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Intramyometrial pregnancy after cryopreserved embryo transfer: a case report.

ABSTRACT: BACKGROUND:Intramyometrial pregnancy is a rare subtype of ectopic pregnancy. The cases following IVF-ET were few reported in recent years. The etiological factors include previous uterine trauma like myomectomy, salpingectomy, dilatation and curettage, assisted reproductive technologies and adenomyosis. Early diagnosis is difficult to make due to its various manifestation. The medical treatment includes conservative management with surgical excision, aortic balloon occlusion, uterine artery embolization, MTX etc. Sometimes hysterectomy was performed due to delayed diagnosis. CASE PRESENTATION:In this article, we presented a case of a 28?years old woman who had cryopreserved embryo transfer with a history of right side salpingectomy. We suspected it a right adnexa ectopic pregnancy at the first place, especially the right fallopian interstitial or right uterus cornu due to ultrasonography and medical history. The product of conception was discovered embedded in the myometrium and protruding out from the right side of the posterior uterine wall, with seemingly no connection with uterine cavity nor fallopian tubes. The diagnosis of intramural pregnancy was made intraoperatively and validated after pathological report. The interventions were made early enough that exploratory laparoscopy, hysteroscopy and conservative surgical excision were successfully performed at 7?weeks' gestation preserving the fertility. CONCLUSIONS:It is important for clinicians to be aware of risk factors of intramural pregnancy and maintain an index of suspicion in ART treatment. Ultrasound and laparoscopy are essential managements for early diagnose which make conservative treatment possible and prevent life-threatening consequences.

SUBMITTER: Liu Y

PROVIDER: S-EPMC7011315 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Intramyometrial pregnancy after cryopreserved embryo transfer: a case report.

Liu Yuan Y Wu Yu Y

BMC pregnancy and childbirth 20200210 1

<h4>Background</h4>Intramyometrial pregnancy is a rare subtype of ectopic pregnancy. The cases following IVF-ET were few reported in recent years. The etiological factors include previous uterine trauma like myomectomy, salpingectomy, dilatation and curettage, assisted reproductive technologies and adenomyosis. Early diagnosis is difficult to make due to its various manifestation. The medical treatment includes conservative management with surgical excision, aortic balloon occlusion, uterine art ...[more]

PMID: 32041575

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Project description:The aberrant gene expression in the uterine endometrium and embryo has been the major causes of pregnancy failure in cattle. Therefore, selecting cows having adequate endometrial receptivity and embryos of better developmental competence based on the gene expression could increase the number of calves produced by each cow during its productive life time. We used endometrial and embryo biopsy technology in conjunction with the pregnancy outcome information to establish a direct link between the pre-transfer endometrial or in vivo derived embryo gene expression and pregnancy outcome after embryo transfer. Endometrial samples were collected from Simmental heifers at day 7 and 14 of the estrous cycle, one cycle prior to embryo transfer. In the next cycle, embryo biopsies consisting of 60-70% of inner cell mass and trophectoderm were transferred to the recipients at day 7 of the estrous cycle. The remaining 30-40% parts of the embryos were retained for analysis.Pregnancy diagnosis was performed at days 28 and 42 by ultrasonography and at day 56 by rectal palpation. Those heifers returned to heat at day 21 were considered as non pregnant or non receptive endometrium (NP) while those heifers ended up with successful pregnancy and calf delivery was considered as the calf delivery group or receptive endometrium (CD). Following this, the endometrial samples collected during the pre-transfer period and the embryo biopsies retained during embryo transfer were categorized based on the pregnancy outcome. Those endometrial biopsies collected at days 7 and 14 of the estrous cycle from heifers resulted in successful calf delivery were designated as CDd7 and CDd14, respectively and endometrial biopsies taken at days 7 and 14 of the estrous cycle from those subsequently resulted in no pregnancy were designated as NPd7 and NPd14, respectively. Similarly, the embryo biopsies were classified as those embryo biopsies resulted in successful calf delivery and those resulted in no pregnancy

Project description:BackgroundCryopreservation of embryos plays a major role in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment. However, the storage condition of the cryopreserved embryo can change temporarily due to repeated retrieval of the embryo from the liquid nitrogen (LN2) tank during the practical application during cryopreservation. Whether the implantation potential of a cryopreserved embryo will be damaged when the cane containing it is temporarily exposed to air due to the transfer between the LN2 tank and LN2 container is yet to be elucidated. Also, whether the exposed-to-air frequency (EAF) of cryopreserved embryos influences the clinical outcomes is unclear.ObjectiveTo investigate whether the EAF of cryopreserved embryo affects the clinical outcomes of vitrified-warmed embryo transfer.MethodsA total of 9200 vitrified-warmed embryo transfer cycles were included in this study. All cycles were divided into five groups according to different EAFs (2, 4, 6, 8, or ≥ 10). Post-warming survival rates and clinical outcomes, including implantation, clinical pregnancy and live birth rates were investigated. Kruskal-Wallis test and Pearson's chi-squared tests were used to compare the patient characteristics and clinical outcomes among the five groups. Furthermore, multivariate logistic regression analyses were conducted to investigate the association between EAF and clinical outcomes.ResultsNo significant differences were observed in the positive HCG rate, implantation rate and live birth rate (P > 0.05) among five EAF groups with respect to D3 embryo, D5 blastocyst and D6 blastocyst. Post-warmed survival rate of D3 embryos (P = 0.015) differed significantly among the five EAF groups, but it was not EAF-dependent. Although clinical pregnancy was different among the five groups with respect to D5 blastocyst (P = 0.042), multivariate logistic regression analysis adjusted for confounding variables suggested that EAF did not adversely affect clinical pregnancy or live birth.ConclusionThese findings indicated that human vitrified embryos in the open system could be repeatedly retrieved from the LN2 tank without affecting the implantation potential of the embryo.

Dataset Information

Intramyometrial pregnancy after cryopreserved embryo transfer: a case report.

Publications

Intramyometrial pregnancy after cryopreserved embryo transfer: a case report.

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