what does it mean to have a small uterus
A majority of miscarriages have been thought to be caused past fertile ovum abnormalities; however, our findings advise that a small uterus tin also potentially cause miscarriage. There are no reports on the association between a small uterus and miscarriage. A adult female in her late 20s, whose medical history revealed babyhood astute lymphocytic leukemia, which progressed to remission after chemotherapy, radiotherapy, and bone marrow transplantation. Ultrasound revealed no ovarian follicles in either of the ovaries and small uterus (length, 32 mm) In wheel 15, subsequently ovum collection, frozen embryos with Veeck's classification of G3b9 were obtained. Embryo transplantation was performed during the hormone replacement cycle, resulting in pregnancy. On day 5 of gestational week xviii, the patient experienced balmy lower abdominal pain, and she underwent a spontaneous commitment.
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Groundwork
A bulk of miscarriages accept been thought to be acquired past fertile ovum abnormalities; notwithstanding, our findings suggest that a minor uterus can also potentially cause miscarriage. In that location are no reports on the clan betwixt a small uterus and miscarriage.
Case Presentation
A woman in her late 20s presented to our hospital with the main complaint of infertility. Her medical history revealed babyhood acute lymphocytic leukemia, which progressed to remission after chemotherapy, radiotherapy, and bone marrow transplantation. She underwent Kaufmann treatment for secondary amenorrhea. Afterward getting married, natural menstruum occurred, and thus the treatment was temporarily withdrawn; however, vi months after discontinuing treatment, she experienced amenorrhea, and Kaufmann treatment was recommenced. She was diagnosed with subclinical hypothyroidism based on a thyroid-stimulating hormone level of 5.67 µIU/mL and free thyroxine level of 0.91 ng/dL and was prescribed oral thyradin.
Remarkable findings at the time of initial test at our infirmary included serum E2 (Estradiol) <5.0 pg/mL, Luteinizing Hormone = 26.3 mIU/mL, Follicle -Stimulating Hormone = 57.6 mIU/mL, and Anti-Mullerian Hormone <0.one ng/mL. Ultrasound revealed no ovarian follicles in either of the ovaries and small uterus (length, 32 mm) (Fig. 1AB–BC), suggesting a premature early menopausal stage.
Fig. 1.
Small uterus of approximately 32 mm length (AB+BC).
Computed tomography test for abnormal hepatic function (AST30U/L, ALT65U/L) revealed no abnormalities. Other biochemical claret tests were normal; cervical cancer cytodiagnosis results were negative for intraepithelial lesion or malignancy.
Premarin was used to promote ovarian follicle growth for ovum collection; ascendant ovarian follicle growth was observed in cycles 7 and 12; however, despite ovum collection, no transplantable embryos were obtained. In cycle fifteen, after ovum collection, frozen embryos with Veeck's nomenclature of G3b9 were obtained. Embryo transplantation was performed during the hormone replacement cycle, resulting in pregnancy. Fetal center charge per unit was observed in week 6. Estrogen and progesterone supplementation was given until 9 weeks of gestation. During week 15 of pregnancy, the patient was hospitalized for premature membrane rupture without significant uterine contractions or inflammatory reaction. On twenty-four hours v of xviii gestational week, the patient experienced mild lower intestinal hurting, and she underwent a spontaneous delivery in the toilet. The babe was a boy weighing 246 grand, with an Apgar score of 0 points/0 points.
Discussion and Conclusions
Miscarriage acquired by uterine deformity is common in the 2d trimester. Additionally, the charge per unit of newborn delivery is lower in spontaneous pregnancies in patients with bicornuate and septate uteri than in women with a normal uterus [one]. Withal, there are no reports on the association betwixt a small uterus and miscarriage. Normally, in the presence of uterine myomas, the uterus size increases and possibly decreases the pregnancy rate; this complicates assessing uterus size and miscarriage association. Moreover, irreversible changes to the ovaries acquired by chemotherapy are difficult to evaluate owing to differing individual characteristics [2], and are therefore controversial. All the same, our instance highlights the importance of pregnancy monitoring in women with a small uterus following embryo transplantation.
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A majority of miscarriages have been thought to be caused past fertile ovum abnormalities; however, our findings suggest that a small uterus can as well potentially cause miscarriage. We report a case of miscarriage in a patient with a small uterus (length, 32 mm).
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Chemotherapy may affect ovarian part, but the outcome of subsequent pregnancies may exist difficult to prognosticate attributable to differing individual characteristics.
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Detail care should be paid to pregnancies attained using a precious ovum, following chemotherapy.
Availability of Data and Material
All data generated or analysed during this study are included in this published commodity.
Acknowledgements
The author would like to give thanks Chinatu Takaya, Yoshiharu Nakaoka, Yoshiharu Morimoto for useful word.
Statement of Ethics
Patient approval and consent was obtained.
Disclosure Statement
The author declares that at that place are no competing interests.
Funding Sources
Non applicable.
Writer Contributions
R.F. performed the histological examination and was a major contributor in writing the manuscript.
Rie Kitayama IVF Namba Clinic 1–17–28 Minamihorie Nishi-ku, Osaka 550–0015 (Nippon) E-mail kitayama519@ivfjapan.com Received: May 04, 2019 Number of Print Pages: four For boosted information: https://www.karger.com/CRO This commodity is licensed under the Creative Eatables Attribution-NonCommercial 4.0 International License (CC By-NC). Usage and distribution for commercial purposes requires written permission. Drug Dosage: The authors and the publisher have exerted every endeavour to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and exercise at the time of publication. All the same, in view of ongoing enquiry, changes in government regulations, and the constant flow of data relating to drug therapy and drug reactions, the reader is urged to bank check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is peculiarly of import when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the private authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safe. The publisher and the editor(due south) disclaim responsibility for whatsoever injury to persons or belongings resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
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Commodity / Publication Details
Accepted: May 09, 2019
Published online: June thirteen, 2019
Issue release date: May - August
Number of Figures: one
Number of Tables: 0
eISSN: 1662-6575 (Online)
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Source: https://www.karger.com/Article/Fulltext/500952
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