Human reproduction
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With the introduction of intracytoplasmic sperm injection (ICSI), couples with severe male factor infertility have achieved fertilization and clinical pregnancy rates comparable to other in-vitro fertilization (IVF) patients. However, failure of fertilization still occurs in some patients despite the utilization of microsurgical sperm injection techniques. How such fertilization failure after ICSI might impact later ICSI treatment(s) is unknown. ⋯ Review of semen parameters, superovulation characteristics or other clinical parameters during the three study cycles (pre-index, index, and post-index) was not prognostic of fertilization success or reproductive outcomes in later treatments. Fertilization failure with ICSI therefore could not be predicted by prior cycle performance, although total immotility of spermatozoa at time of oocyte retrieval, total teratozoospermia, and low oocyte yield were common characteristics of couples experiencing complete fertilization failure with ICSI. These findings suggest that fertilization failure in one ICSI cycle does not preclude successful fertilization and delivery in a later ICSI treatment.
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The goal of this study was to assess the risk of adhesions after laparoscopic myomectomy. To this end our enquiry was based on observations with a prospective collection of data. Between October 26, 1990 and October 1, 1996, 45 patients underwent a second look after laparoscopic myomectomy. ⋯ The factors which influenced the occurrence of adnexal adhesions were another surgical procedure carried out at the same time, the existence of adhesions prior to the operation and posterior location of the myoma. The rate of adhesions after laparoscopic myomectomy is low and the adhesions rarely involved the adnexa. We recommend that a second-look laparoscopy be carried out systematically after laparoscopic myomectomy in patients desiring pregnancy.