Comparing the clinical outcomes of intrauterine insemination by two different density gradient preparation methods.

BACKGROUND: Sperm preparation has play an integral part in the success of in-vitro fertilization. The aim of this study was to compare 2 different density gradient preparations for sperm separation in respect to sperm recovery, motility, motion parameters and clinical outcome after intrauterine insemination. METHODS: One-hundred and 21 women who received intrauterine insemination due to ovulation dysfunction were randomly allocated into 2 groups, using either the Percoll (Amersham, Pharmacia Biotech AB, Sweden) or the PureSperm (Nidacon, Göteborg, Sweden) density gradient method for sperm preparation. The characteristics of sperm before and after separation and the clinical outcome of intrauterine insemination were compared between the 2 groups. RESULTS: PureSperm and Percoll demonstrated comparable ability to recover the sperms with progressive motility. There was no difference in motion parameters and the number of sperm recovered with progressive motility between the Percoll and the PureSperm density gradient preparations. The clinical pregnancy rate was also comparable between the 2 groups, 12.5% (7/56) in the PureSperm group compared to 13.8% (9/65) in the Percoll group, (p > 0.05). CONCLUSIONS: Despite using different density composition and volume, PureSperm demonstrated clinical effect comparable to that of Percoll in preparing sperm for intrauterine insemination.

Multidisciplinary examination for prenatal diagnosis of posterior cervical teratoma in early second trimester.

OBJECTIVE: Cervical teratomas represent approximately 3% of all congenital teratomas, which occur in approximately 1 in 20,000-40,000 live births. In this report, we present a case of congenital posterior cervical teratoma diagnosed by a two-dimensional (2D) ultrasound in the early second trimester. CASE REPORT: A 28-year-old woman, gravid 1, para 0, came to our prenatal clinic at 20 weeks of gestation for her first prenatal visit. Results of an ultrasound revealed a fetus with multiple cystic septal mass with internally calcified spots measuring approximately 3 cm over the left fetal neck. Because no other abnormality was noted at that time, magnetic resonance imaging (MRI) and amniocentesis were scheduled on the following day. At the same time, results of a 4D ultrasound revealed the mass size to be same as that measured by the 2D ultrasound; however, the location was defined on the left posterior neck and MRI showed there was no invasion to the intracranial area. The parents opted to continue the pregnancy. In the following prenatal cares, no polyhydramnios was found and the fetal body weight was within the normal growth curve. The baby was delivered by cesarean section at 38 weeks of gestation with Apgar scores of 8 (at 1 minute) and 9 (at 5 minutes). The baby was scheduled for surgical intervention 3 days after birth. Finally, results of a pathological analysis revealed the mass to be a benign cystic teratoma. CONCLUSION: Prenatal diagnosis of cervical teratoma is very crucial, allowing early detection of masses that obstruct the airway. Therefore, a multidisciplinary examination and follow-up are recommended for early prenatal diagnosis.

Endometrioma undergoing laparoscopic ovarian cystectomy: its influence on the outcome of in vitro fertilization and embryo transfer (IVF-ET).

PURPOSE: To evaluate the effect of laparoscopic ovarian cystectomy for endometrioma on the clinical outcome of IVF treatment. METHODS: Patients who received IVF treatment were retrospectively classified into two groups. Group 1 included 95 patients who received IVF due to tubal occlusion. Group 2 included 127 patients who had received laparoscopic ovarian cystectomy for endometrioma(s) followed by IVF treatment. Clinical outcomes of IVF treatment were compared between two groups. RESULTS: More oocytes were harvested per retrieval in Group 1 than Group 2 (p < 0.05). The fertilization rate was higher in Group 1 than Group 2 (p < 0.05). Although the implantation rate was higher in Group 2 (p < 0.05), the clinical pregnancy rate revealed no statistically significant difference between the two groups. CONCLUSIONS: Women who received ovarian cystectomy for endometriomas have fewer oocytes harvested during IVF treatment. However, their chance of pregnancy was comparable to patients with tubal problems who underwent IVF treatment.