Gynecologic and Obstetric Investigation最新文献

{"title":"Are the morphokinetics of embryos obtained from HPV-positive sperm altered? A Retrospective Cohort Study.","authors":"Giorgio Maria Baldini, Daniele Ferri, Dario Lot, Antonio Malvasi, Marco Cerbone, Antonio Simone Laganà, Miriam Dellino M, Domenico Baldini, Giuseppe Trojano","doi":"10.1159/000546754","DOIUrl":"https://doi.org/10.1159/000546754","url":null,"abstract":"<p><p>This study focuses on the potential impact of Human Papillomavirus (HPV) infection in men on assisted reproductive technology (ART) outcomes, specifically examining sperm quality, embryo morphokinetics, and pregnancy rates.</p><p><strong>Objectives: </strong>The study aims to compare the embryological morphokinetics of ART embryos derived from HPV-positive versus HPV-negative sperm, assess fertilisation rates, morphology, and pregnancy outcomes, and determine the prevalence of HPV infection in male ART patients.</p><p><strong>Design: </strong>This is a retrospective cohort study. As established by the sample size, the participants were divided into two groups: the first sperm HPV positive group of 57 cases and the second HPV negative group of 57 cases. Participants/Materials, Setting,: We calculated the sample size for evaluating sperm parameters. The estimated number of patients required for the study was 114. The sample size for the morphogenetic evaluation of embryos was equal to 210 embryos in total. The statistical analysis involved the execution of the Student t-test, the Shapiro test the Mann-Whitney. The Chi-square or Fisher tests were then used depending on the sampled data.</p><p><strong>Methods: </strong>The enrolled couples were treated with in vitro fertilization with ICSI. Results Morphokinetics showed no statistically significant difference between the two groups examined. Therefore, the speed of the various stages of embryonic growth appears substantially identical. Limitations Morphokinetics showed no statistically significant difference (table V) between the two groups examined. Therefore, the speed of the various stages of embryonic growth appears substantially identical. Conclusions Our results suggest that the disease does not worsen the results of ART and does not modify the morphokinetics of embryos; therefore, screening for sperm HPV in males of couples scheduled for ART does not appear advisable.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-22"},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of KLF10 in regulating proliferation of endometriotic stromal cells in endometriosis.","authors":"Boyao Xia, Yang Liu, Jing Li, Shan Jiang","doi":"10.1159/000546836","DOIUrl":"https://doi.org/10.1159/000546836","url":null,"abstract":"<p><strong>Objectives: </strong>Endometriotic stromal cells (ESCs) are extensively found in endometriosis (EM). This study aims to investigate the effects and regulatory mechanisms of KLF10 on the proliferation of ESCs in EM.</p><p><strong>Methods: </strong>Human ESCs from eutopic and ectopic endometrium were isolated and identified. Levels of KLF10, miR-200c-3p, and lncRNA NEAT1 in cells were detected by RT-qPCR and western blot analysis. Expression of KLF10, miR-200c-3p and NEAT1 were silenced in ectopic ESCs, followed by an assessment of cell proliferation. Chromatin immunoprecipitation and dual-luciferase reporter assays were conducted to analyze the binding of KLF10 to the miR-200c-3p promoter. RNA immunoprecipitation and dual-luciferase reporter assays were performed to analyze the interaction between miR-200c-3p and NEAT1. NEAT1 RNA stability was measured.</p><p><strong>Results: </strong>Compared to Eut-ESCs, Ect-ESCs exhibited decreased KLF10 and miR-200c-3p expression and increased NEAT1 expression. Overexpression of KLF10 inhibited the proliferation of Ect-ESCs. Mechanistically, KLF10 transcriptionally promoted miR-200c-3p expression, reducing the binding of miR-200c-3p to NEAT1 and downregulating NEAT1 expression. Combined experimental results showed that miR-200c-3p downregulation or NEAT1 overexpression could alleviate the inhibitory effect of KLF10 overexpression on the proliferation of Ect-ESCs. Limitations We only investigated the function of KLF10 in Ect-ESC proliferation of EM on the cellular level, but the effect of KLF10 on abnormal Ect-ESC migration and invasion remains to be explored. Besides, there is no interference experiments performed on Eut-ESCs, and no animal experiment was included. Conclusions KLF10 transcriptionally promoted miR-200c-3p expression, reduced the binding of miR-200c-3p to NEAT1, thus downregulating NEAT1 expression and inhibiting the proliferation of Ect-ESCs.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-15"},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"S1PR4 promotes cell viability, invasion and glycolysis via the mTOR signaling pathway in endometriosis.","authors":"Huizhi Yuan, Zhongju Xie, Minqing Feng, Jianying Zheng, Rong Geng, Cankun Zhou, Qunxiu Lao, Xiaobin Huang","doi":"10.1159/000546571","DOIUrl":"https://doi.org/10.1159/000546571","url":null,"abstract":"<p><strong>Objective: </strong>Endometriosis is a chronic gynecological disorder that can cause infertility in women of reproductive age, and its clinical treatment still faces significant challenges. However, the pathogenesis of endometriosis remains unclear.</p><p><strong>Methods: </strong>S1PR4 knockdown and overexpression were constructed in primary ectopic endometrial stromal cells (EESCs) with or without the glycolysis inhibitor 2-deoxy-D-glucose (2-DG) and normal endometrial stromal cells (ESCs) with or without the mTOR signaling pathway inhibitor AZD8055, respectively. CCK-8 and Transwell assays were used to evaluate the viability and invasive capabilities. The cellular glycolytic capacity was assessed by measuring the extracellular acidification rate and lactate levels in the cell culture supernatant. An endometriosis mouse model was established in vivo, and histopathological changes in the endometrium were analyzed by hematoxylin-eosin staining. The expression of S1PR4, LDHA, and p-mTOR in endometrium and ESCs was assessed using qRT-PCR, Western blotting or immunofluorescence.</p><p><strong>Results: </strong>Glycolytic levels were increased in EESCs, and inhibiting glycolysis in vitro reduced the viability and invasive capabilities of EESCs, as well as suppressed the growth of ectopic lesions in vivo. S1PR4 was abnormally overexpressed in endometriosis, and knocking down S1PR4 inhibited the viability, invasion, and glycolysis of EESCs, along with downregulation of p-mTOR expression. Conversely, overexpression of S1PR4 promoted the viability, invasion, and glycolysis of ESCs via the mTOR signaling pathway.</p><p><strong>Conclusions: </strong>In endometriosis, S1PR4 enhances cellular glycolysis by activating the mTOR signaling pathway, thereby promoting the viability and invasion of EESCs.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-17"},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of low dose oxytocin with pain intensity and delivery outcomes among primiparas who delivered vaginally with epidural block analgesia.","authors":"Fuxue Tang, Zhijie Zhang, Peikun Han","doi":"10.1159/000546524","DOIUrl":"https://doi.org/10.1159/000546524","url":null,"abstract":"<p><strong>Objective: </strong>This paper aimed to evaluate the influence of low-dose oxytocin (LDO) on pain intensity and delivery outcomes in primiparas who delivered vaginally with epidural block analgesia (EBA).</p><p><strong>Methods: </strong>A total of 150 primiparas were retrospectively collected, and finally, 120 cases were included. They were divided into a control group (n = 60, received EBA) and an oxytocin group (n = 60, received EBA combined with LDO). Analgesic onset time, analgesic duration, time to flatus, and time to first bowel movement were compared. Pain intensity was assessed using the Visual Analog Scale (VAS) at pre-analgesia, cervical dilation of 3 cm, and fetal delivery. Serum levels of cortisol (Cor), norepinephrine (NE), and C-reactive protein (CRP) before and 24 hours post-delivery, postpartum bleeding, Apgar scores, delivery outcomes, and adverse reactions were compared.</p><p><strong>Results: </strong>The oxytocin group had shorter times for gas passage and first bowel movement, as well as shorter durations of the first, second, and third stages of labor (p < 0.05). VAS scores at cervical dilation of 3 cm and fetal delivery were lower than pre-analgesia in both groups (p < 0.05), with no inter-group differences at each time point (p > 0.05). Serum Cor and NE decreased, while CRP increased at 24 hours postpartum (p < 0.05), with no inter-group differences (p > 0.05). The oxytocin group had less postpartum bleeding at 2 hours (p < 0.05), a higher natural delivery rate, and a lower incidence of uterine atony (p < 0.05), with no significant difference in Apgar scores (p > 0.05).</p><p><strong>Conclusion: </strong>EBA with LDO shortens labor duration, promotes gastrointestinal recovery, reduces uterine atony, postpartum hemorrhage, and vaginal assistive delivery rates, without affecting analgesia or stress response.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-17"},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does daily co administration of gonadotropins and letrozole during the ovarian stimulation improve IVF outcome for normal, poor and sub optimal responders?","authors":"Jigal Haas, Raoul Orvieto, Adva Aizer, Ettie Maman, Merav Noach-Hirsh, Lilach Marom Haham, Oshrit Lebovitz, Moran Shapira, Ravit Nahum","doi":"10.1159/000546147","DOIUrl":"https://doi.org/10.1159/000546147","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have described similar or improved IVF outcomes following co-administration of letrozole during ovarian stimulation (OS) in different patients' sub-populations.</p><p><strong>Objectives: </strong>Address and identify the sub-group of patients that might benefit from letrozole co-treatment throughout the entire OS. Methods,Setting, Participants: We reviewed the medical files of patients attending our IVF unit over a three-year period, for different indications, who underwent two successive IVF cycle attempt, where the 2nd included the co-administration of 5 mg Letrozole from OS day 1 until trigger day.</p><p><strong>Results: </strong>Two hundred patients met the inclusion criteria and were included in the study. Of whom, 65 were poor responders (oocytes≤ 3) during the first IVF cycle attempt, 85 were sub-optimal responders (4-9 oocytes) and 50 were normal responders (≥ 10 oocytes). The total dose of gonadotropins (4525±1553 vs. 4293±2166, p = NS) and length of stimulation (11.3±2.2 vs. 11.1±2.3, p=NS) were comparable between the two cycle attempts. Numbers of follicles ≥ 13mm (7.2±4.7 vs 6.2±4.3, p < 0.001), retrieved oocytes (8.6±6.1 vs. 6.9±5.5, p<0.001), zygotes (5.7±4.5 vs. 4.5±3.7 p<0.001) and number of TQE (2.5±2.5 vs. 1.8±1.9, p<0.001) were significantly higher in letrozole cycles. Sub analysis according to patients' ovarian response during the first attempt revealed that the poor and sub-optimal responders significantly benefit from the letrozole co-administration, while the normal responders did not.</p><p><strong>Conclusions: </strong>Letrozole co-administration during OS for IVF increases the number of retrieved oocytes, zygotes and TQE in poor and suboptimal responders but not in normal responders.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-12"},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and Perinatal Outcomes Associated with Intrapartum Antibiotic Regimens in Women with Prolonged Membrane Rupture and Unknown GBS Status: A Retrospective Comparative Study.","authors":"Raneen Abu Shqara, Shany Or, Gabriela Goldinfeld, Lior Lowensetin, Maya Frank Wolf","doi":"10.1159/000546792","DOIUrl":"https://doi.org/10.1159/000546792","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To compare maternal, neonatal, and microbiological outcomes among patients with unknown Group B Streptococcus (GBS) status and prolonged rupture of membranes (ROM &gt;18 hours) who received intrapartum prophylaxis with either ampicillin or clindamycin.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A retrospective comparative cohort study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials: &lt;/strong&gt;A total of 1,507 term singleton pregnancies with ROM &gt;18 hours and unknown GBS colonization status: 1,418 received ampicillin, and 89 received clindamycin due to reported penicillin allergy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;A tertiary university-affiliated hospital in northern Israel, from March 2020 to May 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients were stratified by antibiotic regimen. The co-primary outcomes were clinical chorioamnionitis and neonatal intensive care unit (NICU) admission. Secondary outcomes included maternal complications (intrapartum fever, endometritis, cesarean delivery) and neonatal morbidities (Apgar &lt;7, cord pH &lt;7.1, respiratory distress, ventilation support). Post-delivery chorioamniotic membrane swabs were cultured. Multivariate logistic regression was used to identify independent predictors of outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared to ampicillin, clindamycin treatment was associated with higher rates of clinical chorioamnionitis (14.6% vs. 2.3%, p&lt;0.001), intrapartum fever (28.1% vs. 4.1%, p&lt;0.001), maternal sepsis (2.2% vs. 0.3%, p=0.011), puerperal endometritis (13.5% vs. 2.6%, p&lt;0.001), cesarean delivery (36.0% vs. 18.1%, p&lt;0.001), and postpartum antibiotic use (14.6% vs. 5.4%, p&lt;0.001). Among neonates of patients treated with clindamycin compared to ampicillin, the rates were higher for NICU admission (19.1% vs. 4.4%, p&lt;0.001), Apgar &lt;7 at 5 minutes (4.5% vs. 0.8%, p=0.001), cord pH &lt;7.1 (7.9% vs. 2.0%, p&lt;0.001), respiratory distress (13.5% vs. 5.4%, p&lt;0.001), and ventilation support (invasive 2.2% vs. 0.2%, p=0.019; non-invasive 7.9% vs. 1.1%, p&lt;0.001). Hypoxic brain injury occurred more frequently in the clindamycin group (2.2% vs. 0.1%, p=0.016). GBS was isolated more often in chorioamniotic cultures of patients treated with clindamycin (19.1% vs. 1.1%, p&lt;0.001). In multivariable analysis, clindamycin treatment (adjusted odds ratio [aOR] 7.7, 95% CI 3.8-15.5, p&lt;0.001) and artificial rupture of membranes (aOR 2.6, 95% CI 1.1-6.3, p=0.031) were independently associated with clinical chorioamnionitis. Clindamycin treatment was also independently associated with NICU admission (aOR 3.71, 95% CI 1.9-7.1, p&lt;0.001). Other factors associated with NICU admission were: the presence of meconium-stained amniotic fluid (aOR 3.28, 95% CI 1.7-6.2, p&lt;0.001), clinical chorioamnionitis (aOR 3.11, 95% CI 1.3-7.2, p=0.009), and umbilical cord pH &lt;7.1 (aOR 4.76, 95% CI 1.9-11.4, p&lt;0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Limitations include the retrospective, single-center design, the small size of the clindamycin group, and the abs","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-17"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between Plane Assessment of Prolapse Degree and POP-Q Scores after Three-Dimensional Reconstruction of Female Pelvic Organ Prolapse.","authors":"Lifan Shen, Huijun Bai, Xueyu Sun, Ping Liu, Chunlin Chen","doi":"10.1159/000546464","DOIUrl":"https://doi.org/10.1159/000546464","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to combine dynamic magnetic resonance imaging (MRI) with three-dimensional (3D) reconstruction and form a plane based on osseous structures to evaluate the degree of pelvic organ prolapse (POP). The correlation of this novel evaluation approach with the POP-Q system was assessed.</p><p><strong>Method: </strong>A retrospective analysis was conducted on 71 POP patients with POP-Q stage ≥ II. The dynamic MRI images of those patients were reconstructed in three dimensions. A plane was created by using the midpoint of the line between the inferior margins of the two pubic bones and the starting points of the superior margins of the bilateral sacrotuberous ligaments (the pubic inferior midpoint - sacrotuberous ligament starting point superior edge plane). Distances from the lowest point of the anterior vaginal wall, cervix, and rectal ampulla to this evaluation plane were measured, modeled, and categorized. The consistency and correlation of the categorized results with POP-Q scores were verified by performing a kappa analysis and Spearman's rank correlation analysis, respectively.</p><p><strong>Result: </strong>The highest consistency with POP-Q scores was found in the prolapse of the central pelvic cavity (kappa = 0.713, P < 0.05), followed by the anterior POP (kappa = 0.427, P < 0.05), and posterior POP (kappa = 0.261, P < 0.05), with all showing statistically significant differences. The strongest positive correlation was observed between central POP and POP-Q scores (r = 0.864, P < 0.01), followed by posterior POP and POP-Q scores (r = 0.710, P < 0.01), with both exhibiting a strong positive correlation. Anterior POP and POP-Q scores showed a moderate positive correlation (r = 0.586, P < 0.01).</p><p><strong>Conclusion: </strong>The results of the proposed evaluation method were highly consistent in the anterior and central pelvic cavities and strongly correlated in the central and posterior pelvic cavities. In particular, the assessment of the posterior cavity showed a strong positive correlation with that of the POP-Q system. The evaluation plane demonstrated high consistency and correlation with the POP-Q system.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-20"},"PeriodicalIF":2.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction Statement.","authors":"","doi":"10.1159/000546086","DOIUrl":"https://doi.org/10.1159/000546086","url":null,"abstract":"","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1"},"PeriodicalIF":2.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of lymph node metastasis and risk factors in 424 patients with low-grade endometrioid endometrial carcinomas.","authors":"Lina Cao, Xiaoyuan Lu, Yijun Wang, Luyao Wang","doi":"10.1159/000546522","DOIUrl":"https://doi.org/10.1159/000546522","url":null,"abstract":"<p><strong>Objectives: </strong>Objectives: To explore the lymph node metastasis (LNM) and related risk factors of low-grade endometrioid endometrial carcinomas (EEC), and analyze the efficacy of related risk factors in predicting LNM.</p><p><strong>Design: </strong>Data from 424 patients with low-grade EEC treated between January 2019 and June 2024 were retrospectively analysed, according to the International Federation of Gynecology and Obstetrics (FIGO) 2009.</p><p><strong>Methods: </strong>Univariate and multivariate logistic regression analyses were used to examine the factors associated with LNM. Receiver operating characteristic (ROC) curves were plotted to assess the predictive efficacy of independent risk factors for LNM.</p><p><strong>Results: </strong>The rate of LNM was 7.8% (33/424). Histological grade, tumour size, depth of myometrial invasion, cervical stromal invasion, lymphovascular space invasion (LVSI), microcystic, elongated, fragmented (MELF) pattern, carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199), and human epididymis protein 4 (HE4) were associated with LNM. However, only LVSI, MELF pattern, depth of myometrial invasion, and CA125 were identified as independent risk factors. The area under the ROC curve (AUC) for CA125 and depth of myometrial invasion was 0.796 and 0.734, respectively. The optimal cut-off value for CA125 was 31.36 U/mL, with a maximum Youden index of 53.9%. Combining CA125 with depth of myometrial invasion improved diagnostic accuracy compared to either parameter alone.</p><p><strong>Limitations: </strong>Retrospective nature of the study and limitation to a singlecenter study.</p><p><strong>Conclusions: </strong>LNM is more likely with independent risk factors. Combining CA125 and depth of myometrial invasion enhances diagnostic accuracy for LNM. This study provides valuable insights for predicting LNM risk in low-grade EEC patients and guiding stratified management.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-18"},"PeriodicalIF":2.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Localization of Diffuse Adenomyosis on Frozen Embryo Transfer Outcomes and Perinatal Outcomes: A Prospective Cohort Study of 585 Patients.","authors":"Sunita Sharma, Sourav RoyChoudhury, Meenakshi Karan, Kishan Shaw, Pranab Paladhi, Prithwis Palchaudhuri, Dibyendu Datta, Ratna Chattopadhyay, Arup Majhi","doi":"10.1159/000546437","DOIUrl":"https://doi.org/10.1159/000546437","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the impact of localization of diffuse adenomyosis on reproductive outcomes after frozen embryo transfer (FET).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This prospective cohort study was conducted between January 2019 and December 2022. A total of 585 infertile women undergoing the first FET cycle were recruited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials, setting, methods: &lt;/strong&gt;The study population included 368 women with diffuse adenomyosis where 167 women had diffuse adenomyosis of outer myometrium (OM) (Group A) and 201 women had diffuse adenomyosis of the junctional zone (JZ) (Group B). 217 women with male infertility were taken as controls. Adenomyosis was diagnosed on TVS using MUSA criteria where diffuse adenomyosis patients with two or more features were included. These patients were further divided based on the localization of adenomyotic lesions in OM or JZ. All the patients underwent FET cycle. Pregnancy outcomes and complications were compared between different groups. Additionally, adenomyosis patients as a whole were compared with the control group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Women with diffuse adenomyosis have similar (P &gt; 0.05) pregnancy rates (36.14% vs. 35.94%), biochemical pregnancy rates (11.27% vs. 3.84%) and clinical pregnancy rates (32.06% vs. 35.02%), but higher miscarriage rates (22.03% vs. 9.21%; OR: 2.79, 95% CI 1.14 to 6.79, P = 0.024), and a lower live birth rates (20.65% vs. 29.95%; OR: 0.61, 95% CI 0.41 to 0.89, P = 0.011) than women without adenomyosis. However, in women with diffuse adenomyotic lesions affecting the JZ (group B) exhibited significantly lower positive pregnancy (26.37% vs. 47.9%; OR: 0.39, 95% CI 0.25 to 0.60, P &lt; 0.0001), clinical pregnancy (23.38% vs. 42.51%; OR: 0.41, 95% CI 0.26 to 0.65, P = 0.0001) and live birth (16.42% vs. 25.75%; OR: 0.57, 95% CI 0.34 to 0.94, P = 0.029) compared to those with adenomyosis of the OM (group A), but comparable (P &gt; 0.05) biochemical pregnancy (11.32% vs. 11.25%) and miscarriage (23.4% vs. 21.13%). Pregnancy complications were comparable between the adenomyosis groups; however, there was a significantly higher incidence of pregnancy complications, particularly gestational hypertension (OR: 6.41, 95% CI 1.79 to 22.92, P = 0.0042), IUGR (OR: 9.08, 95% CI 2.01 to 40.99, P = 0.0041), and PTL (OR: 9.41, 95% CI 3.09 to 28.62, P = 0.0001) in adenomyosis patients compared to the controls.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;It is an observational prospective study, and the study included patients with endometriosis as a comorbidity. The population size is limited to ascertain the effect of diffuse adenomyosis on pregnancy complications, particularly between subgroups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study emphasizes the importance of evaluation and localization of adenomyotic lesions before initiating ART, which can aid in effective counseling and personalized treatment strategies to optimize reproductive outcomes. Pregnan","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-15"},"PeriodicalIF":2.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}