Comparison of the perinatal outcomes after laparoscopic myomectomy versus abdominal myomectomy.

BACKGROUND/AIMS: To compare the perinatal outcomes after laparoscopic myomectomy (LM) versus abdominal myomectomy (AM). METHODS: The medical records of 105 Japanese females who delivered after myomectomy from 2004 to 2012 at Osaka Medical College were reviewed retrospectively. RESULTS: Of the 105 females who delivered after myomectomy, 48 had undergone LM and 57 had undergone AM. There were no significant differences in the perinatal outcomes including the rates of emergency cesarean sections, preterm deliveries, placental abnormalities, pregnancy-induced hypertension, low Apgar score, non-reassuring fetal heart rate patterns, and intrauterine fetal death. No significant difference was observed in the incidence of post-partum hemorrhage. There was no uterine rupture in either group. 15 (31%) of the females who had LM were candidates for transvaginal delivery, and 14 delivered vaginally (93% success rate). In contrast, 20 (35%) of the females who had AM were candidates for transvaginal delivery, and 19 delivered vaginally (95% success rate). CONCLUSION: There were no significant differences in the perinatal outcomes between the females who had LM and AM. Moreover, both groups had a high rate of successful transvaginal delivery after selecting the appropriate candidates.

Difference in mitochondrial gene expression in granulosa cells between recombinant FSH and hMG cycles under in vitro fertilization and transfer.

PURPOSE: Examination of the mitochondrial mRNA expression in granulosa cells from an unspecified population of infertile patients to evaluate whether recombinant follicle stimulating hormone (recFSH) is more effective in producing higher quality embryo rates compared with human menopausal gonadotropin (hMG). METHOD: Thirty-nine patients who underwent the in vitro fertilization and embryo transfer program were retrospectively examined. Patients were administered recFSH (n = 18) or hMG (n = 20) in a long protocol where GnRH agonist was used. Granulosa cells were obtained during oocyte retrieval and examined for mitochondria mRNA expression ratio against GAPDH. Expressions of mitochondria mRNA were evaluated by real-time PCR analysis. RESULTS: The high-quality embryo rate in the hMG cycle was higher than in the recFSH cycle, and the total dose of hMG showed a positive correlation with the expression level of mitochondrial genes in granulosa cells. Moreover, mitochondria mRNA expression was higher in the hMG cycle than in the recFSH cycle. CONCLUSIONS: Compared with recFSH, hMG induces a higher mitochondrial gene expression ratio in granulosa cells at the time of oocyte retrieval and, therefore, may lead to higher quality embryo rates.