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[PMID]:28745706
[Au] Autor:Akhundova NN
[Ad] Endereço:The Azerbaijan Medical University. Department of Obstetrics and Gynecology, Baku, The Republic of Azerbaijan.
[Ti] Título:[The combination of endoscopic techniques in the diagnosis and treatment of various forms of infertility in women].
[Ti] Título:Sochetanie éndoskopicheskikh metodov v diagnostike i lechenii razlichnykh form besplodiia u zhenshchin..
[So] Source:Khirurgiia (Mosk);(7):44-48, 2017.
[Is] ISSN:0023-1207
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To improve the methods of simultaneous laparoscopy and hysteroscopy for the diagnosis and treatment of various forms of secondary infertility. MATERIAL AND METHODS: 420 women with various forms of infertility were examined and treated at the Caspian Hospital (Institute of Obstetrics and Gynecology). Patients were divided into three groups: tubal-peritoneal infertility - 212 women, different forms of endometriosis - 113 patients, polycystic ovarian disease - 95 women. We proposed safer method of laparoscopic surgery. RESULTS: There were no injuries of internal organs and bleeding from the puncture site if Veress needle and the first 'blind' trocar were deployed according to proposed method. We consider that choice of operative hysteroscopy technique should be differentiated in case of benign gynecological diseases. Anesthesia-free operative hysteroscopy by S. Bettocchi may be performed if diagnostic hysteroscopy is tolerable. Simultaneous laparoscopy and hysteroscopy are safe for patients.
[Mh] Termos MeSH primário: Histeroscopia
Infertilidade Feminina
Laparoscopia
Complicações Pós-Operatórias/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Azerbaijão
Endometriose/complicações
Doenças das Tubas Uterinas/complicações
Feminino
Seres Humanos
Histeroscopia/efeitos adversos
Histeroscopia/métodos
Infertilidade Feminina/diagnóstico
Infertilidade Feminina/etiologia
Infertilidade Feminina/cirurgia
Laparoscopia/efeitos adversos
Laparoscopia/métodos
Avaliação de Processos e Resultados (Cuidados de Saúde)
Síndrome do Ovário Policístico/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171130
[Lr] Data última revisão:
171130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.17116/hirurgia2017744-48


  2 / 2712 MEDLINE  
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[PMID]:28843382
[Au] Autor:Parry JP; Riche D; Rushing J; Linton B; Butler V; Lindheim SR
[Ad] Endereço:Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Mississippi Medical Center, Jackson, Mississippi. Electronic address: drprestonparry@gmail.com.
[Ti] Título:Performing the Parryscope technique gently for office tubal patency assessment.
[So] Source:Fertil Steril;108(4):718, 2017 Oct.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To demonstrate a novel approach to office tubal patency assessment through infusing air into saline during flexible office hysteroscopy. We also provide data addressing pain and patient experience relative to hysterosalpingography (HSG). DESIGN: Video presentation of clinical technique with supportive crossover data (Canadian Task Force classification II-1). Its University of Mississippi Medical Center Institutional Review Board protocol number is 2013-0230. SETTING: Academic hospital. PATIENT(S): Women undergoing office hysteroscopy and ultrasound, with a subset also having HSG. INTERVENTION(S): Air infusion into saline during office hysteroscopy. MAIN OUTCOME MEASURE(S): The focus is on demonstrating how the technique appears and is performed, with supplemental Likert data addressing subjective pain and preference relative to HSG. RESULT(S): When performed as described, this office technique has 98.3%-100% sensitivity to tubal occlusion and 83.7% specificity. The gentle technique is central to accurate outcomes, which is facilitated through use of a small-caliber (<3 mm), flexible hysteroscope and avoiding uterine overdistention. Patients are far more likely to report maximum discomfort with HSG. Among patients who also had HSG, 92% somewhat or strongly prefer hysteroscopic assessment. Also, 96% of patients reporting maximum discomfort with HSG had mild to no discomfort with the described technique. CONCLUSION(S): Air-infused saline at flexible office hysteroscopy can accurately, gently, and rapidly assess tubal patency. Coupled with strong patient preference for this technique over HSG, it is a promising option for evaluating fertility. CLINICAL TRAIL REGISTRATION NUMBER: NCT02005263.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Ambulatórios/métodos
Doenças das Tubas Uterinas/diagnóstico
Testes de Obstrução das Tubas Uterinas/instrumentação
Histerossalpingografia/instrumentação
Histeroscopia/instrumentação
Infertilidade Feminina/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Estudos Cross-Over
Testes de Obstrução das Tubas Uterinas/métodos
Feminino
Seres Humanos
Laparoscopia/métodos
Visita a Consultório Médico
Gravidez
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170828
[St] Status:MEDLINE


  3 / 2712 MEDLINE  
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[PMID]:28579408
[Au] Autor:Xu B; Zhang Q; Zhao J; Wang Y; Xu D; Li Y
[Ad] Endereço:Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha City, People's Republic of China.
[Ti] Título:Pregnancy outcome of in vitro fertilization after Essure and laparoscopic management of hydrosalpinx: a systematic review and meta-analysis.
[So] Source:Fertil Steril;108(1):84-95.e5, 2017 Jul.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess and compare pregnancy outcomes in hydrosalpinx (HX) patients treated by Essure, laparoscopic salpingectomy, and proximal tubal occlusion (LPTO) before IVF. DESIGN: Systematic review and meta-analysis. SETTING: University-affiliated teaching hospital. PATIENT(S): Women undergoing Essure, laparoscopic salpingectomy, and LPTO for HX before IVF. INTERVENTION(S): The overall combined risk estimates were calculated by means of fixed- or random-effects models. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate (CPR) and live birth rate (LBR). RESULT(S): In total, 3,065 patients were included in 33 studies. Thirteen of them were comparative studies among 3 surgical methods and no intervention. In the analysis of comparative studies, there were no significant differences in implantation rate (IR), CPR, and ongoing pregnancy rate/LBR between salpingectomy and LPTO groups. The CPR, IR, and LBR of Essure were significantly lower than those of the laparoscopic surgery (salpingectomy and LPTO) group, with a CPR of 34.1% vs. 44.0% (relative risk [RR] 0.71; 95% confidence interval [CI] [0.51, 0.98]), an IR of 17.3% vs. 38.0% (RR 0.45; 95% CI [0.27, 0.74]), and an LBR of 22.2% vs. 37.4% (RR 0.57; 95% CI [0.35, 0.91]). CONCLUSION(S): Management of HX by laparoscopic salpingectomy and LPTO yielded the same effect on the improvement of the pregnancy outcome after IVF. The hysteroscopic placement of Essure devices to treat HX before IVF produces inferior pregnancy outcomes compared with those following the laparoscopic approach. More multicenter randomized, controlled trials are warranted in future research to further examine the conclusion from this meta-analysis.
[Mh] Termos MeSH primário: Doenças das Tubas Uterinas/epidemiologia
Doenças das Tubas Uterinas/terapia
Fertilização In Vitro/estatística & dados numéricos
Infertilidade/epidemiologia
Infertilidade/terapia
Laparoscopia/estatística & dados numéricos
Esterilização Tubária/instrumentação
[Mh] Termos MeSH secundário: Adulto
Terapia Combinada/métodos
Comorbidade
Feminino
Seres Humanos
Gravidez
Resultado da Gravidez/epidemiologia
Prevalência
Fatores de Risco
Esterilização Tubária/estatística & dados numéricos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170818
[Lr] Data última revisão:
170818
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170606
[St] Status:MEDLINE


  4 / 2712 MEDLINE  
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[PMID]:28532600
[Au] Autor:Gorwitz RJ; Wiesenfeld HC; Chen PL; Hammond KR; Sereday KA; Haggerty CL; Johnson RE; Papp JR; Kissin DM; Henning TC; Hook EW; Steinkampf MP; Markowitz LE; Geisler WM
[Ad] Endereço:Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: RGorwitz@cdc.gov.
[Ti] Título:Population-attributable fraction of tubal factor infertility associated with chlamydia.
[So] Source:Am J Obstet Gynecol;217(3):336.e1-336.e16, 2017 Sep.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Chlamydia trachomatis infection is highly prevalent among young women in the United States. Prevention of long-term sequelae of infection, including tubal factor infertility, is a primary goal of chlamydia screening and treatment activities. However, the population-attributable fraction of tubal factor infertility associated with chlamydia is unclear, and optimal measures for assessing tubal factor infertility and prior chlamydia in epidemiological studies have not been established. Black women have increased rates of chlamydia and tubal factor infertility compared with White women but have been underrepresented in prior studies of the association of chlamydia and tubal factor infertility. OBJECTIVES: The objectives of the study were to estimate the population-attributable fraction of tubal factor infertility associated with Chlamydia trachomatis infection by race (Black, non-Black) and assess how different definitions of Chlamydia trachomatis seropositivity and tubal factor infertility affect population-attributable fraction estimates. STUDY DESIGN: We conducted a case-control study, enrolling infertile women attending infertility practices in Birmingham, AL, and Pittsburgh, PA, during October 2012 through June 2015. Tubal factor infertility case status was primarily defined by unilateral or bilateral fallopian tube occlusion (cases) or bilateral fallopian tube patency (controls) on hysterosalpingogram. Alternate tubal factor infertility definitions incorporated history suggestive of tubal damage or were based on laparoscopic evidence of tubal damage. We aimed to enroll all eligible women, with an expected ratio of 1 and 3 controls per case for Black and non-Black women, respectively. We assessed Chlamydia trachomatis seropositivity with a commercial assay and a more sensitive research assay; our primary measure of seropositivity was defined as positivity on either assay. We estimated Chlamydia trachomatis seropositivity and calculated Chlamydia trachomatis-tubal factor infertility odds ratios and population-attributable fraction, stratified by race. RESULTS: We enrolled 107 Black women (47 cases, 60 controls) and 620 non-Black women (140 cases, 480 controls). Chlamydia trachomatis seropositivity by either assay was 81% (95% confidence interval, 73-89%) among Black and 31% (95% confidence interval, 28-35%) among non-Black participants (P < .001). Using the primary Chlamydia trachomatis seropositivity and tubal factor infertility definitions, no significant association was detected between chlamydia and tubal factor infertility among Blacks (odds ratio, 1.22, 95% confidence interval, 0.45-3.28) or non-Blacks (odds ratio, 1.41, 95% confidence interval, 0.95-2.09), and the estimated population-attributable fraction was 15% (95% confidence interval, -97% to 68%) among Blacks and 11% (95% confidence interval, -3% to 23%) among non-Blacks. Use of alternate serological measures and tubal factor infertility definitions had an impact on the magnitude of the chlamydia-tubal factor infertility association and resulted in a significant association among non-Blacks. CONCLUSION: Low population-attributable fraction estimates suggest factors in addition to chlamydia contribute to tubal factor infertility in the study population. However, high background Chlamydia trachomatis seropositivity among controls, most striking among Black participants, could have obscured an association with tubal factor infertility and resulted in a population-attributable fraction that underestimates the true etiological role of chlamydia. Choice of chlamydia and tubal factor infertility definitions also has an impact on the odds ratio and population-attributable fraction estimates.
[Mh] Termos MeSH primário: Infecções por Chlamydia/diagnóstico
Doenças das Tubas Uterinas/epidemiologia
Infertilidade Feminina/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos
Alabama/epidemiologia
Estudos de Casos e Controles
Chlamydia trachomatis/isolamento & purificação
Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos
Feminino
Seres Humanos
Estudos Soroepidemiológicos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170524
[St] Status:MEDLINE


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[PMID]:28394461
[Au] Autor:Maclachlan N; Hunt G; Fowkes S; Frost M; Miller J; Purcell-Jones G; Sullivan P; Barbon A; Routh A; López FJ; Price EC
[Ad] Endereço:Assisted Reproduction Unit/Anaesthetics, Jersey General Hospital, St. Helier, Jersey, Channel Islands.
[Ti] Título:Successful treatment of infertility in a female Sumatran orangutan Pongo abelii.
[So] Source:Zoo Biol;36(2):132-135, 2017 Mar.
[Is] ISSN:1098-2361
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In 2011, a female Sumatran orangutan housed at Durrell Wildlife Conservation Trust became infertile following a massive antepartum hemorrhage in labor and the delivery of a stillborn infant. The placenta was infected with Pantoea sp. Hysterosalpingography (HSG) revealed blocked fallopian tubes, and pressurized fallopian tube perfusion was used to reverse the tubal occlusion. She subsequently conceived and following an intensive training program, we were able to measure umbilical artery waveform analysis for fetal well-being and placental localization to exclude placenta previa, which could complicate pregnancy and lead to catastrophic hemorrhage. The female went on to deliver a healthy offspring. We suggest that these techniques should be considered for other infertile females in the global captive population.
[Mh] Termos MeSH primário: Animais de Zoológico
Doenças dos Símios Antropoides/terapia
Doenças das Tubas Uterinas/veterinária
Infertilidade Feminina/veterinária
Pongo abelii/fisiologia
Hemorragia Uterina/veterinária
[Mh] Termos MeSH secundário: Animais
Doenças dos Símios Antropoides/diagnóstico por imagem
Doenças dos Símios Antropoides/etiologia
Doenças das Tubas Uterinas/diagnóstico por imagem
Doenças das Tubas Uterinas/terapia
Feminino
Histerossalpingografia/veterinária
Infertilidade Feminina/diagnóstico por imagem
Infertilidade Feminina/etiologia
Infertilidade Feminina/terapia
Perfusão/veterinária
Gravidez
Resultado do Tratamento
Hemorragia Uterina/complicações
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170526
[Lr] Data última revisão:
170526
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE
[do] DOI:10.1002/zoo.21350


  6 / 2712 MEDLINE  
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[PMID]:28295272
[Au] Autor:Zhang T; Li F; Liu J; Zhang S
[Ad] Endereço:Department of Ultrasound, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
[Ti] Título:Diagnostic performance of the Gynecology Imaging Reporting and Data System for malignant adnexal masses.
[So] Source:Int J Gynaecol Obstet;137(3):325-331, 2017 Jun.
[Is] ISSN:1879-3479
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the Gynecology Imaging Reporting and Data System (GI-RADS) for diagnosis of malignant adnexal masses in a Chinese population. METHODS: A retrospective study was conducted of patients who underwent evaluation of suspected adnexal masses at a hospital in Tianjin, China, between January 1, 2015, and January 31, 2016. Ultrasonographic diagnosis was based on the GI-RADS classification-a standardized summary of imaging data that estimates the risk of malignancy-and compared with the final pathological diagnosis. RESULTS: Among 242 patients, thick wall, solid papillary projection, solid area, central blood flow, ascites, and GI-RADS classification were associated with malignancy (P<0.05 for all variables). The 263 masses evaluated were classified as GI-RADS 2 (functional cyst; n=65), GI-RADS 3 (benign neoplasm; n=68), GI-RADS 4 (one or two morphological findings suggestive of malignancy; n=101), and GI-RADS 5 (≥3 morphological findings suggestive of malignancy; n=28). Four malignant cases with false-negative findings were misclassified as GI-RADS 3, whereas 24 benign cases with false-positive findings were misclassified as GI-RADS 4. The sensitivity, specificity, false-positive rate, false-negative rate, accuracy, and Youden index of the GI-RADS classification were 96.4%, 84.3%, 18.5%, 3.0%, 89.3%, and 80.7%, respectively. CONCLUSION: The GI-RADS classification performed well in the diagnosis of malignant adnexal masses.
[Mh] Termos MeSH primário: Doenças dos Anexos/classificação
Doenças dos Anexos/diagnóstico por imagem
Sistemas de Informação em Radiologia/classificação
[Mh] Termos MeSH secundário: Doenças dos Anexos/patologia
Adulto
Idoso
Doenças das Tubas Uterinas/classificação
Doenças das Tubas Uterinas/diagnóstico por imagem
Doenças das Tubas Uterinas/patologia
Feminino
Seres Humanos
Meia-Idade
Cistos Ovarianos/classificação
Cistos Ovarianos/diagnóstico por imagem
Cistos Ovarianos/patologia
Neoplasias Ovarianas/classificação
Neoplasias Ovarianas/diagnóstico por imagem
Neoplasias Ovarianas/patologia
Estudos Retrospectivos
Ultrassonografia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170316
[St] Status:MEDLINE
[do] DOI:10.1002/ijgo.12153


  7 / 2712 MEDLINE  
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[PMID]:28238382
[Au] Autor:Horn LC; Angermann K; Hentschel B; Einenkel J; Höhn AK
[Ad] Endereço:Institute of Pathology, Division of Breast, Gynecologic & Perinatal Pathology, University of Leipzig, Germany. Electronic address: hornl@medizin.uni-leipzig.de.
[Ti] Título:Frequency of papillary tubal hyperplasia (PTH), salpingoliths and transition from adenoma to borderline ovarian tumors (BOT): A systematic analysis of 74 BOT with different histologic types.
[So] Source:Pathol Res Pract;213(4):305-309, 2017 Apr.
[Is] ISSN:1618-0631
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Borderline ovarian tumors (BOT) arise from cystadenomas and represent a transition step within the development of low-grade ovarian carcinomas (Type I tumors). That pathway mirrors the adenoma-to-carcinoma sequence known for colorectal cancer. It has been suggested that papillary tubal hyperplasia (PTH) and salpingoliths may be associated with the development of BOT. To evaluate the frequency of the presence of benign cystadenoma and its transition to BOT in a given patient as well as the presence of PTH and salpingoliths we re-valuated in 74 consecutive cases of BOT with different histologic types. The majority of cases represented serous-BOT (60.8%), followed by mucinous BOT (25.7%), other histologic types were rare. 86.5% showed an adenoma-BOT sequence, which was seen in all mucinous BOT but was missed in 15.6% of serous BOT. Two cases had salpingoliths without associated PTH. PTH was seen in four out of the 74 (5.4%) BOT and occurred only in cases with serous histology. The vast majority of BOT represent a transition from benign cystadenoma to BOT in cases with mucinous and serous histology. Salpingoliths are rarely seen in association with BOT and occurred exclusively in BOT with serous histology. PTH may represent a distinct lesion but is rarely seen in association with BOT, especially in those with non-serous histology. Further studies are needed to evaluate the frequency and pathogenetic association of PTH with BOT.
[Mh] Termos MeSH primário: Transformação Celular Neoplásica/patologia
Cistadenocarcinoma/patologia
Cistadenoma/patologia
Doenças das Tubas Uterinas/patologia
Neoplasias Ovarianas/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Hiperplasia/patologia
Meia-Idade
Lesões Pré-Cancerosas/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170228
[St] Status:MEDLINE


  8 / 2712 MEDLINE  
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[PMID]:28184438
[Au] Autor:De Silva PM; Chu JJ; Gallos ID; Vidyasagar AT; Robinson L; Coomarasamy A
[Ad] Endereço:Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, Academic Department, Birmingham Women's Hospital NHS Foundation Trust, Metchley Park Road, Edgbaston, Birmingham, UK.
[Ti] Título:Fallopian tube catheterization in the treatment of proximal tubal obstruction: a systematic review and meta-analysis.
[So] Source:Hum Reprod;32(4):836-852, 2017 04 01.
[Is] ISSN:1460-2350
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Study question: What is the chance of clinical pregnancy when fallopian tube catheterization is used for proximal tubal obstruction? Summary answer: The pooled clinical pregnancy rate of tubal catheterization after proximal tubal obstruction is 27% (95% CI 25-30%). What is known already: Restoring fallopian tube patency by performing tubal catheterization has fallen out of favour since the increased availability of IVF. Our study is the first systematic review and meta-analysis to investigate reproductive outcomes following tubal catheterization for proximal tubal obstruction. Study design, size, duration: We undertook a systematic review and meta-analysis of 27 observational studies consisting of 1720 patients undergoing tubal catheterization for proximal tubal obstruction, who attempted to conceive naturally after the procedure. Participants/materials, setting, methods: Systematic literature searches were performed in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. A total of 2195 titles and abstracts were reviewed. Only studies that reported outcomes when tubal catheterization was performed with no other tubal surgery were included. Twenty-seven cohort studies matched the inclusion criteria for the meta-analysis. Main results and the role of chance: The meta-analysis showed a pooled clinical pregnancy rate of 27% (95% CI 25-30%) after the use of tubal catheterization for unilateral or bilateral proximal tubal obstruction (27 studies, 1556 patients). In women with bilateral obstruction (14 studies, 617 patients), the clinical pregnancy rate was 27% (95% CI 23-32%). Our meta-analysis demonstrated that the pooled cumulative clinical pregnancy rates were 22.3% (95% CI 17.8-27.8%) at 6 months, 25.8% (95% CI 21.1-31.5%) at 9 months, 26.4% (95% CI 23.0-30.2%) at 12 months, 26.0% (95% CI 22.8-29.7%) at 18 months, 27.0% (95% CI 24.0-30.5%) at 24 months, 27.9% (95% CI 24.9-31.3%) at 36 months and 28.5% (95% CI 25.5-31.8%) at 48 months. The pooled live birth rate (14 studies, 551 patients) was 22% (95% CI 18-26%). The pooled ectopic pregnancy rate (27 studies, 1556 patients) was 4% (95% CI 3-5%). The included studies scored satisfactorily on the Newcastle-Ottawa quality assessment scale. Limitations, reasons for caution: The pooled clinical pregnancy rate after tubal catheterization was found to be almost comparable to that after IVF. However, included studies were small, non-comparative series with significant clinical heterogeneity in population characteristics, follow-up and surgical equipment, technique and experience. Wider implications of the findings: These findings suggest fallopian tube catheterization as an alternative strategy to IVF in patients presenting with proximal tubal obstruction. Further research should focus on comparing different surgical techniques of fallopian tube catheterization with IVF and provide cumulative reproductive outcomes over long-term follow-up. Study funding/competing interest(s): No funding was required and the authors have no competing interests to declare. Registration number: N/A.
[Mh] Termos MeSH primário: Doenças das Tubas Uterinas/cirurgia
Infertilidade Feminina/cirurgia
Taxa de Gravidez
[Mh] Termos MeSH secundário: Adulto
Cateterismo/métodos
Feminino
Seres Humanos
Gravidez
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170211
[St] Status:MEDLINE
[do] DOI:10.1093/humrep/dex022


  9 / 2712 MEDLINE  
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[PMID]:28151551
[Au] Autor:He Y; Ma X; Xu J; Li S; Wu H; Liu Q; Kong L; Luo J; Liu H
[Ad] Endereço:Departments of Ultrasonography, Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, Guangdong Province, Guangzhou, China.
[Ti] Título:Comparison of Assessment Methods for Fallopian Tubal Patency and Peritubal Adhesion Between Transvaginal 4-Dimensional Hysterosalpingo-Contrast Sonography and Laparoscopic Chromopertubation.
[So] Source:J Ultrasound Med;36(3):547-556, 2017 Mar.
[Is] ISSN:1550-9613
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The purpose of this study was to compare transvaginal 4-dimensional hysterosalpingo-contrast sonography with laparoscopic chromopertubation and evaluate the former's clinical value in assessing fallopian tubal patency and peritubal adhesion. METHODS: Fifty-six patients visiting infertility clinics were included in the study and underwent surgery by their own choice in 1 month. In total, 112 fallopian tubes were assessed. Twenty-five were primarily infertile, and the rest were secondarily infertile. Laparoscopic chromopertubation was taken as the reference standard. RESULTS: In a comparison of fallopian tubal patency between transvaginal hysterosalpingo-contrast sonography and laparoscopic chromopertubation, the sensitivity, specify, positive predictive value, and negative predictive value of hysterosalpingo-contrast sonography for diagnosing blocked fallopian tubes were 88.4%, 85.2%, 90.5%, and 82.1% respectively. In a comparison of spray at the fimbrial end between the no-peritubal adhesion and peritubal adhesion groups, the spray score at the fimbrial end in the no-peritubal adhesion group was significantly lower than that in the peritubal adhesion group. In a comparison of periovarian diffusion between the no-peritubal adhesion and peritubal adhesion groups, the periovarian diffusion score in the no-peritubal adhesion group was significantly lower than that in the peritubal adhesion group. In a comparison of periovarian diffusion between the patent-tube and blocked groups confirmed by chromopertubation, the periovarian diffusion score in the patent group was significantly lower than that in the blocked group. CONCLUSIONS: Transvaginal hysterosalpingo-contrast sonography is a method with high sensitivity and specificity for screening fallopian tubal patency and peritubal adhesion.
[Mh] Termos MeSH primário: Meios de Contraste
Doenças das Tubas Uterinas/diagnóstico por imagem
Aumento da Imagem/métodos
Imagem Tridimensional/métodos
Laparoscopia/métodos
[Mh] Termos MeSH secundário: Adulto
Estudos de Casos e Controles
Testes de Obstrução das Tubas Uterinas/métodos
Tubas Uterinas/diagnóstico por imagem
Feminino
Seres Humanos
Histerossalpingografia/métodos
Sensibilidade e Especificidade
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170203
[St] Status:MEDLINE
[do] DOI:10.7863/ultra.15.11056


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[PMID]:28112384
[Au] Autor:Chua SJ; Akande VA; Mol BW
[Ad] Endereço:The University of Adelaide, Adelaide, Australia, SA5005.
[Ti] Título:Surgery for tubal infertility.
[So] Source:Cochrane Database Syst Rev;1:CD006415, 2017 01 23.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Surgery remains an acceptable treatment modality for tubal infertility despite the rise in usage of in vitro fertilisation (IVF). Estimated livebirth rates after surgery range from 9% for women with severe tubal disease to 69% for those with mild disease; however, the effectiveness of surgery has not been rigorously evaluated in comparison with other treatments such as IVF and expectant management (no treatment). Livebirth rates have not been adequately assessed in relation to the severity of tubal damage. It is important to determine the effectiveness of surgery against other treatment options in women with tubal infertility because of concerns about adverse outcomes, intraoperative complications and costs associated with tubal surgery, as well as alternative treatments, mainly IVF. OBJECTIVES: The aim of this review was to determine the effectiveness and safety of surgery compared with expectant management or IVF in improving the probability of livebirth in the context of tubal infertility (regardless of grade of severity). SEARCH METHODS: We searched the following databases in October 2016: the Cochrane Gynaecology and Fertility (CGF) Group trials register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO; as well as clinical trials registries, sources of unpublished literature and reference lists of included trials and related systematic reviews. SELECTION CRITERIA: We considered only randomised controlled trials to be eligible for inclusion, with livebirth rate per participant as the primary outcome of interest. DATA COLLECTION AND ANALYSIS: We planned that two review authors would independently assess trial eligibility and risk of bias and would extract study data. The primary review outcome was cumulative livebirth rate. Pregnancy rate and adverse outcomes, including miscarriage rate, rate of ectopic pregnancy and rate of procedure-related complications, were secondary outcomes. We planned to combine data to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). We planned to assess statistical heterogeneity using the I2 statistic and to assess the overall quality of evidence for the main comparisons using GRADE methods. MAIN RESULTS: We identified no suitable randomised controlled trials. AUTHORS' CONCLUSIONS: The effectiveness of tubal surgery relative to expectant management and IVF in terms of livebirth rates for women with tubal infertility remains unknown. Large trials with adequate power are warranted to establish the effectiveness of surgery in these women. Future trials should not only report livebirth rates per patient but should compare adverse effects and costs of treatment over a longer time. Factors that have a major effect on these outcomes, such as fertility treatment, female partner's age, duration of infertility and previous pregnancy history, should be considered. Researchers should report livebirth rates in relation to severity of tubal damage and different techniques used for tubal repair, including microsurgery and laparoscopic methods.
[Mh] Termos MeSH primário: Doenças das Tubas Uterinas/cirurgia
Tubas Uterinas/cirurgia
Infertilidade Feminina/cirurgia
[Mh] Termos MeSH secundário: Feminino
Fertilização In Vitro
Seres Humanos
Conduta Expectante
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170411
[Lr] Data última revisão:
170411
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170124
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD006415.pub3



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