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Assisted Reproductive Techniques and submucous myoma
Submucous myomas have negative effects on fertility. To maintain fertility, conservative treatment should be suggested to women who wish to become pregnant, especially young patients. The patient was a 33-year-old woman, who had had secondary infertility for 3 years. Upon vaginal ultrasound, we noti...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Brazilian Society of Assisted Reproduction
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489814/ https://www.ncbi.nlm.nih.gov/pubmed/34415133 http://dx.doi.org/10.5935/1518-0557.20210042 |
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author | Nikbakht, Roshan Dorfeshan, Parvin |
author_facet | Nikbakht, Roshan Dorfeshan, Parvin |
author_sort | Nikbakht, Roshan |
collection | PubMed |
description | Submucous myomas have negative effects on fertility. To maintain fertility, conservative treatment should be suggested to women who wish to become pregnant, especially young patients. The patient was a 33-year-old woman, who had had secondary infertility for 3 years. Upon vaginal ultrasound, we noticed a submucous myoma measuring 26 mm x 31 mm with a compressive effect on the anterior surface of the endometrium. Ovarian reserve was low. The gold standard of myoma treatment is surgical intervention. But, for the following reasons: the adverse effects of surgery on the endometrium (intrauterine adhesion), the patient's refusal to undergo a myomectomy and her request for pregnancy, our strategy for treating was to reduce volume of submucous myoma and start the assisted reproductive techniques (ART) cycle, simultaneously. We administered three courses of Gonadotropin-releasing hormone analogues (GnRHa) and then induced controlled ovarian hyperstimulation. Ovum pick up was done. Finally, we transferred two embryos (4 and 6 cells). In subsequent patient visits, βhCG was positive after 14 days. At the last patient visit, the heart of the embryo was formed. From this finding, it may be concluded that combined GnRHa and ART is the treatment of choice for infertile women with uterine submucous myoma, considering the reduced ovarian reserve and response. |
format | Online Article Text |
id | pubmed-8489814 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Brazilian Society of Assisted Reproduction |
record_format | MEDLINE/PubMed |
spelling | pubmed-84898142021-10-07 Assisted Reproductive Techniques and submucous myoma Nikbakht, Roshan Dorfeshan, Parvin JBRA Assist Reprod Case Report Submucous myomas have negative effects on fertility. To maintain fertility, conservative treatment should be suggested to women who wish to become pregnant, especially young patients. The patient was a 33-year-old woman, who had had secondary infertility for 3 years. Upon vaginal ultrasound, we noticed a submucous myoma measuring 26 mm x 31 mm with a compressive effect on the anterior surface of the endometrium. Ovarian reserve was low. The gold standard of myoma treatment is surgical intervention. But, for the following reasons: the adverse effects of surgery on the endometrium (intrauterine adhesion), the patient's refusal to undergo a myomectomy and her request for pregnancy, our strategy for treating was to reduce volume of submucous myoma and start the assisted reproductive techniques (ART) cycle, simultaneously. We administered three courses of Gonadotropin-releasing hormone analogues (GnRHa) and then induced controlled ovarian hyperstimulation. Ovum pick up was done. Finally, we transferred two embryos (4 and 6 cells). In subsequent patient visits, βhCG was positive after 14 days. At the last patient visit, the heart of the embryo was formed. From this finding, it may be concluded that combined GnRHa and ART is the treatment of choice for infertile women with uterine submucous myoma, considering the reduced ovarian reserve and response. Brazilian Society of Assisted Reproduction 2021 /pmc/articles/PMC8489814/ /pubmed/34415133 http://dx.doi.org/10.5935/1518-0557.20210042 Text en https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Nikbakht, Roshan Dorfeshan, Parvin Assisted Reproductive Techniques and submucous myoma |
title | Assisted Reproductive Techniques and submucous myoma |
title_full | Assisted Reproductive Techniques and submucous myoma |
title_fullStr | Assisted Reproductive Techniques and submucous myoma |
title_full_unstemmed | Assisted Reproductive Techniques and submucous myoma |
title_short | Assisted Reproductive Techniques and submucous myoma |
title_sort | assisted reproductive techniques and submucous myoma |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489814/ https://www.ncbi.nlm.nih.gov/pubmed/34415133 http://dx.doi.org/10.5935/1518-0557.20210042 |
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