İlker ŞENGÜL, Demet ŞENGÜL, İnci KAHYAOĞLU, Serkan KAHYAOĞLU, Sertaç BATIOĞLU, Leyla MOLLAMAHMUTOĞLU, Şahin ÖNEN, Kamil MÜFTÜOĞLU

Tubal endometriosis as an insidious risk factor for tubal implantation in a procedure of assisted reproductive technique

Endometriozis çoğunlukla kadın infertilitesi ile ilişkilidir ve sperm ve/veya embriyo hareketleriniengelleyici, uterus kasılma fizyolojisinde belirgin bir bozulma ile kendini gösterir. Bir ender olguolarak, İnvitro Fertilizasyon Embriyo Transferi (İVF-ET) prosedürü sırasında, bir tubalendometriozis hastasında bilateral tubal gebeliği sunduk. Laparoskopik değerlendirmede, 20-30milimetre çapında bilateral tubal ampullada ektopik gebelik teşhis edildi ve bilateral salpenjektomigerçekleştirildi. Endometriozisin, embriyo hareketini olası geciktirici etkisini gösteren,endometriyotik implantlar her iki tüpün mukozal yüzeylerinde patolojik olarak saptandı.Endometriyotik implantların oluşturduğu tubal mukozal ortam, transfer edilen embriyolarınektopik tubal implantasyonu için orijinal uterus endometriyumu gibi davranır. Bununla birlikte,biz, bir İVF-ET prosedürüne geçmeden önce, transfer edilen embriyoların tubal implantasyonuolasılığını azaltmak için, endometriozisli hastalara bilateral tubal kapama veya salpenjektomiuygulamasının göz önünde tutulmasının yararlı olabileceğini düşünmekteyiz.

Bir yardımcı üreme tekniği p rosedüründe tubal imp lantasyon için sinsi bir risk f aktörü olarak tubal endometriozis

Endometriosis is often associated with female infertility and exhibits a massive impairment in thephysiology of uterine contractility that interferes with sperm and/or embryo movements. Wepresent an unusual case of bilateral tubal pregnancy during an Invitro Fertilization-EmbryoTransfer (IVF-ET) procedure in a tubal endometriosis patient. Bilateral tubal ampullary ectopicpregnancies, 20-30 milimeters in diameter were diagnosed during laparoscopic examination andbilateral salpingectomy was performed. Endometriotic implants were detected pathologically onmucosal surfaces of both tubes demonstrating the possible deleterious effect of endometriosis onembryo movement. Tubal mucosal environment containing endometriotic implants may behavelike original uterine endometrium for ectopic tubal implantation of transferred embryos. However,we think that in order to decrease the probability for tubal implantation of transferred embryos;consideration of bilateral tubal closure or salpingectomy for patients with endometriosis beforeproceeding to an IVF-ET procedure may be useful.

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