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Up to the present time, it is generally considered that males with KS are almost all infertile, but the situation in female patients is not so clear. Some women with this syndrome are infertile, whereas some have successfully conceived. Although pregnancy is not impossible in women with KS, they are at high risk for sterility. Afzelius et al. reported only three successful pregnancies in 12 women with KS who
tried to conceive.
The patient came to our infertility clinic at the age of 32 years because of primary infertility for 8 years.
She had the classical triad of KS (chronic sinusitis, bronchiectasis, and situs inversus) with recurrent respiratory problems, including difficulty in clearing sputum and dyspnea from childhood. There was no history of salpingitis, use of intrauterine device, endometriosis, or pelvic or tubal surgery. The infertility examinations included basal body temperature charts; hysterosalpingography; semen analysis; antisperm antibodies; and assays of serum thyroxine, prolactin, and follicle-stimulating hormone. All these data were within normal limits. Laparoscopy was normal except for a mild degree of right peritubal and periovarian
adhesions. Adhesiolysis was performed without difficulty.
Bilateral patency of the tubes was confirmed by chromopertubation during laparoscopy. Biopsies from the nasal mucosa were also obtained. The specimen was fixed in glutaraldehyde and processed for the examination of electron microscopy. Transmission electron microscopy (TEM) revealed an absence of dynein arms in the cilia.
The first IVF-ET attempt was done after downregulation of pituitary function with Lupron (gonadotropin- releasing hormone analogue) and ovarian stimulation with follicle-stimulating hormone (FSH)/human
menopausal gonadotropin (hMG). Ovum retrieval was performed with transvaginal ultrasound. Unfortunately, the patient did not conceive. A right ovarian pregnancy occurred spontaneously 2 years later. During
laparotomy at that time for wedge resection of the right ovary, no pelvic adhesions were noted. A second IVF-ET was attempted 3 months after the ectopic pregnancy, but it was again unsuccessful. Because of the
previous failures of IVF-ET, a third attempt was made using assisted hatching by zona drilling with acid Tyrode's solution. This was successful and the patient, at the age of 38, conceived twins. The gestational course
was uneventful except for transient dyspnea during the third trimester because of difficulty in clearing sputum.
At 35 weeks, because of premature rupture of the membranes and malpresentation of one fetus, cesarean section was performed. Both newborns' weights were appropriate for gestational age (2462 and 2870 g), and they each had Apgar scores of 9 and 10 at 1 and 5 min, respectively. The two babies were both healthy.
A Successful Pregnancy with In Vitro Fertilization and Embryo Transfer in an Infertile Woman with Kartagener's Syndrome: A Case Report
Tseng-Kai Lin, Robert Kuo-Kuang Lee, Jing-Tsuing Su, Wan-Yi Liu, Ming-Huei Lin and Yuh-Ming Hwu
Journal of Assisted Reproduction and Genetics, Vol. 15, No. 10, 1998
Link za tehnicke detalje rada:
http://www.springerlink.com/content/t82k21303jk70723/
Ovo je ukratko iz jedne studije slucaja- dakle, devojka je uspela jednom prirodno da zatrudni ali je bila vanmatericna, ostala je trudna tek sa trecom IVF i to sa blizancima (zdrave bebe).
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