Papers by Márcia Barreiro
JBRA Assisted Reproduction
Objective: Data on the possible influence of women´s region of residence, within the same country... more Objective: Data on the possible influence of women´s region of residence, within the same country, on the outcomes of medically assisted reproduction cycles are scarce. This study aims to assess the impact of the women's region of residence on the results of in-vitro fertilization cycles. Methods: We evaluated in-vitro fertilization cycles between 2010 and 2017, performed in a northern Portugal assisted reproduction center. We defined two groups: Douro Litoral (group 1; n=783), and Trás-os-Montes and Alto Douro (group 2; n=178). We analyzed demographics and cycle-related variables, and we calculated the rates for embryo transfer cycles. We used the Mann-Whitney and Chi-square tests and p<0.05 was considered statistically significant. Results: We included 961 cycles. The region of residence had no effect on the following variables: women´s age; body mass index; or duration of infertility (p>0.05). Group 2 had a statistical significant lower number of previous cycles than group 1 (1.3±0.5 and 1.5±0.7; p=0.005). In the sub-analysis of cycles with embryo transfer (n=781), group 1 obtained had rates of normal fertilization (62.5% vs. 57.5%; p=0.04), miscarriage rate (30.0 vs. 10.9%; p=0.007), and lower implantation rates compared to group 2 (33.3% vs. 50.0%; p<0.001). Conclusions: Women from the region of Trás-os-Montes e Alto Douro had a lower number of previous cycles, compared to those from the Douro Litoral, despite the absence of statistical significant differences in terms of age or infertility duration. These findings reinforce the need to contemplate the sociodemographic and socioeconomic variables in this context.
Zygote
SummaryWe have previously presented a stereological analysis of organelle distribution in human p... more SummaryWe have previously presented a stereological analysis of organelle distribution in human prophase I oocytes. In the present study, using a similar stereological approach, we quantified the distribution of organelles in human metaphase I (MI) oocytes also retrieved after ovarian stimulation. Five MI oocytes were processed for transmission electron microscopy and a classical manual stereological technique based on point-counting with an adequate stereological grid was used. Kruskal–Wallis and Mann–Whitney U-tests with Bonferroni correction were used to compare the means of relative volumes (Vv) occupied by organelles. In all oocyte regions, the most abundant organelles were mitochondria and smooth endoplasmic reticulum (SER) elements. No significant differences were observed in Vv of mitochondria, dictyosomes, lysosomes, or SER small and medium vesicles, tubular aggregates and tubules. Significant differences were observed in other organelle distributions: cortical vesicles pre...
Ovarian hyperstimulation syndrome (OHSS) can be a serious condition. There are very few cases des... more Ovarian hyperstimulation syndrome (OHSS) can be a serious condition. There are very few cases described of massive vulvar edema in OHSS. Ovarian hyperstimulation can also have an important impact on thyroid function. We present a case of severe OHSS, massive vulvar edema and severe thyroid dysfunction in a young woman with a congenital hypothyroidism submitted to a second IVF cycle for anovulation. The particularities of this case are related to the fact that it had severe and rare complications, even being a second IVF cycle, conducted in the same way as the previous one, in which there was no pregnancy.
Objective: Surgical treatment of stress urinary incontinence has evolved over the last years with... more Objective: Surgical treatment of stress urinary incontinence has evolved over the last years with the appearance of new techniques, among them the TVT (Tension-free Vaginal Tape) and recently the TVT-O (Transobturator Vaginal Tape Inside-Out). The aim of this study was to compare the outcome of these two techniques. Study design: Retrospective observational study. Population: Women treated with TVT (n=73) or TVT-O (n=55), without associated vaginal surgery, between January 2003 and December 2005. Methods: Intra-operative and post-operative complications, length of hospital stay , and the rates of success and improvement were analysed. Statistical analysis was performed with Student t test and χ 2 test. Results: Age, parity, menopause status and urodynamic examination were similar in the two groups. Length of hospital stay was also similar (TVT=1,71 days vs TVT-O=1,42 days). Follow-up was 10,47 months for TVT and 6,25 months for TVT-O. Bladder perforation occurred only in the TVT gro...
European Journal of Obstetrics & Gynecology and Reproductive Biology
Acta médica portuguesa
Since two decades we witnessed the publication of several studies devoted to the study of the inf... more Since two decades we witnessed the publication of several studies devoted to the study of the influence of the presence of hydrosalpinx on the results of embryo transfer techniques. The aim of this study is to present the results of treatment and pregnancy outcomes in women with a history of infertility associated with unilateral hydrosalpinx, visible on vaginal ultrasound, which were subjected to unilateral occlusion with Essure® and subsequent treatment with in vitro fertilization. We performed a prospective analysis of a sample of 6 women, with a history of infertility and unilateral hydrosalpinx, between April 2010 to May 2013. In all cases we proceeded to unilateral hysteroscopic placement of the Essure® microinsert, prior to performing a cycle for in vitro fertilization. Of the 6 patients undergoing in vitro fertilization, 4 became pregnant (66.7%). Of these, two were uneventful pregnancies until delivery and 2 are still under surveillance, without complications. Of the patien...
Case Reports, 2013
We present a case of a 29-year-old woman, with a history of ectopic pregnancy, which required lef... more We present a case of a 29-year-old woman, with a history of ectopic pregnancy, which required left salpingectomy, and with a tortuous and impermeable right fallopian tube, compatible with hydrosalpinx. As hydrosalpinx itself can compromise a future pregnancy, treatment with Essure was proposed before passing to medically assisted procreation techniques. Five months after placement of Essure in the right fallopian tube, an in vitro fertilisation cycle was successfully completed and the woman had a singleton pregnancy and vaginal delivery without intercurrences.
Ultrasound in Obstetrics and Gynecology, 2003
Ultrasound in Obstetrics and Gynecology, 2004
Ultrasound in Obstetrics and Gynecology, 2004
Ultrasound in Obstetrics and Gynecology, 2004
nbn-resolving.de
Objective: To report a case of hyperthyroidismo associated to molar pregnancy. Patient(s): A 23-y... more Objective: To report a case of hyperthyroidismo associated to molar pregnancy. Patient(s): A 23-year-old black young woman, gravida 1 para 1, who presented with nine weeks of amenorrhea and was admitted with a history of five days of diffuse vaginal bleeding, nausea and vomiting. Intervention(s): On examination, the patient was tachycardiac, orthostatic and febrile. Thyroid was slighty enlarge. Gynecological exam revealed presence of vesiculated material in the vaginal cavity, and a tender, soft, 15-week uterus was palpated. Pelvic ultrasound showed a heterogeneous cystic intracavitarian uterine mass. Quantitative serum human chorionic gonadotropin (hCG) level was found to be significantly high. Thyroid function tests demonstrated findings consistent with hyperthyroidism. Support treatment and beta-blockers were given, and uterine evacuation by aspiration curettage under ultrasound guidance was performed. Histologic examination confirmed the diagnosis of complete molar. Result(s): The patient experienced rapid resolution of symptoms with a dramatic decline in hCG and free thyroxine levels within a week of procedure. After 9 months of follow-up, she remained asymptomatic and her thyroid function was within normal ranges. Conclusion(s): Human chorionic gonadotropin bears structural homology to pituitary thyrotropin. The extremely elevated levels of hCG in patients with molar pregnancy can lead to hyperthyroidism. Therapy consists of evacuation of the mole with rapid achievement of euthyroidism. Severe hyperthyroidism needs to be controlled by medical treatment such as antithroid drugs and betablockers.
Acta Médica Portuguesa, 2014
Introdução: Desde há duas décadas que assistimos à publicação de vários estudos dedicados à avali... more Introdução: Desde há duas décadas que assistimos à publicação de vários estudos dedicados à avaliação da influência da hidrossalpinge nos resultados de técnicas de transferência de embriões. O objectivo deste trabalho é apresentar os resultados do tratamento e vigilância gestacional em mulheres com história de infertilidade-associada a hidrossalpinge unilateral, visível no exame ecográfico transvaginal-submetidas a oclusão unilateral com Essure ® e tratamento subsequente com fertilização in vitro. Material e Métodos: Análise prospectiva de uma amostra constituída por seis mulheres, com antecedentes de infertilidade e hidrossalpinge unilateral, entre Abril de 2010 e Maio de 2013. Em todos os casos procedemos a exclusão de hidrossalpinge recorrendo à colocação unilateral de um dispositivo Essure ® por via histeroscópica antes da realização de um ciclo para fertilização in vitro. Resultados: Das seis doentes submetidas a fertilização in vitro, quatro engravidaram (66,7%). Destas, registaram-se duas gravidezes de termo sem intercorrências até ao parto e duas gravidezes encontram-se em vigilância, sem intercorrências conhecidas até à data. Das doentes que não engravidaram após fertilização in vitro (n = 2, 33,3%), uma engravidou espontaneamente durante a vigilância subsequente. Discussão: O avanço da histeroscopia no tratamento de hidrossalpinge, recorrendo à implantação do dispositivo Essure ® , representa uma alternativa válida à abordagem laparoscópica. Conclusão: Este estudo sugere que a oclusão tubar unilateral, induzida pelo dispositivo Essure ® , melhora os resultados do tratamento com fertilização in vitro em casos de infertilidade associada a hidrossalpinge unilateral, visível no exame ecográfico transvaginal.
Ultrasound in Obstetrics and Gynecology, 2004
Ultrasound in Obstetrics and Gynecology, 2004
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Papers by Márcia Barreiro