Lateralization of ovarian follicles.

BACKGROUND/AIM: To evaluate a possible lateralization of antral follicle count (AFC) based on the finding that endometriosis, if present, is more commonly found in the left hemipelvis. METHODS: We evaluated the records of 6,617 baseline ultrasounds conducted at our Reproductive Center between 2007 and 2011 in a university teaching hospital setting. We included all ultrasounds with an AFC of 1 or greater and excluded those with incomplete documentation or with ovarian cyst, including endometriotic cysts (n = 909). The main outcome measure was the comparison of the number of antral follicles between the right and left ovary. RESULTS: The number of antral follicles in the right ovary (median 18, range 15-22) was significantly higher than in the left ovary (median 16, range 13-20) among women with polycystic ovaries (PCO, AFC ≥24). Similarly, the number of antral follicles in the right ovary (median 8, range 6-10) was significantly higher than in the left ovary (median 7, range 5-9) in women with no PCO but normal ovarian reserve (AFC 10-23). CONCLUSIONS: In women with PCO and non-PCO with normal ovarian reserve, the right ovary contains a higher number of antral follicles than the left ovary.

Serum albumin levels in women with ovarian hyperstimulation syndrome with or without polycystic ovaries.

OBJECTIVE: To evaluate serum albumin levels in women with and without polycystic ovaries (PCO) before and during the development of ovarian hyperstimulation syndrome (OHSS), and to compare them with control women who did not develop OHSS. METHODS: We conducted a case-control study in a teaching hospital in which 49 women who developed OHSS after ovarian follicular stimulation for infertility were evaluated and compared with 91 control women who did not develop OHSS. The main outcome measures were levels of serum albumin, measured once in control subjects and before and after the development of OHSS in cases. RESULTS: Among women who developed OHSS, 30 had PCO and 19 others had no PCO. The mean baseline serum albumin level in women with PCO who subsequently had severe OHSS (38.8 ± 1.0 g/L) was lower than in those who developed moderate OHSS (41.8 ± 0.8 g/L) (P < 0.05) and in the control group (41.7 ± 0.4 g/L) (P < 0.03). CONCLUSION: Baseline serum albumin levels in women with PCO who subsequently develop severe OHSS are lower than in those who develop moderate OHSS or do not develop OHSS. Confirmation of these findings with a large study is needed.

Multidose methotrexate treatment of cervical pregnancy.

BACKGROUND: Cervical pregnancy is a rare form of ectopic pregnancy. The treatment ranges from medical treatment with methotrexate to hysterectomy. CASES: We report two cases of cervical pregnancy with fetal cardiac activity that were successfully treated with multidose methotrexate. CONCLUSION: Due to the possible severe complications of cervical pregnancy and its surgical management, multidose methotrexate treatment in hemodynamically stable women is an appropriate option.