ABSTRACT
Background: Ovarian superovulation and increased follicle-stimulating hormone concentration for infertility treatment may be the risk factors of developed granulosa-cell tumor. The aim of this report is to introduce a case of granulosa-cell
tumor which was discovered after ovarian stimulation
Case: A 31-yr-old woman with clinical presentation of massive abdominal distention was referred to the gynecology and oncology department of an academic hospital, Mashhad University of Medical Sciences in Aug 2017. She had the history of secondary infertility and was undergoing In Vitro Fertilization protocol and ovarian stimulation, but, the cycle was canceled. The patient suffered from gradual abdominal distention one month after the end of IVF procedure despite pregnancy failure. 2-3 months after management of the ovarian hyperstimulation syndrome, investigation revealed large ovarian mass and increased tumor marker inhibin. Exploratory laparotomy was performed and revealed stage III ovarian cancer. The final pathology report indicated juvenile granulosa cell tumor. So, optimal surgical staging and cytoreductive surgery without fertility preserving were perfumed. Chemotherapy was recommended due to the advanced stage of ovarian cancer. Unfortunately, she experienced metastatic diseases in pelvic and abdomen in less than six months; and currently is receiving the second and third line chemotherapy
Conclusion: Persistent ovarian enlargement or ascites during or after infertility treatment should be carefully considered and managed
ABSTRACT
Human T-cell Lymphotrophic virus type 1 [HTLV-1] has infected more than 20 million people worldwide. Northeast of Iran, Mashhad, the capital of Razavi Khorasan Province, is endemic for HTLV-1 with a prevalence of 3% among general population. We evaluated the ICSI outcome in our program for [HTLV-1] serodiscordant couples [SDCs] with the female infected in comparison with control group. This study was performed between 2007 and 2011 in Novin Infertility Treatment Center [Mashhad, Iran]. We examined 32 ICSI cycles of HTLV-1 infected women in comparison with an age matched control group [n=62]. ICSI outcome was compared regarding fertilization rate [FR], embryo quality parameters, implantation rate [IR], clinical pregnancy rate [PR], and abortion rate [AR]. Fertilization [p=0.15], implantation [p=0.33], and pregnancy rate [p=0.12] were similar between the groups. No difference was found regarding the number of transferred embryos [on day 2 or 3] and cryopreserved embryos, multiple pregnancies, or abortion rates between the groups. Our results suggest that the embryo quality and ICSI outcome are not affected by HTLV-1 infection in serodiscordant couples. The major finding of this study is that the outcome of ICSI in HIV-I-infected patients and seronegative controls is similar.