[Embryo implantation in cesarean section]. / Implantación embrionaria en cicatriz de cesárea.

BACKGROUND: Ectopic pregnancy continues to be a life threatening emergency as well as a menace to women fertility. Documented cases site tubal ectopic pregnancy as the most frequent location in 97% of cases. Being the previous cesarean scar the most rare location (< 1%), therefore, rarely reported. OBJECTIVE: To explain the process of diagnosis and treatment as well as the discussion of current modalities. CLINICAL CASE: 28 years old patient who goes to the outpatient service at Santa Rosa de Lima Hospital for presenting scarcely transvaginal stain of two days of evolution (which was detected by speculoscopy exploration) without referring pain. Transvaginal ultrasound showed 9.1 weeks of gestation pregnancy, located in the previous cesarean scar, with a heartbeat of 150 beats per minute. Subsequently, a laparotomy was preformed obtaining the product without further complications.

[Treatment of patients with endometriosis and infertility]. / Tratamiento de pacientes con endometriosis e infertilidad.

BACKGROUND: The Word Endometriosis Society estimates that 176 millions of women in the world have experienced endometriosis symptoms way before their quality of life has been compromised. Despite the advances, endometriosis continues to be a challenge for doctors nowadays. OBJECTIVE: The purpose of this article is to make an attempt to unify the foundations and theories worldwide accepted on endometriosis infertility treatment. CONCLUSION: Infertility management caused by endometriosis remains daring. Laparoscopic cystectomy for ovarian endometriomas larger than 4 cm of diameter improves fertility compared with drainage and coagulation. Those with mild disease (I and II) after surgical reconstruction can undergo ovarian stimulation with artificial insemination. At the identification of endometriosis it must be treated surgically, except in those patients that because of special circumstances (elderly, compromised pelvis, azoospermia, etc.) is advisable to appeal in vitro fertilization with embryos transference, like in advanced stages cases (III and IV).