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Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(10):599-606
DOI 10.1590/S0100-72032005001000006
PURPOSE: comparative analysis of the outcome of women with advanced pelvic endometriosis and women with tubal sterilization submitted to intracytoplasmic sperm injection (ICSI). METHODS: ninety-three infertile women, with normal menstrual cycle, without hormonal or surgical treatment during 12 months, body mass index of 20-25, ovaries with no tumors or cysts were included in the present study and divided into two groups: tubal sterilization (TUB), 39 women, and endometriosis (EDT), 54 women with III-EDT and IV-EDT, undergoing ovulatory induction using r-FSH and ICSI. Clinical and laboratorial data were compared. chi2, Fisher, Student's t, and Mann-Whitney tests were employed. RESULTS: lower estradiol levels (2,243.1 vs 1,666.3; p=0.001) and lower number of follicles per patient (16.9 vs 13.9, p=0.001) were noted in EDT group, in spite of more units of r-FSH (1,775.6 vs 1,998.6; p=0.007, for TUB and EDT, respectively). There were no differences in the rates of retrieved oocyte (69 vs 73.5%; p=0.071) as well as in normal fertilization rates (83.7 vs 81.7%; p=0.563, for TUB and EDT, respectively. However, lower number of top quality preembryos were obtained in patients from EDT group (36.5 vs 24.8%, TUB and EDT, respectively; p=0.005). Total pregnancy (41.0 vs 42.6%; p=0.950) and implantation rates (13.9 vs 14.5%; p=0.905) were not different when groups TUB and EDT were compared. CONCLUSIONS: ovaries of women from EDT group seem to be less responsive to ovulatory induction with r-FSH. EDT seems to impair the mean number of follicles and top quality preembryos with no impairment of retrieved oocyte and fertilization rates. However, once obtained, preembryos from EDT patients are able to exhibit similar implantation potential and pregnancy when compared with patients from TUB group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(10):599-606
DOI 10.1590/S0100-72032005001000006
PURPOSE: comparative analysis of the outcome of women with advanced pelvic endometriosis and women with tubal sterilization submitted to intracytoplasmic sperm injection (ICSI). METHODS: ninety-three infertile women, with normal menstrual cycle, without hormonal or surgical treatment during 12 months, body mass index of 20-25, ovaries with no tumors or cysts were included in the present study and divided into two groups: tubal sterilization (TUB), 39 women, and endometriosis (EDT), 54 women with III-EDT and IV-EDT, undergoing ovulatory induction using r-FSH and ICSI. Clinical and laboratorial data were compared. chi2, Fisher, Student's t, and Mann-Whitney tests were employed. RESULTS: lower estradiol levels (2,243.1 vs 1,666.3; p=0.001) and lower number of follicles per patient (16.9 vs 13.9, p=0.001) were noted in EDT group, in spite of more units of r-FSH (1,775.6 vs 1,998.6; p=0.007, for TUB and EDT, respectively). There were no differences in the rates of retrieved oocyte (69 vs 73.5%; p=0.071) as well as in normal fertilization rates (83.7 vs 81.7%; p=0.563, for TUB and EDT, respectively. However, lower number of top quality preembryos were obtained in patients from EDT group (36.5 vs 24.8%, TUB and EDT, respectively; p=0.005). Total pregnancy (41.0 vs 42.6%; p=0.950) and implantation rates (13.9 vs 14.5%; p=0.905) were not different when groups TUB and EDT were compared. CONCLUSIONS: ovaries of women from EDT group seem to be less responsive to ovulatory induction with r-FSH. EDT seems to impair the mean number of follicles and top quality preembryos with no impairment of retrieved oocyte and fertilization rates. However, once obtained, preembryos from EDT patients are able to exhibit similar implantation potential and pregnancy when compared with patients from TUB group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(1):53-58
DOI 10.1590/S0100-72032004000100008
PURPOSE: to correlate endometrial thickening diagnosed by ultrasonography with hysteroscopic findings in postmenopausal women. METHODS: a transversal study with hysteroscopic evaluation was performed in 121 postmenopausal women, with endometrial thickening diagnosed through transvaginal ultrasonography. In 98 women there was no history of hormonal replacement therapy, while the remaining 23 received different types of hormone; 55 patients complained of vaginal bleeding and the remaining did not present this condition. The endoscopic examinations were performed in the outpatient clinic, using a 4 mm rigid hysteroscope. For uterine cavity distention carbon dioxide (CO2) was used. Biopsy was performed in all patients, with a 3 mm Novak type curette, and the collected material was submitted to a histopathological study. RESULTS: endometrial thickening varied from 6 to 38 mm, with a mean of 10.7 ± 5.3 mm. The hysteroscopic findings were: polypoid lesion in 51 patients (42.1%); atrophic endometrium in 15 patients (12.4%); senile synechia in 15 patients (12.4%), focal thickening in 13 patients (10.7%); cerebroid lesion in 6 patients (5.0%); proliferative endometrium in 5 patients (4.1%); mucus in 5 patients (4.1%); myoma in 4 patients (3.3%); secreting endometrium in 3 patients (2.5%); endometrial hyperplasia in 3 patients (2.5%); and cystic atrophy in 1 patient (0.8%). Correlation between hysteroscopic findings and cytopathology was observed in 30 of 51 cases of polypoid lesion, in 12 of 15 cases of atrophic endometrium and in all cases in which the diagnosis of endometrial hyperplasia or adenocarcinoma was suspected. CONCLUSION: in the majority of the patients, the hysteroscopic examinations revealed that there was no genuine endometrial thickening but rather other types of lesion in the uterine cavity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(1):53-58
DOI 10.1590/S0100-72032004000100008
PURPOSE: to correlate endometrial thickening diagnosed by ultrasonography with hysteroscopic findings in postmenopausal women. METHODS: a transversal study with hysteroscopic evaluation was performed in 121 postmenopausal women, with endometrial thickening diagnosed through transvaginal ultrasonography. In 98 women there was no history of hormonal replacement therapy, while the remaining 23 received different types of hormone; 55 patients complained of vaginal bleeding and the remaining did not present this condition. The endoscopic examinations were performed in the outpatient clinic, using a 4 mm rigid hysteroscope. For uterine cavity distention carbon dioxide (CO2) was used. Biopsy was performed in all patients, with a 3 mm Novak type curette, and the collected material was submitted to a histopathological study. RESULTS: endometrial thickening varied from 6 to 38 mm, with a mean of 10.7 ± 5.3 mm. The hysteroscopic findings were: polypoid lesion in 51 patients (42.1%); atrophic endometrium in 15 patients (12.4%); senile synechia in 15 patients (12.4%), focal thickening in 13 patients (10.7%); cerebroid lesion in 6 patients (5.0%); proliferative endometrium in 5 patients (4.1%); mucus in 5 patients (4.1%); myoma in 4 patients (3.3%); secreting endometrium in 3 patients (2.5%); endometrial hyperplasia in 3 patients (2.5%); and cystic atrophy in 1 patient (0.8%). Correlation between hysteroscopic findings and cytopathology was observed in 30 of 51 cases of polypoid lesion, in 12 of 15 cases of atrophic endometrium and in all cases in which the diagnosis of endometrial hyperplasia or adenocarcinoma was suspected. CONCLUSION: in the majority of the patients, the hysteroscopic examinations revealed that there was no genuine endometrial thickening but rather other types of lesion in the uterine cavity.