[Sertoli-Leydig tumor. Clinical case]. / Tumor de Sertoli y Leydig. Caso clínico.

We report a 16 year old girl presenting with secondary amenorrhea, a history of voice coarsening, hirsutism and a body mass index of 35 kg/m2. Pelvic ultrasound and CT scans showed a retro uterine dense mass. She was operated and a left ovarian tumor was excised. Pathological examination disclosed a Sertoli-Leydig tumor.

[Severe ovarian hyperstimulation syndrome: an intensive care disease]. / El sindrome de hiperestimulación ovárica severa; una patología de cuidados intensivos.

Ovarian hyperstimulation syndrome is a severe and potentially fatal iatrogenic disease that affects 2% of women subjected to pharmacological induction of ovulation. The newest data on the clinical picture, risk factors, pathophysiology and management of this disease, are reviewed.

[Color Doppler of the utero placental territory and its relationship with the placental localization: normal and elevated resistance groups]. / Doppler color del territorio útero-placentario y su relación con la ubicación placentaria: grupos de resistencia normal y elevada.

Forty two pregnancies of gestational age between 20 and 40 weeks were studied, 26 with normal uterine artery resistance; Group A, and 16 with elevated UA resistance; Group B. Three categories of placental location were established: Type I; central, Type II; partially lateralized including uterine midline, Type III; completely lateralized not including uterine midline. A Diasonic doppler duplex color equipment was used to assess the systole/diastole ratio (s/d ratio). Five different pints of the uteroplacental vascular territory were evaluated in each patient; right and left bottom uterine artery (cervico ithsmical union), right and left top UA (laterally outstanding point of the uterine wall), and inter villous space. The results were analyzed with Statview (Macintosh) statistics software. Placental Type II, prevailed on Group A, Type III prevailed on Group B, Types II and III were predominantly located on the right side of the uterus. S/D ratio was higher in Group B than in Group A in all five sites. S/D rel was higher on left side than on right side measurements. On Group B, left placental side patients had significantly higher s/d rel on non placental uterine artery than right placental side patients. When one altered uterine Doppler flow value is found, all the uteroplacental vascular territory show a high resistance patterns. The lateral placental location patterns tend to express higher resistance values. Right lateral placental locations have even higher resistance values than left ones. The placental location classification is suggested as a screening method for detecting the group of patients in risk of having altered values of Uterine Doppler Flow Velocimetry.

[Follicular and endometrial growth profiles in stimulated cycles with clomiphene citrate]. / Perfil de crecimiento folicular y endometrial en ciclos estimulados con citrato de clomifeno.

To study follicular and endometrial growth patterns in Clomiphene Citrate (CC) stimulated cycles, 50 CC cycles of 31 infertile women with patient Fallopian Tubes, were followed, 17 spontaneous conceptional cycles of fertile women were followed as controls. The pattern of follicular growth was similar in both groups until the day before ovulation in which CC cycles showed larger follicular diameters than spontaneous ones; 23.8 +/- 3.1 mm versus 21.6 +/- 2.9 mm (p = 0.013). Follicular rupture occurred on day 16.1 +/- 2.9 in CC cycles, and on day 15.1 +/- 1.85 on spontaneous conceptional ones. This suggests that the follicle, under the influence of CC, has to reach a larger critical mass to produce enough estradiol to revert the hypothalamic blockage produced by the drug, thus permitting the preovulatory LH surge. Endometrium under CC action, was always thinner than in natural cycles. On the day of follicular rupture, the CC cycle's endometrium measured 11.1 +/- 2.02 mm and the natural cycle's endometrium measured 10.6 +/- 1.8 mm (ns). This finding could be attributed to a antiestrogenic effect of CC on the endometrium. It is concluded that cycles under CC action have different follicular and endometrial growth patterns than spontaneous conceptional cycles.