Early Diagnosis of Congenital Uterine Anomalies: Is the Three Dimensional Ultrasound Approach the Suitable Choice? 3D in Uterine Anomalies

Purposes: Congenital uterine anomalies (CUA) are benign conditions associated with relatively serious complications affecting the reproductive life. Due to their infrequency CUA are often misdiagnosed, exposing the patient to possible future complications. Case description: We report the cases of three women affected by an unknown CUA, which underwent three different diagnostic and surgical approaches. Conclusions: A correct and early diagnosis of CUA is mandatory to allow a correct clinical and therapeutic management. In our opinion we might avoid the use of MRI considered as the second line technique after 2D-US, keeping in mind that in CUA the diagnostic value of 3D-US has the same accuracy as MRI

Prostatic tissue: an unexpected finding in a mature ovarian teratoma: case report and systematic literature review

Purpose: Prostatic tissue in an ovarian teratoma is an unusual finding, whose initiation in a 46, XX karyotype tissue is yet to be clarified. We present a case from our files and review the literature for this intriguing finding. Methods: Unstained histology sections of the ovarian teratoma containing prostatic tissue were evaluated using immunohistochemistry for PSA and androgen receptor. Results: Both PSA and androgen receptor immunostainings were positive in the prostatic tissue. From the literature review, it appears that most of the patients (74%) with similar findings were either pregnant or experiencing a miscarriage, menopausal or infertile at presentation, showing that an imbalanced hormone status is frequently associated with the presence of male structures in ovarian teratomas

HPV-related vulvar diseases and perspectives of p16INK4a immunochemistry: a review of the literature

Two different types of vulvar intraepithelial neoplasia (VIN), HPV-related and HPV-unrelated, should be considered as two separate entities with different management options. The incidence of HPV-related VIN is increasing worldwide and is implicated in carcinogenesis. Our objective is to investigate the use of p16INK4a immunostaining or p16INK4a/p53 double staining for the detection of HPV-related disease to overcome the problem that histological criteria often have significant overlap

Could art cycles have a detrimental effect on ovarian reserve? A retrospective case control study

Even if it is supposed damage of repeated ART (assisted reproductive technology) cycles on oocyte pool, there is still no evidence in literature. Aim of the study is to investigate whether infertile women who undergo to several ART cycles can show a lower ovarian reserve measured by AMH (Anti-Mullerian hormone) levels

Beyond the beyond: first case of 9 cytoreductive surgeries in a long-surviving ovarian cancer patient: case report

The role of surgery in recurrent ovarian cancer (ROC) is debated. Multiple prospective and retrospective series reported improved survival with optimal secondary surgical cytoreduction, but definitive results from randomized trials are needed. Up to the fourth cytoreductive surgery for recurrent disease in an attempt to improve patients' prognosis has been reported

Age-related AMH decrease in ART patients

The anti-müllerian hormone (AMH) is an indicator of ovarian reserve in women, related to the antral follicular reserve. It’s unclear if oocyte retrieval (pick up), could be detrimental to ovarian reserve. In this study, we investigate AMH levels in ART patients submitted to one or more oocyte retrievals

Sonohysterosalpingography: Comparison of foam and saline solution

Purpose. To compare sonohysterosalpingography (sono-HSG) with foam instillation (HyFoSy) versus saline solution (HyCoSy) in the evaluation of tubal patency. Methods. We prospectively enrolled 37 infertile women, scheduled for laparoscopy. The women were randomized into two groups: HyFoSy (group I) and HyCoSy (group II). The patients of both groups underwent laparoscopy with dye test. We assessed the diagnostic performance (sensitivity, specificity, and overall accuracy) of HyFoSy and HyCoSy, compared with laparoscopy and dye test, in the assessment of tubal patency. Results. Sono-HSG findings in tubal patency assessment obtained in the HyFoSy group were concordant with laparoscopic results in 94.4% of cases, with a sensitivity of 87.5% and a specificity of 100%, whereas in the HyCoSy group, concordance occurred in only 57.8% of examinations, with a sensitivity of 50% and a specificity of 66.6%. Conclusions. HyFoSy allows a more accurate diagnosis of tubal patency compared with HyCoSy

Ultrasonography reappraisal of tubal patency in assisted reproduction technology patients: Comparison between 2D and 3D-sonohysterosalpingography. A pilot study

BacKGroUND: The aim of this study was to compare 2D and 3D-sonohysterosalpingography (2D-3D-HyFoSy) with previous diagnostic laparoscopy in the diagnosis of tubal patency, and compare each procedure in terms of procedure’s time, perceived pain and complication rate. MeTHoDS: We prospectively recruited infertile women, previously submitted to laparoscopy and randomly allocated into 2D-HyFoSy (group I) and 3D-HyFoSy (group II). We analyzed the results in term of sensitivity, specificity, positive predictive value and negative predictive value in tubal patency evaluation of both procedures in comparison with laparoscopy. RESULTS: We enrolled 50 women, 25 in group I and 25 in group II. 2D-HyFoSy findings obtained in group I, were concordant with laparoscopy in 81% of cases, with a sensitivity of 80% and a specificity of 92%. In group II, a correspondence was present in 88% of examinations, with a sensitivity and specificity of 98% and 91.4% respectively. 3D-HyFoSy was found to be faster and less painful than 2D (P<0.001). coNclUSioNS: in the diagnosis of tubal occlusion, in the high-risk population, it seems advisable to us using the 3D-HyFoSy as the first-level examination, while, in low-risk patients, if the tubes appear obstructed in 2D-HyFoSy, the 3D-HyFoSy should be indicated before submitting patients to operative laparoscopy