Fallopian Research Articles

Advancements in siRNA delivery using nanotechnology for reproductive tract cancers: From targeting to enhancing treatment efficacy

Cancers of the reproductive system, which include those of the cervix, uterus, ovaries, fallopian tubes, and vagina, are major global health concerns. Even with improvements in traditional therapies such as radiation and chemotherapy, managing these tumors is still difficult, frequently associated with side effects, and has limited effectiveness. Targeted cancer therapy now has better options, thanks to the development of small interfering ribonucleic acid (siRNA) as a potentially effective therapeutic procedure through the ribonucleic acid interference (RNAi) technique in recent years. Nevertheless, there are many challenges in the clinical translation of siRNA, especially in terms of delivering drugs effectively to tumor-specific areas while reducing off-target effects. Nanotechnology has emerged as a transformative perspective that could show a promising approach for providing a revolutionary solution to the problems related to siRNA delivery. By carefully crafting nanocarriers, including liposomes, polymeric nanoparticles, and lipid nanoparticles, scientists have made incredible strides toward improving the bioavailability, stability, efficacy, and selectivity of siRNA treatments. Furthermore, due to their customizable characteristics, nanocarriers could be used to target specific tumors of the reproductive tract, enhancing the effectiveness of the treatment by taking advantage of tumor-specific indicators and microenvironments. In this review, we will summarize and delve into leveraging the synergistic benefits of targeted delivery and enhanced therapeutic potency using the RNAi technique. These innovative strategies hold immense potential to reshape the treatment landscape, offering new hope for patients with these devastating reproductive tract malignancies.

Role of genetic variations and protein expression of β-Microsemino protein in intrauterine insemination outcome of unexplained infertile men: A case-control study

Background: Intrauterine insemination (IUI) is often the first-line treatment for unexplained infertility. β-Microsemino protein (MSMB) is an abundant protein in seminal plasma that has an inhibitory effect on spontaneous acrosome reaction. Objective: The present study aimed to evaluate MSMB gene variations and protein expression on IUI success rate in unexplained infertile men. Materials and Methods: A case-control study was performed on 100 unexplained infertile Iranian men referred to the Royan Institute, Tehran, Iran for IUI (50 men with IUI positive result [IUI+], and 50 men with IUI negative result [IUI-]). Couples with female infertility factors (such as hormonal disorders, infrequent menstrual period, abnormality in uterus, fallopian tubes, or ovaries) and men with infections of the male accessory glands, hypogonadotropic hypogonadism, clinical varicocele, retractile testis, genital trauma, drug use, or concurrent hormonal treatment Y chromosome microdeletions, and abnormal karyotype were excluded from the study. The polymerase chain reaction sequencing was performed for the promoter and the coding regions of MSMB functional domains. To study the protein expression, the total protein of sperm was extracted, and sandwich enzyme-linked immunosorbent assay was performed. Results: 4 variations were detected (rs12770171, rs10993994, rs2075894, and rs4517463). None of them showed significant differences between the IUI+ and IUI-groups. The mean value of protein expression did not show any differences between the groups. Conclusion: In conclusion, there is no association between genetic variations of promoter and coding regions of MSMB functional domains as well as its expression with IUI success in unexplained infertile men. Key words: MSMB, Beta microseminoprotein, Infertility, Male infertility.

Murcs Association: A most severe form of Mayer-Rokitansky-Küster-Hauser Syndrome, case report and literature review

BACKGROUND Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) is a congenital abnormality of sexual development characterized by an aplastic or hypoplastic uterus, as well as the absence of the cervix and the upper third of the vagina. It may be limited to the reproductive tract (MRKH type 1), or in association with abnormalities of the extragenital tract, usually of renal and skeletal origin (MRKH type 2). The presence of a pattern of multiple anomalies has been described, specifically characterized by aplasia of the Müller ducts (MU), renal aplasia (R), and alterations of the cervicothoracic somite (CS), which has been called the MURCS association. METHODOLOGY A search was performed in the Medline database via PubMed using the following terms: “Mayer–Rokitansky–Küster–Hauser Syndrome”, “Mullerian anomalies”, “genetics of agenesis/hypoplasia of the uterus and vagina”, “uterine cervical aplasia and agenesis”, from 1979 to 2023, a total of 316 studies were found, 58 studies were selected that included women with a diagnosis of MRKH or MURCS association. CASE REPORT A 34-year-old woman attends a gynecologist evaluation presenting primary amenorrhea, with external genitalia with normal development, but has multiple spinal abnormalities. The image reports the absence of the uterus and the superior two-thirds of the vagina, renal aplasia, scoliosis, and cervical, thoracic, and lumbar spinal abnormalities. CONCLUSIONS Mullerian abnormalities are a set of abnormalities of sexual development in which the development of the uterus, fallopian tubes, and vagina are mainly affected. Within this group, there is MRKH syndrome. In these variants of GREB1L (estrogen growth regulation gene in breast cancer type 1 gene), variants have been reported in familiar cases of bilateral renal agenesis. Establishing the cause of these clinical entities is controversial, making it difficult to deny or affirm whether the atypical forms of the MRKH syndrome and the MURCS association belong to the same phenotypic spectrum originating from common or related causes or simply different entities.

Clinicopathological features and prognostic analysis of synchronous mucinous metaplasia and neoplasia of the female genital tract

Objective: Synchronous mucinous metaplasia and neoplasia of the female genital tract (SMMN-FGT) occurring at multiple sites during the same period of time is extremely rare, and the aim of this study was to investigate the clinicopathologic features of SMMN-FGT and its relationship with prognosis. Methods: We retrospectively analyzed the clinicopathological features and follow-up records of 25 cases of SMMN-FGT diagnosed from January 2012 to October 2022 in the case database of Obstetrics and Gynecology Hospital of Fudan University. Results: The mean and median age at onset were 47 and 46 years old, respectively. Clinical manifestations included irregular vaginal bleeding or drainage, pelvic pain, and ovarian cysts, etc. Germline genetic test confirmed Peutz-Jeghers syndrome (P-J syndrome) in two patients. All patients underwent surgery, and some had postoperative adjuvant radiotherapy and/or chemotherapy. The most frequent site of lesion was the cervix (21 cases), with 11, 10 and 16 cases occurring in the endometrium, fallopian tubes and ovaries, respectively. Six cases involved three sites simultaneously, and only one case had all four sites involved at the same time. Among the 9 cases with P53 mutation phenotype, 6 cases had gastric-type mucinous adenocarcinoma, 2 cases had lobular endocervical glandular hyperplasia, and 1 case had mucinous adenocarcinoma, whereas all the minimally deviated adenocarcinomas had wild phenotype of P53. The median follow-up time was 59 months, during which 3 cases died and 6 cases developed local recurrence or distant metastasis. According to our analysis, postoperative recurrence or metastasis was correlated with the FIGO stage of the disease, the number of lesion sites and the severe degree of the uterine lesions (P＜0.05). Conclusions: SMMN-FGT had a relatively good clinical prognosis, and even advanced patients could benefit from surgery and adjuvant therapy. In young patients, the ovaries may be preserved if no evidence of lesions were seen after adequate evaluation. In SMMN-FGT, gastric-type mucinous adenocarcinoma occurring in the cervix may have a better prognosis than gastric-type mucinous adenocarcinoma of the cervix alone, so the accurate diagnosis of SMMN-FGT is critical for clinical management.

The effect of endometriosis on the fertility of women

Endometriosis is defined by the presence of ectopic endometrial tissue outside the uterus, frequently located on pelvic organs such as the fallopian tubes and ovaries, and occasionally beyond the pelvic region. This condition manifests as dysmenorrhea, chronic pelvic pain, dyspareunia, and subfertility. Despite extensive research, the etiology and pathogenesis of endometriosis remain unclear, with laparoscopy being the definitive diagnostic method. The association between endometriosis and infertility has been extensively debated. Endometriosis can impair fertility by disrupting embryo implantation, altering hormone levels, and compromising oocyte quality. This literature review aims to examine the effects of endometriosis on female fertility. The review encompasses documents from clinical trials with control groups involving 196 to 22,416 reproductive-age participants (25-42 years), and case studies published over the past thirty-seven years from various regions (USA, Australia, Turkey, Africa, and Europe. Reputable databases such as BMJ, NEJM, Elsevier, AJR, Medline, and PubMed were utilized, with references compiled in the bibliography. A risk-benefit analysis indicates that up to 50% of women with endometriosis experience infertility. Consensus on treatment options remains elusive. The relationship between endometriosis and infertility is supported by studies of both fertile and infertile women, animal studies, donor sperm studies, and in vitro fertilization outcomes. Diagnostic methodologies based on endometrial changes are providing insights into potential mechanisms of infertility, especially in women with milder disease. However, clinical management of endometriosis-related infertility has not shown conclusive success beyond in vitro fertilization.

Comprehensive analysis of artificial intelligence techniques for gynaecological cancer: symptoms identification, prognosis and prediction

Gynaecological cancers encompass a spectrum of malignancies affecting the female reproductive system, comprising the cervix, uterus, ovaries, vulva, vagina, and fallopian tubes. The significant health threat posed by these cancers worldwide highlight the crucial need for techniques for early detection and prediction of gynaecological cancers. Preferred reporting items for systematic reviews and Meta-Analysis guidelines are used to select the articles published from 2013 up to 2023 on the Web of Science, Scopus, Google Scholar, PubMed, Excerpta Medical Database, and encompass AI technique for the early detection and prediction of gynaecological cancers. Based on the study of different articles on gynaecological cancer, the results are also compared using various quality parameters such as prediction rate, accuracy, sensitivity, specificity, the area under curve precision, recall, and F1-score. This work highlights the impact of gynaecological cancer on women belonging to different age groups and regions of the world. A detailed categorization of the traditional techniques like physical-radiological, bio-physical and bio-chemical used to detect gynaecological cancer by health organizations is also presented in the study. Besides, this work also explores the methodology used by different researchers in which AI plays a crucial role in identifying cancer symptoms at earlier stages. The paper also investigates the pivotal study years, highlighting the periods when the highest number of research articles on gynaecological cancer are published. The challenges faced by researchers while performing AI-based research on gynaecological cancers are also highlighted in this work. The features and representations such as Magnetic Resonance Imaging (MRI), ultrasound, pap smear, pathological, etc., which proficient the AI algorithms in early detection of gynaecological cancer are also explored. This comprehensive review contributes to the understanding of the role of AI in improving the detection and prognosis of gynaecological cancers, and provides insights for future research directions and clinical applications. AI has the potential to substantially reduce mortality rates linked to gynaecological cancer in the future by enabling earlier identification, individualised risk assessment, and improved treatment techniques. This would ultimately improve patient outcomes and raise the standard of healthcare for all individuals.

Do we more often opt for conservative management of ovarian tumors after changing the Dutch national guideline on enlarged ovaries? A nationwide cohort study.

Increasing evidence shows that conservative management of ovarian tumors classified as benign, based on ultrasound assessment, is safe. Therefore, conservative management has been adopted as the preferred strategy for certain ovarian tumors assessed as benign in the Dutch national guideline on enlarged ovaries in 2013. The aim of this study was to examine whether implementation of this guideline has led to changes in the number of women/100 000 women undergoing surgery for an ovarian tumor in the Netherlands. Histopathology reports were requested for all examinations of ovarian and fallopian tube specimens (including cyst enucleations) registered in Palga, the Dutch nationwide pathology databank, from 2011 (before guideline adaptation) and 2019 (after guideline adaptation). Reports on prophylactically removed adnexa, removal for other primary tumors (e.g., endometrial carcinoma), and for patients under 18 years of age, were excluded from the analysis. Interobserver agreement for the inclusion and classification of reports was assessed using Cohen's Kappa analysis. A total of 34 932 reports were retrieved, 13 917 of which were included in the analysis. In 2011 and 2019, respectively, 96.3/100 000 versus 68.8/100 000 women aged ≥18 underwent surgery for benign ovarian tumors, and 19.6/100 000 versus 18.3/100 000 for borderline and malignant tumors combined. The number of women/100 000 who had surgery for a benign ovarian tumor per 100 000 women declined by 28.5% (p < 0.001) between 2011 and 2019. The largest difference between 2011 and 2019 was observed in the number of women per 100 000 women who underwent surgery for a serous cystadenoma (-40.7%; 20.8/100 000 vs. 12.3/100 000), followed by endometrioma (-33.2%; 14.7/100 000 vs. 9.8/100 000), simple epithelial cyst (-57.3%; 8.4/100 000 vs. 3.6/100 000), and corpus luteum cyst (-57.0%; 4.0/100 000 vs. 1.7/100 000). Cohen's Kappa for the interobserver agreement was 0.96. The number of women/100 000 undergoing surgery for a benign ovarian tumor has substantially decreased in the Netherlands when comparing data before and after implementation of the national guideline in 2013, while the number of women/100 000 undergoing surgery for a malignant or borderline tumor remained the same. These findings suggest successful implementation of the updated guideline, and a measurable effect on increased adoption of conservative management for benign-looking ovarian tumors.

A misleading case of Mullerian anomaly: fibroid degeneration and growth involving non-functional, non-communicating rudimentary horn

ObjectiveTo report a rare, misleading fibroid degeneration involving a non-functional, non-communicating horn in a woman with a unicornuate uterus. While the presence of a functional rudimentary horn may lead to signs and symptoms that recommend its removal, non-functional cases are rarely reported, and due to their apparent functional inactivity, the need for their removal has never been reported. No previous report showed the possibility of a degenerative process in a non-functional rudimentary horn causing patient discomfort. DesignThis is a step-by-step narrated video showing a unique case of fibroid degeneration and growth of a non-functional, non-communicating rudimentary horn in a unicornuate uterus (ASRM classification 2021) and its surgical management. SettingUniversity Academic Hospital ‘‘A.O.U. delle Marche – Università Politecnica delle Marche” Ancona, Italy. SubjectA 48-year-old Caucasian nulliparous premenopausal woman was referred to our institution because of abdominal pain and an enlarging adnexal mass. Her personal history showed primary infertility with a previous diagnosis of unicornuate uterus. Given the possibility of ectopic ureters in these occurrences, a complete computed tomography scan was performed, and no genitourinary alterations were found. Pre-operative imaging (ultrasound evaluation, computed tomography, and magnetic resonance) provided a provisional diagnosis of a suspicious ovarian fibroma. InterventionsConsidering the patient’s age, lack of desire for pregnancy, and volumetric increase of the adnexal mass, a laparoscopic intervention to perform mass removal and prophylactic bilateral salpingectomy was planned. The patient was counseled about the low risk of an underlying malignant transformation. Therefore, the decision to remove the intact mass via a mini-laparotomy at the end of the surgery was shared.Once the abdominal cavity was entered, the right unicornuate uterus was found in anatomical continuity with the ipsilateral broad ligament, fallopian tube, and ovary. These structures were wholly attached to the right pelvic wall.On the other side, cranially compared to the right hemi-uterus, a roundish myoma-like mass was detected in direct connection with the left broad ligament, fallopian tube, and ovary.In light of a changed intraoperative finding, the amputation of the left rudimentary horn and prophylactic bilateral salpingectomy were performed. Main outcome measuresShowing the fibroid degeneration and growth of a non-functional, non-communicating rudimentary horn in a unicornuate uterus (ASRM classification 2021) treated laparoscopically. ResultsLaparoscopic removal of the uterine horn was successful, and no intra- and postoperative complications occurred. The patient was in good health at the six-month follow-up visit. The histopathological examination confirmed the fibroid degeneration and the absence of endometrium. ConclusionThe lack of symptomatic cases of rudimentary non-functional horns reported in the literature led gynecologists to consider them a silent Mullerian anomaly. This unique case demonstrates that even non-functional rudimentary horns can undergo symptomatic transformation processes requiring surgery. This information may be helpful for more comprehensive counseling of women and for considering the possibility of this occurrence in the diagnostic work-up of misleading Müllerian anomalies. With this in mind, surgical treatment can also be better planned as the technical aspects change compared to what is expected for an adnexal pathology.

Intrauterine device (IUD) migration to the fallopian tube: a rare location for a translocated IUD with no visceral injury

BackgroundLoss of Intra Uterine Device (IUD) following silent perforation of the uterus either during or after IUD insertion is an uncommon finding due to a lack of immediate follow-up. We report a rare case in which uterine perforation following the migration of IUD to the right fallopian tube without visceral injury. The patient presented with lower abdominal pain and pain during sex for one year since IUD insertion. On examination, we noted tenderness on the right suprapubic region and on speculum examination, no IUD thread was seen. A radiological pelvic examination showed an empty uterus without an IUD. Laparotomy and retrieval of migrated IUD was done followed by repair of perforated uterus.ConclusionMigrated IUD with silent uterine perforation without visceral injury is a distressing clinical condition both to the patient and the clinician. This case is reported to increase awareness in doing immediate vaginal examination and pelvic ultrasound post-IUD insertion.

Diagnosis and management of isolated serous tubal intraepithelial carcinoma: A qualitative focus group study.

A Serous Tubal Intraepithelial Carcinoma (STIC) without concomitant invasive carcinoma is occasionally identified and associated with a high risk of subsequent peritoneal carcinomatosis. Management needs optimisation. This study explores professionals' opinions and clinical practices regarding the diagnosis, counselling, treatment and follow-up of isolated STIC to facilitate clinical decision making and optimise the direction of future research. A secondary aim is to assess international clinical guidelines. Focus group study. Four online sessions. International panel (n = 12 countries) of gynaecologists, gynaecologic oncologists, pathologists and medical oncologists (n = 49). A semi-structured interview guide was used. Two independent researchers analysed transcripts by open and axial coding. Results were organised in domains. Relevant (inter)national guidelines were screened for recommendations regarding isolated STIC. Professionals' opinions and clinical practices regarding isolated STIC management. Regarding pathology, most professionals identified the SEE-FIM protocol as standard of care for high-risk patients, whereas variation exists in the histopathological examination of fallopian tubes in the general population. Confirmation of STIC diagnosis by a specialised pathologist was recommended. Regarding work-up and follow-up after STIC diagnosis, there was variety and discordance. Data on outcomes is limited. As for treatment, chemotherapy and PARP inhibitors were not recommended by most. Eleven guidelines provided limited recommendations. We identified recommendations and highlighted knowledge gaps in the diagnosis and management of isolated STIC. Moreover, recommendations in clinical guidelines are limited. There is an agreed need for international collaboration for the prospective registration of isolated STIC.

Adnexal torsion: A comprehensive review of types, pathophysiology, diagnosis, and management strategies during pregnancy

Adnexal torsion is a gynecological surgical emergency which during pregnancy can be associated with high patient morbidity and fetal mortality if not managed promptly. Fertility preservation is an essential concern. The underlying pathophysiology involves ovarian tissue torsion on its pedicle, leading to decreased venous return, stromal edema, internal hemorrhage, and infarction. It can affect females of all age groups, and they present mainly with an acute onset of pelvic pain, followed by nausea and vomiting. Multiple risks can lead to adnexal torsion, including ovulation induction, use of in vitro fertilization, and the presence of an ovarian mass. Early diagnosis is challenging and mainly depends on clinical suspicion, ultrasound, or MRI findings; however, it is necessary to preserve the function of the ovaries and fallopian tubes and prevent the occurrence of infertility. Once adnexal torsion is suspected, surgery or detorsion is the main line of treatment. This review will summarize the most relevant studies on risk factors, radiological findings, and managing maternal adnexal torsion in pregnancy.

Superficial and Invasive Spread of High-grade Squamous Intraepithelial Lesion and Squamous Cell Carcinoma: A Case Report.

We present a case of extensive spread of high-grade squamous intraepithelial lesion (HSIL)/cervical intraepithelial neoplasia grade 3 (CIN3) with foci of invasive squamous cell carcinoma (SCC) in a premenopausal woman. Superficial spread of CIN3 and cervical SCC to the endometrium and/or fallopian tubes is rare, especially in countries with cervical cancer screening programs. Our case occurred during the COVID-19 pandemic, which may have been a major contributing factor to delayed detection and, consequently extensive spread.

Factors Influencing the Visualization of Fallopian Tubes in Hysterosalpingo-Contrast Sonography (HyCoSy)-The Value of Multimodal HyCoSy in Visualizing the Fallopian Tubes.

Four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) can non-invasively evaluate the patency of the fallopian tubes and is increasingly used in clinical practice. However, some factors may lead to false-positive diagnoses. This study aims to analyze the factors affecting clear imaging of the fallopian tubes in 4D-HyCoSy and explore methods to improve the quality of fallopian tube imaging. A total of 118 patients were enrolled in this retrospective study. After injecting the SonoVue into the uterine cavity, three modes of HyCoSy were completed in sequence: 4D-HyCoSy, 2D-HyCoSy, and second harmonic imaging (SHI). Participants were divided into two groups: the easy visualization group (fallopian tubes could be visualized using only 4D-HyCoSy) and the difficult visualization group (a multimodal combination was required for visualization). The position of the uterus, the relationship between the ovaries and the uterus, endometrial thickness, time of catheterization in the uterine cavity, presence or absence of lesions in the uterine cavity, whether intestinal gas covers the fallopian tubes and the imaging effect of different modes on the fallopian tubes was analyzed, to determine the key factors affecting the clear imaging of the fallopian tubes. The positional relationship between the ovary and the uterus (OR = 4.711, 95% CI: 1.322-19.77, P = 0.023), the positioning of the uterus (OR = 3.843, 95% CI: 1.129-15.26, P = 0.04), endometrial thickness (OR = 3.985, 95% CI: 1.168-15.99, P = 0.036), and the duration of intrauterine catheter placement (OR = 3.547, 95% CI: 1.042-13.52, P = 0.05) were independent factors that affecting difficulty in visualizing the fallopian tubes. Uterine position, the positional relationship between the ovary and the uterus, endometrial thickness, and the time of catheter insertion are factors that affect visualizing the fallopian tubes during 4D-HyCoSy. The combination of multimodal imaging, especially the combination of 4D-HyCoSy with SHI mode, can help improve the quality of fallopian tube visualization.

Examining the impact of age on chemotherapy completion in epithelial ovarian, fallopian tube and primary peritoneal cancer: a retrospective cohort study in Thailand

ObjectiveTo explore the difference in chemotherapy completion and reasons for discontinuation between older (≥70 years) and younger (<70 years) patients.DesignRetrospective cohort study.SettingSingle tertiary centre in Thailand.ParticipantsThe patients who received chemotherapy...

Histomorphological Pattern of Fallopian Tube Lesions in a Tertiary Care Hospital

Histomorphological Pattern of Fallopian Tube Lesions in a Tertiary Care Hospital

An Approach to Improve Endometrial Receptivity: Is It Beneficial to Flush The Uterine Cavity with Follicular Fluid and Granulosa Cells? A Phase III Randomised Clinical Trial.

The follicular fluid (FF) of mature oocytes contains a high concentration of growth factors and cytokines that have the potential to influence implantation in either a paracrine or autocrine manner. During the physiological processes of ovulation, FF enters the fallopian tubes in conjunction with the oocyte. The purpose of this study is to evaluate implantation and clinical pregnancy rates following uterine flushing with FF and granulosa cells in infertile women with moderate male factor infertility after ovum retrieval for intracytoplasmic sperm injection (ICSI). This phase III randomised clinical trial enrolled 140 women with moderate male factor infertility who intended to undergo ICSI at Royan Infertility Clinic (Tehran, Iran). A computer-generated program and opaque sealed envelopes were used to randomly allocate patients to either an intervention group (n=70) or a control group (n=70). Participants in the intervention group received 2 ml of clear FF (without blood contamination) from 2 to 3 dominant follicles after oocyte retrieval. The control group only underwent uterine cavity catheterisation. The intervention group had a clinical pregnancy rate of 38.5% (25/65) compared to the control group [42.9% (27/63); P=0.719] and an implantation rate of 24.1% compared to the control group (27%; P=0.408). These rates did not differ between the groups. There were no statistically significant differences between the intervention and control groups in terms of pregnancy-related complications-ectopic pregnancy, blighted ovum or anembryonic pregnancy, and abortion. Uterine cavity flushing with FF from mature follicles following oocyte retrieval had no effect, either positively or negatively, on clinical pregnancy or implantation rates in women with moderate male factor infertility (registration number: NCT04077970).

An Ayurvedic Management of Bandhyatva Associated with Bilateral Tubal Blockage

In Ayurveda, infertility is addressed under the concept known as "Bandhyatava," which is described in ancient texts such as Charak Samhita, Sushrut Samhita, Ras Ratna Samuchya, and Harit Samhita. Acharya Sushrut described four crucial factors for fertility: Ritu (menstruation), Kshetra (functioning reproductive organs), Ambu (digestive juices) and Beej (healthy sperm and ovum). It occurs due to the vitiation of Vata dosha where Kapha dosha also contributes to the formation of blockage. Beeja Grahana is unable due to Sanga Strotodushti of Artavavaha i.e., tubal blockage which leads to failure of conception. Fallopian tube is an essential part of the Artavavaha Srotas as the Beej Samagam (ovum and sperm) takes place here. In the current case scenario, Bandhyatva is due to Tubal Blockage. A 37-year-old female patient was reported to PTSR OPD with the complaints of irregular menses with decreased duration and wants to conceive irrespective of unprotected sexual intercourse since 3 years. Her HSG scan suggestive of B/L fallopian tube cornual blockage. Aims and Objectives: To maintain the balance between the four factors to conceive through Sanshodhan therapy. Patients has been treated with Sanshodhan Karma followed by 3 consecutive cycles of Sahacharadi Taila Uttarbasti and 3 cycles of Phalghrita Uttarbasti along with Shaman Chikitsa. Results: After completion of treatment Bilateral Tubes were patent observed in Sonohysterosalpingography. Conclusion: This case study found that the treatment administered was highly effective in addressing infertility caused by tubal blockage.

Fallopian tube deciduosis with massive hemoperitoneum in a second-trimester pregnancy: a case report of ultrasound findings

Fallopian tube deciduosis with massive hemoperitoneum in a second-trimester pregnancy: a case report of ultrasound findings

Spontaneous bilateral ectopic pregnancy. A case report from Regional Hospital of Niamey

Spontaneous bilateral ectopic pregnancy is an extremely rare event, occurring in 1/750 to 1/580 of all ectopic pregnancies, and in 1 case in 200,000 pregnancies. Nonetheless, this occurrence appears to be on the rise owing to Assisted Reproductive Technology. In this report, we present a singular case of spontaneous bilateral ectopic pregnancy in a 28-year-old patient under our care. The diagnosis was established during exploratory laparotomy, revealing an unruptured ectopic pregnancy on the left and a ruptured ampullary ectopic pregnancy on the right tub, resulting in hemoperitoneum. Bilateral salpingectomy was performed. The patient received one pack of red blood cells transfusion in postoperative period. The recovery period was simple. She left the hospital on post-operative day 3. We recommend a systematic exploration of the contralateral fallopian tube in order to eliminate the risk of a bilateral ectopic pregnancy, which could result in a fatal outcome. Keywords: Bilateral ectopic pregnancy, Salpingectomy, Regional Hospital Center, Niger.

Capillary Haemangioma of Fallopian Tube: Usual Tumor at Unusual Site

Fallopian tube neoplasms are uncommon, accounting to approximately 1-2% of all female genital tract neoplasms. Hemangiomas are the most common soft tissue neoplasms. We present an unusual case of capillary hemangioma of fallopian tube which was incidentally detected in a patient who underwent abdominal hysterectomy with salphingo-oophorectomy.