[Peritoneal cyst. A case report]. / Cisti peritoneale. Caso clinico.

Cystic mesothelioma is a rare benign tumor of the abdominal and pelvic peritoneum, consisting of solitary or multiple cysts. No more than 130 cases are reported. Several risk factors such as chronic peritoneal irritation, caused by foreign bodies, infection or endometriosis, were hypothesized but the pathogenesis is still unknown. A 51-year menopausal woman was submitted to ultrasonography because of abnormal uterine bleeding. The scan revealed a right ovarian cyst (size 81 x 64 mm) with the feature of serous cyst. In the anamnesis a cystectomy of the right ovary and appendectomy were reported. At laparoscopy, then converted in laparotomy, a cyst arising from peritoneum of the posterior surface of the uterus was found. The right ovary was normal. The histopathological finding was: serous simple cyst of peritoneum. Ultrasonographic diagnosis was not confirmed by surgery; in fact, sometimes, it may be difficult to establish the origin of pelvic cystic mass, from ovary or peritoneum, by ultrasonography. It is mandatory to suggest a laparoscopy and/or laparotomy in case of pelvic cystic mass that does not regress in the time even after administration of oral contraceptives.

Artificial insemination with donor cryopreserved semen: importance of the volume of semen and influence of ovulatory dysfunctions.

The study deals with a program for artificial insemination by means of cryopreserved donor sperm, conducted at AIED (Italian Association for Demographic Education) in Rome from 1983 to 1986. Two groups of women, both having an average age of 30, and with an equal proportion of women with factors of reduced fertility, were inseminated with a different volume of cryopreserved sperm: a) 100 women were inseminated with an average number of 6.3 straws per cycle (total number of cycles 297) and 55 pregnancies were obtained (pregnancy rate = 0.185 per cycle); b) 100 women were inseminated with a lower average number of straws; 4.1 per cycle (total number of cycles 297); in this group 23 pregnancies were obtained (pregnancy rate = 0.077 per cycle). The quality of the semen, the methods for pinpointing ovulation and for depositing seminal liquid in the female genital tract were the same for the two groups. The difference between the pregnancy rate of the two groups was statistically significant (p less than 0.0001). Altogether, 50 women with ovulatory dysfunctions underwent ovulation stimulation and among these 20 conceptions were recorded. These conceptions were obtained with 47 cycles of application (average number of cycles preceding conception cycle 1.35). This value proved to be higher than that for women not undergoing stimulation (1.10). Nevertheless, the difference was not found to be statistically significant even if considered separately for the two groups treated with different volumes of semen.(ABSTRACT TRUNCATED AT 250 WORDS)

Ultrasound evaluation of the ovarian hyperstimulation syndrome.

282 cycles in 106 women going to be artificially inseminated at the AIED Center in Rome have been studied by means of ultrasound monitoring in order to evaluate the incidence of the ovarian hyperstimulation syndrome. In none of the patients, either in pharmacologically stimulated cycles (82 in 36 women) or in non stimulated cycles (200 in 70 women) moderate or severe hyperstimulation syndrome was reported. Only few mild cases occurred. In the non stimulated group only five cases with mild hyperstimulation occurred (2.5%). 31 pregnancies have been obtained (15.5% of all studied cycles). In the stimulated group 11 cases with signs of mild hyperstimulation occurred (13.4%) and 19 pregnancies were obtained (23.1%) of the stimulated cycles). No twin pregnancy was observed. The only molar pregnancy reported occurred in this group. All signs of hyperstimulation--either in stimulated cycles or in non stimulated patients--regressed spontaneously in the same cycle and anyhow they were not detected by ultrasound monitoring in the subsequent cycle.