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To record the sequence, Stephan Gordts and Ivo Brosens of the Leuven Institute for Fertility & Embryology in Belgium performed transvaginal laparoscopy, which involves making a small cut in the vaginal wall and observing the ovary with an endoscope.
"This allows us direct access to and observation of the tubo-ovarian structures without manipulation using forceps," says Gordts.
For the photos of ovulation, which only accidentally captured the critical moment, Jacques Donnez at the Catholic University of Louvain (UCL) in Brussels, Belgium, used gas to distend the organs for photography. However, Gordts and Brosens planned the procedure to coincide with ovulation and used saline solution to "float" the structures.
Perfect timing
Observation was timed for the day of the peak of the patient's luteal hormone cycle. Ovulation was predicted to occur on the evening of the day of the LH peak, and the endoscope introduced at 6 pm.
A small amount of saline was used to float the opening of the fallopian tube, its fimbriae (the "fingers" that sweep the egg into the tube) and the ovary itself. This gives a more natural appearance than gas, says Gordts.
In the video, the fimbriae can be seen sweeping in time with the patient's heartbeat. A mucus plug can be seen protruding from the ovary – this contains the egg.
"The ovum is not captured 'naked'," says Gordts. "There is no eruption like a volcano."
Gordts says that in clinical practice it is not easy to organise the observation of ovulation. "We were probably lucky to be successful at our first attempt," he says.
A rare view into fertilization, embryo development, and laboratory procedures performed during an IVF cycle. Take an exclusive look inside one of the most advanced, state-of-the-art in vitro fertilization (IVF) laboratories to see how RMA of New York performs IVF and other advanced reproductive technologies using strict identification standards.
Medical and laboratory video footage documents egg retrieval, insemination, embryo development from cleavage stage (day 2-3) to blastocyst stage (day 5-6), intracytoplasmic sperm injection (ICSI), assisted hatching, embryo transfer and embryo cryopreservation.
Reproductive Medicine Associates of New York
www.rmany.com
635 Madison Avenue, 10th floor
New York, New York 10022
Telephone: (212) 756-5777
Facsimile: (212) 756-5770
15 North Broadway, Garden Level - Suite G
White Plains, New York 10601
Telephone: (914) 997-6200
Facsimile: (914) 997-8111
Reproductive Medicine Associates of New York, Long Island
400 Garden City Plaza, Suite 107
Garden City, NY 11530
Telephone: (516) 746-3633
Facsimile: (516) 746-3622
Reproductive Medicine Associates International Mexico, S.C.
Prolongacion Paseo de la Reforma 1232, Oficina 1213
Colonia Lomas de Bezares
Delegacion Miguel Hidalgo
Mexico, Distrito Federal 11910
Telephone: 011-52-55-2167-2515
Fax: 011-52-55-2167-6434
A Lecture Presented by Dr. Mostafa Yakoot to Vascular Surgery Congress. TITLE: SAFETY & EFFICACY OF A NEW HONEY OINTMENT (PEDYPHAR) FOR DIABETIC FOOT ULCERS. Based on the original article in JWC by: Yakoot M, Abdelatif M, Etman M.
Caesarean section is the most common way to deliver a breech baby in the USA, Australia, and Great Britain. Like any major surgery, it involves risks. Maternal mortality is increased by a Caesarean section, but still remains a rare complication in the First World. Third World statistics are dramatically different, and mortality is increased significantly. There is remote risk of injury to the mother’s internal organs, injury to the baby, and severe hemorrhage requiring hysterectomy with resultant infertility. More commonly seen are problems with noncatastrophic bleeding, postoperative infection and wound healing problems. It should be added that the increase in maternal mortality rates could be slightly skewed due to the fact that Caesarean sections are often used during high-risk pregnancies and/or when mortality is already a strong possibility.
One large study has confirmed that elective cesarean section has lower risk to the fetus and a slightly increased risk to the mother, than planned vaginal delivery of the breech however elements of the methodology used have undergone some criticism.
The same birth injuries that can occur in vaginal breech birth may rarely occur in Caesarean breech delivery. A Caesarean breech delivery is still a breech delivery. However the soft tissues of the uterus and abdominal wall are more forgiving of breech delivery than the hard bony ring of the pelvis. If a Caesarean is scheduled in advance (rather than waiting for the onset of labor) there is a risk of accidentally delivering the baby too early, so that the baby might have complications of prematurity. The mother’s subsequent pregnancies will be riskier than they would be after a vaginal birth (uterine rupture). The presence of a uterine scar will be a risk factor for any subsequent pregnancies.
A spontaneous vaginal delivery (SVD) occurs when a pregnant woman goes into labor with or without use of drugs or techniques to induce labor, and delivers her baby in the normal manner, without forceps, vacuum extraction, or a cesarean section. Assisted vaginal delivery (AVD) occurs when a pregnant woman goes into labor with or without the use of drugs or techniques to induce labor, and requires the use of special instruments such as forceps or a vacuum extractor to deliver her baby vaginally.
Otto Placik MD. a board certified Chicago Illinois based plastic surgeon presents instructional video on post genital surgery (labia minora reduction aka labiaplasty or labioplasty or clitoral hood reduction) massage exercises for treatment of labum minora psot surgical fibrosis or hypersensitivity. Photos pictures and video of anatomic models are reviewed . Great for patients thinking about or planning labiaplasty or vaginal cosmetic surgery