Managing Endometrioma to Optimize Future Fertility

Abstract Background Testicular torsion is a urological emergency and needs urgent intervention to prevent testicular loss and impaired future fertility. It is commonly seen in the neonatal and adolescent age groups. Testicular torsion can also present outside these common age groups with uncommon symptoms and signs. We report case series of patients managed at Lily Hospitals Limited, Warri, Delta State, Nigeria with atypical presentation of testicular torsion. Case Presentation The first patient was a 35-year-old male that presented with recurrent right testicular pain of 1-year duration, described as dull aching with no constitutional symptoms, physical examination findings were not pathognomonic of testicular torsion, he had scrotal exploration with right orchidectomy and left orchidopexy. The second patient was a 39-year-old male who presented with recurrent right testicular pain of 4-days duration, described as dull aching with no constitutional symptoms. Physical examination findings were not classical for testicular torsion, he had scrotal exploration with bilateral orchidopexy. Conclusion Testicular torsion although common in neonatal and adolescent age groups can also present outside these age groups with uncommon symptoms and signs, a high index of suspicion is thus invaluable in any patient presenting with testicular pain despite the age and severity to avoid missing the diagnosis as this can lead to testicular loss.

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Successful pregnancy after localized resection of perforated uterus in choriocarcinoma and a literature review

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200602001-00084 ◽

2006 ◽

Vol 16 (Suppl 1) ◽

pp. 445-448 ◽

Cited By ~ 4

Author(s):

N. Behtash ◽

S. Ansari ◽

F. Sarvi

Keyword(s):

Acute Abdominal Pain ◽

Young Patients ◽

Rare Event ◽

Myometrial Invasion ◽

Exploratory Laparotomy ◽

The Body ◽

Uterine Perforation ◽

Term Pregnancy ◽

Successful Pregnancy ◽

Future Fertility

Choriocarcinoma is an aggressive neoplasm arising in the body of the uterus. Rapid growth and myometrial invasion may be followed by uterine perforation. In this study, we present the cases of two young patients (18 and 19 years of age) with acute abdominal pain and shock, while they were under chemotherapy due to persistent trophoblastic disease. During emergent exploratory laparotomy, localized resection of uterus was performed. They had their first successful term pregnancy 5 and 4 years after surgery, respectively. Uterine perforation following choriocarcinoma is a rare event. Hysterectomy is recommended in emergency conditions, but localized resection of uterus should be considered in women who are desirous of future fertility.

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Sperm Selection Procedures for Optimizing the Outcome of ICSI in Patients with NOA

Journal of Clinical Medicine ◽

10.3390/jcm10122687 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2687

Author(s):

Kaan Aydos ◽

Oya Sena Aydos

Keyword(s):

In Vitro Selection ◽

Assisted Reproductive Technologies ◽

Reproductive Technologies ◽

Testicular Sperm Extraction ◽

Obstructive Azoospermia ◽

Sperm Retrieval ◽

Vitro Fertilization ◽

Great Hope ◽

Future Fertility

Retrieving spermatozoa from the testicles has been a great hope for patients with non-obstructive azoospermia (NOA), but relevant methods have not yet been developed to the level necessary to provide resolutions for all cases of NOA. Although performing testicular sperm extraction under microscopic magnification has increased sperm retrieval rates, in vitro selection and processing of quality sperm plays an essential role in the success of in vitro fertilization. Moreover, sperm cryopreservation is widely used in assisted reproductive technologies, whether for therapeutic purposes or for future fertility preservation. In recent years, there have been new developments using advanced technologies to freeze and preserve even very small numbers of sperm for which conventional techniques are inadequate. The present review provides an up-to-date summary of current strategies for maximizing sperm recovery from surgically obtained testicular samples and, as an extension, optimization of in vitro sperm processing techniques in the management of NOA.

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Fertility intentions among the working population of Dalian City born between 1980 and 1989

Journal of Biosocial Science ◽

10.1017/s0021932021000213 ◽

2021 ◽

pp. 1-12

Author(s):

Hongyan Qiu ◽

Qun Zhang ◽

Jin Zhang ◽

Qingshan Wang ◽

Lihong Liu ◽

...

Keyword(s):

Family Income ◽

Reproductive Behaviour ◽

Fertility Intentions ◽

Second Child ◽

Number Of Children ◽

Child Policy ◽

Future Fertility ◽

The Future ◽

Dalian City ◽

Ideal Number

Abstract In October 2015, the Chinese Government announced that the one-child policy had finally been replaced by a universal two-child policy. China’s universal two-child policy is highly significant because, for the first time in 36 years, no one in an urban city is restricted to having just one child. This cross-sectional study was conducted to explore future fertility intentions and factors influencing individual reproductive behaviour (whether to have two children) in Dalian City. A total of 1370 respondents were interviewed. The respondents’ mean ideal number of children was only 1.73, and urban respondents’ sex preference was symmetrical. A total of 19.0% of the respondents were unmarried, 64.5% were married and had childbearing experience and only 6.3% of married respondents had two children. Among the 1370 participants, 30.4% stated that they would have a second child, while 69.6% refused to have a second child in the future. Binary logistic regression analysis (Model 1) showed that the following characteristics were associated with having only one child in the future: being female, being older, having a lower education level, being born in Dalian, having a lower family income and reporting one child as the ideal number of children. Model 2 (comprising only respondents with childbearing experience) showed that respondents who were female, had a lower family income and were unable to obtain additional financial support from parents were more likely to intend to stick at one child. In addition, respondents’ ideal number of children and childbearing experiences had a significant influence on future fertility intentions. These results suggest that fertility intentions and reproductive behaviours are still below those needed for replacement level fertility in Dalian City. China’s policymakers should pay more attention to these factors (socioeconomic characteristics, economic factors, desired number of children and childbearing experiences) and try to increase individual reproductive behaviour.

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Misoprostol treatment for early pregnancy failure does not impair future fertility

Gynecological Endocrinology ◽

10.3109/09513590.2013.879855 ◽

2014 ◽

Vol 30 (4) ◽

pp. 316-319 ◽

Cited By ~ 5

Author(s):

Ilia Bord ◽

Michael Gdalevich ◽

Ravit Nahum ◽

Simion Meltcer ◽

Eyal Y. Anteby ◽

...

Keyword(s):

Early Pregnancy ◽

Pregnancy Failure ◽

Future Fertility ◽

Early Pregnancy Failure

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Cesarean Scar Pregnancy Treated by Artery Embolization Combined with Diode Laser: A Novel Approach for a Rare Disease

Medicina ◽

10.3390/medicina57050411 ◽

2021 ◽

Vol 57 (5) ◽

pp. 411

Author(s):

Felice Sorrentino ◽

Vincenzo De Feo ◽

Guglielmo Stabile ◽

Raffaele Tinelli ◽

Maurizio Nicola D’Alterio ◽

...

Keyword(s):

Diode Laser ◽

Uterine Artery Embolization ◽

Uterine Artery ◽

Artery Embolization ◽

Artery Ligation ◽

Cesarean Scar Pregnancy ◽

Cesarean Scar ◽

Dilation And Curettage ◽

Management Protocol ◽

Future Fertility

Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy which represents a consequence of a previous cesarean section. It is associated with major maternal morbidity and mortality and has potential implications on future fertility. Because of possible serious complications, CSP should be swiftly diagnosed and treated. There is no management protocol for this rare, life-threatening condition, and each patient should be evaluated individually. Several types of conservative treatment have been used to treat cesarean scar pregnancy: dilation and curettage (D&C), excision of trophoblastic tissues, local or systemic administration of methotrexate, bilateral hypogastric artery ligation, and selective uterine artery embolization with curettage and/or methotrexate administration. In our study we present a cesarean scar pregnancy of a 40-year-old woman who was treated with angiographic uterine artery embolization (UAE) followed by hysteroscopic diode laser resection. Our combined UAE–hysteroscopic laser surgery appears to offer an effective, safe, and minimally invasive surgical treatment.

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Clinical and demographical factors associated with fertility counseling in colorectal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e24047 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e24047-e24047

Author(s):

Chengwei Peng ◽

Lena Masri ◽

Stefanie Roman ◽

Scott Sherman ◽

Daniel Jacob Becker

Keyword(s):

Colorectal Cancer ◽

Rectal Cancer ◽

Univariate Analysis ◽

Cancer Center ◽

Survivorship Care ◽

Demographic Shift ◽

Curative Intent ◽

Younger Patients ◽

Future Fertility ◽

Fertility Counseling

e24047 Background: The incidence of colorectal cancer in patients younger than 50 has been increasing over the past 2 decades. This demographic shift has important implications for survivorship care, in particular regarding issues of future fertility especially in light of USPSTF’s recommendation for colorectal cancer screening to begin at 45. Although ASCO has longstanding recommendations for fertility counseling in patients with cancer, the rates of fertility counseling in younger patients with colorectal cancer are unknown. Methods: Records for new patient visits for colorectal cancer in patients younger than age 55 in a large academic cancer center between 2012 and 2019 were queried for patient demographics, disease characteristics, and documentation of fertility counseling. Associations between demographic/clinical characteristics and fertility counseling were explored. Univariate and multivariable logistical regression analyses were performed using SAS v9.4. Results: Among 194 patients who met inclusion criteria, 39.2% of patients were female, 10.4% were African American, 31.4% had rectal cancer, and 69.6% were treated with curative intent. Approximately 14.5% of patients had Medicaid insurance. Age ranged from 22-55. The overall rate of fertility counseling among all patients was 15.5%. Of these patients, 43.3% were male. In univariate analysis, age less than or equal to 40 (p < 0.01), female gender (p = 0.03) and curative intent therapy (p = 0.03) were associated with fertility counseling. These factors were again statistically significant in multivariate analysis: age < 40, female, and curative intent therapy (Table). Race, stage of cancer, insurance status, prior exposure to chemotherapy, year of diagnosis and colon vs rectal cancer were not associated with counseling. Conclusions: The rate of fertility counseling was very low among patients with colorectal cancer, and exceptionally low among men. Despite changes in the demographics of colorectal cancer, it does not appear that appropriate changes have been made in fertility counseling. Increases in fertility counseling were not seen in more recent years despite recognition of increasing incidence in younger patients. Additional studies to identify barriers to counseling and strategies to improve survivorship care are urgently needed.[Table: see text]

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Abdominopelvic Pain in Patient with Uterus Didelphys and Unilateral Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA Syndrome)

Frontiers in Emergency Medicine ◽

10.18502/fem.v5i3.5897 ◽

2021 ◽

Author(s):

Zahra Tavoli ◽

Ali Montazeri

Keyword(s):

Renal Agenesis ◽

Primary Diagnosis ◽

Case Presentation ◽

Uterus Didelphys ◽

Future Fertility ◽

History Of ◽

Ohvira Syndrome ◽

Obstructed Hemivagina ◽

Magnetic Resonance Imaging Mri

Introduction: Uterus didelphys with obstructed hemivagina associated with ipsilateral renal agenesis (OHVIRA syndrome) is a rare female urogenital malformation and delay in its diagnosis could lead to several complications. Case presentation: A 21-year-old virgin woman was admitted to the emergency department (ED) with severe abdominal pain, without fever and vaginal discharge. She reported a history of cyclic abdominopelvic pain and dysmenorrhea for 5 years. The primary diagnosis (OHVIRA syndrome) was made using ultrasonography, spiral computed tomography (CT) and magnetic resonance imaging (MRI). In addition, laparoscopy was performed to confirm diagnosis and drain hematosalpinx. Then, hysteroscopy was carried out for septum resection and catheter insertion. At one-month follow-up the ultrasonography showed normal left hemicavity of uterus associated with significant decrease in dysmenorrhea. Conclusion: Being aware of OHVIRA syndrome and clinical suspicion of this rare anomaly are essential for making a timely diagnosis, preventing complications, relieving symptoms, and preserving future fertility.

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