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Tubal endometriosis as an insidious risk factor for tubal implantation in a procedure of assisted reproductive technique

Year 2011, Volume: 33 Issue: 2, 248 - 252, 17.03.2011

Abstract

Abstract

Endometriosis is often associated with female infertility and exhibits a massive impairment in the physiology of uterine contractility that interferes with sperm and/or embryo movements. We present an unusual case of bilateral tubal pregnancy during an Invitro Fertilization-Embryo Transfer (IVF-ET) procedure in a tubal endometriosis patient. Bilateral tubal ampullary ectopic pregnancies, 20-30 milimeters in diameter were diagnosed during laparoscopic examination and bilateral salpingectomy was performed. Endometriotic implants were detected pathologically on mucosal surfaces of both tubes demonstrating the possible deleterious effect of endometriosis on embryo movement. Tubal mucosal environment containing endometriotic implants may behave like original uterine endometrium for ectopic tubal implantation of transferred embryos. However, we think that in order to decrease the probability for tubal implantation of transferred embryos; consideration of bilateral tubal closure or salpingectomy for patients with endometriosis before proceeding to an IVF-ET procedure may be useful.

Keywords: Pregnancy, ectopic, endometriosis, embryo transfer

 

Özet

Endometriozis çoğunlukla kadın infertilitesi ile ilişkilidir ve sperm ve/veya embriyo hareketlerini engelleyici, uterus kasılma fizyolojisinde belirgin bir bozulma ile kendini gösterir. Bir ender olgu olarak, İnvitro Fertilizasyon Embriyo Transferi (İVF-ET) prosedürü sırasında, bir tubal endometriozis hastasında bilateral tubal gebeliği sunduk. Laparoskopik değerlendirmede, 20-30 milimetre çapında bilateral tubal ampullada ektopik gebelik teşhis edildi ve bilateral salpenjektomi gerçekleştirildi. Endometriozisin, embriyo hareketini olası geciktirici etkisini gösteren, endometriyotik implantlar her iki tüpün mukozal yüzeylerinde patolojik olarak saptandı. Endometriyotik implantların oluşturduğu tubal mukozal ortam, transfer edilen embriyoların ektopik tubal implantasyonu için orijinal uterus endometriyumu gibi davranır. Bununla birlikte, biz, bir İVF-ET prosedürüne geçmeden önce, transfer edilen embriyoların tubal implantasyonu olasılığını azaltmak için, endometriozisli hastalara bilateral tubal kapama veya salpenjektomi uygulamasının göz önünde tutulmasının yararlı olabileceğini düşünmekteyiz.

Anahtar sözcükler: Gebelik, ektopik, endometriozis, embriyo transfer

References

  • Clayton HB, Schieve LA, Peterson HB, Jamieson DJ, Reynolds MA, Wright VC. Ectopic pregnancy risk with assisted reproductive technology procedures. Obstet Gynecol 2006; 107: 595-604.
  • Lyons RA, Saridogan E, Djahanbakhch O. The reproductive significance of human Fallopian tube cilia. Hum Reprod Update 2006; 12: 363-72.
  • Kissler S, Zangos S, Wiegratz I, Kohl J, Rody A, Gaetje R, Doebert N, Wildt L, Kunz G, Leyendecker G, Kaufmann M. Utero-tubal sperm transport and its impairment in endometriosis and adenomyosis. Ann N Y Acad Sci 2007; 1101: 38-48.
  • Vegheş S, Lupaşcu I, David C, Vişan V, Vasiliu V. Specifics of therapy of tubal infertility in patients with endometriosis. Rev Med Chir Soc Med Nat Iasi 2005; 109: 542-7.
  • Yoo JK, Lee JJ, Song JH, Jeon SC, Kang JH, Kim S, Park CH, Cho DH. A case of simultaneous bilateral tubal pregnancies following the ovulation induction and intrauterine insemination. Korean J Obstet Gynecol 2001; 44: 2372-5.
  • Kauppi-Sahla M, Rintala H, Mäkinen J. Bilateral tubal pregnancy: a case report and review of the literature. Eur J Obstet Gynecol Reprod Biol 1991; 40: 145-7.
  • Aanesen A, Flam F. Bilateral tubal pregnancy following in vitro fertilization and transfer of two embryos. Eur J Obstet Gynecol Reprod Biol 1996; 64: 235-6.
  • Klipstein S, Oskowitz SP. Bilateral ectopic pregnancy after transfer of two embryos. Fertil Steril 2000; 74: 887-8.
  • Sánchez Contreras J, Hernández Vivar LE, Villalobos Cid MA, Risco Cortés RJ. Conservative treatment of interstitial ectopic pregnancy and endometriosis with laparoscopic methotrexate and potassium chloride and complementary management with nasal nafarelin. Report of a case and review of the literature. Ginecol Obstet Mex 2000; 68: 35-8.
  • Hunter RH. Tubal ectopic pregnancy: A patho-physiological explanation involving endometriosis. Hum Reprod 2002; 17: 1688-91.
  • Nabekura H, Koike H, Ohtsuka T, Yamaguchi M, Miyakawa I, Mori N. Fallopian tube prostaglandin production with and without endometriosis. Int J Fertil Menopausal Stud 1994; 39: 57-63.
  • Bogdanskiene G, Berlingieri P, Grudzinskas JG. Association between ectopic pregnancy and pelvic endometriosis. Int J Gynaecol Obstet 2006; 92: 157-8.
  • Marcus SF, Brinsden PR. Analysis of the incidence and risk factors associated with ectopic pregnancy following in-vitro fertilization and embryo transfer. Hum Reprod 1995; 10: 199-203.

Bir yardımcı üreme tekniği prosedüründe tubal implantasyon için sinsi bir risk faktörü olarak tubal endometriozis

Year 2011, Volume: 33 Issue: 2, 248 - 252, 17.03.2011

Abstract

Endometriozis çoğunlukla kadın infertilitesi ile ilişkilidir ve sperm ve/veya embriyo hareketlerini engelleyici, uterus kasılma fizyolojisinde belirgin bir bozulma ile kendini gösterir. Bir ender olgu olarak, İnvitro Fertilizasyon Embriyo Transferi (İVF-ET) prosedürü sırasında, bir tubal endometriozis hastasında bilateral tubal gebeliği sunduk. Laparoskopik değerlendirmede, 20-30 milimetre çapında bilateral tubal ampullada ektopik gebelik teşhis edildi ve bilateral salpenjektomi gerçekleştirildi. Endometriozisin, embriyo hareketini olası geciktirici etkisini gösteren, endometriyotik implantlar her iki tüpün mukozal yüzeylerinde patolojik olarak saptandı. Endometriyotik implantların oluşturduğu tubal mukozal ortam, transfer edilen embriyoların ektopik tubal implantasyonu için orijinal uterus endometriyumu gibi davranır. Bununla birlikte, biz, bir İVF-ET prosedürüne geçmeden önce, transfer edilen embriyoların tubal implantasyonu olasılığını azaltmak için, endometriozisli hastalara bilateral tubal kapama veya salpenjektomi uygulamasının göz önünde tutulmasının yararlı olabileceğini düşünmekteyiz

References

  • Clayton HB, Schieve LA, Peterson HB, Jamieson DJ, Reynolds MA, Wright VC. Ectopic pregnancy risk with assisted reproductive technology procedures. Obstet Gynecol 2006; 107: 595-604.
  • Lyons RA, Saridogan E, Djahanbakhch O. The reproductive significance of human Fallopian tube cilia. Hum Reprod Update 2006; 12: 363-72.
  • Kissler S, Zangos S, Wiegratz I, Kohl J, Rody A, Gaetje R, Doebert N, Wildt L, Kunz G, Leyendecker G, Kaufmann M. Utero-tubal sperm transport and its impairment in endometriosis and adenomyosis. Ann N Y Acad Sci 2007; 1101: 38-48.
  • Vegheş S, Lupaşcu I, David C, Vişan V, Vasiliu V. Specifics of therapy of tubal infertility in patients with endometriosis. Rev Med Chir Soc Med Nat Iasi 2005; 109: 542-7.
  • Yoo JK, Lee JJ, Song JH, Jeon SC, Kang JH, Kim S, Park CH, Cho DH. A case of simultaneous bilateral tubal pregnancies following the ovulation induction and intrauterine insemination. Korean J Obstet Gynecol 2001; 44: 2372-5.
  • Kauppi-Sahla M, Rintala H, Mäkinen J. Bilateral tubal pregnancy: a case report and review of the literature. Eur J Obstet Gynecol Reprod Biol 1991; 40: 145-7.
  • Aanesen A, Flam F. Bilateral tubal pregnancy following in vitro fertilization and transfer of two embryos. Eur J Obstet Gynecol Reprod Biol 1996; 64: 235-6.
  • Klipstein S, Oskowitz SP. Bilateral ectopic pregnancy after transfer of two embryos. Fertil Steril 2000; 74: 887-8.
  • Sánchez Contreras J, Hernández Vivar LE, Villalobos Cid MA, Risco Cortés RJ. Conservative treatment of interstitial ectopic pregnancy and endometriosis with laparoscopic methotrexate and potassium chloride and complementary management with nasal nafarelin. Report of a case and review of the literature. Ginecol Obstet Mex 2000; 68: 35-8.
  • Hunter RH. Tubal ectopic pregnancy: A patho-physiological explanation involving endometriosis. Hum Reprod 2002; 17: 1688-91.
  • Nabekura H, Koike H, Ohtsuka T, Yamaguchi M, Miyakawa I, Mori N. Fallopian tube prostaglandin production with and without endometriosis. Int J Fertil Menopausal Stud 1994; 39: 57-63.
  • Bogdanskiene G, Berlingieri P, Grudzinskas JG. Association between ectopic pregnancy and pelvic endometriosis. Int J Gynaecol Obstet 2006; 92: 157-8.
  • Marcus SF, Brinsden PR. Analysis of the incidence and risk factors associated with ectopic pregnancy following in-vitro fertilization and embryo transfer. Hum Reprod 1995; 10: 199-203.
There are 13 citations in total.

Details

Primary Language English
Journal Section Case Reports
Authors

İnci Kahyaoğu

Serkan Kahyaoğlu

Kamil Müftüoğlu

İlker Şengül

Demet Şengül

Şahin Önen

Leyla Mollamahmutoğlu

Sertaç Batıoğlu

Publication Date March 17, 2011
Published in Issue Year 2011Volume: 33 Issue: 2

Cite

AMA Kahyaoğu İ, Kahyaoğlu S, Müftüoğlu K, Şengül İ, Şengül D, Önen Ş, Mollamahmutoğlu L, Batıoğlu S. Tubal endometriosis as an insidious risk factor for tubal implantation in a procedure of assisted reproductive technique. CMJ. June 2011;33(2):248-252.