Hysteroscopic myomectomy in a submucous fibroid 3 mm from the serosa: A case report - Case report from the endoscopy service of Ginendo-RJ

This is a case report of a 39-year-old black woman, nulliparous, married who presented a heavy menstrual flow with clots and dysmenorrhea. Gynaecological examination of the uterus revealed RVF, mobility, no pain, slight enlargement, and right displacement. Magnetic resonance imaging (MRI) of the pelvis showed a 40 mm submucous fibroid with intramural component less than 50%, type 1, with a 3 mm distance from serosa. In an office hysteroscopy, it was noted a 40 mm submucous fibroid with an intramural component with less than 50%, type 1, classified in STEP-W submucous fibroids classification as a Score 6, Group II. The patient was submitted to partial hysteroscopic myomectomy, removing 60% of the fibroid volume in a 48.75-minute surgery. GnRH analogue was indicated for 3 months before another intervention. In the second evaluation MRI revealed a 22 mm-fibroid with intramural component more than 50%, type 2, with a 7 mm distance from serosa. Hysteroscopy found a 20 mm submucous fibroid, with intramural component more than 50%, type 2, Score 4, Group I on STEP-W classification. The patient was submitted to a second hysteroscopic myomectomy with complete removal and 10.5 minutes operating time, without complications. © 2006 Springer-Verlag.

Avaliação da liberação de lh e da concentração de progesterona em protocolos ovsynch e heatsynch em bubalinos (bubalus bubalis)

The objective of this study was to evaluate the LH surge after last hormonal injection of synchronization of ovulation protocols in buffalo. Fifteen multiparous buffaloes received 25 mg of Lecirelin in Day 0, and 150 mg of D-Cloprostenol on Day 7. On Day 8, estradiol benzoate was injected in Group 1 (0.5 mg, n = 5) and Group 2 (1.0 mg, n = 5). On Day 9, five buffaloes received 25 mg of Lecirelin (Control). Blood samples were collected for measure the LH concentrations on Day 7 and then every 3 hours until 72 hours after the PGF 2a injection. For evaluation of LH surge were compared the interval between PGF 2a injection to LH surge, duration, amplitude and area under the LH peak. The LH surge occurred 51.0 + 0.0 hours, 47.3 + 2.7 hours and 47.0 + 3.8 hours after PGF 2a injection for Control, Group 1 and Group 2, respectively (P > 0.05). The duration of LH peak in Control (7.8 + 1.5 hours) was shorter than Groups 1 and 2 (10.5 + 1.5 hours vs. 10.8 + 2.4 hours, respectively; P < 0.05). The amplitudes of LH peak were 4.5 + 0.4 ng/mL, 4.0 + 0.4 ng/mL and 4.3 + 0.8 ng/mL for Control, Group 1 and Group 2, respectively (P > 0.05). The area under LH peak for Control (4.8 ± 0.7) was smaller than the areas of the Groups 1 and 2 (8.8 ± 2.5 vs. 8.7 2.2, respectively; P < 0.05). In summary, the estradiol benzoate injection provided higher duration and area of LH peak than GnRH injection in Ovsynch protocol in buffalo.

Eficiência do protocolo Ovsynch em ovelhas da raça Santa Inês

Twenty six Santa Inês ewes were asigned to three treatments to evaluate the efficiency of the Ovsynch protocol. In the treatment 1 - control (n=8), the estrus was synchronized with sponges containing 60 mg MAP for 14 days. On D14, 300 IU eCG were administered. In treatment 2 (n=9) the Ovsynch protocol was used: 25 μg of GnRH (D0), 37.5 μg of PGF2α (D7) and 25 μg of GnRH (D9). In treatment 3 (n=9) the modified Ovsynch protocol was used: the administration of PGF2α and second GnRH as two days early. Estrus detection was accomplished using teaser. All ewes were mated twice with 12 hours of interval. Pregnancy rate (PR) was evaluated by ultrasonography 30 days after the end of mating. Estrus response was of 88.46% on average, and without differences among treatments (p>0.05). The interval for onset of estrus was greater (p<0.05) in T1, when compared with T2 and T3 (41.31±7.2, 13.37±8.42 and 6.75±5.2 h, respectively). The time of receptivity was greater (p<0.05) in females of T1 and T3 (40.5±6.49 h and 53.68±10.27 h, respectively), compared to females of T2 (34.56±7.2 h). The duration of the induced estrus did not differ significant among treatments (p>0.05). Pregnancy rate was significantly greater (p<0.05) in ewes synchronized with Ovsynch protocol (37.5%, 62.5% and 25% for treatment 1, 2 and 3, respectively). The results show superior efficiency of the Ovsynch protocol, under the experimental conditions.

Hysteroscopic myomectomy in a submucous fibroid near from tubal ostia and 5 mm from the serosa: A case report from the Endoscopy Service of Ginendo-RJ

This is a case report of a 27-year-old white woman, nuliparous, single, who presented a heavy menstrual flow with clots, dysmenorrhoea and anaemia. Gynaecological examination of the uterus revealed anteverted position, mobility, no pain, slight enlargement and right displacement. Magnetic resonance imaging of the pelvis showed a 29-mm submucous fibroid with intramural component more than 50%, type 2, in the posterior wall, with a 5-mm distance from serosa. In office hysteroscopy, a 30-mm submucous fibroid with an intramural component with more than 50%, type 2, near around 5 mm from left tubal ostia, classified in STEP-W submucous fibroids classification as score 6, group II, was noted. GnRH analogue was indicated for 3 months before intervention to treat anaemia. The patient was submitted to hysteroscopic myomectomy with direct mobilisation technique, with the fibroid completely removed without complications in a surgery which lasted for 52 min and 20 s. © 2008 Springer-Verlag.

Sincronização do estro e da ovulação utilizando protocolos de curta duração durante a pré- estação reprodutiva em ovelhas Suffolk

This study was carried out with the objective of examining the effect of the short-term estrus synchronization protocol. Ewes were divided in four groups: Control Group (MAP sponges for 12 days, and eCG at withdrawal); Groups I, II and III used the sponge for four days, and 100 μg of PGF was applied at withdrawal; and additionally, Group I (0.1 mg of Estradiol benzoate - EB, in the sponge placement, and in the withdrawn 400 UI of eCG and 50 μg of GnRH 48h later); Group II (35 mg of injectable progesterone and 0.1 mg of EB in the sponge placement, and 400 UI of eCG at withdrawal, and 50 μg of GnRH 48h after); Group III (35 mg of injectable progesterone and 0.2 mg of EB in the sponge placement, and 400 UI of eCG at withdrawal, and 50 ?g of GnRH 56h after). Exams were accomplished for ultrasound and determine the plasmatic concentrations of progesterone and observations of the beginning the estrus and the ovulation. The lack of eCG in Group I caused this protocol to be less efficacious in induction and synchronization of estrus and ovulation. The Control Group had a greater synchronization of estrus and ovulation.

Cost-effectiveness comparison between pituitary down-regulation with a gonadotropin-releasing hormone agonist short regimen on alternate days and an antagonist protocol for assisted fertilization treatments

Objective: To compare cost-effectiveness between pituitary down-regulation with a GnRH agonist (GnRHa) short regimen on alternate days and GnRH antagonist (GnRHant) multidose protocol on in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcome. Design: Prospective, randomized. Setting: A private center. Patient(s): Patients were randomized into GnRHa (n = 48) and GnRHant (n = 48) groups. Intervention(s): GnRHa stimulation protocol: administration of triptorelin on alternate days starting on the first day of the cycle, recombinant FSH (rFSH), and recombinant hCG (rhCG) microdose. GnRHant protocol: administration of a daily dose of rFSH, cetrorelix, and rhCG microdose. Main Outcome Measure(s): ICSI outcomes and treatment costs. Result(s): A significantly lower number of patients underwent embryo transfer in the GnRHa group. Clinical pregnancy rate was significantly lower and miscarriage rate was significantly higher in the GnRHa group. It was observed a significant lower cost per cycle in the GnRHa group compared with the GnRHant group ($5,327.80 ± 387.30 vs. $5,900.40 ± 472.50). However, mean cost per pregnancy in the GnRHa was higher than in the GnRHant group ($19,671.80 ± 1,430.00 vs. $11,328.70 ± 907.20). Conclusion(s): Although the short controlled ovarian stimulation protocol with GnRHa on alternate days, rFSH, and rhCG microdose may lower the cost of an individual IVF cycle, it requires more cycles to achieve pregnancy. Clinical Trial Registration Number: NCT01468441. © 2013 by American Society for Reproductive Medicine.

Timing of prostaglandin F2α treatment in an estrogen-based protocol for timed artificial insemination or timed embryo transfer in lactating dairy cows

Objectives were to investigate progesterone concentrations and fertility comparing 2 different intervals from PGF2α treatment and induced ovulation in an estrogen-based ovulation synchronization protocol for timed artificial insemination (TAI) or timed embryo transfer (TET) in lactating dairy cows. A total of 1,058 lactating Holstein cows [primiparous (n=371) and multiparous (n=687)], yielding 34.1±0.33 kg of milk/d at various days in milk were randomly assigned to receive treatment with PGF2α on either d 7 or 8 of the following protocol: d 0: 2mg of estradiol benzoate + controlled internal drug release device; d 8: controlled internal drug release device removal + 1.0mg of estradiol cypionate; d 10: TAI or d 17: TET. Only cows with a corpus luteum at d 17 received an embryo and all cows received GnRH at TET. Pregnancy diagnoses were performed by detection (transrectal ultrasonography) of an embryo on d 28 or a fetus on d 60. Fertility [pregnancy per artificial insemination (P/AI) or pregnancy per embryo transfer (P/ET)] was affected by breeding technique (AI vs. ET) and time of PGF2α treatment (d 7 vs. 8) at the 28-d pregnancy diagnosis for TAI [32.9% (238) vs. 20.6% (168)] and TET cows [47% (243) vs. 40.7% (244)] and at the 60-d pregnancy diagnosis for TAI [30% (238) vs. 19.2% (168)] and TET cows [37.9% (243) vs. 33.5% (244)]. The progesterone (P4) concentration at d 10 altered fertility in TAI cows, with higher P/AI in cows with P4 concentration <0.1 ng/mL compared with cows with P4 concentration ≥0.1 ng/mL, and in ET cows, with higher P/ET in cows with P4 concentration <0.22 ng/mL compared with cows with P4 concentration ≥0.22 ng/mL. Prostaglandin F2α treatment at d 7 increased the percentage of cows with P4 <0.1 ng/mL on d 10 [39.4 (85) vs. 23.2 (54)]. Reducing the period between PGF2α and TAI from 72 to 48h in dairy cows resulted in a clear reduction in fertility in cows bred by TAI and a subtle negative effect in cows that received TET. The earlier PGF2α treatment benefits are most likely mediated through gamete transport, fertilization, or early embryo development and a more subtle effect of earlier PGF2α treatment that may be mediated through changes in the uterine or hormonal environment that manifests itself after ET on d 7. © 2013 American Dairy Science Association.

Timed artificial insemination programs during the summer in lactating dairy cows: Comparison of the 5-d Cosynch protocol with an estrogen/progesterone-based protocol

The objective of this study was to compare a GnRH-based to an estrogen/progesterone (E2/P4)-based protocol for estrous cycle synchronization and fixed timed artificial insemination (TAI), both designed for synchronization of ovulation and to reduce the period from follicular emergence until ovulation in cows with a synchronized follicular wave. A total of 1,190 lactating Holstein cows (primiparous: n = 685 and multiparous: n = 505) yielding 26.5 ± 0.30 kg of milk/d at 177 ± 5.02 d in milk were randomly assigned to receive one of the following programs: 5-d Cosynch protocol [d -8: controlled internal drug release (CIDR) + GnRH; d -3: CIDR removal + PGF2α; d -2: PGF2α; d 0: TAI + GnRH] or E2/P4 protocol (d -10: CIDR + estradiol benzoate; d -3: PGF2α; d -2: CIDR removal + estradiol cypionate; d 0: TAI). Rectal temperature and circulating progesterone (P4) were measured on d -3, -2, 0 (TAI), and 7. The estrous cycle was considered to be synchronized when P4 was ≥1.0 ng/mL on d 7 in cows that had luteolysis (P4 ≤0.4 ng/mL on d 0). To evaluate the effects of heat stress, cows were classified by number of heat stress events: 0, 1, and 2-or-more measurements of elevated body temperature (≥39.1°C). Pregnancy success (pregnancy per artificial insemination, P/AI) was determined at d 32 and 60 after TAI. The cows in the 5-d Cosynch protocol had increased circulating P4 at the time of PGF2α injection (2.66 ± 0.13 vs. 1.66 ± 0.13 ng/mL). The cows in the E2/P4 protocol were more likely to be detected in estrus (62.8 vs. 43.4%) compared with the cows in the 5-d Cosynch protocol, and expression of estrus improved P/AI in both treatments. The cows in the 5-d Cosynch protocol had greater percentage of synchronized estrous cycle (78.2%), compared with cows in the E2/P4 protocol (70.7%). On d 60, the E2/P4 protocol tended to improve P/AI (20.7 vs. 16.7%) and reduced pregnancy loss from 32 to 60 d (11.0 vs. 19.6%), compared with the 5-d Cosynch protocol. In cows with their estrous cycle synchronized, the E2/P4 protocol had greater P/AI (25.6 vs. 17.7%) on d 60 and lower pregnancy loss from 32 to 60 d (6.7 vs. 21.7%) compared with cows in the 5-d Cosynch protocol. Follicle diameter affected pregnancy loss from 32 to 60 d only in the cows in the 5-d Cosynch protocol, with smaller follicles resulting in greater pregnancy loss. Pregnancy per AI at d 60 was different between protocols in the cows with 2 or more measurements of heat stress (5-d Cosynch = 12.2% vs. E2/P4 = 22.8%), but not in the cows without or with 1 heat stress measurement. In conclusion, the 5-d Cosynch protocol apparently produced better estrous cycle synchronization than the E2/P4 protocol but did not improve P/AI. The potential explanation for these results is that increased E2 concentrations during the periovulatory period can improve pregnancy success and pregnancy maintenance, and this effect appears to be greatest in heat-stressed cows when circulating E2 may be reduced. © 2013 American Dairy Science Association.

Variação na secreção de LH, FSH e no desenvolvimento folicular de novilhas nelore submetidasa protocolos de inseminação artificial em tempo fixo com diferentes concentrações de progesterona

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Mês de parição, condição corporal e resposta a protocolos de inseminação artificial em tempo fixo em vacas de corte primíparas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito de protocolos de sincronização de ovulação na taxa de prenhez em vacas leiteiras mestiças mantidas a pasto no verão

Pós-graduação em Zootecnia - FMVZ

Métodos de castração de machos Aberdeen Angus x Nelore terminados em pastagem

Pós-graduação em Zootecnia - FCAV

Utilização do implante de progesterona intra-vaginal e acetato de deslorelina em éguas acíclicas associados ou não a luz artificial para o controle da sazonalidade repprodutiva

Pós-graduação em Medicina Veterinária - FMVZ

Efeitos do benzoato de estradiol e/ou GnRn na função ovariana de ovelhas Santa Inês

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Suplementação com monensina pré e pós-parto associada a estratégias de sincronização da ovulação em vacas Nelore

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)