suggesting the involvement of other contributing factors. The findings provide valuable insights for clinical management and further research in this field, contributing to a better understanding of the etiology and predictors of hypertensive disorders of pregnancy.
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Background: Preeclampsia with or without severe symptoms, chronic hypertension with or without superimposed pre-eclampsia/eclampsia, gestational hypertension, HELLP syndrome, or eclampsia all pose a significant risk of morbidity for both the mother and the unborn child. The aim of this study was to investigate if the albumin-to-creatinine ratio in urine spots and the serum beta-hCG level correlate with the hypertensive illness of pregnancy.”Method: “The current inquiry was conducted during the months of October 2020 and August 2022 at the obstetrics and gynaecology department of Subharti medical college in Meerut, Uttar Pradesh. The study was not open to women who were more than 20 weeks pregnant, had gestational diabetes mellitus, had more than one pregnancy, had chronic hypertension, chronic renal disease, chronic liver disease, cardiac disease, systemic lupus erythematosus, or haematological illnesses. We measured the levels of serum beta hCG and the urine albumin-creatinine ratio, and we compared them between the groups.”Results: After ensuring that each participant had given their informed permission, the trial comprised a total of 200 patients. In the hypertensive group of the participants in the study, 31% were between the ages of 21 and 35, and 29% were less than 20 years old. With increased beta hCG and UACR, there was a higher incidence of hypertensive retinopathy, acute renal failure, DIC, and PPH among the patients, as well as the poorest fetal outcomes. (p<0.05)Conclusions: The presence of a substantial relationship between hypertensive diseases and raised levels of beta-hCG during pregnancy, as well as a greater ratio of urine albumin to creatinine. There is a considerable increase in the incidence of fetal growth retardation, preterm, and mortality occurring within the uterus among mothers who have higher levels of beta-hCG and urine ACR.
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Background: Prenatal detection of genetic abnormalities is one of the biggest challenges of current fetal medicine. Prenatal screening for chromosomal abnormalities can be done using biochemical tests. The screening is a risk estimation test and not a diagnostic test.Methods: Statistical data treatment had been performed on a sample of 362 pregnant women for prenatal screening. This was a retrospective data analysis study undertaken at the National Reference Laboratory, Redcliffe Labs.Results: Nine (2.48%) women out of 362 were screen positive for chromosomopathy. The point biserial correlation between variables (Free ?-hCG - Free Beta Human Chorionic Gonadotrophin, PAPP-A- pregnancy associated plasma protein-A and NT-(nuchal translucency) amongst patients with positive and negative screen test was statistically significant. There was a positive correlation between positive screen for chromosomopathy and hCG, MoM, NT MoM whereas a negative correlation between them and PAPP-A. This study indicates that higher values of hCG and lower values of PAPP-A MoM as seen in the positive screen patients is associated with a significant risk of chromosomopathy. A positive correlation between age and screen positive cases was seen. The McNemar’s test indicated a significant reduction in screen positive cases when biomarkers were added to screen for Trisomy 21 in women aged >35 years (n=86). 81 women eventually screened negative.Conclusions: The analyses stresses on the importance of using state-of-the-art, prenatal noninvasive screening software to help provide a predictive outcome, individualized for that pregnant woman.
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Background: Gestational trophoblastic diseases (GTD) consist of a group of neoplastic disorders arising from placental trophoblastic tissue after normal or abnormal fertilization. The WHO classification of GTD includes hydatidiform mole, invasive mole, choriocarcinoma, placental site trophoblastic tumor, and miscellaneous and unclassified trophoblastic lesions. This study aimed to analyze the risk factors related to the gestational trophoblastic disease. Material & Methods: This prospective study was conducted at the Department of Obstetrics & Gynecology in Uttara Adhunik Medical College & Hospital, Dhaka, Bangladesh for 1 year; from April 2020 to March 2021. A total of 100 subjects were included in this study. Informed written consent was taken from the study subjects. Data was collected using a pre-formed data sheet. Data processing and analysis were done by using SPSS version 17. The test statistics used to analyze the data were descriptive statistics, the McNemar Chi-square test, and Repeated Measure ANOVA statistics. All patients underwent necessary investigations. All information was kept confidential and used only for this study purpose. The ethical Clearance Certificate was obtained from Bangladesh Medical College. Results: The majority of the patients were more than of 38 years age (53, 53.0%). Out of these patients, 50 (50.0%) were para one, while 40 (40.0%) were para more than four, most of the patients (63, 63.9%) were illiterate and 5 (5.0%) were graduates, most of the subjects (73, 73.0%) belonged to the low socioeconomic group. The most common presenting symptom was bleeding per vagina (35, 35.0%) followed by pain in the lower abdomen (24, 24.0%), the passage of moles (16, 16.0%), hyperemesis gravidarum (14, 14.0%) and dyspnea in 11 (11.0%) subjects. Conclusion: The disease was common in extremes of ages, low para, and grand multiparous women. The hydatidiform mole was the commonest type of trophoblastic disease in these patients. The most common presenting complaint was bleeding per vagina followed by pain in the lower abdomen. The hydatidiform mole was diagnosed in 65 (65.0%) patients, the invasive mole in 28 subjects (28.0%), and choriocarcinoma in 7 (7.0%) patients. No patient had a placental site trophoblastic tumor.
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Background: Pregnancy-induced hypertension occurs in approximately 3 to 5% of pregnancies and is still a major cause of both fetal and maternal morbidity and mortality worldwide. Pre-eclampsia is risk factor for stillbirth, intrauterine growth restriction (IUGR), low birth weight (LBW), preterm delivery, respiratory distress syndrome, and admission to neonatal intensive care unit. Overall, the incidence of preeclampsia ranges from 5 to 15% in India. This study conducted to assess the predictive value of raised beta-human chorionic gonadotropin (?-hCG) levels in development of pregnancy-induced hypertension in antenatal women and follow up the risk patients and reduce both maternal and perinatal morbidity and mortality.Methods: The present study was conducted in the department of obstetrics and gynaecology, L.L.R.M Medical College and associated SVBP Hospital, Meerut during the period of January 2021 to December 2021 on 400 antenatal women with 12 to 20 weeks of gestation. Estimation of serum beta hCG level was done by enzyme linked fluorescence immunoassay. The cases were followed up in antenatal clinics, 4 weekly till 28 weeks, fortnightly up to 34 weeks and thereafter weekly till delivery for the development of PIH.Results: From the study it was found that women with elevated beta hCG values in 12-20 weeks were at increased risk of developing PIH. The sensitivity of ?-hCG for development of PIH was found to be 90%. It was found that specificity, positive predictive value (PPV), negative predictive value (NPV) of ?-hCG for development of PIH was 82%, 41.7%, 98.3% respectively. However, p value of ?-hCG for development of PIH is 0.001 which is highly significant.Conclusions: From this study we found that that measuring second trimester serum beta-hCG levels is a good predictor of pregnancy induced hypertension and showed association with elevated levels of beta hCG with development and severity of PIH, but sensitivity and positive predictive value of beta hCG are low in this study to be useful for mass screening marker on its own.
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Background: Gestational trophoblastic disease (GTD) is a group of disorders arising from abnormal trophoblastic cells. Gestational trophoblastic neoplasia (GTN) is a malignant counterpart of GTD. In the earlier era, morbidity and mortality associated with GTD was very high, 90-95% presenting with metastatic GTN in 1980抯.Methods: This is a prospective study to analyze the incidence and to identify the risk factors of post-molar GTN and to evaluate the role of Beta-hCG level as a predictive factor of post-molar GTN, conducted in the department of Obstetrics and Gynecology, Institute of Maternal and Child Health (IMCH), Government Medical College, Kozhikode, on patients attending the vesicular mole(VM) clinic. Group A (remission group - was diagnosed after 6 months of follow-up with undetectable Beta-hCG values) and Group B (post-molar GTN). The two groups were compared for identifying risk factors.Results: There were 79 cases of molar pregnancy registered in VM clinic with an incidence of 4.87/1000 deliveries. Of the 79 patients with GTD, 17 were diagnosed to have GTN during follow-up with an incidence of 21.51% of GTD. Incidence of post-molar GTN were significantly more among patients with history of previous molar pregnancy. The median Beta-hCG level at 2 weeks post-evacuation and the ratio of Beta-hCG levels at 1week to 2 weeks post-evacuation was found to be highly predictive of post-molar GTN.Conclusions: Incidence of GTD was higher compared to international studies. The ratio of post-evacuation Beta-hCG at 1 week to Beta-hCG at 2 weeks is the most reliable predictor of post-molar GTN.
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An epithelioid trophoblastic tumor (ETT) is an extremely rare gestational trophoblastic tumor. Cases of ETT present with abnormal vaginal bleeding in women of reproductive age group with marginally elevated beta human chorionic gonadotrophin (B-hCG) levels. Here, we describe a series of four patients (all were females) including histomorphology, immunoprofiles, and diagnostic difficulty of this rare entity. All cases were in their reproductive age group. The mean pre-treatment hCG level was 665.24 (mIU/mL). Microscopically, all cases had a tumor showing an epithelioid appearance arranged in large nests and sheets. Individual tumor cells were round to polygonal with abundant eosinophilic cytoplasm, with central vesicular nuclei and prominent nucleoli. Areas of hemorrhage, necrosis, and intercellular hyaline-like material deposition were identified in all cases (100%). Immunohistochemically, tumor cells in all cases showed diffuse positivity for AE1/AE3 and p63 (100%). GATA3 was available in one case (25%), which was positive in the tumor cells. In one case (25%), hPL was focally positive, and in one case (25%), it was negative. SALL4 was performed in two cases (50%) and was negative in tumor cells. The mean Ki67 labeling index was 19.2 (range 10–30%). All four patients underwent surgical intervention and were treated with hysterectomy. The mean follow-up in this series was 39.4 months (range 6–70), and all patients are alive to date with a mean survival of 32.8 months (range, 4–67).
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Invasive mole is a rare gestational trophoblastic neoplasia with proliferative trophoblast invading into myometrium or uterine vasculature. Primary management of invasive mole is chemotherapy, but hysterectomy can be performed in selective cases. In this report, we discuss two cases of invasive mole, which required surgical intervention in the form of a hysterectomy. Both patients had a favorable outcome and are in remission.
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Background: Assess the risk factors, clinical presentation and type of intervention indicated in ectopic pregnancies at American mission hospital in Bahrain. Methods: This is a retrospective cohort study conducted from August 2021 to April 2022 at American mission hospital in Bahrain. All patients (n=205) who attended the hospital from January 2017 to June 2021 with a presentation suggestive of ectopic pregnancy were extracted from the electronic medical record database and reviewed. Data was recorded on Microsoft Excel version 16.61.1 and numerical data was extrapolated into graphs and tables via IBM SPSS Statistics version 28.0.0.0 (190). Data was subjected to descriptive and stratification analysis. Results: The leading risk factor for ectopic pregnancy was previous pelvic surgery (40.4%). The most reported symptom was amenorrhea (65.9%). Risk of rupture was tripled when serum B-hCG level was elevated, rendering it the strongest predictor of rupture according to our data (95% CI=1.25, 7.19; p-value 0.0139). Majority of patients (56.4%) were treated with methotrexate with a success rate of 88.7% and 8.5% of cases were managed expectantly. Those who failed medical management or presented with rupture were treated surgically.Conclusions: Our study found B-hCG levels to be the most sensitive predictor of rupture and need for surgical intervention. Therefore, management was largely, but not exclusively, based on B-hCG levels. Majority of cases were treated medically and patients undergoing expectant management experienced no complications.
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Cesarean scar ectopic pregnancy is one of the rarest of all ectopic pregnancy increase in number of cesarean section leads to increase in number of cesarean scar ectopic pregnancy. Early diagnosis and prompt management help in reducing mortality and morbidity occuring due to scar ectopic pregnancy. We are reporting a rare case of cesarean scar ectopic pregnancy G5P3L3D1 with period of gestation 7 weeks 3 days with previous all 4 deliveries by cesarean section. Cesarean scar ectopic pregnancy are life threatening as they pose a great risk of maternal hemorrhage as the patient vital are the stable patient managed medically with injection Methotrexate
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Abstract Objective To compare the oocyte maturation rate in the treatment of in vitro fertilization (IVF) in terms of the use of human chorionic gonadotropin (hCG), agonist gonadotropin-releasing hormone (GnRH) and dual trigger and to evaluate the associated risk factors for sub-optimal maturation rates. Methods A retrospective cohort study with 856 women who underwent IVF. They performed oocyte retrieval and were classified into 3 groups (1 - hCG, 2 - GnRHagonist, 3 - dual trigger). The primary outcome was maturation rate per trigger, and the secondary outcomes were the pregnancy rate per oocyte retrieval and the correlations between low maturation rate as well as the clinical and treatment characteristics of women. Results The maturation rate was 77% in group 1; 76% in group 2, and 83% in group 3 (p=0.003). Group 2 showed women with better ovarian reserve, greater number of oocytes collected, and more mature oocytes and embryos compared with the other groups (p<0.001). The cumulative clinical pregnancy rate was no different between the groups (p=0.755). Low ovarian reserve and low doses of follicle-stimulating hormone (FSH) administered during the stimulus were associated with a higher chance of null maturation rate. Conclusion The oocyte maturation rates and IVF results were similar in all groups. Low ovarian reserve is associated with the worst treatment results.
Resumo Objetivo Comparar a taxa de maturação oocitária no tratamento de fertilização in vitro (FIV) emrelação so o uso de gonadotrofina coriônica humana (hCG), agonista de hormônio liberador de gonadotrofina (GnRH), e gatilho duplo e avaliar os fatores de risco associados a taxas de maturação subótimas. Métodos Estudo de coorte retrospectivo com 856 mulheres submetidas à FIV. Elas foram classificadas em 3 grupos (1 - hCG, 2 - GnRH agonista, 3 - gatilho duplo). O desfecho primário foi a taxa de maturação por gatilho, e os desfechos secundários foram a taxa de gravidez por recuperação de oócitos e as correlações entre a baixa taxa de maturação bem como as características clínicas e do tratamento das mulheres. Resultados A taxa de maturação foi de 77% no grupo 1; 76% no grupo 2, e 83% no grupo 3 (p=0,003). O grupo 2 apresentou mulheres com melhor reserva ovariana, maior número de oócitos coletados, oócitosmaduros, e embriões, emcomparação aos demais grupos (p<0,001). A taxa cumulativa de gravidez clínica não foi diferente entre os grupos (p=0,755). Baixa reserva ovariana e baixas doses de hormônio folículoestimulante (FSH) administradas durante o estímulo foram associadas a uma maior chance de taxa de maturação nula. Conclusão As taxas de maturação oocitárias e os resultados de FIV foram semelhantes em todos os grupos. A baixa reserva ovariana está associada aos piores resultados do tratamento.
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Humains , Femelle , Grossesse , Fécondation in vitroRÉSUMÉ
@#We report a case of a 24-year-old Filipino male who complained of general weakness, polydipsia, weight loss, bitemporal headaches, loss of libido and behavioral changes. Endocrine work-up revealed neurogenic diabetes insipidus and panhypopituitarism. Brain MRI showed multiple intracranial tumors in the left frontal lobe, pineal and suprasellar region with moderate non-communicating hydrocephalus. Intracranial mass biopsy with ventriculo-peritoneal shunting was done. Histopathology of the mass and CSF revealed a germinoma. He underwent chemoradiotherapy while on maintenance hormone replacement.