Biomedical subjects

L L Too

Publications and source records attributed to L L Too.

5 recordsLinked to original sources

PubMed2000

Successful birth after intracytoplasmic sperm injection for severe male factor infertility in a woman with poor response to controlled ovarian hyperstimulation.

Poor responders to controlled ovarian hyperstimulation (COH) present a clinical challenge for in vitro fertilization (IVF) and embryo transfer. The failure of IVF for the treatment of severe male-factor infertility can now be overcome by intracytoplasmic sperm injection (ICSI). The infertile couple documented in this case report came to our hospital because of bilateral tubal occlusion and severe oligoasthenospermia. After three poor-response cycles to COH, one mature oocyte was retrieved and was fertilized using ICSI. Normal fertilization ensued and one good-quality, eight-celled embryo was transferred into the woman's uterus. A single gestation was confirmed by ultrasound seven weeks after transfer. Amniocentesis was performed at 16 weeks and demonstrated a normal male fetus with a karyotype of 46,XY. The patient had a spontaneous, normal, vaginal delivery of a 2,650 g healthy male infant.

Adult↗

PubMed1999

Pregnancies resulting from in vitro matured oocytes retrieved from patients with polycystic ovary syndrome after priming with human chorionic gonadotropin.

OBJECTIVE: To describe pregnancies that resulted from in vitro matured oocytes derived from two unstimulated, anovulatory patients with polycystic ovary syndrome after priming with hCG before oocyte retrieval. DESIGN: Case series. SETTING: McGill Reproductive Center, Royal Victoria Hospital, McGill University. PATIENT(S): Two women with polycystic ovary syndrome. INTERVENTION(S): Progesterone induction of a withdrawal bleeding episode. The administration of subcutaneous hCG 36 hours before oocyte retrieval in a natural menstrual cycle. In vitro maturation of immature oocytes, fertilization, and ET. Luteal support with oral estrogen and progesterone. MAIN OUTCOME MEASURE(S): Pregnancy outcome. RESULT(S): Two clinical pregnancies were confirmed after oocyte maturation in vitro, fertilization with intracytoplasmic sperm injection, and ET. CONCLUSION(S): The administration of hCG 36 hours before harvesting of immature oocytes may improve the maturational and developmental competence of the oocytes and the pregnancy rates of unstimulated patients with polycystic ovary syndrome.

Adult↗

PubMed1999

Primary repair of cornual rupture occurring at 21 weeks gestation and successful pregnancy outcome.

The successful delivery in a 31 year old woman at 33 weeks gestation is reported, after repair to a cornual rupture which occurred at 21 weeks gestation. The patient exhibited acute abdominal pain and pending shock. Emergency laparotomy showed a cornual rupture and an intrauterine vital fetus having intact amnion membrane. On the patient's family's insistence, primary repair for a cornual rupture was performed and preservation of the fetus attempted. Postoperatively, tocolytic agent with ritodrine hydrochloride was administered and close follow-up of the patient was uneventful. The patient had a smooth obstetric course until 33 weeks gestation when premature rupture of the membranes occurred, soon followed by the onset of labour. She underwent an elective Caesarean section and delivered a normal male fetus weighing 2140 g with Apgar scores at 1, 5 and 10 min of 6, 8, and 9 respectively. Because of this successful outcome, we suggest that primary repair for such an unusual patient should be accepted.

Abdomen, Acute↗

PubMed1999

Borderline ovarian tumors complicating pregnancy: a case report.

Although the majority of ovarian tumors complicating pregnancy are benign, they still pose a challenge because of the difficulty in differentiating between benign and malignant tumors during pregnancy. To our knowledge, the value of color Doppler ultrasound in the diagnosis of borderline malignant tumors complicating pregnancy remains unclear. We present the case of a 29-year-old pregnant woman with an ovarian tumor of low malignant potential. Preoperative ultrasound revealed a well-encapsulated cystic complex on the left ovary measuring 16 x 18 x 12 cm with an internally smooth surface, multiple septa ranging from 2 to 4 mm in thickness and a small solid component 2 cm in diameter, with a resistance index of 0.42. The differential diagnosis preoperatively was a borderline tumor. The patient underwent a left oophorectomy at 18 weeks of gestation. Frozen pathology indicated a mucinous cystadenocarcinoma of low malignant potential. A thorough surgical staging was completed. The final pathology confirmed mucinous cystadenocarcinoma of low malignant potential, stage IA. Postoperatively, the patient had an uneventful course and did not receive any adjuvant therapy. She delivered a normal male fetus weighing 3,450 g at 38 weeks of gestation. We conclude that color Doppler ultrasound is helpful for the preoperative diagnosis of borderline tumors of the ovaries but its usefulness for making an accurate diagnosis may require further evaluation.

Adult↗

PubMed1994

Selective embryo reduction in multiple pregnancies resulting from assisted conception.

BACKGROUND: Assisted conception not only raises the pregnancy rate by treating infertility, but also increases the chance of obstetrical complication of multiple pregnancy. So it is important to develop a means by which the number of developing embryos can be reduced. METHODS: Eight multiply pregnant women (from triplets to octuplets) asked to have the number of viable fetuses reduced. By means of sonar guided puncture, a mixture of demerol and xylocaine was injected to the fetal thorax until the fetal heart ceased to beat. The procedures were done between the 7th and 11th week of gestational age. Repeated scans were done for three consecutive days to confirm the viability of the remaining fetuses. RESULTS: Except for vanishing twins, no serious complication was noted. For six of the women, 10 healthy births have resulted; the remaining two have ongoing pregnancies. CONCLUSIONS: The procedure described is an easy, safe and effective method to diminish obstetrical morbidity of multiple pregnancy.

Abortion, Induced↗