[Reccurent pregnancy loss - review]. / Opakované potrácení - prehledový clánek.

OBJECTIVE: Informative review of possible causes and therapy of habitual pregnancy loss and infertility. DESIGN: Review. SETTINGS: Department of Gynecology and Obstetrics, General Faculty Hospital of Charles University, Prague. SUBJECT AND METHOD: The repeated (habitual) loss of pregnancy is defined by three or more spontaneous abortions. Approximately 0,4 to 1% of women are affected. The pregnancy loss is more frequent in women younger than 20 and older than 35 years. The frequency of spontaneous abortions parallels the number of previous pregnancies. The causative treatment of women with recurring abortions is not available, however, it is recommended that such women are evaluated by available methods to eliminate etiological causes of repeated pregnancy losses. CONCLUSIONS: Effective therapy is possible when the diagnostic reason for repeated abortions is determined. Nevertheless, the causes leading to repeated pregnancy losses are identified only in approximately 12% of women. However, alleged and unexplained infertility, resulting in habitual pregnancy losses has a favorable prognosis.

[A relation between the polycystic ovary syndrome and the status of ovarian hyperstimulation syndrome in IVF patients after controlled hyperstimulation]. / Do jaké míry je rozvoj ovariálního hyperstimulacního syndromu v prímé souvislosti se syndromem polycystických ovarií u IVF pacientek podstupujících rízenou hyperstimulaci ovarií?

OBJECTIVE: Ovarian Hyperstimulation Syndrome (OHSS) is a severe health complication observed in some patients undergoing hormonal stimulation during IVF. Some authors present that OHSS is associated with Polycystic Ovary (PCO) and with a high count of growing follicles (more than 18) responding to FSH hyperstimulation, although none of them is sufficient to predict the onset of OHSS. The aim of this study is to analyze the association between PCOS and OHSS the Inhibin B-based TFF/SBM index. DESIGN: Retrospective analysis. SETTING: Assisted Reproduction Center, Department of Obstetrics and Gynecology, 1st Faculty of Medicine, Charles University and General Faculty Hospital in Prague, Sigma-Aldrich, Prague, Immunotech, a.s., Prague. METHODS: Serum and follicular fluid of 36 women (high responders with more than 18 growing follicles) in IVF program were collected at the day of oocyte pick up and used for analysis of Inhibin B. Age: mean 30.2 years (24-35 years, median 31.0 years), BMI: mean 22.34 (18.3-29.7, median 21.6). For every patient, the TFF/SBM index was calculated as follows: [concentration in FF] x [growing follicle count]/ [concentration in serum] x [body mass]. A distribution of the following parameters were compared: OHSS status, TFF/SBM index based on Inhibin B, growing follicle count and the incidence of PCOS. RESULTS: Values of the TFF/SBM index showed an association with the severe form of OHSS but not with the incidence of PCOS. CONCLUSION: These observations suggested that the incidence of PCOS is not associated with the development of severe form of OHSS, but may be still associated with a high count of growing follicles.

[Combined hormonal contraception in woman with persistent functional ovarian cysts--case report]. / Vyuzití nehormonálních úcinku kombinované hormonální kontracepce u pacientky s recidivujícím výskytem ovariálních cyst--kazuistika.

OBJECTIVE: This case report refers about possibilities of conservative treatment of functional ovarian cyst by oral hormonal contraception including women after hysterectomy. DESIGN: Case report. SETTINGS: Department of Gynecology and Obstetrics, First Faculty of Medicine, Charles University and General Teaching Hospital, Prague. SUBJECT AND METHOD: We present the case of patient after hysterectomy with persistent functional ovarian cysts. The case shows that low-dose hormonal contraception could protect to development of functional ovarian cysts. CONCLUSION: Generally acknowledged influence of combined hormonal contraception to risk of recurrent ovarian cysts is possible to use in the woman after hysterectomy whose do not require contraceptive effect more.

[Ovarian torsion in the first trimester gravidity after stimulation in vitro fertilization--case report]. / Torze ovaria v prvním trimestru gravidity po stimulaci v IVF-ET programu--kazuistika.

OBJECTIVE: To direct attention to ovarian torsion as one of the causes of acute gynecological disorder after ovarian stimulation in vitro fertilization in the first trimester. DESIGN: Case report. SETTINGS: Department of Gynecology and Obstetrics, First faculty of Medicine, Charles University and General Teaching Hospital, Prague. SUBJECT AND METHOD: We present the case of a pregnant patient after ovarian stimulation in vitro fertilization when delay in determining the diagnosis led to ovarectomy. CONCLUSION: Although ovarian torsion is not a frequent cause of acute abdominal pain, it should be borne in mind during the process of differential diagnosis--especially with woman after ovarian stimulation in vitro fertilization. In order to save the ovary is important to determine the diagnosis in time and carry out laparoscopy revision with detorsion of the twisted ovary. This case is intended to draw attention to the clinical characteristics and findings which accompany torsion, thus potentially reducing the time which elapses from patient admission to surgery.