RESUMO
OBJECTIVES: To establish the effect of adenomyosis on IVF/ICSI outcomes in infertile patients with endometriosis who were pretreated with long-term (>/=3 months) GnRH-agonist prior to IVF/ICSI. STUDY DESIGN: Retrospective study in 74 infertile patients with surgically proven endometriosis who were treated with IVF/ICSI between January 2002 and March 2007. The diagnosis of adenomyosis was based on transvaginal ultrasound criteria. All patients were pretreated with long-term (>or=3 months) GnRH-agonist prior to IVF/ICSI. RESULTS: 90.4% of the patients were diagnosed with endometriosis rASRM stages III-IV. Adenomyosis was demonstrated in 27% of them and was predominantly located in the posterior wall of the uterus. The following IVF/ICSI outcomes were found: a mean duration of GnRH-agonist use prior to IVF/ICSI of 5.35 months (3-26); a mean dosage of FSH used of 208IU (75-450); the mean number of oocytes retrieved was 8.73 (1-30); the mean number of embryos obtained was 3.86 (0-16); the mean number of embryos transferred was 1.6; a mean fertilization rate of 43.6%; a mean implantation rate of 26.3%; a mean miscarriage rate of 24.3%; and a clinical pregnancy rate (fetal heart activity on ultrasound beyond 12 weeks of gestation) of 31.7%. No significant differences were found for any of the IVF/ICSI outcomes between women with and without adenomyosis. CONCLUSIONS: Adenomyosis had no adverse effects on IVF/ICSI outcomes in infertile women with proven endometriosis who were pretreated with long-term GnRH-agonist.
Assuntos
Endometriose/tratamento farmacológico , Fertilização in vitro , Injeções de Esperma Intracitoplásmicas , Adulto , Regulação para Baixo , Endometriose/diagnóstico por imagem , Feminino , Hormônio Liberador de Gonadotropina/agonistas , Humanos , Leuprolida/uso terapêutico , Indução da Ovulação , Hipófise/efeitos dos fármacos , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Resultado do Tratamento , UltrassonografiaRESUMO
A survey of computed tomographic (CT) findings in adrenal pathology is given based on a series of 50 patients examined over a period of 18 months. CT is an accurate non-invasive method of adrenal imaging and is the method of choice as primary radiological investigation in patients suspected of having adrenal disease or recurrent adrenal tumor.
