Gynecologic and Obstetric Investigation最新文献

{"title":"Time Matters: Evaluating the Clinical and Infectious Outcomes in Rupture of Membranes <12 Hours versus 12-18 Hours, at Term: A Retrospective Study.","authors":"Raneen Abu Shqara, Lior Lowenstein, Maya Frank Wolf","doi":"10.1159/000548662","DOIUrl":"10.1159/000548662","url":null,"abstract":"<p><strong>Objectives: </strong>The objectives of this study were to identify factors associated with intrapartum fever (IPF) and clinical chorioamnionitis in patients with term prelabor rupture of membranes (PROM) lasting <18 h and to evaluate microbiological findings in chorioamniotic swab cultures from patients with IPF.</p><p><strong>Design: </strong>This was a retrospective study. Participants/Materials: A total of 6,828 patients with term PROM were included and categorized into: PROM <12 h (n = 5,745) and PROM 12-18 h (n = 1,083). Exclusion criteria included multiple gestations, fetal anomalies, and incomplete medical records.</p><p><strong>Setting: </strong>The retrospective study was conducted at Galilee Medical Center, a tertiary care hospital, between March 2020 and May 2024.</p><p><strong>Methods: </strong>The primary outcome was clinical chorioamnionitis, diagnosed by intrapartum fever (IPF) ≥38°C and ≥2 clinical signs. Secondary outcomes included maternal (delivery mode, IPF, postpartum complications) and neonatal (Apgar scores, neonatal intensive care unit (NICU) admission, early onset sepsis) outcomes. Chorioamniotic swabs were obtained from patients with IPF for microbiological analysis. Statistical analysis included chi-square or Fisher's exact tests, Mann-Whitney U tests, relative risks (RRs) with 95% confidence intervals (CIs), and multivariate logistic regression to identify independent predictors of clinical chorioamnionitis and IPF.</p><p><strong>Results: </strong>PROM 12-18 h was associated with higher rates of clinical chorioamnionitis (3.9% vs. 2.3%, p = 0.002; RR 1.73, 95% CI: 1.23-2.45) and IPF (4.8% vs. 2.3%, p < 0.001; RR 2.13, 95% CI: 1.34-3.31) compared with PROM <12 h. The risk of clinical chorioamnionitis increased progressively with PROM duration, reaching a maximal elevation between 16 and 18 h (adjusted RR 5.23, 95% CI: 2.80-9.76, compared with PROM ≤4 h). Vaginal delivery was less frequent (76.9% vs. 83.4%, p < 0.001), whereas cesarean (16.2% vs. 11.4%, p < 0.001) and vacuum-assisted delivery rates (6.9% vs. 5.2%, p = 0.029) were higher with PROM 12-18 h. Postpartum antibiotic administration was more common (4.1% vs. 1.7%, p < 0.001), and postpartum hospitalization was longer (2.4 vs. 2.1 days, p = 0.003), respectively. Neonates born after PROM 12-18 h had higher rates of NICU admission (4.9% vs. 3.1%, p = 0.003), sepsis workups (4.6% vs. 3.0%, p = 0.007), and NICU antibiotic treatment (2.9% vs. 1.6%, p = 0.003). Multivariate analysis identified parity as protective against chorioamnionitis (OR 0.38, 95% CI: 0.21-0.69, p = 0.002) and IPF (OR 0.52, 95% CI: 0.31-0.89, p = 0.017). Epidural analgesia increased the odds of IPF (OR 2.20, 95% CI: 1.61-3.90, p = 0.048), while meconium-stained amniotic fluid was associated with higher odds of chorioamnionitis (OR 2.86, 95% CI: 1.45-5.63, p = 0.002). Positive chorioamniotic swab cultures were more frequent in PROM 12-18 h than PROM <12 h (59.6% vs. 35.7%, p < 0.001; RR ","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"312-321"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174790","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":"Société Suisse de Gynécologie et d'Obstétrique (SGGG) Congress Congrès annuel de Gynécologie Suisse.","authors":"","doi":"10.1159/000553071","DOIUrl":"https://doi.org/10.1159/000553071","url":null,"abstract":"","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":"91 Suppl. 1","pages":"1-81"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317056","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":"Vaginal Natural Orifice Transluminal Endoscopic Surgery for Gynaecological Oncology Procedures: A Systematic Review.","authors":"Nina Reza Pour, Charlotte Benton-Bryant, Jan Baekelandt, James Elhindi, Kanchana Ekanyake, Supuni Kapurubandara","doi":"10.1159/000548436","DOIUrl":"10.1159/000548436","url":null,"abstract":"<p><strong>Introduction: </strong>Natural orifice transluminal endoscopic surgery (NOTES) is a minimally invasive technique that accesses the abdominal cavity through natural orifices, eliminating the need for abdominal incisions. While this approach holds significant promise, particularly with its adaptation as vaginal NOTES (vNOTES), long-term safety data remain limited, especially beyond benign indications and hysterectomy. This review aims to evaluate the feasibility and outcomes of vNOTES in gynaecological oncology procedures that do not involve concurrent hysterectomy.</p><p><strong>Methods: </strong>This systematic review, registered with PROSPERO (CRD42022380581) and conducted per PRISMA guidelines, searched MEDLINE, Embase, CINAHL, SCOPUS, and CENTRAL up to March 31, 2023. Using MeSH, Emtree, and keywords including \"vaginal natural orifice transluminal endoscopic surgery,\" \"vNOTES,\" and \"gynaecological surgery,\" studies were selected if they included women undergoing vNOTES for oncological indications without hysterectomy.</p><p><strong>Results: </strong>Of 5,367 records screened, 58 underwent full-text review; four articles (n = 6) were included for oncological procedures without hysterectomy. These involved staging of peritoneal (n = 3), endometrial (n = 2), and cervical cancers (n = 1). Mean age was 54.3 years, BMI 30 kg/m2, and operative time 93.5 min. Mean estimated blood loss was 17.2 mL. No conversions occurred. One patient developed a postoperative fever (12.5%), managed conservatively.</p><p><strong>Conclusion: </strong>This review highlights the limited but promising evidence for vNOTES in gynaecological oncology beyond hysterectomy. It offers a potential minimally invasive alternative for complex pelvic procedures requiring retroperitoneal access, including obturator pathology, sentinel lymph node dissection, and mesh excision. Careful patient selection and use within a research setting, mirroring protocols for transanal total mesorectal excision, are recommended. Prospective case registration via the International NOTES Society is advised to support safe implementation.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"352-361"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280093","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":"10.1159/000551481","DOIUrl":"10.1159/000551481","url":null,"abstract":"","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"384-385"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638631","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":"Effects of Delivery with Epidural Anesthesia on Peripartum Serum Inflammatory Factors and Hemodynamics in Women with Gestational Hypertension.","authors":"Fei Chen, Wen-Kai Li, Li-Li Yin, Yun-Xia Chen, Rui-Qian Lai, Dong-Ya Zhang, Yan-Peng Hao","doi":"10.1159/000551804","DOIUrl":"10.1159/000551804","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to analyze the changes in serum inflammatory factors and hemodynamics in women with hypertensive disorder of pregnancy (HDCP) who undergo delivery with epidural anesthesia.</p><p><strong>Methods: </strong>A total of 100 HDCP pregnant women were admitted to our hospital from June 2021 to December 2023 and divided into a control group (conventional delivery, i.e., vaginal delivery without analgesia) and a painless group (delivery with epidural anesthesia, i.e., continuous epidural analgesia), with 50 cases in each group. The levels of serum tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), as well as hemodynamic parameters including heart rate (HR), mean arterial pressure (MAP), and cardiac output (CO), were measured and compared between the two groups at the following time points: pre-analgesia (T1), full cervical dilation (T2), fetal delivery (T3), and 24-h postpartum (T4). Maternal and neonatal outcomes were also compared between the two groups.</p><p><strong>Results: </strong>The painless group had shorter first, second, and third stages of labor and colostrum time than the control group, and the 1-min APGAR score was higher than that of the control group (p < 0.05). The TNF-α and IL-6 levels in T2, T3, and T4 in the painless group were lower than those in the control group (p < 0.05). The TNF-α and IL-6 levels in T2, T3, and T4 in the painless group were lower than those in the control group (p < 0.05). The fluctuation range of MAP, HR, and CO levels in T2, T3, and T4 in the painless group was smaller than that in the control group (p < 0.05).</p><p><strong>Conclusion: </strong>Delivery with epidural anesthesia for HDCP mothers can reduce perinatal inflammatory factor levels and stabilize hemodynamic parameters.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"563-572"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716645","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":"Endometriosis and Endometrial Polyps Co-Occurrence in Individuals Not Seeking Pregnancy: A Case-Control Study.","authors":"Veronica Bandini, Noemi Salmeri, Anna Preda, Beatrice Bracci, Elena Cosentino, Michele Vignali, Paolo Vercellini","doi":"10.1159/000552113","DOIUrl":"10.1159/000552113","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Endometriosis and endometrial polyps are both estrogen-dependent conditions, and an association between these two pathologies has been observed in infertile women. Our research question was: \"Is there an association between endometriosis and endometrial polyps also in a study population not selected for infertility?\" Therefore, we aimed to assess whether the prevalence of endometrial polyps is higher in patients with endometriosis not seeking pregnancy compared with a general gynecologic outpatient population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This is a case-control study including 438 women with endometriosis and 438 controls without endometriosis attending routine gynecologic visits, consecutively identified from the electronic health records of the Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials, setting, methods: &lt;/strong&gt;Between November 2021 and July 2025, all participants underwent transvaginal ultrasound, with standardized pelvic/uterine assessment according to the IETA, IDEA, and MUSA criteria. Patients using hormonal therapy at the time of the examination or in the previous 2 months were excluded. The primary endpoint was the prevalence of endometrial polyps in the two study groups. Point estimates of proportions in each group and odds ratios were calculated with corresponding 95% confidence intervals. Multivariate logistic regression was used to calculate adjusted odds ratio.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age was 32 (28-36) years in the 438 cases and 32 (26-36) years in the 438 controls (p = 0.13). Most participants were Caucasian, with a comparable distribution of ethnicities between the two study groups (89.3% and 87.2%; p = 0.23). Prior use of hormonal treatment was reported significantly more often by women with endometriosis (72% vs 48%; p &lt; 0.001). Endometrial polyps were detected in 7/438 women with endometriosis (1.6%) and in 11/438 without endometriosis (2.5%; OR 0.63, 95% CI 0.24-1.64, p = 0.35). When both current and past diagnoses of endometrial polyps were considered, prevalence rates were 3.4% in cases and 5% in controls (OR 0.67, 95% CI 0.34-1.31, p = 0.24). Similar findings were observed after adjusting for statistical and clinically relevant variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Considering the unexpectedly small number of endometrial polyps detected, a type II error cannot be excluded. Moreover, a 2-month hormonal therapy washout period among previous users might have been too short to fully rule out a potentially persistent protective effect of medications on the development of endometrial polyps. A possible misclassification bias cannot be excluded as polyps were diagnosed by ultrasound without direct visualization by hysteroscopy and histologic confirmation. No centralized image review was performed, introducing potential inter-operator variability. Finally, as no individual matching betwe","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"633-640"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987144","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":"Erb's Palsy: Visual Diagnosis in Art before Medical History?","authors":"Pien E J de Ruiter, Stella A Bult, Jeroen R Dijkstra, Thomas M van Gulik","doi":"10.1159/000546120","DOIUrl":"10.1159/000546120","url":null,"abstract":"<p><p><p>Background: Close observation is fundamental to both art and medicine, although both disciplines use it in different ways. As doctors need to practice observation of their patients every day, visual arts are increasingly used for the development of observational skills within the medical curriculum. This is particularly useful for students and residents in surgery or in specializations with a surgical component such as gynecology and obstetrics, where close observation of anatomical structures and radiological imaging is essential in providing quality care. Conversely, artists - through close observation - have depicted the world around them for decades. As a result, they might have unintentionally pictured medical abnormalities, before conditions were officially described in the medical world. Several authors have described medical findings in artworks throughout history, such as the visual diagnosis of Erb's palsy.</p><p><strong>Objectives: </strong>The aim of this paper was to identify and describe depictions of Erb's palsy in art history.</p><p><strong>Methods: </strong>Authors observed and analyzed several paintings in the Rijksmuseum in the Netherlands on visual medical abnormalities corresponding to obstetrical birth injuries. Additionally, in January 2025 a PubMed search was conducted using the terms \"erbs palsy,\" \"birth injuries,\" \"brachial plexus neuropathies,\" and \"art.\" The paintings of three articles concerning the depiction of Erb's palsy in art were included. A standardized table was constructed in collaboration with medical specialists and used to analyze clinical features of Erb's palsy in the artworks.</p><p><strong>Outcome: </strong>PubMed search resulted in three different articles concerning the possible diagnosis of Erb's Palsy in a painting of Albrecht Dürer, i.e., Madonna and Child (ca. 1505). In total, five different paintings from the 16th and 17th century were analyzed regarding the presence of clinical features of Erb's palsy. Three paintings matched six out of seven of the clinical criteria, as stated in the standardized table. Two paintings matched five out of seven clinical criteria of Erb's palsy. It should be noted that the art-historical principles of the so-called Renaissance elbow and the technique of \"foreshortening\" might have contributed to the depiction of incorrect anatomical features, as a result of artistic freedom rather than the depiction of medical abnormalities.</p><p><strong>Conclusions: </strong>This paper suggests that artists' close observations could possibly have led to depictions of Erb's palsy centuries before the condition was formally described in the medical profession. The findings serve as a reminder that close observation is essential for the work of medical professionals and highlight how art can contribute to training the clinical eye of medical students, residents, and doctors. </p>.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"26-35"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Endometrial Compaction after Progesterone Administration on Pregnancy Outcomes in Artificial Frozen Thawed Embryo Transfer Cycles: A Prospective Cohort Study.","authors":"Azadeh Akbari Sene, Tayebe Azadbakht, Mahnaz Ashrafi, Eva Esmael, Fatemehsadat Amjadi, Zahra Zandiyeh, Azar Mohammadzadeh, Arash Mohazzab","doi":"10.1159/000547321","DOIUrl":"10.1159/000547321","url":null,"abstract":"<p><strong>Objectives: </strong>The primary aim of this study was to assess the association between endometrial compaction and pregnancy outcomes in Hormone Replacement Therapy-Frozen Embryo Transfer (HRT-FET) protocols. The secondary objective was to investigate the correlation between serum progesterone levels and pregnancy success in FET cycles.</p><p><strong>Design: </strong>Prospective cohort study was conducted during January-April 2024.</p><p><strong>Setting: </strong>The study was conducted at a university-affiliated hospital in Tehran, Iran.</p><p><strong>Participants: </strong>Infertile women under 40 years undergoing HRT-FET participated in the study. Patients with uterine and genetic factors were excluded.</p><p><strong>Materials and method: </strong>Data on endometrial thickness and serum progesterone levels were gathered, and patients were divided into groups based on the presence or absence of endometrial compaction using transvaginal sonography. Univariate and multivariate statistical analyses, including logistic regression models, were employed to assess factors associated with pregnancy outcomes.</p><p><strong>Results: </strong>Ninety participants with similar demographic profiles were enrolled in the study. The biochemical and clinical pregnancy rates were higher in the group with endometrial compaction, at 37.3% and 33.3%, respectively, compared to 15.4% in both categories for the group without compaction, with a statistically significant difference in biochemical pregnancy rates (p = 0.022). The live birth rate was also higher in the compaction group (21.6%) compared to the non-compaction group (7.7%), showing a borderline statistical difference in the chi-square analysis (p = 0.072). No significant difference in serum progesterone levels was observed between patients with and without endometrial compaction.</p><p><strong>Limitations: </strong>While simultaneous evaluation of endometrial compaction and serum progesterone with adjustment for confounders enhanced internal validity, the study's single-center design and limited sample size restricted subgroup analyses and statistical power. Further research with larger cohorts and consideration of progesterone administration routes is needed to confirm and extend these findings.</p><p><strong>Conclusions: </strong>Endometrial compaction on the day of embryo transfer is linked to increased rates of biochemical and clinical pregnancies. This association remains consistent regardless of serum progesterone levels, highlighting the independent influence of endometrial compaction on pregnancy success.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"251-258"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636885","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":"Prognostic Impact of Estrogen and Progesterone Receptor Expression across Histological Subtypes and Clinical Factors in Epithelial Ovarian Cancer.","authors":"Khayal Gasimli, Alice Melodie Wilke, Iryna Schmeil, Bahar Gasimli, Thomas Karn, Sven Becker, Ruza Arsenic, Ahmed El-Balat","doi":"10.1159/000547773","DOIUrl":"10.1159/000547773","url":null,"abstract":"<p><p><p>Objective: Epidemiological and in vitro studies of epithelial ovarian cancer (OC) strongly suggest a link between hormone receptor (HR) expression, tumorigenesis, and survival. Antihormonal therapies have shown antitumor activity in OC, both alone and combined with other treatments. The primary objective of this study was to examine the expression patterns of estrogen- and progesterone receptors (ER and PR) in OC across different histological subtypes and assess their prognostic value in disease progression.</p><p><strong>Design: </strong>Retrospective analysis of data from 164 patients who received primary treatment at University Hospital Frankfurt between January 1999 and December 2019.</p><p><strong>Materials, setting, methods: </strong>The expression of both HRs was determined through immunostaining of tissue samples and evaluated using the immunoreactive score (IRS) according to Remmele and Stegner. Correlation and survival analyses evaluated the prognostic and predictive significance of HR expression.</p><p><strong>Results: </strong>The correlation between ER and PR expression with histological subtypes was significant (p = 0.002 and p = 0.013, respectively). Strong ER and PR expression was more common in HGSC, low-grade serous carcinoma, and EC, while low PR expression was linked to higher tumor grading (p = 0.032). Notably, clear cell carcinoma patients with weak PR expression had better survival rates than those with strong PR expression (p = 0.025). The difference in overall survival (OS) between ER-positive and ER-negative patients was minimal (55 vs. 51 months; p = 0.906). Median progression-free survival (PFS) and OS were slightly better in cases with weak PR expression (24 and 58 months) compared to strong PR expression (19 and 53 months; p = 0.797 and p = 0.45, respectively). In cases with strong ER expression and suboptimal debulking (TR >1 cm), disease recurrence was delayed (median PFS: 8 vs. 14 months; p = 0.038), a difference not seen after optimal debulking or in overall OS.</p><p><strong>Limitations: </strong>This single-center, retrospective study limits generalizability. We could not distinguish PR isoforms or assess ER/PR ratios or interactions, limiting molecular insight.</p><p><strong>Conclusion: </strong>ER and PR expression did not demonstrate a significant overall impact on survival in the entire cohort. However, the expression patterns and associated prognosis of ER and PR differed significantly depending on histological subtypes and clinical factors. </p>.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"283-297"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Different Endometrial Preparation Protocols on Pregnancy Outcomes in Women with Polycystic Ovarian Syndrome Undergoing Frozen Embryo Transfer: A Network Meta-Analysis.","authors":"MeiFang Zeng, Hailing Jiang, Baoping Zhu, JinLiang Duan","doi":"10.1159/000547119","DOIUrl":"10.1159/000547119","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to investigate the impact of various endometrial preparation protocols on pregnancy outcomes in women with polycystic ovarian syndrome (PCOS) undergoing frozen embryo transfer (FET).</p><p><strong>Method: </strong>We conducted a comprehensive search of electronic databases, including PubMed, Embase, and the Cochrane Library, from their inception until February 2024 to identify relevant studies. The network meta-analysis (NMA) was performed using STATA 14.0 software.</p><p><strong>Results: </strong>Seventeen studies met the inclusion criteria, encompassing 16,082 FET cycles (four randomized controlled trials and thirteen observational studies). Women with PCOS undergoing FET using the gonadotropin-releasing hormone agonist (GnRH-a) + hormone replacement therapy (HRT) protocol demonstrated a higher clinical pregnancy rate (CPR) compared to those using HRT alone (OR 1.50, 95% CI: 1.13-1.99). No significant differences were observed in the ongoing pregnancy rate (OPR) and ectopic pregnancy rate among the four examined endometrial preparation protocols (human menopausal gonadotropin [HMG]/follicle-stimulating hormone [FSH], letrozole [LE], HRT, and GnRH-a + HRT). Regarding the miscarriage rate (MR), the LE ovulation induction protocol exhibited a lower MR than the HRT protocol (OR 0.59, 95% CI: 0.46-0.74). The surface under the cumulative ranking curve indicated that the GnRH-a + HRT protocol was the most effective for the CPR. In contrast, the LE ovulation induction protocol was the most effective for minimizing the MR.</p><p><strong>Conclusion: </strong>Our NMA suggests that the GnRH-a + HRT protocol results in a higher CPR compared to the HRT protocol in PCOS women undergoing FET, albeit with a higher risk of miscarriage. While offering comparable CPRs and OPRs to the GnRH-a + HRT protocol, the LE ovulation induction protocol presents a lower MR than the other endometrial preparation protocols.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"339-351"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951825","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}