Decrease in serum anti-Müllerian hormone level per puncture with laparoscopic ovarian drilling using ultrasonically activated device.

PURPOSE: To determine the contributing factor in infertility treatment with laparoscopic ovarian drilling (LOD) to the decrease in serum anti-Müllerian hormone (AMH) levels in patients with polycystic ovarian syndrome using an ultrasonically activated device. METHODS: A retrospective analysis was performed in 60 patients (aged 23-36 years) who received 25-120 punctures in each ovary with LOD treatment from January 2014 to December 2018. RESULTS: The mean decrease in serum AMH level per puncture with LOD was 0.07 ± 0.04 ng/ml in all 60 patients and 0.08 ± 0.04 ng/ml in patients with ≥10 ng/ml preoperative serum AMH level, which was significantly higher than in those with <10 ng/ml (0.05 ± 0.02 ng/ml). The mean decrease in serum AMH level per puncture in patients with body mass index (BMI) < 18.5 kg/m2 (0.10 ± 0.03 ng/ml) was significantly higher than in those with BMI 18.5-25 kg/m2 (0.07 ± 0.04 ng/ml) and >25 kg/m2 (0.06 ± 0.02 ng/ml). CONCLUSIONS: The mean decrease in serum AMH levels per puncture with LOD using an ultrasonically activated device depends on the preoperative serum AMH level and BMI of patients.

Characteristics of patients with subchorionic hematomas in the second trimester.

AIM: The aim of this study was to investigate the etiological characteristics of patients diagnosed with subchorionic hematoma. METHODS: A case-controlled study was performed to compare characteristics of patients and controls. Via ultrasound examination, 47 pregnant patients were found to have subchorionic hematomas and 1075 had no evidence of subchorionic hematomas (controls). In the second trimester, patients were compared with regard to endocervical Chlamydia trachomatis and other vaginal microorganisms. RESULTS: The overall incidence of subchorionic hematomas in this pregnant population was 4.2%. Maternal clinical characteristics did not differ between cases and controls. Evaluation of the vaginal flora revealed that the positive rates of coagulase-negative staphylococci (cases: 12.8%; controls: 4.1%; P<0.01) and Gardnerella vaginalis (cases: 12.8%; controls: 2.5%; P<0.001) in the cases were significantly higher than those of the controls. The negative rate of Lactobacillus in the cases was significantly higher than that of the controls (cases: 42.6%; controls: 27.6%; P<0.05). CONCLUSION: Pregnant women with subchorionic hematoma in the first trimester showed changes in vaginal flora in the second trimester, which suggests a possible association with subchorionic hematoma and vaginal flora change.