RESUMO
Introduction:Endometriosis is a common inflammatory disease and a major cause of infertility through various mechanisms. Materials and method: We conducted a retrospective study in infertile women with endometriosis who underwent in vitro fertilization (IVF) in order to evaluate the particularities and outcome of ovarian stimulation. Results:A total of 59 patients aged 24-40 years were included. Clinical characteristics of the studied group revealed dysmenorrhea in 66.66% of cases, previous ovarian surgery in 57.89% and primary infertility in 78.94%. The most used protocol was the short one with antagonist (64.91%), followed by the long protocol with agonist (22.80%), and Dual-stim protocol (12.28%). The number of ovarian stimulation days varied between 8-14 days. The total number of oocytes obtained ranged between 0-12. Standard IVF was performed in 40.35% of cases and FIV-ICSI in 59.64% of cases; 78.94% of patients were able to obtain an embryo and blastocysts were obtained in 42.10% of cases. All patients aged under 35 obtained at least one viable embryo. Fresh or frozen single embryo transfer was furtherly performed with a day 3 embryo or a blastocyst. Fresh embryo transfer was mainly performed with day 3 embryos (60.46%). The overall biochemical pregnancy rate in the studied lot was 35.59%. The biochemical pregnancy rate was 40% in the group of patients aged under 35 and 35.13% in the group aged over 35 years. Conclusion:Women with endometriosis are a special category of poor ovarian response mainly due to the decline in ovarian reserve and inferior IVF results are expected due to a lower number of retrieved oocytes, lower fertilization rates, poor embryo quality and altered endometrial receptivity.
RESUMO
Introduction: Oncofertility represents a new field, dedicated to patients at childbearing age who are diagnosed with a neoplasic disease and who want to have a biologic child after they complete the oncological and surgical treatment. Because of new screening and treatment methods, most patients survive the disease, but the main long-term complication remains infertility. Young women with breast cancer are candidates for preserving their fertility mostly because of the risk of chemotherapy-related infertility due to the alkylating agent, causing dose-dependent destruction of oocytes and follicular depletion and thus bringing cortical fibrosis and ovarian blood-vessel damage (1). "Prof. Dr. Panait S #226;rbu" hospital is the first medical facility in Romania which performs oncofertility procedures among breast cancer patients within the program "Newborn Oncofertility". Material and Methods: Within the program run by our hospital 21 patients (13 men and 8 women) came for fertility preservation, including 5 patients diagnosed with breast cancer. Our specialists in reproductive medicine performed ovarian stimulation and oocyte pick-up, after which the genetic material was cryopreserved. The procedure could be performed only if the patients were under 35 years old, and provided the case had been previously discussed within the tumor board and the patient had received the oncological agreement. Disscution: There was a slight predominance of breast cancer patients who addressed the clinic with a view for preserving their fertility and those who met the conditions could start the procedure immediately, without any delay when it comes to oncological or surgical treatments. There were no side effects during ovarian stimulation treatment. Oocytes or embryos were cryopreserved using the method of vitrification.
