title: [Woman with surgical reconstruction of anal atresia who realized pregnancy with in vitro fertilisation].
abstract: BACKGROUND
  Anal atresia is a congenital anomaly, very life-threatening and urgent. Surgical treatment of this anomaly consists of colostomy first, and then of anal reconstruction.
  
  
  METHODS
  We presented a 31-year old female with the surgery treatment of anal atresia in the early childhood. In the reproductive period, due to tubal infertily, the patient was included in the program of in vitro fertilization (IVF), in the Clinic for Gynecology and Obstetrics "Narodni front", Belgrade. Within this program a long protocol of ovarian stimulation was performed. Ultrasonographic and color Doppler monitoring of the patient was applied by the use of an ultrasonographic apparatus type Siemens Acuson X 150, while any hormonal examinations were performed by an Architect Abbott unit. During the IVF program, the growth of follicules was controlled by the use of ultrasonography, microcirculation of the ovaries and the uterus was marked by a power-pulsating color Doppler, and hormonal examination was performed starting from the day of stimulation up to the day of injecting Pregnyl. The patient was administered Suprefact (buserelin) sc from the 21st day of the menstrual cycle, as well as from the 3rd day of the cycle, for totally 11 days. The patient was given 29 ampoules of Gonal F (recombinant human FSH) 75 IJ im and 15 ampoules of Menopur (menotrophin) im. Due to a modified pelvic anatomy, the left ovary aspiration was disabled, while the right ovary aspired seven oocytes successfully. Three embryos were inserted in the uterus. The delivery was performed by cesarean section.
  
  
  CONCLUSIONS
  In the reported patient with a modified pelvic anatomy due to four corrective surgeries of anal atresia, and tubal infertility in the reproductive period, the method of choice for the realization of pregnancy was the IVF procedure. The realized pregnancy and the delivery could be considered highly successful in regard to possible risks.
authors.affiliation: Ginekolosko-akuserska klinika "Narodni front", Odeljenje za arteficijalne reproduktivne tehnologije, Beograd, Srbija. elag@sezampro.rs
authors.forename: Eliana
authors.initials: E
authors.lastname: Garalejić
authors.forename: Biljana
authors.initials: B
authors.lastname: Arsić
authors.forename: Dragana
authors.initials: D
authors.lastname: Bojović-Jović
authors.forename: Milija
authors.initials: M
authors.lastname: Veljković
authors.forename: Biljana
authors.initials: B
authors.lastname: Macanović
authors.forename: Dejan
authors.initials: D
authors.lastname: Pavlović
authors.forename: Bojan
authors.initials: B
authors.lastname: Vasić
authors.forename: Dragana
authors.initials: D
authors.lastname: Lekić
mesh_terms: D000328:Adult; D001006:Anus, Imperforate / Q000601:surgery*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D011247:Pregnancy