While an association can be addressed among endometriosis and subfertility, the causal relationship has not been elucidated yet. Impaired oocyte quality in endometriosis patients has been accused for the unsuccessful outcomes of assisted reproductive techniques. There are limited studies in literature evaluated association between endometriosis and oocyte morphology. We conducted this retrospective study to evaluate whether morphological abnormalities of oocytes are more common in women with endometriosis than women with diagnosis of male factor infertility as a source of healthy oocytes. Totally 1568 oocytes, 775 (49.4%) in endometriosis groups and 793 (50.6%) in control group were evaluated for morphological parameters before ICSI cycles. Abnormal oocyte morphology was detected in 352 (22.4%) of 1568 oocytes. Of the abnormal oocytes, 208 (59.1%) were in endometriosis group and 144 (40.9%) in control group (p < .001). The following dysmorphisms were significantly higher in oocytes retrieved from endometriosis group: dark cytoplasm; dark, large or thin zona pellucida; and flat or fragmented polar body (p < .05 for all). When morphological parameters for oocytes of endometriosis patients evaluated, the oocyte defects has increased significantly in endometriosis patients. These findings are thought to be useful to clarify the subfertility in endometriosis patient, which needs to be confirmed with further studies.

Injury of the cervical spine involving the spinal cord such as results from diving into shallow water causes very severe disability. In spite of progress in medical science, results of the treatment and rehabilitation of such patients are not satisfactory. Every effort should be undertaken to give young swimmers, the most frequent victims of diving injuries, proper instructions to prevent spinal cord injury. A broadly conceived national prevention programme, developed under the catch-phrase 'Do Not Jump into the Unknown', has been under way in Slovenia during the past 3 years,. and has been promoted in collaboration with the Health Protection Institute of Slovenia. In these years the number of new spinal cord injuries decreased (one-two per year), but it is too early to conclude that this is the result of the prevention activities. But it is obvious that knowledge of this type of injury is now much more widespread.

Objective:The aim of the study was to compare patients with and without endometriosis regarding performance rates, difficulties, and complications associated with transvaginal oocyte retrieval (TVOR) procedures.Material and Methods:A prospective cohort study was conducted at the In Vitro Fertilization Unit of the Division of Reproductive Endocrinology and Infertility Department of a university hospital. Fifty-eight patients with endometriosis and 61 patients without endometriosis underwent TVOR procedures consecutively. Primary outcome measures were; number of needle entries per patient and performance rating defined as the total number of oocytes retrieved per vaginal needle entry. The requirement for manual compression of the abdominal wall (assistance) to reach the ovaries, procedure-related pain, and procedural complications were also evaluated.Results:The median number of needle entries through the vaginal wall per patient was comparable between the two groups (p=0.45). Performance rates were higher in the control group (p=0.001). Performance rates and total number of the needle entries through the vaginal wall were not significantly correlated with ovarian endometrioma (OMA) diameter (r=0.28; p=0.68; r=0.275, p=0.068, respectively) in the endometriosis group. Body mass index (BMI) scores were found to be correlated with the number of the needle entries and higher BMI scores were associated with higher numbers of vaginal wall punctures (p<0.001). The requirement for manual compression of the abdominal wall was significantly higher in the control group (57.4% vs 27.6%, p=0.001). A similar proportion of women needed analgesic medications after the TVOR procedure in both groups (10.3% vs 16.4%, p=0.33). Hospital readmissions for any symptoms were also comparable between the two groups (p=0.22). Three women were treated for pelvic infection, all of whom were in the endometriosis group.Conclusion:Endometriosis seems to cause a challenge for TVOR that may have reflection on individual surgeon’s performance rates for the procedure, independently from the diameter of a pre-existing OMA or ovarian adhesions. Obesity is another factor that may present a challenge for the procedure.

Ovarian fibromas generally occurs in eldery women but also can seen rarely in reproductive aged young patients. Management of patients at reproductive ages with ovarian mass like ovarian fibromas, which can occur in young women, is a challenging subject. Although their benign feature, most of the surgical procedure includes laparotomy and oophorectomy. However laparoscopic surgery could be an option for the diagnosis and treatment. We report a case of multiple, bilateral, calcified fibromas in an infertilite 24 year old patient, treated successfully with laparoscopic ovarian sparing and complete resection of the fibromas.There is no common consensus on the treatment of fibromas especially in reproductive-aged women. Particularly in cases like we presented, fertility-sparing approaches like laparoscopic minimally invasive surgical techniques can be the appropriate treatment choice.

The enhanced recovery after surgery (ERAS) protocol is an evidence-based, multidisciplinary practice that involves preoperative, perioperative, and postoperative interventions, which are aimed at accelerating functional recovery and improving postoperative outcomes. 1 The ERAS protocol aims to minimize complications associated with surgery and shorten the recovery period to an optimum level.A shorter preoperative fasting period, effective pain control, rapid mobilization, and early postoperative feeding are ensured to reduce catabolic and inflammatory surgical responses. 2 The ERAS protocol is actively used in different surgical disciplines, such as gynecologic oncology, benign gynecology, urology, and hepatobiliary surgery,