Four distinct patterns in the ultrasonic appearance of preovulatory endometrium can be identified and described in patients undergoing stimulated cycles in an in vitro fertilization program. Ultrasonically, this endometrial response can be seen as a quantitative change in thickness and a qualitative change in gray-scale appearance or reflectivity. The application of this additional parameter of endometrial assessment together with the conventional measurement of follicular diameter as a means of optimally timing oocyte collection has been associated with a reduction in the preoperative ovulation rate from 10.9 to 3.2%, an increase in the fertilization rate from 59.2 to 82.5%, and in a pregnancy rate per embryo transfer of 20.5% in our program without the use of hormonal assays.
This report presents our experience with gamete intra-Fallopian transfer (GIFT) in cases with non-endometriotic pelvic adhesions. Two-hundred-and-eight GIFT attempts, where pelvic adhesions were identified laparoscopically in patients with no previous history of endometriosis, were subdivided into two groups: (i) post-surgical (n = 134) and (ii) non-surgical (n = 74). The extent of the adhesions was further classified according to the American Fertility Society (AFS) classification system. The overall clinical pregnancy rate was 39.4% (82 out of 208 attempts). There was no significant difference in the clinical pregnancy rate per attempt between the surgical (38.8%) and the non-surgical (40.5%) groups. A gradual, but not significant decline in the pregnancy rate was noticed from adhesion Stages I to III, but Stage IV had a significantly lower pregnancy rate (22.7%) than Stage I (47.4%). The intra-uterine pregnancy rate was observed to be higher, but not significantly, in the non-surgical (37.8%) than in the surgical (29.1%) cases. The overall ectopic pregnancy rate was 7.2% per attempt and 18.3% per clinical pregnancy. In the post-surgical group, the ectopic pregnancy rate per pregnancy was 3.5 times that in the non-surgical (23.2% versus 6.5%, respectively), and it was significantly higher in Stage IV (40%; two out of five pregnancies) than in Stage I adhesions (11.1%; three out of 27 pregnancies). In cases with a history of tubal surgery, the ectopic pregnancy rate was 33.3% (10 out of 30 pregnancies). Our results indicate that GIFT can offer a successful treatment option for selected cases with non-endometriotic pelvic adhesions.
22nd World Congress on Ultrasound in Obstetrics and Gynecology
Poster abstractswere superposition, which > 15 mm and > 10 mm were respectively in 54.93% (39/71 cases), 87.32% (62/71 cases) with endometrial cancer and in 32.85% (45/137 cases), 65.69% (90/137 cases) with endometrial hyperplasia. (2) The pathological finding and staging: 63 cases were confirmed to have type1 endometrial cancer and 8 cases with type 2 endometrial cancer, among which there were in 1 stage 77.46% (55), in 2 stage 11 cases (15.71%), in 3 stage 3 cases (4.29%) and in 4 stage 2 cases (2.86%). 66 cases of 71 resected uterus cases showed myometrial invasion (92.95%), deep myometrial invasion in 13 cases (13/71, 18.0%). In 2 stage 11 cases, which showed superficial myometrial invasion in 8 cases and deep myometrial invasion in 3 cases. In 3 stage 3 cases which showed superficial myometrial invasion. In 4 stage 2 cases, the superficial and deep myometrial invasion were respectively 1 case. Conclusions: When the Tumor confined to the corpus uteri, there exists a certain correlation between degree of myometrial invasion and staging. Once the local and/or regional spread of the tumor, the degree of myometrial invasion was not important for staging.
P02.10Abstract withdrawn.
P02.11Abstract withdrawn.
P02.12 Advances in transvaginal 3D volumetric imaging: potential clinical impact of virtual ultrasound hysteroscopy
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