Introduction/Objective The aim of this paper is to present changes of tumor necrosis factor-α (TNF-α) levels in uterine flushings and serum of infertile female patients before and after hysteroscopic polypectomy. Methods A total of 82 infertile female patients were included in the study. The patients were divided into two groups. The first group was the experimental group and comprised 56 infertile women with endometrial polyps, whereas the second group was the control group of 26 infertile women who were not diagnosed with endometrial polyps. Results The results of this research primarily suggest that TNF-α concentrations obtained from uterine flushings and serum of infertile patients diagnosed with endometrial polyps differed before and after a surgical procedure. In the control group of patients, there was no significant difference observed regarding TNF-α concentrations in serum and uterine flushings of women without endometrial polyps. A comparison between these two groups revealed differences in TNF-α concentrations in both venous blood and uterine flushings. These differences were considered statistically significant. Conclusion Endometrial polyps are one of the causes of higher TNF-α levels in both uterine flushings and serum.

Introduction. Granulosa cell tumors are rare neoplasms of ovary with low malignancy potential and late recurrence. They originate from the granulose of the ovary stromal cells and have the ability to produce estrogens. The main treatment is surgical and implies hysterectomy with bilateral salpingo-oophorectomy, omentectomy, taking peritoneal biopsies, and cytological analysis of the peritoneal washing. When found in young women who have not given birth, a conservative approach can be considered. Fertility sparing surgery is safe only for early FIGO stages IA tumors ?? IC, where it is necessary to make unilateral salpingo-oophorectomy and complete staging. Case outline. We present a case of young woman with granulosa cell tumor who was accidentally discovered, and after an adequate surgery and chemotherapy she gave a birth to a healthy child. Conclusion. Young women who have not given birth and who have been diagnosed with granulosa cell ovarian tumor can be treated conservatively after adequate disease staging and confirmation that the disease is at an early stage.

Introduction. Ovarian endometriosis has been identified as a risk factor for occurrence of endometriosis-associated ovarian carcinoma. We presented a rare case of simultaneous clear cell/ endometrioid ovarian carcinoma and endometriosis of the ipsilateral ovary. Case report. A 47-yearold patient underwent surgery for right ovarian endometriotic cyst. A total hysterectomy with bilateral salpingooophorectomy, lymphadenectomy in the right psoas muscle region and omentectomy were performed as well as multiple peritoneal biopsies. Six cycles of chemotherapy were instituted postoperatively using the Taxol-CBDCA protocol. Abdominal and pelvic CT did not demonstrate recurrence of the disease postoperatively and after completed chemotherapy treatment. Six months after the completion of treatment, the patient felt well without the disease recurrence. Conclusion. Clear cell and endometrioid subtypes of ovarian carcinoma have good prognosis if they are diagnosed and treated at an early stage of the disease. In our patient, the carcinoma was detected in the first stage and successfully treated with combination therapy, i.e., surgical and chemotherapy.

Introduction. Unilateral ovarian and Fallopian tube agenesis is an extremely rare anomaly that is usually associated with uterine and renal anomalies. This anomaly is usually incidentally detected during laparoscopy or laparotomy performed for other indications. We have reported a rare case of unilateral ovarian and Fallopian tube agenesis in an infertile patient with a normal uterus. Case report. A 34-yearold infertile patient was admitted to our clinic for laparoscopy and hysteroscopy, indicated for the right Fallopian tube occlusion and an endometrial polyp. The patient underwent laparoscopy and hysteroscopy. Unilateral right ovarian and Fallopian tube agenesis was diagnosed during laparoscopy. Upon exploration of peritoneal surfaces, omentum and intestinal serosa, neither ectopic nor remnant tissues of the ovary or Fallopian tube were found. Renal anomalies were not identified on the ultrasound examination. The hormone panel and karyotype were normal. Her partner's semen analysis was normal. The patient conceived spontaneously one year later. Serial ultrasound examinations showed normal fetal intrauterine growth and development. The patient vaginally delivered a live, female newborn at 40 weeks' gestation, weighing 3,350 grams, 53 cm long, with 9/10 Apgar scores at birth. The patient and her newborn were discharged home on the third postpartum day. Conclusion. Unilateral ovarian and Fallopian tube agenesis is rarely associated with a normal uterus. Laparoscopy is the gold standard in the diagnosis of ovarian and Fallopian tube agenesis. Unless other obstetric indications are present, this anomaly is not specific and it is not an indication for a Caesarean section, and vaginal delivery is a possibility at term pregnancy.

Introduction.Uterus didelphys results when Mullerian duct fusion is completely arrested during development. We presented a rare case of nonobstructive uterus didelphys occurring simultaneously with an endometriotic cyst of the ovary. Case report. A twenty-nine-year-old, nulliparous patient was admitted to our Clinic for laparoscopic treatment of an endometriotic ovarian cyst. Diagnoses of right ovarian endometriotic cyst and nonobstructed uterus didelphys were established with bimanual pelvic exam and two-dimensional transvaginal ultrasound. Diagnoses were subsequently confirmed by laparoscopy and magnetic resonance imaging. Laparoscopic incision and drainage of the endometriotic cyst were performed, followed by biopsy and coagulation of endometriotic lesions. Histopathology confirmed ovarian endometriosis. Gonadotropinreleasing hormone analogue (GnRHa) was prescribed postoperatively, for a total of 3 months. Ten months after completion of treatment, the patients was without disease recurence. Conclusion. Nonobstructive uterus didelphys is rarely associated with ovarian endometriosis.Uvod. Dvostruka materica nastaje kada potpuno izostane fuzija Milerovih kanala. U radu je prikazan redak entitet dvostruke materice neopstruktivnog tipa, udružene sa endometriotičnom cistom jajnika. Prikaz bolesnika. Pacijentkinja stara 29 godina, nulipara, primljena je na našu kliniku za laparoskopsku operaciju endometriotične ciste jajnika. Bimanuelnim ginekološkim pregledom i transvaginalnim 2D ultrazvukom dijagnostikovana je endometriotična cista desnog jajnika i dvostruka materica neopstruktivnog tipa. Dijagnoza je kasnije potvrđena laparoskopijom i magnetnom rezonancom. Urađena je laparoskopska incizija i drenaža sadržaja ciste, sa biopsijom i koagulacijom endometriotičnog žarišta. Patohistološki je potvrđena endometrioza jajnika. Postoperativno pacijentkinji je ordiniran analog gonadotropin oslobađajućeg hormona, u vremenu od tri meseca. Deset meseci nakon završenog kompletnog tretmana, pacijentkinja je bila bez recidiva bolesti. Zaključak. Dvostruka materica neopstruktivnog tipa je retko udružena sa endometriozom jajnika.