Journal of Reproductive Medicine

No abstract text is available yet for this article.

Background: In modern gynecology an intrauterine device (IUD) with levonorgestrel is often used as a method of contraception. The levonorgestrel-releasing intrauterine system is small and T-shaped. In Slovenia, only a gynecologist may insert it. CASES: We present 2 clinical cases in which, despite strong evidence that no perforation had occurred during insertion, the IUD was found outside the uterus. If the IUD threads are not visible or the IUD cannot be located in the uterine cavity, an X-ray of the abdomen must be performed...

Background: Renal angiomyolipomas are uncommon during pregnancy, but it is important to consider them in the differential diagnosis, for the increased risk of complications such as bleeding, renal artery compression, and renovascular hypertension. Case: A 42-year-old woman was admitted at 34 weeks of gestation for severe abdominal pain in the right flank associated with severe hypertension. During the postadmission immediate cesarean section for fetal compromise, abdominal exploration revealed a massive retroperitoneal hematoma (around 30 cm) up to the cecal region until the lower edge of the liver...

No abstract text is available yet for this article.

Background: Sarcoidosis is a multisystem inflammatory disease of unknown etiology. It is uncommon, with an incidence of approximately 16.5 per 100,000 men.1 It is characterized by noncaseating epithelioid granulomata that typically affect the chest, skin, eyes, and, much less commonly, the genital system (<0.2% of cases). Sarcoidosis can affect any of the scrotal structures, although due to its rarity, investigation of solid masses of the testes are largely targeted towards excluding either a malignant or infective etiology...

Background: Cesarean section is the most frequently performed obstetrics operation. It can be associated with short- and long-term risks, one of which is uterine scar dehiscence. Women with uterine scar dehiscence often fear pregnancy because they are advised it may increase the risk of uterine rupture. It is generally recommended that women undergo transvaginal or laparoscopic repair of the uterine dehiscence before any future pregnancies. Case: A 32-year-old woman with a previous transverse lower-segment cesarean section complicated by severe uterine dehiscence, diagnosed by MRI before pregnancy, was treated with expectant management during a subsequent pregnancy...

Background: Fetoscopic laser coagulation of the placental anastomoses is the standard treatment for twin-to-twin transfusion syndrome (TTTS). Despite certain improvements in fetoscopic technique, every fourth fetoscopic procedure is still complicated by preterm premature rupture of membranes, leading to ascending infection, fetal demise, and/or preterm delivery. re-TTTS occurs after fetoscopy in 2–14% of cases, impairing the outcome. Case: A 26-year-old woman underwent laser coagulation of placental anastomoses because of stage III TTTS at 21/6 weeks of gestation...

Background: Heterotopic pregnancy is defined as the simultaneous presence of 2 or more pregnancies at different implantation sites, most commonly one intrauterine and one ectopic. Triplet heterotopic pregnancy refers to the presence of specifically 3 concurrent gestations with at least 1 being abnormally implanted. Heterotopic pregnancy is a potentially life-threatening condition that requires thorough diagnostic workup and prompt intervention. Case: We report the fourth case of triplet heterotopic pregnancy after ovarian stimulation with gonadotropins...

Objective: To evaluate the association between leptin level, adiponectin level, gestational weight gain, maternal constitutional factors, and the weights at birth and at 1 year of age in infants born to women with gestational diabetes mellitus (GDM). Study Design: Fifty-one women with GDM were recruited from June 2011 to September 2011. Leptin and adiponectin levels in maternal and cord blood were measured and their correlations with infant’s birth weight and weight after 1 year were evaluated using Pearson correlation analysis...

Objective: To compare the distribution of proopiomelanocortin (POMC) in decidua and placenta samples from missed abortion and voluntary termination cases in order to research the effects in the etiology of missed abortion. Study Design: Decidual materials were collected from patients who were diagnosed with missed abortion (n=19) and legal voluntary termination cases (n=15) under 10 gestational weeks. Materials were divided into 2 groups for examination. For all samples, POMC primary antibody was performed by immunohistochemical staining...

Objective: To describe the relationship between severe diminished ovarian reserve (DOR) and assisted reproductive technology outcomes. Study Design: Retrospective cohort including all United States’ fertility centers reporting to the CDC National ART Surveillance System, 2004–2012. Among women aged <41 (504,266 fresh autologous IVF cycles), we calculated cancellation rate/cycle and pregnancy rate/transfer, stratified by age, by maximum follicle-stimulating hormone (FSH)...

Objective: To review the clinicopathological characteristics, diagnosis, and treatment of tubal gestational trophoblastic disease (GTD) misdiagnosed as tubal pregnancy. Study Design: From January 1, 2004, to December 31, 2013, a total of 619 patients with GTD were recorded at the Obstetrics and Gynecology Hospital of Fudan University. Among them, 4 cases of tubal GTD were initially misdiagnosed as tubal pregnancies. We retrospectively analyzed the clinicopathologic characteristics, diagnosis, treatment, and prognosis of those 4 patients...

Objective: To evaluate the effects of estradiol on endometrial regeneration and stromal fibrosis after endometrial curettage. Study Design: This is an experimental, prospective study. Combining ovariectomized rabbits and different doses of estrogen replacement, we divided 33 female rabbits into 4 groups: control, low estrogen, moderate estrogen, and high estrogen. Hematoxylin-eosin staining and Masson’s trichrome staining were used to assess the regeneration of endometrial glands and the degree of stromal fibrosis...

Objective: To compare the uterine transverse diameter (UTD) in women with normal uteri and women with uterine canalization defects as well as to assess its performance for ruling out such defects. Study Design: Retrospective analysis of prospectively collected data in a series of selected women with primary or secondary infertility. Measurement of UTD and 3D volume acquisition for subsequent off-line analysis was performed in order to identify possible canalization defects...

Objective: To examine the cost benefit of performing hysteroscopic polypectomy (HP) in infertile women with endometrial polyp(s) before controlled ovarian hyperstimulation with intrauterine insemination (COH/IUI). Study Design: Decision analytic model comparing costs and clinical outcomes. Results: HP and COH/IUI costs ranged from $537–$12,530 and $800–$7,600, respectively. Performing an HP before COH/IUI lowered fertility cost by $7,652 per clinical pregnancy...

Objective: To assess the feasibility of a standardized approach to biometric measurement of the fetal frontal lobe and to construct frontal lobe growth trajectories throughout gestation. Study Design: A sonographic 3-dimensional (3D) volume set was obtained and measured in 101 patients between 16.1 and 33.7 gestational weeks. Measurements were obtained by 2 independent raters. To model the relationship between gestational age and each frontal lobe measurement, flexible linear regression models were fit using penalized regression splines...

Objective: To assess young women’s preferences and attitudes towards various options to create families at a time when women are increasingly postponing childbearing due to greater career focus and widespread availability of contraceptives. Study Design: Reported data were obtained from an electronic survey distributed over 6 months to approximately 7,000 females enrolled in American universities. Results: Most respondents ranked preferable childbearing modalities as follows: natural conception, assisted reproductive technologies, adoption, anonymous oocyte donation, and directed oocyte donation...

Objective: To assess the efficacy and safety of combined hysteroscopic morcellation/endometrial ablation for treating abnormal uterine bleeding (AUB). Study Design: Prospective case series from 5 U.S. gynecology clinics. Women with intrauterine polyps and/or type-0 myomas and transformed Uterine Fibroid Symptom and Health-Related Quality-of-Life (UFS-HRQoL) symptom severity score ≥47 points (100 possible) underwent hysteroscopic morcellation (MyoSure) of intrauterine pathologies before endometrial radiofrequency ablation (NovaSure)...

OBJECTIVE: While prenatal 3D ultrasonography results in improved diagnostic accuracy, no data are available on biometric assessment of the fetal frontal lobe. This study was designed to assess feasibility of a standardized approach to biometric measurement of the fetal frontal lobe and to construct frontal lobe growth trajectories throughout gestation. STUDY DESIGN: A sonographic 3D volume set was obtained and measured in 101 patients between 16.1 and 33.7 gestational weeks...

OBJECTIVE: Serendipitous Signs, Symptoms, Laboratory Parameters, and Instrumental Patterns of Amniotic Fluid Embolism: Lessons from an Analysis of Case Reports. STUDY DESIGN: Wide analysis of the case reports on AFE published from 1990 to 2014. A scoring system for quantifying the relevance was attributed to each sign, symptom, laboratory parameter, and instrumental abnormal pattern in AFE cases. Principal component rotated factor analysis was used to reduce data...