This is a case report and review of the diagnosis and management of rudimentary horn pregnancy in a unicornuate uterus.
Human ; Female ; Young Adult ; PREGNANCY ; UTERUS

Background: Gonadotropin-releasing hormone agonist (GnHRa) is used postoperatively for pain eradication and recurrence prevention in patients with endometriosis. However, the hypoestrogenic state induced by these agents limits its acceptability and safety. Objective: To know the effect of 1.88 mg monthly injection of GnHRa therapy for post-operative treatment of endometriosis-associated pain. Methodology: Prospective longitudinal study conducted between May 2010-February 2011. Six patients with endometriosis-associated pain were given 1.88 mg GnHRa SC every 4 weeks for 12 weeks. Endometriosis-associated pain was graded using the Biberoglu and Behrman scale. Serum estradiol is measured and adverse symptoms were recorded. Results: Mean pelvic pain scores during treatment were significantly lower than before treatment at all time points. Serum estradiol levels after the 2nd dose were within the therapeutic window (20-50 pg/ml) and remained so during the treatment period. Conclusion: Half-dose GnHRa maintained therapeutic effectiveness is postoperative patients with enmetriosis-associated pain. Favorable levels of plasma estradiol were maintained wihtin therapeutic window. No adverse events were recorded.
Human ; GONADOTROPIN-RELEASING HORMONE ; ENDOMETRIOSIS

Objective: To determine which of the following factors at initial surgery-such as diameter of largest endometriotic cyst, number of cysts, diseases severity, type of surgery (laparoscopy versus laparotomy), or postoperative medical therapy-best correlated with the time of recurrence of ovarian endometrioma. Design: A retrospective descriptive study was performed on 25 patients who underwent initial surgical excision of endometriotic cyst and had cyst recurrence demonstrated either on ultrasound or repeat surgery. The clinical presentation of cyst recurrence was described. The operative findings of the first and second surgeries were compared. Factors which may affect the time of cyst recurrence were evaluated. Results: Cyst recurrence was demonstrated by ultrasound in 24 (96 percent) cases; repeat surgery for recurrence was done in only 10 (40 percent) cases. The different factors in the initial surgery: type of operation, size, number, and laterality of the endometriotic cyst, disease severity, adhesions and postoperative medical therapy, did not influence the time of recurrence of ovarian endometrioma. Disease severity was a significant factor on repeat surgery. Conclusion: The different factors aforementioned, which were present in the first surgery, did not influence the time of recurrence of ovarian endometrioma.
Human ; Female ; Adult ; ENDOMETRIOSIS ; RECURRENCE

Perineal endometriosis is a rare complication of episiotomy. This is a case of a 44-year old woman with cyclic perineal pain and a history of episiotomy. A wedge biopsy of the perineal mass confirmed the diagnosis of endometriosis. Awareness of the occurrence of this rare type of extrapelvic pain during menses secondary to perineal cudometriosis is important.
Human ; Female ; Adult ; ANAL CANAL ; ENDOMETRIOSIS ; NEURALGIA

OBJECTIVES: To determine the incidence of ectopic pregnancy after IVF at the Center for Advanced Reproductive Medicine and Infertility (CARMI) in St. Luke's Medical Center-Global City (SLMC-GC) and to describe the clinical characteristics of these patients and identity possible risk factors for ectopic pregnancy following IVF.

STUDY DESIGN: This is a descriptive cross-sectional study, with the digital database of CARMI as the source of patient information. Demographic and clinical data were obtained and tabulated. Statistical analyses were performed to identify possible risk factors for the tabulated. Statistical analyses were performed to identify possible risk factors for the development of ectopic pregnancy in IVF cases.

RESULTS: There were a total of 243 clinical pregnancies among the 929 IVF-ET cases from September 2011 to April 2015. There were five cases of ectopic pregnancy. Frozen embryo transfer was the only variable found to be significantly associated with ectopic pregnancy (p=0.003).

CONCLUSION: The ectopic pregnancy rate among IVF cycles in CARMI is 2.1%. Only frozen embryo cycle was found to be significantly associated with the development of EP. The other clinical variables that were studied showed no statistical significance.

Background: Growth hormone has been used as an adjunct in ovarian stimulation of IVF cycles for the past three decades. However, the exact mechanism of its role in improving oocyte quality has not been thoroughly investigated. Although a clear indication for GH co-treatment is in infertile women with GH deficiency, GH has been given mostly to poor ovarian responders. Method: This paper is a review of the most recent published data on the role of GH supplementation in improving oocyte quality in younger women who are suboptimal or unexpected poor responders to standard ovarian stimulation. Results: Retrospective cohort and randomized trials demonstrated an improvement in oocyte quality through morphological parameters, mitochondrial function, biomarkers, GH receptors, insulin growth factor, markers of oxidative stress, mature oocytes, good quality embryos, implantation rate, clinical pregnancy and live birth. Conclusion Current data suggest GH supplementation may improve oocyte and embryo qualities, endometrial receptivity, clinical pregnancy and live birth. However, better quality evidence is needed before a recommendation can be made for GH supplementation to be given to infertile women who are suboptimal or poor ovarian responders.
growth hormone ; hormone receptor ; IGF-1 ; IVF

Background: PCOS is a common gynecologic disorder and recent studies have found that they are more prone in developing depression and anxiety compared to the general population. The Hospital Anxiety and Depression Scale (HADS) is a popular and simple self-administered instrument reliable for detecting states of anxiety and depression. Using this simple screening tool, it may lead to the identification of such mental disorders that may warrant timely psychiatric referral. Objectives: We aim to determine the prevalence of anxiety and depression among PCOS patients using the HADS-P questionnaire. We also aim to determine association between depression & anxiety and disease characteristics. Methods: This is a cross-sectional study using convenience sampling of PCOS patients >18 years old in Philippine General Hospital. The HADS-P, a self-administered rating scale with independent subscales for anxiety and depression, was administered to the participants after securing consent. A cut–off score of >8 points on either of the depression and anxiety subscale was used to determine their respective prevalence. Logistic regression analysis was used to determine the association of clinical variables with anxiety or depression. Results: A total of 253 patients with PCOS were recruited. On the basis of a HADS-P score of >8.0 per category, the prevalence of PCOS patients who were suggestive to have anxiety was 46.25% (n: 117, 95% CI: 39.98-52.60%), while 9.09% (n: 23, 95% CI: 5.85-13.33%) of them were suggestive to have depression. Crude logistic regression identified presence of depression, infertility, impaired glucose tolerance and prominent acne as predictors of anxiety; whereas low parity, hirsutism and presence of anxiety were predictors of depression. Adjusted logistic regression identified only presence of depression and infertility were significant predictors of anxiety (n: 116, LR χ2 (5): 15.46, p<0.01); while presence of anxiety increase the odds of depression by 2 to 13 fold, it was not statistically significant (n: 116, LR χ2 (5): 9.79, p: 0.08). Conclusion There is a high prevalence of anxiety and depression among PCOS patients. The factors that were seen to be significantly associated with the development of anxiety were the presence of depression, impaired glucose tolerance, infertility and prominent acne, while for the development of depression were the presence of anxiety, hirsutism and low parity. Screening for anxiety and depression is of paramount importance and physicians should be vigilant for the need of possible psychiatric intervention.
Anxiety ; Depression ; Hads ; 4-amino-4' ; -hydroxylaminodiphenylsulfone ; Polycystic Ovary Syndrome