Clinical decisions in the management of infertility associated with endometriosis are difficult because many clinical decisión points have not been evaluated in randomized clinical trials. Laparoscopy is the gold standard for diagnosis of endometriosis and the decision to perform it should take into consideration factors such as patient´s age, duration of infertility, family history, pelvic pain, pelvic mass on ultrasound. Conservative surgical treatment of endometriosis must be directed to reproductive function recuperation by eliminating implants and reconstruction of the altered pelvic anatomy. Laparoscopic treatment of endometriosis as compared with laparotomy allows short time of hospitalization, faster recovery, smaller incisions. Surgical treatment of endometriosis associated infertility includes ablation of endometriotic implants and adhesions to improve fertility in minimal an...

En 1978, Robert Edwards y Patrick Steptoe lograron el primer embarazo con fertilización in vitro en una mujer con obstrucción tubárica bilateral; este hecho marcó un hito en el tratamiento de la infertilidad y desde entonces las técnicas de reproducción asistida no han dejado de perfeccionarse. En 1987, se logró obtener óvulos por punción ovárica guiada por ecografía transvaginal. En 1992, Palermo logró el primer embarazo con la técnica de inyección de espermatozoide intracitoplasmática (ICSI). A mediados de la década de los 90 se introdujo la biología molecular a la medicina reproductiva, lográndose el desarrollo de nuevos tratamientos de gran trascendencia para las parejas con problemas de infertilidad.

Clinical decisions in the management of infertility associated with endometriosis are difficult because many clinical decisión points have not been evaluated in randomized clinical trials. Laparoscopy is the gold standard for diagnosis of endometriosis and the decision to perform it should take into consideration factors such as patient´s age, duration of infertility, family history, pelvic pain, pelvic mass on ultrasound. Conservative surgical treatment of endometriosis must be directed to reproductive function recuperation by eliminating implants and reconstruction of the altered pelvic anatomy. Laparoscopic treatment of endometriosis as compared with laparotomy allows short time of hospitalization, faster recovery, smaller incisions. Surgical treatment of endometriosis associated infertility includes ablation of endometriotic implants and adhesions to improve fertility in minimal an...

En 1978, Robert Edwards y Patrick Steptoe lograron el primer embarazo con fertilización in vitro en una mujer con obstrucción tubárica bilateral; este hecho marcó un hito en el tratamiento de la infertilidad y desde entonces las técnicas de reproducción asistida no han dejado de perfeccionarse. En 1987, se logró obtener óvulos por punción ovárica guiada por ecografía transvaginal. En 1992, Palermo logró el primer embarazo con la técnica de inyección de espermatozoide intracitoplasmática (ICSI). A mediados de la década de los 90 se introdujo la biología molecular a la medicina reproductiva, lográndose el desarrollo de nuevos tratamientos de gran trascendencia para las parejas con problemas de infertilidad.

The digenesia Müller ducts or agenesis of the uterus and vagina, known as Mayer-Rokitansky-Kuster-Hauser syndrome is a disorder of the female reproductive characterized by primary amenorrhea and abnormalities associated with urogenital tract. We present six cases of patients with Mayer-Rokitansky syndrome, describe the clinical presentation, management, and we review the literature.

OBJECTIVE: To evaluate the efficacy of intravaginal mysoprostol to induce abortion in patients with intrauterine fetal death. DESIGN: Prospective, transversal study. MATERIAL AND METHODS: 34 patients (28 with missed abortion and 6 with anembrioned pregnancy) to whom mysoprostol was administered at the dosis of 100 ug, every 4 hours for 4 doses. RESULTS: Success was obtained in 95%, as 28 patients (82.4%) expulsed products of conception and 4 patients (11.7%) had cervical modifications that permited emergency ditalation and curettage. In 75% result was obtained with the second dosis of the product, without associated complications. There were 2 failures. We did not find differences in gestational age, parity, and number of applications required. CONCLUSION: Mysoprostol is an efficacious drug with low cost.

The digenesia Müller ducts or agenesis of the uterus and vagina, known as Mayer-Rokitansky-Kuster-Hauser syndrome is a disorder of the female reproductive characterized by primary amenorrhea and abnormalities associated with urogenital tract. We present six cases of patients with Mayer-Rokitansky syndrome, describe the clinical presentation, management, and we review the literature.

A case-control study was designed to evaluate risk factors for gestational trophoblastic disease. At Arzobispo Loayza Hospital, between 1984 lo 1992. The incidence of hydatidyforme mole was 4,711000 deliveries. Mean age of the study group was 28,42 years. High school level of education was associated with lower risk (OR=0,48; CI=0,233-0,98). Socioeconomic status was not related to risk. No effect of protection or risk was related to the parity of the patients. Women with the disease bad an average age at first pregnancy (19,97 years) lower than that of controls (21,22 years). The personal history of previous gestational trophoblastic disease was associated with an odds ratio of 6.51; however, it was without significance (p=0,101).

To determine the incidence and characteristics of presentation of endometriosis patients with infertility. DESIGN: In a retrospective study of medical records of 2720 patients attending the Infertility Clinic of the Archbishop Loayza Hospital, between the months of January 1993 and July 1997 was revised RESULTS: Of the 532 patients underwent laparoscopy or laparotomy and 773 cases of endometriosis was found, representing 32.5%. They entered the study 166 cases that met the inclusion criteria. The age of the patients was 33.3 ± 4.9 years (mean ± standard deviation). 59% of the cases occurred in stage I of endometriosis. Most patients (59.6%) had primary infertility and infertility average time was 51.2 (± 38.4) months. 75.9% of the patients had some type of symptoms, primarily pain (dysmenorrhea, dyspareunia, chronic pelvic pain), but only 25.9% had alterations in the pelvic exam. 66% ...

Objective: To determine the current status of male infertility in a general hospital. Design: Descriptive, retrospective study. Material and Methods: We reviewed 371 charts of male patients attended at Arzobispo Loayza Hospital Infertility Service in a 4 - year period. Inclusion criteria were male infertility diagnosis with pathological results in two or more spermatograms and/or ejaculatory sexual dysfunction. Results: We found 79 cases of male infertility, incidence 21,3%. Average age at diagnosis was 35, 9 years, average time of infertility 4 years, 64,8% with primary infertility. Most frequent diagnosis were infection of accessory sexual glands (38%), abnormal seminal plasma (16,5%), azoospermia (15,2%), idiopathic astenozoospermia (12, 7%). Most frequent germ found was hemolytic Streptococcus alpha (50%). 22,8% of the couples conceived mostly with antibiotics use, intrauterine insem...

OBJECTIVE: To determine demographic and clinical characteristics of patients with infertility due to salpingitis. SETTING: Arzobispo Loayza Hospital, from January through June 2001. MATERIAL AND METODOS: Review of clinical registries of 77 patients with infertility due to salpingitis. RESULTS: Fifty-two patients (67%) were between 30 and 39 year-old; 54 (70%) began sexual relations beyond 18year old, 31 (40%) had only one sexual partner and 35 (40%) two; 18 (23%) had a previous episode of pelvic inflammatory disease (PID) and 30 (39%) pain and/or thickened adnexae. CONCLUSIONS: Most patients with infertility due to salpingitis do not present risk factors for PID or previous PID episodes. Diagnosis was done by infertility sequelae.

Objective: To evaluate clinical and hormonal findings related to polycystic ovary. Design: Retrospective study. Setting: Gynecology and Infertility Service, Arzobispo Loayza Hospital. Material and Methods: Hormonal profile was determined in 69 reproductive age patients with transvaginal ultrasound diagnosis of polycystic ovaries. Results: Patients presented oligoamenorrhea in 67,7%, infertility in 28,8%, hirsutism in 23,7% and body mass index > 25 in 42,4%. LH was elevated in 47,1 %, LH/FSH > 2 in 24,5% and high testosterone in 20,9 %. Sixty-four per cent of obese women presented oligoamenorrhea, 42,8% hirsutism, 50% infertility and 50% high LH. Conclusion: There was hormonal and clinical correlation with obesity in polycystic ovaries patients.

Objective: To evaluate clinical and hormonal findings related to polycystic ovary. Design: Retrospective study. Setting: Gynecology and Infertility Service, Arzobispo Loayza Hospital. Material and Methods: Hormonal profile was determined in 69 reproductive age patients with transvaginal ultrasound diagnosis of polycystic ovaries. Results: Patients presented oligoamenorrhea in 67,7%, infertility in 28,8%, hirsutism in 23,7% and body mass index > 25 in 42,4%. LH was elevated in 47,1 %, LH/FSH > 2 in 24,5% and high testosterone in 20,9 %. Sixty-four per cent of obese women presented oligoamenorrhea, 42,8% hirsutism, 50% infertility and 50% high LH. Conclusion: There was hormonal and clinical correlation with obesity in polycystic ovaries patients.

Objective: To determine the current status of male infertility in a general hospital. Design: Descriptive, retrospective study. Material and Methods: We reviewed 371 charts of male patients attended at Arzobispo Loayza Hospital Infertility Service in a 4 - year period. Inclusion criteria were male infertility diagnosis with pathological results in two or more spermatograms and/or ejaculatory sexual dysfunction. Results: We found 79 cases of male infertility, incidence 21,3%. Average age at diagnosis was 35, 9 years, average time of infertility 4 years, 64,8% with primary infertility. Most frequent diagnosis were infection of accessory sexual glands (38%), abnormal seminal plasma (16,5%), azoospermia (15,2%), idiopathic astenozoospermia (12, 7%). Most frequent germ found was hemolytic Streptococcus alpha (50%). 22,8% of the couples conceived mostly with antibiotics use, intrauterine insem...

OBJECTIVE: To determine demographic and clinical characteristics of patients with infertility due to salpingitis. SETTING: Arzobispo Loayza Hospital, from January through June 2001. MATERIAL AND METODOS: Review of clinical registries of 77 patients with infertility due to salpingitis. RESULTS: Fifty-two patients (67%) were between 30 and 39 year-old; 54 (70%) began sexual relations beyond 18year old, 31 (40%) had only one sexual partner and 35 (40%) two; 18 (23%) had a previous episode of pelvic inflammatory disease (PID) and 30 (39%) pain and/or thickened adnexae. CONCLUSIONS: Most patients with infertility due to salpingitis do not present risk factors for PID or previous PID episodes. Diagnosis was done by infertility sequelae.

In 106 women attended at the gynecological outpatient service, we found that sexual activity and sexual desire decrease after menopause, mainly because of less sexual desire, not explained by 60% of patients. Patients with history of pelvic surgery had less satisfactory sexual relations. Sexual initiative of Peruvian postmenopausal women is minimal.

In 106 women attended at the gynecological out patien service, we found that sexual activity and sexual desire decrease after menopause, mainly because of less sexual desire, not explained by 60% of patients. Patients with history of pelvic surgery bad less satisfactory sexual relations. Sexual initiative of Peruvian postmenopausa women is minimal.

In 106 women attended at the gynecological outpatient service, we found that sexual activity and sexual desire decrease after menopause, mainly because of less sexual desire, not explained by 60% of patients. Patients with history of pelvic surgery had less satisfactory sexual relations. Sexual initiative of Peruvian postmenopausal women is minimal.

In 106 women attended at the gynecological out patien service, we found that sexual activity and sexual desire decrease after menopause, mainly because of less sexual desire, not explained by 60% of patients. Patients with history of pelvic surgery bad less satisfactory sexual relations. Sexual initiative of Peruvian postmenopausa women is minimal.

Polycystic ovary - Pathophysiology, Clinical Features, Diagnosis, Treatment.