The leptin:BMI ratio appears to be highly predictive of IVF success. Elevated leptin concentrations, particularly relative to BMI, may negatively impact fertility by assisted reproduction, possibly through direct ovarian actions resulting in impaired oocyte quality and/or early embryo development.
Laparoscopic gonadal removal in two patients, one with XY gonadal dysgenesis and the other with complete androgen insensitivity is described. In both cases, the gonads were either located deep in the inguinal canal or adherent in that area. Digital blunt dissection using a finger passed through the lateral lower abdominal trocar incision site (12 mm) at the mid-clavicular line of the lower abdomen, combined with external palpation/elevation of the inguinal ring, allowed rapid dissection and isolation of the desired structures and vascular pedicles.
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