Follicular and endocrine profiles associated with different GnRH-antagonist regimens: a randomized controlled trial.

This trial assessed the impact of early initiation of gonadotrophin-releasing hormone (GnRH) antagonist on follicular and endocrine profiles compared with the fixed GnRH-antagonist protocol. Eighty-five oocyte donors were randomized to GnRH antagonist starting in the mid-luteal phase of the prestimulation cycle (degarelix-ML group), on stimulation day 1 (early follicular phase, degarelix-EF group) or day 6 (fixed protocol) (mid-follicular phase, ganirelix-MF group). Subjects in the degarelix-EF and ganirelix-MF groups received placebo in the prestimulation cycle.

Adnexal torsion: color Doppler and three-dimensional ultrasound.

Objective: To correlate preoperative ultrasound and color Doppler findings in patients with surgically proven adnexal torsion.

Materials And Methods: A 5-year retrospective study included 36 patients with acute lower abdominal and/or pelvic pain. Twenty-four patients had complete adnexal torsion followed by adnexectomy.

2D and 3D hysterosalpingo-contrast-sonography in the assessment of uterine cavity and tubal patency.

Objective: To demonstrate the diagnostic efficacy of 2D B-mode, color and pulsed Doppler Hy-Co-Sy and 3D B-mode and power Doppler Hy-Co-Sy.

Study Design And Methods: One hundred and fifty-two women were recruited into the 2D B-mode, color and pulsed Doppler Hy-Co-Sy study and 116 other women were recruited into the 3D B-mode and power Doppler Hy-Co-Sy study. We assessed the diagnostic performance (sensitivity, specificity, PPV and NPV) of 2D and 3D Hy-Co-Sy, compared to hysteroscopy, and laparoscopy and dye test in the assessment of uterine abnormalities and tubal patency, respectively.

Assessment of placental vascularization by three-dimensional power Doppler "vascular biopsy" in normal pregnancies.

Aim: To describe the evolution of placental vascularization during a normal course of gestation and the blood flow 3D power Doppler indices obtained by "placental vascular biopsy."

Methods: A prospective study was carried out on 99 normal singleton pregnancies from 14 to 40 weeks. Placental vascularization was evaluated by 3D power Doppler ("placental biopsy").

Influence of hormonal stimulation on in vitro fertilization/embryo transfer outcome.

Objective: To compare efficacy and efficiency of ovarian stimulation therapy.

Study Design: Retrospective study compares ovarian response as number of retrieved oocytes, fertilization rates, endometrial patterns, number of pregnancies and pregnancy rates to different stimulation protocols.

Results: The least number of cancelled cycles was in long protocols with buserelin.

B- and T-cells in the follicular fluid and peripheral blood of patients undergoing IVF/ET procedures.

Problem: To analyse percentage of total and memory CD27(+) B-cells and other lymphocyte subpopulations in the peripheral blood (PB) and follicular fluid (FF) of infertile married couples.

Method Of Study: Forty-eight couples from in vitro fertilization/embryo transfer (IVF/ET) programme were divided into four groups: patients with previous unsuccessful fertilization (n = 13), ectopic pregnancy (n = 8), multiple (at least three) failed IVF/ET (n = 18) and missed abortions (n = 9). Control group consisted of 15 married couples with healthy children.

Vaginal aplasia associated with anatomically and functionally normal uterus.

Maldevelopment of the vagina is usually combined with aplasia/hypoplasia of the uterus. Complete vaginal aplasia with a normally developed uterus and cervix is an extremely rare form of developmental failure. The accepted treatment for this kind of maldevelopment is hysterectomy plus creation of a neovagina.

Fetal hand movements and facial expression in normal pregnancy studied by four-dimensional sonography.

Aim: To evaluate the developmental pattern of fetal hand movements and facial activity and expression during the second and third trimester of pregnancy by four-dimensional ultrasound (4D-US).

Subjects And Methods: A total of 25 fetuses in uncomplicated pregnancies were analyzed; 15 fetuses at 13 to 16 weeks and 10 fetuses at 30 to 33 weeks of gestation were studied with abdominal 4D-US. After standard assessment in two dimensional (2D) real-time B mode, a 4D mode was switched on.

The detection of stage I ovarian cancer by three-dimensional sonography and power Doppler.

Objective: The objective was to determine the diagnostic accuracy of three-dimensional (3D) sonography and 3D power Doppler imaging, used together with standard 2D transvaginal grayscale and color/power Doppler modalities, for preoperative sonographic assessment of suspected ovarian lesions.

Methods: Five-year retrospective analysis was performed by our experts on ultrasonography and surgery on the reports from 43 referred patients with suspected stage I ovarian cancer. All patients were evaluated during the week prior to surgery at our department.

[Ultrasonography in acute pelvic pain].

Acute pelvic pain may be the manifestation of various gynecologic and non-gynecologic disorders from less alarming rupture of the follicular cyst to life threatening conditions such as rupture of ectopic pregnancy or perforation of inflamed appendix. In order to construct an algorithm for differential diagnosis we divide acute pelvic pain into gynecologic and non-gynecologic etiology, which is than subdivided into gastrointestinal and urinary causes. Appendicitis is the most common surgical emergency and should always be considered in differential diagnosis if appendix has not been removed.

Evaluation of serum CA 125 concentration before and during hormonal induced cycles as predictor of IVF/ET outcome.

Problem: To evaluate the role of CA 125 in prediction of in vitro fertilization and embryo transfer (IVF/ET) outcome.

Method Of Study: Serum CA 125 concentrations were evaluated in the spontaneous and stimulated cycles of 33 patients. CA 125 was measured using a microparticle enzyme immunoassay (MEIA) (Abbott, Diagnostics, USA).

Three-dimensional ultrasonographic ovarian measurements and in vitro fertilization outcome are related to age.

Objective: To evaluate whether the number of ovarian antral follicles, ovarian volume, and ovarian stromal blood flow change with age and to prospectively analyze whether three-dimensional ultrasonographic measurements predict ovarian response and IVF outcome.

Design: Prospective analysis.

Setting: Assisted reproductive unit.

Preoperative assessment of ovarian tumors by CA 125 measurement and transvaginal color Doppler ultrasound.

The accuracy of combined use of serum CA 125 and transvaginal color Doppler for preoperative assessment of ovarian lesions in premenopausal patients was evaluated. Seventy-six ovarian lesions were analyzed the day before surgery using transvaginal color Doppler ultrasound. On the same day, serum CA 125 was measured in each patient.

Ultrasonic assessment of the postmenopausal uterus.

Objectives: To assess the role of different forms of ultrasound in the evaluation of peri- and postmenopausal uterus.

Methods: B-mode ultrasound, colour and pulsed Doppler sonography, three-dimensional ultrasound and three-dimensional power Doppler sonography are non-invasive tools used repeatedly for assessing morphology and vascularity of the uterus and uterine lesions in peri- and postmenopausal patients.

Results: The application of transvaginal colour Doppler to the peri- and postmenopausal patients for the screening for endometrial and myometrial malignancy may be a viable option if combined with ovarian screening in the same scan.

Ultrasonic assessment of the peri- and postmenopausal ovary.

Objective: To analyze the role of B-mode ultrasound, color and power Doppler examination and three-dimensional ultrasound with and without power Doppler facilities in evaluation of the peri- and postmenopausal ovaries.

Methods: Review of the literature on ultrasonic assessment of the ovaries in postmenopausal patients.

Results: Ultrasound has assumed an increasing role in the evaluation of the peri- and postmenopausal ovaries.

In vitro fertilization in spontaneous cycles--our experience.

Objective: To study the efficacy of a simple protocol of natural cycle in vitro fertilization.

Method: A retrospective study of 59 natural treatment cycles in 37 infertile couples with previous unsuccessful attempts of conventional in vitro fertilization.

Results: In 24% of cycles, the aspiration was cancelled because of inadequate visualization of follicles or because of preterm ovulation.

Screening for uterine abnormalities by three-dimensional ultrasound improves perinatal outcome.

The main goal of our study was to assess the true incidence of surgically correctable uterine abnormalities (congenital uterine anomalies, submucous leiomyoma, endometrial polyps and intrauterine synechiae) in the infertile population attending our tertiary infertility clinic. All of the infertile patients enrolled in the study were evaluated by three-dimensional ultrasound. Another objective was to assess pregnancy rates before and after operative hysteroscopy in patients affected by uterine causes of infertility.

Events from ovulation to implantation studied by three-dimensional ultrasound.

During the last decade transvaginal color Doppler has played an important role in increasing understanding of early human development. Although our knowledge of early pregnancy development has recently improved, little is known about the most critical period of human development: between conception and implantation. Recent advances in 3D ultrasound have made studies of follicular development, ovulation and uterine receptivity more accurate.

Three-dimensional sonoembryology.

Three-dimensional (3D) ultrasound plays an important role in obstetrics, predominantly for assessing fetal anatomy. Presenting volume data in a standard anatomic orientation valuably assists both ultrasonographers and pregnant patients to recognize the anatomy more readily. Three-dimensional ultrasound is advantageous in studying normal embryonic and/or fetal development, as well as providing information for families at risk for specific congenital anomalies by confirming normality.

Three-dimensional power Doppler in study of embryonic vasculogenesis.

Three-dimensional power Doppler sonography plays an important role in obstetrics, predominantly for assessing the relationship between fetal vascular system and surrounding organs. Presenting volume data in a standard anatomic orientation is valuable for assisting both ultrasonographers and pregnant patients to recognize anatomy more readily. This investigation was designed as an observational cross-sectional study.