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You searched for:"Luiz Eduardo Vieira Diniz"
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Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(6):311-315
DOI 10.1590/S0100-72031999000600002
Purpose: to verify the effects of the goserelin depot as GnRH agonist for hypophysis suppression, during the controlled ovarian hyperstimulation (COH) for in vitro fertilization and intrauterine embryo transfer (IVF & ET). Method: this is a prospective study of 110 cycles of 101 women. Goserelin depot was administered subcutaneously as a single dose; for some women (87 cycles) it was administered in the first phase of the menstrual cycle, and in 23 cycles it was administered in the luteal phase. The administration of menopausal gonadotropins was daily, until the identification of at least two follicles with a diameter equal to or larger than 18 mm; at this time the chorionic gonadotropin was administered and the follicular aspiration was programmed. Results: the women's age average was 36.7 years (between 23 to 42 years). The main indications for IVF & ET were: tubo-peritoneal factor (75.2%), endometriosis (10.9%), ovulatory factor (7.9%), male factor (3.0%) and unexplained infertility (3.0%). Of the total of the cycles, 28 (25.5%) cycles were cancealed. In 7 cycles (8.04%), for which goserelin depot was administered in the first phase of the menstrual cycle, it was necessary to perform the ovarian cysts aspiration before beginning the ovulation induction. On the average, 3.3 embryos were transferred for each patient (1-5 embryos per woman). Of the total of 70 embryos transferred, 16 clinical pregnancies resulted (pregnancy rate: 22.85%). Conclusion: the goserelin depot administration is a useful alternative for pituitary suppression for IVF & ET, since its results are similar to those observed in the literature, and the patient does not need to come every day to receive medication, a fact of extreme importance in a public service.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(6):311-315
DOI 10.1590/S0100-72031999000600002
Purpose: to verify the effects of the goserelin depot as GnRH agonist for hypophysis suppression, during the controlled ovarian hyperstimulation (COH) for in vitro fertilization and intrauterine embryo transfer (IVF & ET). Method: this is a prospective study of 110 cycles of 101 women. Goserelin depot was administered subcutaneously as a single dose; for some women (87 cycles) it was administered in the first phase of the menstrual cycle, and in 23 cycles it was administered in the luteal phase. The administration of menopausal gonadotropins was daily, until the identification of at least two follicles with a diameter equal to or larger than 18 mm; at this time the chorionic gonadotropin was administered and the follicular aspiration was programmed. Results: the women's age average was 36.7 years (between 23 to 42 years). The main indications for IVF & ET were: tubo-peritoneal factor (75.2%), endometriosis (10.9%), ovulatory factor (7.9%), male factor (3.0%) and unexplained infertility (3.0%). Of the total of the cycles, 28 (25.5%) cycles were cancealed. In 7 cycles (8.04%), for which goserelin depot was administered in the first phase of the menstrual cycle, it was necessary to perform the ovarian cysts aspiration before beginning the ovulation induction. On the average, 3.3 embryos were transferred for each patient (1-5 embryos per woman). Of the total of 70 embryos transferred, 16 clinical pregnancies resulted (pregnancy rate: 22.85%). Conclusion: the goserelin depot administration is a useful alternative for pituitary suppression for IVF & ET, since its results are similar to those observed in the literature, and the patient does not need to come every day to receive medication, a fact of extreme importance in a public service.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(7):519-523
DOI 10.1590/S0100-72032003000700009
PURPOSE: to analyze the accuracy of sonohysterography for the evaluation of the uterine cavity in patients with an implantation failure, at the first attempt of an in vitro fertilization cycle. METHODS: in a prospective double blind study, the authors analyzed patients previously submitted to at least one embryo transfer, who presented implantation failures. The patients were submitted to a sonohysterographic examination followed by a diagnostic hysteroscopic examination, carried out by different professionals each of whom was not aware of the results of the other. The results were recorded and only interpreted after the end of the trial. Sonohysterography was performed by the introduction of a urethral catheter 8 into the uterine cervix followed by infusion of physiological saline. The anechoic interface shown by the physiological saline can reveal abnormalities, like uterine polyps or submucosal myomas. Hysteroscopy was performed with a Karl Storz equipment, 4 mm 30º rigid telescope, and infusion of physiological saline for uterine cavity distention. RESULTS: twenty-eight of the 33 originally selected patients for this study were analyzed. Sonohysterography detected abnormalities in 8 patients, five with endometrial polyps (62.5%), two with endocervical polyps (25.0%), and one with submucosal myoma (12.5%). Hysteroscopy (gold standard) detected abnormalities in 7 patients, two with endometrial polyps (28.6%), two with cervical polyps (28.6%) and one with submucosal myoma (14.2%). Sonohysterography, when compared with diagnostic hysteroscopy, presented 71.4% sensibility, 85.7% specificity, 62.5% positive predictive value, and 90% negative predictive value of. CONCLUSION: due to its low positive predictive value, the authors suggest confirmation of the sonohysterography result by diagnostic hysteroscopy. Because sonohysterography presents a good level of specificity and a favorable low negative predictive value, the authors suggest that after a normal sonohysterography diagnostic hysteroscopy to evaluate the uterine cavity before in vitro fertlization is not necessary. This study leads to the conclusion that sonohysterography is a good screening method for the detection of polypoid lesions of the uterine cavity, which could be responsible for implantation failures in in vitro fertilization cycles.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(7):519-523
DOI 10.1590/S0100-72032003000700009
PURPOSE: to analyze the accuracy of sonohysterography for the evaluation of the uterine cavity in patients with an implantation failure, at the first attempt of an in vitro fertilization cycle. METHODS: in a prospective double blind study, the authors analyzed patients previously submitted to at least one embryo transfer, who presented implantation failures. The patients were submitted to a sonohysterographic examination followed by a diagnostic hysteroscopic examination, carried out by different professionals each of whom was not aware of the results of the other. The results were recorded and only interpreted after the end of the trial. Sonohysterography was performed by the introduction of a urethral catheter 8 into the uterine cervix followed by infusion of physiological saline. The anechoic interface shown by the physiological saline can reveal abnormalities, like uterine polyps or submucosal myomas. Hysteroscopy was performed with a Karl Storz equipment, 4 mm 30º rigid telescope, and infusion of physiological saline for uterine cavity distention. RESULTS: twenty-eight of the 33 originally selected patients for this study were analyzed. Sonohysterography detected abnormalities in 8 patients, five with endometrial polyps (62.5%), two with endocervical polyps (25.0%), and one with submucosal myoma (12.5%). Hysteroscopy (gold standard) detected abnormalities in 7 patients, two with endometrial polyps (28.6%), two with cervical polyps (28.6%) and one with submucosal myoma (14.2%). Sonohysterography, when compared with diagnostic hysteroscopy, presented 71.4% sensibility, 85.7% specificity, 62.5% positive predictive value, and 90% negative predictive value of. CONCLUSION: due to its low positive predictive value, the authors suggest confirmation of the sonohysterography result by diagnostic hysteroscopy. Because sonohysterography presents a good level of specificity and a favorable low negative predictive value, the authors suggest that after a normal sonohysterography diagnostic hysteroscopy to evaluate the uterine cavity before in vitro fertlization is not necessary. This study leads to the conclusion that sonohysterography is a good screening method for the detection of polypoid lesions of the uterine cavity, which could be responsible for implantation failures in in vitro fertilization cycles.