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Abraham Golan - One of the best experts on this subject based on the ideXlab platform.

  • interstitial pregnancy management and subsequent pregnancy Outcome
    Acta Obstetricia et Gynecologica Scandinavica, 2013
    Co-Authors: Ran Keidar, Ram Kerner, Abraham Debby, Ron Sagiv, Abraham Golan
    Abstract:

    We report on management and subsequent Fertility Outcome of interstitial pregnancy in a retrospective cohort study (Canadian Task Force classification II-3) at a university affiliated teaching hospital. Of 706 women with extrauterine pregnancy, 14 consecutive women with interstitial pregnancy were treated by methotrexate, laparotomy or laparoscopy between 1997 and 2007. The first four women, with significant hemoperitoneum, were treated by laparotomy. Of the next 10 women, four were selected for medical treatment with methotrexate. Only one case was treated successfully. The other six women had laparoscopic treatment. Of nine laparoscopies, one was converted to laparotomy due to excessive blood loss during the procedure. Of nine women desiring a child, three were infertile, whereas six conceived with an intrauterine pregnancy. A change from diagnosis later in pregnancy and laparotomy to more conservative treatment, mainly by laparoscopy, suggests a possibly better subsequent pregnancy rate.

  • Laparoscopic salpingostomy versus laparoscopic local methotrexate injection in the management of unruptured ectopic gestation.
    American journal of obstetrics and gynecology, 1996
    Co-Authors: U Zilber, Moty Pansky, Ian Bukovsky, Abraham Golan
    Abstract:

    Our goal was to determine whether laparoscopic salpingostomy is preferable to laparoscopic methotrexate injection in the management of unruptured tubal gestation. Forty-eight patients with unruptured tubal pregnancy were prospectively randomized to either laparoscopic salpingostomy or laparoscopic local methotrexate injection in a university medical center. Operation time, duration of hospital stay, decrease in levels of beta-human chorionic gonadotropin, and Fertility Outcome were compared between the two groups. The salpingostomy group had a longer operative time (p < 0.0001) but a shorter hospital stay (p < 0.01) and a lower incidence of persistent trophoblastic activity (5% vs 14%), although this difference did not reach statistical significance. The time interval until beta-human chorionic gonadotropin disappearance was similar (13.9 and 13.7 days), and the subsequent intrauterine pregnancy rate was similar in the two groups (83.5% and 81%). One repeat tubal pregnancy occurred in the salpingostomy group. Both these methods of conservative management are equally effective and each one has its merits.

Sheena E M Lewis - One of the best experts on this subject based on the ideXlab platform.

  • effects of vasectomy on spermatogenesis and Fertility Outcome after testicular sperm extraction combined with icsi
    The Journal of Urology, 2006
    Co-Authors: Carmel Mcvicar, D A Oneill, Neil Mcclure, B Clements, Stephen Mccullough, Sheena E M Lewis
    Abstract:

    BACKGROUND: Each year 40 000 men have a vasectomy in the UK whilst another 2400 request a reversal to begin a second family. Sperm can now be obtained by testicular biopsy and subsequently used in assisted conception with ICSI. The study aims were to compare sperm yields of men post-vasectomy or with obstructive azoospermia (OA) of unknown aetiology with yields of fertile men and to assess any alteration in the clinical pregnancy rates after ICSI. METHODS: Testicular tissue was obtained by Trucut needle from men who had undergone a vasectomy >5 years previously or had OA from other causes and from fertile men during vasectomy. Seminiferous tubules were milked to measure sperm yields. Numbers of Sertoli cells and spermatids and thickness of the seminiferous tubule walls were assessed using quantitative computerized analysis. RESULTS and CONCLUSIONS: Sperm yields/g testis were significantly decreased in men post-vasectomy and in men with OA, relative to fertile men. Significant reductions were also observed in early (40%) and mature (29%) spermatid numbers and an increase of 31% was seen in the seminiferous tubule wall (basal membrane and collagen thickness) of vasectomized men compared with fertile men. Clinical pregnancy rates in couples who had had a vasectomy were also significantly reduced.

  • effects of vasectomy on spermatogenesis and Fertility Outcome after testicular sperm extraction combined with icsi
    Human Reproduction, 2005
    Co-Authors: Carmel Mcvicar, D A Oneill, Neil Mcclure, B Clements, Stephen Mccullough, Sheena E M Lewis
    Abstract:

    Each year 40 000 men have a vasectomy in the UK whilst another 2400 request a reversal to begin a second family. Sperm can now be obtained by testicular biopsy and subsequently used in assisted conception with ICSI. The study aims were to compare sperm yields of men post-vasectomy or with obstructive azoospermia (OA) of unknown aetiology with yields of fertile men and to assess any alteration in the clinical pregnancy rates after ICSI. Testicular tissue was obtained by Trucut needle from men who had undergone a vasectomy >5 years previously or had OA from other causes and from fertile men during vasectomy. Seminiferous tubules were milked to measure sperm yields. Numbers of Sertoli cells and spermatids and thickness of the seminiferous tubule walls were assessed using quantitative computerized analysis. Sperm yields/g testis were significantly decreased in men post-vasectomy and in men with OA relative to fertile men. Significant reductions were also observed in early (40%) and mature (29%) spermatid numbers and an increase of 31% was seen in the seminiferous tubule wall (basal membrane and collagen thickness) of vasectomized men compared with fertile men. Clinical pregnancy rates in couples who had had a vasectomy were also significantly reduced. (authors)

Kwang Yul Cha - One of the best experts on this subject based on the ideXlab platform.

  • Fertility Outcome after tubal anastomosis by laparoscopy and laparotomy.
    The Journal of the American Association of Gynecologic Laparoscopists, 2001
    Co-Authors: Sun Hee Cha, Mee Hwa Lee, Jeong Hwan Kim, Chung N. Lee, Tae Ki Yoon, Kwang Yul Cha
    Abstract:

    Abstract Study Objective To evaluate Fertility Outcome and benefit of laparoscopic tubal anastomosis compared with laparotomy Design Retrospective study (Canadian Task Force classification II-2). Setting University hospital. Patients Eighty-one women requesting reversal of sterilization. Fertility Outcome was analyzed in 76 patients for a minimum of 6 months. Intervention Laparoscopic tubal anastomosis in 37 women and abdominal tubal anastomosis in 44. Measurements and Main Results In both groups anastomosis was performed in two layers with four stitches using microsurgical technique. Overall pregnancy rates were 80.5% in the laparoscopy and 80.0% in the laparotomy group. The mean interval from operation to pregnancy was similar in the two groups (p = 0.9). Mean operating time was significantly longer for laparoscopy (201.9 ± 33.8 min) than for laparotomy (148.7 ± 32.5 min), including diagnostic laparoscopy. However, mean hospital stay was shorter for laparoscopy than for laparotomy (3.3 ± 2.0 vs 6.1 ± 0.6 days, p Conclusion Laparoscopic tubal anastomosis is less invasive and could be an alternative to laparotomy for reversal of tubal sterilization. Advanced laparoscopic equipment and much experience could enhance the pregnancy rate and reduce operating time.

  • Laparoscopic tubal anastomosis: Fertility Outcome in 202 cases.
    Fertility and sterility, 1999
    Co-Authors: Tae Ki Yoon, Sun Hee Cha, Hae Ree Sung, Hyung Gon Kang, Chung No Lee, Kwang Yul Cha
    Abstract:

    Abstract Objective: To evaluate the Fertility Outcome after laparoscopic tubal anastomosis for reversal of sterilization. Design: Retrospective clinical study. Setting: A private practice affiliated with a university medical school. Patient(s): Two hundred two women who desired reversal of tubal sterilization. Intervention(s): Laparoscopic tubal anastomosis. Main Outcome Measure(s): The cumulative pregnancy rate (PR) and factors that influenced the Fertility Outcome. Result(s): The cumulative PR in the 186 patients for whom follow-up data were available was 60.3%, 79.4%, and 83.3% at 6, 12, and 18 months after operation, respectively. Five patients (3.2%) had ectopic pregnancies; one of these patients subsequently conceived normally. There were no statistically significant differences in the PR according to the sterilization method used, the site of the tubal anastomosis, or the length of the fallopian tube after surgery. The intrauterine PR was 87.1% (149/171) with bilateral anastomosis and 60% (9/15) with unilateral anastomosis. The PR decreased with increasing patient age (mean [±SD], 35 ± 3.6 years) but was still 70.6% (12/17) in patients aged 40–45 years. Conclusion(s): Our findings suggest that laparoscopic tubal anastomosis is a highly successful procedure. This less invasive approach could be considered the procedure of choice in patients who desire reversal of tubal sterilization.

  • Fertility Outcome after laparoscopic microsurgical tubal anastomosis
    Fertility and sterility, 1997
    Co-Authors: Tae Ki Yoon, Sun Hee Cha, Hae Ree Sung, Chung No Lee, Kwang Yul Cha
    Abstract:

    Objective: To evaluate Fertility Outcome after laparoscopic microsurgical tubal anastomosis. Design: A retrospective study. Setting: InFertility Medical Center affiliated with University Medical School. Patient(s): Fifty-four patients, who had previously undergone tubal sterilization, seeking reversal. Intervention(s): Laparoscopic microsurgical tubal anastomosis was performed. Main Outcome Measure(s): Pregnancy success was assessed. Result(s): The overall pregnancy rate (PR) was 77.5% (38/49) and 29 patients already have delivered healthy offspring. Pregnancy in seven patients is ongoing and one case ended in abortion. There was one case of ectopic pregnancy. The pregnancy success according to the method of previous tubal sterilization was 16 of 24 with the Fallope-ring method, 14 of 15 in cases of cauterization, and 8 of 10 in patients in whom the Pomeroy technique was used. The pregnancy success according to the site of anastomosis was 3 of 4 in cornual-isthmic, 4 of 5 in isthmic-isthmic, 26 of 35 in isthmic-ampulla, 3 of 3 in cornual-ampulla, and 2 of 2 in ampullaampulla. The pregnancy success according to the tubal length was 5 of 7 at a length ≤4 cm, 3 of 5 at 5 cm, 15 of 17 at 6 cm, and 15 of 20 at lengths ≥7 cm. Conclusion(s): Considering the high PR in our minimal follow-up period of 12 months, laparoscopic microsurgical tubal anastomosis could be an alternative procedure to microsurgical laparotomy in patients requesting reversal of tubal sterilization.

Carmel Mcvicar - One of the best experts on this subject based on the ideXlab platform.

  • effects of vasectomy on spermatogenesis and Fertility Outcome after testicular sperm extraction combined with icsi
    The Journal of Urology, 2006
    Co-Authors: Carmel Mcvicar, D A Oneill, Neil Mcclure, B Clements, Stephen Mccullough, Sheena E M Lewis
    Abstract:

    BACKGROUND: Each year 40 000 men have a vasectomy in the UK whilst another 2400 request a reversal to begin a second family. Sperm can now be obtained by testicular biopsy and subsequently used in assisted conception with ICSI. The study aims were to compare sperm yields of men post-vasectomy or with obstructive azoospermia (OA) of unknown aetiology with yields of fertile men and to assess any alteration in the clinical pregnancy rates after ICSI. METHODS: Testicular tissue was obtained by Trucut needle from men who had undergone a vasectomy >5 years previously or had OA from other causes and from fertile men during vasectomy. Seminiferous tubules were milked to measure sperm yields. Numbers of Sertoli cells and spermatids and thickness of the seminiferous tubule walls were assessed using quantitative computerized analysis. RESULTS and CONCLUSIONS: Sperm yields/g testis were significantly decreased in men post-vasectomy and in men with OA, relative to fertile men. Significant reductions were also observed in early (40%) and mature (29%) spermatid numbers and an increase of 31% was seen in the seminiferous tubule wall (basal membrane and collagen thickness) of vasectomized men compared with fertile men. Clinical pregnancy rates in couples who had had a vasectomy were also significantly reduced.

  • effects of vasectomy on spermatogenesis and Fertility Outcome after testicular sperm extraction combined with icsi
    Human Reproduction, 2005
    Co-Authors: Carmel Mcvicar, D A Oneill, Neil Mcclure, B Clements, Stephen Mccullough, Sheena E M Lewis
    Abstract:

    Each year 40 000 men have a vasectomy in the UK whilst another 2400 request a reversal to begin a second family. Sperm can now be obtained by testicular biopsy and subsequently used in assisted conception with ICSI. The study aims were to compare sperm yields of men post-vasectomy or with obstructive azoospermia (OA) of unknown aetiology with yields of fertile men and to assess any alteration in the clinical pregnancy rates after ICSI. Testicular tissue was obtained by Trucut needle from men who had undergone a vasectomy >5 years previously or had OA from other causes and from fertile men during vasectomy. Seminiferous tubules were milked to measure sperm yields. Numbers of Sertoli cells and spermatids and thickness of the seminiferous tubule walls were assessed using quantitative computerized analysis. Sperm yields/g testis were significantly decreased in men post-vasectomy and in men with OA relative to fertile men. Significant reductions were also observed in early (40%) and mature (29%) spermatid numbers and an increase of 31% was seen in the seminiferous tubule wall (basal membrane and collagen thickness) of vasectomized men compared with fertile men. Clinical pregnancy rates in couples who had had a vasectomy were also significantly reduced. (authors)

Fujie Zhao - One of the best experts on this subject based on the ideXlab platform.

  • Fertility Outcome analysis after surgical management of tubal ectopic pregnancy a retrospective cohort study
    BMJ Open, 2015
    Co-Authors: Kailei Jiang, Fujie Zhao
    Abstract:

    Objectives To compare the subsequent Fertility and risk of recurrence of an ectopic pregnancy (EP) in women who had had an EP, according to the type of surgical treatment they received—that is, salpingectomy, salpingostomy or tubal anastomosis. Methods A retrospective cohort study was carried out between January 2003 and September 2011 of 618 patients admitted to hospital with tubal EP and who had received surgical treatment (salpingectomy, n=434; salpingostomy, n=112; and tube anastomosis, n=72). Main Outcomes included the first intrauterine pregnancy (IUP) and recurrent EP. Results The crude IUP rates up to 24 months after surgery were 55.5% for salpingectomy, 50.9% for salpingostomy and 40.3% for tubal anastomosis treatments. In the multivariate-adjusted model, with the patients receiving salpingectomy as the reference group, HR for patients after salpingostomy and tubal anastomosis treatments for IUP were 0.912 (95% CI 0.762 to 2.017) and 0.619 (95% CI 0.328 to 0.927), respectively. The 2-year cumulative recurrent EP rates were found to be 8.1% for salpingectomy, 6.3% for salpingostomy and 16.7% for tubal anastomosis treatments. Taking the patients receiving salpingectomy as the reference group, the patients who received tubal anastomosis had a positively higher risk of recurrent EP (HR=2.280; 95% CI 1.121 to 4.636) in univariate analysis. Adjustment for other potential confounders only slightly attenuated the HR. Conclusions The patients with an EP receiving tubal anastomosis treatments appeared to have a lower 2-year rate of IUP and a higher risk of recurrent EP after adjustment for other potential risk factors.